Message From The Director
A Culture of Humility and Respect
Over the years, we've learned the importance of applying cultural humility and health equity as we serve Contra Costa's diverse communities. We encourage patients and clients to engage in their care and by coming from a place of respect we also gain their trust. We know that respect and trust are more important than ever especially amongst our immigrant population given the current political climate in Washington.
About a decade ago, we decided to make a small but significant change to how we ask patients about what language they speak. Our registration clerks now ask, "What language do you prefer for your healthcare?" instead of "Do you speak English?"
The revised language is more respectful and welcoming. According to Sally McFalone, head of CCHS' linguistic access services, the results have been higher quality service and care with less likelihood of error.
Eliminating Other Barriers
Barriers to access go beyond language differences. Our system can be difficult to navigate, which is why we have long offered patients help from our promotoras and African American health conductors to be connected with services.
Earlier this month, our promotoras and Behavioral Health Division coordinated a community event at our Pittsburg Health Center on healthcare and legal resources for immigrants and refugees. About 35 community members turned out for the event and several received follow-up appointments or referrals to apply for Medi-Cal, access behavioral health services and apply for citizenship. A calendar of events is available on our website.
We also use re-entry health conductors to help those returning to the community from prison—also known as returning citizens—navigate health services. The re-entry conductors connect their clients to the Transitions Clinic, a clinic designed specifically for returning citizens that offers care, support and medical treatment. The Transitions Clinic operates in tandem with REMEDY, a support group network that offers mentoring to making it possible for returning citizens to lead a healthy and productive life after incarceration.
Our health equity work continues with other populations as well. Our hospital and health centers are developing sensitive methods for collecting information about people's sexual orientation and gender identity. Our new monthly gender clinic at the Martinez Health Center, which serves transgendered patients, has been operating for six months now. I'm pleased to say that CCRMC & Health Centers and our Behavioral Health Division have once again been named national leaders in LGBT healthcare equality by the Human Rights Campaign Foundation.
These various efforts are not only the right thing to do from an equity perspective, they're increasingly becoming the right thing to do from a financial one.
Under the current federal waiver, we're being paid for health outcomes and not just services delivered. If we don't address the health of those in our system who are most vulnerable, we won't perform well enough to get paid. Fortunately, the race, ethnicity and language (REAL) data we collect helps us design culturally appropriate programs and interventions to address the health needs of all of our patients.
Of course, there is only so much we can do as a county health system. There are many socioeconomic factors that impact people's health beyond anything we do in our clinics. I want to commend our Board of Supervisors for tackling these upstream issues as part of its new multi-department committee looking at the racial inequities in our criminal justice system. We had our first meeting this month and I'm hopeful we will see forward-thinking policies come out of this work to address disparities in our community.
Going the Extra Mile:
These CCHS Employees are GEMs
Click here to find out how the people named below went the extra mile.
Judith Palmieri, RN
Ogechi Nnanna, RN
Phoebe Oliveira, RN
Genevieve Nwosu, LVN
Alfeo Reminajes, MD
Maritess Rayrao, LVN
Val Alex Empleo, LVN
Sharman Wong, OD
Jessica Los Banos, LVN
West County Staff
Nursing Staff at North Richmond Center for Health
David Carey, MD
Bertha De La Paz
Tamra Groode, FNP
Erin Daisley, FNP
Maria Fairbanks, RN
Concord Health Center Nursing Staff
HazMat Response Team Leads Mercury Cleanup Effort in Antioch
Our Hazardous Materials Response Team (HazMat) and its partners conducted a weeklong cleanup and community education campaign last month after someone spilled mercury in an Antioch neighborhood.
Investigators found the toxic metal in seven separate areas of the 2200 block of Manzanita Way on March 13 after receiving a complaint about an unidentified silvery substance in the roadway. It was the third mercury spill reported in the neighborhood since December.
HazMat and workers from the U.S. Environmental Protection Agency and California's Department of Toxic Substances Control used instruments that measure mercury vapor in the air to locate and collect the substance, which was scattered around the neighborhood. There were no mercury-related illnesses reported.
The source was not determined. Local, state and federal officials will continue to monitor the situation for the next few months.
HazMat also went door to door to share information with concerned residents, and distributed hundreds of bilingual fliers to help them identify mercury, the signs of mercury poisoning, and safe disposal options.
While it is not illegal to possess mercury, it is illegal to dispose of it except at approved household hazardous waste disposal sites. Contra Costa residents can drop off mercury in a container for free at the Delta Household Hazardous Waste Collection Facility in Pittsburg, Central Contra Costa Sanitation District in Martinez, or West County Resource Recovery in Richmond.
Mobile App Makes TB Medication Compliance Easier
Our tuberculosis program is now using a mobile health app to ensure patients are taking their TB medications.
With the Emocha app, TB patients upload videos of themselves taking their medications, which are viewed and tracked by public health staff from the convenience of their work desktops. Contra Costa is the first public health agency in the Bay Area to use the Emocha video technology for TB medication compliance.
Typically, public health nurses visit the homes of TB patients several times during the 6- to 12-month long medication regimen. TB Nurse Program Manager Laurie Crider said medication compliance with patients using Emocha is nearly 100 percent. The secure online tool also saves resources and staff time since TB program staff don't have to make daily home visits.
About 25% of the 42 patients in Contra Costa with active TB are currently using Emocha, Laurie said.
New Free Valet Parking Service for Patients
Patients and visitors to Contra Costa Regional Medical Center and Martinez Health Center now are being offered free valet parking. The valet service, which debuted on March 22, was initiated to address the ongoing parking issues at the Martinez campuses.
The valet service, operated by Signature Parking, is available Monday to Friday from 8 a.m. to 5 p.m. Drivers leave their cars with valets stationed in front of the hospital or Martinez Health Center and take a claim ticket.
So far, patients love the new free service, said Timothy Thompson-Cook, chief operations officer at CCRMC & Health Centers. Making it easier to find parking and get to appointments on time is in keeping with CCRMC & Health Centers' goal of being patient and family centered, Tim said.
Employees, meanwhile, now have the option to use attendant-assisted parking in designated areas to avoid having to look for parking. Those who'd rather not leave their keys with a Signature attendant can use street parking or the Teamsters lot across the street from the hospital.
After 30 days into this new service, a survey for staff, patients and visitors will be circulated to gather important feedback on their experiences and what still needs improvement, Tim said. He added, "Although there has obviously been a huge improvement in parking overall, we have a long way to go before we can celebrate. Receiving ongoing feedback will absolutely accelerate that process."
Public Health Releases Health Advisory Regarding Opioid Abuse in Contra Costa
The Public Health Division has reissued a health advisory regarding its efforts to combat opioid painkiller misuse in the community, calling on all providers to follow the Alameda-Contra Costa Medical Association's prescribing guidelines.
The advisory also details community efforts to raise awareness about the national epidemic and the local expansion of medication-assisted treatment and other substance use disorder (SUD) services.
The Contra Costa Board of Supervisors proclaimed March to be Prescription Drug Abuse Awareness Month at its March 21 meeting, part of a statewide effort to draw attention to an epidemic that causes thousands of deaths nationwide every year.
For up-to-date information about California's opioid epidemic, including county statistics for deaths, overdose-related visits to emergency departments, and per-capita prescriptions for opioid medications, visit the California Department of Public Health's new Opioid Overdose Surveillance Dashboard.
CommunityConnect to Deliver Whole Person Care
Whole Person Care (WPC) is a statewide waiver pilot program for vulnerable Medi-Cal recipients to improve health outcomes and reduce utilization of high-cost services. CCHS is participating in the program, which it is calling "CommunityConnect," as the core goal is to increase linkages and services and to assist patients in managing their health through appropriate utilization of services.
CommunityConnect is being managed through our Public Health Division and will consist of two tiers of case management services, touching 14,400 patients per year. Services provided cannot be ones that are currently billed through Medi-Cal. Eligible patients must have full-scope Medi-Cal. We are using a data-driven risk score model to identify patients who may benefit from our services: case management, care coordination, resource linkage and peer support. This risk score incorporates components of physical health, past utilization and social determinants of health to predict which people may benefit from additional services to stabilize their health and well-being. Only patients identified through the risk model can be enrolled.
The $40 million-a-year program is in the process of hiring staff, mapping enrollment workflows and training new managers, with services scheduled to be delivered in May. The initial batch of patients will be existing CCHS patients who are not enrolled in other case management programs.
For more information on the CommunityConnect program, please visit cchealth.org/care
Public Health, AODS Speak Out About Alcohol and Tobacco Products Marketed to Youth
Public Health Director Dan Peddycord and Alcohol & Other Drugs Services Chief Fatima Matal Sol joined health officials from across the Bay Area at a press conference last month to discuss the continued prevalence of alcohol and tobacco marketing practices that target youth in our communities.
The media event released new data from the California Department of Public Health's "Healthy Stores for a Health Community" survey, which highlighted the need for continued, local-level education and advocacy.
The study, a follow-up to the CDPH's inaugural The 2013 Healthy Stores Survey, assessed the availability of tobacco products with added flavoring or kid-friendly packaging, as well as in-store advertising and marketing practices of other products including alcohol drinks and sugar sweetened beverages.
The survey found that close to 80% of stores selling tobacco near schools in Contra Costa sell tobacco products with youth-friendly flavors like watermelon, tropical blast and cherry limeade. In addition, many flavored cigarillos and little cigars sell for under $1, making them attractive and affordable to youth. The findings also show that electronic cigarettes are widely available in Contra Costa and across the region. Close to two-thirds of stores in Contra Costa sell e-cigarettes, battery-operated products that turn nicotine and other chemicals into an aerosol that is inhaled by the user. This is of particular concern because new research shows that these products are "gateway" devices that often lead youth to regular tobacco use.
Seventy-seven percent of stores that sell alcohol and tobacco sold "alcopops," sweetened alcoholic drinks available in single bottles or cans that often resemble energy drinks popular with youth. While sweet, alcopops are potent and dangerous — one 24-ounce can contain as much alcohol as four or more standard drinks.
For more information, visit healthystoreshealthycommunity.com
New Online Scheduling System at CCRMC Goes Live in May
On May 7, staff from the nursing unit, registration, Professional Development Department and staffing office at Contra Costa Regional Medical Center will begin using a new online work-scheduling system called ShiftSelect. This Web-based system can be accessed on the internet any time.
With the ShiftSelect system, CCRMC staff can request to work and for time off online. They can also choose to get a phone call, text message and/or email about last minute open shifts. CCRMC is in the first phase of roll out; the second and the third phase timeline will be announced at a later date.
For more information, visit the ShiftSelect team page on iSITE or contact Staffing Office Manager Nancy Hendra at Nancy.Hendra@hsd.cccounty.us.
Behavioral Health to Add Full ccLink Access at All Clinics in 2017
The Behavioral Health Services Division is now working to bring ccLink clinical documentation to all of its behavioral health clinics by this fall. Timelines for Alcohol & Other Drugs counselors, including Discovery House, are still in progress, with the goal of going live as soon as possible after the behavioral health clinics.
BHS's Information Technology Plan aims to realize the Health Services Department's (CCHS) goal of integrating health records system-wide by the end of 2017. The change reflects the growing need for shared information as Behavioral Health works with other CCHS divisions to integrate care for patients.
While BHS clinics currently use ccLink, powered by Epic, for scheduling, e-prescribing and referrals, they will soon have full use of the ccLink system for clinical documentation. Network providers and community-based agencies will access the system through the ccLink Provider Portal.
The BHS IT plan will also include upgrading the division's current first generation electronic billing system, PSP/Insyst, with a next generation billing system, Echo ShareCare, by early 2018.
Behavioral Health and the IT department have formed a governance structure to plan and implement the transition.
Mental Health Wellness Program Hosts Graduation
The Coaching to Wellness program recently celebrated its first graduation event on February 8, 2017. Program participants and their families came together to recognize those graduating from the program and emphasize that "small changes can make a big difference" when it comes to wellness and recovery. Attendees also heard from several County and community programs, including the Office for Consumer Empowerment's Social Inclusion Committee and Service Provider Individualized Recovery Intensive Training (SPIRIT), 211 and the Crisis Center, Putnam Clubhouse, and RI International. Congratulations, graduates!
Coaching to Wellness is a program for mental health consumers who have certain chronic health conditions, such as hypertension and diabetes. In this consumer-centered program, participants receive short-term intensive peer and nurse support, including one-on-one sessions, groups, goal setting assistance, referrals and linkages to primary care and after-care support. The program is available to adult mental health consumers receiving psychiatric-only services at one of our specialty mental health clinics who meet program criteria.
The program was featured on a webinar hosted by America's Essential Hospitals titled "Nurse and Peer Teams Coaching People with Comorbidities."
For more information, contact Sakura Barrientos at Sakura.Barrientos@hsd.cccounty.us.
Perinatal Bereavement Training, May 11-12
The Contra Costa Health Services Perinatal Bereavement Task Force will be utilizing the "Resolve Through Sharing (RTS) Bereavement Training: Perinatal Death" model developed by Gunderson Health System in 1981 for a two-day training in Pleasant Hill on May 11-12.
The Resolve Through Sharing (RTS) model is a comprehensive 2-day training known world-wide as the "Gold Standard" in perinatal bereavement education. The CCHS Perinatal Bereavement Task Force (Fetal Infant Mortality Review Program and Contra Costa Regional Medical Center & Health Centers staff) will be the first to offer this training in Contra Costa County!
The target audience for the training includes nurses, social workers (all levels of practice), public health nurses, home health workers, chaplains, midwives, genetic counselors, physicians/physician assistants, child life specialists, ultrasound sonographers, lactation consultants, and funeral directors.
For more information, please contact the Fetal Infant Mortality Review program at 800-696-9644.
Thanks to these employees who have given us long years of service:
Birda Arnold, Fayechoy S. Chao, Sukhwinder K. Malhi
Maria C. Liberato, Sheila M. Lenzi, Frank E. Wallace III
Fernando Mendoza, Jr., Joseph G. Doser, Jr., William E. Fung, Blanca P. Camacho, Elina M. Webb, Violeta Jimenez, Nenette R. Reyes
Debra Stewart, Katherine Reece, Erlyn Mambretti, Karen Sandri, Suzanne E. Thompson, Kathi Schwertscharf, Karen L. Rodrigues, Thalia L. Siegel, Susan B. Meltzer, Ayore R. Riaunda
Mireya Gutierrez, Joseph J. Macedo, Jr., Magarita Maciel, Karen J. Mehl, Rosemary Ramirez, Thongphet Sirilay, Ana M. Jimenez, Maria P. Rodiles, Loun Cardona, Mario E. Eyzaguirre, Hanada Fasheh, Jose A. Robles, Nancy R. Marchitiello, Kathryn M. McCabe,Farina N. Khan, Christine P. Brighton, Habib Amin, Cho Nai Cheung, Michael A. Dossey, Joselito E. Isidro, Zeny M. Ramiro, Randall L. Sawyer, Graciela E. Vaquerano, Michael S. Dickson, Bryan R. Richard, Wanda I. Bly, Ron M. Hamiter
Michel M. Madlock, Siegfred S. Macias, Deshante C. Hall, Veronica Rubio, Rachel Steinhart, Jeffrey M. Yan, Sherry Yeager, Candice Young, Daisy Lam, Charlene R. Bianchi, Roderick D. Berbano, Michelle M. Collins, Jeremiah Z. Juruena, Brenda J. Stewart, Christine M. Madruga, Donald C. Hwang, Flor Bazan
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