Cost of Care Recession 

Don't get sick: Crisis in coverage

Partner: 
Modesto Bee
Summary: 

Doctors in Stanislaus County say mounting numbers of out-of-work professionals and laid-off blue collar workers have joined the chronically poor and undocumented in clinic waiting rooms throughout the region, threatening to overwhelm its fragile safety net. The deep recession has pushed the ranks of Central Valley uninsured to unprecedented levels, while a dire state budget deficit has forced lawmakers to cut key health care programs for the state’s poorest residents. These two trends reveal a troubling new reality: Across class lines, people are struggling to access care -- or simply are going without.

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Don't Get Sick: Multimedia Profiles
Lauren M. Whaley, CHCF Center for Health Reporting | February 22, 2011
A family with a host of health issues whose top breadwinner gets laid off. A woman out of work and desperate for care. A man losing his teeth and dental coverage and a doctor trying his best to treat everyone who walks through his door.
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Don't Get Sick: The crisis in Stanislaus County
Jocelyn Wiener and Ken Carlson | February 22, 2011
A health care crisis is sweeping the Central Valley, devastating middle-class and poor families and threatening to overwhelm the region’s fragile safety net. The deep recession has pushed the ranks of the uninsured here to unprecedented levels. At the same time, a dire state budget deficit has forced lawmakers to drastically scale back or eliminate key health care programs for the state’s poorest residents. At the nexus of these two trends lies a troubling new reality: Across class lines, people are struggling to access care — or simply are going without.
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Middle-class conundrum: Too wealthy for aid, too poor to afford
Jocelyn Wiener, CHCF Center for Health Reporting | February 22, 2011
For a long time, Laura and David Hinton were living their version of the American dream. He earned a steady income as a driver for Arrowhead Water. She waitressed part time at Marie Callender’s. They owned a boat. They took their three young daughters to Disneyland. They bought a three-bedroom house more than a decade ago and decorated it with family photos and angel figurines. Then, on May 22, 2009, the bottom dropped out. Story continues below video.
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Modestan loses smile when Medi-Cal drops optional benefits
Jocelyn Wiener, CHCF Center for Health Reporting | February 22, 2011
John Stygar doesn’t smile anymore. With only four teeth remaining in his mouth, he’s too embarrassed. “Everybody that knows me has mentioned that I’m not the same person, because I’m not the perky, happy, smiley guy that I used to be,” he said. Story continues below video  
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Hughson woman feels effects of health-care cuts to indigent
Ken Carlson, The Modesto Bee | February 22, 2011
Stanislaus County’s indigent adult health program has been a safety net for some of the county’s poorest residents, as well as people whose jobs and health insurance have disappeared during the recession. But the county’s struggles to maintain the state-mandated program, amid a budget crisis and a shortfall in the revenues that fund adult indigent health services, has threatened to cut off many patients who need the help. Under the program, county residents age 21 to 64 who earn less than $1,806 a month and don’t qualify for Medi-Cal, receive free or low-cost care at the Health Services Agency clinics in Modesto, Ceres, Turlock and Hughson. The county also pays for medication, lab tests, surgery, hospitalization and other medical services.
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Bullet Points: Government health cuts in Stanislaus County
Staff Reports | February 22, 2011
Here’s a look at some government health cuts in Stanislaus County, and at prospective cuts in Gov. Jerry Brown’s proposed 2011-12 state budget: CUT • 55,000 county adults on Medi-Cal lost their dental, podiatry, audiology, psychology and other “optional” benefits in July 2009. • 126 staff positions lost since 2005 at the county Health Services Agency, which provides health care to low-income residents. • Almost 200 employees lost in the past three years at county Behavioral Health and Recovery Services, which oversees mental health and drug and alcohol services. The department also closed three mental health clinics.
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Doctor: Looking for nontraditional ways to treat uninsured
Ken Carlson, The Modesto Bee | February 22, 2011
A 30-year career in health care has given Dr. Eric Ramos of Modesto special insights into patient care. He developed his calm bedside manner and compassion for patients working as a nurse for several years before going to medical school in Southern California, where he grew up. The former high school wrestler did a primary care residency at the former Stanislaus Medical Center in Modesto, and after finishing the training in 1992, stayed to practice here. Story continues below video  
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Graphic: Services on decline; health insurer breakdown
Staff | February 22, 2011
Click here to download the graphic on services on the decline in Stanislaus County.  
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Graphic: A look at indigent care
Center Staff | February 22, 2011
Click here to download the graphic showing the surge in indigent patients in Stanislaus County.    
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PDF: Day 1 in print
Center Staff | February 22, 2011
Click here to download the Day 1 package as it appeared in The Modesto Bee. February 20, 2011.
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Unemployed and Uninsured: Learning which illness to fight
Ken Carlson, The Modesto Bee | February 22, 2011
When she awakes in a bunk bed every morning, in a room with a Justin Bieber poster and other girly decorations, Juli Leavitt is reminded how her life has changed since the economic downturn. In 2009, the payroll company that employed her as an operations supervisor lost 40 percent of its business in 60 days. Leavitt and several co-workers were laid off. She gave up a condo in a gated community and moved into her friend’s Turlock home. There, the 61-year-old, silver-haired Leavitt shares a room with her friend’s 9-year-old daughter.
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Senior: A Stanislaus County program that works for her pulled away
Ken Carlson, The Modesto Bee | February 22, 2011
During the state budget crisis in 2009, one stroke of Gov. Arnold Schwarzenegger’s pen eliminated funding for an obscure program that helped seniors and disabled adults live independently in Stanislaus County. Susan Deshais, 76, of Riverbank was among 100 people who lost the help they received from the Area Agency on Aging’s Linkages Program. For her, the program worked. The program’s case managers made sure that her medical needs were met and arranged for other services to help her live safely at home. Deshais’ case manager called her once a month, arranged for a dentist to fit her with dentures free of charge and made sure she had diabetic supplies, a walker and grabbers for picking up hard-to-reach items.
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TwentySomethings: In a state of insurance 'limbo'
Jocelyn Wiener, CHCF Center for Health Reporting | February 22, 2011
During the school year, Nikki Boudreau has access to health care through California State University, Stanislaus, where she’s a senior. But come summertime, and during school breaks, she is uninsured. Under federal health care reform, young people up to the age of 26 can be insured through their parents’ health plans. But that only works if their parents have health insurance. The 22-year-old art student isn’t so lucky. Her father worked in home improvement until the housing bubble burst. Her mother did child care. Neither is insured. So Boudreau is on her own.
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Health services director: Patients' stress is visible
Ken Carlson, The Modesto Bee | February 22, 2011
Dr. Del Morris can see the stress on the faces of the newer patients at the Stanislaus County health clinics. Some have lost their homes. Others are worried they may never work again. In addition, most all of these new patients are sick. “They are just average working people who lost their jobs,” says Morris, the medical director of the Stanislaus County Health Services Agency clinics. “They don’t apply to the program because they want a health screening. They come to see me because they have a medical problem.”
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Nurse: More middle-class patients accessing system
Jocelyn Wiener, CHCF Center for Health Reporting | February 22, 2011
Older patients often assume Planned Parenthood is all about condoms and birth control pills, and feel embarrassed to be seen there, she said. But, as the economy continues to stagnate, and so many have lost jobs and insurance, they’re beginning to get past that stigma. The total number of visits to the clinic has increased from less than 12,000 in 2006 to almost 18,000 last year. DeLaurier-O’Neil, 58, has worked in nursing on and off since 1975. Last year, she came to Planned Parenthood out of retirement because she, herself, needed health insurance.
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Modesto JC Student: Waiting out an illness
Jocelyn Wiener, CHCF Center for Health Reporting | February 22, 2011
A few months ago, Josue Jimenez had a fever and a bad stomach ache. On the first and second day, he wasn’t too worried. By the third day, he started getting nervous. Why wasn’t he better yet? “I should go to the doctor,” he thought. But Jimenez, a Modesto Junior College student, doesn’t have health insurance. And he knew his family didn’t have the money to pay for a doctor. So he got in bed and waited. And waited. After five days, he finally started feeling better. The prospect of falling sick again makes him nervous. “I might have to wait until it becomes a very serious problem and is considered an emergency,” he said. “Or just not go at all.”
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PDF: Day 2 in print
Staff | February 22, 2011
Click here to download the Day 2 package as it appeared in The Modesto Bee. February 21, 2011.  
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Healthy Change: 'Benefactor' approach in Modesto provides for uninsured
Jocelyn Wiener, CHCF Center for Health Reporting | February 22, 2011
There are two entrances to St. Luke's Family Practice. The first door to this unique nonprofit Catholic doctors' office — housed at the back of a Modesto shopping center — is for well-to-do patients who pay an annual premium to access boutique-style medicine. The other door, a few feet away, is for the uninsured. For the seven years St. Luke's has been in existence, a steady stream of gardeners, housecleaners and others who are down on their luck has come through this second door, seeking medical care after everyone else has turned them away.
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Healthy Outlook? Doctors, officials seek new solutions
Jocelyn Wiener and Ken Carlson | February 22, 2011
The national health care crisis has hit hard in Stanislaus County. About 90,000 residents are uninsured, including a quarter of all adults ages 18 to 64. Poor and, increasingly, middle-class residents are struggling to access care. They are filling county clinics, crowding emergency rooms and, as they fall through holes in a fraying safety net, forgoing treatment. The county now faces a pressing question: What can be done to relieve their misery?
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PDF: Day 3 in print
Staff | February 23, 2011
Click here to download the Day 3 package as it appeared in The Modesto Bee. February 22, 2011.
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PDF: Indigent Health Services Information
Staff | February 23, 2011
Click here to download a PDF on Indigent Health Services Information.
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Where To Get Help
Staff | February 23, 2011
Click here to download the full PDF of Where to Get Help.
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Capital Public Radio features Modesto uninsured project
Center Staff | February 25, 2011
Reporter Jocelyn Wiener appeared on Capital Public Radio's Insight on Wednesday to discuss the project "Don't Get Sick: Crisis in Coverage." The Center partnered with The Modesto Bee to produce the project, which spanned three days and included 18 stories and four audio slideshows. Wiener talks about how across class lines, people are struggling to access care -- or simply are going without. Listen here.  
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Chat Transcript: Doctor, reporter answer health care questions
Center Staff | February 25, 2011
Following the publication of "Don't Get Sick: Crisis in Coverage," Dr. Eric Ramos, chief medical officer of Doctors Medical Center, and Modesto Bee health reporter Ken Carlson, answered questions from readers concerning health coverage in Stanislaus County. Click here to download the transcript as a PDF or scroll through the chat below. Don’t Get Sick: Crisis in Coverage Live Chat, Feb. 23, 2011, Noon-1 p.m. @ www.modbee.com
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Valley Public Radio features Crisis in Care radio package
Center Staff | March 10, 2011
Multimedia reporter Lauren M. Whaley partnered with a team of reporters from the Center and the Modesto Bee to produce this radio story as part of Don't Get Sick: Crisis in Coverage project. Valley Public Radio featured the radio package to start off their hour-long Quality of Life program. Listen to the piece here. 
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