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Cabell County, WV

OUCH (Offering the Uninsured of Cabell County Healthcare)
Cabell County, West Virginia
Community Size: Approx. 100,000
Program Started: October 2002

Overview and Structure:

OUCH, developed from the Community Access Program (CAP) targets the health needs of the working-uninsured of Cabell County, West Virginia. The OUCH program funding comes from three sources: the employee who is uninsured ($36/month), the employer ($36/member/month), and community funds ($178/member/month). Each participant receives $3000 of covered services per member per year. The participant may choose to spend the allotment on medical, dental, vision, or pharmaceuticals. Businesses may participate if they are located in Cabell County, meet income guidelines, and not have offered insurance in the past twelve months.

Features:

• Individuals are not excluded for pre-existing conditions 
• Co-pays are kept to a minimum amount to encourage preventive care and wellness
• Innovative three-share approach ($36/month from the participant, $36/month from the employer, and the third share coming from the community fund) 
• Negotiated fees with provider participants to "stretch the dollar" 
• Benefit plan that includes medical, dental, vision, pharmaceuticals, lab, and x-ray 
• Care navigators who personally assist each participant and help them maximize health services received 
• Know the maximum expense for OUCH depending on the number enrolled 
• Enroll children under the age of 19 in CHIP

Outcomes (October 2002-April 2003)

• Advisory Board with 25 members from various community agencies 
• Over 18 businesses currently enrolled 
• Over 250 providers are participating and both local hospitals 
• Exempted from Insurance laws; reports to legislature quarterly (WV Senate Bill 723) 
• Participants now have a "medical home" that in the past would have usually gone to the ER

Eligibility/Number served:

• Full-time and part-time workers (minimum of 20 hours per week) 
• 200% of the federal poverty level 
• Working individuals aged 19-64 · Not eligible for insurance coverage

Financing/Costs:

OUCH receives federal dollars to address the needs of the working-uninsured in Cabell County. Valley Health Systems, Inc. is the lead agency for the OUCH program.

Lessons learned:

• We have been able to link participants to CHIP, BCCSP, and other programs that they would have never known about on their own. 
• A true community project has evolved and brought many agencies to the same table. 
• Through a survey we were able to determine the need for healthcare in our area. 
• Don't apologize for what you can't do. 
• Learn from the experience and success of similar programs (ie. We talked with members from the Muskegon Project and then adapted that model to fit the needs in our community).

Contact:

Lanie Masilamani
Director
OUCH Program
2585 Third Avenue
Huntington, WV 25703
Phone: 304-697-8285
Fax: 304-525-3338
Email: lanie@vhs-wv.org

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