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Publications on Immigrants

HealthConnect in Our Community is one component of a three-part initiative to address the health and related needs of children in Miami-Dade County. This report provides findings from five focus groups, two with community workers and three with parents. Both staff and parents are pleased with the program. They believe that the greatest strength of the program is its responsiveness to the cultural diversity represented in Miami-Dade County. The focus group participants also provided some areas for improvement, such as the need to raise the program's visibility in the community; improve targeting of services; and standardize data collection protocols.

In 2005 The Children's Trust of Miami-Dade County initiated HealthConnect in Our Community, designed to improve the health of children and adolescents in the county. The program uses community workers to reach out to underserved children and their families. The Urban Institute and three local consultants conducted a formative assessment the program's first year of operation. In a six-day site visit we interviewed 26 individuals, observed program operations in 19 separate locations, and conducted five focus groups, three with clients and two with program staff. This report summarizes the findings from the evaluation, and provides recommendations for improving the program.

This brief presents highlights from rigorous, independent evaluations of the Healthy Kids programs in three California counties: Los Angeles, San Mateo, and Santa Clara. Launched by Children’s Health Initiatives (CHIs) in these counties between 2001 and 2003, the three Healthy Kids programs provide children with comprehensive health insurance coverage, including a broad range of medical, dental, and vision care; prescription drugs; and mental health services. Children are eligible for Healthy Kids if they are ineligible for California’s two major state insurance programs, Medi-Cal and Healthy Families, and live in families with incomes up to 300 percent of the federal poverty level (FPL) in Los Angeles and Santa Clara counties, and 400 percent of the FPL in San Mateo County. Most of the children enrolled in Healthy Kids have family incomes at or below the poverty level. This brief describes some of the many positive impacts that Healthy Kids programs have had on children’s access and use of dental services. For more information on these and other findings on the three programs, see http://www.urban.org and http://www.mathematica-mpr.com/health/chi.asp.

A second series of focus groups with parents of children enrolled in the Los Angeles Healthy Kids program found that opinions of the program remain favorable despite its recent fiscal challenges. Healthy Kids had provided comprehensive, affordable coverage to nearly 45,000 poor children from birth through age 18 until mid-2005, but funding shortfalls led the program to cap enrollment for older children and enrollment levels for all children subsequently slipped. Still, the program remains highly valued by parents for providing high quality, comprehensive coverage and parents report good access to linguistically appropriate care and affordable out-of-pocket costs.

The Los Angeles Healthy Kids program, during its first four years, extended comprehensive, affordable coverage to over 40,000 poor and vulnerable children, and improved their access to and use of care. Yet, the program also faced serious challenges, primarily related to financing. Funding for children ages 6 through 18 ran short in spring 2005 and Healthy Kids capped their enrollment. State health reform efforts that could have stabilized funding for the program have failed. Based on interviews with over 40 stakeholders, this case study analyzes the complex challenges that the Los Angeles Healthy Kids program faces at this critical juncture.