Health Alliance for the Uninsured (HAU)

PROJECT PURPOSE

HAU programs reduce barriers and improve access to basic and specialty health care services for low income, uninsured adults in Oklahoma County. This project would expand HAU services statewide, with a phased approach, partnering with safety net clinics, local hospital systems, and other state/county resources to benefit low income and working poor residents in rural and underserved communities. HAU programs include the following: ? Care Connection coordinates FREE diagnostic and specialty care services, including surgery, for low-income, uninsured patients of HAU's clinic network. Physicians volunteer their services, with hospitals, imaging and surgery centers contributing facility services. ? The Cooperative Central Pharmacy (CCP) Program provides access to prescription medications for acute and chronic illnesses from two sources: o HAU partners with OK County to purchase and distribute bulk medications to clinic patients. About 4,800 patients accessed free medications through this program in 2021 despite prolonged COVID shutdowns. o HAU enrolls patients in pharmaceutical company prescription assistance programs (PAPs) for long-term access to chronic disease medications. ? The Healthcare Services Navigation Program helps low income, uninsured clients navigate central Oklahoma?s complex healthcare referral network. HAU is the central hub of the referral network, which includes OKC Heartline 211, hospital systems, Unite Us, and clinic network.

EVIDENCE

Since 2007, HAU has demonstrated capacity to identify unmet community health care needs and work with free/charitable clinics and collaborative partners to address these needs. HAU?s public/private partnership network helps us ensure that our programs are effective, sustainable, and free for all patients. HAU programs benefit 10,000 individuals annually, and our program model could be effectively replicated in any OK municipality with need (low income, uninsured adults) and resources (clinics/FQHCs, providers, telehealth hubs). ARPA funding would enable HAU to expand services statewide, with a phased approach (geographically, programmatically), focused on serving low- income/working poor residents in rural communities.

POPULATION DESCRIPTION

HAU programs benefit low income, uninsured adults. HAU client household income does not exceed 300% of the federal poverty level. HAU clients cannot have private insurance, Medicare, Medicaid, Indian Health Services, or Veterans Administration health benefits. HAU helps every new client determine if they are eligible for Medicaid coverage and connects them with enrollment specialist if they qualify. Even after Medicaid expansion, OSDH estimates that about 14.3% of Oklahoma?s population is uninsured (https://www.okoha.com/OHA/Health_Care_Issues/Uninsured/OHA/Uninsured/Uninsured.aspx?hkey=a1684a2f-a786-4e27-bdcf-12fc4b0549e9). The most common disqualifiers for Medicaid coverage are a). too much income or b). individual does not have a social security number and/or cannot show proof of citizenship. The majority of individuals who do not qualify for Medicaid coverage DO qualify for HAU services. The majority of HAU clients are Hispanic. Some are homeless/precariously housed, but many fit within the ALICE acronym - Asset Limited, Income Constrained, Employed. They work but earn well below a living wage. These populations are always hit hardest by community crises, but COVID was devastating for both patients and safety net providers (https://www.nejm.org/doi/pdf/10.1056/NEJMp2114010?articleTools=true). HAU clients are more likely to get COVID, die from COVID, lose their job or their house. Our clinic partners ? already overburdened and under-resourced ? struggled to stay open.

PERFORMANCE MEASURING

Safety net clinics will be responsible for collecting, tracking, and reporting individual patient outcomes. HAU will track the project?s performance according to the following metrics: Community Health Outcomes: Number of individuals served, participating clinics/partners, reduction in ER visits for basic care. Medication Assistance: Number of prescriptions distributed, dollar value of prescriptions distributed, client enrollment in pharmaceutical PAP, participation from local/county/state health systems in bulk medication purchasing partnerships, satisfaction with program structure/delivery (client/partner surveys). Navigation: Referral completion rate, number of referrals Care Connection: Number/value of procedures provided, number of volunteer specialty providers recruited/retained, referral success rate (goal is 100%), satisfaction with program structure/delivery (client/partner surveys).

ONGOING INVESTMENT AMOUNT

$

ONGOING INVESTMENT DESCRIPTION

None

ONGOING INVESTMENT REQUIRED

Able to continue operation without additional funding from the State of Oklahoma