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Santa Clara Family Health Plan

Local Initiative - Health Coverage for Immigrants

August 3, 2006

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Who is Santa Clara Family Health Plan…

• A community based health plan that provides no or low cost health insurance to qualified seniors, adults, and children in Santa Clara County, California.

• Founded in 1997.

• Local Initiative Plan for Medi-Cal Managed Care Program in Santa Clara County.

• Community Health Plan for Healthy Families Program.

• Established first Healthy Kids Program in the Nation.

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Our members…• 97,430 SCFHP Members by Program

• 73% are Medi-Cal • 13% are Healthy Families (SCHIP)• 14% are Healthy Kids

• SCFHP Members by Ethnicity

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62% Hispanic 4% Black

10% Vietnamese 2% Filipino

9% White 2% Chinese

6% Asian 5% Other

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Santa Clara County’s Approach to Covering Immigrants:

Radical Incrementalism • Created Healthy Kids and the Children’s

Health Initiative (CHI), 2001

• Spearheaded by People Acting in Community Together (PACT) and the Working Partnerships, USA with county health department, local health plan, county government

• CHI goal: provide comprehensive health, dental and vision coverage to 100% of children in SCC living below 300% of the federal poverty level.

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Immigrant Children in Santa Clara County

• Medi-Cal• US Born: 12,000• Naturalized Citizen: 9,000• Non-Citizen: 37,000

• Healthy Families • US Born : 2,000• Naturalized Citizens: 2,000• Non-Citizen: 7,000

(UCLA CA Health Interview Survey, 2003)

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CHI Lessons Learned • Immigrant advocacy organizations included in CHI

• Coordinated, multi level Outreach, Enrollment, Education :

• In reach: County/Community Clinics & Hospitals

• Outreach: Community and School

• Family Resource Center

• Member education and retention

• Trained community based Application Assistors

• Piloted One-e-App online application, streamlining open door “One-Stop” access

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• Total Health Kids 13,321

• Covers all children

• Cost per child per year is $1000

• Family pays, $4 to $12 per month per child. Up to $12 to $36 per family

• $5 co-pay for specialist and pharmacy

Healthy Kids Program

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Immigrants in Healthy Kids

• Over 96% of the children enrolled in Healthy Kids come from immigrant families.

• 90% of the immigrant children are undocumented

• Immigrants by Ethnicity in Healthy Kids

86% Hispanic 1% White

5% Vietnamese 1% Chinese

2% Filipino 4% Other

1% Korean SCFHP – July 2006

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• Santa Clara County and City of San Jose Tobacco Settlement Funds

• FIRST 5 Santa Clara County Commission

• Santa Clara Family Health Plan through the Santa Clara Family Health Foundation

• Corporations and individuals

• Foundations: David & Lucile Packard Foundation, California Health Care Foundation, The California Endowment, The Health Trust, others.

• Federal SCHIP funds: County Children’s Health Insurance Program (C-CHIP)

Funding the Healthy Kids Program

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Healthy Kids Program link to State of California Programs

•One-E-App, online application, can be used for 3 programs (MC/HF/HK) and has capacity to interface with State Healthy-App On line System

•C-CHIP allows Counties to draw federal resources for qualified children

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Healthy Kids Model & Effort

• 17 Counties in California have replicated the HK model

•California at tipping point for covering all children in California

•Tobacco Tax Act 2006: $371 Million of the expected $2.1 Billion per year will be dedicated to children’s health insurance

•Determined and Focused Advocacy Efforts at state and local levels: 100% Campaign- Children’s Partnership, Children Now & PICO California (Sponsored by California Endowment)

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CHI & Healthy Kids StudyMathmatica/UCSF/Urban Institute-2006

•54% of Healthy Kids Children are from Two Parent Working Families

•43% of Healthy Kids Family has lived in Santa Clara County for more than 36 months

•63% of Healthy Kids were uninsured for at least 6 months

•Access to Usual Source of Care for those with Healthy Kids is 91.4% versus 54.4% for uninsured children

•Healthy Kids access to Dental Service for those with Healthy Kids is 81.3% versus 28.5% uninsured children

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CHI & Healthy Kids StudyMathmatica/UCSF/Urban Institute-2006

•Outreach effort have been successful. Over 114,276 children have received assistance with applications for MC/HF/HK in Santa Clara County (January 2001-June 2006).

•30,000 children have been provided health insurance coverage by Healthy Kids since 2001

•“In Reach” is effective. 68% of all children applied at clinic sites

•Mutliple strategies to create “word of mouth” referral system started with outreach at clinics, Social Services, Schools, SCFHP Family Resource Center, Churches, Community Centers and Non-Profit Organizations

•CHI has been and continues to be flexible and adaptable to the needs of the community and children of Santa Clara County

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Healthy Kids

Radical Incrementalism: Our Children and Our movement for a Healthy Santa Clara County