CCHS Director Anna Roth

Message From The Director

Thankful for All of You

Thanksgiving marks a time to reflect and appreciate the many and diverse gifts in our lives. Certainly, one thing that I'm most appreciative of is the remarkable, passionate and dedicated people I have the privilege to work with every day — our employees, our partners, our community and, most importantly, those we serve.

hough this marks my 25th year in the system, moving into my new role as Health Director this year has provided me the opportunity to learn new things and meet new people. At every turn, I have been moved by the dedication and hard work of our employees across the department and in partnership with our community. Each day, in every aspect of our system, I see Contra Costa Health Services' employees working together to make Contra Costa County a better place to work, live, and pursue the things that bring us joy and meaning. In some cases, it's a simple act of kindness that helped someone tackle an especially difficult situation. In others, it's introducing an innovative approach to magnify the impact and reach of our work. In every, case it's a demonstration of the power of people.

I want to thank those of you who took the time to share your experiences with me. Personal and professional, positive and negative - your stories are an inspiration and serve to remind all of us of what really matters… the health of all people in our community with special attention to those who are most vulnerable.

I want to thank you for giving care and comfort to those in need, for meeting anxiety and fear with compassion and understanding, for providing stability in an ever-changing environment, and for always standing up for what you believe. These acts, big or small, do not go unnoticed. They are an integral part of what makes Contra Costa Health Services so vital. It is an honor to be working with such a dedicated and caring community.

As we pause this week to reflect and give thanks, I want to give special thanks to those who may not be able to celebrate Thanksgiving; to those whose commitment to service finds them serving others as well as to those whose may not be able to celebrate due to personal circumstances. Wishing all a safe a peaceful holiday.

Many thanks,

Anna

Find out how the CCHS employees named below went the extra mile.

Women, Infants & Children

New WIC Office in West County Opens

Our Women, Infants & Children (WIC) Program opened the doors to its new West County office in San Pablo on Monday, Nov. 19.

The new 7,500-square-foot facility replaces the aging WIC office in Richmond. WIC serves an average of 5,900 participants per month. WIC is a federally funded supplemental nutrition program that helps pregnant and postpartum women, infants, and children up to age 5 have a healthy life style. It provides nutrition education, breastfeeding support, checks for healthy foods, and referrals to other resources throughout the county.

The modern facility will improve the environment of care experienced by WIC participants and their families. The new site is located at 501 Gateway Avenue in San Pablo, behind the West County Health Center (WCHC). The proximity to WCHC will facilitate coordination of care for WIC participants.

CCHS collaborated on the project with the city of San Pablo, which owns the property. A grand opening celebration is scheduled to take place on Nov. 20 from 3 p.m. to 5 p.m.

Homeless Services

County Works With Cities to Secure Critical Homeless Funding

Our Health, Housing and Homelessness (H3) Services Division is asking city councils across Contra Costa to do their part for residents without housing by declaring a local shelter crisis.

That declaration will enable participation in California's new Homeless Emergency Aid Program (HEAP), which will provide Contra Costa with $7.2 million in 2018-19 for sheltering services, including outreach, prevention and rental assistance. HEAP will help expand our county's capacity to connect residents who are experiencing homelessness to the services they need.

Thirteen councils have passed this declaration so far, including those in Antioch, Martinez, San Pablo, Richmond, Pittsburg, Walnut Creek and Pleasant Hill.

About 2,300 Contra Costa residents spend any given night in shelters or living on the street, according to previous annual point-in-time counts.

Injury Prevention

Grant Provides Free Child Safety Seats to Public Health Nursing Clients

A one-year state grant will enable our public health nurses to give free child safety seats to their low-income clients and provide education on how to use the seats properly.

The $75,000 "Child Passenger Safety" grant will go toward a variety of activities to promote occupant safety and decrease injuries and deaths due to improper use of car seats, boosters or seat belts. Funding for the grant was provided to Contra Costa Health Services by the California Office of Traffic Safety (OTS), through the National Highway Traffic Safety Administration (NHTSA).

At least 70 clients of Public Health Nursing's comprehensive home-visiting program will be eligible to receive free child safety seats. Clients will also get safety-seat education classes and safety-seat inspections.

A nationwide survey conducted by the National Highway Traffic Safety Administration found that two out of three car seats are misused. Car crashes remain the leading cause of death for children, and car seats save lives by reducing the risk of injury or death.

For more information, contact Public Health Nursing Manager Marilyn Condit.

Government Affairs

Proposed Public Charge Rule Changes Signal Chilling Effect on Benefit Programs

CCHS and other County agencies will continue to provide federally-funded benefit programs and services to community members despite a Department of Homeland Security (DHS) proposal to more broadly factor immigrants' use of public programs into decisions related to lawful permanent status (also known as "green cards").

DHS recently proposed changes to expand the types of benefits that may be considered for "public charge," a term that indicates a person who may be likely to become dependent on the government for subsistence. A public charge determination could be used to reject an immigrant's application to keep his/her legal status to stay in the U.S. or to become a lawful permanent resident.

Under the proposed rule, programs such as Medi-Cal (except emergency care), CalFresh ("food stamps"), and housing assistance (public housing or Section 8 housing vouchers) will be weighed as public charge factors. Under current law, these are not considered to be public charge. WIC benefits will not be counted as a public charge under the new proposal.

"Healthy people make healthy communities, and we're worried this rule change will discourage people from accessing health care services or services that they depend on to be healthy," said Contra Costa Health Services Director Anna Roth.

The proposed changes are not yet final. DHS is currently collecting public comments. After the comment period is over, DHS will review the comments and possibly make revisions before issuing a final rule. This process is expected to stretch into 2019.

For more information, visit our web page on this topic.

Contra Costa Health Plan

Federal Decision Impacts CCHP Medicare Members

The Center for Medicare and Medicaid Services (CMS) has decided to eliminate all Medicare Cost programs for seniors including two such programs of Contra Costa Health Plan (CCHP).

Earlier this year, CMS announced it will be closing Medicare Cost Plans in counties where two or more Medicare Advantage Plans exist. This means CCHP will have to discontinue its Senior Health Basic and Senior Health Plus plans on December 31, 2018.

CCHP has been reaching out to the 400 members impacted by the change and informing them of their options. Those members can either return to original Medicare FFS or join one of the four Medicare Advantage plans in Contra Costa, or choose a Medigap program.

Those who opt for original Medicare could still see their CCRMC or CPN providers with Medicare serving as the primary payer. However, they would have to cover 20% copays themselves, unless they purchase Medigap coverage.

There are 25 CCHP members with Medicare, Medi-Cal, and Medigap who remain with CCHP and their current providers at no added costs.

Detention Health

Mural Creates Healing Space for Patients in Martinez Jail

Inmates with mental health issues recently helped paint a mural in a courtyard at the Martinez Detention Facility to help provide a calming environment.

The mural, which was funded by the Contra Costa Regional Health Foundation, depicts a Mt. Diablo landscape. A stencil outline was done by artist Bianca Nandzik beforehand to facilitate the painting process.

Several inmates, CCHS detention-health staff and Sheriff's deputies participated in the painting of the mural over two weekend in October and November.

The courtyard space in the mental health module at the jail previously had no signage or color on the walls. David Seidner, our mental health program chief, said the mural will provide a focal point for patients experiencing psychotic symptoms and help them remain connected to the reality of their environment.

Other "recovery" murals have been done previously in Contra Costa Regional Medical Center's inpatient psychiatric unit and psychiatric emergency department.

Environmental Health

Environmental Health Helps With Waste-Tire Cleanup Near Watershed

Our Environmental Health Division recently partnered with the San Francisco Conservation Corps to remove more than 300 tires illegally dumped in the Wildcat Creek Basin and Wildcat Creek Watershed in North Richmond.

The tires were removed and hauled away to a tire recycler over a three-day period by Conservation Corps volunteers. The tires were likely dumped there by thieves who stole the wheels from a nearby auto-dismantling facility for their metal rims. After removing the rims, the thieves then ditched the unwanted tires.

The waste tires pose a health threat because water can accumulate in them and serve as breeding grounds for mosquitoes carrying West Nile Virus. The tires can also negatively impact marine life in the creek.

This clean-up was made possible through the CalRecycle Local Conservation Corps Grant Program, which provides funding for tire enforcement agencies, like Environmental Health, to remove waste tires on public lands.

Emergency Response

HazMat Crew Responds to Incident at Country Club

Our Hazardous Materials response team mitigated a dangerous situation following the accidental mixing of pool chemicals at the Orinda Country Club in September.

The problem began in the early morning hours of Sept. 12 when the club's pool-chemical vendor accidentally hooked up acid to the bleach tank, creating a strong chlorine smell in the area.

A 12-member HazMat team worked 12 hours to ensure the safe disposal of the inadvertently mixed chemicals. The Orinda Police Department and the Moraga-Orinda Fire Department were also part of the initial response to the accident.

Community Partnerships

Pilot Program Successfully Provides Case Management Services to Community Clinics

CommunityConnect, our whole person care program, will soon be providing social case management services to more than 300 patients at community clinics that are part of Contra Costa Health Plan's Community Provider Network (CPN).

In the fall of 2017, CommunityConnect began a case-management pilot with 50 eligible patients assigned to each of the three CPN providers: La Clinica de la Raza, LifeLong and Kaiser. The effort involved a remarkable amount of coordination and collaboration between Community Connect, CCHP and CPN.

An evaluation of the initial six-month pilot period identified successful outcomes in linking patients to established systems of care and supporting social needs. Top needs identified included dental care, connection to behavioral health services (through the Behavioral Health Access Line), and transportation assistance information.

"We have many patients who are in need of guidance in navigating their healthcare," said Kate Lewis, LifeLong Brookside San Pablo Center Manager.

"For the people who were eligible and engaged, it was incredibly valuable for them to get access to so many great resources and support of the case Managers."

Kaiser Medi-Cal Strategies and Operations Manager Praneeti Parjan said "[the pilot] has been a wonderful learning opportunity for us and we appreciate the collaboration."

Following the success of the pilot, CommunityConnect plans to expand social case-management services from 50 to 120 patients at each of the three CPN organizations.

"CCHP is grateful that our members represent 85% of the Community Connect patients and that those high-risk utilizers in each of our three provider networks have access to the case management provided under this program," said CCHP CEO Patricia Tanquary. "This program broadens the number of CCHP members receiving case management from CCHP so together we can reach more members ."

Staff Engagement

Safety-Culture Survey Spurred Improvement Efforts

The 2017/18 Patient Safety Culture Survey team has released a final report of its year-long effort to initiate improvement efforts at Contra Costa Regional Medical Center (CCRMC) & Health Centers based on survey results and staff feedback.

One year ago, more than 1,300 CCRMC/HC employees participated in the biennial survey, which measures staff perception of our patient-safety culture and identifies strengths and areas for improvement. The survey team, led by Medical Director of Quality & Safety Dr. Sonia Sutherland, then analyzed the data and shared results at 16 roadshows across the delivery system.

This was the first time CCRMC/HC tailored the safety surveys for the three main areas of the delivery system: the hospital, health centers and the jails. After sharing the results, the team went to work to engage staff in all three areas about what specific kinds of changes they wanted to see. The team held numerous focus groups, as well as planning and testing sessions.

As a result of this collaborative work, the following actions were taken:

• Hospital: Developed a Ticket to Ride 2.0 form to enhance handoffs and transitions
• Detention Health: Started multidisciplinary case reviews to solidify teamwork
• Health Centers: Workshops were held on giving and receiving feedback in order to improve communication

The team is now looking ahead to the 2019 patient safety culture survey, which is expected to be released in the late spring.

Ambulatory Care

Just What the Doctor Ordered: Walk With a Doc Program Earns Anti-Obesity Grant

The City of San Pablo is supporting our Walk With a Doc program at West County Health Center with a $44,000 grant to help combat obesity by taking families out to our parks. This is part of a nationwide movement to integrate park visits into disease treatment and prevention through parks prescription programs. CCHS is collaborating with the East Bay Regional Parks District in the grant activities.

As part of the Walk With a Doc program, patients go on hikes with physicians and naturalists and participate in other healthy outdoor activities at local and regional parks. The excursions will begin with a group medical visit at our West County Health Center. Participants will then be taken by bus to a park and provided a nutritious lunch while being shown how to prepare healthy meals. Besides hiking, people can do yoga or Zumba and can even get a massage.

To sign up, staff or patients may fill out this form https://tinyurl.com/ya4gn2co

For more information, contact Dr. Alan Siegel at Alan.Siegel@cchealth.org

Honors & Recognitions

Partnering for Health Award Winners Named

Ten CCHS programs were honored with Partnering for Health Awards at the Contra Costa 2020 event in September.

The Partnering for Health Awards recognize CCHS employees for collaborative work they've done in the past year with our communities — including patients, clients, consumers and or family members — to foster innovation and create health in our county. This was the award program's first year.

The winners were chosen by a community panel from dozens of nominated programs. Winners were recognized at the Pleasant Hill Community Center during the Sept. 27 CoCo2020 learning session, which was focused on patient and community engagement.

Learn more about the award winners.

Honors & Recognitions

CCRMC & Health Centers Wins Awards for Gender Clinic, Improvement Work

At a conference in Sacramento last month, Contra Costa Regional Medical Center (CCRMC) & Health Centers won two awards from the state for an innovative service line and for the system's outstanding improvement work.

The California Department of Health Care Services (DHCS) gave CCRMC/HC an Award of Excellence for its gender clinic, which serves transgender, gender non-conforming and non-binary clients ages 18 and older at our health centers in Martinez, Pittsburg and West County.

Contra Costa also won DHCS' Distinguished Improvement Award for meeting the most PRIME targets, closing the most gaps and for the integration of behavioral health system data into our electronic health record. PRIME (Public Hospital Redesign & Incentives in Medi-Cal) is a federal pay-for-performance program encompassing dozens of quality metrics.

Honors & Recognitions

Contra Costa HazMat Takes Top Honors at Urban Shield Contest

Congratulations to our HazMat team for winning first place in the hazardous materials emergency response competition at this year's Urban Shield event. Our HazMat crew competed against 11 other agencies.

Send feedback and story ideas to editor Will Harper at will.harper@cchealth.org