A health care 'deluge'

County program enrollment sessions suspended after successful, frenzied opening

November 13, 2008|By Larry Carson | Larry Carson,larry.carson@baltsun.com

After just a few enrollment sessions, the county's new health access program for the uninsured attracted so many applicants that sign-up sessions were suspended so staff members could catch up.

During the nine sessions, about 1,100 residents representing 716 households filed applications, said the county health officer, Dr. Peter L. Beilenson, and many of the applicants were found eligible for state and federal health insurance programs.

The long lines and twice-weekly afternoon sessions at the east Columbia library were so well attended that the sign-ups were suspended, and Beilenson said the enrollment efforts will be redirected.

Now, the program will turn to community-based enrollment, meaning residents can apply at locations throughout the county, including the Chase-Brexton Columbia clinic, Howard Community College, the North Laurel Multi-Service Center and through county public schools.

In addition, starting next month, advertising will be targeted at small-business owners who can't afford to provide health insurance for their workers, Beilenson said.

Called Healthy Howard, the private nonprofit effort is designed to offer access to affordable, comprehensive health care to the roughly 20,000 limited-income county residents who are uninsured. Participants will pay from $50 to $115 a month, based on income and family size. For that, they will get up to six doctor visits per year (seven for women), access to specialists, dental discounts, and a health coach intended to create an individual health improvement plan designed to boost each person's general health and reduce emergency room visits.

For the first year, the goal was to enroll about 2,200 people.

So far, fewer than half the applications received have been fully processed.

"We were literally deluged," Beilenson said. "It got to the point very quickly that we couldn't do all of it at the same time."

The frantic activity was wearing down the workers, too, he said.

"They've been burning out, working really hard," Beilenson said, adding that he helped enroll people during one session to see how things were going.

What had been planned as three-hour sessions routinely stretched to five, Beilenson said.

"It's been pretty amazing," said Glenn E. Schneider, director of health policy and planning under Beilenson, as he prepared to begin the last enrollment session Oct. 30.

One change was made very quickly, Beilenson said, because of the time it takes to complete each application using a specialized electronic enrollment system.

Instead of trying to fill out each applicant's electronic application all at once, workers switched to accepting initial documents, then arranging to telephone each person at home to verify other information. If any more documents were needed, people were asked to come back to a later session and drop them off.

At the final October session, more than 50 people were lined up in a hallway, spilling out into the library entrance as they waited for the 4 p.m. start.

Maureen Pike, a newly hired employee, worked quickly to organize applicants into two lines - one for new applicants and the other for those dropping off requested documents. Each person got a number and friendly reassurance that he or she would be helped.

Cindy Carlisle, 50, of Ellicott City was at the back of the line, waiting to drop off a copy of her birth certificate and auto registration, she said. She had spent an hour on line earlier in October but didn't have everything she needed.

An unemployed office worker, Carlisle said her neck was injured when a man drove into the rear of her car three years ago and then backed up and drove away. Carlisle required several surgeries. She later lost her job and has no insurance.

"The way the economy is, there's a lot of people losing their jobs and homes," she said. "They'll be able to get the care they need."

Collin Laird, 25, of North Laurel sat near the front of the line, also waiting with pay stubs and other documents. He is a full-time college student, he said, while working part time as a restaurant server.

In eight years of working in retail since graduating from high school, he said, he has had health insurance for eight months.

"I just kinda feel like I'm OK, but I do have a worry that something horrible could happen," he said, adding that he needs dental work he can't afford.

The program began enrolling people Oct. 1, though medical treatment isn't scheduled to start until January.

A key element in the plan is using existing state and federal health programs to reduce the number of uninsured, and Beilenson said that Healthy Howard's electronic application system, imported from California, is proving a help with that. That is because the program contains eligibility information for other programs, so applying for one is tantamount to applying for all.

"This is a kind of side benefit of doing the Web-based enrollment because we have the rules for all these programs on it," Beilenson said.

So far, people have qualified for an expanded Kaiser Permanente low-cost program offering two years of insurance for up to 450 people, the federally funded State Children's Health Insurance Program and another state program called Primary Adult Care.

"This is about as much as we can handle," he said. "So far, it's been very successful."

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