Mt. Sinai patients" advocate helps them fight health bureaucracy
A couple of years of ago, a woman with stage IV colon cancer came to see Penny Schwartz, the program coordinator in the Department of Social Work Services at the Mount Sinai Medical Center.
The woman had been to five different hospitals, but she was refused treatment because she was uninsured and couldn"t pay for the care.
Schwartz soon discovered why the woman couldn"t apply for Medicaid's she was afraid to reveal her identity because of a domestic violence situation.
Schwartz, who knows the ins, outs and access points of the health care system, was able to persuade higher-ups at Medicaid to give the patient's who was fully eligible's benefits under a different social security number and process her case by hand to ensure that the patient would remain safe.
As a result, the woman received treatment and ended up living five years instead of only one.
â€œWithout help navigating this complex system, this patient would have died much sooner because she was at stage IV, Schwartz said.
As the director of REAP, the Resource, Entitlement and Advocacy Program at Mount Sinai, Schwartz is responsible for helping people obtain and understand their benefits and entitlements, especially those that relate to health-care access.
REAP, which was founded in 1989 with a grant from Mount Sinai, predominately serves people from Yorkville, East Harlem and Central Harlem. Its goal is to provide people with information and assistance with applying for government entitlements, public health insurance programs, home-care services and other specialized programs.
â€œWe"re talking to people about two of the most private things in the world's their bodies and their money. So trust is very important, Schwartz said.
Schwartz said it is also important to understand each patient in order to better help them navigate the health-care system.
â€œThe health-care system is very complex. I can tell you stories about people with doctorate degrees who could not figure out how to access heath care for their mothers, Schwartz said. â€œIt"s like a foreign language's we call it â€˜insurancese"'s so I consider us the translators.
The REAP program also determines the sliding scale fee rate for outpatients who are ineligible for public health benefits, and ensures that members of the community with limited or no health insurance have access to high-quality health-care services.
The help REAP provides extends outside the office. Schwartz and her staff coordinate paperwork for patients and represent them at insurance offices. They also make sure to take care of the patients" family members.
â€œIf someone comes to us and says they need Medicaid, we look at everybody who they are responsible for or who is responsible for them, Schwartz said.
Schwartz, who received her doctorate of social welfare from Hunter College and her Masters of Science in social work from Columbia University, said her greatest reward is helping her patients.
â€œPeople who come to us are very often lost and they don"t know where to turn, she said. â€œPatients get more access to care if they come to us.
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