2014 Annual Report
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Our Vision for Patients Educated, engaged and empowered patients actively managing their health and becoming advocates for healthy living within their family and the community, inspiring others to value that good health is true wealth.
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2014 Annual Report
- 1. ANNUAL REPORT 2014 Thank you for suppor ng our future
- 2. To improve the health of the community by providing culturally sensitive, integrated primary and preventative health care to all, regardless of ability to pay or immigration status, and collaborating with community partners to address the social determinants of health. BOARD OF DIRECTORS • Julio Garcia, Chair Program Director, Nuestra Casa • Melieni Talakai, Vice-Chair Staff Nurse, San Mateo County Mobile Clinic • Karen Hernandez, Treasurer Senior Data Analyst, Santa Clara University • Jonathan Lindeke, Secretary Attorney-at-law • Marisela Alvarez Associate Teacher, Peninsula Family Services • Nancy Alvarez Parent Involvement, Cesar Chavez/Green Oaks Academy • Adrian Amaral Operations Manager & Volunteer Coordinator, East Palo Alto Tennis & Tutoring • Manuel Arteaga Social Worker, San Mateo County Child Support Services • Vernal Bailey Community Advocate • Karen Blackwell Community Advocate, Human Resource Consultant • Marcelline Combs Community Advocate • Senseria Conley Community Advocate • Siteri Maravou President, Ultimate Homecare Services • Elizabeth Sosa BA Candidate at Canada College • Raymond Mills, Board Liaison Executive Director, Voices of Recovery • Sherri Sager, Board Liaison Chief Government Relations Officer, LPCH ADVISORY COUNCIL • Patricia Bresee, Chair Commissioner, Superior Court of San Mateo County (ret.) • Maya Altman Executive Director, Health Plan of San Mateo • Greg Avis Founding Managing Director, Summit Partners • Caretha Coleman Principal, Coleman Consulting • Christopher G. Dawes President & CEO, Lucile Packard Children’s Hospital • Greg Gallo Partner, DLA Piper • Rose Jacobs Gibson Former San Mateo County Supervisor • Lily Hurlimann Health Systems Consultant • Dr. Ross Jaffe Managing Director, Versant Ventures • Jim Koshland Partner, DLA Piper • Dr. Phil Lee Faculty, UCSF and former Assistant Secretary of Health, Clinton administration • Dr. Richard Levy CEO, Varian Medical Systems (ret.) • Gordon Russell Partner, Sequoia Capital (ret.) • John A. Sobrato Founder & Principal, Sobrato Organization • Dr. Fred St.Goar Cardiologist – Director, Fogarty institute for Innovation • Jane Williams CEO, Sand Hill Global Advisors Our presence and our work demonstrate a commitment to the idea of equity, not as an abstraction, but as something that has to do directly with the lives of the people we work with. Built on Bedrock: Our Mission —Jack Geiger, MD, founder of Community Health Center movement Michelle Falise, Graphic Designer Federica Armstrong, Photographer
- 3. “Beau ful” “Le wai ng” “Quick” “Organized” Dear Friends, January 2014 opened with a groundbreaking ceremony attended by Congresswomen Jackie Speier and Anna Eshoo and our key advisors and supporters. Rudolph & Sletten’s team swung into action and within 14 months built our new health home that more than doubles our capacity. Finally, we have space to spare in a beautiful new health center. We designed with the goal of improving every aspect of the patient experience—reducing wait times, bringing key services together under one roof including pharmacy, radiology and optometry, and providing an attractive environment that honors the diversity of our patients. Seeing the faces of the patients as they streamed into the lobby the first day was exhilarating and hearing their remarks confirmed that we hit the mark! Our mission is the same but the systems and resources we have put together has turned Ravenswood into a sophisticated primary care organization that is constantly transforming itself in response to the needs of our patients and the fundamental changes in health care itself. But collectively, we are committed to equity in health care and motivated by compassion for people. I’m reminded of a remark by Congressman Elijah Cummings of Maryland when he spoke to community health center leaders that “We hold responsibility to be witness to the pain in our communities… You have to be the interpreter of that pain. We change the trajectory of people’s destiny.” We present this annual report with gratitude to all who have supported us. Luisa Buada, RN, MPH CEO, Ravenswood Family Health Center
- 4. STRATEGIC OBJECTIVES Empowering team care It takes a savvy team to motivate patients to improve their health. Building skills and confidence at every level is a priority. In the new health center, each department has a team-room where provider, health coach and medical assistants work side-by-side. Staff training is reinforced by testing retention. Ravenswood is ahead of the curve in fostering inter-professional collaboration in team-based care with the goal of enabling each team member to understand the value they contribute. Harnessing technology to improve the system of care, Ravenswood uses data-driven applications, information technology and evidence-based measures to improve processes and outcomes of care. Our Decision Support team can mine data to meet a myriad of report requirements from government and private funders. Providing cost effective, affordable care is a balance of organizational productivity, managing a sustainable payor mix and cultivating donor engagement by successfully conveying the reality of community needs. “It’s really all about the patient because we may only spend 4 hours a year with the patient, and the rest of the time they are making all the decisions. So we’re just acknowledging that and helping patients to make better decisions. You have to orient patients to their role so they understand that they are the only ones that can make a difference.” Educated, engaged and empowered patients actively managing their health and becoming advocates for healthy living within their family and the community, inspiring others to value that good health is true wealth. Our Vision for our patients —Chief Medical Officer, Jaime Chavarria, MD Patients are after all the ones who drive real change.
- 5. Pediatric | Women’s Health | Family Practice | Dental | Behavioral Health | Optometry | Radiology Health care for the whole Family
- 6. TRANSFORMING THE CULTURE OF CARE Our CMS Health Care Innovation project accelerated our transformation into a Patient-Centered Medical Home (PCMH) with well-trained care teams skilled in managing coordinated care for our high-risk/high cost chronic disease patients. In June 2014 the National Commission on Quality Assurance recognized Ravenswood as a Level 2 Patient-Centered Medical Home. “Creating the infrastructure was key,” says Christy Silva, Project Planning Manager.“ Now we know what a care team looks like and can see the processes and pinpoint areas that we need to improve.” Training our staff to perform at “the top of their license or certification” from provider to M.A. is primary if we are to ensure we do the best thing for the patient. THE PATIENT: AGENT OF CHANGE In promoting healthier behavior, there’s no one size that fits all when coaching patients. In a new initiative, Ravenswood is employing a screening tool to uncover a patient’s level of motivation from “No, I can’t, I won’t” to “I’m doing it”. No futile admonitions. Instead the care team customizes coaching to tip the balance towards a healthier lifestyle. The Activated Patient Teresa migrated to the U.S. from El Salvador in 2006. A health assessment found she had multiple health risks including untreated diabetes and hypertension. Her blood sugar was 380 and her combined cholesterol over 400. Medications have steadily lowered all three measures. With multiple health issues to deal with, not surprisingly she also had bouts with depression and anxiety so she was referred to our behavioral health team and met with a psychologist for 6 months. Martha Escobedo, an experienced health coach, was on Teresa’s care team. She helped Teresa make major changes to her diet. Teresa absorbed the lessons. Now whenever she shops in the market, she reads the labels before purchasing anything. She can rattle off the names of the greens she buys and how she prepares them. Vegetables are now a major part of her daily diet. She has a sense of well being these days and has gained an upper hand in managing her health. EXPANDING ACCESS TO DENTAL CARE WITH THE VIRTUAL DENTAL HOME PROGRAM With a folding dental chair, computer, portable x-ray and other equipment, RFHC’s Virtual Dental Home team of dental hygienist and assistant has been providing dental exam, cleaning and preventive care to pre-schoolers. For the past 3 years the project has been funded by First 5 San Mateo County to increase dental access in low-income communities by bringing dental care to Head Start sites, Peninsula Family Services, and recently to Puente in Pescadero. From July 2014–June 2015, a total of 230 children were treated. For most of them, it was their first dental experience, and for their parents, an opportunity to learn how to preserve the health of their children’s teeth. Notable Successes in 2014
- 7. 41,360 visits 13,573 visits 2,438 visits 6,543 enrollments Patient Profile Primary Medical Care Dental Care Behavioral Health Health Coverage Enrollment 95%are Latino, African American, or Pacific Islander 73%live at 100% of Federal Poverty Level * 40%are covered by Medi-Cal 51%are uninsured 70%are residents of East Palo Alto (28% of city’s population) 39%are pediatric patients 5%are homeless *$24,250 for family of 4 ** Percent of total number of patient diagnosed with the condition. SELECTED PRIMARY DIAGNOSES Asthma Diabetes Hypertension Overweight/Obese Depression/Mood disorders Anxiety Disorders Substance Abuse Patients 748 1,290 1,534 2,516 688 501 283 Visits 1,766 4,254 4,044 3,695 2,004 1,380 510 Percent** 6% 10% 11% 19% 5% 4% 2% SERVICES BY CATEGORY
- 8. What a difference a year makes 2014 2015 IMPROVING THE PATIENT EXPERIENCE Reduced lines and wait time • Kiosks in lobby for electronic queuing • 60 exam rooms including triage, immunization, procedure rooms Convenient access • Peery Family Pharmacy • Radiology – x-ray, ultrasound, mammography (opening Summer 2015) • Optometry Resources to promote wellness • Audio/visual system for patient education • Access to Stanford Health Library MINIMIZING ENVIRONMENTAL IMPACT Saving energy • Solar panels • Motion activated lights • 4 electric care charging stations • Bike racks for staff and patients Saving water • Low-flow faucets/toilets • Water catchment to harvest rain for landscaping
- 9. FISCAL YEAR 2013–14 Grants Contributions and donations Net Patient Service Capital Campaign All other Revenue Total 5,761,816 2,434,991 9,972,874 14,152,422 559,501 32,881,604 REVENUE Clinical Operations Resource Center Operations Development Management & General Total Expenses 13,165,022 108,501 511,405 4,618,689 18,403,617 EXPENSES Financial Summary Assets Cash Insurance/Patient Receivables Grants/Other receivables Campaign pledges Property & Equipment Other assets Total Assets Current Liabilities Long-term Liabilities Total Liabilities Net Assets Unrestricted Temporarily Restricted Total Net Assets TOTAL LIABILITIES & NET ASSETS 2014 5,597,676 975,331 2,527,643 5,443,680 12,299,570 204,895 27,048,795 3,084,418 725,000 3,809,418 13,140,570 10,098,807 23,239,377 $27,048,795 2011 899,460 832,370 1,575,242 1,352,216 5,005,006 167,150 9,831,444 1,494,480 125,000 1,619,480 5,683,248 2,528,716 8,211,964 $9,831,444 2012 2,649,243 854,455 1,581,113 802,529 5,006,737 205,889 11,099,966 1,151,803 125,000 1,276,803 6,967,734 2,855,429 9,823,163 $11,099,966 2013 222,383 1,176,881 1,532,833 1,203,875 6,431,545 211,021 10,778,538 1,892,148 125,000 2,017,148 6,848,371 1,913,019 8,761,390 $10,778,538 STATEMENT OF FINANCIAL POSITION FY 2011–2014
- 10. $5, 000,000+ Mark Zuckerberg and Priscilla Chan Health Resources and Services Administration $2,000,000-$4,999,999 Palo Alto Medical Foundation/Sutter Health Silicon Valley Community Foundation John and Susan Sobrato $1,000,000-$1,999,999 Cisco Systems David and Lucile Packard Foundation John and Jill Freidenrich Dick and Sue Levy Peery Foundation Gordon Russell and Tina McAdoo $500,000-$999,999 John and Marcia Goldman Foundation Sand Hill Foundation $250,000-$499,999 Anonymous The Avis Family Foundation Kaiser Permanente $100,000-$249,999 The Grove Foundation $50,000-$99,999 Anonymous Patricia Bresee Cassani/St. Goar Family Fund Greg and Penny Gallo Ross and Eve Jaffe Cathie and James Koshland Andrew and Judith Ann Mendelsohn Craig and Jane Williams $25,000-$49,999 Maya Altman Bothin Foundation Luisa Buada Ted and Sissy Geballe Pitch and Cathy Johnson The Joseph and Vera Long Foundation Linda and Tony Meier Randy and Julie Merk Sherri Sager Robie Spector Up to $25,000 Manuel Arteaga California Bank and Trust Jaime Chavarria Harvey Cohen Alain and Rosemary Enthoven Thomas Fogarty Rose Jacobs Gibson The Koret Foundation in Honor of John Sobrato Phil Lee Aaron and Sitara Lones O’Brien Family Charitable Trust Harlan and Rebecca Pinto Greg and Nancy Serrurier David and Barbara Slone Talakai Family Geoff and Colleen Tate $500,000+ Centers for Medicare and Medicaid Services Health Resources and Services Administration San Mateo County Health System Sequoia Healthcare District $100,000 to $499,999 First 5 San Mateo County Lucile Packard Children’s Hospital Stanford Menlo Park Surgical Hospital Sobrato Family Foundation Tipping Point Community $50,000 to $99,999 The Grove Foundation Hurlbut-Johnson Charitable Trusts Stanford Hospital and Clinics $25,000 to $49,999 Center for Care Innovations Henry Schein Laurel Foundation Leslie Family Foundation The San Francisco Foundation Stanford Graduate School of Business (via The Coulter Family Foundation & William F. Meehan III Charitable) Susan G. Komen for the Cure Foundation $10,000 to $24,999 Almanac Holiday Fund Blue Shield of California Foundation Flora Family Foundation George H. Sandy Foundation SanDisk Foundation $5,000 to $9,999 Christiana Foundation National Childern's Oral Health Foundation: America's ToothFairy $500 to $4,999 Bloomingdale's Community Health Partnership Natembea Foundation Summa Peto Foundation < Ravenswood Family Health Center Inauguration GRANTMAKERS IN 2014CAPITAL CAMPAIGN GIFTS AND COMMITMENTS
- 11. 100,000+ Anonymous $50,000 to $99,999 Gordon Russell & Tina McAdoo $10,000 to $49,999 Anonymous (2) Ross Jaffe The Ranzetta Family Charitable Fund Wells Fargo Jane Williams $5,000 to $9,999 John and Judith Doyle Donna S. Ito Randall Merk Michael S. Kenny & Company LLC Orix Foundation F. Tracy Schilling Mark Stevens Edward Storm Tosa Foundation $1,000 to $4,999 Baxter International Foundation Denis Baylor Bohannon Foundation Patricia Bresee James Pelham Burn California Healthcare Foundation Jaime Chavarria Elisa and J. Howard Clowes Frances Codispoti Community Health Partnership Elizabeth Dixon El Camino Hospital Lucille Glassman Gregory and Kelly Golub Karen Grove Pat Groves Richard Hamner Nancy Handel Kimberly Harney Alan Herzig Joel and Susan Hyatt Kurt and Sue Jaggers Frank and Ruth Lutes Duncan and Shirley Matteson Melissa McMahon Mid Peninsula Dental Society Lawrence S. and Ivonne Montes De Oca Kuechler E. Kirk Neely and Holly Myers Caroline Pease Viviana Mur and Jeffrey Peters Harlan and Rebecca Pinto Dr. Laura K. Bachrach Prober Cecil Reeves Sherri Sager Jane Farish Savage Gregory and Nancy Serrurier Silicon Valley Community Foundation Srinija Srinivasan Alexander Stepanov Wilson Sonsini Goodrich & Rosati Wayne and Cheryle Yost $500 to $999 Tom Bailard Clare Kirkconnell Barr Jane Baxter Elizabeth Bilafer John Buada Penelope Duckham Sally and Craig Falkenhagen Russell Fernald Skyles Runser, III and Hillary Glann Matthew and Connie Ives Jason Family Foundation Jewish Community Foundation Steven Alexander and Jeanette Kennedy Hewlett and Elizabeth Lee Janette Mandema Mandema Family Foundation McKesson Medical-Surgical Marshall Mohr Kevin Francis Murphy Francis Murphy National Association of Community Health Centers Eileen O'Leary Brian Quo Robert F. Sawyer Fred Schwerer Lee Shulman Lane L. Spencer Srija Srinivasan Harshal Varangaonker and Reshma Thadani The SAP Charitable Fund Tien Tran Steven Wilhelm and Carole Wunderlich Bobbie Wunsch Up to $499 Philip G. Abrahamson Rosemary V. Aguirre Douglas and Kathleen Alexander Don and Kay Alexander Audrey Alonis Anonymous (14) David J. and Joanne Arata Catherine Aries-McMillan Sackett and Associates Mark Balestra Kathleen Balestra Marilyn Balistreri James H. Baron Louie Barranco Susan M. Bartalo David Bell Vera Bennett Jeanne Bergin Anne S. Bergman Jane V. R. Bernasconi Betty Bernstein Linda Beyce Tina Bird Stuart Birger Margaret Blackford Richard D. Bland Jeffrey Bloom Seth Blumberg Susan Boiko David Oakes and Sheila Botein John M. Box Sandra & Richard Boyce John Boyle Cheryl Branco Juliet Brodie Martin Bronk Robert and Elizabeth Brown Earl and Helen Brubaker Charles and Kathi Buada Patti Anne Buada George and Judith Bulloch Robert and Lillian Burt Richard Peers and Allison Butler Joan Caldwell Mirry Capio Anne A. De Carli John Joseph Carrasco Kathleen Chang Hui Chen Dianne Child Yau Chin Jessica Chiu Jennifer Christensen Thomas and Charlotte Clinite Harvey Cohen E. John Sebes & Baraba Coll Charles & Carol Collier Marcelline Combs James Frank Cooper Beverly Wheeler Crowell Calling All Crows Paul and Anne DeCarli Peter J. Dehlinger Maia Dehlinger Ann and Ross Dehovitz Margaret E. Dennis Mary Ann Carmack & Rodney L. Derbyshire Scott and Lisa Dettmer Thomas Dewan Ricardo Diaz William Ding-Everson Lance Dixon Joseph & Mary Dooling Merlin and Sandra Dorfman Robert Dragony John C. Dusterberry Stephanie Elson Alain Enthoven William and Cheryl Fackler Frank and Jeanne Fischer Natalie Fisher Bob Flanagan Robert Foglesong Arthur D. Folker Donald and Rhonda Foote Deborah Ford-Scriba Carla Foster Theresa Foster George & Helene Fredrickson Perrin French Judith Frost Gabriel Garcia Vania Garcia Matias L. Gonzalez Nereyda Gonzalez Drew McCalley and Marilyn Green Peter and Suzanne Greenberg Richard and Lynda Greene Patricia Griffin Linda Griffin Stasia H. Grose David M. Hale David and Shirley Hammond John Harbaugh Laura Hassett Olivia Davis Hawkins Kate Haynes Henry J. Kaiser Family Foundation Peter G. and Cynthia M. Hibbard Alice Hom Gretchen W. Hoover Cortney S. and Stanford Y. Hsu Josie Huang IBM Employee Services Center Karen Inaba Stephen Ing Peter Johanson Kathleen L. Joki Julie Jomo Robert Jordan Jacqueline Kao Neale Kavanagh Karen Kavanagh Todd and Julie Kaye Lisa Keamy John T. Woodell and Kirsten Keith Kevin L. Keithley Kevin and Jeanette Kennedy Key Club at College Track Chad Kim Robert Feiner and Barbara Kirsch Susan Klinck Peter and Ann Knopf Arthur and Helena Kraemer Stuart Friedman and Cynthia Krieger Bishara Kubein Nurith Kurn Kristin Kuzma Phurpa and Sophie Ladenla Diane Lai Kristopher Larson Venny Lee Aiyana Lent Nate Levine Alan Leviton Sally Lillis Abel Rubio and Maria Lisola Harry and Carol Louchheim Charles Mack Linda MacKenzie Sanjay Makhijani Linda Maki Dmitri Manin Myldred Mann Siteri Maravou Rosa Waltzer Mass Neil Matatall Cathy Mathews John McMurtry P. Herbert Leiderman, MD Fernando S. Mendoza Douglas Menke Aida Metzenberg Stan Metzenberg Microsoft Coporation Matching Gifts Joseph Mikowicz Raymond D. Mills Edward and Sumaya Miner Larry Mishkind Vin Moffatt Anshu Mohllajee (continued on back cover) INDIVIDUAL AND CORPORATE DONATIONS IN 2014
- 12. Brian Moore Olga Moshopoulos Mark Moulton Cindy Munn Sandy Napel Richard Nasca Peter and Elizabeth Neumann Christina Ng Heather Nichols Lucille Nilmeyer James Nisbet Roland Hsu and Julia Noblitt Duane Bay and Barbara Noparstak Robert T. Nurisso Luther and Carol Orton Patricia O'Shea Carbery O'Shea Anna Ostrom Ruth Owen Ana Pagan Jacqueline M. Palacios Jean Parmelee G. Lyndall Parsons Ramesh C. Patel Jane M. Paulson Eric Anders Pedersen Paul Perret Hongdu Ly and Duyen Pham Richard Pollak Deburah Powers Angela Rajagopalan Patricia Ratto Jan Reed Richard Simpson and Ann Reisenauer Eleanor Rhoades Cookie Ridolfi Barbara Riper John Hornberger and Mary Anne Rodgers Ron and Judith Romines Genevieve Rosol Diana Ru Peter Rudd Corrine and Timothy Ruschin Robert A. Russo Gary Sanders Martin Schiffenbauer Jessie G. Schilling Joseph Schwartz Thomas C. Schwartzburg Franco Sechi Robyn Setzen John and Pamela Shannon Sydney Sharples Barry Sharrow David Shawver Jerry Shefren Esther Shih Carol Simone Bindya Singh Henry Sipma C. Sismone Jane H. Slauson David and Barbara Slone McKay Sohlberg Michael R. Jacobson & Trine J. Sorensen Geetha Srikantan Saroja Srinivasan William and Dana Starling Craig Stephens Laura Stern Douglas Stevens David Flamm and Margaret Stevenson Jan Swan Melieni Talakai Dr. Joan Talbert Annie L. Tate Raj Thadani Lewis and Patricia Thomas Barbara Towner-Winchester Quynh Tran Carmel Triska Mahender and Shyama Mohallajee Ttee Carolyn Tucher Christopher Uhler Isabel Valdes Brian K. Visitacion Vivian G. Walker Leonie Walker Terri Watters Roger and Trish Way Cynthia Welson Holly Welstein Cindy Welton James P. Wiggins Lucie Williams Thomasyne Lightfoote Wilson Troy Winkles Janice Lowe & Paul Wise Irving W. Wolf Deborah Wright Henry and Rita Wu Justin Wu Shih Wu Connie Wu Edmond Yau Darren Yee Simon Yen Henry Yen Kimberly Young Robert English and Anna M. Zara Leslie and Marilyn Zatz Marilyn Zatz June Zhang Joseph Ziony Carol and Ronald Zuckerman Thanks for your support! INDIVIDUAL AND CORPORATE DONATIONS IN 2014 (Continued from interior)