live Finalist / 2019
Behavioral Health Care at Planned Parenthood
Idea submitted in the My LA2050 Grants Challenge by Planned Parenthood Pasadena and San Gabriel Valley
We're seeking support to revolutionize sexual health care by piloting behavioral health across our growing network of Planned Parenthood health centers and by expanding our patient navigation program, which links patients to a range of medical and social services. Planned Parenthood is a safe space and an essential safety net. We pride ourselves on delivering compassionate, judgment-free care, and this expansion into mental health will be our next step to care for our patients more holistically.
Briefly tell us a story that demonstrates how your organization turns inspiration into impact.
We were founded in 1933 by a pioneering woman doctor and fourteen visionary women, who were united in their belief that everyone in LA should have access to contraception, regardless of income or insurance. We’re one of the oldest Planned Parenthood affiliates in the nation, which is testament to LA’s longstanding dedication to women’s rights and public health. When our first health center opened 85 years ago, dozens of publicly funded clinics across the city had shuttered due to the Great Depression. Indigent women and families all over LA County had been cut off from sexual and reproductive care, and our founders worked tirelessly to correct this inequity. This was our guiding ethos then, as it is now: Everyone should have access to health care–no matter what. During our early history, we provided diaphragms and sex ed from a small Pasadena bungalow. Today, we’re the most trusted and sought-after provider of sexual and reproductive care for 24 communities in Northeast LA and the San Gabriel Valley, serving 65,000 patient visits each year and delivering over 15,000 opportunities for sex education.
Although we remain committed as ever to our founding mission, over the past eight decades, we’ve evolved our medical services to deliver more comprehensive, compassionate, and first-rate health care. For instance, in 1961, less than a year after oral contraceptives received FDA-approval, women across the San Gabriel Valley could access the pill with revolutionary ease, not only at our health centers but also through community partnerships we forged with libraries, grocery stores, and even churches.
We continue to innovate new ways to deliver health care and respond to patient and public health needs. In doing so, we’re breaking down structural barriers to accessing care by making it more timely, relevant, and equitable for all people. In recent history, we’ve made strides to deliver more inclusive care for our LGBTQ+ patients. Last year, we became the only public provider of PEP/PrEP HIV-prevention medicine in our service area, and this year, we launched trans care, including hormone therapy. For this work, we were recently awarded the Health Care Innovation Award from the national Planned Parenthood federation.
Which of the live metrics will your submission impact?
- Healthcare access
- Rates of mental illness
- Residents receiving coordinated healthcare services
In which areas of Los Angeles will you be directly working?
- East LA
- San Gabriel Valley
How will your project make LA the best place to live?
Our project will make LA the best place to LIVE by ensuring 35,000 local people can access behavioral health care. Our decision to pilot behavioral health was inspired by feedback from patient focus groups and input from community partners. In 2017, nearly a third of LA residents reported missing over a week of work due to mental health issues, and the Kaiser Foundation has shown that only a third of California’s need for mental health is being met by the current provider landscape. Since our health centers are often the only source of care for the majority of our patients, we believe Planned Parenthood is uniquely positioned to become both a safe space and a safety net for not only sexual and reproductive care but also for mental and emotional well-being.
Program Strategies and Timeline: During the grant period, we’ll pilot a two-phased approach to launch behavioral health. Throughout 2019, we’ll screen all adult patients for depression and anxiety, provide direct interventions, and offer warm hand-offs to our referral partners. This pilot will provide the data to develop a long-term service delivery plan that responds to local gaps in care. We’ll also test innovative interventions, such as offering patients drop-in support groups for symptoms-based issues like grief or shame and linking patients to licensed clinical social workers via telehealth. During this period, we’ll expand our referral network and continue to develop our patient navigation program, so that we can successfully connect patients into counseling as well as to a range of support services that can directly address other social determinants of health, including housing/food insecurity and substance abuse. At the grant end, we’ll enter the second phase, offering in-network, ongoing counseling sessions for all patients.
Population Served: The target population is the 35,000 unduplicated patients we serve each year from our four sites in Pasadena, Eagle Rock, Alhambra, and Glendora. We’re opening three new health centers in the next three years, expanding into new communities, and LA2050 support will provide for these future patients as well. Our typical patient is a young woman seeking birth control. Despite this trend, over 13% of our patients are men, and 12% are over the age of 35. Our service area houses one-fifth of LA County’s population and is one of the most ethnically and racially diverse areas in the country. Over 50% of our patients identify as Hispanic/Latinx. In terms of race, 52% of our patients are White (including Hispanic); 25% Multiracial; 16% Asian/Pacific Islander; 6% Black; and 1% Other. Cities in our service area feature some of the highest income inequality in the state, and this disparity creates barriers to care. In the last year, 92% of our patients lived at 200% or below the Federal Poverty Level and 66% lived at 100% or below. For a family of four, living at 100% the poverty level translates to less than $25,750 a year.
In what stage of innovation is this project?
Pilot project (testing a new idea on a small scale to prove feasibility)
Please explain how you will define and measure success for your project.
At our Planned Parenthood affiliate, every department tracks and reviews dashboard indicators in each area of our strategic plan. This evaluation is done quarterly and then assessed by the Board of Directors, which convenes at least ten times per year. On a monthly basis, our Leadership Team also reviews 51 metrics pertaining to: Health Center Access; Revenue; Service and Quality; Compliance; Outreach and Marketing; and Finance. Each month, we track whether or not we are on-target or within 5% of our goal, and if we are not, we respond intelligently. Health center managers and their staff undergo a similar monthly performance evaluation process on 40 metrics pertaining to: appointment access, quality indicators, patient satisfaction, and financial performance. Although our affiliate is only a mid-size network of health centers, one of our profound strengths is that—because our leadership and health center staff convene so frequently to communally analyze the organization’s most current results—we can quickly address the problems, act on the needs, and adapt to the trends revealed by our data. As part of this pilot, we’ll incorporate behavioral health metrics into both the evaluations performed by our Leadership Team and our health center staff.
Additionally, we’re currently collaborating with the USC Masters in Social Work program to develop an evaluative tool to define and track outcomes related to our expanded patient navigation work. This evaluative tool will be incorporated before the end of 2019 and will enable us to better assess our ability to successfully hand-off patients to both external health care and social service providers.
We also use patient surveys and reviews to qualitatively evaluate our services and our health centers, and we frequently engage patients in focus groups and maintain an active patient advisory council.