Health Reform 

Bridge to reform: Medi-Cal enrollment programs face rural challenges

Partner: 
Bakersfield Californian
Summary: 

Kern County, with some of the state’s highest rates for diabetes, heart disease and obesity, is home to a test case for the federal government’s new Health Care Coverage Initiative. We examine the successes and challenges of an innovative health care demonstration program for the county’s lower-income population that provides them with a publicly funded “medical home.”

Impact Summary: 

Kern County, with some of the state’s highest rates for diabetes, heart disease and obesity, is home to a test case for the federal government’s new Health Care Coverage Initiative. We examine the successes and challenges of an innovative health care demonstration program for the county’s lower-income population that provides them with a publicly funded “medical home.”

Results
Bridge to health care reform strained in Kern
John Gonzales and Steven Mayer | August 21, 2010
For Sharon Vermillion, life in Weldon has always meant a winding trip through the Kern River Canyon to gather life's essentials; everything from aspirin to sensible shoes can be bought more cheaply 55 miles away in Bakersfield. But with chronic pain through much of her body and a sky-high cholesterol count, health care is one thing the 57-year-old waitress would rather not owe to a twisting drive along the rapids.   "Life would be so much easier if I could see a doctor near home. My entire physical being would change," said Vermillion, who is uninsured, like many in the town of 2,300 east of Lake Isabella.
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Results
How the program works
John Gonzales and Steven Mayer | August 21, 2010
Evaluators of the Health Care Coverage Initiative estimate that 1.6 million lower-income Californians, possibly more, will qualify for the program. Dylan Roby, part of the evaluation team at the UCLA Center for Health Policy Research, offered these details on how the program will proceed and who it will help. * Nine counties that had demonstration projects -- including Kern -- will prepare to enroll as many people as possible who are at zero to 200 percent of federal poverty level, a limit of $44,100 in annual household income for a family of four. A request to do so is expected to be granted on Sept. 1, with implementation scheduled for Feb. 1, 2011. One county, Los Angeles, limits its enrollment to the poorest applicants, 133 percent of federal poverty level.
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Results
Doctors needed as health care reform approaches
John Gonzales and Steven Mayer | August 21, 2010
Dr. Katherine Schlaerth loves her work, but there's not a lot of downtime at the crowded nonprofit Family Health Center in central Bakersfield. "There are no lulls around here," Schlaerth said with a tired smile as she double-checked a patient's chart before moving to her next appointment. Despite her job satisfaction, when Schlaerth contemplates the state of health care in Kern County and other areas of the state, her outlook darkens. "I do worry about what's going to happen in the future," she said. There's a lot to worry about. Over the next few years, an estimated 62,000 uninsured patients in Kern are expected to come looking for a "medical home" -- a primary care doctor with all the fixings -- offered up by federal health care reform.
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Results
Health Initiative Timeline
John Gonzales and Steven Mayer | August 21, 2010
July 2006 -- Governor signs State Senate Bill 1448, initiating development of the Coverage Initiative to provide health care coverage to eligible uninsured citizens and documented adults. March 2007 -- Kern Medical Center awarded federal grant of $10 million per year for a three-year period to implement pilot health care project. Kern the only inland county of 10 counties chosen to participate. November 2007 -- Los Angeles-based COPE Health Solutions approved to administer coverage initiative in Kern County. February 2008 -- Kern's care initiative begins enrollment; focuses on individuals with history of high use of county medical services. Early 2008 -- Clinica Sierra Vista backs out of pilot project; says initiative did not meet expectations.
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