When venturing into unknown territory, there are certain essential tools -- food, water, a map and, if possible, a guide familiar with the terrain and culture.
The state's new health care exchange will be strange territory for many residents, and so those in charge of it are training people to help the more than 330,000 uninsured Nutmeggers navigate the landscape.
Access Health CT, the state's health care exchange, has joined with the state Office of the Healthcare Advocate to launch the Navigator and Assister Outreach Program. The program is training 300 "in-person assisters" -- librarians, hospital and clinic workers, health department staff and community volunteers -- to educate residents about the exchange and the options available to them through it.
"A lot of the people (who will use the exchange) haven't had insurance for a while or may never have had it," said Kate Gervais, manager of Access Health's Navigator and Assister Outreach Program. "And this can be very confusing. Our goal is that everyone who is eligible for the exchange has access to the information they need."
The health insurance exchanges are a key piece of the federal Affordable Care Act, which aims to provide coverage to millions of uninsured Americans starting in 2014. Enrollment will begin Oct. 1 and continue through March 31.
The state exchange is expected to enroll 100,000 its uninsured residents in its first year.
The people in your neighborhood
There will be three companies selling insurance through the exchange, and each of them will offer a variety of plans. Some people will qualify for subsidies to help cover insurance cost; some will qualify for free coverage through Medicaid.
With so many options, the exchange is not something people will be able to just sit down and use with no introduction, Gervais said. That's where the assisters come in.
These are, simply put, the people in your neighborhood -- volunteers and employees from such agencies as the Stamford Department of Health and Social Services, the Bridgeport Child Advocacy Coalition and the AmeriCares Free Clinics. The idea is to connect the uninsured or underinsured with information about the new marketplace, using the people who know them best, Access Health Chief Executive Officer Kevin Counihan said.
"You tend to trust your neighbors," Counihan said.
Karen Gottlieb, director of the AmeriCares Free Clinics, with sites in Bridgeport, Norwalk and Danbury, agreed. She said the clinics, which will soon include a mobile clinic in Stamford, serve a total of roughly 2,700 patients. Gottlieb said her hope is that every client who is eligible for insurance through the exchange will have the opportunity to learn about it.
"All of our patients are uninsured," she said. "Some of them are undocumented (and not eligible for insurance through the exchange), but some qualify for expanded Medicaid, and some will qualify for subsidized insurance. The goal is that all of them know what their options are."
Educating not selling
Gervais emphasized that the assisters won't be selling insurance or even telling residents which option to pick.
"We can only say `Here's the information -- consider these factors,' " she said. "We cannot say `Consider this plan.' Only brokers can do this."
The assisters will be overseen by six navigator organizations, each in a different region of the state. The navigators will connect with other community resources, including small businesses, to spread the word about the exchange by organizing public education events.
Assisters and navigators have to undergo a lengthy training period, 34 hours for assisters and 40 for navigators, and pass a certification exam.
Training has already started, but so far only basics have been covered, Gottlieb said. Five workers from the clinics will be trained as assisters, and Gottlieb is also being trained.
"The training so far as been about the history of insurance, and cultural diversity, and the establishment of the exchange," Gottlieb said.
The real "meat," she said, namely the ins and outs of the exchange , won't be covered until the next session in September.
In Fairfield County, the navigator organization is the Trumbull-based Southwestern Area Health Education Center, which is part of the larger Connecticut Area Health Education Center Program, established in 1995 by the Connecticut General Assembly. AHEC aims to connect state residents with health care and health providers, not unlike the navigator program itself. The navigators basically will function as a sort of "mother ship" to the assisters, said Meredith Ferraro, executive director of Southern AHEC.
"Our role is really to help the assisters target the areas where the uninsured are," she said.
For the most part, assister organizations, like AmeriCares, already have a good idea who these people are and how to reach them, Milagrosa Seguinot, community health worker project coordinator for Southern AHEC.
"They know their communities," she said. "They know the cultural aspects of it. They know the language."
Both assisters and navigators will receive money to fund their efforts. Assister organizations will get $6,000 in federal funds to support assisters' work through the exchange's open-enrollment period. Gervais said the navigator organizations will also be paid, but that compensation will vary. A total of about $320,000 will be allocated for the six navigator organizations, Gervais said. That money will come from grants from the Connecticut Health Foundation and other organizations.
The main objective of the program is to help residents make smart insurance choices.
"This is a very difficult topic and even if people know some information about it, there's a lot of myths and misinformation out there," Gervais said.
acuda@ctpost.com; 203-330-6290; twitter.com/AmandaCuda; http://blog.ctnews.com/whatthehealth/
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