In 2020, there were 700 overdose deaths in San Francisco, which was more than double the number of COVID deaths. Though the proximal cause of death is Fentanyl, 60% of those who died were using methamphetamines, which means that many of those deaths may have been prevented by targeting stimulant use. UCSF Citywide serves nearly 2000 people annually with serious mental illness (SMI), homelessness, and institutionalization (long-term locked psychiatric hospitalization and incarceration).

Permanent vision loss is prevalent among the aging and will continue to rise. There are gaps and barriers resulting from fragmented care locally and globally. The health inequity among the aging, visually impaired population is also a public health issue with an economic burden on state and federal resources. The CDC reports that 4.5M over age 40 report that they are blind. This number is expected double to 9M by 2050. There are 21M more who reports having “vision problems” not correctable with conventional glasses, contact lenses, or refractive laser surgery.

My CHIP project focuses on conservation of personal protective equipment (PPE) for the 23,000 workforce members in the Los Angeles County Department of Health Services throughout the COVID-19 pandemic. The objective was to find new ways to extend our existing supply of PPE, identify safe and effective alternatives, and secure new supply that met agency standards. Emphasis is on the decontamination or re-processing of N95 respirators, as there was a critical supply shortage of N95s at the onset of the pandemic.

Yousef "Dr. Yo-Yo" Turshani, witnessed the protests of summer 2020 and sensed an opportunity. He leveraged his role on the Pediatrics Exam committee of the American Board of Pediatrics to make a change that could have national implications. What is on the Board exam directly influences what residencies believe matters; what is taught or valued. That influences the students who learn from the docs and thereby all who work with pediatricians.

After issuing statements on racial justice during Summer 2020, health care institutions’ attention towards health justice has decreased substantially. Meanwhile, health equity work is often (1) uncompensated and (2) undertaken by people from under-represented communities. This combination results in a “minority tax” on these colleagues, causing ongoing professional and psychological harm.

As indicated in the subtext of my CHIP title, I’m sharing a mix of project and leadership journeys. Especially in the pandemic era, it seems (at least for me), the threads of personal and professional experience are increasingly intertwined. For my CHIP, I started with the question of: How might we develop and implement a respectful, comprehensive, and trauma-informed model of care for pregnant and parenting people that better coordinates existing medical, behavioral health and social services and creates continuity across the birth divide?

While it’s clear that racism and not race has been determined the driver for racial healthcare disparities, it can be frustrating and feel merely theoretical for providers to realize impactful mitigating efforts. My plan is to provide Provider Scorecards reflecting individualized performance metrics stratified by race as a reminder of provider onus regarding health disparities and alerting them to disparities they may unintentionally perpetuate. The goal would be to create a tangible monitor for unconscious bias.

I wanted to leverage resources to support standardization for county behavioral health plans. County behavioral health plans are responsible for the provision of behavioral health services to person with severe and persistent mental illness and services for substance use disorders to Medi-Cal beneficiaries in their counties. There are 58 counties in California ranging in size from smallrural to extra-large with much variation in how services are delivered.

I wanted to respond to the social climate of our world after the murder of George Floyd resulting in protests globally. In the midst of these protests, the COVID-19 pandemic ravaged the countries around the globe, highlighting health care disparities in its wake, including marginalized populations disproportionately affected by the pandemic. Our students at USC were no exception to the widespread outcry for social justice. They too were protesting and broadened their attention beyond social reform nationally focusing their attention on the social climate at USC demanding change.

I was working on a A3 to address racial equity in the workplace. Through the A3 process it was ascertained that 35% of staff did not feel comfortable discussing race and racism in the workplace, resulting in an organizational culture and environment unable to advance racial equity. The goal of the project was to continue the A3 process to advance racial equity by increasing staff awareness and comfortability (staff feeling safe) in discussing and addressing racism in the workplace. The target was 100% of staff would have comfort discussing racism in the workplace by December 2021.