Needy kids paying for program's funding ills

By ALICIA CALDWELL

© St. Petersburg Times, published January 6, 2001

Kicking a problem upstairs is the easiest thing in the world to do.

You escape responsibility, and focus blame on someone else. It's almost always a copout.

Almost.

A persuasive case can be made that looking for state help with the Healthy Kids program is not merely an easy way out. Pinellas is the only Florida county that has come up short on its local match -- money that would provide health insurance for 1,500 children of the working poor.

We're talking about the kids of people who cut your grass and ring up your groceries every week.

About 1,500 of those children are on a waiting list because the Pinellas program has raised about half the $405,000 needed for the local match. Most of the rest of the program's money comes from the federal government, with some from the state.

This is how the Pinellas shortfall happened:

A taxpayer-funded local board, the Juvenile Welfare Board, has been tapering its financial support for the program over the last few years. This was no surprise to the people charged with rounding up the local money each year. It was a long time coming.

"This was one of those things that needed to be really looked at," said Myrtle Smith-Carroll, chair of the Juvenile Welfare Board. "If we didn't come to this decision, it wouldn't become an issue in the community. And sometimes that's the only way to go."

You could stop here and criticize the board. You could question their priorities and ask what could be more important than making sure children could see a doctor for an ear infection instead of going to an emergency room. And you would have an eminently arguable point.

But look a little further into the history and operation of the Healthy Kids program, and the proposals made by some Tallahassee children's advocates start making a whole lot more sense.

Karen Woodall is one of them. She thinks the local match is ridiculous. The state, she says, with an annual budget of $50-billion and the annual interest from a $17.4-billion tobacco settlement, ought to pick up the tab.

"It's causing children in the state to be denied access to a federal program," said Woodall, who lobbies for several health care advocacy groups.

Florida is the only state that requires a local match. That requirement comes wrapped in history, and it's useful to know it. Florida was out front when the Legislature in 1990 created a program to pay for health insurance for its many uninsured, low-income children. A match was required not only to stretch scarce dollars, but to elicit local commitment.

The feds entered the equation seven years later with big money and lots of rules. They would pay 69 percent of the program cost, leaving the states to pay the rest.

Florida kept the match requirement, but it got more complicated. The number varies, but every county gets a certain number of fully subsidized slots. Those counties with more needy kids than slots would have to pay part of the premium cost for the extra kids. Last year, local communities paid $10.2-million, about 9 percent of the program cost.

However, not every community can, or will, come up with the match to cover all needy children. So uninsured children, including those 1,500 in Pinellas, probably won't get the benefit of federal dollars earmarked for Florida.

Tallahassee lawmakers are likely to say that it is unfair to make this the state's problem -- that counties ought to cough up the money necessary.

State, federal, local -- all tax money is our money. Think about who gets hurt when debate dwells there. Is it fair to lay this political fight on the shoulders of a 5-year-old with strep throat?

Recent coverage

More local money needed to insure children (January 5, 2001)

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