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King County Children's Health Initiative
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A local approach to improve the health of low-income children. To ensure that all children in King County receive needed preventive health care services, CHI provides support in obtaining health care coverage and coordination in finding the right health care home.
Children’s Health Initiative 2008 Annual Measurement & Evaluation Report (PDF)
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Looking for health insurance or help finding a doctor or dentist?
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 Do you have children under the age of 19 and need free or low cost health insurance or help finding a doctor or dentist?
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History
The Children’s Health Initiative (CHI) is designed to surmount the barriers children face in receiving consistent access to health care services.
Chronology
In April 2006, Executive Sims convened a Children’s Health Access Task Force (CHATF) of child health experts to advise King County on the creation of an innovative county-based children’s health program.
Children’s Health Access Task Force
In June 2006, the CHATF recommended the Children’s Health Initiative (CHI), a local approach to improving the health of low-income children. The first component proactively finds, enrolls, and links eligible low-income children to medical and dental homes, needed wrap around services and integrated preventive care. The second element has been updated to consist of innovative pilot programs to improve the effectiveness of health coverage for low-income King County children.
Washington State Children’s Health Care Act of 2007
In March 2007, the Governor signed into law the exemplary new State Children’s Health Care Act, which expands coverage to all children in families earning less than 250% FPL in July 2007 and to families earning less than 300% FPL in January 2009. It became clear that it was more important than ever for local efforts to sign families up for the new coverage and to make sure that expanding health coverage leads to improvements in children’s health.
In May 2007, the County Council passed Motion 12507 adopting the CHI and expressing its intention to dedicate $1 million for outreach and linkage annually in 2007, 2008, and 2009.
CHI Outreach and Linkage to a Medical Home
Children’s Health Initiative (CHI) Outreach and Linkage to a Medical Home is using the Kids Get Care Program model. CHI outreach teams are based in geographic areas with high numbers of uninsured and low income children. Four outreach teams launched in 2007 met and exceeded outreach and access goals including children successfully enrolled in health insurance, community staff trained, children scanned for developmental and oral health issues and parents trained about preventive care and health insurance. Outreach efforts have improved contact with hard-to-reach immigrant populations through coordination with community health workers with appropriate language.
Outcome measures
Number of applications submitted and approved (see graph):
CHI Pilot Projects
The innovative pilot approaches to improve children’s health in King County are supported with private funding that match local government outreach dollars. The pilot programs will dovetail with the State policy priorities and include best practices in outreach and linkage, oral health quality improvement and integration, mental health integration into primary care, on-line enrollment, and financial sponsorship.
Community Challenge Grants
In early 2007, Group Health Cooperative announced a $1 million contribution to the Children’s Health Initiative (CHI) and challenged the community to double its investment through private donations. In the spring of 2007, Washington Dental Service generously came forward with a $1 million contribution and this fall, over $1 million in private contributions for the matching requirement was raised, exceeding the matching fund goal. The following organizations contributed to the CHI:
- Children’s Hospital and Regional Medical Center
- Community Health Plan
- Evergreen Medical Center
- First Choice Health
- Group Health Cooperative
- Harborview Medical Center
- Molina Healthcare of Washington
- Northwest Hospital
- OneHealthPort
- Providence Health System
- Robert Wood Johnson Foundation
- Swedish Medical Center
- United Way of King County
- University of Washington Medical Center
- Valley Medical Center
- Virginia Mason Medical Center
- W. K. Kellogg Foundation
- Washington Dental Service
- Washington State Hospital Association
The CHI community challenge grants will fund the following pilot projects:
- Online enrollment. Within Reach (formerly Healthy Mothers, Healthy Babies) has developed a web-based application assistance site at www.parenthelp123.org for health and other social services programs, including food stamps. With expanded health coverage rules there is greater impetus to simplify enrollment mechanisms into Medicaid programs. The Children’s Health Initiative (CHI) online enrollment work would explore a King County pilot project to create the electronic connection between the new Parenthelp123.org website and DSHS and to create a version for use by application workers and others who assist with outreach. In addition to electronic enrollment, the CHI could pilot an addition to the ParentHelp123 website that would allow families to select their health plan, physician and dentist.
- Oral health. An oral health demonstration project funded by Washington Dental Service (WDS) would improve the delivery of oral health services to children between 250% FPL and 300% FPL prior to the 2009 date set for this by the State and begin preparatory efforts for a “buy in” option for families over 300% FPL. The project would include development of a subsidized product for the estimated 1,000 children eligible that could utilize the dental risk assessment strategies envisioned by the State, offer a network of participating dentists to be reimbursed at rates similar to current PPO network rates, and be administered by the WDS to provide greater simplicity and ease for providers, clients and the State. For more information about the WDS demonstration project, KC Kids Children's Oral Health Program: www.kckidsdental.org
- Mental health. Innovative efforts to achieve early identification and treatment of children’s behavioral issues are needed. A behavioral health pilot project exploring the effectiveness of behavioral health specialists in primary care settings using mental health screening tools for maternal depression and childhood behavioral and mental health issues for children ages zero to 12 could add immense value to our systems of care. A similar approach used by the Odessa Brown Children’s Clinic has shown substantial access improvements for low-income families needing mental health services. Another program at Highpoint Clinic in West Seattle , which made a behavioral health specialist available to primary care physicians, was identified as a best practice and is worth consideration for replication. Part of the pilot project would be to analyze how such a model could be sustainable financially for more medical practices.
- Health Education Tools. CHI works with community organizations like Head Start and Family Support Centers to promote preventive health care for children. Workshops on health issues such as “Developmental and Oral “Red Flags”, Well Child Check-Ups, Health Care Homes and Family Education, are available free of charge to community organizations, early childhood educators and groups working with children and their families. STARS hours are available for some classes.
For more information about this and other Executive initiatives for King County go to: www.metrokc.gov/exec/initiatives.aspx
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