Message From The Director
Disaster Strikes Far Too Often
Our hearts and prayers go out to those who have been impacted by the hurricanes, floods and acts of senseless violence.
We are overwhelmed lately by the number of environmental disasters occurring around us -- devastating hurricanes in Texas, Florida, Puerto Rico and the Caribbean Islands, and earthquakes in Mexico City -- all of which required a coordinated response from the emergency management community. These events, along with the tragic massacre in Las Vegas last month, remind us of our obligation to remain in a constant state of readiness to respond should a disaster occur in the county or neighboring cities or counties. We know that as county workers we all have responsibilities as disaster service workers, and CCHS' Emergency Management Team (EMT) has specific roles and responsibilities to protect the health of our communities in partnership with the countywide emergency management community, including first responders.
Preparedness Saves Lives
We know that it is important for the EMT, whose members represent all divisions in the department, to prepare and train year round and to learn from experts throughout the state. In addition, we know that through every disaster important lessons are learned and by learning from others' experiences, we are better prepared for all contingencies. On September 27, more than 100 members of our EMT participated in a training session where we discussed our obligation to prepare, practice and perform. We heard from leaders on the ground during the San Bernardino mass shooting and Napa County's response to the Lake County fire.
Learning From the Field
Corwin Porter, assistant director of the San Bernadino County Public Health Department, shared how during the San Bernardino shooting, the immediate response involved law enforcement and emergency services but the psychological trauma and post-traumatic stress continued to have long-term impacts on the staff involved. Statewide mutual aid agreements help those affected to obtain aid from surrounding counties. In this case, we dispatched several of our behavioral health specialists and environmental health specialists to provide services.
Napa County Health Officer Dr. Karen Relucio, who was responsible for managing the health and safety of evacuees from the Lake County fire, described the initial chaos as hundreds of area residents sought shelter at the fairgrounds in Calistoga. Many had no possessions or medications, and some brought their pets and livestock. She also described the systematic response to the management of shelters and administration of medical care by county staff, Medical Reserve Corps (MRC) and volunteers.
One key takeaway from these great speakers was that the response doesn't end when the disaster ends. In some cases, it is only the beginning. Victims often need basic, life-sustaining aid such as food, shelter and health care. But there are often also long-term impacts, such as post-traumatic stress. We also learned the complications involved with providing medical care to fragile individuals in shelter settings.
Prepare Yourself and Your Family
We have seen in recent incidents the courage and heroism of neighbors helping neighbors before government help arrives. We as disaster service workers may be the face of government help for our communities. It is important that we not forget to prepare individually and with our families so we are able to respond quickly to a disaster. Make sure you have emergency supplies at home and that you have a plan to ensure your family's safety. Refer to emergency.cdc.gov to learn more about emergency preparedness.
Thank you all for the work that you do to ensure that we are prepared to respond to emergencies. I encourage you to participate in available training and establish your own emergency plan at home.
Learning From a Real Event – Massive Fires
Our EMT preparation and training served us well when we were called upon to provide mutual aid to our neighbors in Napa, Sonoma and Solano counties. EMS Director Pat Frost coordinated medical mutual aid through the Regional Medical Health Operating Area Coordination (MHOAC) program. Dr. David Goldstein directed our Departmental Operations Center with great participation by all of our divisions.
EMS coordinated the dispatch of ambulances to aid the distressed counties. EMS also coordinated the safe routing of 85 evacuated veterans from the Yountville Veterans Home to skilled nursing facilities in our county.
Hospitals in Contra Costa County also received transfers of patients needing medical care. CCHP aided the Partnership Health Plan in meeting the needs of their enrollees. Behavioral Health provided much-needed crisis counseling to evacuees in shelters. Our Medical Reserve Corps provided on-site medical care to those in shelters. Environmental Health and Hazardous Materials are providing staff and expertise to aid in the massive toxic waste cleanup now required before rebuilding.
I want to personally commend all of our participating staff for the tremendous job they did in their crucial roles throughout the fires.
Recruitment Underway for New Health Director
Many of you may know that I retired from almost four decades of service to the residents of Contra Costa a few years ago. Since that time, I have continued to serve as the Health Director and Health Officer and watch over the implementation of the Affordable Care Act.
Our County Administrator has begun a statewide search to find a new health director. Interviews are expected to begin in mid-November. Until a suitable candidate is hired, I will continue to serve you and the county's residents as Health Director. There will always be important issues to contend with and never a perfect time to transition, but I am confident that now we have dedicated leaders working hard every day for the health and safety of Contra Costa. A new health director will be in good hands. I've been blessed to be able to do something I love with people I love for so long. I will have more to say when the time comes, but, for now, I just wanted to let you all know what's going on.
Going the Extra Mile:
These CCHS Employees are GEMs
Click here to find out how the people named below went the extra mile.
Debbie Sanchez Amador
Jaime Baculpo, PHN
Alicia Grand, PHN
Maritza Vukalcic, PHN
Riza Wilford, PHN
Nayeli Zavala, PHN
Dawn Dailey, PHN
Connie Hsiao, RN
Remi Daodu, RN
Susan Salazar, RN
Susan Musisi, RN
Sinju Kawk, RN
Utilization Review Unit
Contra Costa Health Plan
Contra Costa Health Plan Recognized for Customer Service, Quality Care
The National Committee for Quality Assurance (NCQA), the national evaluator of health plans, has recognized Contra Costa Health Plan (CCHP) for delivering exceptional service and clinical quality.
CCHP, which offers a full range of health services to more than 200,000 patients in Contra Costa, became one of only four Medi-Cal plans to earn "Commendable" status from the National Committee for Quality Assurance (NCQA) this year.
"The NCQA is a standard-setter in the health plan industry, and it is gratifying to know we measure up well," said Patricia Tanquary, CCHP's Chief Executive Officer. "This new designation reflects the quality outcomes and commitment of our staff, and our organizational culture of improvement."
The NCQA is a national nonprofit that accredits and certifies a wide range of healthcare organizations and medical practices.
To achieve this designation, CCHP submitted to a rigorous accreditation process from a team of doctors and health plan experts. The accreditation included how well the health plan managed all parts of its delivery system, with its doctors, clinics and hospitals and administrative services, to continuously improve the quality of care and services for its patients.
Accreditation standards include evaluation of service accessibility for patients, quality of care including how the plan uses patient feedback, services for wellness/prevention, and care coordination services for members who are living with chronic illnesses.
"Achieving an accreditation status of Commendable from NCQA is a sign that a health plan is serious about quality. It is awarded to plans whose service and clinical quality meet or exceed NCQA's rigorous requirements for consumer protection and quality improvement," NCQA President Margaret E. O'Kane said.
CCHP has provided high-quality, affordable care to Contra Costa residents for 43 years, and was the nation's first federally-qualified, state-licensed, county-sponsored HMO. Through the Affordable Care Act, CCHP has enrolled more than 70,000 people into Medi-Cal Managed Care since 2014.
Emergency Medical Services
EMS Helps Law Enforcement Develop Overdose-Response Program
Our Emergency Medical Services Division has recently been working to develop a program for local law enforcement agencies to prevent deaths from drug overdose.
The life-saving program, developed by Lafayette Police Chief Eric Christensen with feedback from EMS, will provide training to local law enforcement to administer Naloxone. Naloxone is used to reverse the effects of overdosing from opioids.
Currently, only Lafayette P.D. has received formal approval from EMS to administer Naloxone in the field. However, several law enforcement agencies have received training and are in the process of getting authorization to use Naloxone.
Thanks to Senate Bill-1438, Contra Costa Emergency Medical Services joins a statewide effort to put Naloxone in the hands of trained personnel.
Women, Infants & Children
WIC Breaks Ground on New West County Site
Supervisor John Gioia (center) leads the ceremonial groundbreaking for the new WIC site across from the West County Health Center. The new WIC site is expected to open in early 2019.
Contra Costa Regional Medical Center
CCRMC Wins Excellence Award for Patient Satisfaction
Contra Costa Regional Medical Center (CCRMC) recently won an award for being among the most improved hospitals for patient satisfaction in the United States from NRC Health.
NRC Health, a national firm that measures patient satisfaction at healthcare facilities around the country, selected CCMRC for one of its excellence awards in the category of Most Improved Facility in the ranking of Overall Hospital Rating for medium-size hospitals.
The winners were selected from the extensive database of NRC Health hospital clients for their performance over the last four quarters.
"We're honored to receive this Excellence Award," said Anna Roth, CCMRC's Chief Executive Officer. "We believe our system belongs to the patients. Their voices and perspectives are essential ingredients that can bring about powerful change when we work side by side."
Hospital, Health Centers & Detention Health
Patient Safety Culture Survey Returns
Contra Costa Regional Medical Center (CCRMC) & Health Centers began circulating its Patient Safety Culture Survey on November 1. The survey measures staff perception of our patient-safety culture and identifies strengths and areas for improvement.
This year, CCRMC is circulating three versions of the survey with questions specific to different clinical settings: ambulatory care, detention health and inpatient/hospital. The surveys, which are available online or on paper, can be completed by staff through November 30.
The survey was developed by the Agency for Healthcare Research & Quality and is used by more than 1,100 hospital systems. Although the survey is voluntary, participation from all CCRMC & Health Centers staff is highly encouraged and appreciated. Responses are anonymous.
For more information, contact Dr. Sonia Sutherland at Sonia.Sutherland@hsd.cccounty.us. Results from the 2015 survey can be viewed on iSITE.
Family, Maternal & Child Health
Nurse-Family Partnership Honored by Board of Supervisors
The Contra Costa Board of Supervisors helped celebrate the 5-year anniversary of Public Health's Nurse-Family Partnership program with a proclamation on Oct. 17, in advance of a party for graduating mothers and their children.
NFP is a Public Health program that connects vulnerable first-time mothers with resources, information and support.
Mothers who meet program criteria are each connected with a public health nurse who visits the home regularly during pregnancy and throughout the first two years of the newborns' lives.
Nurses tailor their support to the individual, coaching their moms about how to keep themselves and baby healthy, providing emotional support, connecting them with needed services and talking through the challenges of the moment.
Contra Costa's NFP program is affiliated with a federal nonprofit organization of the same name that provides an evidence-based, national model for community home-visiting programs across the country.
Working with the California Department of Public Health, CCHS began using NFP's curriculum in 2012 to improve prenatal health and better post-birth outcomes for both mothers and children in Contra Costa. The local version of the program is funded in part through the Affordable Care Act.
In addition to its anniversary, NFP celebrated another milestone in October by graduating its 100th participating family.
Hazardous Materials Programs
HazMat Team Wins Award at Urban Shield
Our HazMat Response team came in second at Urban Shield in a contest for responding to different types of hazardous material releases. Meanwhile, two HazMat staffers also won the categorizing hazards contest at a hazardous materials response conference.
Behavioral Health Hosts Community Forums for MHSA Funds
The Behavioral Health Services Division (BHS) in October held two of its three regional community forums to discuss local mental health services and use of Contra Costa County's funding from the Mental Health Services Act (MHSA). Another forum is scheduled in December.
The forums are part of a state-required outreach process to ensure that county MHSA funds, budgeted at $51.6 million in 2017-18, are used in ways that align with the community's behavioral health needs and goals. MHSA funding currently supports more than 80 county mental health programs and services.
The public-facing community meetings include an overview of how MHSA works and the programs and community partners that it funds in Contra Costa County, as well as opportunities for attendees to communicate directly with service providers. BHS uses feedback from the forums to inform the county's MHSA Three-Year Program and Expenditure Plan.
The first forum was held Oct. 5 in Richmond. Another is scheduled in Martinez on Oct. 25, and the last forum is Dec. 7 in Brentwood. All are welcome to attend – click here for details.
Email Warren Hayes at Warren.Hayes@hsd.cccounty.us for more information.
AODS Solicits Feedback at Prevention-Focused Community Forums
The Alcohol & Other Drugs Services program (AODS) and its community partners are holding a series of community meetings to discuss prevention priorities and areas of need, culminating in a Nov. 17 meeting in Martinez to discuss findings and develop key priority areas.
Feedback from the Prevention Community Forums will help AODS update its five-year County Strategic Prevention Plan and set goals that align with the community's identified concerns regarding underage drinking, underage use of marijuana and prescription drug misuse.
The meetings are geared toward the community at large including youth, and anyone interested is welcome to participate. Meetings include an overview of the current efforts of AODS and local groups that work with it.
Since August, AODS has held community forums in San Ramon, Richmond, Antioch and Lafayette. A fifth is scheduled on Nov. 2 in Concord.
For more information about meetings, visit cchealth.org/aod or contact Isabelle Kirske at Isabelle.Kirske@hsd.cccounty.us
CCHS and Sheriff's Office Team Begins Improvement Work for County Jail Health Services
An interdisciplinary team of CCHS and Sheriff's Office Custody Bureau staff has launched an improvement-focused analysis of the physical and behavioral health services our department offers in Contra Costa County's jails.
Contra Costa Detention Health provides services to about 1,430 adult inmates housed at the Martinez, Marsh Creek and West County detention facilities at any given time.
The goal of the Value Stream Mapping week-long event held in late August and September was to analyze our services, identify areas for improvement and develop a shared vision of future health services for inmates.
In coming months, participants in the mapping exercise will develop projects focused on improving specific service-delivery processes, including in the areas of intake, medication delivery, specialty care and reentry.
Watch a video of the report-out from the Value Stream Mapping exercise.
For more information about the project, contact Roberto Vargas at Roberto.Vargas@hsd.cccounty.us or Erika Jenssen at Erika.Jenssen@hsd.cccounty.us
Report Shows Child Deaths in Contra Costa Are Often Preventable
A review of 21 child deaths in Contra Costa during 2013 shows that nearly all of them were preventable.
The report, produced by the Contra Costa Child Death Review Team and the Child Abuse Prevention Council of Contra Costa County and released in October for national SIDS Awareness Month, found that 18 of the cases were "probably preventable."
Those cases including deaths by drowning, motor vehicle crash, sleep-related deaths including Sudden Infant Death Syndrome (SIDS) and accidental asphyxia, and firearms.
The 2013 Contra Costa County Child Death Report offers several recommendations for reducing the incidence of future childhood deaths, including a countywide "Safe to Sleep" campaign, promotion of active supervision and child abuse prevention, youth anti-violence programs and firearm safety laws.
The team includes representatives from the Contra Costa Sheriff-Coroner, District Attorney, local police, Health Services, Children & Family Services and others. Dr. Jim Carpenter, a pediatrician at Contra Costa Regional Medical Center, chairs the team.
The team reviews coroner's investigations of some child deaths to determine if and how they could have been prevented. The team does not review natural deaths in which the child was receiving medical care for a known condition, such as a disease, that caused the death.
Coroner's cases that were reviewed represented about one-quarter of the county's child deaths in 2013.
Green Business Program Recognizes Local Businesses at Sustainability Gala
Several local businesses that have committed to environmentally-friendly practices were recognized by the Contra Costa Green Business Program at Sustainable Contra Costa's 9th Annual Contra Costa Leadership in Sustainability Awards Gala.
At the Sept. 20 event in Concord, the Green Business Program, housed by the Hazardous Material Program, recognized Crestwood Healing Center and East Bay MUD North Area Service Center as newly certified by the program, and Ace Truckbox Center, Big Air Heating and AC, Burrough & Sons Auto, European Auto Repair, InVision Communications, the Marriott Hotel in San Ramon, Marvin Gardens Real Estate, Quick Mount PV, The Rising Loafer Café and Whole Foods Market in San Ramon as recertified businesses.
Thanks to these employees who have given us long years of service:
Kim D. Law
Leo J. Sacauskas, Sally V. McFalone
Susan C. Guest, Kenneth A. Saffier, May A. Riley, Marlene Uri Stanton, Minda V. Lejano, Beth A. Chew, Sylvia Elizarraraz
Michael Puell, Margaret S. Ewing, Katherine Hudson, Susan C. Conner, Jacqueline C. Maguire
Jalilah N. Bell, David J. Jaskolski, Stephanie Y. Haley, Luz M. Perez, Scott R. Faivre, Saraphi Chawengchot, Herbert A. Chew, Teresa D. Gibson, John L. Gragnani, Ziba Rahimzadeh, Leda I. Mullen, Wendy A. Katchmar, Elmer M. Taglorin, Charles E. Holly, Donald R. Maree
Oliver Z. Graham, Lydia L. Dela Cruz, Bernadette Lopez-Ganancial, Kathleen A. Gibson, Tracy D.C. Golphin, Monica D. Tilley, Stephen C. McDonald, Patricia Weisinger, Mayra L. Arriola, Christopher L. Davis, Lisa D. Browne, Joslyn R. Windham
Pyra M. Aarden, Elizabeth V. Jones, TabithaW. Goldenberg, Robert E. Gribben, Christine B. Johnson, Mary K. O'Shea, Vinod Sharma, Karin L. Stryker, Maria V.E. Warriner, Amalia E. Marroquin, Sabrina M. McMurry, Cristina C. Cruz, Karina Martinez, Teresa C. Alcala, Cheryl R. Chu, Lisa L. Ostheimer, Cynthia L. Holland, Tina T. Sarvi, Bre-Ariyaun W. Kalilikane, David R. Pepper, Irene Z. Ramirez, Michael S. Wai, Souheil A. Ben Salha
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