Woman sues county after exclusion from health care program

A car accident victim is suing San Mateo County, claiming she was left without medical care and in debt after being unfairly excluded from a health coverage program for the working poor.

Dina Vera, a 32-year-old orderly from Burlingame, claims the county violated the law requiring it to provide medical care to the indigent. The lawsuit argues that the county denied Vera admission to the program on the grounds that her employer offered insurance.

The lawsuit was filed Jan. 15 in San Mateo Superior Court. Vera is being represented by attorneys from the San Mateo County Legal Aid Society and the Western Center on Law and Poverty. The groups have raised issues with the county’s Wellness Education Linkage Low Cost program in the past.

After an Aug. 26 car accident, an uninsured Vera was brought by ambulance to the San Mateo County Medical Center emergency room where she was treated for back injuries and asked to return for rehabilitation therapy. At that time, Vera applied for the WELL Program, which provides discounted medical care for Peninsula residents who do not qualify for Medi-Cal.

Vera was rejected from the program weeks later. She filed two appeals, explaining she would not be eligible to enroll for company insurance until the next open enrollment in June 2008. Neither appeal allowed her to present her case in person or rebut the information on which the county was basing its decision, Douglas said.

Vera, who brings in $1,680 in gross monthly wages, is now in debt and delaying needed rehabilitation, Douglas said.

The lawsuit claims Vera’s right to due process was violated. It seeks to have the appeals process changed so that rejected applicants may tell their stories in person and review the reasons they were not enrolled. Douglas said another seven to 10 other clients are currently having problems with the appeals process.

San Mateo County’s Board of Supervisors met in closed session to discuss the case Wednesday but have not issued a legal response. Supervisor Jerry Hill said the program has an extensive appeal process.

“There has to be certain criteria and some people don’t meet the requirements,” Hill said.

The attorneys representing Vera also threatened a lawsuit over the WELL program in November, claiming a restrictive income cap and costly fees were turning many poor people away. County officials are in negotiations in that case.

tbarak@examiner.com

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