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A New Outlook

Will Dean

A New Outlook

For Desert Healthcare District and Foundation Director of Communications and Marketing Will Dean, it’s all about showing up.

Words by Daniel Hirsch • Photos by Lani Garfield 

As seen in Issue 4 of DAP Health Magazine

Will Dean knows how to deliver a message to people. “It’s about meeting people where they are, whether that’s in their actual workplace, like the farm fields, or in their churches,” he says. 

Meeting People Where They Are

As director of communications and marketing for the Desert Healthcare District and Foundation, Dean’s job is to raise awareness about the efforts of the District’s partners to equitably advance health and wellness throughout the Coachella Valley.

For him, meeting people where they are takes many forms. It’s in standard communications work: relaunching a website, drafting press releases, updating social media. Or it could mean promoting farmside mobile clinics to ensure agricultural workers have access to vaccines, as Dean did for the District throughout the COVID-19 pandemic.

Communication as Key to Healthcare Access

As Dean explains, health care access relies on communication — about what people needing care understand about their resources, and about what providers are able to hear from prospective patients. “Not everyone has the same opportunity to access care. There are barriers that people face, such as language barriers or lack of transportation,” he says. “Listening to people and their stories is so important to understanding why they may not seek care.”

Advocating for Equal Access

Dean’s ability to communicate on behalf of health care campaigns has benefited DAP Health. Since 1999, the nonprofit has received $3.5 million from the District’s grant program. This funding has supported everything from efforts to computerize patient records to running an HIV-testing van parked outside of gay bars.

According to former District CEO Dr. Conrado Bárzaga, Dean effectively advocates for equal access to health care because he’s committed to hearing directly from the people that benefit from it.

“He goes to the homeless encampment where we’re serving those community members… It really enhances the work, to tell the stories from a very truthful perspective,” says Bárzaga. “He’s someone who is always looking to do what’s right, to communicate in a very sensitive manner the importance of bringing equity to the distribution of health care.”

From Journalism to Healthcare Advocacy

Dean’s sensitivity for reaching people comes from a decades-long career as a journalist. It may also come from the acute understanding of the experience of not always being the recipient of the stories and media that one might want or need.

Growing up in the 1970s in Hardinsburg, Kentucky — a rural county seat with a population of roughly 2,000 people — Dean was a voracious magazine reader. He’d read anything he could grab, from Reader’s Digest to TV Guide. But as a young Black person who knew he was gay from an early age, Dean would rarely see himself reflected in the media he consumed. Copies of Jet and Ebony provided what Dean describes as “a variety of examples of Black excellence and possibility,” but finding Black LGBTQ+ stories proved harder.

The eye for good writing and deep appreciation for meaningful representation stayed with Dean throughout his journalism career, starting in his 20s at the Park City Daily News in Bowling Green, Kentucky and working for papers like the Savannah Morning News. 

After a mid-career Knight Fellowship at the University of Missouri School of Journalism, Dean landed in Palm Springs for a community editor role at Gannett daily The Desert Sun. There, he fulfilled a dream he’d had ever since he was that magazine-devouring boy: running a magazine all his own. From 2012 to 2018, he edited Desert Outlook, a monthly LGBTQ+ publication published by his employer.

“It came about because our then executive editor, Greg Burton, called all the editors into a meeting and asked us if we thought an LGBTQ+ publication would work here,” says Dean. “And, if I recall correctly, everyone said no — except me.”

Starting in 2012, Dean ran Desert Outlook with a passionate meticulousness, leading a small team of writers and designers. The monthly printed stories on same-sex marriage and the migration of HIV patients to the desert. Dean fondly remembers interviewing actor Cheyenne Jackson, who gave Dean an equally memorable muscle-bound hug. It was a public-facing role that had Dean attending events multiple times a week— restaurant openings, political gatherings, theatre premieres, and more. 

“He had high standards, and he was very conscientious about basically everything he did,” says Michael Jortner, an Outlook contributor and longtime friend of Dean. “He would be on every photo shoot to make sure it was as close to what he was looking for. And it was the same with the writers.” 

Transition to Healthcare Leadership

After Outlook published its last issue in May 2018, Dean didn’t stop to rest. He started work at the District that June. He filled a position that has made great use of his journalism skills and editorial eye, overseeing the publication of the District’s first history book — telling the story of how the foundation formed in 1948 to build Palm Springs’ first hospital, only to grow to grant $80 million to local health care nonprofits. Working with Riverside University Health System, Dean is poised to launch a public health campaign about harm reduction related to fentanyl overdosing.

The demands of Desert Outlook and the District pushed Dean to take a “social hibernation” from the arts, culture, and community events that have so defined his time in Palm Springs. (Dean has also been on the boards of various organizations, such as Dezart Performs and Brothers of the Desert.) It’s a slow-down that Dean says he’s newly emerging from. Recently, he’s worked on his own writing projects, such as contributing a profile of jazz drummer Daniel “Big Black” Ray to Palm Springs Life.

Embracing Diversity and Inclusion

Dean is also launching a new, roving social club called The Mix Palm Springs, which focuses on fostering and celebrating diversity in social spaces. A recent summer camp-themed event at resto bar Reforma featured the lawn game cornhole (AKA bean bag toss) and s’mores. “It’s highly curated at the moment,” says Dean of this new venture, which is currently open by invitation only. “But that’s also part of ensuring that people know it’s a safe, welcoming space.”

Attention to detail. Respecting people’s needs. Showing up. All in a day’s work for Will Dean.

Where Did All This Peanut Allergy Come F …

Where Did All This Peanut Allergy Come From?

Words by Ellen Bluestein

 

According to the American College of Allergy, Asthma & Immunology, as of 2017, 2.5% of children in the United States have peanut allergy. While that percentage may seem small, it translates to more than 1.8 million kids with a potentially fatal condition. 

 

“Probably about 20 years ago, it was clear that this was not only a growing problem, but it had already become a public health problem in the United States and around the world,” says Dr. Andrew Liu, a pediatric allergist at the University of Colorado. “I don’t know that we’re sure why or how peanut allergy has become so prevalent. But I think it’s pretty clear that it’s real.”

 

Researchers have been exploring several possible hypotheses. One — the hygiene theory — explores the idea that with the advent of germ-killing cleaning products, our environments no longer provide the exposure to microbes that the immune system recognizes and learns to fight off.

 

“What is a microbe-rich environment? One where we’re living around a lot of animals,” says Dr. Liu. “There have been a lot of studies where it looks like allergies are less common in kids growing up in farming environments or in developing nations where people live very closely to their animals. Some people think … that the immune system doesn’t see enough of those microbial exposures early because we’ve gone and cleaned up our environment.”

 

Early exposure to peanuts — between four and six months of age — may be one way to reduce the allergy. “The original observation was in Israel, where they had this teething cracker called Bamba which has peanut in it,” says Dr. Liu. “And they observed that within communities where this was a common cultural practice, the prevalence of peanut allergy in the kids was really low compared to what they were seeing in other communities.”

 

This led to more research and ultimately a definitive study on prevention. Children were given Bamba or a derivative, and then followed. Those who received the cracker were unlikely to develop peanut allergy compared to those who didn’t get it. “It looked like early exposure … when our bodies are learning about what is safe … is an essential time period,” says Dr. Liu. “If the immune system learns that the peanut is not something to be concerned about, then that stays.”

 

While there is still much to be discovered, Dr. Liu is optimistic that there will be remedies for those who suffer from the life-threatening condition. “There’s work going on to develop treatments to either reduce or prevent the severe reactions to those who are peanut allergic,” he says. “There continues to be investment in a lot of research … to try to get to that place where there are treatments that can be helpful for people and young kids who are allergic.”

All in the Family

All in the Family

How spouses Andy and Johnny Glorioso found themselves both working in sexual wellness at DAP Health — and loving it.

 

As seen in Issue 4 of DAP Health magazine 

 

Words by Trey Burnette • Photos by David A. Lee

 

Andy Glorioso, who’s been HIV+ since 1986, has worked in HIV/AIDS social services for 23 years. In 2018, he finished his last day of work at San Diego’s largest clinic, jumped in his packed car, and drove out to Palm Springs. The next morning, he was at his new job at DAP Health, where he currently serves as PrEP navigation manager. 

While Andy was settling into Palm Springs, Johnny was relocating from San Francisco — where he’d worked for more than two decades as an E.R./trauma nurse — to similarly create his new desert home. He first discovered the Orange Clinic (as DAP Health’s Palm Springs sexual wellness clinic is known) as a patient. He has been on PrEP for five years, and still uses the clinic for quarterly checkups. From the beginning, he loved the availability of free services and the openness of providers. 

Both men understand stigma and anxiety are intricately linked to sexual behavior and health, and that normalizing frank talk about sex and sexual wellness is the first step in caring for their respective patients. Their mission is to empower through education.

After a patient tests negative for HIV, Andy can get them started on PrEP, the pre-exposure prophylaxis that uses antiviral medications to help prevent the spread of the virus. There are a variety of drugs available — some are daily pills; another is a bimonthly injection. Using a judgment-free attitude, Andy helps patients decide which path is best for theirs needs.

Using the same “come as you are” mindset, Johnny does patients’ PrEP follow-up, testing them for HIV and sexual transmitted infections (STIs). He soothes those who test positive for either, explaining treatment of the former and quick and easy cures for the latter.

“Once they leave the clinic, we don’t know what happens,” says Andy of the patients under the men’s care. “But every once in a while, I get an email that says, ‘Thank you. My experience and the information I received was life-changing.’ Then I know what we did — what we are doing —is working.” 

Though both had a connection to DAP Health, the two first met on a dating app mere weeks after each moved to Palm Springs. Their first chat was a long one. The next night, they saw a movie. Within a few months, they’d moved in together. Marriage happened six months after that, with Andy taking Johnny’s last name.

By 2022, Johnny was working as a sexual health nurse at The Dock, as the Orange Clinic was known when it debuted within the Barbara Keller LOVE Building in 2015. The space opened its rebranded doors in the newly renovated, former county structure christened the Annette Bloch CARE Building across the way in January 2023. The sexual wellness clinic in Indio was unveiled in July 2022. The two present clinics currently serve about 1,075 patients per month. In late 2023, a third DAP Health sexual wellness clinic will open at the Stonewall Medical Center in Cathedral City.

It’s not just within the walls of DAP Health that the Gloriosos are making a difference. Part of the sexual wellness outreach team, they both participate at local events such as Pride, Leather Pride, International Bear Convergence, and White Party Palm Springs. The Orange Clinic has also partnered with several live-in rehabs in the valley, offering education and free testing.

And it’s not just at work that Andy and Johnny are peppered with questions about sexual wellness. They’re social, and people know what they do for a living, so friends and acquaintances aren’t shy about seeking professional advice, either face to face or via Facebook Messenger. The men are more than happy to bring interested parties into the DAP Health family. 

The couple loves living in Palm Springs and working at DAP Health. They were drawn to the city and the organization for their respective progressive attitudes and values. DAP Health, like the men, cares about community. They agree the nonprofit is different from any other place they’ve worked — or visited as patients. “We treat and educate people, at no cost to them, all without an ounce of shame,” says Johnny, adding that birth control, pregnancy testing, and other support services are also available. “It’s work that each of us takes to heart.”

Then there’s the fact that they’re always near each other from nine to five. “The real joy for me is seeing my husband throughout the course of the day,” says Andy. “We generally have a good time together, so we also have fun together at work.”

“Except when the natural way we relate to each other in private spills over,” adds Johnny with a wink and a smile. “To give you an example, when I was gone for a few hours recently, Andy apparently decided to clean out all of my work drawers the way he thought they should be. And when I came back, I couldn’t find anything — just like at home!”

The Science of Positivity

The Science of Positivity

“Never say never because limits, like fears, are often just an illusion.” — Michael Jordan

Words by Kay Kudukis

 

In the 1990s, a recurring skit on SNL called “Daily Affirmations with Stuart Smalley” had Al Franken portraying an insecure, support group-addicted, self-help schlub in a cardigan. He was the antithesis of the popular, flashy, mindset gurus like Tony Robbins. Stuart would frequently look at himself in the mirror and say, “I’m good enough, I’m smart enough and, doggone it, people like me.”

Although Franken was poking fun at the new fad, it wasn’t very new. Over 3,000 years ago, the Greeks were writing meditations and guidelines touting the best ways to live. The idea is actually 5,000 years old, but back then there was no alphabet, which made writing hard.

By the 1800s, poets and renowned authors were onto it, but scientists didn’t take notice until the 1970s, when they asked, “Is there anything to this?” It took a few decades, and a lot of studies, but the answer is — in wildly unscientific terms — it’s definitely a thing. Turns out, there’s true power in the science of positivity!

Yes, science. The University of Chapel Hill conducts a Positive Emotions and Psychophysiology Laboratory studying “how positive emotions affect people’s thinking patterns, social behavior, health, and physiological reactions.” Johns Hopkins and the Mayo Clinic promote positive thinking to lower blood sugar and high blood pressure, and to reduce the risk of heart attacks and strokes by lowering cortisol.

The human brain is the most complex thing in the known universe, and yours is fueled by your thoughts. Ever heard that if you repeat a lie long enough it becomes the truth? If your brain is filled with negative self-chatter, it will come to believe it. If your inner monologue is positive, the brain responds, and your stress levels decrease along with your blood pressure.

There is another tool called “reframing” that makes you more productive. It’s where “I hate doing the dishes” becomes “I can’t wait to get these dishes done and have a nice clean sink.” Such positivity releases dopamine and serotonin into your system, and if you add a smile? Well, a study at the University of Kansas concluded that smiling is such a powerful source of endorphins that your stress levels go down even when you fake a smile. So now you’ve got a buzzy cocktail of dopamine, serotonin, and endorphins in you, and the dishes are done.

If you need a little extra help, DAP Health is here for you. Its medical professionals won’t do your dishes, but they do have some unique Wellness Services, including a Zoom group based on positivity and related to achieving goals.

Michael Jordan didn’t get to be the GOAT by talent alone. In fact, he attributes his success to positive thinking. He never told himself he couldn’t. “I can accept failure,” he famously said. “Everyone fails at something. But I can’t accept not trying.”

So be like Michael. Flip that switch. It’s not going to make you a great basketball player, but you’ll absolutely, positively, win at this game we call life.

Can I Tell Them Who I Am?

Jean-Marie Navetta

Can I Tell Them Who I Am?

After 17 years at PFLAG, Palm Springs resident — and Out & Equal’s new vice president of learning — knows all about diversity, equality, and inclusion in the workplace.

As seen in Issue 4 of DAP Health magazine 

Words by Victoria Pelletier • Photos by David A. Lee

Jean-Marie Navetta’s bio at PFLAG ended with the quip, “Jean-Marie is, most importantly, living proof that philosophy majors can get real jobs.”

Of course, Navetta is far more than a “philosophy major.” Educator, advocate, leader, prophet, sage, dreamer, superwoman? Now we’re getting closer. Navetta’s illustrious career in the diversity, equity, and inclusion (DEI) space through LQBTQ+ education and advocacy points to her why in life. She envisions a world wherein no one needs to ask the question she’s often asked herself on the first day of a new job: “Can I tell them who I am?” For those committed to actualized DEI in business and beyond it, the universal answer must become, “Yes, you can!” And one must not lose any sleep over it.

I recently sat down for a Zoom interview with the Palm Springs resident as she prepared to take on a new professional role as vice president of learning at Out & Equal, “the premier organization working exclusively on LGBTQ+ workplace equality,” per the nonprofit’s website. “Through our worldwide programs, Fortune 500 partnerships, and our annual Workplace Summit conference, we help LGBTQ+ people thrive and support organizations creating a culture of belonging for all.”

The biggest takeaways from our conversation? Inclusion begins with education, and full inclusion means changing systems and the culture. Navetta is deeply committed to all of the above. She reminds me — and all of us, for that matter — that changing systems and culture is especially daunting in the current, uber-polarized environment. “DEI work was a given,” Navetta notes as she looks back on her early pro years, adding that “opposition has become far more sophisticated in how they are resisting it; this level of sophistication should cause us to be concerned and be more vigilant and relentless in our work.”

Bottom line? There’s plenty of work to do to overcome the regression that is afoot in government, business, and broader culture. 

Navetta remembers the first time she encountered PFLAG. A teenager at the time, she observed a Pride parade from the sidelines and thought, “Wow…if only.” After earning that golden philosophy degree, Navetta considered law school for a while before settling into communications roles. Heart and mind stirred during those early years in the workplace. She recognized the forward momentum of the inclusion movement and knew she wanted to be a part of an unscripted future in DEI.

A work stint in Washington, D.C. provided the entry point for a career in her education and advocacy work. While working as a press secretary there, Navetta volunteered with a local PFLAG chapter. Impressed by her passion, intellect, and ability, the chapter director submitted her resume to PFLAG HQ, knowing Navetta’s drive and skills were needed at the national level. The pivot from communications to advocacy and education was now underway for Navetta, and would grow for the next 17 years with PFLAG.

“I had to find my space in the movement,” she says while reflecting on her early days in DEI, so she gobbled as much information as possible, taking deep dives into topics like butch/femme identity. Navetta had experienced, personally, that queerness could lead to discrimination and even hostility in the workplace. Like many in the LGBTQ+ community, she has been leery at times about “being out” in the office, and she understands that many workers remain confused by the difference between acceptance and full inclusion and belonging. “Look around,” she declares with a resolute voice. We need workplace advocacy because, “we’re losing ground on the policy and cultural acceptance fronts.” 

Of course, the current political climate does not help advance DEI efforts in education or in business. In the most sobering moments of our conversation, Navetta laments the insidious ways elected representatives stoke regressive legislative action. “Legislation is designed to shut discussions down, and it makes you realize we have to do more.” Pondering the impacts of her work as a DEI champion and guide for businesses, Navetta adds, “Restrictions on how we talk about things in education, government, in documents, etc. means that one of the last places we can have this conversation is in the workplace.”

Effective DEI work in the workplace can move the broader cultural conversation forward, though. “Look at marriage equality — there was phenomenal grassroots activism, yet the influence of private sector employers was incredibly powerful in driving change and judicial decisions forward.” Navetta sees business shaping many more DEI advancements. “Let’s use the time and place where people spend more time than anywhere else [work] to educate and advance LGBTQIA+ rights, inclusion.”

Citing court challenges to DEI based on religious freedom arguments, I ask Navetta if she thinks companies might reverse course on DEI progress because of recent legislation and court rulings. Despite the legislative and judicial headwinds, she feels positive about the prospects of businesses staying the course. “Most of the companies that we see committed will continue on their path forward; most companies understand that [DEI] helps with business performance.”

Indeed, Navetta’s new role at Out & Equal gives her the leverage to scale up her DEI educational work in a way that could have broad, global impact. Immediately, her leadership at the organization’s workplace summit — the world’s largest of the kind — will provide opportunities to present a diverse portfolio of LGBTQIA+ programs to a significant, cosmopolitan audience. 

Our superwoman with the golden philosophy degree remains a global force in the DEI space. She feels supported by her wife of 23 years, Jude Medeiros, plus a cohort of generous colleagues. Then there’s the considerable quality of life she has found by moving from grey and chilly San Francisco to warm and sunny Palm Springs in 2018. The local international airport certainly makes her frequent travel less of a burden, and the community of friends the couple has cultivated recharges Navetta’s oft-depleted batteries come evening or the weekend. She’s even found time to volunteer to teach queer youth about their history at the LGBTQ Community Center of the Desert’s satellite space in Coachella. 

Basically, Navetta believes she was born at the perfect time into a difficult world, buoyed by infinite possibilities. “I am excited to be educating LGBTQIA+ leaders and the next generation,” she offers with a look of satisfaction.

I, like many of you, look forward to the day Navetta’s question — Can I tell them who I am? — is always answered in the affirmative.

The Plight of the Migrant Farmworker

Portrait of Farmworker

The Plight of the Migrant Farmworker

 

The health care needs of an essential yet marginalized community require special attention that is long overdue.

 

As seen in Issue 4 of DAP Health magazine 

 

Words by Trey Burnette

 

Migrant field workers are one of society’s most indispensable people. They’re the frontline of not only the United States’ $162.7 billion agricultural industry but, arguably — considering their hands are the first to touch the harvested food consumed by virtually all Americans — of the nutrition and health care industries. 

They’re also one of the most marginalized and neglected populations. A whopping 23% of farmworkers in the U.S. live in poverty. The average individual’s annual income falls between $12,500 and $14,000 ($17,500 to $19,999 for families). And neither does the National Labor Relations Act of 1935 (which permits private sector employees to organize into trade unions, engage in collective bargaining, and go on strike) nor the Fair Labor Standards Act of 1938 (which preserves the right to a minimum wage and “time-and-a-half” overtime pay for toiling more than 40 hours a week, plus prohibits the employment of minors in “oppressive child labor”) cover most workers. Beyond the low pay and lack of many workplace protections, health care is one of the most significant stressors for farmworkers. Some 25% of them depend on community health centers. 

Of the 2.5 million farmworkers who live and work in the U.S., 500,000 to 800,000 reside in California. Their age falls between 14 and 61, and most have been working for 18 years. Some 34% of them identify as women. Another 400,000 are minors.

In 2021, the U.S. Department of Health and Human Services reported that, of the 1,015,162 agricultural workers and their family members who received health services, the most common diagnoses were being overweight/obesity (25.5%), hypertension (11.4%), diabetes (9%), anxiety disorders, including post-traumatic stress disorder (5%), other mental health issues (7%), and asthma (2.5%.) But that isn’t the full scope of the health issues facing this community, because only 56% of U. S. field workers have health insurance. In California, that number drops to 37%. No matter where they are, many never seek help.

Israel Ochoa manages DAP Health’s Centro Medico Oasis in the agricultural town of Thermal, just southwest of Mecca. He is the son of migrant farmworkers, and most of his days are spent serving farmworkers and their families. His assessment of his clinic’s patients aligns with the national statistics. He says access to affordable, nutritious food is a leading cause of their health issues. Fieldwork is arduous manual labor; the workers are up before sunrise and have to power through an excruciating workday. They rely on inexpensive sugary beverages like Gatorade, colas, and juices to stay hydrated and maintain energy, and eat a lot of processed food that “keeps” and can be eaten throughout their long workdays.

Furthermore, their children’s diets are not immune to their parents’ work schedules. Typically, 2.5 families live in one mobile trailer, and the kids are usually left with breakfast food they can make without having to turn on a stove — cereal, Pop-Tarts, or microwavable dishes. All eligible California children can get a no-cost breakfast and lunch at school, but obtaining those meals in the summer is difficult, if not impossible, because moms and dads can’t afford, or aren’t allowed, to take time off work.

Fear of being fired is also why workers don’t take personal or medical time off. They’re generally contracted, getting paid in two ways: by the hour ($15.50, plus 40 cents per box of product harvested and packed) or just by the box (about $4.25 per). Workers should get three sick days per season, but aren’t paid if they don’t work. Most avoid reporting job injuries for similar reasons. 

There are many other barriers to prosperity for farmworkers in the U.S. The lack of legal residence status is an obstacle. Nationally, 64% of workers are estimated to be undocumented — that figure is 75% in California — and most government programs, except for emergencies and sliding-scale payments, require documentation. Fortunately, on January 1, 2024, Medi-Cal expands full-scope health care for all income-eligible residents of California, regardless of immigration status. Obtaining preventive and routine care at a clinic will help people avoid emergency room visits and more severe illnesses. 

Veronica Garcia is a care coordinator specialist regional coordinator and certified enrollment counselor at DAP Health. Alongside five siblings, she was raised in Coachella by her single farmworker mother, who also toiled at a citrus-packing plant. She does frontline community work and says her employer has an excellent outreach program. With the expanded Medi-Cal program, more people will be counseled and given health care. Outreach is critical because health workers can personally converse with farmworkers and clarify program misunderstandings. Many people think government programs, like Medi-Cal or the Medically Indigent Services Program, are debt services, so people hesitate to utilize them. 

In addition to program education, Dr. Frank Figueroa — a councilmember for the city of Coachella who serves on DAP Health’s board of directors, as he did on Borrego Health’s board of trustees — says other fears about using programs can be laid to rest. He, whose grandparents and parents were farmworkers, states there’s the belief that those applying for permanent residence, work visas, or citizenship will be “flagged,” only to face negative consequences like losing rights they currently have, or could gain in the future. Undocumented workers are scared of deportation if they seek help. Applying DAP Health’s educational outreach to explain legal rights, enrollment, and using health care benefits will spur great progress in the health of this population. 

Education is also a challenge toward that progress. It’s estimated that 78% of farmworkers lack a high school diploma, with ninth grade being the average level of education. Just over 1% of these employees have a college degree, so there is a need to improve technology literacy.

Riverside County Supervisor Manny Perez, a son of migrant farmworkers, says that one of the many things that make DAP Health a superior federally qualified health center (FQHC) is its ability to provide affordable housing, a significant need for farmworkers as rents increase. He also strongly advocates for community clinics because they can address specific community needs like nutrition education through ancillary services. 

While Perez believes community health centers like Centro Medico Oasis are expertly poised to provide care for the rural poor, Ochoa insists finding health care providers to serve in remote locations such as Thermal is a challenge. All true. But it’s a challenge DAP Health is determined to meet as it endeavors to bring better wellness to this vital yet often-forgotten populace.

Impactful Planning

Karla Kjellin and Jeff Elder give back
Karla Kjellin and Jeff Elder

Impactful Planning

Karla Kjellin-Elder and Jeff Elder wanted to give back. Then they discovered planned giving at DAP Health and created a bona fide legacy.

 

As seen in Issue 4 of DAP Health magazine 

 

Words by Greg Archer • Photo by Peter Grant

 

The way the light catches on the silver lettering of the Karla Kjellin-Elder & Jeff Elder Social Services Wing signage at DAP Health encourages another look. Maybe it’s the modern design — sleek, long, and lean — or the way the name spreads out so boldly along the wall. Regardless, you’re bound to notice and possibly wonder: Who are the Elders?

It’s fun keeping up with the engaging couple. In conversation, it becomes vividly apparent that Karla Kjellin-Elder and Jeff Elder have long been committed to giving back to their community. This is true as it relates to DAP Health, specifically when the couple began to mindfully plot out their estate plan. They saw all too clearly how a legacy gift assists the nonprofit in continuing to ensure the overall health and well-being of the community. 

The Elders first got involved with HIV/AIDS-related services with AIDS Services Foundation Orange County, which now is under the Radiant Health Centers umbrella. They had lived in Orange County at the time and eventually rooted themselves in the organization — Karla was extensively involved with the food pantry, while Jeff was on the board and became president. When they moved to La Quinta in 2018, they realized it was time to take a tour of DAP Health.

“It was unbelievable and overwhelming what DAP Health was doing,” admits Jeff of discovering the organization’s reach. “AIDS Services Foundation hadn’t been able to do all that yet. You saw what could really happen out here in the desert. So, we got very excited about the organization and wanted to get involved.”

The Elders began attending various galas and Partners for Life events, suddenly finding themselves among people who were passionate about helping. The more involved they became with the nonprofit, they donated their time and resources, and learned more about planned giving — specifically, opportunities for “naming rights.” DAP Health’s social services wing was brought up. 

“‘Social services’ sounded like a motherly thing,” Karla shares. “I think DAP Health strives to be a kind of family for people who may have lost theirs because of ailments or whatever. That’s very sad, to think that somebody is basically homeless, even if they have a home, because they have nobody to nurture and care for them. That’s the good thing DAP Health does — nurture the whole person, not just the ailments, not just a condition. That’s why the term ‘social services,’ to me, sounded like a big hug.”

That department at DAP Health connects clients to social services for which they are eligible. This includes ensuring individuals have access to food, housing, transportation, home health care support, and more.

“We want to give, and be part of the community,” Jeff says. “If you’re part of a community, you help make it a healthy community, a really functioning community.”

They’re both quick to point out that when it came to establishing some kind of legacy gift, they wanted it to benefit DAP Health. To that end, they created their first-ever trust, and divided it into five parts — one each for their four children, and one part for a charity of their choosing. Their intention was clear. Each child would need to donate 10% of whatever they received in the inheritance to a charity of their choice, but to make the donation in the Elders’ name.

“We set up a donor-advised fund, and that fund is how we donate 90% of the money,” notes Jeff. “There are two organizations we give a lot of money to — DAP Health and The Living Desert. And so, when we pass away at some point, our children can give to various charities, and we would expect that a big portion of that will probably go to DAP Health.”

Planning it all in advance brought about a stronger sense of clarity and vision for the Elders. “To me, it’s like having or donating to a utility. It’s just something you do,” Karla says of philanthropy. “So yes, you can take your inheritance and give it to your kids, but it’s also important, I think, to have a portion of your money go to a charity, just like a portion of your income goes to a utility and a portion goes to rent.”

There are several kinds of donations accepted by DAP Health. To be sure, individuals can give money. But assets can also be considered. This can be anything from donor-advised funds, life insurance, and real estate to retirement plan assets and appreciated securities.

“There’s an entry point for everyone when it comes to planned giving,” says DAP Health Interim Chief Development Officer Chris Boone. “You can volunteer at one of our four Revivals store, you can give money, you can participate in our annual Health Equity Walk, go to a gala. There’s something for everyone.”

End-of-life conversations, however, may not always feel comfortable. “Sometimes, having those kinds of conversations can be difficult, because you’re talking about end of life and the decisions you’re trying to make,” Boone says. “But at the end of the day, the conversation is always centered around, ‘What do you want to leave, and what do you want to be remembered for doing in this world?’ Planned giving is all about impact, and helping others in your community.”

Moving forward and into 2024, Boone says he and the DAP Health team are excited about new possibilities that have emerged. In addition to sharp attention on planned giving, the goal is to have the organization’s Vision Forward capital campaign wrapped up in the next year, which, he says, “is a fantastic milestone. We can’t wait to celebrate our success thanks to donors like the Elders.”

Another significant opportunity to expand DAP Health’s impact is the recent acquisition of the Borrego Health system, which saw the nonprofit go from serving 10,000 patients a year at two locations in the Coachella Valley to more than 100,000 patients a year at 25 clinics located throughout 240 rural and urban zip codes from the Salton Sea to San Diego. The list of services offered now includes OB-GYN, pediatrics, urgent care, pharmacy, and veterans’ health — all of which will be covered under DAP Health. “We’re really excited about it because it really opens the door to a whole new community of folks to help. And that’s going to be huge. It’s a big thing to chew on,” Boone notes.

The Elders admit they were nicely taken aback when they first saw their names on the wall at DAP Health. Deep down, it felt like a full-circle moment for the couple, who have long been donating their time and resources to charitable organizations, and, in turn, making an impact.

“We tell people, ‘If you have money, give money. If you have time, give time. And if you have both, give both,’” states Jeff. “We’ve been fortunate. Some people hoard their money, so that when they die, their kids have this giant inheritance. We gave our kids a good education and raised them well. And they seem like they’re OK. Our plan really is about getting as much as we can out of life while we’re still alive, but whatever is left, a big piece of that should still go to charity because we really should be helping.”

Learn more about planned giving at PlannedGiving.DAPHealth.org.

Breaking Down Barriers

Breaking down barriers

Breaking Down Barriers 

By addressing social determinants of health — those nonmedical factors that influence patient outcomes —DAP Health is creating equity.

 

As seen in Issue 4 of DAP Health magazine

 

Words by Ellen Bluestein 

 

In its efforts to deliver care based on the needs of the individual, DAP Health’s innovative, whole-person approach continues to extend beyond the medical to address the systemic and societal forces that often prevent patients from receiving that care.

Known as social determinants of health (SDOH), these factors are the outside influences that impact a patient’s ability to seek or maintain health care. “They’re the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks,” says DAP Health Chief of Community Health C.J. Tobe. “Typically, there are five different categories that social determinants of health are broken into: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and then social and community context.” Each can have a profound effect on health outcomes. 

Now that DAP Health oversees a total of 25 clinics in Riverside and San Diego counties, this broadened area of service brings increased challenges to care. “We recognize that addressing social determinants of health is important to improve patient outcomes,” says Enhanced Care Management Operations Supervisor Claudia Barron. “First and most importantly, we conduct patient assessments, and we go beyond medical conditions. Our case management teams are trained to address social determinants of health, like housing insecurity, transportation barriers, financial challenges. And we also understand that every patient is unique and has their unique challenges. So, we focus on creating personal care plans. We also get trained by our health plans so that we can connect patients with resources.”

“We early on learned that having a great doctor and fabulous medicine is not enough,” says Senior Director of Social Services Zayda Welden, who oversees the nonmedical programs and services for HIV clients. “All these other factors are so important, or as important, as having the best infection specialist.”

Welden continues: “Clients have the best intentions, but if they cannot get here because they are living in the back dumpster of some building that offers shade — and if they leave, someone else will come in and take the place — they’re not going to leave,” she says. “If someone is not able to walk to the bus stop two miles to get on the bus and come in for the appointment, they’re not going to come in. If they don’t have money to buy gas, they’re not going to come in. So, we can have the best clinic and the best treatment available. If they are not coming in, then our work is not done.” 

To address this barrier, DAP Health has instituted transportation programs. “We have the ability to give clients bus passes and gas cards,” says Welden. “Now, not everybody has a car, so 

we have bus passes available for them. We have two kinds: one that is for seniors and disabled individuals, and one that is a regular monthly bus pass.”

It should be noted that, at this time, the medical transportation benefit is funded through grant programs limiting access to HIV-positive clients living in specific geographic areas who qualify. 

Welden also cites food insecurity as a negative social determinant of health. “Every patient who comes into the clinic gets asked a few questions in regard to food insecurity,” she says. “If they say, ‘Yes, I need a bag of food for the next two or three days,’ then we will provide that bag of food, no questions asked.” DAP Health’s nutritionist carefully chooses the nonperishable items that go into the bags, ensuring that they are both shelf stable and nutritionally substantive. 

“A lot of people downplay the importance of access to good, nutritious food,” says Tobe. “That’s going to be a social determinant of health — making sure people are able to eat several balanced meals per day. There’s fresh water. We found out that in our Oasis clinic, there’s not fresh water. That’s another social determinant of health.”

At said Oasis clinic (also known as Centro Medico Oasis, located in the town of Thermal), most clients work in agriculture, an often-grueling business with long hours and low pay that can profoundly affect health and well-being. “What we’ve gathered from talking to patients is that not all of them have or work for a company full-time where they get vacation, benefits, and all that,” says Oasis Clinic Manager Israel Ochoa. “The majority of them get three sick days, so once they’re gone, they don’t get paid. A lot of them would rather work unless it’s really, really necessary, or they’re really sick. They don’t have the luxury of benefits.”

Some clients also don’t have the luxury of literacy. “Centro Medico Oasis is 95% Spanish-speaking,” says Ochoa. However, for roughly 60% of the community, the first language is Purépecha, a Spanish dialect from Central Mexico. While these clients speak Spanish, there are some differences that prevent them from fully understanding it. When it comes to reading and writing, it’s Purépecha, not Spanish, that’s used. Most of the staff at the clinic speak English and Spanish, but there are times — during mental health appointments, for example — when clients and providers need interpretation assistance. For that, an online translation service is employed. 

From environment to education, work to worship, many factors influence health outcomes. “Negative social determinants of health…don’t discriminate. Anybody can face them,” concludes Tobe. Identifying and implementing programs to address them is the key to combatting them. “It’s really all about creating different access points or ways for people to obtain different services,” he continues. “It’s coming up with innovative ways to be able to eliminate that red tape, reduce those barriers, and meet people where they are that’s going to help support people living their healthiest and best life.

“With this marriage between DAP Health and Borrego Health, I think we’ll be able to take a lot of the foundational work that we’ve done…[and] then build on that infrastructure and replicate different programs — or even create new programs to address different social determinants of health for our complex patient population.”

social determinants of health

Against All Odds

Corina Velazquez

Against All Odds

 

The average age of a chief operating officer is 51. Corina Velasquez had earned that esteemed title by 36.

 

As seen in Issue 4 of DAP Health magazine

 

Words by Kay Kudukis • Photo by Zach Ivey

 

Being a medical assistant (MA) wasn’t the dream of Corina Velasquez in grade school. She was into poetry and prose. She was good at it too. Won an award and everything. In high school, that dream morphed into one of law school and a seat on the bench. All that changed with one test.

“I dropped out of high school midway through because I got pregnant with my daughter,” Velasquez says. She was 17 when she gave birth. It didn’t take long for her to realize that, domestically, she was in a bad situation. She left the father within two years.

“Statistics say I’d still be at my house on government assistance, but I didn’t let my fear of not being good enough stop me,” she says. She returned to her studies, became a certified phlebotomist, and took a job working in-patient at Eisenhower Health.

But Velasquez had her sights set on becoming an MA, so it was back to school. After a few internships, she got her first paid MA position at Borrego Health’s Centro Medico Cathedral City, which had previously been a private practice. Velasquez was also able to draw blood in the small, one-doctor clinic, where it was hard enough to get a patient through the door, much less go elsewhere for blood tests.

It was a great time in Velasquez’s life. She was 24, had a full-time job in an exciting field, and she’d found love again. They had two daughters, but after 10 years together (three of them married), they divorced. They’re such good co-parents, people think they’re still a couple.

Born in Ventura County, Velasquez completed kindergarten in Coachella after her single mom moved the family of four there, courtesy of a new job. A middle child, she was sandwiched between an older brother and younger sister. Eventually, her mom purchased a mini-mart where Velasquez worked after school and on weekends. That came in handy when she was transferred back to her old stomping grounds, subbing for the Coachella clinic’s MA, Carmen Ruiz, who now pulls double duty as the clinic manager at both Palm Springs Family Health and Desert Hot Springs Specialty Care. Both are Borrego Health centers now under DAP Health’s auspices. 

As Velasquez learned more about federally qualified healthcare centers (FQHCs), she asked her mom to refer mini-mart customers to their clinic, emphasizing their zero-discrimination policy, discounted medications, and sliding scale fees. When Ruiz returned from maternity leave, she discovered that, due to Velasquez’s expert outreach, Coachella had gone from treating six patients a day to routinely more than 30.

“I had worked with the company for a couple of years, and it was very different working with Corina,” Ruiz emphasizes. “Very different than working with anyone else. We would just look at each other and I’d say, ‘Did you see what’s going on in the lobby?’ And she’d say, ‘Yeah, I got it.’” Ruiz is referring to drop-in patients and the workload ahead. “Corina knew exactly what I was talking about. She was always going the extra mile, and I was the same way. We made a really good team.”

Velasquez agrees. “Carmen and I had this amazing working relationship where we could communicate without even talking. Just boom, boom! It was awesome.” 

When Borrego Health graduated from paper to electronic health records (EHR), it chose to conduct training at the small Coachella facility. Trainers came in but didn’t bring step-by-step learning tools. 

“I created screenshots at the nurses’ station so I could remember, because I knew the instructors weren’t going to be there forever,” Velasquez recalls. Shortly thereafter, she happily accepted a promotion to become the trainer of the new system — for all Borrego Health MAs. 

Velasquez also began learning about quality and compliance. Soon she was auditing charts, helping with audit tools, and in 2011, was asked to manage a brand-new clinic. She would be stocking, staffing, and problem-solving.

She did so well that it was requested that she find her replacement, and do it all over again. Wet, lather, rinse, repeat. Every clinic, from soup to nuts.

At the same time, changes were going on at the upper levels of the organization. The VP of operations was promoted to COO, the regional director of operations became VP, and Velasquez applied to be — and was appointed — regional director in 2012, where she stayed until her 2015 promotion to VP of patient access.

Her rise to the C suite came in 2021. With Borrego Health then serving more than 120,500 patients (roughly 463,000 annual visits) throughout Riverside and San Diego counties, being chief operating officer was a big job. It’s an even bigger job now that she serves in that capacity at DAP Health. It’s a role that was previously absent at the organization — one created just for her.

“Corina is simply a force to be reckoned with,” says DAP Health CEO David Brinkman. “Her journey is such an inspiring one. She’s a doer whose presence is nonetheless so warm and welcoming. I’m tremendously excited to have her keep doing what she does best for us now that we are one, integrated health care agency.”

Here’s an anecdote from her early years, which shows why Velasquez has been so successful: She was working with a provider who had a reputation for being “a little too direct” (as she gently puts it), when he snapped at her in front of a patient. 

“I went into his office when we were done, shut the door, and said, ‘Let that be the last time that happens. I’m here to work with you. So, let’s make this a good day.’ He just looked at me, then smiled and said, ‘We’re gonna do just fine.’ After that, it was a really good relationship. At the end of the day, everybody wants the same thing. Sometimes, they just need a different map on how to get there.”

Now 39, Velasquez can look back and offer advice to other young adults, no matter their situation. “Even when you don’t believe in yourself, be curious enough to ask the questions because that can open so many doors to things that you never thought you’d even be in the right vicinity of.”

Before DAP Health’s acquisition of Borrego Health, when things were up in the air, Ruiz one day felt inspired to call Velasquez to say, “I just want to thank you. I know what you’ve done, and what you’re capable of doing. We don’t know exactly what you do for us behind the scenes, but things happen because of you. Good things.” 

As it turns out, Velasquez has core values — strength, truth, justice, optimism—that she shares with Wonder Woman. Like Velasquez, Wonder Woman has profound healing, telepathy, and supernatural leadership powers. 

Isn’t it interesting that Wonder Woman and Velasquez have never been seen in the same place at the same time. Make of that what you will

Where Barbie Fears To Tread

Women of Impact

Where Barbie Fears To Tread

With “Barbie” being the biggest movie of 2023, it’s a perfect time to not only raise awareness, but to actually do something about the state of women’s care. It may surprise you to know that DAP Health is already the projected leader.

 

As seen in Issue 4 of DAP Health magazine

 

Words by Kay Kudukis • Photos by Zach Ivey

Whether or not you liked the movie “Barbie,” you have to admit it’s causing … feelings. But since neither Barbie nor Ken have genitalia, or any internal organs, it has kept some salient points, like women’s health care, from being explored on screen. 

Still, they could have thrown in a scene where America Ferrera’s character chooses a blue razor over a pink one while explaining that the latter is, save for color, exactly the same as the former but that, since it’s marketed “for women,” it’s available at a 13% price hike. Or that in 21 states, feminine hygiene products are still taxed as luxury items — which is some very dark state humor. Both are victims of the unwritten “pink tax” that requires women to pay more for bare necessities.

The film’s all-girl Supreme Court screamed “goals” and, independently of “Barbie,” DAP Health thought that was a good idea too. There are now six women on the nonprofit’s board of directors, and we’ve “poked the bear,” so to speak, and asked them to weigh in with their experiences and concerns. 

“You can find numerous stories where women ‘know’ there is an issue and they are ignored by their doctor,” says DAP Health Board of Directors Vice Chair Lauri Kibby, an investor and entrepreneur in Palm Springs. “As if the ‘hysteria’ label continues to exist — though much more subtle.”

If you’re late to the game, in the mid-20th century, women with “unexplained malaise” were diagnosed with hysteria.

Bottom line? We need a big wake-up call in the medical community, which even today has an astoundingly limited understanding of the intricacies of a woman’s body and how it relates to her well-being. “The medical profession has has been bound by the assumption that women’s health management and issues are similar to male health management and issues,” Kibby continues. “This could not be further from the truth. As a consequence, research methodologies, and even provision of care, has mimicked male health care, resulting in insufficient — and often delayed — diagnosis, and in many cases, the cause of serious prognosis or early death.”

Dignity Health St. Mary Medical Center Hospital President and CEO Carolyn Caldwell of Long Beach, also a DAP Health board member, calls attention to something of which many women are guilty. “They are often so busy taking care of their families, they forget to take care of themselves,” she says. “It is critical that the health care powers that be educate women on the importance of self-care.” 

But many women are single parents who work, and seeing a doctor or having tests requires time off, not to mention the cost of childcare, so they skip it. That only compounds whatever ill might be silently brewing. 

“Due to a historically patriarchal health care system, women are prone to increased and often untreated forms of heart disease, mental illness, cancers, and other complex medical issues unique to women,” adds Palm Springs’ Eve E. Fromberg-Edelstein, an attorney and partner at Fromberg Edelstein Fromberg who also sits on the nonprofit’s board. 

NPR cites a study showing middle-aged women with chest pain are twice as likely to be diagnosed with a mental illness (instead of a heart condition) than their male counterparts, indicating women’s medical concerns are often dismissed at higher rates than those of men.

“Listening to women and responding to their concerns is a step in the right direction,” suggests Kibby, who also spearheaded DAP Health’s new Women of Impact initiative (see sidebar). “Training doctors and medical students that there are differences, and changing methods of research to include the biology of women, are all preliminary steps to changing the culture of women’s health care.”

“I will say this,” adds board member and Palm Springs business owner Athalie LaPamuk of her involvement in Women of Impact. “I was initially drawn to serving on this particular committee because, for the last eight years I have lived in the desert, I have continued to see my gynecologist in New York City once a year. That just seemed normal given the lack of women’s care options here. Hopefully, our women’s health initiative at DAP Health can change that. I think it’s been proven that a community is only as healthy as its women, so this is very important.”

DAP Health Associate Chief of Operations Nereida (Nedy) Terrazas served at Borrego Health for over 20 years, and has been involved in women’s health care since 2014. She comes into her new role within the integrated system with experience, ideas, and big plans, including practical ones such as moving from paper medical records to the much more efficient electronic ones. She also wants to address the issue of women missing appointments. “We are looking into an Uber health account so we can begin offering transportation services to our patients,” she says. Many families have only one car, and during clinic hours, the husband often uses it for work.

Terrazas seconds Caldwell’s concerns that lacking self-care is a major issue. “Your health should always be a priority,” she says. “Women tend to be the caregivers and make the health care decisions for our families. If we’re not well, who will replace us? Preventative care keeps us healthy so we can take care of our families. We cannot afford to skip it.”

Professor Karyl E. Ketchum, Ph.D. — who also serves on DAP Health’s board — is the department chair of women, gender, and queer studies at California State University, Fullerton. She brings good tidings: “Healthy women are better able to engage in economic activities, both within and outside the home, contributing to increased household income, economic growth at the community level, and improved living standards.”

With such strong and strongly empowered women in place within its leadership and workforce, DAP Health (which estimates that more than half of its patient population is female) is set to galvanize women throughout Southern California thanks to much-needed improvements in female-specific health care. What a perfect premise for a … “Barbie” sequel!

Fade in: 

Palm Springs Barbie, in vintage Bob Mackie, sips a chilled beverage in her immaculately appointed Midcentury Modern doll house as Pregnant Midge gushes over the award-winning, holistic, patient-centric care she is receiving at DAP Health.

Barbie is inspired to create an “In the Pink” world tour, and to kick off her opening speech, she uses the words of yet another member of DAP Health’s governing body in Palm Springs, U.S. Soccer Foundation Chief Revenue Officer Ginny Ehrlich: “So many are headed in the wrong direction when it comes to women’s health. But not DAP Health. Instead of stripping women of their ability to determine what’s right for their own bodies and well-being, we are offering them the respectful and comprehensive health services they need … and deserve!” 

Greta Gerwig, call me.

Sidebar:
Women of Impact, the newest initiative for DAP Health, came together through the passion of a powerful group of community, board of directors, and staff members dedicated to setting the “gold standard” of health care for women and children in our community.

“We all know there are severe gaps and barriers to good quality care for the women in our community and the families they care for,” says WOI Chair and DAP Health Board of Directors Vice Chair Lauri Kibby. “Our goal with Women of Impact is to fund programs that will address those gaps and educate the public about how they can be part of this movement.”

You can join Women of Impact — or get more information about the WOI tours that began this fall at Centro Medico Cathedral City — by contacting Chas Kidder at ckidder@daphealth.org.

Caption: DAP Health PrEP Navigator Livi Moreno photographed by Zach Ivey in a dress by Peepa’s Palm Springs from Revivals

Caption:  DAP Health's Women of Impact Committee members photographed by Zach Ivey.