The Specialty Care Initiative (SCI) is a statewide collaboration between Kaiser Permanente Community Benefit and CHCF focused on improving access to specialty care services for vulnerable populations in California. Beginning in 2007, more than 20 coalitions engaged in strategies to address regional needs by increasing access to specialty care for vulnerable populations, decreasing inappropriate demand for specialty care, and improving health care delivery for the safety net.

The initiative supported those community coalitions that were able to develop and implement strategies to improve specialty care access. CHCF funding targeted rural regions ineligible for Kaiser funding — generally those in Northern California. Although each coalition pursued multiple approaches to address their community’s needs, the strategies across the initiative coalesced into four clusters:

1. Embedding guidelines into the referral process: better manage the demand for existing specialty care appointments by ensuring more appropriate referrals.
2. Building/expanding specialty care networks: increase the availability of specialty care appointments for the safety-net population.
3. Increasing primary care provider (PCP) capacity and scope of practice: better manage the demand for specialty care appointments by increasing PCP capacity to manage basic specialty care needs.
4. Integrating care coordination: better manage the demand for existing specialty care appointments by improving referral coordination and reducing no-show rates.

The SCI coalitions since have shifted focus to deepening, sustaining, and spreading their effective strategies.

The full evaluation of the initiative and an executive summary plus four case studies completed in October 2011 are available as Document Downloads.

A map of the SCI sites that shows the reach of these efforts and provides contact information is available through the Related CHCF Page link below.