It’s that time of year where families, educators, and school administrators get back to familiar routines. Families are preparing their children for the first day of school with the right tools, like pencils, notebooks, and even health insurance coverage. Yet there is one thing about this school year that is different from years past—for the very first time, many families have access to quality, affordable health coverage for their children. That’s right! All low-income children in California, regardless of their immigration status, can apply for full-scope Medi-Cal and get needed care—giving them one more tool to stay healthy and be better prepared to learn. Those who qualify will get coverage for free or at very low cost, and they can stay covered up to the age of 19, giving them the opportunity to access comprehensive health services at no cost. Learn more about Health4All Kids.
This back-to-school season provides a great opportunity to make sure families enroll their kids in coverage since parents and guardians are most engaged this time of year. With just over 6.2 million students in public schools, educators and leaders will be interacting with many parents and guardians in the coming weeks. Parents will visit new classrooms and introduce themselves to new teachers. When they walk through the door this year, let’s make sure to tell them about Health4All Kids.
With the Health4All Kids expansion of Medi-Cal, up to 225,000 children will be newly eligible for comprehensive health coverage, including access to preventive care and other critical health services. Students will be able to see a doctor regularly, get routine checkups at the dentist, and get the care they need when they start to feel under the weather. Healthy students make better learners and, with this new opportunity for coverage, more students have the chance to lead healthier lives.
Educators know that healthy students make better learners. Help us publicize this new opportunity by distributing health coverage materials from the ALL IN For Health Back to School Toolkit. It includes easy-to-use materials to share with families, as well as tools to help spread the word, like robocall scripts and sample text for parent newsletters. Together, we can make sure ALL KIDS are ALL IN for health coverage!
Providing a young child with oral health care helps ensure long-term oral health for the future. But today, California’s children are facing an oral health care crisis. In 2013, over half of the children enrolled in Medi-Cal did not receive an oral health visit through the program and, at 57 percent, the numbers were no better for the program’s youngest enrollees, aged zero to three. For pregnant women, one study found that over half of all pregnant women had experienced a dental problem and, of them, six in ten were not receiving oral health care. The need for urgent action to address the interconnected needs of both generations is evident.
As we explore ways to better meet the oral health care needs of children and families, early childhood home visiting programs can be a critical resource in reaching families with information about good oral health practices early in their child’s life. The strategies used by home visiting programs to achieve results—like the frequency and duration of visits to the family, early intervention, anticipatory guidance, and education—can be effective in improving children’s oral health.
There is also a growing recognition that the dentist is not the only provider that can address children’s oral health needs. A team approach is necessary to provide the comprehensive oral health education, preventive services, and care management families need. Home visitors can be an integral part of the team, especially given the severe lack of oral health providers available to treat children and the systemic barriers that pregnant women and young children face in getting care.
Therefore, it only makes sense to build a stronger connection between home visiting and oral health in a way that maintains the fidelity to the home visiting model and does not overburden home visitors with onerous requirements.
Our recommendations for next steps:
- Provide home visitors with the training and resources they need to incorporate oral health practices into their activities.
- Collect oral health data from home visiting programs so that we can better understand the impact of home visiting on the oral health of children and families, and develop the evidence base for funding to include oral health practices in home visiting programs.
- Create stable funding streams to support home visiting overall so that it is a viable avenue to bring preventive services to children and families, including preventive oral health services.
These next steps create an opportunity to give home visitors the tools they need to better serve the oral health needs of children and families. They also give advocates the opportunity to increase awareness in both the home visiting and oral health communities on the importance of this strategic connection. Together, we can create a system of oral health care in which early childhood home visitors are a key part.
You can read more details about each of our recommendations in “Healthy Mouth, Healthy Start: Improving Oral Health for Young Children and Families Through Early Childhood Home Visiting.”
The American story is inherently one of immigrants. Like so many in our country, my parents came to the United States from Mexico some 40 years ago in search of a better future for their children. Today, my three sisters and I are leading lives our parents once dreamed of—with a career dedicated to making a difference, in a home that is your own, or a schedule that you are able to set for yourself. For many, these are simple things, but to many immigrants, they are what make America special.
Whether your family came to America decades ago or months ago, faith in the American Dream remains the same, and immigrants continue to come to this country to find a better life for their family and make the country a stronger place. This is particularly true in California, home to more than 10 million immigrants and where half of children have at least one immigrant parent. During this past month, The Children’s Partnership proudly joined the #IAmAnImmigrant movement sweeping the nation for Immigrant Heritage Month, reminding us that America’s strength is reflected in our diversity built over generations.
Immigrants are part of the fabric of our society and their well-being is directly linked to our country’s well-being today and in the future. While many policies increasingly reflect that value, others continue to not. We were deeply disappointed by the recent Supreme Court deadlock that effectively blocked the Obama Administration’s executive actions to expand the Deferred Action for Childhood Arrivals (DACA) program to more DREAMers and implement the Deferred Action for Parents of Americans and Legal Permanent Residents (DAPA) program. The impasse continues a broken immigration system that harms the healthy development of immigrant and citizen children alike. In California, thousands were denied the peace of mind such policies offered and the security of health coverage that could have followed.
While we continue to fight for all families that call this country home, in California, we continue our path of immigrant integration by making important strides for the health and well-being of immigrant families. As of May 16, 2016, low-income undocumented children can enroll in full-scope Medi-Cal (California’s Medicaid program), opening the door to free preventive services and other critical services. With access to the care they need to be healthy, children are on a trajectory to be better prepared for school and life. More recently, Governor Jerry Brown signed legislation authorizing the State to request a waiver from the federal government to allow undocumented immigrants to purchase unsubsidized insurance through Covered California, the state’s health insurance marketplace. While the decision will ultimately rest with the federal government, the “Health4All” movement in California continues on to ensure all members of the family have affordable, comprehensive health coverage.
Creating an equitable health care system that works for everyone, no matter where they were born, will require more than just securing coverage. Helping newly insured families navigate a health care system that may be new to them and creating a culturally appropriate system of care that meets the needs of California’s uniquely diverse residents will help ensure the health of not just immigrant families but all families as well. Here are some ways that can be accomplished:
- Tailor outreach materials to better meet the needs of California’s diverse families.As we help families understand their coverage and care, we need to make sure they understand the information shared and that resources created and disseminated by the State, health care entities, and community organizations are personalized to different cultures and are in appropriate languages. Time-intensive, targeted, culturally competent, innovative outreach strategies have proven effective in enrollment assistance. Similarly, we can apply these strategies to help families understand the health care system and get the care they need. Linguistically and culturally targeted materials can supplement work to reach families through trusted messengers, including schools, small businesses, religious organizations, and other non-health channels.
- Create a system of care that works for families’ needs. While the traditional medical office works for many, there are other ways communities can work to better meet the needs of families. Families often face financial, transportation, and language barriers when seeking traditional, office-based care. Local health centers, schools, and community centers may be more appropriate for some. By supporting efforts to bring health care to the community, we can create mechanisms to better deliver health care to all families. For example, school-based health centers have proven successful in providing critical health care services to children and making sure students who are unable to get health care elsewhere can receive it at school.
- Develop a workforce that families trust. In traditional medical settings, it is often a team of providers that offer community members a health home they trust. In addition to the doctor or dentist, there are others on the team that deliver health information and care and serve as trusted sources for such information and care. Given the number of newly insured, we have an opportunity to look at trained members of the community, such as community health workers and promotores, as well as public health nurses, home visitors, and appropriate school personnel that are responsive to families’ unique needs. Not only is it more effective in reaching the millions of newly insured families, but it is also a smart use of the tremendous resources we have to make up our health care workforce. The State should support community-based education, care coordination, and support models, not only because such models improve families’ health literacy and overall health outcomes, but also because such an investment is also an investment in preventive care, which leads to both healthier children and adults and is cost effective in the long run.
Good health is critical to a successful future for everyone. When immigrants come to this country, they come with the highest expectations of what America can do for their families and what they, in return, can do for America. For the millions of immigrants in California, the ability to contribute to this nation goes hand in hand with their health status. This Immigrant Heritage Month, we celebrate our diversity and renew our commitment to doing more to support the health and well-being of every member of our immigrant communities, for their sake and our own.
Over the past six years, the Affordable Care Act (ACA) and subsequent efforts to build on its impact have made incredible improvements in the lives of tens of millions of Americans. As a result, health insurance is fairer, more affordable, and more accessible across the country. In California, one of the greatest success stories for health reform, the law has opened doors to coverage for over six million consumers. California was the first state in the nation to enact legislation creating a health insurance marketplace, Covered California, and an early adopter of the Medicaid expansion to ensure more low-income Californians enrolled in coverage. In taking a lead on implementation, California has put the needs of consumers first and provided greater security for children and families.
Providing quality health insurance and care is an investment in the future of our children and lays the groundwork for children to succeed in school and life. Before the passage of the ACA, increases in public coverage through both Medicaid and the Children’s Health Insurance Program (CHIP) placed a national focus on children’s coverage. As a result, the national rate of uninsured children fell more than 65 percent from 14.9 percent to 4.8 percent between 1997 and 2015. With this strong foundation, the ACA created new coverage opportunities for the majority of the remaining uninsured—primarily adults.
Today, over 5.6 million children, more than half of California’s children, are enrolled in Medi-Cal. Medi-Cal provides affordable health care to children who need it most—especially millions of children of color who have historically faced disproportionately poorer health outcomes. A strong future for health care in America will build on the progress of the ACA, but it also requires us to defend and enhance Medicaid and CHIP at the federal and state levels, given their historic success in providing child-specific health benefits to the nation’s most vulnerable children.
Our new report, “The Affordable Care Act and Children’s Coverage in California: Our Progress and Our Future,” offers a look into the incredible progress California has made in health care reform and the future actions we must take to continue to support a healthy future for all California children, including furthering children’s coverage successes through the strengthening of Medicaid and CHIP. In conjunction with the report, our California and federal action agendas present our recommendations for advancing children’s coverage.
At The Children’s Partnership, we have proudly joined national and statewide partners to advocate critical health care reforms impacting millions of children and families, before and as part of the ACA. As we reflect on these past six years and celebrate the incredible accomplishments to advance the health of American families, we will continue to serve as a voice for children and work to improve a system of coverage and care that serves our children and their specific needs. We look forward to ongoing work with our partners to make this a reality.
Read the report and action agendas at:www.childrenspartnership.org/childrenandtheaca.
Today in California and across the country, millions more Americans have access to quality, affordable health coverage. Thanks to the Affordable Care Act, and the tremendous efforts by states, advocates, faith-based organizations, schools, businesses, and communities, including our collaboration with schools through the ALL IN For Health Campaign, more families and children than ever are enrolled in coverage. With coverage, families and children can see a doctor, fill a prescription, and have the peace of mind that health insurance coverage provides—but only if they understand what having an insurance card can mean for them.
Too many people, particularly the newly insured, find health insurance confusing, frustrating, and often overwhelming. For children, their ability to get the care they need depends on their parents’ ability to understand and navigate the coverage system on their behalf. When at least 1 in 3 parents of young children have limited health literacy skills, we know a family’s understanding of health insurance and the health care system will impact a child’s ability to get the care they need.
Part of this understanding is knowing the benefits made available through the ACA and Medi-Cal. A key benefit, for example, is access to preventive services, such as well-child visits, immunizations, and developmental screenings for children, with no additional out-of-pocket costs. Before the ACA, many families, especially minority and low-income families, faced cost barriers that discouraged them from going to the doctor or dentist for a checkup. Instead of going to a primary care doctor to get chronic asthma under control or going to a dental care provider for a cleaning, children ended up in the emergency room with a preventable asthma attack or tooth abscess. Access to regular, preventive health care is a key element to helping all Americans become healthy and stay healthy. Preventive care is particularly critical to children’s development, helping them thrive in school and grow up to become healthy adults. As coverage becomes more widely available, it is time to help families navigate an unfamiliar health care system and ensure that families are using that coverage to get care before health problems arise.
At The Children’s Partnership, we are excited to add this new focus to our ALL IN For Health Campaign and build on our powerful partnership with California schools to educate families about the importance of understanding coverage, including seeking preventive health care. We have developed a new flyer that reinforces the concept of preventive health and gives families four easy steps they can take today to get their families the care they need to stay healthy. To help families keep track of their children’s preventive health visits and other medical information, we’ve also developed a handy card to store key information.
Educating families about how to use their insurance and the importance of preventive services is critical to the well-being of children and their ability to succeed in school. We are excited to continue our work with schools to better the health of California’s students and families and do our part to make sure that the vision of the ACA—a healthier America—becomes a reality.
During February, we commemorate Children’s Dental Health Month and, in doing so, reflect on the state of oral health for kids in California and what needs to be done to improve it. Tooth decay is the number one childhood chronic disease—two to three times more common than childhood obesity or asthma. Yet it is preventable. Here is some work The Children’s Partnership is doing to promote solutions to the problem.
- Helping families understand their dental benefits and how to use them. Many families in California may not know that if their child is enrolled in health coverage through Medi-Cal or Covered California, he or she also has dental coverage. Schools, businesses, doctors, nurses, and communities all have a role to play in helping families understand how to get the dental care their children need. That’s why we created brand new flyers to help families navigate dental coverage for their children. It will be especially important to educate families whose children may not have had coverage in the past, such as low-income undocumented children who will be newly eligible for Medi-Cal later this year. We will be sharing these flyers through schools, clinics, and other partners. Please help us get them out to families, too!
- Bringing dental care to children where they are in the community. Underserved children, who suffer from poor oral health, face significant obstacles in obtaining dental services. Many low-income families have difficulty getting needed dental services because they lack affordable transportation, lose pay when they miss work, and face other socioeconomic barriers. Bringing care directly to them bypasses these barriers and, for many, may be the only option for getting care. The Virtual Dental Home (VDH) is an innovative and cost-effective system for providing dental care to California’s most vulnerable children in community settings. The VDH model uses technology to connect specially trained dental hygienists and assistants, located at community sites (such as schools and Head Start sites), with dentists in offices or clinics to facilitate comprehensive dental care. We are sponsoring legislation—AB 648 (Low)—which would provide a one-time start-up investment in training, equipment, technical assistance, and other support that providers need to begin implementing the VDH so that it can be brought to underserved communities across the state.
- Encouraging a sustainable system of care for children in Medi-Cal. Now that more kids than ever have health and dental coverage, we need to make sure they can use it. Approximately 5.6 million California children are enrolled in Medi-Cal, but fewer than half of these children are receiving necessary dental care. While progress has been made, Medi-Cal continues to fall short of meeting the dental care needs of the state’s most vulnerable children. We need a sustainable system that brings care to children in community settings, utilizes community health workers to educate and engage families and coordinate care, and provides enough dentists in the right places to address the restorative dental care needs of children. For example, the State should implement a program like the ABCD program in Washington State and a similar program in Alameda County that supports a whole team to address the oral health needs of young children.
- Shaping the State’s oral health plan. This year, TCP is helping to develop the State Department of Public Health’s statewide oral health plan, led by the newly appointed Dental Director, to ensure the plan makes meaningful recommendations for improving children’s oral health and action is taken to begin timely implementation. All of California’s kids deserve the dental care they need to not suffer in pain, do well in school, and avoid costly health problems later on in life.
Please join us in helping families understand their children’s dental coverage and how to get care by promoting these much-needed statewide systems. Contact Jenny Kattlove, Senior Director of Programs, with any questions at firstname.lastname@example.org.
For decades, community organizations, policymakers, and advocates have worked together to make sure every member of the family could experience the benefits and security that health coverage provides. Families have bravely made their voices heard to make sure their kids could lead healthy and happy lives and the state of California is listening. Last year, the first victory in the journey toward health for all was achieved—all children, regardless of immigration status, will soon get free or low-cost health coverage through Medi-Cal. If a child under the age of 19 meets income guidelines, he or she will qualify for Medi-Cal. As we celebrate this milestone, we must continue our work to educate families, build awareness, and make sure every family takes advantage of this important opportunity.
Although the expansion of benefits to all children is expected later this year, families can act now to make sure that their kids get the comprehensive health coverage they need as soon as possible! Families can begin enrolling their children in restricted Medi-Cal (also known as emergency Medi-Cal) TODAY. Then, once the expansion is in place, those children enrolled in restricted Medi-Cal will be automatically enrolled into full-scope Medi-Cal. Families can apply without fear and know that their immigration status information is kept private. To enroll, immigrant families should visit www.localclinic.netto identify a local clinic to apply at or visit their local county human services office.
The expansion of Medi-Cal will help thousands of California children, but many families have questions and concerns about applying. The ALL IN For Health Campaign—the TCP-led effort to equip the education community with tools to help families connect to health coverage and care—has created a new flyer for schools to distribute to families. The flyer includes the most important facts about the expansion of Medi-Cal to undocumented children and how to get enrolled today. With our school and early learning partners, we can reach many of California’s more than 9 million children, including this newly eligible population, encourage families to enroll in restricted Medi-Cal now, and connect them to enrollment assistance. We also plan to continue learning about how we can better reach families with this information. We want to do all we can to work with trusted community centers, such as churches, clinics, small businesses, and more to help get the word out that it’s safe to apply.
Getting more kids enrolled in health coverage is key to children getting the care they need to grow up healthy. When children have health coverage, they can get preventive care that catches potential health issues before they become a problem. It also enables families to build a relationship with a doctor, dental provider, or other health care provider so that they have someone to call on when health issues do come up. Finally, children with health coverage are much less likely to miss school and are better prepared to learn and succeed in the classroom!
We hope you will join us in making sure all families have this important information and take the next step to enroll their kids in coverage. And, together, we will work toward a statewide solution so that all Californians, both children and adults, have access to quality, affordable coverage. Help spread the word by sharing “The ABCs of Health Coverage for ALL Kids” with your community.
As the new President of a dynamic and innovative children’s advocacy organization, I am constantly learning—from community members, partners in the field, policymakers, my staff, and many others. At TCP, it is our organization-wide commitment to learning that informs our work to better meet our primary goals of ensuring all children have access to quality, affordable health care and reap the benefits of digital opportunities. To learn more about our work, I invite you to take a look at our recently released California and Federal Policy Agendas, where we as an organization have the chance to make good on our mission to improve the health and well-being of children in the Golden State and across the nation. These agendas reflect how what we are learning influences our work as we continue to evolve with the changing political and social landscape for children.
In 2016, we will build upon TCP’s two-plus decades of work to continue securing key advances for children across the nation. I’m excited to work with our partners to ensure that all children have quality health coverage that meets their needs. This includes continued work in California to make certain that children’s voices are heard as the implementation of the Affordable Care Act moves forward, as well as in the implementation of the recent extension of Medi-Cal to all-low income children, regardless of immigration status, and in the work of refining processes to make obtaining coverage as seamless as possible for every family that qualifies. Nationally, we will continue to advocate so that the crucial and bipartisan Children’s Health Insurance Program’s success in providing affordable, child-specific, and comprehensive coverage continues.
For this work and more, we recognize the importance of reaching families in their communities as key to a successful outreach effort to ensure newly eligible children and families enroll in health coverage and access preventive care. From community-based organizations to government agencies to private companies, we will continue to partner with diverse organizations to make sure families have the information they need to access health coverage and care. Our ALL IN For Health Campaign has already delivered 7.3 million messages to families encouraging them to enroll in affordable health coverage, thanks to the help of partners in the education community. In the coming year, we will deliver even more messages with the help of our partners.
We will also continue promoting the smart use of technology to improve the quality of care received by our most vulnerable children and to empower families to take control of their children’s health. And we will keep pushing to ensure that the 5.5 million California children enrolled in Medi-Cal receive the dental care they deserve—especially considering that dental care is the number one unmet chronic health care need for children.
When I took the helm of The Children’s Partnership late last year, I brought with me my personal and professional mission of ensuring families are healthy and able to pursue their dreams. I am excited to learn from families in California about how our work moving forward can better meet their needs. These policy agendas reflect what our team has heard and represent our next step toward making that mission a reality. We hope you will take the time to read them and learn a bit more about TCP and our work this upcoming year.
Healthy students make good learners. That’s the logic behind The Children’s Partnership’s ALL IN For Health Campaign, an effort to equip educators with the tools they need to connect children and families to health coverage and care. We’ve heard the impact of health on kids’ ability to learn from on-the-ground stories, including teachers who have seen students rack up absences and, as a result, fall behind in school. These are children who don’t get the health care they need or whose toothache or poor vision prevent them from concentrating in class. Many of these children don’t have health coverage and, thus, are not getting preventive or timely care when they have a health problem.
Health coverage and care are key elements to making sure that students are in class and ready to learn. Students with health coverage are more likely to graduate from high school, go on to college, and contribute more in tax revenue as adults. The understanding that health is a key component to school success is now fueling a new federal initiative. Late last week, the US Department of Education (ED) and the US Department of Health and Human Services (HHS) announced Healthy Students, Promising Futures. This campaign offers schools a number of high-impact opportunities to improve the health of their students, from connecting eligible students to health coverage opportunities to promoting healthy practices through physical and health education.
As a result of the Affordable Care Act, millions of children and adults now have health coverage. And now that students have that coverage, schools have the opportunity to move students up the wellness continuum, beyond the point of simply not being ill to being truly well. They can do this by connecting students to preventive care and educating them on healthy habits. ED and HHS recommend delivering health services to students directly in schools, providing support services and case management to at-risk students, and partnering with local hospitals and organizations. And, by promoting healthy habits such as eating well and engaging in physical activity, schools can encourage healthy habits that last a lifetime.
At The Children’s Partnership, we share the Administration’s commitment and have acted on it through our ALL IN For Health Campaign. To reach as many families as possible, we’ve enlisted the leadership of the California State Superintendent of Public Instruction, Tom Torlakson, and partners like California School Boards Association, California Parent Teacher Association, and California Head Start Association, among many others, to help connect schools and early learning sites across California to the information and materials they need to help families understand their coverage options and help them enroll. As a result, we’ve been able to deliver over 7.3 million messages informing families about their health coverage options and how to enroll and connect to care.
We applaud the Obama Administration for highlighting and supporting this high-yield connection between health and education and look forward to seeing what can happen when more schools and members of the health care community partner to help every student in the country thrive.
If you’re a school or early learning center in California, use our toolkit to help eligible students and family members enroll in affordable health coverage. And learn more aboutThe Children’s Partnership’s experience in conducting a statewide campaign that partners health advocates and the education community in order to benefit the children and families they both serve.
We are now in the midst of the third open enrollment period for Covered California, the state’s marketplace for affordable health coverage options. And schools and early learning centers across California are once again at the forefront working to inform families about the opportunity to enroll in coverage. Using The Children’s Partnership’sALL IN For Health toolkit, schools and early learning sites are making calls, passing out flyers, sending newsletters, sharing social media messages, and, ultimately, connecting families to enrollment assistance.
But after a successful first two years of enrollment, what should schools and other outreach partners be focused on this year? Based on the research, we know there are some top points to emphasize to make sure kids and their families get covered and stay covered:
- Financial Help Can Lower Monthly Costs: A recent Covered California survey showed that many uninsured individuals who can benefit most from affordable coverage options still do not understand that they can get financial help to lower monthly costs. Therefore, we need to focus our messages on the premium subsidies available through Covered California and the fact that Medi-Cal is free or very low cost. On the flip side, it is also important to remind families that if they don’t get coverage, they might have to pay a fine of $695 per person or 2.5 percent of their income—whichever is greater.
- Enrollment Help Is Available: Studies after previous enrollment periods demonstrate that many people seeking health coverage prefer to talk with someone who can help them understand their coverage options. ALL IN can arrange for Certified Enrollment Counselors who speak English, Spanish, and potentially other languages to be available on site—such as at schools or early learning centers to walk families through the enrollment process and ensure they enroll.
- Shop Around and Renew Every Year: Each year there are new plans and new prices available. Everyone is encouraged to shop the health coverage marketplace during open enrollment and ensure they have the plan that best meets their family’s needs and budget, especially if the family has had any changes in income. For those with coverage through Covered California that are satisfied with their coverage, they will be automatically re-enrolled in their health plan. Medi-Cal will mail renewal packets each year, and families must respond to keep their coverage.
These are just a few messages schools and early learning providers can spread to make this third year of open enrollment as successful as possible. If you have additional ideas on what to focus on or would like to partner with the ALL IN For Health Campaign, please contact us.
Covered California open enrollment is November 1, 2015, to January 31, 2016. Medi-Cal enrollment is available all year long. Apply through www.coveredca.com.