HCA Factbook 2024-2025

OVERVIEW

The OC Health Care Agency (HCA) is a regional provider, charged with protecting and promoting individual, family, and community health through coordination of public and private sector resources. The HCA provides a variety of preventive and regulatory services. The funding for the HCA is complex, with 169 different funding sources and more than 200 State and Federal mandates. The mandates under which the HCA operates require the County of Orange (County) to provide for or regulate certain health services. Many also carry specific requirements for staffing, operations, claiming, and recordkeeping.

A portion of the HCA’s services are preventive in nature, and many of the HCA’s services target specific specialty populations. Some examples of services include mental health services, substance use disorder (SUD), preventive health services for older adults, health care for individuals who are incarcerated, communicable disease control, child health and disability programs, immunizations, public health field nursing and public health clinics, food protection, hazardous waste regulation, water quality monitoring, and pollution prevention.

EXECUTIVE ORGANIZATIONAL CHART

Ian Kemmer DIRECTOR OF BEHAVIORAL HEALTH SERVICES

Joanne Lim DIRECTOR OF CORRECTIONAL HEALTH SERVICES

Veronica Kelley AGENCY DIRECTOR

James Kim

DEPUTY DIRECTOR OF GOVERNMENT AFFAIRS & COMMUNICATIONS

Jenna Sarin DIRECTOR OF PUBLIC HEALTH AND NURSING SERVICES

Kelly Sabet

CHIEF COMPLIANCE OFFICER OFFICE OF COMPLIANCE

Lorraine Daniel ASSISTANT AGENCY DIRECTOR

ADMINISTRATIVE SERVICES

Mindy Winterswyk DIRECTOR OF SPECIALIZED MEDICAL SERVICES

Regina Chinsio-Kwong COUNTY HEALTH OFFICER

ADMINISTRATIVE INFRASTRUCTURE

Director’s Office

Leads the HCA’s primary focus to serve and promote equitable health and safety in Orange County. Under guidance and leadership of the Agency Director and Assistant Director, the Director’s Office provides administrative guidance for all of the HCA’s operations.

Administrative Services (AS)

The HCA’s Administrative Services team provides internal operations that support the HCA, enabling staff to provide the best possible service to our community. Administrative Services is an integral component of the Agency’s ecosystem ensuring seamless operation and efficiency through the provision of comprehensive support to all service areas. Administrative Services has a workforce of more than 300 staff organized in the following structure:

 Accounting and Finance Services

 Administrative Operations

 Human Resources

 Information Technology

 Management Services

 Procurement and Contract Services

 Research Office

Office of Compliance and Privacy

HCA’s Compliance Program is responsible for ensuring organizational compliance with federal and state regulatory requirements. The Compliance Program establishes standards of compliance and ethical conduct for HCA staff, provides ongoing support and education, and offers a mechanism by which to report suspected violations. The Office of Compliance also works to prevent, detect and correct potential violations of law and policy. Additionally, they are responsible for the daily management of privacy incidents, breach analysis, and reporting.

Office of Government Affairs and Communications

Includes divisions which support executive leadership and facilitate cross-collaborative development, implementation, and improvement of initiatives. Serves as the Agency’s liaison to the County of Orange Board of Supervisors, the County Executive Office, and external elected officials. Government Affairs and Communications has a workforce of nine organized in the following structure:

 Communications

 Custodian of Records

 Grants and Funding Opportunities

 Legislation and Policy

BEHAVIORAL HEALTH SERVICES (BHS)

BHS services areas include Specialty Mental Health Services (SMHS), Mental Health Plan (MHP), Organized Delivery System (ODS), Behavioral Health Services Act (BHSA), with numerous requirements in statute. BHS is also the safety net for the uninsured who have a serious mental illness or substance use disorder. BHS has a workforce of more than 1,500 staff organized in the following structure:

 Adult and Older Adult Services (AOA)

 Behavioral Health Services Act (BHSA)

 Children and Youth Services (CYS)

 Crisis and Acute Care Services (CACS)

 Data Analytics and Evaluation (DAE)

 Forensics

 Substance Use Disorder Services (SUD)

CORRECTIONAL HEALTH SERVICES (CHS)

CHS provides comprehensive health care services to all adult inmates within the County of Orange correctional facilities operated by staff from the Orange County Sheriff’s Department, as well as to youth residing within the residential facilities operated by staff from the OC Probation Department and Social Services Agency. CHS provides these health services to approximately 40,000 to 60,000 individuals each year. CHS has a staff of more than 500 delivering mandated services 24 hours a day/7 days a week, organized in the following structure:

 Adult Correctional Health (CHS)

 Juvenile Health Services (JHS)

 Orangewood Children and Family Center (OCFC) Medical Services

Joanne Lim, MSN, RN DIRECTOR

Correctional Health Services

(714) 834-5518

jolim@ochca.com

PUBLIC HEALTH SERVICES (PHS)

PHS monitors and investigates the occurrence of disease, injury, and related factors in the community, and in collaboration with community partners, develops and implements preventive strategies to maintain and improve the health of the public. PHS serves the uninsured and underinsured populations, with a workforce of more than 700 staff organized in the following structure:

 Clinical Services Division (CSD)

 Communicable Disease Control Division (CDCD)

 Community and Nursing Services Division (CNSD)

 Environmental Health Division (EH)

 Health Promotion and Community Planning (HPCP)

 OC Public Health Laboratory (OCPHL)

Jenna Sarin, MSN, RN DIRECTOR

Public Health and Nursing Services

(714) 834-4099

jsarin@ochca.com

SPECIALIZED MEDICAL SERVICES (SMS)

SMS includes divisions which ensure medical emergency response and disaster management, medical care for eligible children, probate and Lanterman-Petris-Short Act conservatorships for individuals who are no longer able to make decisions for themselves, and health support for County staff. SMS has a workforce of approximately 350 staff organized in the following structure:

 California Children’s Services (CCS)

 Emergency Medical Services (EMS)

 Employee Health Services (EHS)

 Medical Safety Net (MSN)

 Office of Public Guardian (PG)

(714) 834-5052

mwinterswyk@ochca.com

COUNTY HEALTH OFFICERS

The Health Officer role is unique and challenging. California law requires each county to appoint a Health Officer, who must be a physician. California law gives local Health Officers several distinct duties, requiring them to enforce and observe local orders and ordinances pertaining to public health and sanitation laws, orders prescribed by the California Department of Public Health, and statutes relating to public health. Health Officers are authorized to control contagious, infectious, or communicable disease which can include isolation and quarantine orders to prevent and control the spread of disease. Additionally, the state grants Health Officers broad authority to take action to protect and preserve public health in emergency situations. The Health Officer may declare a local health emergency when necessary, which can then be extended by the Board of Supervisors. As a physician, the Health Officer will be a trusted voice during outbreaks or emergencies as both the media and the public seek experts in times of crisis.

Regina Chinsio-Kwong, DO COUNTY HEALTH OFFICER

(714) 834-2729

rchinsiokwong@ochca.com

Almaas

Shaikh, MD

DEPUTY HEALTH OFFICER

(657) 250-5872

ashaikh@ochca.com

AGENCY KEY RESOURCES

OC Links Behavioral Health Services Information and Referral Line

855-OC-LINKS (625-4657)

Live chat online at www.ochealthinfo.com/oclinks

Monday to Friday from 8 a.m. to 6 p.m.

OC Navigator

www.ocnavigator.org Connects to resources in Orange County for health, wellness, and other supportive services.

Health Referral Line (800) 564-8448 – Monday to Friday from 8 a.m. to 5 p.m.

Provides general information about Public Health Services and referrals to community resources.

Reporting foodborne illnesses or food facility complaints

Over the phone by calling (714) 433-6418 or online at: https://bit.ly/OCEH_File_A_Complaint

OC Health Care Agency Media Line (714) 834-2178 or press@ochca.com

OC HEALTH CARE AGENCY SOCIAL MEDIA

ADMINISTRATIVE SERVICES

FY 2025-26 Budget: $20,929,580

Total Employees: 160

The HCA’s Administrative Services team provides internal operations that support the HCA, enabling staff to provide the best possible service to our community. Administrative Services is an integral component of the Agency’s ecosystem ensuring seamless operation and efficiency through the provision of comprehensive support to all service areas. Administrative Services has a workforce of more than 300 staff organized in the following structure:

 Accounting – Accounting Services is organized into five units: (1) Claims and Financial Reporting, (2) Disbursements, (3) Environmental Health, (4) Medical Billing Unit and (5) Public Guardian which provide professional accounting support, Medi-Cal billing services and court accounting among other services.

 Financial Services – Financial Services develops and maintains the 5-year Strategic Financial Plan, prepares and monitors the HCA’s annual budget, and ensures financial year-end reporting is accurate and correct and in alignment with Federal, State and County policies.

 Human Resources – The Human Resources (HR) team works to attract, retain and develop a highly-skilled and competent work force so the HCA can provide outstanding service. Day-to-day support

includes recruiting, compensation, performance management, policy and procedure review and training.

 Information Technology – The HCA Information Technology (IT) department administers the Agency’s robust and secure technology infrastructure; develops and manages complex applications in support of the Agency’s mission; and assists Agency programs with essential operational support while adhering to strict Federal, State and County privacy and compliance frameworks.

 Management Services – Management Services includes Facilities Services and Building Management, and the Safety Program. Facilities Services and Building Management support HCA staff to provide a safe working environment for staff and clients. The Safety Program ensures compliance with Cal/OSHA regulations.

 Procurement and Contract Services – The Procurement and Contract Services (PCS) Division is responsible for the day-to-day procurement and contracting activities which includes the planning and coordination of all processes to procure goods and services. PCS responsibilities include adherence to funding source requirements such as Uniform Guidance, State, and local requirements.

 Research Office – The Research Office utilizes their expertise in statistical analysis, data science, and spatial science to support the interpretation of data and information for all divisions within the HCA. Research collaborates with all divisions of the HCA, County Agencies,

The HCA Factbook | HCA Administrative Infrastructure

the State and a wide range of community organizations to generate data management, reporting, dashboards and visualizations, performance tracking, and analysis.

 Project Management – Project Management focuses on strategies to foster a culture of quality and process improvement aligned with the overall goals and objectives of the HCA by collaborating with Service Areas, and other agency and County departments to undertake crosssectional projects to meet the evolving needs of the Agency.

 Policy and Procedures – Administrative Policies and Procedures is responsible for overseeing agencywide policies and procedures. This includes ensuring that all policies are developed, monitored, tracked, updated, and retired to stay aligned with business objectives and regulatory requirements.

 Agenda Staff Report (ASR) Coordinator – The ASR Coordinator is responsible for processing ASRs in accordance with the ASR County Policy, Countywide ASR Guidance and the Board of Supervisors Rules of Procedure.

ANNUALIZED SERVICE AREA ENGAGEMENTS

1,639 EPRP requests processed

21,417 / 2,932 Volunteer and intern hours / Volunteers

BEHAVIORAL HEALTH SERVICES (BHS)

FY 2025-26 Budget: $804,658,849

Total Employees: 1,269

Individuals Served (Unduplicated): 38,834 (FY 2024-25)

Director, Behavioral Health Services

Ian Kemmer (714) 834-2160

ikemmer@ochca.com

Behavioral Health Services (BHS) is the Medi-Cal Specialty Mental Health Services (SMHS), Mental Health Plan (MHP), Organized Delivery System (ODS) for the provision of substance use disorder services to Medi-Cal beneficiaries, Behavioral Health Services Act (BHSA), with numerous requirements in statute. BHS is also the safety net for the uninsured who have a serious mental illness or substance use disorder, with a workforce of more than 1,300 staff. The following summarizes the divisions and services that BHS is required to offer.

 Adult and Older Adult Services (AOA) – Includes Veteran services, offers a full range of programs to adults with mental health conditions that are at risk of more serious issues without treatment and supportive services. These services range from Outpatient Services, which provide psychiatric medications, therapeutic services, peer support, and other supportive services; to our FSP Programs, which serve individuals with the most severe symptoms who need more intensive and focused

services. These programs have a “whatever it takes” approach to treatment and often work in the field and in client homes to ensure needed treatment is being provided. AOA also offers Housing and Supportive Services for individuals with serious mental illness, Peerrun Wellness Centers, Transportation Services, and Supported Employment Programs.

 Behavioral Health Services Act (BHSA) – The Behavioral Health Services Act (BHSA) modernizes the Mental Health Services Act, passed by voters in 2004, to address today’s behavioral health system and needs. These reforms expand services to include treatment for people with substance use disorders, prioritize care for individuals with the most serious mental illnesses, provide ongoing resources for housing interventions and workforce, and continue investments in prevention, early intervention, and innovative pilot programs.

 Children and Youth Services (CYS) – Offers a broad array of treatment and early intervention services to children, adolescents, transitional aged youth, and their families who are experiencing symptoms of mental health and/or co-occurring physical or substance use disorders. Full-Service Partnerships (FSP), traditional outpatient mental health services, as well as collaborative service delivery with Social Services Agency (through WRAP - Wellness Recovery Action Plan and STRTP - Short-Term Residential Therapeutic Program), OC Probation (in Juvenile Hall and other Probation settings), and the Courts, are offered.

The HCA Factbook | Behavioral Health Services (BHS)

 Crisis and Acute Care Services (CACS) – Provides responsive services to adults and youth in a behavioral health crisis. Services include mobile mental health Crisis Assessment Team (CAT), Psychiatric Emergency Response Team (PERT), OC Links (24/7 Resources line), Crisis Stabilization Units (CSU), Crisis Residential Programs, and In-home Crisis Stabilization services, as well as inpatient psychiatric hospital services and the coordination of the 988 Suicide and Crisis Lifeline.

 Data Analytics and Evaluation (DAE) – Oversees the endto-end development of complex data projects designed to enhance program evaluation and quality improvement, clinical decision-making, and financial and resource forecasting in the areas of mental health and substance use. Creates and maintains analytics applications and dashboards, and assists with documenting complex workflow designs as they relate to systems that support data collection, analysis and business operations.

 Forensics – Includes CONREP, the Jail Based Competency Program, and Incompetent to Stand Trial, at both the Felony and Misdemeanant levels. Forensics also includes the CARE Act and other collaborative court programs. CARE Act focuses on serving persons with untreated schizophrenia spectrum or other psychotic disorders, who are not clinically stabilized in on-going voluntary treatment and unlikely to survive safely without supervision, need services and supports to prevent relapse or deterioration, and are likely to benefit from participating in a CARE plan or agreement.

 Substance Use Disorder Services (SUD) – Provides an array of prevention, treatment, and recovery support services for individuals that include Residential Treatment, Outpatient Treatment, Perinatal Services, Narcotic Treatment Programs (NTP), Medicated Assistance Treatment (MAT), Withdrawal Management, Intensive Outpatient Program, and the clinical oversight of the State’s Opioid Abatement Funding Plan in Orange County.

ANNUALIZED SERVICE AREA ENGAGEMENTS

486,210

OC Navigator sessions

700,031

OC Navigator pageviews (How many times a user visited OCNavigator.org and viewed a page)

564

Community events promoting mental health and substance use awareness

41,885

OC Links calls received

9,605

Crisis Assessment Team (CAT) responses + 1,528 additional dispatches

CORRECTIONAL HEALTH SERVICES (CHS)

FY 2025-26 Budget: $162,893,523

Total Employees: 1,296

Director, Correctional Health Services

Joanne Lim (714) 834-5518

jolim@ochca.com

Provides comprehensive health care services to all adult inmates within the County of Orange correctional facilities operated by staff from the Orange County Sheriff’s Department, as well as to youth residing within the residential facilities operated by staff from OC Probation and Social Services Agency.

 Adult Correctional Health Services (CHS) – Provides 24/7

medical, mental health, dental, nursing, and pharmaceutical services to all inmates in the County’s adult correctional facilities. Contractual agreements include, but are not limited to, specialty physician services; telehealth; and inpatient hospital services. Mental health services include dedicated psychiatric units with designated Lanterman-Petris-Short (LPS) beds for the provision of inpatient hospital level of psychiatric care.

 Juvenile Health Services (JHS) – Provides medical, dental, nursing, and pharmaceutical services for youth who reside in the County’s residential facilities operated by OC Probation and Social Services Agency. Contractual agreements include, but are not limited to, specialty physician services; telehealth; and inpatient hospital services.

 OC Cares – As part of Orange County’s Integrated Services 2025 Vision, CHS collaborates with various County Agencies to deliver enhanced services to address mental health and substance use disorders. Individual and group therapy, crisis intervention, medication management, comprehensive discharge planning, and linkage to community services are provided to assist in the successful integration of the individual back into the community.

 Orangewood Children and Family Center (OCFC) Medical Services – Provides medical, nursing, and pharmaceutical services for youth residing in the County’s emergency children’s center. Contractual agreements include but are not limited to, specialty physician services; telehealth; and inpatient hospital services.

The HCA Factbook | Correctional Health Services (CHS)

44,826

Intake Screenings conducted by nursing staff (Adult/Juvenile)

144,523 Nursing encounters

2,126

Average daily census of inmates with a mental illness requiring services

3,086,006

Total number of medications dispensed by CHS pharmacy

2,073

Specialty clinic services - Onsite

3,430 Specialty clinic services - Offsite

92,269 Physician & nurse practitioner encounters

$3,462,559 Medication assisted therapy (MAT) pharmaceutical costs

PUBLIC HEALTH SERVICES (PHS)

FY 2025-26 Budget: $181,126,063

Total Employees: 728

Individuals Served (Unduplicated): 266, 298

Director, Public Health and Nursing Services

Jenna Sarin (714) 834-4099

jsarin@ochca.com

Public Health Services (PHS) monitors and investigates the occurrence of disease, injury, and related factors in the community, and in collaboration with community partners, develops and implements preventive strategies to maintain and improve the health of the public.

 Clinical Services Division (CSD) – Located on 17th Street in Santa Ana houses several services including:

 Immunization Services for infants and children, including childhood vaccines and vaccines required for school entry, seasonal Flu, international travel vaccines, COVID, and Mpox vaccines.

 17th Street Testing Treatment and Care clinic provides testing and treatment of sexually transmitted infections and HIV outpatient medical care, as well as counseling, education, and preventive options such as HIV Pre-Exposure Prophylaxis and HIV Post Exposure Prophylaxis for uninsured patients.

 Pulmonary Disease Services Clinic provides, tuberculosis disease screening, diagnosis, and treatment for active and latent tuberculosis infection. The Clinic also provides direct observation therapy and case management services.

 Communicable Disease Control Division (CDCD) – Works collaboratively with local health care providers, government agencies, and community partners to identify outbreaks of disease and develop strategies to limit their further spread. CDCD monitors disease surveillance data to track trends over time, to define emerging concerns and vulnerable populations, and provides clinical and epidemiological guidance to residents, providers, and the broader community. The Division is also responsible for registering and issuing certificates for all births and deaths that occur in Orange County, including births for babies that were born outside of a hospital setting.

 Community and Nursing Services Division (CNSD) – Provides nursing services in the home and community, including case management, client advocacy, community resource information, and assistance with accessing health care. Services are provided to all residents of Orange County who meet the criteria regardless of financial status. Nurses in the Community and Nursing Services Division provide services in a variety of programs that target specific populations and/or health needs. Services also include essential services such as Health Care Program for Children in Foster Care,

Childhood Lead Poisoning Prevention Program, services to Children and Youth with Special Health Care needs and to parents/survivors of Sudden Infant Death Syndrome/Sudden Unexplained Infant Death (SIDS/SUID), and services for unsheltered and unhoused individuals.

 Environmental Health Division (EH) – Is a regulatory agency that relies heavily on education and outreach to obtain compliance. Services include retail and wholesale food protection, foodborne illness investigations, restaurant and public pool inspections, childhood lead exposure prevention, water quality, and ocean water protection, oversight of solid waste facilities, hazardous materials surveillance and mitigation, underground and aboveground storage tanks, body art facilities and practitioners, medical waste management inspections, and a used oil recycling education program.

 Health Promotion and Community Planning (HPCP) –

Protects the health and safety of Orange County residents by building the capacity of individuals, organizations, and communities to promote optimal health and prevent disease, disability, and premature death. HPCP is comprised of three principal units: Nutrition Services (NS), Tobacco Use Prevention Program (TUPP), and Local Oral Health Program (LOHP). HPCP programs share a common understanding that chronic disease prevention is best achieved through the coordinated implementation of a variety of concurrent public health interventions across the lifespan in a variety of settings. HPCP is responsible for coordinating and promoting health as well as chronic disease and injury prevention services and initiatives countywide. Programs provide and support direct

health education and access to resources and services, health awareness campaigns, community capacity building, and inform policy to promote and improve health to high-risk communities.

 OC Public Health Laboratory (OCPHL) – Provides specialized laboratory testing including water quality testing for assessing, investigating, and analyzing infectious diseases of public health concerning Orange County. OCPHL provides reference laboratory services to Orange County clinical and hospital laboratories and receives specimens as required under California Code of Regulations (CCR) Title 17 regulations. The Laboratory operates as a Bioterrorism reference Level B Laboratory as part of the Centers for Disease Control Laboratory Response Network for Bioterrorism (LRN). The Laboratory also provides foodborne disease surveillance as a part of the Centers for Disease Control PulseNet program. In 2025, the Public Health Lab moved from its 40-year-old Santa Ana site to a state-ofthe-art facility in Irvine, improving public health emergency readiness by co-locating with EMS and Public Health Nursing for better coordination.

Communicable Disease Control Division

Health Promotion and Community Planning

Community and Nursing Services Division

6,898

Communicable disease cases investigated

17 MILLION

Drowning prevention campaign impressions

6,464

Community and nursing services Individuals served

177,776

Number of birth and death certificates issues

200 FAMILIES

Breastfeeding training engagements

5,773

Health referral multi-lingual phone calls managed

455 Outbreaks investigated

3,356

Dental kits distributed

1,395

Children in foster care support

Clinical Services Division

Environmental Health Division

2,893

Pulmonary disease patients served

26,420

Facility permits issues, including retail food, markets and public schools

5,538

STI and HIV patients served

8,599

Family health clinic patients seen

OC Public Health Laboratory

7,440

Ocean water data points collected and analyzed

211,761

Analytes (lab samples being analyzed)

SPECIALIZED MEDICAL SERVICES (SMS)

FY 2025-26 Budget: $70,278,666

Total Employees: 206

Director, Specialized Medical Services

Mindy Winterswyk (714) 834-5052

mwinterswyk@ochca.com

 California Children’s Services (CCS) – Statewide program that determines medical eligibility and may provide authorizations for medical care, case management, financial assistance, and medically necessary physical and occupational therapy services to children who meet the CCS eligibility criteria. The program is managed by the California Department of Health Care Services (DHCS) and is administered by the local county health care departments.

 Emergency Medical Services (EMS) – Plans, coordinates, and oversees the pre-hospital emergency medical services systems in response to individual needs and community crisis and coordinates the Agency’s emergency response functions related to all-hazard disasters affecting the health care system.

 Employee Health Services (EHS) – Provides occupational health services to County employees and new hires, promoting health and safety in the workplace. Through innovative approaches, EHS offers flexible, convenient services throughout the County, and efficiently manages communicable disease cases.

 Medical Safety Net (MSN) – Orange County’s safety-net program for low-income adults providing urgent, emergent medical services and necessary follow-up care through a public-private partnership between the HCA and community health care providers. The MSN program DOES NOT provide comprehensive health coverage. Most MSN members should qualify for financial assistance to purchase health coverage.

 Office of Public Guardian (PG) – Authorized by California statute to provide Lanterman-Petris-Short Act (LPS) conservatorship and Probate conservatorship. The office oversees the care of individuals who are no longer able to make decisions or care for themselves due to cognitive impairments or a grave disability.

188,725

911 calls for emergency medical service with ambulance transport 18,000

1,921 New

7,712

EMT/paramedic/mobile intensive care nurses authorized

21

Total ambulance company/ vehicle Inspections

19,302

Specialty center patient triage (trauma, cardiac, stroke, childrens)

THE HCA FACTBOOK

Quality Health for All Our Community. Our Commitment.