Joined In Action
PMB 212, 1910 E. 4th Avenue
Olympia, WA 98506-4632
Medical Care Access Coalition (MCAC)
Marquette County, Michigan
Community Size: 64,634 residents (2000 census)
Year Program Started: The Medical Care Access
Coalition (MCAC) incorporated in September 2000. MCAC launched
the direct patient care program, Medical Access Program-Plan C,
in September 2001
Overview & Structure:
Medical Care Access Coalition (MCAC) is a
faith and community based initiative, and a 501(c)(3) non-profit
organization. It is comprised of civic leaders and
representatives from medical, public health, mental
health/substance abuse, faith-based and consumer groups of
Marquette County, Michigan. The vision of MCAC is to provide
that "All people will have access with dignity to quality,
affordable healthcare." The mission of MCAC is to "Develop
a model system to provide needed healthcare to underserved
individuals in Marquette County, and to assist other communities
in doing the same."
- Medical Access Program-Plan C: Program for
low-income adults who do not qualify for
state-based medical coverage and can not afford private
healthcare coverage. This program includes access to volunteer
primary and specialist physician care, the 10 most requested
laboratory panels, radiology, medications, dental, disease
management, and limited urgent care. There is no cost to the
patient for enrollment into MAP-Plan C and services are
provided by volunteers, donated by local agencies, or provided
under grant funding.
- Medical Access Program-Plan A: State funded
medical program for adults under 35% of the federal poverty
level who do not have dependants. Eligibility is determined by
the Michigan Family Independence Agency (state welfare
agency), and the program is administrated by the Medical Care
Access Coalition for all 15 counties in
Michigan’s Upper Peninsula.
- Dental Access Program: Medical Access
Program-Plan C patients receive limited dental care through
local volunteer dentists and the Marquette County Health
Department Dental Clinic. Services include urgent dental care
(pain, swelling, and/or bleeding), oral cleanings, and limited
dental lab work.
- Volunteer Medical Clinic: In June of 2002,
the Medical Care Access Coalition, with a grant from the
Marquette County United Way, launched a volunteer primary care
clinic. This “mobile volunteer clinic” meets for one night
every week, in one of two donated medical offices. Primary
care is provided by utilizing volunteer physicians,
nurse practitioners, physician assistants, nurses, and other
volunteer support staff. As part of the Medical Access
Program-Plan C, clinic patients are provided access to all
other ancillary services (radiology, laboratory, medications,
dental, and specialist referrals).
Marquette County boasts a tremendous
volunteer spirit. 100% of the county’s primary care providers
and over 60% of specialists (for a total of over 135
physicians and mid-level practitioners) treat Medical Access
Program-Plan C patients on a volunteer basis. Both county
hospitals donate care to the volunteer program, providing
needed lab work and radiology to uninsured patients.
- From September 1st 2000 through November
1st 2003, local hospitals and volunteer physicians have
donated $401,194.00 in-kind. Local dentists have donated
- From September 1st, 2000 though November
1st 2003, $360,368 has been dispensed in donated brand name
medication samples. MAP – Plan C pharmacy costs are about
$10.00 per member per month, or less than 1/6th the cost of
state funded programs. 97% of all prescriptions presented are
filled. 50% of all MAP – Plan C patients utilize medications
sampling programs to secure brand named medications at no cost
to the patient.
- 18% of all MAP-C enrollments (about 300
persons to date) have been placed into state funded medical
programs from September 2000 through December of 2003.
- State and Federal funds are combined with
local donations and grant funding to provide medical care for
Marquette County’s uninsured.
Eligibility/ Numbers Served:
- The Michigan Primary Health Care Profile
of Michigan Data Book 2002 records that 7,465 of Marquette
County’s 64,634 residents lack state or private healthcare
coverage. Of that number, 3,237 qualify for the Medical Access
Program – Plan C (those earning less than 200% of the Federal
Poverty Level, having no access to state programs, and having
limited ability to pay for private insurance).
- Since its establishment in September 2001,
the Medical Access Program has enrolled 850 to 1000 new
persons each year, and maintains an active enrollment
population of 550 to 650 persons at any time. 71% of MAP-Plan
C patients are working full or part time. Among rates of
chronic illness, 12% of MAP-Plan C patients have been
diagnosed with diabetes, 29% have been diagnosed with asthma,
12% have been diagnosed with hypertension, and 35% have been
diagnosed with depression.
Financing / Costs:
MCAC’s budget is 1.5 million dollars annually,
with a majority of those funds earmarked for the administration
of the state-funded Medical Access Program-Plan A. Aside from
state originated Plan A funds, MCAC’s Plan C program is
supported by grant funding, donations from the individuals,
community organizations, and the faith communities; volunteers
and in-kind donations.
- The vast majority of medical practitioners
already provide donated medical care to their uninsured and
low-income patients. Creating an organized and easily
accessible referral service allows those physicians to save
time and effort by avoiding eligibility determination, allows
for better donation tracking, helps to secure more medications
at greater ease to the medical office, ensures a better
continuum of care, and helps to streamline a fragmented
referral service to other volunteer doctors.
- With proper recruitment and training,
community volunteers will constitute a reliable, skilled, and
empathetic enrollment staff for a volunteer access program.
The use of volunteers will also provide needed manpower for
medications programs, clinic programs, and extra help with
office clerical needs.
- Upon seeing the benefits of an efficient
referral agency that utilizes the participation of volunteer
physicians, hospitals will support endeavors that can
quantitatively prove cost savings through a lowering of
non-emergent usage of the hospital’s emergency room.
- Providing accessible preventative care,
such as that found in the Medical Access Program-Plan C,
decreases incidents of non-emergent usage of the emergency
department. Such programs therefore save money for uninsured
consumers, insurance companies, health insurance purchasers,
as well as area hospitals.
- Regional organization of access programs
provides a stronger voice before state legislatures, higher
organization among existing human service programs, and a
better service delivery system for a community’s uninsured
- Enrollment into a community access program
will help to locate persons eligible for State Medical
Coverage, Medicaid, and/or SCHIP programs. MCAC has seen
placement of 18% of their MAP-Plan C population into state
covered programs (about 150 people per year). The result is an
increase of federal and state funds into the local economy,
along with a more healthy local population with a broader
field of options for their medical care.
Thomas Viviano, Executive Director
Stacie Ketchum, Director of Finance
Christopher F. Palombo, Director of Outreach and
1414 W. Fair Ave #26
Marquette MI 49855