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Initiative gets public scrutiny

The Baltimore Sun

Barney R. Putnam Jr. of Columbia wants to find help for a woman at his church who has cancer but no health insurance.

Rick Larsen works for a small contractor, and his fiancee, Annette Martinez, is a waitress. Both Elkridge residents are healthy, but they, too, are uninsured.

They were among the small group who came to speak to Howard County Executive Ken Ulman and Dr. Peter L. Beilenson, the county health officer, at the first of three public meetings on the Healthy Howard health access plan intended to eventually cover all 20,000 of the county's uninsured residents.

Half of the seats were filled Tuesday night at Linden Hall, the community center at Dorsey's Search Village Center, but Ulman said he was satisfied with the turnout. "I didn't know what to expect. People asked good questions," he said.

"Frankly, it was bigger than we thought," Beilenson said, noting that there is no contention over the program, "so I didn't expect much" of a crowd. "The real story is a year from now," he said.

Both men noted, however, that a film crew from a national news network attended the meeting, indicating that the Healthy Howard plan is getting noticed regionally and beyond.

Two more sessions are planned next week, from 6 p.m. to 8 p.m. Monday at Glenwood Community Center, and from 6 p.m. to 8 p.m. Tuesday at the Savage Volunteer Fire Station.

The purpose of the meetings is to hear from people with questions or suggestion about the ambitious program, which intends to enroll about 2,000 uninsured people in its first year of operation, beginning July 1.

The plan is not health insurance, and it is not portable outside Howard County. As Ulman and Beilenson again explained at the meeting, it would enroll legal American residents who have been without health insurance for at least one year and who have lived in the county for at least that long.

For income-based monthly fees of $50 to $115, participants would receive care designed to improve overall health and reduce the need for visits to hospital emergency rooms.

People enrolled in the program would have access to Howard County General Hospital but would have to pay $75 per emergency room visit if they are not admitted. If they are admitted, the hospital will forgive bills for services for program members.

Health coaches would work with each person to devise a plan to lead a healthier life and find programs for heavily discounted or free prescription drugs and services such as day care for a person who needs time for regular exercise.

Larsen, 38, said the company for which he works has about 15 employees and does not offer health insurance. He is keenly aware that he could be injured.

"Without health insurance, I could come home and be out of work for six months" if he got hurt, he said.

Martinez, 42, said she could buy coverage through her job, but it would cost $200 a month with a $1,200 deductible, meaning she would have to spend $2,400 a year before getting any benefit.

"I couldn't afford it," she said.

Ed Rekas of Dorsey Hall wondered if the county spends $500,000 on the program in the next budget year, as planned, will that expense rise as the program expands? More importantly, will the county track results before investing more money?

"Where's the $500,000 taken from?" Rekas wanted to know.

Beilenson said data on health outcomes from the program are a vitally important segment of the program because that information could be used by other governments or research groups to craft their own or national programs.

Ulman said the local tax money will be part of his budget request next spring to the County Council, which will have the final say.

"This is a priority of this administration," he said, and "a half-million dollars seemed to me to be reasonable, especially since more than that [$700,000] is to be raised privately. Participants will pay about $1.6 million in fees, completing the funding for the projected first-year budget of $2.8 million.

Ken Aldrich, Maryland operations director of the Minuteman Civil Defense Corps, wanted assurances that no illegal immigrants would be enrolled, and Beilenson said that is why the program will check for legal residency.

Viviana Simon of Alianza De la Communidad, a county-based advocacy group, came to get information she can pass on to the Hispanic community.

Putnam sat quietly through the 40-minute session taking notes. He belongs to Hopkins United Methodist Church in Highland, where he said another member needed a $3,000 test for cancer recently, and had trouble even raising a 5 percent down payment. He didn't know the details of the woman's illness or how she will pay for treatment the test suggests.

"If she qualifies and comes in" to the county's new program, he said, she would be enrolled in a state program and the county would pay a large deductible so she could get treatment.

The question is, what happens to her until July.

"She's very upset," he said.


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