child care - Digital Library Collections

CHILO
HEALTH
ted to using all federal funds. In October he submitted
a preliminary plan to HCFA and announced
that Pennsylvania's state health insurance program
would immediately open enrollment to children on
its waiting lists. The governor also publicly committed
to a process for developing an expanded state
plan to allocate the balance of the state's federal
funds beginning July I, 1998 (the first day of the
next Pennsylvania budget year).
"We now have more work to do to keep the
pressure on and make the changes in [our state
program] and Medicaid that we need in Pennsylvania,"
commented Joan Benso, executive director of
the Pennsylvania Partnerships for Children. "But
at least we're offto a good start."
Positive initiatives by managed care plans. A
number of successful strategies to improve children's
health have been undertaken by managed
care organizations. HealthPartners in Minnesota
has produced a 14-minute videotape called "Food
for Thought," which stresses the importance of
early stimulation for infants' brain development and
gives parents concrete tips on interacting with their
babies. Every family with an infant born in a Health­
Partners clinic receives the video and a picture book
before the child's rust birthday. HealthPartners has
also released the video for free mass distribution
throughout the Minneapolis-St. Paul area, using
public libraries, video stores, child care providers,
community clinics, and other organizations.
The Columbus Health Plan and Dayton Area
Health Plan (DAHP) ofOhio emphasize well-child
care by urging parents and physicians to make sure
that all enrolled children have a health check by
their birthday each year. If a child has not seen a
physician by then, nurses follow up with home
visits. The DAHP program also provides health
checks at local schools when students miss their
doctors' appointments.
The state ofMaryland is likewise working with
schools to meet the health care needs of young
people. Under Maryland's HealthChoice Program,
Medicaid MCOs are required to contract with all
school-based health centers and to reimburse their
services at the established Medicaid rate. In many
other parts of the country, teens enrolled in managed
care often lose access to school-based services,
or their school-based providers lose access to
reimbursement.
An Oregon MCO, Kaiser Permanente Interstate
West of Portland, has developed a comprehensive
teen pregnancy clinic that provides social
work, health education, medical care, counseling,
and follow-up until after the baby is born. The
program also includes adolescent-{)nly birthing
classes and mentors who support pregnant teens
during labor.
Moving Forward: A 1998 Agenda
for Action
The top priority for child health advocates in
1998 must be the successful implementation
of the new CHIP program at the state and
federal levels. Box 2.1 describes some of the key
issues on which to focus as states gear up to extend
health coverage to uninsured children in working
families. CHIP offers a tremendous opportunity to
provide health care to millions of uninsured children,
but it will take hard work to make this happen
in every state.
Other issues, of course, remain important, including:
• Increasing Medicaid coverage of uninsured children.
Milljons of urunsured children qualify for
Medicaid but have not been enrolled. States
should vigorously promote the program
through celebrity advertising campaigns, posters
at sporting events, and other creative outreach
efforts using schools, child care and nutrition
agencies, cWld support agencies, public
and community health providers, civic organizations,
recreation programs, and the like. In
addition, states should make applying for
Medicaid family-friendly, with short and simple
forms, options to apply by mail, and a
minimum of red tape. States should also make
sure that eligible families losing cash assistance
under the 1996 welfare law (see chapter 1) do
not lose Medicaid coverage.
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