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Welcome PRIME Projects

Written by Naishadh Buch, PharmD on in LVMC News

Lindsey Arevalos, a 2007 Lompoc High School graduate, is the project coordinator of LVMC’s Public Hospital Redesign and Incentives in Medi-Cal program also known as PRIME. The ve-year, multi- million dollar initiative, is part

of the Medicaid 2020 waiver approved by the Centers for Medicare and Medicaid Services on December 30th, 2015.

Lindsey Arevalos, a 2007 Lompoc High School graduate, is the project coordinator of LVMC’s Public Hospital Redesign and Incentives in Medi-Cal program also known as PRIME. The ve-year, multi- million dollar initiative, is part

of the Medicaid 2020 waiver approved by the Centers for Medicare and Medicaid Services on December 30th, 2015.

“LVMC’s overall PRIME goal is to stabilize access to medical care through the transformation of the local health care delivery system,” according to the application submitted by Arevalos, in coordination with LVMC Chief Executive Officer Jim Raggio and consultant George Koortbojian.

The PRIME program involves projects that focus on

improvements in ambulatory care for high-risk populations in efforts to improve patient care and efficiency explains Chief Operations Officer Naishadh Buch.

LVMC’s annual allocation for the PRIME program is $2.8 million for the first three years, with a slight drop off in the fourth and the fifth years.

“These projects will allow LVMC to better position itself to respond to upcoming healthcare system changes,” Buch said. “LVMC will use evidence-based quality improvement methods to achieve ambitious, year-over- year performance targets. All federal funding for this program is contingent on meeting these targets.”

Arevalos, who was born at the former hospital site, received a bachelor’s of science in nutrition and a minor in psychology from Cal Poly San Luis Obispo in 2012, and in June earned a master’s degree in agriculture with a specialization in food science and nutrition. In the fall, she plans to begin working on her second master’s degree, in healthcare administration.

She initially thought she’d be a pediatrician or a nurse. She had an opportunity to work at Lompoc Skilled Nursing, and quickly became the director of Social Services before being hired by LVMC.

“I’m doing this in the community where I was born and raised,” Arevalos said. “If I were doing it somewhere else, it wouldn’t be as meaningful.”

Outpatient Clinics

One element of PRIME are the emerging outpatient clinics under the umbrella of LVMC aimed at decreasing the number of patient transfers to hospitals out of the area and to provide a structure to retain and recruit local and new specialists

to the area, respectively. Those clinics include hematology/oncology; general surgery; Ear, Nose, Throat; orthopedics and obstetrics.

The specialty clinics are critical, Arevalos said, as certain medical specialty care has become more dif cult to access for patients, especially those with low-income. By retaining and recruiting for specialty care in the Lompoc community, patients will not have to travel out of the area to receive specialty care.

Family Caregiver Support Network

Another aspect of PRIME is a “care transitions” effort to provide post-discharge follow-up assistance for high-risk patients, including home visits and caregiver education. The post-discharge follow-up program will begin in the early fall and will be managed by the Case Management Director Jean McKinnon, who assisted with the care transitions portion of the PRIME application. The aim of the program is to prevent hospital readmissions, while also getting patients access to the necessary resources, as well as medication management

and even help at home with needs such as smoke detectors.

The LVMC Family Caregiver Support Network will enable all caregivers within the Lompoc Healthcare District to have their needs assessed and referred to the appropriate resources within the community. The center would be not only for those caring for a senior but those who are caregivers for a disabled family member, for instance.

Millian Hearts Initiative

Also under PRIME is the Center for Disease Control and Prevention’s Million Hearts Initiative, designed to prevent 1 million heart attacks and strokes by 2017. Because heart disease accounted for 25.9 percent of deaths in Santa Barbara County for 2012 (most recent statistics available) and was the leading cause of death overall in the county, this element of PRIME is critical.

The initiative will use evidence-based practices
to provide medical care and prescribe certain interventions to reduce the number of heart attacks and strokes.

Healthier Food Initiative

An obesity prevention project for PRIME includes a “Healthier Foods Initiative,” starting with including nutrition labeling at the hospital’s Ocean’s Seven Cafe; an increase in the offerings of healthy beverages and the installation of healthy food choices within 5-feet of the cashier.

Additionally, a program will be put in place to increase screening for obesity and heart disease at the hospital-based clinics.

That’s relevant, Arevalos said, because an estimated 35 percent of the children in Lompoc are overweight, which is approximately 10 percent higher than other cities in the county. In 2012, 56.5 percent of adults in the county were overweight or obese.

Arevalos finds great satisfaction in coordinating the diverse array of projects in PRIME.

“The Lompoc Healthcare District will be changing over the next ve years, and I am extremely excited to be a part of it,” Arevalos said.

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Author: Naishadh Buch, PharmD, Chief Operations Officer

Dr. Naishadh Buch, PharmD began his duties at the District in early 2010, in his current position. Dr. Buch previously served as an Intern Pharmacist for Los Angeles County-USC Medical Center in Los Angeles; Wal-Mart; Sav-On Drugs and Veteran's Administration and Kaiser Permanente Medical Centers and Scripps Mercy Hospital. From 1983-1994, Dr. Buch was an officer in the United States Marine Corps.