Few people have done as much to connect Spokane County residents with health care coverage as Ralph DeCristoforo, who retires today as Health for All Project coordinator at the Spokane nonprofit agency Community-Minded Enterprises.
The 59-year-old former Air Force captain, who recently underwent surgery for back injuries suffered in the military, sees health care as a social support necessary for a strong economy and not as a commodity for those who can afford it.
DeCristoforo estimates that since Dec. 1, 1999, Health for All has helped more than 50,000 people in Spokane County find public or private health care resources.
That doesn’t include the number of people helped statewide by social services workers DeCristoforo has trained and kept informed during his 10 years as project coordinator.
“He truly is our community’s brain trust on social service programs, particularly health care programs available publicly and privately,” said state Rep. John Driscoll, D-Spokane.
Driscoll, director of Project Access, a network of medical providers offering specialized care to the uninsured, has depended on DeCristoforo to help stabilize the lives of Project Access patients.
“Whenever I need information related to safety net programs, the first person I call is Ralph,” Driscoll said.
As a member of the Medical Clinics Committee, DeCristoforo has been a longtime advocate for the underserved, said Tina Bayne, associate professor and assistant dean of the undergraduate program at the Washington State University College of Nursing in Spokane. Bayne is the chairwoman of the group, which meets several times a year to discuss health care access for the poor.
“I see him as an ambassador for connecting persons without adequate health care coverage with available resources,” Bayne said. “He has done an enormous amount of good for Spokane.”
Jean Farmer, executive director of the Northeast Community Center, where DeCristoforo once volunteered, said his will be difficult shoes to fill, but she wouldn’t be surprised to see him emerge as a volunteer at some other social service agency.
“He will continue to look for new ways improve access to health care for families,” Farmer said.
DeCristoforo served in the Air Force for 24 years – 12 as an enlisted man and 12 as an officer. It was in the military, he said, that he learned how to translate “government speak” into English, a handy skill when navigating the labyrinth of government-run medical services.
While he was stationed in England in the early 1990s, DeCristoforo lived in the community, not on base, and received health care from the publicly funded National Health Service.
A British friend once told him, “You know, in England we have health care so we can work. In America, you have to work to get health care.”
They are words he recalled years later after immersing himself in the intricacies of an American health care system few can understand and many cannot afford.
After retiring from the Air Force in 1994, he obtained his master’s of health policy and administration from Washington State University-Spokane.
His thesis became the formula for the Health for All Project, a response to broad federal guidelines that allows the nonprofit organization to do outreach to any person who is potentially eligible for Medicaid.
“If we found out you weren’t eligible for Medicaid, we were allowed to link you for what you may be eligible for,” whether public or private health coverage.
“So many state-run programs are negatively branded for low-income or working poor when the average or above average person in Spokane County is eligible,” DeCristoforo said.
For example, DeCristoforo said, because of Apple Health for Kids, “there is no reason for any child in Eastern Washington to be uninsured because of the income guidelines,” which are 300 percent of the federal poverty level. “All of our uninsured children are under 300 percent.”
Yet it is estimated that 75,000 Washington children remain uninsured, largely because their families do not know they are eligible for coverage.
With the economic downturn, Health for All has seen a dramatic change in its clients, DeCristoforo said.
“Since January 2008, the whole population has changed,” DeCristoforo said, and he started seeing “people who have never had to ask for anything or look for services.”
Health for All clients are typically referred to it by other social services, clinics and emergency rooms. As many as 200 people a month are referred to the agency by Providence Holy Family Hospital’s emergency room alone.
Though he saw problems with the Patient Protection and Affordable Care Act, signed into law by President Barack Obama earlier this year, he believes there is cause for hope in many of its provisions.
Removal of lifetime limits, prohibiting denial of coverage based on pre-existing conditions, and establishing health insurance exchanges are all necessary reforms.
But, he said, it’s insurance reform, not health care reform. “The financial mechanism is the tail wagging the dog.” Real reform would provide uniformity and structure, he said. It would benefit both society and the economy.
DeCristoforo believes society has a cost to it, and health care and education are two of those main costs.
“The amount of money you make shouldn’t be driving how much you get, because the amount you get is going to drive how much money you are able to make,” he said. “We pay for police and fire (protection). You don’t get more because you make more money.
“What is health care for?” DeCristoforo asks. “Once we answer that question as a community and a society, everything else will fall into place.”