As California develops its Health Benefit Exchange, and counties expand the ways people apply for public health programs, eligibility workers and officials in four California counties shared their feedback about the Medi-Cal and Healthy Families enrollment process.

Researchers conducted four focus groups with eligibility workers in Alameda, Fresno, Humboldt, and Los Angeles Counties and one with Humboldt County officials. Input from the remaining counties' officials was received through phone interviews and questionnaires.

Asked to discuss the current office environment, the enrollment landscape, and improvement ideas, participants shared their perspectives and concerns. Some highlights:

• Caseloads are high, and budget cuts pose challenges.
• The client base has changed – there are more first-time applicants and more applicants with complex financial situations.
• County staff members were concerned about obtaining documentation and managing client frustration over slow processes.
• Some questioned the value of online application options.
• Eligibility workers were generally unaware of the system changes expected in 2014.

This issue brief is available under Document Downloads.