State of Health of Florida's Children: Fragile

Tallahassee, FL – As lawmakers start their budget negotiations, critics say the health of Florida's children is poor and getting worse. But as Margie Menzel reports, some of the budget items on the table could make a big difference.

Florida has fallen four places in two years in Kids Count, the national study by the Annie E. Casey Foundation, which last year ranked Florida 36th of the 50 states in overall health, education, safety, economic security and other signs of child well-being. And this year, with programs that serve children facing further cuts, advocates fear the state will decline even further. Dr. Louis St. Petery, a pediatric cardiologist and vice president of the Florida Pediatric Society:

"National organizations have published information regarding the state of the health of Florida's children, and it's abysmal," St. Petery said. "Florida ranks at the bottom in many different parameters, whether it's dental health or many other issues. And I don't see this session of the Legislature moving forward to fix any of those problems."

Florida failed a study on children's dental health released in February by the Pew Center on the States, with just 23.8 percent of the state's Medicaid-enrolled children getting dental care in 2007 compared with a national rate of 38.1 percent. Then there's the infant mortality rate - 7.3 percent in Florida, 6.7 percent nationally. Yet the House budget would eliminate the state's Healthy Start coalitions, which have reduced infant deaths by 20 percent since taking over pre-natal care from the county health departments in 1991. Children's advocate Roy Miller says the House plan to save $4 million on the coalitions by returning pre-natal care to the counties would take the state backwards.

"The health departments weren't able to provide the services, and that's why the coalitions were formed," Miller said. "And the coalitions have done a really good job. But now we're ready to dispense with them and go back to a system of care that did not work. And 25 of Florida's 67 counties, they're not prepared to provide those services anyway."

As to the percentage of Florida children with health care coverage, it's still one of the worst in the U.S. - 48th or 49th of the 50 states, depending on the study.

"There are different studies that show different numbers," said Rich Robleto, executive director of the Florida Healthy Kids Corporation, which provides low-cost children's health insurance to 1.8 million kids. "We see studies that show about 550,000 kids uninsured. I've seen other studies that take the number up above 800,000. The numbers are both large enough that it doesn't concern me. There's just too many that are out there and that we want to go get."

Robleto says the Legislature is poised to fund 22,000 more slots - a budget item of $37 million. He also points to the KidCare reform bill passed last year, sponsored by Sen. Nan Rich, D-Weston, and Rep. Jimmy Patronis, R-Panama City. The measure has since boosted KidCare enrollment via electronic verification of income and by cutting or eliminating wait periods for families who miss a payment or have been insured by a provider charging more than five percent of the family's income.

"And we have seen a pretty consistent pattern of growth since the passage and implementation of that bill," Robleto said. "We still think there's a large market out there that we would like to achieve, but we are very pleased that enrollment continues to grow, and I think to a large extent, it's thanks to the reform legislation that passed last year."

Not heard in committee this year, however: companion bills by Rich and Rep. Juan Zapata, R-Miami, that would expand eligibility to the children of legal immigrants and state workers who make less than 200 percent of poverty, groups included in the federal reauthorization of the Children's Health Insurance Program. Karen Woodall, a lobbyist for low-cost children's health insurance:

"Those are some important changes that would get us closer to getting bonus points and maximizing our revenue from the federal government and expanding coverage to more children in this state," said Woodall. "And unfortunately, the legislation's not moving."

Meanwhile, a class-action lawsuit on behalf of Florida's 1.6 million children on Medicaid is progressing in Miami before Federal District Judge Adalberto Jordan. Jordan could order the state to assure that Medicaid children have access to health and dental care equal to that of children on commercial insurance by paying providers enough that they'll take Medicaid patients and by removing administrative barriers to care.