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HEALTHWATCH : Medical Services Merger Means More Efficient Care for Children : The two government-funded agencies have joined forces to serve low-income youths.

September 16, 1993|LEO SMITH | SPECIAL TO THE TIMES

Ventura County's annual birthrate, notes local pediatrician Gary Feldman, has jumped from about 8,000 to 11,000 over the past five years. It's not surprising that to a doctor, those numbers add up to a greater need for health care.

"About 40% to 50% of those children are born to parents who were not born (in the United States). Many folks are here and they are very productive, but they are low-income," said Feldman. "From the perspective of children's services, we have an ever-increasing responsibility."

Because of that responsibility, Feldman said, he is pleased to be involved with the county's Children's Medical Services (CMS) public health program. About nine months ago, CMS became the umbrella title for California Children's Services (CCS) and the Child Health and Disability Prevention Program (CHDP).

Both of those government-funded programs (they are run primarily by state and federal money) provide health care for low-income children.

Through CHDP, the county provided immunizations and comprehensive health screenings to 53,228 children last year, said Lois Manning, the CMS program manager. Screenings range from hearing and vision tests, to psychological evaluations. In all, about 105,000 county children are eligible for the services.

Manning said about 1,900 children are now receiving ongoing treatment for chronic and severe illnesses--everything from leukemia to cerebral palsy to heart disease--through CCS.

Before the merger of the two children's health organizations, one had little contact with the other, said Manning. And she should know. She headed up both of them when they were independent. "The merger has made the two programs talk to each other," she said.

"The other day a mother got a hearing aid for her child and we took care of it through CCS," said Manning. "She also needed a well-child exam to get the child into school, and CHDP did that. In the past, the person talking to the mother about the hearing aid would not have talked to her about the exam . . . she would have had to find it on her own."

As streamlined as the programs have become, there are some factors involved in making one's way into and through the system. No big surprise, if you've ever wandered through the health care and insurance worlds.

Feldman said much depends on a family's level of poverty. Just because a child qualifies for a screening through CHDP does not mean he or she is eligible for Medi-Cal. And that can cause some problems.

"After a CHDP screening we may tell mom, 'your child has pneumonia,' " said Manning, "but we don't pay to hospitalize them."

"If a kid has Medi-Cal there's no problem," Feldman said. "But if the family is making too much money for Medi-Cal, we might find a health problem but not be able to treat it."

Manning said of the children now being treated through CCS, about 45% are on Medi-Cal. "In most counties, that's 60% to 70%," she said. "That means that even our poor farm workers own two cars or a house, so they don't qualify for Medi-Cal."

Though the CMS merger has strengthened the county's ability to serve local youth, said Feldman, it has also pointed out some glaring gaps.

"We have one big problem . . . the uninsured child," he said. "There are a number of conditions that are not so serious that they qualify for CCS, but they do require ongoing care. And we have a number of children who are screened but do not see care."

And there's still the problem of some families not being able to afford a regular physician for their children. "It's one thing to go for a screening," said Feldman, "but it's another to be able to go see Dr. X when you scrape your knee."

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