News from Planned Parenthood Mar Monte
In era of health care reform, PPMM services even more in demand- read now.
A day in the life of a PPMM health center- read now.
"Parenting with Love" at Gilroy health center- read now.
Good news in Nevada- read now.
In era of health care reform, PPMM services even more in demand
There are a lot of questions buzzing in the community about health care reform now that implementation of the Affordable Care Act (ACA) is just eight months away in 2014. We want you to know one thing for sure: Planned Parenthood Mar Monte health centers and services – including reproductive health services and primary care for adults and children – will be even more in demand in the new health care landscape than they are now.
As PPMM CEO Linda Williams put it, “With the huge influx of people who will be eligible for Medi-Cal and private health insurance for the first time, our capacity will be desperately needed. We already know how to serve those new patients: We accept flexible walk-in visits. We are accustomed to having entire families in our waiting rooms. And we welcome groups of patients, which is the way teens often support each other when they come in for the first time.”
Our current patients who will now have broader insurance coverage in the few areas of PPMM without a physician shortage are still likely to prefer receiving their health care at PPMM. This was our experience 20 years ago when many California counties switched to Medi-Cal managed care. Also, it is likely that California will continue its subsidized Family PACT family planning program for low-income people, primarily immigrants, who don’t qualify for Medi-Cal or the new state health care exchange, Covered California. We will be here to serve these patients in a system that will be more crowded than ever. For those still without any health care coverage, primary care in California and all services in Nevada will also remain available on a fee-for-service sliding scale.
Some local counties and other payers already have asked us to expand our comprehensive primary care for adults and children to our health centers that currently provide reproductive health care only. Over the next few years, the more successful Obamacare is with bringing newly eligible people into health care coverage, the more essential our health centers will be because of the scarcity of providers and the pressing need for reproductive health care among young women and men. Certainly, this was the case with Massachusetts Planned Parenthood when the state’s very similar health care reform law was enacted seven years ago.
The good news is that the same public health insurance or commercial plans that currently cover our Medi-Cal patients in California are likely to dominate the expanded Medi-Cal market, and the commercial plans will participate in Covered California as well. We are very familiar with them as they are with us, and we have been focused on negotiating improved reimbursement rates, especially for comprehensive primary care.
We have learned from Massachusetts’ experience, however, that our greatest challenge will continue to be inadequate reimbursement rates for our services. Many Medi-Cal services are compensated at rates established in 1985, and a retroactive 10% rate cut will be imposed if a current court case is unsuccessful. California’s Medi-Cal payment rates are already the lowest in the nation and Nevada’s aren’t much better. This severely limits the number of physicians available and becomes even more of a problem with every passing year of rising costs. When those rates were established, for example, nurse practitioners were paid less than medical assistants receive today.
There is a bill in the California Legislature, SB 640, that would prevent the state from enacting the 10% Medi-Cal rate cuts if the court case to block them is unsuccessful. We urge our supporters to contact their legislators and let them know that it is essential to support the bill and block these cuts.
As we continue to prepare our health centers for the implementation of ACA, we must also educate our patients about their new options, including when and how they should enroll. PPMM will have an important role to play in the age of health care reform.
“There’s no question in my mind,” Linda said. “We’ll be needed more than ever.”
On a recent spring afternoon at the PPMM health center in Mountain View, California, there were a few teenage girls quietly leafing through contraception information pamphlets near the reception desk. A pregnant woman watched her two children play with toys in the corner while their father read a magazine. This is a typical snapshot of a PPMM health center waiting room. Groups of friends and families come in for their reproductive health care as well as for primary care, ranging from cancer screenings to check-ups for hypertension and other chronic conditions.
PPMM health centers outside of Santa Clara County – including the Family First center in Fresno and the B Street center in Sacramento – also provide primary care services, and the Mountain View center is a good example of the kind of family care our patients receive.
“Planned Parenthood is a household name in this community,” explained Rene Galvan-McLeod, the Mountain View center manager. “It’s really not unusual for us to have a 2-month-old baby in the waiting room at the same time as an 80-year-old patient. People know they can get basic health care here, whether it’s a well-baby check or testing for cholesterol.”
The health center sees about 20 elderly people every week. Often a mother or daughter come in for contraceptives or cancer screening and then bring in other members of the family for different health services. In fact, some teenagers who receive reproductive health care at the center have been patients since they were toddlers.
Rene said a Filipino mother brought her children in recently to get school vaccines, and the center ended up providing services for her teenage daughter and husband as well. Because the center had a physician who spoke Tagalog, the Filipino language, members of the family were able to communicate easily about health check-ups that they hadn’t had in a long time.
It is common for uninsured patients to come in for a check-up and end up being treated for a previously undiagnosed condition. Courtney Nelson, a health service specialist at the center, recently saw a middle-aged woman who hadn’t had a well-woman exam in five years. A cancer screening detected a mass in her breast, and she was immediately referred to Valley Medical Center for diagnosis and treatment. “There is a real harmony of service - the center working with hospitals like Valley Med and Stanford,” Courtney said. “We were also able to work with this woman and her son to overcome some of the transportation issues she had and make sure she could make it to all of her appointments.”
When health care reform begins next year, this kind of family care and “one-stop-shopping” will be available to a new population of patients who have never had health coverage before. They will see for themselves the kind of care that makes PPMM special.
Gilroy mom, Rosa has learned how to keep from feeling overwhelmed by parenthood since she began bringing her baby girl to PPMM's new program, Crianza con Cariño ("Parenting with Love"). The program has even helped her with her older children, such as when she found herself in the toy department of her local Kohl's store recently and her four-year-old son Mario was about to have a meltdown. She took a deep breath, kept her cool and managed to set firm boundaries without raising her voice. Mario meltdown averted.
Crianza con Cariño began as a pilot program for new mothers at the Gilroy health center in September when PPMM was among the proud first recipients of a Jean Gerlinger Award grant from the Bella Vista Foundation. The grant funds the program to help mothers nurture their babies in a setting where they also receive their health care, and participants are referred through the Gilroy center's perinatal services. The "founding group" of five mothers are pregnant or have newborns, and most have older children as well. Because a majority of the center's perinatal clients are Spanish-speaking, the group meetings are conducted entirely in Spanish.
Rosa began coming to the group last fall when she was five months pregnant, and she was happy to find a place where she could learn about effective parenting techniques with mothers who were facing the same challenges. She was also pleased to find child-care on site. "This is a special time and place just for me where I can listen to others' advice," she said at a recent Tuesday group meeting.
Another mom in the group, Gaby, said she is grateful to have a safe space where she can ask questions. "I wanted to learn to have more tolerance and learn how to calm myself and relax when (parenting) gets really hard," she said. "It has helped me to be patient when I understand better what my baby is going through, what's on my kids' minds."
Group meetings, facilitated by the center’s perinatal coordinator, Erika Garcia and Adolescent Family Life Program case manager, Sareli Beltran, focus on a variety of early parenting lessons including The Importance of Touch and Establishing Nurturing Parent Routines. Sareli – who is also a parent of young children – said the participants have been especially interested in learning about ways to empathize with their babies and older kids in times of stress.
"I think it really helps them to know that they're not the only ones feeling clueless about parenting sometimes," she explained. "We're teaching them to take care of their child but also take care of themselves."
There is widespread research showing that when children are raised in a nurturing home, they are more likely to grow up feeling confident, secure and able to make healthy decisions for their own lives and their families. Crianza con Cariño is another example of how PPMM programs help build brighter futures for families and strong communities.
Sareli Beltran hopes that one day the program might expand to another frontier: "It would be great to have a group for dads as well!"
Good news in Nevada
Call your Nevada State Senator and say you are counting on their support for this bill. Use the map to find your Senator, and look up the phone number here.