By Matt Perry
California Health Report
More than 7 million Californians have no health insurance at some point during any given year. For many, this means no doctor visits and no preventive care. Poor, frustrated and desperate, these citizens often think they have no access to healthcare.
In truth, there are thousands of low-cost and no-cost clinics and agencies that support the uninsured.
Californians for Patient Care (CPC) maintains a robust database of more than 5,000 contacts linking the uninsured with a wide range of discount services.
“This is the most comprehensive database of its kind in the state,” boasts Carmella Gutierrez, the organization’s president. “There are actually more options than people think.”
Included services are dentists, hospitals, Medicare, Medi-Cal, mental health, prescriptions, vision, hospice and palliative care. But the database also lists other critical services for the uninsured: food, domestic violence prevention, and alcohol and drug treatment.
Targeted patient groups include children, women, seniors, veterans and the homeless.
Californians for Patient Care says the most surprising aspect of California’s population of uninsured and “underinsured” – those with insufficient health coverage – is that many are solidly middle-class: they run small businesses, are self-employed or have recently been laid off.
“It’s working families,” says communications director Anissa Routon.
“They’re people we don’t associate with the traditionally uninsured,” echoes Gutierrez.
Gutierrez cited her own brother as an example. Employed for 24 years at a casino, he was laid off and eventually lost the insurance for his family – including three children – that he was able to keep for a time after he lost his job.
Still, he wouldn’t try the available low-cost options, preferring to wait until he got a new job.
“It would make me crazy,” sighs Gutierrez, who frequently sent her brother lists. “Ron, here are the clinics!”
CPC‘s outreach efforts target both these middle-class patients and low-income Californians.
Users of the site’s MyHealthResource simply type in their location, check the health services they want, and select a distance they’re willing to travel – 5 to 50 miles.
Gutierrez emphasizes that patients can travel anywhere to access needed treatment – even to neighboring counties.
“You don’t have to be a resident of that county to get services there,” she says.
On average, website visitors spend just two minutes on the site, “and then they boogie,” she adds.
Desperate Californians learn about CPC from health professionals, government resources like California’s Office of the Patient Advocate, or the statewide 2-1-1 number – a telephone resource for services ranging from health to food and shelter.
The four-member staff attends statewide health fairs once or twice monthly. These include the hugely popular Remote Area Medical clinics where patients often line up in the early morning hours for free medical and dental services.
Other health fairs dotting the state are sponsored by state legislators to serve constituents.
CPC leaders estimate that Latinos constitute nearly 60 percent of California’s uninsured, so they work with organizations like Telemundo and the state’s 10 Mexican Consulates. When the Capitol-based organization can’t attend these health fairs in person, they provide hundreds of hard copy directories for local health services.
Their message to the distressed: “Besides this one-time intervention, there are plenty of resources in their area,” says Gutierrez.
She says paper printouts are essential because many poor patients lack internet access.
Isabel Flores, program coordinator for the Mexican Consulate in Sacramento, was contacted earlier this year by CPC and began handing out information at monthly health fairs that serve all ethnicities.
“(Our) consulate serves 24 different counties so sometimes I don’t have all that information,” says Flores. “It really has been great to have their information here.”
In April, CPC also offered its website in Spanish after receiving a project grant from the Californian Endowment. (The Endowment also sponsors HealthyCal.org.)
While 10% of site visitors come for consumer information – health insurance, Medicare, Medi-Cal, and other topics – most use it for the site’s MyHealthResource database and its list of service providers.
A major goal of the organization: break down as many barriers to healthcare access as possible. The website’s annual 50,000 unique visitors are asked only for their location. No registration or personal information is required.
Yet these “privacy” and “no barriers” strategies also have their downsides. The organization knows little about its users, and doesn’t track whether they actually receive services from the providers listed in the database.
After visiting the website, William Henry Howard was in fact discouraged by yet another healthcare denial. Following a search for low-cost dental services – the third most popular service request on the website – Howard received a return phone call telling him that only extractions were provided. He didn’t realize that only one clinic was unable to help him – not the entire network of dentists.
At the end of last year, CPC pioneered a Share Your Story section of its website. Yet even there, many of the testimonials describe needed services rather than healthcare successes.
No user testing has been done for the website, which is sometimes painfully evident. Search results listing lengthy government offices and their departments often look exactly – and confusingly – the same.
“I wasn’t specifically aware that they had this database,” says Anthony Wright, executive director of Health Access, a patient advocacy organization focusing on consumer legislation and policy. “This is a first and important step, but sometimes people need more than an online directory.”
Started in 2004, CPC is partially funded by the California Hospital Association, which has a keen financial interest in its success. Last year California hospitals suffered $12.5 billion in unreimbursed expenses according to the association, which fears that some rural and urban hospitals could close by the end of this year.
When patients get the services they need, say Gutierrez and Routon, they are immensely appreciative.
“We get a lot of people on our site who are helping out members of their family,” says Routon. “Their whole community is trying to help them get the care they need.”
“People are so needy,” says Gutierrez. “And so thankful to get the services they need.”
As California’s economy continues to sputter, the clinics found on the organization’s website can be a true lifesaver for patients without sufficient healthcare.
“We’re their starting point and hopefully their very effective connector,” says Gutierrez.
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