Family First Health’s Center of Excellence provides patients with substance use disorders the support they need to reach, and maintain recovery. Our team links patients to community resources/support services, then walks alongside each patient to ensure that critical needs are met and that the patient remains in care for as long as needed. The goal – to give each patient the supports needed to get, and stay healthy. The team is currently seeing patients at our George Street, Hanover, and Columbia centers. For more information please call 717-801-4864.

As I prepare for my day, I look over my list of patients and see a name that is unexpected. I typically see Mr. Jones three to four times a year for his blood pressure, which is generally under control. He is listed as coming in to discuss a “personal issue” with no other information. When the time of Mr. Jones’ appointment arrives, my nurse rooms him but is unable to gain any further information. When I walk into his exam room I discover to my surprise that he has brought a friend with him who talks first explaining that that his friend has asked him to come with him to support him as he tells me something. Mr. Jones goes onto to explain that he is using heroin every day and he wants help to get rid of this problem. He shares that as he works to provide for his family he is tired of having to keep using just to keep the withdrawal symptoms under control so that he can function. We go onto have an initial conversation about his struggles, how he ended up in this place of addiction and how he hopes things can change if he can be free of it. We then proceeded to get him setup for a more formal intake visit with myself and the Substance Use Services team to start him on buprenorphine and connect him with the various services we have to offer to support him in the recovery process.

Later I had the chance to reflect on this interaction and the various interactions I had experienced with Mr. Jones previously. Last October we began using a different screening tool for substance use in our patients at each visit. Since that time I had seen Mr. Jones on three previous occasions where each time he answered the screening questions denying any illicit drug use or misuse/overuse of prescription medications. Entering into this work of treating addiction in the context of primary care, I thought that these occasions would be rare, but there have been a number of them where existing patients disclose their struggle with addiction to drugs and alcohol. They, like Mr. Jones, have expressed that because of the relationship we had developed and then hearing that we were providing this service to help patients with addiction, they felt comfortable disclosing to me their history of use.

As a result of these kinds of experiences, I am convinced that integrating screening and treatment into primary care is key to addressing the current levels of opioid and alcohol dependence in our country. The relationship that exists with a primary care provider establishes a foundation of safety for disclosure for patients who want their lives to be different. By then utilizing this bridge created by primary care, behavioral health providers, and treatment facilities can experience more meaningful connections with patients resulting in improved outcomes.

______________________________________________________________

Debra Bell, M.D.

Medical Director, Center of Excellence: a Substance Use Program of Family First Health

This is part of a series intended to bring into focus the important role that Medicaid plays in the health of our patients, our organization and the larger community and what we all have to lose if proposed cuts to Medicaid are implemented.

Two years ago, Kim had her first heart attack. At the time, she was working four different jobs, none of which offered health insurance. She was trying to keep her head above water, feed and clothe herself, and she was working herself to death. Six months after her first heart attack, came the second. Because of her health, Kim was unable to work any longer and had to go on disability. Too young for Medicare, Kim had to apply for Medicaid. One of the five medications she takes costs $45 per month, and there is always the concern of more medical issues as she ages. Kim shared, “Altogether, my monthly medical bills could end up costing me over a thousand dollars a month and that’s not including hospital stays, ambulance costs, etc.” Without Medicaid, Kim says she would be unable to pay for housing, utilities, and food. What happened to Kim could happen to anyone, one health condition changed everything.

In cases like Kim’s Medicaid is a ‘safety net’, a way to give people access to the healthcare they need who may not be able to access traditional insurance options. In the Health Care Safety-Net Toolkit for Legislators, Melissa K. Hansen notes:

“Medicaid plays multiple roles in the health care safety net, including as an important source of financing for safety-net providers, a coverage option for vulnerable populations, and as a mechanism for policymakers to develop new payment and delivery system models.”

It is also important to remember that younger individuals are just as vulnerable, they often won’t carry insurance because they don’t feel sick at the moment. Unfortunately, sometimes disaster strikes, and you end up in the hospital with thousands of dollars in bills that you cannot afford.

Zach was diagnosed with Type 1 Diabetes when he was 10 years old. Now 27, he can no longer be on his parents insurance but still faces a lifetime of insulin, diabetic supplies, and medical appointments. A college graduate, Zach has had difficulty finding full-time employment in his field. He works as an elementary school substitute teacher and depends on Medicaid to help keep him healthy and active for the kids he teaches. Zach put it best when asked why Medicaid matters to him, “Because I don’t want to die,” he said.

Two individuals at very different points in their lives, out of millions that utilize the Medicaid ‘safety net’ every day. Medicaid users are everyone; your family, your friends, and your neighbors. They are people who need on-going healthcare assistance or just a hand up in a time of need. Medicaid matters to them because without it, they would face an unknown medical future, and it should matter to you because everyone wants a healthy community.

If you have questions about Medicaid or need help applying, please contact our patient benefits team at 717-846-6776.

_______________________________________________________________________________________________________________________________________

Shannon L. McElroy, Family First Health Marketing and Outreach Coordinator

This is part of a series intended to bring into focus the important role that Medicaid plays in the health of our patients, our organization and the larger community and what we all have to lose if proposed cuts to Medicaid are implemented.

The first thing that Sharon said to me was, “Medicaid matters because lives matter, for the rich, the poor, and the orphans.” Sharon and her husband are all too familiar with orphans; they adopted two, Sara and Richie. Sharon’s husband works in the tech industry and the family has private insurance but struggle with high premiums and a $10,000 deductible. They are a family not unlike many; in the past they have had to avoid some medical issues if they feel they can live without it, even knowing that it is not in anyone’s best interest.

Unfortunately, their daughter Sara has struggled due to Fetal Alcohol Syndrome, intestinal failure, and an Autism Spectrum diagnosis; all medical issues that cannot be ignored. Luckily, Medicaid helps pay for long-term medical treatments for children who have special healthcare needs, without regard to family income, otherwise the family might be bankrupt. “Families need access to [Medicaid] keep their heads above water because they need to work to survive,” Sharon shared. The IV fluids Sara needs to keep her alive cost $600 a day and at one point, Sara spent four months in a hospital in Virginia, the only one that could accommodate her conditions. Sharon and her husband couldn’t take care of their children without Medicaid.

CHIP advocate, Tamara, utilized the program for her daughter for two years. As part of a middle class family, Medicaid was not an option for them because they did not qualify due to income and there was no private insurance option that they could afford. The CHIP program is another excellent option for children because families can make any amount of money and still be eligible. “If CHIP was not in existence, I would have had to pay high prices,” Tamara stated, “I would not have been able to afford other things for my daughter.”

 

Crystal is mom to four active kids aged 5 to 13 years old. Medicaid is vital for this working mom and her family; Crystal has worked two jobs for five years, and neither job is able to provide health insurance for her. Having Medicaid has enabled her to keep up to date with her children’s vaccines, checkups, and other health issues that come up. “I would have to try to hope their little bodies would be able to fight off any illnesses they caught,” Crystal shared, “or end up charging medical bills, causing me to be in great debt.” In addition to the normal well-child checks and sicknesses that come up, Crystal’s son was diagnosed with ADHD. Without assistance, the family would be unable to afford his medication and bi-monthly appointments.

Three different stories, three different families, out of millions that utilize Medicaid every day. Medicaid matters to them because with it they know that their children get the healthcare they need to be well. For a closer look at the percentage of children covered by Medicaid or CHIP in your county, look at the interactive map from the Georgetown University Health Policy Institute:

Percent of Children Covered by Medicaid/CHIP by County, 2011-2015

Watch for our next story to meet some additional individuals who have been affected by Medicaid. If you have questions about Medicaid or need help applying, please contact our patient benefits team at 717-846-6776.

_______________________________________________________________________________________________________________________________________

Shannon L. McElroy, Family First Health Marketing and Outreach Coordinator

This is part of a series intended to bring into focus the important role that Medicaid plays in the health of our patients, our organization and the larger community and what we all have to lose if proposed cuts to Medicaid are implemented.

Insurance systems are different in every country, from single payer systems to private markets, and no system is more complex and confusing than in the United States. Luckily, we have a safety net in place for some of our most vulnerable citizens; Medicaid. Medicaid seems to have a bad rap; I have heard people say that it is only for “those” people or that no one on Medicaid works. I am here to dispel the Medicaid myths.

Risa Lavizzo-Mourey, CEO of the Robert Wood Johnson Foundation, put it best, “What is Medicaid all about? It’s staying true to the mission: to care for people historically left behind.” So who are the individuals that have been left behind? Medicaid and the Children’s Health Insurance Program (CHIP) currently cover approximately 74 million people, 36 million of those being children. Not only is this large amount of people covered, they are covered well and receive excellent, and sometimes life-saving care. Let’s take a look at the Medicaid facts:

• Infant deaths have been significantly reduced because of Medicaid coverage for pregnant women.
• Medicaid covers at least three quarters of all disabled adults on Supplemental Security Income (SSI).
• 62% of long-term care for seniors is paid for by Medicaid. The average cost of nursing home care with a semi-private room was more than $83,000 in 2012.
• Six out of ten able-bodied adults on Medicaid have a job, and 78% of Medicaid recipients are part of a household with at least one person working full time.
• Medicaid helps pay for long-term medical treatments for children who have special healthcare needs, without regard to family income.
• 32 million children on Medicaid receive school-based services like speech and occupational therapy.

No one can deny the number of people covered by Medicaid at one time or another; more than half of Americans report either being on Medicaid at some point in their lives or knowing someone who has, but what we often hear is that the care received is not as good as with private insurance. The Henry J. Kaiser Foundation reports that Medicaid’s impact on health outcomes continues to grow:

“Access to screening and preventive care in Medicaid translates into well-child care, earlier detection of health and developmental problems in children, and earlier diagnosis of cancer, diabetes, mental illness, and other chronic conditions in people of all ages. Access to primary care providers and specialists, prescription drugs, and other services improves the likelihood that Medicaid enrollees will get treatment for both their acute and chronic conditions.”

As I started working on writing this series about Medicaid I reached out to patients, friends, and family to gather stories about who is on Medicaid and why. While I expected to hear some amazing stories about people who have received excellent healthcare in dire situations, I did not expect to receive such an outpouring of emotion and thankfulness. People came out of the woodwork because they wanted to tell me their stories. People who are single, people who are widowed, people who work, people who adopted children, people who are sick, people who are human; people who all think Medicaid matters.

Watch for our next story to meet some of the individuals who have been affected by Medicaid. If you have questions about Medicaid or need help applying, please contact our patient benefits team at 717-846-6776.

_______________________________________________________________________________________________________________________________________

Shannon L. McElroy, Family First Health Marketing and Outreach Coordinator