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Health Care Expansion in Santa Cruz

Hospice Palliative Care Services

“Why palliative care and why now?” Hospice of Santa Cruz County (HSCC) leaders Michael Milward, Executive Director, and Kieran Shah, Chief Strategy Officer addressed this question for the December HIPC audience. Studies have shown that patients who communicate with providers early on about serious and terminal illness have better outcomes. With this in mind, HSCC unveiled their Palliative Care Pilot in January of 2016. In this same year, Hospice sponsored and partnered on multiple events to advocate for the importance of increased conversations with patients regarding serious and terminal illnesses. These events included multiple sold out showings of Dr. Atul Gwande’s documentary, Being Mortal, and a large CME program with keynote speaker, Dr Rachelle Bernacki of Ariadne Labs.

HSCC’s Palliative Care Pilot results in less fragmentation in the care patients receive, reduced patient suffering, support and reduced burden to family caregivers, and re- prioritization of healthcare resources. After 1 year of the pilot, HSCC has cared for 33 patients with 17 discharged. Of the 17 discharged patents, 11 were moved to full hospice care.

The outcomes of the Palliative Care pilot can be measured through the Triple Aim: better health, better care, and better value. The current findings from the pilot include improved patient experience, the opportunity to experience End of Life Care in the home rather than the hospital, increased social and emotional support for patients and families, all while lowering the cost of care.

Kaiser Permanente Expansion

In January 2017 three new Kaiser Permanente clinics will open in Santa Cruz County. The Kaiser Permanente expansion team presented to HIP Council on their services and expansion plans in the County. The Kaiser Permanente team included the following key staff: Dr. Cal Gordon Physician Lead for Santa Cruz Expansion, Dawn Bussey Director of Public Affairs, Irene Chavez SVP and Area Manager, Niraj Singh Executive Director – Market Expansion, Dr. Raj Bhandari Physician in Chief, Sherry Novick Northern California Director of Community Benefit, and Steve Wahl Santa Cruz Community Benefit Manager.

Kaiser Permanente’s expansion includes clinic sites in downtown Santa Cruz, Watsonville, and Scotts Valley, as well as a foundational partnership with Watsonville Community. The expansion results in local employment for nearly 30 Kaiser Permanente staff members who live in Santa Cruz County. Kaiser Permanente will offer their commercial health plan in January 2017, and plans to offer Medicare Advantage in January 2018.

This expansion has led to many questions from leaders and community members in Santa Cruz County. During the HIP Council, Kaiser Permanente’s expansion team answered some of these questions.

Q: Will Kaiser work with the Central CA Alliance for Health? A: The Kaiser Permanente team has met with the Alliance and discussions for a future partnership have been initiated.

Q: How will Kaiser serve the low-income population? A: Kaiser Permanente Santa Cruz will be looking at the Santa Clara County model for their local community benefit program. This granting opportunity focuses on providing financial support in specific program areas to community clinics, social services and other non-profit organizations.

Q: Will Substance Use Disorder and Behavioral Health services be provided by Kaiser Permanente in Santa Cruz? A: Yes, these needs will be a priority. There are plans to meet with Vanessa De La Cruz, Chief of Psychiatry of Santa Cruz County, to discuss partnerships with the County in providing SUD and BH services.

Q: Will Kaiser Permanente partner with educational institutions? A: It is important for Kaiser Permanente to partner with educational organizations to train and nurture competent health care practitioners. In San Jose, Kaiser will debut a Family Practice Residency and Psychiatry Residency program in 2018. This residency program will hopefully expand to residencies in Santa Cruz County clinics.

Q: Will dental care be offered? A: Yes, Kaiser Permanente has initiated discussions with Dientes Community Dental and the County to offer dental care. In San Jose, community dentists use Kaiser Permanente surgery centers to perform oral surgeries. Kaiser Permanente will consider a similar service model in Santa Cruz.

Q: Will Kaiser Permanente Health Plan rates remain the same over time? A: Yes, Kaiser Permanente intends to keep health plan rates consistent in the county.

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