Health Care Quarterly
San Jose and Silicon Valley Business Journal
October 22, 1999

Community not taking advantage of Federal program
By Cindy Ling
Special to The Business Journal

Healthy Families, a federal program started in 1998, aims to give low-income working families an affordable way to provide health coverage for their children.

But despite its potential, enrollment figures have been disappointing. In Santa Clara County, slightly over 4,000 children have enrolled in the program - less than half of the 9,000 projected.

"We need help getting the word out, and in dispelling the fears immigrants have," said Nancy Gere, a spokeswoman for the Santa Clara Family Health Plan, one of the participating health plans.

Simple as 1-2-3

Healthy Families provides a way for kids to get health care without costing an employer any money and without any paperwork. Basically, all the employer has to do is to tell employees about the program."

"We do the rest," said Victor Perez, a spokesman for the Santa Clara Family Health Plan. We can provide applications for employers to have on hand or payroll stuffers to put in employee paychecks to let them know about the program."

Mr. Perez will visit the workplace to explain the program as well as arrange for someone to come and help eligible employees enroll.

"This is an ideal program for employers who can't afford to subsidize health care for employees' families," said Jim Tucker, a spokesman for the San Jose Silicon Valley Chamber of Commerce.

Needed service

Studies show that uninsured children go without preventive care, immunizations and basic medical care. Children especially need preventive care for normal growth, nutrition and development. In California, an estimated 1.6 million children -- 17 percent -- are uninsured.

In Santa Clara County, an eligible family pays between $4 and $27 a month for a comprehensive health plan that includes medical, dental and vision care.

All the eligible children in the family are covered. Once enrolled, families are covered for one year. Families can choose from plans such as Blue Cross, Blue Shield, Kaiser and the Santa Clara Family Health Plan for their health insurance.

Ms. Gere points out recent changes should boost enrollment. The income threshold has been increased from 200 percent to 250 percent of poverty level, pending final approval from the federal government, anticipated this month.

"This will help because our cost of living is so high here," said Ms. Gere. A family of four will be able to have household income up to $41,750. Deductions are allowed for child care and child support payments.

Another recent change already in effect is that children of legal immigrants who arrived after August 22, 1996, are now eligible to apply immediately. Previously, there was a five-year waiting period.

Beau Carter, executive director of Integrated Healthcare Association based in Walnut Creek, would like to see more done to simplify the application process by combining the application for Medi-Cal and the Healthy Families program. Families would then automatically be steered into the program they qualify for.

"The government can do a better job of making the process easier and we have the resources available to do it," Ms. Carter said.

The Integrated Healthcare Association is hoping that tobacco settlement money can be used toward the Healthy Families program and other programs that help cover the uninsured.

Getting the work out

Others are helping to get the word out. Numerous community agencies have staff who have been trained to assist in the enrollment process. Schools, community agencies, various associations and medical providers have all been enlisted.

Mr. Perez has been going to local chambers of commerce and business groups to make presentations to employers. Economic and Social Opportunites, a nonprofit organization based in San Jose, sent mailers to all residents in Gilroy with their August water bills.

Regional Medical management of Santa Clara County, an integrated health care plan based in San Jose, has had success in reaching the Vietnamese community. They have targeted doctor's offices, Vietnamese newspaper and radio, community events and also have spread information through word of mouth. The agency has set up a small help station in East San Jose dedicated to the Healthy Families program and has enrolled more than 1,000 people in the past year.

"We make ourselves available to where the need is," said Maria Tham, spokeswoman for Regional Medical Management.

The help station has evening and weekend appointments available, and sees people on a drop-in or appointment basis.

"We want to help get resources to the people who need them, educate them about their eligibility and benefits, and get them insured," said Ms. Tham.

Cindy Ling is a freelance writer based in San Jose.
You can reach her at phantomss@aol.com.