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LACK OF COMMUNICATION RESULTS IN CHILDREN WITHOUT HEALTH INSURANCE by Lauren Tejeda The number of children without health insurance in the United States is growing. At the present time, in the United States there are approximately 11 million children that are not covered by any form of health insurance. According to "Covering Uninsured Children and Their Parents" and article by the Children's Defense Fund, a nonprofit organization, there are an estimated 250,000 children eligible for insurance but are not on the plan in New York State. Many think that the problem lies in the lack of communication between the program and those who are eligible for the program. Anne Lynch, co owner of Lynch abstracting in Poughkeepsie, New York says that she has never been given information about New York's Children's Health Insurance Program (CHIP). "I have three children, ages 10, 14, and 21. I have never had health insurance for any of them because I always thought that I couldn't afford it," said Lynch. "No one told me about CHIP. I have been paying out of my pocket their whole lives." Health directors, as well as academics agree that there is a lack of dignity in the system. Annette Johnson, Director of the School Health Program in New York said that there are major faults in the child health care system and the way it is perceived. "One of the major reasons that children fall through the cracks of the health care system is that the information telling parents what their kids are eligible for, has not been effectively spread through the community," Johnson said. She said that companies who employ parents whose children are not receiving the proper health care, need to fully inform their employees about the benefits they can receive. "Parents require one-on-one assistance to gather documentation, complete enrollment forms, file applications and ensure timely and accurate procession of their applications" said Johnson. Another facet of the problem can be attributed to how the system is perceived and the way that it gives off a welfare implication. According to Johnson, such a welfare implication generally connotes a sense of inadequacy on the part of the parents, causing them to avoid these programs. "Working poor parents are leery of applying for Medicaid because of its welfare dependant implications," she said. Polly Rodgers, Social Worker for Vassar Brother's Hospital's Pediatric Unit in Poughkeepsie, agrees, and says her job is to help Medicaid-eligible as well as other parents to decide what program is right for them. "We work with all economic brackets, we have found that Medicaid has severe limits, but Child Health Plus is easily accessible. It's about time, we have seen families with high medical bills relocate to escape the cost," Rodgers stated. Dr. Lawrence Shaffer of the Children's Medical Group in Poughkeepsie, N.Y. said that he saw more of a problem with those who did not qualify for Medicaid. "Until there was Child Health Plus, they would fall through the cracks. Normally what would happen is that their bills would rise, and then they would apply for Medicaid. This is because Medicaid has certain rules that if you have a lot of doctor bills, you can register for it, and you can get it even if you make more than the qualified amount," he said. Child Help Plus has reduced the number of children without health insurance greatly, yet some feel that solutions that would make the system more user friendly and readily available need to be implemented. Annette Johnson, Health Director for New York State said that the numbers of uninsured children receiving care could increase dramatically if communities and employers worked together to advertise the services that are available. "If more in-depth review and personal attention were paid by case workers in the health care system, than the recipient pool would expand naturally because fewer children would fall through its cracks," she said. Polly Rodgers, a social worker, said she feels that while she can only speak for in-house hospital, social work, there are limitations to what she can do. "I love CHIP, and I have been helping as many families as possible to get registered for it, but just a few weeks ago I received a letter stating that CHIP will not be sending any more applications because they are too swamped," she said. "Parents are now required to call which now leaves them with one more problem, especially when immediate care is necessary." Dr. Shaffer said that The Children's Medical Group of Poughkeepsie will do everything they can to insure that their patients will get the care they need. "Poughkeepsie is a relatively unique place and I think that there is very little that falls through the cracks, mainly because we have an office policy that we treat children irregardless of the income of their parents," said Shaffer. "So we will always treat them, and if they don't have insurance, we give them the forms and we talk them through the system." Although Dr. Shaffer says he feels confident about the current medical care for children in Poughkeepsie, he said that he felt the problem with children's health care in New York and America is that it is not universal and uniform. "In order for New York's programs to succeed, overcoming enrollment barriers and implementing effective outreach strategies will be crucial".