California Health Care Improvement Projects (CHIPs)

Ako Jacinto presents his CHIP

California Health Care Improvement Projects (CHIPs) are designed by CHCF Health Care Leadership Program participants with the goal of addressing meaningful challenges or opportunities in health care. 

Browse CHIPs to leverage the work of CHCF alumni and find opportunities to collaborate in order to improve health for Californians.

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Maximizing the PPE Available for Los Angeles County Workforce during COVID-19

Konita Wilks

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. I review the operational phases: discovery, obtaining buy-in or negotiations, and implementation; and discuss what guided our decision-making at each phase. 250,000 N95 respirators were generated to replenish the depleted emergency stockpile for our LA County healthcare workforce as a direct result of my CHIP project.

June 1, 2022
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A Telehealth Journey: From Emergency Response to Sustainable Operations

Jessica Moore

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. Over the next two years, my team and I wrestled with infrastructure, workforce, and staffing for this new model and how we might implement it in ways that were equitable and meaningful to patients and their families. The objectives were constantly shifting due to a combination of internal and external forces. Ultimately, we achieved a somewhat steady state with 20% telehealth visits which are primarily integrated into our in-person clinics. The bigger issues of equity and patient experience will require continued advocacy and effort to ensure that the disparities that already exist in access do not persist in the expanded telehealth model.

June 1, 2022
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Designing a Mobile Primary Care Clinical Model for Clinicians rather than patients

Payam Parvinchiha

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. We further hypothesize that by delivering on clinician needs our program will deliver exceptional patient outcomes as well.

June 1, 2022
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Racial Equity in the Workplace

Kimberlee Pitters

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.

June 1, 2022
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Improving the Quality of Applied Behavior Analysis Service with a Pay For Value Program

Edwin Poon

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. Providers will have the opportunity the earn up to 4% of their annual total claims amount if they meet preset quality benchmarks.

June 1, 2022
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Implicit Bias Training, Just the Beginning

Lisa Richardson

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 reflected upon this unique time in history. I did not want to create any further harm to our students. I felt compelled to address not only our students’ concerns but also address how our employees can make better decisions personally and professionally in response to the change our students yearned for and demanded. So, I quickly pivoted my CHIP to work on Implicit Bias Training for the Student Health Clinic at the University of Southern California. My goal was simple, to implement the first implicit bias training at the Student Health Center at USC.

June 1, 2022
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Standardizing of “5150” Training Across Counties

Lucero Robles

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. For my project, I focused on training for individuals whom the county designates “writing authority” which authorizes a person the professional responsibility to place a person on an involuntary hold when the person’s mental disorder makes them a danger to themselves, and/or others and/or gravely disabled. I will refer to this as “5150/5585” which are the regulatory sections of the Welfare and Institutions Code (“5150” for adults and “5585” for minors). The regulation defines persons who are designated to perform the activity of involuntary detainment, including the role of the county in the designation of this authority. To receive this designation, an individual must complete training on professional and legal responsibilities of performing this activity. Each of the 58 counties in California develops and delivers this training to persons who may be granted 5150/5585 “writing authority”. The training content and hours in training varies from county to county. There is no standard statewide training.

June 1, 2022
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