This past spring, the Texas Legislature chose not to expand the state's Children's Health Insurance Program (CHIP). For those of us who are dedicated to creating communities of healthy children, this was disappointing — a detriment not only to the health of Texas' children but also to the future well-being of our entire state. While this and the current discussion about health care reform might foster cynicism, especially for the more than 9 million children and 37 million adults estimated to be lacking medical insurance, it's important to remember that organizations in the private sector are taking innovative steps to serve otherwise underserved populations.

Here in Houston, Texas Children's Hospital is addressing the problem on the front lines: the neighborhoods where uninsured and underinsured children live. Project Medical Home (PMH), a network of pediatric physician practices created by Texas Children's, offers consistently excellent primary care to children in neighborhoods previously lacking comprehensive pediatric health services.

PMH does more than provide sick-child and preventive care to Houston's underserved children; it offers them a true “medical home.” Children and families are seen in dedicated pediatric practices, not general service clinics with rotating teams of physicians, and they see the same caregivers visit after visit, establishing relationships with doctors and staff that last through young adulthood. With office environments as warm and welcoming as any in Memorial or The Woodlands, PMH encourages return patients, transforming one-off visits by sick kids into ongoing relationships between caregivers and families.

Since the first PMH opened in 1999, its five practices have served approximately 56,500 children and families through more than 181,000 total visits. Patients and families turn to PMH for treatment of acute and chronic conditions, preventive care such as immunizations and nutrition counseling, and critical non-health services like literacy programs. PMH also offers social services support, helping families obtain medical insurance and locate other vital resources.

A key factor in the success of PMH is that the practices are deeply engaged with community organizations in the neighborhoods they serve. The newest practice, in the Corinthian Pointe subdivision, is a true model of collaboration between nonprofit organizations.

In 2006, Windsor Village United Methodist Church, which was creating the subdivision for middle- and low-income families, began working with Texas Children's Hospital to bring pediatric care to Corinthian Pointe. After close collaboration on the specific needs of the community, the Corinthian Pointe PMH practice opened in May 2009. In just a few months, it has become a welcome addition to the community, accommodating, on average, more than 750 monthly patient visits.

But we're not just benefiting the immediate communities. As we introduce more children to comprehensive care, we also reduce burdens on the overall health care system. Since 2006, Texas Children's Hospital Emergency Center has realized a 26 percent decrease in non-emergency visits from children living in areas served by PMH practices. With an average per-visit cost of $130 for treating a PMH patient, compared to an average per-visit cost of $500 at the Emergency Center, this model of care offers significant savings. And beyond the immediate economic advantages, we know from a number of studies that investment in children's health will provide long-term benefits to the community in the form of healthier, more productive adults.

Texas Children's Health Plan (TCHP), the hospital's affiliated HMO offering children's Medicaid and CHIP, is also targeting low-acuity emergency visits. A survey of TCHP members indicated that 54 percent took their children to emergency rooms because their primary care physician's (PCP) office was closed. In response, TCHP developed a structure to support extended hours at network primary care offices. Like PMH, TCHP is closely aligned with community organizations. It deploys outreach workers at more than 150 local events and health fairs annually to educate families about available coverage options. Texas Children's is also partnering with other organizations, including the Houston Independent School District, to connect every uninsured child in public school with health care coverage.

These are just some of many initiatives improving children's health in Houston and across the country. Efforts like these not only offer an antidote to the cynicism that is surrounding the health care debate but also provide an example to lawmakers of what can be accomplished.

And we know we are making a difference. A 2008 Texas Children's-sponsored survey indicated that the number of uninsured children in our service area had fallen over the last five years. Of course, this was due in part to our strong economic climate, as we know that children's coverage is highly correlated to their parents' employment status. Given the current economic environment, positive action by our Legislature (such as expanding CHIP benefits from six to 12 months) becomes all the more vital. We must also encourage active engagement with the community organizations that understand the real needs of these families.

And we must continue to prove to them that children's health is not just another cost but a true investment in our future.