PUBLIC HEALTH/County acts to provide insurance for all kids
Santa Clara County, Calif., started a program in January that is aimed at providing universal health care for all of the county’s children. As of April, the county had enrolled 8,200 of its estimated 70,000 uninsured children in one of three health care plans.
The Children’s Health Initiative (CHI) is a cooperative effort of the county’s board of supervisors; Working Partnership USA, an advocacy group founded by the executive officer of San Jose, Calif.-based South Bay AFL-CIO Labor Council; and San Jose, Calif.-based People Acting in Community Together, a faith-based organization. The program’s goal is to provide health coverage for every child whose parents have an income at or below 300 percent of the federal poverty level. For example, a family of four with an income of $51,150 would be eligible for coverage under the new program.
The CHI is an extension of a county outreach program that has been enrolling children in the state’s Medicaid program, Medi-Cal, for four years. Through that outreach program, the county discovered that, although many families with children were technically poor, they had higher incomes than were required for Medi-Cal and the state- and federally funded Healthy Families program.
To bridge the gap, the county started a managed health care plan named Healthy Kids. Under the plan, children receive complete medical coverage including preventive check ups, specialist care, hospital services, mental health care, alcohol and drug treatment, vision care, dental care and prescription coverage.
Healthy Kids costs $87 per member per month. The family pays $4 to $6 per child per month, with a maximum $12 to $18 monthly payment per family. The remainder of the program, which costs $14 million to $18 million annually, is being funded with private donations, with money from the county’s and San Jose’s shares of California’s tobacco settlement, and with money from the state’s tax on tobacco products. The money is used to pay premiums, to support outreach efforts and to solicit donations to continue the program.
Since the CHI and the Healthy Kids programs began, the county has used volunteers at community and faith organizations to enroll families for one of the health plans. Also, it has run radio and television advertisements to attract enrollees. “Just locating the kids is difficult,” says James Beall, county supervisor and chairman of the county’s health and hospital committee. “Finding the kids, finding the families and getting the people to reveal whether they have health insurance — it’s not easy. Hundreds of people have volunteered their time to help make our program a success, and without that, it just wouldn’t work.”
Beall expects that enrolling all of the county’s uninsured children will take a few years, but he is confident that the county’s efforts will pay off in the long run.
“By making people eligible for these health care programs, two things will happen: The kids will become healthier, and [that] will reduce the expense of emergency room visits, which are not cost-effective,” he says. “We can almost guarantee that those things will happen, so we think [the CHI] is both a morally and fiscally prudent thing to do.”