What’s Up, Doc

By Tommy A. Purvis

Posted August 2, 2012 in News
A Medicaid Demonstration Waiver is the catalyst for a rapidly filling low-income healthcare plan for San Bernardino County residents known as ArrowCare. The authorized demonstration project for the highly controversial Patient Protection and Affordable Care Act (read: Obamacare) was able to fall into compliance with the Coverage Expansion and Enrollment Demonstration (CEED) of the often misunderstood federal legislation early. As a result, there are plans to increase and expand health care coverage to as many as 500,000 low-income uninsured residents in California in a trial run of the federal legislation that goes into full effect in 2014.

San Bernardino was in the first wave of legacy county applicants chosen by the state Department of Health Care Services to launch a Low Income Health Program (LIHP) to meet CEED criteria. Such a program would target 30 percent of the county’s population—or half a million people—that lack health care coverage. Nearly 64 percent of adults are overweight or obese in the county, and at least ten percent of have diabetes. So it is not too surprising to hear the region has the third-highest heart disease incident rate in the state. Yet, 17 percent of the population lives at or below the Federal Poverty Level (FPL) of $908 per month for one adult, or $1228 for two.

So far, ArrowCare is a “bridge to a healthy community” that has been able to provide coverage for 15,900 applicants out of the 20,000 available spots for people that meet eligibility requirements found mostly through outreach from the Transitional Assistance Department (TAD) of the San Bernardino County Human Services and the California Partnership. This coalition of community-based groups—which has spread from the Bay Area to San Diego—is organizing locally in an effort to ensure ArrowCare meets its full potential and is structured to meet community specific needs.

To be approved for coverage a candidate must be between the ages 19 and 64, a U.S. citizen or a person with satisfactory immigration status, a resident of San Bernardino County and have an income below the FPL. The plan has a network of providers already in place from Ontario to Needles. There is also preventive medicine, mental health, a pharmacy and hospitalization at the Arrowhead Regional Medical Center. ArrowCare also looks to eventually decrease emergency room wait time as patients stop using the department as a primary care physician.

“The focus of this program is to minimize emergency room visits through primary care and special services,” says Veronica Rodriguez, a program development specialist with TAD.

Ron Boatman, the assistant hospital administrator of Arrowhead Regional Medical Center, warns that it is too early to draw conclusions after seven months of ArrowCare, as he optimistically draws comparison to a prior grant. A two-year study of emergency department visits funded by Kaiser Permanenete found that 120 persons with uncontrolled diabetes had a 41 percent reduction in emergency room visits—727 incidents in the first quarter to 298 in the last—after being treated through a primary care physician. The transition was able to save nearly $100,000 in emergency room costs.

The cost of the $10 billion waiver to fund the LIHP statewide found will be found in the $84 billion in savings the Congressional Budget Office (CBO) says the Affordable Care Act will accumulate over the next 11 years. The CBO also found that repealing the law would cost taxpayers $109 billion over the next decade in the most recent revision of numbers.

The impact is the kind of progress that Maribel Nunez, a community organizer with the California Partnership, was able to envision when she was an agitator for health care reform in for a six-month stint in 2009-10. Back then, she was as a health care activist for a Democratic National Committee project known as Organizing for America that advocated and organized for the health care legislation as part of President Obama’s agenda. Nunez says she felt a sense of renewed purpose in her current effort when U.S. Supreme Court Chief Justice John Roberts became George W Bush’s Earl Warren in the 5-4 decision to uphold the major provisions found in the Affordable Care Act. For more information, check out www.arrowcare.org.

One Comment


    I think the people who are like the ones mentioned in the post need to be look out for the plans which not only covers the services of the doctor but even the costs of the prescription drugs !

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