Hub & Spoke

New Consortium Website

This Just In!

In a week otherwise sorely lacking in the "extremely pressing issues that demand blog comment" department, we decided to create our own breaking news story by publishing a new and improved (and way cooler looking) website for the Consortium.  

Many of you may be asking yourselves, 1) "The Consortium has a website?" and 2) "Aren't I currently on the Consortium's website?"  

The answers to those questions are 1) Yes, and 2) No.  

To be sure, the Consortium publishes this blog, but we also have a website dedicated to the Consortium itself - complete with staff bios, descriptions of our past and current projects, information about our member clinics, and a new web-based tool that allows advocates to automatically send our government representatives messages about issues affecting healthcare for low-income communities.  (This last feature is our favorite.)

In a whirling dervish of circular website navigation, we also provide a link on that site back to…this one.

So if you've got 37 seconds, follow this link to our new site and, if you're so moved, drop us an email or post a comment and let us know what you think!

and the worst are full of passionate intensity...

Remember those couples in high school who celebrated their six-month anniversaries? There was, as we remember it, always something pretty underwhelming about that particular milestone.  In making such a big deal of reaching half a year, these starry-eyed lovers seemed to unwittingly signal that maybe the full 12 months was a bit too much to ask for.  

The lifespan of adolescent romance came to mind this week as we read news reports marking the 6th-month anniversary of the national health care reform law.  

For health centers and our uninsured, low-income patients, the anniversary worth celebrating doesn't come until 2014, when Medicaid expansions will move millions more onto insurance coverage and into our clinics.

So while important provisions of the law take effect this week, health centers will, to extend the analogy, probably send the happy couple a card, and skip the party.  

There may, however, soon be a time when we need to organize a massive block-party style Health Reform celebration with all our friends and neighbors.  

Because we know this: Health Reform is something of a political hot potato in a country where 45% of the population still doesn't really know what the law says, and the people who feel most passionately about it seem intent on striking it from the books.  

It occurs to us that if the only people who care about Healthcare Reform are the people who want to overturn it, then eventually it really will be in trouble.  

Health centers need to take up the flag as Chief Defenders of Healthcare Reform.  We owe it to our patients to make sure that this landmark, groundbreaking, game-changing law is around in 4 years, when it really starts getting good.  

The six month anniversary of health care reform might not have significant impact for our target population, but the legacy of this law is in our hands.

To the future, and beyond!

Mark your calendars, oh denizens of Richmond!  Saturday, September 25th is the When.  The What?  A community meeting for residents to weigh in on a weighty question: 

Assuming resources to make lasting improvements in health, safety, wealth, and education in Richmond, what do we envision for the future of our city?  

It's a provocative question.  It acknowledges that Richmond struggles in some major ways to provide its residents with opportunity.  

Yet implicit in the question is also the idea that we, the people and businesses of Richmond, love our fair city, and feel strongly that it's worth transforming into the place we believe it can be.

Of course, many readers probably didn't get beyond the "assuming resources" part of the question.  Without resources to make change, it can't happen.  And who's got resources these days?

Richmond does!  Or, at least, it probably will, thanks to what appears to be a massive (though as-yet undetermined) investment in the community by The California Endowment, a foundation aiming to make deep and sustained change in 14 cities throughout the state over the next decade.  

By focusing its investment in specific places, the Endowment's acting on the common-sense (and research-supported) idea that the health and well-being of a community depends on a broad range of factors that goes well beyond simply whether the community has access to hospitals and clinics.  Schools, safety on the streets, career opportunities, parks, streets, clean air - all these and more obviously impact the health of a city's residents.  

Perhaps most importantly, the Endowment has made clear that the most fundamental goal of its community investments will be to empower residents themselves with the skills and knowledge to push for improvements in their cities.  

In other words, the idea is to enable change from within, following the community's own priorities and naturally sustaining itself far into the future.  

The buzz-word for this is Systems Change.  The tool for this is Advocacy.  The people whose energy, creativity, and ideas we'll be relying on for this are the Youth of this city.  (For more, visit the Healthy Richmond website here.)

So the Endowment has spurred community members in Richmond to come together to map out a course for reinvigorating the city.  

A Steering Committee made up of stakeholders from the non-profit, business, and local government spheres formed about a year ago, and have been working diligently to develop the first draft of this roadmap.

Now it's time for the broader community to come to the table and jointly develop a plan.  

Which gets us back to September 25th, the next "community engagement" meeting - which will be held at 9:30am-2:00pm at Grace Lutheran on Barrett.  Lunch will be served, and space is limited, so call the number on this flyer to reserve your spot!

We plan to be there.  We hope you will, too!

Success Story

Just a quick post today with an update on the fantastic success of the "lemonade from lemons" program that community clinics and Contra Costa Health Services set up in the wake of the April, 2009, Board of Supes' decision to close Basic Health Care coverage for undocumented immigrants.

The 20-second version is that the program, which streamlines patients who would have been eligible for BHC into appropriate primary care at their choice of community clinic, has been operating at record levels of demand in 2010.  Click here for a fact sheet with more detail.  

And as we take the opportunity to point out every time we see a Supervisor, problems that popped up within the program's first year are starting to come under control due to strong efforts by community clinics and the County.  

A little while ago, the Consortium kicked off a series of meetings between La Clinica and CCHS providers aimed at creating a forum for working out patient transfer protocol - particularly complex when a patient is discharged from County care but still in need of specialty care services not offered by community clinics.  

One great development so far: CCHS instituted a policy to allow 30 days of post-hospitalization coverage for undocumented patients discharged from CCRMC.  This is huge.  

Also: telecommunications technology is coming to the rescue: La Clínica providers now have a CCHS provider contact list that allows them to connect directly with each other in a timely manner.  And CCHS providers have access to a messaging service at La Clínica where they can leave messages for clinic providers about prospective patients that will be handed-off fromone system to the other.

In short, things are Working.  And that, when it comes to the health care world, is a pretty big deal.  

What's in a brand name?

As many of our readers will already know, today is the day that Planned Parenthood Golden Gate officially loses its affiliation with Planned Parenthood's national body, meaning that all the clinics in San Francisco, Sonoma, Marin, Alameda and San Mateo that have Planned Parenthood signs on their doors have to take those signs down and call themselves something else. They'll still operate, but not under the tried and true brand-name that we all know and love. As newspaper and radio reports have detailed, de-affiliation from Planned Parenthood is a very rare and dramatic thing. A sort of "nuclear option" for troubled clinics. For us here at the Consortium, the imbroglio brings up some important issues, not least because one of our members is Planned Parenthood Shasta-Diablo, and we've received our fair share of calls asking how PPGG's saga has and will affect PPSD. Here are some of our thoughts on the matter: First, Planned Parenthood Golden Gate is not Planned Parenthood Shasta-Diablo. This may seem pretty self-evident, but we think it bears repeating because as perceived by the general public, Planned Parenthood is Planned Parenthood, period. The fact is, however, that Planned Parenthood affiliates operate as independent, self-contained nonprofit corporations. They share neither finances nor governance. The only things they share, actually, are their name and of course standards and protocols set out by the national office. The point here is that what happens to the (former) Planned Parenthood in Alameda or San Francisco does not directly affect Planned Parenthood Shasta-Diablo in Contra Costa or Solano. That said, it's clear that there are huge indirect effects. The foremost being that PPSD will likely be moving in to fill the new void in at least some of the counties. This is an important point - that even in this time of Medi-Cal payment delays and chronic under-funding of women's health programs, Planned Parenthood in Contra Costa/Solano is thriving. All this raises the issue of branding, and specifically brand loyalty among clients and patients. When the PPGG clinics make their name change, their patients will face a choice: to stay with a newly-named organization or to seek care elsewhere. When PPSD clinics open up in the same counties, that choice will be even more stark - stay with what was Planned Parenthood, or go to what is now Planned Parenthood. How much does that brand name matter? In our opinion, it matters quite a bit - it's the proverbial good housekeeping seal of approval, the thing that tells prospective clients that care provided here is high-quality and reliable. But client-provider relationships matter a ton, too. So it will be interesting to see the movement of patients in the wake of today's disaffiliation. Finally, just a note on the importance of nonprofit governance by boards of directors. There are many, many criteria that board members typically need to meet. Membership in the organization; fundraising prowess; political astuteness. But as the PPGG situation demonstrates, perhaps the most important is the ability to provide sound fiscal oversight. Nonprofits are, after all, corporations handing real money in often very real amounts. The need for hard-headed number-crunchers on nonprofit boards is no less than the need for them on the board of Starbucks or Apple Computer. In this, the revocation of PPGG's affiliation, grounded in financial troubles, serves as a strong warning for nonprofits everywhere.