Health Care
Within
Reach Thousands more are now eligible to receive Medi-Cal in Sonoma County. Could you be one of them?
A Special Advertising Supplement
A Healthy Community
for All
Human Services Department plays key role in meeting county’s health care coverage needs by Shannon Springmeyer
J
erry Dunn got into public service for the same reason expanding customer service hours to Saturdays. as most other civil servants: to help people. He’s been “We want to serve clients as quickly as we can, with as serving the residents of Sonoma County for 17 years and much friendliness as we can, and with as much respect for is now the Human Services Department director. He says them as we can,” Jerry says. that right now he finds his work particularly rewarding. The department is also working closely with Covered “It’s a wonderful time,” Jerry says. California and the network of community clinics to provide Jerry’s referring to the department’s role in helping seamless integration of services. The department’s “no provide access to health care coverage to thousands of wrong door” approach means that whether residents start Sonoma County residents who were previously uninsured. the process of signing up for health coverage with the Under the federal Patient Protection and Affordable county or with Covered California during open enrollment Care Act, Medi-Cal has been expanded to people who periods, eligibility staff will help them to get the highest were previously not eligible. Before, only certain lowlevel of benefit that they are eligible for. If they are not income groups could qualify for free health coverage Medi-Cal eligible, residents may qualify for premium under Medi-Cal, such as children, pregnant women or assistance through Covered California. During Covered those with a disability. California open enrollment periods, county staff will help Now, after the January 2014 Medi-Cal expansion, them with the application, health plan selection and adults ages 19-64 can qualify for enrollment, or provide the option Medi-Cal if they earn under a certain to apply online or call Covered amount. The income limits have been California directly. raised, too, meaning individuals Jerry also wants residents could qualify even if they work or to understand that even though own property, like a car or home. An Covered California has a limited estimated additional 18,000 county open enrollment period in a residents are now eligible for Medigiven year, residents can enroll Cal, offering many of them access to in Medi-Cal anytime if they are health coverage for the first time. eligible. County staff also check Jerry is excited to be able to offer to see if applicants qualify for health coverage to so many in the other benefits, like CalFresh community who would otherwise most grocery assistance. likely end up in the emergency room. The ultimate goal, Jerry says, “Health care access is critical is for the community to become for everybody in our community,” stronger by connecting residents Jerry says. “Being able to have to support systems that help them access to affordable health care meet basic needs, such as access is just a huge component of a to fresh food or health care. Jerry Dunn person’s ability to live in a self“I think it contributes to the Human Services Department Director sufficient manner. Since many of overall economic health of the our department’s programs are all community and the way we live,” around helping people to get to that Jerry says. “We’re all stronger when ultimate goal of self-sufficiency, access to health care is a we take care of each other.” foundation to that.” For more information about the Affordable Care Act In order to reach those who are now eligible, the Human and the changes it brings, visit www.sonoma-county. Services Department has “geared up,” adding staff and org/healthcarereform/.
“ We’re all stronger when we take care of each other.”
Caring for the Community
• Providing a critical safety net during times of hardship • Promoting maximum independence and well-being • Protecting vulnerable children and adults
sonomacounty.ca.gov/Human-Services
1-877-699-6868
2 | Health Care Within Reach: Expanded Medi-Cal | Spring 2014 | A Special Advertising Supplement | Sonoma County Human Services Department
When She Needed It Most
Patty PerLee unexpectedly found herself without health insurance after she decided to switch careers. Patty says she was relieved to discover she was eligible for Medi-Cal. Photo by Todd Jenkins
Medi-Cal gives woman security during transition by Mike Blount
I
n June 2013, a lot of things were changing for Patty PerLee. The 56-year-old had decided to leave her sales position at the car lot where she worked. She had been in the car sales business for more than 20 years, but she needed to find a job with better pay and more flexible hours so she could take care of her elderly mother and help look after her grandson. In the car sales business, Patty often worked long hours well into the night. Patty decided becoming a real estate agent was the answer. In real estate, Patty could set her own hours, allowing her to spend more time with her family. She did some research and found an online course she could take. “The course lasted a few months, and in Patty PerLee October, I passed the test for my license,” Patty says. Medi-Cal recipient “I thought I would just go right into my new career, so I quit my job thinking I would be up and going soon.” But the weeks continued to pass as Patty waited for her license to arrive. During that time, she was burning through her savings. Worst of all, she had no health insurance. “Of course, having no income and being out of a job made me feel a little anxious,” Patty says. “I was really nervous about not having any medical coverage because breast cancer runs in my family. I have a sister who has breast cancer. Diabetes also runs in our family. Not to
mention I could fall down and break a leg. That alone would cost thousands.” Patty later learned that her real estate license would take even longer to arrive because of a delay in processing her paperwork. Not wanting to go without health insurance for any longer, Patty decided to apply for coverage through Covered California. “I knew there was a deadline, and I wanted to make sure I had some kind of coverage,” Patty says. “But they told me I didn’t qualify because I had no income and forwarded my information to Medi-Cal. I just assumed I didn’t qualify, but all I had to do was apply.” Because of recent changes to Medi-Cal, adults between the ages of 19-64 can qualify if they meet income requirements. Patty is now fully covered through Medi-Cal, including hospitalizations and medical checkups with no co-pay. Patty has since received her license and is now working as a real estate agent. She says she doesn’t plan on being on Medi-Cal for long, but she is glad that she has coverage as she transitions into her new career. “Medi-Cal gives me a little breathing room, and I’m thankful that it’s there,” Patty says. “Applying was simple and straightforward, and now, I don’t have to worry. Don’t just assume you don’t qualify. Just go online and apply. It’s easy.”
“ Applying was simple and straightforward, and now, I don’t have to worry.”
Medi-Cal Expansion Brings Health Care to More People Under new eligibility rules, a working adult who earns up to
138 percent of the federal poverty level (FPL) can now qualify for Medi-Cal. For example,
an adult living alone can now earn up to $16,105 a year and still qualify.
Approximately 18,000 residents of Sonoma County are newly eligible for Medi-Cal, which was expanded under the federal Patient Protection and Affordable Care Act. For more information about the Affordable Care Act and changes it brings, visit www.sonoma-county.org/healthcarereform/
Medi-Cal also relaxed income limits for . Now, you do not need to have a disability or children to qualify, and you can own property or have a job.
pregnant women and families
Even if you’ve applied before and were not eligible, you may qualify now. If you’re unsure whether you’re eligible, you can visit www.MyBenefitsCalWIN.org to find out. Or, you can call 1-877-699-6868, Monday to Saturday from 8 a.m. to 6 p.m. Eligibility workers answer questions and take applications over the phone. Residents also can apply in person at the county office: 2550 Paulin Drive, Santa Rosa, or at additional locations listed on the back page.
A Special Advertising Supplement | Health Care Within Reach: Expanded Medi-Cal | Spring 2014 | Sonoma County Human Services Department | 3
A Safety Net for
Peace of Mind Santa Rosa residents say goodbye to unexpected medical expenses by Edgar Sanchez
F Francisco Monterroso and Nora Mercado left surprise medical bills behind when they qualified for free Medi-Cal coverage after recent changes to eligibility rules expanded the program. Photo courtesy of Francisco Monterroso and Nora Mercado
Are You Eligible? Expanded Medi-Cal now covers adults ages 19-64 who make up to 138% of the federal poverty level (FPL).
For example, these households could now qualify*:
1 Individual
Can earn up to
$1,342 per mo.
Family of 2
Can earn up to
$1,808 per mo.
Family of 3
Can earn up to
$2,275 per mo.
Family of 4
Can earn up to
$2,742 per mo. *Based on 2014 FPL
rancisco Monterroso had never ridden in an household budget. ambulance — until one day in 2012, when he This year, he sought a new health care plan for fainted in a Sonoma County clinic. himself and his wife through Covered California, The Santa Rosa man, squeamish by the state’s health insurance marketplace. The nature, was getting blood work done as part of a couple’s daughter learned of the new, higher physical. He was tense as the nurse repeatedly income limits for Medi-Cal and encouraged her pricked his left arm with a needle before finding parents to apply. They discovered that they were a vein. The nurse had drawn three vials of blood eligible for free coverage through Medi-Cal. and was starting on a fourth when he blacked Today, Francisco urges anyone without out. Someone dialed 911. An ambulance rushed medical insurance to sign up for it. For many Francisco to a hospital, low-income residents, where doctors blamed his the time to do so is nerves for his collapse. now. Thanks to an At the time of the expansion of Medi-Cal incident, Francisco lacked under the new federal medical insurance — he health care law, many was having the analysis have the opportunity done in a free clinic. Weeks to get coverage for the after the fainting episode, first time. Medi-Cal is Francisco Monterroso Francisco almost fainted extending coverage to Medi-Cal recipient again after being billed many people who were nearly $11,000 for the previously ineligible. ambulance ride and his “Having Medi-Cal 90-minute stay in the ER. insurance is a blessing,” Luckily, he qualified for Sonoma County’s Medical Francisco, 56, says. “My wife had never had Services Program for low-income residents, so medical insurance since we arrived here.” The his share of the bill dropped to $846, which he couple, originally from Guatemala, are legal paid with his daughter’s help. But the incident permanent residents in California. impressed upon Francisco the importance of Today, Francisco is in good health, and hopes having a safety net. his ongoing access to health care will help Last year, Francisco had medical insurance him stay that way. He takes advantage of the through North Coast Fisheries, Inc., a Santa preventive services that are included in Medi-Cal, Rosa seafood processor, where he works as a like annual physicals. Nora, 60, suffers from leg handyman. issues, arthritis and other woes, but is glad to “But it was expensive,” says Francisco, finally have access to health coverage. whose insurance premium was $390 a “Now I have the hope of getting better month, an amount that severely strained his medical attention,” Nora says.
“ Having Medi-Cal insurance is a blessing.”
To find out if you are eligible, go to www.MyBenefitsCalWIN.org and click on the tab: “See if I am Eligible.” Or, call the Sonoma County Human Services Department at 1-877-699-6868.
4 | Health Care Within Reach: Expanded Medi-Cal | Spring 2014 | A Special Advertising Supplement | Sonoma County Human Services Department
What is CalFresh? If you qualify for Medi-Cal, you most likely also qualify for CalFresh, California’s nutrition assistance program designed to help low-income individuals and families receive fresh, healthy food. According to a recent study, there were 47 million meals that were missed by Sonoma County residents in 2013. That’s 47 million times someone went to bed hungry or skipped lunch. CalFresh helps put fresh food on the table so families don’t have to go hungry. However, according to the USDA, only one-third to one-half of those eligible are enrolled in the program. Receiving CalFresh is easy. Funds are deposited on an electronic benefits transfer (EBT) card, which are accepted at most convenience stores, supermarkets and some farmers markets. Those funds can be used to purchase healthy foods, such as fruits, vegetables, whole grains and lean protein. Applying is easy, too. Low-income families and individuals can apply online, in person or over the phone. For more information about CalFresh, visit www.sonomacalfresh.org. You can apply quickly and easily for CalFresh and Medi-Cal at the same time. Just visit www.MyBenefitsCalWIN.org.
Wayne Howlett uses CalFresh to help him put fresh food on the table while he’s going to school to pursue a higher-paying career. Photo by Todd Jenkins
Eating Healthy When in Need CalFresh helps man purchase fresh food by Mike Blount
W
ayne Howlett was having trouble finding a job and had to move back in with his parents at 24. Finding suitable employment turned out to be more difficult for Wayne than for most. He was born unable to hear high frequency noises from a genetic condition, limiting the duties he could perform at a job. Wayne’s parents tried to help him the best that they could, but it was hard to make ends meet with an extra person in the house. Wayne decided to apply for CalFresh to help out with the cost of food. “My family can only do so much and they only have so much money,” Wayne says. “I wanted to do anything I could to make myself less of a burden, so I applied for CalFresh to buy healthy food to eat — stuff like fruits and vegetables.” Once he filled out the paperwork at the Sonoma County Human Services office, Wayne was approved within three days to receive CalFresh benefits. Wayne says the process
was very easy and straightforward. Now, he’s using CalFresh to eat healthy while he attends a truck-driving school in hopes of making that his new career. Wayne says CalFresh also kept him going until he found a job at a McDonald’s restaurant.
“ [CalFresh] can help you get back on your feet.” Wayne Howlett CalFresh recipient
“For low-income people like me, it’s a great thing to have and it allows me not to worry about how I’m going to eat,” Wayne says.
“It also helps me manage my budget because with the low income I’m receiving now, I can balance out my food costs with CalFresh.” Wayne says that he uses CalFresh to purchase food, such as apples, oranges, lettuce and chicken. He also uses it to purchase cases of water to drink. Wayne says he plans to start using CalFresh to purchase fresh fruits and vegetables at the local farmers market. Wayne says he intends to stop receiving benefits as soon as his income allows him to be self-sufficient. But for now, he is thankful that the program is in place. “I don’t want to be on CalFresh forever, so I’m working toward a better career,” Wayne says. “I want other families who need it to be able to have it, and I want others to use it, too. Think of it like a way to be a help, rather than a burden — to get what you need, rather than what you want. It can help you get back on your feet.”
A Special Advertising Supplement | Health Care Within Reach: Expanded Medi-Cal | Spring 2014 | Sonoma County Human Services Department | 5
Sonoma County eligibility workers Anna Reyes and Chris Rhodes enjoy being able to help others receive health care coverage. Photo by Todd Jenkins
Here to
“ We’re trying to help clients from the moment they call in or walk in the office.”
Help
Anna Reyes Sonoma County eligibility Worker
County eligibility workers make customer service a priority
A
s an eligibility worker for the Sonoma County Human Services Department, Chris Rhodes feels he’s on a special mission — and not the type he helped plan in the Air Force. He is motivated to help people get the health care coverage they need and are eligible to receive, either through expanded Medi-Cal or premium assistance through Covered California. His job holds personal significance. Chris was raised by a teen mom and benefited from Medi-Cal as well as the food stamp program, now called CalFresh. He grew up to become fifth-generation military, and after leaving the service, he followed in the footsteps of his grandmother, an eligibility worker in Sacramento County.
“I feel I’m blessed to be here,” Chris says. “I definitely understand there’s a need out there, and there are a lot of people who need help. So for me to be able to come in this position and help out, coming from a similar background, it feels good.” Chris’ life story may be distinct, but his passion is typical of Sonoma County eligibility workers. They’re “a family,” he says. “Our department prides itself on that. Everyone is always willing to help out.” That spirit translates to customer service. The Human Services Department has a “no wrong door” policy. Anna Reyes, a lead eligibility worker, explains that this means county residents don’t have to find a specific desk or call a specific person to get assistance.
by Evan Tuchinsky
“We’re trying to help clients from the moment they call in or walk in the office,” Anna says. “It’s all to help our clients; we put them number one.” The expansion of Medi-Cal also brought expansion to the Human Services Department. The county has hired new teams of eligibility workers and redesigned the office to streamline the application process. Along with its normal business hours on weekdays, the department has eligibility workers available by phone on Saturdays. Anna says the department answers around 600 calls a day. Each call brings a person with particular circumstances; eligibility workers give individualized attention to each and every one. Both Chris and Anna recall specific people — a mother of two, a
woman with cancer, an elderly gentleman — who never could afford health insurance but now have coverage after applying through the county. “Talking to clients, I get an overall sense of relief from them,” Chris says. “Choosing health coverage, and knowing it’s a law now to have health coverage, can be very stressful, but they’re just really grateful and appreciative. “As we continue to grow, and as we continue to adapt to all these changes, the word is getting out there and a lot more people are signing up. Overall it’s been a tremendous help to the community.”
How to Apply Applying for Medi-Cal is now faster and easier than ever, and more people qualify than ever before. Eligibility staff at the Sonoma County Human Services Department are happy to answer any questions or help guide you through the process.
There are four ways to apply: • Log on to www.MyBenefitsCalWIN.org • Call 1-877-699-6868 • Apply in person at 2550 Paulin Drive, Santa Rosa, or see the back page for other locations. • By Mail. Call 1-877-699-6868 for a paper application.
Here’s what you’ll need: • Identification • Social Security Number, if applicable • Documentation of citizenship or residency status, if applicable (birth certificate, legal residency card or passport) • Proof of residence in Sonoma County (driver’s license, utility bill) • Proof of current income (recent pay stub, tax return)
6 | Health Care Within Reach: Expanded Medi-Cal | Spring 2014 | A Special Advertising Supplement | Sonoma County Human Services Department
Kim Seamans, Economic Assistance director at the Sonoma County Human Services Department, works to make applying for MediCal as easy and pleasant as possible. Photo by todd jenkins
Medi-Cal
Mythbuster Kim Seamans sets the record straight by Evan Tuchinsky
W
hen it comes to Medi-Cal, misconceptions abound. People see state-provided health insurance as a program of last resort, reserved only for unemployed Californians or those with disabilities. The truth is, Medi-Cal covers working adults and families — and even more of them since the January 2014 expansion under the Affordable Care Act. Around 18,000 Sonoma County residents became eligible for Medi-Cal under new eligibility rules. But 40 percent of those now eligible still haven’t signed up. “There is reluctance to apply for it until something medically has gone on and they have to have coverage,” says Kim Seamans, director of the Economic Assistance Division of Sonoma County’s Human Services Department. Kim comes across a lot of myths about MediCal; here are eight common ones, along with the facts.
Myth: It’s difficult to apply. Fact: The requirements have been simplified
Myth: I’ve been denied before, so ... Fact: Policies have changed. Eligibility workers
under the Affordable Care Act, and the Human Services Department has trained staff who can assist people with their questions when they’re filling out their paperwork.
will assess your current circumstances, apply them against the new rules and help you become eligible. Sonoma County Human Services has a “no wrong door” policy, whereby if you don’t qualify for MediCal, workers will help you find what you do qualify for through Covered California.
Myth: If I have a job, I can’t qualify. Fact: As long as your annual income is within the Medi-Cal limit, you are eligible. That limit is 138 percent of the federal poverty measure for a single working adult, which for 2014 calculates to $16,105. Limits increase with family size.
Myth: I have too much property. Fact: Under the new rules, for most people there is no longer an assets test, so state officials will not consider their home, vehicles or bank accounts when determining eligibility.
Myth: I need to have children, or be disabled or elderly, to apply. Fact: Parents do apply for Medi-Cal for their children, but adults can get coverage on their own. Adults between the ages of 19 and 64 are now eligible within the income limits, regardless of their family circumstances.
Myth: I need to organize hundreds of documents before finding out if I’m eligible. Fact: Eligibility workers employ a number of electronic certification measures before ever asking for verification of income and residence. Most applicants only need their Social Security card and proof of citizenship or legal residency (such as a birth certificate or immigration document). An applicant whose income cannot be verified electronically only needs to supply the most recent pay stub or tax return, while a utility bill or rental agreement can serve as proof of residence.
Myth: I will not get good health care with Medi-Cal. Fact: Sonoma County has a very robust system of community clinics, and the level of care at the clinics has been referred to as “the Cadillac of care.” Medi-Cal customers will get full service and full attention to their medical problems. Specialty care is available, as are case management and care for chronic conditions. There probably are fewer private doctors who accept Medi-Cal here than in some other areas, but that doesn’t prevent patients from getting good care. Medi-Cal is required to provide the same minimum level of coverage as any health plan through Covered California and private insurers.
Myth: The people at Human Services aren’t going to be nice, and it’s going to be embarrassing to go in there. Fact: Eligibility workers try their utmost to make applying for Medi-Cal and CalFresh a pleasant experience for people. The Human Services Department has a high expectation for customer service, and staff members bend over backwards to help people and treat people with respect.
A Special Advertising Supplement | Health Care Within Reach: Expanded Medi-Cal | Spring 2014 | Sonoma County Human Services Department | 7
Could Free Health Coverage Be Yours? Under the new expanded Medi-Cal eligibility rules, more people are eligible for free health coverage than ever before. Think you might be one of them? Call, go online or stop by to enroll today. Get the security and peace of mind that comes with being covered — and be on your way to CalFresh! Don’t forget to ask about most likely a healthy tomorrow. If you qualify for Medi-Cal, you
Enrolling Is Easy Call 1.877.699.6868
Go Online www.MyBenefitsCalWIN.org
By Mail Call for application: 1.877.699.6868
In Person Call the nearest enrollment location listed below for an appointment.
, too.
qualify for grocery assistance
Medi-Cal Enrollment Locations: CLOVERDALE
Alexander Valley Healthcare (Serving current patients only) 6 Tarman Drive 707-894-4229
FORESTVILLE
Forestville Wellness Center 6550 Front St. 707-887-0290
GUERNEVILLE
Russian River Health Center 16319 3rd St. 707-869-2849 West County Health Center 16255 1st St. 707-869-8256
HEALDSBURG
Alliance Medical Center 1381 University Ave. 707-433-5494
OCCIDENTAL
Occidental Area Health Center 3802 Main St. 707-874-2444
PETALUMA
Petaluma Health Center 1179 North McDowell Blvd. 707-559-7500
SANTA ROSA
Brookwood Health Center 983 Sonoma Ave. 707-583-8700 Community Action Partnership 1300 North Dutton Ave. 707-544-6911 Healthy Kids/Covered Sonoma 625 5th St. 707-565-4516 707-565-4476 707-565-4471
Healthy Kids at the Santa Rosa WIC Office 1450 Guerneville Road 707-565-6583 707-565-6586 Roseland Pediatrics 711 Stony Point Road, Suite 17 707-578-2005 Sonoma County Human Services 2550 Paulin Drive 877-699-6868 Sonoma County Indian Health Project (Serving current patients only) 144 Stony Point Road 707-521-4545
Women’s Health and Birth Center 583 Summerfield Road 707-539-1544 Women’s Health Specialists 3317 Chanate Road 2C 707-537-1172
SEBASTOPOL
Sebastopol Community Health Center 6800 Palm Ave., Suite C-2 707-824-9999
SONOMA
La Luz Center 17560 Greger St. 707-938-5131
Southwest Community Health Center 751 Lombardi Court, Suite B 707-547-2222
Sonoma Valley Community Health Center 430 W. Napa St., Suite F 707-939-6070
Vista Family Health Center 3569 Round Barn Circle 707-303-3600
WINDSOR
Alliance Medical Center 8465 Old Redwood Highway, Suite 400 707-687-2498