Plan to save Santa Cruz County's Healthy Kids in place

Health coverage for undocumented children at stake

By Jason Hoppin
Santa Cruz Sentinel
POSTED:   06/13/2014
WATSONVILLE >> The Affordable Care Act's expansion of Medi-Cal has been hailed as a major leap forward for health coverage for the poor, but it leaves behind a big group: California's 2.6 million residents who came here illegally.
That population, which includes an estimated 1 million children, is largely left out of federal health care reforms. And now many California counties, including Santa Cruz, are scrambling to make sure immigrants get access to primary care physicians, as well as vision, dental, mental health and other specialty care.
Here, several local providers and community groups appear to have saved Healthy Kids — at least for the next year — a program started in 2002 with the aim of insuring all county children regardless of their immigration status. The Santa Cruz County Board of Supervisors is being asked to sign off on the final piece of the deal as part of its budget deliberations later this month.
"For us, we have that sense of responsibility to our community," said Salud Para la Gente fund development coordinator Rosalba Contreras, who said Healthy Kids is key to the mission of the group's network of low-income clinics. "This is why we are working in collaboration with other organizations to make sure the program continues, because it is important for our community, especially here in Watsonville."
Healthy Kids has had ups and downs with funding, and in 2009 was forced to implement a waiting list. The revised program would cap enrollment at 900 — not enough to cover everyone but something supporters hailed as a significant step.
The issue is especially important in the Pajaro Valley. Prior to the Affordable Care Act, 88 percent of the county reported having health coverage. But in the Pajaro Valley, that number was 67 percent, with more than twice as many there using the emergency room as their main source of care.
Shaila Ramos, a 23-year-old UCSC junior, said she benefitted from Santa Clara County's Healthy Kids program as a teenager. Ramos began seeing a doctor regularly and found she needed glasses, a development that boosted her academic achievements.
"I think it's very important that we keep it alive," Ramos said. "It makes more of a difference than just (having) health care. It changes a child for the good, you know? It gives them an opportunity to belong to society."
The county is being asked to commit $300,000 during upcoming budget talks. The Palo Alto Medical Foundation already pledged $100,000. Stanford's Lucille Packard Children's Hospital, which recently opened a clinic on Bay Avenue, offered $50,000. Dominican Hospital's Dignity Health gave $25,000, Salud offered $20,000 and the Monterey Peninsula Foundation pledged $150,000 over the next three years.
In addition, the Central California Alliance for Health, which manages the program, has agreed to plow several hundred thousand dollars back into the plan. David Brody, executive director of First 5 of Santa Cruz County, said the Monterey Peninsula Foundation's multiyear grant is key because there are no guarantees beyond next year.
"What we realized as we got into this and these commitments started flowing in is that we needed to not just provide a 12-month solution to the county, to the Board of Supervisors, to our various constituents, but we needed to think in a multiyear time frame," said Brody, whose group helped organize the effort with United Way of Santa Cruz County. "Try to assemble a credible plan that we could keep the program going two, three years out."
The issue is critical to safety-net clinics like Salud Para la Gente, which sees 25,000 low-income patients a year and is required to provide coverage to patients regardless of whether they have insurance. Salud provided $9.6 million in uncompensated care last fiscal year, despite an annual budget of less than half that amount.
The problem is not unique to Santa Cruz — a 2012 study by UCLA's Center for Health Policy Research estimated that with the Medicaid program expansion covering more people, including adults making up to 133 percent of federal poverty wages, the percentage of the state's uninsured who are in the country illegally would zoom from 19.5 percent to 40.8 percent.
Rev. Robin Mathews-Johnson of Watsonville's First United Methodist Church, who is involved in the issue through Communities Organized For Relational Power In Action, or COPA, said continuing coverage is a moral imperative.
"I'm a Christian and I want to live my faith," Mathews-Johnson said. "I can talk about it for an hour on Sunday, but this is part of our commitment to living out our commitment to the community. ... Health care is a big need in Watsonville."