Ashley Piaskowski: A whole new Legacy

Since July, Ashley Piaskowski has been the patient enrollment and outreach coordinator for Legacy Health - Legacy is the new name of Dirne Community Health Center.

Starting Oct. 1 - the first official shopping day for the Idaho Health Insurance Exchange - Piaskowski and her team will be available to help thousands of local residents implement the Affordable Care Act (ACA), also referred to as Obamacare.

This interview was conducted at Legacy Health.

What have you done in the past that qualified you for the challenge of the Legacy job, or, as it's more commonly known, the "health navigator" position?

I was a public information coordinator at Lewis-Clark for two years and after that assistant manager at Bardenay Restaurant.

At the restaurant, I learned a lot about the way I handle challenges and stressful situations. I learned to think on the fly - how to manage people and juggle personalities.

I'm a self-proclaimed impatient person, yet professionally, when it comes to managing, I've learned to demonstrate patience and I've learned I have a pretty large capacity for tolerance.

Did anything surprise you about your management style?

I found out that for the most part you can do anything - even if you didn't think you can. I'm a horrible cook and yet I did quite a bit of kitchen work at Bardenay.

I'm kind of always looking for the next challenge, so the biggest thing for me was finding something challenging.

What did you think you were getting into at Legacy?

I thought I was going to approach Legacy patients, as well as other people out in the community, to discuss the health care reform act and what it means for them.

Basically I was given a very broad stroke with things. I'm on an HRSA (Health Resources and Services Administration) grant. There are close to $150 million in these grants spread out across the country. The majority of the money is going toward hiring personnel. I've already hired two full-time people under me.

If I understand it right, your job is to educate local residents about the rules and regulations of Obamacare so that they can obtain health insurance. How did Legacy become involved in this?

Local community health centers nationwide are already organized and seen as community leaders for health information. They're also considered a trusted source of information.

We've got a number of populations targeted for our services and we're here for anybody looking for health insurance - not solely low-income people.

What's the absolute bottom line here?

All eligible individuals are required to have health insurance by 2014 and all small businesses are required to provide health insurance for their employees by 2015.

How comfortable are you with advising people on this stupendously complex new law? Do you actually understand it?

Yes, I feel about 85 percent comfortable now with the ACA and how it affects individuals.

Unfortunately, concerning the late-penalties that come with not having health insurance, we know some specifics but not enough yet to get remarkably specific with people. We know, too, that a lot of incomes are qualified for subsidies and assistance on health care premiums, but we don't know at this time to what degree.

How will you convince people they need to sign up?

We'll go through the importance of having health insurance and why it's important to at least apply and see what you qualify for - it never hurts until you try.

People are scared of the unknown. If they just know they've got their application in, they'll know what they can qualify for regarding health care plans, subsidies and any additional health care.

We're recommending that before open enrollment starts Oct. 1, people go to www.yourhealthidaho.org and sign up for the newsletter and updates there to prepare for the exchange - or "health care marketplace."

What happens Oct. 1?

You will be able to go online at www.yourhealthidaho.org and apply for health insurance.

You'll get instant feedback and you'll know exactly what you qualify for - whether it's Medicaid or Medicare or different types of private insurance. You won't need to wait to learn your options.

Once you make your decision, you can sign up immediately, if you want, by making a payment. That's up to the individual. Insurance coverage can begin as early as Jan. 1, 2014.

Enrollment will be open from Oct. 1 to March 31, 2014.

What about penalties?

Even though open enrollment lasts until March 31, the penalty for not having health insurance begins Jan. 1, 2014.

If you don't get health insurance you're going to be penalized. The penalties in the first few years are minimal but they rise fairly sharply after that. The money will be taken out of your tax refund.

Who need not apply?

If you already qualify for Medicare/Medicaid or have private health insurance from an employer, you don't have to. Also, you do not need to apply if you're below the poverty line.

What's your plan on getting the word out?

Our approach is intended to be helpful, educational, personal and very grassroots oriented.

We'll be offering workshops, presentations and handing out brochures on this. The workshops will be free and open to anyone who wants to attend them. Also, we'll be doing one-on-one appointments to help people complete their applications.

There'll be resources available for people who speak other languages.

Our community outreach is meant for any individual in the community looking for information on ACA and how it impacts them. For example, I'll be going to organizations and businesses as well as doing nonprofit board of directors presentations. Our coverage areas are Kootenai and Shoshone counties.

Where do you expect to run into problems such as people being unreceptive to your message and then taking out their displeasure on you?

Well, this is really not about Obamacare. It's more about health care options for the individual. The idea behind it is to be individually responsible and prepared for potential health care situations where you might need coverage.

There's going to be a lot of hand holding. I believe it's going to be more time consuming that they give it credit for.

And I'm worried about not being able to answer a lot of questions about specific individual situations. Everyone's unique and there are a lot of details.

Do you have plans to ask for outside help?

Yes, I'm looking for volunteers to help with outreach and enrollment in the Idaho Health Exchange. The commitment can be as much or as little as someone's willing to do and training will probably be between five and 10 hours. Some of their tasks would include preparing individuals for filling out the application. They're not, however, allowed to walk people through their applications.

What are some of the basic questions you expect to hear?

Why do I need health insurance? Where can I go to learn more? What is the Idaho Exchange? What will my options be? Will I be qualified for Medicaid, Medicare, CHIP, tax subsidies?

Any worries keeping you up at night?

I worry about the federal government changing the rules at the last minute and there are always the rumors of that as we're fast approaching Oct. 1. It's in the news every day and it's moderately worrisome.

How do you feel about working for Legacy?

They're an amazing resource for this community. To be a part of it is a great source of pride for me.

I'm OK with being behind the scenes on this. It's really a big dream of mine that this project turns out remarkably successful and a good example of Legacy setting benchmarks and precedents. It's really great to be at forefront to make sure Legacy is the one answering these questions and being here as a community resource.

Information: mylegacyhealth.org