Medicaid Managed Care - U.S. Senate Special Committee on Aging

172 Communicating the Quality Message
115
have the phone reconnected so she can stay in touch with her health care provider.
Appropriate repayment plans are implemented along with long distance and collect call
blocks on the phone line.
Finding a safe place to leave their children while they go to a doctor is also an obstacle
for many <strong>Medicaid</strong> recipients. In the 1992 survey, about half the members said they take
their children along on doctor visits. The second most common alternative to child care was
leaving them with a friend. The third most common was leaving them home alone.
To help its members overcome this obstacle, Medica Health Plans makes a point of
seeking to contract with health care providers who have play spaces and/or child care personnel
on site at their offices and clinics. For many <strong>Medicaid</strong> mothers, knowing that a clinic
is "child-friendly" has made a big difference in getting them to keep their medical
appointments. In very rare cases, usually involving high-risk pregnant women who have
been prescribed bed rest by their physician, Medica Health Plans has arranged and paid for
a limited amount of child care.
OVERCOMING BROADER BARRIERS: SOCIAL
SERVICE COORDINATORS
Medica Health Plans believes strongly that enhancing access to care for low-income and special-needs
populations requires an integration of social and medical services. People who are
worried about being evicted from their apartment, who do not have sufficient food or warm
clothes for their children, or who are wondering how they are going to pay their electric bill
and keep their lights from being shut off, are unlikely to have the time, energy, or money to
seek or follow through on medical care, even when they desperately need it. In addition, the
unrelenting stress of living with poverty can often trigger or aggravate a medical condition.
To help meet the social service needs of its low-income members, Medica Health Plans'
State Public Programs department took the unusual step of hiring social service coordinators
in 1994. The coordinators help link Medica Health Plans' <strong>Medicaid</strong> members with
community resources. Sometimes they do this by working directly with a member, either
over the phone or in person; other times, the social service coordinators simply supply information
about community resources to a member's health care provider, who passes it on to
the member at an appointment.
The specific jobs performed by the social service coordinators are as varied as the individuals
who are referred to them for help. Medica Health Plans' coordinators have done
everything from helping a first-time mother buy clothes and equipment for her newborn
infant to aiding a destitute family in its search for livable housing to accompanying a
woman as she sought a restraining order against her abusive husband.
Such efforts can have a substantial effect on the health of a Medica Choice <strong>Care</strong> member.
In the case of Lisa,' for example, the actions of a Medica Health Plans social service
coordinator may have prevented a premature birth. Lisa, a young pregnant woman with no
family support, had a low-paying job-so low that she qualified for Minnesota's Medical
Assistance. During the twentieth week of her pregnancy, Lisa went into premature labor.
Her physician was able to stop the labor from progressing but told Lisa she would have to
remain in bed for the remainder of her pregnancy. Lisa quit her job. Unable to keep up with
her bills, she soon found herself without a phone, and with a warning letter that her electricity
was about to be shut off, and an eviction notice from her landlord. Yet because of the
doctor's orders, she was too frightened to leave her home and apply for public assistance.
At this point, a nurse who had been checking on Lisa notified a Medica Health Plans
social service coordinator of the seriousness of the young woman's living conditions. The
coordinator went to work immediately on Lisa's behalf. She called local community organizations
with the resources to help keep Lisa from getting evicted or having her electricity