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SNI Forward Newsletter January 2022


Welcome to the SNI Forward, our quarterly snapshot of the transformation progress at California’s public health care systems and the work of the California Health Care Safety Net Institute (SNI).

It is fair to say we are all struggling with the continued ups and downs of COVID-19 as we confront the Omicron surge. Now, more than ever, it is important to focus on wellness by supporting ourselves and those around us. In these challenging times, we want to acknowledge the commitment of everyone who works in public health care systems. We are grateful for everything you have done over the past two years to keep our communities healthy and safe.

The 2021 Quality Leaders Awards recognize just a few of the public health care systems that have demonstrated innovative approaches to advance care, equity, and population health. Check out the winners below to hear their inspiring success stories, many of which underscore the critical role public health care systems and their staff are playing in the pandemic.

Beyond the provision of COVID-19 vaccinations and care, upstream initiatives such as food assistance and supporting the safe return to in-person learning have become integral parts of community-based care delivery. Our most recent blog post below highlights how one health system increased care and critical services to those facing homelessness.

In the year ahead, SNI will continue to support members in their COVID-19 and care delivery transformation efforts. Just last week, SNI virtually launched its Racial Equity Community of Practice – funded by the California Health Care Foundation – to support systems to advance racial equity efforts at their organizations. The excitement and energy in the “room” was palpable, with more than 40 individuals across 11 systems challenging themselves to examine their identities, contemplate how change happens, and reframe their thinking to effect change in their organizations. In the coming months, SNI will also continue to support systems to improve virtual care, address staff wellness, and implement important aspects of CalAIM.

Giovanna Giuliani
Executive Director
California Health Care Safety Net Institute

Member Spotlight

An on-the-ground look at how the County of Santa Clara increased care and services for those experiencing homelessness during the pandemic.

Disaster service workers from the County of Santa Clara check a client’s temperature. Photo credit: County of Santa Clara Health System

For five years, David’s hammock was his home along San Jose’s Guadalupe River. He lived on a boat in the Berkeley Marina before his fibromyalgia and irritable bowel syndrome made him too sick to work as a network architect and contractor. Unable to pay the docking fees and not wanting to burden his family, he moved into the hammock with two sleeping bags and a foam pad.

“Homelessness beats you up. It’s like you’re a boxer who had a long career,” said David, 43. He averaged eight ER visits a year, not counting urgent care.

When COVID-19 emerged in early 2020, the County assessed and relocated unhoused people in Santa Clara County like David. Those who had contracted or been exposed to COVID-19 or were at high risk for serious illness could shelter at one of 14 hotels leased by the County. The County of Santa Clara reassigned employees as disaster service workers (DSWs) to staff the hotels and emergency shelters. Overnight, this diverse workforce of community workers, library warehouse assistants, park and probation employees were deployed and plunged into entirely new roles.

Alicia Anderson, senior manager at the County’s Department of Behavioral Health Services, trained DSWs who “did not have a lot of experience working with folks experiencing homelessness.” A week-long crash course, which she helped design and deliver with others from the County’s Office of Supportive Housing, covered the knowledge and skills for DSWs to work with people possibly in crisis nonjudgmentally. Workers also learned how to try and keep people safe from COVID-19 when there was a scarcity of personal protective equipment and a surplus of fear.

2021 Quality Leader’s Award (QLA) Winners

In December, we were pleased to continue the tradition of the QLAs at the virtual CAPH/SNI Annual Conference, thanks to funding from Kaiser Permanente. The QLAs highlight innovative approaches to improve care and advance population health in California’s public health care systems. Learn more about our 2021 winners below.

Top Honor – Contra Costa Health Services

Vaccine Equity Initiatives
Through novel engagement and outreach strategies, CCHS (Contra Costa Health Services) expanded access to the COVID vaccine in communities and neighborhoods that have been historically disadvantaged. CCHS built relationships with hundreds of community-based organizations and faith-based communities to reach residents and provide reliable vaccine information from trusted messengers. Through brick-and-mortar sites and mobile clinics, CCHS provided over 27,000 mobile vaccine doses at nearly 300 unique locations throughout their County.

Innovation – San Francisco Department of Public Health

San Francisco’s Safe Return to In-Person Learning
In March 2020, when San Francisco schools transitioned to distance learning, many students became at risk for falling behind educationally, physically, and psychosocially. To chart a path to return to in-person learning, the San Francisco Department of Public Health developed evidence-based guidance, policies, and procedures that facilitated the reopening of K-12 schools for the 2020-2021 school year and influenced school reopenings across the State.

Care Redesign – Ventura County Health Care Agency

Encampment Outreach
Leading a unique network of organizations – including cities, state parks, fire, law enforcement, and numerous county agencies – and working outside the scope of the traditional health care system, Ventura County Health Care Agency (VCHCA) is addressing the challenges experienced by vulnerable persons living in encampments. VCHCA has established a successful network to address its most at-risk patients’ complex social, political, environmental, and health equity concerns through these partnerships.

Population Health – Los Angeles County Department of Health Services

ACEs-LA Initiative
Identifying and reducing Adverse Childhood Experiences (ACEs) – stressful or traumatic experiences that occur before the age of 18 – creates opportunities to prevent toxic stress’s long-term health and psychosocial impacts. Los Angeles County Department of Health Services launched the innovative ACEs-LA initiative, consisting of three comprehensive, high-touch programs that effectively screen for and respond to families impacted by adversity and toxic stress.

Health Equity – Kern Medical

Mobilizing Health Equity by Vaccinating the Most Vulnerable
Kern County is the third-largest county in California, with nearly all of its population living in medically underserved areas. To vaccinate vulnerable populations in the community, Kern Medical created fully functioning clinics, which provide comfort and privacy, in remote areas of the County, where there are limited resources and access to care. Through these efforts, the majority of vaccines provided by Kern Medical have gone to at-risk populations and they’ve built trust and connected previously unengaged patients to care.

Honorable Mention – UC San Diego Health

Mobile Vaccination Units: Providing COVID-19 Vaccinations to Populations in Need
San Diego is home to a large international community, connecting communities between Mexico and the United States, and serves as a hub for refugees and asylum-seekers from around the world. In a multi-pronged and large-scale effort using mobile vaccination units, UC San Diego Health partnered with the San Diego Refugee Communities Coalition to vaccinate refugee communities in San Diego and with the County, the Consulate of Mexico and multiple US companies to vaccinate over 10,000 workers employed in Baja California, Mexico.

Honorable Mention – Riverside University Health System

Controlling High Blood Pressure in the Midst of a Pandemic
The COVID-19 pandemic has had devastating impacts on chronic disease outcomes. Riverside University Health System (RUHS) saw the challenges their patient population faced in dealing with the social and economic costs of the pandemic, while also trying to manage their own health care needs. Focused on improving the rate of blood pressure control, RUHS implemented a multidisciplinary approach that resulted in an increase in blood pressure rechecks and subsequent improvement in overall blood pressure control.