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OLE Health clinics in Napa, Solano counties leverage tech to maintain care amid coronavirus pandemic

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OLE Health has been coordinating with local hospitals and government officials as it manages patient care during the COVID-19 pandemic.

Within the first three weeks of the coronavirus crisis, the number of OLE Health’s uninsured patients rose from 17% to 23%, according to CEO Alicia Hardy.

OLE Health is a system of federally qualified health centers whose patients largely represent Napa County’s underserved population. The Business Journal interviewed Hardy on May 13.

What has been the biggest impact from COVID-19 to OLE Health, two months into the pandemic?

During this crisis, we have made a complete transition from providing in-person health care to our 37,000-plus patients, to providing that care primarily via “telehealth,” aka via telephone and video.

We’ve been strategic in our coordination with local, state and regional authorities, with public health, with homeless outreach organizations, and with partner health care organizations and hospitals.

We’ve consolidated some of OLE Health’s sites temporarily, limited in-person patient visits to only those deemed essential and re-structured our workforce. Our goal has been to minimize the number of patients and employees entering our facilities in order to keep everyone safe at home and ensure compliance with social distancing. The situation has been changing globally almost by the minute, and the same is true for us here at OLE Health.

How has your staff responded to the changed environment?

During a time when we can’t see our patients in person, and we can’t care for them in person, we’ve had this epiphany that we can still 100% still be here for them, and there are creative, new ways that we can provide their health care and connect with them that technology allows us to do. We are texting them important safety messages, reaching out to high-risk populations with check-in phone calls, coordinating provider-patient visits via appointment text links that connect patients to their physicians, and coordinating with community partners to focus on the immediate needs of food insecurity, mental health issues and more.

Our staff have been personally impacted by school closures and the stress of how much all of our lives have changed, but they amaze me every day with their dedication to our patients and to their jobs, even learning new skills as we’ve restructured. Everyone has a different situation and handles stress differently, so we’ve made sure to communicate to staff the many resources available to them and to patients, both externally and internally.

Our OLE Health behavioral health team has implemented a system to provide private counseling sessions for any staff who just want to talk to someone, a professional, they can trust.

There’s also been this incredible feeling of mutual encouragement and support, as we’re all in this together and working together to be here for our patients. A feeling of camaraderie. You can see that just looking at our social media — the praise and enthusiasm our staff and our community has for the people who work at OLE.

Have there been any furloughs or layoffs of staff? If so, how many and types of positions affected?

I’m so proud that we have not furloughed or laid off any staff since this pandemic crisis began, and we’re optimistic about the future in that regard, as well. Our board of directors was very supportive as we pursued and received a substantial and forgivable SBA loan that has ensured at least eight additional weeks of keeping each and every OLE Health member on staff.

Have you received feedback from staff that people are canceling or skipping their medical appointments?

Our No. 1 priority has been the safety of our staff, our patients and our community, and because of the nature of this pandemic, that meant ceasing all nonessential in-person appointments right when this all started.

Our IT team did a phenomenal job of implementing an entirely new telehealth system and training Call Center and provider staff right away. We’ve begun surveying our patients to gauge their experience, and so far it has been incredibly positive feedback.

That said, we are experiencing a lower-than-normal volume of visits, which tells me that even with telehealth, patients are delaying their own care or not engaging as regularly with us.

What has been the revenue impact so far?

The percentage of our patients who are uninsured has increased as a result of the job losses in the community, which means that there is less reimbursement overall.

We’ve also had a drop in overall visits, partially due to suspending some nonessential or higher-risk services, such as dental care, optometry, acupuncture, and other specialty services and because of the need to cease in-person and “nonessential” patient visits.

As we’ve ramped up our telehealth services, and as Medi-Cal has allowed for reimbursements previously not approved for telehealth, that situation has improved. However, we are still experiencing significant revenue losses each week due to lower visit volume overall.

As CEO, what is your overall feeling about this situation?

As the mother of three young children, I’m very aware of the unique challenges this pandemic has added to our lives besides the devastating loss of jobs — such as school closures and the inability to rely on traditional and established child care options, the loss of social support for kids and adults alike, as well as all of the other daily complications to living life.

I am so proud of how the 270 employees at OLE Health have stepped up to the plate, and admire so much the resiliency and flexibility of both our staff and our patients as we’ve made these changes.

Our patients and providers have had to learn how to interact with each other via technology rather than traditional in-person care.

I’m also grateful for the established relationships we have with our state and local organizations, such as Napa Valley Community Organizations Active in Disaster (COAD) to coordinate efforts.

Thanks to the incredible generosity of our community members — organizations like Grocery Outlet, Jameson Animal Rescue Ranch, the Napa Valley 1839 FC soccer league, E&J Gallo Winery — so many sponsors and supporters have just shown up to help because they care. We are able to be flexible and adjust our focus to what our community and our patients need in the moment — and right now food insecurity and mental health are such critical needs to address.

How has the financial situation of OLE Health’s patient population changed, as far as you can tell?

Many of our patients work in the service, hotel, wine and tourism industries in the Napa Valley and so obviously many have lost their jobs. We are expecting an influx of new patients who are finding themselves without health insurance, many who have not traditionally been without private health insurance.

What are the longer-term impacts on the patient community from the economic issues stemming from the virus threat?

OLE Health provides care to some of the most vulnerable members of our community, to individuals and families who already faced significant challenges economically prior to COVID-19.

This virus will further increase disparities in our community as unemployment rates rise, the academic performance gap widens, the need for mental health services increases and the ability to access healthy and affordable food becomes even less attainable.

OLE Health has always provided whole-person care by integrating medical, dental, behavioral health, nutrition and other services into our model of care.

We are continuing to do just that, and one example is these incredibly impactful food-distribution events we’ve held each week for several weeks now, providing food to more than 25,000 individuals in our community so far.

OLE Health was started by farmworkers and a handful of volunteer physicians to provide a solution to a need they identified in our community back in 1972. Through the decades, we’ve adapted to the health needs of our community to be here for the people who need us most. And I’m so proud that we are continuing to do this very thing — care for our patients in whatever way they need — in these most unusual of times.

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