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Winter 1998 ~ Vol 1, #2
Dear Friend, This issue of DRIS News highlights the impact of health care reform in rural California, reports on the successes of the first nine months of implementation of the DRIS Initiative and looks ahead to the challenging work before the DRIS Community Health Councils.
Beginning in April of 1997, the California Institute for Rural Health Management through a grant from The James Irvine Foundation began the implementation of the DRIS Initiative to support a community-based planning process in the development of formal provider networks in five rural California sites: Humboldt/Del Norte, Imperial and Siskiyou Counties, Lompoc and Ridgecrest. We are pleased to report that as of January 1998, the DRIS Initiative is alive and working through five established Community Health Councils (CHCs), thanks to the tremendous efforts and commitment of hundreds of volunteer rural community leaders. Community leadership is essential to determining how health services will be provided in a rural community. The DRIS CHCs have provided a forum for a large number of community leaders not otherwise linked to health care, to participate in the critical issues of community health status, health care access and quality of care. In bringing providers of health care together with employers, community leaders and consumers; physicians and hospital administrators are also getting the chance to hear what purchasers of health plan coverage and/or health services in their area really care about. An example of the success of the DRIS learning objectives occurred in Lompoc. After an initial DRIS education session by the Community Health Systems Consultant, the Mayor of Lompoc found out that the local hospital and local physician IPA could not obtain a Health Net contract. As a County of Santa Barbara employee living in Lompoc, she received Health Net health insurance from her job but had to use Santa Barbara Medical Foundation providers or pay considerably more out-of-pocket. That meant for specialty care or hospitalization she had to drive over an hour to Santa Barbara, bypassing the providers in her community. So she talked to other City employees who met with Health Net and expressed their desire to expand patient choices to hospital and specialty care in Lompoc. The employees were successful in leveraging their consumer power and now Lompoc Hospital and the Lompoc IPA enjoy contracts with Health Net. The DRIS Initiative process is “Data Driven”. CIRHM envisions that the program will offer the potential for facilitating varying developmental strategies based on local market and community realities. While some rural values will be common to the distinct rural Californias— the desert, the central valley, the northeast mountains and the northwest coastal areas, it is imperative to recognize that each of these regions has unique competitive forces at work. As a community based Initiative, informed decision making by the community based on objective data is critical. The five sites have nearly completed their community assessments which provide a snapshot for the health service area demographics, epidemiology, provider supply, service utilization, health care financing, and employer and provider surveys. Analysis and presentation of data to the CHCs will continue through March, 1998. In addition to the basic data set, each community by virtue of its geography and population has had unique data requests. For instance, Imperial County, which has a 69% Hispanic population, chose to look at all of its data by Hispanic and non-Hispanic criteria. Humboldt/Del Norte Counties chose to segregate their data into seven regions based on organic service areas. Ingenuity in data collection tactics was demonstrated by the Ridgecrest DRIS site team. Due to the economic downsizing of Ridgecrest, the usual formula-based census projections were inaccurate. Instead, the DRIS Consultants measured the population decline by calculating the change in waste water effluent over time. Armed with their community assessment data, the DRIS Initiative Community Health Councils over the next months will be able to make informed decisions about possible integrated service delivery and/or financing functions to pursue at the local level in the development of their rural integrated systems. We hope that the information presented in this latest newsletter will be helpful to your integration efforts. Sincerely, |
© CIRHM