You asked how New Britain Partners in Health assists uninsured individuals obtain health care coverage.

SUMMARY

New Britain Partners in Health is a nonprofit group of medical professionals and business and community leaders whose goal is to improve access to medical care and coverage for the uninsured and those who face other obstacles (e. g. , language barriers). A three-year federal grant from the U. S. Department of Health and Human Services funds the program, which is one of over 200 similar Healthy Communities Access Programs nationwide.

The group (1) screens individuals for Medicaid and insurance coverage eligibility, (2) helps eligible individuals receive free medications from pharmacies, (3) assists individuals with obtaining referrals and appointments, and (4) provides care management for those with chronic diseases. It seeks to educate individuals on the medical services and coverage opportunities that currently exist, the need for a “medical home” (a place to receive primary care), and how to be self-reliant in the future. Interested individuals may contact New Britain Partners in Health at (860) 893-0800.

HEALTHY COMMUNITIES ACCESS PROGRAM

Congress authorized the Healthy Communities Access Program (HCAP) in 2002 under Section 340 of the Public Health Service Act, as amended (Health Care Safety Net Amendments of 2002, Public Law 107-251). The U. S. Department of Health and Human Services’ (HHS) HCAP grants provide resources and an opportunity for a wide variety of public and private health care providers, local government, and community-based organizations to coordinate and strengthen their services for uninsured individuals.   In the HCAP model, community stakeholders identify strategies to fill identified or documented gaps in medical care access and coverage using approaches that best address their unique local needs, according to HHS.  

HCAP assists communities and health care providers: 1) develop or strengthen integrated community health care delivery systems that coordinate health care services for uninsured individuals and 2) develop or strengthen activities related to providing coordinated care for uninsured individuals with chronic conditions. An HCAP provider is a federally-qualified health center (FQHC), a hospital with a low-income utilization rate greater than 25%, a public health department, or an interested public or private sector health care provider or organization that has traditionally served the medically uninsured and underserved.  

HCAP activities include: (1) increasing the accessibility and availability of primary care “medical homes” through coordination with existing FQHCs, private providers, and public health departments; (2) improving continuity of care; (3) standardizing financial eligibility systems for sliding fee needs-based discounts; (4) creating or strengthening coordinated volunteer private physician networks that equitably distribute the uninsured caseload among participating providers; (5) developing pharmacy assistance programs; (6) developing or improving case management programs and tools used among providers; (7) coordinating and expanding transportation services to health care facilities, translation, health education, and outreach services; and (8) coordinating patient intake, eligibility screening, and appointment scheduling.

There are over 200 HCAPs nationally, according to Enrique Juncadella, Director of the New Britain Partners in Health HCAP. Other Connecticut HCAP grant recipients (past and present) include Griffin Health Services Corporation in Derby, Community Health Center in Middletown, Middlesex Hospital in Middletown, Yale-New Haven Hospital in New Haven, and Waterbury Hospital Health Center in Waterbury.

Additional information on HCAPs is available from HHS Bureau of Primary Care’s website at http: //bphc. hrsa. gov/cap/Default. htm.

NEW BRITAIN PARTNERS IN CARE

HHS awarded an HCAP grant to New Britain Partners in Care in September 2003. Operations began in February 2004 with a staff of 9. The group, which includes New Britain General Hospital, runs four programs designed to improve access to medical care and coverage for the uninsured and those who face other obstacles (e. g. , language barriers). The four programs are Access to Care Eligibility Screening, Pharmacy Assistance, Referral Service, and Care Management.

While many people learn about New Britain Partners in Health by word of mouth, the group is currently working to promote its services in and around the New Britain area. It has issued press releases and is distributing informational brochures.

Interested individuals may contact New Britain Partners in Health at (860) 893-0800.

Access to Care Eligibility Screening

Staff members interview individuals to determine their eligibility for public assistance programs, such as Medicaid. For an individual who is not eligible for Medicaid, staff determines if he is eligible to receive discounted services at the local FQHC, which has a sliding fee schedule based on need. Since February 2004, New Britain Partners in Health has processed 2,000 eligibility applications. Of those, 400 individuals were eligible for existing government programs.

Pharmacy Assistance

In exchange for extended patents on drugs, pharmaceutical companies offer “compassionate care programs” through which medications for chronic illnesses is free for those in financial need. These programs are not well advertised or easy to use. Each pharmaceutical company has its unique eligibility standards and procedures, which causes the programs to be underutilized, according to Juncadella.

New Britain Partners in Health helps determine if individuals are eligible for the programs and, if so, how to make use of them. Since March 2004, staff has processed 1,300 pharmacy assistance applications that have resulted in individuals receiving $ 100,000 worth of free drugs.

Referral Service

New Britain Partners in Health started a referral service in December 2004. Staff assists individuals with obtaining referrals to and appointments with specialists. From there, they do anything necessary to ensure that the person goes to the (and has a productive) appointment. This may include providing appointment reminders, arranging transportation, or coordinating translation services.

Care Management

Since August 2004, New Britain Partners in Health has also provided care management for individuals with chronic illnesses (e. g. , diabetes, HIV, cardiovascular disease). A nurse coordinates the patient’s medical information with all involved doctors, makes sure the patient is educated on his care plan, and follows up with the patient to make sure he is following the plan (e. g. , taking his medication, exercising).

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