Health Notes

Healthy Howard wants $500,000 more from county

February 21, 2010|By Larry Carson | larry.carson@baltsun.com

Healthy Howard, Howard County's health access program for the uninsured, is requesting another $500,000 infusion of county funds for the fiscal year starting July 1. The program is also getting a new $150,000 grant from the Horizon Foundation.

Horizon President and CEO Richard M. Krieg said the foundation is also giving $100,000 to Chase Brexton Health Services in Columbia, the nonprofit that provides primary medical services to the Healthy Howard program. Horizon provided $500,000 to help Healthy Howard get started in January 2009.

The Horizon grants, Krieg said, are "just to support the ability of low-income people without insurance in Howard County to get the help they need," especially with no federal solution to the lack of universal health care in place. Krieg said the foundation's leaders feel a particular need to help low-income Hispanic people, who now make up about one-forth of Chase Brexton's clientele.

The money for Chase Brexton could help it increase access for people using the expanded state Medicaid program, or other insurance programs for low-income families that make them ineligible for the Healthy Howard program. Often, he said, families have trouble finding doctors who will accept them.

"The big picture is access to care," Krieg said, adding that the foundation, born from the merger of Johns Hopkins Hospital with Howard County General Hospital in Columbia, particularly wants to support the prevention and wellness aspects of the Healthy Howard plan.

"This grant will enable the Chase Brexton clinic to increase the enrollment of low-income Hispanic, African-American and other patients" who are not enrolled in Healthy Howard, Krieg said. "It will also allow the clinic to accommodate an increase in Medicaid patients resulting from Health Choice expansion in Maryland," he said.

The money will also expand aid for those who need treatment for chronic diseases. Chase Brexton charges low-income clients fees based on what they can afford.

Meanwhile, Healthy Howard, the program that charges limited-income, uninsured Howard County patients a small monthly fee for access to a comprehensive network of health providers, is slowly growing, according to Dr. Peter L. Beilenson, the county's health officer.

"We're pleased with the grant. We have several other grant applications out," Beilenson said.

Healthy Howard has 671 patients enrolled, he said, with another 408 applicants being processed. In addition, he said, 2,550 who applied were eventually enrolled in other existing insurance programs. Healthy Howard is enrolling about 60 people a month, which he said is all the new patients Chase Brexton can handle in one month. Earlier predictions of enrolling 2,000 people in the first year were overly optimistic, Beilenson said.

Although medical treatment began in January 2009, Beilenson said he won't have enough data to fully evaluate the program until April, when the county's annual public budget process for the coming fiscal year begins. Although the first few patients have been receiving medical treatment for just over one year, the effects of the health coaches the program uses to try to change patients' daily habits and improve their general health takes longer to evaluate, he said.

So far, however, he said it appears the program is helping to cut emergency room visits.

"We seem to be helping to reduce hospital emergency visits," Beilenson said. "I'm very comfortable with how the program is doing." In view of the sour economy and the county's budget crisis, he said he has requested a third $500,000 county grant. "We expect to be flat-funded," he said.

Beilenson knows his budget request will likely come under sharp scrutiny from County Councilman Greg Fox, the five-member body's only Republican, who has argued that since enrollment of uninsured people has been much slower than anticipated, the program shouldn't need as much county money.

Fox said Monday that he's seen no statistics or other evaluations from Beilenson, so he reserved comment. He said he'll again be concentrating on "the cost effectiveness of the program" when the council reviews the budget in May.

Beilenson said Healthy Howard is very efficient, costing less than $2,000 per person per year, compared with a national average of $7,400. He said the program needs more county money, despite the overly optimistic predictions of enrolling 2,000 people in the first year.

First, private grants aside from Horizon's have been hard to get.

"Every single Baltimore-area foundation said, 'Your county is too wealthy,' " he said.

Second, Healthy Howard is just now getting large enough to profit from economies of scale, he said. The more people enrolled, the higher the income the program has from members' monthly fees.

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