People who are homeless or indigent are being taken advantage of by out-of-town insurance brokers, according to homeless advocates who say the brokers are all but bribing people who live on the street to sign up for policies they don’t. they can afford and in the end. making it harder for them to get health coverage.
The issue is just one of the many health-related issues homeless individuals face.
Chandra Smiley is CEO and executive director of Community Health Northwest Florida, one of the primary places homeless and low-income people can go locally for medical care. Last year alone, Community Health saw nearly 10,000 homeless patients at the organization’s 22 sites in Escambia and Santa Rosa counties.
Smiley said for at least the past nine months, insurance brokers have been traveling to the Pensacola area and “aggressively” convincing people to sign up for health insurance that ended up creating more problems than it helped. .
Brokers usually receive a commission from the insurance companies for each person they sign up.
“These brokers, as best as we can tell, come from Jacksonville, come here and literally in the middle of the night, wake people up from the park bench in front of Alfred Washburn and make them sign up for these advantageous plans.” , Smiley explained. “They give it like a $20 gift card or something like that, and so these individuals will sign up and then lo and behold, their co-payments are high.”
Leigh Oliver, a case manager with Lakeview Center’s mental health services outreach program, Homeless Assessment Response Team (HEART), also heard from clients who were approached to sign up for the plans. of private health insurance, and also saw the brokers in action.
Oliver said an insurance broker he spoke with gave him a card with an address in Georgia.
“I’ve actually seen it on street corners, but in grocery stores where there’s a higher homeless population,” Oliver said. “They would come to maybe say, the Dollar General or something like that, where they were down the street. It’s probably not the politically correct term, but that’s kind of what they used to do. I’ve heard stories (from customers) of them offering $1 to $5 to $50 tablet gift cards for just different and different things.
“You know when you have an individual who has nothing in his pocket, if you say I’ll give you $5, (the individual says), ‘OK, that’s all I’ve got,'” Oliver continued. Social Security. They will receive copies of their ID. What is the use of this information, I never really understood. I’ve had individuals say that they filled out the (insurance) application like they had a paper application, some have electronic, and some have paper and they’ll have the individual fill out the entire application.” .
Worthless insurance prevents a real opportunity for coverage
Not only can most not afford the co-payment, in some cases their pharmaceutical coverage is inadequate and expensive and their primary care doctors are located hundreds of miles away in another city. As a result, they don’t get the care they need, and private coverage means they can’t qualify for the Medicare or Medicaid plans they normally qualify for.
“We are trying to work with patients to get them converted to Medicare straight or what they had before and there are challenges that come with that because we are talking about a transient population and they have to make the call (to the insurance company). So what we ended up doing was enrolling (in one of the insurance networks that signed up individuals). So now we’re like, “Well, at least we’re in the network,” and they can come to us for care and then maybe we can make the transition to Medicaid later, because really what’s best for the patient is to have that Medicare or Medicaid right.”
Homeless shelters across the area have reported that health insurance brokers are being kicked out of their campuses. Community Health operates a clinic at the Waterfront Rescue Mission in Pensacola, where staff have banned brokers from their property.
“They prey on the vulnerabilities of individuals who are lied to about what they need and how to get it,” said Clay Romano, president and CEO of Waterfront Rescue Mission. “So that literally prevents them from actually being able to see anyone here on campus or even one of the other places for Chandra Community Health or even the Health and Hope Clinic. It’s disgusting to be quite frank with you, so we’re going to pursue them to the fullest extent of the law.
The Respite Dorm program that offers some relief
The issue highlights the need for more medical care for those who are homeless and indigent. One way advocates are trying to address this is through a Waterfront Respite Dorm pilot program offered in partnership with Community Health. The program offers people a place to stay and recover after they have been released from the hospital. Without it, most have returned to the streets, which is not a safe or healthy place to recover.
“They just need a safe, clean space to rest for a week,” Smiley said. “If you and I go and have gall bladder surgery and are told to stay home for a week, we have our nice comfortable houses that are clean that we can rest in. For people who are homeless and are not in a shelter. or in a program, they sleep in campsites and out in the woods (and this is) just not the best place to recover. These beds are really for those who are released from the hospital and need to recover for a week or two. Depending on their condition and what they have been released from, it is a place where they can go and receive care.”
There are currently 10 hospital beds in the dormitory and there are plans to add six more in an adjacent room. Details are still being decided, but medical staff and case managers will be available to provide care and offer services to help them transition from homelessness, if they choose.
Without these beds, many people are simply abandoned literally on the side of the road or at the door of shelters like Waterfront. Romano said they had two such cases recently. In one case, a man missing a leg was left in front of his campus with his prosthetic limb leaning on a nearby pillar, and another involved a woman.
“A two-county health facility took her in a taxi, took her there and the taxi driver dropped her off around 9:30, 10 o’clock at night,” Romano described. “He left her in the yard of our campus where she stayed all night until she crawled from the grass over the concrete to where she stopped, right in front of our door where I found her. We have to stop allowing this to continue to happen. It happens more often than I like to admit.”
Before becoming president of Waterfront, Romano worked at Baptist Health Care where he helped found the Faith Health Network, a network of organizations that educate and help people who are low-income or uninsured access services of health care without relying on hospital emergency rooms for everyday medical problems. which increases costs and waiting times.
“They’ve been crying out for something like this for a long time because unfortunately the reality is when a homeless person gets sick, they end up in the ED (emergency department), which is the most expensive access point for the health system . . . They don’t have a primary care provider. The ED is their primary care and they’re bottlenecking the services of people who may be experiencing an acute care situation.”
For this reason and others, Romano said local hospitals are interested in supporting the Respite Dorm concept, possibly through sponsorships. Romano said that West Florida has agreed to be a part of the program and that they are still working on memorandums of understanding with Baptist and Sacred Heart hospitals.
About three dozen people have gone through the pilot respite program so far. Romano said they hope to officially open in the near future, but are still putting together the full schedule. Meanwhile, they are securing more hospital beds from Baptist’s legacy campus that became available after the hospital moved to its new campus.
The plan is to eventually offer 16 beds at Waterfront’s Pensacola campus and another 10 at its site in Mobile, Alabama, where health care providers are also interested in collaborating. The need is far greater than the limited number of beds they can offer right now, but advocates say it’s a place to start, especially since adequate medical insurance coverage can provide additional income to help those in need. cure
“We’re taking it, and we’re giving them an option for a clean, healthy environment,” Romano said. “We have to give life care at home that they don’t necessarily have and at the same time generate a stream of income doing so for the health systems, so the health system wins, we win and the person gets healthier faster ., and we have the chance to change their lives in a positive way through other services.”
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