A New NAEC Level III Epilepsy Center for Adults in Southern San Joaquin Valley of CA, Initial Experience of the Kern Medical Epilepsy Center

Epilepsy care has largely improved across the United States in the past decades, as reflected in Epilepsy Monitoring Units (EMU) bed availability, admissions, neurological procedures, and epileptologists. However, this has not been evident in many underserved areas. The vast majority of National Association of Epilepsy Centers (NAEC) accredited centers are located in major metropolitan areas, and some states lack epilepsy centers entirely. Kern Medical (KM) is the public safety-net hospital in Bakersfield, California (CA) that serves Kern and surrounding counties in the Central Valley. In 2018, an epilepsy center at KM was established with the support of the USC Epilepsy Care Consortium and received NAEC Level III accreditation to serve the over 34,000 patients who suffer from epilepsy in Kern County alone. Here, we review the initial 4-year experience of the KM Epilepsy Center by retrospectively analyzing a prospectively maintained database in light of the general NAEC data from 2012-2019. This experience demonstrates that epilepsy care can be coordinated across complex and competing health systems and socioeconomic barriers separated by large geographic distances through creative, physician-driven strategies of resource sharing and goal alignment across the health care ecosystem. However, considerable challenges remain in providing the requisite care to patients in need, even in highly resourced states like CA. This experience can inform future efforts to integrate epilepsy care across the region and beyond.