1. Arkansas: Nonprofit Seeks More ARKids Arkansas Advocates for Children and Families plans to increase enrollment in the state health insurance program for children by 22, 000 over the next three years. Eleven percent of Arkansas children, or about 70, 000, are uninsured, according to the Little Rock-based nonprofit. Of those, an estimated 44, 000 are eligible but not enrolled in ARKids First. Arkansas ranks 32nd in the nation--tying with South Carolina--in the percentage of uninsured children, according to the Kaiser Family Foundation. "We could make a big dent in the state's uninsured rates if we could just get all the kids eligible for ARKids First enrolled," said Rich Huddleston, director of Arkansas Advocates for Children and Families. The group also hopes to work with state and federal officials to raise eligibility requirements to cover more children. Arkansas Advocates for Children and Families is partnering with groups around the state to increase enrollment. "In 1997, we were one of the worst states in the country for uninsured rates," Huddleston said. "We made huge strides, but we should never think that our work is over." Elizabeth Wright Burak, Arkansas Advocates' health policy director, said Finish Line will try to reach children they haven't successfully reached in the past. "This is going to be more difficult because these are kids that have been eligible but for whatever reason haven't enrolled," Burak said. A statewide survey found ensuring that children have access to high quality affordable health insurance coverage is the top concern of Arkansans regarding children's health care, according to the 2007 Natural Wonders report by Arkansas Children's Hospital. Rachel Simpson of Benton enrolled all three of her children, ages 5-17, in ARKids after a physician told her about the program six years ago. It has helped the family cover vaccinations and medical expenses, including asthma medication for her 5-year-old son, Logan, and four years of tests and exams for her 7-year-old daughter, Katlyn, who had kidney problems. Simpson said she and her husband can't afford health insurance offered at his job as a commercial electrician. The family policy costs about $5,200 a year, has a $1,000 deductible, and co-pays are $25 per doctor visit. "It's just too much," said Simpson, who works part-time as a clerk in a doctor's office. "That gets expensive when you're trying to pay your bills and take care of your kids too." Each year, Simpson gets an ARKids re-enrollment form. She has to answer questions verifying her children still qualify for the program and send it back to the Arkansas Department of Human Services. If she doesn't return it, her children lose coverage. "It would probably be something that would slip a lot of people's mind," Simpson said. "It's human error." Getting families to fill out the re-enrollment forms is a challenge, Munsell said. Parents may forget, move, or decide they don't need the coverage. Often parents don't realize their children have lost coverage until they get to the doctor's office. "Many families are busy and they don't think about health insurance until their child is sick," she said. Over the next few months, Finish Line partners will begin holding sessions to educate parents around the state, and work with community leaders, schools, public forums, churches and other entities to get the word out, Burak said. Bob Young, executive director of Healthy Connections Inc., a community health center in Mena, said one of the centers main focuses will be working with school nurses. In July and August, nurses will be trained to help parents fill out applications for ARKids First, and set up a system to remind parents about re-enrollment. Healthy Connections will spread the word through various public and private groups, including churches, clinics, and doctors' and dentists' offices. "Our issue is we have so many kids and families and enrolled, the ones that aren't enrolled now are apparently difficult to reach or difficult to convince," Young said. Part of the campaign will be correcting misconceptions about the program, such as the belief that children have to have immunizations to participate, he said. "It's the future of our children that's going to be at stake if we don't do something about improving their health situation," Young said. Arkansas Advocates for Children and Families will also work with legislators and the state Department of Human Services, with the hope of extending ARKids eligibility from 200 percent to 300 percent of the federal poverty level which would affect about 20, 000 Arkansans. Huddleston said he would also like the state to offer families above 300 percent of poverty an option to pay for ARKids coverage. As private health-insurance premiums rise, more middle income families are losing health-care coverage, he said. Many families have incomes too high to qualify for ARKids First but too low to afford private insurance. "People on both sides of the aisle (Democrats and Republicans) agree that we should cover kids, but the question is how are we going to do it," Huddleston said. [Carolyne Park, Arkansas Democrat Gazette, 05/25/08] 2. Delaware: School Lunch Info to Target Kids for CHIP A bipartisan group of legislators and Insurance Commissioner Matt Denn unveiled legislation to get data from schools on children who take part in free and reduced price lunch programs and use it to find kids who are eligible for health coverage from the state but not enrolled. The legislation would allow Delaware to take advantage of federal rules providing for transfer of information from school districts to the Department of Health and Social Services. Approximately 5,000 children in Delaware are enrolled in the state's version of the Children's Health Insurance Program, or CHIP, which provides comprehensive health coverage for $25 or less a month to families often described as "working poor"--above the federal poverty line and not eligible for Medicaid but without enough income to purchase health insurance. However, another 8,000 kids in Delaware are estimated to be eligible for CHIP but are not enrolled. As a result, Delaware returns about $3 million of its annual federal allotment for the program. "This bill puts in place a process that will result in many Delaware families who might not otherwise know that they were eligible for CHIP finding out that they are eligible," said Commissioner Denn, who has been working on CHIP outreach strategies since last year. "The school districts will gather up the information from those parents willing to disclose it, forward it to DHSS, and DHSS will reach out to the parents." "Currently, Delaware actually sends money back to the federal government that could be used on insuring our kids. Instead, we need to find those kids and put that money to good use," Sen. Blevins said. "Information-sharing between schools and CHIP is a logical way to find children who are eligible for CHIP but not enrolled," said Sen. Sorenson. "This legislation is about creating connections between different parts of government and getting them to work together for a worthwhile goal--making sure our children are healthy," Rep. Maier said. "The number of children without health insurance has been increasing for the last four years. We need to reverse that trend by doing everything we can to find children who are eligible for the programs that we already have," Rep. Schooley said. In July 2007, Commissioner Denn announced that the Department of Insurance would assist in CHIP outreach activities, which are generally done by DHSS. That effort has included distributing CHIP information and applications to children in the summer feeding program, through Delaware Technical and Community College's financial aid offices, through the federal bankruptcy court, and through a variety of community social service organizations that have volunteered to help. Also, Commissioner Denn announced a plan to provide a cash incentive to schools whose nurses sign children up for CHIP, replicating a successful program from CHIP's early years. For each student enrolled in CHIP by the nurse, a school will receive $50 for school supplies, funded by the Department of Insurance. "We will continue to try to identify and enroll eligible families every way we can, with all the community partners we can," Commissioner Denn said. [Matthew Denn, Delaware Insurance Commissioner, 01/09/08]