New Program Brings Hope to Uninsured Adults
When Marin Community Clinics’ patient Victoria was referred to an outside allergist for help with her asthma, she received a big shock — the recommended medication would cost $38,000 a year! Previously prescribed medications hadn’t helped, and this new medication was likely to give her a better quality of life.
An overwhelming situation
For any of us, the cost of this medication would be disturbing, but Victoria is an undocumented immigrant and was ineligible for medical insurance. Plus, she had another problem to overcome — Victoria was highly allergic to her roommate’s cat and needed to move.
How could she possibly pay for her new medication, deal with a host of other health issues, and find affordable housing?
The situation was overwhelming, so she decided to contact the Clinics for help. Victoria was immediately referred to a Clinics access navigator who enrolled her in a new statewide program.
Path to Health Program: a milestone in increasing equal access to care
Previously, an undocumented immigrant was only eligible for a restricted (emergency care only) Medi-Cal program. Now, a new pilot program called “Path to Health” gives eligible adults access to primary, specialty, and preventive care. Sponsored by the statewide County Medical Services Program (CMSP), the program goals are to improve health outcomes, reduce the use of emergency rooms and hospitals, and help community health centers expand outreach to those who are uninsured.
“Path to Health can help out so many of our uninsured patients,” reports Brenda Moreno, Clinics Access Navigator. “This program gives them a chance to take care of their medical issues without having to worry about how to pay for services.”
“Path to Health could not have come at a better time,” according to Clinics CEO Mitesh Popat, MD, MPH. “Whereas the federal government has in many ways turned its back on immigrants, California is stepping up to the plate. This is truly a milestone in the state’s commitment to providing equal access to care.”
Clinics selected as pilot site
Marin Community Clinics is one of 11 community health centers in the state to participate in the pilot program. To date, we have enrolled over 300 patients in Path to Health. By 2021, up to 25,000 low-income adults are expected to enroll throughout the state; in Marin, we are estimating that up to 4,000 individuals could benefit.
Comprehensive services at low or no cost
Low-income adults ages 21 to 64 who do not have immigration documentation and are currently enrolled in Medi-Cal’s emergency services program are eligible for Path to Health.
Patient services include office visits at all Marin Community Clinics sites with no co-pay for primary care, and some specialty care such as orthopedics and cardiology. Additional services include preventive health screenings, annual physicals, immunizations, cancer screenings, selected lab and diagnostic tests, and certain minor office procedures. Prescription drugs are part of the program and require a small co-pay. The Clinics will receive reimbursement from CMSP for services.
With help from the Clinics and Path to Health, Victoria is now able to purchase her asthma medication at low-cost and take full advantage of the Clinics’ services — and she has found a new home.