Quality of Early Childhood Health Care in the Los Angeles Healthy Kids Program

The Los Angeles Healthy Kids program was created in 2003 to provide health insurance to uninsured children ages 0–5 years in families with household income below 300 percent of the federal poverty level (FPL) who are ineligible for SCHIP or Medicaid. A quality of care survey sampled parents of 538 children ages 12–72 months enrolled in the program for at least one year, with a response rate of 91 percent. Parents reported whether they discussed their young child's development and received recommended content of preventive care. Results show that quality of preventive care for children in Healthy Kids has similar patterns as care for children in low-income households, both in California and nationally, based on the 2003 National Survey of Children's Health. Among children with a recent preventive care visit, parents of only 31 percent of children in the Healthy Kids survey were asked about their concerns, and only a quarter received information about their specific concerns. Content of preventive care is well below American Academy of Pediatrics (AAP) recommendations, although it is consistent with statewide and national levels of care. Given that parental concerns about health and development are predictive of later learning and developmental problems, more systematic elicitation and discussion of concerns is an important area for strengthening care quality.