‘Passionate about health equity’: Alicia Hardy, CEO of OLE Health in Napa and Solano counties

‘Passionate about health equity’: Alicia Hardy, CEO of OLE Health in Napa and Solano counties

Alicia Hardy, CEO of OLE Health in Napa, believes comprehensive, quality health care shouldn’t be reserved for those whose wallets are the fattest.

“I’m so passionate about health equity,” the 45-year-old said. “Everyone should have a right to access high quality care. We need to find a way to provide that.”

OLE Health is the only nonprofit health center in Napa County. OLE has seven clinics in Napa and Solano counties that serve nearly 40,000 patients; some of whom are the most vulnerable in the community.

Next summer, it combines forces with CommuniCare Health Centers in Yolo County. Previously reported as to be completed in January, Hardy said the merger was delayed six months to ensure there would be no disruption in revenues or billing what with all the state and federal agencies the health care providers deal with.

Besides working on equitable health care, Hardy is cognizant health care workers are enduring “multiyear pandemic fatigue” that has led many of them to leave the profession.

“There has been a lot of discussion about strategies to mobilize different levels of health care workers,” Hardy said. This means a community health clinic might be less reliant on having physicians on staff, but could instead have mid-levels. Staffing shortages are affecting medical facilities throughout the nation, not just locally. “We need to be strategic with the time and resources we have. This is more of a long-term strategy. It’s bigger than the pandemic.”

As of July 1 OLE Health and CommuniCare Health Centers will become one entity. Why merge with the Davis-based entity?

CommuniCare and OLE have very similar DNA, making organizations vital community partners. We provide similar services, we share a common mission, and we are both deeply rooted in our communities.

As the health care landscape continues to shift, uniting as one entity is a strategic step that better positions both organizations to meet the new challenges that lie ahead. Part of the decision is about financial sustainability, but it is also about elevating the position of the organization to better advocate for resources and policy changes that will improve our delivery system overall.

OLE and CommuniCare both celebrated 50-year anniversaries in 2022. What do you attribute the longevity to?

Our longevity is a result of the deep connection we have to our patients, to our employees, and to our communities, as well as the generous support of donors and funders over the years.

Each year the need for services only continues to grow and the commitment of our staff and our teams to meet this need is an important part of our ability to sustain our respective organizations.

The merger means the new entity will have 17 sites serving more than 71,000 patients across Napa, Solano and Yolo counties. How do you anticipate your job as CEO will change going forward?

When we expanded into Solano County, the primary shift was building new relationships in the county and understanding the differences in the landscape and unique needs of the community.

I anticipate that the merger with Yolo will feel similar, developing relationships with local government and other stakeholders. The difference will be new relationships with everyone on the CommuniCare side, integrating our teams and our cultures and creating a shared vision for the future.

I also expect to spend more time personally visiting each of the sites and investing in broad communication to ensure that we are all on the same page and moving in the same direction.

So many, but if I had to choose, I would say the gaps in our health care system and the well being of our workforce.

There is not enough access to specialty care. There is not enough insurance coverage for everything our patients need. The system is confusing and difficult to navigate, and the administrative burden is heavy.

We do everything we can to help, including offering care coordination and eligibility and enrollment assistance, but for our patients the barriers are many.

(Also,) our workforce has spent the past three years providing care during the pandemic, and that comes with compound stress and a collective mental and emotional fatigue that our care teams feel every day.

The needs of our patients are increasingly complex, resources and time are limited, and there is never enough access to meet the need. I worry about supporting the mental health and well-being of our care teams and the constant pressure of offering that support when we work in a high-pressure, high-volume system.

Over 25% of the health care workforce has left since the pandemic began, and that just leaves those still working with an even greater burden of care. It’s a challenge because the people who are still here have to carry the extra burden and the demand has not slowed. There are fewer people going into the industry.

What is your approach to making tough and important business decisions?

I depend on data, my team, and key advisers. I always use the framework of how the decision in question could impact our patients, our workforce, or our community.

Health care is constantly changing and there are many unknowns, so I approach decisions with a relatively high tolerance for risk and make the best decision I can with the information I have at the time.

What lesson did you learn early in your career that you now recognize as an important one?

The most important lesson I learned was to embrace change and to understand that helping people navigate the discomfort of change is a critical role of a leader. Mindset is a choice and I have found that choosing to be solution-oriented rather than resisting change helps move the work forward with energy and positivity.

I try and pay attention to what energizes people. I try and find projects or areas of focus for those on my team where they can connect to that area of passion, or curiosity or expertise. I try to combine the message of our mission with the unique talents that everyone brings to OLE.

Workforce shortages; that we will not have enough people to provide the care that our communities need. I believe this will continue to be an issue for years to come. I am also concerned about the affordability of housing and how we can create healthy communities where people can afford to live and work in the same community.

In health care, success has to be measured broadly and really focus on our overall impact on well-being and health. We track so many access and quality metrics, and at the end of the day it is about whether we helped create a path to a better quality of life.

Did we move the needle in the right direction on controlling hypertension and diabetes? Did we expand services and increase our total unique patients served? Do our employees feel supported and do they feel that OLE Health is a great place to do this very important work. Our mission drives our strategy, and our success is based on executing on our mission for the greatest number of patients possible.

But success to me really comes down to the questions: Is someone’s life better because of what we did? Was someone heard because our social worker listened to them? Was someone seen because a physician helped them? Was someone better off because of an interaction with our employees? If yes, then I call that a success.

The North Bay provides us terrific access to incredible talent, allowing us to be able to hire some of the best and brightest to care for the communities we serve. It is also a very desirable place to live that offers a high quality of life and close community connections.

The biggest drawback is the cost of living and the barriers that cost creates for our workforce, both in recruitment and retention. There is also a high level of competition for talent.

I would eliminate the fee-for-service model of reimbursement completely.

It restricts our ability to provide truly patient-centered care and be more creative about how providers and care teams spend their time delivering services.

If all payers worked under a capitated model, then our teams could adjust their approach based on each individual patient's need. I think communities would be healthier, and providers would be happier because the focus would be on value, not volume. We would get paid a set amount for keeping people healthy.

Nutritional education, lifestyle management and quick home visits are things we don’t get paid for. We can’t design our care model to meet patients’ needs because none of that reimbursable.

The question is: How do you really transform the care you need to have flexibility and have it be financially sustainable? The state is working toward that with Medi-Cal management plans through a pilot alternative payment method.

How does the national economy impact your business and what are you doing about it?

The national economy and inflation have had a huge impact on our business. Just like other industries we have increased compensation to help support staff dealing with higher cost of living.

We also rely on the generosity of our donors and have implemented more aggressive fundraising strategies and grant funding opportunities.

What led you to live and work in Peru and Nigeria, and how did your experiences in both countries bring you to where you are today?

From a young age, I have wanted to see the world and learn from different cultures. As I grew older, I knew that I wanted to live a life of service and giving back to communities — both local and global.

After graduating from Boston College, I participated in an international volunteer program where I lived and worked in Peru for two years. I left Peru, not only with a deep appreciation for the culture and the language, but also for the struggles for food, economic, and housing insecurity that so many families experience every day.

Peru reinforced this commitment to service, hoping that I could find a career devoted to addressing injustice through reducing various social disparities.

During graduate school, I was fortunate to travel on a grant-funded project to Nigeria to study access to contraception for HIV-positive women in the city of Abuja. I learned about how important it is to have access to accurate information and health care resources.

My time in Nigeria further reinforced my commitment to health equity and making a difference in historically marginalized communities. Both opportunities gave me new perspectives on the impact of poverty, the diversity of people's lived experiences, the power of resilience.

These experiences are what brought me to OLE 13 years ago and are what help me to try to lead from a place of humility and empathy as we work together to create better health for the communities we serve.

I think I would have learned finance and quantitative skills earlier. I learned much of these skills on the job and now am completing my MBA, but I think if I had been more well-rounded in my skills earlier, that would have helped.

We often gravitate toward what we love, which for me as a literature major was reading, writing, and more of the soft skills. I think it is important to push yourself to balance out areas where you need to develop greater expertise.

My very first job was waiting tables. My first career job was as a teacher in a very underserved and high crime neighborhood in the South Bronx.

I was working at a small charter school in Hunts Point, and then co-founded a middle school for girls. It was an amazing experience that taught me so much about community organizing and the importance of relationships. That experience is what inspired me to go back to school to get my first master’s at UC Berkeley in their management and planning program through the School of Social Welfare.

I loved learning in partnership with the community, and I wanted to enhance my skill set and strengthen my leadership to have even more impact in the future.

Is this the job you wanted when you were young? If not, what were your earlier career aspirations?

My father was a physician, and my mother was a nurse. Sometimes on the weekend I would go with my dad as he did his rounds at the hospital. He had such a great bedside manner, and his patients were so grateful to him for the care he provided. I always thought I would follow in his footsteps and even started as premed in college.

Then I realized that I could not tolerate blood or bodily fluids. So that is how I ended up on the administrative side of health care.

I am the first born of three in my family and I was always comfortable with taking the lead, managing extra responsibilities and making decisions. I can't think of any one specific example, but I would say I had leadership qualities from a young age.

I love spending time with my family and three kids, who love arts and crafts, cooking and spending time outdoors.

Also, exercise for me is essential. I have run several marathons and I find that running is both calming and meditative, a good way to clear my mind.

I also love to read, particularly fiction and long novels that engage my imagination and expand my way to thinking about the world. Stress management has been more important than ever these past two years trying to balance a demanding job, being in a full-time MBA program at Yale School of Management and leading through COVID.

What advice would you give someone just starting his or her career in your industry?

If you want to be a leader, it is so important to truly understand the work. I would advise anyone to do different front line jobs, where you are really in the weeds and understand the day-to-day experience before taking on any leadership role.

My first job at OLE Health was as a behavioral health provider. I have a licensed clinical social worker license, and while I aspired to leadership and knew I would not be a clinician long-term, doing that work and hearing patient stories firsthand was invaluable. I still use those experiences in my decision-making because I know what that experience feels like.