Seated behind a small desk at the South County Center in Fairfax, a pen in one hand and a health insurance application in the other, Gov. Mark R. Warner interviewed a Salvadoran couple seeking affordable health care for their children.
Warner copied down their Social Security numbers, chatted with them in Spanish about their three daughters and translated their answers onto a Medicaid application form.
The Democratic governor extended a helping hand yesterday during a stop in Northern Virginia highlighting the state's retooling of its Children's Health Insurance Program, which includes Medicaid and the Family Access to Medical Insurance Security. FAMIS provides comprehensive, low-cost health care coverage for children in families that earn too much to qualify for Medicaid but not enough to afford private health insurance.
The result of the overhaul, Warner said yesterday, has been a much-welcomed enrollment increase in both programs statewide, bringing health insurance and preventive health care to thousands of children who would not be covered otherwise.
"When I came into office, unfortunately we hadn't done a very good job with our FAMIS program," said Warner, who has been governor for a year. "Other states had 60, 70 and 80 percent of the eligible children enrolled."
Virginia had enrolled 36,134 of the 100,000 children believed eligible -- a rate so low that the state had to return $56 million in federal funds over the last two years, officials said.
"You have only a certain amount of time to spend the money," said Linda L. Nablo, director of the state's Division of Child Health Insurance Program. "If you don't spend it, you have to give it back. It's this administration's intention to get to the point where we're not giving back any money."
It didn't help, Warner said yesterday, that applicants were required to complete a 13-page enrollment form, that FAMIS and Medicaid weren't coordinated and that some families struggled to afford the state program's monthly premiums. Officials administrating the programs say those problems have been corrected.
"You needed a PhD or a case manager assigned to you to fill out the old forms," Warner said. "The bureaucratic maze was a mess. . . . My sense was, and my belief was, that we took a program that was user-unfriendly and made it user-friendly. The best evidence of that are the new enrollment numbers."
As of last Friday, Warner said, more than 50,728 children are enrolled in FAMIS, and Medicaid enrollment is 283,666, up from 250,103 children one year ago.
In addition to streamlining the forms, officials have made it easier for applicants by setting up, as Warner put it, "one-stop shopping" for assistance at the state's 122 local departments of social services. Before September, applicants had to call a toll-free number for help. Now, they have both options.
Sometimes applicants would apply for FAMIS and find out they qualified for Medicaid, or vice versa. Frustrated, they would not complete the application process.
"We were losing 80 percent of the referrals because of that," said Cynthia B. Jones, deputy director of the Virginia Department of Medical Assistance Services.
Now, there is one application form, making movement between programs much easier. Also, the eligibility rules have been revised so that all children in a family can be in one program.
Medicaid is the most comprehensive government-sponsored program available to those without health insurance.
The program has income limits, and children will not qualify if they are undocumented immigrants. If a child's parent or guardian makes too much money to qualify, the child can be linked with FAMIS.
The FAMIS program was unveiled in August 2001 after the General Assembly instructed the state to restructure its Children's Health Insurance Program. FAMIS is comprehensive like Medicaid, but participants must be legal U.S. residents for at least five years.
Children who don't quality for either program are usually directed to local programs that act as a safety net.