Documenting Health Disparities & Building Capacity for Advocacy among COFA Migrants in the Puget Sound Region


Grantee: Children’s Alliance
Timeframe: July 2017 – June 2020 | Total Amount: $240,000

Year 1: July 2017 – June 2018. Amount: $75,000
Year 2: July 2018 – June 2019. Amount: $75,000
Year 3: July 2019 – June 2020. Amount: $90,000


This project will build capacity in the Compact of Free Association (COFA) migrant community in the Puget Sound region to engage in advocacy for institutional changes necessary to increase access to health care and reduce health disparities. With funding from the PHPDA, Children’s Alliance will pursue two pathways for addressing the health access and outcome disparities faced by COFA migrants in the region.

  1. Document health disparities and the need for access to health care, as well as community resiliency.
  2. Build capacity for advocacy for institutional changes to ensure access to health care.

Under current federal law, COFA migrants are categorized as “not qualified” immigrants, making them ineligible to receive Medicaid and several federal safety net programs. However, because they are considered lawfully present, they are eligible for Health Benefit Exchange coverage and subsidies under the Affordable Care Act. Yet, this population experiences disproportionately high rate of poverty, and many are unable to afford coverage through the Exchange, even with subsidies. Poverty and lack of access to health coverage have only exacerbated health disparities.

Both quantitative and qualitative data specific to COFA migrants in Washington is extremely limited. Children’s Alliance’s work in documenting the need will be focused on community-based documentation of qualitative data that captures the impacts of systemic health inequities, along with the incredible strengths and resiliencies that fortify these communities. Children’s Alliance staff will coordinate with COFA migrant community members to collect qualitative data concerning the health needs and barriers experienced by the community, as well as the assets of these communities.

Children’s Alliance staff will package data into presentable forms and share via various mediums, for example blog posts or testimony.

Documenting the health disparities experienced by COFA migrants serves to increase awareness and promote institutional change. Data will be shared with policymakers, advocates and others who are impacted by and/or influence health disparities. In sharing the lived experiences of this community, we seek to ensure any institutional changes impacting the health of COFA migrants are informed by the historical and persistent disparities they face.

Children’s Alliance’s staff will engage and recruit COFA migrant community members to participate in advocacy training, including annual Advocacy Camp in fall of 2017. This three-day training includes: expert training in advocacy, community organizing and strategic communications; hands-on opportunities to practice new skills; dialogue and analysis about how to advance racial equity through public policy advocacy; and other skills.

About our Grantee

Children’s Alliance

The mission of the Children’s Alliance is to improve the well-being of children by effecting positive changes in public policies, priorities and programs. Our work is shaped by a core belief that ending racial and ethnic inequality is key to making sure all children can reach their vast potential.

Major Grant

View all projects >>