Children had long wait times for appointments for initial assessment in behavioral health clinics in San Bernardino. It was brought to my attention when I had a family member who needed services quickly. There were efficient teams, but they were overwhelmed with the adult population, substance use disorder recovery services, and other programs within the clinic. I was not sure how to address this until I did those interviews with other stakeholders and realized there was an opportunity to build a children’s wellness center separate from our regular behavioral health clinics.

In 2021, direct care staff turnover in our agency was close to 35%. We are a treatment foster family agency and residential therapeutic program for youth and families impacted by the child welfare and juvenile justice systems. In a field where stability and consistency of healthy relationships is vital to the success of our clients, this was a crisis.

Imagine an under-resourced place in East San Jose where Vietnamese immigrants live with significant health and social disparities. The community is painfully aware that due to legacy of war, political persecution, and mass displacement, they have been through significant multigenerational trauma. They prioritized and advocated for the building of a trusted place where they can receive mental health services in their own language or through an interpreter that they trust.

As the population ages, we see many senior parents moving in with their adult children and grandchildren. Many of these caregivers need to work outside of the home, which leaves the seniors alone and unprotected. There are daytime options for supervised care, but Symphonie is an Adult Day Health Care (ADHC) center with an increased emphasis on quality and high-value care. Adult Day Health Centers provide supervised low acuity health care during the day which helps to lower rates of institutionalization. Symphonie provides care to both the special needs adult, but also to caregivers.

Nationwide, Black patients who are admitted to the hospital experience disparities in pain management, patient communication, length of stay, and readmission rates. This disparity is seen at UCSF Health, where black inpatients have lower patient communication scores, higher lengths of stay in the hospital, and higher readmission rates than the rest of the patient population. In addition, there is limited engagement and input from community members in the care that hospitalized patients receive at UCSF Health.

Central City Community Health Center, Inc. is a federally qualified health center that relies on 340B savings to supplement our care to the uninsured and underinsured communities we serve. Unfortunately, our 340B program has never been optimized to fully realize the full benefits of the program. In 2021, we were experiencing multiple organizational barriers including lack of 340B program awareness among our staff, not capturing savings from providers we refer our patients to, and many missed opportunities that led to potentially millions of dollars being left on the table.

The City of Compton, California and community of North Long Beach, California continue to experience extraordinary barriers to lifesaving medical care. With the highest rates of maternal mortality, infant mortality, and homicide in Los Angeles County, these areas lack essential lifesaving medical services including, a high-risk hospital-based birthing center, a neonatal intensive care unit, and a level-one trauma center.

As the largest health care profession, the nursing workforce is a major contributor for improved health outcomes and enhancement of the patient care experience. Despite our diverse patient population, this is not reflected in the racial and ethnic composition of the California nursing. workforce, resulting in concerns for cultural and linguistic congruency. Focus should center on upstream factors driving workforce inequities, which include lower rates of retention and graduation. among under resourced minority students in health care professional programs, including nursing. and medicine.