Shock Follows DOH Action Barring Navigators

Sep 12, 2013

Pinellas County government officials suffered a blow Wednesday when they learned about the state Department of Health's order barring enrollment Navigators from local health department property.

Pinellas County Commission Chairman Ken Welch

The Navigators are supposed to fill a key role in carrying out the Affordable Care Act by helping uninsured people enroll in health plans that are to be offered through an online Marketplace, which is to open Oct. 1.

Pinellas County, in partnership with the local health department, recently won a $600,000 federal grant to hire and train the enrollment workers. The Department of Health had agreed to hire and train 15 Navigators to work at 22 sites, according to a memo sent to county officials Wednesday from Health and Community Services Director Gwendolyn Warren.

Now the county will have to hire and train the Navigators to fulfill the requirements of the grant without the help of the health department, she wrote.

Ken Welch, Pinellas County Commission chairman, said Wednesday afternoon that he could hardly find words to express his frustration. "It's really sad and disappointing to see once again our Tallahassee leadership just determined to politicize health care," he said.

"I'm hoping cooler heads are going to prevail," Welch said. "It makes no sense."

The Obama administration was also exasperated. Fabien Levy, spokesman for the Department of Health and Human Services, called the DOH action "another blatant and shameful attempt to intimidate groups who will be working to inform Americans about their new health insurance options and help them enroll in coverage, just like Medicare counselors have been doing for years."

Levy said HHS is confident that Navigators will still be able to do their jobs.

In the letter Grigg sent to the health department directors, he wrote that the staff may accept informational materials from the Navigators to hand out upon request.

“However, Navigators will not conduct activities on the grounds of the health departments,” Grigg wrote. He said the policy was developed after some had asked DOH for permission to operate within state facilities, presumably because uninsured people often seek treatment there.

Dr. Marc Yacht, retired Pasco County Health Director, said the policy will “significantly compromise a multitude of needy Floridians from getting critical health care.” He called it “cruel and irresponsible.”

Grigg’s note said the policy is consistent with requests from other groups in the past, which he did not name. The order makes an exception for federally qualified health centers that are operating within local health departments; 41 such clinics in Florida received $8.1 million in federal grants specifically to help uninsured patients enroll in a health plan.

The Navigator program in Florida is being funded by a separate set of federal grants totaling $7.8 million.  The largest, $4.2 million, went to the Covering Kids & Families Program at the University of South Florida. USF is distributing the money to 10 organizations around the state that will hire, train and supervise the outreach workers.

A spokeswoman for DOH, Ashley Carr, said there was a need for “clarity” and “a consistent message” across the agency. “Navigators are not acting on behalf of the Department of Health,” she wrote, “and this program has raised privacy concerns due to the consumer information that will be gathered for use in a federal database.”

Florida Gov. Rick Scott and other high-level Republicans who are opposed to a law passed by Democrats in the White House and Congress have raised concerns that the program may involve privacy risks for consumers. HHS says that concern is unwarranted because of the way the data hub will function.