WHEREAS, the State of California has created the California Healthy Families Program to provide comprehensive health insurance coverage to all uninsured children under 200% of the federal poverty level who do not qualify for Medi-Cal; and,
WHEREAS, Healthy Families provides a unique opportunity to decrease the number of uninsured children in our State; and,
WHEREAS, the UCLA Center of Health Policy Research estimates that 562,000 children are eligible for Healthy Families statewide, and that 3,000 to 6,000 San Francisco children are eligible for the program in ten San Francisco zip codes with a disproportionate number of uninsured children; and,
WHEREAS, the California Managed Risk Medical Insurance Board (MRMIB) has been given responsibility to oversee the administration of the Healthy Families Program on the State level; and,
WHEREAS, the State legislation creating Healthy Families, Assembly Bill 1126 (Villaraigosa), does not allow either emancipated minors, minors living away from home or undocumented children to participate in the program; and,
WHEREAS, these children and youth require general medical care and may need specialized services such as family planning, sexually transmitted diseases, mental health, substance abuse and sexual assault services; and,
WHEREAS, Healthy Families is premised on providing health care coverage to children through commercial health, dental and vision plans; and,
WHEREAS, this principle may not fully recognize the historic contribution that safety net and traditional providers have played in delivering services to vulnerable, uninsured children; and,
WHEREAS, MRMIB has drafted proposed regulations for the Healthy Families Program which have a broad definition of safety net and traditional provider for the purposes of designating the community provider plan; and,
WHEREAS, the proposed Healthy Families regulations allow for an application fee of $25 to be paid to certain entities that assist families in enrolling their eligible children in the program; and,
WHEREAS, the State's plan indicates that the Child Health and Disability Program (and its providers) will be a "gateway" for the Healthy Families Program; and,
WHEREAS, the current regulations do not allow providers and County health departments to assist in the education and enrollment of children into Healthy Families or receive the application assistance fee; and,
WHEREAS, the Department of Public Health is concerned that the outreach and education component of Healthy Families may not be coordinated with the administration of the program given that two different State agencies -- the State Department of Health Services and the California Managed Risk Medical Insurance Board, respectively -- are responsible for these activities; and,
WHEREAS, the State legislation encourages health plans to create screening and referral protocols for children who need supplemental services; now, therefore, be it
RESOLVED, that the Health Commission strongly encourages MRMIB to seek a legislative amendment to Assembly Bill 1226 (Villaraigosa) which will allow emancipated minors and minors not living at home to receive services under Healthy Families; and, be it
FURTHER RESOLVED, that the Health Commission urges MRMIB to work with the State Department of Health Services and health advocacy organizations on the feasibility of serving undocumented, uninsured children through a State-only funded program; and, be it
FURTHER RESOLVED, that the Health Commission urges MRMIB to adopt a safety net and traditional provider definition for Healthy Families which is based on the number of uninsured served by providers and on the actual utilization of safety net and traditional providers in a health plan's network; and, be it
FURTHER RESOLVED, that the Health Commission urges MRMIB to revise the regulations to allow providers and County health departments to assist in the education and enrollment of children into Healthy Families and to prohibit any person or entity from receiving any compensation (an application assistance fee) for assisting with such enrollment; and, be it
FURTHER RESOLVED, that the Health Commission encourages MRMIB to use any funds designated for application assistance fees to create a competitive grants program whereby local agencies could form coalitions and apply for funding to assist in community outreach and education; and, be it
FURTHER RESOLVED, that the Health Commission strongly urges the State Department of Health Services to require the Medi-Cal/Healthy Families education and outreach contractor to utilize and subcontract with community-based organizations and public agencies (such as, social services, health and school districts) to develop locally-driven outreach plans specific to community needs; and, be it
FURTHER RESOLVED, that the Health Commission strongly endorses requiring health, dental and vision plans to develop Memorandums of Understanding with local health departments for the provision of certain public health services.
I hereby certify that the foregoing resolution was adopted by the Health Commission at its meeting of Tuesday, January 6, 1998
Sandy Ouye Mori, Executive Secretary to the Health Commission