Operation Access: Contra Costa Specialty Care Initiative

John Muir/Mt. Diablo Community Health Fund

Operation Access: Contra Costa Specialty Care Initiative

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Uninsured patients who can’t afford surgery face overwhelming obstacles to obtaining necessary treatment. Most surgeries run thousands or tens of thousands of dollars – costs that are out of reach for nearly anyone without insurance. People who do not speak English and need medical interpretation face even greater barriers to care. 

Many of these patients postpone treatment and experience worsening symptoms until an emergency develops. This negatively affects their health and quality of life, strains the resources of already overcrowded emergency departments, and drives up health care costs. 

By mobilizing volunteer surgical teams, hospitals, and community clinics, Operation Access (OA) makes medically necessary outpatient surgical procedures available to uninsured people who neither qualify for government support nor have enough income and savings to pay for the procedures themselves. Since 2009, OA’s Contra Costa referrals have more than tripled, largely due to state and county budget cuts. In response, through 2016 the John Muir/Mt. Diablo Community Health Fund (CHF) has invested $1,724,307 in support of OA’s work in Contra Costa. 

It began with a CHF grant that underwrote OA’s three-year plan of action that built on a strategic alliance among OA, local hospitals, their volunteer medical professionals, and community clinics. Today that alliance includes growing volunteer surgical teams at John Muir Health, Kaiser hospitals and Premier Surgery Center, as well as community clinics that include: Contra Costa Health Services’ Healthcare for the Homeless Program, La Clínica de La RazaLifelong Brookside Community Health CenterPlanned Parenthood Northern California, Brighter Beginnings Antioch & Richmond Health Centers, Sutter Delta Antioch Clinic, and RotaCare Bay Area’s Concord and Pittsburg clinics.

Additional CHF grants have supported implementation (including screening, diagnosis, and same-day surgeries and procedures), evaluation, capacity building and fundraising.

A CHF-funded 2010 evaluation found that due in part to the increased organizational capacity our grant enabled, access to surgical and specialty care through OA for low-income, uninsured Contra Costa County residents increased by 250 percent and clinical referrals to OA increased by 144 percent, with patient satisfaction extremely high.

Since 2009 approximately 1,800 Contra Costa patients have received donated specialty care services and outpatient surgeries.

In addition, OA:

  • Increased the number of John Muir Health physician volunteers
  • Increased the number of central and east Contra Costa Kaiser Permanente
  • Brought ophthalmology services to Contra Costa County at the Kaiser Martinez Special Procedures Center and Premier Surgery Center. The CHF’s 2015 grant expanded this retinopathy treatment program.
  • Added general surgery, vascular surgery and gynecology services at John Muir Health Aspen Surgery Center.
  • Implemented and expanded a gastrointestinal (GI) program at John Muir Health Concord & Walnut Creek campuses.
  • Provided training to La Clínica’s case managers to insure appropriate and accurate referrals to OA.
  • Established a no-fee transportation program for patients with transportation hardships

2016 is the final year of CHF support and OA intends to use that support to deliver specialty care services to 375 additional uninsured adults, and launch:

  • An oral surgery program in partnership with La Clínica and the Contra Costa Dental Society
  • A new orthopedic partnership with Sequoia Surgical Pavilion
  • A new interpreter program