How The Uninsured Can Get Covid-19 Care

Thursday, March 26th 2020

Texas has the highest number of uninsured in the country. What happens to people who don’t have a primary care doctor or health insurance if they suspect they might have Covid-19?
Central Health is the local network of clinics and doctors who offer medical care to the uninsured. Decibel's Judy Maggio talked with Central Health President and CEO Mike Geeslin about how and where the uninsured can find care during this pandemic.

Judy Maggio: You know Texas has more uninsured people than any other state in the nation. So obviously there are going to be a lot of people out here who are worried about symptoms and don't have insurance, don't have a primary care doctor. What would be your advice to them?

Mike Geeslin: First, I think it's important to note that just because you're uninsured does not mean that you don't have access to care especially during a pandemic crisis like this. Central Health is the health care district for Travis County, and our mission is to provide health care to those that need it the most. And we do this through a number of different partners. Our largest primary care partner is CommUnityCare Health Centers.

We partner with Lone Star Circle of Care, with People's CommUnity Care and the two major hospital systems here in town: HCA St David's as well as our partner Ascension Seaton. There's a vast care network that we've built and assembled for individuals that do find themselves uninsured and that are living at or below 200 percent of the federal poverty level and need enrollment in a healthcare program not only to take care of their hospital needs, but also their primary care needs.

JM: So if someone falls into that category, what services are provided if they're worried about coronavirus? Is there a way for them to reach out to you? Should they go to one of these CommUnityCare Clinics or People's Community Clinic? What would be the first step they should take?

MG: If they are symptomatic and they feel that they may have been exposed to the coronavirus, we would ask that first they call one of the hotline numbers. Individuals that are staffing that hotline will assist you with triaging and getting lined up for testing, if your symptoms indicate that you do need to be tested. But I think it's important to note that not everybody is going to be tested. So that's why we're having to use, through our clinical partners, guidelines to determine who all needs to be tested.

JM: So what would be some of the symptoms that somebody would need to reach out about? What are some of the symptoms to look for?

MG: First I need to give the disclaimer that I'm not a medical doctor. So I'm not providing any medical advice. Covid-19 is a respiratory infection. In some of the materials and information that we've been putting out, we note that there's coughing and sneezing, fever. So there's a variety of symptoms related to respiratory viral infections that people would experience. Some people may feel like it's a mild case of the flu or a really bad cold. But that's the sort of symptoms that people need to be paying attention to.

JM: It sounds like if somebody is feeling some of those types of symptoms and fever, and we've seen a lot of those warning signs, they should call the hotline number. Let's talk also about the care providers in your network. I know there are a lot of clinics, they're fully staffed, a lot of them. Is there a concern about a shortage of masks and protective gear and ventilators and those types of things. What have your providers told you?

MG: First of all we have a national shortage. Texas and Travis County are no exception to that. And yes we are hearing about shortages of personal protective equipment or PPE. I really want to commend not only clinical leaders but hospital leaders for stepping up and really working to conserve that PPE and make sure that they're taking steps so that their providers can be protected. But more important that the people that they're serving or caring for are also protected as well.

JM: So once again, we want to let everyone know that just because you don't have insurance doesn't mean you can't get quality treatment for coronavirus. Anything else that you want to make sure the public knows? Especially the people who are in that low-income category? A lot of these people feel like they can't stop working as well. So they're in the professions that don't necessarily provide them with a healthcare plan. Any other message you want to get out to those folks?

MG: These are very challenging times. As a society, here in Travis County, we haven't lived through anything like this.

JM: Right.

MG: But I think it's important to note that Central Health, we fund healthcare for one in every seven people. At our Medical Access Program, we have over 24,000 enrollees. And our Medical Access Program Basic, which is a sliding-fee scale program, we have over 35,000 enrollees. We're able to serve and pay for health care for a lot of people and as a result, we've built a vast network of providers that can provide care not only for Covid, but if you have chronic conditions that need to be managed, we can provide care for that as well. This type of safety net wasn't just assembled yesterday. This is something that we've been building on since our inception. And yes, we're going to test it. And we ask for peoples' patience. We may have to take measures to conserve various protective equipment supplies, but our goal is to provide healthcare to those that need it most. And that's what our mission focus will be.

JM: Mike, there's a lot of mixed messages and a lot of information coming at us. What about people who may be worried about getting out and going to a clinic if they have a medical issue, perhaps it's not Covid-19.

MG: Right. We are fortunate to partner with CommUnityCare Health Centers and that is a federally qualified health center and one of the largest in Texas. They are quickly moving to a telehealth model. You've heard the phrase telehealth or telemedicine, or remote medicine. But the idea is that providers and patients can talk on the phone or over a computer connection just like we're doing now, and be able to receive care. And it's not only certain testing that the provider might perform to see if a patient needs to be tested or helping to manage their conditions that they had pre-Covid, but also filling prescriptions as well. So there's a way to seek care without necessarily having to come into a clinic. If you are scheduling an appointment with CommUnityCare, you can call 512-978-9015 and they will walk you through the steps to be able to use their telehealth or their telemedicine options.

Another important point is pharmacy. It's not just about daily interaction with a medical provider. It's about maintaining their medications. So again, CommUnity Care, we're thankful to partner with them. They are providing means to do curbside delivery at one of our clinics. It's the Southeast Health and Wellness Center. And they also have other pharmacy partners that can ensure that people have a 60 or a 90 day supply of medications as we go through this response period.

This interview has been edited and condensed for clarity.

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