Applied Behavior Analysis (ABA) is a type of behavioral therapy commonly used to treat children diagnosed with Autism Spectrum Disorder (ASD). The treatment is long-term, intensive, and highly individualized. If the service is poorly designed or implemented, it may lead to behavioral regression and the need to restart treatment. The goal of my CHIP is to improve the quality of ABA service with a PayFor-Value (P4V) program. Two metrics were used as lead indicators: 1) percentage of supervision conducted by board certified clinicians and 2) utilization rate of approved treatment hours.

I wanted to design a care model that was focused on delivering on the needs of clinicians as a primary intention. Too often I’ve found that in order to meet the patient needs sacrifices and compromises are made regarding the needs of clinicians in clinical program design. The common thinking is that it’s incumbent on clinicians to sacrifice for the sake of their patients. Instead, we interviewed clinicians on what were there most pressing needs and build our clinical care delivery program with those insights.

Telehealth has always interested me as a model of care to decrease barriers and increase access to care, but prior to the pandemic state of emergency there wasn’t a reimbursement model for FQHCs in primary care. We were doing some telehealth with remote specialists, bringing patients to the clinic for visits, but nothing in primary care or with remote patients. Then everything changed. Over 2 weeks in March 2020, we went from 100% in-person visits, to only 15%, the remaining 85% remote telehealth.

The CHIP was a focal point of the CHCF program, but my true CHIP came through learning about myself as a leader during challenging times. Fueled by burning questions and supported by mentors, friends and family, I managed to thrive during the past two years. Given all the crises in the world, and given my personal and professional investment in mental health, what could I do to contribute? How might we improve our communities’ health and wellbeing?

Project Goal: To engage community organizations to identify the needs and create mental health solutions for children of military families.

Project Goal: To provide virtual psychiatric consultation to 10 patients per week with urgent psychiatric needs within 72 hours of seeing their PCP. This will decrease levels of PCP burnout, decrease number of urgent referrals to psychiatry, and increase percentage of referrals accepted by psychiatry. 

Project Goal: Sustain and expand the ZSFG Social Medicine program by September 2020 via a) Securing $2M in financial support to grow team; b) Investing in staff engagement and professional development, and assessing measures of teamwork and engagement; c) Developing new internal and external cross-sector partners to expand service delivery – e.g., housing + substance use linkage; d) Scaling this team-based model of care to ZSFG inpatient and psychiatric units, and 1 outside hospital; e) Tracking # patients served, # admissions/readmissions averted, % reduction in return ED visits, % reducti

Project Goal: To improve access to needed behavioral health services for patients and reduce the frequency of providers reporting unmet need for same-day behavioral health services for complex psychosocial issues.

Project Goal: Support the launch of the first Safe Haven Clinic with Mendocino County in 2021 in a SNF commandeered by the County as a COVID Alternate Care Site (ACS) and purchased with CARES act funds – Whitmore Lane, Ukiah CA.   

Project Goal: Using a train the trainer model a series of three trainings, a set of clinically applicable tools for each and a training team will be training to deliver the training. The training will be conducted for all county employees by June 2022.