Health care access a critical problem for poor Dallas-Fort Worth ...

Behind all the signs of suburban prosperity and exurban growth, the five North Texas counties stacked in a rough triangle above Dallas deal with one critical disparity between rich and poor: access to health care for thousands of their children.

Beyond ABC 2012, an assessment of children?s health, will be released Monday by Children?s Medical Center Dallas. It said that while 8 percent of children in the U.S. have no medical insurance, and 14 percent in Texas, the counties of Collin, Denton, Cooke, Fannin and Grayson all have uninsured rates at least twice the national average, with Cooke the highest at 23.9 percent.

According to the 2010 U.S. census, 8.5 percent of the 453,403 children under 18 in those five counties live in poverty. Almost 104,000 are enrolled either in Medicaid or CHIP, the Children?s Health Insurance Program, which covers children from families with incomes above the Medicaid limit but at or below 200 percent of the federal poverty level, $23,050 for a family of four in 2012.

The problem, said Regina Montoya, Children?s senior vice president for external relations and general counsel, is that all of those children face enormous difficulty in simply finding a doctor to care for them.

Only 31 percent of Texas physicians now accept Medicaid patients, according to a 2012 survey by the Texas Medical Association, down sharply from 42 percent in 2010.

?You have a card that says you have insurance,? Montoya said. ?But what if no one accepts it? When you have situations like that, and parents can?t find physicians, they come to hospitals like ours, to the emergency rooms. They go to the most expensive place you can go.

?And as a hospital, you don?t want an emergency room filled with kids who don?t need to be there.?

To begin meeting that need, Children?s has opened three MyChildren?s Pediatric Practices in East Plano, West Plano and McKinney, Montoya said.

?We?ve made a commitment to provide medical homes for as many kids as we can ? and we?re a private, for-profit hospital. We don?t get any county funds,? she said. ?Basically, these are offices that will accept any kid, with bilingual staff and physicians. And they?re like any other medical office ? you make an appointment, you meet your doctor, you know your doctor. It?s your medical home.?

But with fewer doctors accepting Medicaid or CHIP, and with the region?s explosive growth ? the five-county population grew from about 1.1 million residents in 2000 to 1.6 million a decade later ? the gulf between available caregivers and those who need them grows ever wider. The vast majority of the growth was centered in Collin and Denton counties, and each saw the number of families with kids living in poverty roughly double in 10 years.

?I don?t think anyone could have predicted how fast the area has continued to grow,? Montoya said. ?We certainly look at the prosperity associated with this growth, all the great and positive aspects. But there are some critical needs in the human infrastructure, and that?s what this report highlights.?

It also includes an extensive list of recommendations covering health, economic security, education and safety. First on the list is protecting funding for state programs that address the health and safety of children as the Texas Legislature meets next year and deals with a budget shortfall for fiscal year 2013-14.

Other recommendations: Ensure that every county has at least one health care provider who treats pregnant women on Medicaid; enlist faith groups and civic leaders to help low-income residents access Medicaid, CHIP and similar programs; and persuade legislators to increase reimbursement rates to pediatric providers who accept Medicaid or CHIP.

?Our mission is to make life better for children, and in Beyond ABC we?re trying to highlight the issues children face,? Montoya said. ?We?re asking, ?What?s it like for a child growing up in these five northern counties?? And what?s extraordinary is the amount of change we?ve seen in the two years since we last did this report.?

The counties are increasingly diverse, racially, ethnically and economically. From 2008 to 2011, Collin County experienced a 69 percent increase in Medicaid enrollment, and Denton County a 76 percent jump. And from 2007 to 2011, both saw enrollment in CHIP double.

And despite those dramatic increases, officials estimate that 69 percent of Texas? uninsured children are eligible for Medicaid coverage but aren?t enrolled, even as the percentage of physicians who accept Medicaid declines.

Source:http://www.bangkokpost.com/news/health/320838/health-and-fitness-agenda-world-diabetes-day

Source: http://yourdailyupdateblog.com/archives/34054

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