What Obamacare means for Circle Family

CEO says covering the uninsured will improve their finances

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By TOM HOLMES

Forest Park resident Dr. Andre Hines is looking forward to the full implementation of The Patient Protection and Affordable Care Act (PPACA), which is informally referred to as "Obamacare."

The CEO of Circle Family HealthCare Network (CFHCN) tells the following story to illustrate why she favors the health care reforms signed into law by President Barack Obama in 2010. Last year, regulators from the State of Illinois were meticulously reviewing every aspect of Circle Family's Humboldt Park site while she was frantically trying to find a way to meet her payroll because the state is so far behind on its payments to her agency.

"I was angry for the whole three days of the review," she said. "The state has never skipped a beat in reviewing us, but I can't get the money from them to pay my staff. I've never heard of the state missing a payroll, but I have the burden of figuring out where the money is going to come from to meet the payroll of a small community health center."

When the reviewers couldn't find one error after examining the charts and told her that the clinic had done an excellent and unprecedented job, Hines replied, "I realized only an hour ago that I would be able to pay this outstanding staff tomorrow. Do you understand the impact of that?"

According to statistics from the Chicago Public Schools' lunch program, 90 percent of the children who attend Austin public schools are from poor families, 6 percent are working poor, and 4 percent are lower-middle income. According to the 2000 U.S. Census, the per capita income in Austin is approximately $12,823. Currently, Austin is recognized as one of the most crime-ridden areas in Chicago. The neighborhood is plagued by illegal drug markets and high murder rates. About a quarter (24.1 percent) of Austin's population live in poverty, according to the Center for Labor and Community Research (unemployment was 21 percent in 2011).

Because the state has been so slow in reimbursing providers, Circle Famly missed payroll for all employees by a few days twice in 2011 and at present is one month behind in paying the doctors and senior management, Hines said, including herself.

At the end of her financial rope, she decided to go directly to her representatives in Springfield. Five clients and six staff climbed into a van and drove to the state capital for a meeting with state Sen. Don Harmon (39th) and state Sen. Camille Lily (4th) and state Rep. La Shawn Ford (8th).

"I expected it to go like it usually does," Hines recalled. "They would listen and then say, 'Thank you for coming and we'll get back to you.'"

Instead, Circle Family's CEO was blown away. Ford reserved a big boardroom and invited two representatives from the governor's office to sit in. When the people from the state were finished with all of their questions, they asked if any of the visitors wanted to say anything, to which one mental health client responded, "Yes, I have a question for you. How long would any of you work if you didn't get your paycheck?"

Ford followed up with a phone call the next day to say that the state comptroller's office was putting Circle Family on the expedited payment list, which means that Circle Family will get a check every month.

That response made the situation better regarding Medicare and Medicaid payments, but it did not do anything to cover expenses for services to uninsured patients who are charged as low as $15 for a visit, which would ordinarily be billed for $116.

That's why Hines said, "We're really excited about health care reform because as you can imagine, being a health care center in the community we serve where so many people are not covered, there will be a source of income for us once health care gets rolled out."

What will change in 2014 when Obamacare is fully implemented, Hines predicted, is that more people will be covered, which means that Circle will be paid.

"We serve so many people who we don't get paid for right now," she said, "and that will be seriously minimized with health care reform.

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