Little girl at doctors office

Collaborative care helps the poor and vulnerable in Hood River

There was never a lack of desire to provide free or low-cost care for the many uninsured patients in the Columbia Gorge’s Hood River County. Providers and programs struggled for years to find the best way to care for this vulnerable population.

The key was to develop a workable system – now known as the Gorge Access Program, or GAP, which opened in June 2012 – that established consistent standards for free or low-cost care, streamlined the paperwork for busy providers, and coordinated the program under one umbrella. 

“This was not a hard sell with the clinics and the providers here,” says Kristen Dillon, M.D., a physician with Columbia Gorge Family Medicine and a major impetus behind GAP. “Our goals were to create a dignified experience for patients, a system that’s financially feasible, and a process that’s easy for primary care providers.”

GAP is modeled closely after Project Access Now, which Providence organized and helps fund for uninsured patients in the Portland area. “We realized Providence is an important partner locally,” says Trish Elliott, a supervisor at Hood River County Health Department, which administers GAP as an in-kind donation. 

GAP serves Hood River County adults and children at 200 percent or lower of the federal poverty level. All local primary care providers, as well as many specialists, participate. The GAP team at the health department handles enrolling patients, accessing labs and other services (including mental health care), working with Providence’s Medication Assistance Program to get free or low-cost medications, and coordinating referrals to local social service agencies. 

Patients are charged a portion of the cost for each visit, and the balance is donated by the provider. So far, about $150,000 of donated care has been provided with outreach and enrollment continuing. “We know that even with the federal Affordable Care Act, there still are uninsured residents in our county,” says Elliott. “GAP is an important bridge to ensure that everyone has access to quality medical and mental health care.”