Bushwick — A few weeks after the World Trade Center attacks, it took Carmen Santana only a few hours to sign up for and receive emergency Medicaid for her asthma--health insurance that has been available since September 11 to most low-income New Yorkers. But come the end of January, when Santana's term on the four-month temporary insurance ends, she and about 55,000 other city residents will likely lose coverage in a matter of seconds. In all, by early March more than 93,300 city households could lose health insurance as quickly as they gained it when they filled out a simplified one-page form. (The standard Medicaid application is eight pages.)

Many of them are expected to qualify for traditional Medicaid and can apply for it now. But health care advocates say that too few beneficiaries are aware that their newfound health insurance is only temporary and that they must contact the city's Human Resources Administration to reapply. "There's no organized effort to reach out to them," said Assemblymember Richard Gottfried, chair of the Assembly health committee.

The solution, according to every health care advocate who testified at an Assembly hearing last Monday: extend Disaster Relief Medicaid. "There are no other options that I'm aware of at this point," said Tom Early, CEO of Health Plus, a managed care organization representing three-quarters of the city's Medicaid enrollees. Applying for regular Medicaid, Early noted, takes at least 45 days. If people don't apply by December 15, he said, "we will see a lot of people dropping off as of February 1."

The city says it plans to put together a public awareness campaign, but adds that if you are receiving the disaster benefits, "you really need to make yourself available," said Iris Jimenez-Hernandez, deputy commissioner at HRA.

Disaster Relief Medicaid was also available to people whose incomes are usually too high to qualify for public health insurance--to $23,484 for a family with four kids. A new state health insurance program that was supposed to have started earlier this year could have kicked in for them when the emergency benefits expire. But the scheduled early-2001 launch of Family Health Plus, the long-awaited health coverage for adults who have children eligible for the successful Child Health Plus public insurance plan, has been postponed repeatedly.

It was scheduled to finally start in October--and then the planes hit New York City. Now, as widespread failures continue to plague public benefit computer systems, it remains unclear exactly when Family Health Plus will finally launch. While state officials blame the city's computer problems, many upstate districts have not begun running Family Health Plus, either, a situation state Comptroller H. Carl McCall attributes in part to the state Department of Health's delays in getting contract information to his office.

Representatives from the city say they are discussing transition possibilities with the Pataki administration and with the federal Department of Health and Human Services. But as of now, the state health department says it is not considering extending Disaster Relief Medicaid. To make sure the program got help quickly to people who needed it, New York had to obtain waivers from the feds eliminating required documentation like citizenship or legal immigrant papers and proof that applicants within a household are in fact related. Said Kathryn Kuhmerker, deputy commissioner for the Office of Medicaid Management at the state Department of Health, "These federal requirements cannot be suspended indefinitely."

Whatever the solution, there is certainly a demand for continued care. Early reports that of the 900 people Health Plus has enrolled in Disaster Relief Medicaid at Elmhurst and Coney Island hospitals over the last two weeks, the bulk, when asked if they would like to be contacted when their four months comes to a close, have said, "Contact me."