Pupils in need of care sought

The Baltimore Sun

As a part of Howard County's plan to provide access to affordable health care for every resident, county officials said yesterday they will use the school system to try to identify thousands of children who haven't enrolled in existing state programs for which they might be eligible.

Letters are to be sent to the homes of all 48,500 students in the county school system this month, alerting families to Medicaid and the State Children's Health Insurance Program. "We believe we can get anywhere from 2,000 to 4,000 [children enrolled] with no new county dollars," Ulman said.

It is something any jurisdiction in Maryland can do if officials make it a priority, said Ulman and Dr. Peter Beilenson, county health officer. And it is virtually cost-free to the county, they said.

Printed letters and e-mailed school newsletters in five languages will tell families about available government-funded health care programs and invite them to enroll if their children are eligible. The letters will go out within the next two weeks, according to county schools Superintendent Sydney L. Cousin.

As June ended, 9,102 Howard children were enrolled in the State Children's Health Insurance Program, said Glenn Schneider, the county's director of health policy. Beilenson said census estimates indicate that between 3,250 and 5,500 uninsured children in Howard might be eligible for either SCHIP or Medicaid.

Ulman is planning to announce Oct. 16 the details of a plan to cover all the county's estimated 18,000 to 27,000 uninsured residents with affordable health care. The current system, in which people without other resources go to hospital emergency rooms, is increasingly unworkable, Ulman and Beilenson said.

"This is one way to identify children. The more information we get back, the better we can address it," Ulman said. Beilenson described the attempt to enroll more children as "low-hanging fruit" compared with the more difficult parts of the county's health plan.

"The No. 1 reason why kids don't have insurance is because their parents don't have insurance," Beilenson said yesterday at a news conference in Ellicott City. "It's the stupidest system in the world."

Many people working two or more jobs to pay for shelter, food, clothing and transportation don't know about available programs and don't have time to research health insurance, Beilenson said, and most adults assume that if they don't qualify for public programs, neither do their children. An estimated 84 percent of uninsured adults are working, he said.

Howard plans to hire two additional Health Department workers to help enroll people who respond to the letters, Beilenson said.

Eligibility guidelines for either Medicaid or the State Children's Health Insurance Program - currently the subject of political debate in Washington - are much more lenient for children than for adults.

While an adult must have an income below 40 percent of the federal poverty level to qualify for Medicaid, children can get coverage if their family's income is up to 185 percent of the poverty level. Children can qualify for SCHIP with family incomes from 186 percent to 300 percent of the poverty mark. That means a family of three can have an income up to $51,510 and still have children who qualify for assistance. The eligibility ceiling ranges from $41,070 for a family of two to $103,710 for a family of eight.

Ulman and Beilenson said enrolling children in the programs is an easy way to reduce the number of uninsured residents whom the county is trying to cover, and also provides more information about people without insurance.

The county recently announced a partnership with health care organization Kaiser Permanente, which has a medical center in Columbia, to provide low-cost health insurance to up to 175 uninsured families. More than 200 have responded, officials said.

"We really don't believe county government can do this alone," Ulman said, which is why he said he values the partnerships with the school system and Kaiser Permanente.


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