Orange County Collaborative

CaliforniaKids/ Orange County Collaborative z The collaborative launched the CaliforniaKids program in 1999 with the mission to provide the uninsured ...
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CaliforniaKids/ Orange County Collaborative z The collaborative launched the CaliforniaKids program in 1999 with the mission to provide the uninsured children in Orange County access to health care services. z The collaborative consists of: y y y y y

Hoag Hospital St. Joseph Hospital Mission Hospital St. Jude Hospital CHOC

z CHOC Health Alliance manages the provider network. z CaliforniaKids provides enrollment and customer service to the members. z School nurses, community organizations and providers identify and enroll eligible children.

CaliforniaKids/OC Collaborative: How it works z The CaliforniaKids benefits package: y y y y y y

Preventive and Primary Medical Services (Blue Cross) Vision Services (VSP) Dental Services (Delta Dental) Prescription Drugs (Wellpoint Pharmacy) Behavioral Health Services (Magellan) 24-Hour Nurse Hotline (McKesson HBOC)

z Premium: $38.46 per member/per month y Original members are fully subsidized y New members (as of 1/03) pay $15pmpm

z Co-payments: $5-$10 depending on the service z Current enrollment: 4,933 children y

Fully subsidized: 3,648 --

Partially subsidized: 1,285

California Kids/OC Collaborative Operational Information z June 1999 to December 2002 y Collaborative raised dollars that were matched by other Foundations and utilized to subsidize the entire premium (then $33.58pmpm) y Parents paid a one time application fee y Prior to July, 2002, providers were paid a capitated rate; since July 2002, providers are paid a negotiated fee-for-service rate

z January 2003 to present y CaliforniaKids began a shared-premium for new members: $15pmpm y Effective July 2003 CaliforniaKids experienced a rate increase of $4.88 pmpm (now $38.46 pmpm)

z All administrative costs are donated by the health plans. y Therefore, every dollar contributed to CaliforniaKids is used to cover the cost of health care for a child.

CaliforniaKids/OC Collaborative Funding Sources z Individuals: United Way of Orange County z Foundations y y y y

UniHealth The California Endowment The California HealthCare Foundation Angel’s Care

z Businesses y y y y y

Hoag SJHS: St. Joseph, Mission, St. Jude Kaiser Southern California Dodge Dealers CalOPTIMA

CaliforniaKids/OC Collaborative Expansion Projects z Perhaps 12,000 more children-- uninsured and ineligible for public programs-- could be covered by California Kids if subsidies were available: y Children in families between 250 -300% Federal Poverty Level y Children with immigration issues

z St. Joseph Health System and the Orange County Congregation Community Organization (OCCCO) are working with California Kids to secure new funding, e.g.: y y y y

Additional provider partners for the collaborative A bi-national arrangement with Mexico Proposition 10 funding Employer/employee shared premiums

CaliforniaKids/OC Collaborative Workplace Expansion Proposal z OCCCO has applied to The California HealthCare Foundation for a planning grant to hire an Outreach Coordinator to work with employers. y Workplace outreach will promote Medi-Cal and Healthy Families to workers with uninsured children. CHOC will assist with enrollment and utilization. y At least 75% of uninsured children are eligible for public programs. y Employers will be asked to split the premium for ineligible children with their workers and CaliforniaKids. y The employer’s share is tax deductible as a charitable donation. The worker’s share is handled by payroll deduction.

CaliforniaKids/OC Collaborative Public Education Campaign z Help raise awareness about children’s health coverage as well as raise funds. y Faith congregations y Civic groups y Non-profit service organizations

z How you can help: y Form an education committee for children’s healthcare y Promote enrollment in public programs y Encourage employers to offer CaliforniaKids to workers’ children who need it y Urge Prop. 10 support for health coverage

California Kids/OC Collaborative The Doll Project z Sonoma project sets an example for Orange y Adults and children in Sonoma County made 1,000 clothespin dolls, each representing 8 uninsured children in Sonoma County, and put them up for “adoption.” y Placed together, the doll display visually depicts the scope of the opportunity, while paying tribute to the uniqueness of each child.

CaliforniaKids/OC Expansion y Every child is special. Public insurance programs, private partnerships and caring employers make it possible to give every Orange County child a healthy start.

CaliforniaKids/OC Collaborative How the Community Can Help

z Form an education committee. z Assist the Doll Project to dramatize the need. z Support Proposition 10 funding for CaliforniaKids. z Invite CAAs to tell your members/employees about Medi-Cal and Healthy Families. z Share the cost of CaliforniaKids premiums for your worker’s children who do not qualify for public programs.