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).
Over the past few months, the courage, strength, and compassion of our health care providers has never shined brighter. We want to thank those on the front lines of the COVID-19 response for their tireless efforts to provide essential health care services, and to protect our communities during this crisis.
Since the beginning of the pandemic, public health care systems have played an integral role in the response effort across the state. While working alongside local public health departments and emergency personnel, public health care systems proudly answered the call to prepare for the anticipated surge of cases. They freed up space within their facilities, converted non clinical spaces into care settings, and rapidly accelerated testing capacity. True to their mission and commitment to serving those most vulnerable, public health care systems prioritized care for homeless populations.
As members adapt to the operational changes associated with this massive effort, SNI continues to promote flexibilities in current program requirements and will build resources to support expansion of new care delivery models, such as telehealth. In this newsletter, we share examples of how SNI is supporting members during this time and the important role Whole Person Care has played in the COVID-19 response.
We stand strong in our commitment to support our members, and are adapting our technical assistance services to meet the needs of the moment, so that public health care systems can focus on what matters most, caring for their patients.
We hope you enjoy this edition of the SNI Forward.
California Health Care Safety Net Institute
Supporting Our Members During COVID-19
The health care delivery system has changed rapidly over the past several months to address the COVID-19 pandemic. During this time, SNI has been helping members navigate new flexibilities in program implementation and care delivery as a result of COVID-19. For example, as a part of surge planning efforts, public health care systems redeployed their workforce and postponed other types of non-essential care, including primary and preventive care. Therefore, the ability to meet the goals of programs like PRIME and QIP was significantly impacted.
To address this, SNI has been working hand-in-hand with CAPH and the Department of Health Care Services to recommend and implement revisions to programs like these, including modification of performance targets during the crisis so that systems are not penalized for focusing on their response to COVID-19.
At the same time, public health care systems are rapidly evolving their models of care delivery, standing up telehealth platforms, offering phone and video visits, and expanding engagement in patient portals at a pace never before seen.SNI recently launched peer support opportunities for telehealth learning that will expand over time to include discussions on remote patient monitoring, team-based care roles and workflows in telehealth, and virtual interpretation services to name just a few.
Closely tied to telehealth is the planning for recovery and reopening, and evolving care models over the longer term as we return to a “new normal.” Public health care systems are beginning to develop their plans and models and SNI will be a key partner by facilitating peer learning and virtual sessions to help design the future of care.
WPC’s Critical Role in the COVID-19 Response
The value of Whole Person Care (WPC) has never been more evident than in this moment, as we face a national public health crisis. By serving those most vulnerable, including those who are homeless and have other complex social and medical needs, WPC bridges gaps in care coordination and connects individuals to a range of essential health and social services. A recent WPC evaluation further highlights how cross sector integrated care improved the health outcomes of high-risk individuals with complex needs.
When the pandemic hit, WPC played a central role in the state’s response to COVID-19. The organizational partnerships, as well as the data sharing and referral systems, developed through WPC allowed counties to respond in a more timely and coordinated way. By leveraging the infrastructure in place under WPC, counties were able to rapidly identify and engage vulnerable populations, especially those who need isolation and quarantine support, and house them in motel rooms procured with the help of multidisciplinary WPC staff. The WPC infrastructure also facilitated the development of cross sector planning efforts, including the need for PPE, hospital surge, and ED protocols. SNI continues to support these initiatives by advocating for additional flexibility in WPC funding and working closely with county partners to leverage funding streams like California’s Project Roomkey.
Community Health Workers (CHWs) and behavioral health peers play a critical role in WPC. Prior to the pandemic, in collaboration with our county partners, we gathered WPC leads and CHWs/Peers from across the state to discuss hiring and training practices, trauma-informed care principles, and strategies to integrate CHWs/Peers into care teams. The meeting provided a solid foundation for CHW/Peers to build on as they address the unexpected shift to more virtual care due to COVID-19. Many CHWs/Peers have rapidly transitioned to telephonic outreach, or in some cases video conferencing, which can be especially challenging when working with vulnerable populations who often don’t have access to the necessary technology. CHWs/Peers are learning how to maintain the high-touch and face-to-face communication so unique to their roles in a virtual environment. As their work continues to evolve, SNI will be there every step of the way, supporting members and our WPC pilots through this transition.