Los Angeles County (along with California and the remaining United States) is in the worse overdose crisis in our history, driven by fentanyl and methamphetamine. No community is unimpacted by overdose, which spares no racial, ethnic, socioeconomic status, or age group. The historic response to substance-related crisis – to encourage people who use drugs to seek substance use treatment – is a necessary but insufficient response with when not paired with robust prevention and harm reduction initiatives that reach the people most in need.

The advancement of Health Equity, including the identification of outcome gaps and the development of processes to close those gaps, has become a major focus for the Centers for Medicare and Medicaid Services as well for managed commercial insurance plans. This project was designed to identify the most significant and urgent Health Equity opportunity within a county hospital and to create a pilot intervention to close high priority identified gaps.

am Director of Women’s Health for Eisner Health, an FQHC which provides physician and midwife care to 2000 birthing people annually at two safety net hospitals in Los Angeles. Local, statewide, and national data all show significant health disparities around maternal morbidity. The majority of maternal morbidity is secondary to the need for transfusion. Women who present to labor and delivery anemic are more likely to need transfusion.

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.

Problem: Currently, more than half of California kindergartners have experienced tooth decay, and by third grade, this number rises to over 70 percent. If left untreated, tooth decay effects children's overall health, social-emotional development, and academic performance.

Dental Decay is the most common chronic disease among school aged children. In fact, dental disease is more common than childhood asthma. By the time children go to school, 50% of them have already experienced tooth decay in California. As a result, children miss school, learn less, are in pain, or end up in the emergency room due to oral infections. Research, and reports support this position (California Children’s Report Card gave a C- for Oral Health Care in 2020). Treating decay in very young children is very challenging. The good news is that decay is a totally preventable disease.

Healthcare prices are hard to understand and navigate for patients and healthcare teams. Health care affordability (out-of-pocket patient costs) is a leading health care concern for Americans and a key voting issue. More than half of Americans worry about the availability and affordability of health care, and more than a quarter have delayed care because of high costs. I am passionate about this work after having a friend lose her life savings due to healthcare costs and my own family has faced large medical bills without guidance to navigate our healthcare system.

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.

Due to the COVID-19 pandemic, participation in recommended routine screening declined across the country – in the first six months of the pandemic alone there were 10 million missed cancer screenings. As a result of this decline, individuals are not receiving appropriate early screening and diagnosis, resulting in an increase in cancer diagnoses at advanced stages of the disease. Delayed diagnosis is expected to lead to a higher cost of care, loss of productivity, and increased morbidity and mortality that would have been avoided with appropriate screening.

Care coordination among patients with severe mental healtillnessesss has been a long-standing challenge. Patients seen in mental health clinics oftentimes have inadequate control of diabetes, hypertension, and dyslipidemia. In addition, more than 60% of this population also suffers from co-occurring substance use disorders. Without addressing these chronic medical problems, patients with poorly managed medical conditions often were lost to follow-up.