Enrollment assistance: Definitely not a one time stop


Thank you to all of my new readers. I have been floored and humbled by the reactions to this blog. I write because really similarly to Harry Potter’s pensieve, sometimes you need somewhere to temporarily place a memory so you do not feel its weight but can still remember its immediacy and rawness. I write whenever I have time- mostly bus rides home and the last few days have a flurry of last minutes to meet a 1/15 deadline. I write whatever I feel like writing, mostly about the cases that my teammates and I love to remember or are super frustrated by. What follows are some of our favorite moments in the last two days, and what a great two days we have had.

There’s a case that has been circling my mind for months now. I first met Antonio over the summer. He came in unannounced, scared. He entered my office with his work hat, his lunch bag, and a powerful immediacy in his demeanor. Everything about him gave off rays of fear: his posture was slouched and curled in; his hands fisted tight around his body. He wouldn’t look me in the eye. I said, “Antonio, I’m Graciela– how can I help you today?” and the flood gates opened. He told me about not having health insurance for the last ten years. He told me about the pain in his hands and back from long days of work. He told me about how badly he wanted health insurance and at the time, I was stuck. Here was a man asking for my help in July but the Health Insurance Marketplace would not open until October. He and I had a long chat that Friday about his health insurance options. More importantly we dedicated some time to what I call the “game plan”. Antonio cannot read or write. He does not speak English. His memory is poor. He has no cell phone and he self admittedly doesn’t check the mail regularly. His brother has a cell phone but he often misplaces it. He has no computer and he never has used one. He gets to his visits with me via bus.

I asked if he would please come back and see me the first Friday of October, that I would wait after work hours just for him. I asked him, hoping that the answer would be yes, but as a prior student of mathematics (granted, I am awful at calculus) I knew that probability and chance were not in our corner.  He turned and said, “yes, just write it down on my piece of paper.” Antonio left and a lot of time passed. Fast forward to October. It’s Friday and an appointment request announcing Antonio comes up on my screen, and I think, “No way. No way will he come.” After a summer of my first experiences with cancelled appointments, forgetful clients, apathy I thought I knew it all. I thought I had learned that I had no real business getting my hopes up and Antonio walked in, and with it shattered that. He walked in, documents in hand, ready to go; the website was not as ready. We had no way at the time of knowing how long it would be until the website was up and running so he and I did a phone application that day. We were on the phone for over an hour. He was really nervous and scared so my co-worker and I did our best to set him at ease: we giggled about the bad music, we offered him chocolates, got him through it. They told us he would hear something in 6 weeks, and we didn’t like it, but we stomached it. We told him, come back to us as soon as you hear anything.

I’ve discovered a new law of emotional physics in our office. If my team thinks about someone hard enough, that’s the day they walk in to seek our aid. We bump into them on the streets, on the train, in the halls of our office, but somehow, the universe lines up, and you land on our stoop so we can help you. Flash forward to mid-November, six weeks pass and I’m worried. I thought about Antonio often during those weeks, wondering, hoping he would get through and emotional physics works out and Antonio walks in. He has not heard ANYTHING and after a call to the call center, they confirm that they have lost his application. I just about lose it, but its not the right time for my emotions- it’s about Antonio. My co-worker work quickly together- he takes care of lightening the mood and calming Antonio down and I blast through an application but then we get the yellow screen of death. I call this the screen that some of our immigrant applicants get when they apply and the system can’t find them. It’s the end to that application- they’re not going to be able to get through electronically right now.

We met with Antonio 4 more times to try and get his application and nothing we did, nothing the call center tried worked. Finally, Antonio’s life story changed- his income and household size changed. So much time had passed from our original discussion that he now became eligible for Medicaid instead. Fast forward to this week: we are ecstatic to say that we have enrolled Antonio in CountyCare. At this point, Antonio is our friend, and we are relieved to know he will have health insurance. Today I get to give him his confirmation and explain how his insurance will work!!

Many think enrollment assistance is a one time deal, a one stop shop. For some it is. For others, its about multiple touches– calls, visits, applications– to get them through. It’s all about the follow-up. It’s all about the follow-through: “I do exactly what I say I will do.” It’s all about faith. It’s all about turning something scary into something easy. It’s about recognizing and validating humanity. It’s about new friendships. People like Antonio show us why enrollment is and needs to be so much more beyond the application. It’s definitely not for the weak of heart.


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