Community
Telehealth Increases Access to Care for Medi-Cal Patients – Let’s Keep It OPINION
Telehealth may not make for a good Norman Rockwell painting, but it does make for good medicine. It’s an improvement, a step forward that helps us get healthier and close gaps in care.
Nearly a century ago, a Norman Rockwell painting titled “Doctor and Doll” was published on the cover of the Saturday Evening Post, a popular American cultural magazine.
It depicted an older gentleman wearing a suit, doctor bag at his feet, pressing a stethoscope to the chest of a little girl’s toy doll. A cluttered desk and worn chair sit atop a forgettable rug. It’s an old image of health care in America. A country doctor caring for his neighbors via a “house call.”
Of course, we know it was not that simple. Healthcare was rudimentary compared to today’s standards – that is if you had access to care at all. Average life expectancy reflected that. If you were born white in 1929 you would be lucky to reach your 60s. If you were Black, you weren’t likely to reach your 50s.
While things are far from perfect, at least they have improved. Healthy lifestyles and modern medicine have made living into your 80s commonplace. Significant racial disparities remain, but the gap is closing. And the number of people with health coverage has never been higher. But while Medi-Cal (the state sponsored coverage for people who have low-incomes) now covers nearly 14 million people, many still lack appropriate access to care.
Access to care is a complex issue, but sometimes it’s as simple as geography. Taking an hours-long bus ride across town to visit the doctor isn’t practical for most people. Add lost wages, a lack of childcare, and the fact that you don’t feel good, and it’s downright impossible.
Solutions available in employer-based health insurance for years, like virtual care through an app or over the telephone, haven’t been an option for people on Medi-Cal.
Until the pandemic.
When the federal and state governments declared emergency last Spring, federally qualified health centers like WellSpace Health were able to provide care virtually via telephone and video, a practice that had been prohibited previously.
Virtual care is wildly successful. Over the past two weeks, 5,015 patients accessed care remotely rather than visiting our health centers. Half of primary care visits and 85% of behavioral health visits were virtual. According to a statewide survey of community health centers, which serve 1 in 5 Californians, there has been a 75% decrease in no-show rates since the implementation of telehealth. A study conducted by the California Pan-Ethnic Health Network reported a significant number of patients from communities of color engaging in telehealth and having a high level of patient satisfaction.
As an internal medicine doctor and the chief medical officer WellSpace Health, it makes sense. Technology has given us the ability to conduct a modern day “house call.” We can go to the patient and break down significant barriers to care. If the patient requires a hands-on assessment or treatment, we can take that step. But frequently, especially in behavioral health, hands-on care is not necessary.
Our ability to provide virtual care under the emergency order will expire soon. Permanent authorization will require action by the Legislature and the governor through the budget process. Assembly Bill (AB) 32 by Assemblymember Cecilia Aguiar-Curry (D- Winters) provides the template for action.
In this budget cycle, the governor must take advantage of a once-in-a-lifetime opportunity to address inequality in our health care delivery system. By adopting the provisions of AB 32 into the FY21-22 final budget, it will guarantee that all Medi-Cal beneficiaries – regardless of where they seek care – can use all telehealth modalities, including telephonic care, indefinitely.
Telehealth may not make for a good Norman Rockwell painting, but it does make for good medicine. It’s an improvement, a step forward that helps us get healthier and close gaps in care.
It even brings back the house call.
Dr. Janine Bera is the chief medical officer for WellSpace Health and chair of the California Primary Care Association Telehealth Clinical Task Force.
Activism
Oakland Post: Week of April 24 – 30, 2024
The printed Weekly Edition of the Oakland Post: Week of April 24 – 30, 2024
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Alameda County
DA Pamela Price Stands by Mom Who Lost Son to Gun Violence in Oakland
Last week, The Post published a photo showing Alameda County District Attorney Pamela Price with Carol Jones, whose son, Patrick DeMarco Scott, was gunned down by an unknown assailant in 2018.
Publisher’s note: Last week, The Post published a photo showing Alameda County District Attorney Pamela Price with Carol Jones, whose son, Patrick DeMarco Scott, was gunned down by an unknown assailant in 2018. The photo was too small for readers to see where the women were and what they were doing. Here we show Price and Jones as they complete a walk in memory of Scott. For more information and to contribute, please contact Carol Jones at 510-978-5517 at morefoundation.help@gmail.com. Courtesy photo.
City Government
Vallejo Welcomes Interim City Manager Beverli Marshall
At Tuesday night’s Council meeting, the Vallejo City Council appointed Beverli Marshall as the interim city manager. Her tenure in the City Manager’s Office began today, Wednesday, April 10. Mayor Robert McConnell praised Marshall’s extensive background, noting her “wide breadth of experience in many areas that will assist the City and its citizens in understanding the complexity of the many issues that must be solved” in Vallejo.
Special to The Post
At Tuesday night’s Council meeting, the Vallejo City Council appointed Beverli Marshall as the interim city manager. Her tenure in the City Manager’s Office began today, Wednesday, April 10.
Mayor Robert McConnell praised Marshall’s extensive background, noting her “wide breadth of experience in many areas that will assist the City and its citizens in understanding the complexity of the many issues that must be solved” in Vallejo.
Current City Manager Michael Malone, whose official departure is slated for April 18, expressed his well wishes. “I wish the City of Vallejo and Interim City Manager Marshall all the best in moving forward on the progress we’ve made to improve service to residents.” Malone expressed his hope that the staff and Council will work closely with ICM Marshall to “ensure success and prosperity for the City.”
According to the Vallejo Sun, Malone stepped into the role of interim city manager in 2021 and became permanent in 2022. Previously, Malone served as the city’s water director and decided to retire from city service e at the end of his contract which is April 18.
“I hope the excellent work of City staff will continue for years to come in Vallejo,” he said. “However, recent developments have led me to this decision to announce my retirement.”
When Malone was appointed, Vallejo was awash in scandals involving the housing division and the police department. A third of the city’s jobs went unfilled during most of his tenure, making for a rocky road for getting things done, the Vallejo Sun reported.
At last night’s council meeting, McConnell explained the selection process, highlighting the council’s confidence in achieving positive outcomes through a collaborative effort, and said this afternoon, “The Council is confident that by working closely together, positive results will be obtained.”
While the search for a permanent city manager is ongoing, an announcement is expected in the coming months.
On behalf of the City Council, Mayor McConnell extended gratitude to the staff, citizen groups, and recruitment firm.
“The Council wishes to thank the staff, the citizens’ group, and the recruitment firm for their diligent work and careful consideration for the selection of what is possibly the most important decision a Council can make on behalf of the betterment of our City,” McConnell said.
The Vallejo Sun contributed to this report.
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