Ten years in the health care jungle
By Dan Cabot
Published: November 19, 2009
On Friday last week, the Vineyard Health Care Access Program (HCA) celebrated 10 years of service to the community with an open house at its New York Avenue offices.
The Vineyard Health Care Access staff includes, (left to right), Mary Leddy, Kellen Andrade, Sarah Kuh, the director, and Maria Mouzinho. Photo by Ralph Stewart Created by the Dukes County Health Council, the program helps Vineyarders find their way through an arcane maze of 10 or more federal and state health insurance programs, confusing regulations, and sometimes difficult proofs of eligibility. As Vineyarders consider Mass. Health, Commonwealth Care, and the Health Safety Net, as well as Medicare and Medicaid, Prescription Advantage, and disability benefits, which program applies? How does a person qualify? How does a person enroll?
To make matters worse, for those who qualify for low-income programs, the process has to be repeated every year, often with new rules, new requirements, and new proofs of eligibility. No one can be expected to survive very long in that tangled jungle without a guide.
Sarah Kuh and her staff at HCA are expert, experienced guides. Three have been there for more than eight years, and they undergo constant training to keep up with changing regulations. Each member of the staff travels off-Island to workshops six times a year, in addition to taking online courses.
Anyone can find himself or herself suddenly without health insurance. Ms. Kuh cites an imaginary example of a self-employed person in the building trades, perhaps a finish carpenter, who has experienced several months without jobs in the current economic recession. After a time, he finds that he cannot keep up with the health insurance premiums he has been paying. HCA is not an insurance agency and does not administer state or federal insurance programs, but what HCA can do is tell the carpenter what low-cost or no-cost programs he is eligible for and help him through the application process.
Because subsidized coverage has to be renewed every year with new proof of eligibility, HCA also gets frequent calls from pharmacies or the hospital to say that a particular client's coverage has expired. HCA then scrambles to solve the emergency.
At the moment, according to Ms. Kuh, there are 2,500 clients active on the HCA rolls, or about one in eight Islanders. Because about one-quarter of HCA's clients do not speak English, three of the HCA staff speak Portuguese and one speaks Spanish.
Half of HCA's funding comes from Dukes County and the six Island towns. The other half comes from state and private grants and from contributions from individuals. However, hard economic times have hit HCA too, and the program's income is down by about one-third from two years ago. Ms. Kuh has had to reduce her staff from five counselors to four. At the same time, demand for HCA has increased with the sagging economy, and clients are having a hard time finding dental care, prescription medicines, and access to specialists.
On Friday, HCA celebrated ongoing success against difficult odds. A press release quotes client Madeline Ezanno: "This is a program that our community absolutely needs. They have helped my family and so many people I know. I can't imagine where we would be without their services."
The Vineyard Health Care Access Program, 114 New York Avenue, Oak Bluffs. For more information, call 508-696-0020.
