Sunnyvale, CA
Wednesday, September 18, 2002

FAMILY HEALTHCARE CENTER
SERVES COMMUNITY

Santa Clara Family Health Plan CEO Leona Butler, whose nonprofit organization administrates the Healthy Kids program, beams as she and her staff show visitors their new facility.

But her excitement goes beyond the new carpets and freshly painted rooms. Based in Campbell but serving the entire county, the organization has just achieved a major milestone: insuring more than 10,000 children who don't qualify for other public health plans with comprehensive medical, dental and vision coverage.

The program was " the missing piece" to fulfilling the county's goal of providing health insurance for all of its children, Butler says.

"It's been an extraordinary year," she notes. "Our entire staff has just been on sort of a permanent high. We probably couldn't have picked a harder time." But it's a time when it's most needed, she adds.

Achieving that goal, however, means crossing language barriers and cultural barriers to help spread the word, Butler adds.

There are almost 800 kids living in Sunnyvale who are currently insured with the Healthy Kids Plan, according to Laurel Anderson, vice president of marketing for the program. The kids come from different ethnic backgrounds whose families speak languages including Spanish, Chinese, Vietnamese, Russian and Farsi,
she said.

"This is a very good thing for my son," said Quinglian Mao, who has lived in Sunnyvale for two years.

Mao said that for a monthly insurance premium of $4 his 15-year-old son gets complete medical coverage. Things weren't easy, as both he and his wife lost their jobs in 2001. Fortunately, his wife managed to find a job a few months ago. Although their son is eligible for coverage through his wife's work, Mao said he would rather pay the premium and continue with the county plan because "it is so good."

Other residents agree. Diana McDaniel has lived in Sunnyvale nearly all her life —more than 50 years. She said her two children, ages 8 and 12, are covered by the county's Healthy Kids Plan and she couldn't be happier. Healthy Kids was started at the beginning of 2001 to satisfy the goal of the nonprofit Children's Health Initiative, which was to insure 100 percent of the county's children. Some children were already eligible for health coverage through the state and federal Medi-Cal and Healthy Families programs, Butler says. But undocumented families and families who earned between 250 and 300 percent of the federal poverty level weren't eligible for those programs. The number of those people in the county is significant and continues to grow during the economic downturn, she says.

Healthy Kids is a managed health-care program, but it is different from the traditional HMO — health management organization — in that it is nonprofit and almost all the doctors they've approached have been willing to participate, Butler says.

Parents can apply for their children 18 and younger by filling out a two-page application. Program staff make sure applicants understand the forms as well as verify applicants' income and eligibility. Coverage begins the first of the following month, and parents — many of whom have never had health insurance — are
encouraged to attend orientations that teach them about their benefits and responsibilities.

Program participants receive medical, vision and dental coverage and are able to change their doctors, see their medical records and be involved in medical decision-making.

The program helps people choose a doctor or clinic that is near their home or work, speaks their language and provides the kinds of treatment their children may need.

All the county's clinics and hospitals and almost all the pediatricians in the county are participants, as well as many of the area's family practitioners, according to Butler. In addition, doctors whose patients join Healthy Kids are usually willing to accept the program, and program staff are willing to talk with doctors and encourage them to accept it on the patients' behalf, she says.

Healthy Kids pays preferred care providers a fixed amount every month per patient, which gives them an incentive to maintain children's preventative care. In addition, the program pays for all regularly scheduled pediatric care. "We're able to keep costs down because we're not for-profit," Butler says. "Our doctors are working
at less than they would charge you, but not a whole lot less."

Craig Walsh, executive director of the Santa Clara Family Health Foundation, which oversees the funding for Healthy Kids, says the program needs about $1 million a year for every 1,000 children it insures. It receives $3 million from the county's tobacco settlement money, $2 million from the state's tobacco tax money, more than $1 million from the city of San Jose, and money from other agencies, companies and individuals. Because much of the money is not from
public sources, it can be used for children in undocumented families who would otherwise receive no assistance, he says.

"We think that, in reality, 14,000 will enroll," Butler says. "There will always be some number that won't, due to fear, movement and children turning 19. But we want to reach as many families as possible."

For more information about the Healthy Kids Fund, call 408.254.5038 or visit www.healthykidsfund.org or www.CHIkids.org. To enroll in the program, call 888.244.5222.

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Jana Seshadri contributed to this story.
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