Safety Net Clinic Coalition Five Year Impact Report
For over ten years, Trina Mendez suffered from chronic toothaches that tormented her with persistent pain and forced her to hide her smile. Even after becoming eligible for Medicare, dental visits remained unaffordable. It was not until Trina experienced a dental emergency that she was able to receive treatment from Dientes Community Dental. Trina was one of the tens of thousands of Santa Cruz County residents who benefited from the expansion of community health centers and her story is one of many demonstrating the impact of extensive growth in the safety net from 2012 to 2016. Today, Safety Net providers serve 90,000 patients of which 78% are low income and 67% are Hispanic. At the August HIPC meeting, Elisa Orona, Executive Director of the Health Improvement Partnership of Santa Cruz County, unveiled the Safety Net Clinic Coalition (SNCC) Five-Year Impact Report. The report highlights five years of impact including a 42% increase in visits to safety net clinics. It also shows that this increase was likely the result of hiring practices, coverage expansion, and other factors such as physical expansion efforts and improved primary care practices. During her presentation, Elisa emphasized activities of clinic partners including integrated behavioral health in primary care, legislation and programs directly leading to coverage expansion, and clinic construction projects.
Leaders from Safety Net clinics also participated in the presentation, sharing their continued efforts and future endeavors. Laura Marcus, Executive Director of Dientes Community Dental, spoke of collaboration with Salud Para La Gente to open the Beach Flats Dental Clinic. Dientes will continue to implement their Oral Health Access Strategic Plan for Santa Cruz County. Amy Peeler, Chief of Clinic Services at Santa Cruz County Health Services Agency, explained efforts to expand Medication Assisted Treatment (MAT). The Health Services Agency is also planning a remodel and physical expansion at their Emeline Clinic. Eva Montes-Portis, Area Services Director of Planned Parenthood Mar Monte, mentioned a transition to a new CEO and plans to increase capacity through the use of unoccupied space. Dori Rose Inda, CEO of Salud Para La Gente, and Anita Aguirre, Director of Patient Services, talked about Salud’s participation in a tele-health pilot focused on increasing access to specialty services integrated care. Salud plans to continue expanding dental and behavioral health and has introduced a chiropractor to their team. Leslie Connor, Executive Director of the Santa Cruz Community Health Centers (SCCHC), announced their expansion of MAT and plans to become a Pediatric Center of Excellence. SCCHC is working to decrease unnecessary hospital utilization through a Dignity Health - Dominican Hospital high utilizer group initiative. SCCHC is also partnering with Dientes to provide dental services in Live Oak and/or Santa Cruz. The HIP Council expressed enthusiasm for the SNCC partners’ future plans and marveled at the tremendous strides made in the local health care system over the past 5 years.
Health Information Exchange
Bill Beighe, Physicians Medical Group Chief Information Officer, presented on the Santa Cruz Health Information Exchange (SCHIE). SCHIE delivers patient information to a network of providers to establish connectivity and ensure continuity of care for patients who have received medical attention from multiple providers. A physician can securely access information about a patient’s medical history directly from their previous providers to ensure accuracy of patient health information and the highest quality of patient care.
SCHIE allows local providers to use a closed-loop referral and define a care team of medical professionals to share data and remain involved in a patient’s complex care. The provider can also assign levels of access to members of a care team to ensure appropriate sharing of information. SCHIE also uses syndromic surveillance to help identify and control outbreaks of disease within the community. The system reports data to the CDC, as well as local public health departments, contributing to county-wide population health reporting.
SCHIE is operated by Physicians Medical Group. However, it is currently transitioning to a local governance board of representatives from the health care community. The new organization, Santa Cruz Information Exchange Organization (SCHIO), is currently merging platforms with Orange County Partnership Regional Health Information Organization (OCPRHIO) to leverage similar infrastructure at a lower cost. SCHIO relies on grant funding for functionality enhancements, as well as service contracts with participating entities. According to Beighe, the costs of the program are far less than the money it could potentially save by preventing repeated or unnecessary tests.