August 18, 2003

Jonathan Fielding, M.D.
Director of Public Health, Los Angeles County

Dear Mr. Netkin:

Supervisor Antonovich forwarded me your concerns about public charge billboards.

For several years, the Department of Health Services (DHS) and other County departments have been working to enroll families in health coverage programs in order to provide these families with access to preventive services and medical care.  One common barrier to families enrolling in programs for which they are eligible is that they fear that enrollment will jeopardize their immigration status.  To address this fear, on July 20, 1999, the Board of Supervisors directed the Chief Administrative Office to work with County departments to develop a comprehensive public charge outreach campaign.  The billboard that you photographed was designed by a workgroup that included representatives from the departments of Health, Public Social Services, Mental Health, Community and Senior Services, and Children and Family Services, in response to the Board's directive.

In late 2001, DHS received a one-time-only grant from the State for efforts to increase enrollment in Healthy Families and other low or no-cost health coverage programs.  Part of this funding went towards public charge advertising, including the billboard you saw.  The billboards ran from November 5, 2001 through January 31, 2002.

You also asked whether the County does any other type of outreach to the undocumented population.  Although we are not doing large-scale advertising, DHS incorporates the public charge message into our efforts to assist families in enrolling in health coverage programs.  More than 70% of all uninsured children in Los Angeles County are eligible for Medi-Cal or Healthy Families.  If we do not assist in enrolling these children, which includes addressing public charge fears, they will not have access to the preventive services they need to keep themselves and the people around them healthy.  In addition, the County would bear the cost of providing medical treatment to these uninsured children, which often takes place in emergency rooms rather than physician offices.

Thank you for sharing your concern.  If you have any questions or need additional information, please let me know.

[Jonathan Fielding]