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King County
Executive Office
Ron Sims, King County
Executive 701 Fifth Ave.
Suite 3210
Seattle, WA 98104
Phone: 206-296-4040
Fax: 206-296-0194
TTY Relay: 711

Children’s Health Access Task Force Final Report

Executive Summary

heathcoverAn estimated 16,000 children living in King County (4%) have no health insurance, according to 2004 survey data. About half of these 16,000 uninsured children are eligible for existing publicly-funded insurance programs. After Public Health-Seattle & King County (PHSKC) conducted an internal study on uninsured low-income children in King County, County Executive Ron Sims concluded that the County has a unique opportunity. In partnership with the State of Washington, which has declared its intention to cover all children in the state by 2010, the County has begun work to design an innovative program to provide health and dental insurance coverage and access to a medical home – a regular source of healthcare that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective – for most of the 16,000 children uninsured in King County.

To make a difference in children’s health, it is essential to have both health care coverage and a health care delivery system that is ready to provide early preventive services and link children to needed care. Recognizing this dynamic, in April 2006, King County 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. Dr. Maxine Hayes, the Washington State Health Officer, and Dr. Ben Danielson, the Medical Director at Odessa Brown Children’s Clinic, co-chaired the Task Force, with support from Milliman consultants and actuaries who carried out actuarial and programmatic analyses of various program designs. The Task Force met three times between April and June 2006 and recommended the creation of a program that will dovetail with the State’s 2010 goal and build on the innovative work of the King County Health Action Plan, such as the Kids Get Care program.

Task Force Recommendations

The Task Force recommends a phased approach to improving the health of low-income children, starting with an outreach and access phase in 2006, followed in 2007 by a health insurance program to fill in the “gap” left by current public coverage programs and culminating in 2010 with full statewide coverage.

  • Phase 1: Outreach and Access Improvement: The Task Force recommends investing funds to identify and sign up the estimated 8,000 low-income children eligible for existing publicly funded insurance programs by implementing a targeted access and outreach program, and connecting families to comprehensive preventive services including oral and mental health and a medical home.

  • Phase 2: “Gap” Insurance Program for Children: The Task Force recommends creating a basic gap medical and dental insurance program that would be offered to an estimated 5,000 children in families under 300 percent of the federal poverty level or children who are not eligible for existing public or private programs. These programs will be similar to existing publicly-funded health programs in terms of benefits, eligibility and cost, and have minimal cost sharing.

  • Phase 3: Consolidation with State Programs in 2010: Governor Gregoire has set a goal for the State of Washington that all children in the state will be covered by health insurance by 2010. By 2010, the King County program should either be consolidated into the state’s coverage programs or the state should provide the financial resources to King County to continue this program as a component of the state’s overall strategy.

  • In addition, the Task Force recommends King County aggressively seek partners and funding opportunities, conduct a comprehensive evaluation of the initiative, coordinate efforts with the State of Washington’s child health expansion efforts, and employ strategies that reward quality and efficiency that align with the goals of prevention and overall improved health status.

As next steps, the Task Force proposes that Task Force staff continue to finalize the programmatic and financial information necessary to move the proposed program through King County’s decision process with the King County Council and to explore funding partnerships with foundations and private organizations. Concurrently, the Task Force recommends that two committees be established to steer the implementation process—an Outreach Committee, and an Operations and Policy Committee – to guide outreach strategies and provide general oversight and guidance, respectively, As the committees develop an implementation strategy, the Task Force strongly recommends they adopt innovative program design features and reimbursement strategies that promote the use of incentives to improve health status and align with the work of the Puget Sound Health Alliance.