County prepares to launch a pilot covering gap in health services for the uninsured.

Maria Elena Manzo tells a tale of two families living in two counties. Manzo works for the Central Coast chapter of Breathe California, a nonprofit that promotes lung health, making house calls and helping families develop plans for asthmatics to stay healthy.

She recalls a day two years ago when she visited a Watsonville household where a 14-year-old girl had asthma. She worked out a plan for the girl to take Advair, a control medication they hoped would keep her from having a serious episode.

Within an hour, Manzo made her next stop at a similar household in Pajaro, just over the Monterey County line. Like the Watsonville parents, this couple also worked in agriculture, and also were undocumented immigrants. Their 6-year-old son needed Advair but at about $800 a month and without health insurance, there was no way the family could pay. Their plan, they told Manzo, was to wait until he couldn’t breathe, and bring him to the ER where emergency care would be covered, even though they were uninsured.

The difference: Santa Cruz County covers some health services for undocumented immigrants, who remain uninsured even with Obamacare.

There are some 55,000 undocumented immigrants in Monterey County, excluded from Covered California, the state health exchange, and eligible only for Medi-Cal that covers acute care, not chronic conditions.

“Right now, if you have no insurance at all, you come into Monterey County health clinics and see doctors on a sliding scale,” says Julie Edgcomb, director of clinic services for the Monterey County Health Department. “The problem is, say a doctor writes a prescription or refers you to a lab and radiology: None of those are paid for.”

That’s changing with a $500,000 pilot project launching this fall.

The county’s plan is to pay for lab tests, radiology and pharmacy services. Natividad Medical Center, the county safety net hospital, will provide lab and radiology; five Walgreens locations countywide will fill prescriptions, then invoice the county Health Department. (The Walgreens details are still being worked out, but will probably require a $10 copay. Certain meds, like Hepatitis C treatment, which exceeds $80,000, will not be covered.)

Those services will go on until that $500,000 runs out. Then Edgcomb will analyze the data to see if patients have better clinical outcomes, and if the cost of their care goes down.

Manzo told her asthma story to Edgcomb at a meeting in March, when they started formulating the plan. She was there as a health provider, and as a congregant of Salinas’ Sacred Heart Church, a member of Communities Organized for Relational Power in Action (COPA). COPA, an alliance of labor, faith and community-based activists, has made health care access a priority.

“The bible is full of stories about healing and caring for your neighbor,” says COPA leader Jack Herbig of St. Mary’s-by-the-Sea Episcopal Church. “We think that everyone should have health care.”

Manzo, Herbig and other members of COPA’s team successfully lobbied the Health Department and the Board of Supervisors for $500,000. The supervisors are scheduled to consider final authorization of the pilot Sept. 15.