Our Partner CAPH

SNI Forward Newsletter December 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).

As we near the end of the year, we have been reflecting on our growth and achievements in 2022. SNI, like many organizations, has embarked on a journey to look deeper within ourselves, both as an organization and as individuals, to reflect on the impacts of structural racism and to discern our role in addressing them. As part of this effort, SNI defined its commitment to health equity and is pleased to share our proclamation statement below.

On a related note, SNI and our members continue to make progress in our Racial Equity Community of Practice (CoP), which helps strengthen members’ commitment to anti-racism and their capacity to develop strategies that embed equity throughout the organization. Systems are taking advantage of one-on-one coaching with consultants, continuing to learn from peers in structured sessions, and are learning more about successful leadership practices. Below, we highlight Alameda Health System’s equity journey in our latest CoP blog series.

Another key area of focus is our workforce wellbeing programming. Since launching in August, SNI hosted three webinars on the current state of workforce burnout, evidence-based solutions, and measurement approaches. Next up, SNI will host an in-person workshop on leadership approaches to foster a culture of wellbeing.

In a week’s time, we will be heading to Napa for our annual conference. We have a great lineup of nationally known speakers, health care policy experts, and social justice champions who will discuss health equity, health care affordability, midterm election results, climate action, and more. Hope to see you there!

Giovanna Giuliani
Executive Director
California Health Care Safety Net Institute

SNI’s Commitment to Advancing Health Equity 

SNI, along with our partner organization the California Association of Public Hospitals and Health systems (CAPH), has been on a journey of contemplation and reflection with a commitment to acknowledge the implications of structural racism and historical marginalization. As part of this effort, CAPH and SNI developed a proclamation statement to demonstrate our pledge to foster equitable health and create an inclusive and equitable workplace. This statement will be posted on our new website launching in early January 2023.

CAPH and SNI are dedicated to cultivating an inclusive culture. We commit to this practice within our organization and within our community.

Our Mission:
Our mission is rooted in the belief that achieving equity is accomplished by addressing systemic inequities and treating every Californian justly. We welcome that every person brings a unique perspective and experience to advance this mission. We recognize the historical footprint of oppression that has led to structural racism, discriminatory barriers, racist policies, and unjust practices and outcomes that disproportionately and negatively impact communities of color. We are dedicated to advancing equitable distribution of opportunities, resources, and health outcomes for the individuals and communities served by our members, California’s public health care systems.

Our Actions:
We take our role and responsibility in shaping the world and driving equitable health care delivery seriously. As an influencer and voice of California’s public health care systems, CAPH/SNI will:
• Integrate diversity, equity, inclusion, and justice into our mission and daily work.
• Prioritize advancing equity and countering structural racism in the development of policies, practices, and programs to strengthen and improve the health care safety net.

Our Vision:
Our vision is to be a leader and thought partner in the creation of more equitable health outcomes. We are aware of the oppressive and inherited systems within health care, but truly believe that through our voice and influence in health policy, advocacy, and program development, we can increase access to patient-centered, high quality and equitable health care and work towards addressing patients’ social needs to improve the health status of our communities.

New Blog Highlights SNI’s Community of Practice and Alameda Health System 

As part of a new blog series focused on SNI’s Racial and Equity CoP program, we highlight Alameda Health System’s equity journey and the role of peer support in the CoP. “We provide equal care but not equitable care across the board. And that’s the challenge we are tackling,” said Mark Fratzke, chief operating officer, Alameda Health System (AHS).

Fratzke and his AHS colleagues are grappling with this complex challenge alongside 70 safety net peer members from 12 California public health care systems as part of the CoP. In this blog, you will read about how AHS is designing and delivering robust equity programs, and how the CoP is helping to shape their work. Not only is AHS sharing their successes with their peers, but they are also learning from other systems, including UCLA Health and San Mateo Medical Center.

Photo Credit: Katherine Haynes, senior program officer at the California Health Care Foundation, and Dr. Mini Swift, vice president of population health at Alameda Health System, attend a Community of Practice meeting in Oakland.

Ambulatory Care Workshop: Back to Basics in a COVID-endemic World 

Earlier this month, SNI hosted an in-person workshop on Rebuilding Ambulatory Care: “Back to Basics” in a COVID-endemic World.”

Over 60 ambulatory care directors, chief medical officers, and other public health care system leaders gathered in Oakland to discuss how they are rebuilding their ambulatory care delivery systems in the context of pandemic-driven workforce issues, delayed care, and hybrid in-person and virtual care. Prior to the workshop, SNI surveyed systems on care teams and staffing ratios, empanelment processes, and scheduling practices, and how they have evolved as a result of COVID-19. SNI used the results to design the meeting and highlight themes and bright spots.

Riverside University Health System shared how they leveraged Rapid Improvement Events from their multiyear Lean journey to redistribute tasks to other care team members and maximize providers’ time. UCSF Health presented their data-driven approach to determining the right panel size using an algorithm that balances the demand and supply of care. Finally, Los Angeles County Department of Health Services shared how they simplified their scheduling templates from 450 unique appointment types to a standardized set.

Attendees also participated in roundtable discussions to strategize with their peers and identify key takeaways and intentions to strengthen and rebuild their ambulatory care departments.

“Members walked away with pearls of wisdom, large-scale ideas for how to redesign their systems, and everything in between. We’re glad to be able to bring leaders together in-person again, as we all face this new stage of COVID-endemic health system operations,” said Giovanna Giuliani, executive director of SNI.

Photo Credit: Serena Sy, executive director of primary care, and Angela Suarez, primary care medical director, from Santa Clara Valley Medical Center Hospital and Clinics attend the recent ambulatory care workshop.