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Monterey County Health Department: Clinic Services Bureau

Monterey County Health Department: Clinic Services Bureau. Patient Centered Medical Home Caroline Kennedy, M.D. Medical Director Salinas, CA. Monterey County Community Clinics: Who are we?. Federally Qualified Health Center Look-Alike Bureau of the Monterey County Health Department

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Monterey County Health Department: Clinic Services Bureau

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  1. Monterey County Health Department: Clinic Services Bureau Patient Centered Medical Home Caroline Kennedy, M.D. Medical Director Salinas, CA

  2. Monterey County Community Clinics:Who are we? • Federally Qualified Health Center Look-Alike • Bureau of the Monterey County Health Department • 160,000 patient visits per year • 7 Clinics: • 5 in Salinas; 2 on the Monterey Peninsula • 4 Family Practice • 1 Pediatrics • 1 Internal Medicine • 1 OB/GYN

  3. Patient Visits (303% growth)

  4. Teaming up with Specialty Care • Bring specialty care into the clinics • Easier for patients to get to their appointments • Translation services available at our clinics • Providers of specialty care are not available to our patients in our community • Provides specialty care to those uninsured on a sliding scale • Notes are immediately available for primary care physician review • Specialists bring with them a knowledge base that can be tapped by the primary care and OB providers; facilitating the curb side consult • Patients in need are referred to us by the specialist that they encounter in the ER or hospital

  5. Current Specialty Care at the Clinics • OB/GYN: • Perinatologist as part of high risk OB clinic • OB/GYN for Colposcopy at Seaside Family Health Center • Pediatrics: • Nephrology – University of California, San Francisco • Urology – University of California, San Francisco • Pulmonology – Stanford University • Cardiology • Psychiatry • Internal Medicine/Family Practice: • Adult Cardiology • Adult Pulmonologist (none in Monterey County taking Medi-Cal) • Adult Rheumatology • Adult Dermatology • Adult Endocrinology (none in Monterey County taking Medi-Cal) • Adult Psychiatry (Nurse Practitioner, Physician Assistant, and Physician)

  6. Other Essential Team Members • Psychiatric Social Worker (Licensed Clinical Social Worker) • Team of Public Health Nurses • Stationed in clinics for visit on same day as provider • Home visits, including team of nurses, nutritionists, and social workers • Emphasis on asthma, obesity, and diabetes • ER follow-up access is in the design process, with implementation later in 2011

  7. Residency Clinic • University of California, San Francisco Affiliated Family Practice Residency • 24 Residents (8 per year) • 16,402 visits per year • Physician recruitment opportunity • Clinic located in Natividad Medical Center where residents provide inpatient care

  8. What we have done so far • Residents work in teams with: • 1 faculty member • 5 residents • Shared inbox for labs and refills (EHR = Epic) • Each resident has a panel balanced in • # of Diabetics • # of Hypertensives • # of patients over 50 and 65 years old • # of OB patients • # of Chronic Pain patients on Schedule 2 • Matched on English/Spanish language 90% of the time

  9. Contact Information Caroline Kennedy, MD Medical Director e-mail: kennedyci@co.monterey.ca.us cell: (831) 998-3337

  10. Questions

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