live / 2014
The Achievable Clinic: quality healthcare for families and people with developmental disabilities
Please describe yourself.
Collaboration (partners are signed up and ready to hit the ground running!)
In one sentence, please describe your idea or project.
Our comprehensive health center offers high quality, comprehensive health care for individuals with developmental disabilities.
Does your project impact Los Angeles County?Yes (benefits a population of LA County)
Which area(s) of LA does your project benefit?
- Although based in Culver City, we serve families across LA County.
What is your idea/project in more detail?
The Achievable Clinic is a state-licensed Federally Qualified Health Center (FQHC) specializing in providing appropriate, coordinated, continuous, high-quality and comprehensive healthcare services to our under-served community members, with a special focus on serving individuals with developmental disabilities and their families who lack access to such care in the broader community. Federal support comes with compliance requirements that do not always take into account the unique needs of our clients. Achievable is looking to collaborate with LA2050 in order to align our model of care with FQHC rules and expectations while still meeting the complex healthcare needs of our clients as well as ensuring long term financial sustainability.
What will you do to implement this idea/project?
FQHCs that focus on special populations such as residents of public housing, persons experiencing homelessness or agricultural workers, are subject to special waivers and accommodations that allow the FQHCs to address the unique health care needs of these groups. No such process currently exists for people with developmental disabilities.
It is our hope that we can demonstrate to HRSA the merits of designating people with developmental disabilities as a special population. Consequently such a designation would allow us to get the proper reimbursement rate for services rendered as well as allow us to receive continued HRSA grant funding.
In that regard, we believe that a significant portion of funding could be allocated to the efforts of our CEO and additional consulting support as Achievable looks to streamline operations, ensure federal, state and county compliance, grow our patient base and ensure that we are properly compensated for the care we provide to our clients.
How will your idea/project help make LA the healthiest place to LIVE today? In 2050?
The groups of people we serve are amongst the most medically complex individuals in the county. By better serving their needs, we can help the healthcare safety net better deal with the impacts via reduced hospitalizations, visits to ER’s and better management and prevention of chronic health conditions that can be reduced via on-going, culturally competent and timely care. The impacts go beyond the thousands of clients we serve, to their families and other care-givers which often neglect their own health even as they care for our patients.
Whom will your project benefit?
The Achievable Foundation is a nonprofit organization founded in 1996 with the mission of significantly improving the health and quality of life of under-served individuals living in Los Angeles County who have developmental disabilities such as autism, intellectual disability, cerebral palsy and epilepsy.
Individuals with developmental disabilities have numerous complex health care needs and experience poorer health than the general population, including disproportionately high incidence of chronic conditions and preventable mortality. Although state and federally-supported Community Health Center programs provide significant support for meeting the needs of many vulnerable populations, there is no specific framework for addressing the unique challenges posed in serving a patient base made up primarily of individuals with developmental disabilities.
We aim to serve the tens of thousands of potential clients that may seek our services from across the entire county of Los Angeles.
Please identify any partners or collaborators who will work with you on this project.
The Achievable Clinic is leveraging our strategic partnerships with organizations like the Westside Regional Center (WRC)–where we are co-located– to offer a growing spectrum of health care services to the expanding number of individuals with developmental disabilities who have MediCal insurance coverage through L.A. Care Health Plan. Based on the latest information from L.A. Care, there are over 2,286 clients at WRC (or roughly one third of all WRC clients) signed up with one of L.A. Care’s health plan providers.
As part of an extensive outreach plan, Achievable is looking to become the medical home of choice for many new L.A. Care clients. Serving as a medical home to L.A. Care clients places our clinic in a strategic position to contribute significantly towards L.A. Care Health Plan’s Triple Aim goals of achieving excellent patient outcomes, excellent patient experiences, and cost effectiveness and efficiency on behalf of our shared clients. To that end, we seek to improve patient experiences while minimizing long-term medical costs through an integrated, whole-person approach to addressing the ongoing healthcare needs of our community members.
If we can demonstrate the effectiveness of this strategy working with WRC, this could be expanded to the other Regional Centers across LA County that together serve tens of thousands of individuals with developmental disabilities.
How will your project impact the LA2050 “Live” metrics?
- Healthcare access
- Obesity rates
- Rates of mental illnesses
- Percentage of residents receiving coordinated healthcare services (Dream Metric)
Please elaborate on how your project will impact the above metrics.
We will improve access to healthcare by being able to serve thousands of clients via our FQHC clinic with enhanced Special Population status allowing for possibly more funding and technical assistance as we implement our clinical care model.
We can address the obesity crisis by working with more clients and families in our patient centered medical home model. Individuals with developmental disabilities have numerous complex health care needs and experience poorer health than the general population, including disproportionately high incidence of chronic conditions and preventable mortality.
Although state and federally-supported Community Health Center programs provide significant support for meeting the needs of many vulnerable populations, there is no specific framework for addressing the unique challenges posed in serving a patient base made up primarily of individuals with developmental disabilities.
We also address the mental health issues via our specialists in mental health through our UCLA and Cedars partnerships with their specialty care clinicians working at our clinic. Collaborating with the Regional Centers also allows for better coordination of services, including various social needs such as housing assistance and job support and independent living skills offered by our partners at Westside Regional Center.
Please explain how you will evaluate your project.
Achievable deliverables would include both a planning document that will be shared with our Health Resource Services Administration (HRSA) liaison and other leaders, as well as the establishment of a meeting subsequent to delivery of our alignment document to determine next steps and action plans to effect changes to the current model that apply to clinics like the Achievable Clinic. In addition, evaluation of the success of the project would include the formulation of a long-term plan for obtaining Special Population designation for the Achievable FQHC. This should translate into enhanced technical assistance, potential new funding support, and waivers that may allow us to meet compliance requirements without compromising our client needs or undermining long-term fiscal sustainability.
What two lessons have informed your solution or project?
We are learning that the federal healthcare system is very much oriented towards a volume and efficiency level that makes it hard to take into account the complex healthcare and support needs of people with developmental disabilities. In order to build sustainable safety net supports for these individuals, it will be necessary to build in more flexibility into the compliance requirements as well as more support options that can take into account the different business models that have to evolve to accommodate the unique needs of our patients. We also realize that in order for other parts of the community to pursue this access to healthcare gap for clients with developmental disabilities it is vital to have viable demonstration pilots to learn from and Achievable can be one of those such blueprints with your support.
Explain how implementing your project within the next twelve months is an achievable goal.
Twelve months will allow us to begin the research and initial interaction stages of implementation, including scheduling meetings with the appropriate federal authorities. That being said, we are aware that this is the beginning of long-term investment in effecting truly wide-ranging change that could impact how possibly millions of americans get access to healthcare. The system does not take into account the unique needs of people with developmental disabilities, and our hope that this process will begin changing how the healthcare network works for this growing part of our community.
Please list at least two major barriers/challenges you anticipate. What is your strategy for ensuring a successful implementation?
The primary challenges are that this process may be laying the groundwork for eventual change that may take more than 12 months. Change at the Federal level is incremental. In addition, we are not aware of the process other groups have utilized to effect similar changes for special populations that have received special support like homeless clients and those in agricultural regions that have migrant workers. That being said, raising awareness even at the initial stages of this project may allow us to get some of the technical assistance and support that the Federal government provides to other special population designees.
What resources does your project need?
- Money (financial capital)
- Publicity/awareness (social capital)
- Community outreach