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By Carol Harrison
The Eureka Reporter
December 1 , 2007
An unexpected state budget cut for outreach and enrollment efforts for children’s health insurance has not had nearly the impact on Healthy Kids Humboldt as on other counties.
"It was icing on the cake for us,” Healthy Kids Humboldt Coordinator Catherine DeSantis said of Gov. Arnold Schwarzenegger’s $34.6 million cut of outreach and enrollment grant money from the state’s final 2007-08 budget.
The unexpected blue pencil work took $288,000 from Humboldt County and more than $9 million from Los Angeles County agencies.
"We started later than a lot of the children’s health initiatives who had already worked through their three-year cycle of funding,” DeSantis said.“We’re good through the end of 2009 and we built our core enrollment activities into our infrastructure. But after the first three years, they built their whole program on the grant money and had nothing left.”
The financing for Healthy Kids Humboldt after 2009 is uncertain.
"It will continue, but there are a lot of political questions that will determine how it will continue,” said Allan Katz, executive director of the Community Health Alliance, which is the umbrella organization that coordinates the local effort to insure all children.
"The best-case scenario has the federal government reauthorizing the State Children’s Health Insurance Program, (Healthy Families in California) and the state passing legislation to cover children, but if SCHIP doesn’t get reauthorized or if the state is slow, it will be difficult to sustain the kind of fundraising we’re doing. Fewer kids will get coverage.”
President George W. Bush vetoed the SCHIP reauthorization and Congress has failed to override the veto.
The Center for Community Health Studies at the University of Southern California stated the governor’s cut of Outreach, Enrollment, Retention and Utilization grants is “threatening the collapse of (Los Angeles) County’s already fragile infrastructure of schools, clinics and agencies working together to enroll uninsured children.”
Statewide, the center reported that many children’s health initiatives are operating at the brink.
"Anticipated funding deficits threaten to close these programs and disenroll thousands of children in the absence of state funding,” the report stated.
"Humboldt and many other counties were spending money on the assurance that this grant was going to be renewed,” Katz said. “It was a done deal, a three-year program that was really a three-year promise from the governor and the Legislature.”
Healthy Kids Humboldt is four months into the second year. In a previous interview, Katz said the program impacted 1,500 children through CalKids, Healthy Families or Medi-Cal.
The program extended health insurance coverage to 250 children in the county. Children in families making up to 300 percent of the federal poverty level — roughly $62,000 for a family of four — and undocumented children are eligible for CalKids insurance.
The medical, dental and behavioral health coverage costs parents $10 per child per month to a maximum of $30 per family.
In addition, DeSantis partially credits outreach and enrollment efforts with boosting to 2,800 the number of county children enrolled in Healthy Families, which covers children in families making up to 250 percent of the federal poverty level.
When Healthy Kids Humboldt started in August 2006, Healthy Families enrollment stood at 2,100.
The governor’s veto eliminated funding for a full-time enrollment person subcontracted through Changing Tides Family Services and a part-time enrollment specialist with Healthy Kids Humboldt.
"Changing Tides Family Services will still work with us to do fundamental outreach, but the one-on-one, person-to-person that’s so valuable is just a loss we’ll have to learn to live with,” said Susan Buckley, who supervises DeSantis as the program director for Maternal Child and Adolescent Health.
"(The cut) is forcing us to do more of a grass-roots outreach,” DeSantis said. “We will not be able to do as much advertising.”
Katz said the grass-roots support across the county has earned Humboldt County a statewide reputation.
"This community has been amazing, extraordinary in its support,” he said. “We’re the only children’s health initiative in the state that’s gotten substantial support from the church and business community.”
DeSantis said the Humboldt County Department of Health and Human Services absorbed two positions in public health to keep the children’s insurance effort moving forward despite the OERU cut.
In addition, she said Changing Tides, Northcoast Children’s Services and the Humboldt County Office of Education continue to disseminate information, seek out the uninsured, publicize the program and refer qualified families.
"Instead of them helping us enroll, they’ll be referring to us for enrollment,” DeSantis said. "We’ve recovered the blows from this cut. It’s old news for us. We want to keep the public interested in the concept of insuring their children.”
Enrollment will get easier by the end of January as the county shifts over to an electronic enrollment system with improved capacity to track and streamline the process for consumers.
"The county has continued to maintain its commitment to the children’s health initiative,” Katz said. “It was a loss, but they’ve really bounced back.”
DHHS Director Phillip Crandall put the full weight of his agency behind the children’s health insurance effort in fall 2005 and had it up and running in a year.
While DeSantis paints it as business as usual and Katz pats the county on the back, DHHS personnel are still scratching their heads.
"It was such a shocker to us,” DHHS Assistant Director Jeanne Vidad said of the cut. "We’re still in shock, especially since the governor promised the money and the cut wasn’t even on the radar in the January release and May revise.”
The county started its services July 1, which made a cut retroactive to the beginning of the fiscal year harder to absorb.
"We’re still backpedaling and trying to figure this out, but we are going forward,” she said. "There are always cuts, but we have a passion for the children’s health initiative. We’re going to continue to find ways to make sure the program stays intact.”
Vidad said being an integrated department with public health, mental health and social services helps to meet the funding needs of Healthy Kids Humboldt and to seek future grants.
"We are disappointed we lost our funding, but we have our goals and priorities,” she said. "It is a priority to make sure every child in this county has health insurance. We have two more years to figure out how to keep that going.”
Katz said Healthy Kids HUmboldt is $63,000 away from raising the $403,000 needed to pay for CalKids insurance this year.
He wants to double to 500 the number of children enrolled in CalKids and knows the cut in outreach and enrollment money makes it hard to reach those who weren’t on the radar last year.
The Center for Community Health Studies reported 25 Healthy Kids programs operating in California, with Placer County debuting this fall as the 26th.
Another five counties, including Humboldt County, provide coverage through the CalKids insurance vehicle.
In its September 2007 report, the center estimates children’s health initiatives are meeting about 39 percent of the total need for coverage. Los Angeles is one of seven counties meeting half or more of the estimated need for coverage. Los Angeles County reaches 53 percent of the estimated eligible compared to San Mateo at 90 percent, Santa Cruz at 87 percent and San Joaquin at 85 percent.
Katz said Healthy Kids Humboldt had reached 20 percent of the eligible in its first year.
One out of six children in Humboldt County lacks health insurance, Healthy Kids Humboldt reported.
To find out if your child qualifies for one of the three health insurance programs available for children, phone 707-442-6066.
Regardless of immigration status, children up to the age of 19 are eligible.
A family of four can make up to $5,200 a month and qualify for coverage that ranges in cost from free to $10 per child with a maximum of $30 per month for all children in a family.
"One of the main things we’re trying to do is get each child a primary medical and dental home,” said Catherine DeSantis, program coordinator for Healthy Kids Humboldt.
"When Johnny gets an earache, we want mom to have already been to the doctor with him and filled out the paperwork so she knows who to call and they know her. In so doing, it eliminates unnecessary and costly trips to the emergency room and gets the family started on preventive care.”
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