Evaluation Needs from the Healthy Kids Program

Perspective

Kena Burke, MPP, Executive DirectorChildren’s Health Initiative of

San Luis Obispo, CAMarch 2, 2009

Description of program

The Children’s Health Initiative of San Luis Obispo County (CHISLO)

• CA not-for-profit 501 c 3 • Established in 2004 to provide health insurance

for children – under the age of 19 – who do not qualify for state programs (Medi-Cal

[Medicaid] / Healthy Families [SCHIP]) – due to income guidelines or residency requirements.

Description of program

The Children’s Health Initiative of San Luis Obispo County (CHISLO)

• CA not-for-profit 501 c 3 • established in 2004 to provide health insurance

for children – under the age of 19 – who do not qualify for state programs (Medi-Cal

[Medicaid] / Healthy Families [SCHIP]) – due to income guidelines or residency requirements.

Description of program

Description of program

• Average number of enrollees: – approximately 580 children

• Approx. 180 are under 6• Approx. 400 are over 6

• Waiting list for 6 – 18 year olds: 733

• $1273 per member per year…$933,842– Just for the waiting list!

Description of program

Source of major funding:All 0 to 5 year olds

First 5 San Luis Obispo County (PROP 10)– $350,000– Premiums / Administration– State funds match 1:4, except

» calculation based upon premium of $1000» SLO Co 1:5…

Description of program

Source of major funding:6 – 18 year olds:

• The California Endowment $150,000• The Blue Shield of CA Foundation $ 63,000• San Luis Obispo County $200,000

– 6 – 18 year old children – requires match– 5% cut this year (-$10,000)

Description of program

Characteristics of 0 – 5 year old population• Most costly population to cover • BUT MOST COST EFFECTIVE• Most needy… our youngest children need access

to pediatricians & dentists based upon immunization schedules

• Most poor

Description of program

• Characteristics of 6 – 18 year old population– Least expensive to cover of under 19 population– Population accessible through schools –

• health-related matters to these children will more than likely present as school-related:

– excessive absenteeism (dental caries)– lower overall test scores/classroom achievement (failure to

thrive)

– Access to dentists and then, pediatricians– Most poor

Challenges of program

• $738,000 funding needed just to maintain– $1.3 million for all SLO county children– $400 Million annually statewide

• Highly-sensitive political landscape• Pressure to find solutions!

• This is where we use excellent evaluation data!

TARGETS

Who can Make the Decisions?

Let’s pretend we know!

What information will

they need to make their decision?

BIG FIVE LEGISLATORS PUBLIC

TARGETSInformation must appear • wise …economically…

– To expand a fiscal budget during a time of a billion dollar deficit

– Cost-effective & prudent• appropriate…

– relevant & timely; and • most importantly, appeal to a politician’s

sense of electable characteristics -

TARGETS

WHO & WHAT influences the decision makers?

– Those who have influence within decision makers party.

BIG FIVE LEGISLATORS PUBLIC

Evaluation Reports Press Releases

Media LTE/Op ED

Local Advocates Ad Campaigns

EXAMPLES!

A reminder: Why Health Insurance?

• The importance of health coverage to children’s well-being and simply their life outcomes. (California Budget Project: Lasting Returns: Investing in Health Coverage for California’s Children, February 2005. page 12. )

A child who has a good health will have a much better chance at good educational outcomes.

The single one indicator for success in life with all the variables put together ….

EDUCATION!

• A 2002 state evaluation of the benefits to children having comprehensive health coverage through the Healthy Families Program found that for children in the poorest health, school attendance and performance improved after enrollment in Healthy Families. In particular, children’s ability to pay attention in class and keep up with school activities improved significantly the year after enrollment in Healthy Families; performance in each of these two areas improved by 68 percent.[1]

•[1] Managed Risk Medical Insurance Board, Health Status Assessment Project – First Year Results (November 2002) p.9.

A reminder: Why Health Insurance?

• Uninsured children also have a higher incidence of dental disease. Nationally, dental caries is the most common childhood disease.

• Among 5 – 17 years-olds, dental caries is more than five times as common as asthma and seven times as common as hay fever. (US Department of Health and Human Services. Oral health in America: A report of the Surgeon General. Rockville, MD: DHHS, National Institute of Dental and Craniofacial Research, National Institutes of Health 2000.)

• Locally, county school Superintendent Julian Crocker notes that, “Tooth problems are the leading cause of absences in San Luis Obispo county schools.” “Invest now in our children’s future health,” 13 February 2007. www.sanlusiobispo.com/mld/sanluisobispo/news/editorial/16686489.htm

A reminder: Why Health Insurance?

Recent Studies and Their Use

• USC Preventable Hospitalizations– Study – Perfection!

• Data collected… third party government agency– Insured vs Uninsured– Income Stratification (control group)

• ADDRESSED ALL KEY MESSAGESConsequences and the evidence of Delayed Care

– Its Cost– Prevention – and how much more cost EFFECTIVE

health insurance is for all children!

– Look at the IMPACT…

Recent Studies and Their Use

• Packard Study on 3 Healthy Kid Counties– Study – OK!

• Data collected… self-reported: Healthy Kid Families• Feels Good

– Access to health improves– Unmet health care need declines –

» What?» Policy Wonk!

– Parent Confidence Grows… » except…