Healthy Howard program wins over some former opponents

Funding appears to have broader support this year

May 12, 2011|By Larry Carson, The Baltimore Sun

Howard County's unusual health access program for the uninsured is winning a much warmer reception for the coming budget year, after its county funding barely survived a 3-2 County Council vote last year.

"I'm going to support it," Ellicott City Democrat Courtney Watson said at a Tuesday meeting, after praising the program's efforts to attract more private grants and complimenting the health department's expanded "Door to Health" electronic application program. Watson voted against using county money for the program last spring because she said public money should not be used to pay for health coaches to guide patients. That key element of the program will run on private money next year.

Even Republican Greg Fox — a critic of the program since its inception in late 2008 — said he could support it, though he's still not sure. "Maybe. It all depends. I don't know yet," he said after an uneventful question-and-answer session with county health officer Dr. Peter L. Beilenson.

The casual discussion this year was a big change from the tense, often combative exchanges during similar sessions in the past two years.

Fox said he is impressed that the program attracted $259,000 in grants for the next fiscal year and he realizes a nonprofit entity like Healthy Howard is needed to apply for and receive grants.

"You're linking people with services," Fox told Beilenson. In past years, Fox had argued that the program was a publicity grab for County Executive Ken Ulman — a Democrat who many believe has higher political ambitions — and that It has enrolled far too few residents to be worth the county money. A cheaper public education campaign could do as well, he said.

Watson, who supported Fox's attempt to cut at least $300,000 from the program last spring and then promoted a slightly smaller cut of her own, survived a strong Republican election challenge in a tough political year for Democrats.

"I think the controversy and criticism was healthy, in that it pushed them to do more with the funds and improve the program," Watson said.

Howard County has contributed $500,000 to the program for each of its first two years. It was created by Ulman and Beilenson, a former Baltimore City health officer and Democratic congressional candidate, as their signature program. They pitched it as a local alternative to the lack of national health insurance and as a possible pilot program that could be replicated elsewhere. Democrats pushed health reform through Congress in March 2010.

Healthy Howard provides health care from county-based doctors and services for residents who can't afford to buy their own insurance, but can pay a small monthly fee. The program took in $318,810 in fees between July and last month.

Beilenson said funding limits enrollment to 750 people at any one time, though 1,202 county residents have been served since the program's inception. About 6,500 more applied, but learned they don't need Healthy Howard because they are eligible for existing health insurance programs. Thanks to a grant of 175 slots in a Kaiser Permanente health insurance program for lower-income people, Beilenson said, there is no waiting line of applicants for Healthy Howard.

The program, which is not insurance, will halt enrollment on July 1, 2013 and will go out of business when the new national health care insurance system starts in 2014. Beilenson is working on creating a regional health insurance co-op to lower premiums for lower income people who may have trouble affording insurance even with a government subsidy.

Beilenson told the council that the private grants will pay for health coaches who work individually with the 750 uninsured county residents enrolled in the program to help them achieve healthier living and eating habits. The idea is to reduce expensive emergency room visits and chronic diseases by helping people improve their overall health. Healthy Howard's coaching program is one of 22 finalists nationally for a federal Department of Health and Human Services award, Beilenson said.

Beilenson said the Door to Health electronic application, launched in mid-January, had by Monday helped 2,460 low-income people apply for every existing program for which they qualify. The application combines formerly separate state, county and Healthy Howard workers into one unit and uses a specialized process Howard is modeling for the state. That's a tripling of the rate of applications under the old system.

The electronic program uses each applicant's basic information and automatically applies it to every possible aid program, except for Social Services programs like food stamps or temporary cash assistance.

"We merged Healthy Howard people with children's health insurance and the Medicaid people," Beilenson said. He is not asking the county for more new money to do that for the next year.

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