Los Angeles County, Calif.
Sickle Cell Disease is an inherited disorder of the red blood cells that causes bouts of extreme pain, organ damage, and premature death. The prevalence is highest among individuals of African and Hispanic descent and affects approximately 100,000 individuals across the country. Advances in treatment have extended the lifespan so substantially that what was once thought of as a pediatric condition has become a disease of adults as well. Los Angeles County is home to nearly half of California’s adults living with the disease, with a concentration in South Los Angeles. Although nearly 70 percent of adults with sickle cell disease rely on public healthcare programs, there was no public clinic in the area to address the needs of these patients. Emergency Department utilization for this patient population, state-wide exceeded 3 ER visits per person annually. The LA County Department of Health Services at Martin Luther King, Jr. Outpatient Center has taken an innovative and collaborative approach to the care of a complex adult condition in developing the only public clinic in the region. Drawing on the principles of the Patient-Centered Medical Home, the clinic pairs a primary care nurse practitioner with an experienced hematologist and nursing care management to offer the full range of services. Partnerships with the Sickle Cell Foundation of Southern California, and the Center for Inherited Blood Disorders provide co-located mental health care, community health workers with lived experience. These resources are combined with complementary therapies of acupuncture and yoga for chronic pain management. Because the services are simply a re-organization of resources already available within the partnering organizations, the novel program is sustainable and cost efficient. The program closes a critical healthcare gap for adults with sickle cell disease residing in Los Angeles County.