December 21, 2001 - ‘Public-private partnership’ provides a way to bring health care to low-income Wichita residents who lack health insurance

Ylonda Dennis, an eligibility specialist at the Kansas Department of Social and Rehabilitation Services (SRS), recently talked about a concerned woman with cancer. The woman had no health insurance and was astonished when Ms. Dennis, who is stationed at the Center for Health and Wellness in northeast Wichita, told her that medical care was available through a program called Project Access.

Ms. Dennis said the woman, who she called a "cancer survivor," got so emotional she had to excuse herself and call back the next day for more information.

"She told me she just couldn’t believe it was real," Ms. Dennis said.

Ms. Dennis is one of six SRS eligibility specialists who have been stationed in six primary care clinics across Wichita. Moving from their SRS jobs in the Finney State Office Building in downtown Wichita, to the clinics has given them a unique prospective on their jobs. It has also provided the clinics with much needed help in determining which part of the health care system can assist the patients coming through their doors. For the most part, the six clinics treat low-income patients without health insurance.

"It’s a public-private partnership, and SRS is an integral part of the team," said Anne Nelson, program director for Project Access. "This project is reaching a population that has not been reached before."

The eligibility specialists assigned to the clinics gather income verification from patients for enrollment in health programs for which they are eligible for. The programs include Medicaid, HealthWave, and Project Access.

Medicaid is the state/federal health insurance program for low-income people; HealthWave is a federal/state program providing health insurance coverage for children from working families without health insurance; and Project Access is a community-based program coordinating donated medical services from physicians, hospitals, pharmacies, and others for uninsured, low-income Sedgwick County residents. The eligibility specialists also help people gain access to other SRS-administered programs such as food assistance and child care.

To the eligibility specialists, the addition of Project Access to the mix of health programs they determine eligibility for is a godsend. A number of them said that before Project Access, the hardest thing about their work was telling someone who is sick that there was no help available.

"I don’t like not being able to help," said Glenda Reynolds, an eligibility specialist who worked for two years with United Methodist Health Clinics. Ms. Reynolds now trains eligibility specialists at the Wichita SRS Area Office, and fills in for workers on vacation at the clinics.

Like Ms. Dennis, Ms. Reynolds also gave an example of a woman facing cancer who had no health insurance, but was able to receive healthcare through Project Access. The woman works two part-time jobs and receives child support for her three children. This income was above eligibility standards for state and federal health programs.

"But the biggest group of people we are unable to help are single adults," Ms. Reynolds said. "Unless they are old, disabled, or pregnant, there’s nothing for them."

The stationing of SRS eligibility specialists in the clinics began when Project Access started in September, 1999. Dr. Michael Bates, board president of Project Access, called the assistance provided by the eligibility experts a "huge" part of the program’s success. "

It’s very helpful." Dr. Bates said of the SRS assistance. "Because the clinics are underfunded, they don’t have the staff to do eligibility interviews."

Project Access has been recognized nationally, and regularly receives inquiries from other communities trying to emulate the programs’s success. The program is operated with volunteer help from almost 70 percent of physicians in Sedgwick County. In addition to donated care from physicians, Sedgwick County hospitals provide free care for Project Access patients, many area pharmacies fill prescriptions below their cost for people in the program, and the county and city governments chip in to help patients pay for prescriptions.

To be eligible for Project Access, patients must live in Sedgwick County, have income below 150 percent of the federal poverty level, have no medical insurance, and not receive other state or federal medical benefits. For the most part, patients enrolled in Project Access receive primary care through the clinics and specialty care through Project Access. Between September 1, 1999 when Project Access began, and August 31, 2001, 2680 patients have accessed donated specialty care through the program.

Dr. John Whitfield, administrator at the Hunter Health Clinic, said the program saves money by catching possible serious illnesses early.

"There is more emphasis on preventive care," he said. "It allows people to be functioning members of society, instead of becoming dependent on society."

Project Access Program Director Anne Nelson said when she attends national meetings, people are surprised by the partnership and coordination between her program and SRS, the state’s Medicaid agency. "You mean Medicaid?," she said she has been asked many times when she describes the cooperative venture.

About 20 percent of those who come in for medical assistance at the clinics qualify for Medicaid, Ms. Nelson said. Some others qualify for Medicare, the federal program for older Americans. But many of the uninsured gain access to healthcare through Project Access.

Marlene Dreiling, director of the Guadalupe Clinic in south-central Wichita, said the SRS worker at her site has been a tremendous help.

"She’s there to help people fill out the paperwork," Ms. Dreiling said. "A lot of times she helps children get into the HealthWave program. What it does, is helps us send people where they need to be for healthcare.