Modesto Bee Article

By Ken Carlson, Modesto Bee Staff Writer
last updated: August 14, 2009

Healthy Families, a health care program covering nearly 1 million children in California, is getting an $81.4 million contribution from a state commission.

The money could provide coverage for more than 200,000 children, but probably isn't enough to keep hundreds of thousands of older children from being dropped from Healthy Families starting next month.

The program covers office visits, hospitalization, and dental and vision care for children up to 18 years old in struggling families that don't qualify for Medi-Cal. The lost coverage is related to state budget cuts that left Healthy Families with a $194 million shortfall for the 2009-10 fiscal year.

Almost 14,000 children are covered in Stanislaus County.

The First 5 State Commission announced the contribution Thursday afternoon to cover nearly a quarter-million children, up to age 5, through June. The commission was formed to distribute tobacco tax funds after voters passed Proposition 10 in 1998. It receives $85 million to $100 million per year and gives money to Children and Families commissions in local jurisdictions.

Also Thursday, the state board that runs Healthy Families determined that there are insufficient funds to cover program costs and will have to disenroll children starting in September.

"We just found out (about the contribution) at our meeting today," said Ginny Puddefoot, a staff member with the Managed Risk Medical Insurance Board in Sacramento. "We haven't done the analysis on exactly what the budget impact will be."

Pursuing solutions

First 5 is giving the money to the insurance board, which will calculate how many children it will benefit and continue to work on solutions in the next two weeks, she said.

Officials had estimated that 669,000 children in California, or up to 65,000 per month, would need to be disenrolled in the next nine months, but that was before the First 5 contribution shrank the shortfall to $112.6 million, Puddefoot said.

Kris Perry, executive director of First 5 California, said the commission approved the contribution to ensure the survival of Healthy Families. She said the money comes from reserves and won't stop the funding of other Proposition 10 programs in the counties.

"In the current economy, now more than ever, families rely on affordable health care to keep their children healthy and safe," Perry said, urging other groups to lend support. "We encourage like-minded partners to come forward with assistance to ensure the program's survival."

Perry said the contribution is consistent with the mission of Proposition 10, which taxes cigarettes to fund education, health, child care and other programs for expectant parents and young children.

Puddefoot said the governor's office, the Legislature, the insurance board and advocacy groups are working to come up with other solutions for Healthy Families, including ways to cut costs through efficiencies.

"We hope to find a solution between now and Sept. 1," she said. "If that doesn't happen, then the board has no option to do what's needed to make up the shortfall."

The state would disenroll children at the time of their annual renewal. Families with a renewal date in September would receive 30 days' notice that coverage would end Oct. 1, she said. Children who lose coverage are placed at the top of the waiting list and are first to be reinstated if new funding comes through, she said.

Waiting list grows

To prepare for the budget crunch, the state started putting new applicants for Healthy Families on a waiting list in July. As of Tuesday, 55,200 children were on the list, up from 45,800 the previous week.

Nilda Johnson, a program manager for the Stanislaus County Health Services Agency, said the First 5 contribution should preserve coverage for local children 5 and younger, but "there are still those kids who are 6 and above who will be impacted by disenrollment."

She added that "we worry about those children who have health problems that need continuing care. If they are disenrolled, where will they go?"

Children being treated for cancer or other diseases covered by California Children's Services are exempt from losing Healthy Families coverage. But some patients with chronic conditions could be removed from Healthy Families, Johnson said.

Families who face losing coverage, especially those whose income has changed in the past year, should ask their application assistants if they are now eligible for Medi-Cal or the Kaiser Permanente Child Health Plan, she said.

If they are not eligible, parents may have to pay the sliding fees at county health centers or other safety-net clinics when their children need medical attention.

Johnson said she didn't have an estimate on how many Stanislaus County children could lose Healthy Families coverage in September.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.