CitySquare has been involved from the start: Health and Wellness Alliance for Children

The Health & Wellness Alliance for Children (the Alliance) is a coalition with the goal that “Every child achieves their fullest health, well-being, and potential.”

·        The Alliance plans to use a “collective impact” approach to work across sectors, including health, education, government, the faith community, nonprofit service providers, and others, to form and implement a common agenda for change in children’s health.

·         The initial clinical focus will be children’s asthma, though over time the Alliance plans to tackle children’s health across issues.

·         The initial geographic focus will be on Dallas County, though the Alliance is working with partners throughout North Texas.

Why asthma?

·         While there are many health issues that demand our community’s attention, it is important to focus on one area in order to have a measurable impact.

·         Addressing asthma allows us to focus on several areas that are crucial to children’s health overall: improving financial and physical access to care, improving quality of health care delivery, equipping children and families with tools for wellness, creating asthma-healthy physical environments.

·         The Alliance can use its experience with asthma to expand focus to other areas in the near future.

·         Asthma and other pulmonary illnesses are the top causes for admission to the emergency department at Children’s Medical Center, indicating a real community need.

·         Other communities around the country have had great success in using a coalition approach to improve child asthma.

Who is involved in this effort?

·      The Steering Committee and Working Groups include representatives from many organizations across North Texas, including hospitals, physicians, school administrators, school nurses, the faith community, family health and wellness service providers, urban planners, city and state government, and others.

·         Children’s Medical Center (Children’s) has committed to catalyzing this effort. However, the Alliance is comprised of and led by a cross-section of Dallas community stakeholders committed to children’s health. The effort is and will be driven by the community, not just one organization or sector. 

·     Children and their families have been involved since the start in interviews and workshops to better understand the challenges they face and potential solutions.

 Dallas County Asthma Data

Asthma outcomes

·         Approximately 60,000 children in Dallas have asthma, 9% of all Dallas children[i]

·         In Texas, 54% of children with asthma missed at least one school day per year due to their condition[ii]

·         In 2012, nearly 1500 children in Dallas County visited an emergency room or were admitted to a hospital due to asthma[iii]

·         The hospitalization rate for African-American children is 3.8 times the rate of white children in Dallas (2010)[iv]

·       Annual economic costs to Dallas including cost to families and to medical care facilities across the community is estimated to be a staggering $60M[v]

Potential contributing conditions

·        18% of Dallas children don’t have health insurance; this exceeds the 15% fraction across TX, which is the highest percentage of uninsured children of any US state (2010)[vi]

·         While 46% of Dallas children are covered by Medicaid and CHIP, it is estimated that 76% percent of Dallas physicians would not accept new Medicaid or CHIP patients[vii]

·         Children with asthma are especially susceptible to the effects of ozone pollution, and Dallas’s ozone levels exceed the EPA’s legal standard[viii]

·         Child poverty in Dallas: 29% of Dallas kids live in poverty; 28% have inadequate food and nutrition; 35% live in a single-parent home[ix]

[i] Harrison, Whitney (MPH, Epidemiologist), Texas Asthma Control Program, Dept. of State Health Services. “Asthma Morbidity and Mortality in Texas and Health Region 3.” October 17, 2011.

[ii] Harrison, 2011.

[iii] Dallas Fort Worth Hospital Council Foundation, 2013.

[iv] Texas Health Care Information Collection (THCIC), Inpatient Hospital Discharge Public Use Data File, 2010.

[v] The cost estimate per child based on: Li Yan Wang et. al; “Direct and Indirect Cost of Asthma in School age Children”.  Preventing Chronic Disease (January 2005).  This number is multiplied by the number of children with asthma in Dallas.

[vi] Harris, J., Hogan, J., and the Beyond ABC Advisory Board, ed. Beyond ABC:  Assessing Children’s Health in Dallas County, 2011.

[vii] “Texas State Health Facts”. Henry J. Kaiser Family Foundation. ; Harris, J., Hogan, J., and the Beyond ABC Advisory Board, ed. Beyond ABC:  Assessing Children’s Health in Dallas County, 2011.

[viii] “Dallas-Fort Worth: Current Attainment Status”. Texas Commission on Environmental Quality. <http://www.tceq.texas.gov/airquality/sip/dfw/dfw-status>.

[ix] Harrison, 2011.

Children's health in Texas

Eight per cent of children in the U. S. have no health insurance coverage.  That compares to Texas with 14% of its children uninsured.

Here's some even more shocking news:  According to the good folks at Children's Medical Center, 5 North Texas counties have twice the national average with it comes to uninsured children.

Here's the harsh reality:

Fannin County (Bonham) 16.3% uninsured children

Collin County (McKinney, one of the wealthiest counties in the nation) 16.7% uninsured

Denton County (Denton)  17.4% uninsured

Grayson County (Sherman) 19.1% of children have no health coverage

Cooke County (Gainesville) almost 1/4 of children with no coverage at 23.9%

The character of a people must include some measure of just how much they value their children, all of their children. 

We can do better. 

Where's the leadership? 

“COVER TEXAS NOW”

ADVOCACY DAY AT THE CAPITOL

MARCH 30, 2011

Join advocates from around the state as we focus lawmakers’ attention on health insurance.

OVERVIEW:

• Meet at the Capitol at 10am (buses will be available from Dallas)

• Hear up-to-the-minute information from legislators and issue experts and share breakfast with health advocates from across the state

• Gather on the Capitol Steps for a press conference on the importance of health care in this legislative session

• Participate in scheduled meetings with legislators and their staffs

• Lobby Day events will end at 5pm

Texas has had the highest uninsured rate in the nation for two decades, and it’s time to get covered!

• Texans have new opportunities to get quality, affordable insurance and our state can benefit from new federal resources—legislators need to make health care reform work in Texas.

• We can’t balance the budget on the backs of sick people. Lawmakers are proposing cuts up to 30% for health insurance and health care services—this will take our state farther backward instead of helping get Texans covered!

Join us if any of the following issues are important to you:

• Protecting CHIP and Medicaid health coverage for 3 million Texas children and nearly 1 million adults including expectant moms, seniors and those with disabilities.

• Ensuring that hospitals stay open for everyone. Cutting resources to hospitals reduces availability and puts everyone at-risk during a medical emergency.

• Ensuring seniors and the disabled are able to continue receiving care in nursing homes and in their communities

• Ensuring access to all the benefits Texans should get from national health reform and preparing for full reform implementation in 2014.

HOW CAN YOU SIGN UP TO ATTEND LOBBY DAY?

Register NOW! Cover Texas Now Lobby Day is free, and registering early helps us make your day as worthwhile as possible.

Visit www.covertexasnow.org to register for Lobby Day and check bus pick-up location and times.

Participants should wear a bright green t-shirt to the event!

Dallas Bus and Travel Info

Team Lead: Jessica Davila (jdavila@citysquare.org)

Bus Meeting Information:

East Dallas Christian Church
629 North Peak St., Dallas, TX 75246
Parking lot on the southwest corner of Worth St. and N. Peak St

Time: Meet at 5:30 am to leave at 5:45 am sharp

Need more details? Call 214-303-2146 or email JDavila@citysquare.org

Can’t make it to Austin on March 30?

Contact us for more information on how you can get involved – in your own backyard! Sign up for email alerts, contact your legislator, or even plan an event in your area for the same day. Let your lawmakers know that people in your community are talking about health!

Pro Life?

Clearly the Texas legislature functions as a strongly "pro-life" elective body. . .up to a point. 

The legislators' decisions during this session indicate that they are determined to take rather drastic measures to protect the unborn.  However, once a child arrives in a low-income family, all bets are off! 

The following story was reported by Christy Hoppe on the actions of our elected representatives appeared in The Dallas Morning News last Thursday, March 10. 

The notion that non-profit organizations and churches can pick up the slack in the budget is simply ill-informed.  Further, the costs associated with cuts in funding for the needed care typically are passed along by medical professionals to those with private insurance.  The fact is, helping poor children helps us all. 

But, you read the report and let me know your reactions.

Bill on pre-abortion sonograms comes as Texas legislators plan to slash contraceptive, OB-GYN care for poor


AUSTIN — The Legislature’s push to limit abortions by compelling women to see a sonogram of fetal development comes as the state is cutting back on medical services to low-income pregnant women.

Republican lawmakers are poised to slash $850 million from pregnancy care and family planning in the next two-year budget — a 29 percent cut from current spending.

That would shut down avenues for poor women to find contraception and choke off payments to OB-GYN doctors who might care for those who become pregnant, advocates say.

“There is a responsibility that comes with this desire to tell women what to do with their pregnancy. Clearly, we’re not meeting it,” said Rep. Mark Strama, D-Austin, who has sponsored a bill to extend women’s health services.

Abortion opponents say that although the budget crunch is real, the sonogram requirement isn’t connected to it.

“We can’t solve our problems by eliminating people,” said Kyleen Wright, president of Texans for Life and a strong supporter of the sonogram requirement that both the House and Senate have approved.

The solution, she said, is for private pregnancy crisis centers, adoption services, religious groups and communities to step up their help for poor women.

“We will pick up the pace. We will meet the need,” Wright said.

Fifty-five percent of Texas births are to women on Medicaid.

Payments to doctors

Most of the proposed budget cuts would come through reducing payments to doctors, who are reimbursed for the care they provide pregnant women on Medicaid. It means physicians will either turn away poor patients or lose money treating them.

Tom Banning, chief executive of the Texas Academy of Family Physicians, outlined a grim reality: Medicaid reimburses doctors 70 percent for the cost of services. Most physicians make up the losses in their charges to privately insured patients, but the proposed cuts make that equation harder.

The state has cut reimbursements 2 percent this year and is proposing 10 percent cuts for next year. In addition, Congress is considering a Medicare reimbursement cut of 31 percent.

“It’s got the doctors completely spooked,” Banning said, and many plan to stop seeing patients who require federal help. That will drive more patients to emergency rooms, where their conditions are often worse and
more expensive to treat.

In Athens in East Texas, a group of family doctors began offering prenatal screening for Medicaid patients three years ago. When they started, 120 newborns a year from the area were ending up in the neonatal intensive care unit of Dallas County’s Parkland Memorial Hospital, Banning said.

Last year, it was down to two infants. But if doctors’ payments are cut, “you’ll see a tidal wave hit the emergency room of women who haven’t gotten any prenatal care,” Banning said.

To read entire report click here.

Health care reform: a study of one

The current national debate on health care reform stirs up emotions while provoking heated argument even among friends.  Just listen at about any water cooler in offices around town.  Or, bring up the topic during coffee time before Sunday School next week and see what breaks out! 

Most of us enjoy the luxury of debate, hopefully friendly. 

For some individuals and their families the debate is anything but theoretical or abstract.  Think for a moment.  I expect you have a story or know someone with a story that moves quickly toward the harsh realities associated with no easy access to health care when most needed.  Often we hear horror stories about how we'll all be forced to wait for treatement if health care reform passes the Congress.  The fact is, millions wait today thanks to our current system that leaves almost 50 million Americans without access to comprehensive care. 

A few days ago, Dallas Morning News' columnist, Steve Blow reported the tragic story of  Xavier Ramirez.  I'm grateful to Blow for bringing reality into our theoretical arguments.  For me, Xavier's story settles the issue and ends the debate.  We need reform and we need reform now. 

I've published the entire story below.  Take a moment to read it and let me know what you think.

Fort Worth tragedy underscores dire health care situation
January 3, 2010
STEVE BLOW

In all the talk of politics and policy, we sometimes forget why a health-care overhaul is needed in the first place.

But Xavier Ramirez should remind us.

The morning after Christmas, the 17-year-old student's body was found on the running track at his Fort Worth high school.

He had been doing his family's wash at a nearby coin laundry. While the clothing washed, he apparently went for a jog on the track, collapsed and died.

News stories mostly focused on the outpouring of young grief for the well-liked, much-admired young man.

But there's another angle that deserved more attention.

It may be too strong to say that Xavier died from lack of health insurance. But it's certainly why he never got the heart exams he needed.

In the fifth game of his high school football season, near the end of the third quarter, Xavier asked to come out of the game.

Paschal High School coach Matt Cook said that was highly unusual. Xavier was one of the most dedicated, hardworking players on the team.

"He said he had taken a hit in the chest and was having a hard time catching his breath," Cook recalled.

Xavier's heart was racing even when the game ended. A trainer insisted they go to the hospital emergency room to check it out.

Doctors at John Peter Smith Hospital performed a few tests on Xavier. They discharged him that night with instructions to get follow-up cardiac testing.

And that's when Maria Martinez discovered that she had no health insurance on her son.

He had been covered under the state's Children's Health Insurance Program. But Martinez learned that she no longer qualified. Her income was just dollars over the limit.

Martinez works at a company that manufactures plastic bags. When she tried to get Xavier on the insurance there, she was told he couldn't join outside the enrollment period.

It's possible the pre-existing heart condition wouldn't have qualified for coverage anyway.

Martinez worried endlessly about her son's heart. She was desperate to get the tests done.

Xavier, on the other hand, was sure he was healthy. He wanted the medical tests just to clear him for a return to sports.

Trying to satisfy both mother and son, Coach Cook began looking for a solution.

The local children's hospital said it would begin the tests if the family could pay $3,000 in cash up front.

It might as well have been $1 million. Martinez is a single mother. Both Xavier and his older brother worked after-school jobs to support the family.

On the advice of a doctor friend, Cook was helping the family write a letter of appeal for free care at the county hospital.

They were still working on that when Xavier's heart apparently failed as he circled the track.

For those of us blessed with good health and good insurance, it's easy to be cynical about health-care legislation.

The need is more apparent to others. Like the mother who can barely speak through her weeping. And the coach who lost a model student and athlete.

"I'm really upset that he didn't get the care he needed," Cook said.

Xavier's family couldn't come up with $3,000 for the needed tests. But in the wake of his death, friends quickly raised $8,500 for his funeral.

And somehow, for Cook, that makes it even worse.

"It's mind-boggling that we can raise $8,500 to put somebody in the ground, but coming up with $3,000 to save somebody's life ..."

He paused, searching for words.

"I'm sick to my stomach," Cook said.

[For a direct link to Steve Blow's story click here.]

CHIP needs your help today!!!

IMPORTANT PUBLIC HEALTH UPDATE FROM AUSTIN: Last night, the Texas House blocked consideration of a bill that would allow families with no health care options for their children to buy into the Children's Health Insurance Program (CHIP). Meanwhile, Gov. Perry said he does not support the bill, in his words because, "That is not what I consider to be a piece of legislation that has the vast support of the people of the state of Texas."

State leaders need to hear from you and as many Texans as possible immediately!

Call the Governor's office at (888) 746-9714 and tell him, "I and the majority of Texans DO support the CHIP bill to cover 80,000 additional Texas kids."

Contact your elected legislators, House Speaker Straus, and Lt. Gov. Dewhurst, and say, "Pass the CHIP buy-in bill in SB 841 or HB 2962."

Here are the toll-free phone numbers you'll need:

Speaker Straus: (888) 327-2086
Lt. Gov. Dewhurst: (866) 934-2619
To contact your Senator and your representative click here.

Ask your friends and family to call their elected officials--before time runs out to get 80,000 additional uninsured children the health insurance they need to stay healthy.

Please call immediately. Time is running out!!!

SCHIP on Dallas Morning News website

So, here's one man's opinion.

Reactions more than welcome!

Happy Valentine's Day!

.

The facts about children's health in the U. S.

My friend, Janie Metzinger of the Mental Health Association of Dallas sent this message around earlier this week. I believe it provides the factual reality facing us as we consider the cost of blocking health coverage benefits to all of our children. We need to improve the overall system of health care delivery to all of our children.

Somehow it seemed appropriate to add this post to what is below regarding the hymn heard in church on Sunday.

Please consider the facts.

_________________________________

BACKGROUND: A recent study published in the New England Journal of Medicine underscores concerns for children’s health raised by the President’s veto of the SCHIP legislation. (Please see The Dallas Morning News article below.)

Contrary to the rhetoric of some SCHIP opponents, the Children’s Health Insurance Program was specifically designed for children in families of middle class and moderate incomes. These families are not eligible for Medicaid, which was designed for children in very low-income families.

CHIP parents are hard-working. They often work in the construction, health care, hotel, restaurant and manufacturing industries. Many work for small businesses who simply cannot find affordable insurance to offer to their employees.

CHIP is a public-private partnership. A portion of the money for the program is put in by state governments. (Texas uses a portion of the Tobacco Settlement money for this purpose.) The state’s portion is matched by the federal appropriation, and parents pay a sliding scale premium for CHIP insurance for their children.

The state contracts the program out to private insurance carriers who vie for the business. Parents then choose which plan they want for their children. CHIP covers preventive care, lab tests, X-rays, hospital care, prescription drugs, physical therapy, rehabilitation, mental health and dental care.

Texas consistently leads the nation in the number and rate of uninsured children within our borders.

ACTION: Please contact you Senators and Members of the House of Representatives to tell them that you support CHIP. A vote may come as early as today on the veto override.

Here's the article from The Dallas Morning News from last week:

Study: Medical care for children often falls short
Doctors score low on preventive steps, tests for seriously ill infantsThursday, October 11, 2007

MELVILLE, N.Y. – Children are not faring well in the health care system, a team of researchers reports today in the largest analysis of its kind. The study, published in the New England Journal of Medicine, concludes that overall, doctors gave children the appropriate outpatient medical care only 47 percent of the time.

"They got an F," said Dr. Joseph Hagan, a Burlington, VT pediatrician. Dr. Hagan co-edited the American Academy of Pediatrics' latest update to its children's health guidelines, due out later this month.

"It's sad, but I think it reflects some unpleasant realities about our current health care system or, I might say, non-system," Dr. Hagan said.

The report, by the Seattle Children's Hospital Research Institute and the nonprofit Rand Corp. research group, is the first comprehensive look at children's health care quality. The findings are particularly troubling because nearly all the 1,536 children in the nationwide study had insurance.

Eighty-two percent were covered by private insurance. Three-quarters were white, and all lived in or near large or midsize cities.

Experts said minority children, those with more restrictive government insurance, and the millions with no insurance at all certainly fare even worse.

The compliance rate was even worse than that found in a study of adults: They got only 55 percent of recommended care.

The study was based on a review of two years of medical records of children in 12 metropolitan areas.

The new research found children's doctors did best in providing the recommended care for acute medical problems – 68 percent. They scored just 53 percent for treating chronic conditions and 41 percent for preventive care.

"I was really taken aback by the results for preventive care," said Dr. Rita Mangione-Smith, lead investigator at the Seattle institute and an associate professor at the University of Washington. "It was really kind of distressing to me that there was some really basic stuff that we should be doing that's just not happening."

The researchers found, for example, that only 19 percent of seriously ill infants with fevers taken to doctors had the correct laboratory tests to determine the underlying ailment. Only 44 percent of children with asthma, the study found, were on the right medication.

"How can we appropriately treat an infant if we don't test?" Dr. Mangione-Smith asked Wednesday.

The research also discovered babies aren't receiving routine checks of their height and weight to ensure proper growth. Some youngsters aren't receiving all of their recommended vaccinations. And children are not being appropriately screened for anemia, a marker for learning disorders.

"There can be dire consequences for the children, for their families and for society as a whole," including death, when these easily managed conditions are not controlled, said Julia Paradise of the Kaiser Family Foundation.

Some experts said the results highlight the importance of the debate over the proposed expansion of the Children's Health Insurance Program, which Congress approved and President Bush vetoed.

A vote to override the veto is set for next week. [Which, in fact, is likely today! LJ]

Ms. Paradise noted that the proposed expansion of the CHIP program was to include the first major initiative to measure and find ways to improve quality of care for children covered by that program and by Medicaid – low-income groups that generally have more health needs than others.

The study was funded by the Centers for Medicare & Medicaid Services, the Robert Wood Johnson Foundation of Plainsboro, N.J., and the California HealthCare Foundation.

The researchers noted they had incomplete medical records for some children, no children from rural areas were included, and more than half the families asked to participate didn't respond.

Dr. Mangione-Smith and the other experts said they hope the new findings will lead to action to address the shortcomings. Dr. Hagan said doctors can do more to keep up with the latest care guidelines. But he said they can't solve all the problems, such as insurance plans that don't cover crucial screenings and the inadequate time pediatricians have to spend with each child.

Basing payments to doctors on measurements of performance, as Medicare has done in some cases, should be considered, said Dr. James Perrin, a pediatrician at MassGeneral Hospital for Children.

"It's not so much training doctors as rearranging incentives to encourage people to provide high-quality care," said Dr. Perrin, co-author of an editorial in the journal on the need to improve the quality of care for children.

Another big challenge, Dr. Mangione-Smith said, is to change pediatrician training, which now focuses on treating acute illnesses in a hospital.Dr. Mangione-Smith advises parents to go to the pediatrician armed with as much information as possible.

"Come in with your own checklist," she said. "Ask your doctor, 'Is their weight OK today? Should she be checked for anemia?' "

(McClatchy Newspapers, The Seattle Times and The Associated Press contributed to this report.)

SCHIP support needed

Julia Easley, our good friend and partner at Children's Medical Center Dallas, sent the following our way last week after President Bush vetoed the SCHIP legilation. This message comes to us from one of our best hospitals in Dallas. Read on!
______________________________

Last week, President Bush vetoed the SCHIP Reauthorization Act.

Your help is needed again to ask the House of Representatives to override the President's veto.

Background
Congress must reauthorize the State Children's Health Insurance Program (SCHIP) this fall. Called CHIP in Texas, the program insures more than 300,000 low-income children including 43,000 Dallas area children.

The SCHIP Reauthorization Act will provide $35 billion over five years to fund an expansion of SCHIP. An additional four million children are expected to be covered under this bill.

Both the U.S. House of Representatives and the U.S. Senate passed the bill by wide, bipartisan majorities last week and sent it to the President. He vetoed the bill.

The next step is for the U.S. House of Representatives to attempt to override the president’s veto, which will require a two-thirds majority vote. Our representatives need to hear loud and clear that we want them to pass the bill and override the veto.

You can help!
Please take just three minutes to write your member of the U.S. House of Representatives and urge them to override the president’s veto and support this vital program for children’s health.

Here's a simple way to write your members of Congress: Go to http://capwiz.com/nach/issues/alert/?alertid=10377536&type=CO.

This link is provided by the National Association of Children's Hospitals.

Follow these steps:
1. Click on the link
2. Enter your zipcode and click Go
3. You will see a prepared message that you can edit if you'd like.
4. Add your name at the bottom and enter your contact information
5. Under hospital affiliation, choose TX-Children's Medical Center Dallas
6. Send your message
7. Share this with others if you'd like

The choice to participate is yours alone.

If you do participate, thank you for volunteering to speak up for the hospital and the children we serve.

For additional information about SCHIP go to: http://www.childrenshospitals.net/nach/schip .

If you would like more information about this campaign, please contact Julia Easley, director of Advocacy at Julia.Easley@Childrens.com.

Veto

Last week Congress sent a bill to President Bush that would have provided an opportunity to secure comprehensive health insurance coverage for an additional 4 million uninsured American children. Currently in the United States, 9 million of our children have no health coverage. This legislation would have cut that number almost in half.

The President's plan for funding the State Children's Health Insurance Program (SCHIP) calls for an increase in funding of $5 billion over the next five years, an amount that will not cover the costs for those currently enrolled in the program. The administration's plan is a step backwards.

Congress envisioned an increase of $35 billion that would have been funded by a 61 cent increase in tobacco taxes. Sort of a "Win-Win" for those concerned for real gains and long term savings in public health costs and outcomes.

On the Senate side enough votes are in place to override the Presidential veto, but such is not true in the House of Representatives.

I'll leave others to debate the details relative to cost, those who would be eligible for coverage, speculation about intentions and competing philosophies.

But this I know. Every child in America needs health care that is high-quality, accessible and affordable to their families. Further, if improved public health is our real goal, health care should not be bought and sold like a market commodity.

The way we've been delivering health care options to low-income and middle-income families just doesn't work. The time has come for bold change. In the long run reform that leads to universal coverage will be the very best investment for the nation. Every cost benefit analysis I've seen makes this case very clear.

Here in Texas for every $1 the state invests in CHIP, we receive $2.64 in matching funds from the federal government. Bringing tax dollars back home helps everyone in Texas.


No doubt, the legislation will return to Congress for a vote to override the President's veto. One of our Senators, Kay Bailey Hutchison voted for the bill. Unfortunately, Senator John Cornyn voted against the legislation. I hope everyone reading here will contact their Representatives in the House and urge a vote for SCHIP.

I pray the President will reconsider his veto for the sake of our children and for all of our communities.

Everyone needs health care, and emergency rooms don't count.





.

ABC News: Children, Families and Health Care--Part 3 and last night's debate

Facing the reality of 9,000,000 uninsured children in the United States turns out to be sobering work.

Take a look at this report by ABC News:

"Red Tape and Bureaucracy in Health Care" (June 10) http://abcnews.go.com/Video/playerIndex?id=3264531.

We must do better.

[As in previous segments of this series, please tolerate the commercial message at the beginning of the report.]

_________________________________

Don't know about you, but I found last night's Presidential debate on CNN among the Democratic candidates using the YouTube question format to be interesting and refreshing compared to previous debates. Ordinary folks asking the questions that concerned them.

Opinion: there would have been many more questions on the Iraq War if the U. S. "recruited" its soldiers from a national draft. Funny how current, pressing self-interest shapes our primary concerns, huh? I find it to be the same with the issues associated with poverty, like the video above.

What do you think?


.

ABC News: Children, Families and Health Care--Part 2

Understanding what our nation's 9 million children and their families face because they lack health insurance coverage is essential to any meaningful progress on the issue.

At Central Dallas Ministries, we see children who fall into this category every day.

Here is another report from ABC News on the challenging subject (please don't let the 15 second commercial message at the beginning confuse or discourage you!):

"Children's Defense Fund's Take" http://abcnews.go.com/Video/playerIndex?id=3240814.

Did I say already that we must do better?


.

ABC News: Children and Health Care--Part 1

Interested in learning more about the reality of American health care for children and families?

Over the next few days we'll take a look at four reports that will be more than instructive.

ABC News has just completed the series of stories on the crisis related to the nine million children in America who remain uninsured, highlighting the various barriers that keep families from being able to get and keep health insurance for their children.

We provide medical services for some of these children every day here at Central Dallas Ministries. As a matter of fact, our patient waiting areas overflow daily with families like those seen in the ABC report.

Here's the link for our first report (please forgive the short commerical at the beginning of the video report!):

"Some Kids Die in Insurance Gap" (June 3) http://abcnews.go.com/Video/playerIndex?id=3240621

Let me know your reactions.

We can do better! We must do better!

.

Real World

At times our conversations and debates concerning public policy leave us "stuck" in abstractions and theoretical concerns. After all, most of us here have the luxury of conversation about what are, for millions of other people, matters of life and death, literally.

Just this week I received a comprehensive report from the Children's Defense Fund of Texas (CDF) on how Medicaid and the Children's Health Insurance Program (CHIP) work or, in far too many cases, don't work in Texas ("In Harm's Way: True Stories of Uninsured Texas Children").

The format of CDF's report is brilliant.

Woven among the typical statistical analysis provided by such reports are the stories of real life people--men, women, children and families. These stories make the report "live."

Issues addressed include matters of recertification, income limits, delays in the process, impact of the value of owned vehicles, etc. Basically, the report educates us about what consumers of these insurance products already know all too well: they are not set up to serve the most in the best manner. Attepmts to contain costs by erecting barriers to useage can prove to be deadly.

The report is dedicated to the memory of Devante Johnson.

Here's his story as told by the CDF report:

Thirteen-year-old Devante Johnson had advanced kidney cancer and could not afford to be without health care coverage. But last year, that is exactly what happened, when Devante spent four desperate months uninsured while his mother tried to renew his Medicaid coverage.

For years, Devante and his two younger brothers were covered by Medicaid. Texas families who qualify for Medicaid or CHIP are required to renew their coverage every six months, and Devante's mother, Tamika, had tired to get a head start by sending in her paperwork two months before Medicaid was set to expire.

The application sat for six weeks until it was processed and transferred to CHIP, because an employee believed their family no longer qualified for Medicaid. At that point the paperwork got lost in the system. Tamika grew more and more desperate as she watched her son get worse. "I did everything I possibly could," Tamika said. "I would literally get off the phone in tears, crying because they [CHIP employees] frustrated me so much."

For four months, Devante went without health insurance as employees unsuccessfully attempted to reinstate his coverage. As a result, he could no longer receive regular treatment and had to rely on clinical trials for care. Meanwhile, his tumors grew. Time was running out.

It wasn't until a state representative intervened that Devante's coverage was immediately reinstated. Two days later, Devante was able to start a promising new treatment. But, it was too late.

Devante Johnson died on March 1, 2007.
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The "bottom line" of the CDF report on Texas is very simple and straightforward. Every child in the state who is uninsured should be enrolled in either Medicaid or CHIP today. Making this policy decision is smart for children and for every Texas taxpayer.

Beyond being smart, such a strategy is the right, just and compassionate thing to do.

[Read and/or download the full report at: http://www.childrensdefense.org/site/
DocServer/InHarmsWay.pdf?docID=3961.]

Action item: CHIP and the Texas Legislature

Last week the the House Health and Human Services Committee of the Texas House of Representatives approved CSHB109 and passed it along to the full house for a vote. The proposed legislation aims to reform Texas' Children's Health Insurance Program (CHIP). On the Texas Senate side basically the same provisions will be put forward in Senate Bill 81.

The bill includes a list of improvements that will help provide medical coverage to the children of low-income, working families across the state.

It eliminates the current 90-day wait period for uninsured children who are eligible. It restores the annual (12 month) certification requirement so that parents no longer have to go through the process twice annually. The proposed bill also raises the allowed "wealth" of a family to $10,000 liquid assets, plus reasonable values for up to two automobiles. The legislation also allows for the calculation of net income after deductions for child care and some work related expenses, as well as child support costs.

The proposed plan also adds an estimated $59.1 million in state revenue to the CHIP budget, while increasing the federal match as a result of the state's increased commitment to improving health care for children in Texas.

The bill will also restore funding for outreach so that the coverage can be more adequately marketed across the state.

Action: contact your Representative in the Texas House now and urge support for CSHB109. Contact your State Senator now and urge support of SB81.

If you don't know who your House and Senate members are, visit http://www.house.state.tx.us/welcome.php and http://www.senate.state.tx.us/.