About the Sites

This Innovation Lab is an opportunity to reimagine the role(s), partnerships, and strategies of Community Health Centers (CHCs) in working with local, state and national partners to address the Vital Conditions facing the most vulnerable in their communities.  The pilot CHCs will join a cohort of regional peer leaders, as well as engage as appropriate and mutually beneficial with national thought leaders such as the Community Initiatives Network and the Rippel Foundation, to explore and co-create new practices, tools, and metrics for CHC stewardship of organizational and system changes that will foster thriving at the patient, organizational and community levels.

Anchorage Community Health

Anchorage Neighborhood Health Center is a Federally Qualified Health Center providing primary health care services for everyone in the community, with a special focus on those who face extra barriers to care. Anchorage Neighborhood Health Center began in 1974 as a handful of clinicians providing care out of a trailer in Fairview. Since then, it has grown to become one of Alaska’s largest and most comprehensive primary care medical and dental practices. 

Lab Participants:

Lisa Aquino, CEO
Kate Powers, Director of Quality Integration
DeeDee Fowler, CFO

 

Belonging & Civic Muscle

Basic Needs for Health & Safety

Lifelong Learning

Meaningful Work & Wealth

Humane Housing

Reliable Transportation

Participation in the Anchorage Equity Committee of the Assembly

Strong representation of community members as part of our health center board of directors

Working hard to shift the culture at ANHC to a culture of continuous improvement and psychological safety – creating structures where feedback can be heard

Focus on trauma informed care for staff – welcoming all patients into our health center and meeting term where they are at.

Establishing mobile medical team that is providing care at shelters in our community – going directly to those who need health care the most and removing as many barriers as possible
Diabetes Self Management and Education Support & Diabetes Prevention Program - intent to provide patients with the tools and opportunity to learn how to engage in their health

Community Health Worker Apprenticeship Program

Partnering with University of Alaska and Alaska Pacific University to create career leaders for staff in dental and medical assistant realms

Refugee clinics allow recent arrivals to clear one barrier before entering Alaska’s workforce by completing refugee physical

Strong partnerships with the Alaska Literacy Program peer leader navigator which creates job opportunities

Pilot navigator program to support patients without stable housing - continuing to fund this permanently for patients of ANHC
Partnering with People Mover and Municipality of Anchorage to ensure that ANHC is on an established Bus Route

Advocating for safe road conditions and snow removal challenges to allow patients to access needed services (not just health care)

Community Health Centers of Lane County

Lab Participants:

Suzanne Roelof, Chief Operations Officer
Pediatrician Sandra Rood, MD, Associate Medical Director
Lauren Halas, Quality Improvement and Performance Supervisor
Aimee Franklin, RN, Nurse Manager

 

Belonging & Civic Muscle

Basic Needs for Health & Safety

Lifelong Learning

Meaningful Work & Wealth

Humane Housing

Thriving Natural World

Reliable Transportation

Collaborate and make connections within the community including public health, governmental leaders providers, agencies, community members, funders etc. Examples include:
  • CHCLC Health Council - connection to community members
  • Diversity, Equity, and Inclusion partnerships and work: pronoun button campaign, collaboration with Transponder, HIV Alliance, needle exchange program
  • Friendly Faces collaboration - multiple partners in transportation, healthcare, and social services to reduce ER usage
  • Community Substance Abuse support - Narcan distribution program, Fentanyl test strip pilot
  • Trauma Healing project - trainings
Provide primary medical care and integrated behavioral health.
  • Dovetail - Community Health Worker program integrated into clinics
  • Bicycle Safety - helmet distribution
  • CGM - remote monitoring capabilities; collaboration with CCO
  • Tiered care plan in pediatrics to provide additional care coordination for higher acuity needs
  • Access team to facilitate medical insurance coverage
  • Collaboration with Health and Human Services division as peer to help provide adequate air and water including in times of wildfire
  • Collaboration with Public Health department to begin Mobile Primary Care
  • Increasing access to primary care services through implementation of Transition of Care Access (TOCA) team
  • Super Saturday - pediatric well check and immunization days
  • School Based Health Center
Fund and provide training/educational supports: social/emotional and wellness training:
  • Group diabetes education visits - pilot underway
  • Medical Assistant Apprentice Program
  • Leadership development training program through Lane County
  • Continuous Quality Improvement - monthly review for increased learning
  • Crisis Prevention Institute training - all staff for deescalation skills
  • Motivational Interviewing training - RNs to support Tobacco Cessation
  • Dovetail - education for patients
Culture change within CHCLC to better align daily work to Vision of Healthy Work Environment
  • Flexible and Alternative Schedules
  • Increased recruitment in support staff
  • Staff involved in decision making
  • Medical Assistant Apprentice Program
  • Dovetail - coaching and Community Health Worker program
  • Wildfire support for staff impacted
  • Refugee Welcome
  • School Based Health Center
Collaboration with Health and Human Services Housing and Public Health Divisions.
  • Dovetail
  • PRAPARE screening - done previously; use of data inconsistent currently
Partnership with Public Health Emergency Action Response team
  • FEMA collaboration for Emergency Response
  • Wildfire shelter collaboration
  • Health Corp
  • Ride Source transportation services for patients
  • Oregon Taxi contract
  • PRAPARE screening

Family Health Centers

 

Lab Participants:
Jesus Hernandez, CEO
Melodie White, COO
Tawn Thompson, Director
Dr. Brendan Smith, Director of Quality
Aliya Quidwai, Director of Operations at Advance
Mike Ellis, CIO

Belonging & Civic Muscle

Basic Needs for Health & Safety

Lifelong Learning

Meaningful Work & Wealth

Humane Housing

Thriving Natural World

Reliable Transportation

Leadership is encouraged to engage in community work through CHI (Coalition for Health Improvement), local community boards (e.g., Housing Authority), and build connections advocacy.

The board is selected to represent the patient community and those who are active in the community.

Internal belonging is inherent in our small community. There are only a few health systems locally leading to our own employees and staff caring for each other’s families.

The culture of FHC encourages listening and guiding staff and providers to understand the diversity of the community and provide access to those who may not feel a sense of belonging at other clinics or areas of the community.

Access to healthcare regardless of insurance status. Community health workers are able to identify with and navigate patients to social services in our community. Strong harm reduction models and engagement with local services to address opioid addiction and corrections responses.

FHC maintains agility to be able to respond to basic needs for H&S when community or clinic needs to adapt.

Creating career tracks and opportunity for advancement. We have evaluated our job descriptions and requirements to help support learning and career development regardless of ability to access higher education. This creates economic opportunity for future generations in our community.
Goes along with lifelong learning.
Coordination with Okanogan Housing Authority and Community Action to facilitate housing needs for patients. We identify these needs with brief screening for SDoH centered on housing, food, transportation and financial insecurity.
Green committee
Clinics in most areas of county to ensure better access to healthcare (e.g., Twisp, Omak, Tonasket, Brewster, Bridgeport)
Advance transportation program (under development)

Rogue Community Health

Comprehensive Primary Care and Human Services provider with deep connections to the community and the members, patients, clients, and tenants served.

Lab Participants:
William North
Calisa Warnke
Christine Winters
Danielle Martin
Charles Kitzman

Belonging & Civic Muscle

Basic Needs for Health & Safety

Lifelong Learning

Meaningful Work & Wealth

Humane Housing

Thriving Natural World

Reliable Transportation

Vital Conditions: Patient Advisory Council, Member Advisory Council, Cultural Diversity and Awareness

Urgent Services: Community voice in power sharing arrangements and design of programs and services

Vital Conditions: Primary healthcare – medical, dental, behavioral, mental

Urgent Services: SUD and harm reduction

Vital Conditions: RCH Workforce Development department, career pathways, CHW Training Program, Teaching Health Center program

Urgent Services: Universal Basic Income, Family Success Plans

Vital Conditions: Success fund

Urgent Services: Comprehensive community workforce training

Vital Conditions: Transitional Housing

Urgent Services: Sheltering for SUD patients

Vital Conditions: Solar energy and charging stations

Urgent Services: Disaster Case Management

Vital Conditions: non-emergent transportation

Urgent Services: Bus and taxi passes

Siskiyou Community Health Center

Lab Participants:
Jennifer Johnstun
Kimber Byrd

Belonging & Civic Muscle

Basic Needs for Health & Safety

Lifelong Learning

Meaningful Work & Wealth

Reliable Transportation

Siskiyou’s mission and vision is aligned. We visibly support and create awareness around issues related to civil rights and human rights, particularly access to healthcare
Food: We have given out food boxes during emergency relief
Physical Activity: Counseling, promote among staff
Reproduction: Access to affordable contraception and family planning services. Family planning minus contraception in schools.
Provide routine health care, behavioral health, dental, and pharmacy services.
Try to integrate services and make it easier to acces
Support school physical events to promote physical activity
Early childhood outreach services promoting healthy pregnancy and family planning
  • Partnerships with schools
  • School Based Health Centers
  • Employee tuition assistance programs
  • Outreach focused on child development and parenting
As an employer provide ongoing training and opportunities for advancement or on the job training, well paying jobs and employer of choice
Employee programs
Bring services to where people are. Provide vouchers and connect to transportation
Clinics in rural areas, schools, etc.

Yakima Neighborhood Health Services

Established in 1975 inside a tiny house on 8th Street, Neighborhood Health today serves more than 23,000 patients with more than 90,000 visits annually. We were the first Health Center in the state to achieve the highest level of recognition possible as a Patient-Centered Medical Home and we are accredited by the Joint Commission and Bureau of Primary Health Care.

Lab Participants
Rhonda Hauff, CEO
Chris Newman, COO
Annette Rodriguez, Chief Housing & Homeless Officer
Michelle Sullivan, Chief Quality & Compliance Officer
Mike Vachon, Director of Strategic Initiatives

Basic Needs for Health & Safety

Humane Housing

YNHS provided our 29,941 patients and clients with over 145,000 visits for medical, dental, mental health, outreach, case management, and care coordination in 2022 at our twelve sites throughout Yakima County.
In 2004, YNHS was a founding partner of the Homeless Network of Yakima County, a collective impact model of agencies to address the needs of individuals experiencing homelessness. Since that time YNHS’ permanent housing services grew and now provide humane, consistent, and permanent supportive housing throughout Yakima County for over 190 people, including over 100 families. YNHS serves our communities in 9 locations throughout Yakima County. We are also a Coordinated Entry Access point for our local Continuum of Care, leading to permanent supportive housing and medical respite care for chronically homeless individuals and families. Wrap around services and support are provided by competent and culturally appropriate health professionals and housing staff.