Wednesday, August 15, 2012
Hood River County has one of the highest rates of uninsured individuals in the state (about 33 percent versus the state average of 21 percent).
The downswing in the economy has caused many existing patients to lose prior coverage available under the Oregon Health Plan.
La Clinica Del Cariño, the longtime source for low-income patient care, is reaching maximum capacity within its current budget.
As these challenges have become a growing concern within the county, health care providers and advocates joined together to look for a solution. What emerged is what may become a model for many small towns in Oregon.
The new program is called the Gorge Access Program, or GAP, and is being administered through the county public health department.
Local physicians and clinics, in coordination with public health staff and Providence Hood River Memorial Hospital, have joined together voluntarily to create a backup option for those who cannot afford care.
Local lead advocates and coordinators for GAP include Dr. Kristin Dillon of Columbia Gorge Family Medicine, Ellen Larsen, director of Hood River County Public Health department, Trish Elliott, nursing supervisor with the public health department, and Karen Joplin, Hood River County Commissioner.
Because the health department provides community referral and information services, the partners felt it made sense to house the program there.
“Our staff really enjoy working with GAP. They understand the impact that having access to regular preventive medical care can have in someone’s life,” said Elliott.
The goal is to provide a coordinated system to create “medical homes” for those without insurance and who have a household income of 200 percent of federal poverty level or less.
Local physicians and clinics have been offering “charity care” on a regular basis for years. The GAP system hopes to better coordinate the physicians’ and clinics’ efforts.
The program aims to provide every resident of Hood River County with a regular source of health care by ensuring access to primary care and other health services for low-income, uninsured members of the community.
GAP candidates are identified through enrollment and eligibility determinations at the health department. Patient co-pays are determined by household size and income. Once enrolled, they receive a patient identity card that does not label them as uninsured, allowing them to receive care like other insured patients with GAP providers.
Hood River physicians, mid-level providers and organizations are banding together to volunteer their time to make the program work, receiving back only nominal fees and the hope that the program will have an impact on the health of the community as a whole.
“The medical providers in Hood River have been remarkably open to GAP. Many have referred patients into the program, and have agreed to accept new patients that qualify in the program,” Elliott said.
The health department helps to coordinate the distribution of patients to local providers, adjusting referrals as physician practices reach their maximum capacity for uninsured care.
According to Larsen, the program “is not insurance coverage. The goal is to establish people with a primary care provider.”
Besides being able to demonstrate income at 200 percent or less of the federal poverty level, eligible individuals must be Hood River residents. There is no age restriction.
The program includes coverage for basic lab tests and imaging. Higher-cost hospital-based services will be assessed for eligibility in the Providence system. There will be a contribution for care based on income level.
To be considered for enrollment, applicants will need to provide proof that they live in Hood River County, proof of income and photo identification. Help is available in making an initial appointment.
Since medical providers are volunteering to donate their time, Larsen advises that those qualifying for GAP “need to be sure to keep their appointments. Not keeping appointments could cause providers to withdraw their donation from the program.”
Dillon received a grant from PacificSource to identify which population groups were relying on emergency room visits for routine health care (one of the costliest sources for non-emergency care). Her data will help target those populations for GAP enrollment.
For more information on the program or to schedule an eligibility screening, contact Elliott at 541-386-1115.