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Seeks to make insurance available to county's 69,000 kids
Sunnyvale--A groundbreaking health initiative will go into effect in Santa Clara County at the start of the new year. Approved by the Santa Clara County Board of Supervisors, the children's health initiative will make Santa Clara County the only county in the United States to make health insurance accessible to all children.
"I'm tickled to be a part of this," says county Supervisor Pete McHugh. "So many of us have been lucky enough to have insurance as part of our job or a family member's job, but there are so many folks out there who don't have it. They'll have access to regular preventative health care instead of only being able to use emergency rooms when things have already reached a dangerous stage."
McHugh's office reports that an estimated 69,000 children in the county don't have health insurance. According to McHugh, all of these children would receive coverage under the new plan.
But the plan's goal goes beyond making all children in the county eligible for insurance--of the 69,000 children without insurance, says McHugh, 50,000 fall in the eligible but not enrolled category.
"Those 50,000 children aren't enrolled because people aren't aware of the coverage they can receive," McHugh says. "We have people canvassing the county right now increasing awareness and evaluating families for eligibility."
"A lot of the problem lies in the bureaucratic red tape from the state and federal governments," adds Robert Sillen, director of Santa Clara Valley health and hospital system. "The eligibility process is very difficult and threatening, but a lot of that is changing--our process will be much more simplified."
County Supervisor Blanca Alvarado, another key supporter of the initiative, states, "People are also falsely fearing that [if they join a special insurance program] they're subject to government scrutiny. But our program won't have any connection to any other government agency. We're also going to be working directly out of schools. With the help of schools, the likelihood of identifying in need kids will be higher. Our people are going to malls, grocery stores, even door to door."
The program, managed and coordinated by a public agency called Santa Clara Family Health Plan, will consider any child whose parents have an income at or below 300% of the federal poverty level as eligible. This year, a family of four with an income at or below $51,150 qualifies for the program.
McHugh says eligible children between the ages of under 1 year old to 19 will receive a benefit package similar to Healthy Families that includes full medical, mental health, dental, vision and pharmacy coverage. He says that the program will cost between $0 and $18 per month depending on each family's size and income. The price includes no annual deductible. Participants receive free preventative service, and doctor and emergency room visits will cost only $5 per visit.
To the supervisors, the preventative services mean the most.
"These kids don't get the preventative treatment that will get them started on life with a healthy footing," Alvarado says. "You can almost guarantee that they're not getting dental prevention. Or they may need glasses. They're not getting the necessary physicals for growing bodies."
The original proposal for the program came from Working Partnerships USA and People Acting in Community Together (PACT).
"[Alvarado] has been the primary advocate," McHugh says. "As the rest of the board rallied around her, we were able to secure $3 million."
The $3 million comes from $25 million of tobacco settlement funds put at the disposal of the board of supervisors.
"The results [of children not having medical insurance] are so severe that we had an obligation to do something," Alvarado says. "We were in a good position to act because of the tobacco funds and the fact that there were no stipulations for what we use it for. Counties don't typically have that kind of discretionary money to work with."
Since the first $3 million, the families first commission that allocates Proposition 10 money has added $2 million in matching funds. The county's General Fund provides $1.9 million and $1 million comes from the Santa Clara County Health Fund.
Hence, $7.9 million of the necessary $14 million has already been raised in order to make the fund a reality, according to McHugh. He says he hopes to see some money from the city of San Jose, as well as from other area foundations and agencies.
The application and enrollment process begins on January 2, 2001. "Although we don't have all of the money yet, we have sufficient funds to get [the program] up and running," Sillen says. "If we wait for all of the money, we'll never get started."
"This is an historic moment," he continues. "Not only in the county's history, but in the history of the state and the country, as well. There's no doubt that this is a very high-value program."
McHugh agrees, adding, "The thing that excites me is that we're the first county in the country to propose this. This is what government should be about."
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County supervisors approve children's health initiative
Daniel Hindin
Web extra to the December 21-27, 2000 issue of Metro.