SHIP provides one-on-one counseling to beneficiaries, Maultsby said. The interaction with consumers can take a variety of forms, from home-based, one-on-one counseling, to telephone counseling, and communications at public events and fairs.

There are 54 SHIP programs in the 50 states, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. Maultsby said that the grants to states and territories range from $37,000 (e.g., Guam) to $3 million and more (e.g., Pennsylvania, Florida, and California). During the last fiscal year (April 1, 2010, to March 31, 2011) the SHIP programs had over 2 million one-on-one client contacts. If we combine the number of one-on-one client contacts with people who were provided information and training at public outreach events, including enrollment events, close to 5 million people were served by SHIPs.

There was a 6 percent increase in the number of client contacts in the 2010 grant year compared to the prior grant year, Maultsby said. Of the roughly 15,000 counselors providing assistance, more than half are volunteers (57 percent). Recruiting, training, managing, and retaining volunteers is a very large undertaking. Ensuring that the volunteer coordinators receive sufficient training to manage the large and changing volunteer staff is very challenging to SHIPs. Providing training in volunteer management to SHIPs has been a CMS priority this past year.

Local SHIPs sponsor public and media outreach activities in conjunction with their CMS regional offices. There are 10 regional CMS offices across the country, and a number of partners at both the federal and local levels engaged with SHIPs in approximately 63,000 outreach events this past grant year compared to 55,000 the prior year. These efforts reach beneficiaries from all racial and ethnic groups and urban and rural areas. A penetration rate of SHIP services has been estimated using a formula that takes into consideration the number of beneficiaries served in counties, by zip code. This allows program directors to examine if they are reaching beneficiaries according to income level, such as in targeted geographic areas, Maultsby said.

The goal of the SHIP program is to provide local access to services. Having a 1-800 number at the state level is insufficient. Counselors need to be available at the local level to understand and meet local needs. An approach that works well in an urban area may not work well in a rural area. States have to devise different ways to provide information. In many rural areas, for example, there is no Internet access. The Iowa SHIP has developed a circuit rider program where counselors drive to areas on a regular basis to provide information and one-on-one counseling to beneficiaries.

To ensure that the information that counselors provide is accurate, timely, and appropriate, training is provided on a regular basis, Maultsby



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