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North Sound ACH

North Sound Accountable Community of Health

Archives for October 2022

Working together to uphold Vital Conditions

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It has been almost one year since a “greater than” 100-year flood impacted Whatcom, Skagit, and other counties around the state of Washington. Close to 2,000 households were displaced in North Sound, and one year later many of those families are still waiting for repairs or permanent placement. 

Access to affordable housing was already severely limited, and the flooding increased the demands on scarce options, leading to some tough trade-off conversations. Who do you prioritize during an emergency – households who have been waiting in a queue for months or longer, or those impacted by an emergency asking to have their needs met more quickly? These are tough conversations and they will remain tough for some time to come.

I saw a picture (right) this week of the air quality around the Space Needle in Seattle and, even though so many of us have been living with the smoke, this picture posted by Washington’s Emergency Management Division tells an unhealthful story.  

When we see air quality like this, it’s why we have such respect for the Vital Conditions for Well-Being (click here to see our Resource Library, as it calls out a thriving natural environment as being essential to health and well-being). This air quality was not just unhealthy for vulnerable community members – it was unhealthy for all of us. So imagine those among us who didn’t have a safe place to stay inside and wait out the smoke, but because of housing insecurity were forced to stay outside and breathe that air. I know we do heating shelters in the winter, and cooling shelters when it’s too hot. Are we now looking at needing clean-air shelters as well? 

We’re happy to see cooler weather and rain dampen the fires and clear out all the smoke. We’re also aware that community members are anxious about another wet fall, and what is on the way. There is a network of partners who have been meeting to discuss flood response and the next few meetings will focus on preparing for what comes next as the rainy season continues. With this network, we’ll be better prepared than we were 12 months ago. We have lots of partners in Whatcom and Skagit to thank for that, and both counties now have Long Term Recovery Groups set up for households still recovering from last fall.

Our team has also been heading to meetings – yes, in-person meetings. A successful presentation at the WA Public Health Association meeting on the Collaborative Action Network, and a chance to interact and brainstorm with ACH teams from across the state at the HCA/ACH Learning Symposium happened in the same week in October. We’re beginning to plan our first in-person partner convening for January in three years (Save The Date announcement coming soon!). We’re going to take our technology learnings from remote meetings and use them to optimize real-time meetings. Yes, that should be fun!

We also have about 40 people (partners, board, and team members) from across the region heading to Phoenix, AZ to attend the Facing Race Conference; continuing to learn the language that will allow us to identify, mitigate, and dismantle structural barriers is a commitment we have.  We look forward to bringing those learnings back to the region. 

We appreciate the time and energy that you put into learning and planning initiatives with each other and with our team. Thanks for providing those chances to work together and see how far we can go! 

Collaborative Action Network: Aspirations and Actions

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I am often asked the rationale behind the common agreements that we have asked all partners to commit to. For those who aren’t familiar with them they are linked here.

Since 2014, when leaders from across five counties and eight tribal nations formed what is now North Sound ACH, the underlying focus on advancing equity has been present. To further that end, in December 2020 the Board of Directors made this even more explicit, adopting a set of goals for the organization to ensure that all people in the region have access to the conditions relied on every day for well-being. Operationally, we incorporated those goals into contracts between us and our partners – the set of common agreements mentioned above. 

In a recent , questionable billing practices of nonprofit health systems for patients at or near the federal poverty level were explored, and examples were used from one of our health system partners, Providence. (Please also read the response from Providence at this link.)

As a backdrop, the Affordable Care Act set requirements for nonprofit health systems to disclose their charity care, an intention to help the most vulnerable individuals and families in our communities. Some states, including Washington, followed by enacting legislation to identify if and who would be eligible for free or discounted care; you can find a brief description of Washington’s requirements at the Attorney General’s website.  

It is unacceptable when practices leave people at lower income levels to be buried in even more debt when there are programs to mitigate those circumstances. But we cannot jump to condemn the individuals and caregivers who work with those systems, who have been serving patients under some of the most trying conditions our nation has ever faced. When system-level decisions are made, the systems must work to acknowledge and correct those system-level decisions.   

Regionally, we are working to change the conditions that leave people suffering and struggling, and advance strategies where all community members can thrive. It is a worthy goal, and we’re grateful to have a wide array of regional partners on board with us, including strong practitioners from Providence.    

We believe in what our partners have committed to – not just in writing, but in action. We also believe that North Sound ACH can be of support as our partners navigate tough times. As we have done in the past, we will provide a space for anyone to join in advancing equitable well-being across the region, with our partners and even within our own team here at North Sound ACH. This requires that we all are able to point out when we or I stumble and to work together to do better.