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Santa Clara Family Health Plan Local Initiative - Health Coverage for Immigrants August 3, 2006

Santa Clara Family Health Plan Local Initiative - Health Coverage for Immigrants August 3, 2006. Who is Santa Clara Family Health Plan… A community based health plan that provides no or low cost health insurance to qualified seniors, adults, and children in Santa Clara County, California.

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Santa Clara Family Health Plan Local Initiative - Health Coverage for Immigrants August 3, 2006

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  1. Santa Clara Family Health PlanLocal Initiative - Health Coverage for ImmigrantsAugust 3, 2006

  2. Who is Santa Clara Family Health Plan… • A community based health plan that provides no or low cost health insurance to qualified seniors, adults, and children in Santa Clara County, California. • Founded in 1997. • Local Initiative Plan for Medi-CalManaged Care Program in Santa Clara County. • Community Health Plan for Healthy Families Program. • Established first Healthy KidsProgram in the Nation.

  3. Our members… • 97,430 SCFHP Members by Program • 73% are Medi-Cal • 13% are Healthy Families (SCHIP) • 14% areHealthy Kids • SCFHP Members by Ethnicity 3

  4. Santa Clara County’s Approach to Covering Immigrants: Radical Incrementalism • Created Healthy Kids and the Children’s Health Initiative (CHI), 2001 • Spearheaded by People Acting in Community Together (PACT) and the Working Partnerships, USA with county health department, local health plan, county government • CHI goal: provide comprehensive health, dental and vision coverage to 100% of children in SCC living below 300% of the federal poverty level.

  5. Immigrant Children in Santa Clara County • Medi-Cal • US Born: 12,000 • Naturalized Citizen: 9,000 • Non-Citizen: 37,000 • Healthy Families • US Born : 2,000 • Naturalized Citizens: 2,000 • Non-Citizen: 7,000 (UCLA CA Health Interview Survey, 2003)

  6. CHI Lessons Learned Immigrant advocacy organizations included in CHI Coordinated, multi level Outreach, Enrollment, Education : In reach: County/Community Clinics & Hospitals Outreach: Community and School Family Resource Center Member education and retention Trained community based Application Assistors Piloted One-e-App online application, streamlining open door “One-Stop” access

  7. Healthy Kids Program • Total Health Kids 13,321 • Covers all children • Cost per child per year is $1000 • Family pays, $4 to $12 per month per child. Up to $12 to $36 per family • $5 co-pay for specialist and pharmacy

  8. Immigrants in Healthy Kids • Over 96% of the children enrolled in Healthy Kids come from immigrant families. • 90% of the immigrant children are undocumented • Immigrants by Ethnicity in Healthy Kids

  9. Santa Clara County and City of San Jose Tobacco Settlement Funds FIRST 5 Santa Clara County Commission Santa Clara Family Health Plan through the Santa Clara Family Health Foundation Corporations and individuals Foundations: David & Lucile Packard Foundation, California Health Care Foundation, The California Endowment, The Health Trust, others. Federal SCHIP funds: County Children’s Health Insurance Program (C-CHIP) Funding the Healthy Kids Program

  10. Healthy Kids Program link to State of California Programs • One-E-App, online application, can be used for 3 programs (MC/HF/HK) and has capacity to interface with State Healthy-App On line System • C-CHIP allows Counties to draw federal resources for qualified children

  11. Healthy Kids Model & Effort • 17 Counties in California have replicated the HK model • California at tipping point for covering all children in California • Tobacco Tax Act 2006: $371 Million of the expected $2.1 Billion per year will be dedicated to children’s health insurance • Determined and Focused Advocacy Efforts at state and local levels: 100% Campaign- Children’s Partnership, Children Now & PICO California (Sponsored by California Endowment)

  12. CHI & Healthy Kids StudyMathmatica/UCSF/Urban Institute-2006 • 54% of Healthy Kids Children are from Two Parent Working Families • 43% of Healthy Kids Family has lived in Santa Clara County for more than 36 months • 63% of Healthy Kids were uninsured for at least 6 months • Access to Usual Source of Care for those with Healthy Kids is 91.4% versus 54.4% for uninsured children • Healthy Kids access to Dental Service for those with Healthy Kids is 81.3% versus 28.5% uninsured children

  13. CHI & Healthy Kids StudyMathmatica/UCSF/Urban Institute-2006 • Outreach effort have been successful. Over 114,276 children have received assistance with applications for MC/HF/HK in Santa Clara County (January 2001-June 2006). • 30,000 children have been provided health insurance coverage by Healthy Kids since 2001 • “In Reach” is effective. 68% of all children applied at clinic sites • Mutliple strategies to create “word of mouth” referral system started with outreach at clinics, Social Services, Schools, SCFHP Family Resource Center, Churches, Community Centers and Non-Profit Organizations • CHI has been and continues to be flexible and adaptable to the needs of the community and children of Santa Clara County

  14. Healthy Kids Radical Incrementalism: Our Children and Our movement for a Healthy Santa Clara County

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