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Meet Michelle—a fifth grade soccer player recently diagnosed with asthma. Since Michelle’s mother made a doctor’s appointment when her cough lasted longer than a week, she received much needed medical treatment, and her ailment didn’t sideline her from being a normal kid. Before then, Michelle received preventative services, such as vision and dental care and immunizations. Now, Michelle focuses on her studies not her illness and no longer misses as much school.

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Health Insurance Enrollment

Although Pennsylvania made significant progress expanding access to affordable health insurance for children and families over the last two decades, some children do not have health care, despite qualifying for public health insurance programs such as the Children’s Health Insurance Program (CHIP) and Medicaid. Currently, more than 9,000 children in Allegheny County are uninsured. These children are five times more likely to have unmet medical concerns, and three times more likely to not have access to prescription drugs, like asthma inhalers. Additionally, uninsured kids are 30 percent less likely to get medical treatment when injured.

So just how much is 9,000? Allegheny County’s uninsured children could:

• Form 900 Little League Teams
• Fill 152 School Busses
• Pack 360 Classrooms

To address this problem and expand access to affordable health insurance for children and families, Allies for Children partnered with the Office of Mayor William Peduto, the Allegheny County Health Department, the Consumer Health Coalition and Enroll America. The group developed a plan called Healthy Together and later received a $200,000 implementation grant from the National League of Cities to connect children to available health care coverage and ensure they received the basic services they need and deserve. Due to the success of the campaign, Pittsburgh was prominently featured  in reports about the national initiative. To continue advocacy efforts around healthcare, Allies for Children convened a Southwestern Pennsylvania coalition to educate legislators about the importance of both CHIP and Medicaid. Although recent attempts to repeal the Affordable Care Act and restrict federal funding failed, the coalition will continue its advocacy efforts to ensure children’s health is a priority among lawmakers.

Network Adequacy

Currently, Allies for Children is working to create policies to ensure that health plan provider networks offer children adequate care and access to a sufficient number of doctors, without having to travel long distances from their homes. Health insurance coverage is important, but without quality, affordable and timely care, even insured children may not receive the treatment they need and deserve. New managed care regulations require states to set new criteria for quality of pediatric care, including the accessibility of pediatric providers. The goal is for the Department of Health to adopt evidence-based standards, including oversight provisions, by the July 1, 2018 deadline.

To reach this goal, Allies for Children is actively engaged in an alliance with partner organizations, centered around a collaboration with the University of Pittsburgh’s Medical-Legal partnership, to understand and document barriers to care for vulnerable children in Allegheny County.  Allies for Children will play a leading role in convening Southwestern Pennsylvania partners, including insurance enrollers, FQHCs, advocates for children with exceptional needs, and providers for feedback and participation in constructing a survey tool used to better understand local barriers.

School Breakfast

To build a local health alliance and address food access issues facing children and youth, Allies for Children partnered with Greater Pittsburgh Community Food Bank and school districts throughout Allegheny County. The successful collaboration resulted in a report entitled Breakfast Basics: A Comprehensive Look at School Breakfast Participation in Allegheny County. The report, released during the 2016 School Breakfast Week, highlights how school policy changes can help combat childhood hunger and increase the number of breakfasts schools serve. In 2017, an updated report found that Allegheny County outperformed the state in reaching Governor Wolf’s School Breakfast Goal. On average, 56 students that qualify for free and reduced price meals are eating breakfast for every 100 that eat lunch. In Pennsylvania, on average only 50 students that qualify for free and reduced price meals are eating breakfast per 100 eating lunch. Governor Tom Wolf’s 2020 goal is to reach 60. Currently, Allies for Children and Greater Pittsburgh Community Food Bank are working with schools to implement alternative breakfast models or determine the viability of CEP.