We are a Federally Qualified Health Center with a commitment to patient care that revolves around Excellence, Access, Community, and Compassion.
We are currently on a three-year journey to receive recognition from the National Committee for Quality Assurance (NCQA) as a Patient-Centered Medical Home (PCMH). This represents an innovative program for improving primary care. In a set of standards that describe clear and specific criteria, the program helps us organize care around patients, working in teams and coordinating and tracking care over time.
The Patient-Centered Medical Home is a health care setting that facilitates partnerships between individual patients and their personal physicians, and when appropriate, the patient’s family. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.
We do not turn anyone away based on their inability to pay.
Providing health services to individuals with little or no healthcare insurance: We welcome everyone who needs health services into our centers, and we have well-trained Patient Financial Services staff who support patient access to public health assistance programs.
Serving all patients in a language and manner that best suits their needs: Our communities have large Spanish-speaking populations, and our strong commitment to appropriate bilingual care and educational materials has made us a model of community service.
Developing strategies to minimize the transportation challenges affecting our rural communities: Because we operate community-based centers, our hours and locations support access. We work with local transit companies to optimize routes and provide transportation vouchers. We have also obtained financial support to operate patient vans.
Strategically responding to the changing healthcare environment: In the public sector, fiscal challenges are increasingly limiting our patients' choices. As a vigorous advocate for the health of our patients, we continually assess community needs, pursue new funding opportunities to serve those needs, and implement forward-looking programs that expand our patients' care options.
Building strong partnerships with specialists, hospitals and community services agencies and political representatives: The needs of our patients often extend beyond the services we offer within our centers. Over the years, we have built a strong network of specialist referrals resources.
Establishing policymaking leadership by active participation in various health consortia at the local, regional, state and national level, and by maintaining strong relationships with California's political representatives: To preserve the ability of our patients to access health services in the rapidly changing healthcare environment, we participate in crucial political policymaking opportunities where our experience and knowledge make an important contribution.
Healthy communities are comprised of healthy people. This is the most basic understanding shared by everyone who works at MCHC. Our life's work is to support the health of every individual in our community—regardless of their ability to pay. Using a broad definition of health, we work with community partners to provide care where and when it is needed. Through our participation in the Chronic User System Of Care (CUSOC), we are part of a pioneering effort to collaborate with other community services to help those people in our community who utilize services the most by:
1. Improving their health care by moving from a crisis-based approach to a preventive and management approach, and
2. Reducing the overall community costs of health care and social services.
Working with Ukiah Valley Medical Center, the Mendocino County Jail, Ford Street Project, Mendocino County AIDS/ Viral Hepatits Network and others, MCHC is working to identify and address the needs of people who spend a disproportionate share of time in county jail or the hospital emergency room.
The County Medical Services Program (CMSP) first awarded our collaborative with a planning grant to see whether we could identify a way to reduce county jail bookings and ER visits by sharing data (with patient permission) and providing intensive case management. CMSP liked what they saw and decided to fund an implementation grant to put the plans in motion. While UVMC is the grant administrator, both the planning grant and the implementation grant applications were written by our own Catherine Rada.
The $150,000 grant has a two-year term, and CMSP would like us to serve 50 people the first year and 200 people the second year. The program began in July 2011. Since then, participants have been identified based in part on data gleaned from the planning phase.
The way it works is this: trained personnel at the jail and hospital identify high utilizers who have (or are eligible for) CMSP health coverage. The people are interviewed by case managers from Ford Street or MCAVHN to determine the level of interest they have in changing their situation. If they show a genuine commitment to working with health and social services providers to move from a crisis-based approach to a more stable management approach for their care, they may be considered for the program. Participants sign a waiver so members of the collaborative can work together to serve the participants. While the CMSP grant was funded in July 2011, the collaborative had been working to implement the CUSOC plan since January, providing services at no charge when necessary.
The MCHC point person for the effort is Karen Rizzolo. She noted that in addition to improving health care and reducing costs, another benefit has come from working together to identify a better way to manage high utilizers. “As we’ve worked through how to manage these patients, we’ve formed relationships that help non-CUSOC patients. We (collaborative members) have a new way of communicating and we’re more aware of the resources available in our community,” she said.
Others are noticing, too. Recently, a CUSOC participant had to go to court. A CUSOC case manager accompanied him and explained the program to the judge and public defender, who appreciated the work done for the individual participant and wondered how more people might be helped by a CUSOC-like model. While the grant is for two-years, the impact of CUSOC may be much longer. If CUSOC can prove its efficacy, it may become a model for managing high utilizers elsewhere.
“At first, a lot of resources may go toward stabilizing a patient, but then the costs drop because the patient is not in crisis mode. They’re not in jail or going to the ER every month anymore; they are getting care before their condition deteriorates so the care doesn’t have to be so intense, and they feel more in control of their lives,” Karen said. Karen stressed that CUSOC is not inflicted on patients, but a privilege that patients receive if they demonstrate they really want to make a change.
Our staff is made up of caring people who give to their community and who believe they can make the world a better place. Whether organizing a coat drive so our patients will be better protected from winter's cold or volunteering on a Saturday to provide free dental care during "Give Kids a Smile Day," MCHC's staff is devoted to our mission of care.
Equal Opportunity Employer
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