Graduate Bryanna Samborski Making Specialty Healthcare a Reality for Underserved
Due to the ongoing efforts by Redwood Community Health Coalition, nearly one out of every five residents in the Marin, Napa, Sonoma and Yolo Counties have access to patient-centered primary care through its health centers. Sixty percent of those patients have incomes below the Federal Poverty Level and close to 25 percent are uninsured. Couple that with the recent passing of California Bill SB 10 (which allows immigrants living in California illegally to be able to buy insurance through the state health exchange), the coalition has a very large population who needs its services.
The nonprofit works with a network of 13 federally qualified community health centers in more than 40 sites, providing infrastructure, expertise and program support. For 2015 OOMPH graduate Bryanna Samborski—and now population health coordinator at the nonprofit—her mission is to close the gap between specialty healthcare services and access, specifically for the Medi-Cal and underinsured populations.
“Our patients have all the access they need to primary care, but what happens if our primary care physician has a question about speciality care, doesn’t feel comfortable prescribing certain medications?” Samborski muses. “These physicians don’t have the same options as those who work in a hospital or an integrated care organization.”
In order to bring specialty care to these underserved populations, numerous parties need to agree on the logistics. Working on a grant through Partnership Health Plan to improve this access, step one is holding a visioning session, led by the Center for Care Innovations. “We’re going to bring everyone together,” Samborski says. “One person from each health center, patients, referral coordinators, different front-line staff. We’ll learn about potential pilots that we can start next year. Centers and personnel are receptive to these changes; everybody wants to fix this. The only issue is that because of the Affordable Care Act and other QIP measures and quality measures, there’s a lot on everyone’s plate. It’s all about how we can collaborate together because there’s more power when we work together. The people we work with obviously care about the underserved, the poor, the downtrodden. But steering the focus can be challenging because there’s so many things they have to worry about, including their own primary-care measures.”
It’s all about how we can collaborate together because there’s more power when we work together.
As Samborski is imagining what those pilot programs could be—whether it’s launching e-consults or developing centralized hub clinics where specialists can work out of—she continues to draw upon the knowledge and skills gained from completing the OOMPH program. We recently sat down with Samborski at the coalition’s office to learn about her OOMPH experience.
What brought you to OOMPH?
I graduated from SF State with a bachelor’s in nutrition. I was working toward being a registered dietician by doing an internship after my undergrad, which is really difficult to do. I wanted a master’s degree but was nervous about getting one in nutrition because it’s too specific; there’s only so many things you can do with that. I thought public health has more options, different things to learn. So I applied and got accepted! I didn’t know I wanted to do public health, but once I started I really loved it. That was more of the direction I wanted to go rather than just work in a hospital.
Did you continue to pursue the internship?
When I started OOMPH, I got accepted to do my internship to be a registered dietician, which I did in New Orleans. I worked in a hospital, a school, a community center because you have to do your rotations at different sites. Afterward, I worked at Oshner Hospital in Louisiana and St. Bernard Parish Hospital, where I set up their outpatient diet education.
So you were doing your internship while studying in OOMPH?
A huge chunk of my internship was about community outreach and involvement, a lot of which was about managing a program and time. I would go into work each day, and say, “This is what I learned at school yesterday.” Especially in New Orleans: I was learning about social class, racism, gender inequality and how that affects daily life. This is what I loved about OOMPH: I was able to pick all my projects and make them nutrition-based. For example, during one project I focused on the New Orlean’s population while I was there and that was great.
Also, the online format worked really well for me! I just came home for the on-campus weeks. Collaborating with my classmates was easy: We’re all on different time zones—Dubai or England, for example—so it worked well. I don’t think I would have been able to get my master’s had it not been online.
Where do you see public health heading in the next five years?
Better access. We have #healthcareforall, and we spend a lot of time telling people, “You qualify. You can get healthcare.” I see more collaboration and more sharing of knowledge and resources. People getting together and trying to do what’s best for people rather than profit. That’s what we already do, but doing more of it.