Position: PACE Medical Director Organization: North East Medical Services Location: San Francisco, California Reporting Relationship: The PACE Medical Director reports to the Chief Operating Officer, Diana Kawasaki-Yee Website: https://www.nems.org/
The Opportunity North East Medical Services (NEMS), one of the largest community health centers in the country targeting the medically underserved Asian population, has initiated a nationwide search for an outstanding physician leader to serve as its Founding PACE Medical Director. The organization is expanding its service footprint by offering a Program of All-Inclusive Care for the Elderly (PACE) beginning January 1, 2021. NEMS PACE will fulfill a growing need in the community by providing a nationally recognized model of care aimed at helping seniors stay within their homes and community as long as possible with dignity and grace.
Reporting to the Chief Operating Officer, the PACE Medical Director is responsible for developing a transformative vision of improved healthcare for participants, collaborating with an interdisciplinary team of caregivers, investing in team development and education across all levels, and striving for a high level of participant satisfaction. S/he will be a key member of the senior management team and will participate in the strategy to achieve overall program goals of growth, financial performance, quality and medical management, and service to the community.
Organization Background/Culture North East Medical Services (NEMS) is one of the largest community health centers in the United States targeting the medically underserved Asian population. Based in San Francisco, the non-profit community health center offers comprehensive healthcare services to a variety of patients, a majority of whom are uninsured or low-income. NEMS offers linguistically competent and culturally sensitive healthcare services in many languages and dialects, including Cantonese, Mandarin, Toishan, Vietnamese, Burmese, Korean, Spanish, and Hindi.
NEMS operates twelve clinics throughout the San Francisco Bay Area, with the main clinic located at 1520 Stockton Street in Chinatown/North Beach; seven additional clinics in San Francisco's Chinatown, Portola, Visitacion Valley, Richmond districts and Sunset districts; as well as satellite sites in Daly City and San Jose.
NEMS has over 80 healthcare providers fluent in over 15 languages and dialects who offer a range of medical specialties, including Internal Medicine, Pediatrics, Family Practice, Obstetrics/Gynecology, Dentistry, Optometry, Ophthalmology, Cardiology, and Radiology. In addition, ancillary services such as acupuncture, mental health, podiatry, nutrition, pharmacy, laboratory, and social services strengthen the quality of care that patients receive.
The unique multilingual and culturally sensitive direct service staff allows patients to adequately express themselves in a familiar environment to increase the relevancy and excellence of care they receive. Health education programs, many of which bridge the gap between Western and Asian medical practices, are available at the clinic and through weekly radio broadcasts on local Chinese media. The programs address preventative healthcare education and practices as it relates to the cultural needs of the community.
HISTORY NEMS was founded in 1968 and began serving patients in 1971 in response to the lack of adequate healthcare services for uninsured and underprivileged Asians in San Francisco, taking part in a nationwide movement to establish community-based health centers. Over the last 42 years, NEMS has grown from a small primary care clinic to a large, comprehensive healthcare organization, serving an estimated 250,000 people since its creation. NEMS became a federally qualified health center (FQHC) in 1992 and has received federal funding through the Community Health Centers (CHC) program since inception.
In 1999, NEMS formed a managed care Management Services Organization (MSO) to provide medical services for Medi-Cal, Healthy Families and Healthy Kids patients from the San Francisco Health Plan. NEMS is a major provider for the Healthy San Francisco universal health access program, serving over 25% of all program participants. To meet the growing demands for its services, NEMS opened its first satellite clinic in San Francisco’s Visitacion Valley in 2000. Additional clinics throughout San Francisco and in Daly City and San Jose followed between 2004 and 2012. Today, NEMS operates 12 clinics throughout the San Francisco Bay Area.
NEMS has a long history of collaborating with national, state, and local agencies to build a stronger health care safety net for the medically underserved population in the San Francisco Bay Area. NEMS is an active member of the California Primary Care Association (CPCA), the National Association of Community Health Centers (NACHC), and the Association of Asian Pacific Community Health Organizations (AAPCHO). In addition, NEMS has established formal collaborations with the San Francisco Department of Public Health (SFDPH) and the San Francisco Health Plan (SFHP). As one of the founding members and the largest health center in the San Francisco Community Clinic Consortium (SFCCC), NEMS collaborates with FQHCs, look-alikes, and other clinics on consortium-wide initiatives. NEMS has also worked with Self-Help for the Elderly and Mercy Housing projects including John King Senior Community and Dorothy Day Community to provide health education outreach and screenings to elderly community members. In 2017, NEMS was honored by Supervisor Sandra Fewer (oversees Richmond District (D-I)) at the San Francisco Board of Supervisor’s meeting for NEMS’ exceptional work in the community.
Due to the growing number of elderly patients at NEMS, the organization developed services for senior patients focused on improving access to medical and dental appointments and decreasing wait times to pick-up their pharmacy prescriptions. NEMS also provides care coordination through the Chronic Care Management (CCM) services for its senior patients. NEMS offers a robust health education program that is utilized by many elderly patients. In 2018, NEMS delivered over 350 workshops, classes, and presentations, including over 250 one-hour long physical activity classes. Health education workshops include a wide range of topics, varying from stroke prevention, the aging spine, age related eye disease, to drug safety and healthy eating. Recreational activities targeting those with limited mobility are also provided throughout the week, such as seat exercise, Tai Chi and cooking classes.
Total Patients: 70,095
Total Encounters: 375,558
Percent of Patients who are Uninsured: 11.6%
Percent of Patients who have Medicaid (Medi-Cal, including dual eligible): 71.6%
Percent of Patients who are 100% or below Poverty: 48.0%
Percent of Patients who are Asian: 89.5%
Percent of Patients who are Elderly (65+): 20.3%
Percent of Patients who speak little or no English: 80.9%
AWARDS AND RECOGNITION
Patient Centered Medical Home, Certificate of Recognition Level 3 Nine of NEMS’ twelve clinics have been recognized by the National Committee for Quality Assurance (NCQA) as Patient Centered Medical Homes since 2013, achieving Level 3 status in 2014. Level 3 is the highest level of recognition possible for patient-centeredness, care management, and continuous quality improvement.
Quality Improvement Award NEMS has received Quality Improvement Awards from the federal Health Resources and Services Administration (HRSA) annually since 2014. As a Health Center Quality Leader, NEMS has placed in the top 30% of the adjusted quartile rankings for Clinical Quality Measures among federally qualified health centers across the nation.
Northern California Achievement Award, 80% by 2018 Colorectal Cancer Screening Rate NEMS’ high colorectal cancer screening rates were acknowledged by the American Cancer Society at California’s Fourth Annual Colorectal Cancer Roundtable.
Latent Tuberculosis Infection, Certificate of Recognition The State of California Department of Public Health, Center for Infectious Diseases presented NEMS with a Certificate of Recognition in 2018 for substantial efforts in promoting the testing and treatment of latent tuberculosis infection.
Hep B United Champion Award NEMS' efforts to eradicated hepatitis B in Asian and Pacific Islander communities were recognized by the Centers for Disease Control (CDC) Know Hepatitis Campaign and Hep B United in 2013.
Excellence Awards, San Francisco Health Plan Since 2005, NEMS has received multiple awards for excellence for our role in the San Francisco Health Plan. These include: Award for Excellence in Quality Care (2005); Platinum Award for Excellence (2006-2007); Excellence in Health Technology (2010); Excellence in Customer Service (2012).
MISSION, VISION AND VALUES
Our Mission: To provide affordable, comprehensive, compassionate, and quality healthcare services in a linguistically competent and culturally sensitive manner to improve the health and well-being of our community. Our Vision: To be a premier community health center offering a comprehensive array of high-quality healthcare services and improving the health status of the communities we serve. Our Values:
Caring and Compassion: provide healthcare and support services focused on, determined by, and evaluated by our patients
Improved Performance: provide healthcare and support services with ever-increasing quality
Accessibility and Affordability: provide healthcare and support services that reflect the optimum opportunity for patients and meets the requirements of the funding organizations
Strong Teamwork and Creativity: among all departments and staff that demonstrate our reliance on one another to meet the needs of our patients
Rewards and Recognition: at personal and organizational levels, for individual and group contributions to the achievement of the mission, vision, and values
Ethical Practice: provide healthcare and support services that conform to the highest standards of ethical and medical practice
Financial Responsibility: provide careful management of human and fiscal resources to meet the organization's mission
ABOUT PACE The PACE model is centered on the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible. PACE is an alternative to nursing home care and – through an interdisciplinary care team (IDT) of physicians, nurse practitioners, nurses, social workers, therapists, van drivers, and aides – coordinates and provides preventive, primary, acute, and long-term care services, so older individuals can continue living in the community.
PACE began in 1971 in San Francisco as a noble idea by Dr. William Gee and social worker Marie-Louise Ansak to design a comprehensive system of health and social care that allowed people to receive care while living at home. Today, that idea has expanded into a nationally replicated, federally funded program. Currently, there are 131 PACE programs operating 260 PACE centers in 31 states helping elderly individuals maintain their independence, dignity, and quality of life.
Each PACE provider delivers a full range of health and long-term care services, including hospital, emergency, and nursing home care. Once enrolled in PACE, the amount you pay each month will not change no matter what care and services a participant might need. There is never a co-pay, deductible, or coverage gap. The program provides all the care and services covered by Medicare and Medicaid, as authorized by the interdisciplinary team, as well as additional medically necessary care and services not covered by Medicare and Medicaid.
Services Delivering all needed medical and supportive services, a PACE program is able to provide the entire continuum of care and services to seniors with chronic care needs while maintaining their independence in their home for as long as possible. Services include the following:
Primary Care (including doctor and nursing services)
Medical Specialty Services
Nursing Home Care
Adult Day Care
Laboratory / X-ray Services
Social Work Counseling
PACE also includes all other services determined necessary by a team of healthcare professionals to improve and maintain a participant’s overall health.
PACE costs significantly less than institutional care. In 2020, it is estimated California paid $68.7 million less than it would have if participants were served outside of PACE.
PACE costs 30-40% less than placement in skilled nursing facilities.
PACE keeps frail seniors in their homes and communities with high rates of satisfaction. 93% of PACE participants would recommend PACE to a close friend or relative.
PACE participants have lower rates of hospital and ER utilization than those served by other plans.
NEMS PACE NEMS has engaged key providers and community stakeholders in San Francisco to support and endorse their establishment of a PACE program to serve San Francisco. Some of the providers and community stakeholders that have provided support include:
Sutter Health California Pacific Medical Center
San Francisco Community Clinic Consortium
San Francisco Health Plan
Elected Officials (Senator Scott Wiener, Assembly Member Philip Y. Ting, and
Assembly Member David S. Chiu)
NEMS PACE offers a variety of services, with many of them provided onsite in a welcoming, bright space with beautiful greenery and artwork throughout. The newly constructed PACE Center in an area of San Francisco where approximately forty (40%) percent of the projected PACE eligibles reside, and comes equipped with its own physical therapy room, private showers with heated floors and towels, a medical clinic, a dental clinic, a kitchen where meals are served, laundry services, staff offices and a conference room. The Center can accommodate a maximum census of 160 participants and an average daily attendance of 85 participants once capacity is reached.
To qualify for NEMS PACE, an individual must:
Be 55 years of age or older
Meet the California Department of Healthcare Services (DHCS) requirement for nursing facility level of care
Be able to live safely in the community at the time of enrollment, and
Live in the City and County of San Francisco, California
Position Summary The PACE Medical Director is responsible for the management and oversight of the physicians, physician extenders, pharmacists, and other staff assigned to his/her team. The PACE Medical Director oversees the clinical care provided by the NEMS PACE program and ensures quality clinical service delivery to PACE participants. The PACE Medical Director is also responsible for overseeing clinical service contracts for the PACE program.
It is expected that the PACE Medical Director will spend approximately 50% of his/her time overseeing administrative responsibilities and the remaining 50% focused on part-time clinical practice.
Provide clinical leadership to the PACE program and participate in the development and implementation of the PACE program, including policies and procedures for clinical services and the quality improvement program (QI).
Participate in NEMS PACE short and long-range strategic-planning activities as a senior member of the program leadership team while promoting excellence in inter-professional practice, integrated medical management systems and the provision of high-quality care and service.
Supervise clinical PACE staff, including physicians, physician extenders, rehabilitation therapists, registered nurses, and other members of the clinical team.
Provide direct primary clinical care, including oversight of inpatient management, assessments, and call coverage, which will be rotated with other physicians working in PACE, as well as leading the interdisciplinary team.
Coordinate quality assurance activities including the development, implementation, and ongoing evaluation of a quality assurance plan for the program.
Ensure that clinical standards are developed, and monitoring mechanisms are established to assess the quality of care provided; care delivery is in compliance with organizational and regulatory standards and guidelines; and that the clinical competence of practitioners is maintained.
Promote NEMS PACE awareness by interacting with community groups and conducting presentations to enhance program visibility and impact.
Serve as a liaison between the program and the physician/provider community, including participation in regional or national geriatric societies.
Review all appeals and grievances.
Participate in the Quality Improvement Committee, Ethics Committee, and other work groups, as assigned.
Develop a plan of care for each patient, including complete medical history, physical examination, diagnosis, appropriate treatment and/or referral, and hospitalization when necessary.
Collaborate with a wide range of healthcare and social services staff, working together as an interdisciplinary team.
Work jointly with the PACE Program Director to develop, implement, and update policies and procedures for the medical care of PACE participants.
Work with the PACE Program Director in evaluating staffing needs as census changes.
Evaluate and assist in establishing contracts for a wide range of clinical services, including hospital, pharmacy, specialists, and nursing homes.
Oversee the utilization of inpatient, pharmaceutical, specialty, and institutional long-term care services.
Qualifications, Knowledge & Abilities Ideal candidates will have a minimum of five years as a practicing clinician and five years of physician leadership experience (i.e., Chief Medical Officer, Medical Director, or Program Director). Demonstrated experience in program development and community relations for the elderly population also preferred. This is a startup infrastructure with mature organizational resources and support, and therefore this person must demonstrate an entrepreneurial mindset as well as an ability to work across the broader organization.
Additional qualifications and characteristics include:
Knowledge of principles and practices of healthcare administration; experience leading multi-disciplinary clinical initiatives.
Advanced analytical and communication skills necessary to organize, plan, lead and manage a growing clinical enterprise.
Well-versed in industry and professional standards of healthcare, utilization management, quality improvement, and other medical management functions.
A demonstrated record of relationship building and positive collaboration with senior executives, medical staff and other caregivers in a diverse clinical setting.
Passion for developing and managing high performing teams.
An even keeled individual able to balance multiple tasks in accordance with changing deadlines and priorities in a fast-paced environment.
Embraces the organization's mission, vision and values and demonstrates a customer-centric approach when interacting with colleagues, participants, members of the community and other key stakeholders.
Proven ability to work sensitively and effectively with individuals of diverse ethnic and cultural backgrounds.
Education and Training
Graduate of an accredited School of Medicine.
Valid M.D. or D.O. license, in good standing, to practice medicine in the State of California.
Board certified Geriatrician strongly preferred.
Knowledge of geriatric medicine and special needs of complex geriatric patients.
Must be able to fluently speak, read and write English.