HEALTHY FAMILIES/MEDI-CAL: Increased Enrollment Through School Lunch Programs
The federally funded Free and Reduced Price Lunch Program is an effective way to target children potentially eligible for California's state-sponsored insurance programs, according to a new Consumers Union study. Of the 1.85 million California children lacking health insurance, 1.1 million are assumed to be eligible for Healthy Families and Medi-Cal, but are not enrolled. Calling schools "perhaps the most obvious mechanism for reaching large numbers of young people" who might be eligible for either state program, the Consumers Union tested the enrollment links between the Healthy Families/Medi-Cal programs and the National School Lunch Program under the Healthy Kids, Healthy Schools project. Based on the fact that both programs have similar eligibility requirements, the pilot program -- started in 1998 and funded by the Henry J. Kaiser Family Foundation and the David and Lucille Packard Foundation -- called for parents to receive a form to request information about Healthy Families/Medi-Cal along with information about the school lunch program. School food services directors collected the completed lunch forms and forwarded requests for Healthy Families/Medi-Cal applications to the state Department of Health Services. The form accounts for more than 27% of the total number of Healthy Families/Medi-Cal requests -- the top source of application requests as of Nov. 1999. Diana Bianco, a staff attorney and health policy analyst for Consumers Union, said, "Using schools to reach uninsured children makes tremendous sense. And schools have compelling reasons to get involved because healthy children are better learners." Currently, 130 districts in 46 counties participate in the optional program.
Although the program has met with success, Consumers Union acknowledged that several steps must be taken before the school lunch program and Healthy Families/Medi-Cal can be fully integrated. For example, there is no citizenship or immigration status requirement for the school lunch program, but to receive Healthy Families/Medi-Cal benefits, a child must be a U.S. citizen or permanent resident. Additionally, the two programs differ in how they determine family income. The lunch program counts the average monthly income of all household members, while Healthy Families/Medi-Cal considers the gross annual income for the child and the adult legally responsible for the child. Income verification also varies between the programs. Whereas applicants for the school lunch program only represent and sign under penalty of prosecution that the information supplied is correct, Healthy Families/Medi-Cal applicants must supply extensive documentation of their income. To overcome obstacles such as these, federal or state legislative changes would be necessary (Consumers Union report, 12/21).