State health officials are hoping to team with Maryland Comptroller Peter Franchot this spring for a statewide effort to identify more children who are eligible for federally funded health insurance.
Under the plan, an outgrowth of Howard's County's pioneering health-access program, Franchot's office would search through state income-tax records to find families with incomes that qualify them for participation in the much-debated State Children's Health Insurance Program, or SCHIP, and then send letters notifying them that the program is available.
In July, Howard County officials intend to start a program to begin providing health access to up to 20,000 uninsured county residents. A key part of that plan is to use existing programs such as SCHIP to cover up to 5,000 county children.
Franchot agreed in October to help identify Howard County residents whose children might be eligible for the program and send letters to them. The letters are to go out to 22,000 Howard families this month.
Franchot has offered to do the same for all jurisdictions in Maryland.
"It did seem like a good idea," said John G. Folkemer, deputy state health secretary for financing. "Obviously, it would be more efficient if we can work out something statewide. We're trying to figure out how that can be done"
Dr. Leland Spencer, health officer for Kent and Caroline counties on the Eastern Shore, said he is enthusiastic about Franchot's offer.
"I'm constantly amazed at how many people have come into the health department when they're in trouble and they qualify for some kind of a program, but they don't know it," he said. "I would venture to say that most health departments around the state see this on a daily basis. By the time they come to us, they're in a desperate situation. They need care, but they're out of money."
When his staff informs people that they qualify for an existing program "they're shocked," he said.
Action during the recent special session of the General Assembly expanded state Medicaid insurance coverage to about 100,000 more people, and Folkemer said that information could be covered, along with SCHIP availability, in the same statewide mailing.
"We're working with the comptroller's office now on how we could do that," he said. "It's probably one of the most effective ways we could target the outreach we do."
Congress and President Bush are struggling over financing to expand SCHIP, although expectations are that it will continue to be funded at current levels for at least the next year.
Because the state Medicaid expansion and Howard County's program are to begin July 1, the comptroller's statewide letter could go out in June, Folkemer said.
In Maryland, 103,000 children are enrolled in SCHIP, which has an income ceiling of three times the federal poverty level, which makes the ceiling $41,070 for a family of two up to $103,710 for a family of eight. About 300,000 children are covered by Medicaid, the program for lower-income families, Folkemer said.
"I think it's a great idea," said Vincent DeMarco, president of Citizens Health Initiative, a private nonprofit that pushed for the expansion of state Medicaid programs. "Using the comptroller's facilities is wonderful."
Folkemer said the maximum income for Medicaid eligibility was increased for a Maryland family of four from $5,700 a year to a little less than $24,000 a year.
Franchot has delayed mailing letters to Howard County residents until this month at the request of county officials, who said they needed time to prepare to handle the anticipated response.
"We were getting deluged on our help line, from 50 to 100 calls a day," said Dr. Peter L. Beilenson, Howard's health officer. "We feared a gigantic backlog."
The help-line number is 410-313-HELP.
Working with the Howard-based Horizon Foundation, the county has obtained $60,000 in grants to hire up to six temporary workers to take phone calls.
The letters were to go out the first of the year, Beilenson said. A similar letter due to go home with the county's 48,000 public school students was delayed until the county can add the workers, Beilenson said.
"We thought it would be more sensible [to wait], and it was not incredibly time-sensitive," he said.
"Every week, we get 60 and 80 new applications," Beilenson said. "We're way above what we expected."
Franchot said several other counties have asked about his offer to identify families eligible for SCHIP and that he is eager to help.
"Talbot County, Charles, Caroline and Kent have inquired," Franchot said, adding that he "communicated specifically to the governor and suggested we send out a letter to all the jurisdictions other than Howard County."
Linda Kahler, the Talbot County Health Department's director of administration, said her county asked Franchot for help and was advised to wait until a statewide letter could go out.