Progress on the County Safety-Net, In LA and Fresno

Consumer, community and health advocates have been cheered by events this week that should improve access to health care in two major California counties for the remaining uninsured.

* Tomorrow, October 1, Los Angeles will launch “My Health LA,” a new program to provide primary and preventive care for the remaining uninsured, including those excluded from Medi-Cal.

* On another front, Fresno County got help this weekend when Governor Brown signed a bill to provide it budget flexibility so it can continue its indigent care program–something it voted to end just last month.

Given the new context of the Affordable Care Act (ACA), other counties are looking to adjust or extend their safety-net services in the coming year. With our success in enrollment Californians in ACA coverage, counties are appropriately looking to see how to revamp and extend their safety-net services for the remaining uninsured, including for those without options under the ACA due to immigration status. We are pleased to see progress by counties, the traditional health provider of last resort, to be innovative in meeting the ongoing needs of the remaining uninsured in their communities. In particular, immigrants are a crucial part of California’s economy and community–they should be fully included in our health system as well.

A study conducted by Health Access California last year found that California’s safety net for the remaining uninsured is uneven, with different eligibility rules on income and immigration and different services offered county-by-county.

LOS ANGELES: LA County is taking a major step forward today in launching My Health LA. Hundreds of thousands of low income people who have been denied access to health care will be able to sign up for care for the first time. We applaud Los Angeles County for My Health LA, and stepping up to provide a medical home that includes care that is primary and preventive, not just emergency and episodic. It’s inspiring to see Los Angeles, for so long ground zero of the crisis of the uninsured, work to fulfill the promise of health care reform, that everyone—regardless of income or background—could have access to basic care. When we start open enrollment in November, all Angelenos below poverty will be eligible for something–and if not Covered California or Medi-Cal, then My Health LA. We want to spotlight those counties that are stepping up to ensure access and afford basic care.

The program was approved by the Board of Supervisors last week and is slated to cover approximately 150,000 low-income uninsured Angelenos and build on the success of its precursor, Health Way LA.

Applicants must be L.A. County residents, age 6 and older, below 138% of the Federal Poverty Level, uninsured, and not eligible for Medi-Cal. My Health LA is a primary care program financed through 65 million dollars approved by the Board of Supervisors.  It covers primary and preventive care including pharmacy and in limited cases, dental services.  MHLA also covers specialty care and urgent and emergency care at DHS facilities.

Link to DHS/My Health LA Website:  http://dhs.lacounty.gov/MHLA

Link to Federal Poverty Levels:  http://file.lacounty.gov/dhs/cms1_215467.pdf

MHLA Customer Service Line:  1-844-744-6452 (MHLA)

FRESNO: While several counties look to augment or extend their services, Fresno County was the only county to take action to roll back eligibility in their indigent care, in a vote last month. But that decision had a 90-day stay, pending legislation that was signed into law by Governor Brown this weekend. AB2731(Perea) gives Fresno County the budget flexibility it says it needs to continue to provide safety-net services. We hope that with these new developments, Fresno County revisits its recent vote and commits to continue to provide safety-net health care services for the remaining uninsured. California is stronger when everyone has access to care and coverage. It’s more cost-effective to have access to primary, preventive, and specialty care than to just address the issues in the emergency room. By ensuring that Californians have that access, counties can make sure that their residents are healthy and contributing economically to their communities.”

The Health Access report from last year on the county safety-net can be accessed by visiting www.health-access.org or directly by visiting:

http://health-access.org/files/expanding/California%27s%20Uneven%20Safety%20Net%20-%20A%20Survey%20of%20County%20Health%20Care.pdf