www.InsureAllKids.org - California's Children's Health Initiatives

California Counties' Children's Health Initiatives: A Story of Success

March 2001: 1 County 1,335 Children Covered	January 2007: 23 Counties 86,000 Children Covered

The Children’s Health Initiative (CHI) is a unique and replicable model for improving children’s access to health care. Pioneered in Santa Clara County and replicated throughout California, the CHI effectively combines:

A new, locally-funded insurance program for children in families with incomes under 300% of the Federal Poverty Level (FPL) not currently eligible for existing Medi-Cal (Medicaid) or Healthy Families (S-CHIP) coverage;

Expanded outreach activities based on the message that all children living in the county can be signed up for health coverage, often wherever they access care; and

A “One Open Door” strategy of integrating screening and enrollment processes across multiple public programs, greatly simplifying the experience for families.


The CHI model is a success. Over the past five years, the CHIs have substantially increased the number of children with health insurance in California. Not only are over 86,000 children been currently enrolled in the county-based insurance programs, the CHIs have added tens of thousands of children to the Medi-Cal and Healthy Families programs as well.

	What Makes the CHI Model Successful: CHIs foster innovative partnerships between local government agencies, health care providers, community-based organizations and other public and private stakeholders. These linkages help communities leverage resources to provide cost-effective access to health care for all children.

	Evaluation: Rigorous evaluations in Santa Clara and San Mateo Counties by teams including Mathematica Policy Research, Urban Institute and the University of California, San Francisco show that CHIs work. Highlights from the Santa Clara evaluation include: Health improvements: Unmet health care needs declined, and children’s access to medical and dental care dramatically improved once a child received coverage. More children covered: The CHI brought about increased enrollment in other publicly funded health insurance programs for children (Medicaid and SCHIP). The bottom line: Local CHI funding was leveraged to bring increased state and federal funding for health coverage to the county.

	How the CHI Model Has Been Replicated: Twenty-three counties in California have operational CHIs covering a total of roughly 86,000 children through local Healthy Kids insurance programs. Another nine counties have CHIs in earlier stages of development.

	Policy Implications and Recommendations: Local programs and policy solutions that worked, and recommendations on what remains to be done in California and around the country.

	Selected Media Coverage and Press Releases: See what the press has said about the CHIs’ success.

This site is designed to give advocates, policy makers and organizations working to expand health care coverage for children the tools to learn from the CHI's success and implement their key components in communities nationwide.