Hub & Spoke

Community Health Centers Launch Local Community Health Vote 2012

 

Community Health Centers in Contra Costa and Solano Counties are now offering patients the opportunity to register to vote and to receive information on the voting process as a service to the community.  As non-profit organizations, La Clínica de La Raza, Brookside Community Health Center, LifeLong Medical Care, and Planned Parenthood Shasta Pacific offer non-partisan voter registration and education as part of their commitment to help staff and clients become more engaged in their community. 

Why health centers are registering voters:

This effort is part of Community Health Vote 2012; a national initiative started in 2008 by the National Association of Community Health Centers (NACHC) to establish permissible, nonpartisan voter engagement activities -- voter registration, voter education, and get-out-the-vote (GOTV) in the low-income, medically underserved communities served by health centers across America.

Voter engagement is a natural extension of community health centers’ long time bi-partisan grassroots advocacy mission, and is consistent with the founding purpose of being leaders in improving the life and well-being of their communities.  By integrating voter registration into the daily activities and highlighting the importance of voting, health centers hope to help patients and communities be more informed and civically engaged.

How it works:

When patients check-in for their appointment, they have the opportunity to register to vote.  Completing a voter registration application takes just a few minutes, and the Health Center collects and submits completed forms to the Secretary of State’s office as a courtesy to patients and community members. 

The deadline to register to vote in the upcoming June Primary Election is May 21^st. To register, individuals must be a U.S. citizen, at least 18 years old by Election Day, and a resident of California.

The importance of community health centers:

Brookside, La Clínica, LifeLong, and Planned Parenthood provide comprehensive, high-quality primary and reproductive health care services to residents of Contra Costa and Solano Counties. They offer services at affordable prices for the uninsured and medically underserved. According to 2010 Office of Statewide Health Planning and Development (OSHPD) data, community health centers recorded approximately 280,000 patient encounters in Contra Costa and Solano Counties.

Why your vote matters!

1.  One vote can and often does matter in election outcomes
2. If you don’t vote, you give someone else the power to affect your life and the lives of your family.
3. If you don’t vote, you double the value of someone else’s vote.
4. When you vote, you send a signal to whoever gets elected to pay attention to you and the needs of your health center, especially when you are a health center patient or staff member.
5. Your vote is your voice in what happens in this country and the only person who can silence your voice is you.

Visit your local health center and register to vote!

The America We Want

Here's a riddle: What steadily shrinks for the first 39 years of its life and grows blazingly fast for the next 30?

(Sorry, gents - the answer's unfortunately not, as a general rule, "my hairline.")

Give up? 

It's the income gap in America - the difference in the percentage of the nation's wealth held by the richest 1% of the population and that held by everyone else.  Without getting into too many details, the more-than-somewhat-alarming fact of life in the USA these days is that if you're at the very top, you're sitting prettier than ever, and if you're not up there, things are looking grimmer.  

PBS had a great segment on this yesterday, which got us thinking.  

It got us thinking about what kind of America we Americans are making with the public policies we're enacting into law.  

Because regardless of what's to blame for the widening gyre that's blasting through the middle class, it seems that at least part of the answer to social inequality has to be wise federal legislation designed to bring us all together on common ground.

Case in point: Federal Healthcare Reform. Which, incidentally, just passed its anniversary. 

Congressman George Miller was in Concord this week to celebrate what the law's already provided to the sick and otherwise hard-to-insure.  He introduced Dr. Walker of CCHS (to whom he referred as his mentor on health policy) and a panel of regular people - from all walks of life - who're now able to access medical care that just months ago would have been totally out of reach.  

And then Mr. Miller said something so spot-on we wrote it down verbatim:

“On the horizon, there’s an insane idea that they can repeal this and replace it with a voucher. A voucher is the most expensive way to do healthcare… I don’t think that’s America. I don’t think it’s our future… As people find out more and more about this plan, I hope they will understand this is a generally great American idea.”

Right and right. Half of Congress is up in arms about how un-American it is to spend tax dollars on greater healthcare access for everyone. But America is what we make it through conscious policy choices. And the America that we here at the Consortium want to see isn't one where 1% of Americans have dream lives and the other 99% just scrapes by. 

One hundred percent of us deserve some basic things equally. Including health care.

In a society wedged further and further apart, Healthcare Reform honors the American ideal that we all have the right to a fair start.  

So, Mr. Miller, count community clinics in for the fight to keep Reform on the books. And thank you, as always, for your leadership!

Saving Medi-Cal will take more than optimism

Have you ever fallen a bit into the red ink with your personal finances? Sure, who hasn't.  Have you then, as a sort of family recovery plan, written a budget that puts you back in the black, but does so based in large part on the expectation that your boss will agree to raise your salary by $12 billion?  

If you answered yes to these questions, you may qualify for a job at the California Department of Finance, or perhaps in the governor's office itself, where the zeitgeist is a certain rose-tinted optimism about the generosity of the California public.  

Specifically, an optimism that in a June special election California voters will agree to extend about $12 billion in what were originally meant to be temporary tax increases.  Absent these tax extensions, the service cuts that Sacramento will have to make in order to balance the state budget will make drastically severe a quaint understatement.  

(As the comic to the right says, if you think the $1.7 billion in Medi-Cal cuts that Gov. Brown proposed in January are bad, consider what they'll be if he's got to find a dozen or so billion more dollars to squeeze out of state programs.)  

Actually, given that taxes do need to be raised somehow, the plan to bring tax extensions to the voters is a politically savvy one, given that it's harder for opponents in the Legislature to block something that's going to The People for approval.  Also, if a recent PPIC poll is any indication, it has at least a chance of succeeding.

To our mind, however, the PPIC poll demonstrates the possibility, but not the probability, of success.  If we - you, us, and all of the People Who Care about Our Community - want to save Medi-Cal and health centers from the chopping block, we've got to get out and vote in June.  

To that end, we at the Consortium are launching a major voter registration push, starting now.  More detail will follow - suffice to say that this will be our top advocacy priority in Spring 2011.  (BTW - if you're reading this and aren't registered - or have moved recently and need to re-register - follow this link to get the quick-and-easy process started.)  

But! We can't do it alone, and so we're writing to say: Join us! If you're an individual who can help out on the campaign to sign up voters, drop us a line and we'll put you to work! If you're an organization that's also doing voter reg. work this spring, let's figure out how we can work together to canvass the whole region.  

Future registered voters of Contra Costa and Solano Counties, we're coming for you! 

Waving Hi to a New Medi-Cal Plan

Guided by the time-tested adage that "week-and-a-half-old news is still news worth blogging about," we're interested in sparking a conversation here at Hub & Spoke about the recently-finalized 1115 Medicaid Waiver.  

As most of our readers will know, 1115 Medicaid Waivers are agreements between the state and federal governments that determine how California structures major parts of its Medi-Cal program.  It's a "waiver" because the agreement on Medi-Cal structure, while approved by the feds, deviates from the plain-vanilla federal template that the Medicaid program would otherwise default to.  

Here's how the LA Times framed the story:

The Obama administration on Tuesday approved a $10-billion plan to help California modernize and expand its Medicaid health insurance program for the poor, pushing the state to the forefront of the national effort to implement the new healthcare law.

The administration's much-anticipated decision to grant a so-called Medicaid waiver could ultimately help cover hundreds of thousands more Californians over the next five years. State and federal officials hope that will bolster efforts to improve the quality and efficiency of care provided to the state's poorest residents.

So, that said, the question for this community is this: how will the new 1115 Medicaid Waiver impact Contra Costa and Solano Counties?  

More specifically:

1. In Contra Costa County, given that a Health Coverage Initiative already exists - a facet of the previous 1115 Waiver - what will change for low-income adults under the new Waiver?
2. In Solano County, what are the opportunities presented by the new Waiver that the County might have the resources to take advantage of?  

We don't pose these questions rhetorically - we really do want to know.

So if you, dear reader, have insight into any of these mini-mysteries, please comment below and share the wisdom for our online community!

Meet Jackie Jones

This week we have the distinct pleasure of introducing you, the community at large, to the new (well, two months new) site manager for La Clinica North Vallejo, Jackie Jones.

Jackie took a break from her breakneck-paced schedule to answer such burning questions of ours as, “what is your professional background,” and “what is your favorite type of food?”  We found her dedicated, delightful, and generally awesome. 

And so, without further ado, we give you Ms. Jackie Jones, Site Manager Extraordinaire, in several bullet points:

• Previous gig:  Site manager at Petaluma Health Center (an FQHC) for 6 years.  This involved 1.5 hrs of commuting from Richmond each day; cutting that down to less than 30 mins per day is, not surprisingly, one of the many reasons Jackie is glad to be at La Clinica.

• A wealth of knowledge: Jackie’s eager to put into play in North Vallejo the best practices she learned the hard way in Petaluma – she comes with a deep well of knowledge and experience in maintaining excellent clinic operations.  She’s also field-tested in the dicey game of electronic health records, having quarterbacked Petaluma’s successful shift from paper-cuts to megabytes.  Reflecting on her process of learning-by-doing in her previous gig, she quips, “I’m glad to know what I’m doing this time around.” 

• Vision for North Vallejo: “FQHCs are sites that can and want to grow - to do the things that will bring continuity of care and quality care to the patient.  I’m looking forward to bringing my experience to the table.  I’ve got a great group here, and I’ll be engaging them in everything I’m doing.” 

• Ideal vacation: Anywhere without a ringing phone.  Cruise ships work well for that sort of thing.

• Favorite food: Mexican.

• Favorite recent movie: Taken (“It had me on the edge of my seat the whole time!”)

Delightful!  From all of us here at the Consortium: Welcome to Solano, Jackie! 

Good news on teen birth rates

Never let it be said that the Consortium only writes depressing blog posts on the lack of funding for healthcare services! Even in the midst of budget crisis, cause for celebration is worth celebrating.

Last Monday the CA Dept. of Public Health announced that rates of teenage births in this state continue a 16-year downward path - bucking the national trend and providing some of the most compelling evidence yet that California's reproductive education and birth control programs are wildly successful uses of state and federal funds.  

(Note to the legislature and Governor: this is why it's a bad idea to cut programs like FPACT, the Family Planning, Access, Care and Treatment program that leverages $9 in federal support for every $1 the state spends.)

Check out this great radio interview by Planned Parenthood: Shasta-Diablo's Adrienne Bousian, explaining why California pretty much rocks when it comes to teenage sexual health.

There will be no singing Kumbaya in this chamber

You know it's going to be a rough year in Solano County government when - 22 minutes into 2010's first Board meeting - Supervisor Kondylis says, "This is the most sexist, outrageous slap I've ever received, and you ought to be ashamed of yourselves."

She was referring to this morning's 3-2 vote to retain Supervisor John Vasquez as Chair of the Board - and, perhaps more significantly, the corresponding 2-3 defeat of the motion that Kondylis assume the role instead.  Supervisors Vasquez, Mike Reagan, and Jim Spering voted with the majority; Supervisor Kondylis and Linda Seifert with the minority.  

The vote raised several contentious issues.  Namely, the apparent rift between the men and women on the Board; and the sense that the decision to reappoint Vasquez to Chair had been a fait accompli before the meeting started (a charge that Supervisor Spering flatly denied), which carries 'open government' implications.  

For us at the Consortium, it also raised an interesting policy question: how should board chairs be chosen?  In Contra Costa County, the chair's position rotates through the districts, so that the transition from Supervisor Bonilla to Supervisor Gioia this year was more like a technical matter than a political one.  

What are the relative merits of these different mechanisms for shifting power?  In Solano, the more democratic process for choosing a Board Chair could - arguably - lead to a less democratic result inasmuch as supervisors from some districts (and thus their constituents) could be excluded indefinitely.  On the other hand, a power shift without respect to the varied strengths among a particular set of supervisors could theoretically lead to less effective leadership (though I haven't seen this play out actually).  Finally, what is the 'power' we're talking about in the first place?  It may not be much.  Supervisor Kondylis herself said today that the role of Board Chair boils down to moderating meetings and signing mountains of paperwork.  

All that aside, the underlying concern here is that - as we move into another terrible budget cycle - the Board in Solano appears fractured and fractious.  The best county policies come from compromise and consensus.  So, as Supervisor Vasquez wryly put it this morning, the Board has a lot of mending to do.  We hope it mends fast.  

World AIDS Day

As anyone who's visited Google's homepage today knows, it's World AIDS Day - a time to take stock of where we are in the fight against a devastating global disease. 

I'm not an HIV/AIDS expert and don't pretend to be, but even a layman's glance at the "Evolution of HIV/AIDS in California 1981-2008" by the state's Office of AIDS shows that public health and medical science have made dramatic gains in the past decade.  

AIDS deaths have fallen steeply:

 As have diagnoses:

  

The authors of the study describe these and other positive trends as the result of successful prevention, care, treatment, and surveillance activities in California and nationwide.  Hear, hear!  

The problem, of course, is that these programs just got smashed to bits in the latest state budget cycle.  HIV/AIDS education and prevention; HIV counseling and testing; early intervention projects; HIV/AIDS housing; home and community-based care; therapeutic monitoring.  All completely eliminated in a combination of cuts approved by the legislature and line item vetoes by the governor.  

In turn, cuts trickled down to counties, which had to make their own cutbacks, like these in Contra Costa that we blogged about a few weeks ago.   

So on this World AIDS Day, I'm thinking less about the World and more about my neighborhood.  Cuts to HIV/AIDS prevention and education threaten to reverse the great work that's been done in California.  

Restoring funding should be a priority in 2010.   

A modest proposal

Bad news for the teeth of children living in Solano County. 

Trying to get a handle on a multi-million dollar deficit, the County’s Board of Supes voted on Oct 27 to cut about $165,000 from the Smile in Style program. 

Smile in Style teaches students how to maintain good oral health, screens for dental decay, provides kids with cavity-fighting rinses, and runs school-based dental sealant clinics.

Instead of 12,000 children served over the next year, Smile in Style will now reach only 5,000. 

For context: in California two-thirds of all kids suffer from an oral health problem by the third grade.  Over a half-million students miss at least one day of school due to non-routine dental issues.  California ranks second-to-last among all 50 states in children’s health status (beating only Texas)

As programs like Smile in Style lose funding, we’re likely to see even worse outcomes (worse than Texas!).

That’s why I think the state should change its strategy on oral healthcare for kids.  I suggest that we simply require full extraction of every California child’s teeth by age 8.  In place of teeth, each child will be issued his or her own set of dentures, upgradable every 3 years. 

Consider the benefits.  First, it’s a fiscal no-brainer.  By eliminating teeth, and thus all tooth-related diseases, we could close all state-supported dental programs. Unused funds would be redirected to other under-funded programs not as amendable to creative solutions.

Americans reportedly spend $2 billion per year on toothpaste, mouthwash, and floss.  Millions would be saved from a switch to baking soda-based denture solvents.

And estimates have it that we spend an aggregate of 38.5 days over an average lifespan standing in front of the sink, toothbrush in hand.  Imagine what you could do with an extra month of life!

Rather than slowly starving programs like Smile in Style to death – which solves neither our long-term fiscal deficits nor our healthcare problems – let’s pull the plug and start afresh.  No teeth, no problems!

Or we could raise the taxes necessary to adequately fund cost-effective preventive oral healthcare programs like Smile in Style. 

Either way.

Good news from Solano County's Board of Supes

Grand Jury Report: Rejected!

Good news from Solano County.  The Board of Supervisors on Tuesday voted unanimously to reject the Civil Grand Jury's recommendations to wall off public funding to community providers - like La Clinica North Vallejo - that provide services to patients regardless of their immigration status.  Follow this link for a video of the brief discussion on the topic, which featured a former Solano Coalition for Better Health board member speaking out in favor of La Clincia and Supervisor Reagan stating his personal thoughts on the matter, which despite his official vote are more along the lines of the Grand Jury's recommendations.  Scan ahead to 3:06 on the video player to start from the relevant part.  

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CA's healthcare system gets a D, but that's not the whole story

Today's Sac Bee runs a story on a new Commonwealth Fund study showing that California's health care system comes in 31st among 50 states and DC when scored on factors like access, prevention and treatment, avoidable hospitalizations, and healthy lives.  In other words, when scored on anything that matters, our healthcare system is - when compared to 60% of the states in the U.S. - sadly under-performing.  

Except, that's not quite true.  The 31st-out-of-51 rank is an average of over 30 indicators and masks where California does well - in leading healthy lives.

Here, we ranked number 5 overall.  Minnesota took first, and Hawaii second, if you were curious.  And with all that trudging through snow and hiking over volcanoes, respectively, I think their populations have an unfair advantage.  

Healthy living, in the study, is determined by a combination of mortality amenable to health care, infant mortality, breast cancer deaths, adults limited in activities, adults who smoke, children obese/overweight, and some others.  

These are important indicators not just of health but of overall good living and happiness.  I think it's interesting how a state like ours can rank so low when measured by our overall healthcare system but can finish in the top 5 when ranked by - frankly - how healthy we are.  

More evidence, I guess, that our state's and nation's health is determined by far more than how many hospitals or doctors or clinics we have.  Or, as the report itself says,

There is little question that health outcomes are heavily shaped forces both outside and inside the health care system. Income, education, and housing and work environments significantly influence the extent to which people are able to live healthy and productive lives. Other health determinants that are closely intertwined with cultural and socioeconomic factors also affect people’s expectations of and interactions with the health system.

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Millions remain uninsured under federal reform proposal

New York Times and others report this morning on the US Senate Finance Committee's health reform legislation - just recently scored by the Congressional Budget Office.  It's an $800 billion proposal (below the $1 trillion ceiling set by Obama) that would actually cut the deficit (another of Obama's edicts - not to raise the deficit - met).  

But here's what we have to remember: millions would remain uninsured (25 million, to be exact, the vast majority of whom would be US citizens), and the uninsured will still need places to go for health care.  

(Insert shameless plug for community clinic funding here.)