Let’s fill gaps in state’s health care system

Faith Hidalgo, 12, of Meadow Vista is examined by Roger Gallant at a new rural health clinic that opened in Weimar in March.
Faith Hidalgo, 12, of Meadow Vista is examined by Roger Gallant at a new rural health clinic that opened in Weimar in March.

For the past five years, California has been sprinting toward a future once thought impossible of healthy people and healthy communities. For the first time in a generation, the Affordable Care Act offered us the opportunity to realize the dream of health for all – and we went for it.

The health reform law is proving to be a tremendous benefit to millions of previously uninsured Californians. Demand for care has never been higher, and we see the benefits in our patients every day. Lives are truly being changed.

Covered California was successfully launched and continues to grow, Medi-Cal has navigated the complex process of expansion, and community clinics and health centers have embraced the increase in patient populations.

Unfortunately, millions of Californians remain uninsured. The shortage of primary care providers is growing, and insured patients still face significant barriers to care. Our health care systems are in transition, trapped between the past and the future, and we still don’t have enough clinics and health centers.

Our work is not done.

Senate Bill 4 by state Sen. Ricardo Lara is our next great lift. If passed, every Californian would have access to comprehensive health coverage.

But coverage does not equal care. If we want to deliver on the promise of health, we need to ensure that we have a robust system that enables patients to receive care in a timely manner in an appropriate setting.

For example, SB 323 by Sen. Ed Hernandez would provide immediate relief to the primary care provider shortage in our most vulnerable communities by allowing nurse practitioners to provide care in line with the full extent of their education and training. That is a step forward.

AB 690 and AB 858 by Assemblyman Jim Wood would expand access to behavioral health services in community clinics and health centers. Within the primary care setting, as many as 26 percent of patients have a psychiatric disorder.

When left unaddressed, mental illness can make it difficult for patients with chronic physical illness to manage their health, translating into significant and costly physical problems for both patients and the health care system. These bills would increase access to behavioral health services and improve access to more integrated medical and mental health care, two more steps forward.

Longer term, SB 147 would allow health centers to test a program that promises to improve patients’ access to care, improve the quality of care and reduce the cost of care.

Day by day, step by step, each victory brings us closer to health care for all. I urge our elected officials not to stop short in realizing the dream.

Carmela Castellano-Garcia is president and CEO of the California Primary Care Association, which represents 1,100 nonprofit community clinics and health centers.