Puente’s health care interventions: the difference between living and dying

It was a nightmare come to life. One day a few years ago, La Honda resident Wayne Petersen got sick. His muscles were weak and he felt tired all the time. Sometimes he couldn’t speak or swallow his food. His gait was unsteady and at one point, he fell out of his car because he couldn’t stand.

Terrifying as his symptoms were, Petersen didn’t have a health care plan to deal with them. He had been denied medical insurance due to pre-existing conditions.

By the time he came to Puente for help, Petersen had already spent his entire life savings on private doctor visits. He was broke, and in spite of their efforts, none of the experts he’d consulted could figure out what was wrong with him.

That changed almost as soon as Petersen met with Safety Net Manager Lorena Vargas de Mendez, who discovered he qualified for San Mateo County’s Medicaid Coverage Expansion Program. Within a month Puente helped Petersen access the San Mateo County Health System. He got a primary care physician, who referred him to a series of specialists. He underwent echocardiograms, breathing analysis, liver monitoring, blood cell counts – “everything you can imagine,” he says.

Finally, Petersen was diagnosed with Myasthenia Gravis, an autoimmune disease that presents only about 30,000 cases a year in the U.S. The neuromuscular disorder has already meant the end of Petersen’s career.  It has made simple things, like a trip to the grocery store, too strenuous to undertake. Eventually it will claim his respiratory system.

“I was used to making good money. Now it’s just surviving day-to-day,” says Petersen.

Today Petersen is managing his disease with Puente’s help. San Mateo County Public Health Nurse Karen Hackett, who is stationed with Puente, pays him regular visits and oversees his regimen of medications, doctor’s visits and physical therapy.

Vargas de Mendez also helped Petersen, who relies on a skimpy Social Security income, cut down on his electricity bill and weatherize his home with a PG&E discount.

“We can’t stop the progress of his disease, but at least he has a better life,” says Vargas de Mendez. “Just the fact that we are here in this isolated area really expedites the process of qualifying for health care. It could make the difference between living and dying.”

Of his experience with Puente, Petersen says: “Lorena helped me with a lot of stuff – got me in touch with everyone I needed, then saw me through everything.”

Puente launches health care survey

For years, Puente’s programs have made the connection between having health coverage and leading a healthy life.

“Puente really does save lives. It isn’t just a band-aid approach,” says Kerry Lobel, Executive Director of Puente. Petersen’s story is a testament to Puente’s wraparound approach to getting participants the care they need.

No one could have prevented Petersen’s disease. But changes to U.S. health care landscape will give future patients recourse to affordable healthcare before they go bankrupt.

Puente has launched an unprecedented, sweeping South Coast community health care survey to gather information on people’s current health care access; inform them about Puente’s own health care services; and help them meet the requirements contained in the Affordable Care Act.

Nicolás Romero talks with Ben Ranz about the South Coast health survey

Nicolás Romero talks with Ben Ranz about the South Coast health survey

Puente staff and volunteers will visit every home in Pescadero, Loma Mar, La Honda and San Gregorio. In so doing, they will also be able to gather more demographic details than any U.S. Census.

“People who didn’t have insurance before are now going to be required to get it. And we will be on the forefront of connecting people to these new services,” promises Puente Community Outreach Coordinator Ben Ranz, who is directing the survey. Ranz has gone door-to-door in Pescadero, explaining that the mandatory enrollment period is from October 1, 2013 to March 31, 2014 – and if people don’t sign up, they’ll be fined

“That’s a new concept for folks on the South Coast,” explains Ranz.

Getting folks signed up for medical insurance is one thing. Getting them to go to the doctor is another.

With no doctor on the South Coast, and the nearest medical office 18 miles away, it’s very difficult for locals to seek regular check-ups. Often they wait so long that an emergency develops for a disease, or a chronic condition worsens. Some illnesses can be prevented or symptoms lessened with early intervention.

“Most people say ‘no’ when we ask them if they’ve seen a doctor in the last 12 months.  It seems that people only go to the doctor when they’re sick,” says Ranz.

Distance will no longer be an obstacle to medical care starting next year. A mobile health clinic, staffed by bilingual doctors and nurses, will be housed on the South Coast.

The mobile clinic, a co-initiative of Puente and San Mateo County Health System, will serve roughly 3,000 adults in Pescadero, La Honda, Loma Mar and San Gregorio who have literally been without access to primary care since 2009.

Puente's survey crew: Barbara Guzman, Mariela Lopez, Alicia Vega and Ben Ranz

Puente’s survey crew: Barbara Guzman, Mariela Lopez, Alicia Vega and Ben Ranz

Ranz and his team are keen to ensure a strong demand, so one of their survey questions touches on the most convenient days of the week to visit the health van if it were available.

The survey, which Ranz developed with Puente youth workers, Mariela Lopez and Barbara Guzman, along the guidance and support of the Stanford Office of Community Health, will go a long way toward helping Puente understand which medical programs people qualify for. That data, in turn, will help Puente ensure that no one who needs a doctor gets left behind.

For more information about Puente’s community health survey or to contribute, please contact Community Outreach Coordinator Ben Ranz at (650) 879-1691 ext. 143 or branz@mypuente.org. To learn about enrolling in California Covered , contact Safety Net Services Manager Lorena Vargas at (650) 879-1691 ext. 116 or branz@mypuente.org.

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