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Document 816 of 1000.

May 31, 1999, Monday

SECTION: Local; Ed. FINAL; Pg. 4A

LENGTH: 1049 words

HEADLINE: RED TAPE SNARLS HEALTH CARE PLAN FOR POOR KIDS
STATE WILL ENROLL 33% FEWER THAN EXPECTED

BYLINE: Burt Hubbard, News Staff Writer

BODY:
Colorado's program to provide health insurance to tens of thousands of uninsured children stumbled in its first year.

The state will enroll about one-third fewer children than expected because parents were discouraged by intimidating forms, a cumbersome bureaucracy and monthly fees.

''What we have found in the last year is that the implementation of these programs by the states has been very, very slow for a variety of reasons,'' said Rep. Diana DeGette, D-Colo. ''People thought it would move much more quickly.''
Colorado health officials expect the pace of enrollments to pick up in the coming year as they drop fees, simplify forms and set up enrollment centers.

''It always takes time to get the wrinkles out,'' said Barbara O'Brien, executive director of the Children's Campaign. ''I'm completely confident that over the course of the next year or two, we'll get this straightened out. ''
In 1997, Congress freed billions of dollars so states could provide health insurance to an estimated 11 million uninsured children.
Many come from working families who don't qualify for Medicaid but can't afford health insurance. Others haven't signed up for Medicaid even though they are eligible.

Colorado began its program, Child Health Plan Plus, last year. Families earning up to 185 percent of the poverty level, which is $30,850 for a family of four, can get coverage through six health maintenance organizations. The federal government pays two-thirds of the cost, with the state paying the rest.

The state expected to enroll 22,000 to 25,000 children by June 30 this year, said Dean Woodward, deputy director of the state Department of Health Care Policy and Financing.

As of the end of May, only 16,000 were enrolled, Woodward said. ''It's beginning to pick up, but it was slow going for awhile,'' he said.

The 16,000 enrolled are only about one-fifth of the estimated 76,000 uninsured children in the state, said Bonnie Sherman, executive director of Child Health Advocates, which administers the program for Colorado.

Sherman said the problems started with the application forms. ''It ended up being this kind of ugly bureaucratic form,'' she said. ''It looked like an IRS form.''
Sherman said it contained warnings about penalties for lying and use by illegal aliens, which tended to scare off applicants.

Woodward said the state, with the help of consultants and other organizations, is revising the form to make it easier to fill out and less intimidating.

A federal inspector general's report in May, which looked at programs in Colorado and 18 other states, found widespread problems with forms that were too long and too complex.

''You have lengthy forms that practically take a graduate degree to fill out, '' said DeGette, who has introduced legislation to simplify the forms and streamline the process nationally.

Sherman said California spent $21 million advertising its program and then expected applicants to fill out a 28- page form. The results were dismal.

In Colorado, the monthly premiums also discouraged applicants, Woodward said. Premiums for families above the poverty level ranged from $9 to $30 per month depending on incomes, he said.

Sherman said Colorado's fees were among the highest in the nation, established using the theory that families who paid for insurance would use it more wisely.

''We took it a bit too far,'' she said. ''When you're talking about the difference between buying propane to heat your home in the winter and paying a health insurance premium, it's a no-brainer choice.''
Woodward said the state probably will lower or eliminate the premiums.

Another problem: The first marketing campaign didn't target the right audience, Sherman said.

The message, ''low-cost health care just for kids'' probably just appealed to families eligible for welfare and not to working families. ''We were really missing people that probably needed it the most,'' Sherman said.

This year the message will focus on affordable health insurance for working families, she said.

Child Health Advocates has set up about 40 satellite facilities throughout the state to look for families who need the insurance, she said. A pilot program in Grand Junction signed up 70 percent of eligible families compared with the 20-percent rate statewide, Sherman said.

Finally, working families ran into a social services bureaucracy that historically had orders to carefully scrutinize welfare applicants. Now, it was being asked to actively solicit applicants.

''We're asking them to make a whole cultural change,'' Sherman said. ''They used to be rewarded for not enrolling people, and now they're being rewarded for enrolling people.''
O'Brien said the scrutiny by some social services workers did not sit well with applicants. ''These are proud, hard-working families,'' she said.

The inspector general's report also found that illegal alien residents feared being deported if they applied for their U.S.- born children, and legal aliens thought they would have a tougher time getting U.S. citizenship if they took part in the insurance program.

Woodward doesn't think those are major problems in Colorado.

All of the problems prompted DeGette's legislation to cut waiting times and reward states for enrolling families.

''We are just trying to make it easier for families to get their kids health insurance,'' DeGette said.

INFOBOX
60, 000 kids still uninsured
As many as 60,000 uninsured children in Colorado haven't taken advantage of the state's Child Health Plan Plus low-cost insurance program.

The program is available for families who earn up to 185 percent of poverty levels. For a family of four, that is $30,895. The state does not include child support income in its calculations and allows deductions for day-care and medical expenses.
Child Health Advocates, which administers the program, has set up two hot lines for families to get applications and information. They are (800) 359-1991 and (303) 692-2960.

Families can also apply at the Child Health Plan plus office at 4300 Cherry creek Drove South, building B.

Child Health Advocates has set up 40 satellite centers throughout the state that will help with applications.

Burt Hubbard

NOTES:
Banner p.1A - KIDS' HEALTH PLAN LAGS / STATE INSURING 33% FEWER THAN EXPECTED AS RESULT OF FEES, COMPLEX FORMS
SEE END OF TEXT FOR INFOBOX

LOAD-DATE: June 3, 1999

Document 816 of 1000.


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