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Health Budget Under Attack

Funding: Davis plan to cut workers who help the poor get insurance will only further stress system, critics argue.


A network of health-care outreach workers that helps 1.1 million poor families enroll in state health insurance programs is itself ailing.

The outreach workers who comb public schools and community centers for underprivileged children and their working-class parents in need of health insurance face a serious funding shortage at a time when more than 7 million people statewide are underinsured.

Gov. Gray Davis' proposed budget for fiscal year 2002-03 eliminates $12 million in advertising for the Medi-Cal and Healthy Families insurance programs. That amount includes $6 million for school- and community-based outreach programs that hire workers to enroll patients, troubleshoot problems and help with annual renewals.

The state Senate has approved the cut. The Assembly's budget subcommittee, however, has voted to restore half of the funding. The matter goes this week to the budget conference committee, where the fate of the appropriation will be determined before a final spending package is sent to Davis.

Failure to fund outreach workers would hamper efforts to improve the health of a vulnerable population and further stress the public health-care system, advocates said.

"By enrolling eligible individuals in these programs, they get preventive and ongoing care and no longer will need to get their care in the emergency room, where problems are much bigger and more costly," said Assemblyman Keith Richman (R-Northridge), a physician.

At Valley Community Clinic in North Hollywood, outreach staff, known as promotoras, help mostly poor, uneducated Latino families bridge the language, cultural and financial divide that prevents them from enrolling in the Healthy Families and Medi-Cal insurance programs.

The clinic's outreach program operates on a $128,000 annual grant from the state Department of Health Services, officials said. Eight promotoras working in 20 public schools have enrolled more than 20,000 children and their parents since the clinic began the outreach program two years ago.

"Without the promotoras, we would go back to a time when children would only see a doctor if they were chronically ill," said Olga Duran, the clinic's outreach program director. "Sick kids can't think, can't learn and can't go to school. We would be back to square one."

At UC San Diego Community Pediatrics, 16 outreach workers have launched a letter-writing campaign to protest the cuts, said Elaine Pizzola, program supervisor for the agency's Health Insurance Access Through Schools project. The agency has enrolled 1,000 children in its first year of operation.

Michael Cathey, an outreach coordinator with Community Health Councils Inc., in Crenshaw, said outreach workers are invaluable.

Eleven workers served 676 families, including 1,142 children, through the clinic's Accessing Benefits for Children Project in the last fiscal year, he said.

"Cutting off the funding for outreach is like cutting off your nose to save your face," he said. "It may save a little money now, but it will cost a lot in the long run."

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