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North Sound ACH

North Sound Accountable Community of Health

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Gratitude and reciprocity this Spring

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April 22 was Earth Day and it was appropriate to spend part of the day standing with our colleagues and partners of Children of the Setting Sun as they modeled what it means to be stewards of this planet we call home – Mother Earth. There were two themes that stuck with me as I walked away – gratitude and reciprocity. 

Gratitude for the reminder of all this planet provides for us – the warmth of sun on our faces, the ground underneath us, the ability to grow and harvest food, the air that sustains us. Taking a moment to use all of our senses to feel the earth around us. I don’t know about you, but I don’t take enough time to be still and feel all that surrounds me. I was grateful to stand with others doing the same and feeling out connection to each other. 

One speaker at the event spoke to reciprocity – what the earth gives us, and noting our responsibility to give back, to care and nourish this place we call home. Another shared this quote – “the one thing we hold in common is the earth.” Imagine if we could carry that thought with us every minute of every day. Would we make the same decisions if we recognized our unbreakable connections to each other and this earth, and our responsibility to future generations?  

Like you, we are moving out of our home offices and starting to be in spaces with real human beings again. It is both wonderful and a little anxiety producing. I want to wear a button that says “don’t forget that you still need to wash your hands, and keep some physical distance if you feel ill!” Plus, realizing that people I’ve met over the last two years are both shorter and taller than I thought. Zoom was a bit of an equalizer in that way, which I hadn’t thought of before. 

And on April 23, our team received an award from the Center for Human Services, and we’re sensing that same theme of reciprocity again. Our work and their work are integrally intertwined. To be thanked because we were able to leverage resources so that a partner could continue to have such an impact is humbling, because our opportunities occur because there are such amazing partners doing great work. That plus the dress code was ‘business casual.’ Imagine what that could look like after two years of zoom attire!!

Our hearts are with those who are struggling this month – looking for adequate housing, food, jobs, along with those arriving from Afghanistan, Ukraine, and other countries. They arrive here in the North Sound region every day, and our partners continue to have open arms to welcome them. Please reach out if you want to help support their work. We are raising funds for them, where 100% of what you donate goes directly to partner organizations. 

Thinking of you as the sunlight in our days grow longer – 

Car safety technicians trained in the North Sound

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Becoming a parent is an exciting and very busy time – there are many things to prepare for in order to keep your environment safe for a new baby. Car seats are an expensive but very necessary item to purchase, and the Region 11 Child Passenger Safety team helps caregivers prepare to carry their children safely in their cars, at no cost to the caregivers. Supported by a variety of funding sources, and often working out of local fire departments, law enforcement agencies, and social service agencies, these nationally-certified technicians meet with individuals and families, as well as groups and agencies like hospitals, to provide education and information on proper car seat safety.

Technician Erica Littlewood and expecting parent Tasha going over installing a car seat. Meg Stephenson / North Sound ACH

Morgan and Tasha are first time parents, and after buying a car seat, did an internet search to find who in the area could help them install and understand how to use the seat properly. For those who have not had to use or install a car seat, it may be surprising to learn how complicated it can be. Fortunately, trained technicians in this program are in each county in the North Sound.

North Sound ACH Project Manager Erica Littlewood is the Washington state Region 11 coordinator for the Child Passenger Safety program, and has been doing this work for 16 years. Region 11 consists of Whatcom, Skagit, Island, and San Juan counties. Snohomish County is its own region, and Region 11 and Snohomish County work closely together. 

Technician Erica Littlewood demonstrates installing a car seat with expectant parents Morgan and Tasha. Meg Stephenson / North Sound ACH

After scheduling an appointment, Erica met Morgan and Tasha at the Geneva Fire Station in Bellingham. During the session, Erica explained how car seats should be properly installed, how to use the car seat’s harness (practicing on a baby doll), and an overview of the laws around the different car seats (when an older child can start using a booster, can sit in the front seat, etc).

“This is why we’re doing this, so we feel more powerful,” Morgan said.

Did you know: technicians recommend taking your baby out of the child safety seat every 1-1.5 hours – even though it may be tempting not to disturb baby if they fall asleep, it is better to take them out of that restrictive seat.

Hospitals will ask parents if they have a car seat installed before the birthing parent is discharged, but may not have a trained technician to go over the seat with parents at that time. Making an appointment ahead of time with a technician in your area is recommended.

Erica held a training for 11 new technicians who will work in Whatcom, Skagit, Island, and San Juan counties, as well as two technicians who will work in Snohomish and Pierce counties, in October 2021. Training the technicians, supplying the class with relevant equipment, and teaching space came from North Sound ACH, South Whatcom Fire Authority, and the Children’s Museum of Skagit County. The class was financially supported by the state Child Passenger Safety program.

Shawneri Guzman with South (Snohomish) County Fire is a trainer technician, with Trevor Bolton of San Juan Island EMS at the October training. Meg Stephenson / North Sound ACH

Shawneri Guzman works for South (Snohomish) County Fire and has been a child passenger safety technician for 20 years. She didn’t take this type of class when she had her own children, and when she was first trained it was an “eye-opener” for her. Whether the new technicians getting trained were there for their jobs or just as a community volunteer, they do it to help their communities, Shawneri said.

“It’s rewarding to know the family is leaving safer than when they arrived,” she added.

In her 20 years, she’s seen a lot of changes – car seats are more complicated but safer, cars are more complicated, families have changed.

“Culturally, a lot of people come to this country with no experience with car seats, [and] they just want to do what’s right,” Shawneri said.

Trevor Bolton of San Juan Island EMS at the child passenger seat training. Meg Stephenson / North Sound ACH

How can I find a seat or a technician?

The Child Passenger Safety program also has a limited number of car seats for donation to families who are referred by local agencies. For more information, contact Erica at erica@northsoundach.org.

You may search for technicians in your area by going to https://cert.safekids.org/get-car-seat-checked (it will include languages other than English if available).

Where can people donate?

If people want to support the program, they can donate to Safe Kids Northwest:
PO Box 764
Burlington, WA 98233
with “child passenger safety” on the memo line

Funds go to purchase new car seats for the donation program. It’s great if people can share a gently-used car seat with family or friends, but they should not resell a seat or purchase a used seat.

Other resources:

Region 11 Child Passenger Safety Program

National Highway Traffic Safety Administration

Safe Kids Coalition

Collaborative Action Network Cohorts – next steps

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Creative tension is common when a group is in liminal space. And it is exactly what is needed for co-creating something new.

During our February learning session, we held space for diverse perspectives to share their hopes, concerns, and questions about the emerging Collaborative Action Network (CAN) Cohorts.

Together, we:

  • Sought clear answers AND recognized we need more time for partner input
  • Experienced discomfort with uncertainty AND excitement for creating something new
  • Acknowledged the need for pragmatism AND the desire for reimagining solutions (and better future for all people and places)

The new cohorts offer a tangible opportunity for partners to create a just and inclusive culture and the necessary conditions for all community members to thrive. The trust and commitment of the North Sound ACH partners is rare – and it will be exciting to see how partners bring this to life over the course of 2022.

FAQs

What do we mean by “cohort” and “focus area”?
A cohort is a grouping of Network selected focus areas that have a strong affinity or common theme. It is also a way for North Sound ACH staff and partners to organize and manage the Focus Areas. We have five cohorts:

  • Equity
  • Vital Conditions
  • Emerging Focus Areas
  • Practice Transformation
  • Care Coordination

Focus areas are the more discrete, actionable areas that Network participants have identified for collaborative learning and action. For example: food security, oral health, or mobile integrated health.

How were these cohorts and focus areas identified?
The North Sound ACH team identified these cohorts and focus areas based on reports from contracted partners, requests and reflections from leaders across the region, and an environmental scan. These topics are driven by our network members and will continue to be shaped by network members.

Can we change our commitments to cohorts or focus areas?
We anticipate that our network will grow and evolve over time. Partners who have signed contracts committing to a particular level of participation in a cohort can amend their contracts if another focus area emerges as an organization priority.

We also hope that additional people will join us over time, sharing their expertise and experiences. Organizations that are not currently engaged with North Sound ACH may join the network and cohorts at any time.

What could the work look like?
Our partner-based workgroups are a forerunner to the Network cohorts, such as the Regional Opioid Collaborative (ROC) and the Oral Health Local Impact Network (LIN). At the February partner learning session, Yuki Yang of Ideal Options shared that the ROC is like a “beta version” of the cohorts.

We come across different funding sources, and we can’t apply for it because we’re for-profit; having this space in these cohorts, to identify these situations, we’re always going to our community partners and saying, there’s this opportunity [for funding], do you want to apply for it and we’ll help support your efforts?
But it’s not always clear what those organizations want or need he money for, so these having cohort discussion to identify what are the solutions we’re searching for, or what are the things we want to try, and then also knowing what funding sources are available, we can say, there’s this opportunity, let’s apply or have a lead organization apply who is a non-profit and we will all deliver on whatever the solution is … that is what we’re talking about: coming together, finding funding, delivering a solution, and being in action.”

Hear more from Yuki at the February meeting recording, starting at 44:59.

What do partners say so far?
Mike Parker of Opportunity Council recognized there is comfort with “prescriptive contracts with defined measurement,” such as the Medicaid Transformation Project. However,

Those things don’t afford a lot of creativity, and so while this may feel unsettling and a little bit new it also can be a spark of creativity. For us, working regionally is one of the great benefits, has been one of the great benefits through [the Medicaid] transformation program. The problems we deal with are so regional or wider than that even, so I just look for more creative opportunities to do out of the box solutions, because obviously what we’ve been doing hasn’t been creating the thriving conditions we want.
So this type of model is maybe exactly what we need to do because it’s different, because it will afford opportunities for us to connect across our different organizations, service territories, you name it, languages… so I’m hopeful.”

Nicole Picknell of South (Snohomish) County Fire said its taken time for her and colleagues in her line of work to get comfortable with creative thinking.

Its super hard for us to be ok with being comfortable with the uncomfortable,” she shared. But working with others, “With the north sound ACH, we did start bringing the community resource paramedics together, and that really started us to find a space that we could feel comfortable in talking about, and there’s value in listening to other people, cause theres things I’ve learned on here that I’m like, oh I had no idea that we actually have a connection.”

Hear more from partners by watching the February learning session on our YouTube page.

We invite you to bring more questions to the team – you can always email us at Team@NorthSoundACH.org – and at the next partner learning session on March 16. There, we will break out the attendees into the cohorts they are participating in, to get started together!

Embracing Liminal Space

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What a wild couple of months we’ve had. Another COVID surge, long-lasting impacts from several atmospheric rivers (a new term for me to learn), and winter weather that saw us at 7 degrees on December 26, and 46 degrees one week later on January 2. Definitely not our typical winter weather. 

We have been working with community-based organizations to form what we’re calling a Community Response Network, building relationships so that we will be more prepared when the next disaster comes. Most often the organizations that step forward are fueled by volunteers, and they amaze us as they step up and step in, time and time again to help neighbors and their communities recover.

Recently, one of our partners (Community Initiatives) introduced us to the concept of liminal spaces – the space between the known and unknown – and it appears to be a space that North Sound ACH finds itself in often. Marco Morales, North Sound ACH project manager, shared a similar concept of Nepantla – a Nahuatl word that represents the notion of ‘in-between-ness.’ We are in between a very structured Medicaid Transformation Project and a future state focused on advancing equitable well-being. We get to take what we’ve learned over the past five years and design our next steps. 

As we collaborate with local and regional leaders, the tension in this space is important to acknowledge. Co-design and co-creation don’t always come with strict borders and rules, with answers to every question. It is a space for creativity and design. We recognize that it’s uncomfortable for some. We’re used to rules; even though we bristle against them, they let us know where the borders are for what’s allowed or not allowed. This liminal space is exciting, uncomfortable, and terrifying at the same time. 

North Sound ACH is looking for organizations and individuals who want to join this creative space with us! Check out the commitments that partners are making this quarter, working in concert to elevate strategies that work. We know the end that we’re seeking – to create a just and inclusive culture and the necessary conditions required for all community members to thrive. 

Whether we’re talking recovery from COVID or flooding, advancing equity, or advocating for health and social services that meet the needs of all in a community, we embed targeted universalism in all discussions, knowing we need multiple strategies in order for everyone to meet any common goal that we define. There are moments of conflict with those who want a single strategy to rally around, but we know that single strategies do not reach everyone, and we don’t want to leave anyone behind. 

We hope you will check out the Collaborative Action Network, and think about whether this is a space you’re interested in joining. We’ll be announcing ways to engage in the coming months. Hope to see you there!

Enter the Year of Radical Imagination

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The end of 2021 was something you just can’t prepare for. One hundred year floods and record breaking windstorms, on top of a new COVID variant was not how anyone in the region wanted to slide into 2022. On November 15, disastrous floods and storms hit our region with such force it toppled most emergency response agencies. 

Our first indication of this was when Jose Garcia of Everson was swept away in the early hours of flooding after clinging to a tree in a parking lot for several hours. He was on the phone with his family desperately trying to be rescued, but the rescue never came and tragically Mr. Garcia was the first casualty of the floods. All disasters are chaotic in the early hours and days of response, but it was clear that without additional agencies stepping in to support community members, more lives would be lost. 

In Whatcom County, the days that followed the flooding were full of late night calls from community partners who were rescuing, literally rescuing people, from rising flood waters in their homes and cars. There were minimal shelter options at the stage. I called Liz Baxter, our CEO, immediately asking permission to start booking hotel rooms, and her immediate response was “of course.” 

In partnership with Community to Community, Christ the King Church, Catholic Community Services, and the Whatcom County Health Department, we collectively sheltered over 30 families and nearly 100 people in area hotels. Each agency rose to the occasion and regardless of knowing if reimbursement was possible, just doing what was needed for folks who had lost nearly everything. 

In the spirit of targeted universalism, we know that all communities should have resources to be prepared and protected against emergencies and disasters – but if we have learned anything over the last two years, a one size fits all emergency response strategy can have devastating effects on communities that are repeatedly impacted. Community health workers and Promotoras are at the heart of a response, and fiercely dedicated to the communities they serve. They are doing the work often unpaid and unseen. We want to change that in 2022, by leveraging our positions of power and connections to advocate for those workers who are the backbone of community resiliency. 

Though these last two months have been some of the most challenging work of my career to date, I am profoundly grateful for each and every one of our staff who stepped into this work immediately. We’ve also learned so much about secondary trauma lately, and are prioritizing self-care for the team in 2022. It’s time to expand the practice of emergency response from a solely patriarchal practice to a model of community well-being and belonging. North Sound ACH does a pretty awesome job on advocating for the latter, so I have high hopes that 2022 is a year of bridging and radical imagination.

— Nicole Willis, COO

We Can Do Better

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It has been such an amazing experience to be part of an organization intentionally created to be a disruptive influence. To be asked to challenge the status quo and to advance equity, even when it unsettles us. 

I like order and process, logic and strategy. But sometimes the need for all that order gets in the way when people in the community are hurting. We can’t always wait for the perfectly planned solution in order to meet needs. In other words, we cannot sit idle while people around us suffer. 

I have had many opportunities to bear witness to the creativity and generosity of ordinary people, stepping out of their daily routine to help communities in crisis. Many of you know that North Sound ACH has embedded targeted universalism into our work — agreeing on a universal goal while employing multiple strategies for diverse communities to reach that goal. Whether we’re talking about our application and hiring process, or how to get food to people displaced by flooding, there are always multiple approaches that can meet the needs of people in need. It does require us to keep remembering our universal goal, and not get caught up in whether we agree or not on specific strategies.  

I try to describe choices as always having tension. Imagine a large rubber band in front of you, one end is choice 1 and the other is choice 2. In reality, all along the rubber band are options, if we choose one, it pulls and strains on the other options. There are few perfect answers, but many options that have an impact – positive to some, challenging to others, depending on our perspective. We constantly have to ask ourselves, who is impacted by this decision (or indecision); who does it advantage or disadvantage? Whose voices have shaped and influenced the decision under consideration?

We are in the middle of multiple disasters and must find ways to keep people at the center of our goals and objectives. Processes should support our end goals, not get in the way of meeting them.

We need to do better. The person next to us might need our help and compassion. The child in front of us might be our doctor or mayor or librarian in 25 years. Our job is to prepare others to lead. At least that is my job, and I am grateful to have it.