Luis Pardo, executive director of Worksite Wellness L.A., admires the identification badge of one of his staffers on a recent afternoon. He tilts it to reveal a key-themed hologram overlaying the card.
"You see that? You can’t counterfeit these things," Pardo says.
The badge belongs to Carmen Ochoa, one of Pardo's staff. She was the third person in the state to be certified as an enrollment counselor: a person who helps people select and buy health insurance on the state-run marketplace Covered California set up under the federal Affordable Care Act.
Ochoa will work under the auspices of Worksite Wellness L.A. The organization already had experience sending people to businesses across Los Angeles, helping employees and their family members sign up for Medi-Cal and other health care programs. In September, Worksite Wellness became a certified enrollment entity for Covered California, which meant it could begin contracting enrollment counselors.
Ochoa's final approval came through on Sept. 26, making her one of the few certified enrollment counselors when the health care exchange opened on Oct. 1. Pardo says the approval process was more involved than he usually experiences.
"We’ve had many, many contracts with federal, state and local governments and all those different kinds of things, so we’re used to this kind of stuff," Pardo says. "I was not expecting the amount of paperwork that was required of us."
Enrollment counselors must attend 20 hours of in-person courses, take online training modules and tests and pass a rigorous background check. Every step takes a lot of time and effort. Other community organizations have had difficulty getting their staff members certified.
"I assumed that we would be through the certification during the summertime and that we would be ready October 1," says Sonya Vasquez, a program director for Community Health Councils in south Los Angeles.
Six Community Health Councils staff members began the process to become enrollment counselors in mid-September. Three of them received their certifications this week. In the meantime, Vasquez says she's had to tell clients either to wait, or has directed them to organizations with certified counselors.
"It’s hard, because it’s like this perfect storm," she says. "You’re trying to get all these people educated and ready to enroll people, and tons of people are ready to be enrolled. As a community advocate, it’s hard to see people wanting to enroll and you not being able to help them."
Covered California has changed its estimates of how many certified enrollment counselors it plans to have available this year. A letter sent on June 26 to board members of the California Health Benefit Exchange contained an assumption that 20,000 counselors would be available beginning on July 1. An August 22 webinar contained a table detailing a training schedule that would prepare 16,000 certified enrollment counselors by the end of this year. Officials for Covered California now say they hope to have 5,000 by the end of December. About 600 have been certified so far.
"The numbers of enrollers isn’t the key issue. Enrollment is what matters," asserts Peter Lee, executive director of Covered California.
Lee says things have gone slowly in part because this past summer his agency decided it needed to further tighten the approval process.
"In the last four months, we’ve actually raised the bar on what it takes to become a certified enrollment counselor, including having to go through the fingerprinting and background check, having good reviews of the parent organizations," Lee says. "Our number one priority is to make sure that when a consumer goes to a certified enrollment counselor, they know they’re someone they can trust."
Lee downplays the counselor shortage, pointing out that Covered California has other ways to help people buy insurance: independent brokers, county workers and call centers. However, he can not say how much of the enrollment load each is expected to handle.
Despite the delays, people are still expressing interest in becoming enrollment counselors. Last Thursday night, a small group of UCLA medical school students gathered at a café near campus. They were meeting with professors and advisers to discuss the possibility of getting certified.
"I think that this is a really great opportunity for getting patients plugged into the healthcare system and letting them receive services that they definitely need," says Caleb Wilson, a second-year student at the school.