In January 2023 the DEA and SAMSHA announced elimination of the X-waiver as a requirement to prescribe Suboxone (buprenorphine/ naloxone) for opioid use disorder which presented an opportunity to reduce one barrier to treatment, access to X-waivered providers, among patients at a suburban community health center. This project looked at the willingness of primary care providers not previously X-waivered to begin prescribing Suboxone for patients on a stable dose before and after a peer-led training.

At the height of the COVID-19 surges, hospitals were overwhelmed as the number of patients seeking care surpassed bed capacity. A significant bottleneck to hospital discharges in San Francisco was the delay in transferring to post-acute facilities due to the required 10 to 20-day quarantine period and lack of SNF bed availability.

There is a severe shortage of licensed SNF beds even as demand for SNF beds is increasing. Since 2001, the number of licensed SNF beds has decreased by 43% in San Francisco.

When a child receives an autism diagnosis, the work has just begun. Parents are faced with a myriad of challenges, many of which may persist across the lifespan. Social skill deficits is one of the hallmark features of the disorder. This can impair a baby’s ability to give a social smile, or an adult’s ability to obtain and maintain meaningful employment.

Clinicians at Keck Medicine of USC are burned out due to the COVID 19 pandemic, competing demands on their time and insufficient support to achieve work life balance. This project was designed to establish a team-based care program at Keck Medicine of USC to reduce clinician and staff burnout in the Family Medicine Department. Burnout affects over 50% of physicians and nurses and leads to reduced access to care due to sick calls, reduced patient safety and lower quality of care.

Street Medicine is the delivery of individually tailored health and social services to people experiencing unsheltered homelessness (PEUH) in their own environment. Because Street Medicine has historically existed on the margins of the medical field – run as part time teams with volunteer staff - and because of that individually tailored approach, the field lacks universally recognized measures of success.

Whole Person Integrated Care (WPIC) is a section within SF DPH’s Ambulatory Care that brought together programs serving people experiencing homelessness (PEH)/transitioning out of homelessness to provide coordinated and integrated care. As part of WPIC’s development, our Urgent Care (UC) clinic integrated with Street Medicine’s Open Access clinic. Two-thirds of the patients are PEH, and the program addresses both urgent needs and transitional primary care for individuals who are unconnected to care and not getting their needs met elsewhere in the system.

Background: Substance abuse by pregnant women is a public health crisis. In, 2019, the U.S. was in the grips of an epidemic, with >70,000 opioid drug overdoses. In 2020 ED visits for opioid abuse went up 45% and studies have estimated an almost 30% increase in opioid overdoses. This has resulted in an ever-increasing number of babies struggling with highly traumatic abstinence (NIDA).

The two largest patient groups in California are Kaiser members (9 million) and patients served by California’s FQHCs (7 million), but you could not find two more dissimilar health systems. Kaiser and nearly all other health systems organize their providers in medical groups; FQHCs are private non-profits that employ and support their providers independently. The separation between individual FQHCs results in inconsistent access and quality, an inability to retain talent and resources, and diminished voice in the broader health care system.

Chronic diseases (eg: heart disease, stroke, DM, kidney disease, cancer) account for 5 of the top 10 causes of death in our country. Obesity is a well-known risk factor for all these chronic diseases, and we have almost 40% of US adults and 20% of children obese in the US, and the COVID pandemic has only worsened these trends. We currently have outstanding innovations in the field of medicine that focus on medications, delivery methods, and surgeries, yet our communities continue to struggle with chronic disease management and increasing rates of obesity.

Rather than seeing COVID-19 as an insurmountable obstacle, I, along with my team at Community Health Centers of the Central Coast (CHCCC), Inc., viewed it as an opportunity to accelerate the pace of innovation. To better meet the needs of the community, the CHC Behavioral Health and Psychiatry Departments are committed to moving beyond brick-and-mortar clinics to a ‘click and mortar’ clinic in the sky, the Cielo Center for Integrated Health. Like many health centers CHCCC quickly shifted to virtual care not long after the pandemic emerged.