Who We Are
The Supportive Care Collaborative is a regional network of organizations and leaders working together to strengthen care and support for people living with serious illness across the San Francisco Bay Area.
We are organized as a collaborative because the problem calls for it. No single organization, clinician, or community can close the gaps in serious illness care alone. It takes community organizations, health systems, and community members working side by side. It takes funders and advocates aligned around shared priorities. It takes clinical expertise paired with community trust. When these relationships are strong, more people get the support they need.
We work across sectors to expand understanding of palliative care and advance care planning, strengthen partnerships across community and clinical settings, engage in bidirectional learning, and advocate for more responsive systems of care. We center this work on communities that have had the least access to serious illness support, and we design our programs to reflect the languages, cultures, and lived experiences of the people we aim to reach.
Our work is organized through regional chapters across the San Francisco Bay Area. Each chapter is shaped by local relationships, assets, and needs while contributing to a broader network of shared learning and action. Together the chapters form a network that is locally grounded and regionally connected.
This is work that matters deeply. We cannot prevent serious illness. We can change how well our communities respond, and how people feel as they live through it.
We envision a future in which people living with serious illness experience the highest possible quality of life for as long as possible, with care and support that reflect their wishes, values, and needs.
The Supportive Care Collaborative began in 2014, when the San Francisco Department of Aging and Adult Services and the Department of Public Health convened community organizations, clinicians, health systems, and other leaders to ask a shared question: how do we make sure people living with serious illness in San Francisco have access to the care and support they need? That gathering became the San Francisco Palliative Care Task Force, with a clear charge to develop a strategy for expanding palliative care across the city.
The Task Force produced that strategy, and then kept going. In 2016 the group became the San Francisco Palliative Care Work Group, a formal work group of the Long Term Care Coordinating Council, which reports to the Mayor. Over the years that followed, the Work Group built our core programs, conducted Learning Journeys research that engaged approximately 550 people across Black, Chinese, and Latino communities to understand what works in advance care planning, and developed the partnerships and trust that make this work possible.
None of it would have been possible without partners and funders who believed in it from the beginning. UCSF has been a foundational partner since the earliest days, bringing clinical expertise, research rigor, and a commitment to health equity. The philanthropic support of the California Health Care Foundation, the Gordon and Betty Moore Foundation, the Hellman Foundation, and the Stupski Foundation made this work possible. We are grateful to each of them, and to the many community organizations, clinicians, and city leaders who have contributed over the years.
In 2026, as our partnerships grew beyond San Francisco, we became the Supportive Care Collaborative, a regional network working to ensure that people living with serious illness across the Bay Area have access to the care, support, and planning they deserve. The San Francisco chapter remains our founding home.
Our History
Why We Exist
Serious illness touches virtually every family and every community. It is one of the most profound human experiences there is, and one of the hardest to navigate alone. Yet, too many of us face it without the support we need, not because that support does not exist, but because it is fragmented, hard to find, or simply does not reach our communities that need it most.
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People living with serious illness often need much more than treatment alone. They may need relief from pain and other symptoms, help understanding their options, support for difficult family conversations, and guidance as they make healthcare decisions that reflect what matters most to them.
Many of these supports already exist. But they are often fragmented, under-resourced, hard to access, or poorly connected. As a result, people and families struggle to find the information, relationships, and care they need, and communities often lack the coordination and investment needed to respond well.
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The Supportive Care Collaborative exists to help close these gaps. We bring together leaders across community, clinical, civic, and philanthropic settings to strengthen collaboration, align around local priorities, and improve how support is delivered and experienced, with a particular focus on communities that have had the least access.
This is why equity is not a separate commitment for the Supportive Care Collaborative. It is central to everything we do. We partner with trusted community-based organizations, design programs that reflect language, culture, and lived experience, and prioritize relationships in communities where barriers to access are greatest.
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Today, this commitment is visible in our community partnerships and our major programming (PREPARE, HEAL, and CARE Together). In San Francisco, our work has focused on reaching Black, Chinese, and Latino/a/x older adults, communities that have historically had less access to palliative care and advance care planning. As we expand across the Bay Area, we will bring this same intentionality to additional communities, guided by the principle that the most trusted voice in any community is someone who already belongs to it.
Our Commitment to Reaching Everyone
The burden of serious illness is not shared equally. Communities that have been underserved face higher barriers to timely, respectful care, including care that reflects their language, culture, and lived experience. Structural racism, discrimination, and mistreatment within healthcare systems have shaped who gets care, what kind of care they receive, and whether that care is trusted. The result is a set of disparities that are well documented, persistent, and deeply unfair.
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The data tells a clear story. Nearly three quarters of adults have never heard of palliative care.1-3 Among communities of color, awareness is even lower.1,2,4 And yet when people understand what palliative care offers, nine in ten Californians say they would want it if they faced a serious illness, regardless of race or ethnicity.5 The gap is not in desire. It is in awareness, access, and trust.6
Those same patterns show up in advance health care planning. Only 24% of Black and 29% of Hispanic older adults have an advance directive, compared with 44% of White older adults.5 Black, Hispanic, and low-income Californians are more likely to report feeling judged or discriminated against by their healthcare providers, and less likely to say they trust them.5 These disparities do not reflect a lack of interest in planning or in care. They reflect a lack of culturally responsive outreach, trusted relationships, and systems that have historically failed to meet communities where they are.
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People of color are also more likely to experience unmanaged pain and other symptoms, to receive care that does not reflect their wishes, and to have less access to the kind of support that helps people and families navigate serious illness well.4,7-14 These are not random failures. They are the predictable result of structural inequities that have persisted for generations.
The Supportive Care Collaborative serves as a regional connector, convener, and catalyst. We create the conditions for organizations and leaders to build relationships, share knowledge, identify opportunities, and take action together. We do not do this work for our community. We do it with them.
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In practice, this means bringing the right people into the room. Clinicians and community organizations that might never otherwise meet. Funders and frontline workers aligned around shared priorities. Health systems, neighborhood nonprofits, community leaders, and community members learning from each other. We create the structure for those relationships to form and deepen over time.
From those relationships, action follows. Our work includes public education and community engagement, resource sharing, and advocacy for more responsive systems of care. The specific focus and programming depend on local needs and priorities, which is why our chapter-based model matters. Each chapter is locally grounded, shaped by the relationships, assets, and communities it serves, while contributing to a broader network of collaborative learning and resources.
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The goal is not more meetings or more programs. It is stronger ecosystems of care and raising community capacity, so that people living with serious illness and their families can find the support they need, in the communities where they live, in ways that reflect who they are.
How We Work
Our Programs
Meet The Staff
Executive Director
Loren Pogir
Loren Pogir is the Executive Director of the Supportive Care Collaborative. She leads the organization’s strategy, partnerships, chapter expansion, and day-to-day operations, working closely with community partners, health systems, funders, and local leaders to strengthen collaboration and improve support for people living with serious illness.
Loren brings extensive experience in strategy, finance, and operations across healthcare, financial services, and philanthropy. She is the Founder and Managing Partner of Transforming Care Partners, a consulting firm focused on improving the experience of aging, serious illness, and end-of-life care. Prior to founding Transforming Care Partners, she was a Managing Director at the Gordon and Betty Moore Foundation, where she directed a $40 million annual grantmaking program in healthcare. She also served as Chief Operating Officer of the BlackRock Investment Institute and as Director of Strategy at BlackRock, and began her career at Ernst and Young in the Health Care Strategy Group.
Loren holds a BBA and an MPA from the University of Texas at Austin and is an advisor to the Serious Illness and End-of-Life Funders Group, part of Grantmakers in Aging.
Medical Director
Grant Smith, MD
Grant Smith is the Medical Director of the Supportive Care Collaborative. He is a Clinical Associate Professor of Medicine at the Stanford School of Medicine, and he serves as the Medical Director of the Stanford Serious Illness Community Partnerships Team. He is an attending physician on the palliative care inpatient consult service and in the outpatient palliative care clinic in Palo Alto. Grant received his medical degree from Harvard Medical School and completed his residency in internal medicine and his fellowship in hospice and palliative medicine at the University of California, San Francisco.
He leads the Collaborative’s palliative care educational programming and helps guide organizational strategy, growth, quality, and expansion. He is the founder of the Peninsula and South Bay Chapter and a co-founder of the East Bay Chapter, helping extend the Collaborative’s work across the region.
Director of Community Education and Training
Morela Madriz-Ray
Morela Madriz-Ray is the Director of Community Education and Training for the Supportive Care Collaborative. She is our Master Trainer who leads workshops for English- and Spanish-speaking community members, trains ACP Internal Champions to deliver advance care planning education through the PREPARE Together program, and supports outreach to new partners in Latino communities. Her work helps make these conversations more accessible, trusted, and relevant.
Morela brings more than 30 years of experience in healthcare and education. She began her career as a Medical Director and Chief Physician in remote villages of Venezuela before continuing her medical career in city hospitals. After moving to the Bay Area, she worked as a care aide for people nearing the end of life, an experience that deepened her commitment to compassionate care and community education.
In 2010, Morela joined Homebridge, where she developed curricula in English and Spanish, trained personal care attendants, and served as Lead Traveling Instructor for the Career Pathways Program, teaching IHSS providers across California. She has worked as a bilingual instructor for the American Heart Association and Public Authorities in San Francisco, San Mateo, and Marin Counties, and has owned a company that certified healthcare professionals, care providers, and community members in lifesaving skills.
Morela holds multiple health-related certifications, including Plant-Based Nutrition from Cornell University and Mental Health and Crisis Intervention. She has been a featured guest on KIQI 1010AM and regularly hosts nutrition and English tutoring seminars in the Mission District of San Francisco.
Director of Chapter Development and Partnerships
Olivia Tigre Nerimora, MHA
Olivia Tigre Nerimora is the Director of Chapter Development and Partnerships for the Supportive Care Collaborative. She helps coordinate the Collaborative’s chapter-based work across the region and builds relationships with community, clinical, civic, and philanthropic partners. Her role focuses on strengthening the network, supporting local chapter development, and bringing new partners into the work.
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Olivia brings more than ten years of experience coordinating and leading research projects, with a strong focus on community-based participatory research that centers underrepresented communities. In her current role as Project Manager for the Palliative Care Center of Excellence, she leads initiatives to expand education and awareness of specialty palliative care, with the goal of increasing engagement across diverse communities.
Our Chapters
Supportive Care Collaborative | San Francisco
San Francisco Steering Committee
Co-Chair
Kelly Dearman
Kelly Dearman is the Executive Director of the San Francisco Department of Disability and Aging Services and brings more than 15 years of experience developing policies and services to help San Franciscans thrive as they age. Before joining DAS, she was Executive Director of the San Francisco In-Home Supportive Services Public Authority, which helps older adults and people with disabilities live independently and participate in their communities. She is also a former President of the San Francisco Human Services Commission.
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Kelly currently serves on the California Association of Area Agencies on Aging, is an alternate board member of USAging, and is a member of the San Francisco Long Term Care Coordinating Council. She holds a BA from the University of California, Berkeley, a JD from UC Hastings Law, and an MA in Political Science from Rutgers University.
Co-Chair
Anni Chung
Anni Chung is the Executive Director of Self Help for the Elderly, a Bay Area community-based organization that provides a comprehensive range of health, housing, educational, social, and recreational services to more than 40,000 seniors each year across the San Francisco Bay Area. Self Help for the Elderly serves mostly immigrant, low-income, limited English proficient Asian and Chinese seniors, with a mission to promote independence, well-being, and dignity for older adults through culturally aligned services and programs.
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Anni currently serves on the Steering Committee of the API Council and as the Elder Abuse Chair of the Family Violence Council in San Francisco. In October 2020, she was appointed by Governor Newsom to the California Commission on Aging. She is also the producer of a public affairs television program called Chinese Journal on KTSF-TV 26.
Committee Member
Sarah Nouri, MD
Dr. Sarah Nouri is an Assistant Professor in the Division of Palliative Medicine at UCSF, where she specializes in caring for people with serious illness in both outpatient and inpatient settings. Her research focuses on achieving equity in access to high quality palliative care among racially, ethnically, and socioeconomically diverse populations.
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Her current work includes community-engaged research on advance care planning in Black, Chinese, and Latino communities in San Francisco, as well as mixed methods research on the use of and outcomes associated with digital health in palliative care. She is committed to mentoring learners and increasing workforce diversity in the field.
Committee Member
Sandra Rivas
Sandra Rivas is the Director of Senior Programs and Operations for Day Services at On Lok, overseeing day-to-day operations for On Lok 30th Street Senior Center and Openhouse and On Lok Community Day Services. In her previous role as Assistant Director of Programs and Operations, she managed five departments and eleven programs serving more than 1,500 older adults, including nutrition, social services, activities, and volunteer programs. She joined On Lok in 2018 as Program Manager for Community Services.
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Sandra brings 13 years of expertise in residential care settings for older adults, care coordination, hospice and Alzheimer’s care, culturally appropriate community programming, and disease prevention. She holds an Associate Degree in Nursing from the College of San Mateo.
Committee Member
Bridget Sumser
Bridget Sumser is a social worker with a palliative care program for adults, focusing on the whole person and the family by addressing social and emotional well-being through counseling, care planning, and support navigating the healthcare system.
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Bridget’s research and academic work centers on palliative care education, including implementing interprofessional courses and studying how different specialists can integrate palliative care principles into their practices. She earned her master’s degree at the New York University Silver School of Social Work, where she completed a Zelda Foster Fellowship in palliative and end-of-life care, and subsequently completed a palliative care social work fellowship at Beth Israel Deaconess Medical Center. In 2015, the Social Work Hospice and Palliative Care Network honored her as an emerging leader in the field.
Supportive Care Collaborative | Peninsula and South Bay
Peninsula and South Bay Steering Committee
Committee Member
Sonia Sifuentes
Sonia Sifuentes is the Director of Programs and Services at Bay Area Cancer Connections, where she leads the organization’s programs supporting people affected by breast and ovarian cancer across the Bay Area.
Committee Member
Vanessa Souza
Vanessa Souza is Senior Manager of Community Engagement at the Alzheimer’s Association, where she works to expand awareness, education, and support for people and families affected by Alzheimer’s disease and other dementias across the region.
Committee Member
Mukund Acharya
Mukund Acharya is President of SUKHAM, a community organization dedicated to the well-being of South Asian older adults and their families. He also serves on Stanford Health Care’s Patient and Family Advisory Council, bringing a community and patient perspective to the Collaborative’s work on the Peninsula and in the South Bay.
Citations
01
Flieger SP, Chui K, Koch-Weser S. Lack of Awareness and Common Misconceptions About Palliative Care Among Adults: Insights from a National Survey. J Gen Intern Med 2020;35(7):2059-2064, doi:10.1007/s11606-020-05730-4
02
Huo J, Hong YR, Grewal R, et al. Knowledge of Palliative Care Among American Adults: 2018 Health Information National Trends Survey. J Pain Symptom Manage 2019;58(1):39-47 e3, doi:10.1016/j.jpainsymman.2019.03.014
03
Trivedi N, Peterson EB, Ellis EM, et al. Awareness of Palliative Care among a Nationally Representative Sample of U.S. Adults. J Palliat Med 2019;22(12):1578-1582, doi:10.1089/jpm.2018.0656
04
Cheng BT, Wangmo T, Hauser JM. Patterns of Palliative Care Beliefs Among Adults in the U.S.: Analysis of a National Cancer Database. J Pain Symptom Manage 2019;58(6):1056-1067, doi:10.1016/j.jpainsymman.2019.07.030
05
Loggers ET, Maciejewski PK, Jimenez R, et al. Racial and Ethnic Differences in Advance Directive Possession: Role of Demographic Factors, Religious Affiliation, and Personal Health Values in a National Survey of Older Adults. Journal of Palliative Medicine. 2013;16(9):1042-1049
06
Grant MS, Back AL, Dettmar NS. Public Perceptions of Advance Care Planning, Palliative Care, and Hospice: A Scoping Review. J Palliat Med 2021;24(1):46-52, doi:10.1089/jpm.2020.0111
07
Clark MA, Person SD, Gosline A, et al. Racial and Ethnic Differences in Advance Care Planning: Results of a Statewide Population-Based Survey. J Palliat Med 2018;21(8):1078-1085, doi:10.1089/jpm.2017.0374
08
Cole AP, Nguyen DD, Meirkhanov A, et al. Association of Care at Minority-Serving vs Non-Minority-Serving Hospitals With Use of Palliative Care Among Racial/Ethnic Minorities With Metastatic Cancer in the United States. JAMA Netw Open 2019;2(2):e187633, doi:10.1001/jamanetworkopen.2018.7633
09
Digitale JC, Nouri SS, Cohen EL, et al. Differential Use of Outpatient Palliative Care by Demographic and Clinical Characteristics. J Pain Symptom Manage 2023;66(2):e163-e176, doi:10.1016/j.jpainsymman.2023.04.007
10
Hardy D, Chan W, Liu CC, et al. Racial disparities in the use of hospice services according to geographic residence and socioeconomic status in an elderly cohort with nonsmall cell lung cancer. Cancer 2011;117(7):1506-15, doi:10.1002/cncr.25669
11
Oh DHW, Conell C, Lyon L, et al. The Association of Chinese Ethnicity and Language Preference with Advance Directive Completion Among Older Patients in an Integrated Health System. J Gen Intern Med 2023;38(5):1137-1142, doi:10.1007/s11606-022-07911-9
12
Portanova J, Ailshire J, Perez C, et al. Ethnic Differences in Advance Directive Completion and Care Preferences: What Has Changed in a Decade? J Am Geriatr Soc 2017;65(6):1352-1357, doi:10.1111/jgs.14800
13
Rodriguez GM, Popat R, Rosas LG, et al. Racial and Ethnic Disparities in Intensity of Care at the End of Life for Patients With Lung Cancer: A 13-Year Population-Based Study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2024;42(14):1646-1654, doi:10.1200/jco.23.01045
14
Smith AK, Earle CC, McCarthy EP. Racial and ethnic differences in end-of-life care in fee-for-service Medicare beneficiaries with advanced cancer. J Am Geriatr Soc 2009;57(1):153-8, doi:10.1111/j.1532-5415.2008.02081.x
Recent and Upcoming Presentations
We are increasingly invited to share our work with clinicians, community leaders, and others across the field.
American Association of Hospice and Palliative Medicine Annual Assembly, March 2026
UCSF Division of Palliative Medicine Grand Rounds, March 2026
USAging Conference, July 2026