People who are homeless or insecure are being taken advantage of by out-of-town insurance brokers, according to homeless advocates, who say the brokers are only bribing people living on the streets to sign policies they can’t afford and ultimately making it harder to get health insurance.
The issue is just one of the many health issues facing homeless people.
Chandra Smiley is the executive director and CEO of Community Health Northwest Florida, one of the main places homeless and low-income people can go for local medical care. Last year alone, Community Health saw nearly 10,000 homeless patients at the organization’s 22 locations in Escambia and Santa Rosa counties.
Smiley said that for at least the past nine months, insurance brokers have traveled to the Pensacola area and “aggressively” convinced people to sign up for health insurance, which has caused more problems than it has helped.
Brokers typically then receive a commission from insurance companies for each person they sign up.
“These brokers, the best we can tell, they come out of Jacksonville, come here and literally in the middle of the night, wake people up from their park benches in front of Alfred Washburn and get them to register these benefits. plans,” Smiley explained. “They give them like a $20 gift card or something, and so these people sign up, and then, lo and behold, their co-pays are high.”
Leigh Oliver, of the Lakeview Center’s Mental Health Services Outreach Program, Homeless Assessment Evaluation Team (HEART), also heard from clients who were approached to sign up for private health insurance plans and even saw brokers in action.
Oliver said one of the insurance brokers he spoke with gave him a card with a Georgia address.
“I’ve actually seen them not on street corners, but in stores where there’s more of a homeless population,” Oliver said. “I’d see them at, say, a Dollar General or something like that, where they’d be running around the street. It’s probably not the correct political term, but they kind of did. I’ve heard stories (from customers) of them offering $1 to $5 to $50 gift cards to tablets just for different, 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) “Okay, that’s all I’ve got,” Oliver continued. “They get their social security number. They receive copies of their ID. What that information is used for I never really understood. I’ve had individuals say they filled out the (insurance) application as if they had a paper application, some electronic, some paper, and the individual has to fill out the entire application.”
Worthless insurance prevents the possibility of real coverage
Not only can many not afford the co-pays, but in some cases their drug coverage is inadequate and expensive, and their primary care physicians are 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 programs they would normally receive.
“We’ve been trying to work with patients to get them back to straight Medicare or whatever they had before, and there are challenges that come with that because we’re talking about a transient population and they have to call (insurance. company). So what we ended up doing was enrolling (with one of the insurance networks that enrolled individuals). So now we say. “Well, at least we’re in network,” and they can come to us for care, and then maybe we can move them to Medicaid because that’s really what’s best for the patient. they have that direct Medicare or Medicaid.”
Area homeless shelters have said they are kicking health insurance brokers off their campuses. Community Health operates a clinic at the Waterfront Rescue Mission in Pensacola, where staff have banned brokers from their property.
“They’re praying about the vulnerability of individuals who are being lied to about what they need and how to get it,” said Clay Romano, president and CEO of the Waterfront Rescue Mission. “Then it literally prevents them from actually seeing someone here on campus or even at one of the other locations at Chandra Community Health or even the Health and Hope Clinic. It’s disgusting to be completely honest with you, so we’re going to take them to the full extent of the law.”
A residential retreat program that offers some assistance
The issue highlights the need for more medical care for homeless and vulnerable people. One way advocates are trying to address that is through the Waterfront Respite Dorm pilot program offered in partnership with Community Health. The program offers people a place to stay and recover after being discharged from hospital. Without it, most are returned to the street, which is not a safe or healthy place for recovery.
“They need a safe, clean space to rest for a week,” Smiley said. “If you and I went and had gallbladder surgery and they said stay home for a week, we have our nice, comfortable homes that are clean where we can rest. For people who are homeless and they are not in shelter. or in the program they sleep in camps and forests (and that is not the best place to recover). These beds are really for those who are being discharged from the hospital and need to recover for a week or two. Depending on what they’re in and what they’re being released for, that’s a place they can go and get some help.”
There are currently 10 hospital beds in the dormitory, with plans to add six more in an adjacent room. Details are still being determined, but medical staff and case managers will be available to provide care and offer services to help them transition out of homelessness if they choose.
Without these beds, many people are simply dumped literally on the side of the road or at the doorstep of waterfront-type shelters. Romano said they have had two such incidents recently. In one case, a man who was missing a leg was left in front of their campus with his prosthetic limb resting on a nearby pillar, while another involved a woman.
“The two-county health facility put him in a taxi, brought him here, and the taxi driver dropped him off at 9:30, 10 at night,” Romano described. “We left him in the front yard of our campus where he stayed overnight until he crawled through the grass over the concrete to where he came to a stop right in front of our door where I found him. We must stop allowing this to continue. It happens more often than I care 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 educates and helps low-income or uninsured people access health care without relying on hospital emergency rooms. for everyday medical problems. which increases costs and waiting time.
“They’ve been clamoring for something like this for a long time because, unfortunately, the reality is that when a homeless person gets sick, they’re going to end up in the ED (emergency department), which is the most expensive access to the health care system. . They do not have a primary care provider. The ED is their primary care, and they are hindering services for people who are likely to experience an acute care situation.”
For that reason and others, Romano said local hospitals are interested in supporting the Respite Dorm concept, possibly through sponsorships. Romano said West Florida has agreed to be part of the program and they are still working out memorandums of understanding with Baptist and Sacred Heart hospitals.
About three dozen people have gone through the pilot deferment program so far. Romano said they hope to officially open in the near future, but they’re still putting the whole plan together. 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 10 more in Mobile, Alabama, where health care providers are also interested in partnering. The need is far greater than the limited number of beds they can offer now, but advocates say it’s a place to start, especially because adequate health insurance coverage can provide additional income to those who need help.
“We take them and give them the option of a clean, healthy environment,” Romano said. “We’re going to give them the home life care that they don’t necessarily have, and at the same time we’re going to create a revenue stream doing it for the health systems, so the health system wins, we win, and the person gets better faster.” , and we get the opportunity to positively change their lives through other services.”
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