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 vaccine eligibility and administration expand, we look forward to the days where we can return to a more “normal” day-to-day life. Over the past few months, public health care systems have played a key role in facilitating a safe transition to post-pandemic life, especially through vaccination efforts for vulnerable individuals. By implementing mobile clinics, street outreach, partnerships with community-based organizations, drive-through clinics, and other strategies, public health care systems are successfully reaching those most at-risk in their communities. To support member sharing, SNI is compiling these tactics and will share lessons learned and successful practices across the membership to help inform ongoing efforts.
In this newsletter, we highlight the new Quality Incentive Pool (QIP) program, which launched in January and builds off an earlier version of the program that was implemented in 2017. By ratcheting up performance and quality expectations, QIP aligns more closely with State and Medi-Cal managed care plan priorities, and further integrates the improvement of health care disparities. We also share how Whole Person Care (WPC) pilots in Ventura and Los Angeles leveraged community health workers and peers to help serve those most in-need during the pandemic, and a unique COVID-19 outreach program for farmworkers at Natividad Medical Center.
Looking ahead, SNI will maintain support of members’ vaccination efforts and is developing programming to help members build an organizational culture of racial equity. The Section 1115 Medi-Cal waiver proposal has been released by the Department of Health Care Services (DHCS) for public comment and SNI will continue to prepare members for the next phase of transformation, including work already underway to help WPC pilots successfully transition as outlined in California’s CalAIM initiative.
California Health Care Safety Net Institute
Quality Incentive Pool (QIP) Builds On Earlier Successes
In June 2020 with the expiration of PRIME, a Medi-Cal Section 1115 waiver program, California had an opportunity to redesign the QIP to integrate successful components from PRIME and the first few years of QIP. This “new” QIP, which began January 1, 2021, continues to challenge public health care systems to improve quality and reduce health care disparities via ambitious pay-for-performance targets in multiple domains of care. By design, the measures in the new QIP closely align with the priorities of DHCS and Medi-Cal managed care plans. Read more about the program’s structure and measures here in our latest publication.
Natividad Medical Center Partners with Farmworkers to Combat COVID-19
As COVID-19 was taking hold in Monterey County, Dr. Erika Romero and her colleagues from Natividad Medical Center launched a unique outreach program for one of their highest risk populations – farmworkers.
Clinicians were deployed to dozens of farms and packing houses to provide in-person education, resources, and PPE supplies during “charlas” or chats with farmworkers.
Together, in partnership with the farmworkers and agricultural leaders, they developed strategies to combat the spread of COVID-19, including precautions to protect themselves, their families, and their co-workers. For example, farmworkers created smaller cohorts to carpool, work, and eat together, which could contain the virus (if contracted) and potentially prevent the whole facility from shutting down.
Now, as the focus shifts to vaccination, clinicians and communications staff from Natividad are working on a community-driven education campaign with farmworker organizations.
Learn more from clinicians and staff on Natividad’s outreach team:
Community Health Workers and Peers Are Essential to Counties’ COVID-19 Response
Community health workers (CHWs) and peers play a critical role in connecting vulnerable individuals to healthcare and other social services. During the pandemic, these frontline workers were often the first point of contact for many in their communities – providing resources and solving challenges such as how to quarantine safely, access health care services, and put food on the table.
In our recent blog, we highlight how three WPC pilots leveraged CHWs and peers’ greatest assets – flexibility and community connections – to adapt how they provide services and help clients safely shelter in place. CHWs in Ventura supported individuals at isolation and quarantine sites, as well as those experiencing homelessness through street outreach.
For WPC clients in Los Angeles, CHWs engaged with their clients virtually to maintain a connection with their care teams. In Santa Cruz, peers delivered essential items like food and household supplies to medically vulnerable clients. Read more.