Overview: Franklin Health Access is a collaborative initiative that was developed to assist a specific portion of the local population that would otherwise not be served. The mission of Franklin Health Access is to improve the health and well being of uninsured, financially disadvantaged people through advocacy, education, treatment, and access to services. Franklin Health Access provides a link to a network of health care providers and community resources for residents of the Franklin Community Health Network service area whose income falls at or below 200% of federal poverty guidelines. It does not offer an insurance product, but rather a program that manages unreimbursed care for participating individuals and organizations in rural west central Maine.
Providers:Participating physicians and other providers donate their services and control how many unreimbursed care "slots" they make available to the program. Some or all of their slots can be for existing patients. Providers have also participated in developing the program's qualification standards, educational components, and sliding fee scale.
Outreach:Franklin Health Access reaches out to area residents who do not have health insurance and who are interested in improving their well being. Community health advocates, social workers, and staff of federally qualified health centers have been trained to recruit, screen, and refer appropriate potential "members" to the program.
One-Stop Qualification:Eligible candidates can enroll in the program by telephone, mail, or in person at their neighborhood health center or the program office. Procedures and paperwork are minimal and straightforward. Conditional Membership cards are issued to each new member based on presumptive eligibility, offering immediate access to all participating providers and services. Project staff assist residents in accessing other programs they may be eligible for, including but not limited to state assistance and medication prescription discount programs. (Any member who is later able to obtain Medicaid or any other form of insurance coverage is discharged from the Project.) Once final eligibility for the program is determined, a Health Card is issued, indicating their membership and co-pay level, which is based on household size and income. The Health Card is identical in appearance to the cards used by all other patients and staff in the health network.
Decentralized Care Management:Every member is assessed (virtually all in their home setting) for short and long-term medical needs and to identify any psych-social issues which affect their overall health/life picture and their ability to access care. Personal Health Goals are established, and an advocate whose skills match that particular member's needs is assigned to provide ongoing support, guidance, and assistance. Each member is also given verbal and written self-help information, including a comprehensive medical handbook. Subsequent discussions with their Personal Health Advocate, their physician(s), and Project staff ensure access to and appropriate use of available services. The communication and educational components of the Project foster clarity and strengthen continuity of care.
Patient Choice and Responsibility:Franklin Health Access promotes wellness and autonomy within a patient-centered framework. Members are able to choose among participating primary care providers and are responsible for managing their own health. They must be willing to work with a Personal Health Advocate. Each member is provided with the necessary tools for improved health care and decision making. The empowerment of each individual is continually encouraged and supported by the advocates and program staff.