A Renovated Urgent Care Facility for South L.A.

Denece Johnson remembers all too well having to stand for hours at Hubert Humphrey Medical Comprehensive Health Center’s urgent care facility to see a doctor or to get her prescription for high blood pressure refilled. There were never enough seats to fit the number of people in need.

But this week she marveled at the $7.8 million renovation that doubled the waiting room capacity and will soon offer more patient rooms to accommodate the need. No longer will patients have to use dilapidated, dark bathrooms, trip on upturned linoleum floor tiles or wait in the rain in the parking lot while they watch the time go by.

“People were in the parking lot, standing around waiting,” said the 59-year-old South Los Angeles resident. “It was sheer, pure hell. Facilities in South Central were overlooked for a long time. But now they are making this place to be decent.”

The renovation, which includes a large, clean and well lit waiting area with new chairs and televisions, was a priority for Los Angeles County Board of Supervisors Chairman Mark Ridley-Thomas’ so that all county residents—whether they are insured or not—receive better healthcare service.

The Hubert Humphrey facility has approximately 126,000 visits —35,000 from the urgent care—every year for a range of ailments. The center’s specialties include optometry, ophthalmology, podiatry, gynecology and HIV prevention.

The expansion added 2,200 square feet to the urgent care center with the new waiting room, triage center, registration space and seven exam rooms which should be completed by the end of summer. In addition, a new air conditioning system was installed to replace the broken down unit which made the place unbearably hot in summer and an additional 50 parking spaces were added to ease congestion.

For Dr. Cesar Aristeiguieta, director of Emergency Medical Services at Hubert Humphrey, the new urgent care facility could not come too soon.

“The place was really run down,” he said. “Now the patients will also be much happier.”

With the Affordable Care Act, set to be implemented in 2014, more residents will be covered by affordable insurance and more federal resources will be invested in prevention. Hubert Humphrey is only one piece of Chairman Ridley-Thomas’ health and wellness strategy for his constituents. The opening of a new hospital, the Multi-Service Ambulatory Care Center and plans for a Psychiatric Urgent Care Center on the Martin Luther King, Jr. campus in Willowbrook are key steps toward strengthening the county’s health system that will not only serve as engines for economic development and neighborhood revitalization, but also to bring a holistic approach to preventive medicine.

“We are focused on improvement of care and experience for our patients at county facilities,” said Chairman Ridley-Thomas. “The implementation of the Affordable Care Act will mean a new level of service and competition and that is a good thing. I look forward to celebrating more milestones as we endeavor to improve our health system.”

Free STD Testing Kiosk Moves to Trade Tech

The county’s first sexually transmitted disease (STD) testing kiosk in a college setting is now available at Los Angeles Trade-Technical College. The digital tablet and touch-screen kiosk was installed in the student health center at Elm Hall to make STD home testing kits more widely and immediately available. In the first four hours of its launch, the kiosk at Trade-Technical College had 20 orders, reinforcing a message of empowerment to women who want to find out about their health and wellbeing in an easy and reliable manner. The kiosk is part of a larger information and testing program spearheaded by Los Angeles County Board of Supervisors Chairman Mark Ridley-Thomas to help increase awareness about sexually transmitted diseases. The Second Supervisorial district has the largest rates of in his district, where STDs like Chlamydia and gonorrhea. The statistics are stark. In 2010, there were 20,337 Chlamydia cases and 2,136 gonorrhea cases reported in females ages 15-24. The kiosk is part of the Los Angeles County Department of HIV And STD Programs award-winning “I Know” home test kit program launched in 2009. New digital tablets and touch-screen kiosks now make home testing kits more widely and immediately available to women. Women who use the kiosks or digital tablets to order a kit are able to receive their kit on the spot, without waiting for it to arrive by mail. All “I Know” materials and the website are available in both English and Spanish, and there is no cost to use the home testing program. The kiosk enables secure access to the program’s website to record kit orders, so that women can later obtain their results from the program website, or by calling a toll-free number. Women throughout the Ccounty will be continue to be able to order kits from the www.DontThinkKnow.org website, or by calling the County STD Program’s toll-free hotline number, 1-800-758-0880, to have test kits sent to them by mail. “We must endeavor to reduce these rates of infection,” said Chairman Ridley-Thomas. “Education and empowerment are essential tools to addressing this problem.” Young African American and Latina women bear a disproportionate burden from these infections. In 2010, there were 19,831 reported cases of Chlamydia and 2,481 reported cases of gonorrhea among African American and Latina women. These totals represent more than two-thirds of all reported female Chlamydia cases, and more than 72% of all reported female gonorrhea cases, in 2010. The burden of these infections is especially heavy on younger African American and Latina women ages 15-24, who had roughly 7 in 10 of all Chlamydia and Gonorrhea cases among African American and Latina women. Chlamydia rates are much higher for young African American and Latina women; and Gonorrhea rates are much higher among African American women. Among Latinas ages 20-24, Chlamydia rates (cases per 100,000 population) are nearly double that of white women of the same age; among African American women 20-24, the rate exceeds six times that of whites. The disparity is even greater in the Gonorrhea rate for African American women ages 20-24, which is more than nine times that of whites, and nearly twelve times that of Latinas. These disparities are similar among 15-19 year-olds. “This program has been incredibly successful in promoting testing and finding STD cases,” said the Dr. Peter Kerndt, former STD Program Director at the Los Angeles County Department of Public Health, noting that few clinics can show a comparable rate of case detection, and that none can perform testing for such a broad cross-section of at-risk women. In addition, according to Dr. Kerndt, not all women can or will access a clinic, due to lack of transportation, privacy fears, or the lack of symptoms typical of these STDs. The program has proved both popular and effective. Well over 6,000 kits have been ordered through the program since its launch in June 2009. In 2012, a total of 1,179 specimens were sent to the Public Health Lab through the program; and 9.4% of testable specimens were positive for either Chlamydia or gonorrhea – a case-detection rate that exceeds that of many clinics serving young women. The program received a National Association of Counties achievement award in 2010, and has sparked interest in many other jurisdictions. In addition, an evaluation study of the “I Know” media campaign in 2009 found that women who had seen the campaign were 1.5 times more likely to have been tested for Chlamydia and Gonorrhea in the past six months. Plans are underway to expand the program to three other California counties in 2013. For more information about the “I Know” program, click here.

Dr. Robert Ross Delivers Keynote at Charles Drew University

Dr. Robert Ross delivered the keynote address at Charles Drew University’s Inauguration of its new president, Dr. David Carlisle. The text of his inspirational speech, in which he extols Dr. Carlisle’s brilliance, record of accomplishment and integrity, as well as the university’s crucial role as a centuries-old institution serving African-American and Latino communities, is featured in full below:

Thank you, and thank you to the friends, family and supporters of Charles R. Drew University, the dedicated faculty, the supportive administration and staff, the students, the Trustees, and of course, our new President, Dr. David Carlisle.

The definition of Inauguration:

· The formal admission of someone to office; a ceremonial induction into office.

· A ceremony to mark the beginning or introduction of something.
· The beginning or introduction of a system, policy, or period.

So, among three standard dictionaries – the British & World English Dictionary, the Merriam Webster Dictionary, and Dictonary.com – three similar, but not identical definitions.

In preparing for these remarks today, I initially struggled with the question of which of these three definitions was most appropriate for this particular ceremony, at this particular time, on this particular day. Which one of these three would I hinge this set of 10-minute, 600 seconds worth of remarks about?

Answer: all three. Upon reflection, this ceremony is certainly about the induction of a person. But it is also about a thing, an institution. Most powerfully, it is about an idea.

As to the first definition, and the one that is most concretely evident as recorded in the printed program, we are indeed marking a “ceremonial induction into office.” It is the representation among the three definitions of the term “inauguration” that is about a particular person being inducted into a particular office.

I have known Dr. David Carlisle for more than two decades, although I will confess that in the earlier portion of that time frame, we did not get to know one another well. We were both participants in the Robert Wood Johnson Foundation Clinical Scholars Program in the late eighties. I can attest to the fact that, at the time, David embodied, certainly by reputation, being both clinical, and a scholar. (For me, I represented one of the two, and it most certainly was not the scholarly portion.)

Ladies and Gentlemen, allow me to submit that Dr. David Carlisle is a timeless sort of leader. He is a leader who represents the sensibilities and values from a bygone era, but desperately needed in leaders of our current time.

He is obviously bright, even brilliant, certainly accomplished, utterly mission driven, and of tremendous integrity. He is soft spoken, even-tempered, fair-minded, justice-oriented, and, in the tradition of leaders of academic institutions, science-, data-, and evidence-driven. Today’s leaders appear to be suited to the accommodation of political convenience – and even celebrated for their ability to craft political maneuvering.

David, on the other hand, is the umpire dutifully calling balls and strikes, and fair and foul balls, in the World Series Game. He will not sacrifice integrity or truth for the politics or drama of the stage or the moment. He will call them the way he sees them, and he will do so in service of integrity, accountability, and the mission of this extraordinary institution. And he will do so because the institution is bigger than any one of us.

Which brings me to the second definition of the term “inauguration”: a ceremony to mark the introduction, or in this case, the re-birth, of some “thing”. The “thing”, in this case, is Charles R. Drew University, the only historically African-American, Hispanic-serving educational institution in the 230-year plus history of this great nation. This “thing”, the institution, is different – even unique – a community-birthed and community-driven institution who, named after a great figure in African-American history and American medical lore, endures and even thrives in spite of all conceivable manner of financial, political, leadership, and management challenge.

Nearly two years ago our foundation, The California Endowment, was approached to rally to the cause of this institution, and the question on the table for me as CEO, and ultimately, our Board of Directors, was the following: was Charles R. Drew University, as a financially embattled institution, “an investable proposition?”

Many other institutions answered either “no”, or “we’ll wait and see.”

My answer to our Board of Directors – as I requested funding and support for CDU — was a “Yes, we must.” And a key reason was its people. The community it served. The institution’s mission-hungry and passion-driven students. It’s highly committed faculty, sticking with the institution through all and any manner of difficulty. A staff who would never give up on the value that the institution brings to the community.

Which brings me to the third definition of the term “inauguration”: the beginning of a system, policy, or period. And what, precisely, is the “system” or “period” that we, more accurately, “re-inaugurate” today? Most critically, it is that of an idea. And that idea is the idea of health justice. It is as alive and as powerfully relevant today as it was circa 1965 to 1968, when Martin Luther King, Jr. and Mahatma Gandhi and Cesar Chavez and Malcolm X and the Civil Rights Act and the Voting Rights Act were controversial vehicles of social change and social justice and social equity.

While the idea of Martin Luther King, Jr. and Cesar Chavez is too often symbolically reduced to holidays and postage stamps, and festivals, and parades, it is the daily, weekly, and monthly work and commitment to service by Charles R. Drew University that keeps the idea of social and health justice meaningfully, authentically, and palpably alive. And that idea has been fed, nourished and nurtured by the passing of a social justice relay baton, a torch if you will, handled and carried by individuals carrying the names of Drew, and Hawkins, and Gill, and Satcher, and Williams, and Hopper, and Francis, and Dowling, and Norris, and Baker, and Wilson, and Ridley-Thomas, – and now Carlisle.

Men and Women, Ladies and Gentlemen, there is no more extraordinary moment than the moment of now to realize the vision and mission of Charles Drew University. An African-American President of these United States has imposed his leadership will on this nation, to bring forward a policy instrument, a policy platform, in the name of the Affordable Care Act. Accessible, affordable, quality care for all. We cannot waste this moment, and CDU is rising at precisely the right moment in time.

You have a community, and a student body, and an administrative staff, and a faculty, and a Board of Trustees behind you. And you have Dr. David Carlisle to lead you there.

Thank you for permitting me and The California Endowment an opportunity to contribute to an extraordinary saga in the history of health justice in this nation. God Bless You, and the Charles R. Drew University, and congratulations to Doctor David Carlisle.

Robert K. Ross, M.D.
President & CEO
The California Endowment
February 2013

School Based Clinic Opens at Dominguez High School


New School Based Clinic at Dominguez High School

Not too long ago when students at Dominguez High School in Compton got sick, the only option was a trip to the nurse’s office.  At best, the nurse was equipped with a thermometer, a tongue-depressor and a hard vinyl couch where students could recline until a parent arrived.  Fast forward to health care delivery in 2013.

Now students are able to walk a few yards on campus to visit a brightly colored, full-scale health clinic, complete with doctors, nurses, dentistry services and even a small scale pharmacy.  The St. John’s Well Child & Family Center at Dominguez High School  is one of eight  new school -based clinics in the Second District ,  with an on-site  health clinic available not only to students but to the community at large.  In addition, seven more centers serving both students and families are expected to open in the next five months. Establishing school based clinics has been a priority for Los Angeles County Board of Supervisors Chairman Mark Ridley-Thomas, who has secured $4.1 million in county funds and partnered with the Los Angeles, Compton and Lennox Unified School Districts to build the centers.

“These clinics are an integral part of a community,” said Chairman Ridley-Thomas. “This is where easy access to medical care and preventing illnesses begins.”

As part of a national emphasis on preventive care, nearly 2,000 school-based health centers have been opened nationwide, according to the most recent National Assembly on School-Based Health Care census.

At these clinics, students and their families  can be treated for acute illnesses, such as  the  flu, or chronic conditions,  such as  asthma  and  diabetes . They can receive pre-natal care, reproductive health care, immunizations, dental care, vision and treatment for hearing problems. The Dominguez High School clinic is expected to open full time in March.

“We really want to be seen as a medical home not just for students but for communities that we serve,” said S. Nomsa Khalfani, chief of Policy and Support Services St. John’s Well Child & Family Center. “Some people think of a school - based clinic as a nurse’s office. But this is like walking into any other doctor’s office.”

Khalfani said lack of easy health care access can adversely impact a child’s education.  Recently, one student at Dominguez was missing days of school, prompting administrators to find out why.  They discovered he was sick but had not gone to the doctor because his family lacked insurance. The clinic, which has been operating on a part - time basis since September, was able to treat him and follow up with the family to make sure he was recovering.

“Enabling students, [or their parents] to have access to healthcare without missing school or work so they can go to the doctor is important,” said Khalfani. “Schools are a hub where families get resources and where students and families can get help quickly.”

At other school clinics , such as the  Jefferson High School Wellness Center, operated by South Central Family Health Center, students come in frequently for non-urgent illnesses like colds or stomach ailments. But they are also using the clinic to get questions answered about contraception and the threat of sexually transmitted diseases. Approximately a quarter of all chlamydia and gonorrhea infections in Los Angeles County in 2010 were diagnosed in South Los Angeles, according to the STD Morbidity Report for Los Angeles County.

“There are a lot of children who do not know or do not think they will get it,” said Dr. Gustavo Roldan, the on-site physician at Jefferson. “ But there are a high percentage of kids getting STDs like gonorrhea or chlamydia. There is definitely a lot of peer pressure to have sex.”

To help in student outreach, Genevieve Filmardirossian, associate director and chief operations officer of South Central Family Health Centers and her staff meet with school administrators once a month to discuss student and community needs.

She also plans to hire two students to serve as “teen workers” to conduct presentations to the students about health related issues like obesity and peer pressure. Zaira Castro, 16, wants to be one of the teen workers to help her classmates understand that the decisions they make in haste could end up causing them major problems in the future. She sees friends with terrible nutrition habits, eating too much junk food. Other friends are sexually active but not physically active, she said.

“I don’t know if they have all the information on the consequences of what can happen. It is easier to influence them if it’s by someone their age,” said Castro, who wants to be a psychiatrist. “If an adult is telling me what to do I wouldn’t pay attention but they will listen to me because I am a teen.”