Citing debt, homeless advocates threaten to sue county 

Advocates for the poor are threatening to sue San Mateo County, claiming a program designed to help low-income residents access health coverage has cast many of them into debt — either through costly fees or a restrictive income cap.

In a Thursday letter to the San Mateo County Board of Supervisors, attorneys Melissa Rodgers of the Legal Aid Society of San Mateo County and Catherine Murphy of the Western Center on Law and Poverty said they will "take appropriate legal action" if their concerns are not resolved.

Rodgers and Murphy claim their clients, who are enrolled in the county’s Wellness Education Linkage Low Cost (WELL) Program, have been charged annual fees and high co-payments thatexceed their ability to pay. Other people who cannot afford medical care have been denied access to the program based on their assets or income without regard for individual circumstances, according to the complaint.

The 11-year-old WELL program provides discounted medical care for Peninsula residents who do not qualify for Medi-Cal and whose household incomes fall below 200 percent of the federal poverty level — a family of three bringing in $34,340 annually or less.

The complaint claims the program’s $250 annual fee and various co-payments — from $10 for an office visit to $550 for same-day surgeries — puts care out of reach for many, violating the county legal mandate to provide indigent care.

While those enrolled in the program have been taken to collections by the county when they cannot pay their bills, those who are turned away from the program altogether suffer a more serious fate, Rodgers said.

"People receive medical bills they can’t afford to pay and some have decided to postpone medically necessary care as a result," Rodgers said.

While she stated in the letter to supervisors that a lawsuit would be filed by today, Rodgers acknowledged that both sides are talking and she is waiting to see if the Board of Supervisors will approve proposed changes to the WELL Program at its Dec. 4 meeting, including waiving the annual fee for the poorest residents.

County counsel Michael Murphy said San Mateo County is satisfying the legal requirements to provide indigent care and that anyone turned away from the WELL Program is entitled to appeal the decision.

Supervisor Jerry Hill expressed surprise that the issue had been raised.

"San Mateo County has been extremely liberal and generous with its interpretation of our mandate to provide indigent health care, so it comes as a surprise that our policies are being challenged," he said.

tbarak@examiner.com

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