Timely access to specialty care is a significant and growing challenge for low-income Californians who depend on safety-net institutions--public hospitals and community clinics and health centers--for their healthcare. To better understand the size and causes of the problem, as well as to encourage effective solutions, Kaiser Permanente Northern and Southern California Regions' Community Benefit Programs partnered with the California Association of Public Hospitals (CAPH) and the California Primary Care Association (CPCA) in 2006 to examine specialty care access for uninsured and Medi-Cal populations. Project activities included a statewide survey of safety-net providers, discussion papers, roundtable forums, and technical assistance teleconferences. Then, in 2007 Kaiser Permanente Community Benefit and the California HealthCare Foundation (CHCF) came together to fund 28 planning grants and 23 implementation grants to regional provider coalitions across California to identify local barriers to care and develop strategies to improve access. Implementation projects began in early 2009. The work has focused on three areas: the demographics of specialty care for California's underserved; the size and scope of access problems; and the cultivation of innovative strategies to improve access and manage demand. The purpose of this report is to share findings from these activities with a broad audience.
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