During Katrina relief efforts, Scripps CEO Chris Van Gorder and staff cared for nearly 5,000 patients, donating 2,000 physician hours and 4,000 staff hours.

From cooking classes to vision testing to disaster medical response to providing medical care for the homeless, San Diego-area hospitals are strong parts of the community. Many of the programs are designed to fill the gaps between insurance and Medi-Cal.

The programs and services provided range from partnerships with other community organizations such as Sharp’s with the Coronado Yacht Club and Cortez Racing Association to benefit hospice construction, UCSD’s mobile eye clinic, Kaiser’s cash support of groups such as the Coalition of Neighborhood Councils and Scripps’ leadership in preparing to manage health care following a disaster.

Taking Care Around The Globe

Scripps Hospital Foundation offerings include healthy cooking classes, senior driving classes and mobile medical screenings. Yet this gives insight to what the major medical provider does for its community.

One example is the Scripps Graduate Medical Education program that, through Scripps Green Hospital and Scripps Clinic, provides care to homeless clients who receive services at St. Vincent de Paul Village. The effort began in 1998 when Dr. Stanley Freedman, former director of the Internal Medicine Residency Program, reflected on the residents’ experiences at Green Hospital. He and the residents concluded that Green demographics didn’t provide residents with a broad enough cross-section of society.

“A significant portion of our patient population is middle to upper class,” says Dr. Parham Khanbolooki, chief resident of the Internal Medicine Residency Program at Scripps Hospital in La Jolla. “This (program) gives us a chance to work with individuals from a different socio-economic background. We diversify the patient care we are exposed to. I think it’s good. Disease doesn’t discriminate based on how much money you make or where you live. At the same time, it is good to be diversified in terms of the patient population you work with.”

From treating hypertension to diabetes to pneumonia, the medical program is a combination urgent care clinic and outpatient medical clinic. “The volunteers that work at St. Vincent’s allow patients who otherwise would not have access to medical care to have access,” says Khanbolooki. “I think all individuals, regardless of socio-economic background, deserve medical care. This is a good way of giving back to the community.”

Supplies and prescription drugs are provided to the clinics from outside sources including hospitals and pharmacies.

In 2006, Scripps contributions to community benefit programs and services totaled $214 million. “Our core mission is delivery of health care services,” says Scripps CEO Chris Van Gorder. “And doing what we can within our resources to meet the unmet health care needs of this community.” The most dollars contributed are for charity care. Hospitals with emergency rooms must take care of anyone who shows up regardless of ability to pay. “If we find out people are within certain percentages of the poverty level,” Van Gorder says, “in many cases, we don’t even send them a bill.”

Volunteers Provide Relief

Along with institutional programs, staff at Scripps is encouraged to volunteer their medical expertise around the world, including such programs as the Scripps Health-Fiji Alliance project, through which physicians provide medical and surgical services in Fiji; or by participating in the American Heart Walk to raise research funds. Leading by example is Van Gorder. An avid volunteer with the Sheriff’s Department’s search and rescue team and a CPR instructor for the Red Cross, Van Gorder has parlayed his personal commitment into hospital programs that respond to nationwide crises.

“We are being perceived as a leader in that area across the country,” Van Gorder says. “The surgeon general, after Katrina hit, asked us to send our medical response team.”

Scripps participated in Katrina relief efforts in Houston during September and October 2005, providing more than 4,000 staff hours and 2,000 physician hours to serve nearly 5,000 patients. Also, as a commissioner for the Emergency Medical Services Authority (another volunteer position) Van Gorder understands disaster preparedness at the state level.

This month, Scripps will be part of the state’s test of a Hospital Administrative Support Unit, a concept where a health care system provides the administrative team to operate a mobile disaster hospital. In the Aug. 25 statewide drill, Van Gorder and his staff will be the administrative team. “We will have 10 to 15 administrative people doing everything from medical records coordination to the volunteer coordination to the medical leadership in this drill. It is our intention to volunteer our people, in the event of a disaster, to operate this hospital in two 12-hour shifts.” Staff would have to balance the day-to-day operations of the Scripps system as well as the mobile hospital.

Other Scripps programs and staff support medical education in high schools, drive a mobile medical unit around San Diego and volunteer with schools in literacy programs and at chemical dependency programs.

Another small piece of the large effort is Scripps’ Promotoras program, a breast cancer outreach to the Hispanic community. Promotoras are community health workers on staff at Scripps to help bridge access to care for early breast cancer detection. Directed by Kendra Brandstein and funded through the San Diego affiliate of the Susan G. Komen Breast Cancer Foundation, this program sends bilingual women to speak with women about the importance of early screening and direct them to community clinics. “We, at the hospital, see large numbers of late-stage breast cancer in the community,” Brandstein says, “making it even more important to continue our work.”

Just blocks away from Scripps Mercy in South County is the Chula Vista Well Being Center. The center offers support groups, senior activities, birthing classes, specialists’ talks and health career development. External funding sources include Komen and San Diego Border Health Education Center. It is one of several such Scripps centers throughout the county.

Money Makes A Difference

Last year, Kaiser Permanente gave $1.9 million in grants to San Diego organizations. “A good chunk of that went to community health centers in the county, which care for the uninsured on an outpatient basis,” says Diane Strum, director of government and community relations for Kaiser in San Diego. Other community organizations funded by Kaiser include San Diego Neighborhood Funders and the Coalition of Neighborhood Councils.

Reaching outside its membership base, Kaiser provides community services for low-income and underinsured patients. The hospital participates in community education, prevention, detection and treatment programs including the American Cancer Society, Y-Me San Diego, Clinical Trials and Cancer Registry.

Cal State San Marcos received funds from Kaiser to bolster and expand access to its nursing school. “We are involved with the community college district and various hospital collaboratives to do what we can to fund either faculty positions or provide funds for weekend nursing programs to accommodate more nursing students because of the shortages,” Strum says. Sharp, Scripps and UCSD work together to finance SDSU faculty for nursing programs. “There is a common interest and most of the health systems in San Diego County are doing something to try and open up slots for nursing students,” Strum says.

Kaiser is a hospital and a health plan, Strum explains. “The money we give comes from premium dollars,” she says. Sponsorship funding includes the MAAC Project, the Mental Health Association and the Diversity Gala at SDSU to raise money for scholarships.

“The philosophy (behind Kaiser’s community involvement) stems from what we perceive to be a social mission and our value systems,” Strum says. “Providing service to our members and contributing to the communities in which we provide services has been, since the inception of Kaiser Permanente, part of our value system. As the years have gone on, we’ve done more and more. Within the last 20 years we’ve seen a big jump as our revenues and memberships have grown.”

Programs Take Care To The Public

‘The goal is to help one person at a time,’ says Dr. Ellen Beck, cofounder of the Student-Run Free Clinic Project. (photo/lambertphoto.com)

Mobility is key to these programs. Taking medicine to where it is needed is a big part of the outreach. As a teaching hospital, UCSD Medical Center has the benefit of student and new doctor enthusiasm. As young adults who want to cure the world, these doctors are making their own dreams reality by taking their medicine to student-run clinics in church basements and school rooms.

Dr. Ellen Beck is a cofounder of the Student-Run Free Clinic Project, developed about 10 years ago. “The students had a dream of starting a free clinic or somehow serving the underserved,” Beck says. “We realized you didn’t need a building, what you needed is a good community partner. If we could identify one already doing work, we could offer some clinical services to strengthen their effort.” The professor and her students approached Harvest for the Hungry in Pacific Beach and offered medical services in addition to the meals being served in a church. “It went very well,” she says. “There were far more students than we knew what to do with. We have an empowerment model: The goal is help one person at a time take charge of their life and achieve well-being.”

Making Them See Better

Rolling out vision care to preschool children is UCSD’s Department of Ophthalmology EyeMobile, which makes rounds every school day year-round. More than 55,000 low-income children have been screened and 12,000 visit the EyeMobile at 190 locations throughout the county during the year. “Our goal is to provide a model community program for assuring that little children have the vision needed for success in school and in life,” says Barbara Brody, clinical professor in the department of ophthalmology and family and preventative medicine. “This is a partnership between UCSD and the community that has been in existence for five years. We are working now to ensure the program’s funding for the next five years.”

The vision program began with a concern about preventing amblyopia, commonly called “lazy eye.” When caught early, the condition many times can be treated with glasses and cured. Funded through community foundations and donations, today’s expanded program screens everybody in community partners’ low-income preschools. Glasses are provided and follow-ups are done to ensure the child is wearing the glasses. Brody’s tales of success include one little boy who never participated in class. “He stayed on the outskirts,” Brody says. “He was found to need glasses and with them he became a full participant in the classroom.” Another story is of a young girl who was so enthralled with the vision her new glasses gave her that she wouldn’t take them off in order to nap. The situation was resolved with the gift of a case that allowed the girl to hold her glasses during her nap.

UCSD Stroke Experts On Call

Dr. Thomas Hemmen says UCSD can provide stroke care within 20 minutes of notification. (photo/lambertphoto.com)

Also mobile, the UCSD Stroke Center makes available its staff and expertise to the community. A stroke typically must be treated within three hours to benefit the patient. Thomas Hemmen, assistant professor in the department of neurosciences at UCSD, says acute strokes are not very common and it is not financially viable for most hospitals to pay for full-time staff to treat a still under-recognized problem. UCSD’s center makes available to area hospitals its five stroke specialists along with two fellows and a neurologist. It is their intent to provide care throughout the county within 20 minutes of notification. For hospitals in El Centro and Brawley, they created telemedicine, through which the attending physician can provide care via video link.

The original intent of the Stroke Center was to provide a center of excellent education. When it became the only place in town to provide acute care, UCSD enhanced its services.