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Friday, December 19, 2014

Debt management aid can be crucial

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By Natalia Jacquez / New Mexico Daily Lobo

Kate O’Donnell explains the Presbyterian Hospital application process for financial assistance to Maria Cabrera at Casa de Salud Family Medical Office in the South Valley. O’Donnell is a “promotora,” or health navigator, in the South Valley, and mainly helps Hispanic and Latino people manage severe medical debt.

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Kate O’Donnell’s last patient of the day is Maria Cabrera, who has acquired more than $57,000 in medical debt.

The two sit in a dimly lit room in the Casa de Salud Family Medical Office, where O’Donnell works as a medical debt manager. She works with Cabrera and several dozen other South Valley residents who are struggling with medical debt.

“Hoy llenaremos el formulario para asistencia financiera de Presbyterian,” O’Donnell said to Cabrera. “Today we’ll fill out the financial assistance form for Presbyterian.”

Like many of the people O’Donnell works with, Cabrera only speaks Spanish. This is the regular routine for O’Donnell’s clients; they begin as patients at the Casa de Salud clinic.

“I worked here when I had the misconception that I wanted to go into medicine,” said O’Donnell, who graduated from UNM with a B.A. in Spanish and Portuguese in 2012.

She began as an intern at the clinic as an undergraduate student. O’Donnell said she was assigned to take vital signs, draw blood and do anything that a nurse might do in a regular clinical setting.

Casa de Salud offers its patients medical services ranging from gynecologic, to chiropractic, to needle exchange to acupuncture — all at low cost.

One of the most popular services at the clinic is medical debt management.

Many of the people who come to see O’Donnell have little access to technology like computers and smart phones, she said.

“When I give instructions for paying payment plans … it’s always paper maps or really a lot of things they can hold in their hand instead of saying go to this website, or go to Google maps,” O’Donnell said.

Paying debts online is a task that proves difficult for older generations, yet it is a situation people face every day, she said. Hospitals are transitioning into the digital era. Paper billing is almost gone and is being replaced with email billing. For people without technological skills, O’Donnell said she must guide them meticulously through their debt process.

“Seeing the way people react to having to come against technology, to feeling completely alone and unable to access things, I see a lot more depression in my clients and social isolation,” she said.

Cabrera said depression about her inability to pay her bills and deal with hospitals has offset her willingness to go on after her hospital stay.

“Sometimes I think I would’ve been better off if I had just died, I’d be more at peace,” Cabrera said.

Not knowing the language to deal with debt is one of the disadvantages many immigrants living in the South Valley have, O’Donnell said. Most of O’Donnell’s clients are of Mexican origin and are between 30 to 65 years old and have a limited education.

According to a study by Nerdwallet Health, Latinos are 24 percent more likely than Caucasian Americans to struggle with medical debt and about 28 million Latinos were uninsured last year.

O’Donnell said the constant phone tag and desk transfers she faces while debating with agencies over the phone is a tedious task even a technologically literate person could have trouble doing.

O’Donnell works with hospitals and collections agencies on lowering patients’ debts and scaling them down to reasonable payment plans, she said.

For her, the most important task is trying to bridge the technological gap her patients fall in by mediating and translating their processes towards lesser medical debt.

While O’Donnell once considered becoming a doctor, she said she realized that her career in social work can be just as healing for some people.

“I always knew that people could be treated as people within a clinical setting. I always used to tell the doctors I worked with and they all thought I was crazy,” she said.