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Too many kids, few funds for county program


San Francisco Examiner

More children are landing in the county's healthcare system safety net than health officials anticipated, sending county officials in search of more funding.

Outreach workers have found so many children eligible for "Healthy Kids" the county's new subsidized health insurance program, that officials are revising projections and applying for more financial support.

It was originally estimated that 5,400 children would qualify for Healthy Kids within the first three years, but more than 4,300 have already signed up since the county started taking applications last January.

With such a pace, Toby Douglas, the county's Health Access Initiative manager, said there are probably more than 8,000 Peninsula children eligible for the program.

"Our enrollment rate is way faster than we ever expected," he said. "We just have a lot of families out there. The need is there. Now we need to sustain the funds we have and continue to look for more funds and also look at local fund raising."

Healthy Kids is part of the countywide Children's Health Initiative, which aims to ensure that every child on the Peninsula has health coverage. Under the Initiative, outreach workers see if children qualify for the federal/state Medi-Cal health insurance program or the state's "Healthy Families" program.

The county-level Healthy Kids program attempts to bridge the gaps left by the federal and state programs, which do not cover illegal immigrants or children whose families earn more than 250 percent of the federal poverty level.

Both public and private entities have lent huge support to Healthy Kids. The biggest donors are the county itself, two healthcare districts and the First Five Commission, which distributes cigarette tax money to programs for children under five years old.

Such backing has produced a healthy $6.5 million annual budget for five years, but the swelling enrollment rate could still create a $2 million shortfall, especially for children ages six to 18.

Advocates for the Children's Health Initiative are now turning back to funders for more support. They will be asking the Peninsula Healthcare District for $950,000 on Nov. 20. The District already gave the Initiative project $750,000 for one year, and Douglas said that more uninsured children than expected were found within the district's mid-county service area.

"It is so important to at least maintain our current level of funding," he said. "The $750,000 they funded us is not covering the kids in their district now. If we don't get at least another $750,000, we may have to look at disenrolling kids."

District board member Terilyn Hanko believed in the value of the program, but wants to balance the Initiative funding with other worthy programs.

"We really need to take a hard look at what members in the community are in greatest need and where the dollars see the greatest number of people," she said.

According to county statistics, the large majority of Healthy Kids enrollees are Spanish-speaking children living in severely impoverished families.

"Most of the families that come to us are Latinos," said community health advocate Sandra Vivanco. "I think Anglo people need to get more information that this is not only for the low income but also for the middle class."

County figures estimate that a family of three must make $61,000 just to make ends meet on the Peninsula, but the federal poverty level for a family the same size is $15,600.

This discrepancy makes many needy Peninsula families ineligible for state and federal programs, which is one of the reasons Healthy Kids will cover children from families that make up to 400 percent of the federal poverty level, or $62,400 for a family of three.

Still, outreach workers for the Children's Health Initiative have found many uninsured youth who qualify for federal and state health insurance programs that cap at 250 percent of the federal poverty level.

In the first six months of the Initiative implementation, Medi-Cal roles have swelled 38 percent and Healthy Families grew 26 percent. All told, San Mateo County has 20,000 children on Medi-Cal and 6,700 on Healthy Families -- many more than the 4,300 on Healthy Kids.

But from Vivanco's on the ground perspective, there are many more children waiting to enroll in Healthy Kids. There can be any number of reasons for the huge need for insurance -- the down economy, employers dropping insurance coverage, a large number of uncounted illegal immigrants.

But whatever the reason for the demand, county health director Margaret Taylor and the Children's Health Initiative team are committed to meeting it.

"We are really tremendously impressed with work the outreach workers have done," she said "A whole generation of children will now benefit from having good, preventative health care."

Healthy Kids demographics

The county's new health insurance program, "Healthy Kids" is booming. Below is a demographic breakdown of the 4,300 county children who are filling the roles.

Male -- 52%
Female -- 48%

0 to 5 -- 19%
6 to 12 -- 44%
13 to 18 -- 37%

Preferred language
Spanish -- 88%
English -- 11%
Other -- 1%

Percent of household federal poverty level
(Federal poverty level for a family of three is an annual income of $15,600.)
0-150% -- 80%
151-250% -- 13%
251-300% -- 4%
301-400% -- 3%

-- Sara Zaske