Publication Date: Wednesday, January 05, 2005
When healthcare costs too much
When healthcare costs too much
(January 05, 2005) MayView Community Health Center project aids the chronically ill
by Jocelyn Dong
On a recent Monday afternoon at MayView Community Health Center, Monserrat was swaddled tight as a sausage in pink blankets, snoozing in the arms of her mother, Evangelina.
Evangelina first walked through the doors of the Palo Alto medical clinic in June, seeking prenatal care. Earlier that month, she had arrived in the United States from Mexico with her husband. They had been unable to find work in their homeland, and emigrated hoping their luck would be better here.
MayView exists for people like Evangelina, and baby Monserrat. The 30-year-old health center, located in the Santa Clara County Courthouse building near California Avenue, provides essential, affordable health care to 4,000 of the area's poor.
Although Evangelina's husband now is able to eke out living taking on gardening jobs, health insurance for the family -- like the majority of MayView's patients -- is out of the question.
This past summer, the clinic launched the Family Stability Project with a $5,000 grant from the Palo Alto Weekly Holiday Fund. The program is designed for patients who have chronic conditions and need ongoing health care but might be tempted not to seek it due to the expense. Patients in the Family Stability Project receive medical treatment for one year for free.
"People can feel discouraged," JoAnn Cabrera, executive director of MayView, said of the chronically ill. "Most healthy people come in two times a year. If it has to be more often, those medical costs can be astronomical if their income is $14,000 (a year) for a family of four."
In Cabrera's office last week, donated gifts sat piled on the floor -- kids' games, a small mountain bike, a white teddy bear clutching a velvet heart. Knowing that patients' budgets are tight, board members have collected toys for the families that need a little extra cheer this holiday season, Cabrera explained.
During the rest of the year, poverty forces many families to choose between medical care and rent or food, Cabrera said. Food and rent tend to get the higher priority.
And yet, the choice to forego care has been shown to cost more in the long run. National studies reveal that patients who regularly see a healthcare provider have better overall health, improved outcomes for specific diseases and lower healthcare costs over time.
MayView charges its patients for treatment on the basis of their ability to pay. A person may receive $100 worth of care and co-pay $25 if they can, for example.
So far, the Family Stability Project has enrolled 23 patients who have chronic health issues like diabetes or a risk for developing tuberculosis, people for whom a lack of care would be especially dangerous. In the three months since the program's launch, MayView has provided about $5,000 worth of medical services to these individuals and families, Cabrera said.
It also extends the free treatment to several dozen homeless men and women who were already patients of the clinic.
Evangelina takes part in the new program. Her prenatal care had been paid for by the state, but health coverage ended following Monserrat's birth. The MayView staff then signed Evangelina up for the Family Stability Project because she tested positive for tuberculosis, meaning she has been exposed to the germ in the past.
Treatment for the infection takes nine months of daily medication and regular visits to the doctors. The clinic is willing to do anything it can to keep those patients coming in -- and not just for the individual's sake.
"It's a public-health concern to prevent an outbreak of tuberculosis," said Cabrera, who hopes to enroll at least 50 families in the project this first year.
As has been the trend throughout the country, more uninsured adults have been coming through the clinic's doors this year. Nationwide, community health centers saw an 11 percent increase in uninsured adults in 2004, due to a still-flagging economy and continuing unemployment.
Fortunately, at MayView, the rise in uninsured adults has been balanced out by a decrease in the number of uninsured kids. A state health-insurance program that targets children and reimburses the clinic for their visits has helped a lot.
Cabrera does worries about possible state funding cuts next year, but at least this year's budget increased $50,000 over last year's, to $2.1 million. The executive director's financial goal for the clinic now is to have a $100,000 fund available for emergencies.
"You need to respond immediately to something that happens," Cabrera said. This fall, for example, the clinic didn't receive flu shots, leaving the population vulnerable. "That's the kind of thing -- you want to be at your strongest, instead of cutting back staff."
Regardless of the clinic's future battles over funding, Evangelina is glad that MayView was there this year to help her baby come into the world healthy and give them both a chance for better lives.
"If not for this help, I wouldn't have treatment. I'm very thankful," Evangelina said through a Spanish translator.
Senior Staff Writer Jocelyn Dong can be reached at jdong@paweekly.com.
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