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TMVII is a New Sexually Transmitted Fung …

TMVII is a New Sexually Transmitted Fungus

Trichophyton Mentagrophytes Type VII (TMVII for short) is in the news, and you may have heard about it. It’s a rare fungus that causes a treatable rash on the skin.

It was recently found in the U.S. for the first time. The patient is a male New Yorker in his 30s who traveled to California, England, and Greece, where he had sex with men.

He developed a red, itchy rash on his genitals, legs, and buttocks. Despite multiple oral antifungal treatments, it took more than four months for the rash to heal completely.

No one yet knows how TMVII will develop in this country. It could become the next mpox, or it could not. In France, 13 cases were reported last year, 12 of them in men who have sex with men.

For now, there is no need to panic. But there is a need for vigilance.

Since TMVII is spread through skin-to-skin contact, including during sex, it’s technically a sexually transmitted infection. And while the sole case in the U.S. has been in a man, the fungus can affect a person of any gender, gender identity, or sexual orientation. Stay informed, be aware, and know that seeing a doctor who can report the incidence helps with statistical data and research.

Also know that we are still seeing sporadic mpox cases, and that that poses a higher risk, especially for those who are immunocompromised. Please ensure you are fully vaccinated.

At DAP Health, we believe that good sex is good. Sex is healthy. Shame-and-stigma-free. Live your best sex life by going for regular STI testing, and learning about prevention measures such as DoxyPEP or DoxyPrEP for STI prevention, and PrEP or PEP for HIV prevention. If you’re HIV-positive, stay on your meds. Undetectable = Untransmissible.

 

For more about TMVII, read below:

If you develop a new rash, please visit one of DAP Health’s three sexual wellness clinics (in Palm Springs, Cathedral City, or Indio), where our experts can see, diagnose, and treat you.

Symptoms

  • Appearance: TMVII infections typically present as red, itchy, and scaly rashes. The rashes often appear in ring-like patterns, which is characteristic of ringworm infections.
  • Affected Areas: Commonly affected areas include the groin, legs, buttocks, and other body parts. The rash can expand and may become more pronounced if left untreated.
  • Additional Symptoms: In some cases, the affected skin may blister, crack, or ooze. The infection can cause significant discomfort and may impact the quality of life due to persistent itching and irritation​.

Transmission

  • Direct Contact: TMVII is primarily transmitted through direct skin-to-skin contact with an infected individual. This can happen during close physical activities, including sexual contact.
  • Indirect Contact: The fungus can also spread through contact with contaminated objects such as towels, clothing, bedding, and surfaces.
  • Zoonotic Transmission: TMVII can be transmitted from animals to humans, particularly from pets like dogs and cats that may harbor the fungus​.

Prevention

  • Personal Hygiene: Maintaining good personal hygiene is crucial. Regularly washing and thoroughly drying the skin, especially after sweating or bathing, helps prevent fungal infections.
  • Avoiding Shared Items: Avoid sharing personal items like towels, clothing, and grooming tools with others.
  • Pet Care: Ensure pets are free from fungal infections by having them regularly checked by a veterinarian and treating any infections promptly.
  • Prompt Treatment: Treating fungal infections promptly in both humans and animals can prevent the spread of the fungus to others​.

Diagnosis

  • Clinical Examination: Dermatologists typically diagnose TMVII through a clinical examination of the affected skin. The characteristic appearance of the rash often provides initial clues.
  • Laboratory Tests: Confirmation is done via laboratory tests, including:
    • Microscopic Examination: Skin scrapings from the affected area are examined under a microscope to detect fungal elements.
    • Culture: Fungal cultures are grown from skin samples to identify the specific strain.
    • Molecular Testing: DNA-based methods like PCR (polymerase chain reaction) can accurately identify TMVII and differentiate it from other dermatophytes.

Treatment

  • Topical Antifungals: For mild infections, topical antifungal creams, lotions, or powders containing terbinafine, clotrimazole, or miconazole are often prescribed.
  • Oral Antifungals: In more severe or resistant cases, oral antifungal medications such as terbinafine, itraconazole, or fluconazole may be required. These medications have been effective, though resistance can complicate treatment​.
  • Combination Therapy: Combining topical and oral treatments may be necessary for persistent infections. Monitoring for side effects and interactions with other medications is important, especially with drugs like itraconazole, which can have significant side effects​.

Research and Future Directions

  • Ongoing research aims to better understand the genetic mutations that confer resistance to common antifungal treatments. International collaboration is crucial for tracking and managing the spread of TMVII and similar resistant strains​.

Pride-Themed Podcast Features Our Very O …

DAP Health's Director of Gender Health & Wellness Mita Beach Shines in IEHP iHeart Media Pride-Themed Podcast

 

The latest episode of the IEHP podcast “Covering Your Health” launched on iHeart Media this morning. In celebration of Pride month, host Evelyn Erives sat down with DAP Health’s Director of Gender Health & Wellness Mita Beach. Together, they delved into the unique challenges faced by the LGBTQIA+ community when it comes to health and wellness. From mental health support to inclusive health care practices, Mita shared valuable insights and strategies for promoting well-being, including how to best be an ally. “Educate yourself,” urged Mita. “Ally is a verb.”

 

Click here to listen to the Pride-themed episode.

 

To learn more about DAP Health’s Gender Health & Wellness programs, click here.

 

For more on Mita, please read below.

 

Mita Beach, LBBP, is the director of Gender Health & Wellness at DAP Health. In this role, Mita is leading the strategic development and implementation of health and wraparound services for trans and gender-diverse patients.

With an impressive background that includes serving as the manager of Gender Health & Wellness at DAP Health, Mita has a proven track record of enhancing program development and delivering comprehensive health services. Their experience extends to working as a trans health navigator at Borrego Health, where they conducted patient assessments and facilitated support groups.

Mita brings over 20 years of corporate leadership experience and 15 years of consulting expertise in LGBTQ+ rights, sexual health, and sexuality education. They have designed and facilitated numerous workshops across various sectors, demonstrating a commitment to fostering inclusive and supportive environments. 

Mita is an active member of several professional organizations, including the World Professional Association for Transgender Health (WPATH), the Association of Medical Professionals with Hearing Loss (AMPHL), the National Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies (NALGAP), and the National Coalition for Sexual Freedom (NCSF).

How Do I Sign Up For My Chart?

How Do I Sign Up For MyChart?

To sign up for a DAP Health MyChart account, just follow the simple steps below.

Versión en español a continuación

 

Visit the MyChart Website

Go to DAP Health’s MyChart sign-up page and follow the directions. You will be asked to enter at least your name, date of birth, legal sex, and email address.

 

Create Your Username and Password

Follow the instructions to create a MyChart username and password. Ensure your password is secure and meets the required criteria.

 

Verify Your Identity

You may be asked to verify your identity by answering security questions or receiving a verification code via email or SMS.

 

Set Up Security Questions

Choose and answer security questions to help protect your account.

 

Review and Accept Terms and Conditions

Read the MyChart terms and conditions, and accept them to complete the sign-up process.

 

Access Your MyChart Account

Once your account is created, you can log in using your username and password.

 

If you encounter any issues during the sign-up process, contact your DAP Health clinic by phone or in person at your next appointment.

 

To learn more about MyChart, please click on this link.

 

¿Cómo Me Registro en MyChart?

 

Para registrarse y obtener una cuenta DAP Health MyChart, simplemente siga los sencillos pasos a continuación.

 

Visite el Sitio Web MyChart

Vaya a la página de registro MyChart de DAP Health y siga las instrucciones. Se le pedirá que ingrese al menos su nombre, fecha de nacimiento, sexo legal y dirección de correo electrónico.

 

Crea tu Nombre de Usuario y Contraseña

Siga las instrucciones para crear un nombre de usuario y contraseña de MyChart. Asegúrese de que su contraseña sea segura y cumpla con los criterios requeridos.

 

Verifica tu Identidad

Es posible que se le solicite que verifique su identidad respondiendo preguntas de seguridad o recibiendo un código de verificación por correo electrónico o SMS.

 

Configurar Preguntas de Seguridad

Elija y responda preguntas de seguridad para ayudar a proteger su cuenta.

 

Revisar y Aceptar Términos y Condiciones

Lea los términos y condiciones de MyChart y acéptelos para completar el proceso de registro.

 

Acceda a su Cuenta MyChart

Una vez creada su cuenta, puede iniciar sesión con su nombre de usuario y contraseña.

 

Si tiene algún problema durante el proceso de registro, comuníquese con su clínica de DAP Health por teléfono o en persona en su próxima cita.

 

Para obtener más información sobre MyChart, haga clic en este enlace.

 

DAP Health Standardizes Electronic Healt …

DAP Health Standardizes Electronic Health Records Across its Entire Network

The upgrade to OCHIN Epic, Dax Copilot, and MyChart will greatly improve user experience for both patients and providers.

Versión en español a continuación

In the fast-evolving landscape of health care, embracing advanced technology is crucial for enhancing patient care and streamlining operations. DAP Health is proud to announce the organization-wide adoption of OCHIN Epic, a state-of-the-art electronic health record (EHR) system. Designed to improve health care delivery for both providers and patients, this comprehensive platform, along with its innovative components Dax Copilot and MyChart, promise to revolutionize the way we manage health information and interact with our patients.

Advantages for Providers

Seamless Integration and Efficiency

OCHIN Epic offers a robust and integrated solution that brings together various aspects of patient care into a single, user-friendly interface. Providers can access complete patient histories, lab results, and medication records in real time, reducing the need for multiple systems and paperwork. This integration ensures that health care professionals have all the information they need at their fingertips, enabling more accurate diagnoses and personalized treatment plans.

Enhanced Collaboration and Communication

One of the standout features of OCHIN Epic is its ability to facilitate better communication and collaboration among health care teams. With shared access to patient records, doctors, nurses, and specialists can collaborate more effectively, ensuring that every team member is on the same page regarding a patient’s care plan, whether those team members are at DAP Health or at other health organizations. This coordinated approach reduces the risk of errors, enhancing the overall quality of care.

Dax Copilot: Revolutionizing Documentation

The Dax Copilot component is a gamechanger for health care providers. This AI-powered assistant helps with clinical documentation (AKA charting), allowing providers to focus more on patient care and less on administrative tasks. By transcribing and organizing clinical notes in real time, Dax Copilot reduces the burden of documentation, improves accuracy, and frees up valuable time for providers to engage more meaningfully with patients.

Benefits for Patients

Empowerment Through MyChart

For patients, MyChart is a key feature of the OCHIN Epic system that offers a multitude of benefits. MyChart is an online portal that provides patients with secure access to their health records from a computer, tablet, or smartphone, enabling them to take a more active role in managing their health. While one does not have to have a MyChart account to remain or become a DAP Health patient, there are many advantages. Below are some of the ways MyChart empowers patients.

Access to Health Information

Patients can easily view their medical history, immunization records, and test results (past and current) through MyChart. This transparency helps patients stay informed about their health status and understand their treatment plans better.

Appointment Management

Scheduling, rescheduling, or canceling appointments has never been easier. MyChart allows patients to manage their appointments online, providing convenience and reducing the need for phone calls or in-person visits.

Medication and Prescription Management

Patients can request prescription refills and review their medication lists through MyChart. This feature helps ensure that patients adhere to their prescribed treatments and reduces the risk of medication errors.

Communication with Providers

MyChart facilitates direct communication between patients and their health care providers. Patients can send messages, ask questions, and receive responses from their care team, enhancing their engagement and satisfaction with the care they receive.

Telehealth Integration

In an era where telehealth is becoming increasingly important, MyChart offers seamless integration for virtual visits. Patients can attend telehealth appointments, receive follow-up care, and consult with specialists from the comfort of their homes, ensuring continuity of care even during challenging times.

“Adopting OCHIN Epic, along with its powerful components Dax Copilot and MyChart, represents a significant step forward in our commitment to not only providing high-quality, patient-centered care, but to enriching the relationship between patients and their provider, and provider workplace experience as well,” says DAP Health Chief Medical Officer Dr. Joseph Aquilina. “This advanced EHR system not only enhances efficiency and collaboration among providers, but empowers patients to take control of their health. By leveraging this technology, we aim to create a more connected, informed, and engaged community. Together, we can achieve better health outcomes and a brighter future for all.”

Please note that MyChart is not intended for urgent or life-threatening situations. In such cases, patients are urged to visit urgent care or the ER, or to call 9-1-1.

To learn more about MyChart, please click on this link.

DAP Health Estandariza los Registros Médicos Electrónicos en Toda su Red

La actualización integral a OCHIN Epic, Dax Copilot y MyChart mejorará enormemente la experiencia del usuario tanto para los pacientes como para los proveedores.

En el panorama de la atención médica en rápida evolución, adoptar tecnología avanzada es crucial para mejorar la atención al paciente y agilizar las operaciones. DAP Health se enorgullece de anunciar la adopción en toda la organización de OCHIN Epic, un sistema de registros médicos electrónicos (EHR) de última generación.

Diseñada para mejorar la prestación de atención médica tanto para proveedores como para pacientes, esta plataforma integral, junto con sus componentes innovadores Dax Copilot y MyChart, prometen revolucionar la forma en que administramos la información de salud e interactuamos con nuestros pacientes.

Ventajas Para los Proveedores

Integración Perfecta y Eficiencia

OCHIN Epic ofrece una solución sólida e integrada que reúne varios aspectos de la atención al paciente en una interfaz única y fácil de usar. Los proveedores pueden acceder a historiales completos de pacientes, resultados de laboratorio y registros de medicamentos en tiempo real, lo que reduce la necesidad de múltiples sistemas y papeleo. Esta integración garantiza que los profesionales de la salud tengan toda la información que necesitan al alcance de la mano, lo que permite diagnósticos más precisos y planes de tratamiento personalizados.

Colaboración y Comunicación Mejoradas

Una de las características destacadas de OCHIN Epic es su capacidad para facilitar una mejor comunicación y colaboración entre los equipos de atención médica. Con el acceso compartido a los registros de los pacientes, los médicos, enfermeras y especialistas pueden colaborar de manera más efectiva, asegurando que todos los miembros del equipo estén en sintonía con respecto al plan de atención de un paciente, ya sea que esos miembros del equipo estén en DAP Health o en otras organizaciones de salud. Este enfoque coordinado reduce el riesgo de errores y mejora la calidad general de la atención.

Dax Copilot: Revolucionando la Documentación

El componente Dax Copilot cambia las reglas del juego para los proveedores de atención médica. Este asistente impulsado por IA ayuda con la documentación clínica (también conocido como gráficos), lo que permite a los proveedores centrarse más en la atención al paciente y menos en las tareas administrativas. Al transcribir y organizar notas clínicas en tiempo real, Dax Copilot reduce la carga de documentación, mejora la precisión y libera tiempo valioso para que los proveedores interactúen de manera más significativa con los pacientes.

Beneficios Para los Pacientes

Empoderamiento a Través de MyChart

Para los pacientes, MyChart es una característica clave del sistema OCHIN Epic que ofrece una multitud de beneficios. MyChart es un portal en línea que brinda a los pacientes acceso seguro a sus registros médicos desde una computadora, tableta o teléfono inteligente, lo que les permite desempeñar un papel más activo en la gestión de su salud. No es necesario tener una cuenta MyChart para permanecer o convertirse en paciente de DAP Health, existen muchas ventajas. A continuación se detallan algunas de las formas en que MyChart empodera a los pacientes.

Acceso a la Información de Salud

Los pacientes pueden ver fácilmente su historial médico, registros de vacunación y resultados de pruebas (pasados ​​y actuales) a través de MyChart. Esta transparencia ayuda a los pacientes a mantenerse informados sobre su estado de salud y comprender mejor sus planes de tratamiento.

Gestión de Citas

Programar, reprogramar o cancelar citas nunca ha sido tan fácil. MyChart permite a los pacientes administrar sus citas en línea, brindando comodidad y reduciendo la necesidad de llamadas telefónicas o visitas en persona.

Gestión de Medicamentos y Recetas

Los pacientes pueden solicitar resurtidos de recetas y revisar sus listas de medicamentos a través de MyChart. Esta característica ayuda a garantizar que los pacientes cumplan con los tratamientos prescritos y reduce el riesgo de errores de medicación.

Comunicación con Proveedores

MyChart facilita la comunicación directa entre los pacientes y sus proveedores de atención médica. Los pacientes pueden enviar mensajes, hacer preguntas y recibir respuestas de su equipo de atención, lo que mejora su compromiso y satisfacción con la atención que reciben.

Integración de Telesalud

En una era en la que la telesalud se está volviendo cada vez más importante, MyChart ofrece una integración perfecta para las visitas virtuales. Los pacientes pueden asistir a citas de telesalud, recibir atención de seguimiento y consultar con especialistas desde la comodidad de sus hogares, lo que garantiza la continuidad de la atención incluso en tiempos difíciles.

“La adopción de OCHIN Epic, junto con sus potentes componentes Dax Copilot y MyChart, representa un importante paso adelante en nuestro compromiso no solo de brindar atención de alta calidad centrada en el paciente, sino también de profundizar la relación entre los pacientes y su proveedor, y la experiencia en el lugar de trabajo del proveedor. también”, dice el Dr. Joseph Aquilina, director médico de DAP Health. “Este avanzado sistema EHR no sólo mejora la eficiencia y la colaboración entre los proveedores, sino que también permite a los pacientes tomar el control de su salud. Al aprovechar esta tecnología, nuestro objetivo es crear una comunidad más conectada, informada y comprometida. Juntos podemos lograr mejores resultados de salud y un futuro más brillante para todos.”

Tenga en cuenta que MyChart no está destinado a situaciones urgentes o que pongan en peligro la vida. En tales casos, se insta a los pacientes a visitar la atención de urgencia o a la sala de emergencias, o llamar al 9-1-1.

Para comenzar a usar MyChart, haga clic en este enlace para ver un video instructivo.

Meet DAP Health Chief Compliance Officer …

In My Life

DAP Health Chief Compliance Officer Dana O’Neal Erwin lives by Maya Angelou’s motto: Do the best you can until you know better. Then when you know better, do better.

Words by Kay Kudukis

 

DAP Health Chief Compliance Officer Dana O’Neal Erwin was born in Punta Gorda, Florida, and raised in Miami and Tallahassee alongside four sisters. Dad was a lobbyist. Mom was a housewife who’d gotten a full nursing scholarship at Tulane but who did not practice in the field post-graduation. Instead, she married and had children. “I always felt like she would have been happier had she had a career,” says Erwin. “I think that’s why I’m a career person.”

Five years older than Erwin, sister Donna was 15 when she turned to drugs, creating great stress for the family. Donna got pregnant and had a daughter, whom their parents adopted. That’s how Erwin came to have four sisters, but she wasn’t around for most of that. At 14, she was sent to a boarding school in Tennessee. That’s where she cleaned the school’s restrooms after classes, made brooms at a broom factory, sold on the floor at a department store, and rang up customers at McDonald’s. “I’ve just always worked,” she says with a smile.

She dreamed of being an attorney. “Girls aren’t lawyers,” claimed Dad. “You will be a nurse, like your mother.” Disappointing, but Erwin admits she did love dissecting stuff in biology. Two years were spent at Southern College in Collegedale, Tennessee. The rest at Walla Walla Community College and Walla Walla University in Washington state, where she married.

 

Neurosurgery, Nursing, and Night Shifts

After graduation, Erwin experienced being a nightshift neurosurgery nurse overwhelmed with tragic accidents. “It’s the most depressing job I’ve ever had in my life,” she laments. “We had an unusual number of new paraplegics and quadriplegics.” Some survivors begged for mortal release post-surgery. Dark stuff.

­“I had no business being the lead nurse fresh out of school,” she continues, “but I was the only RN they had on nightshift on the unit. There were licensed practical nurses (now known as licensed vocational nurses) who worked on that floor for 18 years and knew everything about neurosurgery.” She loved the challenge, but the veterans weren’t thrilled to take orders from a kid just out of college.

After a year and half on that neurosurgery unit, Erwin transferred to the much cheerier labor and delivery department. “When one of the OB-GYNs had a terrible skiing accident and was unable to do surgeries, she became the chief quality officer,” Erwin explains. “That was when quality in health care was becoming ‘a thing.’ She recruited me to help her build the Quality program. So, I worked with her after my labor and delivery shifts.”

Erwin would call in patient reviews to the insurance companies, which led to her being offered a position with Kaiser-Group Health. “They were starting complex case management in their contracted network in Eastern Washington, and asked if I could come assist with a pilot program.” It ticked all of Erwin’s boxes. She accepted, spending a wonderful decade working with a high-functioning and loyal team of nurses.

During that time, Erwin and her husband had three children, then divorced after eight years. “We’re still very good friends,” she says. Not long after, pals set her up with a wheat farmer at a friend’s birthday party. That man had three children too, and they clicked. They married, Brady Bunch-ed it up on his farm for the next 20 years, the eight growing together as a family.

 

Degrees, Data, and DAP Health

By 2015, their nest was empty. The farm was sold, hubby started consulting in Denver and Canada, and Erwin craved a new challenge. Although she’d already furthered her education in health care administration and management, and had been consulting for years herself, she wanted a master’s. Not an overachiever at all, she obtained one in nursing leadership. Through that experience, she found out she excelled at statistics — using data to solve real-world problems, which comes in super handy in compliance and quality management. And no, she’s not a lawyer, but the compliance and risk piece scratches that itch.

Erwin spent five years at a federally qualified health center (FQHC) in Washington state. A friend from the Joint Commission kept calling with consulting opportunities, which led to her spending three years at a large hospital in Idaho, two years at a critical access hospital back in Washington state, and two years in Colorado as chief compliance officer for a national PACE program.

When Erwin was called to join Borrego Health, she politely sent regrets. But they were persistent, and in 2021, she finally acquiesced. She’d barely signed on as their CCO when DAP Health acquired them, offering her their CCO role. She was thrilled.

“I've never worked for an organization that has the mission and philanthropy we have here, and the support we get from the community and the state,” she says enthusiastically. “Thanks to our very active board and CEO, we have such a great reputation. It’s one of the most exciting places I’ve worked.”

Life is full of surprises, both cruel and kind. Sister Donna overdosed at 28, leaving her institutionalized until her death eight years ago. Dad suffered a massive heart attack that resulted in his death at 59. Remembering the past with her remaining sisters has been healing, and although she recently divorced Hubby #2, they, too, remain great chums.

Erwin believes everything that happens is an opportunity to rethink one’s values. “It’s all in how we look at the human race, despite color, gender, whatever,” she says. “We have patients down in Indio who are hardworking, but who don’t have running water or proper housing. Everyone has different challenges, but everyone can greatly benefit from the culture DAP Health has built.”

“In my life, I’ve loved them all.”

– Lennon & McCartney.

Medi-Cal Now Available to All Low-Income …

Medi-Cal Now Available to All Low-Income Families Regardless of Immigration Status

Words by María José Dúran

Versión en español a continuación

 

A new California law that went into effect in January 2024 allows all low-income residents — regardless of immigration status — to qualify for free or low-cost health insurance through Medi-Cal.

“It’s a great step to include all who contribute to California,” says DAP Health’s Community Education and Enrollment Manager Joanna Ibarra.

This new rule making undocumented adults ages 26-49 eligible for Medi-Cal is the last in a series that started in 2016 with coverage for immigrant children, then older adults, youths, and lastly, all age groups.

To qualify for Medi-Cal, individuals’ or families’ income must be under the 138% line of the Federal Poverty Level, which varies depending on household size.

With Medi-Cal Full-Scope, families and individuals can get all their health needs covered.

“It covers everything, not just emergency services at the hospital,” explains Ibarra, “from sick visits, primary care, preventive care, basic dental care, medications, x-rays, imaging, prenatal care continues to be a benefit, labor and delivery, behavioral health, hospitalization, physical therapy, occupational therapy, to transportation.”

However, fears of the public charge rule — a noncitizen who is likely to become primarily dependent on the government — stop many who qualify for Medi-Cal from applying for this benefit, as it can hinder immigration court cases or applications.

“There’s a lot of misinformation,” says Ibarra. “We have encountered a lot of fear around public charge. A lot of patients refuse to apply for anything because of it.”

In 2022, the government made an amendment to the Public Charge Rule, excluding noncash benefits such as health care.

“It clearly tells us that noncash benefits shouldn’t affect you, which includes health care,” Ibarra says.

The application for Medi-Cal can be submitted online through info.benefitscal.com. An identification document (not necessarily a state ID), proof of address, and proof of income are necessary for the process.

“Another way [to apply for Medi-Cal] is to come to one of our clinics and we have enrollment counselors who can assist from step one to last,” Ibarra explains. “We guide people, enter their information for them.”

For those who still don’t qualify for Medi-Cal due to income limits, DAP Health offers financial assistance on a sliding scale, also regardless of immigration status. Low-income families earning up to 200% of the Federal Income Poverty Guidelines can benefit from discounted medical visits.

“Health care is expensive for everyone,” Ibarra says, “so the sliding-fee scale is something that really has been beneficial to our community.”

Many uninsured patients in Southern California’s Latino communities suffer from conditions that require constant preventative care and access to medication, such as diabetes or high blood pressure. Ibarra says these patients can benefit from access to Medi-Cal. “Preventative medicine is what people did not have access to.” 

Ibarra points out the importance of accessing health insurance. “We need to maintain being healthy, active, and involved in our lives, not worried about “Am I going to get sick?” or “Will I have to go to work sick?”

 

Medi-Cal Admite a Personas de Bajos Ingresos Sin Estatus Migratorio de Cualquier Edad

Por María José Dúran

 

Ahora todas las personas que califican sin importar su estatus migratorio pueden acceder a seguro de salud gratuito o a bajo costo a través de Medi-cal.

Una nueva ley que entró en vigor en enero de 2024 permite que todos los residentes de California de bajos ingresos puedan solicitar seguro de salud gratuito a través del programa Medi-Cal.

“Es un gran paso para incluir a todos los residentes de California”, dice la jefa de Educación de Salud para la Comunidad y Registro de DAP Health Joanna Ibarra.

Con Medi-Cal Full-Scope (cobertura completa), las familias o individuos que califiquen pueden conseguir cobertura para todas sus necesidades de salud.

“Lo cubre todo, no solo servicios de emergencia en el hospital”, explica Ibarra, “desde visitas de enfermedad, atención primaria, cuidados preventivos, cuidado dental básico, radiografías y otras pruebas de imagen, cuidado prenatal, parto y nacimiento, salud mental, hospitalizaciones, fisioterapia, terapia ocupacional, hasta transporte.”

Para poder acceder a Medi-Cal, las familias o individuos de California deben tener unos ingresos anuales que estén por debajo del 138% del Nivel de Pobreza Federal, algo que varía dependiendo del número de personas en el hogar. Puede consultar si su familia califica en este enlace.

Sin embargo, el miedo a convertirse en carga pública impide que muchos soliciten este beneficio. La carga pública es una norma por la que una persona que no es ciudadana de los Estados Unidos y esté en riesgo de convertirse en mayoritariamente dependiente del gobierno es penalizada en los casos de inmigración o de corte migratoria.

“Hay muchísima desinformación”, dice Ibarra, “nos hemos encontrado mucho miedo alrededor de la carga pública. Muchos pacientes no quieren solicitar ningún beneficio por esto”.

Pero la norma de carga pública excluye los beneficios que no son en dinero efectivo. “Claramente nos dice que si el beneficio no es en efectivo no te afecta, lo que incluye los seguros de salud”, dice Ibarra.

Los interesados pueden solicitar Medi-Cal a través de la página web info.benefitscal.com. Para el proceso son necesarias una identificación (no necesariamente un documento oficial estatal), prueba de residencia y prueba de ingresos.

“Otra manera [de solicitar Medi-Cal] es venir a una de nuestras clínicas donde tenemos consejeros de registro que pueden asistir desde el primer al último paso”, explica Ibarra. “Nosotros guiamos a las personas, les ayudamos a llenar los formularios con su información”.

Para los que tengan ingresos anuales superiores y no puedan solicitar Medi-Cal, DAP Health ofrece asistencia financiera en escala gradual sin importar el estatus migratorio. Familias con ingresos que no sobrepasen el 200% del Límite de Pobreza Federal pueden solicitar servicios médicos con descuento.

“Los seguros de salud son caros para todo el mundo”, dice Ibarra,”por eso la escala gradual que ofrecemos en DAP Health ha sido de gran ayuda para nuestra comunidad”.

En el sur de California, muchos pacientes latinos sin seguro médico padecen enfermedades crónicas que requieren atención preventiva constante y acceso a medicamentos, como la diabetes o la presión arterial alta. Ibarra afirma que estos pacientes se podrían beneficiar del acceso a Medi-Cal. "La medicina preventiva es a lo que la gente no tenía acceso."

Ibarra resalta lo importante que es tener accesso a un seguro ide salud como Medi-Cal. “Necesitamos mantener nuestra salud, actividad y desarrollo de nuestras vidas, y no estar preocupados de si me voy a enfermar o voy a tener que ir a trabajar enfermo.”

Meet DAP Health Chief Operating Officer …

Against All Odds

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

Words by Kay Kudukis • Photo by Yohana Moreno

 

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.

 

The Humble Beginnings

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 the mini-mart where she worked full-time, and where Velasquez also 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 former Borrego Health centers now under DAP Health’s auspices.

 

As Velasquez learned more about federally qualified health 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.”

 

A Born Leader

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.

 

Entering the C-Suite

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.

Meet DAP Health Chief Medical Officer Dr …

Semper Gumby

In English, the Latin unofficial motto of the U.S. Navy translates as “Always Flexible.” It perfectly describes DAP Health’s new Chief Medical Officer Dr. Joseph Aquilina

Words by Kay Kudukis

His parents were first-generation Sicilian-American, so of course the entire family went to Grandma’s house for Sunday sauce. It was a nice break from the other six days when, evenings and after school, the three kids helped Mom and Dad in the family’s cleaning business. Cleaning neither garments nor houses. Car dealerships and fitness centers — any business in Buffalo that hired them. In addition, Dad worked two more jobs hoping to give his kids a better version of the American dream than his.

Joseph Aquilina, the only boy, a middle child, took up trombone and football. Maybe because he had an interest, or maybe because after school extracurriculars were more fun than cleaning. But he was drawn to the social aspects, the camaraderie. He even ended up combining both activities when the band performed at Rich Stadium for a Buffalo Bills game. Quite a score for the teenager.

Young Joe played offensive guard and defensive end in high school football. Generally, those positions had a heavier body type than that of Aquilina, who’d grown tall but not thick. His build was more like a quarterback, or a tennis player. He picked up the racket when he was stationed in London, but more on that later.

Because of his size, Joe worked harder to stay on the team, and can still recall the fantastic feeling at homecoming when they called his name: “Playing first string, defensive end, Joseph Aquilina.”

 

College Bound

Some plan their post-secondary life and know exactly where they’ll be after their senior summer. Others haven’t a clue. Aquilina fell into the latter category. He thought he might like to go to college — that’s what all the kids in his honors classes were doing — but he didn’t quite know how he was going to do that. His sister had been the first of any generation to attend college, but she stayed local. He did not want to do that.

His parents didn’t have the knowledge or funds to assist, so he relied on his friends for help and ideas. The University of Rochester came up, so he applied and received academic scholarships. Bonus: It was 90 miles away from Buffalo. Far enough away to live on campus, yet close enough to bring his laundry home on the weekends. “I thought I was busting out,” Aquilina says with a laugh.

He loved Rochester. “I had such a sense of independence. You can control your own schedule. I got my first non-family job at the Fine Arts Library. It was wonderful. I was a gallery guard. I could do my homework, watch the art exhibit, make sure no one touched anything, and get paid to study.”

 

Life in the Lab Was Too Boring

He chose microbiology as a major, but discovered the monotony of the lab didn’t really suit him. That was a problem. One day, a solution walked in: Urologist Dr. Bob, who came to take his wife (head of the lab) to lunch. “He was an affable, gregarious, fun guy,” Aquilina recalls. “And I just asked, ‘Hey, Dr. Bob. Can I join you one day, kind of see what your day is like?’”

Dr. Bob was equally as affable at work with patients, nurses, and staff. “Everybody knew and liked him. I thought, ‘I could do this,’” Aquilina grins, remembering. “It just seemed like a very social, fun job, and he really enjoyed it. So I thought maybe I should consider medical school. I had no idea what that meant.”

His counselor knew, and the news was good. Aquilina already had most of the credits needed. He just had to take the MCAT. His score did not disappoint. He was going to be a doctor!

 

In the Navy

His father wanted to mortgage the family home to pay for it, which terrified Aquilina. “What if I fail? Then he’s gonna lose the house. No way.” He had friends in ROTC at Rochester. “I thought, ‘Well, they seem like they’re happy.’” He cold-called the Navy. The recruiter couldn’t believe his luck. “Yes, we’ll absolutely pay for medical school. When can you start?”

Aquilina graduated from Loyola’s Stritch School of Medicine in Chicago in May of 1994. In July of 1995, he reported for flight surgeon training at Naval Operational Medicine Institute in Pensacola.

For the two years he worked as a flight surgeon, he was deployed for six months on the USS Tarawa, attended to 500 Marine flyers, got a pilot’s license, and logged more than 300 flight hours in a CH46 helicopter.

He got married, they had twin daughters, and he continued to move up in positions and responsibilities within the Navy’s medical sector. That included three years in the U.K., and six months deployed in Kuwait before returning to San Diego. There he earned his MBA, explored his tech fascination with a “side hustle” in dental charting software while concurrently wrapping up his 22 years of service as the director of outpatient health clinics.

 

In Uniform No More

Now both single and a civilian, Aquilina was ready to explore different opportunities. He worked in business development for a year, then shifted back to a team environment overseeing larger medical groups and implementing new initiatives.

For eight years, he served on the board of Glenner Memory Care Centers, specializing in adult day care centers and family resources, becoming well-versed in the workings of nonprofits.

If you peep his social media, you’ll see his playful side: goofy pictures with his kids, visits to tennis matches, and adventures in sailing. In 2014, he met his now fiancé, a concierge physician in San Diego. Last summer, Dr. Joe was a tennis coach for the Special Olympics. 

 

At Long Last, DAP Health

When he learned of DAP Health’s merger with Borrego Health, he saw a unique opportunity. “It’s a beautiful mission, and that was a huge attraction for me,” he says. “It seemed like an organization that really lived its values, which was really, really enticing.”

Right now, he splits his time between San Diego and Palm Springs, and his personal needs are simple: tennis partners. He says he ranks himself a solid 4.0, but “I will play whenever, wherever, with whomever.” 

Semper Gumby.

Everything You Ever Wanted to Know About …

Everything You Ever Wanted to Know About Injectable PrEP to Prevent HIV

Words by Daniel Hirsch

When it first came out in 2012, Truvada — the first-to-market pre-exposure prophylactic (PrEP) to prevent HIV — was a gamechanger. Since then, the CDC reports that more than 300,000 people in the U.S. take PrEP in the form of a daily pill. The FDA also ultimately approved both generic Truvada and a gentler-on-the-kidneys PrEP medication known as Descovy. In 2022, a new player hit the field: Apretude, a brand of longer-lasting injectable PrEP.

To learn more about injectable PrEP, I spoke with DAP Health PrEP Navigation Manager Andrew Glorioso, who has worked in HIV care for 25 years, and who has lived with HIV for even longer.

What is Apretude?

Apretude is an injectable medication that’s used to prevent someone from acquiring HIV. It involves coming to the clinic once every two months for an injection.

What’s the benefit of injectable PrEP over taking a pill? Isn’t oral PrEP enough?

It’s all about lifestyle and being able to provide more options. There was a time when all we had to provide people were condoms. Then we got PrEP. We’ve been continuing to expand what’s available.

Both oral and injectable PrEP protect against HIV with the same level of efficacy — both are 99.9% effective [if taken as prescribed]. However, what Apretude has is the benefit of medication adherence. People who are on oral medication are taking one pill once a day, but are they really taking it once a day? Having to come into the clinic every two months for Apretude actually helps with medical adherence.

Who exactly is injectable PrEP for?

It can help people in situations where it’s difficult to adhere to a regimen. It’s not a one size fits all kind of thing. It takes talking to each individual and determining what makes sense based on their lifestyle. We deal with lots of individuals who may have mental health, substance use, or housing stability issues. Apretude might be a great option because they don’t have to worry about storing their medication or keeping track of pills.

Also, if somebody comes in and they’re interested in Apretude, one of the first things I ask them is: How do you feel about getting a shot? If you really don’t like needles, Apretude is not the thing for you.

Do the shots hurt? Are there any other side effects?

It’s a regular-gauge shot. It’s not like a little pin prick in the shoulder. Some people have reported having injection-site soreness for a couple of days and maybe a little nodule developing under the skin. So, it’s not completely without its possibility of adverse effects. That said, we also have people who are using Apretude and love it. They love knowing they don’t have to worry about taking their PrEP for two months.

Is injectable PrEP more expensive? Is it covered by insurance?

Our ability to get Apretude for individuals depends greatly on the type of health care coverage they have. If somebody is on the state’s Medicaid program (MediCal), or IEHP out here in the Coachella Valley, those programs actually give individuals the option of injectable or oral PrEP, so it’s great. Medicare will cover both versions of PrEP. For people who have private insurance, it depends on the plan. And then for people who are uninsured, we don’t really have a mechanism right now to get them access to Apretude. We can easily get them access to oral PrEP medication for little to no cost. Anybody who wants PrEP can be on oral PrEP. All they have to do is visit Injectable PrEP - DAP Health to make an appointment to see me or one of my colleagues in the PrEP Navigation department.

Urgent Care vs. ER

Knowing when to go where can make a world of difference.

Words by Daniel Vaillancourt

In the realm of health care, knowing when to seek urgent care (AKA immediate care) or head straight to the emergency room can be crucial for timely and effective treatment. Both urgent care centers and ERs serve distinct purposes, and understanding the differences can help you make informed decisions about where to seek medical attention.

 

Urgent Care: Swift Solutions for Minor Ailments

Urgent care centers are designed to handle non-life-threatening illnesses and injuries promptly. They’re ideal for situations where immediate attention is necessary but doesn’t require the full-scale resources of an ER. Common issues treated at urgent care include minor cuts, sprains, colds, flu, and infections. Additionally, urgent care is a suitable option for conditions like mild asthma attacks or minor allergic reactions.

One key advantage of urgent care is accessibility. These centers typically offer extended hours, including evenings and weekends, making them a convenient choice for those seeking prompt medical attention without having to schedule an appointment. Moreover, the cost of care at an urgent care facility is generally lower than that of an emergency room, making it a cost-effective option for non-emergent situations.

 

Emergency Room: Critical Care for Life-Threatening Situations

The ER is reserved for serious, life-threatening conditions that demand immediate attention and a higher level of care. If you or someone you know is experiencing symptoms such as severe chest pain, difficulty breathing, sudden and severe pain, or signs of a stroke, it’s imperative to head to the emergency room without delay.

Emergency rooms are equipped with specialized staff, advanced diagnostic tools, and resources to handle critical situations. They provide a wide range of services, including trauma care, surgical interventions, and treatment for severe illnesses. Time is of the essence in emergencies, and the ER is designed to provide swift and comprehensive care to stabilize patients and address urgent medical issues.

 

When to Choose Urgent Care vs. the ER

Understanding when to opt for urgent care versus the emergency room can save time and resources while ensuring you receive the most appropriate care for your condition. Here are some guidelines to help you make the right decision:

 

Urgent Care

Minor injuries and illnesses

Common cold, flu, and fever

Minor cuts and burns

Sprains and strains

Mild allergic reactions

 

ER

Chest pain and difficulty breathing

Severe injuries, fractures, or head injuries

Sudden and severe abdominal pain

Signs of a stroke (sudden numbness, confusion, trouble speaking)

Loss of consciousness or severe dehydration

 

In case of doubt, it’s essential to prioritize your safety and seek immediate medical attention. If you’re unsure whether your condition is an emergency, it’s better to err on the side of caution and go straight to the ER.

By recognizing the appropriate setting for your medical concern, you can ensure timely and effective care, promoting better health outcomes.

Click here to see DAP Health's four urgent care locations.