Washtenaw Health Plan

Our Courtyard Transforms! It's Now...Built To Play!

A couple of years ago, WHP staff took a photo in the courtyard between our building and the Department of Health and Human Services. What was then benches and rosebushes is now…a playground!

This project was funded by the Ralph C. Wilson Jr. Foundation Initiative, Built to Play.

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For parents coming in and out of the Washtenaw Health Plan, Washtenaw County WIC or the Michigan Department of Health and Human Services, this could be a nice break in a day of errands! Maybe next time, the kids will not just “tolerate” coming to our campus, but will actually look forward to it!

The transformation was quick (it just took a few days!), and we will still have the nice trees turning colors in the fall.

For more details about why the health department applied for the grant, read this conversation on the Built to Play website with WCHD Communications and Community Health Promotion Manager Susan Ringler-Cerniglia.

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Six Things I Learned about Healthcare While Working at the WHP

Editors Note: This post was written by a wonderful summer intern, Madeline Higgins, as a reflection on her work over the summer. Madeline is a student in the MPH program at the University of Michigan School of Public Health, and we are sure she will go on to do great things!

I was lucky to intern at the Washtenaw Health Plan this past summer, where I got to observe the services that WHP provides and work with a new program involving Community Health Workers. Meanwhile, the federal government was attempting to greatly reduce the Affordable Care Act, which had the potential to negatively impact the health of residents in Washtenaw County. While I learned many facts, protocols, and systems, the items listed stick out most in my memory.

 

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1. There is a significant gap in understanding of the reality of healthcare and policy impact from federal legislators.

I believe this stems from decision makers finding information that enforces their current worldview instead of looking at fact-based data. While watching and reading about the legislative process for healthcare reform, I was struck by the lack of listening and understanding from both sides of the aisle. While everyone utilized individual stories to demonstrate their points, there was little conversation about population-level health outcomes. After reading reports and statistics which utilized a population health framework, it is obvious to me that overall, the Affordable Care Act has positively impacted health in the US.

 

2. You can work minimum wage full time and not qualify for Medicaid (as a single individual household).

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I learned this towards the end of my time with WHP. I hadn’t done the math before, and it was hard for me to imagine living on the minimum wage in the Ann Arbor area in regards to housing costs, let alone health care. To me, this further demonstrates the need for a livable minimum wage.

 

 

3. Pre-existing condition protections help us all.

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At some point in our lives, we are likely to experience some health setback where we utilize the healthcare system. It is advantageous to us all to include people with pre-existing conditions in the insurance pool because one day that could be us!

 

 

4. Everyone has questions about healthcare- and it is important to find places to get good information.

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The Washtenaw Health Plan is a great place to ask for help! No matter your insurance plan, there seem to be terms and deadlines that won’t make a lot of sense until you ask an expert or seek reliable resources. I also wrote a blog post this past summer about reliable resources regarding health care access, and it totally changed the way that I look for information about health.

 

5. People who do direct service work can (and must) also do policy advocacy.

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Washtenaw County is organized and ready for action! I sat in on many meetings where people were putting their heads together to make sure they had the right information to talk to colleagues, legislators, and their clients about how federal policy change (for example, reduction in SNAP benefits) is detrimental to our community. This is vital to both keeping their jobs but also elevating the health status of the Washtenaw County population.

 

6. Above all, if healthcare was treated like a human right, the tone of this conversation would be very different.

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People at the WHP recognize that healthcare is more complicated than having access to insurance. Health is about access to nutritious foods, opportunities to relax, space to exercise, and of course the occasional donut from Dom’s. Working in the county government showed the interconnectedness of the systems that comprise of people’s access to health. I believe if we are more inclusive to people’s needs we can work together to improve the health of Washtenaw County.

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Washtenaw Health Plan Services for Immigrants

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Here at the WHP we provide confidential services to all people regardless of their immigration status.  We assist individuals and families with any health coverage needs, from identifying eligibility to completing applications.  We help people figure out if they are eligible for Medicaid, MOMS, Emergency Medicaid, Washtenaw Health Plan, or the Marketplace (subsidized insurance under the Affordable Care Act).  WHP even assists individuals whom need help understanding their employer’s insurance options.

To ensure that all individuals and families have access to services and resources at WHP, we have Arabic, French, and Spanish speakers on staff.  In addition, we have access to a language line that provides real-time interpretation services for anyone who prefers to receive information in their native language.  Our language line services assist us in helping families in understanding documents, and gives families the confidence to ask the questions they need answered. The language line can assist with over 240 different languages.

WHP staff (and Public Health staff) have access to interpreter services for Acholi to Zyphe from  Language Line Solutions .  

WHP staff (and Public Health staff) have access to interpreter services for Acholi to Zyphe from Language Line Solutions.  

In addition to helping individuals and families identifying what health coverage they are eligible for, WHP can provide families with referrals and resources to address additional needs that go beyond health. We refer families to agencies throughout Washtenaw County. Some of our referrals include: Catholic Social ServicesJewish Family Services and Hope Clinic.

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With the current immigration climate, we are aware that many individuals and families need the necessary resources to feel safe in their community. WHP provides families with Know Your Rights information, including updated lists of attorneys helping community members with immigration questions and community organizations that advocate for immigrants such as the Washtenaw County ID Project and Washtenaw Interfaith Coalition for Immigrant Rights (WICIR).  WHP can now notarize Power of Attorney forms and translate foreign driver’s licenses.

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In May 2017, the Washtenaw County Board of Commissioners approved funding and resolutions to aid immigrants regardless of citizenship or immigration status. One of the resolutions includes Washtenaw County being a welcoming community, respecting and cooperating with all families.  Another resolution specifies that Washtenaw County policy is to only ask about immigration services for specific purposes, allowing people to feel safe when interacting with the county government. Lastly, having a policy in place to aid in restricting deportation and provide more appropriate immigration sanctions for immigrants and non-citizens who have been convicted of crimes.  As Washtenaw County employees, we support these resolutions everyday in our work. 

The Washtenaw Health Plan is dedicated to helping people access and receive healthcare regardless of their immigration status.  All WHP staff recently attended the Welcome Michigan Statewide Convening to discuss supporting and welcoming immigrants across Michigan. 

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-T. South Peterson

Have questions about healthcare?  Call 734-544-3030 or walk-in to our office Monday - Friday from 9am-4pm.  Post a question in the comments section below and we will answer you. 

Healthcare Counts blog posts in Español / Spanish are here.

Information about immigration and healthcare from Healthcare Counts is here.

Washtenaw County Immigration Policy May 2017

Michigan Immigrant Rights Center

National Immigration Law Center

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Actualizado ** Entendiendo el Deducible de Medicaid, o "Spenddown"

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In English - Updated** Understanding A Medicaid Deductible, or "Spenddown"

La mayoría de los programas de Medicaid cubren todos los beneficios esenciales de salud, como visitas al médico y al hospital, servicios de atención dental y de visión. Sin embargo, algunos programas sólo cubren beneficios limitados. Por ejemplo, el Medicaid de Servicios de Emergencia y el programa MOMS (información aqui) proporcionan servicios parciales a los inmigrantes. Otro programa "parcial" se llama el programa Deducible de Medicaid (anteriormente llamado Medicaid Spenddown).


El programa de Deducible de Medicaid está disponible para personas con discapacidades, ancianos, niños y padres de niños que están sobre el límite de ingresos para el Medicaid completo. A fin de calificar para un deducible, también tendría que cumplir con una prueba de activos (que tiene en cuenta sus activos, excluyendo una casa y un coche). Un individuo que está sobre el límite de ingresos para Medicaid y tiene muy pocos activos puede ser aprobado para el programa de deducible. El Departamento de Salud y Servicios Humanos (DHHS) especificará la cantidad del deducible, un número que oscila entre menos de cien dólares y varios miles de dólares. Este número se basa en los ingresos de su hogar.

LA IDEA ES SIMPLE, PERO LA ACCIÓN ES COMPLICADA

Con un deducible mensual de Medicaid, para que Medicaid llegue a ser completamente activo, las facturas que ascienden al deducible deben ser alcanzadas en un mes determinado. El individuo es entonces responsable del deducible y DHHS paga el resto. Por ejemplo, digamos que el deducible de Martha fue fijado en $ 800, y Martha tiene una factura del hospital en Mayo por $ 5,000.

Martha es responsable de pagar los $ 800 al hospital y DHHS paga $ 4,200. Para que DHHS pague, se debe presentar un informe de deducible.

Si la factura fue incurrida el 1 de Mayo y se presentó un reporte de deducible, durante el resto del mes Martha tiene Medicaid completo y Medicaid pagaría por cualquier servicio médico necesario, como gafas, limpieza dental o medicamentos. A partir del 1 de Junio, Martha no tiene Medicaid, pero de nuevo tendría que cumplir con un deducible.

Si Martha ingresó al hospital el 31 de Mayo y no tenía gastos médicos antes de esa fecha, no alcanzaría el deducible hasta el 31 de Mayo. A partir del 1 de Junio, el deducible / spenddown se restablecería, por lo que probablemente no sería posible de que le limpien los dientes en Mayo! Algunas personas, particularmente las personas que viven en hogares de ancianos, cumplen con su deducible cada mes, pero la mayoría de la gente no.

Recuerde: Para que Medicaid se active, las facturas y un Reporte de Deducible deben ser enviados al trabajador social del DHHS. El deducible debe ser alcanzado de nuevo cada mes para que Medicaid se active.

 

LOS DEDUCIBLES DE MEDICAID PUEDEN AYUDAR, PERO NO SE CUENTAN COMO COBERTURA DE SALUD COMPLETA

Importante: El programa de Deducible de Medicaid no cumple con los mandatos de la Ley de Cuidado de Salud a Bajo Precio. Esto significa que si esta es la única cobertura que tiene, se le puede aplicar una multa al presentar los impuestos al final del año.
La buena noticia es que usted puede tener un plan del mercado de seguromedicos o una cobertura de seguro de su empleador junto con un deducible de Medicaid. (Recuerde, Medicaid puede ser un seguro secundario.)


¿CONSEGUÍO LA COBERTURA CORRECTA?

A veces un individuo es aprobado para el programa de deducible pero realmente debe tener Medicaid completo. Si usted piensa que debe tener cobertura completa, la oficina del Washtenaw Health Plan ofrece una evaluación gratuita. Para obtener ayuda para presentar las facturas de su deducible de Medicaid o si cree que debe recibir Medicaid completo, vaya a la oficina del Washtenaw Health Plan. El horario de atención es de lunes a viernes de 9:00am a 4:00pm. Estamos ubicados en 555 Towner, Ypsilanti, MI.


¿Preguntas? Llame (734) 544-3030.

-Haley Haddad, Ingrid Fonseca, Ruth Kraut and Meredith Buhalis

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Who Is The WHP And What Do We Do?

Who is the Washtenaw Health Plan?

The simple answer to the question of who is the Washtenaw Health Plan goes like this:

We are a non-profit. We are a public-private partnership supported with the help of Washtenaw County, our local health systems, University of Michigan Health System and St. Joseph Mercy Health System, and other local healthcare providers. We started as a safety net health program for low-income Washtenaw County residents who didn't have access to insurance, and we still run that program. [Read about our history here.]

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But now, thanks to the Affordable Care Act, more people have other options--Medicaid, the Marketplace, employer insurance. So the WHP's Plan B safety net program still exists, but first we'll see if you qualify for insurance that meets the Affordable Care Act mandate. We believe in healthcare coverage. We have seen it save lives. The Affordable Care Act is not perfect, but we believe it moves us in the right direction--toward healthcare for all

So nowadays, we spend most of our time helping people figure out their healthcare options

The WHP staff at our holiday celebration!  Come meet us in person! 

The WHP staff at our holiday celebration!  Come meet us in person! 

We help you assess your healthcare coverage options. We advocate with and for you if you need help with DHHS or the health insurance Marketplace. We have learned a lot about the systems and policies that make the healthcare systems run, and sometimes what might seem like magic to you is just us having done this application hundreds of times before. 

We explain unfamiliar terms like deductible and maximum out-of-pocket costs. We listen to what you need. We explain what kind of proofs you need to provide for income or immigration verifications. We write this blog, and maintain this website.

All of this work is motivated by a deep and abiding belief that everybody deserves access to health care. Yes, everyone. So we'll help people who are parents or kids, tall or short, fat or thin, employed or unemployed, single or families, immigrant or citizen, happy or sad. We'll help you if you know exactly what you are eligible for, or if you have no idea what your options are. We'll speak English, Spanish, French or Arabic in the office, and if you speak a different language--we'll call for interpretation help. We'll help you if you live in Washtenaw County, and we'll help you if you don't. 

In Other Words: We Help People--Like You!

And, in fact, the tagline of our new advertising campaign is: We Help People--Like You!

Our hope for 2017 is that we will help even more people like you.

With our new ad campaign, we've got ads running on buses with our friends over at the Ann Arbor Area Transportation Authority (also known as The Ride). We are distributing posters around town as well. Thanks to The Ride for donating the advertising space on the buses, and thanks to Pete Sickman-Garner for his graphics design work.

Look for these posters on The Ride!

Look for these posters on The Ride!

We've shown you some of the advertising posters in this blog post, but here's how you can help us!

1. Download some poster copies here (they print in 8-1/2" x 11" or 11" x 17"). Post them where you work or play! You can also share them electronically or on social media. 

2. Ride the bus? Take a picture of one of our posters on the bus. Tag us on social media, and we'll send you a prize pack! You can find us on facebook, instagram, and twitter @coveragecounts. 

3. Have you been helped by us? Word of mouth works--tell your friends! (Also--reviews work too. Feel free to review the Washtenaw Health Plan on Yelp or Google+.)

Here's to 2017! Help Us Help More People--Like You!

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Get 'Em While It's Hot Out! Immunizations are Free and Essential

It's Hot! It's August! It's...National Immunization Awareness Month! 

Plus--school is about to start, and kids in certain grades need to have their immunizations up to date! In fact, in some cases adults need boosters or new vaccines as well.

Huuuuuuge Benefits

Immunizations (also known as vaccines, or "shots") pay big dividends:

  • They protect you and your children from diseases that in years past injured and killed many people;
  • They protect other people--vulnerable people like babies, senior citizens, and people whose immune systems are weak--from getting sick. 

Vaccines Are Free

Under the Affordable Care Act, required vaccinations are part of preventive care--and generally, whether you have Medicaid, a Marketplace plan, or employer coverage--they will be covered 100%.

For uninsured children, the Washtenaw County Public Health immunization program has a Vaccines for Children program; and there are discounts for uninsured adults as well. (But wait a minute--if you are uninsured, come visit the Washtenaw Health Plan or another assister agency for help getting covered!)

Vaccine Waivers

New state law in Michigan (2015) tightens up the requirements for families who want to opt out of some or all immunizations. As Washtenaw County Public Health notes, 

If a child is not up-to-date on her or his vaccinations, a waiver is required for the child to enroll in: a licensed childcare; preschool or Head Start;  kindergarten; seventh grade; or a new school district. Under the new rules parents or guardians must participate in a science-based educational session with their local public health department. In Washtenaw County, waiver appointments can be scheduled by calling Washtenaw County Public Health at 734-544-6700.

Learn More

Background information on vaccines can be found here:

English

Spanish

 

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WHP Profile: Meredith Buhalis

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Meredith Buhalis began working at the WHP just weeks before the April 1st, 2014 start of the Healthy Michigan Plan. She hit the ground running, doing her first application on her own on opening day! Since then, Meredith has been an asset to the WHP, doing a very high volume of enrollments.  As part of the WHP team, Meredith works to help a diverse group of clients navigate the complexities of the current health care system.

Although getting health care coverage is the main focus of the WHP, educating people about their options and supporting clients to become their own advocates is her passion.  A client wrote this about Meredith.

 "She is amazing and she will help you! She has put the power back into my hands. These programs are funded and if you are eligible they should NOT ever be out of your reach. Call Meredith. Get the help you need to gain the coverage you deserve."
Check out the website and subscribe to our blog!

Check out the website and subscribe to our blog!

During the Coverage Counts CMS grant, Meredith worked out of the Livingston County Department of Public Health and has helped many community members in both Livingston and Washtenaw counties. Now, Meredith is full-time at the Washtenaw Health Plan offices in Ypsilanti.

Meredith first studied education and human development at Antioch College where she fully absorbed the founder's pleas to graduates, "Be ashamed to die until you have won some victory for humanity." After college and brief careers in house painting and restaurants, Meredith attended the School of Information at the University of Michigan. As part of hi-ce, she taught school librarians to use the Internet and helped organize the World Wide Web, pre-google.  She worked with nonprofits, technology and social workers before moving on to the wonderful world of school libraries.  Now she puts her organizational, creative, and people skills to good use at the Washtenaw Health Plan.  

Times change. Now, Meredith and family are covered by employer insurance!

Times change. Now, Meredith and family are covered by employer insurance!

For instance, Meredith designed the healthcarecounts.org website. Recently, our website and blog has been commended for its amazing marketing team. And that team is primarily Meredith!

Meredith lives in Ann Arbor with her husband, the singer/songwriter Chris Buhalis, daughter and dog. 

--Haley Haddad and Ruth Kraut

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Updated** Understanding A Medicaid Deductible, or "Spenddown"

En Espanol - Actualizado ** Entendiendo el Deducible de Medicaid, o "Spenddown"

Most Medicaid programs cover all essential health benefits, like doctor and hospital visits, dental care and vision services. However, some programs only cover limited benefits. For example, Emergency Services Medicaid and the MOMS program (information here) provide partial services to immigrants. Another "partial" program is called the Medicaid Deductible program (previously called Medicaid Spenddown).

The Medicaid Deductible program is available to people with disabilities, the elderly, children and parents of children who are over the income limit for full Medicaid. In order to qualify for a deductible, you also would have to meet an asset test (which takes into account your assets, excluding a house and car). An individual who is over the income limit for full Medicaid and has very few assets may be approved for the Deductible program. Department of Health and Human Services (DHHS) will specify the amount of the deductible, a number ranging from less than one hundred dollars to several thousands of dollars. This number is based on your household income.

The Idea Is Simple, But The Action Is Complicated

With a monthly Medicaid deductible, for Medicaid to become fully active, bills amounting to the deductible must be reached in a given month. The individual is then responsible for the deductible and DHHS pays the remainder. For example, let's say Martha's deductible was set at $800, and Martha has a hospital bill in May for $5,000. Martha is responsible for paying the $800 to the hospital and DHHS pays $4,200. In order to get DHHS to pay, a deductible report has to be submitted.

If the bill was incurred on May 1, and a deductible report was submitted, then for the rest of the month Martha has full Medicaid, and Medicaid would pay for any necessary medical service, such as  glasses, a dental cleaning, or prescriptions. Starting on June 1, Martha does not have Medicaid, but again would have to meet a deductible.

If Martha went into the hospital on May 31, and didn't have medical expenses before then, she wouldn't meet the deductible until May 31. Starting on June 1, the deductible/spenddown resets, so she probably wouldn't be able to get her teeth cleaned in May! Some people, particularly people living in nursing homes, do meet their deductible each month, but most people do not.

Remember: In order for Medicaid to become active, the bills and a Deductible Report must be sent to the DHHS caseworker. The deductible must be reached again each month for Medicaid to become active.

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Medicaid Deductibles can help, but they don't count as FULL health coverage

Important: The Medicaid Deductible program does not meet the mandates of the Affordable Care Act. That means that if this is the only coverage you have, you may be assessed a tax penalty when filing taxes at the end of the year.

The good news is that you can have a Marketplace plan or employer insurance coverage along with a Medicaid deductible. (Remember, Medicaid can be a secondary insurance!) 

Did you get the right coverage?

Sometimes an individual is approved for the Deductible program but really should have full Medicaid. If you think you should have full coverage, the Washtenaw Health Plan offers a free assessment. For help submitting bills for your Medicaid deductible or if you think you should have full Medicaid, stop into the Washtenaw Health Plan. Walk-in hours are Monday through Friday from 9am to 4pm. We are located at 555 Towner, Ypsilanti, MI. 

Questions? Call (734) 544-3030.

--Haley Haddad and Ruth Kraut

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WHP Profile: Ruth Kraut - Manager of the Year

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Ruth Kraut recently won Manager of the Year for Washtenaw County.  In addition to being a stellar program manager at the Washtenaw Health Plan, Ruth also bikes, hikes and blogs about schools.  Enjoy reading about her!  She is amazing and we wouldn't be who we are without her.

From the nomination:

Ruth is an extremely effective collaborator. In whatever area she is working in, she actively seeks out opportunities to engage with colleagues and community partners to enhance the work and the ultimate outcomes. She leads a team of staff on a large grant project to provide Medicaid outreach and enrollment assistance to our county's most vulnerable citizens. She is able to find each team member's strengths and is masterful at bringing out their best contributions. She is very supportive and encouraging to her team.

Michael Appel, Measie James and Ruth at a Bike Ypsi event.

Michael Appel, Measie James and Ruth at a Bike Ypsi event.

Ruth is hard working, knowledgeable and passionate about the work. Her dedication is infectious. She is very proactive, always seeking out new opportunities and solutions to further our work. She willingly shares her knowledge and expertise with many others, including staff and others in our community. She is in demand as a trainer regarding the new enrollment requirements of the Affordable Care Act and the Medicaid expansion. She makes very complicated information easy to understand, encouraging and inspiring others to get involved in the work.

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Ruth is always looking for new ways to achieve the WHP goals. She sought and we received a large federal grant to provide Medicaid outreach and enrollment assistance to vulnerable populations, including immigrants, homeless kids and their families and teens. She sought out and we received another grant to conduct an immigrant mental health needs assessment and to provide mental health services to immigrants. She always has the larger WHP mission and vision in mind, as she proactively seeks out ways to achieve the vision. She sees the big picture and at the same time, she stays on top of the details. She consistently goes above and beyond, finding creative ways to ensure that our most vulnerable county residents are getting the care they need.

Ruth and staff member Michael Randall celebrate their birthdays.

Ruth and staff member Michael Randall celebrate their birthdays.

The WHP serves the county's most vulnerable citizens, working to ensure that they get access to the health care services that they need, when they need it. Access to health care services has been a big unmet need in our community. The Affordable Care Act is improving that, but much work needs to be done to get to full implementation. Ruth's work with individual clients of the WHP, and her work with partners in the community is having a tremendous impact, and moving the needle on this important indicator of community health.

Ruth won an award for Manager of the Year and also won an award as part of the Washtenaw County Public Health department team that helped create the Washtenaw County Dental Clinic.

Ruth won an award for Manager of the Year and also won an award as part of the Washtenaw County Public Health department team that helped create the Washtenaw County Dental Clinic.

Ruth is responsible for many key programs for the WHP. Her role of Program Administrator is all encompassing, and she manages and participates in a large number of programs, all aimed at expanding access to health care services. She was a key member of the team that worked on establishing the Washtenaw County Dental Clinic. She leads the WHP Community Coordination and Dental Services Workgroup. She has program responsibility for the WHP's role as lead agency for safety net health in the Coordinated Funding process. She willingly takes on projects that will further the organization's goals. She is Manager of the Year each and every day, as she models hard work and dedication in service to our county residents.

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WHP Profile: Jean Amador

It's Friday! Learn about a WHP staff member.

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