Publications by Ariel Klein for Health Policy Center

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The Covering Kids and Families program was a national initiative of the Robert Wood Johnson Foundation to reduce the number of eligible but uninsured children and adults through enrollment in Medicaid and SCHIP. This report presents trends in media use and in-person outreach conducted by state grantees and local projects funded through the initiative. While grantees faced funding and staffing limitations, demand for their services remained high due to decreases in state-funded outreach. Grantees stretched their resources by partnering with other organizations, relying heavily on media outreach to reach large numbers of families, and performing outreach at already-established events.

This report concludes a comprehensive evaluation of The Data & Democracy II project, a program funded by The California Endowment and implemented by UCLA. These organizations sought to increase the capacity of local community-based organizations (CBOs) to collect, analyze, and interpret data to identify and prioritize areas for action. The program was structured after the Train-the-Trainer model, in which a group from local CBOs is trained in these skills and required to disseminate the information by conducting workshops in their own communities. We examine the program's effectiveness, long-term impacts, and challenges through observations, surveys and case studies.

In 2003, the Children's Health Initiative of Greater Los Angeles (CHI) launched the Healthy Kids Program to cover children in families with incomes below 300 percent of the federal poverty level regardless of immigration status. Concurrently, the CHI contracted community-based organizations to support outreach to uninsured children eligible for any public program, including Medi-Cal (California Medicaid). We analyze five years of data on enrollment and disenrollment to investigate whether, in addition to Healthy Kids enrollment, CHI outreach generated "spillover" enrollment into Medi-Cal. Findings suggest outreach contributed to modest increases in Medi-Cal enrollment that were somewhat offset by increases in disenrollment.

Launched in 2003, the Los Angeles Healthy Kids Program covers children in families with incomes below 300 percent of the federal poverty level regardless of immigration status. This report presents findings on utilization of health services by children ages 0 to 5 enrolling during the program’s third year. These children were more likely to receive a preventive care visit, receive any primary care visit, or have a prescription filled, compared to children enrolling during the program's second year. Hospital and emergency room visit rates remained at a constant but low level from the program's second year to the third year.

This report presents findings from the first 18 months of an evaluation of San Mateo County's Health System Redesign and Adult Coverage Initiative (ACE), an effort to improve access to high quality care for uninsured and underinsured adults and improve the financial sustainability of the San Mateo Medical Center (SMMC) and related delivery systems. The County has begun implementation of team-based care, disease management, Advanced Access scheduling, and electronic medical records. Enrollment in the ACE program continues to exceed expectations, and data collected for the evaluation show increased access to care and receipt of doctor visits.

In early 2003 San Mateo County, California launched the Children's Health Initiative (CHI), to ensure that all children have access to comprehensive health insurance coverage. Healthy Kids covers uninsured children below 400 percent of poverty and primarily serves poor, undocumented Latino children. A survey of parents of Healthy Kids enrollees found that in the first year of enrollment, children experienced improvements in access to and use of medical and dental care; a reduction in missed school days due to health problems; reduced unmet need; increased parent confidence in getting care and satisfaction with quality; and reduced financial worries. Moreover, use of preventive and dental services continued to improve during the children's second and third years of continuous enrollment.

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