Youth Health Plan Grows

Hoping to fill in the gaps for uninsured families in Los Angeles County, a coalition of healthcare providers will announce an ambitious $112-million program today to expand medical, dental and vision coverage for 150,000 children over the next three years.

The Children’s Health Initiative, a collaboration among the California Endowment, the L.A. Care Health Plan, the county Department of Health Services and other public and private entities, provides insurance for children in families that do not qualify for federal Medi-Cal or a state program because of income or immigration status.

The new coverage is available to families who earn up to 300% of the federal poverty level -- about $55,000 for a family of four -- and to those who are undocumented immigrants with similar incomes. Parents would pay a fee based on income level.

With funding from Blue Shield of California, the California Community Foundation, Kaiser Permanente and other sources, the initiative has raised more than $88 million toward its funding goal and began enrolling children 18 and younger in April. Today’s formal announcement marks the start of a major enrollment and publicity effort.

“This is a big step forward,” said Howard A. Kahn, chief executive officer of L.A. Care, a nonprofit HMO. “We’re going to be able to say to Los Angeles County families that no [child] needs to go uncovered.”

The initiative builds on the already established Healthy Kids program, which is funded by First 5 L.A. with $100 million in Proposition 10 tobacco tax money for children up to age 5. More than 3,700 children have enrolled in Healthy Kids.

Expanding Healthy Kids coverage to older children was essential because about 80% of uninsured children in Los Angeles County are between 6 and 18, according to the UCLA Center for Health Policy Research. In addition, nearly 75% of uninsured children qualify for but are not enrolled in government-funded Medi-Cal or Healthy Families, a state-sponsored program for low-income households.

About 350,000 Los Angeles County children in low-income families lack health insurance, UCLA researchers estimate. According to studies, such children are far more likely to use a hospital emergency room as a regular source of care and more likely to delay treatment for serious illnesses. They are also far less likely to have vision and dental care.

A key goal of the new initiative is to help about 90,000 children enroll in government-funded health insurance programs. An additional 60,000 who might not qualify for those programs would receive the new coverage over the next three years, Kahn said.

The new enrollment effort is expected to relieve the county’s overburdened healthcare system and save tax dollars by reducing emergency rooms visits.

“Virtually every child that comes through our facilities will qualify for some kind of health coverage. We really shouldn’t have any more uninsured coming to county facilities,” said Wendy Schiffer, director of children’s health initiatives for the county Department of Health Services. “That in and of itself will be very beneficial.”

An important part of the initiative, she added, would be to educate newly enrolled parents about their expanded options and encourage them to seek preventive care. The initiative includes a network of about 3,400 physicians.

Forty community-based agencies will offer information and help in enrolling families. The initiative has also set up a toll-free information line: (888) 452-5437 (4LAKIDS).

Annetta Marlowe, a 42-year-old mother of four, said that her children are healthier since she enrolled them into the Healthy Kids program and she doesn’t feel so helpless as a parent.

The North Hills resident works at a day-care center that pays minimum wage and provides no health insurance or other benefits. Before, routine childhood maladies meant a trip to the emergency room.

“It was long hours of waiting, no follow-up visits, no referral to specialists,” Marlowe said. “You kind of hope for the best and hope the medication will work the first time around and that it doesn’t become more serious.”

Marlowe recalled several scary episodes: when 8-year-old Michael contracted pneumonia and when Simon, 16, and a friend brought home an unspent bullet they found. Simon pounded on the bullet with a hammer, which sent it ricocheting off a wall and into his neck. Marlowe rushed home from work to find her son being loaded into an ambulance. He was wounded but has recovered. Because of such incidents, she is thankful her kids are now covered.

“It’s made a big difference,” she said. “I can take them in for regular checkups now, and they are not behind in their immunizations. It’s very good.”

The California Endowment is contributing more than $10 million to the Los Angeles County initiative, and such private sector investment is replicable statewide, said endowment President Robert K. Ross.

“We’re hoping for a kind of wow effect,” he said. “That policymakers will conclude that if Los Angeles County can do this, there may be a strong likelihood that we can do it statewide.”

Authorities are studying the feasibility of creating an Internet-based application that would determine which program a family qualifies for and which documentation is required. The application then would be automatically routed to the appropriate agency.

The system is being used in some Northern California counties but would be a much bigger task to set up in a county the size of Los Angeles, Schiffer said.