Outline of Alameda Countys Health Care System for the Medically Indigent - PowerPoint PPT Presentation

Loading...

PPT – Outline of Alameda Countys Health Care System for the Medically Indigent PowerPoint presentation | free to download - id: 14f502-Y2FkM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Outline of Alameda Countys Health Care System for the Medically Indigent

Description:

Outline of Alameda County's Health Care System for the Medically Indigent ... Medi-Cal and County General Funds (CMSP) However, Medi-Cal covers less than of ... – PowerPoint PPT presentation

Number of Views:38
Avg rating:3.0/5.0
Slides: 29
Provided by: publi173
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Outline of Alameda Countys Health Care System for the Medically Indigent


1
Outline of Alameda Countys Health Care System
for the Medically Indigent
  • Alameda County Re-Entry Task Force October 11,
    2007
  • Dr. Tony Iton, County Health Officer PH Director

2
The Context
  • The Medically Uninsured

3
Our Broken Health Care System in CA
6.5 Million Uninsured
20 of Population
Source California Health Interview Survey, 2005
4
(No Transcript)
5
(No Transcript)
6
Fig. 1. Types of Health Coverage Among Alameda
County Residents (total 1,475,000)
Source California Health Interview Survey, 2005.
7
Source California Health Interview Survey, 2005.
Note that numbers may not add to 100 due to
rounding.
8
84 of the Uninsured Work
Source California Health Interview Survey, 2005
9
The Situation in Alameda County
10
Alameda County Health Care Services Agency
Environmental Health
HCSA Administration/Indigent Health
Behavioral Health Care Services
Public Health Services
Office of the Director/Health Officer
Indigent Health Care Services
Administration
Administration
Environmental Health Services
Cross-Departmental/Cross-Jurisdictional Health
Services
24 Hour Services
Outpatient Services
Administrative Services
Communicable Disease Control Prevention
Vector Control Services
Referral Services
Support Services
Family Health Services
Administration/Infrastructure Support
Community Health Services
U.C. Cooperative Extension
Day Treatment
Ancillaries
Public Health Nursing
Emergency Medical Services
Outreach
Office of AIDS
11
HCSA Indigent Care Spending 96 million in 2007
12
The Safety Net
  • Serves
  • uninsured,
  • underinsured, and
  • portion of the Medi-Cal population (123,000).
  • Comprised of
  • ACMC (3 hospitals and three outpt. clinics),
  • 10 community-based clinics,
  • and Health Care for the Homeless

13
(No Transcript)
14
W
E
N
JGPH
FH
Highland Hospital
AHS
LaC
TV
WO
Ax
TC
15
(No Transcript)
16
Major Payor Sources
  • Medi-Cal and County General Funds (CMSP)
  • However, Medi-Cal covers less than ½ of the poor.
    Must be categorically linked or disabled.
  • States are desperately looking for ways to
    decrease spending on Medicaid thus passing the
    financial burden down to counties.
  • Alas working poor, homeless adult singles, new
    immigrants are left out and must depend entirely
    on the safety net.

17
CCLHO Proposal To CDCR Receivership
18
Brief Context
  • CCLHO approached by Mr. Bob Sillen, Receiver for
    CDCRs medical system (California Prison Health
    Care Receivership Corporation or CPR), to draft a
    proposal to help strengthen public health in
    Californias prisons. (Seek Foundation support?)
  • CCLHO has been working diligently over the past
    few years to reinvigorate a joint CDCR-DHS-CCLHO
    committee on communicable disease policies and
    control within CDCR.
  • CPR has engaged several health care medical
    informatics experts and intends to enhance the
    availability of electronic health data,
    electronic registries, telemedicine within CDCR.

19
Brief Context (cont.)
  • Several innovative city-based programs have been
    developed including LAs Going Home--Los Angeles
    program and Oaklands Project Choice.
  • Several counties (LA, San Diego, Riverside, San
    Bernardino, and Alameda) have been involved in an
    effort organized by Regional Congregations and
    Neighborhood Organizations (RCNO) to develop a
    Public Health Reentry Initiative to provide a
    seamless system of support for parolees who are
    seeking solutions to their health needs.
  • Kern and San Diego counties HIV and mental
    illness case management programs for re-entering
    prisoners.

20
The Status Quo
21
High Prevalence of PH Problems
  • DHS study reveals that the prevalence of
    hepatitis C in California prisons is 34,
    hepatitis B (past infection) is 28, hepatitis B
    current/chronic infection is 3.5, and HIV
    prevalence is 1.8.
  • Estimates of prisoners with serious mental health
    suggest rates as high as 20, while substance
    abuse rates are estimated to be 85.
  • Other diseases of special interest include
    coccidiomycosis for which specific surveillance
    strategies within CDCR may be indicated.
  •  

22
Missed Opportunities
  • There are 5 clear intervention points in the
    cycle of incarceration and re-entry into
    communities
  • County Jail
  • Prison Intake
  • Incarceration
  • Anticipating Release
  • Re-Entry To Counties.
  • During this cycle, effective health assessment,
    record keeping, appropriate intervention, and
    inter-agency communication, is critical to
    optimize the use of the scarce health resources
    devoted to this population.

23
Recommendation 1
  • Establish a robust and competent public health
    infrastructure within CDCR

24
Recommendation 2
  • Work in partnership with CDCR to develop an
    electronic Continuity of Care Record (CCR),
    accessible to county public health departments
    (and DPH), that would serve as an electronic
    health passport for prisoners upon release

25
Recommendation 3
  • Establish within CDCR a pre-release screening,
    education, and discharge coordination process,
    which may include a pre-release health
    curriculum, community health directory,
    electronic transmission of medical records to
    receiving county, and vouchers for establishing
    health access in the accepting communities.

26
Recommendation 4
  • Develop a standardized medical screening at
    intake and pre-release that screens for chronic
    disease as well as communicable disease and other
    diseases of particular public health
    significance, such as hepatitis C,
    chronic/carrier Hepatitis B, HIV, and TB.

27
Recommendation 5
  • Work with CCLHO, CHEAC to advocate for simple
    reactivation of Medi-Cal benefits for those
    re-entering prisoners whose Medi-Cal was
    suspended at incarceration.

28
Based on discussions with health officers,
knowledgeable local and state public health
department staff, CDCR medical staff, Receivers
medical staff, and community based organizations
involved in prison health and re-entry issues,
and given the ongoing internal initiatives that
CDCR is already pursuing under the Receivers
tenure, it is CCLHOs conclusion that
Recommendation 2 provides the greatest
opportunity for CCLHO and CDCR collaboration.
About PowerShow.com