Access Program An Acute Success
GRAND RAPIDS — Their stories are compelling.
For instance, a semi-retired, uninsured farmer was suffering from fluid in his lungs. He didn’t know where to turn for medical help until he was directed to Project Access, which immediately got him admitted to an intensive care unit. He stayed in the program for six months until he qualified for Medicare, and he credited Project Access with saving his life.
Then there was the 46-year-old single mother with a history of breast cancer in her family and without health insurance, who became very concerned when she discovered a lump in one of her breasts. Project Access arranged for her to have her first mammogram in four years, which turned out to be negative, and she was thankful that her biggest fear was relieved.
Those are just two of the many testimonials that Project Access has received over the past year. Project Access is a referral program whose purpose is to help the working poor without health insurance get the medical assistance they need, without charge.
The program is guided by the physicians who make up the Kent County Medical Society (KCMS) and the Kent County Osteopathic Association (KCOA) — 350 doctors who donate their time and services to Project Access.
“We started seeing patients last year, and the year before that was an organization year,” said William “Chip” McClimans, KCMS and KCOA executive director.
“The medical society got the osteopathic association to join in, and started this. Basically, Project Access is its own association now, its own organization. So even though my doctors volunteer for it and even though many of my board members and the board members of the osteopathic board are Project Access board members, it is its own entity,” he added.
Area hospitals and clinics have joined with the physicians in the two medical societies to provide care to county residents ages 18 to 64 who are without insurance, not enrolled in a medical program, and are at or below 150 percent of the poverty level.
That annual income for a single person is $14,700. For a household of four, it’s $30,000. Those under 18 aren’t included in Project Access because they can qualify for Medicaid or the MI Child program, while those over 65 can get coverage through Medicare. In addition, pregnant women automatically qualify for Medicaid.
In a little more than a year, Project Access has provided $757,023 worth of free medical care to those enrolled in the program — a figure fairly equally spilt between the physicians and the hospitals. Just this year, 434 patients received 560 referrals through early May and 177 of those referrals were for specialty care.
“Right now, we’re committed to working with the M.D.s and the D.O.s. We are bringing in some ancillary care, like physical therapy and the contribution from therapists. Even though they’re not physicians, they are important to the work that physicians do,” said Patricia Dalton, director of Project Access.
“We also link with pharmaceutical programs and discount drug opportunities for patients that help them be better patients to the physicians who are trying to help them,” she added.
Not only did KCMS and KCOA launch Project Access last year, but the two groups also unveiled a prescription discount card in 2005. Known as the Physician’s Rx Care Pharmacy Benefit Program, a result of a partnership the societies created with the Physician Leadership Access Network Inc. and Pharma Futures Inc., McClimans said the card has saved residents about $283,000 on their drug costs from last June through April.
“That is with roughly 15,000 to 17,000 cards out there and we have probably another 20,000 that we could hand out,” he said, adding that the card is good at 100 pharmacies in the county and 50,000 across the country.
Anyone without prescription drug coverage can get the free discount card. All a county resident needs to do is send a self-addressed and stamped envelope to KCMS and KCOA at 1400 Michigan St. NE, Grand Rapids 49503.
Medicare recipients with Part D prescription coverage can use the discount card to help pay for drug costs that Part D doesn’t cover: yearly purchases that range from $2,200 to $3,600. McClimans said the card can also be used for drugs that are not listed in an insurer’s formulary or listed under Medicaid.
“It’s virtually for every drug that is out there, brand names or generic. We’ve added a 15-percent discount on Beltone hearing products and a 25-percent savings on vision products from JC Penney,” he said.
To join Project Access, an applicant has to be from 18 to 64 years old and a resident of Kent County and be able to prove both age and residency. An applicant also needs to supply some proof of income, such as a paycheck stub that is less than a month old or last year’s federal tax return.
Applicants can’t be eligible for Medicaid, Medicare or another public insurance program and can’t be covered by a plan at work. Nor can applicants have a medical home, meaning that they haven’t been treated at a local clinic within the last three years.
Project Access coordinates patient appointments for primary care, specialty care, lab work, radiology and hospitalizations. For more information about Project Access, call (616) 459-1111.
“It’s a great program that is being led by and administered by the physicians in the community,” said McClimans. “The doctors wanted to be able to do this and run their own program without getting into the politics of whether it’s hospitals, or county government, or what have you. They wanted to take the lead on this.”