With a population of approximately 1.2 million people, Sacramento County reflects a richness and diversity of people and culture. While the median family income is $30,000, nearly 25% of the County's residents live below the poverty level. Many residents have incomes of less than 100% of the poverty level and qualify for Medicaid. Keren Aviad relocated from her native Pennsylvania specifically to address this problem in Sacramento County. As a volunteer, she confronts challenges of helping to preserve safety net services for vulnerable community members by helping the remaining safety net clinics coalesce and act together as the Sacramento Community Clinic Consortium despite their differing missions and approaches to service.
In one the first Medicaid Managed Care experiments in the nation, California implemented mandatory HMO coverage for most of the 145,000 Medicaid eligible persons. The program is managed by the state, with no local oversight and little community participation in policy making. Thus, the real needs of the people whose lives are affected by this experiment sometimes are lost in bureaucracy and remain unfulfilled. Within the first year of this experiment, 8 of 21 clinics closed their doors.
Aviad is determined to counteract the detrimental effects of this health care initiative. She has been instrumental in helping the Consortium obtain start-up funding, secure volunteer strategic planning consultants and complete a successful application for 501(c)(3) tax exempt status for the organization. Furthering the effort, she participated in California's Managed Risk Medical Insurance Board hearing to help set the course of the "Healthy Families" program and encouraged qualified clinics to become certified enrollment contractors, thus ensuring a new revenue source for the clinics.
Through careful research, analysis and community organization, Aviad helped impact health care policy at the highest governmental levels as well as within affected sub-communities. From 1997-1998 she served with the Sacramento Clinic Outreach and Prevention Effort as a member of the Americorps VISTA program.