"The fastest-growing income group among
the uninsured are those making $70,000 and
above. It's a terrible situation. People who
used to contribute to the community now
are recipients."

—Rachel Yoskowitz of IFS

does not cover 100 percent."
"I have no insurance coverage for doctor visits or
prescription medications. We had health insurance
for everyone, but it went up to $1,200 per month.
We now only have emergency coverage."
"We have no coverage for prescriptions, dental
or vision."
These answers represent real people living in the
Jewish community Among them are:
• a 42-year-old man with a wife and five children
whose business is not generating any income and
who can't afford health insurance for anyone;
• a 38-year-old woman who cannot afford insur-
ance for herself and her husband, but whose chil-
dren are covered by Medicaid;
• a 47-year-old single man has no insurance
because he cannot afford it and his $20,000 income
is too high for him to qualify for Medicaid;
• and a 57-year-old woman whose business earns a
very low income and has been without insurance for
a few months.
Physicians are familiar with these stories. Some
hear about them at synagogue when someone pulls
them aside to ask for help for themselves or friends.
Many doctors help people when they can from their
homes or offices.
What Project Chessed does is formalize the process
by managing the cases and channeling patients to the
appropriate doctors, who share the mitzvah of treat-

Iur

Dr. Steven .
heads the Project
Chessed steering
committee.

ing them on an equitable rotating basis.
So far, with very little nudging, nearly 150 doctors
have signed up to participate. Internal medicine is
well represented, but the roster also includes such
specialists as gynecologists, ophthalinologists, den-
tists, allergists, urologists and gastroenterologists.
More still are needed.
"Members of the Jewish community from all
walks of life and professions were consulted and
have assisted immensely in bringing together the
necessary components that have helped to flesh out
the program," Dr. Dunn said. "The scope and struc-
ture of Project Chessed is a testament to their com-
mitment and the power of Jewish grassroots efforts."

How It Works

Once the word gets out this month through
brochures and other marketing pieces, patients ages
18-65 will come to the JFS office in West
Bloomfield to be evaluated by Clara Elinger or
Andee Marcus, job-sharing nurse practitioners
whose first priority is to determine financial eligibili-
ty and urgency of need.
They also can help clients fill out Medicaid appli-
cations or steer them to low-cost insurance policies,
if need be.
Once eligible, patients are given Project Chessed
cards — similar to insurance cards — that will be rec-
ognized at specified doctors' offices and at such partner
institutions as William Beaumont Hospitals, Detroit
Medical Center, Providence Hospital and Medical
Center, St. Joseph Mercy. Oakland, Botsford Health
Care Continuum and Millenium Diagnostic Center.
The Project Chessed card is another way the pro-
gram allows patients to be treated with dignity. The
card carries its own plan code, signifying no co-pay
or a modest one, thereby eliminating awkward
moments about payment.
"We treat them as we would treat any others; they
are not second-rate patients," said Dr. Daniel
Panush, a Millenium internist who committed the
services of his group's physicians and diagnostic cen-
ter to the project.
Patients return to Project Chessed with forms and
prescriptions filled out by doctors. The nurse practi-
tioners then manage their care — arrange for follow-
ups or medical testing at participating hospitals or
diagnostic centers.
And they help secure prescriptions — the most
complex element of Project Chessed. Volunteers
assist with filing applications with drug companies'
drug assistance programs, which supply most drugs
free to those who qualify. But often, there's a lag of

Dr. Panush

Norman Keane

Robert Naftaly

Jodee Fishman Raines

up to eight weeks between application and delivery.
And some drugs aren't covered at all.
Physicians help by dispensing samples and an
existing JFS prescription program fills in some gaps.
"We would like to use designated pharmacies
where people would have a nominal. co-pay to get
medications," Yoskowitz said. "We are finalizing
arrangements with them to become designated phar-
macies — that's an important piece."
It takes money to supply these prescription drugs
in the interim.
"That's where the community can help," said
Robert Naftaly, a steering committee member. "We
need contributions from people who care to fund
the drug costs, which continue to go up faster than
anything else."
He estimates the need to be $400,000 to
$500,000 a year.

National Pilot?

Project Chessed is similar to Project Access in
Asheville, N.C. Begun in 1996 by the Buncombe
County Medical Society, this model to serve the
uninsured in a specific county by all its medical soci-
ety members has been replicated elsewhere around
the country
But Project Chessed, which serves all of Metro
Detroit through volunteer physicians, could become
a national model for Jewish or other religious or eth-
nic communities interested in taking care of their
own.
"This is the greatest example of generosity and
caring of a community," said Norman Keane, JFS
executive director. "When we started two years ago,
we wondered if we'd be able to put all the pieces
together. It's remarkable. It's not JFS, but a major
community project."
Other agencies involved include the Jewish Fund,
the Jewish Federation of Metropolitan Detroit, Yad
Ezra, the
Jewish No PATIENT LEFT BEHIND on page 18

2/24
2005

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