RADFORD – The expression “some things are worth fighting for” is an age-old sentiment. If you want something – or need something – badly enough, you will go the extra mile to make it happen. But what happens if nobody knows the route to take? When the words “what if” turn into “I can’t” who is going to stand in the gap and say, “You don’t have to settle for less. We can make this work.”? Radford University’s FAMIS program, under the direction of Waldron College of Health and Human Services faculty member Rhonda Seltz, is helping turn the tide for thousands of Virginians who don’t have health insurance and feel there is no help in sight.

FAMIS (Family Access to Medical Insurance Security) is a health-care program funded by a 2008 Project Connect grant from the Virginia Health Care foundation and Anthem Blue Cross Blue Shield Foundation and is designed to identify and help enroll 1,000 uninsured eligible children and pregnant women in state-sponsored health insurance programs.

Former Governor Mark Warner was a key proponent of health care and his vision was to reach all eligible children. “He didn’t want any child to fall through the cracks,” Seltz recalls. Though decisions resulting from the federal budget reduction act virtually wiped the program’s success off the books, Seltz says, other elected officials rallied around the cause with the mantra, “We all need to pull together. We have to make this program work.”

“We’re only a 1/3 of a way where we should be in our enrollment for this area because it’s like we are having to start from scratch,” Seltz says. “We went without funding more than a year and a half. Even though we slowed down, we never totally quit. We sent people to their local central processing units.” Seltz birthed the RU initiative and she says, “I am not going to let it die.” The program is once again gaining momentum and Seltz says with the nation’s focus on healthcare reform, a grass roots effort needs to make made to get the wheels turning again and let Virginians know there is help for the uninsured.

The program has been recently been focusing more on the unemployed and FAMIS representatives are a visible presence at local work force training centers and rapid response events. When a mother or father receives a notice saying they’ve been laid off, one of their first concerns is how to afford healthcare for their children when it will be a struggle enough alone to provide basic needs.

“Ironically, adults are much more desperate for health care than the children,” Seltz says. “There are safety nets for children, such as FAMIS and Medicaid. Parents may have a low enough income to qualify for free health clinic care or federally qualified health centers.” Programs are available in Floyd, Roanoke, Laurel Fork, Troutdale, White Top, and if funding is provided, Montgomery County by 2010.

There is so much emphasis on the unemployed that sometimes the employed get overlooked, Seltz says. Some families will pray premiums in excess of $1,000 a month. “People do not have to purchase a $1,000 monthly plan from their employer if their children are eligible for FAMIS,” she says. There is no family premium. Co-pays are either $2 or $5. This also covers dental and visual care and hearing tests. More than 75% of the people who sign up for FAMIS fall into Medicaid assistance guidelines.

Seltz believes the program is not finding the people that need to be reached. There are currently an estimated 120,000 children in Virginia that are not enrolled in state-sponsored health care programs such as FAMIS. Because of the economic crisis, more focus is on the unemployed. She says the program needs to get the attention of first-time users who may be reluctant to ask for help since they’ve never had to seek assistance from an agency. She stresses to families that there is rarely affordable insurance but she doesn’t want people to shy away from FAMIS because they feel they have no other options. “I look at it this way. They’ve paid an enormous amount of taxes. Now they can finally take advantage of health care for their kids,” Seltz says.

When people are gathering information to go with their applications for enrollment, there is sometimes frustration with the paperwork and the information may seem overwhelming. “We go that extra mile for them,” Seltz says. “If there is a problem, for example, getting income information if the head of household is self-employed, we’ll help them. We want them to understand how the system works and there are other options if they’re turned down for Medicaid. Grandparents raising grandchildren or parents raising stepchildren need to know they can get help, too, she says.

When applying for FAMIS, the family member needs to bring proof of income and citizenship and an I.D. Be prepared to answer questions such as the amount spent in one year if they are self-employed, what kind of odd jobs have they worked to bring in extra income and an estimate on how much gas they’ve used in their business over the past year.

Many families may qualify for stimulus packages for COBRA. If they qualify, the federal government will pay 65% and the families pay $35 for their COBRA. Seltz says the employed sometimes are struggling the same as the unemployed. They’re also under the assumption they have to pay the high premiums and there’s no alternative. She says people may not realize the can get good health care coverage through private plans.

Another population that stands to gain from enrollment in FAMIS is single parents. Both mothers and fathers are losing their jobs and when one single parent is relying on the other to cover their children with insurance, problems can arise even when there are the best of intentions

“It’s almost inevitable that when there is a divorce or separation, the non-custodial parent will be responsible for health care costs, plus pay child support. If they get laid off, it doesn’t change the fact that court orders exist stating they are responsible for the health care and support. Sometimes the custodial parent could apply for assistance but that would depend on the relationship with the absent parent.

Though the trend is slowly changing, more men tend to be covered than women because if there were only one person working, the breadwinner most likely would be covered under their employers. In today’s economic meltdown, some jobs may no longer even offer benefits.

FAMIS has a high level of success in approvals for health care coverage. To qualify, a child must be a U.S. citizen or legal permanent resident, be currently uninsured, live in the Commonwealth, be under the age of 19 and meet certain family income criteria. There is not a long waiting period with few exceptions. Loss of insurance because of a decrease in benefits or a layoff is a good cause to apply. Seltz says the employee was already paying at least 10% toward the premium and everybody is or else they wouldn’t be applying.

“There are improvements that need to be made and a lot of barriers have been removed in past years. FAMIS is still not a perfect program but it’s a really good program. We have to continue to make it better. You may have to go out of the area to find a dentist or sometimes you can’t get an appointment for two months with a doctor. Same thing here. There are still things we have to work toward but it’s worth it,” Seltz says.

To learn more about FAMIS and registration sessions, call Seltz at (540) 831-7693 or visit the FAMIS website at www.famis.org.