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2009 MCHC’s implementation of NextGen, an electronic medical record (EMR) system, has been our most demanding undertaking of the year: New equipment is being installed; training in digital processes is now underway; MCHC’s traditional medical records are being digitized and flowed into new systems. When completed, MCHC expects to achieve new efficiencies in patient care and organizational operations. The commitment of MCHC staff has made this prodigious effort possible. MCHC welcomed psychiatrist Silvina Holasek, M.D, onto our Behavioral Health team. She received her medical degree from the Instituto Universitario de Cienias de la Salud, in Buenos Aires, Argentina. After engaging in primary research at the invitation of the Mayo Clinic, she undertook and completed her residency in psychiatry at the University of Texas Medical Branch. She speaks both English and Spanish fluently, and has broadened MCHC’s ability to meet the mental and emotional health needs of our patients. Our community has responded to the MCHC, midwifery-based model of women’s care; Care for Her is expanding into a new wing, now under construction. We expect it to begin welcoming patients in the fall of 2010. A classroom for larger educational presentations, three smaller prenatal/health education rooms, 12 exam rooms and a dedicated lab will provide more comprehensive care to our female patients. Operational and capital support was provided through a grant from the Health Resources and Services Administration. Lakeside Health Center was able to expand access to pediatric care with support funding made possible through the American Recovery and Reinvestment Act (ARRA). Pediatrician Marlene Quilala. M.D. joined staff, anchoring services in our newly designed pediatric building. Well-known in Lake County, Dr. Quilala is Board-certified in Pediatrics: She received her Medical Degree from De La Salle University College of Medicine, Cavite, Philippines, and completed her residency in Pediatrics at Children’s Medical Center of Brooklyn, Brooklyn, New York. MCHC remains committed to caring for with patients with opioid dependency. In 2009, we continued to build on the integrated care model implemented in 2008, which we believe contributed to our seeing substantially more patients who suffer from mental health issues. Also, through frequent case conferences and careful attention to the depression levels of opioid-dependent patients, we are pleased to report that this patient group showed a significant reduction in the use of non-prescribed opiates and in PHQ-9 depression levels. We call this the start of success. The next step will be to improve patient engagement in counseling. With assistance from the Alliance for Rural Community Health, MCHC placed four HealthCorps staff this year, expanding community health education outreach initiatives. To address the decline in child access to oral health services, HealthCorps staff trained to screen children for oral disease, going into schools to provide onsite assessments, supporting dental staff as they provided onsite care. Once again, MCHC staff benefited through the health scholarship program administered by the Alliance for Rural Community Health (ARCH). ARCH also provided the opportunity for support staff received new training opportunities: Reception staff participated in a new customer service training program; we see data showing it achieved an improved patient experience; management staff also received advance training. Patient visits per day: 502
2008 Psychiatrist Stephen Vance, M.D, joined staff, offering an increased level of mental health services to the people of our region. Bringing more that 25 years of clinical experience to his new position, Dr. Vance has filled a critical local services gap that has negatively impacted our patients’ well being. In part, a Mental Health/Substance Abuse Service Expansion grant from the Health Resources and Services Administration (HRSA) made it possible for MCHC to begin offering these sorely-needed psychiatric services. Setting a new record, the staff of Care for Her staff assisted at over 300 births in 2008. This represents a 10% increase in the number of births from the previous year, and means we are now delivering a third of the babies born at our local hospital. MCHC attributes this success to the vitality of our midwifery model of care. To implement our vision to give Care for Her’s growing patient population an improved environment of care and an expanded array of services, MCHC began planning for an expansion into a completely renovated annex at Hillside Health Center; expansion of the program was supported by the California Wellness Foundation; capital funding was offered by Tides Foundation/Community Clinics Initiative, Community Foundation of Mendocino County and the Bradford Foundation. In 2008, MCHC focused on improving patient care by more fully integrating behavioral health and primary care. Our goal was to provide better care for patients troubled by co-occurring disorders. By placing licensed behavioral health providers alongside clinicians on the medical floor, we’ve enhanced patient outcomes, professional collaboration and operational efficiency. Milestones of the program include re-establishing adult psychiatry, creating new collaborative partnerships with area agencies, and a measurable increase in patient compliance with treatment protocols. With support of a Tides Foundation collaborative grant, MCHC increased its focus on improving care to patients affected by, or at risk for, Hepatitis C. The partnership brought MCHC together with Mendocino County AIDS/Viral Hepatitis Network and other Mendocino County health centers to support and advocate for this growing patient population. In the past year, the project identified almost 4,000 at-risk individuals, providing education and medical assessment. Of those tested for the disease, 17% were positive. MCHC began planning for the implementation of an electronic medical records (EMR) system: Hardware requirements were assessed and a trial of NextGen was initiated in Hillside’s pediatric pod. As part of our participation in the Alliance for Rural Community Health (ARCH), MCHC benefitted in the development of the local healthcare workforce: The Empowerment Through Education (ETE) Scholarship Program provided financial awards for minority individuals pursuing healthcare careers. We are proud that MCHC staff members took the opportunity to improve their skills. We also harnessed the “community power” of ARCH-recruited HealthCorps staff: Four young people were sited at MCHC, and their community outreach activities made a lasting, positive impact the health of local youth. Patient visits per day: 480
2007 Founded in 1992, MCHC celebrated 15 years of community service in April 2007. We have grown from a single site with 20 employees, to a 200-person strong healthcare organization that operates three sites in two counties. One of our biggest operational changes this year was the development of a centralized Call Center. Prior to implementation, reception staff answered incoming calls as they were greeting patients. The new software and secure call center is improving customer service in a number of ways: Patients seeking service at Reception are no longer subject to the distraction of ringing phones and too-busy staff members, privacy has been enhanced and, by monitoring actual patient-staff telephone interactions, we can target training to improve service delivery. An unexpected outcome has been the efficiency of the new system: It has increased productivity, increased the hours that a patient can call for an appointment and reduced patient hold times. MCHC significantly expanded its well-recognized model of prenatal care and obstetrics. Care for Her, MCHC's women's health center, employs two OB/GYNs, three full-time Certified Nurse-Midwives and patient health educators. In 2007, we saw a steady increase in patient population. To meet this growing need, we hired Dr. Karen Crabtree. Her experience and commitment to underserved populations has been an excellent fit. Dr. Crabtree has allowed us to bring prenatal services and gynecological services into Lake County. Hillside Health Center, built in the 1950s, had a major facelift in 2007. We consolidated the formerly separate dental, medical and behavioral health reception areas, creating a single point of entry. The beautifully renovated and significantly expanded wait area has improved patient flow, meeting providers' needs while improving facility security. An added children's play corner has been well received. Freeing our physicians to focus on primary care, MCHC collaborated in the development of inpatient hospitalist programs at Ukiah Valley Medical Center, Ukiah, and Sutter-Lakeside Hospital, Lakeport. Now fully implemented, the programs offer numerous benefits from our perspective, including quality-of-life improvements for our physicians and a new level of specialized care for patients affected by urgent conditions. Improving access to specialty care, MCHC extended patient access to orthopedics and nephrology in 2007. With Tides Foundation support, MCHC became part of a collaboration of community health centers designed to improve access to integrated behavioral health services. By placing licensed behavioral health clinicians in the same office with medical providers, behavioral health services are now available where symptoms are most commonly diagnosed-right in the provider's exam room. This cost-efficient model is improving patient outcomes in the area of depression. It is also improving compliance with the life-changing protocols required when someone is affected by chronic illness or substance abuse. As a leader in this innovative approach to care, MCHC is mentoring our partners as they transition to this integrated model. In addition, the Mental Health Services Branch of Mendocino County's Health and Human Agency has selected us as a primary referral source. This was a banner year for our dental program. MCHC hired three new dentists: Dr. Lorraine Prisbrey joined the dental staff at Lakeside; Drs. Richard Chen and. Lina Velasquez joined Hillside's dental team. Dr. Velasquez speaks Spanish fluently, providing a new level of access to our Latino patients. Also in 2007, to better evaluate surgical cases and serve our developmentally disabled patients, we purchased a panoramic X-ray unit. To accommodate our new dentists, Hillside added two dental operatories. Following our tradition of outreach to underserved children in honor of February's National Children's Dental Health Month, our dental staff observed Give Kids a Smile Day on Saturday Feb 3; over 80 children with identified need received treatment. Lastly, after eight years of participation in the Pediatric Dental Initiative of the North Coast (PDI), our collaborative vision was realized; now, low-income children from Mendocino, Lake and Sonoma Counties who have oral surgery needs now have a center close to home at which to receive urgent oral health. Patient visits per day: 500
2006 Following our third review by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), all three of MCHC's health centers achieved accreditation, providing strong evidence of our commitment to patient safety and to quality of care. Along with the rise of childhood caries, there has been a reduction in access to pediatric and sedated dentistry services. To improve patient access to these services, maintain relationships with out-of-area service providers, mobilize supporting resources and advocate for this vulnerable patient group, MCHC created a Dental Case Management position. MCHC responded to new and expanding definitions of privacy and excellence by transforming its Performance Improvement Department: Quality Improvement collects and reports on clinical performance data; Corporate Compliance has expanded duties to bolster MCHC's program to detect and prevent fraud, waste and abuse. To keep pace with the technological changes affecting medicine, MCHC completed first-stage implementation of a comprehensive practice-management/medical-records software system. Though attended by significant costs and training requirements, NextGen is already improving scheduling, billing, and data collection and reporting. A second communication technology, Voice-over Internet Protocol (VoIP), is supporting clearer communication at reduced costs. To improve communication with patients, and among staff at our three rural health centers, we implemented an in-house call center. Today, during working hours, callers connect with a knowledgeable person who can make patient appointments, connect them to others and solve problems. Responding to significant reimbursement changes and a steady decline in patient numbers, MCHC closed its once-successful Opioid Treatment Program. To meet the needs of addicted patients, it transitioned treatment to office-based Buprenorphine therapy. Major facilities improvements for the year included a new roof and four new medical exam rooms at Lakeside Health Center; Hillside Health Center received a $346,000 grant from the California Health Facilities Financing Authority (CHFFA) to expand its obstetrics and pediatrics units and improve patient reception areas. Expanding our community connections, health outreach programs received greater emphasis in 2006: Lakeside Health Center hosted a children's weight-loss summer camp; Hillside Health Center hosted La Buena Vida, a Latino health fair. Contributing to a local solution to the problem of childhood caries, the Dental Department expanded their outreach to schools, labor camps and special needs agencies via in-the-field assessments and treatment. MCHC continued to participate in local, regional, state and national health solutions and policy advocacy. Patient visits per day: 490
2005 To meet underserved community need for psychiatric services for those with serious mental illness, MCHC hired psychiatrist Brian Thomas, MD. Lakeside Health Center underwent significant construction/expansion projects: Five new dental operatories were built with funding support from Delta Dental. Lakeside's behavioral health services expanded following completion of our counseling services building. Our obstetrics and gynecology unit, Care for Her, was bolstered by the hiring of an additional certified nurse-midwife. The department implemented a comprehensive prenatal education program to meet the needs of our community; the program includes childbirth preparation, infant safety and breast feeding. Weaving the safety net a little more tightly, MCHC began homeless community outreach using new van services; van purchase was made possible through Healthcare for the Homeless grant funding. Patient visits per day: 599
2004 With the assistance of a USDA loan, MCHC purchased Little Lake Health Center from The Howard Foundation. MCHC receives a grant from Delta Dental for $90,000 to expand oral health services to Lakeside Health Center patients. Funds permit the addition of three dental operatories and the hiring of another dentist. A federal grant of $498,000 to expand services at its Lake County facility is awarded to MCHC. Once grant projects are implemented, Lakeside Health Center will have added three full-time healthcare providers, expanded farm worker services and increased the number of patient exam rooms to serve 3,440 new patients each year. Conversion of an older site building into a new behavioral health unit is to be the first expansion component. Patient visits per day: 615
2003 Patient visits per day: 515
2002 MCHC undergoes its second Joint Commission review; the review evaluated performance in key areas, including patient rights, patient treatment and infection control. All three centers are recognized for high performance in patient care, and for creating an environment for continuous improvement in professional healthcare practices. MCHC buys the Hillside Health Center building at 333 Laws Avenue, Ukiah, with the assistance of a USDA loan. For the last 10 years, the building has housed MCHC's flagship clinic—Hillside Health Center—and its administrative offices. With the assistance of The Howard Foundation of Willits and federal funding, Little Lake Health Center is opened. In the first year of operation, Little Lake Health Center provides over 20,000 patient visits. MCHC participates in the Cancer Collaborative, focusing on treatment outcomes for breast, cervical and colorectal cancer. With the support of grant funding, MCHC establishes Care for Her, a unique by-women, for-women health unit. Care for Her provides comprehensive prenatal and women's health services at both Hillside and Little Lake Health Centers. Prior to establishing Care for Her, the medically indigent women of inland Mendocino County had very few prenatal care options. Care for Her is a key example of MCHC's responsiveness to the health needs of underserved populations. The unique service model offering women patients access to services provided by an all-female staff is well received by patients. Patient visits per day: 390
2001 MCHC is selected to participate in the second Collaborative sponsored by BPHC. Called Diabetes I, it is a two-year learning program that gives MCHC the opportunity to learn from national leaders in diabetic treatment. The project establishes key health factors to be tracked in diabetic patients, and identifies treatment methods to improve their health outcomes. Because diabetes is one of the fastest growing chronic illnesses in our area, we feel our participation is critically important. By 2004, throughout all MCHC facilities, BPHC's Collaboratives care model for tracking, assessing and improving patient health will be fully implemented. Patient visits per day: 357
2000 MCHC is funded through the Ryan White Care Act to participate in the second BPHC project. Called the HIV Collaborative, this project focuses on bringing multi-disciplinary teams from clinics across the nation together with experts in the field of HIV/AIDS treatment. It teaches our staff how to collect disease-relevant data (tracking CD4 counts, among other discrete factors) and using it to assess protocols and change clinical practice to improve outcomes for HIV/AIDS patients. Central to the Collaboratives model is finding ways to activate patients so that they become more effective participants in their own health care. Patient visits per day: 394
1999 Extending its vision, MCHC opens Lakeside Health Center in Lakeport. Prior to the Center's establishment, Lake County was without a comprehensive care clinic for Medi-Cal patients. Lakeside patient visits quickly outstrip projections, especially in demand for dental services. Because it quickly becomes apparent that transportation is a key problem for Lake County patients, Lakeside gets a van and begins a "health taxi" service. Lakeside continues to grow rapidly, especially in local demand for HIV care and mental health services. MCHC goes through a rigorous review process and is awarded its first accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This certification is a crucial landmark in MCHC's development, rewarding organizational commitment to professionalism and offering proof to providers and funding agencies that practice standards meet or exceed those established for hospitals and clinics. Both MCHC sites receive the accreditation. MCHC participates in its first Collaboratives Project. Constituted by the Bureau of Primary Health Care (BPHC), the Re-Engineering Project was created to make fundamental clinic operations more "user friendly." MCHC improves patient satisfaction by restructuring its operations model. Participation in this BPHC project becomes the initial phase of a long-term commitment by MCHC to achieve excellence in every aspect of our service model. Patient visits per day: 311
1998 Patient visits per day: 278
1997 Michael Carnevale, DO, hired as Medical Director. Patient visits per day: 280
1996 Through a grant from the Irvine Foundation, and in collaboration with Ukiah Valley Medical Center and the Mendocino County Department of Public Health, a Comprehensive Perinatal Services Program (CPSP) was established. The program is named "The Green House;" it offers comprehensive maternal health services to medically indigent women. Patient visits per day: 282
1995 To achieve our vision of providing easily accessible care, MCHC opens First Care, an urgent care clinic intended to alleviate the inappropriate use of the UVMC Emergency Room by non-emergency patients. (The First Care model was not financially viable for MCHC and it was closed in 1998.) Patient visits per day: 213
1994 MCHC remodels and moves into the old Emerald Hills hospital facility at 333 Laws Avenue, Ukiah. (Today, the site houses both its administrative offices and Hillside Health Center.) In September of this year, MCHC receives its first 330 grant from HRSA. These funds provide operational support for comprehensive health services to un- and under-insured people who have incomes at less than 200% of the Federal Poverty Level. Patient visits per day: 187
1993 Patient visits per day: 127
1992 A direct result of the community health task force, Mendocino Community Health Clinics, Inc. (MCHC) is licensed as a nonprofit healthcare corporation. A Board of Directors is recruited. Linnea Hunter is named Executive Director, a position she still holds. Richard M. "Dick" Bailey, Professor of Health Economics, Emeritus, of the University of California, Berkeley, School of Public Health, joins the Board of Directors and becomes its first Chair. As enthusiastic supporters, the Mendocino County Board of Supervisors facilitates a seamless transition to MCHC providers as the County's outpatient clinic closes. In a gesture of support, the Board of Supervisors permits MCHC to occupy the old County Hospital building located on Bush St., Ukiah. The County of Mendocino is designated as a Medically Underserved Population (MUP) and the MCHC service area is federally designated as a Health Professionals Shortage Area (HPSA). A HPSA designation allows medical and dental providers to receive federal support for medical loan repayments, making it easier for MCHC to attract quality clinical personnel to our centers. Also in this year, MCHC is certified as a Federally Qualified Health Clinic (FQHC). This permits MCHC to begin billing Medi-Cal and Medicare, thus establishing a sustaining income stream. In addition to medical and behavioral services, MCHC adds an oral health unit. Patient visits per day: 70
1991 Recognizing that the health of the community is at stake, a task force comprised of concerned County officials and community members convenes. On the task force's recommendation, the County hires consultants to assess the possibility of establishing a not-for-profit medical facility that can provide a broad range of healthcare services.
1989 After years of operating at a deficit, the County of Mendocino is forced to close the inpatient unit of County Hospital. Its outpatient unit, a community clinic, remains open, serving approximately 70 patients each day. Historically, these two County facilities served all the County's residents covered by Medi-Cal and Medicare, along with uninsured and underinsured county residents who lacked access to medical and mental health care. |
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