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The 1997 State Children's Health Insurance Program, delayed by a lack of state funding, finally is under way in Hawaii. Kids health insurance
plan finally gets goingBy Helen Altonn
Star-BulletinFrom July 1 to Sept. 15, the state enrolled 2,427 low-income children for medical insurance.
Officials hope to sign up two to four times that number in the coming year.
About $8.9 million in federal funds was allocated for Hawaii's CHIP program for the 1998-99 federal fiscal year, from October through September. A similar amount was reserved for Hawaii in 1999-2000.
But the state Department of Human Services couldn't draw on the money until July of this year because it didn't have matching state money.
Sylvia Law, a New York University researcher and author on health care issues who was here on sabbatical leave last fall, said it was "outrageous" that Hawaii hadn't taken advantage of the federal money.
Hawaii wasn't alone. According to the Urban Institute, a nonprofit, nonpartisan policy, research and education organization, only 10 states were expected to use the first-year allotment of federal funds for the children's program before the federal fiscal year ended Sept. 30.
CHIP application forms and information are available: GETTING ENROLLED
Check the Web: http://www.coveringkids.com
Human Services' Med-QUEST Division estimates CHIP expenditures will total about $1.86 million from July through September. About $713,731 is from the federal government; the rest from Hawaii's share of tobacco settlement funds.
Hawaii is eligible to receive more than $10 million in federal funds for the next federal fiscal year, which started Oct. 1.
Human Services Director Susan Chandler said states "are arguing very hard that Congress should continue the program and continue the dollars."
She feels it will be continued since it's an entitlement and there is strong congressional support for expanding health insurance.
"I think the time has come in America for Congress to understand the real need for uninsured families," she said.
The federal program only covers QUEST expansion for U.S. citizens, but Hawaii's Legislature has provided state-funded benefits for immigrant children.
The department expanded its Med-QUEST program to cover uninsured children of low-income families.
Those with income up to 200 percent of the poverty level are eligible for CHIP. For example, a three-member family earning $26,000 a year could qualify for CHIP benefits, compared with a $13,000 income cap for Med-QUEST eligibility. The poverty line for Med-QUEST benefits is 100 percent.
Med-QUEST spokeswoman Diane Tachera said about 4,500 island children are expected to be covered under the new program in the next year.
Beth Giesting, executive director of the Hawaii State Primary Care Association, believes the number conservatively could be doubled.
The association estimates 15,000 to 20,000 children may be eligible for Med-QUEST or CHIP, she said. "We would certainly like to see all those kids enrolled."
The association has a Hawaii Covering Kids Project that is trying to identify and enroll eligible children for the programs under a Robert Wood Johnson Foundation grant.
The Department of Human Services is working with the project "to get as much outreach as we possibly can," Chandler said.
"What we're finding, like every other state, is it is slow. We're picking up traditionally Medicaid people, but it doesn't increase the CHIP numbers."
She said 250,000 fliers were distributed to schools and lunch programs and information has been posted on buses and the Internet.
"We're trying a variety of innovative ways to streamline our application process and make sure people understand," Chandler said.
With limited funding and personnel, however, Giesting said, "The public information campaign has not been all that it should be.
"Too darn many families are qualified who haven't heard about the program or don't know they're eligible for it."
She said information must be presented to families on ethnic radio or TV stations and by word of mouth "from people they trust."
"What we're doing with Covering Kids has the right instincts, but with $1 million over three years, we can barely scratch the surface," she said.
A lot more must be done, particularly for immigrant children, she said. "There is a lot of distrust and language barriers. We need one-to-one outreach with people who can speak the language, who look like them and can really communicate."