Aid and Comfort

She was elderly and suffering from severe asthma. Her Medi-Cal benefits were cut off Jan. 1 because the county said she had not submitted the proper forms. The woman said she had turned in the paperwork three times.

The woman, who desperately needed medical care, was at a dead end. But in early March she found Nora Boyajian, a paralegal counselor with the Health Consumer Center, a free advocacy hotline that assists low-income Los Angeles County residents.

Over the telephone, Boyajian could hear the woman’s labored breathing. She sprang into action, first calling the county social services office to request that the woman’s benefits be reinstated. She filed a complaint with the county office and followed up with phone calls to make sure the woman received her benefits.

Dozens of similarly anxious callers contact the Health Consumer Center every day, confused by complicated health forms and changing eligibility requirements or mishandled by the agencies entrusted to provide them with health care, said Barbara Frankel, supervising attorney for the Health Consumer Center.

The Health Consumer Center in Los Angeles County, and five others statewide, were created two years ago with $5 million in seed money from the California Endowment, a Woodland Hills-based private foundation.

Pleased by the center’s success, the foundation has approved $2 million to keep it operating for three more years. But permanent funding from the county or state eventually will be needed, said Gwen Walden, senior program officer for the California Endowment.

Last year, its first, the center answered 25,674 calls countywide. Staff members serve as both advisors and independent mediators for consumers, frequently intervening in thorny cases, asking to speak to supervisors, filing grievances and writing letters to health care agencies.

Nearly 3 million residents in Los Angeles County do not have medical insurance, county officials said. Yet hundreds of thousands of adults and children eligible for Medi-Cal or Healthy Families--a federal children’s health insurance program--are not signed up because they are unaware of the programs, they do not know how to apply for coverage or they fill out the forms improperly, officials said.

For them, health care means a 911 call or a trip to the emergency room--an enormous drain on those resources.

In addition to Frankel and two staff lawyers, the Health Consumer Center is staffed by six counselors--two of whom are law school graduates and a third who has a master’s degree in public health. A project of the San Fernando Valley Neighborhood Legal Services in Pacoima, the center operates out of a busy office filled with voluminous files of government health regulations.

Counselors at the center are known for their ability to wade through complex government health-care forms and regulations that can change monthly. Its association with a legal aid agency that represents the poor also helps.

“When we call people, they know that if legal action can be taken, we will be taking it,” Frankel said.

Most complaints “are about trying to get and keep coverage,” said Beth Osthimer, a senior attorney for the center. Some government health programs require documentation every three months. Also, simple errors by a client--or an agency official--can cut off aid.

That may be what happened to Gariana Megerdichian, a 60-year-old widow from Glendale, who was recently treated for high blood pressure but had no medical insurance.

Megerdichian, who speaks only Armenian, was recently denied Medi-Cal coverage because she was under 65. But Frankel and Boyajian, who translated for her, discovered a Medi-Cal card in the woman’s wallet.

They are still trying to figure out how she got the card and whether she can qualify because of her disability.

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Such cases are typical of the confusion caused by language barriers, changing laws and complex documents that keep people from getting the information and health care coverage they need, Frankel said.

Last summer, the Health Consumer Center was one of several agencies that identified a medical coverage application for pregnant women and children that was so complex--more than 25 pages long--that many individuals simply gave up even if they were eligible. Those advocacy efforts paid off--the form is now just four pages.

“There’s a need for an independent monitor,” said Peter Lee, executive director of the Center for Health Care Rights in Los Angeles, a consumer advocacy group. “They can say ‘we see a pattern of thousands of people who are having problems with complex paperwork.’ They can go to the state and identify a solution.”

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Resources

* The Health Consumer Center of Los Angeles, a project of San Fernando Valley Neighborhood Legal Services, can be reached by calling (800) 896-3203 or by e-mail at hcc@hcc-la.org.

* The hotline, which assists low-income individuals and families throughout Los Angeles County, is open from 9 a.m. to 4:30 p.m. Monday, Tuesday, Thursday and Friday.

* Counselors speak Spanish, Armenian, French, Arabic and Turkish, and people who speak other languages can also be assisted.