1. News Conference Results Med-QUEST's new children and pregnant women application was launched at a news conference on 8 January 2004 and the results are in! * 40 additional calls to Aloha United Way's 211 hotline service on 8 January 2004 * 808 information packets mailed to physicians, state agencies, and community organizations to coincide with the news conference * 16,462 hits to www.coveringkids.com (4 to 10 January 2004); 8,029 above the weekly average * 5,118 applications received by Med-QUEST in January 2004; 432 above the usual monthly average * 5,370 applications received by Med-QUEST in February 2004; 688 above the usual monthly average * 1,168 more children and youth enrolled in QUEST and Medicaid (January and February combined) Media coverage included articles in The Honolulu Advertiser and The Garden Island, television news broadcasts on KHON-2, KITV 4, and KGMB-9, and radio interviews on KSSK, KAHA (The Big Kahuna), and KUMU (Lite 94.7). 2. Med-QUEST Field Tests New Renewal Processes Our Renewal Simplification Workgroup and Med-QUEST's Test Team have been working arduously to publish prepopulated renewal forms and implement new renewal processes. A current sample of the passive renewal form for cases with children can be downloaded at: Passive Renewal Information. Following three weeks of internal testing, Med-QUEST's computer system is mailing passive and active renewal forms to Honolulu's Ongoing Unit III customers. Additional details on this live test and random sample follow-up information are in meeting minutes available on the same web page. 3. CHIP Making Gains as More Children Are Eligible and Enrolled Previous research based on the Community Tracking Study showed that while public health insurance expansions through the State Children's Health Insurance Program (CHIP) greatly increased children's eligibility for public or private health insurance coverage, uninsurance rates remained unchanged because of low take-up by eligible children. However, more recent data show this is changing. Children's uninsurance rates decreased sharply between 1999 and 2001 and these changes were greatest in communities where take-up rates have traditionally been the lowest and uninsurance rates the highest. Although uninsurance rates can be decreased further, state budget pressures threaten the momentum toward higher participation in public programs. Read the article on pages five and six of the recent Robert Wood Johnson Foundation quarterly newsletter ("Advances" Issue 4 2003) which can be downloaded at: www.rwjf.org/search. 4. Study Examines Costs of Enrolling Children in Medicaid and CHIP The January/February 2004 issue of "Health Affairs" published an article entitled "Costs of Enrolling Children in Medicaid and SCHIP." The article examines the process of enrolling children into Medicaid and CHIP (State Children's Health Insurance Program) and the recent administrative hurdles reintroduced to the process to save Medicaid dollars by deterring people from enrolling. Authors of the study found that "it costs approximately $280 to enroll a child in Medicaid or CHIP in the New York City area. This amount could be reduced by approximately forty percent if documentation requirements were simplified." Data were collected from three of the sixteen managed care organizations enrolling children in both Medicaid and CHIP in the greater New York City area. New York City agencies were used in the study because of the simplified enrollment process implemented after September 11, 2001 when Medicaid's computer systems were damaged. These simplified enrollment processes were compared to complex systems used at other times and in other states. The time spent on activities was assessed in order to estimate the costs for major components of the enrollment process. The authors of the study conclude "administrative costs for enrollment absorb sizable amounts of funds that could be realized as cost savings or deployed elsewhere." 5. GAO Issues Report on CHIP Waivers The General Accounting Office has released a report entitled "SCHIP: HHS Continues to Approve Waivers That Are Inconsistent with Program Goals." The Secretary of Health and Human Services (HHS) has approved a number of Health Insurance Flexibility and Accountability waivers allowing states to use unspent State Children's Health Insurance Program (CHIP) funds to extend health insurance to childless adults. GAO and several senators, including the chairman and ranking member of the Senate Finance Committee (which has jurisdiction over CHIP) maintain that using CHIP funds to cover childless adults is not consistent with the goals or the legislative intent of the program. GAO notes in the report covering childless adults with CHIP funds reduces the amount available for future redistribution to states that have used their full CHIP allotments to cover uninsured children and are in need of additional funds to maintain or continue increasing enrollment. GAO concludes that "unless Congress and HHS take actions in response to the matters for congressional consideration and recommendations to HHS.it appears likely that HHS will continue to allow states to use CHIP funds for childless adults, and for parents and guardians, without regard to whether this use is cost-effective." The GAO report can be found at http://www.gao.gov and the ID number is GAO-04-166R.