Sonoma County chipping away at backlog of Medi-Cal applicants

Sonoma County has cut its backlog of people waiting for health coverage under the state’s low-income health program 85 percent in six months. Yet, as a growing corps of county eligibility workers tackle the backlog, the number of people seeking Medi-Cal continues to grow.

In August 2014, 12,565 Sonoma County residents who applied for health coverage were stuck on a waiting list, as county health and human service workers grappled with what top health officials described as a tsunami of applications that flooded in over the previous six months. President Barack Obama’s health care law, launched in January 2014, opened up health care for 70,000 people countywide - 14 percent of the population.

Today, from last summer’s waiting list, 2,660 people are still in line for their Medi-Cal benefits, due largely to technology glitches and overwhelmed eligibility workers. The backlog has hit the poorest county residents hardest, with many people forced to prolong health care amid rising costs of living.

Overall, nearly 10,000 people are currently waiting for Medi-Cal benefits in the county, including 7,240 who have applied in the past three months, according to county officials.

The county’s staff of 216 eligibility workers and supervisors this year - the second year for federal health reform - are re-evaluating family size and annual income for current Medi-Cal recipients, as well as taking on new caseloads and working the backlog.

“We’re still seeing applications come in all year, and this year we also have to have staff assigned to redetermine cases,” said Kim Seamens, a county director in charge of overseeing economic assistance programs. “That’s why we’ve asked for extra staff.”

Included in an $8 million plan to address health and social safety net shortfalls approved by county supervisors last October was money to fund 17 new eligibility worker positions. Supervisors said the new staffing is critical to enroll people for health coverage.

“We’ve seen tremendous increases in Medi-Cal and Covered California enrollment,” said Supervisor Efren Carrillo, who represents the Board of Supervisors on health-related matters. “We’re responding, but we’re not responding as fast as we’d like to.”

Carrillo and other supervisors on Tuesday acknowledged gaps in the health care safety net, and approved an expansion of enrollment offices on Mendocino Avenue in downtown Santa Rosa, to meet the growing demand. The extra space will cost nearly $22,000 more per year for the county to lease the offices, for a total of $583,000 in annual rent. Supervisors pointed out that expanded facilities will house new eligibility workers brought on in the past six months to work the Medi-Cal backlog, and help enroll other low-income residents who are eligible for the free health program but have not signed up.

“We’re focused on getting as many enrolled as possible, and we need to have the space to meet the additional need,” said Supervisor Shirlee Zane. “People are also realizing they can actually get health care for the first time, so we need to focus on getting them access. That’s going to help reduce the heavy burden on our emergency rooms.”

Health officials said since last January, 64,000 county residents have gained coverage through Medi-Cal or Covered California, the state health insurance exchange. An estimated 30,000 people remain uninsured, according to the county. More than half of those people are undocumented residents, officials said.

Roughly two thirds of the uninsured are not eligible for health coverage because their status as undocumented immigrants disqualifies them. The remaining 10,000 people are uninsured because they simply haven’t signed up for federally mandated health coverage on the insurance exchange or don’t know they qualify for free care. Health officials said the county is ramping up efforts to study those shortfalls.

The Board of Supervisors on Tuesday signed off on a yearlong effort to better track the health care needs, demographics and current level of care for undocumented people in the county. Funded by a $120,000 grant from the Blue Shield of California Foundation, the initiative to collect and analyze data on remaining uninsured is aimed at reducing health care disparities.

“We don’t know exactly how many undocumented people are here, but we do know that they’re forced to pay out of pocket, or they end up in our emergency rooms, or they simply don’t get care because they are ineligible,” said Rita Scardaci, the county’s health services director. “This data will help us make sure everyone has access to affordable, and prevention-focused treatment.”

Carrillo said collecting data on undocumented people will help the county develop policies that directly reduce barriers to adequate care. He mentioned San Francisco’s universal health program that covers all residents regardless of immigration status, saying that the city has “done a good job” with its initiative, launched by former mayor Gavin Newsom in 2006. “One of the unfortunate things is we don’t have a clear understanding about who this population is,” Carrillo said. “My hope is that we craft a real plan soon.”

County health officials are expected to present new data gathered about county’s undocumented population to the Board of Supervisors in spring 2016. Any plan to expand health coverage would follow.

You can reach Staff Writer Angela Hart at 526-8503 or angela.hart@pressdemo?crat.com. On Twitter?@ahartreports.