By Katie Kerwin McCrimmon
Brenda LaCombe used to think that it would be easy to find uninsured children.
“I thought they would glow in the dark and they don’t,” said LaCombe, program manager for Pueblo StepUp, a project that finds uninsured children and connects them with public insurance programs and health care providers.
LaCombe learned over the years how to ferret out needy children in schools, child care centers, hospital emergency rooms and Head Start programs. The outreach is working so well that Pueblo is now a model for the state with 91 percent of eligible children enrolled in public health programs, according to the latest statewide figures.
“I’m worse than the people who watch the stock market. I watch that number,” LaCombe said.
In 2009, the Medicaid and Child Health Plan Plus (CHP+) programs were serving 322,000 Colorado children, an increase from 276,000 a year earlier. At the same time, the number of uninsured Colorado children who were eligible for public health coverage benefits but not receiving them dropped significantly.
In 2009, about 87,000 children were eligible for but not enrolled in Medicaid or CHP+. This estimate is down from 109,000 children in 2008 and parallels a national trend.
While Colorado improved its outreach to children, the state’s record for enrolling the poor in Medicaid and CHP+ remained dismal. According to the report, Colorado was lower than all but two states in 2008. Colorado’s computer system for enrolling people in public health programs has been notoriously problematic. The Colorado Benefits Management System, or CBMS, will need to be revamped as Colorado implements health care reform. Read more.
Health experts hope that enrollment for children will increase as programs under the Affordable Care Act expand. Even so, outreach will be key.
Overall, most Colorado children are insured (1.2 million), with 135,000 lacking health coverage. Approximately 85 percent of children eligible for Medicaid were enrolled in 2009, compared to 62 percent of those eligible for CHP+.
Among Colorado’s counties, estimated enrollment rates in both programs ranged from 52 percent in Pitkin County to 91 percent in Broomfield and Pueblo counties.
LaCombe said Pueblo’s programs improved dramatically when her project started partnering with school districts. They have since received grants to help other communities from Greeley to Montrose, Durango and Colorado Springs create similar partnerships.
“We participated in a pilot program to streamline eligibility (applications) with free and reduced lunch programs,” LaCombe said. “Uninsured kids are in schools. They’re in child care programs and in Head Start and ERs.”
LaCombe has found that partnerships are key to successful outreach. She builds bridges with everyone from educators to health providers.
She recalls one case where a distraught mother dissolved into tears when she waited days to bring her 14-year-old son to a specialist for a rash, then found he was not properly enrolled in Medicaid. The mother was told she would either have to pay out of pocket or wait for the boy to be qualified for Medicaid. Hospital officials, who knew the Pueblo StepUp program well, walked the woman to LaCombe’s office where LaCombe was able to tap school records, instantly qualify the boy and get him back to the doctor’s office that same day to receive care.
With economic troubles worsening in Pueblo over the past 18 months, LaCombe has found some parents are reluctant to sign their children up for public health benefits. It helps that their program is not located in a government welfare office.
“We offer a neutral setting,” LaCombe said. “We’re seeing more families who are brand new to the system, who don’t have any idea how to navigate the system, let alone apply for public benefits.
“We’ve had a few families who’ve been in tears. We end up being their counselors. We tell them their tax dollars went toward these programs. Now that they need them, the programs are here for them.”