Hotline to help
uninsured kids

Groups push to cover uninsured
children to take care of
their medical necessities

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By Helen Altonn
haltonn@starbulletin.com

Efforts are being stepped up to find and enroll thousands of uninsured Hawaii children in free state and federal medical insurance programs.

An around-the-clock ASK Aloha Way hotline service will be launched July 15 so people can call 211 free from anywhere in the state to get information on children's' health insurance. They can also log on to www.coveringkids.com.

Estimates differ on the number of uninsured children eligible for free medical benefits: The Hawaii Primary Care Association believes the figure exceeds 14,000; state health and human services agencies say it's closer to 7,000.

Whatever the number, state and private agencies are working to reduce it with activities bolstered by a four-year $700,000 Robert Wood Johnson Foundation grant.

The Primary Care Association will use the grant for the Hawaii Covering Kids Project to create a seamless process to enroll children up to age 19 in free health insurance programs.

The programs include the state Children's Health Insurance Program, QUEST, Medicaid Fee-for-Service (for blind and disabled children), and children's insurance programs for immigrants and citizens of the Marshall Islands, Federated States of Micronesia and Palau.

Benefits include check-ups, emergency care, immunizations, prescription medicine, doctor visits, eyeglasses, counseling and dental care.

About 8,000 children are enrolled in CHIP, 2,400 in the immigrant program and 72,500 in Med-QUEST, according to the Med-QUEST Division of the state Department of Human Services.

Families with income up to triple the poverty level are eligible for CHIP, financed by the federal government and Hawaii's tobacco settlement funds.

Susan Jackson, director of the tobacco settlement project in the state Health Department, said nearly $13 million has been allocated for CHIP, immigrant children and families in the Compact of Free Association. Expenditures to date total about $5.1 million, she said.

Med-QUEST Administrator Aileen Hiramatsu said the Department of Human Services has been authorized to draw an average of $4 million annually from the tobacco fund for the three children's insurance programs.

Initially, it didn't use the full amount because of low enrollment, but expenditures totaled $4,491,631 in the federal fiscal year from October 2000 to September 2001, the department reported.

Barbara Luksch, Hawaii Covering Kids project director, said enrollment of children in the programs began slowly for these reasons:

>> Parents didn't realize they can work and still get medical insurance for their children depending on family size, income and residency. A major outreach and information campaign last August resulted in an additional 1,169 kids in the insurance programs.

>> Immigrant families fear if they apply for a government program it will affect their immigrant status and potential for citizenship. Outreach workers are trying to get the message out in different languages that the insurance programs won't affect immigration status.

>> The application form is too complicated. A simplified form is being tested on Kauai and should be ready by the end of the month, Luksch said. An electronic Web-based application also is being tested so parents can go online and enroll in one of the insurance programs, she said.

What is most helpful for working parents is to have outreach workers meet them at convenient locations in evenings, mornings and weekends to help through the application process, she said, and efforts are underway to increase outreach programs.

Kahuku Hospital will look at ways rural hospitals can increase enrollment of uninsured children in their communities. It will create a data tracking system for its social services department and emergency room. A full-time bilingual outreach worker and part-time assistant will be hired to establish referral systems with community organizations and health care providers.

Ho'ola Lahui Hawaii on Kauai will hire two outreach workers to link with health care providers, including dentists, physicians and mental health professionals. They will set up a telephone number for referrals and conduct informational and training workshops regarding Med-QUEST, public health insurance benefits and resources.

The renewal process also is a concern, Luksch said. "We get them in the front door and they go out the back door." An average of 400 cases a month are closed because of failure to provide information or forms or documentation aren't returned, she said.

The Covering Kids project is working with a Med-QUEST group to simplify the renewal process when a case is closed and a parent must reapply, she said. "It is difficult for the family and it is not cost-effective."