No, I don't mean the Jim Carey movie about a goofy animal detective. I'm writing about the Access Coverage Enrollment Program-that ACE. ACE Ventura provides a medical home in the Ventura County Medical Center medical system and reduced-cost healthcare for low-income, uninsured adults.

California Sen. Sheila Kuehl's SB 1448 established the Health Care Coverage Initiative in 2006, enabling California to access federal funding approved for demonstration projects such as ACE. The federal funds are administered by the California Department of Health Care Services. DHCS awarded a Coverage Initiative grant to the Ventura County Health Care Agency, one of ten such grants in California. Other recipients include Los Angeles and Orange Counties.

Ventura County will receive $10 million per year for three years and expects to develop comprehensive medical services-with an emphasis on preventive and chronic disease care-for some 12,500 people. Services include primary care office visits, immunizations, specialty care, imaging and laboratory work, prescriptions, urgent care, inpatient hospital care and specialty care, including mental health.

Applicants must be 19-64 years of age, uninsured and not eligible for Medi-Cal or other government programs, citizens or lawful permanent residents, live or work in Ventura County, and have a family income that does not exceed 200 percent of the federal poverty level.

The annual enrollment fee is $0, $50 or $100, based on income. Modest co-pays will apply for most services.

Why just adults 19-64 years of age? Because the vast majority of low-income children-90 to 95 percent statewide-are enrolled in Medi-Cal or Healthy Families, and more than half of those not actually enrolled are eligible for enrollment. And, Ventura County already has an ACE for kids. Seniors, 65 years of age and older, receive Medicare or similar benefits.

Why extend services to adults ineligible for existing government programs? Because these low-income uninsured adults already use the county safety net services, but do so inefficiently, with no means for payment. Acute and episodic care is poor care and state law requires the county to absorb the cost. The ACE grant provides the money for the county to develop programs to provide more effective and economic preventive and chronic disease care.

What happens when the grant runs out? Grant recipients were determined to have the ability to develop an infrastructure and financial base to sustain the program going forward, presumably from safety net money more wisely spent.

More information about the Health Care Coverage Initiative is available at www.dhcs.ca.gov/services/Pages/CoverageInitiative.aspx. Eligible patients may be referred to VCMC at 805/677-5260. I'm available at thurstonrc@dock.net.