County Project Napa 1

California State University, Long Beach

Health Care Administration 300

Napa County Profile

Simran Kooner
015197219
October 24, 2017

Professor Dana Brown

County Project Napa 2

Abstract

This paper will present an analysis and evaluation of Napa Countys health care. It will

specifically assess the effectiveness of its system on the population. In addition, it will establish a

health needs and resource profile examination. The research will incorporate general data in

relation to current health care and resources in Napa County.

The research will use government data and focus on cost, access, and quality by illustrating the

most urgent health problems in Napa County. Moreover, it will further explain the consequences

of prominent problems, how the problems have been addressed, and recommendations to address

these problems.

Key Terms: Napa Health Statistics, Napa Data, Napa Health Programs, and Napa Poverty Levels
County Project Napa 3

Total Population and General Demographics

The 2017 estimated total population is 136,484 people in Napa County within the

estimated 39,848,872 population of California. Napa County is a relatively small county

compared to many other counties in California. A larger part of Napa Countys population

consists of 71% Caucasian American. The rest of the population is categorized into the

following: 32% Hispanic or Latino, 14% other, 6% Asian, 4% two or more races, 1% African

American, and below 1% American Indian, three or more races, and Native Hawaiian Pacific

Islander (Suburban Statistics, 2017). Within this population, the male population is around

68,159 and the female population is around 68,325. The median age in Napa County for both

sexes is 39, for male 38, and for female 41. In addition, the population under 18 years is 30,694

and the population 18 years and over is 107,202. The average household size in Napa County is

2. The unemployment rate, 3.4%, is very insignificant compared to countys such as Los Angeles

County. Napa County has a county rank of 8th in California. Lastly, the working age population

(16-64) is 63.5%.

Population Socioeconomic Status

As of 2016, data shows that the entire Napa County has a poverty rate of 10.3% which is

half less than the entire state of California (Jensen, 2016). Child poverty rates in Napa County is

12.5%. California state average child poverty rate is 22.7%, which means that Napa County is

10.2% better. Next, data shows that poverty rate in Napa County is decreasing over time. In

2011, Napa had a 25.5% poverty rate while the average was 22%. Even though the average

poverty rate has increased slightly over time, Napas poverty rate has decreased significantly.
County Project Napa 4

Health Insurance

In Napa County, during the years of 2011-2015, data for insured and uninsured was

incomparably different. More people were insured than uninsured. From ages 0-5 roughly 5.7%

were uninsured, while 94.3% were insured. An estimated 61.1% are insured by private coverage

and 41.4% is insured by public coverage. Next, the age group 6-17 has 5.9% uninsured and

94.1% insured. Of this insured, around 69.3% were insured by private coverage and 30.3% were

insured by public coverage. Lastly, for the age group 18 and older, 5.9% were uninsured while

94.1% were insured. From the people that were insured, 66.8% were insured by private coverage

and 33.7% were insured by public coverage. Also in 2011-2015, 29.6% of the insured population

was on Medicaid (Medi-Cal) or CHIP Coverage (Health Insurance Coverage by Type of

Insurance and Age, 2016). In 2013, the Medi-Cal point-in-time enrollment for Napa County was

7,943 people. Napa County has a Medicare reimbursement average per patient per year of $7,925

(Napa County, 2017).

Medi-Cal Managed Care

The Medi-Cal Managed Care system is an organization that distributes high quality,

reachable, and efficient health care. This system has set up arrangements specifically for your

county in California. Currently, for all of the counties in California there are 10.3 million Medi-

Cal beneficiaries. These beneficiaries obtain their health care through six main models of

managed care. These include the Two-Plan, County Organized Health Systems, Geographic

Managed Care, Regional Model, Imperial, and San Benito (California Department of Health

Care Services, 2017). The managed care model in Napa County is called Partnership Health Plan

of California. This health care organization is community based and non-profit. Partnership

Health Plan of California contracts with the state to direct Medi-Cal beneficiaries to have access
County Project Napa 5

to first-rate and practical health care. Their mission specifically is to help our members, and the

communities we serve, be healthy (Partnership Health Plan of California, 2017). And their

vision is to be the most highly respected managed care plan in California.

Hospitals and Physicians

There are 3 hospitals in Napa County which include Napa State Hospital, Queen of the

Valley Hospital, and St. Helena Hospital (ONeill, 2017). Queen of the Valley Hospital is the

only hospital in the county that has an emergency room and a trauma center, while St. Helena

Hospital only has an emergency room, and Napa State Hospital has neither. All three of these

hospitals however both serve the medically underserved population. Altogether these three

hospitals also provide multiple different medical and surgical services such as: cancer centers,

orthopedics, imaging services, heart center, neurosciences, maternity/infant care,

emergency/trauma, urgent care, a wellness center, and more (ONeill, 2017). Napa State Hospital

is categorized as an acute psychiatric hospital that is government controlled. This facility serves

the surrounding urban area with inpatient and outpatient services. The hospital has 1,362

licensed beds (ONeill, 2017). Next, the Queen of the Valley Hospital is a general acute care

hospital. It is a nonprofit controlled facility surrounding urban area with inpatient and outpatient

services. It has basic emergency and level III trauma services. Queen of the Valley Hospital has

191 licensed beds and has special designations for its trauma center (ONeill, 2017). Lastly, St.

Helena Hospital is also a general acute care hospital like Queen of the Valley Hospital. It is a

nonprofit controlled facility in Napa County and its core markets crosses into six other counties.

This hospital has basic emergency services and 151 licensed beds (ONeill, 2017). Overall, in

Napa County there are 1,705 licensed beds available (whether it is an acute psychiatric hospital
County Project Napa 6

or a general acute care hospital) for the 136,484 population. Which means there is roughly 1 bed

available for every 80 people in Napa County.

In Napa County, there are 485 licensed physicians and California has 103,926 licensed

physicians in total (Huffman, 2016). It is very difficult for patients to find a physician in Napa

County, especially if they are a primary care doctor or specialist. In Napa, there is a 33.3% ratio

of doctors who are primary care physicians when ideally, 50% of doctors should be primary care

physicians (Huffman, 2016). Additionally, almost half of all primary care physicians will be

retiring soon. Most of the physicians in Napa are turning into concierge doctors.

Community Clinics

The clinics in Napa County tend to be independently owned and operated. These clinics

are unassociated with any networks or brands. There are seven clinics in Napa County that are

primary care clinics and chronic dialysis clinics. The primary care clinics include Community

Health Clinic Ole Calistoga, Community Health Clinic Ole Napa, Community Health Clinic

Ole St. Helena, Community Health Clinic Ole Trancas St, and Planned Parenthood Napa

Center (ONeill, 2017). And the chronic dialysis clinic includes Napa Dialysis Center and the

Silverado Dialysis (ONeill, 2017). Napa County also offers free and income based clinics for

low income patients. Some of these clinical services include dental, medical, womens health,

adult health, pediatric health, pediatric dental, and behavioral health (Napa County CA Free and

Income Based Clinics, 2017). A great amount of the population in Napa tends to go to these

community clinics rather than the three hospitals located in Napa County.

Public Health and Mental Health Services

In regards to Public Health and Mental Health Services in Napa County, Napa has a lot of

programs and information regarding the two. For instance, starting off with public health, one of
County Project Napa 7

Napas main goals is to serve the people of their county by protecting health, promoting healthy

lifestyles, supporting families by raising healthy children, working to prevent disease, premature

death, and disability, and responding to disasters (Public Health, 2016). A list of all the specific

services and programs offered in the public health division include child and family health, clinic

services, communicable disease control and prevention, chronic disease and health equity, EMS

(emergency medical services), seasonal influenza (the flu), medical marijuana id care,

prescription RX discount card, public health preparedness, safe and legal disposal of home

generated sharps, vital statistics (birth, death certificates, and burial permits), and WIC (women,

infants, and children) (Public Health, 2016). Next, mental health services in Napa are also

considered very important in this county. Napas mental health services mission is to

responsibly provide mental health services that promote individual strengths, inspire hope, and

improve the quality of life for people within Napa County (Napa County Mental Health, 2016).

Their vision is to eliminate suffering associated with mental illness (Napa County Mental Health,

2016). Napa County Mental Health offers community based mental health services in partnership

with regional organizations to provide a broad range of services to individuals in need of mental

health care. These services include mental health crisis services, mental health community

resources and referral services, adult mental health services, childrens mental health services,

older adult mental health services, and residential services (Napa County Mental Health, 2016).

Childrens Health

In Napa County, there is an estimated of 30,694 children. In the matter of childrens

health: approximately 88% women receive early prenatal care, 84% newborns are exclusively

breastfed while in the hospital, 96% children have health insurance for the entire year, 98%

children have a usual source of health care, 43% young children, ages 0-3, are low income and
County Project Napa 8

have visited a dentist in the last year, 48% children are a healthy weight, 26% students are low

income and eat free or reduced priced breakfast during the school year, 90% students are low

income and eat free or reduced price meals during the summer, 0% schools that have a health

center, and 71% adolescents are not at risk for depression (Napa County, 2017). Furthermore,

touching upon child welfare and economic well-being, approximately 92% young children, ages

0-3, do not experience recurring abuse or neglect, 94% children in welfare system have a

medical exam in the last year, and 100% children are not living in communities of concentrated

poverty (Napa County, 2017). In Napa, there is also a community health initiative, that can apply

to children. They are a nonprofit corporation trying to gain health coverage for everyone in the

county, specifically children. On top of that, they are working with multiple different partners

and organizations to reach out to families in Napa County who need information and assistance

in enrolling in low-cost insurance plans. Their mission is to improve the health of children and

their families residing in Napa County, California by improving access to health care services

through health insurance enrollment, education, advocacy, and resource support (Napa County,

2017). Initiatives like these are what other counties need to implement to have a great childrens

health plan like in Napa County. You will then be able to see positive and healthy results among

the children in your county, as Napa does.

Health Workforce Shortage, Medically Underserved Designations

Napa County is currently facing a great health workforce shortage. To begin with, in

Napa County the Health Professional Shortage Area (HPSA) discipline class Primary Care,

Dental Health, and Mental Health are all designated as a comprehensive health center. Primary

Cares HPSA score is 17 and has a status as designated as of 12/11/2015 (HPSA Find, 2017).

Dental Health HPSA score is 21 and was designated as of 9/30/2004 (HPSA Find, 2017). Mental
County Project Napa 9

Health HPSA score is 19 and has been designated as of 12/11/2015 (HPSA Find, 2017). The

HPSA score ranges from 1 to 26 where the higher the score, the greater the priority.

The California Healthcare Workforce Policy Commission designated Napa County as a

Medically Underserved Population (MUP) in May 1995. 20 out of 58 counties are at least

partially designated. Napa County was divided into Napa Service Area and St. Helena Service

Area. To start off with, Napa Service Area has an index of medical underservice score of 54.10,

where the lowest score (highest need) is 0 and the highest score (lowest need) is 100 (MUA Find,

2017). And for St. Helena Service Area, there index of medical underservice score is 59.50

(MUA Find, 2017). In order to qualify for designation, the IMU score must be less than or equal

to 62.0. Some basic facts that the MUP provides is overlapping hospital markets, overlapping

healthcare shortage areas, overlapping legislative districts, other adjacent MUP, and more (MUA

Find, 2017). Some licensed primary care clinics whose address places them inside this MUP is

The Community Health Clinic Ole Napa, The Community Health Clinic Ole Trancas St, The

Community Health Clinic Ole Calistoga, and The Community Health Clinic Ole Saint

Helena (MUA Find, 2017).

Health Outcomes and Factors

In 2017, County Health Rankings ranked Napa County 6th out of 58 counties in

California for health outcomes. The two sections under the health outcomes include length of life

and quality of life. In terms of length of life, Napa is ranked number 6th in 4,400 premature

deaths (Health Rankings, 2017). For quality of life, Napa is ranked number 9th consisting of poor

or fair health being around 14%, poor physical health days was 3.5%, poor mental health days

was 3.4%, and low birthweight was 6% (Health Rankings, 2017).

County Project Napa 10

Moreover, Napa County is ranked 15th for its health factors. The four health factors

include health behaviors which is ranked 19th, clinical care ranked 19th, social and economic

factors ranked 9th, and physical environment ranked 32. Part of health behavior is 12% adult

smoking, 24% adult obesity, 8.5 food environmental index, 16% physical inactivity, 94% access

to exercise opportunities, 19% excessive drinking, 37% alcohol-impaired driving deaths, 271

sexually transmitted infections, and 21 teen births (Health Rankings, 2017). Clinical care

includes 13% uninsured, 32 preventable hospital stays, 82% diabetes monitoring, and 61%

mammography screening (Health Rankings, 2017). Social and economic factors consist of 89%

high school graduates, 58% some college, 4.6% unemployment, 12% children in poverty, 4.5%

income inequality, 28% children in single-parent households, 7.7% social associations, 341

violent crimes, and 51 injury deaths (Health Rankings, 2017). Lastly, physical environment

encompasses 7.5% air pollution particulate matter, 24% severe housing problems, 76% driving

alone to work, and 30% long commute driving alone (Health Rankings, 2017).

Nutrition and Food Insecurity

In Napa County, nearly 6,000 children live in nutrition and food insecure households.

That turns out to be about 18.6% of the children in Napa County. Food insecure children likely

income-eligible for federal nutrition assistance are around 69%. In 2013-2014, roughly 48% of

low-income households were food insecure. In 2015, Napa is considered to have 9.7 food

insecurity rank and 13,580 food insecure individuals. The likely income eligibility for federal

nutrition assistance such as SNAP, WIC, free school meals, CSFP, and TEFAP is 77% and for

charitable response is 23% for these individuals (County Profiles and California Food Policy

Advocates, 2016). One important food insecurity indicator is that 6.4% of babies are born with

low birth weight. The obesity indicator states that 13.1% of adults are categorized as being
County Project Napa 11

obese. Around 6,700 people are diagnosed with diabetes and 30 people have died due to diabetes

related deaths. Napa County has a great deal of programs designated to help you and your family

eat right. Some of these programs and services can include Cal-Fresh, Napa Local Food

Advisory Council, WIC (women, infants, and children), Napa County Agricultural

Commissioners Office, Queen of the Valley Medical Center Community Outreach, 4-H, Food

Stamp Program, National School Lunch Program, School Breakfast Program, Summer Food

Service Program, and Child Care Food Program (Eat, 2017).

Crucial County Health Problems

Napa County has two major unmet health needs. The first one is overweight and obesity

rates, which is a concern for all age groups. 40% of 5th, 7th, and 9th graders in Napa County are

now overweight or obese (Live Healthy Napa County, 2016). Secondly, mental health is also an

important issue in Napa County. The suicide death rate is above the Healthy People 2020

national objective (Live Healthy Napa County, 2016). In addition, in the past 12 months, nearly

one in five 9th and 11th graders have indicated that they have considered attempting suicide (Live

Healthy Napa County, 2016). These two crucial health problems for Napa County need to be

addressed immediately. If not, the consequences of the problems addressed can be detrimental.

For instance, being overweight and obese can lead to severe health issues. These can include

being diabetic, having high blood pressure, coronary artery disease, coronary vascular disease, a

stroke, a heart attack, and even cancer. And in regards to mental health, if we do not address it as

a problem we can see numbers only going up for suicide. Moreover, you will feel extremely

guilty for not preventing the suicide and saving someone elses life.
County Project Napa 12

My Recommendations for Solutions to the Problems

A solution to these two major health issues listed above could be educating the public on

whats going on in terms of health in Napa County. By doing so, many people will be able to

establish preventative habits and start thinking about living a healthier life, which will reduce the

numbers of these major unmet health needs. Individuals will also then begin to be able to help

others out in need by knowing that there is something that could be done to help someones life

be better. Furthermore, by setting up and financing community events to discuss these two

concerns we can decrease these health problems significantly by tackling them down as a society

altogether. By everyone working together to fix these two problems, we will have a variety of

different ideas leading to a common good, in this case the two major unmet health needs will be

fixed. In a community that addresses overweight, obesity, and suicide rates there will only be

good done by doing so. We will then see positive results and a change that is exceptional.
County Project Napa 13

References

California Department of Health Care Services. (2017). Retrieved October 24, 2017,

from http://www.dhcs.ca.gov/services/Pages/Medi- CalManagedCare.aspx

County Profiles and California Food Policy Advocates. (2016). Retrieved October

24, 2017, from http://cfpa.net/county-profiles

Eat. (2017). Retrieved October 24, 2017, from http://www.countyofnapa.org/ceo/eat/

Health Insurance Coverage by Type of Insurance and Age. (2016). Retrieved October 24,

2017, from http://www.kidsdata.org/topic/774/healthisurance-age10/table#fmt=1183&loc

=339&tf=90&ch=484,1109,1108551,1113,1114,1115&sortColumnId=0&sortType=asc

Health Rankings. (2017). Retrieved October 24, 2017, from

http://www.countyhealthrankings.org/app/california/2017/rankings/napa/county/factors/o

verall/snapshot

HPSA Find. (2017). Retrieved October 24, 2017, from

https://datawarehouse.hrsa.gov/tools/analyzers/HpsaFind.aspx

Huffman, J. (2016). Patients struggle to find a primary care doctor. Retrieved October 24, 2017,

from http://napavalleyregister.com/news/local/ patients- struggle-to-find-a-primary-care-

doctor/article_92344ece-15b4-5950-90b0-6630029fc9e4.html

Jensen, P. (2016). New poverty measure rates Napa near bottom. Retrieved October 24, 2017,

from http://napavalleyregister.com/news/local/new-poverty-measure-rate-napa-near-

bottom/article_6f76abf8-3907-11e3-9492-0019bb2963f4.html

Live Healthy Napa County. (2016). Retrieved October 24, 2017, from

http://www.countyofnapa.org/lhnc/
County Project Napa 14

MUA Find. (2017). Retrieved October 24, 2017, from

https://datawarehouse.hrsa.gov/tools/analyzers/MuaSearchResults.aspx

Napa County. (2017). Retrieved October 24, 2017, from

https://datausa.io/profile/geo/napa-county-ca/

Napa County. (2017). Retrieved October 24, 2017, from

http://pub.childrennow.org/2016/county/napa

Napa County CA Free & Income Based Clinics. (2017). Retrieved October 24, 2017,

from https://www.freeclinics.com/co/ca-napa

Napa County Mental Health. (2016). Retrieved October 24, 2017, from

http://www.countyofnapa.org/Pages/DepartmentContent.aspx?id=4294967776

O'Neill, M. (2017). Retrieved October 24, 2017, from http://gis.oshpd.ca.gov/atlas/places

/list-of-clinics/county/napa

Partnership Health Plan of California. (2017). Retrieved October 24, 2017, from

http://www.partnershiphp.org/Pages/PHC.aspx

Public Health. (2016). Retrieved October 24, 2017, from

http://www.countyofnapa.org/PublicHealth

Suburban Statistics (2017). Current Napa County, California Population, Demographics, and

Statistics in 2016, 2017. Retrieved October 24, 2017, from

https://suburbanstats.org/poplation/california/how-many-people-live-in-napa-county
County Project Napa 15

Total Population and General Demographics:

https://suburbanstats.org/population/california/how-many-people-live-in-napa-county

Population Socioeconomic Status:

http://napavalleyregister.com/news/local/new-poverty-measure-rates-napa-near-
bottom/article_6f76abf8-3907-11e3-9492-0019bb2963f4.html

Health Insurance:

https://datausa.io/profile/geo/napa-county-ca/

http://www.kidsdata.org/topic/774/healthinsurance-
age10/table#fmt=1183&loc=339&tf=90&ch=484,1109,1108,551,1113,1114,1115&sortColumnI
d=0&sortType=asc

Medi-Cal Managed Care:

http://www.dhcs.ca.gov/services/Pages/Medi-CalManagedCare.aspx

http://www.partnershiphp.org/About/Pages/default.aspx

Hospitals:

http://gis.oshpd.ca.gov/atlas/places/list-of-hospitals/county/napa

https://www.thequeen.org

Physicians:

http://napavalleyregister.com/news/local/patients-struggle-to-find-a-primary-care-
doctor/article_92344ece-15b4-5950-90b0-6630029fc9e4.html

https://www.kff.org/other/state-indicator/total-active-
physicians/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%2
2:%22asc%22%7D

Community Clinics:

http://gis.oshpd.ca.gov/atlas/places/list-of-clinics/county/napa

https://www.freeclinics.com/co/ca-napa

Public Health and Mental Health Services:

County Project Napa 16

http://www.countyofnapa.org/PublicHealth/

Childrens Health:

http://pub.childrennow.org/2016/county/napa/

http://www.napachi.org/home

Health Workforce Shortage, Medically Underserved Designations:

https://datawarehouse.hrsa.gov/tools/analyzers/HpsaFindResults.aspx

http://gis.oshpd.ca.gov/atlas/topics/shortage/mup/napa-service-area

http://gis.oshpd.ca.gov/atlas/topics/shortage/mup/st.-helena

https://datawarehouse.hrsa.gov/tools/analyzers/MuaSearchResults.aspx

Health Outcomes and Factors:

http://www.countyhealthrankings.org/app/california/2017/rankings/napa/county/factors/overall/s

napshot

Nutrition and Food Insecurity:

http://www.livehealthynapacounty.org/food-insecurity.html

http://cfpa.net/county-profiles

http://www.feedingamerica.org/research/map-the-meal-

gap/2015/MMG_AllCounties_CDs_MMG_2015_1/CA_AllCounties_CDs_MMG_2015.pdf

http://www.feedingamerica.org/research/map-the-meal-
gap/2015/MMG_AllCounties_CDs_CFI_2015_1/CA_AllCounties_CDs_CFI_2015.pdf

http://www.countyofnapa.org/ceo/eat/

http://cfpa.net/GeneralNutrition/CFPAPublications/CountyProfiles/2004/Napa.pdf

Crucial County Health Problems:

http://www.countyofnapa.org/lhnc/