2021 Annual Report
2021 Annual Report
The Road to Health Equity
MESSAGE FROM
2021-2022 ACTING PRESIDENT & CEO,
Robert E. Beaudry, MSM
MESSAGE FROM
2021-2022 BOARD CHAIR,
David B. Vliet, MBA
CPCA BOARD / OFFICERS & MEMBERS
Chair
David B. Vliet, MBA
Chief Executive Officer
LifeLong
Medical Care
Chair-Elect
Britta Guerrero
Chief Executive Officer
Sacramento Native American Health Center
Immediate Past Chair
Louise McCarthy
President & CEO
Community Clinic Association of Los Angeles County
Secretary
Paulo Soares
Chief Executive Officer
Camarena
Health
Treasurer
Graciela Soto-Perez
Chief Executive Officer
Altura Centers for Health
Speaker
Rakesh Patel, MD
Chief Executive Officer
Neighborhood Healthcare
Vice Speaker
Kevin Mattson
President & CEO
San Ysidro Health
Members at Large
Benjamin Flores, MPH
President & CEO
Ampla Health
Sherry Hirota
Chief Executive Officer
Asian Health Services
Lucresha Renteria
Executive Director
Mendocino Coast Clinics
COMMITTEE MEMBERS
Doreen Bradshaw
Executive Director
Health Alliance of
Northern California
Warren J. Brodine
President & CEO
Eisner Health
Debra Farme,
President & CEO
Westside Family Health Center
Naomi Fuchs
Chief Executive Officer
Santa Rosa Community Health
Alvaro Fuentes
Executive Director
Community Clinic Consortium
Jane Garcia
Chief Executive Officer
La Clinica de La Raza, Inc.
Kerry Hydash
President & CEO
Family HealthCare Network
David Lontok,
Chief Executive Officer
Comprehensive Community Health Centers, Inc.
Melissa Marshall, MD
Chief Executive Officer
CommuniCare Health Centers, Davis Community Clinic
Scott McFarland
Chief Executive Officer
Mendocino Community
Health Clinic, Inc.
Anitha Mullangi, MD
Chief Medical Officer
Saint John’s Well Child & Family Center
Danielle Myers, MD
Director of Health Informatics
Golden Valley Health Centers
Jonathan Porteus
Chief Executive Officer
WellSpace Health
Tim Rine
Executive Director
North Coast Clinics Network
Asa Satariano
Chief Executive Officer
South of Market Health Center
Andrea Schwab-Galindo
Chief Executive Officer
Tiburcio Vasquez
Health Center, Inc.
Ralph Silber
Executive Director
Alameda Health Consortium
Richard Veloz, MPH, JD
Chief Executive Officer
South Central
Family Health Center
Christy Ward
Chief Executive Officer
Share Our Selves
THANK YOU
CARMELA
As we close out another extraordinary year, CPCA would like to recognize the impact of our longtime CEO Carmela Castellano-Garcia who retired in May 2021. During her nearly 25 years leading the organization and the health center movement in California, she helped to position community health centers (CHCs) at the forefront of the state’s health care system
Under her leadership,
Federal funding to
CHCs has increased from
$105M
$776M
During her tenure at CPCA, community health centers have had significant income growth, more than tripling their collective income from $795 million in 1997 to over $6.5 billion in 2019. Patients served increased more than 300 percent during this same period from 2.4 to 7.4 million, and total annual encounters grew by more than 12 million. Under her leadership, Federal funding to CHCs has increased from $105 million to $776 million in 2019, and the number of health center sites has more than doubled to over 1,380 sites in 2019.
In 2015, Carmela oversaw the creation of a new 501(c)4 CPCA affiliate corporation – CaliforniaHealth+ Advocates (Advocates), a social welfare organization that is dedicated to advancing the mission of community health centers through state and federal advocacy. She served as the President and CEO of Advocates for nearly six years.
During her time at CPCA, Carmela worked to strengthen the organization, growing the staff from just three people in 1997 to more than 55 individuals within six departments in 2021. Through her entrepreneurial drive, she worked to build partnerships with vendors nationwide to bring the best programs and services to CPCA members – helping them to strengthen their own organizations and improving their bottom line.
Identifying early on that the organization would need additional funding to sustain the innovative work she was building toward, Carmela worked to diversify the revenue of the organization through forward-thinking strategic partnerships and critical service lines. Through this work, health centers have only become stronger within the larger delivery system and despite the continually changing environment, health centers are not only surviving – but thriving. In doing so, Carmela has propelled CPCA – one of the youngest state PCAs – into the national spotlight as one of the strongest and most forward-thinking PCAs in the nation.
Under Carmela’s leadership, CPCA developed a robust training and technical assistance program aimed at ensuring community health centers are successful within the larger health care system. Each year, CPCA staff provide thousands of instances of phone, email, and in-person technical assistance. She also worked over the past five years to develop a strong leadership team, which was instrumental in pushing the organization to where it needed to be in the future.
Carmela truly dedicated the majority of her career to this organization, community health centers, and the movement. CPCA is extremely lucky of what his organization has become – a nonprofit focused on social justice, centered in mission, and dedicated to its members. It was through bold moves throughout her tenure that got CPCA to this point.
CPCA’s New 2021 – 2031 Strategic Vision:
Charting a Course to Achieve Health Equity and Community Well-being in California
We could not be more excited about our boldest and most ambitious strategic vision to date.
This 2021 – 2031 strategic vision creates a roadmap to a future where community health centers (CHCs) are stronger, more successful, and better-positioned to be integral players in creating just, equitable, and inclusive communities for all in California. CPCA’s strategic planning efforts kicked off in February 2020, right before the beginning of the pandemic and officially concluded in July 2021 when the board of directors affirmed CPCA’s new 10-Year strategic vision.
Strategic Planning Retreat and 2020 Strategic Planning Process
CPCA board members and executive leaders gathered for an in-person retreat in Sacramento from February 13 – 14, 2020. Shortly thereafter in March 2020, the COVID-19 pandemic began and our strategic planning work needed to be re-envisioned and adapted to a new virtual world. Despite the massive challenges to CHCs at the beginning of the pandemic, CPCA’s strategic planning continued and the work became even more relevant. Throughout the rest of 2020, CPCA’s board, members, and staff participated in town halls, board meetings, senior staff retreats, and listening sessions.
The listening sessions were anchored by three subject matter experts who helped process the challenges felt by CHCs and inspired us to envision a better future. They were:
- Carlos Olivares, CEO of Yakima Valley Farmworker Clinic who discussed the benefits of value-based care for community health centers and the role addressing health disparities plays in a payment model change.
- Dr. Soma Saha, Founder and Executive Lead of Well-being and Equity in the World (WE in the World), as well as Vice President at the Institute for Healthcare Improvement showed how addressing health inequities must start at both a systems level and relationships level to enact real change and improve outcomes.
- Michael Curry, Esq., President & CEO of the Massachusetts League of Community Health Centers shared essential strategies for starting the work of addressing systems-level inequities by partnering with others in the community to amplify impact.
Continued Focus in 2021 and Path to Affirming our Strategic Vision
In January 2021, we found ourselves with more pandemic-related challenges as COVID-19 cases and hospitalizations increased and the vaccine was starting to be distributed among health care workers and high-risk populations. With the pandemic as a backdrop, we continued refining the strategies and metrics in our strategic plan in the spring of 2021. Ultimately, the CPCA board affirmed a 10-year strategic vision in July 2021.
CPCA 10-Year Strategic Vision:
To Create a Just, Equitable, and Inclusive Well-being System
Below is a summary of our new strategic vision and strategies:
The Road Ahead
Shortly after the board affirmed the strategic vision, the senior leadership team began working with staff on creating 3-year work plans that lay out the activities and outcomes needed to achieve our strategic vision. We anticipate finalizing the work plans in early 2022 and continuing to work diligently to achieve well-defined outcomes by 2024.
CPCA AS AN
ANTI-RACIST ORGANIZATION
January 2021 started off with many wondering if there would ever be a time when COVID-19 wasn’t impacting our lives.
How should CPCA continue to further its antiracism goals?
In response, CPCA leadership developed a four-prong approach to continue our justice, equity, diversity, and inclusion (JEDI) work and more deeply embed antiracism goals into the fabric of everyday work.
Leadership recognized that for an organization-wide effort toward antiracism to be successful, it needed to be fostered and supported at both the leadership and staff levels. To that end, CPCA developed an internal antiracism work group comprised of staff representation from across departments and inclusive of staff roles from administrative assistant to Vice President. The work group’s purpose was to move the organization further along the antiracism continuum. The work group began meeting in late Spring and continued through the calendar year to work on four specific objectives:
Defining shared anti-racism values to serve as the Association’s north star(see CPCA’s Statement on Being an Antiracist Organization).
Drafting processes and decision- making policies to help identify internal practices that will promote an anti-racist culture.
Defining shared anti-racism values to serve as the Association’s north star(see CPCA’s Statement on Being an Antiracist Organization).
Drafting processes and decision- making policies to help identify internal practices that will promote an anti-racist culture.
In addition to the work outlined above, staff were encouraged to bring additional antiracism ideas and requests to leadership. As a result, CPCA held several informal and impromptu Staff Townhalls that focused on issues such as racism and microaggression in the workplace and held space to reflect in real time on current events happening in the country, such as the Kyle Rittenhouse trial. While not new in 2021, and not specific to internal CPCA activities, it is also important to share that CPCA continued to facilitate antiracism conversations in member spaces, such as the Supporting Black Communities Work Group and the Health Equity Task Force.
CPCA is proud of the antiracism work prioritized in 2021 and is equally dedicated to continuing this important evolution in 2022 and beyond. Please contact Buddy Orange at borange@cpca.org if you have questions or would like to learn more about CPCA’s JEDI work.
Beginning 2022, CPCA will welcome the inaugural Leadership Equity Program (LEP) cohort
Consisting of emerging leaders envisioned by their respective CHC executive leadership team to join the C-suite in 1-5 years, CPCA developed LEP in response to the need for (1) a pipeline of diverse emerging CHC C-suite leaders who are equipped with the knowledge and skills required to mitigate health disparities and advance community well-being and (2) to strengthen community health center capacity to recruit, retain, and advance this diverse cadre of leaders.
LEP offers both a cohort design for participating emerging leaders and capacity-building for their respective CHC executive team to advance emerging C-suite leaders and expand strategies centered on anti-racism, health equity, and community well-being.
The program curriculum is comprised of the following core areas:
Anti-racism &
Racial Equity
Leadership
Development
Participants will recognize the core tenets of Inclusive and Adaptive Leadership, examine personal biases, identify key traits of an effective leader, understand the importance of engaging authentically, and drive change and create an organizational culture of inclusion and belonging.
Health Center Operations &
Facilities Mgmt.
Community
Well-being
CPCA is working with two mission-driven and talented consulting teams,
The Leadership Equity Program is also supported by a committed Advisory Committee guiding the program team throughout the development and implementation of LEP, and is composed of the following individuals:
Alvaro Fuentes
Executive Director, Community Clinic Consortium
Andrea Schwab-Galindo, MPH
Chief Executive Officer, Tiburcio Vasquez Health Center
Anitha Mullangi, MD, MHCM
Chief Medical Officer, St John’s Well Child and Family Center
Britta Guerrero
Chief Executive Officer, Sacramento Native American Health Center, Inc
David B. Vliet, MBA
Chief Executive Officer, LifeLong Medical Care
Kimberly S.G. Chang, MD MPH
Family Physician, Director of Human Trafficking and Healthcare Policy, Asian Health Services
Melissa Marshall, MD
Chief Executive Officer, CommuniCare Health Centers
Naomi Fuchs
Chief Executive Officer, Santa Rosa Community Health
Sayeed Khan, MD
Chief Medical Officer, Molina Healthcare of California
Together, The Program is Aimed to:
achieve our vision
to collectively strengthen
Community Health Centers' Capacity to Achieve
just, healthy, & equitable
Communities Across California
AN APM ON THE HORIZON FOR FQHCs
FQHCs will soon have the chance to apply for a new payment opportunity in California.
This historic moment comes after approximately 20 years of the prospective payment system being in place and the new opportunity- an alternative payment methodology (APM)- aims to build on the best parts of PPS and help FQHCs stabilize payment and leverage more of their care teams to deliver even better patient centered quality care.
CPCA and health centers have been working towards this new opportunity since 2012. Our first attempt at an APM faltered in 2017 when the then-CMS leadership required that we implement the payment model via an 1115 Waiver not a State Plan Amendment (SPA), as was CPCA’s expectation. Since that time, CPCA and health centers have continued exploring value-based payment and kept APM in all leadership meetings with the state. The opportunity for a second attempt at the APM surfaced with the COVID pandemic and the limitations of PPS, coupled with the “stay at home” orders which led to health center revenues dropping precipitously. The state agreed with CPCA that California needed to build a payment model that stabilized and leveraged the vital primary care delivery system that health centers so expertly lead. The state also agreed with CPCA that the APM would be built to be approved as a SPA, which meant it would be voluntary and health centers would receive as much as they would under PPS.
For APM 2.0 as it was referred to at the beginning, CPCA’s board effectuated three new APM Committees – Leadership, Finance and Quality- with a limited number of seats that health centers could apply for so that a group of approximately 30 CHC leaders from across the state would be committed to the intensive work necessary for building out a new payment and delivery model. In addition, the PPS Payment Modernization Work Group met monthly to provide input on the APM 2.0 that was being developed. All feedback from health centers informed the state led APM Stakeholder meetings in 2021. The state’s formal meetings also included the health plan associations, individual health plans, as well as the public hospital association as they have FQHCs.
The culmination of all the meetings and work informs work in 2022 and 2023. Originally the goal was for the APM per-member, per-month PPS equivalent monthly rate to start in January 2023, however, all parties involved have agreed that in order to launch an APM that thoughtfully considers the nuances and complexities of California’s delegated managed care model, an additional year of operational logistic work is necessary. Health centers will still have the opportunity to apply for the APM in 2022, and these health centers will be helping to shape the APM logistics as they help CPCA, state, and plans work through all the necessary logistics of changing payment and payment flow. Additionally, this first cohort of health centers will inform how the quality and access data capture and reporting will be operationalized. The expectation is that the APM payment will start in January 2024, and then year over year all FQHCs in California will have the opportunity to apply to convert their PPS to an APM rate.
In 2022, CPCA, with member input, state, and health plans will work through the outstanding specifics of operationalizing the APM, but the principle agreements are that the FQHCs are entitled to PPS and will be made whole to PPS no matter what. For many FQHCs this commitment plus the flexibility afforded in the new model will help to stabilize cash flow and position FQHCs for more innovative care delivery models.
CPCA and the regional consortia are actively working with health centers on APM readiness assessments and there are a litany of other tools and supports already created and soon coming for those FQHCs interested in applying in 2022. The California Health Care Foundation who is funding CPCA’s APM policy work is also supporting the development of an APM Implementation Guide that will be ready in April 2022 for those FQHCs selected for the APM. The guide will provide an array of tools to help FQHCs think through the array of elements and impacts of the APM model.
Health centers interested in learning more are encouraged to visit our APM Initiative web page, www.cpca.org/apm
Commitment to
Health Equity
COVID-19 Vaccine Response:
Communications & Training
CPCA continued to support health centers in their response to COVID-19 throughout 2021.
We Heard Your Feedback
With each pivot during the second year of the pandemic, CPCA continued its 2020 real time support by conducting weekly webinars, virtual discussion meetings, and partnering with the California Department of Public Health’s (CDPH) Immunization Branch every step of the way. Polls and round table discussions served as a means to aggregate health center feedback, identifying challenges to the delivery system from vaccine ordering and storage, to understanding policy and how to be compliant, all while addressing wildfires and workforce shortages.
Dr. Mike Witte, CPCA’s Chief Medical Officer, held regularly scheduled COVID-19 Clinical Update virtual meetings, covering COVID-19 specific treatments and the unfolding information on vaccinations. CPCA led collaboration between health centers, CDPH, local health departments, and the state’s Third Party Administrator (TPA), Blue Shield, in order to work through vaccine eligibility, the procurement of vaccines, and reporting requirements. Support often came in the form of multiple weekly meetings, a vaccine focused workgroup, updates in CPCA’s Weekly Update, and posting to CPCA’s COVID-19 Connected Community forum. CPCA worked directly with provider associations throughout June of 2021 and advocated for health center needs in an effort to most efficiently and effectively vaccinate not only patients, but their community as a whole.
Nearly simultaneous to the launch of the California Vaccine Program, the Health Resources and Services Administration (HRSA) began inviting health centers to participate in the federal Health Center Vaccine Program. CPCA supported HRSA and the health centers by conducting weekly outreach to health centers that experienced issues with program enrollment. One-on-one assistance was provided by CPCA to work through administrative barriers to accessing the CDC’s Vaccine Tracking System (VTrcks), and the Vtrcks Provider Order Portal (VPOP).
By early August 2021, the State of California had issued two Public Health Officer Orders that placed a vaccine requirement on all health care personnel and, if exempted, laid out requirements for health care work protections to be followed. CPCA immediately convened a member virtual meeting, where more than 350 attendees joined. CPCA continued support on the Orders through their compliance dates, holding two meetings with California Health and Human Services Secretary, Mark Ghaly, M.D. and his team. The California orders soon dovetailed into federal mandates, and support of both continued through the end of the year.
Connected Community – COVID-19 Forum
In early 2021, CPCA launched its COVID-19 Community Forum in Connected Community to support all COVID related discussions.
The COVID-19 Forum is unique in that it is accessible to everyone, not just members; CPCA wanted to support all health centers with resources as well as invite partners and other associations to the conversation. As of the end of 2021 there were more than 7,800 individuals who have access to the COVID-19 community.
To learn more about Connected Community, visit cpca.connectedcommunity.org/home
Training & Technical Assistance
Vaccine equity, everyone having fair and just access to vaccination, has been a focus in the Federal response to curb the COVID-19 Pandemic.
CPCA has been committed to supporting these efforts to ensure that California’s health centers are addressing the social, geographic, political, economic and environmental factors that create barriers to vaccination access and acceptance.
Over 500 attendees attended trainings focused on mass vaccination strategies and building trust within the community. This is in addition to the bi-weekly CPCA COVID-19 Update Call that discusses all pandemic response and vaccine issues.
Immigrant Health & Public Charge Rule
On March 9, 2021, the Biden administration dropped its defense of the Trump public charge rule.
As a result, the U.S. Supreme Court and the Seventh Circuit dismissed the pending cases, bringing an end to the Trump’s Administration public charge rule.
A district court order vacating the rule is now final, meaning that the long-standing 1999 “field guidance” (the policy that was in place before the 2019 Rule) remains in place, making it safe for immigrants and their families to use health, nutrition, and housing programs for which they qualify.
The Biden Administration is currently working to improve the 1999 guidance and has released an Advance Notice of Proposed Rulemaking (ANPRM), which will help establish a permanent public charge rule. CPCA worked with AAPCHO, NACHC and NILC to release a joint sign on comment letter from the community health center (CHC) perspective. After the Department of Homeland Security (DHS) reviews the responses to the ANPRM, we can expect a Notice of Proposed Rulemaking (NPRM), proposing specific changes to public charge policy and again offering an opportunity to comment. The last step would be publication of a Final Rule, incorporating stakeholder comments and hopefully cementing a more responsible regulatory policy on public charge.
Deferred Action for Childhood Arrivals (DACA)
A Texas Federal judge ruled that DACA, a program that allows certain immigrants to temporarily avoid deportation and receive renewable work permits, is illegal and ordered the Biden administration to stop granting new applications. However, the ruling continues to allow current DACA recipients to renew their 2-year work permits. According to the Federal Judge, the Obama administration did not use the right legal procedure to create the program, making it illegal.
In response, DHS announced a notice of proposed rulemaking that would preserve and fortify the DACA policy. CPCA worked with AAPCHO, CCALAC, NACHC, and NILC to compose a sign on comment letter from the CHC perspective. Our comments encourage Congress and the Biden Administration to work together in finding a more permanent solution, while also suggesting improvements to the program that would allow more individuals to qualify.
Resources
Through the efforts of the CA-PIF Outreach and Communications Workgroup, CPCA has been able to provide CHCs resources to help answer questions from their immigrant patients related to health care access and public charge. In 2021 CPCA helped to host six service provider trainings that reached over 1,000 people throughout the state.
In addition to hosting trainings, the CA-PIF Outreach and Communications Workgroup helped to create three community facing documents that help immigrant families navigate the healthcare system, understand their rights to access COVID-19 care, and healthy nutrition food. These documents were translated into five languages: English, Spanish, Chinese, Korean, Tagalog & Vietnamese.
Growing a Diverse Workforce Rooted in Community
Community Health Centers (CHCs) are in California's most diverse communities.
More than half of CHC patients identify as Hispanic (or Latinx), nearly 10 percent identify as Asian and/or Pacific Islander, and six percent identify as Black.
CPCA’s NEW Strategic Workforce Planning Program
The pandemic continues to disrupt the labor market making it essential for health centers to strategically prepare for the future. Skill gaps and shortages. Burnout and turnover. An aging workforce. Changing business models. The list of workforce challenges is endless. Developing a strategic workforce plan and maintaining it over time as an organization evolves provides a clear and actionable framework for addressing these challenges in ways that will keep your organization on track toward achieving its strategic objectives. It is about getting the right people with the right skills in the right roles at the right time to support the CHC’s business strategy now and in the future.
CPCA, with the support of the Health Resources and Services Administration (HRSA), developed a NEW certificate program as part of a national initiative to increase and enhance the development of strategic workforce plans in CHCs. CPCA’s Strategic Workforce Planning Program is based on HCI’s (Human Capital Institute’s) industry-recognized Strategic Workforce Planning certification program, but tailored to the unique needs of CHCs. The inaugural cohort of 40 participants from community health centers and regional clinic associations are obtaining a professional development opportunity, in-depth knowledge on strategic workforce planning, a certificate, and professional credits.
They are learning that strategic workforce planning (SWP) is an agile, dynamic, and data-informed process designed to help organizations forecast and plan the workforce they will need to be successful in the next 3-5 years.
The Inaugural Cohort is Applying the SWP Framework
to develop and sustain a robust and diverse
Health Center Workforce.
The SWP Program’s 8 Learning Objectives
Understand
and articulate your Health Center’s business strategy and connect your strategic
workforce planning processes to it to accelerate business outcomes.
Segment
your Health Center’s roles to determine how each position
contributes value and which roles are a priority versus those in the periphery.
Conduct
an environmental scan of your Health Center to continuously identify and monitor trends that affect the workforce and the organization.
Analyze
the current state of your Health Center to evaluate, benchmark, and inventory today’s workforce.
Construct
a detailed future state for your Health Center through scenario planning of how the organization, environment, technologies, and operational norms will look in the coming years.
Identify
gaps between the current and desired future workforce and organizational state.
Create
an action plan for your Health Center to address, design, and/or restructure elements of the organization’s structure and talent initiatives.
Monitor and Report
with quantitative and qualitative benchmarks and milestones that are identified in the action plan. Report findings to stakeholders and management.
Health Professions Education & Training Initiative
Dr. Luis Padilla, MD, FAAFP
Associate Administrator, Bureau Health Workforce, Health Resources and Services Administration (HRSA)
“We know that providers who receive training in community and underserved settings are more likely to practice in similar settings, such as health centers. This is even more evident when the physician has a connection to a practice location – perhaps because they are part of a minority group or grew up in a rural area. We are moving away from funding traditional institutional curriculum development and focusing on more “training in place” efforts to meet workforce needs.”
— January 2021 CPCA blog interviewThis statement shows that CHCs can increase the likelihood that those trained at a CHC will develop a deeper connection to the mission and culture of CHCs by playing a part in the education of these learners. As a result, learners may be more likely to pursue employment with CHCs. Providing educational opportunities to existing staff also strengthens the workforce and improves existing staff morale. Having visible career paths for all staff and providers helps employees see that there is a future for them to move forward in a familiar place, serving their community.
For this reason, CPCA is also working with HRSA on a second initiative to “grow our own” robust and diverse CHC workforce, the Health Professions Education and Training (HP-ET) Initiative. Our goal is to enhance health centers’ capabilities to recruit, develop, and retain their workforce by exposing health and allied health professions students, trainees, and residents to education and training programs conducted at health centers. Over the course of a year and a half, CPCA has created significant learning opportunities to support CHCs in HPET.
Readiness to Train Assessment Tool (RTAT)
Assists health centers in assessing and improving their readiness to engage in health professions training programs. CPCA encouraged CHCs to participate between September 2020 and February 2021. Community Health Center, Inc sent the RTAT results to participating CHCs in November 2021. Statewide and national reports are expected in March 2022.HP-ET Workgroup
Creates a space for members and CPCA staff to strategize the development of training and technical assistance (T/TA) that supports health center health professions training. The group meets bimonthly to also strategize the development of partnerships with academic institutions to recruit and retain students from our communities who have a strong desire to pursue a career in a CHC.HP-ET Template for Assessment and Action
Provides a road map and series of action items to develop health professions training programs aligned with organizational workforce goals and strategies. It walks health centers through how to lay the foundation for health professions training, assess current and future needs, plan and act, and adjust.Medical Assistant Development Toolkit for Clinical Managers and Supervisors
Highlights practical tools, examples, and resources from California community health centers that help clinical managers and supervisors foster a strong medical assistant team. Topics covered include recruitment, training, career development, finances, and return on investment.HP-ET Resource Library
Offers a one stop shop of toolkits, reports, templates, and previously recorded trainings available to health centers to assist with developing or enhancing training programs and partnerships.HP-ET Webinar Series
Showcases a variety of training programs and models leveraged by CHCs across California. New webinars are being added frequently.
Care Transformation
Adverse Childhood Experiences (ACEs) Aware
Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood (0-17 years). Examples of ACEs such as experiencing/witnessing violence and mental health problems are categorized into three groups: abuse, neglect, and household challenges.
ACEs are common and the economic and social costs to families, communities, and society totals hundreds of billions of dollars each year. However, ACEs are preventable. There are several factors that may increase or decrease the risk of perpetrating and/or experiencing violence. To prevent ACEs, we must understand and address the factors that put people at risk for or protect them from violence.
The ACEs Aware initiative is a first-in-the nation effort to screen patients for ACEs to help improve and save lives. ACEs Aware strives to create a better world for our children, families, and communities by working together across sectors to prevent and address the impact of ACEs and toxic stress. CPCA was contracted by Aurrera Health Group in three ACEs Aware grant activities: Network of Care, Peer to Peer Learning, and Communications. These grants helped organizations offer additional opportunities for providers and other stakeholders to share lessons learned and best practices tailored to specific geographic areas, patient populations, providers, and practice settings.
Communications
CPCA coordinated a statewide communications project that leveraged CPCA’s robust communications structure of networks and partner organizations, to reach staff of the over 1,300 community health centers (CHCs) in California, from CEOs and providers to front line staff. In addition to engaging with CPCA health center members, CPCA partnered with other organizations, including the Regional Associations of California (RAC), and coalitions to support and strengthen CHCs and will utilize these partnerships for this work. Close partnerships with the RAC allowed CPCA to leverage our collective statewide and regional strengths and reduce duplication of efforts for this ACEs Aware Initiative.Communications grant objectives that were met included monthly social media content calendars for subgrantees, Tweets, Facebook posts, LinkedIn posts, CPCA Weekly Update blurbs, an ACEs Aware informational page with links to resources, and an ad retargeting campaign to promote ACEs Aware advertisements to all CPCA website traffic and linked back to acesaware.org. Although CPCA does not directly interact with the communities our members serve and support, our efforts in messaging “Become ACEs Aware” to clinicians made an impact on the number of providers who took part in the training. The ad retargeting campaign, even running for a few weeks, resulted in a reach of over 5,000 – all which were presented with ACEs imagery and directed back to acesaware.org. CPCA’s social media and communications efforts are run internally, and therefore ACEs information/trainings/updates will continue to be disseminated via social channels and throughout our various member communications.
Network of Care
To screen Medi-Cal beneficiaries for ACEs, there are two approved screening tools: the Centers for Disease Control and Prevention (CDC) ACE Assessment Tool and the Pediatric ACEs and Related Life Events Screener (PEARLS). CPCA identified a need among health center providers to build systems and capacities to meaningfully engage with ACEs/PEARLS screening results data for clinical practice and trauma-informed and resilience-oriented (TIRO) systems. The ability to use the screening tools is based on the ability of CHCs to enter screening data into the electronic health record (EHR) and pull reports from data analytics platforms. However, there is a gap in functionality in EHRs and data analytics platforms in using screening results and data to advance clinical practice and care transformation.Ongoing efforts in Network of Care include the integration of ACEs and PEARLS screening tools into most common EHR and data analytic platforms used by CHC’s. CPCA is partnering with EHR/data software vendors to ensure that the ACEs and PEARLS screening tools (pursuant to licensing availability) are incorporated into these EHR and data software systems. CPCA’s continued work in this area includes the development of EHR templates that include the ACEs/PEARLs screening questions and coordinating with data software vendors to ensure that screening results can be pulled from the EHR for reporting and analytic purposes. To effectively test the modifications to EHR templates and data software systems within CHC sites, CPCA is partnering with three Regional Associations of California (RAC) to leverage expertise working directly with member CHCs on projects related to health information technology.
- EPIC OCHIN – Alameda Health Consortium
- eClinicalWorks – Redwood Community Health Coalition
- Relevant – Redwood Community Health Coalition
- NextGen – CPCA
Peer to Peer
CPCA partnered with six RAC organizations to each lead regionally focused peer networks focused on strategies and promising workflow practices for screening patients for ACEs and toxic stress. In the first two quarters, all RAC subgrantees began assessment of providers and their familiarity with the ACEs/PEARLS screening tools. Buy-in from providers and stakeholders was collected to identify existing knowledge of ACEs and potential to screen in various health care settings (e.g., perinatal care, behavioral health, primary care, etc.) and expansion of trauma-informed care across the health center’s care ecosystem. The RAC organizations developed action plans and conducted 18 ACEs peer-to-peer learning meetings.CPCA supported subgrantees with agenda setting and presentations for peer-to-peer meetings, hosted bi-monthly RAC and CHC ACEs Aware coordination calls, and answered technical assistance questions from RAC subgrantees and CHC staff on the ACEs Aware initiative throughout the grant period. On September 21, 2021, CPCA hosted a convening for all RAC subgrantees and other health center ACEs Aware grantees to attend and participate in a peer-to-peer discussion reflecting on lessons learned, challenges, and recommendations of ACEs Aware work sustainability beyond grant funding. Post convening materials include a summary of lessons learned that was shared with all subgrantees and various forms of access to the didactic convening recording. In open-ended responses, participants indicated that the most valuable piece of the virtual convening was hearing from other attendees and speakers on their experiences with ACEs work and focusing on actionable steps to take when thinking about the sustainability of ACEs Aware work beyond grant funding.
Next Steps
CPCA has used the lessons learned to network with other ACEs Aware grantees during ACEs Aware Regional Meetings hosted by Aurrera. Throughout the summer of 2021, these Regional Convenings helped CPCA staff identify partners throughout California to share and learn from each other and participate in discussions on challenges and highlights of our work. Internally, CPCA staff continue to coordinate efforts on available funds that overlap with ACEs work such as activities around Trauma Informed Care, Resiliency and Recovery (TICRR), SDOH networks, and advocacy efforts.
CPCA is creating new opportunities to educate providers and non-providers on ACEs screening and continues to highlight ACEs in peer network settings (e.g., CPCA SDOH peer network) and CPCA online resources available to statewide members at both RAC and CHCs.
Based on feedback from RAC subgrantees, CPCA plans to inform strategic planning of the commitment to standardized training in the area of ACEs, seeking new and strengthening existing cross-sector partnerships to learn about and share workflows and processes, and identify ACEs-focused advocacy opportunities; CPCA is actively working on integrating ACEs and Pediatric ACEs and Related Life-events Screener (PEARLS) tools into the most common EHR and data analytic platforms used by CHCs through our parallel work in the ACEs Aware Network of Care grant. Following integration and testing, CPCA plans to include educational materials on use of the tools along with all other proposed ACEs-related educational opportunities.
Social Determinants of Health (SDOH)
Health outcomes of populations are more often determined by social factors than by medical care. According to Healthy People 2020, Social Determinants of Health (SDOH) are conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes. About 40% of a person's health is attributed to SDOH.
Community health centers (CHCs) have a history of and commitment to addressing community health needs and have a unique opportunity to delve into assessing and understanding the root causes of poor health such as education, poverty, housing, violence, and other SDOH issues. Strong partnerships across sectors helps engage key stakeholders and pool efforts and resources to address SDOH.
CPCA is committed to helping CHCs understand the screening tools available, collecting patient level data with the necessary workflows, building partnerships, and understanding the resources in their community to address the SDOH affecting patients. Beginning in the summer of 2020, CPCA [in partnership with Blue Shield of California (BSC)] supported the Regional Associations of California (RAC) and CHCs through learning cohorts to: (1) develop rapid community health needs assessment (CHNAs) using the MySidewalk’s Neighborhood Dashboard (NHD) digital intelligence tool, and (2) explore strategies to leverage aggregated SDOH data from the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) assessment tool.
NHD generator
BSC engaged CPCA to develop knowledge and proficiency in the newly developed NHD generator for MySidewalk and deliver two train-the-trainer learning cohorts in Blue Shield target counties. Target audiences included RAC and/or primary care providers to discuss the availability and use of NHD in their communities to develop CHNAs and identify and align on priority community health issues. CPCA provided a platform for discussion and technical assistance support to develop rapid CHNA and prioritization working sessions using the MySidewalk digital intelligence tool, NHD.CPCA worked with BSC and MySidewalk to coordinate and develop train the trainer virtual learning cohorts. The NHD generator training offered skills for CHCs and RAC staff to assess their communities, develop cross-sector partnerships, and engage in advocacy work. Training materials were made available to California health care staff and providers. The first training (hosted on March 2, 2021) was co-led by all three partners—CPCA, BSC and MySidewalk. The second training (hosted on June 29, 2021) was led by CPCA staff, engaging participants, and sharing best practices and lessons learned. Both virtual training sessions were attended by a total of 58 organizations from across the state. The evaluation of both trainings indicated high satisfaction from attendees and interest in future opportunities to share best practices in SDOH including partnerships and workflows.
SDOH Learning Cohort
CPCA leveraged relationships with the RAC to recruit CHCs from across the state and worked with RAC to disseminate the PRAPARE assessment tool and explore potential strategies to leverage aggregated SDOH data for integration with the Unite Us platform. A total of 44 health center organizations participated in the SDOH learning cohort. The PRAPARE Learning Cohorts, organized via virtual platform, were made up of CPCA members and BSC stakeholders in target counties divided into four regions:
- Southern California
- Greater Sacramento
- Inland Empire
- Bay Area Coastal
PRAPARE Learning Cohorts followed a nationally established training program with a three-pronged approach to SDOH by working with clinics and other stakeholders to (1) understand what and how to use PRAPARE to collect data, (2) analyze and use data collected through PRAPARE, and (3) develop either clinic resources or community partnerships to address the social needs identified through the data collected via the screening tool. The virtual training sessions also include an overview of SDOH, integration of social needs into health care delivery, and CHC and other Medi-Cal provider requirements. CHCs were also offered one-on-one coaching support. During the one-on-one meetings with health center staff, CPCA worked with the staff to understand the training and technical assistance needs not identified during the live webinars. Evaluation reports across all learning cohorts indicated that participants highly rated the webinars where they were able to hear specific referral options for their region and introductory information to explore leveraging SDOH data.
Next Steps
Health equity and the reduction of health disparities are at the center CPCA’s mission and the work we do. To increase participation in future cohort sessions and improve the quality of information, CPCA plans to expand access and quality of future learning cohort sessions on the topic of SDOH through streamlined processes for ease of access to information, in addition to restructuring content to better highlight well-received areas. The partnership with BSC and MySidewalk allowed CPCA the opportunity for facilitating robust discussions about using the NHD generator and PRAPARE screening tool within existing clinic workflows. This helps address a wide array of health issues, their prevalence, severity, and the ability to evaluate outcomes on issues beyond clinical diagnoses of patients and the communities they exist in. Based on participant feedback of both the NHD generator and PRAPARE screening tool learning sessions, CPCA will continue to engage stakeholders on all aspects of understanding the importance of assessing for unmet social needs and strategizing the implementation process of collecting and analyzing SDOH data.
CalAIM Moves from Ideas into Implementation
After being sidelined by the pandemic, the Department of Health Care Services (DHCS) used much of 2021 to reacclimate stakeholders to their ambitious proposals aimed at reforming Medi-Cal. California Advancing and Innovating Medi-Cal (CalAIM) is a multiyear, layered approach to transform California’s Medi-Cal program, with a special attention to social services and support for the millions of Californians with the most complex needs. CalAIM marks an incredible opportunity to align systems, integrate wholistic care and focus more intentionally on prevention, early intervention, and wrap-around support.
CPCA is focusing our attention and efforts on the following CalAIM programs and services:
- Establish new programs focusing on Enhanced Care Management and Community Supports (In-Lieu-of Services);
- Reform current county specialty mental health and substance use disorder systems;
- Establish a data-driven population health management strategy that assess beneficiaries whole-person needs; and
- Create a new health plan model that fully integrates physical, behavioral, and oral health under one contracted entity.
DHCS postponed the planned implementation of the CalAIM initiative, originally scheduled for January 1, 2021 so that both DHCS and all of their partners could focus their limited resources on the needs arising from the public health emergency due to COVID-19. They picked back up with a clear vision and plan for how to accomplish their goals. CPCA has tracked the implementation since the Department first put forth their policy proposals in 2019. Staff sat on various CalAIM workgroups and also supported health center representatives. Much of CPCA’s communication to health centers about the proposed changes came through the CalAIM Task Force, which is where we vetted the proposals and formulated feedback to the Department.
As the proposals move into implementation, we continue to offer the health center perspective through the state’s implementation workgroup. CPCA is highlighting the need for funding (including transition support, reimbursement, and incentive dollars) to community-based providers, like CHCs, to plan and provide this robust complement of services. Reimbursement rates need to be sufficient for providers to cover the cost of these services for patients at the top tier of complexity and risk. The state also needs to be focusing on ensuring that the care team of the future is diverse, representative of their patient population, and trained to meet demands.
CPCA is using the Managed Care Task Force as a forum to share updates, dialogue about the impact, and provide implementation trainings. We welcome everyone to join and augment our understanding of how CalAIM will impact health centers.
Data Sharing for Achieving Health Equity
To help in the advancement toward health equity, CPCA knows that patient data is at the center of creating impactful stories of community health centers (CHCs) and the patients they serve. These stories play a key role when sharing with state officials, funders, and the many other organizations that support health center patients.
CPCA, in partnership with two California Health Center Controlled Networks (HCCN), are further developing a data aggregation pilot to collect state level data on a quarterly basis. The data aggregation platform is an extension of a platform already in place for social determinants of health (SDOH) data. The goal of the pilot is to identify a roadmap for HCCNs, Regional Associations of California (RAC), and health centers for uploading data to the platform. The pilot is focused on identifying the most efficient way to upload data and will also test a subset of data with an intention to further expand the amount of data that is shared at the state level. This will help CPCA collect data in real-time, in addition to standardizing a modality for effective data sharing, regardless of EHR type – allowing CPCA to be preventative in our healthcare vision and better predict treads across the state.
One of the organizations that has shown interest in data sharing and our pilot program is Redwood Community Health Coalition (RCHC). RCHC is a network of 16 members, 15 community health centers and wellness education site, and a total of 74 sites in Marin, Napa, Sonoma and Yolo Counties. Formed in 1994, their mission is to improve access to, and the quality of care provided for under-served and uninsured people in their four counties. RCHC’s major focus is to strengthen the capacity of member health centers to act as a regional network of comprehensive primary care that provides access to consistently high-quality clinical care, effective care coordination and reduce health disparities. Another organization that has also shown interest in data sharing is the Coalition of Orange County Community Health Centers (the Coalition) which serves over 340,000 patients annually throughout their many facilities. The Coalition was founded in 1974 as a 501(c)3 not for profit organization designed to support and strengthen Orange County’s network of licensed community clinics. For 47 years, the Coalition has served as a membership organization for freestanding, mobile community based non-profit clinics offering a forum in which clinic leaders can share ideas and concerns, as well as to advocate for the clinics and their patients. The overall vision of the Coalition is to be the “voice” of the uninsured and vulnerable population in their area. They have established a safety net providers and key partners which allows them to create quality healthcare for vulnerable and underserved communities.
Behavioral Health
The immediate impacts of loss, isolation, and longer term needs due to the economic fallout highlighted an increased societal interest in behavioral health.
COVID-19 has unfortunately exacerbated mental health and substance use conditions for the general population.
Behavioral Health Workforce (BHWF)
The pandemic (and recovery) highlighted the lack of available behavioral health workforce, especially one that is representative of the populations served at community health centers.
CPCA has prioritized investments to expand the BHWF, including working with the Department of Health Care Services on implementing Licensed Marriage and Family Therapist (LMFT) and looking at post-public health emergency policies to keep the current flexibilities that allows health centers to bill Associate Clinical Social Workers (ASWs) and Associate Marriage and Family Therapists (AMFTs). Specific examples include engaging behavioral health statewide associations, partnering with the National Association of Social Work California Chapter (NASW-CA) and California Association of Marriage and Family Therapists (CAMFT), forming relationships with the California Board of Behavioral Sciences (BBS), and holding informational briefings for legislative and capitol staff members to educate key decision makers of the role community health centers play in California’s behavioral health delivery system.
CPCA has also been partnering with UC Berkely’s California Social Work Education Center (CalSWEC) to create a toolkit for community health centers to prepare, build and implement Masters of Social Work Internship Field Placement Programs, which looks at developing the BHWF pipeline at community health centers for ASWs and LCSWs.
Our goal with an increased focus on behavioral health workforce is to ensure that health centers have the human resources to meet the demand for services and that the diversity of patients’ identities are reflected the workforce composition.
CPCA Staff are committed to supporting systemic and site-specific integration of primary and behavioral health at community health centers through policy change and training/technical assistance.
Behavioral Health Integration Efforts
In 2021, CPCA staff joined colleagues across seven statewide associations to participate on the Delta Center California’s State Policy & Partnership Roundtable. The Delta Center of California is a 2.5-year initiative supported by the California Health Care Foundation and the Robert Wood Johnson Foundation that brings together behavioral health and primary care leaders to accelerate care improvement and integration through policy and practice change. CPCA staff also serve on the Delta Center’s Co-Design team for local learning labs. Each learning lab team consists of representatives from the specialty behavioral health and primary care delivery system. Teams will work together towards shared policy priorities, diving into areas such as financial sustainability for integrated care, best practices in telehealth, building up their workforce capacity, and integrating the disparate systems of primary care with specialty and mild/moderate mental health care. All teams are working to center racial equity and lived experience in their project work to ultimately reduce disparities in care.
Additionally, CPCA continues to support community health centers who expand behavioral health integration by implementing services under the Certified Community Behavioral Health Clinic (CCBHC) model of care. CCBHCs provide integrated, evidence-based, trauma-informed, recovery-oriented, and person-and-family-centered care by offering mental health, substance use disorder (SUD) and primary care services, while having to have established collaborative relationships with other providers and health care systems to ensure coordination of care. The first round of SAMHSA funding for California CCBHCs were awarded in 2020, and since the beginning, CPCA hosts monthly peer-to-peer sharing forums for CCBHCs as they begin to plan, prepare, implement, and improve services under this model of care. Additionally, CPCA uses this forum to connect CA CCBHC grantees to state and federal advocacy.
California community health centers participating in SAMHSA’s CCBHC Program:
Chinatown Service Center
HealthRight360
Korean Community Services
La Maestra Community Health Centers
San Ysidro Health
Santa Barbara Neighborhood Clinics
School Health Clinics of Santa Clara County
South Central Family Health Centers
CPCA continues to offer meaningful and high-quality training and technical assistance to health centers’ integrated health teams. One example is our Diabetes and Depression Learning Cohort focused on integrating primary and behavioral health care to treat co-occurring conditions in health center patients. The learning cohort focused on evidence-based behavioral health practices regarding diabetes and co-occurring depression and understanding how to incorporate these practices in clinic’s workflows and processes.
In looking forward to 2022, we project a substantial year for behavioral health. The state will launch several of their CalAIM policy proposals aimed at integrating and standardizing the specialty behavioral health delivery system. CPCA was intimately involved in the state’s vetting of these proposals before the pandemic, and we are excited to offer the health center perspective as the state seeks to implement.
PARTNERSHIPS
Macro-Eyes & Direct Relief
In 2019, the California Primary Care Association (CPCA) partnered with Macro-Eyes to help bring their Artificial Intelligence (AI) Scheduling software, known as Sibyl, to seamlessly add-on to community health centers’ (CHCs) scheduling systems and increase access to care by predicting when each patient is most likely to show, and then building a schedule that fills gaps before they happen.
In 2021 CPCA expanded this partnership, and in collaboration with Direct Relief and Macro-Eyes, partnered to advance emergency readiness for the increasing threats that have been posed by wildfires and power outages using AI that would help predict infrastructure readiness for every federally qualified health center (FQHC) in California.
Over time, California’s power outages have forced the cancellation of thousands of patient visits at CHCs due to closure. CHCs that lost power, but were still able to open, found themselves crippled by the loss of power, forced to slash services, close sites like dental clinics, and attempt to operate without the computer systems that are the backbone of modern healthcare. Even if a CHC stays in operation without power, without electronic health records, the doctors can’t access lab results, records of current prescriptions, schedules for screening tests like mammograms, records of blood pressure and cholesterol level, or reports from specialists. California’s widespread power shutdowns have revealed a hidden weakness in our health care safety net, and Public Safety Power Shutoff (PSPS) events are likely to become more commonplace as California’s utility companies seek to prevent destructive wildfires during periods of extreme risk.
In January 2021, Direct Relief and the CPCA initiated an engagement with Macro-Eyes to apply machine learning to understand individual health facility and health safety network capacity and readiness for managing Covid-19 vaccinations for the communities they serve. The first phase of this project was a rapid two-month deployment of the Macro-Eyes health readiness product, Striata, which uses artificial intelligence (AI) to machine learn the current state of infrastructure at each FQHC while generating data on the catchment population. Striata learns about health infrastructure from publicly available data and data derived through a set of proprietary
Striata yielded insight into 100% of community health centers included in the master facility list as compared to 3-8% at the beginning of the project.
Striata found that out of 2059 sites, 1258 (61%) were without any form of back-up power, while 212 (10%) were without refrigeration. 721 sites (35%) had both refrigeration and some form of back-up power.
This level of insight from Striata can support strategic targeted investment in the health safety net and identify sites ready to deliver essential services dependent on reliable refrigeration (such as a mass vaccination campaign), as well as sites able to continue to deliver care services during power outages or times of restricted access. This is especially significant in regions where natural disasters are an annual occurrence.
With these statistics in mind, Striata quickly became a resource mapping and investment planning tool where you can see in real-time which facilities have a higher proportion of population at risk of not being able to access health services, and which sites currently have a low resiliency to power outages where investment may improve their ranking. Striata helped pinpoint populations most at risk of wildfires and power outages alongside the existing user interface. This provides insight into whether the health center is fire ready, what are the capacities that need to be built, and whether they have that capacity to improve resilience.
Through this partnership, Striata has the potential to empower regional associations to have a more influential role in the allocation of resources and decision-making power, positioning visibility as an advocacy tool.
Regional Associations of California (RAC)
California is a large and regionally diverse state
with a complex health care market, and as such has a long history of statewide and regional clinic consortia supporting community health centers in our state.
Over the past decades, CPCA and clinic consortia have developed and refined an innovative partnership model and infrastructure to effectively partner and execute coordinated projects, through collaborative programs and resource sharing. In 2021, CPCA embarked on a number of unique partnership opportunities with the clinic consortia and continued, as well as closed out, a number of projects that were started in 2020.
Working with the regional consortia partners, we were able to offer regional training, education and outreach efforts in order to increase knowledge around COVID-19 safety, vaccination efforts and combat vaccine hesitancy.
The consortia continue to be integral thought partners around statewide strategic planning and funding opportunities. As such, CPCA and the regional consortia participate in regular meetings with statewide philanthropic funders to discuss ongoing and time-sensitive issues facing California’s community health centers. Through this work, funders have provided additional support for health centers around COVID-19 vaccine equity, contact tracing efforts, and emergency preparedness.
CONFERENCES & EVENTS
2021 CPCA Virtual Conferences
Prioritizing the health and safety of attendees during the ongoing COVID-19 pandemic, CPCA made the decision to host all 2021 conferences virtually in our online learning portal. Building upon the lessons learned from our 2020 virtual conferences, CPCA offered fresh and relevant content to our members while providing valuable resources and virtual networking opportunities. Here are some of the highlights from our 2021 conferences:
2021 Quality & Technology Conference
The virtual Quality and Technology Conference kicked off a year of virtual conferences in February 2021. Conference attendees included clinicians, quality directors, chief medical officers, EHR staff and chief information officers who gathered to learn and share best practices around quality improvement as well as the strategic application of technology and health information technology in health centers. Given the challenges of the COVID-19 pandemic, much of the content focused on how to use technology and data to drive health equity. One session in particular, “The Telehealth Genie is Out of the Bottle”, gave attendees an opportunity to learn the most up-to-date information about telehealth policy at both the state and federal level. In addition to hearing from engaging speakers, attendees visited the virtual tradeshow to network with exhibitors and be entered to win great prizes including Oculus VR Headset and hundreds of dollars in gift cards.2021 Financial Conference
In May of 2021 CPCA hosted the Financial Conference in our online learning portal. The conference offered a track for both Billing Managers and Chief Financial Officers, and attendees had access to both, which was a perk of virtual content delivery! Session topics included telehealth billing, protecting revenue, operational and financial resiliency, finance implications from COVID-19, and much more. One of the highlights from the conference was hearing from health center CEO’s about how they managed through the COVID-19 public health crisis and went on to strengthen their health center’s financial position while caring for the needs of their communities. Between sessions, attendees also had the chance to work their way through the virtual tradeshow and earn badges as they visited booths to be entered into the prize drawing at the end of the conference.2021 Region IX Clinical Excellence Conference
CPCA’s third boutique conference of the year, 2021 Region IX Clinical Excellence Conference, was hosted jointly with the Western Clinicians Network and convened virtually in June to allow healthcare leadership from across the region an opportunity to focus on health center clinical and management teams with the goal of improving overall efficiency and effectiveness in care delivery. Attendees included Clinicians, Chief Medical Officers, Medical Directors, Dental Directors, Executive Directors, State and Regional Primary Care partners, Board Members and other management positions involved with community or migrant health centers. As the COVID-19 pandemic has highlighted both health disparities and the need to delivery care virtually, one of the most popular live sessions of the conference was “Advancing Health Equity in Telehealth.” Other hot topics included the health impacts of climate change, workforce development and compassion and courage within primary care. Attendees also had a chance to hear from each of our conference sponsors and exhibitors at the two live Exhibitor Round Robin sessions. Again, visiting the virtual booths earned attendees badges into the final drawing at the end of conference.
2021 Annual Conference
CPCA closed out a landmark year of virtual conferences with our 2021 Annual Conference: “Building Upon Resiliency: The Road to Health Equity.” The weeklong conference offered an opportunity for attendees to connect and learn while keeping each other safe as we continue to navigate the COVID-19 pandemic. This year’s conference focused on renewal and building strength within community health centers so that we can ultimately achieve the goal of healthy, equitable communities.
One of the highest reviewed sessions was the live keynote session with Emmy Award winning co-Anchor for NBC News’ Nightline, Ju-Ju Chang. CPCA’s Senior Vice President & Chief Program officer Val Gotingco Sheehan moderated the session, and it was inspiring to hear two strong, successful Asian women discuss the impact of systemic racism on our country and how healthcare disparities have been laid bare throughout the pandemic.
In addition to hearing from our keynote speakers, conference attendees also had the opportunity to learn from the amazing organizations supporting the event at the two live Exhibitor Round Robin sessions. The booths in the virtual tradeshow provided even more valuable resources for members, as well as chances to win great prizes and swag!
On the final day of conference, CPCA’s former President and CEO, Carmela Castellano-Garcia, Esq., was presented with the prestigious Hero Award for her nearly 30 years of work to advance multi-cultural health policy issues. The session was moderated by Carmela’s longtime mentor and CEO of La Clinica de la Raza, Jane Garcia. The conference closed with a prize drawing, and two lucky attendees won Visa gift cards for visiting our virtual tradeshow booths!
Congratulations to all the 2021 awardees!
We are excited to finally see you again IN-PERSON at our 2022 Conferences!
Information on our upcoming conference dates and locations, our safety protocols, and registration links can be found on CPCA's website here: cpca.org.
CPCA MEMBERSHIP
CPCA welcomed four new member organizations in 2021 – Elica Health Centers, Celebrating Life Community Health Center, St. Vincent de Paul Village Family Health Center, and Tender Care Community Clinic Inc. All new member organizations are participating in a comprehensive on-boarding process during their first year of membership to increase their engagement with CPCA and provide a proper introduction to the benefits of their membership.
In Fall 2021, CPCA launched a new CPCA Membership Ambassador Program. The program, that is on-going, proactive, and an intentional connection with members, was developed to increase engagement with as many members as possible for the purposes of maintaining and/or improving member retention, satisfaction, and ensuring all members see the value in participating with CPCA.
CPCA strives to be a strong Association, one that is built on staff and member partnership, developed through engaged members giving constructive feedback to staff to make informed decisions about the Association’s priorities. The program creates meaningful, rewarding, and insightful connections that promotes trust, increases the value of a membership, and enhances the member’s experience with CPCA.
Looking ahead to 2022,
CPCA Ambassadors will be reaching out to member organizations for a formal check-in and look forward to learning more about our member accomplishments and how CPCA can better assist members in any challenges they are facing.
CONSORTIA
Alameda Health Consortium
California Consortium for Urban Indian Health
Central Valley Health Network
Coalition of Orange County Community Clinics
Community Clinic Association of Los Angeles County
Community Clinic Consortium
Community Health Association Inland Southern Region
Community Health Partnership
Essential Access Health
Health Alliance of Northern California
Health Center Partners of Southern California
North Coast Clinics Network
Planned Parenthood Affiliates of California
Redwood Community Health Coalition
San Francisco Community Clinic Consortium
Southside Coalition of Community Health Centers
COMMUNITY HEALTH CENTERS
Alexander Valley Healthcare
Alliance Medical Center, Inc.
AltaMed Health Services Corporation
Altura Centers for Health
American Indian Health & Services
Ampla Health
Anderson Valley Health Center, Inc.
APLA Health & Wellness
Arroyo Vista Family Health Center
Asian Americans for Community Involvement
Asian Health Services
Asian Pacific Health Care Venture, Inc
Avenal Community Health Center
Axis Community Health
BAART Community Healthcare
Bartz-Altadonna Community Health Center
Bay Area Community Health
Big Sur Health Center
Borrego Community Health Foundation
Camarena Health
Camino Health Center
Celebrating Life Community Health Center
Center for Comprehensive Care Diagnosis of Inherited Blood Disorders
Central City Community Health Center, Inc.
Central Neighborhood Health Foundation
Chapa-De Indian Health Program – Corporate Office
ChapCare
Chinatown Service Center Family Health Clinic
Clinica De Salud Del Valle De Salinas
Clinica Monsenor Oscar A. Romero
Clinica Sierra Vista – Corporate Headquarters Office
Clinicas de Salud del Pueblo
Clinicas del Camino Real, Incorporated
CommuniCare Health Centers, Davis Community Clinic
Community Health Centers of the Central Coast, Inc.
Community Health Systems, Inc.
Community Medical Centers, Inc.
Comprehensive Community Health Centers, Inc.
DAP Health
Davis Street Primary Care Clinic
Dientes Community Dental Care
East Valley Community Health Center, Inc.
Eisner Health
El Dorado Community Health Center
El Proyecto del Barrio, Inc.
Elica Health Centers
Families Together of Orange County
Family Health Care Centers of Greater Los Angeles
Family Health Centers of San Diego
Family Health Matters Community Health Center
Family HealthCare Network – Corporate Office
Friends of Family Health Center
Gardner Family Health Network, Inc.
Golden Valley Health Centers
Harbor Community Clinic
Harmony Health Medical Clinic and Family Resource Center
Health and Life Organization, Inc. – Sacramento Community Clinic – Explorer
Hurtt Family Health Clinic – Orange County Rescue
Imperial Beach Community Clinic
Indian Health Center Of Santa Clara Valley, Inc.
Indian Health Council, Inc.
Inland Behavioral & Health Services, Inc.
Jewish Community Free Clinic
JWCH Institute
Kings Winery Medical Clinic / Greater Fresno Health Organization
La Clinica de La Raza, Inc.
La Maestra Community Health Centers – City Heights
LifeLong Medical Care
Livingston Community Health
Livingstone Community Health Clinic
Long Valley Health Center
Los Angeles Christian Health Centers
Los Angeles LGBT Center
MACT Health Board, Inc.-Corporate Office
Marin Community Clinic – Corporate Office
Mendocino Coast Clinics, Inc.
Mendocino Community Health Clinic, Inc.
Mission City Community Network, Inc.
Mission Neighborhood Health Center
Mountain Valleys Health Centers
Native American Health Center – Corporate
Neighborhood Healthcare
North East Medical Services
Northeast Community Clinic – Corporate Office
Northeast Valley Health Corporation
Northeastern Rural Health Clinics
OLE Health – Corporate Office
Omni Family Health – Corporate Office
One Community Health
Open Door Community Health Centers
Parktree Community Health Center – Village
Peach Tree Healthcare
Petaluma Health Center
QueensCare Health Centers
Ravenswood Family Health Network
Redwood Coast Medical Services, Inc.
Redwoods Rural Health Center
Ritter Health Center
ROADS Community Care Clinic
Saban Community Clinic
SAC Health System
Sacramento Native American Health Center
Saint John’s Well Child & Family Center
Saint Vincent De Paul Village Family Health Center
Samahan Health Centers
Samuel Dixon Family Health Center
San Benito Health Foundation
San Fernando Community Health Center
San Francisco Community Health Center Formerly Asian and Pacific Islander
San Ysidro Health
Santa Barbara Neighborhood Clinics
Santa Cruz Community Health Centers
Santa Rosa Community Health
School Health Clinics of Santa Clara County
Share Our Selves
Shasta Cascade Health Center
Shasta Community Health Center
Shingletown Medical Center
Sierra Family Medical Clinic
Sonoma Valley Community Health Center
South Central Family Health Center – Corporate Office
South of Market Health Center
Southern Trinity Health Services
St. Jude Neighborhood Health Center
T.H.E. Health & Wellness Center
Tarzana Treatment Center
The Children’s Clinic, Serving Children & Families
Tiburcio Vasquez Health Center, Inc.
TrueCare
Unicare Community Health Center
United Health Centers of the San Joaquin Valley, Inc.
Universal Community Health Center
University Muslim Medical Association (UMMA) Community Clinic
Valley Community Healthcare
Valley Health Team, Inc.
Venice Family Clinic
Via Care Community Health Center
Vista Community Clinic
Watts Healthcare Corporation
WellSpace Health
West County Health Centers, Inc.
West Oakland Health Council, Inc.
Westside Family Health Center
White Memorial Community Health Center
Wilmington Community Clinic
Winters Healthcare Foundation
EMERITUS MEMBERS
Carl Coan
Irma Cota
Susan Fleischman, MD
Harry Foster
Cathy Frey, MHA
Jose Joel Garcia, JD
C. Dean Germano
John Gressman
Nik Gupta
Ray Hamby
Mike Kirkpatrick
Marty Lynch
Tracy Ream
Gladys Sandlin
Stephen Schilling
Mike Sullivan
Sophie Wong
Peer Networks
CPCA understands the power of peer-to-peer learning, which is why we offer 19 different peer networks for Members to connect with peers who work in health centers throughout the state. These peer networks provide an opportunity to exchange valuable information, share best practice and templates, and provide feedback into state association activities, policies, and training programs.
340B Peer Network
Behavioral Health Peer Network
Billing Managers Peer Network
Clinic Emergency Preparedness Peer Network (CEPPN)
Chief Financial Officer (CFO) Peer Network
Compliance Officer Peer Network (COPN)
Consortia Policy Group (CPG)
Dental Directors Peer Network
Health Information Technology Peer Network
HIV Prevention Peer Network
Human Resources Peer Network
Immigration Peer Network
Marketing & Development Peer Network
Outreach & Enrollment Peer Network
Primary Care Peer Network
Public Affairs Peer Network
Residency Peer Network
Social Determinants of Health Peer Network
Statewide Quality Improvement Committee (SQIC) Peer Network
CPCA STAFF
Executive
Carmela Castellano-Garcia
President & Chief Executive Officer
Robert Beaudry
Acting Chief Executive Officer
Val Gotingco Sheehan
Senior Vice President & Chief Program Officer
Leadership
Andie Martinez Patterson
Senior Vice President of Strategy,
Integration and System Impact
Ginger Smith
Vice President of Member Relations
Buddy Orange
Vice President of Human & Organizational Development
Dr. Michael Witte
Vice President and Chief Medical Officer
Care Transformation
Cynthia Keltner
Director of Care Transformation
DeeAnne McCallin
Director of Health Information Technology
Allie Budenz
Deputy Director of Quality Assurance
Peter Dy
Associate Director of Care Transformation
Yarin Gomez
Senior Program Coordinator of Care Transformation
Jeanita Harris
Associate Director of Data Management
Ekeoma Nwadibia
Senior Coordinator of Quality Improvement
Mina Amin-Rahbar
Associate Director of Data Science
Charlotte Reische
Administrative Coordinator
Lucy Saenz
Deputy Director of Data Informatics
Development & External Relations
Kearsten Shepherd
Director of Development & External Relations
Kokaale Amissah-Aidoo
Assistant Director of Education & Training
Iliana Chevez
Associate Director of Development
Kelly Cimino
Deputy Director of Marketing & Communications
Emily Henry
Senior Development Coordinator
Lindsey Ono
Deputy Director of Events & Sponsorship
Erin Perry
Deputy Director of Education & Training
Courtney Rodseth
Marketing and Sponsorship Coordinator
Tiffany Ruvalcaba
Associate Director of e-Learning
Ayo Taylor
Associate Director of Strategic Communications & Public Affairs
Rachel Tyberg
Senior Administrative Assistant
Finance & Operations
Eva Avila
Finance Coordinator
Heather Barclay
Executive Assistant
Glenna Davido
Senior Member Services Representative
Rosie Gilb
Deputy Director of People Operations
Victoria Gomez
Executive Assistant
Jeanette Hernandez
Finance Coordinator
Janelle Mollgaard
Administrative Coordinator
Lydia Ossentjuk
Associate Director of Finance
Nou Vang
Deputy Director of Finance
Kimberly Yost
Deputy Director of Finance
Government Affairs
Beth Malinowski
Director of Government Affairs
Kelley Aldrich
Associate Director Legislative Affairs
Angela Castellanos
Senior Policy Coordinator
Victor Christy
Deputy Director of Political Engagement
Mahnoor Khan
Senior Policy Coordinator
Trong Le
Deputy Director of Government Affairs
Marisa Melendez
Senior Administrative Assistant
Liz Oseguera
Assistant Director of Policy
Eric Paredes
Associate Director of Grassroots Advocacy
Puneet Purewal
Policy Analyst
Marissa Vismara
Senior Policy Coordinator
Health Center Operations
Christina Hicks
Director of Health Center Operations
Madeline Anderson
Program Coordinator Health Professions Education
Amanda Carbajal
Associate Director of Health Center Operations
Nataly Diaz
Assistant Director of Workforce Development
Michelle (Elle) Grant
Senior Program Coordinator of Licensing & Enrollment
Isaias Iniguez
Associate Director of Workforce Development & Special Populations
Nicole Key
Senior Administrative
Ivan Prado
Program Coordinator Health Center Operations
Emily Shipman
Assistant Director of Health Center Operations
Bao Xiong
Deputy Director of Health Center Operations
Internal Services
Lizbeth Bayardo
Assistant Director of Leadership Equity
Shadi Kanaan
Assistant Director Organizational Effectiveness
CPCA FINANCIAL STATEMENT
Summary of 2020 - 2021
(April 1, 2020 – March 31, 2021)
Consolidated Statements of Activities
CPCA and AFFILIATES
NET ASSETS WITHOUT DONOR RESTRICTIONS REVENUES:
| Grants and Contributions | $4,238,136 |
| Membership dues | $3,088,768 |
| Clinic support services | $1,259,836 |
| Contribution from acquisition of CalHIPSO | $1,244,725 |
| Paycheck Protection Program loan forgiveness | $892,100 |
| Conferences | $542,127 |
| Training and workshops | $355,680 |
| Interest income from loans | $164,783 |
| Interest and investment incomes | $7,011 |
| Other income | $127,091 |
| Net assets released from restrictions | $3,405,063 |
| Total revenues | $15,325,320 |
NET ASSETS WITHOUT DONOR RESTRICTIONS REVENUES:
Program Services:
| Clinic Operations Support | $9,707,406 |
| Legislative | $770,728 |
| Information systems and loan program | $800,149 |
| Total program services | $11,278,283 |
| Management and General | $1,817,920 |
| Total expenses | $13,096,203 |
| INCREASE (DECREASE) IN NET ASSETS WITHOUT DONOR RESTRICTIONS | $2,229,117 |
| NET ASSETS WITH DONOR RESTRICTIONS: Grants and contributions | $8,721,443 |
| Net assets released from restrictions | ($3,405,063) |
| INCREASE (DECREASE) IN NET ASSETS WITH DONOR RESTRICTIONS | $5,316,380 |
| INCREASE (DECREASE) IN NET ASSETS | $7,545,497 |
| NET ASSETS, Beginning of Year | $15,284,238 |
| NET ASSETS, End of Year | $22,829,735 |
ASSETS
| CURRENT ASSETS: Cash and equivalents | $13,179,519 |
| Grants receivable | $1,501,415 |
| Dues and accounts receivable | $564,239 |
| Current portion of loans receivable | $2,366,398 |
| Prepaid expenses | $141,814 |
| Total current assets | $17,753,385 |
| NONCURRENT ASSETS: Long-term certificates of deposit | $715,855 |
| Loans Receivable, Net | $10,182,482 |
| Property and Equipment, Net | $3,934,160 |
| Total Assets | $32,585,882 |
LIABILITIES AND NET ASSETS
| CURRENT LIABILITIES: Accounts payable | $488,821 |
| Accrued expenses | $441,376 |
| Deferred revenues | $77,926 |
| Current portion of loans payable | $340,150 |
| Total current liabilities | $1,348,273 |
| LOANS PAYABLE, NET | $8,407,874 |
| Total liabilities | $9,756,147 |
| NET ASSETS: Without Donor Restrictions | $15,801,153 |
| With Donor Restrictions | $7,028,582 |
| Total net assets | $22,829,735 |
| TOTAL LIABILITIES AND NET ASSETS | $32,585,882 |
2021 FUNDERS
Bureau of Primary Health Care
Blue Shield of California
California Health Care Foundation
California Food Policy Advocates
Sunlight Giving
California Department of Healthcare
Aurrera Health Group
John Snow, Inc.
Kaiser Permanente
Public Health Institute
Sierra Health Foundation
Health Net
University of California, San Francisco
University of California, Davis
The California Endowment
2021 ANNUAL SPONSORS
EXCLUSIVE
PREMIER
ELITE
TRIFECTA
