HEALTH CONSUMER ALLIANCE: Helps Underserved Gain Health Care Access
The Health Consumer Alliance, a new group that will help uninsured Californians obtain health care coverage, was formally unveiled yesterday. The alliance will operate in six counties -- Fresno, Los Angeles, Orange, San Diego, San Francisco and San Mateo -- which together are home to 60% of the state's low-income residents. Each of these counties will operate a Health Consumer Center that will educate consumers about their health care rights and responsibilities, solve problems associated with managed care plans and health care enrollment, collect data about health problems and identify problems in the health care system. "Our job is to help consumers navigate the tangled thicket of today's health care system," said HCA Project Director Stan Dorn. "Managed care can present real challenges. Consumers need independent, expert advocates who are unquestionably on their side and not affiliated with health plans or the government." The two-year, $5 million program is being funded by the California Endowment.
Need An Advocate?
HCA is comprised of eight legal services programs that have experience working with low-income consumers on health care problems (HCA release, 10/15). "The crucial need of our client base is health care. The issue has gotten more complicated. We have many clients who aren't being served, especially children," said San Francisco Neighborhood Legal Assistance Foundation Chair Rob Gooden, who spoke yesterday at the San Francisco news conference where HCA was unveiled (Epstein, San Francisco Chronicle, 10/16). The San Francisco clinic and other community programs will inform low-income residents about available resources such as Medicare, Medi-Cal, Healthy Families and county indigent care programs. HCA's Dorn said that due to state welfare cutbacks, the number of Medi-Cal beneficiaries will drop by more than 250,000 this year. But under federal law, Medi-Cal coverage is supposed to continue even if welfare ends. "Without help overcoming barriers to enrollment in these complicated public programs, too many California families will remain uninsured, even though they are eligible for coverage," Dorn said (CHL interview, 10/15). "We don't think that saving health care dollars is a bad thing. It's a great thing -- as long as people get the medical care they need," said Frank Lalle, director of San Mateo County's Health Consumer Center. "It's not about suing people. The goal is to resolve problems at the lowest possible level. ... We want to find what's the best, fastest, least adversarial way to get the person the medical care that they need," he said (Gathright, San Jose Mercury News, 10/15).
The Chronicle reports that HCA will also serve beneficiaries already enrolled in government entitlement programs. In the San Francisco area, 65,000 indigent people "rely on the county's San Francisco General Hospital for their care," and at least "100,000 people are on the city's Medi-Cal rolls." Forty thousand people in San Mateo County are covered by Medi-Cal, and an additional 100,000 could be eligible but not getting the coverage, said San Mateo County Legal Aid Society's Peter Reid (10/16). Dorn said HCA has an outreach campaign planned for the new program that will include advertising through the media, community organizations and health care providers. "I think this program will help a lot of people and make a real difference," he said (CHL interview, 10/15). In Orange County, the local HCA center is strongly supported by CalOPTIMA, the public-private managed care initiative for low-income Orange County residents enrolled in Medi-Cal (HCA release, 10/15). CalOPTIMA CEO Mary Dewane said, "We actually think it's great. It's another locally based tool to educate and inform our consumers" (Gordon, Orange County Register, 10/15).