Several Sacramento-area community clinics are working to integrate tobacco cessation support for patients, thanks to efforts by UC Davis Health tobacco researcher and physician Elisa Tong and CA Quits, an outreach project created with a $6 million California Tobacco Control Program award.
Launched in fall 2018, the 5-year CA Quits will assist safety-net health systems with integration of tobacco treatment services. California has more than three million people who still smoke, and California’s Medicaid program (Medi-Cal) covers 40% of the state’s smokers.
CA Quits builds on UC Quits, another project led by Tong that enabled all five UC Health systems to collaborate on tobacco treatment workflows. Since its launch, UC Quits has referred over 13,000 patients, including over 2,500 from UC Davis, to the California Smokers’ Helpline, which provides free help that can double the chances of a smoker quitting.
“One of the best aspects of UC Quits has been sharing across institutions how we can better help our patients who use or are exposed to tobacco,” said Tong. “It’s a natural step for us to grow into CA Quits and extend this learning collaborative approach with other health systems across the state.”
The CA Quits team is creating tobacco-topic “learning collaboratives” for safety-net clinic systems. The collaboratives will meet monthly and engage clinic personnel in discussions about how they can assess tobacco use, integrate evidence-based tobacco treatment, and improve quality performance. Safety-net public hospital clinics, including UC Davis Health, have been participating in an ongoing learning collaborative for the California Department of Health Care Services’ (DHCS) Public Hospital Redesign and Incentives in Medi-Cal (PRIME) program.
Sacramento area clinics will be involved in the first statewide learning collaborative for community clinics including CommuniCare Health Centers, One Community Health, Wellspace Health, Elica Health Centers and the Sacramento County Health Center. This also presents an educational opportunity for trainees; Kishor Kapa, a second-year UC Davis Internal Medicine resident, will join the collaborative as part of his scholarly project work.
Tong engaged the local community clinics in January to discuss the importance of tobacco treatment among the Medi-Cal population at the Sacramento Right Care Initiative meeting, which promotes cardiovascular health evidence-based practices. This first Sacramento-area meeting on tobacco treatment also included the Sacramento County Tobacco Education Program and new Oral Health program. The CA Quits team has also provided follow-up technical assistance and training with HALO clinic, in conjunction with the UC Davis Comprehensive Cancer Center’s Office of Community Outreach and Engagement, and the Sacramento Native American Health Center.
CA Quits also is establishing a learning collaborative for Medi-Cal managed care plans, which cover 80 percent of the Medi-Cal population, to implement evidence-based guidelines for tobacco treatment and promotion. Last fall, the CA Quits team worked with Molina Healthcare, a Medi-Cal managed care plan, to promote the California Smokers’ Helpline to 11,000 members who smoke with COPD or diabetes.
“The vision for CA Quits is to start building an integrated health system support for tobacco treatment that triangulates providers, plans and public health partners including the free California Smokers’ Helpline,” Tong said.
Other UC Davis faculty members on the CA Quits team are Ulfat Shaikh in the Department of Pediatrics, Bimla Schwarz in the Department of Internal Medicine and Patrick Romano in the departments of Internal Medicine and Pediatrics. Angela (Jackie) Kaslow is the project operations director working with the CA Quits outreach staff.