CCHS Director Anna Roth

Message From The Director

Planning Pays Off in Recent Response to Emergencies

From fires to planned power blackouts to an industrial explosion, Contra Costa County endured more emergencies over two months in 2019 than it normally experiences in a year.

None grew into catastrophic disasters, like those that have caused so much loss of life and destruction in other California communities. I feel fortunate and thankful that our county was spared the devastation experienced in other parts of the state, even though many Contra Costa residents and CCHS staff had their lives disrupted by the loss of electricity and the fire at the NuStar tank farm.

I am also thankful because, after watching and participating in the local government response to the challenges we did face, I know that Contra Costa is prepared.

No one can predict the outcome of an emergency, but it was reassuring to see responsiveness, coordination and effective action from all departments of our county government when Pacific Gas & Electric shut off power to thousands of customers during two recent periods of extreme fire danger.

Our Department Operations Center (DOC) and the county's Emergency Operations Center (EOC) activated twice in October due to PG&E shutoffs, including during a weekend of wind-fueled brush fires that resulted in the declaration of a local emergency by the Board of Supervisors.

During each emergency, county departments came together seamlessly to participate in the response, ensuring all aspects of the potentially complex situations were considered and addressed swiftly and effectively to help keep our communities safe.

Health Services was heavily involved, from health officers and members of our leadership team who staffed the EOC's Medical/Health Branch to the environmental health specialists who visited hundreds of restaurants to ensure no unsafe food was served to the public during outages.

Many CCHS employees assisted our crucial effort to contact patients depending on electricity for their medical equipment or who have conditions that make losing power potentially dangerous. Staff from Contra Costa Health Plan (CCHP), Public Health, Behavioral Health and our volunteer Medical Reserve Corps made the calls to ensure all those patients had emergency plans and our advice nurses were available to answer followup questions.

That mission required ingenuity as well as effort, because there was no readymade contact list. Public Heath's Epidemiology, Planning & Evaluation (EPE) unit, with assistance from IT's Business Intelligence team, did an amazing job of piecing together incomplete data from many sources to map and identify users of durable medical equipment who lived in affected areas, their level of risk and how to reach them.

Emergency Medical Services coordinated ambulance services throughout, including Sunday, Oct. 27, when high winds and extreme red-flag conditions during a PG&E shutoff caused multiple fires, neighborhood evacuations and injuries from falling trees. We also sent an ambulance strike team to support fire evacuations in the North Bay.

Our Hazardous Materials program monitored gas stations and similar facilities to ensure no spills during the outages and monitored the effects of nearby wildfires on our air quality. Contra Costa Regional Medical Center and most of our health centers, meanwhile, kept the lobby doors open to provide free charging stations for phones and medical equipment. Many of our community hospital partners did the same at our encouragement.

Meanwhile, our Health, Housing & Homeless Services Division managed the safe evacuation of its youth shelter in Crockett and our CORE outreach teams were prepared with water, food, and for potential staff mobilization.

None of this highly coordinated, impactful work happened by accident. At Health Services we plan, train and exercise year-round so that when we are called to fulfill our obligation as disaster service workers, we are efficient, organized and effective.

Programs such as Public Health's Health Emergency Response Unit (HERU) and the Emergency Management Team Work Group help make preparedness part of our culture at CCHS, and after the events of the past three months, I am proud to say their hard work has helped our community in a time of need.

I want to extend my heartfelt thanks to everyone who pitched in to help during the recent emergency activations and encourage any CCHS employee who is interested in getting more involved to ask their supervisor about the EMT Work Group.

I hope you have a healthy, restful holiday.

Find out how the CCHS employees named below went the extra mile.

Public Health

County Bans Sale of Tobacco and Cannabis Vaping Products in Contra Costa

The Board of Supervisors unanimously approved an ordinance in November banning the sale of all vaping products in the unincorporated parts of the county, making Contra Costa among the first jurisdictions in the state to enact such a ban.

San Francisco, Santa Clara County and the cities of Livermore and Richmond have also passed similar ordinances.

"This is truly about improving the public health of everybody," said Board Chairman John Gioia.

The ordinance, which will be implemented and enforced by Contra Costa Health Services, applies to both tobacco and cannabis vaping products.

The passage of the ordinance comes amid a wave of serious vaping-related lung injuries and deaths across the country. The FDA, CDC, and California Department of Public Health have issued health alerts urging everyone to quit vaping altogether, no matter the substance or source.

The Board of Supervisors also voted to expand the prohibition against sales of flavored tobacco products, including menthol, to all unincorporated parts of the county. Previously, the county only prohibited sales of those products for retailers within 1,000 feet of a public or private school, playground, park or library.

Contra Costa Health Plan

Health Plan Begins Offering Rideshare Service for its Members

Contra Costa Health Plan (CCHP) is now offering rideshare services such as Lyft for members with transportation needs through Roundtrip, a health transportation management company.

Building on the pilot started earlier this year by CommunityConnect, our whole person care program, CCHP piloted ridesharing services for 11 members who frequently used taxis to get to and from medical appointments.

The rideshare service received member-satisfaction ratings nine time higher than those using taxis. The rideshare service is also cheaper than taxis: The Health Plan saw a 25% savings during the pilot.

In addition to the cost savings and increased member satisfaction, using a single electronic ride-booking platform allows the ability to view future planned transportation services together, improving the level of collaboration between CommunityConnect and CCHP. Currently, CommunityConnect case managers are able to book rides directly from ccLink with planned expansion of this feature to CCHP as well.

In total, CommunityConnect and CCHP clients have been provided more than 9,000 rides to support patient medical needs during the first six months of the program.

CCHP is now planning to make rideshares a standard part of its standard transportation benefit to members, which includes taxis, buses and paratransit. CCHP is also looking to begin covering the costs of BART rides for members in 2020, Health Plan CEO Sharron Mackey said.

Behavioral Health

New Behavioral Health Center Opening in West County

The newly-constructed West County Behavioral Health Center in San Pablo will be opening in February. The facility is conveniently located next to other CCHS services at the site.

The center will be connected to the West County Health Center, a large outpatient medical clinic, by a covered walkway. This integration of physical and behavioral healthcare will allow for more convenient and comprehensive care so patients can have all their needs met in one place. Also at this location is the recently-opened WIC building, housing a program that provides supplemental foods, healthcare referrals, lactation support and nutrition education.

The new facility, designed specifically for behavioral health programs, will employ a team-care model consisting of psychiatry, nursing, peer support, drug and alcohol treatment other services.

Located at 13585 San Pablo Avenue in San Pablo, the new building will replace the aging sites at 41st Street in Richmond and on El Portal Drive in San Pablo. Behavioral health services for adults at the new site are expected to begin on Monday, Feb. 10; child and adolescent services are expected to start on Monday, Feb. 17.

A grand opening celebration is planned for Friday, Feb. 28 at the new site at 1 p.m.

For more information, contact Steve.Harris@cchealth.org

Emergency Medical Services

Contra Costa EMS Reunites First Responders with Patients They Rescued

Concord resident Kevin O'Conner with wife Donna, surrounded first responders who rescued him.

Kevin O'Conner heard his wife Donna arrive home with friends at about 9:45 on what seemed like another uneventful Friday night in July.

The eventful part of the evening came without warning.

"They say I was talking away like normal," he said of the moments before a heart attack almost claimed his life. "Then I just dropped on the couch."

O'Conner's collapse touched off a high-speed sequence of actions and decisions. Wife Donna called 911 immediately. The emergency dispatcher gave clear, firm directions for CPR. The first arriving police officer brought the automated external defibrillator from his car and administered the first shock.

Fire, ambulance and emergency department all performed on time and effectively. And because they did, O'Conner and his family were able to stand at a podium Wednesday, Nov. 20 and personally thank every first responder and EMS professional who helped to save his life that night.

"Without all of these guys, I would not be here right now," O'Conner said. "They don't get enough thank yous for the job they do."

Kevin's was one of many survival stories told Wednesday the 4th annual Survivors' Reunion Luncheon, an event hosted by the Contra Costa Emergency Medical Services Agency (EMS) to connect county residents who experienced medical emergencies with the first responders who rescued them.

EMS, a division of Contra Costa Health Services, also announced recipients of its annual awards for Contra Costa first responders who demonstrate exemplary service and professional skill at the luncheon, held at The Clubhouse at Boundary Oak in Walnut Creek.

Seven people who survived with help from Contra Costa EMS providers got the chance to give thanks personally during a reception prior to the luncheon. All responders involved, from bystanders who performed CPR to ambulance medics to hospital staffs, received Siren Team awards for their efforts.

Lists of Siren Team award recipients will be posted soon at cchealth.org/ems.

Hazardous Materials

HazMat Working with NuStar on Examining Root Causes of Fire at its Facility

Contra Costa's Hazardous Materials Program is working with NuStar Energy to conduct a root-cause analysis following the October fire at the company's West County facility.

The fire burned two large tanks for several hours during the afternoon and evening of Oct. 15, forcing the closure of Interstate 80, and forcing nearby residents to shelter in place.

Realtime air-quality measurements done by Contra Costa's Hazardous Materials specialists during the fire showed that there were high levels of smoke particulate in the air in areas near the facility. But air samples collected by the Bay Area Air Quality Management District did not show unusually high levels of other toxic substances.

The county fire district is leading the investigation into the origin and cause of the fire. HazMat, meanwhile, will work with NuStar on the root-cause analysis, which explores underlying factors that contribute to industrial incidents as outlined in the county's Industrial Safety Ordinance (ISO).

The county's ordinance currently applies to the three oil refineries and three chemical plants operating in the unincorporated areas of Contra Costa and the City of Richmond's Industrial Safety Ordinance currently applies to one oil refinery and one chemical plant, but NuStar has informed HazMat that it would voluntarily participate in the process.

"While it's really important to understand the cause of an accident, it's just as important to understand the culture and systems in place that led to it," said Board Chair John Gioia, who has proposed expanding the ISO to cover oil tank farms like the NuStar facility.

"Obviously something went wrong. But there is always something deeper, which is what the root-cause analysis will find."

Whole Person Care

Housing Transition Fund Helps Clients Find Homes

More than 500 Medi-Cal recipients have been able to move into new homes this year thanks to financial support from our whole person care program's housing transition fund.

Housing transition funds can be used to pay for housing deposits, first month's rent, moving costs and one-time utility or service fees (telephone, electricity, heating and water). The fund also covers services necessary for an individual's health and safety, such as pest eradication, one-time cleaning prior to occupancy and home modifications.

The housing funds are available to the 12,000 clients enrolled in whole person care, our holistic case management program that identifies and addresses social needs not always met by the health system.

Case manager Koy Phan utilized the housing transition fund to help her client, Alfred Reese, move into an apartment in San Ramon.

Speaking of the partnership with his case manager and the resources available to support him, Alfred said, "I had been waiting for over six years to receive a Section 8 voucher. After finally receiving this voucher I only had 60 days to find a place to live, or I would lose my voucher. With only a few weeks left and no luck finding a place to live after trying so hard, I was introduced to Ms. Koy Phan. She (Koy) used all her resources and connections to make my dream come true after being homeless for more than six years."

For more information, contact linae.young@cchealth.org.

IT Security

Google Apps, including GMail, Now Blocked on CCHS Computer Networks

Gmail and other web-based Google products, such as Google Docs, are no longer accessible from CCHS user computer networks. This was done to protect patient health information and our networks from viruses, ransomware and malware.

Access to non-county email accounts will still be available on the Guest or Employee wireless networks or using your cellular data plan.

Web-based email accounts and social media sites pose a major security threat to patient data on health systems' computer networks. Two years ago, hackers seized control of Hollywood Presbyterian Medical Center's electronic health record using ransomware sent to an employee's web-based email. Hollywood Presbyterian eventually paid $17,000 to the hackers to regain control over its network.

Other web-based emails, such as Yahoo mail, and social media sites are already blocked on CCHS networks. Gmail had been an exception because the Family Medicine Residency Program relied on the Google platforms. That is no longer the case.

Exceptions will be considered on a case by case basis and approved by the employee's division director and the chief information security officer. IT is aware that some programs, require access to Google products to support their clients. Those programs will retain access.

If you have questions about these changes, please contact pwilson@cchealth.org.

Patient Engagement

Contra Costa's Online Patient Portal is now "MyChart"

In October, Contra Costa Health Services renamed its online patient portal "MyChart" and added several new features to improve user experience.

Surveys showed that portal users wanted to communicate and make appointments online with more doctors. That feedback played an important role in the enhancements made to the new MyChart site. CCRMC & Health Centers patients can now use MyChart to:

• Make next-day appointments with doctors other than their primary care providers. Previously, patients can only schedule appointments with their PCPs.
• Email more doctors, including specialists.
• Schedule mammograms.

The new website address for the portal is mychart.cchealth.org. A MyChart app is also available for iPhones and Android devices.

Culture of Continuous Improvement

Employees Show Off Their Innovation Work at Showcase

Four Information Technology employees recently shared their ideas for improving the health system for our patients as part of IT's innovation program pilot.

The innovation program provided the four participants education, tools, support, and time to dedicate to a particular area of opportunity for the organization. Earlier this month, the foursome presented their project ideas at a showcase in Concord to a group of judges and mentors.

Katherine Dial, a clinical systems analyst for IT, shared her proposal for using MyChart, our online patient portal, to help our system performance related to asthma measures. Tyler Heslinga, a business intelligence consultant, proposed expanding the types of appointments that can be made online through MyChart. Bhumil Shah, chief analytics officer, showed how patient outreach isn't centralized and needed refinement. Noel Rasmussen, assistant IT director, discussed ways to reduce the number of patients who leave without being seen.

The four participants are now working to refine their asks and present them to division leads to find a sponsor.

For more information, contact matthew.c.white@cchealth.org or send a pitch for an innovation project to innovation@cchealth.org.

Honors & Recognitions

Hospital and Health Centers Win Award for Meeting Performance Measures

Contra Costa Regional Medical Center (CCRMC) & Health Centers recently won an award of excellence from the state for meeting all 60 PRIME quality metrics in 2018-19 – one of only two public hospital systems in the state to do so.

The California Department of Health Care Services (DHCS) recognized CCRMC & Health Centers for meeting its goals for metrics such as diabetes care, cancer screenings and patient satisfaction. DHCS particularly applauded CCRMC & Health Centers for its innovation work ensuring foster children receive timely care.

The award from DHCS comes on the heels of CCRMC earning a "B" safety grade for fall 2019 from the Leapfrog Group, a consumer-oriented nonprofit that measures hospitals' quality and safety performance.

Homeless Services

H3 Prepares for Annual Homeless Count

Health, Housing and Homeless Services (H3) and its community partners are preparing conduct Contra Costa's annual survey of residents who are experiencing homelessness on Thursday, January 23, 2020 from 5am-9am.

The count needs many volunteers to make it successful. For more information about the PIT count and to volunteer, visit cchealth.org/h3.

The Point in Time (PIT) count documents both sheltered and unsheltered community members and helps government, service providers and community advocates develop effective responses to the challenges faced by people who need permanent housing.

The PIT count identifies people sleeping in emergency shelters and transitional housing, as well as people sleeping in cars, in abandoned properties, or in other places not meant for human habitation. The data is used by the federal and local government to determine funding and programming to best meet the needs of the community.

CORE outreach teams, homeless service providers and law enforcement will canvass encampments and hot spots on foot, while county employees and community volunteers will participate in drive-through canvassing across Contra Costa.

During the 2019 count, 2,295 people were identified as homeless in the county.

Public Health

Public Health Nurses Help Design App for Moms

Public Health Nurses in our Nurse-Family Partnership program have been recognized by state and national officials for their vital role in the development of a new goal-setting app to improve health outcomes for moms and their babies.

The Goal Mama app is the first of its kind and was developed exclusively for clients of the Nurse-Family Partnership (NFP), a nationwide home-visiting program for eligible first-time mothers. In Contra Costa, the program is housed in our Public Health Division within Family, Maternal & Child Health Programs.

The app helps young at-risk mothers set personal and family goals, stay organized about appointments, and access information important to their health and the health of their families.

Our NFP nurses — Jaime Baculpo, Alicia Grand, Nayeli Zavala, Riza Wilford, Maritza Vukalcic, and program manager Dawn Dailey – provided invaluable feedback to the app developers and helped test it for use nationally. The California Department of Public Health and the National Service Office of the Nurse-Family Partnership recognized our NFP team for their role in making the app more useful to clients.

You can view a promotional video for the app featuring several of our NFP nurses.

Volunteer Programs

Help CCRMC Name its Doula Program & Win a Prize

The doula program has been in existence at CCRMC since 2009. The program is fully staffed by dedicated, well-trained volunteers. A doula is a non-medical support person that provides support to moms during their birth.

The doula program is now serving more than 30 mothers a month.

It is time to give our doula program a name. Won't you help?

Please submit suggested names for the CCRMC Doula program to Rhonda Smith, volunteer coordinator, at Rhonda.Smith@cchealth.org no later than Dec. 23, 2019.

Public Health

Active & Healthy Families Program Marks Milestone

The Public Health School-Based Clinics' program Active & Healthy Families (AHF) is celebrating 5 years providing nutrition and healthy lifestyle education in the community.

The AHF program is a family-based group medical appointment program that serves children and youth at risk of co-morbidities such as pre-diabetes and dyslipidemia associated with a high body mass index (BMI).

The graduates of the AHF groups offered in the 2018-19 school-year in cities of Bay Point, Pittsburg and Antioch are the first to receive a scholarship to be used in sport-related activities. The scholarships are made possible with support from the Keller Canyon Mitigation Fund, and are awarded in an effort to give the participants of the AHF program the opportunity to try new activities and to continue to engage in physical activity after they complete the program.

For more information about the program contact the AHF program coordinator Daniela Jaramillo, MS, RDN at (925) 608-5305.

Health Equity

Lactation Lounges Held During Black Breastfeeding Week

To raise awareness in the African American community about the importance of breastfeeding. five events were held in Contra Costa County during Black Breastfeeding Week at the end of August. The week kicked off with a presentation by Family, Maternal and Child Health (FMCH) program staff at CCRMC. It was followed by a panel discussion made up of four black healthcare professionals discussed their experiences breastfeeding and best practices for providers working with black mothers.

The highlight of the week was the four lactation lounges, which were held Tuesday through Friday. At these events, black mothers living in Contra Costa and their families met black breastfeeding professionals, participated in educational workshops, learned about breastfeeding support services and resources in the community.

Over 60 young black pregnant and parenting women attended these events and many expressed an interest in breastfeeding after delivery.

Our Family, Maternal Child Health (FMCH) Program collaborated with staff from the Comprehensive Perinatal Services Program (CPSP), Black Infant Health Program, Women Infant and Children (WIC) and Contra Costa Health Plan (CCHP) to host these lounges. Lifelong Medical Center in San Pablo, First 5 Contra Costa in Antioch, Pittsburg Health Center and West County Health Center hosted these lounges at their sites.

Breastfeeding is the medically recommended, ideal source of nutrition and hydration for infants up to six months old. Despite the well documented health benefits associated with breastfeeding, only 25.5% of Black mothers in Contra Costa County (CCC) exclusively breastfed their babies for three months. Compared to the rate of white mothers, there is a 20% disparity between the exclusive breastfeeding rates of black mothers three months after delivery.

Census

Census 2020: We All Count

The census count comes once a decade, attempting to account for every person in the United States. The count determines congressional districting and allocates critical funding for our communities including roads, affordable housing, schools, and parks.

The Contra Costa County Complete Count Steering Committee brings together community leaders, nonprofit agencies, and media experts to work together to ensure we have a complete county in 2020, in particular "hard-to-count" populations in the County – amounting to 212,356 people in Contra Costa. Every person missed in the census count is estimated to cost $2,000 a year in federal funds. If Contra Costa County undercounts by 5%, we would lose $1.1 billion over the next ten years.

Residents will be able to respond to the census online or over the phone in 13 languages, including English, Spanish, Arabic, Vietnamese, Mandarin, Cantonese, Tagalog, and Japanese. Language guides, glossaries and videos will be provided in 59 additional languages. The confidential data collected will be used solely for statistical purposes.

Learn more through your departments and at cococensus.org and @cococensus on Twitter.

Send feedback and story ideas to editor Will Harper at will.harper@cchealth.org