A curious kid, Emily Duran discovered early that you learn a lot more by listening than talking. So when the adults in her life got together for conversation, she was all ears.
"They would talk about everything — work, family, what was going on with their friends. I heard gossip, I heard recipes, I heard about their dreams. 'This one is dating that one' and on and on.
"But any conversation about health care was always negative. 'So-and-so died of diabetes. So-and-so can't work because of cancer.' I thought, why can't we talk about the positive things out of health care?
But there were not positive stories to tell."
Meet health care's new storyteller.
As chief executive officer of an organization that administers Medi-Cal coverage to 350,000 Kern County residents — more than a third of the county's population — Duran is determined to change the conversation about health care. But she she's not stopping there.
Seven months into her tenure as CEO at Kern Health Systems, Duran has launched a sweeping, visionary approach to helping the region's poorest residents address not only their health-care needs but problems like homelessness and inadequate access to transportation and higher education — barriers that are nearly impossible for families to scale on their own, she said.
"If you don't have a car that starts or you work in the fields, you aren't taking your kid to his wellness checkup. If you're illiterate or if English is a second language, it is difficult to pick up the phone and say, 'I have a problem and I need care.' Delivering care with dignity is what we focus on."
Duran's holistic, inclusive approach has won a legion of admirers throughout Kern County, including Bakersfield real-estate developer Greg Bynum, who nominated Duran for induction into the CSUB Alumni Hall of Fame after working with her on the construction of KHS' new four-story headquarters on Buck Owens Boulevard. A member of the university's first Hall of Fame class in 2007, Bynum had never submitted a nomination before now.
"I wasn't going to suggest somebody just to suggest somebody," he said. "But if I saw someone extraordinary, that would be the time to step up and say something. She was the first one to say, 'I don't belong in this group,' but I reassured her that what she represents as an individual and what she's achieved, as well as the example she's setting for other graduates, that she absolutely belongs in this group."
Supporting her community and quietly volunteering in several organizations, including CSUB's Runner Alumni Mentor Program, is natural for Duran; what doesn't feel natural is being in the spotlight herself, though she is proud to be inducted and take her place as a role model alongside community leaders like Bynum.
"The more blessed you are," Duran said, "the more responsible you are to bless others and give."
'She's always done the right thing'
Going to the doctor as a child, Duran still remembers the sheet of paper with stickers on it that her mom handed to the receptionist.
"She would say, 'That's for our doctor,'" Duran said. "And I knew later in life: Ah, that was Medi-Cal."
Duran grew up in the country, near Delano, where her immigrant father, Serafin Silva, worked in the grape fields until his recent retirement. Her mother, Amelia Silva, was born in Texas and did seasonal farm work but mostly stayed home with Emily, her sister and brothers.
"Growing up, I didn't realize we were poor until later," she said. "We went to a small school with farmers' kids, doctors' kids. Eventually I realized the differences — what they were wearing compared to what I was wearing. I had one pair of shoes. People would think, 'Wow, you're dirt poor.' And we were, but we had a lot of pride, and it was a happy home."
She got her first job at 12 or 13 at Albany Park Elementary School in a summer program for children of migrant workers and has been working nonstop ever since. Duran's friends, family and professional associates all same the same thing: They've never seen anyone work harder.
"I remember going, 'Oh my God! This girl could run this organization right now," said Raji Brar, a friend who met Duran about 20 years ago when both were working at Clinica Sierra Vista, a federally qualified community health center that provides care to the underserved. The two young professionals also were pursuing their graduate degrees at CSUB.
"I wish I had a crazy story about Miss Emily, but she's always done the right thing. Just grind, grind, grind," said Brar, now a successful businesswoman and philanthropist. "In life, you meet folks that leave an impression on you forever, and with Em, I'm like, 'Are you a child genius?'"
At the time, Duran also was a single mother to Caleb, now 23 and a medic in the United States Air Force.
She had worked her way through CSUB, earning a bachelor's degree — cum laude — in public policy and administration, and would eventually receive her master's in health care management, being named the outstanding graduate student for the School of Business and Public Administration.
While still in college, she started her career at Ebony Counseling Center as a case manager for high-risk youth, before joining Clinica Sierra Vista, where she served in a number of capacities, culminating in the role of deputy chief financial officer. Duran left Clinica in 2013 to become the director of provider relations at Kern Health Systems, the largest health plan in Kern County.
"I learned a lot at Clinica," Duran said. "I learned the realities of providing health care services to underserved populations, I learned the realities of applying for every single grant. I also learned how many politics there are behind health care. In that environment, my passion grew to fight for individuals who can't help themselves."
'I don't pride myself on having 350,000 members'
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 — after Del Norte — of all 58 counties in California. Adding to the problem are 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," she 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."
Now, she's 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," she 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."
'You can only raise your kids once'
One man who does get to work with Duran every day is her husband, Miguel Duran. The two met through a mutual friend and were married in 2009, each bringing a son into the marriage.
"Emily is a very loving and kind person, but her strong ambition is what sealed the deal for me," said her husband, a project engineer in construction management. "I believe that just about everyone has both a family and career goal, but it takes a special kind of person to juggle both of those aspects of life and knowing they will win. Her beauty and intelligence are just the icing on the cake.
"I am extremely proud of Emily and all her accomplishments. I know this means a lot to her and our family. She is an exemplary role model to all of us."
Six years ago — when Emily's son, Caleb, was a teenager and Miguel's son, Julian, was a preteen — the couple had twin girls, Rebecca and Charlotte.
"You know, you get smarter with age and experience," Duran said. "When my son was young, I had a full-time job and was going to school. I was lucky that my parents helped, and they still do. I felt I was neglecting my son at times because I had no choice, but now I try to have that work/life balance because you can only raise your kids once."
Duran is incredibly proud of the outcome of her son's raising. An Air Force staff sergeant stationed in Germany, he has helped with the evacuation of refugees in Afghanistan and volunteered for a special project in Jerusalem.
"I see the humanitarian component coming out in him, and it makes me proud. I would drag him with me at Clinica, and we would go to outreach events for the homeless and give out gifts to kids in labor camps. I think that's where he found his passion for helping out."
His mother, meanwhile, is somehow finding the time to deepen her involvement with the community.
Duran recently joined the CSUB Foundation board of directors — where she serves alongside her friend Raji Brar — and is proud to announce that KHS will provide a number of scholarships to students pursuing degrees in health care to address the county's critical lack of primary care providers.
"We tell doctors we are trying to recruit that we're central as a selling point. The beach is two hours away. But why not have more to do here so that we don't have to say, 'Come to Bakersfield and you can drive anywhere you want to go.' We need to promote our strengths, address things that people are concerned about and become the community we want to be."
