Projects & Areas of Interest

July 15, 2015

Advocates for Health Economics and Development (AHEAD)

Priority Areas of Interest:

AHEAD’s Leadership Team consists of a five member Board of Directors, working in close collaboration with three experienced Regional Policy Representatives. AHEAD’s mission is to work with partners and other collaborators to move health and economic development forward in rural and urban underserved communities. AHEAD California moves public health, workforce and economic development initiatives forward by advancing local solutions and statewide policy, linking people and resources, and removing barriers to access.

Priority Areas of Interest and Project Areas of Work:

Primary Care Access – AHEAD’s goal is to help increase primary health care access in rural and urban underserved communities and decrease wait time to access primary care.

Health Coverage Retention and Utilization – AHEAD’s primary objective is to expand health coverage retention and primary care utilization in rural and urban underserved communities.

Work Force Development And Healthcare Workforce Shortages – There are many healthcare workforce challenges facing California, especially in the 44 rural counties in our state. AHEAD will collaborate on a number of fronts addressing:

  • Disparities that exist in our healthcare workforce regarding matching the health workforce demographics with the populations being served.
  • Replication of successful workforce development and pipeline projects that help bring local populations into entry level positions within our healthcare safety net of providers.
  • Healthcare workforce as one means to address unemployment and under-employment especially for youth, single moms, young families, and unemployed military veterans. And the replication of best practice model programs from several successful rural and urban areas, and work to implant them in other communities of need.

Address the shortage of computer technicians/”mechanics,” IT consultants and Chief Information Officers (CIO) available in rural underserved communities.

Mental Health – AHEAD is primarily focused on and has expertise in two areas regarding mental health in rural and urban underserved communities:

Increase knowledge and understanding about mental and behavioral health needs beyond those working directly in the field. Support the expansion of Mental Health First Aid training programs in northern California counties, Central Coast, Central Valley and far southern California Inland Empire area.  

Increase knowledge of those working in mental, behavioral, substance abuse, social services, and primary care in the latest brain development and neuroplasticity science.

Keeping Children Safe From Infectious Disease And Unintentional Injuries – AHEAD has two areas of interest regarding these issues.

Helping to protecting children and vulnerable adults from infectious diseases, by linking and providing parents, caregivers, and policymakers important information about infectious disease and vaccines, based on best current health science, and not based on “junk science” or word of mouth rumors, but do address – especially in newer immigrant communities – fear and mistrust about the government programs.

Support the development of a statewide comprehensive Unintentional Injury Prevention Strategic and Action plan to dramatically increase prevention of unintentional injuries.

Below are brief overview discussions of a selection of AHEAD’s priority areas of interest and projects:

Primary Care Access – AHEAD’s goal is to help increase primary health care access in rural and urban underserved communities and decrease wait time to access primary care. AHEAD’s current primary focus is to take successful models and lessons learned where healthcare safety net provider networks have addressed and resolved or are moving in the right direction addressing Healthcare Professional Shortage Area (HPSA) designations. There are model programs in a couple rural areas which are successfully providing primary care in a timely manner using existing limited workforce and resources available. One example is demonstrated by the most recent healthcare provider availability survey from Imperial County’s Brawley and El Centro based Clinica de Salud del Pueblo. (See Appendix A)

Health Coverage Retention and Utilization – AHEAD’s primary objective in carrying out this project is to expand health coverage retention and primary care utilization in rural and urban underserved communities. We will accomplish this by assisting existing community based organizations (CBO) and local agencies adopt health coverage retention and utilization best practice activities into their current mission and business framework. By partnering with local CBO’s and local agencies already working with families on education, housing, nutrition, family support services, child care, etc. we can help increase health coverage retention and utilization outcomes by working with organizations which already have the trust and relationships with people in their communities and neighborhoods. AHEAD is especially, although not exclusively, focused on communities with high percentages of Hispanic and/or newer immigrant populations. To accomplish this project AHEAD will collaborate with other organizations like the CA Coverage Health Initiatives (CCHI) and other health coverage experienced organizations, to build a new “tool kit” providing the lessons, steps, and training necessary to help local organizations and agencies adopt into their mission and strategic activities model retention and utilization activities. The outcome measurement will be an increase in health coverage retention, increase in use of primary care and decrease in use of emergency rooms for non-emergency health issues. We are also interested in increasing participation in local preventative population health issues such as unintentional injury prevention, smoking cessation, decreasing obesity and utilization of healthy foods, and increase in physical exercise, as examples. Baseline and outcome data will come through our local healthcare safety net partners and community groups collaborating on the project.  Policy lessons learned will be considered for action at the appropriate state, federal or county levels, using AHEAD’s leadership’s extensive policymaking experience, and ability to partner with other policymaking organizations.

Work Force Development And Healthcare Workforce Shortages – There are many healthcare workforce challenges facing California, especially in the 44 rural counties in our state. AHEAD will collaborate on a number of fronts addressing these healthcare workforce challenges, but our current attention is on the disparities that exist in our healthcare workforce regarding matching the health workforce demographics with the populations being served. Our focus of work will be on supporting the replication of successful workforce development and pipeline projects that help bring local populations into entry level positions within our healthcare safety net of providers. The second area of focus is to review and help local healthcare safety net providers, healthcare workforce educators and regional workforce investment boards collaborate successfully to meet all three sectors’ needs. Addressing healthcare workforce disparities issues is also an opportunity to address rural areas higher unemployment and under-employment especially for youth, single moms, young families, and unemployed military veterans. AHEAD will use its workforce development expertise and workforce contacts to replicate model programs and best practices from several successful rural and urban areas, and work to implant them in other communities of need.

An example of a specific area of need and opportunity to take action involves the chronic shortage of computer technicians/”mechanics,” IT consultants and Chief Information Officers (CIO) available in rural underserved communities.  AHEAD is interested in using our Board members’ extensive workforce development experience to partner with education community and military veterans and youth, to create regional model computer skills training programs that also serve as contract hub sites to provide computer and IT support to the various parts of the rural healthcare safety net system.

Measurable outcomes of our healthcare workforce objectives will be captured through healthcare employer surveys and market scans of the unemployment profiles in the areas our projects are carried out in. We will be specifically measuring for changes in the diversity of the healthcare provider settings workforce, unemployment rates of specific groups, such as military veterans, youth and moms with young children. The other measurable indicators are focused on decreasing healthcare workforce shortages and/or time it takes to recruit and fill a healthcare staff opening.

Mental Health – AHEAD is primarily focused on and has expertise in two areas regarding mental health in rural and urban underserved communities. One is the lack of wide spread knowledge and understanding about mental and behavioral health needs beyond those working directly in the field. The national acclaimed Mental Health First Aid training program demystifies mental health and increases community leaders, non-mental health healthcare workforce, law enforcement, community based groups, faith community, youth, and other members of local communities about what mental health is, This project will increase an understanding of what mental health is available or lacking in their community. The program also increases participant’s knowledge what to do – who to reach out to – when they encounter someone with a mental or behavioral health need. AHEAD’s interest is to increase the number of Mental Health First aid trainings in rural and urban underserved communities, including in Spanish speaking communities, and to increase the number and availability of mental health first aid trainer-of-trainer programs.

The second mental health issue area is to increase the knowledge of those working in mental, behavioral, substance abuse, social services, and primary care in the latest brain development and neuroplasticity science.  A large percentage of people working in these fields had brain development training over five to ten years ago, but in the last five years the science around brain development and neuroplasticity has leaped far ahead of their knowledge. Treatment and therapy programs based in 1990 or 2000 brain science are out of line of what we know now about the brain. Rural and urban underserved communities typically are not targeted with up to date training in brain and neuroplasticity science. AHEAD has a trainer and certified continuing education training program on this topic we want to expand into other rural and urban underserved communities.

Keeping Children Safe From Infectious Disease And Unintentional Injuries – AHEAD has two areas of interest regarding these issues.

Protecting children and vulnerable adults from infectious diseases: Unfortunately California has large pockets of unvaccinated childhood populations. Parents who do not vaccinate their children or only selectively vaccinate their children tend to be clustered in two types of populations. One type of non-vaccinators are upper income well educated communities and communities that distrust science, western medicine and pharmaceutical companies. These parents tend not to believe the science and safety measures behind immunizations, and believe their children are safer by being unvaccinated. These parents still cling to long discredited internet spread science reports, such as the British study long ago discredited blaming autism on vaccines. This group of parents and their Hollywood funding partners make up one side of the “anti-vaccine” organizations in California. Even though they are well-heeled financially they represent a relatively small number of parents, and will never abandon their anti-vaccine beliefs.

The other un-vaccinated populations are in newer immigrant communities that have great mistrust of government or are susceptible to fear and word of mouth campaigns about the safety of vaccines. AHEAD is interested in working with this later type of un-vaccinating or under-vaccinating populations. We are interested in working with these types of vaccine hesitant populations on the street level and through the schools where their kids attend. For example California’s large Ukrainian population, especially those coming from the Chernobyl area of Ukraine, and certain Central American and Mexican immigrant populations distrust the safety of vaccines.

AHEAD is interested in working with existing trusted community groups and leaders from these types of communities to help answer their vaccine safety questions and concerns. In underserved communities there is an urgency to address this issue at the street level. SB 277 just passed the California legislature and was signed by the Governor. The bill removes parents’ ability to use Personal Belief Exemption (PBE) to opt out of school vaccine requirements. If they do not vaccinate their children protecting them and those around them from infectious disease, the children will not be allowed to attend public or private schools beginning in the fall of 2016, and will need to be homeschooled. These families are not set up to provide home schooling. They are working families, and many are low income working families. We believe we can create a model approach to working with these families to help them trust vaccines and prevent a mass exodus from key public schools.

The other infectious disease and vaccine issue is focused on helping keep our state policymakers up to date and knowledgeable about vaccine and infectious disease issues in the communities they represent, back in their home districts. There is a need for more feet on the street helping to keep local – very local – teams of vaccine champions made up of 4-6 people well briefed about vaccine and infectious disease issues, who are charged with keeping policymakers, local media and key community leaders up to date on vaccine issues at the district level. The teams need to be made up of local respected community leaders, business leaders, faith leaders and public health and primary care provider types. AHEAD has the connections and experience dealing with vaccines, vaccine policy, and infectious disease and organizing, managing and collaborating with other vaccine policy groups on this project.

Unintentional Injury Prevention Strategic Planning: Unintentional injury is the leading cause of death and hospitalization for California’s children and youth ages 1-19. Over a span of just ten years nearly 10,000 California children are killed, a quarter of a million are hospitalized and more than 4 million are seen in emergency rooms due to preventable unintentional injuries, from burns, traffic vehicle/bicycle/ pedestrian crashes, non-traffic kids left in cars and backover accidents, falls, poisoning, suffocation, drowning and sports related traumatic brain injury.

Unintentional injury statewide strategic plan development and implementation — AHEAD is providing the core staff and leadership for the development of a statewide unintentional injury prevention strategic plan. This project came about when the state’s key public health agencies reported they did not have the capacity or resources to organize and staff such an undertaking, even though they are key stakeholders involved in the project. AHEAD’s role is to keep the project organized – keep the ten working subcommittees staffed and moving forward, and 70+ stakeholder entities engaged. After the strategic plan report is published and disseminated AHEAD will work with the project partners to identify priority issues to organize and collaborate on implementing the strategic recommendations. The goal of the project is to dramatically reduce childhood and youth unintentional injury across California by the year 2020. Prevention does work. One example of success was the effort to upgrade all of the playgrounds in California by first establishing new state-of-the-art-safety-standards which happened between 1996 and 2000, and then enforcing all playgrounds to comply with the safety standards. All playgrounds in California have been retrofitted to meet the new playground safety standards. California went from a state with literally, annually, tens of thousands of children suffered moderate to serious to deadly playground accidents, to a state where the children’s hospitals and trauma centers report it is rare to see a serious or deadly incident involving playground accidents.

There are other issue areas of interest to the AHEAD leadership, but these are our priority issues and project for the next three to five years.