Lisa Russell endured kidney stone symptoms for months until her physical pain began dwarfing her financial anxiety. In the past, if anything ailed her she would simply say, “it’ll go away.”
First, there were the frequent trips to the bathroom. Then severe pain. Finally, Russell, 58, who has no health insurance, noticed blood in her urine.
“I thought I would have to wait until I had to go to the emergency room,” she said, adding that she Googled “lithotripsy,” which she concluded was the most affordable kidney stone surgery. The price tag came back: $100,000.
That’s when she got a call from a woman who said worked for a nonprofit that could help her get the surgery she needed for free. Russell, was obviously skeptical.
“I was kind of reluctant,” Russell said. “She said, fill out all this and I said okay, but I don’t believe this. When they got the ball rolling I said, ‘Wow! it was actually going to happen.”
The woman who contacted Russell was Rosa Urquiza, program coordinator at Operation Access, a Bay Area nonprofit that connects uninsured residents, many of them immigrants, with free surgery and specialty medical services donated by local hospitals, community clinics and medical providers.
The organization has been operating for three decades, and in Sonoma County for the past two. Jason Beers, president and CEO of Operation Access, said Sonoma County has become its largest area of need.
Last year, Operation Access coordinated surgeries and specialty services for 200 Sonoma County residents, Beers said. In most cases, those dollars are part of local hospitals’ charity care, which they are required to provide to maintain their tax-exempt status.
Although, those in need are able to seek that charity care without the help of Operation Access, the process is extremely difficult and involves many bureaucratic hoops.
“We are a structured pathway or program for nonprofit hospitals to provide care that benefits the community,” Beers said, adding that the process to get surgery or specialty services starts with a referral from your primary physician.
“You’d go to a community health center and they’d need to refer you in,” he said. “They refer you to a doctor or medical group. At that point, you’d really be asked for a payment plan.”
That’s where Operation Access comes in.
Dana Codron, senior director of Providence Community Health Northern California, an affiliate of the region’s largest hospital owner, said Operation Access acts as a conduit between some of the North Bay’s most vulnerable residents and medical services that in many cases are scarce.
“If Operation Access wasn’t acting as this hub, a lot of people would fall through the cracks,” Codron said. “There’s not anyone else out there doing this care, we’ve been blessed having this organization in our community for so long.”
Thousands of uninsured
Russell, the Santa Rosa patient, is among more than 35,000 North Bay residents who were uninsured in 2023, according to data from the National Institutes of Health.
For many years, Russell was a caretaker for her mother and ex-mother-in-law. Today, she’s been living off her savings. Fortunately, she lives in a mobile home and doesn’t have “a lot of overhead.”
She said she anxiously awaits the day she can start getting Social Security before her savings runs out. Because of that savings, she doesn’t qualify for Medi-Cal, the state’s version of the federal Medicaid program.
When Urquiza, with Operation Access, phoned Russell a few months ago, Russell was already on the hook for a $3,000 CT scan that led to her diagnosis. The offer of surgery for free sounded too good to be true.
Urguiza said Russell was not alone in her initial disbelief. In some cases, it takes the patient’s medical provider to step in to convince them it’s not a scam, she said.
“Lisa was very worried that there might be costs associated with her care,” Urquiza said. “Sometimes we end up not convincing them. We have them go back to the clinic and the clinic verifies.”
Beers, Operation Access CEO, said skepticism is common reaction at first. Russell’s surgical care was donated by Kaiser Permanente, he said.
The cost of medical care donated by a provider like Kaiser Permanente is tallied and reported “in bulk” at the end of the year, he said. So the exact cost of Russell’s surgery is unclear. Beers said the average value of the waived charges for operating room procedures is about $48,000.
Last year, $4.4 million in donated care was provided for Sonoma residents through Operation Access, Beers said.
“We make sure to tell all our patients that the care is free and to contact us if they receive any bill, as we then communicate with the provider to make sure it is waived if they happen to receive any bill,” he said in an email.
Beers said the number of people needing charity surgeries and specialty care could grow due to changes to the federal Medicaid program.
President Donald Trump’s One Big Beautiful Bill approved by Republican-led Congress earlier this year enacts those changes, both to Medicaid and the Affordable Care Act’s insurance marketplace. Those cuts, according to nonpartisan experts, are expected to cause millions of Americans to lose their health insurance.
Re-widening health care gaps
Prior to the full-implementation in 2014 of the Affordable Care Act, or Obamacare, some 70,000 Sonoma County residents were uninsured. At that time, 20,000 Sonoma County residents were not eligible for health coverage because of their immigration status.
By 2017, 23,000 county residents became newly insured through the state’s Covered California health exchange, an ACA insurance marketplace, while an additional 35,000 county residents received coverage through Obamacare’s expansion of Medicaid.
Medicaid and Obamacare are now inextricably bound, and the looming cuts to Medicaid could result in thousands of local residents losing their health insurance.
That could make the work of Operation Access even more crucial, said Pedro Toledo, CEO at Petaluma Health Center. In many cases, the surgeries coordinated by Operation Access are “life changing,” he said.
About 10% of Petaluma Health Center’s patients are uninsured and have no access to non-emergency surgical procedures and specialty care. Some of the most common types of surgeries provided through charity care include cataract and retinal surgeries.
“It’s a model of what’s possible when local providers unite around a single idea that no one should be denied care because of their income insurance or immigration status,” he said.
Donna Waldman, executive director of the Jewish Community Free Clinic in Santa Rosa, said her clinic refers a handful of patients every month to Operation Access.
Most of the patients who visit the clinic have no health insurance, she said.
“A private physician is not going to take them and hospital care is really expensive,” she said.
Waldman said the clinic’s partnership with Operation Access helps bolster their grant-funded cancer prevention program that provides free “FIT” tests for colon cancer screening. The clinic can refer patients to Operation Access for in-clinic colonoscopy procedures.
“I don’t know what we would do without their help,” Waldman said.
You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.
For more stories of Gratitude go to www.pressdemocrat.com/special-sections
Operation Access
The San Francisco-based nonprofit connects people facing barriers to health care with surgical and specialty services donated by local providers.
To refer a patient or reach out for more information: 415-733-0052, info@operationaccess.org.
Uninsured people who live in Northern California and the Central Valley are eligible regardless of immigration status if they earn up to $5,217 per month for an individual or $10,717 for a family of four (400% of the federal poverty level).