1. Announcement A special welcome to Lisa Kahahane, our new administrative assistant. She started on Monday and is a wonderful addition to our Hawaii Covering Kids team! 2. Internet Connects Families and Children to Health Insurance in California California is the first state to use the internet to enroll low-income children and pregnant women who are eligible but not enrolled in public health insurance programs, including Medi-Cal (California's Medicaid) and Healthy Families (California's Children's Health Insurance Program). The electronic enrollment effort, called Health-e-App, is one of the efforts California is using to streamline eligibility into the state's Medi-Cal and Healthy Families programs. Health-e-App allows individuals to apply to receive health benefits in one of the two health programs by simplifying the application process, allowing for immediate online feedback about eligibility and accepting electronic signatures, which allows individuals to begin receiving benefits. Of the nearly 2 million uninsured children in California, nearly 1.5 million are eligible but not enrolled in Medi-Cal or Healthy Families. This month, the state began testing the "Health-e-App" program in San Diego County, and will decide later this winter whether to expand the program statewide. San Diego is home to an estimated 100,000 children eligible but not enrolled in one of the two programs. "Health-e-App provides for a fast, secure and consumer-friendly [way] to enroll in public health insurance programs," said Sam Karp, spokesperson for the California HealthCare Foundation. "It offers real-time preliminary determination of eligibility, as well as real-time selection of physicians and health plans." The web site is Health-e-App Resource Web Site. 3. Health Centers Significantly Boost Enrollment in CHIP In praise of federally-funded health centers, a report released by the Office of the Inspector General states that these health centers are one of the best ways to enroll eligible children in the State Children's Health Insurance Program (CHIP). Federally-funded health centers are often relied on to target hard-to-reach and minority populations in underserved rural and urban areas. The Office of Inspector General (OIG), of the Department of Health and Human Services, found that, as of February 2000, 73 percent of health centers had enrolled children in CHIP. According to the National Association of Community Health Centers (NACHC), health centers are not-for-profit organizations that provide comprehensive and preventive care to medically underserved and uninsured populations. This network is supported by federal grants and is composed of Community Health Centers, Migrant Health Centers, Health Care for the Homeless Programs, and Public Housing Primary Care Programs. NACHC reports there are more than 1029 community-based health centers in the U.S. today, serving over 11 million people through 3,200 delivery sites in all fifty states, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands. Over four million of these patients are uninsured. In addition, the report found that state enrollment training was the most significant factor that increased enrollment for health centers. The OIG found that centers receiving the training are almost four times more likely to enroll children than those that do not. Outstationing eligibility workers, as well as presumptive eligibility site designations, were also critical to boosting enrollment, the report states. However 61 percent of health centers do not have outstationed workers. The report concludes by recommending that the Health Care Financing Administration encourage states to provide enrollment training and to increase the number of outstationed eligibility workers in these centers, which would increase the enrollment of eligible children in State CHIP. 4. Report on CHIP Evaluation A new report from Mathematica Policy Research, Inc. highlights the progress states have been making in implementing their State Children's Health Insurance Program (CHIP) and asserts that the program is picking up momentum, even after initial challenges. The report summarizes major findings from the first year of Mathematica's national evaluation of CHIP. The analysis was based on CHIP evaluations mandated under Title XXI, quarterly enrollment data submitted by states, and national data on trends in the number of uninsured children. The five-year evaluation, funded by the Health Care Financing Administration (HCFA), began in 1999. Some of the findings include: *More than half of all states have set CHIP eligibility guidelines at 200 percent of the Federal Poverty Level or above. * One million children were enrolled in CHIP in FY 1998, close to two million were enrolled in FY 1999, and recent figures show that 3.3 million children were enrolled in 2000. Enrollment is heavily concentrated in states that implemented their programs in 1998, the first year after CHIP legislation was passed. * Almost all states have tried to streamline and simplify their CHIP application and redetermination policies and forms. Most have eliminated assets testing; many have reduced verification requirements and made similar changes to their Medicaid programs. Challenges include coordinating eligibility between separate CHIP programs and Medicaid and retaining eligible children in CHIP. The full report, "Implementation of the State Children's Health Insurance Program: Momentum is Increasing After a Modest Start," in PDF format is available at http://www.mathematica-mpr.com/PDFs/schip1.pdf. 5. 2001 "State of the States" Released A new report has been released, looking at what steps states have taken to expand health coverage to the uninsured through the Children's Health Insurance Program (CHIP) and the use of insurance market reforms. The report, released by the State Coverage Initiatives, features specific examples of how states increased enrollment in their CHIP programs and addresses how small group and individual markets in states have played a role in reducing the number of uninsured children. The report also outlines states' 2001 policy agendas. To download the report in PDF format, click here: http://www.statecoverage.net/pdf/state01.pdf .