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  • Chapa-De fills major need in area

    Health care centers seeing 24,000 low-income patients

     Andrew Wedgbury

    Nevada City Advocate

    Finding affordable health care has been an ongoing challenge for many area residents. Many go without care because of the cost. 

    With the advent of the Affordable Care Act and California’s Medi-Cal expansion, low-income patients may have modest means to pay for services, but they face the challenge of finding health care providers in the area. This is where Chapa-De Indian Health has stepped in with facilities in Grass Valley and Auburn.

    Originally established for American Indian and Alaska Native people by the United Auburn Indian Community, the organization also offers health care services to non-Indian, low-income families and individuals and Medicare recipients in Placer, Nevada and Sierra counties. 

    The Grass Valley facility was built in 2008 and is located on East Main Street. Its unique architecture reflects the traditional “Roundhouse” shape, with an entrance oriented due East to catch the spirit of the rising sun. Patients can find a full array of services ranging from dental and optometry to behavioral health and pharmacy services.

    “The Roundhouse was the social and spiritual center of the community,” said Lisa Davies, chief executive officer of the Grass Valley facility. “When our architect and former CEO got together, they intentionally designed it as a Roundhouse, which we call pods.

    “Our previous CEO, Carol Ervin, was with the organization for 25 years, and this clinic was kind of her legacy,” she added. “So much detail went into this building … and we want it to be as welcoming as possible.” 

    Davies, who has been CEO since 2010, started at Chapa-De in 2002 as a compliance director. Chapa-De was founded in 1974.

    A study was done in the late 1960s and early 70s by the state that evaluated health care for American Indians in California. One of the big things it learned was that many people on Rancherias had had never been to a dentist, Davies said. 

    The study also revealed a higher incidence of diabetes, depression and substance abuse, as well as higher rates of infant mortality. Davies said the American Indian community then came together and applied for federal and state grant funding. 

    “A group of American Indians in Auburn, who later became the United Auburn Indian Community, got together and opened a part-time dental office with one dental chair. Those were our beginnings,” she said.

    Today, Chapa-De’s two private, non-profit community health centers serve more than 24,000 patients, with about 29 percent being American Indian. 

    “In 2012, our board looked out and saw the Affordable Care Act coming and looked at our communities and saw a population of Medi-Cal patients of maybe 30,000 or 40,000,” Davies said. “And there are few providers that take Medi-Cal.” 

    The board, she said, decided to “expand to meet the need. So that’s what we did. We changed our practices and have expanded to about 230 employees between the two centers.”

    Medical Director Dr. Tracy Thompson has been with the organization for over a year. She previously served for more than 20 years in several clinical facilities for the Cherokee Nation in Oklahoma. He said that Chapa-De focuses on an integrated patient-centered model that stresses not only medical care but preventive health education, from pre-natal to older patients. 

    “Whenever patients come in for their visits, such as child visits, along with their treatments we give the parents information about diet, safety and what they can do at home. It really starts with our pre-natal program and continues on through childhood,” Dr. Thompson said. “As we age, and you continue to see us, we are on that journey with care and education.”

    Davies said that there is team approach to preventive care and treatment in healthy eating, smoking cessation, behavioral health, diabetic education and treatment, and opioid abuse. 

    “There is a major opiate problem in Nevada County, and we have two programs that address that,” Davies said. “One is called PACE, and it’s a program for people who have been prescribed opiates. They go through that program first, learning strategies to manage pain. An adjunct to that is the use of buprenorphine for managing pain. It’s a replacement to help folks get off opiates. We have a whole program for that and it’s pretty intense, with classes managed by an RN.”

    The biggest treatment challenge coming through the door, however, remains related to diabetes. 

    “It’s so rampant, and it’s related to our population being overweight,” Dr. Thompson said. “You could almost call it the silent killer, because many people don’t know they have it.” 

    Mental health is also an ongoing problem. 

    “We do have a psychiatrist at this facility, and therapists also, but I think it’s such a problem because people don’t want to talk about it, it’s kind of a taboo subject,” he said.

    Working as a team, Davies said doctors and therapists talk to each other and make recommendations for patients. The facility also limits its provider load to 16 patients per day, so more time can be spent with patients.

    “There’s a famous saying that the ideal health care system is not one that profits from the patients, but connects with them,” Davies said. “And that’s totally what we are after here."

    About the photo:   

    Dr. Tracy Thompson and CEO Lisa Davies of Chapa-De Indian Health, which has facilities in Grass Valley and Auburn.