Acknowledgement is given to Douglas Bagley, Carolyn Clark, Nancy Delgado,Vicki Edwards, Jonathan Fielding, Leticia Gonzalez, Lucy Johns, Andy Martinez, Arthur Ragazzi, Paul Simon, Marc Strassburg,Sharon Watson,Gary Wells and Toni Saenz Yaffe who reviewed earlier versions of this report.

The Los Angeles County Health Survey is a population-based telephone survey of 8,004 households in Los Angeles County, examining health and health-related issues of children and adults. The survey was conducted in the Spring of 1997 by Field Research Corporation for Los Angeles County Department of Health Services in conjunction with local universities. The children’s data reported here are derived from interviews with 2,363 parents in households with children. The survey was sponsored by California Department of Health Services and The California Endowment.

President Clinton enacted the State Children’s Health Insurance Program (SCHIP) in August 1997. This program allocates $20.3 billion over the next five years to states to provide expanded health coverage for uninsured children between 100-200% of the federal poverty level (FPL) who are not eligible for Medicaid; plus $4 billion for expansion of the Medicaid program.

The program requires each state to either expand Medicaid or to develop a new health insurance program for children. California’s SCHIP program, Healthy Families, is a health insurance model with a benefit plan equivalent to the California Public Employees Retirement System (CALPERS) coverage including dental and vision coverage, with some modifications to make it more child-appropriate. The Healthy Families Program utilizes a total of $478.7 million to provide services to an estimated 580,000 eligible children, less than half of California’s federal share.

California has also instituted a cost-sharing requirement with monthly premiums of $7 per child, maximum $14/month for families at 100-149% FPL and $9 per child, maximum $27/month for families at 150-200% FPL. Co-payments are $5 for most outpatient services excluding preventive services. Los Angeles County DHS’ Community Health Plan (CHP) has been designated as the Community Provider Plan. Families enrolling in the County’s plan will have reduced premiums.

The success of Healthy Families is contingent upon outreach and enrollment. Twelve million dollars have been designated for community-based outreach. A $25 application assistance fee will be paid to organizations that assist families with enrollment. In order to allow more children to be eligible for Medi-Cal, the Healthy Families legislation also includes the following changes to Medi-Cal:

• Increases the income threshold to 100% FPL for children 14-18 years old.
• Waives the asset test for children.
• Allows one month of continuous eligibility for families who no longer qualify for no-share-of-cost Medi-Cal during their transition into Healthy Families.
• Directs the California State Department of Health Services to design a simplified, mail-in Medi-Cal application for children.

  | p. 1 2 3 4 5 6 7 8