jueves, 27 de abril de 2006
The Childrens’ Health Initiative is Here
With the recent grant of $1,000,000 from the Wine Auction, the Children’s' Health Initiative is fully funded and getting underway in Napa County. A rare collaboration of private and government agencies, CHI will have a goal of providing health insurance to all of the children in Napa County. Other major sponsors are Queen of the Valley Hospital, St. Joseph Health System, Napa County, First Five and California Endowment. Though part of a regional effort including Sonoma, Solano and Yolo Counties with Partnership Health Plan providing the insurance product for all four counties, Napa Counties CHI will be a distinct non-profit corporation. Similar initiatives are underway in thirty California counties, and although a statewide plan has passed the legislature with broad bipartisan support, it was vetoed by the governor. Recently the state of Illinois became the first to implement statewide insurance coverage for all children.
Children’s' Health Initiative will enroll children using the existing Medi-Cal and Healthy Families programs as well as a new product, Healthy Kids, that will offer affordable insurance to those children in families up to 300% of the federal poverty level. Many families in this category have employer sponsored insurance for the working member only. Subsidies are available for those who do not qualify for Medical and Healthy Families but cannot afford the premiums for Healthy Kids. An estimated 80% of the uninsured children do qualify for an existing program but have not enrolled because of lack of knowledge or ability to navigate the bureaucratic process. Healthy Families requires payment of a premium monthly, and, since failure to pay disqualifies the member for ninety days, the rate of disenrollment is usually equal to the rate of new enrollment. By being able to provide case management, CHI can reduce the rate of disenrollment while continuing to find and enroll more uninsured children.
Identifying and enrolling children will involve a partnership with the schools. In Solano County they have already enrolled nearly 100% of their children by using the medical information cards filled out by each family when they enroll a child in school. CHI and Queen of the Valley Hospital's Community Outreach Department have already worked with Napa Valley Unified School District to input this information into a computer data base, and efforts are underway to work with the other districts in the county.
Beyond the obvious ethical issues of providing coverage for children, there are many other advantages to the communities on Napa County. The program will emphasize establishing a medical home for these children to decrease expensive and inefficient use of the emergency rooms. By providing preventive care and immunizations, the children will be less likely to spread infectious diseases. Prompt treatment and dental care will decrease school absence resulting in more federal funds reaching the schools. Finally matching federal funds reach the county when eligible children are enrolled in Medi-Cal.
The pilot program is beginning in three schools, and over fifty children have already been enrolled in the new Healthy Kids product. Some children who have not had preventive care for over five years have already been seen in local providers' offices. The organization will soon have more staffing and office facilities, so that early in 2006 the full program will be launched.
Donald N. Hitchcock, MD
Family Practice
Medical Director
Queen of the Valley Community Outreach
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