ST. PAUL, Minn. - Standing at the front of a small classroom on the fourth floor of St. Paul's library, Maureen O'Connell attempted to help the five people at the "MNsure Crash Course" understand how federal health care reform affects their lives.
"So does anybody know what actuarial value means?" O'Connell asked with a smile. No one was sure. Most of the questions were more basic: Ana Reiter, a part-time speech pathologist, wanted to make sure she could transfer from her current COBRA coverage to MNsure (the answer is yes).
O'Connell is the co-founder and project manager for Health Access MN, a major beneficiary of $3.91 million from a federal government grant to private groups that pledged to recruit Minnesotans to sign up for coverage through MNsure, the state's health insurance exchange. These "navigator" groups have a vital role in the success of the health-care law, charged with reaching out to isolated and underprivileged communities.
The federal health overhaul sees a permanent role for groups like Health Access MN, which got a $327,000 grant from MNsure.
Of the 29 organizations to share in those MNsure grants, only two got more than Health Access MN, which was formed only shortly before the grant application deadline. MNsure's grant decisions generated some controversy, as some Democratic lawmakers complained that groups representing black and Somali Minnesotans were underrepresented. April Todd-Malmlov, MNsure's executive director, said the groups chosen proved they had the experience and partnership to make inroads with hard-to-reach communities statewide.
Health Access MN willingly shared its budget proposal and other documents with The Associated Press.
O'Connell is a former assistant commissioner of the state Department of Human Services. She is forgoing a salary for at least the first year of Health Access MN's operations, while retaining other work as a consultant. Most of the $327,000 grant is going to pay other Health Access MN employees.
"This just looked like a really good opportunity to help people," said O'Connell, who cited her own experience with a 2007 breast cancer diagnosis as helping her understand the importance of insurance coverage for people facing health crises. "In political work and policy work, you're always dealing with the compromises. This is about taking the law and making it work for people."
John Freeman, who co-founded Health Access with O'Connell and is serving as its lead navigator, will earn a $70,000 salary for planning outreach and enrollment events, training staff at partner organizations, managing other navigators and working as a navigator himself.
Freeman, the former supervising attorney at the Minnesota Legal Services Coalition, said his work connecting lawyers with indigent clients was good training for the new role.
"I never want to be in a position where we have to charge people for something so critical as understanding their health care options," Freeman said.
Headquartered in a small office building in a St. Paul industrial park, Health Access MN has budgeted for one other full-time navigator besides Freeman who will earn a $35,700 salary. Four more navigators who work a little more than half-time will make $19,278, and a fifth working just over quarter-time will make $9,639. An additional $20,150 will cover a half-time salary for a navigator at the Immigrant Law Center of Minnesota, which is one of a handful of groups partnering with Health Access MN.
The rest of the grant money will cover the group's expenses, from phones and computers to rent and utilities. Like every organization that got the outreach grants, Health Access MN is subject to state audits. In addition, its navigators were trained and certified by MNsure, and subjected to background checks.
Several other organizations have joined in the Health Access MN coalition, including the Minnesota Coalition for the Homeless, the Service Employees International Union, LegalCorps, and several library systems: Bemidji, Anoka County and East Central Regional. Saint Catherine University is providing interns. The aim is to reach certain populations: immigrants and non-English speakers, low-wage workers and low-income households, home health care workers, homeless people, the smallest of small businesses, American Indians and young adults.
Under the federal health-care law, the state exchanges are supposed to figure out how to keep the navigator programs going into the future - specifically, how to fund them. Jenni Bowring-McDonough, a spokeswoman for MNsure, said the plan is for the money to come from the agency's operating budget, which will be funded by a 1.5 percent tax on premiums sold on the exchange.
In return, Health Access MN has pledged to "efficiently enroll a high volume of individuals," in the words of its grant application. Specifically, the group's first-year goal is to enroll 6,000 individuals in a health plan, Medical Assistance or Minnesota Care. On top of that, the group says it will conduct 400 outreach events, and reach a total of 24,000 people through its outreach and education efforts.
Like the larger federal health care law, it's off to a slow start. Freeman said in October, Health Access MN enrolled 41 people through MNsure, and reached 388 people at seven outreach and education events throughout the state. He said the numbers are small because MNsure was slow in getting the grant money to recipients: the money wasn't available until mid-October, even though enrollment itself started on Oct. 1.
Freeman said it was difficult to come up with the estimates. "This is totally brand new," he said. But he said the pace is already picking up.
"We are processing applications. We are enrolling people. Our November numbers already make October pale in comparison," Freeman said. "We already have satisfied customers."
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