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APHA Scientific Session and Event Listing

Kyoko Rice¹, Gregory Stevens, PhD², and Michael Cousineau, DrPH². (1) Division of Community Health, University of Southern California, 1000 S. Fremont Ave, Building A7, Room 7410, Alhambra, CA 91803, 626-457-4024, kyokoric@usc.edu, (2) Family and Community Medicine, University of Southern California, 1000 S. Fremont Ave, Alhambra, CA 91803

Background: Major efforts are underway to provide health insurance to the nearly 800,000 uninsured children in California. With increasing enrollment in Medicaid, SCHIP, and local county-based insurance programs, there are concerns about overwhelming existing provider capacity in some areas.

Purpose: To examine whether adequate primary, dental, and specialty care providers are available to support these efforts at the county level and identify barriers to assuring adequate provider capacity.

Study Design: Analysis of interviews conducted with representatives from the 28 counties with any current local child health insurance expansion activity.

Main Outcome Measure: Representative-reported availability and willingness of providers to participate in child health insurance expansions.

Results: Fifty-seven percent of county representatives expressed a problem with provider availability, willingness, or both. One-third of representatives (n=10, or 32%) indicated that although there are many pediatric providers in the county, capacity issues exist because of a lack of willingness to participate. Of these 12 counties, 43% reported that reimbursement levels were the primary reason for lack of participation. Two-third of counties (n=17 or 61%) expressed that they lack one or more types of providers (primary care, specialist, and dentist). Six out of the 17 counties lacking one or more provider types indicated that they lack both primary care providers and specialists.

Conclusion: Although counties are quickly expanding health insurance to uninsured children in California, more than half of the counties involved in these expansions reported challenges with provider capacity. Without an adequate supply of pediatric providers, even insured children may not be able to access needed health services. Securing sufficient providers to care for newly enrolled children is crucial for success of these expansions.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Articulate the purpose, history, and timeline of development of children's health initiatives in California.
• Describe the details of the program and current progress in enrolling children in the program.
• Understand the reasons for county support or lack of support for a statewide Healthy Kids program

Keywords: Access, Providers

Presenting author's disclosure statement:

Not Answered