During the grant period, 1,641 individuals contacted the Helpline and of these, 1,560 individuals were screened for healthcare coverage eligibility, allowing them to meet their first objective. A total of 1,356 individuals were enrolled in Medicaid and CHIP, just shy of the goal of 1,500.

Their second objective to increase the number of individuals accessing a primary care home was not as easy to accomplish. The Helpline Operator scheduled medical appointments for 494 individuals. Through the partnership with Williamson County and Cities Health District (WCCHD), 343 clients were scheduled for pre-natal appointments. This total of 837 was far below the expected outcome of 6,000 targeted by ICC in their grant application.

ICC reported two major challenges that constrained the results of this objective. First, many of the 1,641 individuals that contacted the Helpline needed specialty care, not primary care, the service the Helpline was positioned to offer. Unfortunately, Williamson County does not have a referral network to link the uninsured to specialists willing to see them at little or no cost. Thanks to the partnership with WCCHD, the Helpline staff was able to refer the cases to a social worker who attempted to assist callers in finding the specialists they needed.

Another barrier for families was the co-pay requested by the Lone Star Circle of Care Clinics (LSCC). As a Federally Qualified Health Center, LSCC is required to charge for appointments, fees ranging from $15 to $50, depending on the patient’s income bracket. The Helpline explained to callers that LSCC was willing to set up payment plans but many opted to forgo the visit because of the expense.

Their third objective was to reduce the number of preventable Emergency Room visits by the clients served. Of the 120 callers ICC was able to track in their database, 64 of them visited the ER within six months of their Helpline-scheduled appointment for a condition that could have been treated by primary care. This was a much higher rate than ICC had hoped but these patients had chronic conditions such as hypertension, diabetes, and depression, conditions that are difficult to manage without significant behavior change which often takes time.

Though the project was unable to greatly reduce emergency room visits, it did lead to system changes that have increased access to primary care for Williamson County residents. Lone Star Circle of Care, the main primary care provider, has implemented a call center for all its patients giving same day and next day appointments for those needing to be seen immediately. In addition, a group of providers are collaborating to implement a specialty care referral system for uninsured patients much like the system in Travis County.

Indigent Care Collaboration is now Integrated Care Collaboration.