California County Provides Children's Health Insurance.

Uninsured children in Santa Clara County, Calif., will become a phenomenon of the past under its new Children's Health Initiative set to begin this month. County supervisors approved a plan in October to insure additional children by combining existing resources with new tobacco settlement funds.

The initiative will provide outreach and enrollment assistance to the county's estimated 69,000 uninsured children with the goal of enrolling them in Medi-Cal (California's Medicaid program), Healthy Families (California's State Children's Health Insurance Program [SCHIP]) or in a separate insurance plan. Of the 69,000 uninsured children, around 50,000 are thought to be eligible for Medi-Cal or Healthy Families.

"The community has adopted the slogan, 'Leave No Child Behind,"' says Leona Butler, executive director of Santa Clara Family Health Plan. She heads a public organization that will administer the health insurance plan under the initiative, and already administers Healthy Families and Medi-Cal in the county. Children are eligible to participate in the Children's Health Initiative if their family income is between 250 percent and 300 percent of federal poverty guidelines, if they are residents of Santa Clara County and if they are not eligible for any other public health insurance program. The initiative will also cover undocumented children who are ineligible for Medi-Cal and SCRIP.

The same benefits package as Healthy Families will be provided, including health, dental and vision services, at an estimated annual cost of $1,000 per child. Annual estimates for the total cost for the first year of the program range between $8 million and $12 million. Funding is expected from the county's tobacco settlement funds, the state's Proposition 10 tobacco tax, the Santa Clara Family Health Plan Foundation and potentially from the city of San Jose's tobacco settlement funds.

Butler said that publicity for the program will promote the idea that no child will be denied coverage, a strategy she hopes will encourage applications. Administrators of the initiative are working closely with Medi-Cal and Healthy Families to enroll children who qualify for either of these programs. They are also working closely with the superintendents of the county schools.

"As research shows, the best place to reach children is at school," Butler says. Some superintendents are considering making it a requirement of school registration for parents to indicate whether their child has insurance, she said. Butler hopes that once the initiative gets going, federal SCHIP money may be available to help fund the program through an amendment to the state's SCHIP plan.

Although this is a county program, it also has support from some state officials. Senator Liz Figueroa says it is "exciting that Santa Clara County's Children's Health Initiative plan will use the tobacco settlement funds for a new program that will guarantee coverage to the 69,000 children who are uninsured. This new program is not only a model for the state of California, but for the nation."