In the midst of contract negotiations

“a physician vacancy does not mean that there is a clinical vacancy, nor that care is compromised.” – Kim McCarl, CCHS

“A bigger medical and dental staff would help alleviate some of the load that our current employed members are carrying.” – Dr. David MacDonald, President, PDOCC

By Allen D. Payton

Last month the Physicians’ and Dentists Organization of Contra Costa (PDOCC) released data showing a high number of doctor vacancies in Contra Costa County Health Services.

According to a Feb. 16, 2023, PDOCC press release, based on county data, there are currently 83 out of 285 employed positions listed as vacant in Contra Costa Health Services, a 29 percent vacancy rate in the system. That includes 27 vacant positions in family medicine and primary care adult medicine, 5 vacant dentist positions and 5 vacant OB/GYN positions. With 19 vacant psychiatrist positions, only 27 percent of employed psychiatry positions are currently filled. 11 vacant employed positions in the emergency department – half of the department’s employed positions – means the county is unable to safely staff the emergency room.

Since November, 5 emergency department doctors have left county employment. The county interviewed and offered positions to 21 new emergency department applicants, but the offer was declined by every applicant.

The problem is expected to get a lot worse in 2024 when Contra Costa County will need an additional 40 primary care providers to care for 30,000 new Medi-Cal patients being added to the county’s health services due to an agreement between the county and California’s Department of Health Services.

The problem continues to worsen. Contra Costa County Health Services added 12,200 patients in the last two months, while only adding 1 new primary care physician. The result is that the average primary care physician employed by the county now has almost 200 more patients on their panel than at the end of 2022. There are no new primary care physicians anticipated to join county employment before July 2023.

On average, the county has only been able to fill three primary care doctor vacancies annually over the last three years.

In response, CCHS Communications Officer Kim McCarl, said doctor shortages are a nationwide challenge, are not compromising care, and confirmed that negotiations between the union and county “are underway”.

She wrote, “We value the medical staff who work across our department.

Health systems across the country are struggling to recruit and retain medical staff at all levels. Contra Costa Health is no different.

It’s important to note that a physician vacancy does not mean that there is a clinical vacancy, nor that care is compromised. We are confident that the right provider is caring for the right patient in the right way at Contra Costa Regional Medical Center and Health Centers every day.

We provide flexibility in work schedule, an emphasis on proactive care, and mission-oriented work that helps us recruit and retain physicians who want to practice in an integrated environment. It’s not uncommon for our physicians to be expert in many areas of clinical medicine which our system values.

We value physicians who embrace our mission and choose to work for Contra Costa Health on a full-time, permanent basis but we also welcome doctors who take a less traditional approach to their careers by working part time or in partnership with other health care entities. These approaches help to alleviate the burnout that has been so costly to hospitals and healthcare systems since the height of the pandemic.

We are proud to be home to one of the most highly rated family medicine training programs in the country. We recruit well-trained physicians who are familiar with our system from each graduating class.

Recruitment and retention of physicians is a top priority at Contra Costa Health. We will continue to explore ways to fill every vacancy across our healthcare system.”

Doctors, Dentists Disagree

That opinion, however, is not shared by the county’s doctors and dentists or by best practice standards for patient care.

The severe shortages most certainly impact patient care, including the time a physician can devote to each patient along with the availability of appointments, according to county doctors.

Contra Costa County’s own policies recommend no more than 1,500 patients to a primary care physician’s panel (the number of patients assigned to a physician). Currently the average panel size for Contra Costa’s employed primary care physicians is 1,879.

“County leaders may be willing to turn a blind eye to severe staffing shortages, but doctors care too much about our patients to let the problem go unaddressed any longer,” said Dr. David MacDonald, PDOCC President. “We hear from patients all the time about how difficult it is for them to schedule appointments in our system. When they finally get an appointment, it is rarely for the amount of time they need because doctors are overstretched and taking on more patients because of all the vacancies. The patients who rely on Contra Costa County Health Services for care should not have to settle for less time and attention than patients in other systems or ones with private healthcare.”

In addition to the primary care vacancies, there are 5 vacant dentist positions and 5 vacant OB/GYN positions. With 19 vacant psychiatrist positions, only 27 percent of employed psychiatry positions are currently filled. 11 vacant employed positions in the emergency department – half of the department’s employed positions – means the county is unable to safely staff the emergency room.

The problem is expected to get exponentially worse in 2024 when Contra Costa County will need an additional 40 primary care providers to care for 30,000 new Medi-Cal patients being added to the county’s health services due to an agreement between the county and California’s Department of Health Services.

PDOCC is calling on county leaders to be proactive by filling the position vacancies which will improve patient care and support county revenues. “It’s hard to believe that Contra Costa County is not working more closely with our union to help it become more attractive and competitive in retaining and recruiting medical and dental talent. I believe the county is moving in the wrong direction and I’m concerned that patients are being put at risk,” MacDonald said.

PDOCC members are currently in negotiations with county management towards a new contract. Issues raised in negotiations by PDOCC members include high patient caseloads, insufficient time for administrative tasks, long waits for primary care appointments and specialty referrals, chronic short staffing and high turnover – all of which combine to negatively impact patient care and health impacts. PDOCC members also state that burnout is at an all-time high.

County Health, PDOCC Respond to Questions

Questions were sent to both McCarl and the union’s spokesman asking if the PDOCC is in the midst of contract negotiations with the county and if so, is this an effort to obtain an increase in compensation for its members.

While McCarl responded, “Yes, negotiations are underway” she did not respond to the additional question about their criticism.

The questions were also sent Tuesday afternoon to PDOCC president, Dr. MacDonald with the .

He responded, “PDOCC is engaged with Contra Costa County in negotiations at the level of state mediation. We have one more session to go.

We are focused on improving patient care and making the workplace in Contra Costa Health Services (CCHS) more sustainable.

We have to be able to hire new medical and dental talent, so compensation has to be more market competitive. This would also help with retention. A bigger medical and dental staff would help alleviate some of the load that our current employed members are carrying. The situation at this time is untenable. And, per an agreement between CCHS and the state’s Department of Health Services, CCHS will become the single system to provide care for MediCal patients in the county (aside from small fraction of MediCal patients covered by Kaiser). This will mean for an additional 30,000 new patients into our system as of January 1, 2024. We’re not ready for that. We will need an additional 40 new primary care providers to handle the influx of new patients. The County is nowhere close to hiring that many (I believe the County has 3 new providers scheduled to start after July of this year).

In addition, half of our emergency department employed positions are vacant. This means that the County partially fills the gap with very expensive temp doctors. We think it would be smarter for the County to take the funds doled out to temps and invest that money in committed, dedicated and County career minded docs who will be here for the long term.

Another issue is that our primary care providers need more protected time to manage their patient panels. The in-basket work – lab follow up, med refills, answering patient calls & emails, etc., has been escalating. Our physicians take this work home with them and it takes away time from their families and individual restorative activities.

All of this after the three-year pandemic onslaught has left our physicians and dentists suffering more from burnout than ever before. The County must step up, be proactive, and work with our union on how to achieve meaningful improvements that will enhance patient care and move our system in the right direction.”

Sponsors needed

The Bay Point Community All-N-One will once again be hosting one of our biggest events, “The Unity In The Community” event on Saturday, June 24th, 2023 from 10am – 2pm. This is a Health & Wellness program for the community to be held at the Ambrose Community Center, 3105 Willow Pass Road in Bay Point.

To be a SPONSOR for the Unity in the Community Event please call contact us.

To REGISTER your organization to participate or for a table at the Unity in the Community event, please download and complete the registration form and submit it to us before April 17, 2023. Unity in the Community Table Res

For questions, please call Mr. Delano Johnson at (925) 812-2939, Irving Joe (925) 858-2675 or Lovetta Tugbeh (925) 727-8291.

Please save the date and be on the lookout for more details to come in the near future.

 

New webpage offers tips, insights to help people understand when to reach out to doctors, hospitals

By Antonia Ehlers, PR & Media Relations, Kaiser Permanente Northern California

Battling the triple threat of COVID-19, influenza and respiratory syncytial virus (RSV) people of all ages are finding themselves sick as this “Tridemic” rages on. With emergency rooms and hospital beds filling up, Contra Costa Health and Kaiser Permanente have partnered to launch a public health education campaign to inform the community about simple self-care recovery tips and virtual treatment options for common illnesses.

“By partnering with Contra Costa Health, we bolster our efforts to disseminate critical health tips to our members and many others throughout the community,” said Dr. Sharon Mowat, pediatrician and physician-in-chief for the Kaiser Permanente Diablo Service Area. “If we can help people safely recover from the comfort of their homes, we can also lessen the extremely long wait times that people are seeing in the overcrowded doctors’ offices and emergency rooms throughout our community.”

The two organizations created a webpage in English (www.coronavirus.cchealth.org/get-care) and Spanish (www.coronavirus.cchealth.org/get-care-es), with information and resources about how people can recover from illnesses and access care from the comfort of their homes. If people have urgent or immediate concerns, they are encouraged to call an advice nurse or doctor’s office for guidance and virtual appointments by phone or video. Contra Costa Health Plan members and people who don’t have health coverage can call the advice nurse at (877) 661-6230. Kaiser Permanente members can call the advice nurse at (866) 454-8855.

Hospitals and ambulances are especially impacted during the winter virus season, so Contra Costa Health and Kaiser Permanente caution people to only call 911 or go to the hospital if their need for care is truly an emergency.

“The good news is most people who get sick can safely recover from home,” said Dr. Sofe’ Mekuria, deputy health officer for Contra Costa Health. “We want people to know the home care options available to them and know how to prepare themselves so they can recover quickly and safely if they get sick.”

Health recommendations include staying home when sick, getting lots of rest, drinking plenty of fluids and separating from others to avoid spreading illnesses. For peace of mind, people are encouraged to stock their medicine cabinets with items including over-the-counter cold/flu medicines to reduce fever and pain, saline spray or drops, cough syrups and lozenges, and COVID-19 home tests.

In addition to the webpage, a communications toolkit with digital graphics and handouts is also available for local schools, businesses and community organizations to share with their members.

To learn more about getting better when you’re sick, visit www.coronavirus.cchealth.org/get-care.

If you have any questions or concerns text Tim Jeremy at (925) 759-6537 or email: timjeremy78@gmail.com.

Especially during flu season; ConFire says respiratory virus calls are straining CCC EMS resources

By Contra Costa Health Services

To ensure continued timely response to true medical emergencies, Contra Costa Health (CCH) encourages residents to call 911 only if the need for care is truly an emergency.

Contra Costa County’s emergency medical system traditionally serves higher-than-usual numbers of patients this time of year, and this month healthcare providers and the agencies providing emergency ambulance service are especially impacted because of COVID, flu and other respiratory viruses.

According to Con Fire, “Respiratory virus calls are straining CCC EMS resources.”

Several hospitals in the community are reporting critically high level of patients occupying beds, with more than 1,200 inpatients reported throughout the county as of Friday. Hospital emergency departments are similarly impacted.

Calling 911 for your health emergency is recommended if it involves:

• Chest pain, difficulty breathing or a fast (120+ beats per minute) resting heartbeat
• Numbness or weakness in any part of the body, seizures, or difficulty speaking
• Fainting, unconsciousness, dizziness, sudden severe pain or headache, or confusion
• Sudden blindness or vision changes
• Heavy bleeding that will not stop with pressure, or broken bones
• Choking, drowning or near drowning
• Severe burns
• Poisoning or drug overdose
• Allergic reactions, especially if there is difficulty breathing
• Someone making a credible threat to harm themselves or someone else

There are other good reasons to call 911 as well. But to reduce strain on the county’s healthcare system, CCH asks anyone considering whether to seek emergency care if a 911 call is the best way to get the services they need, or if contacting an advice nurse or urgent care might be more appropriate.

When many people seek care through 911 at the same time, it reduces the number of emergency ambulances in circulation, ready to respond when someone in the county needs lifesaving care.

Based on a paramedic’s assessment of a patient’s condition and if the number of available emergency ambulances is very low, the paramedic may suggest a patient visit an urgent care on their own or call an advice nurse.

During the winter virus season, patients visiting emergency departments at hospitals in the county may also need to wait longer depending on circumstances at the time they arrive and the severity of their illness or injury.

 

The Leapfrog Group’s biannual safety report gives an “A” grade for limiting patient injuries, reducing medical errors and preventing infections

By Antonia Ehlers, PR and Media Relations, Kaiser Permanente Northern California

The Leapfrog Group recognized Kaiser Permanente Antioch Medical Center with a top score of “A” in its biannual Hospital Safety Grades report, which examined and assigned letter grades to nearly 3,000 hospitals throughout the United States. The medical center received the same A grade in spring of this year. (See related article)

Hospitals received grades based on approximately two dozen measures that analyze patient injuries, medical and medication errors, and infections. The Leapfrog Hospital Safety Grades are updated twice annually, in the fall and spring.

Kaiser Permanente Northern California hospitals continue to be consistently recognized as among the country’s best for outstanding patient safety, positive outcomes, and patient experience.

This fall, 17 Kaiser Permanente hospitals in Northern California received “A” scores including: Antioch, Fremont, Fresno, Manteca, Modesto, Oakland, Redwood City, Richmond, Roseville, San Francisco, San Jose, San Rafael, Santa Clara, Santa Rosa, South San Francisco, Vacaville, and Vallejo. Additionally, Kaiser Permanente hospitals in Sacramento, San Leandro and Walnut Creek received “B” scores.

“We are honored to be recognized as a leader in patient safety,” said Chris Boyd, senior vice president and area manager of Kaiser Permanente’s Diablo Service Area. “Patient safety is at the heart of everything we do. We are incredibly proud of our physicians, nurses and staff members who make a difference every single day.”

The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits, released its Hospital Safety Grades after examining publicly available data on patient injuries, medical and medication errors and infections at U.S. hospitals. The report includes data collected by national health care organizations, including the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services. Scores are calculated based on more than two dozen publicly available measures, and hospitals are then assigned A, B, C, D or F grades for their safety records. The grades are released as a free resource to help patients and their families make informed health care decisions.

“We are honored to be recognized as a leader in patient safety by the Leapfrog Group,” said Sharon Mowat, MD, Physician in Chief for the Kaiser Permanente Antioch Medical Center. “We remain committed to keeping our patients safe from harm, as well as providing outstanding quality and excellent personalized care.”

Kaiser Permanente is one of America’s leading integrated health care providers and serves more than 12.6 million members. Nationally, 24 of 39 Kaiser Permanente hospitals, more than 60 percent, received a Leapfrog Safety “A” grade. Nationwide, approximately 30% of hospitals received an A rating and 28% of California hospitals received an A rating.

For more information and a complete list of the hospital safety grades, visit Leapfrog.

Allen D. Payton contributed to this report.

It is over!

By Allen D. Payton

In the words of Howard Cosell after Muhammad Ali defeated Joe Frazier during the Rumble in the Jungle boxing match, “It is over! It is over! It is over! It is over!” Last month, President Biden said the COVID-19 “pandemic wis over” and on Oct. 17, Governor Newsom announced the COVID-19 State of Emergency in California would end on February 28, 2023. Then, as of Thursday, Oct. 21 the government-imposed restrictions from COVID-19 have completely ended in Contra Costa County.

Without fanfare or even a press release to the media, Contra Costa County Health Officer Dr. Ori Tzvieli issued an order, that day, “rescinding any and all active orders pertaining to COVID-19”.

The new order states, “Orders that (1) prohibited or otherwise restricted the activities of any person in Contra Costa County, either directly or indirectly, or (2) imposed any affirmative obligations on any person in the County, and (3) are or may be interpreted to be operative (collectively, the “Active Orders”), be rescinded.”

Following is Ortiz’ official order:

ORDER OF THE HEALTH OFFICER OF THE COUNTY OF CONTRA COSTA

RESCINDING ANY AND ALL ACTIVE ORDERS PERTAINING TO COVID-19

ORDER NO. HO-COVID19-69

DATE OF ORDER: OCTOBER 21, 2022

Summary of the Order

Commencing on March 14, 2020, with the issuance of Order No. HO-COVID19-01, the Health Officer of Contra Costa County has issued 69 orders regarding the Coronavirus 2019 (COVID-19) pandemic. These orders (including one unnumbered order) will be referred to as the “COVID-19 Orders.” Among the COVID-19 Orders were orders that restricted the activities of individuals, compelled business owners and others to shut down or limit their operations, required the wearing of face coverings, and mandated the testing or vaccination of workers in specified settings. Based on current trends and the availability of vaccinations and treatments, it is no longer necessary to have any active Health Officer orders pertaining to COVID-19, and it is the intent of the Health Officer that any and all COVID-19 Orders that (1) prohibited or otherwise restricted the activities of any person in Contra Costa County, either directly or indirectly, or (2) imposed any affirmative obligations on any person in the County, and (3) are or may be interpreted to be operative (collectively, the “Active Orders”), be rescinded. This Order rescinds any and all Active Orders, effective immediately. This Order does not affect any of the COVID-19 Orders that were issued for the sole purpose of rescinding previous orders.

UNDER THE AUTHORITY OF CALIFORNIA HEALTH AND SAFETY CODE SECTIONS

101040 AND 120175, THE HEALTH OFFICER OF THE COUNTY OF CONTRA COSTA

(“HEALTH OFFICER”) ORDERS:

1. Rescission of Active Orders. Any and all Active Orders are hereby rescinded.
2. Effective Date and Time. This Order takes effect immediately upon issuance.
3. Copies; Contact Information. Copies of this Order shall promptly be: (1) made available at

the Office of the Director of Contra Costa Health Services, 1220 Morello Avenue, Suite 200, Martinez, CA 94553; (2) posted on the Contra Costa Health Services website (https://www.cchealth.org); and (3) provided to any member of the public requesting a copy of this Order. Questions or comments regarding this Order may be directed to Contra Costa

Health Services at (844) 729-8410.

IT IS SO ORDERED:

Ori Tzvieli, M.D.

Health Officer of the County of Contra Costa

Dated: October 21, 2022

Only health plan in state to receive honor

By Antonia Ehlers, PR and Media Relations, Kaiser Permanente Northern California

Kaiser Permanente received the highest rating in the state for the “Summary Quality Rating” for 2023 by Covered California – the state’s marketplace for the Affordable Care Act.

Kaiser Permanente Northern California combined with Kaiser Permanente Southern California earned five stars, which is the highest possible rating for the “Summary Quality Rating.”

“This recognition reminds us how important it is for people to have access to high-quality, affordable health care, especially after many have struggled through the global COVID-19 pandemic,” said Carrie Owen Plietz, FACHE, president of Kaiser Permanente’s Northern California region. “Our physicians, nurses and staff are committed to delivering exceptional, compassionate care to our members and patients who are trusting us with their health care.”

In addition to achieving a five-star “Summary Quality Rating” for overall quality, Kaiser Permanente received five stars for “Getting the Right Care,” a measure of care that is given compared with the national standards for care and treatments proven to help patients. Kaiser Permanente also received four stars for “Plan Services for Members,” which analyzes a health plan’s efficiency, affordability, and management.

“These ratings are yet another example of the collective excellence of our physicians and staff, and further demonstrate their unwavering commitment to consistently deliver the highest levels of care and service,” said Richard S. Isaacs, MD, FACS, chief executive officer and executive director of The Permanente Medical Group. “Thanks to our clinical expertise and our integrated and coordinated approach to care delivery, we are having a positive and often life-changing impact on the health and well-being of our members and patients.”

This is the latest of several accolades and awards Kaiser Permanente Northern California has received. Kaiser Permanente Northern California hospitals have been rated among the best in the nation for maternity care and treatment of stroke and heart failure patients. Most recently, Kaiser Permanente is the only Medicare health plan in California to receive a five-star rating, according to the Centers for Medicare & Medicaid Services’ 2023 Medicare Star Ratings.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.

We currently serve 12.6 million members in 8 states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team of caregivers.

Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health. http://about.kaiserpermanente.org

Plan quality ratings and enrollee survey results are calculated by the Centers for Medicare & Medicaid Services (CMS) using data provided by health plans in 2022. The ratings are being displayed for health plans for the 2023 plan year. Learn more about these ratings: https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/qualityinitiativesgeninfo/aca-mqi/aca-mqi-landing-page.