COUNTY OF DUKES COUNTY Departments 1500 & 800
VINEYARD HEALTH CARE ACCESS PROGRAM
ANNUAL REPORT, FY 2008: July 1, 2007 – June 30, 2008
Massachusetts’ groundbreaking health care reform initiative continues to have a major influence on the Vineyard Health Care Access Program’s activities. Because health care reform created new affordable health care programs, and because it is now mandatory to have health insurance in Massachusetts, the Access Program has seen a dramatic increase in the number of people seeking our enrollment and coverage maintenance services. The Access Program provides enrollment services to 15% of all Martha’s Vineyard residents.
In FY 2008, we had 7,178 total client contacts; 2,524 people were approved for/enrolled in MassHealth, Commonwealth Care, Health Safety Net and related programs; we provided prescription assistance to 250 people; and information, referral, advocacy and assistance services 4,736 times.
The Access Program’s core service continues to be connecting the Island’s lower-income residents with health care. Activities include public benefit health care program enrollment assistance, information and referral and advocacy; referrals to primary care, specialty care and complementary care; helping clients to make appointments and manage medical debt; and creating access to services like specialty care, vision care and prescription medication assistance. FY 2008 approvals for affordable insurance programs include Commonwealth Care – 828; MassHealth – 592 children and 495 adults (1,087 total) and Health Safety Net or “Free Care”-- 607; Medicare Part D and Prescription Advantage for seniors and the disabled -- 183.
The Access Program’s discounted care programs continued to provide affordable services to the uninsured. These include the Dental Access Program, the Specialty Network for the Uninsured (SNU) and the Prescription Medication Assistance Program (PMAP). The SNU is a regional program operated under the Cape and Vineyard Community Health Center Network. It has over 80 participating providers in 26 specialties; there were 680 patient visits for free or discounted specialty care in FY2008.
Outreach increased as a result of having grant-funded staff who could conduct additional activities. In addition to public service announcements, distributing fliers, brochures and cards throughout the community, school mailings, presenting to English as a Second Language classes, and networking with health and human service agencies, we held public meetings, conducted outreach to local congregations, were stationed at public locations (i.e. grocery stores) and had regular paid advertisements in the newspaper. We continued our outreach to clients of the Dukes County House of Corrections and the Community Corrections Program.
The David Kurth Memorial Fund provides emergency financial assistance to Islanders with medical-related expenses that they cannot afford, primarily prescription medication. The Fund was insolvent for nearly half of this year, however, after receiving contributions, we provided $4,556 in financial assistance to 112 low-income uninsured or underinsured Islanders. The Rotary Club of Martha’s Vineyard continues its strong support for this program. Other contributions in FY2008 came from the Farm Neck Foundation, the Peter and Elizabeth Tower Foundation; and individuals and local businesses.
Health Access Initiatives
Vineyard Smiles: The Dukes County Health Council’s Oral Health Working Group provides oversight for Vineyard Smiles, an oral health initiative which was funded by a grant to Island Health Inc. from the Oral Health Foundation (OHF) of Dental Services of Massachusetts. The program focuses on school-based mobile dental services and dental education for children in Head Start and grades K-12; care facilitation for adults with unmet oral health problems; and a community awareness campaign about the importance of oral health. In SY 2008, 412 children received dental care including exams, cleanings, fluoride treatment, sealants and fillings. Every K-2 classroom on the Island participated in Tooth Tutoring. 34 low-income adults received referrals and care coordination via our MV Dental Access Program.
Local and Regional Initiatives: Access Program employees have been involved in a number of additional health care initiatives including:
· The Dukes County Health Council’s Oral Health Working Group
· The MassHealth Training Forum
· The Specialty Network for the Uninsured
· The Tri-County Community of Oral Health Excellence
· Healthy Immigrant Families: Cape & Vineyard Initiative
The Access Program’s sustainability is identified as a goal in the Dukes County Health Council’s workplan. In FY2008 we convened a committee to implement sustainability activities, including seeking support from local health care providers who are able to get reimbursed from insurers because their patients are covered as a result of Access Program enrollment services. Several meetings were held with the Island’s major health care providers to determine their interest in supporting the Access Program, based on models from other access programs in Massachusetts and on the results of our 2006 Sustainability Plan.
The other major area of sustainability effort has been in the area of municipal funding from the County and for the first time, the six Island Towns. Because of fiscal constraints, the County was only able to fund 50% of its share of the Access Program (Department 1500) for FY2009. Each Town had a warrant article that asked voters to decide whether they wished to support Town funding for the Access Program. All six Towns voted in support of funding the program. This maintains the “municipal”, or non-grant, portion of the program’s budget at $90,000, which is around one third of the total budget. These efforts are ongoing in order to stabilize the program’s financial base for the future.
FY2008 funding sources included the County of Dukes County, Massachusetts’ Executive Office of Health and Human Services, the Blue Cross Blue Shield of Massachusetts Foundation, Elder Services of Cape Cod and the Islands, United Way of Cape Cod and the Islands, Community Action Committee of Cape Cod & the Islands and local funders including the Rotary Club, local businesses and individual donors. The program’s total budget for FY2008 was $268,000.
Department 800 consists of the building and grounds at 114 New York Avenue in Oak Bluffs, which houses the offices of the Vineyard Health Care Access Program. We are able to maintain the building through a combination of County funds, grants, donations and volunteer labor. The County’s Integrated Pest Management program provides pest control services to the building. We are fortunate to have to the assistance of the state’s Community Corrections program, which helps us to maintain the grounds. The Town of Oak Bluffs Highway Department is considerate enough to plow our driveway when it snows. Volunteers also help with janitorial services. Some repairs to the building, mainly the roof, are needed.
Program and Staff Information:
Telephone: (508) 696-0020
Fax: (508) 696-7352
Mailing Address: Vineyard Health Care Access Program
P.O. Box 1298
West Tisbury, MA 02575
Office Location: 114 New York Avenue, Oak Bluffs
Board of Directors:
Mary Jane Cleare, PhD
Beth Donnelly, MD
Else Mulder-Membreno, MD
Ex Officio Board Members:
Patricia Begley, RN
Sarah Isenberg, BSN, MA