Crafting a new way to extend medical services to uninsured residents has proved tricky for county health officials.

The health staff was initially overwhelmed in October, when 1,100 people came to the East Columbia library during nine sessions to enroll in Healthy Howard Inc. All but 66 turned out to be eligible for four existing insurance plans for limited-income people.

Now county health officer Dr. Peter Beilenson has come up with a new plan to reopen enrollment while trying to counter criticism from County Council member Greg Fox, a Fulton Republican. Fox argues that too few have been enrolled in the program to justify the county's $500,000 contribution. Healthy Howard offers a full range of health care for legal county residents without insurance for at least six months for as little as $50 a month.

Over the next few months, Beilenson wants to enroll more people in Healthy Howard, while placing applicants eligible for other, existing programs on a waiting list.

"We are not going to be targeting all comers for the next several months," he said.

Beilenson, who will present his revised strategy to the County Council tomorrow, said that his staff is seeking people like part-time community college instructors and students, state and county contractual employees, small-business workers without benefits, residents in subsidized housing, and the parents of children enrolled in a federally funded insurance program for limited-income people.

"We want to make sure we get our enrollment numbers up," Beilenson said, in the hope that public support for the program doesn't wane.

The original goal was to enroll up to 2,200 people in either Healthy Howard or an existing program by October. That's about 10 percent of the estimated number of county residents without insurance. The program, however, is experimental and intended to be a source for research data to see whether the program could be duplicated elsewhere.

"I don't want to be concerned about people questioning using $500,000," Beilenson said. "Politically speaking, if we've got 1,500 [enrolled by year's end] it's defensible. If we're serving 300, there is a real question."

So far, Beilenson has strong support from County Executive Ken Ulman and other council members, including this year's chairwoman, Mary Kay Sigaty, a west Columbia Democrat.

"To me, I'm a bit bemused at this whole issue," Ulman said about Fox's criticisms. "We've been able to get over 1,000 people. That's a huge accomplishment. We always knew this would be a work in progress."

Sigaty said she, too, supports the initiative.

"It is what we should be doing," she said, calling the October enrollment "a pretty good start."

Fox argues that not enough research was done before the program's launch. He has questioned the use of county funds, and ridiculed the questions the program's health coaches would ask participants to promote healthier lifestyles.

"Is his goal to get most people insured or get people in his signature program?" Fox asked.

If so many people are eligible for existing programs, that should have been the county's focus, he said.

"This has been in the press since October," he said. "People should have been banging down the doors."

Asking people if they take walks or are following suggestions about changing eating habits is silly, he suggested.

"I think it's a joke if you're going to track how people do these things," Fox said, though he would not say that the program should be ended or county funds withdrawn.

Beilenson found Fox's criticism groundless.

"We did a tremendous amount of research," he said.

Beilenson said that 299 people the county enrolled in a Kaiser Permanente insurance program also would have qualified by income for Healthy Howard. Full insurance is better, though, Beilenson said. Healthy Howard is not insurance and is only available inside the county.

The effort for the next few months will target people with incomes of roughly $20,000 to $30,000 for one person, or $40,000 to $63,600 for a family of four, Beilenson said. People interested in enrolling can go to the program's Web site,, where they can fill out a brief screening form.

A program worker will call each applicant within two weeks, Beilenson said.

He speculated that many who need health care still may not have read or heard about Howard's unusual program. Ulman agreed with that.

"It's hard to reach out to people," he said.

Joanne Stato, a Baltimore resident who formerly taught English part time at Howard Community College, said she and other adjunct professors had no benefits.

"I prayed for a health benefit program like this while I still worked there," she said, adding that she later found a job with benefits in Baltimore.

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