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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. Turning the Tide on California's Opioid Epidemic

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

    Last week, the US surgeon general sent me a letter. In fact, Dr. Vivek Murthy sent a letter to every one of the more than 900,000 doctors in the United States, asking us to help end the opioid overdose epidemic that now kills more people each year than traffic accidents. His call for us to commit to "turn the tide" on the epidemic hit home for me, both as a physician and as CEO of the California Health Care Foundation, where we are supporting a multipronged effort to fight opioid addiction in our state of 40 million people.

    "We arrived at this place on a path paved with good intentions," writes Dr. Murthy. I can attest to this, as can my colleague at CHCF, the architect of our opioid safety work, Kelly Pfeifer, MD.

    For decades, we clinicians took mandatory classes informing us about the need to regularly assess patients for pain and imploring us not to undertreat pain. Today we know so much more about the biologic processes that cause pain. We also know a great deal more about the neurobiology of addiction and the impact of high-dose, long-term opioid use on the brain's ability to manage stress, pain, and daily functions. As physicians, we want to help patients suffering from chronic pain. But while the promise of long-term benefit from these opioids rarely materialized, addiction and other opioid-related medical problems often did.

  2. Moving Medi-Cal Forward — Together

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

    On July 13 CHCF hosted a briefing in Sacramento on the future of Medi-Cal. More than 500 people joined online, in person, or by phone to hear a distinguished panel of experts discuss the findings and recommendations in a new CHCF-sponsored report from Manatt Health, Moving Medi-Cal Forward on the Path to Delivery System Transformation.

    Panelists and over 40 other experts interviewed for the report agreed on a vision for Medi-Cal as a program with shared accountability among providers to achieve high-value, high-quality, and whole-person care. There was considerable support for the report's recommendations, even as opinions differed about how to move forward and at what pace.

  3. Across the Tracks: To End Homelessness, See the Whole Person

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

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

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

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

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

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