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North Sound ACH

North Sound Accountable Community of Health

Liz Baxter

Find and strive for our ‘universal goal’

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Liz’s Note, May 2022 newsletter

Such tumultuous emotions this week …

I happen to live one block uphill from an elementary school, and every morning I hear the background noise of children arriving and entering the school building. On Wednesday morning I stood and intentionally listened to those sounds instead of leaving them in the background of a busy morning. After another unimaginable night for families, my heart continues to break for them, thinking of the thousands of times that I dropped off my sons at school, never fearing what could happen to them before the end of the day. Our children should be safe, allowed to live without fear of violence, especially in places meant to nurture them and help them grow. That is part of our obligation to them, and the people who surround them.

I spent time talking with partners this week about what targeted universalism is and how much setting the ‘universal goal’ matters, as opposed to identifying a universal strategy. I asked them to imagine how different it would be if our goal was to keep all children safe from violence and harm. Gun control and safety is one of many strategies but it is not the only needed strategy. We also have to think of all the elements that result in young people targeting other young people for death in such horrific ways. Young people are hurting, facing trauma and don’t have the needed support around them to make their way through alone.

I refuse to believe that we are powerless to make these circumstances change. 

Two events come to mind for me – I joined many at Skagit Valley College last weekend for the Spring Powwow. In the wake of Buffalo and California, I was moved to tears watching four generations of dancers from one family as part of the Grand Entry in the afternoon, knowing that for too long, tribes were forbidden from practicing these traditions. Seeing young people as part of rebuilding these traditions is so impactful.

And on Wednesday evening I traveled to Shoreline to watch my grandson compete in a district track meet. I again found myself battling my own anxieties of having so many children gathered together, wondering whether some circumstance would put them in danger, and I felt I needed to be there, to make sure they do not feel alone. They are our future and worth every minute of our time to assure they have every opportunity to thrive. 

I mentioned to one of my team that I remember the day when each of my boys began to understand that they could feel two conflicting emotions at the same time. Happiness and pain, fear and gratitude, hope and anxiety. That is where I am when each of these events rips through a community. I realize that while Buffalo and Uvalde seem far away from Northwest Washington, we had our own experience in Marysville not so long ago. Every community is just like ours, and what happens there happens to all of us too. 

Hug your loved ones, and please wake up each day with a desire to change this world for the better, because we can do that work if we act together. 

Be well,

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 – 

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!

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. 

Calling Us to Action

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More than three years ago the North Sound ACH team and Board made a commitment to embed equity into the work of our organization and with our partners across the region. We embarked on a Tribal and Equity Learning journey together and have been honored to learn from local, regional and national experts who have enlightened and inspired us to the work ahead. 

Over the past two months the fractured health system has been exposed, and the impact of generations of structural racism are being discussed broadly, but for the most part without any tangible expectations being proposed. We know what the problems are but we are stymied about where to begin to address them. Then we have powerful and traumatic events being shown on every screen. There are too many times that America has been shown that the lives of African Americans are worth less than those of white Americans. We see it, we protest, and then we tamp down the anger. Any therapist would tell you that you cannot tamp down anger and injustice forever without it erupting at some point in time. 

I was raised to turn the other cheek; to be polite and understanding to those who would demean me; to always strive to be a better person; to be the example of how things could be better over time. Within my own mixed-race family there are divergent opinions about what is happening across America and how to address these injustices.  The strategies that arise are different for me as an individual with black heritage than they are for me as CEO of a nonprofit, but in the end it comes down to leadership. And the North Sound ACH cannot be silent about social injustice; not if we want to take our journey and make sustainable and lasting change. Not if we want to create a community where all feel a sense of belonging. 

We continue to turn to the Othering and Belonging Institute for thought leadership and especially want to point you to a blog post by their Associate Director Denise Herd. We can listen to john a. powell in a podcast where he speaks in response to George Floyd’s murder. And if you need a more mainstream voice, Trevor Noah recorded his thoughts on racism, George Floyd and COVID here. For many of you, these will be hard to hear. For me and other people of color, this is our legacy in the United States. 

For North Sound, it is time to take action. We will be making changes to 2021 contracts, adding expectations that our partners add efforts to address racism. Together we are a powerful group of leaders across the North Sound region. Imagine if what happened in Minneapolis had happened in Bellingham or Everett. How would you and your organization respond? Do you feel like you have the tools to address that question? Do protests against social injustice have to be met with force? Are there other ways that those in power can respond to anger, fear, and demands for change? How do we test and develop those ‘civic muscles’? 

Across the state counties are implementing COVID recovery plans. Imagine if the governor added an expectation that each county had to develop an actionable plan to denounce hate and address viral racism. Could advancing equity and wellbeing become an integral part of recovery expectations? If not now, I can’t imagine when it could happen.

I live in a lovely neighborhood, and no longer feel safe walking my dogs at night without my white partner. I fear for my adult sons, who work, exercise, and live in predominantly white communities. That everyday fear, anxiety, and heightened awareness takes a toll on me and others who have learned ‘it’s just part of life”. You can’t tell me that I’m lucky to be here and not there, because what happened in Minneapolis could happen in any one of our communities. It probably does happen. The question for us is what can we do to prevent it, to make investments where needed to prepare ourselves, and to have an agreed upon strategy of how we will respond when it happens. 

North Sound ACH cannot be silent. A man’s life was taken while we collectively watched. The people recording did not intervene, although their videos have catalyzed a response around the world. They felt powerless, but we are not without power to make a change. The question is whether you are willing to stand together to make change here. 

Note from Liz (Nov 2019)

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A growing number of communities are observing Indigenous Peoples’ Day in October rather than Columbus Day. Our team, as part of our learning journey, has been exploring the (incorrect) mythology of our nation being ‘discovered’ as a ‘new land’. In reality, the nation was rich with culture, history, and people who had been here, and remain here, even after many attempts to remove them and eliminate them from the history books.

To honor Indigenous communities is to acknowledge the horrors and injustices of the past, and those that continue today. There is much to learn. We are thankful to gracious teachers in our region’s tribal communities who share with us, patiently offering correction and further resources when we inevitably make mistakes.

We reached out to Candice Wilson, former North Sound team member, to hear her thoughts on this time of year. An article was shared by our team that we want to share with you: For Native Americans, Fall is the Least Wonderful Time of the Year.

Please continue to join us on this learning journey.

Liz

Another recommended reading: An Indigenous Peoples’ History of the United States for Young People (ReVisioning American History for Young People) – Roxanne Dunbar-Ortiz. You can get this at your local library.