California county bets on bridge to health reform

As we reported recently, the county of Fresno in California's Central Valley has the distinction of being the one county in the state that decided not to participate in a new health insurance program called Bridge to Health Reform, that could have covered thousands of residents. This week, we travel to the nearby county of Kern, with similar geography and population to Fresno, but that did decide to enter the Bridge to Reform. On the way, Kern has stumbled upon many challenges, but for some patients, the program has changed their lives. Our reporter Farida Jhabvala Romero visited the county seat in Bakersfield and has this story.

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Kern Medical Center is the county hospital in Bakersfield.

(TRANSLATED SCRIPT)

NARR: While at Kern Medical Center, Dinora Martinez asks about one of the services included in her new health insurance.

MARTINEZ: You are telling me that when I have a medical appointment and I don’t have enough for the bus, I can call this number and you can help me with the fare that day?

WORKER: Yes, with any appointment you have for our program. OK?

NARR: Dinora is insured because Kern County participates in the so-called Bridge to Health Reform. Instead of going to the emergency room like before, she visits a primary doctor that knows her. She has had tests for cervical and breast cancer. She also goes to physical therapy sessions to rehabilitate her arm, which she injured in her old job at a carrot packing plant.

MARTINEZ: Imagine if I didn’t have this insurance, in what situation I would be. Without insurance, without a job, in pain and unable to get my medicine, it would be even harder.

NARR: All counties in California, except Fresno, participate in the program. The goal is to insure low income adults that currently do not qualify for the public insurance Medicaid, known as Medi-Cal in California. Dinora says that here in Kern County, it is badly needed. She has a friend that lost her home because she had to pay for her daughter’s medical bills.

MARTINEZ: Here we have a saying. Here the patient does not die of the disease, but from the bill.

NARR: According to researchers at the University of California in Los Angeles, 25,000 adults in Kern County are eligible for the benefits of the Bridge to Reform. But so far, only 7,500 have enrolled. Stephen Schilling is the CEO of the community clinic Sierra Vista. He says that enrolling is cumbersome and takes a long time because you can only do it through the hospital in the city of Bakersfield, and not in rural clinics. Schilling is disappointed with the program.

SCHILLING: It’s been a big idea and with great promise that hasn’t been handled very well. Not many people enrolled. People are not being paid. I’m owed over a $100,000 dollars as we speak because the state is not paying anybody and the counties are then not paying their contract providers.

NARR: The payments have been delayed for 9 months. Kern Medical Center has had to borrow millions of dollars from the County Board of Supervisors to cover their expenses in the mean time. Jacey Cooper, from the hospital, is waiting for a first payment in April. Even with these challenges, she says that the steps that they are taking now are enormous and necessary to get things up and running for health reform in 2014.

COOPER: We used to joke that there was a wall around KMC and we are tearing the wall down! We are building really good relationships with our community partners. And we really do think we are setting ourselves very nicely for health reform and being successful at that by working together as a team… getting the information education and care out there.

NARR: In contrast to Fresno, the only county in California that opted out of this program, the Kern County Board of Supervisors has supported the effort. Jacey says that the supervisors help distribute pamphlets about this medical insurance. Another program promoter is Dinora Martinez, the patient, who tells her friends about it.

MARTINEZ: There needs to be more advertising so people find out about this insurance. How beneficial it is. The other thing is we shouldn’t be afraid. We need to ask about it.

NARR: For the Weekly Edition of Noticiero Latino from Bakersfield, California this is Farida Jhabvala Romero. This story was produced as a project for The California Endowment Health Fellowships, a program of the University of Southern California's Annenberg School for Communication and Journalism.

 

Broadcast was originally published by Radio Bilingue

Audio file