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The San Mateo County Children's Health Initiative (CHI) was established to address community-wide concern that at least 17,000 San Mateo County children lacked access to comprehensive health insurance coverage. Through the efforts of a broad-based, our partners, CHI is an umbrella organization that provides easier access to two existing government funded insurance programs (Medi-Cal and Healthy Families) and adds a third (Healthy Kids) to serve families who don't qualify for the first two.

CHI launched its new initiative and the new Healthy Kids program on January 11, 2022 with an expanded outreach and enrollment program, seeking an ambitious goal of covering 100 percent of eligible children. In the first month, CHI enrolled more than 1,500 children into Medi-Cal, Healthy Families, and Healthy Kids - approximately 10 percent of all uninsured eligible children. To date, over 13,300 children have been enrolled in Healthy Kids.

The initiative is funded with a mix of public and private contributions with close to $40 million raised to date.

The Evolution of the Children’s Health Initiative

The issue of the uninsured in San Mateo County has always been a significant concern in our community. In fact, it was due to several of our local stakeholders’ actions that have ultimately led to the launch of the Children’s Health Initiative.

First, in March 2001, a federal Community Access Program (CAP) grant bolstered prior community work on creating a coordinated approach to expanding health access by integrating health programs and services into a cohesive system of care for the uninsured. The agencies involved with the CAP grant included the San Mateo County Health System (which was later divided into the Health Department and San Mateo Medical Center), San Mateo County Central Labor Council, El Concilio, Health Plan of San Mateo, Ravenswood Family Health Center, and San Mateo County Human Services Agency. These agencies met grant objectives such as increasing Medi-Cal enrollment by 38.5% and Healthy Families enrollment by nearly 60%. With these successes, the CAP Executive Committee began investigating additional approaches to covering low-income children who are ineligible for Medi-Cal and Healthy Families due to income or documentation status.

Second, the Hospital Consortium of San Mateo County identified lack of health insurance for low-income children as a key concern facing its member hospitals and affiliated physicians, and designated the development of a universal health coverage program as one of its top priorities.

Third, the San Mateo County Health System and community-based groups - including key projects through the Partnership for Public Health Initiative and a Community Foundation Partnership grant to Peninsula Community Foundation (PCF) (now Silicon Valley Community Foundation) - improved outreach and enrollment into existing health insurance programs and reinforced the need for a product that serves those who do not qualify for these programs.

Fourth, the experience of neighboring Santa Clara and San Francisco Counties in launching "Healthy Kids" programs reinforced our confidence that we could effectively address this public policy issue at the local level.

Then, in March 2002, the San Mateo County First 5 Commission, at the request of its Health Access Committee, took the first step in launching universal coverage with a long-term investment of $2.3 million per year for ten years to fund health insurance coverage for all eligible children ages 0-5. Two months later, the Hospital Consortium of San Mateo County, PCF and the County, convened a Health Summit bringing together key stakeholders to understand the problem of uninsured children and promoting First 5 funding as a first step towards universal health coverage for all County children. The County announced its interest in matching private funding directed to this effort.

After the Summit, the Hospital Consortium, First 5, Central Labor Council, PCF, HPSM and the San Mateo County Health System and Human Services Agencies established the Children’s Health Initiative Coalition (the Coalition) to launch a Children’s Health Initiative (CHI) that will maximize Medi-Cal and Healthy Families coverage and develop a new "Healthy Kids" insurance program for children ineligible for existing health coverage programs. The CHI vision is universal health care coverage for children ages 0-18 who live in households with annual incomes below 400% FPL.