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The Los Angeles Practice Transformation Network: Paving the Way for Sustained, High-Quality Care in the Safety Net

Posted: July 19, 2019

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In 2015, the Community Clinic Association of Los Angeles County (CCALAC) joined the Los Angeles Practice Transformation Network (LAPTN), an L.A. Care Health Plan initiative to help clinicians achieve large-scale health transformation. Across Los Angeles, the LAPTN deployed coaching teams to mentor and assist over 3,000 safety net clinicians in improving diabetes and depression care. CCALAC engaged 800 providers at 23 organizations under the PTN.

The success of the program has been immense: 587,795 lives were improved through clinical quality improvement, and care management. The program also helped prevent 58,105 hospital encounters that would have cost $136 million to the Medi-Cal program. LAPTN recently ranked fourth nationwide in the number of lives improved as well as the number of hospital visits prevented per clinician. The Transforming Clinical Practice Initiative (TCPI) is a Centers for Medicare & Medicaid Services (CMS) program aimed at transforming clinical practices, reducing unnecessary hospitalizations, building the practice transformation evidence base, and saving money in the health care system. Providers in the initiative have achieved these goals by applying best practices in patient activation, health education, staff satisfaction and retention, workflow redesign, and data integrity. To date, TCPI has saved the health care system $4.9 billion, with LAPTN accounting for six percent of overall savings.

John Wesley Health Centers Improves Diabetes Care Management
For John Wesley Health Centers (JWCH), the LAPTN fostered greater collaboration among the providers and staff, which has improved the organization’s care coordination efforts.

“Care coordinators can focus directly on our diabetic population as they make sure our patients attend their medical, nutrition, podiatry and retinal exam appointments,” says Denisee Alonso, a nutritionist at JWCH.

She recalls a 54 year-old female patient who had an abnormally high hemoglobin A1c (HbA1c). From late winter to early spring 2019, Alonso taught her how to incorporate physical activity and healthier meals into her diet. After the coaching, the patient’s HbA1c level had significantly improved, from greater than 10% to 6.5% (The American Diabetes Association notes that 7% is a goal for HbA1c). Another patient lowered their HbA1c level from 13.9 to 7.7 in the span of four months from January through April 2019.

In the future, Alonso hopes to see increased pre-diabetes and diabetes prioritization across clinics and more focus on nutrition advocacy for prevention. Overall, she remarks that JWCH – with their participation in LAPTN – has provided helpful resources to give comprehensive, quality care to their diabetic population.

HbA1c improvement is a high-priority outcome measure by CMS. Investments in training, data collection, and innovative care coordination through LAPTN has helped nearly 2,500 community clinic patients across with diabetes become healthier and gain control of their diabetes.

Workforce Changes at Family Healthcare Centers of Greater Los Angeles
In addition to improving clinical care by addressing patient conditions, LAPTN efforts also focused on improving clinic operations. Family Health Care Centers of Greater Los Angeles (FHCCGLA) targeted workforce recruitment and retention for their transformation. After implementing an incentive program, first-year attrition rates decreased by 17 percent.

“These changes have positively affected staff as they are more comfortable with their salary. As a result of this, more time is being focused on patients rather than having to train a new person every other month due to turnover,” said Azuree Smith, Human Resources Assistant at FHCCGLA.

She remarked that her LAPTN coach helped her make the HR department more efficient. The next phase of transformation at FHCCGLA will be to proactively track and understand reasons staff give for leaving the clinic via exit interviews. These efforts, as well as trainings on management and communication, will further improve workforce retention. Data on these interventions will be available later this summer.

Empanelment and Care Continuity at Wilmington Community Clinic
Wilmington Community Clinic (WCC) worked with the LAPTN to improve efficiencies in booking patient appointments and increasing patient engagement through empanelment to care teams.

“Empanelment, or the practice of assigning patients to a provider, makes clear to patients that they have a primary provider, which is important to many of them,” said Dr. Susan Ballagh, Medical Director at WCC. “Promoting continuity allows providers and patients to build trusting relationships.”

By linking patients to a specific care team, WCC can better monitor and hold their teams accountable for their patient outcomes.

After LAPTN, WCC will continue to work to improve their capacity to manage appointment demand, provider workload, and patient access to their care teams. The coaching team developed a comprehensive empanelment toolkit to support clinics in managing patient panels and promoting continuity of care with dashboards and automated analysis.

Sustainability of the Transformation Network
Cost savings is a core part of TCPI’s goals. Care management, empanelment, and workforce retention all contribute to cost savings.

Since LAPTN began, L.A. Care Health Plan saved nearly $140 million dollars in hospital claims for people with diabetes and/or depression. The LAPTN exceeded goals and aims set from the beginning of the project. According to CMS, LAPTN clinics consistently met goals on diabetes measures and were in-line with top-performing clinics in the country. In addition, improvement on screening for Body Mass Index (BMI) and Depression symptoms has increased 168% and 175%, respectively.

The 4-year LAPTN program will conclude in fall 2019. L.A. Care, CCALAC, and our partners are exploring opportunities to continue this work going forward. This includes future federal funding as well as policy changes to promote programs that incentivize continued transformation. For example, clinics and health plans across California are weighing the potential to reform how clinics are paid in the Medi-Cal Program. Instead of paying for only face-to-face visits with doctors, Medi-Cal could recognize the alternative visits and non-traditional providers that have made LAPTN a success.

Another example is the Health Homes Program, in which health plans identify high-risk patients with complex health needs and provide a higher level of payment to support enhanced care coordination. LAPTN helped prospective Health Homes providers form the infrastructure they need to participate in the program.

L.A. Care Health Plan is awaiting an announcement of a funding opportunity from CMS to continue this work. Given the success of LAPTN, CCALAC will continue to explore opportunities to support clinics in the areas of practice transformation, diabetes and depression care management workforce development and social determinants of health.

Building for Homeless Health – LA Clinics Paving the Way for Innovative Solutions

Posted: July 16, 2018

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CCALAC’s Member Clinics are leading efforts to address homelessness. Two clinics lend their perspective on how they are building sustainable solutions.
The Children’s Clinic – Providing Upstream, Actionable Answers to Address the Homeless Crisis

Contributed by Elisa Nicholas, MD, MSPH, Chief Executive Officer, The Children’s Clinic

The city of Long Beach is home to over 1,843 homeless individuals according to the 2017 Homeless Count. Additionally, 55% of the population in Long Beach is rent burdened. The Children’s Clinic, Serving Children & Their Families (TCC) served 1,336 homeless patients in 6,000 visits in 2017 through specialized sites for the homeless, a mobile clinic serving the homeless, and our ten other sites. These efforts are in collaboration with the City of Long each Department of Health and Human Services, Mental Health America, Century Villages of Cabrillo, and partner FQHC North East Valley Health Corporation, and many others.

TCC serves as a Patient Centered Medical Home for all ages focusing on moving further upstream with prevention and early intervention services to prevent health and psychosocial issues from becoming chronic health conditions that place individuals at risk for homelessness. TCC works to address issues and connect individuals and families experiencing risk of homelessness or homelessness to services and community resources to help them stabilize their lives.

We know many of the families we serve are at risk of homelessness and/or live in crowded and often unhealthy conditions. This is increasing on a daily basis as rents in Long Beach continue to rise. In our Selective Home Visiting program for at risk newborns, 13% of families referred with a newborn were homeless. In addition the most challenging issues our behavioral health and Medical Legal Partnership staff encounter are families facing homelessness, many of whom are pregnant, female victims of domestic violence, single mothers with young children, or mothers with multiple children with chronic illnesses/severe disabilities.

We know that for optimal child health and wellbeing, housing security is essential. For those children without stable housing, who frequently move, or who are homeless, this leads not only to psychosocial, developmental, and educational issues, but also to poor health outcomes in childhood and even into adulthood.

TCC is working with our many partners to address the continuum of care (COC) through our street outreach work with Mental Health America, our mobile family health center working with Long Beach Rescue Mission and Christian Outreach in Action, our clinic at the Long Beach Multi-Service Center for the Homeless and our clinic site at Century Villages of Cabrillo partners health care with permanent housing for the homeless.

In the building phase is a new clinic in Long Beach co-located with Mental Health America for severely mentally ill homeless and formerly homeless patients. Finally, we are in the planning phase of a clinic and wellness center in central Long Beach with affordable housing in partnership with BRIDGE Housing.

With increased rates and risk of acute and chronic health problems, prevalence and severity of asthma and skin conditions, abuse , exposure to violence and accidents, and emotional distress and developmental delay, corresponding with decreased academic achievement, this is a population that deserves to be served. We know we have a crisis and are fortunate to be a in a community that has recognized the issue and is working together to address it. We continue to educate and advocate for the needs of children, families, and the chronically homeless in our community.

Venice Family Clinic – Leader and Mentor in On-the-Ground Approaches to Homeless Health

Contributed by Coley King, DO, Director of Homeless Services, Venice Family Clinic

There is an acknowledged homeless problem in Los Angeles. Thousands live on the street and in unpermitted spaces, both in the city and in Los Angeles County. And thanks to the Homeless Initiative (a countywide movement to combat and prevent homelessness), we now have the funding to do something about it.

We know those on the street have a much higher burden of illness than the general population. Among them, the most at-risk are what we call “tri-morbid,” meaning they have co-occurring mental health issues, substance dependency and a major medical illness. There is a high medical need within this population.

Part of the Homeless Initiative is to provide outreach services to these patients across LA County. But the county’s efforts have to extend beyond simply sending social workers into the field. The teams going out must have a focus on street medicine.

Focus on the medicine

Through the efforts of the Community Clinic Association of Los Angeles County (CCALAC) and Venice Family Clinic, we’ve created multi-disciplinary teams by partnering a social service agency with a community health center. An agency provides social workers and case managers while we supply the provider—either a physician, a nurse practitioner, or a physician’s assistant—to deliver treatment in the field.

When we have these teams in place, we’ve seen a lot of success. Currently, we have medical providers on teams on the Westside and a few in Mid-City, too. In those areas, we are curing patients who have Hepatitis C. We’re making inroads in substance dependency through Medically-Assisted Treatment. But more importantly, our primary providers are extending beyond their previous comfort zones and doing much more mental health care if a psychiatrist isn’t available.

Bring psychiatry into the field

Another challenge is bringing a psychiatrist onto a multi-disciplinary team, either from a community health center or from the Los Angeles County Department of Mental Health. Psychiatrists are vital and are in shorter supply than the primary care providers.

We have two psychiatrists out there in the field. But when they’re not available, it’s up to the provider to deliver mental health care. If I’m out there as the street medicine provider and my patient is schizophrenic, then I’m the psychiatrist. No one will address their schizophrenia unless I do.

We give them an injectable treatment that’s long-acting, but only because we see a gap in care and are courageous enough to do something. The good news is we’ve had great success with long-acting, injectable psychiatric meds in the field.

The county is working on making psychiatrists available, but more needs to be done.

Housing is key

Of course, the primary goal for the patient is housing. Housing is the primary intervention.

When people become housed, we see an immediate boost in their health. But, along the way, we need to address their medical needs, improve their mental health status, have them on good psychiatric medications if necessary, and show some improvement in their addiction, if not full sobriety.

If we can do all that, then they’re going to be much more successful in housing. They’re going to be much happier. And then it becomes true, supportive housing.

I have one patient that we met in Malibu, where he’d been living up in a camp in the bushes for years. We housed him in senior housing in Claremont that has case management and supportive services. He takes a combination of buses and trains to get to our clinic. Yes, people will take three buses to come visit you if they consider you their medical home. And Venice Family Clinic is home for many.

We’re here to help

Over the last few years, outreach services have exploded, and all the agencies are hiring, trying to build teams. Here at Venice Family Clinic, we’re trying to mobilize community clinics to put providers in the field.

We’re here to help mentor these clinics in this process. We are a leader in homeless outreach and street medicine. In the past, we have mentored several agencies, including Northeast Valley Community Clinic, Saban Community Clinic, and Los Angeles Christian Health Centers. We openly invite providers to shadow us if they’re interested in learning about street medicine.

So, to all our fellow community health centers, join us. Spend two half-days riding along with us. See our best practices, how we partner with social service agencies.

The average age of morbidity from chronic homelessness is 48. The patients need us out there. The community expects us to be out there. It’s simply good medicine.

 

To learn more about how LA Clinics are serving this vulnerable population, check out CCALAC’s Network Adequacy Report prepared in partnership with Health Management Associates (HMA) and with support from L.A. Care Health Plan to benefit low-income and uninsured residents of Los Angeles County.

Extracting and Treating Los Angeles’ Dental Crisis at its Root

Posted: July 3, 2018

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Contributed by Dr. Maritza Cabezas, Oral Health Program Director at Los Angeles County Department of Public Health

Los Angeles, CA – Each year, thousands of those living in Los Angeles County wait eagerly to see a dentist at Care Harbor, an annual free clinic. Despite major strides in health coverage, why do many Californians continue to depend on free clinics for dental services? On Friday, May 4th, 2018, Dr. Maritza Cabezas, Dental Director of the Los Angeles County Department of Public Health’s Oral Health Program (whose mission is to plan, implement, and coordinate all public health interventions that will prevent diseases of the oral cavity in LA County residents) addressed this conundrum with findings from a study of Care Harbor dental patients at CCALAC’s Policy Café entitled, Waiting in Pain: Getting to the Root of LA’s Dental Crisis.

The dental patient survey, conducted at last year’s November Care Harbor event, examined how predictors, such as demographics and patients’ personal experience, may influence access to and delivery of dental health care services. The following are key observations and conclusions from the survey results:

  • Approximately 2,200 Los Angeles residents attended Care Harbor 2017, and about half of those in attendance received dental exams.
  • There were 810 survey respondents: almost two-thirds were male, and respondents were primarily Hispanic.
  • Out of the almost 300 patients surveyed who had Medi-Cal, over 60% of these attendees did not know they had dental insurance.
  • Almost 70% of the total respondents said they needed dental care in the past year but did not receive it primarily because they could not afford it, and secondary and tertiary reasons were because they did not have dental insurance or that their insurance did not cover dental services.
  • Most respondents lived in dental deserts, areas with high population density, low-income, and with no or insufficient dental services.

In addition, an assessment of the role of safety net clinics in LA County after implementation of the ACA, looking at Countywide data and funded by LA Care Health Plan to benefit low-income and uninsured residents of Los Angeles County – found that dental encounters in Los Angeles County had increased from 2012 (308,908) to 2015 (437,514). But, the report states that “nearly two-fifths of adult residents report not seeing a dentist or going to a dental clinic within the past year…For children ages 0-17, roughly 1 in 10 did not access dental care in the last year due to financial reasons.”

Dr. Cabezas and the Oral Health Program team will address the implications of these findings through the first Los Angeles County Oral Health Improvement Plan, which is being established to thoughtfully respond to the dental needs of Angelenos. It is clear from the results of the survey that there is a need to work closely with local agencies to assist vulnerable clients with establishing dental homes (the ongoing relationship between a dentist and a patient to provide comprehensive, continuously accessible, effective care), and to partner with Medi-Cal to diligently educate patients that they also have Denti-Cal.

Along with establishing these partnerships, Dr. Cabezas plans to team up with Care Harbor to emphasize the need for dental follow-ups and referrals, and enrollment into coverage. Her program will conduct further research with a more detailed survey regarding the types of coverage attendees have during the Care Harbor 2018 event later this Fall.

There is a light at the end of the tunnel in eradicating the dental desert dilemma and shortening the dental patient queues at Care Harbor and other similar free clinic events, particularly given the recent restoration of dental coverage through Medi-Cal. With focused and expansively collaborative efforts, Dr. Cabezas intends to extract and treat Los Angeles’ dental crisis at its root.

Highlights from the 17th Annual Health Care Symposium

Posted: March 14, 2018

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Living the Mission, Achieving the Vision

Southern California Health Leaders and Experts Gathered to Discuss Solutions & Best Practices to Improve Patient Care

***High resolution images, videos from the event can be found here***

Los Angeles, CA – The Community Clinic Association of Los Angeles County (CCALAC), held its annual one-day event at the Long Beach Convention Center earlier this month bringing together hundreds of health professionals from across Southern California to discuss health care practice transformation, behavioral health integration, operational reform, policy and advocacy, finance advancement, and workforce cultivation.

According to Louise McCarthy, President and CEO of CCALAC, “Everyday, our Southern California area community health centers and their employees are supporting a wide range of innovations to improve patient health. Our aim has always been to ensure they have the tools and resources they need to improve how patients experience health care, with a direct focus on their unique needs.”

According to Henry Tuttle, Chief Executive Officer of Health Center Partners of Southern California (HCPSA), “It is critically important that we continue to renew and refresh our determinations as health care advocates and practitioners, to ensure our collective efforts are moving the needle as it relates to patient-centered care. This month’s gathering of Southern California’s best and brightest in the industry, all working at the forefront to improve people’s lives at the most fundamental level, was especially encouraging, in spite of these challenging political times.”

According to Isabel Becerra, Chief Executive Officer of the Coalition of Orange County Community Health Centers (COCCHC), “Our role as Federally Qualified Health Centers (FQHCs), offering primary and preventative care to communities in need of reliable and affordable care is more relevant now than ever. We were honored to partner with our colleagues to bring forth this dynamic convening, to share wisdom and best practices in a unified way. The conversations and presentations truly left participants with a refreshed sense of purpose and vision for the year ahead.  We were especially encouraged by our keynote speaker’s presentation and positive feedback during the question and answer period.”

According to Janet Marchibroda, Director of the Bipartisan Policy Center’s Health Innovation Initiative and Symposium Keynote Speaker, “It was an honor to partner with CCALAC, HCPSA, and COCCHC, and present to this group of passionate community health leaders who are making a big difference in the lives of those most vulnerable among us. It is encouraging to see so many individuals come together to lend their thoughts and resources to advance new and innovative policies and strategies to improve patient access to care and reduce health disparities.”

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About CCALAC

The Community Clinic Association of Los Angeles County (CCALAC) is the largest regional association of community clinics and health centers in California. Founded in 1994, CCALAC has 63 members that operate over 350 clinic sites, serving 1.6 million County residents. CCALAC is dedicated to serving and representing the interests of its member clinics as providers of quality health care, including medical, dental and pharmacy services.

SoCal Health Leaders Join to Live the Mission and Achieve the Vision

Posted: February 27, 2018

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On Friday, nonprofit health centers and various stakeholders will convene in Long Beach to share best practices in care delivery at the 17th Annual Health Care Symposium. This day-long event features sessions on practice transformation, behavioral health integration, operational excellence, policy and advocacy, finance and workforce development.

This year’s Symposium will feature Janet Marchibroda, MBA, as its keynote speaker. She is the Director of the Bipartisan Policy Center (BPC)’s Health Innovation Initiative and the Director of the CEO Council on Health and Innovation. Her areas of focus at BPC include advancing innovative strategies to improve health care, using data and technology to improve lives and accelerating medical innovation.

“I hope to learn about the innovative strategies that California’s community health centers are using to build healthier communities,” Ms. Marchibroda said. “I also hope to share my thoughts about how new policies can support community health centers as they deliver comprehensive, patient-centered care to underserved and vulnerable populations.”

Marchibroda will present on Policy Enablers for Transforming Care for Underserved Communities. She will provide insight on recently passed Federal legislation and policies that will support transformative strategies that community health centers are using to improve the health of underserved communities.

Healthcare leaders and partners will share insights on many different topics such as healthcare innovation, value-based delivery, and social determinants of health.

“Because the southern California healthcare landscape is so fragmented and territorial, we don’t often have the opportunity to network with other mission-driven professionals and cross-pollinate ideas outside of our organizational bubbles. Convening this Symposium allows us the chance to exchange ideas and make the health care we all deliver better for those in need,” said Dr. Jay Lee, Chief Medical Officer of Venice Family Clinic (VFC).

Dr. Lee hopes to engage community health center colleagues with his presentation on delivering value-based care.  It will look at the Triple Aim initiative and the journey towards providing quality care at a low cost.

Neighborhood Healthcare, a community health organization, plans to present on social factors that contribute to health inequities.

“Some may argue that they take precedence over medical care,” said Wendi Vierra, Behavioral Health Director of Operations at Neighborhood Healthcare. “If we truly want to improve the health outcomes of those we serve, we can no longer fail to recognize or address the complex social challenges our patients face.”

Other presenters will explain topics impacting the clinics’ finances. “The topic and solutions we will address are focused and timely,” said presenter Lawrence Garcia of Kronick Moskovitz Tiedemann & Girard. “We look forward to working with cutting-edge thought leaders for community health centers.”

Watch live streams, read Tweets, and view photos of the event via CCALAC’s Facebook, Twitter, and Instagram social media pages, using the #HCSymposium2018 hashtag. Attendees will be encouraged to use our exclusive Healthcare Symposium mobile app available via the Apple App Store and Google Play Store.

The Annual Health Care Symposium is hosted by the Community Clinic Association of Los Angeles County (CCALAC), the Coalition of Orange County Community Health Centers (The Coalition), and Health Center Partners of Southern California (HCP).

 

THE COMMUNITY CLINIC ASSOCIATION OF LOS ANGELES COUNTY (CCALAC) is the largest regional association of community clinics and health centers in California. Founded in 1994, CCALAC has 63 members that operate more than 350 clinic sites throughout the County. CCALAC is dedicated to serving and representing the interests of its member clinics as providers of quality health care, including medical, dental and pharmacy services.

Contact: Elaiza Torralba, Communications Specialist, (213) 201-6529
Community Clinic Association of Los Angeles County
700 S. Flower Street, Suite 3150, Los Angeles, CA 90017

Hanging in the Balance: Fighting for Funding of Critical Safety Net Programs

Posted: November 13, 2017

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As Congress’ tax reform debate dominates the headlines, their failure to act on key health programs has left the safety net hanging in the balance. Congress must act now to protect access and coverage for our most vulnerable residents.

On September 30, Congress neglected to reauthorize funding for community health centers and the Children’s Health Insurance Program (CHIP), leaving both programs in a free fall.

Effective January 1, absent immediate action by Congress, community health centers face a 70 percent cut to their federal funding. The federal Department of Health and Human Services (HHS) estimates this will result in the closure of 2,800 health center locations, elimination of more than 50,000 jobs, and a loss of access to care for more than 9 million patients. A survey of health centers nationwide found that more than 70 percent will institute a hiring freeze, and nearly half (43 percent) say they will cut services if funding is not extended. Continue reading →

Congress Must Act on Public Health and Community as the Fiscal Cliff Approaches

Posted: September 27, 2017

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By Rep. Karen Bass (D-California) and Louise McCarthy

Each August we celebrate National Health Center Week and acknowledge community health centers as the key to healthier communities. Each September, Congress re-enters an annual—increasingly partisan—dance to figure out how to fund the government.

This month, Congress must take direct action to protect the key programs that make health centers and the services they provide, possible. The fact is that health centers offer much more than health. Without immediate action by Congress to fund the Health Centers Programs and the Children’s’ Health Insurance Program (CHIP), health centers and the communities they serve face an uncertain future. Continue reading →

The AHCA and a Breathtakingly Callous Federal Budget Could Spell Disaster for Providers of HIV Care

Posted: June 22, 2017

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Craig Thompson, Chief Executive Officer, APLA Health

The Trump presidency has ushered in an era where it seems the only constant is there is no telling what’s going to happen next. Yet the passage of the American Health Care Act (AHCA) by the House and the Administration’s recently released 2018 budget tells us exactly what they would like to see happen: massive cuts to Medicaid and other health care programs; huge reductions in funding for HIV/AIDS—including slashing $59 million from the Ryan White Program—as well as hepatitis C, and STD prevention; cuts to other social safety net programs, including Meals on Wheels, Social Security Disability Insurance, subsidized housing, family planning centers, and more.
Continue reading →

Repealing the Affordable Care Act: What’s at Stake in Los Angeles County?

Posted: January 18, 2017

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By Louise McCarthy, MPP, CCALAC President and CEO

Here in Los Angeles, across California and throughout the United States, non-profit community clinics and health centers provide quality care to all, regardless of ability to pay. From the Antelope Valley to Long Beach, and from Venice to the San Gabriel Valley, LA’s clinics have been working tirelessly to transform and improve care for our County’s most vulnerable. But coverage matters: clinics cannot expand or improve care if everyone is uninsured.

There is so much at stake when it comes to the repeal of the Affordable Care Act: lives are at stake; jobs are at stake; and our economy is at stake. Continue reading →

Safe Med LA: Working Together to Reduce Prescription Drug Abuse and Overdose Deaths

Posted: October 24, 2016

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wesley-ford-bio
Wesley Ford, MPH Deputy Director, Bureau of Health Promotion Los Angeles County Department of Public Health

by Wesley Ford, MPH
Deputy Director, Bureau of Health Promotion
Los Angeles County Department of Public Health

According to the Los Angeles County Coroner’s Office, there have been approximately 400 reported opioid-related deaths per year in Los Angeles County, and prescription opioids are involved in about 60 percent of all drug-related deaths. However, this number is likely an underestimate of actual deaths and does not include overdoses and near deaths. Despite attention grabbing headlines about well-organized drug rings and errant physicians, the majority of individuals who misuse or abuse prescription opioids obtained them from friends, relatives, or their own doctors. Continue reading →

CCALAC and L.A. Care: Transforming Safety Net Care Models and Health Outcomes, One Clinic at a Time

Posted: August 16, 2016

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John Baackes CEO of L.A. Care Health Plan

By John Baackes
CEO of L.A. Care Health Plan

While L.A. Care Health Plan is perhaps best known for providing health care coverage to more than 2 million residents in LA County, our work extends beyond that of a managed care organization. By design, we are also committed to supporting the county’s extensive health care safety net. In fact, it is our mission to provide quality health care access to vulnerable populations and to help the safety net achieve that purpose. For that reason, we are thrilled about our most recent milestone: our Los Angeles Practice Transformation Network (LAPTN) achieved its goal of enrolling 3,100 clinicians.

LAPTN is one of 39 health care collaborative networks selected by Centers for Medicare & Medicaid Services to participate in the national Transforming Clinical Practice Initiative (TCPI). Over the course of four years, LAPTN will receive up to $15.8 million to help LA County clinicians transform their practices and improve care for patients with diabetes and depression. It is an area of health care that needs our attention – and for good reason. We are pleased to collaborate with the Community Clinic Association of Los Angeles County (CCALAC) – one of our key partners on this ambitious project. Through community clinics and health centers alone we have been able to secure the participation of 25 agencies and their 750 plus clinicians. Continue reading →

Community Health: A Non-Partisan Issue

Posted: August 2, 2016

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Tom Van Coverden President and CEO National Association of Community Health Centers
Tom Van Coverden President and CEO National Association of Community Health Centers

by Tom Van Coverden
President and CEO of the National Association of Community Health Centers

In an election season, the headlines may lead us to believe that politicians can’t agree on anything. Not so fast. There is one issue on which both Republicans and Democrats can and do agree: the importance of Community Health Centers in our U.S. health care system. Continue reading →

The Staggering Crisis: Confronting the Health Care Workforce Shortage in California

Posted: March 28, 2016

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Carmela thumb
Carmela Castellano-Garcia, President and CEO of the California Primary Care Association

By Carmela Castellano-Garcia
President and CEO of the California Primary Care Association

Community clinics and health centers (CCHCs) will be the backbone of primary care in California well into the future. The Affordable Care Act has provided coverage options for millions of Californians and many of the newly-insured are choosing health centers as their health homes. According to a recent study by the California Health Care Foundation, safety-net clinics are providing care to 54 percent, or 1.3 million, of new Medi-Cal patients who are enrolled in managed care plans. This is great news and something we all knew would happen, but it has also shined a bright light on the primary care workforce shortage. Continue reading →

Preparing Providers for Effective HIV Intervention: 5 Steps to Get “PrEPared for PrEP”

Posted: February 11, 2016

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PrEP Bios
(left) Leo Moore, MD, MSHPM, Robert Wood Johnson Clinical Scholars Program, University of California Los Angeles (right) Sonali Kulkarni, MD, MPH, Medical Director, Division of HIV and STD Programs, County of Los Angeles Department of Public Health

by Sonali Kulkarni, MD, MPH
Medical Director, Division of HIV and STD Programs
County of Los Angeles Department of Public Health

Leo Moore, MD, MSHPM
Robert Wood Johnson Clinical Scholars Program
University of California Los Angeles

This week the President released a budget that includes a $20 million pilot program to increase access to PrEP, an effective treatment that prevents transmission of HIV. Even prior to this federal recognition of a promising program, LA County has been at the forefront of expanding access to this life-saving intervention. Continue reading →

Promise for the Future: Affordable Care Act Offers Hope in Addressing Diabetes Epidemic

Posted: November 6, 2015

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by Matthew Freeby
Associate Director Diabetes Clinical Programs
Board member of the American Diabetes Association of Greater Los Angeles

Matthew-Freeby-Blog
Dr. Matthew Freeby, Board member of the American Diabetes Association of Greater Los Angeles

November is American Diabetes Month. Nearly 30 million Americans are afflicted with diabetes mellitus –nearly 10% of our population. One in four of those with living diabetes are undiagnosed. The number of affected Americans is reaching epidemic levels and unfortunately is continuing to grow. There are an estimated 1.7 million new cases of diabetes diagnosed annually. It is well-documented that diabetes mellitus impacts health: it is a leading cause of blindness, kidney failure and amputation and a cardiovascular disease risk factor.

Yet there is hope.

When treatment goals are met, diabetes-related risks are quite low; but meeting these goals is a challenge. And it is even more difficult without the proper resources, education and expertise in place. Continue reading →

Making Coverage the Norm: Clinics Lay the Groundwork for Cultural Change

Posted: November 4, 2015

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By Peter V. Lee
Executive Director, Cover California

Peter V. Lee, Executive Director, Covered California
Peter V. Lee, Executive Director, Covered California

Change takes time, and the Affordable Care Act is the single biggest change to our health care system in 50 years. While millions of Californians have gained health care coverage in this new era, many people still do not know about the new options and benefits available to them.

New research shows there are more than 2 million uninsured people in California who are eligible for either Covered California or Medi-Cal. Although we have all worked together to dramatically raise awareness about Covered California and the Affordable Care Act, 36 percent of those uninsured say they do not know about the financial assistance that can help bring health care within their reach.

This is significant because the same research shows that the financial help, or subsidy, is the most important factor that drives people to sign up for health care coverage.

Continue reading →

The Best Laid Plans for the Worst Case Scenarios: Managing the Peculiar World of Clinic Emergency Preparedness

Posted: September 9, 2015

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By Jason Wang MPH, CHSP, CHEP, Safety Officer and Special Projects Program Manager
Northeast Valley Health Corporation

Jason Wang NEVHC
Jason Wang MPH, CHSP, CHEP Northeast Valley Health Corporation

“Emergency preparedness matters.”
“What I do matters and is essential to this organization.”

Like many Emergency Planners, I find the need to remind and reassure myself that my emergency preparedness work matters to my organization. Sometimes emergency preparedness is given the highest priority, especially amidst unusual crises like Ebola or Measles. But more often than not, emergency preparedness is considered low priority in the grand scheme of things. The rollercoaster level of importance; sometimes high or sometimes low, can be frustrating but it is what makes this type of work so interesting.
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How Far We Have Come: Reflections on a Half Century of Health Centers Care

Posted: August 7, 2015

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by Dan Hawkins, Senior VP, Public Policy and Research

danhawkinstightheadshot_webTo measure how far our nation has come in terms of progress in healthcare access, it is important to look back at where Community Health Centers started 50 years ago. It began with a cause — and then an opportunity. The cause, undertaken by community activists and reform-minded doctors, was to bring needed health services into poor and neglected communities nationwide. From Mississippi to Watts, communities rose up around the cause of health equity. President Lyndon Johnson’s War on Poverty was the opportunity we needed to respond to this demand. Continue reading →

Celebrating Partnership: Understanding the Right to Accessing Health Care

Posted: July 15, 2015

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m_katz_headshot_2By Mitchell H. Katz, MD, Director, Los Angeles County Department of Health Services

On June 25, the Supreme Court upheld subsidies for the 34 states that utilize the federal exchange for consumers to purchase coverage under the Affordable Care Act (ACA). That’s a huge relief for 6.4 million Americans who were almost threatened with losing their health insurance.

But, as we all know, there are still millions of people across the nation that haven’t been able to benefit from the ACA because of their immigration status. President Obama stated in his press conference after the decision that, “Health care is not a privilege for a few but a right for all.” That progressive support and direction from our President validates what we’re doing here in California and Los Angeles, specifically. This ruling, coupled with the Governor’s decision to expand coverage to undocumented children, shows that there is increasing recognition of the value of health insurance as vital first step to access to care.

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Pride in Cultural Competence: Los Angeles LGBT Center Leading the Way for LGBT Primary Care

Posted: June 10, 2015

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by Dr. Robert Bolan, Medical Director, Los Angeles LGBT Center

As we celebrate Lesbian, Gay, Bisexual, and Transgender (LGBT) Pride in June we can point to several successes in achieving greater health equity and improving access to care and treatment for LGBT people of all ages. Advocacy by the Los Angeles LGBT Center (The Center) and groups like the National LGBT Primary Care Network has helped make LGBT health a national issue, secure non-discrimination language in the Affordable Care Act and win budgetary support for new biomedical interventions to prevent HIV infection. We currently are making headway to require that electronic health records allow recording our patients’ sexual orientation and gender identity (SO/GI) in a way that facilitates appropriate health maintenance and expands meaningful use guidelines issued by the Centers for Medicaid & Medicare. However, we still have much left to accomplish at clinic front desks and in exam rooms.

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At the Heart of LA’s Health Care Evolution: Integration of Behavioral Health

Posted: May 4, 2015

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By Louise McCarthy, MPP, CCALAC President and CEO

Welcome! LA’s community clinics and health centers (clinics) are at the heart of the health care issues, trends Louise McCarthyand innovations taking place in Los Angeles County and beyond. LA’s clinics see more than 1.4 million patients annually—nearly 15 percent of the entire county population, and nearly half of the population living below the poverty level ($1,962 a month for a family of four). These clinics are working toward a coordinated and cohesive system of care which supports the health of all communities. This blog offers timely and valuable information to help you understand these issues and trends, and their impact on the communities served by LA’s clinics.

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