Publications on Refugees, Asylum Seekers, Undocumented Immigrants

The Los Angeles Healthy Kids program, during its first four years, extended comprehensive, affordable coverage to over 40,000 poor and vulnerable children, and improved their access to and use of care. Yet, the program also faced serious challenges, primarily related to financing. Funding for children ages 6 through 18 ran short in spring 2005 and Healthy Kids capped their enrollment. State health reform efforts that could have stabilized funding for the program have failed. Based on interviews with over 40 stakeholders, this case study analyzes the complex challenges that the Los Angeles Healthy Kids program faces at this critical juncture.

This brief presents data on mental health coverage benefits and enrollees' access to and use of mental health services through the Healthy Kids program in San Mateo County, California. The prevalence of mental health conditions among enrollees is similar to national levels, but despite the generous mental health benefits offered under the program, only a small fraction of enrollees with mental health conditions receive care. Reasons why more children do not use mental health services are explored. The brief also shows that enrollees with mental health needs have higher use of other health services compared to all Healthy Kids members.

The Los Angeles Healthy Kids program was created in 2003 to provide health insurance to uninsured children ages 0–5 years in families with household income below 300 percent of the federal poverty level (FPL) who are ineligible for SCHIP or Medicaid. A quality of care survey sampled parents of 538 children ages 12–72 months enrolled in the program for at least one year. Results show that quality of preventive care for children in Healthy Kids has similar patterns as care for children in low-income households, both in California and nationally. Content of preventive care is well below American Academy of Pediatrics (AAP) recommendations, although it is consistent with statewide and national levels of care.

Over the past year, Immigration and Customs Enforcement has intensified immigration enforcement activities by conducting several large-scale worksite raids across the country. From an in-depth study of three communities—Greeley, CO, Grand Island, NE and New Bedford, MA—this report details the impact of these worksite raids on the well-being of children. The report provides detailed recommendations to a variety of stakeholders to help mitigate the harmful effects of worksite raids on children.

As part of a multi-year evaluation of the Healthy Kids program in Los Angeles, we analyzed service utilization of Healthy Kids enrollees ages 0 to 18 using health plan encounter and claims data and assessed these data for completeness. Results suggest that actual service rates are higher than administrative data indicate. Other evidence from the evaluation suggests that some services are likely reimbursed by Restricted/Emergency Medi-Cal, and other services are provided just prior to enrolling in Healthy Kids. As a result, some encounters are not captured in health plan data for Healthy Kids, and will present challenges for ongoing program monitoring.