If there is one thing Duran has learned during her 25-year career it is that organizations like Clinica and KHS have their work cut out for them in addressing the needs of residents in a county where the poverty rate is staggering and there aren’t enough health care providers to adequately serve the population.
In 2020, Kern County had the second highest poverty rate of all 58 counties in California. Adding to the problem is Kern’s low educational attainment rates — about 76% of residents have a high school diploma, and only 17.6% have a bachelor’s or advanced degree.
“So that paints a very bleak picture of the number of individuals that have barriers for care,” Duran said. “We blame the patient. ‘You’re noncompliant,’ we tell them. But if you live in east Kern and the nearest doctor is in Bakersfield, you drive through the canyon, hopefully there are no rockslides, and now you’re behind schedule to get your mammogram. So you wait another day and you don’t go until you feel a nodule on your breast.”
The reasons for poverty are not simple, and neither are the solutions, Duran said — and that means a comprehensive, collaborative approach is required to improve the lives of the people who count on Kern Health Systems, established by the county Board of Supervisors in 1993 as an independent public agency funded entirely by Medi-Cal payments.
“I don’t pride myself on having 350,000 members,” she said. “That means a third of our population have to rely on publicly subsidized insurance. My goal is to look at those barriers, address access and to partner with other agencies to improve our community.”
Last month, Kern Health Systems announced it had secured more than $19 million in state Department of Health Care Services incentive funds to address housing and homelessness in Kern County. An earlier program KHS supported distributed $14 million to help pay for local recuperative care initiatives, and the organization was among the first in the region to launch COVID-19 education efforts in hard-to-reach communities resistant to vaccination efforts.
“We are throwing our hat into the ring to help address the housing and homeless crisis,” Duran said. “Is that in the scope of a traditional health plan? No. But when we’re paying $7 for gas and the eggs are now $8.99 for a carton, it’s critical times for our employees and our communities.”
When the KHS Board of Directors promoted Duran to CEO over the summer, she offered an ambitious 100-day plan, whose goals she ticked off, one by one, and then some.
“I did a realignment to make sure we had enough staff ramping up to implement several of our newer programs, and we established our health equity program to focus on not only the social barriers, but the cultural barriers to care,” she said.
Now, Duran is looking ahead to 2026, when KHS will dive into the world of Medicare, offering both types of coverage to its clients who qualify.
In the meantime, the new four-story KHS building in central Bakersfield is bursting at the seams and will soon provide space for the Kern County Department of Human Services for the convenience of its members, she said. She worked with Bynum on the massive construction project, which began when she was pregnant with twins.
“I say that the building was my triplet,” Duran joked.
Bynum said it was clear she was selected to lead the project because of her superior skills as an administrator.
“She can look at a big project and understand the necessity to collect all the pieces of the puzzle and make a picture out of it,” he said. “If I could work with her every day, I’d do it.”