| |
Contra Costa Health Services' Chief Equity Officer, Gilbert Salinas, will be providing the Committee with a PowerPoint presentation of the Department's Diversity, Equity, and Inclusion efforts and practices. The following information was submitted by the Department in their budget development material for FY 2023-24:
Equity
As the County's single largest provider of health insurance coverage and care in communities recognized as experiencing the greatest disparities in health outcomes, CCH has implemented initiatives focused on improving health equity and outcomes. For example, CCH has worked to improve access to healthcare services by expanding same day appointments and walk in care in our facilities that are exclusively located in communities that have been recognized as the highest risk for health disparities. We continue to support critical health care access through Contra Costa Cares program which expanded service and enrollment slots. We have also implemented programs aimed at addressing social determinants of health, such as providing housing, food and transportation.
Our efforts to advance equity are organized under four areas:
- Data and measurement.
- Services provided to our community in a culturally appropriate manner.
- Community engagement across all our efforts, and
- Internally focused efforts related to hiring and employees.
Our equity efforts are data-driven, guiding CCH in resource and service allocation. Our facilities are located in neighborhoods where there are historic health disparities. We also examine equity in our key metrics. Two examples of this are the Quality Improvement Program which is overseen by Contra Costa Regional Medical Center and Health Centers where every metric is stratified by race/ethnicity, sexual orientation and gender identity and area of service. These metrics are reviewed monthly and improvement plans are developed to account for health disparities. Contra Costa Health Plan is also addressing equity by regularly reviewing of a core set of metrics, furthering equity across the county as the metrics reflect services provided by CCH as well as the community network of providers.
As we continue to improve our services using an equity lens, we are examining our services. One example of this is the equity work in the Continuum of Care (COC) where CCH and our partners have committed to advancing racial equity throughout the homeless crisis response system. Another example is the work of the PRIDE Initiative to further training around sexual orientation, gender identity and pronouns in our registration staff that greet people when they come for appointments.
Community engagement is another area of focus in our equity efforts. During the COVID-19 pandemic, we started the Historically Marginalized Community Engagement group which continues meeting monthly to share innovative programs, updates on CCH and its partners and explore opportunities and ideas for further collaboration. Our Behavioral Health experts also sustain community engagement through the Behavioral Healthcare Partnership monthly meetings where updates on various projects such as A3 or facility construction updates happen monthly.
Our internal equity work continues in 2023 with a Roadmap which outlines department goals and strategies focused on hiring, promotion and welcoming for all staff. CCH contracted with the Justice Collective to facilitate a team of CCH staff including our Chief Equity Officer to engage in a planning process using the results of a staff survey in 2022 to identify issues and develop solutions. During this year, efforts will be focused on implementing the Roadmap and repeating the staff survey.
Finally, we are supportive of the efforts to create the Office of Racial Equity and Social Justice and look forward to partnering with the new staff to further equity across the county.
| Equity Statistics |
County Residents who received services or were enrolled with CCHS |
Residents enrolled in Contra Costa Health Plan |
Members Enrolled in Enhanced Case Management Services |
COVID-19 Admissions at CCRMC |
| American Indian/Alaska Native |
1,297 |
492 |
36 |
|
| Asian |
66,889 |
27,742 |
482 |
45 |
| Black/African American |
52,998 |
29,955 |
2,080 |
76 |
| Declined/Unknown |
88,713 |
38,984 |
128 |
14 |
| Hawaiian/Pacific Islander |
3,733 |
1,892 |
63 |
2 |
| Hispanic/Latino |
139,585 |
93,342 |
2,337 |
158 |
| More Than One Race |
6,917 |
3,470 |
183 |
13 |
| Other Race |
28,237 |
10,469 |
402 |
31 |
| White/Caucasian |
122,318 |
41,325 |
2,320 |
126 |
| Grand Total: |
510,687 |
247,671 |
8,031 |
465 |
FY 2022/23 Accomplishments-
- Maintained COVID-19 response with mortality rate among lowest in nation while reducing the equity gap in communities of color.
- Awarded funding to expand CCH Equity Team Health Ambassador Program to continue outreach to at risk communities in partnership with Employment and Human Services.
FY 2022/23 Goal Outcomes
CCHP Goal: Enhanced Operations and Regulatory Requirements: Implement strategies to ensure a smooth two-year evaluation of CCHP operations in areas of deficiencies. Implement aggressive and measurable changes in several critical areas including:
- Member engagement activities
- Member and Provider surveys
- Interest payments and turn-around times for claims adjudication
- NCQA results
- HEDIS scores
- Year 1 assessment of the Enhanced Care Management & Community Support Services
- Network adequacy
- Ensure all new benefits have workflows and policies, and staff training (Transplants, Doula Program).
- Evaluate network on adequacies for the age 50+ immigrant status members entering Managed Care Plan (MCP) in May 2022.
CCHP Outcome: Goals met. CCHP’s Quality Department satisfactorily met these goals – both member and provider surveys were performed in accordance with the Department of Health Care Services (DHCS) contract. We submitted all the documents to the National Committee for Quality Assurance (NCQA) for the three-year look back period. Thousands of documents were uploaded on time in the NCQA portal. New benefits in 2022 were implemented on time along with numerous provider trainings for the Enhanced Care Management, Community Health Worker, No Wrong Door, and Transplant programs. CCHP met the Department of Managed Health Care standards for having an adequate network and received certification. New older adults 50+ were integrated into CCHP’s membership ranks. CCHP worked with the Equity office and educated the community and worked with the CARES program to ensure those members became CCHP members and kept them assigned to the Federally Qualified Health Centers (FQHCs) for continuity of care.
Detention Goal: Patients with clinically significant findings will be seen by a clinician within 5 calendar days of intake with a compliance rate of 90%.
Detention Outcome: Goal met. Detention Health Areas of Focus for FY 2022-23 are built upon Safety, Quality, Equity, and Experience of Care. Our vision is to become the healthiest jail. In FY2022-23, we increased provider staffing, instituted a regular educational series for the providers, reviewed clinical cases as a department, and updated our chart documentation and electronic medical records to facilitate communication of the clinical management of the patients. Patients with clinically significant findings as identified through the medical screening at Intake are prioritized to see a clinician within 5 days of arrival to address key clinical needs in a timely manner.
2023/24 Goals/Objectives
Goal: Increase Equity and Reduce Health Disparities.
Objective: Develop ability in all measures to disaggregate by race/ethnicity, location and sexual orientation/gender identity.
Objective: Create the CCHP Equity Office and staff the office with staff experienced in working with vulnerable populations that can work with the community and division on meeting the Health Equity measurements as identified by the Department of Managed Health Care (DMHC) and DHCS.
|