Program links patients, reproductive service
When federal welfare legislation eliminated the automatic link between public assistance programs and Medicaid, many women lost their connection to medical coverage. However, women in New York City are now finding a link to reproductive health services coverage through Planned Parenthood of New York City’s Entitlement Advocacy Project.
The program relies on specially trained counselors at Planned Parenthood centers who are able to directly assist clients in the application process for Medicaid and Child Health Plus, a state insurance program for young people under age 19. By serving as the clients’ representative to the local Human Resources Administration (HRA), which operates the city’s Medicaid program, Planned Parenthood can handle the documentation that is vital for securing such medical coverage.
Since its October 1999 initiation, the program has achieved a 98% rate success rate in obtaining Medicaid coverage for qualified clients, reports Alice Berger, director of health care planning and managed care initiatives at Planned Parenthood of New York City. As of its first year of operation, the program had secured Medicaid funding for about 1,400 clients, she notes.
Counselors are key
Once it received approval from the city’s Human Resources Administration, Planned Parenthood began to assemble the project. The key feature was the selection of entitlement counselors, staff members who would provide the link to the program.
"We knew that what would work would be dedicated staff who were really committed to the concept, and the fact that this is a right that our clients have," says Berger.
The program now has four counselors and is eyeing addition of a fifth, Berger reports. While some private endowment money was used to start the program, it basically has paid for itself due to the number of client visits now covered by Medicaid and Child Health Plus, says Berger.
When clients call Planned Parenthood’s central appointment number, they are asked how they plan to pay for services. Those who are unsure or have no payment plan are then referred to the entitlement counselors, who do a telephone prescreening and set an appointment with the client. Clients bring documents such as proof of age and identity, proof of address, and proof of income. Clients are often seen the same day the application is processed.
Confidentiality is an important aspect of providing reproductive health services. The project has been able to work with HRA so that for some patients, Medicaid cards are mailed to Planned Parenthood, rather than to clients’ homes.
While delivery of service is important, continued advocacy for health care coverage plays an equal role in the project, says Berger. "The advocacy piece is equally as important. Clearly, universal health care is the solution; until that time, we have to continue to change the system in ways people obtain their care, and this is one way to do it."
Resource
For more information on the Entitlement Advocacy Project, contact:
• Alice Berger, Planned Parenthood of New York City, 26 Bleecker St., New York, NY 10012. Telephone: (212) 274-7373. Fax: (212) 274-7218. E-mail: [email protected].
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