The Impact of the Los Angeles Healthy Kids Program on Access to Care, Use of Services, and Health Status (original) (raw)
The staff of the survey division of Mathematica Policy Research, under the leadership of Martha Kovac and Betsy Santos, led the sampling and fielded the survey, achieving very high response rates. We appreciate the support of First 5 LA, whose generous funding made this project possible. Our project officer, William Nicholas, provided critical support and comments throughout survey development and analysis. Our project director, Ian Hill, along with Jenny Kenney, Chris Trenholm, Brigette Courtot and Patricia Barreto reviewed the manuscript and provided helpful comments. We are grateful to statistical consultants Tim Waidmann and Doug Wissoker as well as research assistants Dawn Miller and Asya Magazinnik for their valuable input. We appreciate the help of Elaine Batchlor and Eleanor Young of L.A. Care Health Plan, who facilitated our access to data for sampling. And finally, we are grateful to the hundreds of parents in Los Angeles County who generously gave their time and input when responding to our surveys.
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The Los Angeles Healthy Kids program was created in July 2003 to provide coverage to low-income, uninsured children ages zero to five years who are ineligible for Medi-Cal or Healthy Families. The report provides a descriptive analysis of 1,087 families who completed a baseline survey during 2005. The survey gathered data on children's health status, health care access and use, parental satisfaction, and the enrollment and renewal process. The survey design was modeled after the Evaluation of the Santa Clara County Children's Health Initiative that Mathematica has been conducting since 2001.
The Santa Clara County Children’s Health Initiative seeks to provide coverage through the Healthy Kids initiative to all children in the county whose family incomes are below 300 percent of the federal poverty level. This brief provides new evidence on the effects of insurance coverage on children’s health by looking at how Healthy Kids affects the health of the low-income, undocumented children it serves. The authors found that children in the study group continuously insured for one year were significantly less likely to be in fair/poor health and to have functional impairments than the comparison group of newly insured children. The study group also had fewer missed school days, but the difference was significant only among children who did not enroll for a medical reason. The authors conclude that Healthy Kids had a favorable impact on children’s health.
Outcomes from Children’s Health Initiatives in California
Approximately one-third of uninsured children in California do not qualify for existing federal and state health insurance programs due to family income eligibility thresholds or undocumented immigration status. Recognizing this as a gap in coverage, several California counties have formed coalitions known as Children's Health Initiatives (CHIs) and designed locally-funded and operated health insurance programs known as Healthy Kids. As of January 2007, Healthy Kids programs were in operation in 22 of California's most populous counties, and have collectively covered more than 88,000 children. The earliest CHIs launched their Healthy Kids programs in 2001-2002 (beginning with Santa Clara and San Francisco), and these served as models for seven other counties to launch similar programs in late 2002 through 2004, three in 2005, and ten in 2006. i As these programs spread from county to county, they were supported by an increasing number of organizations including a range of California philanthropies. Two of these agencies-The California Endowment and First5 California-commissioned a multi-component evaluation to assess, in part, the contribution of the Healthy Kids programs to improving access to high quality health care for children. This report highlights findings and recommendations from a broader report regarding the ongoing process of monitoring utilization and quality in Healthy Kids programs in California. It summarizes the selection of utilization and quality indicators, and presents the first round of data provided by nine CHIs that were operational for the full 2005 calendar year. The report also provides a snapshot of Healthy Kids program successes by comparing utilization and quality indicators for Healthy Kids programs to MediCal and Healthy Families (California's State Children's Health Insurance Program (SCHIP)).
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