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Alameda County“Every Team Member Counts”
Collaborative to Recruit and Retain Qualified Medical Assistants in the Safety Net Clinics
Alameda County
1.5 million residents
Median income $61,017
Adult poverty rate of 10.1%
173,000 adults <65 without health insurance
2005-2006 Safety Net care
CMSP served over 63,000
268,000 outpatient visits
73,000 emergency room visits
15,300 hospital admissions
SB 1448: CA Care Coverage
Initiative (CI)
California’s 2005 Federal Medi-Cal Hospital Financing Plan provides $180 million in federal funds
Expands health care coverage to eligible low-income, uninsured persons
SB 1448: Coverage InitiativeOverall Goal and Funding
Designed to :
Increase the number of Californians with healthcare coverage
Strengthen and build upon the existing local healthcare safety net
Improve access to high quality healthcare and health outcomes for individuals.
Funded for at least three years, potentially ongoing
Alameda County Excellence (ACE) Partnerships
Alameda County Medical Center
Alameda Health Consortium
Health Care Services Agency
Alameda County Public Health Department
Alameda Alliance for Health
Alameda County Excellence (ACE )
Emphasizes chronic disease management
Coordination of current programs and system enhancements
Preventive primary care at a designated medical home
Offers a full range of medically necessary services including streamlined chronic disease focused specialty care services.
Alameda County Excellence (ACE ) Delivery System
Focus on medical home
Enhanced chronic disease focused specialty care
Integrated access of behavioral health care
Complements The Overall Goal Improved population management
involving education and collaboration with community-based organizations
Improved access to specialty care through better communication within the provider network and enhanced use of data systems
Improved care capacity through decreased wait time and reallocate clinic hours
NACCHO Project
Recruit, hire and retain culturally competent medical assistants in the community clinics in Alameda County to improve the service delivery for clients with chronic disease
Supportive role to enhance current efforts
$10,000 grant
Medical Assistants
“Generalist”-administrative and clinical duties
1n 2004, 387,000 jobs in the U.S. 14% work in private or public hospitals,
including outpatient facilities $35,997 per year average in Alameda
Co. Medical Assistant employment is
expected to grow an impressive 35% between 2006 and 2016, US Labor Bureau.
Medical Assistant Training
Community college Private programs/post secondary
vocational schools Administrative/medical Responding to emergencies Computer application systems and
literacy
Medical Assistants Expanded Role Used in more specialized services
Unlicensed health care workers have seen their scope of duties expand
RN’s more expensive
RN shortage
Employment for medical assistants to grow much faster than other occupations
Workforce Challenge
Limited post secondary education
Not working at the level trained
Decision making roles
Licensed personnel to accept expanded role
Grant Activities
2-1/2 day trainings on Train the Trainer with Tom Bodenheimer, M.D.
3 Chronic Care Model trainings at Alameda County Medical Center
Community-based organization trainings
Assist with hiring cost
Expanded Role Trainings
Panel management
Review and maintain the disease registry Calls-appointments, labs, and preventive
care Medication reconciliation Arranges referrals
Expanded Role Trainings
Follow up with primary care provider instructions
Assist in working on action plans/behavior changes
After care visits
Targeted outreach for the out of care
Informed,ActivatedPatient
ProductiveInteractions
Prepared,ProactivePractice Team
Improved Outcomes
DeliverySystemDesign
DecisionSupport
ClinicalInformation
Systems
Self-Management
Support
Health System
Resources and Policies
Community
Health Care Organization
Chronic Care Model
Chronic Care Model Focus
System redesign Identify chronic disease client population Use standardized procedures for care Expand staff capabilities to improve care Document health outcomes
Self-management Train staff in self-management goals setting and
follow up Use culturally appropriate, standardized
educational materials Identify and utilize community resources
Challenges
Retention MAs start their careers at CBO’s, but after
6-12 months of training they seek a position with higher pay
Short period to spend the funds
Include medical assistants in the process of improving care
Successes
Use of expert speakers-Tom Bodenheimer, M.D.
Encourage and provide an opportunity for to increase knowledge of chronic disease management
Involvement in the changes
Active recruitment and hiring of MA’s throughout the safety net clinics
Improved Recruitment and/or Retention Of Qualified Workers
Provide opportunities for current staff to lead the changes implemented in team care
Conduct annual staff satisfaction surveys
Hire from the community
Summary
New titles, positions and responsibilities!
Opportunity to learn panel management
Use of the Chronic Care Model for improvement
Promote client self-management
Summary
Share ideas and best practices
Measurement of health outcomes
Increase collaboration between Pubic Health and Safety Net Providers
Every team members counts!