Gabriela Gadayan first brought her 7-month-old son, Cameron, to Spokane Falls Family Clinic when he was three days old. Checkups and vaccinations followed at two weeks, two months, four months, six months and “every time I’ve been worried about something,” said Gadayan, who is 19 and a first-time mother.
Cameron is a healthy boy with dark hair, big eyes and two teeth. During a routine exam last week, he squirmed in his mother’s arms, pulled at the paper on the exam table and played with the doctor’s stethoscope.
“Alright, buddy, you look wonderful,” Dr. Lanie Cox said after looking in Cameron’s eyes and ears and testing his movement. “He’s perfect.”
That’s thanks in part to the state-funded health insurance program that covers mother and baby, paying for Cameron’s doctor visits and check-ups and monitoring Gadayan’s health while she was pregnant.
“It’s nice knowing I didn’t have to worry about what am I going to pay – his doctor bill or my rent,” Gadayan said.
However, more than 5,000 children in Spokane County – about 4 percent – remain uninsured, and a statewide crusade aims to change that by 2010. The new Apple Health for Kids program brings its tour bus to Spokane’s Unity in the Community diversity celebration Saturday in Riverfront Park. The bus is touring the state to raise awareness, pass out applications and help people through the process of signing up their children for state-funded medical coverage programs.
The program streamlines the application process and increases income eligibility levels. Any family earning up to 250 percent of the federal poverty level qualifies for health insurance for children younger than 19. For a family of four, that’s $4,417.50 per month; for a family of three, $3,667.50; and a family of two, $2,917.50. Starting in 2009, the eligibility level rises to 300 percent of the federal poverty level, according to a state news release. That’s income of $63,600 annually for a family of four.
The Legislature also has instructed the Department of Social and Health Services to develop a new program to accept children from families earning more than 300 percent of the federal poverty level into state insurance programs, provided they pay for the coverage.
Since the Cover all Kids initiative was launched last summer, the state has insured 84,000 additional children. Now the state is trying to find the remaining 75,000 who don’t have health insurance, including those in Spokane County.
“In terms of percentages of children who aren’t covered, Washington has made a lot of progress,” said MaryAnne Lindeblad, director of DSHS’s Division of Healthcare Services. “But we really want to get that last 5 percent.”
In Idaho, about 11 percent of children 18 or younger were uninsured as of 2005, according to the 2008 Kids Count study, published by the Annie E. Casey Foundation. That’s down from 13 percent in 2001. Of the children eligible for publicly funded health insurance, about 30,000 are not enrolled, said Cynthia Taggart, spokeswoman for the Panhandle Health District. People in Idaho are eligible for publicly funded health insurance for their children if their families make 185 percent or less of the federal poverty level, Taggart said.
Uninsured children generally end up at the emergency room when they have medical problems, said Dr. A. Chris Olson, medical director for Sacred Heart Children’s Hospital. That’s the most expensive option, he said, and as a result, those children don’t develop relationships with pediatricians who understand their medical history, don’t receive needed vaccinations, and are not screened for a host of problems better treated with early detection, including developmental delays, hearing loss and vision problems.
Healthy children do better in school and are more likely to become employed as adults, Olson said.
“There’s a whole group of kids in our community that are silent, that we don’t see, that aren’t getting the preventative services,” Olson said. “It helps our community overall if we can find those children.”
Randy Hartman, clinic administrator at the Spokane Falls Family Clinic, sees uninsured children regularly but can immediately refer them to benefits specialists who determine their eligibility for publicly funded medical coverage. The clinic is part of the Yakima Valley Farm Workers Clinic network, a community health organization with locations in Washington and Oregon.
“We make sure the patients have every opportunity to get on the health insurance plans, especially the kiddos,” said Hartman who, like other health professionals, said many people don’t realize they’re eligible for publicly funded medical coverage. “People are pretty ecstatic about the option of having health insurance. We’re telling them for the first time about this. It would be nice to have better awareness.”
Ralph DeCristoforo is hoping Apple Health for Kids will help. Through Community-Minded Enterprises in Spokane, DeCristoforo runs Health for All, a proactive access program.
“Even if they’re over the 250 percent (income eligibility), we try to link them with other programs we know about,” DeCristoforo said. “We have no reason to have an uninsured child in Spokane County.”