Expanding Coverage for Children: Santa Clara County Children's Health Initiative

The Santa Clara County Children's Health Initiative (CHI) is an innovative effort to expand health insurance coverage of children in the county. CHI has two parts. The first is a new insurance product, Healthy Kids, which covers children in households with income up to 300 percent of the federal poverty level who are ineligible for the two major state insurance programs—Medi-Cal and Healthy Families. The second is a comprehensive outreach campaign that finds uninsured children and enrolls them in the appropriate program.

Mathematica and its subcontractors, the Urban Institute and the University of California at San Francisco, conducted an initial evaluation of CHI for the David and Lucile Packard Foundation. The evaluation had three components: (1) a process analysis consisting of site visits, telephone interviews, and focus groups to document the ongoing goals and challenges of CHI; (2) an impact analysis of Healthy Kids, which measured the impact of CHI on such outcomes as access to health care and unmet needs for health care; and (3) an enrollment analysis, which estimated the effects of CHI and Healthy Kids on the number of children and families enrolling in Medi-Cal and Healthy Families. Of particular interest to the evaluation were the effects for Hispanic children, who are far more likely than children of other major racial/ethnic groups to be both eligible for these programs and uninsured.

The latest brief combines the findings on medical care use and access from the Santa Clara study with the findings from two other independent evaluations of Healthy Kids programs (in Los Angeles and San Mateo Counties). Across all three counties, evaluation findings show dramatic gains in the well-being of children and their families.

Project Publications

"Stable Coverage Benefits Healthy Kids Children. Issue Brief #5." (June 2007)

"Santa Clara County Children's Health Initiative Improves Children's Health. Issue Brief #4." (March 2007)

"Santa Clara County Children's Health Initiative Outreach and Enrollment Efforts are Effective and Helpful to Parents. Issue Brief #3." (February 2006)

"Santa Clara Healthy Kids Program Reduces Gaps in Children's Access to Medical and Dental Care. Issue Brief #2." (August 2005)

"Expanding Coverage for Children: The Santa Clara County Children's Health Initiative. Issue Brief #1." (April 2005)

"The Effect of New Insurance Coverage on the Health Status of Low-Income Children in Santa Clara County." Health Services Research (April 2007)

"The Santa Clara County Healthy Kids Program: Impacts on Children's Medical, Dental, and Vision Care." Final Report (July 2005); Appendixes (July 2005)

"Impact of the Children's Health Initiative (CHI) of Santa Clara County on Medi-Cal and Healthy Families Enrollment." Final Report (September 2004)

"Evaluation of the Santa Clara Children's Health Initiative: Key Findings." Legislative Briefing (September 2005)

Cross-County Findings

"Three Independent Evaluations of Healthy Kids Programs Find Dramatic Gains in Well-Being of Children and Families, In Brief #1." (November 2007)

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