Children
Without Health Insurance or Regular Health Care
More than 11.5
million children from working families in the United States do not
have health insurance, mostly because their families can not afford
it. Without health insurance, common childhood illnesses often go
untreated and can impair a child’s growth and development; more
serious illnesses or disabilities may never get proper treatment
at all. And without health insurance, it is next to impossible to
get routine preventive care, which can pinpoint a child’s health
needs before they become serious problems.
Linking
Children to FREE Health Insurance
Many uninsured children are now eligible for free or low-cost health
insurance through the state Children’s Health Insurance Program
(CHIP) enacted by the U.S. Congress in August 1997. CHIP is designed
primarily to help children in working families with incomes too
high to qualify for Medicaid but too low to afford private family
coverage. School staff can be instrumental in efforts to enroll
eligible children in free or low-cost health insurance. A recent
GAO study found that 69% of uninsured, Medicaid-eligible children
were either in school or had school-age siblings and so could be
reached through school-based enrollment efforts. Schools across
the country are reaching out to help families enroll their children
in free or low-cost health insurance so that all students come to
school, each day, healthy and ready to learn.
Establishing
School Based Health Centers
Although free or low-cost health insurance is now available
for many children, insurance alone is not enough. According to Making
the Grade, a national program of the Robert Wood Johnson Foundation,
unequal distribution of physicians and other health professionals
across the US, inadequate transportation services, cultural barriers
and institutional practices all impede access to care. In Chicago,
for example, the children-to-pediatrician ratio in poor neighborhoods
is 5,887:1, in contrast to a national average of about 1,000:1.
Even when physicians are present in a community they may refuse
to see Medicaid-enrolled children or Medicaid rules and reimbursement
rates may deter providers from giving care. For example, nearly
half the state Medicaid programs do not pay for care by psychologists
or clinical social workers, even when they are supervised by psychiatrists.
Adolescents
face additional barriers to care. Adolescents are more likely than
any age group to be uninsured. About 15 percent have no health insurance.
Many, despite legal protections, are also unable to secure confidential
services related to substance abuse, sexuality, or emotional problems.
All adolescents confront a shortage of physicians or other health
professionals trained in adolescent health care.
In response
to this health care crisis, parents, school officials, health providers
and public agencies have tested the effectiveness of school-based
health centers in providing care to school-age children. These centers
blend medical care with preventive and psycho-social services and
organize broader school-based and community-based health promotion
efforts. Data proves that school-based health centers are effective
and well-received among parents and health professionals. Learn
more from leading experts in school based health care:
- Making
the Grade is a national program of the Robert Wood Johnson
Foundation, located in the School of Public Health and Health
Services at The George Washington University Medical Center. Through
the Making the Grade Initiative the Robert Wood Johnson Foundation
made $17.5 million available to support state-community partnerships
to establish comprehensive school-based health centers in 12 states.
The website offers a comprehensive overview of the background
and importance of school-based health centers in the United States,
communication and implementation tools for establishing and financing
health centers, standards of care, guidelines for service, and
links to state health resources in each state. - National
Assembly on School Based Health Care
is a nonprofit private association representing school-based health
care providers and supporters. Created in 1995, the National Assembly’s
primary mission is to promote accessible, quality school-based
primary health and mental health care for children and youth through
interdisciplinary and collaborative efforts. The website includes
comprehensive resources on establishing school-based health centers,
standards and guidelines for care, information on financing, implementing,
and evaluating school based health centers, and links to other
resources.