Westside Health Access Project:

A Collaboration Between Community Partners and Hospital Partners Objectives

1. Background about Venice Family Clinic

2. Description of Westside Health Access Project

3. Discussion of Role and Involvement of Hospital Partners Venice Family Clinic

Mission: To provide quality primary health care to people in need.

Venice Family Clinic serves more than 24,000 patients annually. We are the main primary health care provider for low-income, uninsured and homeless individuals and families on the Westside. Comprehensive Services Primary Care • Medical • Reproductive Health • Dental • Prenatal Care • Vision • Children First Early Head Start • Behavioral Health • Pediatrics & Teen Services • Laboratory • Integrative Medicine • Pharmacy • HIV/AIDS • Chronic Disease Management • Health Education & Wellness • Homeless Health Care

Specialty Care Specialty care, provided by volunteer physicians, including , , ear/nose/throat, , , nephrology, , , optometry, orthopedics, physical therapy, pulmonary, sports medicine and rheumatology. Health Centers Services are provided at 10 health centers across the Westside. The “Other” Westside Our community has 134,000 low-income residents. 5,000 of them are homeless. 41,000 of them are children.

We serve 24,000 people who live in low-income households. • 75% live below Federal Poverty Level. • 74% minorities: 57% Latino, 11% African-American, 4% Asian. • 62% now have health insurance, the most in VFC history. • 29% are children. • 14% are homeless.

Health Care System Challenges

• Creating capacity to meet the demand of the newly insured in low-income neighborhoods.

• The Affordable Care Act will not cover everyone. People who are not legally in this country, the mentally ill and the homeless will fall through the cracks.

• Who will continue to care for the most vulnerable regardless of their insurance status? Venice Family Clinic: Caring for Neighbors in Need

If there is one thing we have learned, it’s that we can’t wait for someone else to fix what’s broken in our health care system.

We have to do it ourselves.

Venice Family Clinic is here for the most vulnerable men, women and children in our community. We partner with others who share our commitment to people in need.

Westside Health Access Project

Funded by a grant from Endowment

GOAL: For low income patients on the Westside:

• To provide access to care in their neighborhoods

• To decrease emergency room and hospital utilization and reducing overall health system costs

• To create a more coordinated system of care

Stakeholders

• Venice Family Clinic • Health Care LA IPA • Westside Family Health Center • LA Care Health Plan • Achievable Foundation Clinic • Health Net • OPCC • County DMH • Cedars Sinai Medical Center • Didi Hirsch • Kaiser Permanente West LA • Planned Parenthood • Providence St. John’s Health • George Hoag Family Center Foundation • UCLA Health System

Project Timeline

July 2014-January 2015 Convened Stakeholder Group Identified Key Priority Areas Developed Ideas to Address Gaps

February 2015- Present Established Working Groups Designed Pilots Conducted Pilots Plan to Evaluate Pilots

Key Priorities Identified

1. Emergency Room Utilization

2. Access to Specialty Care

3. Availability of Behavioral Health Services

Overview: ED Utilization

• Improved referral resources • Warm-Handoffs between EDs and Primary Care • Health Information Exchange • Between hospitals • Between hospitals and primary care • Support work of Exodus to open crisis center on Westside • Care Navigation & Care Management

ED Utilization Pilots

ED2C (Emergency Department-To-Community) Cedars-Sinai Medical Center

H.E.R.O. (Homeless Emergency Room Outreach) Kaiser Permanente West LA

Care Navigation Pilot Providence Saint John’s Health Center & OPCC

Health Access for Homeless Individuals: Collaborating with a Medi-Cal Managed Care Plan L.A. Care Health Plan

Overview: of Specialty Care Access

• Create a Specialty Hub • Referral System for Community Clinics • Network of specialty providers • Expand network of in-kind services • Community providers • Services from Hospitals • Pilot special contracts and payment rates to attract specialists • Narrow networks • Paying Medicare rates for Medi-Cal visits Specialty Hub Pilots

Residency Training Clinics Cedars Sinai Medical Center

GI Procedures Providence St. John’s Health Center

Tele-Optometry/Retinal Photos Kaiser West

Curbside Consultation – Hepatitis C Kaiser West Los Angeles

Recruitment of Volunteer Specialists Providence St. John’s Health Center Other Partner Support

Providence St. Johns Specialty Hub Project Funds Equipment, Staff Support, Payment

Cedars Sinai Westside Health Access Administrative support, data analysis and project evaluation

HealthNet OPCC Care Navigation Pilot Staff & Medical Supplies Value of Hospital Partners

• Thought partners

• Financial Support

• Arranging services at their institutions (in-kind, contracts)

• Engaging their community and “associates” Challenges

• Maintaining equal levels of engagement among stakeholders

• Navigating the “different worlds” of institutional culture and systems

• Ensuring the appropriate people are at the table • Decision making, feedback, key informants

Through the Westside Health Access collaborative, we continue to build new bridges that put our patients on a path to better health. Contact Information

Anita Zamora [email protected] (310) 664-7667

www.venicefamilyclinic.org