COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Health Department

DATE:

January 19, 2005

BOARD MEETING DATE:

SPECIAL NOTICE/HEARNING:

VOTE REQUIRED:

February 8, 2005

None

Majority

TO:

Honorable Board of Supervisors

FROM:

Charlene A. Silva, Director of Health

SUBJECT:

Children’s Health Initiative (CHI) annual report and statewide support coverage for all children

RECOMMENDATION:

1

Accept the annual report of the Children’s Health Initiative

2

Adopt a resolution authorizing the president of the Board, on behalf of the Children’s Health Initiative Coalition, to support Californians for Healthy Kids

VISION ALIGNMENT:

Commitment: Ensure basic health and safety for all.

Goals 5: Residents have access to healthcare and preventive care and goal.The report and the resolution contribute to this commitment and goal by providing health care coverage to all children from low-income and middle-income families.

Performance Measures

Measure

Actual 2003

Actual 2004

Projected 2005

Medi-Cal membership for children

20,453

20,580

21,000

Healthy Families membership*

7,400

7,800

8,100

Healthy Kids membership

4,690

5,170

5,500

* 2004 membership is a projection since the state has yet to report final information.

BACKGROUND:

In 2002 your Board established and funded the San Mateo County Children’s Health Initiative (CHI) to address community-wide concern for the county children who lacked access to comprehensive medical, dental and vision health insurance coverage. With your actions, a broad-based, local coalition collaborated to offer every child insurance by providing easier access to two existing government funded insurance programs, Medi-Cal and Healthy Families, and developing and implementing a third new program, Healthy Kids.

Several organizations have been involved with CHI. The Health Department has served as the lead organization in administering the various components of the CHI. It oversees a contract for Healthy Kids’ outreach, enrollment and marketing activities, and the project’s overall administration, evaluation, and fiscal oversight. The San Mateo Health Commission, doing business as the Health Plan of San Mateo (HPSM), serves as the plan administrator for Healthy Kids, receiving a monthly premium per-member per-month to provide comprehensive health benefits. The First 5 San Mateo County Commission and the Peninsula Community Foundation (PCF), on behalf of children ages 0-5 and private donors, have provided the Health Department and HPSM with funds to accomplish these outlined objectives.

DISCUSSION:

The annual report outlines the success of CHI during its second year:

1.

8,900 children have been newly enrolled in Medi-Cal, Healthy Families and Healthy Kids in 2004

2.

Eighty percent of Healthy Kids members have accessed medical and/or dental services over the past year

3.

CHI has leveraged the support and resources of over 60 organizations

4.

CHI has taken a leadership role on the web-based application: One-e-App; paving the way for statewide use of a one-stop enrollment into health coverage.

The report also discusses the challenges facing the program, especially retention. This is largely due to disenrollment. Primary causes are difficulty paying, mobility, and lack of contact due to disconnected phones. Strategies to address disenrollment are: increased contact (quarterly postcard contact to update addresses), phone-based re-enrollment, and hardship assistance for the quarterly family contribution.

CHI’s innovative work has helped spur statewide interest in improving the health of all children. It has been an active partner with the new broad coalition, Californians for Healthy Kids, which has launched a statewide campaign in support of providing health coverage for all children. Californians for Healthy Kids is comprised of a broad array of interests—teachers, businesses, parents, doctors, faith leaders, health plans and community leaders across the state—who are uniting to make affordable insurance available to all children in California and to reform the current state health insurance programs for children. This statewide policy reform continues to be the best approach for sustaining CHI’s groundbreaking work beyond your Board’s five-year funding commitment to the initiative.

FISCAL IMPACT:

There is no net county cost as a result of accepting the annual report or approving the resolution. The approved CHI budget for Fiscal Year 04-05 is $8.2 million. $5.5 million is covered with contributions from First 5 San Mateo County, Peninsula and Sequoia health care districts, and foundations; the County’s Solid Waste Fund contributes $2.7 million.