After completing a fellowship in women’s health at UC Davis in 2007, physician Susmita Mishra joined the medical team at the Sacramento County Primary Care Center. She expected the center would offer potential to grow in her career and serve the community at the same time.
“That has definitely been very true,” said Mishra, who is now the center’s medical director. “But we’ve also been able to do much more than what a typical health center does.”
The “do much more” difference is because of a County-UC Davis Health partnership — or “mutual vision” as Mishra calls it. Providers from both organizations work side-by-side at the center in providing care to patients who are covered by Medi-Cal, uninsured or do not have permanent legal status. They also continuously look for new and better ways to do so.
The collaboration began in 2005 with a unique program known as TEACH (Transforming Education and Community Health), created for UC Davis internal medicine residents wanting to help underserved urban patients. It was a convenient clinical opportunity for them, since the center is adjacent to the Sacramento campus of UC Davis at Stockton Boulevard and Broadway.
The Sacramento County Primary Care Center is a major point of pride for both the County and UC Davis Health in advancing patient care and physician training in our region. “Together, we are committed to giving valuable experience and education to a new generation of health care providers. At the same time, we are ensuring greater access to high-quality, person-centered health care — including primary care, behavioral health and specialty services — for underserved communities,” said Peter Beilenson, director of the Sacramento County Department of Health Services. David Lubarsky, CEO of UC Davis Health, said, “This partnership reflects the inner core values of UC Davis students, faculty and staff. What we have created is a groundbreaking partnership with the Sacramento County Primary Care Center that is a win-win-win." Read more about this unique partnership and the inspiration behind it.
“TEACH in those days involved just five residents in one corner of the building,” said UC Davis residency program director Craig Keenan. “Now it is hard to find a part of the building where UC Davis doesn’t have a presence — students, residents, fellows and faculty.”
Complete, enriching and relevant care
Today, TEACH is incorporated within a comprehensive medical clinic for thousands of patients who consider it their medical home. The primary care team has expanded to include UC Davis Health family medicine physicians and pediatricians, along with faculty and trainees of the Betty Irene Moore School of Nursing at UC Davis.
Specialists in psychiatry, neurology, cardiology, rheumatology, nephrology and sports medicine also see patients regularly. And, if patients need social or community services, they can receive onsite help from county staff and community-based organizations.
“Together, we are committed to giving valuable experience and education to a new generation of health care providers,” said Peter Beilenson, director of the Sacramento County Department of Health Services. “At the same time, we are ensuring greater access to high-quality, person-centered health care — including primary care, behavioral health and specialty services — for underserved communities.”
Breaking down barriers to care
In 2019, UC Davis Health greatly increased its support of the Sacramento County Primary Care Center after a tour by David Lubarsky, CEO of UC Davis Health, and Beilenson. They found that the spacious center was greatly underused. At the same time, the UC Davis Medical Center’s Emergency Department, just three blocks away, was overflowing with patients. Many of those patients were unable to get primary care due to insurance plan contracts that blocked their pathways to access UC Davis Health.
Working together, UC Davis Health and Sacramento County have greatly increased patient visits in the center for both primary and specialty care.
In fiscal year 2020, there were 377 specialty care visits for patients in cardiology, sports medicine, nephrology, neurology and rheumatology. This range of specialty care is unique for a Federally Qualified Health Center (FQHC), and is made possible under a special waiver obtained in 2019. UC Davis specialists at the center are able to see a referred patient within one to 10 days, as opposed to the one to three months it typically takes for an appointment with a specialist.
The successful partnership also reaches beyond the health center’s walls. In May, Sacramento County and UC Davis clinicians from the center teamed up to provide health services to the unsheltered at Loaves and Fishes five half-days a week.
“It’s evolved into an incredibly complete, enriching and relevant setting for both patient care and physician training,” Keenan said. “And we continue to graduate TEACH participants who become safety net providers for us or for underserved communities throughout the U.S.”
Serving a growing number of patients
The center now serves approximately 15,000 patients a year, with over 35,000 visits in 2019 for Medi-Cal, uninsured, Medicare and refugee populations. Traffic has tripled at the center since the partnership between UC Davis Health and Sacramento County began.
Wraparound (or non-health care) services offered include transportation, health coverage, food stamps, housing and legal services through collaborations with a number of community-based organizations, such as such as Sacramento Covered and Legal Services of Northern California (LSNC). Prior to COVID-19 restrictions, Sacramento Covered staff were onsite four days a week to provide enrollment services for patients. LSNC remains onsite twice a month with bilingual representatives to assist undocumented patients and others needing legal assistance.
The wraparound services, together with free parking, make the Sacramento County Primary Care Center a patient-friendly place to seek care, and it’s easier for patients to obtain the additional services beyond health care.
“This partnership reflects the inner core values of UC Davis students, faculty and staff,” said Lubarsky. “What we have created is a groundbreaking partnership with the Sacramento County Primary Care Center that is a win-win-win. Patients get increased access to more health care services and more timely access to care. Sacramento County gets a better, fuller use of their health care facilities. And UC Davis Health now serves far more patients who need us, in a more appropriate care setting.”
He added: “What we also have created is an important partnership with Sacramento County as a whole that they have begun calling a strategic alliance — which it truly is. This success has led to several other important public health partnerships between Sacramento County and UC Davis Health.”
The center team also has ambitious plans for the future, including a clinic for foster children and possibly a sexual health clinic. Both would be based on the example set by the center’s refugee clinic — a national model for culturally appropriate care. An expanded family medicine clinic encompassing women’s health also is under consideration.
“With unlimited space, there is nothing we couldn’t do,” Mishra said. “The center is community-responsive care at its very best.”
UC Davis Health also has partnerships with four other Sacramento region FQHCs, further expanding access to high-quality health services. The focus is on offering continuity-of-care for Medi-Cal or uninsured patients. More information is at health.ucdavis.edu.
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Additional stories about UC Davis Health’s commitment to low-income patients and medically underserved communities are here