Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, April 14, 1994                   TAG: 9404140313
SECTION: EDITORIAL                    PAGE: A-12   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

FOR CHIP-PING IN, KUDOS TO SALEM

Like many central cities, Roanoke offers support services - public housing, public transportation, shelters for the homeless - that are less readily available, when available at all, in the surrounding suburbs. So the valley's lowest-income residents tend to congregate in Roanoke, straining city finances.

The double whammy of Virginia's independent-city system, coupled with the moratorium on annexation into suburban counties, exacerbates the situation. Neighboring local governments may express sympathy, but seldom does it translate into responsibility-sharing.

With one notable exception: suburbanish Salem's generous support, relative to other valley jurisdictions, for the Child Health Investment Partnership.

On this page today is a letter - from Peggy Balla and Brenda Cobbs, executive director and nursing supervisor respectively for CHIP - that gives a good update on this remarkable program.

CHIP is a Roanoke Valley success story. It has been nationally emulated, and is the model for seven other similar programs in Virginia. Set up in 1988 as a private-public coalition, the innovative health-care delivery system shatters barriers to basic health-care services for the valley's low-income children. Living conditions for many poor children - drafty houses, poor sanitation, unbalanced diets - can make them vulnerable to disease and debilitating illness; barriers to basic health care can make them doubly vulnerable.

CHIP breaks down the barriers by giving poor children a medical "home" where they're seen regularly by doctors, dentists and other health specialists providing primary and preventive care. This greatly reduces the chances that sickness will go undetected and untreated until it becomes an emergency.

But CHIP is financially hamstrung, and can't keep up with the valley's rising numbers of medically indigent children. As Balla and Cobbs write, the program faces a $207,000 deficit - at a time when 1,335 children are on its waiting list, and an estimated 4,670 children in the valley are in need of its services.

What Balla and Cobbs don't say: Of the 1,038 children enrolled in CHIP, nearly 65 percent (667) live in Roanoke city. Of the 1,335 on the waiting list, nearly 65 percent (856) live in Roanoke city. Of the 4,670 in need of CHIP's services, 78 percent (3,629) live in Roanoke city.

And how much support does CHIP get from Roanoke city? A grand total of $5,000 per year. If the city agreed to CHIP's recent request for $75,000, it still would mean paying only 16 percent of CHIP's costs of caring for just Roanoke city children - and the city so far has said no.

Contrast all this with Salem's performance. That locality has 140 youngsters enrolled in CHIP, and an estimated 207 more eligible and in need of services. Yet Salem contributes $37,000 a year to CHIP - more than seven times Roanoke city's support. Salem's contribution is also seven times more than Roanoke or Botetourt counties.

In at least this significant instance, Salem far outshines the valley's other local governments, and is in effect helping underwrite the costs for other jurisdictions. On the matter of health care for poor children, and before embarking on the next round of cost-sharing complaints, Roanoke city would do well to heal itself.