Health Care – Alameda County, California

About Us

Project Updates

The Alameda County Access to Care Collaborative is engaged in a number of county-wide initiatives to improve access to health care for low-income, vulnerable populations:

Improving Access to Specialty Care
Behavioral-Primary Care Integration
Medi-Cal 1115 Waiver and Health Care Reform

Improving Access to Specialty Care

Alameda County’s public hospital system, the Alameda County Medical Center (ACMC), convenes the countywide Alameda County Task Force on Specialty Care. The Task Force includes the executive and clinical leadership of ACMC, the community health centers, the Medi-Cal managed care local health plan, and Healthcare for the Homeless.  Projects include:

Web-based referral system to improve referrals from PCPs to specialists at ACMC

• enhancing ACMC’s web-based specialty care referral system, RefTrak, to

• offer referral algorithms and instructions that can be downloaded and used to prepare patients for specialty care visits.
• support the secure exchange of clinical information and lab/diagnostic reports
• support secure email between PCPs and specialists.

• PCPs currently use RefTrak to refer patients for specialty care to ACMC, check on the status of appointments, and look up specialists’ office hours, phone numbers, and emails.
• RefTrak is currently used by Primary Care Providers (PCPs) at ACMC and the 8 private non-profit community health centers in Alameda County

Providing PCP education to enhance the PCP Scope of Practice

• The Task Force is organizing a series of educational sessions for PCPs on ACMC specialty care referral guidelines and evaluations,
• offering mini-fellowships for PCPs to “shadow” specialists at ACMC and increase learning opportunities about specialty care,
• assessing the capacity of community health centers to provide limited specialty care services (e.g. evaluations, simple procedures) on-site, and
• improving specialty care referral guidelines so that they clearly state what needs to be done at a primary care clinic prior to a referral to specialist

Co-locating Specialists with the Primary Care Physicians at Outpatient Clinic locations

• The Task Force is exploring arrangements at the ACMC and community health centers to offer limited specialty care on-site ACMC
• Community health centers are contracting with specialists on a limited basis to see patients and provide consultations at primary care clinic locations
• Bringing specialists into the primary care medical home offers more convenience to the patient and takes advantage of the clinic infrastructure (e.g. bi-cultural/bi-lingual staff, support services)

Behavioral-Primary Care Integration – Countywide Efforts

The Alameda County Access to Care Collaborative founded the Alameda County Task Force on Integrated Behavioral & Primary Care with the purpose of “creating pathways toward collaboration, integrated behavioral and primary care in Alameda County.” Members include: Alameda County Health Care Service Agency and Behavioral Health Care Services, Alameda County Social Services Administration, the Alameda Alliance for Health, Alameda County Medical Center, and the Alameda Health Consortium/Community Health Center Network and the community health centers. The Task Force is currently:

• increasing awareness about barriers to primary care for people with serious behavioral health issues, and barriers to behavioral health services for people with moderate and mild behavioral health issues
• identifying system-wide barriers to the integration of services in Alameda County
• highlighting local efforts to integrate services
• creating an inventory of available services and sharing the information across agencies,
• collecting data on behavioral services for the uninsured and Medi-Cal populations in Alameda County
• monitoring EHR implementation efforts and how these efforts can support integration

Medi-Cal 1115 Waiver and Health Care Reform

The Alameda County Access to Care Collaborative continues to monitor California’s Medi-Cal 1115 waiver proposal and the potential impact on Alameda County. The immediate concern is the upcoming enrollment of more than 20,000 seniors and people with disabilities who are on Medi-Cal into a managed care plan.  A copy of the State’s waiver proposal, is available here.

The Alameda County Access to Care Collaborative is also currently actively working to prepare the safety net system for health reform implementation in 2014. The Collaborative is discussing ways to prepare Alameda County’s safety net system and health providers for the changes under the new law.