While access to community-based palliative care (CBPC) is growing, rural California communities face distinct barriers to its implementation. These include a general scarcity of health care services; difficulty hiring and retaining qualified providers; insufficient technology infrastructure to implement telehealth programs; and socioeconomic issues, like poverty and substance use, that compound the challenges of serious illness care.

In fact, before this project launched, half of rural California counties had no CBPC available, and in nearly 80% of those counties, current CBPC capacity covered less than 20% of expected need.

Following an initial planning grant, five teams of rural CBPC providers, payers, and community partners were selected to participate in CHCF’s two-year “Increasing Access to Palliative Care in Rural California — Implementation Grants” initiative, which runs through August 2019.

These payer-provider efforts align with California state policy. SB 1004 implementation requires Medi-Cal managed care plans to provide access to palliative care services, and early lessons from this project could inform health plans’ strategies for partnering with rural providers.

The project provides funding and technical assistance to support the development and expansion of CBPC services. Participating providers are also enrolled in the Center to Advance Palliative Care’s Payment Accelerator, which aims to equip them with the knowledge and skills necessary to secure sustainable financing arrangements.

Grantees:

• Health Plan of San Joaquin (partners: Community Hospice, Hospice of San Joaquin, San Joaquin General Hospital)
• Hospice Services of Lake County (partner: Partnership HealthPlan of California)
• Outreach Care Network (partner: Health Net)
• ResolutionCare (partner: Health Net)
• Sierra Nevada Memorial Hospital (partners: Health Net, Hospice of Amador and Calaveras, Hospice of the Foothills, Mark Twain Memorial Hospital)