November 1 officially kicks off Open Enrollment, the time of year when most people in the US shop and enroll in health coverage. But did you know, you can get complimentary health insurance navigation and other benefit navigations services at CAP? Joining us today is Rusty Shorey, one of the incredible Benefits Navigators here at CAP to discuss the various ways in which we can help you sort through all the noice of Open Enrollment, Benefits Navigation, and more! Listen to or read the full episode below, and if you're interested in getting assistance through our Benefits Navigation program click “Get Started with Benefits Navigation”.

EPISODE TRANSCRIPT

Intro: Welcome to Vibrant, an affirming healthcare podcast from CAP, Our House and Prism Health. I'm your host, Dustin Vance, and I'll be here sitting down with folks across our agency to get the inside scoop on the work they do to provide compassionate, affirming care to all those in our community. Let's get the show started.

Dustin: Hello folks, and welcome back to another episode of Vibrant. So in case you didn't know, November 1 marked the official start of open enrollment. This is the time when most people shop and enroll in healthcare coverage in the US. If you're not currently enrolled in healthcare coverage, this is an opportunity to get a new plan. It's also a time to update your plan and ensure that you're getting the right amount of coverage that you need. So with that in mind, we thought this might be a great opportunity to highlight the Benefits Navigation program at CAP. So joining us today is Rusty Shorey, one of our amazing benefits navigators here at CAP. Rusty, do you mind introducing yourself and telling us a bit about yourself, how you came to be at CAP, and a little bit about your position?

Rusty: Absolutely. So my name is Rusty, my pronouns are he/him, and I'm a benefits navigator here at Cascade AIDS Project. How I got here was pretty… I mean, it was a pretty interesting story, because I worked in public health for the past seven years. I started in January of 2015, the very first open enrollment in Oregon, and over the course of the pandemic, I actually got laid off. I was working for a small clinic and I was doing forestry work up in Washington when a colleague of mine reached out to me and told me there was a position available at CAP very similar to what I was doing prior. And I had always kind of had a beat on what benefits navigation at CAP was like, just through my conversations with him. He's a very close colleague of mine, and I always really did admire the kind of work that he was doing because at Cap you seem a lot less constrained by metrics and things like that. And he really seemed to be getting to the meat of specifically helping people navigate this prohibitively complicated system of insurance and various other benefits that affect people. So that's how I started here, benefits navigation. [As far as the team] it's myself and my counterpart Sophia, and we're part of the Prevention department. But we kind of inhabit this very specific little realm, which is mostly around insurance, but it's also helping people living with HIV get connected to Care Assist - the state program as part of a federal program that helps folks living with HIV get access to the care medications that they need. So we can also help apply for that.

Dustin: Got you. Well, thanks so much for that great introduction of yourself and a little bit of overview of benefits navigation. Maybe we can dive into a little more of the specifics of the work that comes along with benefits navigation and the work you kind of do day-to-day. What does that look like in your world?

Rusty: Oh, it's varied. I kind of like how just wonderfully varied it is. You know, some days you'll find me out working with people that are experiencing houselessness, people who live their private lives in public, so it can be anywhere from a really complicated enrollment into health insurance, like the Oregon Health Plan or the marketplace, or just simply trying to help folks figure out what kind of insurance they have and where to go to access that insurance. And I'm very privileged and grateful to be able to do that in almost any setting. You'll often find me trudging around outside with my backpack, with my laptop in it, which is pretty cool. Here at Davis Street, I take appointments down in the service center and it's pretty much the same thing, although telephonically. I think our approach is pretty cool. And then it's very, very low barrier. Someone can walk up into our service center and just be like, “hey, I need insurance,” or, “I have questions regarding insurance,” and we can just pop down and have a conversation with them. Someone can shoot us a text or an email or a call and it starts up as like really conversational sometimes just about a question or two about insurance. And that often evolves into like a constellation of various benefits that you may have access to. You may not be able to get access to them through me, but I know of another program, and I can provide a referral. And I think that's another key aspect of what we do is that if we don't have an answer for you, often we at least have somewhat of a direction that you can go in.

Dustin: Alright, so I guess in terms of numbers of people we're serving, how many people are you connecting with benefits on say, like a daily, weekly or monthly basis?

Rusty: It's funny because I see a lot hundreds and hundreds of people per year. With the pandemic, we slowed down quite a bit. Just kind of an unfortunate byproduct of lack of access that we're all experiencing, just kind of being siloed and separated. And something that I'm really trying to build within our department is the fact that we're living, breathing people that you can meet on a one-on-one basis and have conversations about getting access to things such as insurance. So, yeah, it's very big on the people that I see just through my outreach, but quite a bit smaller in the people that I interact with for appointments on like a one-on-one day-to-day basis, unfortunately.

Dustin: Totally understandable there. So we've talked a bit about benefits, navigation and kind of focused in on health insurance as one of the main benefits you help navigate. What other benefits are you helping folks navigate in your role?

Rusty: A big part of it is health insurance, Yeah, but Care Assist would be the other most common one that we help people gain access to. Kind of informally, I have helped people navigate their way into like medical financial assistance programs through the big hospital systems. That's a pretty common one. I'm not really certified to help people with SNAP, unfortunately. The Oregon Health Authority just haven't given us that certification yet. I really hope we can start heading in that direction soon. But yeah, it's mainly public health insurance. At certain times, private health insurance and then access to Care Assist is kind of the mainstay of what I do here in the department.

Dustin: Very cool. So then maybe can we talk a bit about some of the experiences you get in your role? What are some challenges you've faced? What are some of the successes you've celebrated in helping folks navigate insurance or care assist?

Rusty: Definitely, I think the biggest challenge that I've faced, certainly at CAP and kind of throughout my career in public health is the fact that insurance is an incredibly complicated, daunting, and frightening thing. And it is kind of the gatekeeper to whether or not you have access to not just medical services, but the kind of depth and width of your health right? But gaining access to it is just this baffling process for the majority of people and even myself. You know, the mainstay of my job description is helping people access health insurance. And sometimes there are these hard and fast rules that are phrased in incredibly vague ways that even I, as a professional, just have to get a second opinion to be able to understand. The system is very poorly situated to have just people on an individual basis access these things on their own without any kind of support, but that's kind of the expectation that the system has on people. And that's really… I step in as a kind of intermediary between that, and that's definitely one of the bigger challenges, that combined with just the information, or misinformation rather, out there. The successes…iIt's funny because for me these grand sweeping successes, they're really cool, but it's usually the smaller, kind of more intimate ones that I take home with me and help me kind of get through the day-to-day. Working in public health is not easy. So it's these little wins that really keep us going. For instance, a couple of days ago in the rain, I helped someone get access to seeing [their benefits], specifically I verified their insurance, so I got into this big government portal with my laptop and I typed in some of their information, figured out what kind of insurance they had, and through that they were able to make an urgent dental appointment just kind of just in public. And it's an amazing thing to be able to just kind of on the fly help people access these services when in other situations they wouldn't be able to. It's pretty cool.

Dustin: Yeah, I mean, that sounds really incredible. Just that experience that client must have had of having that immediate support that they needed to get an answer to their question, rather than having to, say, sit on a helpline and wait potentially hours to maybe even not get an answer to the question that we're looking for. So I can only imagine.

Rusty: Yeah, certainly. And that's one thing you find kind of with accessing these benefits is if you get a definitive answer, it seems like most people are already kind of primed for that answer to be, “No,” not, “okay, let's come up with a different plan,” or, “okay, let's, let's, let's provide a workaround.” There's something available. And I think one of my big passions is like actually providing just a human face, a face that you can relate to, that you can talk with, that you can share hopes and dreams and experiences with, but also get access to this kind of grim faceless leviathan that is the healthcare system in the United States.

Dustin: Well, speaking of health care systems in the United States, open enrollment began November 1, correct?

Rusty: Correct.

Dustin: So what should folks be thinking about this time of year as they go about trying to do open enrollment, and what resources can your program offer them in terms of benefits navigation?

Rusty: That's awesome, thank you! Great question! So, yes, from November 1 to January 15 is open enrollment for the health insurance marketplace. That's through www.healthcare.gov. And it's very uniquely situated for folks that make a little too much to qualify for the Oregon Health Plan but not necessarily enough to just buy insurance outright without any kind of help. I mean, I can't do that. I have employer sponsored health insurance, and otherwise I can afford it. I don't think many people can. And so that's where this really steps in. There are monthly discounts for how much you have to pay per month for your health insurance. There's cost share reductions as well. And also www.healthcare.gov does provide, you know I can't say specifically how many carriers are represented this year because it will be changing up until the very beginning, but there are many which include Kaiser, Providence, OHSU, Bridgespan, and Moda as well. So it's a really good opportunity for folks to get access to affordable coverage and also kind of take their health care into their own hands. For folks that are living with HIV, there's kind of the added benefit of being connected with Care Assist that can help you pay the rest of the premiums for any kind of plan that you do elect, provided that you get a silver plan, as well as, you know, any kind of private plan that's within their purview as well.

Dustin: Very cool. Well, that sounds like a ton of great information that's going to be really helpful to all of the people listening and all of the people just unfamiliar about open enrollment or benefits navigation and the ways that they can ensure that they're getting access to benefits. If folks have questions or want to learn more or reach out to you, what's some good contact info so that they could get in touch?

Rusty: Yes, my phone number is 503-893-8454 and my email is rshorey@capnw.org. I think that's the best way to do it, just spell it out.

Dustin: Yeah, that's perfect. Thank you so, so much for your time today, Rusty! You've been such a treat to have on the show and really just helping break down those barriers to accessing open enrollment, benefits, navigation and just sharing why the work we do at CAP is so critical and important to the communities we serve. So thank you so much again, and until the next time we have you here, y'all can reach out to Rusty for all your benefits navigation questions!

Outro: Well, that's our show for today folks. Thanks so much for tuning in and we can't wait to share another episode next month. If you have any questions, comments or concerns in the meantime, please don't hesitate to reach out to us at comms@capnw.org. Until then, stay vibrant!

About Cascade AIDS Project

CAP is a non-profit organization that was founded in 1985 as a grassroots response to the AIDS crisis. As the oldest and largest community-based HIV services provider in Oregon and southwest Washington, we seek to support and empower all people with or affected by HIV, reduce stigma, and provide the LGBTQ+ community with compassionate healthcare. We do so by helping to ensure the health and well-being of our program participants each year through health, housing, and other social services. When the need for affordable, accessible, and culturally affirming primary care services was identified as a community need, we responded by opening Prism Health in 2017.  More information can be found at www.capnw.org.