Dr. Dana A. Kuhn understands the terrible toll expensive chronic illnesses can take on families and their loved ones.

“While providing counseling for families, I observed their emotional, psychological and financial struggles,” the Midlothian resident says. “One family I counseled was forced to live off of one income because one parent had to become their child’s primary caretaker.

“They had to sell their home and eventually divorced so their child, whose condition continued to worsen, could qualify for health care under Medicaid. Not only did they lose their child, they were financially ruined. No family should experience that.”

That’s the reason the licensed clinical psychologist says he founded Patient Services Inc. in 1989.

“I realized that if families could afford their health insurance premiums and copayments, then more than likely they would stay financially stable. A financial safety net was needed.”

Dr. Kuhn says his Brandermill-based nonprofit of 60 employees works with physicians, clinics, patient advocacy organizations and patient assistance programs to identify populations that are struggling to afford health insurance premiums and copayments.

His organization helps patients and their families “navigate through the challenges of living with these chronic illnesses,” Dr. Kuhn states. “Our data show that patients only need PSI’s help from one to two years to remain financially stable and not be plummeted into financial devastation.”

He says there is a higher demand for PSI’s services since the Affordable Care Act was implemented in January 2014.

“Even with a policy available and with a subsidy, the costs are still unaffordable for the populations we help with expensive chronic conditions,” he states. “In Virginia, during the open enrollment period from October through the end of February, we’re getting around 200 patients to ask us to help them to afford these premiums.

“The average annual income of the patients coming to us for help with these plans is approximately $39,000, the average age is 40, the average annual premiums are $5,000 and the average coinsurance is $6,000,” Dr. Kuhn adds. “How can a person afford 28 percent of their income on the marketplace plans? The ACA creates access to health policies and creates a need for PSI to help subsidize the cost.”

Dr. Kuhn says PSI funds its life-saving efforts through private donations and some public funding. The organization’s latest filings with the IRS show that it spent $60.9 million in 2013 providing assistance to 18,452 people across the country and referral and education services to 3,360 others.

Patients with chronic diseases such as heart disease, stroke, cancer, diabetes, obesity, and arthritis may be eligible if they do not qualify for Medicaid and meet insurance and financial criteria, he says.

Details are available at www.patientservicesinc.org.

Year and place of birth: March 1953 in Mineola, N.Y.

Current residence: Woodlake in Midlothian.

Alma maters: Columbia International University, bachelor’s degree; Memphis Theological Seminary, master’s in divinity; Emory University and Christian Bible Seminary, Ph.D. in psychology/clinical counseling.

Family: Wife; Jan, a nurse, who is program manager of the Central Virginia Center for Coagulation Disorder’s Virginia Bleeding Disorders Program.

Most frequently requested Patient Services Inc. assistance: Approximately 80 percent of PSI’s assistance is for copayment affordability. This seems to be the greatest challenge for patients with rare and chronic conditions.

Patient Services’ No. 1 project today: Utilizing the latest technology to ensure that our patients can easily apply and receive assistance. To that end, PSI has been undertaking a redesign of its IT platform, which will provide our patients with enhanced customer service and reporting, paving the way for PSI to be the premier nonprofit organization of its kind moving into the next 10 years.

Strategy for achieving it: 1. Listening to our patient’s needs! 2. Leveraging the latest technology available. 3. Utilizing the talented and caring staff at PSI.

Fair Copay VA Campaign is: This year, PSI led the Virginia Alliance for Medical Affordability and Access in a legislative campaign called Fair Copay VA. The campaign addresses the need for fairness in the affordability of copayments for prescription drugs. Health insurers increasingly are moving medications to “specialty tiers,” where there is no limit on the out-of-pocket costs that patients must pay. Al- though any Virginian can be subjected to unreasonably high out-of-pocket costs, those most likely to be affected are living with life-threatening or chronic conditions, such as cancer, hemophilia, hepatitis C, multiple sclerosis and HIV/AIDS. This year, Fair Copay VA advocated for legislation, House Bill 1948, to limit the amount that insured Virginians pay out-of-pocket for these vital medications.

Why House Bill 1948 is needed: Rather than paying a manageable and fixed copayment for their medications, Virginians whose treatments are placed on specialty tiers often are forced to pay coinsurance — or a percentage of the total cost of the drugs. This can mean hundreds or even thousands of dollars per month in additional out-of-pocket costs for just a single medication. Virginians pay their premiums expecting their medical conditions to be covered, only to learn they are not. Making sick people bear a far larger portion of their treatment costs undermines the very concept of insurance. High out-of-pocket costs not only have harmful financial consequences for patients, they also damage patient health and drive up overall costs to our health care system, increasing costs by $100 billion each year. That’s because patients who can’t afford their medications often cut back or discontinue treatment altogether, making them more vulnerable to hospitalization and exacerbated conditions. By hiking out-of- pocket costs, health insurers are destroying a critical safety net for Virginians, often when they need it the most.

Why there was opposition to House Bill 1948: The legislation faced opposition from insurers that are utilizing specialty tiers to pass costs on to patients. The reality is that insurers need to manage costs without penalizing patients. Specialty tiers have increased dramatically over the last decade, despite the fact that prescription drug prices make up only a small portion of health care spending, and drug costs have remained relatively stable during the last 10 years. There are other more effective and equitable ways to manage costs.

Result in General Assembly: House Bill 1948 was tabled for the year. Senate Bill 1394 was sent to the Health Insurance Reform Commission for further study.

How Patient Services Inc. is responding: Our patients still are experiencing financial hardship because their treatments are being placed on specialty tiers. PSI will not rest until we can find a more affordable solution. We will continue to educate lawmakers about these challenges and promote solutions that benefit our patients and the Commonwealth of Virginia.

Foremost challenge facing individuals with chronic illnesses when accessing treatment options: The high cost of out-of-pocket expenses. Patients work with their doctor to pick the best treatment option for them, only to show up at the pharmacy to pick that treatment up and be faced with, in some cases, a $2,000 bill for a 30-day supply. No family should have to choose between paying their mortgage or taking their medication.

Importance of family support: Vital!

Pet: Our family has a “Maltipoo” little dog who seems to rule the roost.

The one thing I can’t stand: Incompetency in performance.

Person who influenced me the most: The Card family who holds 105 patents for tufting for machines for carpet that most people walk on every day.

Reason: They taught me the importance of being and living charitable. It is the “right thing to do.”

Book that influenced me the most: “The Book Thief” by Markus Zusak.