Coachella Valley

Healthcare Initiative

COACHELLA VALLEY HEALTHCARE ACCESS AND WELLNESS STRATEGIC PLAN

December 2010

Coachella Valley Healthcare Access and Wellness Strategic Plan

TABLE OF CONTENTS
BACKGROUND
The Coachella Valley Healthcare Crisis 2 2 2 4 4 4

The Coachella Valley Healthcare Initiative The Approach

Healthcare Access Barriers and Solutions The Strategic Plan Framework Opportunities

THE STRATEGIC PLAN

VISION MISSION 6

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GOALS AND STRATEGIES ACTION PLANS

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PERFORMANCE EVALUATION

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STRATEGIC PLAN RE - EVALUATION

Coachella Valley Healthcare Access and Wellness Strategic Plan

B ACKGROUND

The Coachella Valley Healthcare Crisis . The Coachella Valley has a healthcare crisis due to the magnitude of insufficient healthcare access as well as the disparities in access to healthcare experienced by different communities. There is an alarming shortage of healthcare providers, namely primary care physicians in the region and even fewer who serve in communities with high rates of poverty. Furthermore, the current economic crisis and rising unemployment rates have left many residents without health insurance and unable to afford basic and needed healthcare. The degree of poverty and lack of healthcare services make communities in the Coachella Valley amongst the most underserved in the state of California. The Coachella Valley healthcare crisis is an urgent and compelling problem in need of a solution. The Coachella Valley Healthcare Initiative. Numerous devoted people and organizations have and continue to be dedicated to improving healthcare access for the medically underserved communities in the Coachella Valley. Their tireless efforts are deserving of praise. Previous health and healthcare assessment reports have lead to a better understanding of the Coachella Valleys healthcare needs, strengths, weaknesses, and access barriers. Many residents of the Coachella Valley nevertheless continue to face large disparities and obstacles in obtaining healthcare. The purpose of the Coachella Valley Healthcare Initiative (CVHI) is to improve healthcare access in the Coachella Valley with the goal of reducing healthcare disparities and improving health outcomes and wellness for all residents. Their first endeavor is to facilitate a community-based, collaborative, and regional Coachella Valley Healthcare Access and Wellness Strategic Plan to be used as a community guide with the common purpose to remedy the healthcare crisis. The Approach. In order to understand the breadth of the Coachella Valleys healthcare crisis, the nature of the healthcare access barriers and their solutions, and

Coachella Valley Healthcare Access and Wellness Strategic Plan

promote community engagement and collaboration amongst key stakeholders, CVHI used an array of methods. They included: Community forums Key stakeholder interviews Formative research Geographical information (GIS) mapping

The community forums occurred throughout the Coachella Valley. There were a total of nine community forums with 325 participants and representation from 54 organizations. Participants and organizations included residents, students, healthcare service providers, case managers, social workers, community-based organizations, educational institutions, government agencies, policy makers, and funding sources. Three guiding questions framed the community forum dialogue. These questions were: What are the healthcare access barriers in the Coachella Valley? What are solutions to improve healthcare access in the Coachella Valley? What can you and your organization do to improve healthcare access in the Coachella Valley? Furthermore, thirty-eight individuals participated in the key stakeholder interviews. These key interviews were conducted to gather stakeholder impressions of local healthcare access barriers and solutions and begin to develop the strategic plans vision, mission, goals, and strategies. The CVHI director, research coordinators, health experts, and 25 local volunteer high school, pre-medical, nursing, public health, and medical undergraduate and graduate students conducted formative research. Geographic information system mapping was used to spatially display and analyze important demographic and healthcare system information. The Coachella Valley is considered to be the geographical areas in Southern Californias low desert from the western city of Desert Hot Springs to the eastern community of North Shore bordering the Salton Sea. Healthcare access is defined as access to a system of public health, healthcare delivery, health education, and wellness services.

Coachella Valley Healthcare Access and Wellness Strategic Plan

Healthcare Access Barriers and Solutions. Information from the community forums and key stakeholder interviews were prioritized by participants and analyzed by the research team for thematic similarities. In order of their priority, the healthcare access themes are: 1. Healthcare Costs 2. Healthcare Infrastructure 3. Patient Satisfaction, Cultural Competency, and Cultural Humility 4. Community Health Education & Awareness of Healthcare Resources 5. Transportation These healthcare access themes subsequently guided the formative research and GIS mapping. Findings were described in the CVHI Healthcare Access Report. These healthcare themes and the CVHI Healthcare Access Report serve as the context and information used for the development of the Coachella Valley Healthcare Access and Wellness Strategic Plan. The Strategic Plan Framework. The Coachella Valley Healthcare Access and Wellness Strategic Plan includes a vision, a mission to accomplish the vision, goals to meet the vision and mission, strategies to accomplish those goals, action plans to implement the strategies, and mechanisms for performance evaluation to measure outcomes and strategic plan re-evaluation. Opportunities. Developments and momentum are occurring on the national, state, and local levels that create opportunities to improve healthcare access and wellness in the Coachella Valley. Collaboration amongst all stakeholders is encouraged to take full advantage of all opportunities. The magnitude of the healthcare crisis, the amount of people throughout the Coachella Valley without access to affordable healthcare services, and the health morbidity as a result of these barriers are burdens too large for one

Coachella Valley Healthcare Access and Wellness Strategic Plan

organization to handle alone. Therefore, through a collaborative effort, based on a common purpose and a Coachella Valley Healthcare Access and Wellness Strategic Plan, collective strengths can be maximized to provide optimal healthcare access and wellness for all residents in the Coachella Valley.

Coachella Valley Healthcare Access and Wellness Strategic Plan

T HE C OACHELLA V ALLEY H EALTHCARE A CCESS AND W ELLNESS S TRATEGIC P LAN

V ISION
All residents will enjoy optimal individual and community wellness with healthcare access in the Coachella Valley.

M ISSION
To improve wellness, health outcomes, and healthy environments by promoting an integrated, sustainable, and high quality healthcare system with community engagement; reducing healthcare access barriers and disparities; and advancing health education, prevention, and wellness services for all residents of the Coachella Valley.

G OALS AND S TRA T EGIES

Regarding Healthcare Costs Goal 1. To develop a sustainable source of revenue for the implementation of the Goal 1 Coachella Valley Healthcare Access and Wellness Strategic Plan. Strategies for Goal 1 1. Launch a capital campaign with local stakeholders, philanthropists, businesses, and foundations to ensure 4 years operational costs for implementation of the plan 2. Leverage funding from the new federal healthcare reform law that targets the development of new or expand existing Federal Qualified Health Centers (FQHC) and the creation of programs and services emphasizing prevention and primary care services 3. Create a healthcare district that serves the eastern half of the Coachella Valley 4. Pass a local Measure for designating funds towards improving healthcare access Goal 2. To make health education, prevention, and healthcare services available and Goal 2 affordable to all residents in the Coachella Valley.
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Coachella Valley Healthcare Access and Wellness Strategic Plan

Strategies for Goal 2 1. Create and coordinate free health lectures, workshops, health fairs, screening programs, and prevention services and promote them systematically and widely 2. Expand amount and services of free care clinics 3. Schedule regular and more frequent free healthcare service fairs throughout the Coachella Valley. 4. Promote more physicians and institutions to use sliding scale fees based on income 5. Undertake an insurance education and enrollment campaign 6. Create a program or center where information regarding the new federal healthcare reform laws can be understood and utilized by the public and providers Regarding Healthcare Infrastructure Goal 3. To increase the number of health care providers - doctors, dentists, mental health Goal 3. specialists, nurse practitioners, physician assistants, and pharmacists - specifically primary care physicians serving in the Coachella Valley with emphasis in underserved communities. Strategies for Goal 3 1. Develop healthcare provider residency and other training programs in the Coachella Valley and engage the Federally Qualified Health Centers (FQHC), county clinics, and low cost or free clinics as training sites 2. Increase the amount of dental and mental health services in FQHCs, county clinics and low cost and free clinics 3. Recruit more healthcare providers to work at FQHC , county clinics, and free clinics 4. Build healthcare professional pipelines programs for physicians, dentists, mental health professionals, nurse practitioners and physician assistants and link our local K-12, undergraduate and graduate schools, and post-graduate training programs

Goal 4 . To increase accessibility of healthcare providers serving all residents regardless of their insurance status. Strategies for Goal 4 1. Increase the participation of healthcare providers and institutions to accept Medi- Cal insured patients 2. Increase the number of healthcare providers and institutions to accept sliding scale fees based on income for services
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Coachella Valley Healthcare Access and Wellness Strategic Plan

3. Increase the number of healthcare providers to volunteer at free clinics 4. Provide regularly scheduled specialty clinic services for the medically underserved in the Coachella Valley through a partnership with regional hospitals, local hospitals, local clinics, and healthcare professional training programs 5. Provide temporary specialty telemedicine services for residents who have difficulty finding specialty care until there are an adequate number of specialty healthcare providers serving all residents of the Coachella Valley

Goal 5. To increase the number and availability of wellness and healthcare facilities to all Goal 5. residents of the Coachella Valley. Strate gies for Goal 5 1. 2. 3. 4. 5. Increase availability of evening and weekend hours and promote accordingly. Increase urgent care and same day capacity at current clinics Open independent urgent care centers in underserved communities Expand or build more FQHCs and county clinics in locations of greatest need Open a county Medically Indigent Services Program pharmacy in the Coachella Valley

Goal 6. To promote collaboration and integration among the healthcare systems as well Goal 6 as with community organizations. Strategies for Goal 6 1. Electronically connect the emergency departments, hospital discharge groups, FQHCs, low cost clinics, county clinics, and community-based organizations for enrollment and follow-up services 2. Create a method to share electronic medical records between healthcare institutions 3. Further develop venues and incentives to share information and collaborate in programs and projects such as web-based forums, service provider conferences, and annual healthcare summits 4. Encourage hospitals, clinics, and community-based organizations to share costly new healthcare and wellness facilities (i.e. imaging, laboratory, and education centers) and create new services in partnership (i.e. dialysis and infusion centers) rather than building competitive services Regard ing Community Health Education & Awareness of Healthcare Resources Goal 7. To further develop effective mass health education modalities with emphasis on Goal 7. community engagement, personal responsibility, prevention and healthy lifestyles.
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Coachella Valley Healthcare Access and Wellness Strategic Plan

Strategies for Goa l 7 1. Partner with the school district to update and promote a health curriculum based on above goal 2. Utilize faith based networks to promote and host health education events and activities 3. Promote youth, resident, and health promoter involvement and leadership in peer and community health education workshops 4. Collaborate in providing coordinated and well-disseminated health education events for all residents in the valley

Goal 8. To further develop resource information and enrollment, wellness and healthcare Goal 8. access points throughout the Coachella Valley. Strategies for Goal 8 1. Develop a collaborative effort with training people to orient, enroll, and provide health information at various sites including but not limited to clinics, businesses, government offices, residential developments, and schools 2. Launch a roving enrollment center that travels between these sites and others on a pre-scheduled and publicized basis Regarding Patient Satisfaction, Cultural Competency, and Cultural Humility Goal 9. To promote and improve patient satisfaction and healthcare literacy through 9. cultural competency and cultural humility between the healthcare system and the population. Strategies for Goal 9 1. Create cultural competency workshop certification as part of routine credentialing requirements for healthcare providers and staffs at hospitals clinics, and community based organizations 2. Integrate cultural competency and humility into healthcare provider education and training curriculum 3. Create patient based healthcare literacy workshops 4. Develop and institute a standard patient satisfaction survey to measure progress on both patient healthcare literacy and provider cultural competency and cultural humility

Coachella Valley Healthcare Access and Wellness Strategic Plan

Regarding Transportation Goal 10. To expand Coachella Valley and regional transportation services linking Goal 10. underserved populations with available wellness and healthcare services. Strategies for Goal 10 1. Expand transportation services to Riverside County Regional Medical Center and Loma Linda University Medical Center 2. Better market and inform residents of current transportation services and how to use them 3. Develop local transportation opportunities to wellness and healthcare facilities

A CTION P LANS
Action plans to implement each strategy will be developed beginning at the Coachella Valleys Inaugural Healthcare Summit on December 17, 2010 and continue with the formation of action teams based on each strategy. The action teams will be responsible to implement their action plans. The action plan implementation will also be determined by the CVHI organizational capacity, community partnerships, and input from the CVHI Advisory Council.

P ERFORMANCE E VALUATION
Mechanisms for evaluating the implementation and measuring outcomes of the strategic plan with emphasis on high performance will be determined by CVHI organization capacity, community partnerships, and input from the CVHI Advisory Council.

S TRATEGIC P LA N R E - E VALUATION
Mechanisms to re-evaluate and change the strategic plan in order to incorporate new trends and opportunities and achieve high performance will be determined by CVHI organization capacity, community partnerships, and input from the CVHI Advisory Council.
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