How Does CHIP Help Enrolled Children and Families?
Southwestern Virginia suffers from medical underservice and higher rates of poverty and teen pregnancy than other regions of the State. CHIP serves children in the cities of Roanoke and Salem and the counties of Roanoke, Botetourt and Craig. This particular area, comprising 1,100 square miles, is about the size of Rhode Island and represents urban, suburban, and rural populations; approximately 75% of the population resides in the inner-city of Roanoke.

The target age for enrollment into CHIP is children birth to kindergarten entry, from families with incomes below 185% of the federal poverty level upon enrollment and below 200% at recertification each year thereafter. According to FAMIS eligibility data 13,391 children are living in families whose incomes fall below 200% of poverty within CHIP's service area.

CHIP promotes the health of disadvantaged children by ensuring comprehensive health care, strengthening families, and coordinating community resources. Current resources allow CHIP to serve 1,250 children annually. 82 children are on CHIP's waiting list. The CHIP program has three interrelated components:
  • Primary health care services delivered by physicians and dentist in the private sector
  • Coordination of health and other services by community health nurses
  • Family support and education by home visitors

Primary Health Care Services
Each child enrolled in CHIP is provided a medical home. 98% are Medicaid insured, but because they are CHIP enrolled they have access to a private physician and dentist from a network of 70 local practitioners who have agreed to accept CHIP patients. These physicians and dentists provide primary health care services where the child is known and seen regularly for both well and sick visits, where central records are kept and the doctor can be reached during off-hours. Transportation is provided by CHIP for medical appointments when needed.

Coordination of Health Care Services
Each child enrolled is placed in the care of one of CHIP's five community health nurses. The nurse coordinates the medical and developmental care specific to each child's needs. Nurses prompt families to keep appointments, help ensure that treatment recommendations are carried out, and help parents cope with caring for children with chronic health problems such as asthma, diabetes, sickle cell anemia, and HIV. Coordinated comprehensive health care reduces the number of ER visits: so for every $1 dollar spent on a child’s health care $5 is saved.

Family Support and Education
CHIP works to strengthen the family. To grow up healthy, children need families who are able to provide stable, safe, and nurturing environments.  CHIP home visitors assist the entire family - working with parents to address issues such as housing, nutrition, education, employment, and parenting techniques. Effective parent education and support can build on family strengths so parents feel more knowledgeable, more confident and better able to care for their children.

 

Expanded Services

PEDIATRIC ASTHMA PROJECT

CHIP’s Pediatric Asthma Project provides structured medical case management for children birth to seven diagnosed with a respiratory disease or asthma that is poorly controlled.  Parents learn how to manage household asthma triggers while learning how to recognize the signs and symptoms of an impending attack.

Nurses instruct parents on how to use and manage their child’s medications (including proper dosage), how to chart peak flow days and use spacers that make the most of asthma medications. 

Together with parents, nurses develop an Asthma Action Plan that provides clear, easy-to-follow instructions on managing an asthma attack.  This step-by-step approach helps parents and children break an attack down in to stages with advice that make the disease less intimidating for parents and less frightening for children.

CHIP nurses also use Sesame Street educational videos to help children and parents learn more about asthma, empowering them to take control in the management of the disease through preventive measures, thus decreasing the necessity for emergency medications, emergency room visits and hospitalizations. 

BEGIN WITH A GRIN DENTAL VARNISH PROGRAM

CHIP’s Begin With A Grin program is an innovative approach to providing preventive dental care to children who are most at risk for dental caries and long term dental disease.

The educational component of the program (based on the Virginia Department of Health’s “Bright Smiles for Babies” curriculum) aims to provide parents with information on proper oral hygiene, nutrition and oral health literacy in an effort to reduce high risk behaviors (pre-chewing food, sharing utensils, putting children to bed with sugary drinks) that lead to Early Childhood Caries.

Educational tools include oversized models of the teeth and gums paired with a large toothbrush which allows CHIP nurses to demonstrate proper brushing and flossing technique after which both the parent and child take turns applying the knowledge they have learned in the home visit.  In addition to educational support, nurses apply semi-annual fluoride dental varnish to the teeth of CHIP-enrolled children between the ages of 6 months and 36 months who do not presently receive varnish treatments through another health care provider. 

 

PREGNANT MOMS PROGRAM

It has been proven that organizations that provide integrated care are able to offer superior outreach and continuity of care for families living below the poverty level.

The solution for prenatal care for under-served women relies on outreach and coordination of care and non-medical interventions.  CHIP’s Pregnant Moms Program gives expectant mothers better health care for themselves and their babies in order to increase birth weight, decrease infant mortality, stop high risk behaviors (including smoking, drug and alcohol use), reduce the incidence of prolonged hospital stays and decrease the number of days spent in NICU. 

CHIP ensures that all pregnant women enrolled in the program are covered with health insurance through either Pregnant Medicaid or FAMIS Moms.  Expectant mothers will understand and become accustomed to preventive care including regular prenatal care and specialist support for health risks such as high blood pressure and diabetes, and continue with a medical home after the birth of their babies for postpartum check-ups, regular health exams, and the treatment of pre-existing conditions.

HOPE (Helpful Opportunities for Parents to Excel)

HOPE is the result of a collaborative effort among community leaders and human service agencies. The project was initiated in 1995 by the Family Violence Coordinating Council, which formed a sub-committee to study the project's feasibility. In late 1996, initial funding was awarded through the Family and Children's Trust Fund, allowing staff to be hired.

CHIP of Roanoke Valley acts as the administering agency for HOPE.  Along with access to basic health care services, children need loving homes to encourage emotional and intellectual growth.  The goal of HOPE is to provide the support, encouragement and developmental education that many first-time parents need to help overcome the stresses associated with parenting in the early years of a child’s life. 

Through home visits, parent group meetings and educational mailings, HOPE provides resources to all first-time parents at a time in a child’s development when parents are most receptive to new information.  HOPE builds confidence in new parents as they learn to respond to their baby’s needs and promote his/her healthy development.

MENTAL HEALTH SERVICES

As an early intervention program, CHIP addresses the unique mental health risks children and families in poverty face, through in-home family support and parenting education that helps lessen the detrimental effects of poverty. 

 

Parents of CHIP-enrolled children receive support and encouragement, medical case management, developmental education and family strengthening services, as well as counseling referrals that, when combined, produce confident parents, self-sufficient families, and healthy children with a strong foundation upon which to build future successes. 

 

Mental health services focus on mothers with mental health issues (diagnosed or presenting) and children through age seven who are at risk for serious emotional disturbance, as well as children who are already showing signs of emotional or behavioral issues.

 

FAMIS OUTREACH PROGRAM

CHIP’s FAMIS Outreach Program helps families overcome barriers to application by providing individualized application assistance, trouble shooting and insurance case management. 

CHIP also offers transportation in the CHIP Van to families who do not have a vehicle.  The FAMIS Outreach Worker is available to accompany CHIP’s home visiting staff to the family’s home if they are unable to come to the CHIP office and can assist families to collect needed verifications and a Bilingual Outreach Worker is available to translate for Spanish-speaking families. 

In addition to enrolling CHIP children in FAMIS and FAMIS Plus programs, CHIP’s FAMIS Outreach Worker assists pregnant mothers with applications for Pregnant Medicaid and FAMIS Moms, programs offering prenatal health care coverage to indigent women through their pregnancy and up to six weeks postpartum.


 

2007/2008 CHIP Board of Directors

EXECUTIVE COMMITTEE
President:
     Paul J. Higgins
Vice President:
     Kathy Stockburger
Secretary:
     Ann Hoff, PhD
Treasurer:
     Edward Machado

At-Large:

     Will Lindsey

CHIP of VA Representative:
     Arlene Murphy
Nominating Committee Chair:
     Jim Hinson

 

BOARD MEMBERS
Eunice P. Austin, Esq.
Thomas Becher
Dorothy S. Clifton
Jane R. Conlin, M.S.W., L.S.W.
Ruth H. DeVerter
Allen E. Eskenazi, MD
Joe Gaither
Nancy M. Hans
Stephanie L. Harper, MD, MPP
Molly L. Henry

Paul J. Higgins

James N. Hinson

Ann Hoff, PhD
William H. Lindsey, Esq.

Edward Machado
Penny Muelenaer, MD
Arlene Murphy
Cheryl Murphy

Douglas E. Pierce, MD
James R. Schaaf
Steve Sewell

Kathy Stockburger

Rome (Skip) Walker, MD

Mark Werner, MD

Rosemary Winslow

Clifton A. Woodrum, Esq.