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From the President

Dr. Sandra R. Hernández became president and CEO of the California HealthCare Foundation in January 2014. In her monthly column she reflects on her experiences as a physician and philanthropic leader to comment on the latest reports and projects from CHCF.
  1. Across the Tracks: To End Homelessness, See the Whole Person

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez, President & Chief Executive Officer
    Sandra R. Hernández

    When you travel along bustling Seventh Street in Mission Bay, San Francisco's gleaming center of health science and research, it's impossible to miss the line of tents clinging to the chain link fence along the Caltrain tracks. The mini-village is one of many makeshift encampments of homeless people across the city — like the one behind the backstop on the city ball field at Potrero and Cesar Chavez, where children play. Or the one along the wall at Wisconsin and Eighth Street. Or the one in front of the murals on Florida near Mariposa. It is estimated that 6,600 of San Francisco's residents are homeless.

    Homelessness has long been a pressing national social problem; the desire to do something about it may now be approaching critical mass in California. In Sacramento, state officials are discussing a $2 billion bond issue to support housing for homeless people with mental illness. Around California, local law enforcement leaders are warning that efforts to reduce prison crowding are increasing the populations of people living on the street.

  2. Why It's So Important to Integrate Physical and Behavioral Health Care

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez, President & Chief Executive Officer
    Sandra R. Hernández

    I once had a patient with severe bipolar disorder who moved to the US to get away from people in his native country who tormented him for being gay. He had been hospitalized with preventable pneumocystis pneumonia and was breathing on a ventilator. Although he was HIV-positive, he had not been taking the retroviral medications that would have reduced his risk, and he wasn't taking psychiatric drugs to manage his bipolar condition. I believe that if our health care system were able to share information and manage everyone's psychiatric and medical needs collaboratively, my patient might not have had to endure a harrowing stay in the intensive care unit. He is fortunate to have survived the pneumonia, and thanks to San Francisco's sophisticated system of community-based, integrated care for HIV patients, today he is successfully taking care of himself and getting the care he needs.

  3. Zuckerberg San Francisco General Continues 166-Year Tradition of Opening Doors to All

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez, President & Chief Executive Officer
    Sandra R. Hernández

    I'll never forget how I felt when I first visited San Francisco General Hospital more than 30 years ago. I was an East Coast medical student on a visiting rotation, and the effect on me was immediate: I was inspired and knew I would be happy working there. When I learned the next year that I would be doing my medical residency there, I felt as if I'd hit the jackpot. The hospital represented not only the best of science, but the best of public service. Since opening in 1850 to cope with a Gold Rush cholera outbreak, the hospital has helped train generations of doctors caring for immigrants, refugees, and newcomers of every stripe speaking many languages.

    San Francisco's residents, elected officials, and business leaders have long recognized the hospital's vital role in improving public health, providing broad access to coverage and care, and serving as the city's only Level 1 trauma center. They have demonstrated that understanding by providing tremendous financial, philanthropic, and political support.

  4. Medi-Cal's 50-Year Journey from Narrow Welfare Program to Engine of Change in California Health Care

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez, President & Chief Executive Officer
    Sandra R. Hernández

    When Randy Seriguchi moved to California from the East Coast last summer, the 30-year-old lawyer took a short-term job with a nonprofit education policy group in Sacramento. While the position didn't include health insurance, Seriguchi calculated that he could go without coverage until finding a job with benefits. He certainly didn't expect that he would develop a severe sinus infection just as his temporary job ended and his income dried up. He tried to tough it out with over-the-counter remedies, but the infection continued to get worse.

    "October was one of the worst months of my life," he said. "I had constant facial pain, headaches, and pressure on the right side of my face." On Halloween, Seriguchi descended into delirium. Half his face was paralyzed. His money worries, which had kept him away from doctors that month, finally yielded to the pain and fear, and he went to an emergency room expecting bad news about his health and worse news about how much the care was going to cost. He was shocked to learn from an admitting clerk that he was eligible for emergency enrollment in Medi-Cal, California's Medicaid program for low-income residents, and that there would be no big bills. Doctors ordered a CT scan, diagnosed Bell's palsy (a temporary paralysis of his face caused by damaged nerves), and prescribed medicines to reduce the inflammation and pain.

  5. Federal Task Force Takes Major Step to Unite Care of Body and Mind

    Sandra R. Hernández, President & Chief Executive Officer
    Sandra Hernandez, President & Chief Executive Officer
    Sandra R. Hernández

    The American health care system has just moved closer to a goal that I and many of my physician colleagues have long desired. Recognizing that depression is a prevalent condition that's inextricably linked to patient outcomes for physical diseases, the US Preventive Services Task Force on January 26 recommended that health care providers routinely screen patients 18 and over, including expectant and new moms, for depression. For those who are working toward the vision of a high-functioning health care system that assesses and treats the whole patient — both mind and body — this is a great moment.

    Screening is a powerful tool. The Affordable Care Act (ACA) gives the task force recommendation the force of law, requiring health plans to waive copayments and deductibles for depression screenings. Millions of people with common, treatable behavioral health problems will be able to get the help they need.

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