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North Sound ACH

North Sound Accountable Community of Health

Megan Stephenson

‘Listens’ team helps community recover

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When a natural disaster or other extreme event hits a community, there is often an immediate response – neighbors and strangers donating their time, money, household goods and shelter, jolted into quick action out of compassion. This happened last fall, when Whatcom and Skagit counties experienced catastrophic flooding that impacted thousands of people and displaced over 500 households.

But a less visible response to these disasters is long-term recovery – such as, after the flood waters have receded. After surviving a disaster, individuals and communities experience trauma and stress, and need help recovering emotionally and mentally, in addition to home repair and replacing items lost.

The North Sound Listens team, a partnership of North Sound ACH and the Health Care Authority, provides peer support and crisis counseling to our neighbors impacted by the November 2021 floods and its aftermath. They are on the ground and on the phone, talking to folks Monday through Friday, in English and Spanish.

“Just to have someone listen to your story, that makes a huge difference for survivors,” said Nicole Donovan, program manager for North Sound Listens. The five-person team – Donovan, Maria Santos, Mario Morales, Cindy Harrington, and Tonya Bieche – was formed in April 2022, as part of North Sound ACH’s plan to support rapid community response in emergency situations.

North Sound Listens team, from left: Maria Santos, Nicole Donovan, Mario Morales, Tonya Bieche, and Cindy Harrington.

North Sound Listens is one part of a multifaceted recovery – they work with many other organizations in the community, as well as city, county, state, and federal agencies to try and coordinate the needs of impacted residents. At different stages in recovery, some people need case management – case managers coordinate resource referrals, help with paperwork and recovery plans, schedule volunteers to assist in house repair or other needs. Other times, people need someone like Maria, Mario, Cindy, and Tonya to just listen.

Maria, who has also worked as a homeopathic health and wellness coach, said she asks open ended questions and lets the person she’s visiting lead the conversation. Building trust takes time, and acceptance of help is not always immediate. But the team are present at community spaces, like the Nooksack Food Bank, as well as making regular follow up visits or phone calls, and Maria said this has helped the community to open up to her and her teammates.

Mario has previous experience in emergency management and security, and said that without other agencies and coordination, the North Sound Listens team can’t do the work that they do; everyone sharing resources is what it takes, he said. The North Sound Listens team works with organizations such as the Whatcom Long Term Recovery Group (formerly Whatcom Strong), Opportunity Council, Community Action of Skagit, Nooksack Food Bank, American Legion, Ferndale Community Services, among others.

A lot of community members that the North Sound Listens team meet downplay what they’ve been through, expressing that they don’t want to ‘take from the pie’ of resources, Tonya said, and the others agreed they see this as well. But by expressing their needs and giving attention to their mental health, they are actually building the pie for everyone. “Asking for what you need is a strength, it makes everyone better and stronger,” Tonya said.

Mario Morales and Maria Santos hit the streets.

If you or someone you know has been impacted by the November 2021 floods in Whatcom or Skagit County and needs someone to talk to, call (360) 935-0105. The team is available 10 a.m. to 4 p.m. Monday through Friday, but you can leave a message in any language and someone will return your call. You can also email NorthSoundListens@northsoundach.org.

Read more about the 2021 flood recovery:

The flooding of Everson, Washington by NBC News

Neighbors of Swift Creek displaced by asbestos by Cascadia Daily News

North Sound Accountable Community of Health invests in training medical interpreters

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Last year, North Sound Accountable Community of Health (North Sound ACH) developed a Language Access Survey (LAS) to collect data on languages spoken in the North Sound region, and to better understand how to support partner organizations in providing culturally- and linguistically-appropriate language services in healthcare and social services.

The data collected from the LAS highlighted opportunities to increase non-English language services. In spring 2022, North Sound ACH initiated a pilot project to provide training opportunities to bilingual and multilingual individuals to explore medical interpreting, an identified workforce need in the North Sound. 

The participants in the LAS are North Sound ACH partner organizations, including community grass-roots organizations serving communities and Tribal nations in Whatcom, Skagit, and Island counties. 

The survey showed that the top languages to request an interpreter are: Spanish (95%), Russian (64%), and Vietnamese (24%). The survey also reported the high need for interpreters for Central American Indigenous languages, such as Mixteco Alto and Mixteco Bajo, which is especially challenging to find local interpreters for those languages in a timely manner. 

North Sound ACH offered scholarships for a training class at Whatcom Community College in Spring Quarter 2022; 12 bi- and trilingual students enrolled in Foundations of Medical Interpreting, coming from Skagit, Island, Snohomish, and Whatcom counties, speaking Mixteco, Spanish, and Korean. Of the 12 students, 11 completed the training and are now eligible to take the exam towards certification in medical interpreting. 

There’s a difference between an interpreter and a bilingual employee.”

Rebeca Sixto was one of the students, a bilingual speaker of Spanish and English. Like many immigrant and first-generation children, she has informally been interpreting for her family and community members for years, and was often asked to help translate or interpret at her workplaces. “Sometimes it feels like, oh my gosh I have all this work to do,” she said of being asked to translate while at work, but “I’m doing it for the people that need it.” She said she’s always been the type of person to help people in need. After taking the class, she said she learned there are regulations to follow, to ensure you are interpreting correctly, especially in a medical setting. The students learned about legal and ethical standards for interpreting.

Fellow student Julieta Garcia Suarez said she found that employers often want bilingual speakers, but it didn’t always equate to extra compensation for her skills. “There’s a difference between an interpreter and a bilingual employee,” she said.

The students have all seen a great need for interpreters, and many are motivated to take the state exam to become certified – not just to be appropriately compensated for their skills, but because local interpreters are needed, as demonstrated in the LAS. Many of the students shared stories of being young and interpreting for their parents at medical appointments, or being the “go-to” person for Spanish-speaking patients when working at clinics, even if the person needed help with their children’s school paperwork. Having local interpreters also builds trust in Latinx community members, Sixto said.

North Sound ACH is currently looking for internship sites for the recent graduates of its Medical Interpretation program. Through this internship, the students will practice their communication, translation, and interpretation skills, become familiar with the healthcare environment, and gain confidence to provide excellent services to their clients. 

For those already working in the healthcare field, having a certification will enhance their ability to serve their communities, reduce barriers to interpretation services within their organizations, and be recognized and better remunerated for the work. 

For those with no experience in the healthcare field, this training and certification might be the beginning of a career in the healthcare industry, as the graduate will be equipped to work at organizations that require medical interpretation and translation for their clients. 

In 2023, North Sound ACH will continue to lead efforts with community partners to expand the medical interpretation and certification program to individuals who speak other languages identified in the Language Access Survey. 

Organizations that are interested in hosting interns or learning more about this project can contact us at team@northsoundach.org.

from left to right: Veronica Sanchez, Cristina Morales, Rebeca
Sixto, Jhovana Sanchez, Julieta Garcia Suarez; sitting, Marco Morales. Photo by Gabriela Cardona / North
Sound ACH
Rocio Castillo-Foell, North Sound ACH Director of Community Engagement and Health Promotion, speaks virtually to the interpreter program participants. Photo by Gabriela Cardona / North Sound ACH
From left, Jhovana Sanchez and Rebeca Sixto attend a celebratory dinner with North Sound ACH. Photo by Gabriela Cardona / North Sound ACH

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!

New donation form on the website

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North Sound ACH supports learning, advocacy, and collaborative action across the
region. Building on our regional partnerships, the network can respond quickly and efficiently to
address emerging needs in areas where investments in capacity are critically needed.

We have been asked by many across the region now they can support the work. We now have an online donation form – a simple way for anyone to contribute to several regional programs. Contributing to this work impacts the lives of so many across the region.

Donate

We are currently seeking support for these initiatives:

Afghan refugee resettlement support. Several partner community-based organizations are deeply engaged with newly arrived Afghan families who need immediate support as many arrived with only what they wore on the plane. Your contribution will be sent to partners to help with housing, bedding, hygiene kits, and immunization efforts, as examples. Since some of the smaller community organizations don’t have finance and contracting infrastructure, North Sound ACH is acting as a backbone partner to support them as they do such incredibly important people-to-people support activities.  

Community Health Worker (CHW)/Promotoras Fund. CHWs and Promotoras comprise a trusted workforce that provides interpreter services, navigation, transportation, and education in communities who do not intersect with mainstream messaging or traditional ways of accessing resources. They are often unpaid for their services. Working with community-based organizations, North Sound ACH is building a fund to support training, transportation, and equitable payment for the time this workforce spends advancing well-being in often overlooked communities.

Thank you for your support!

Afghan Families Coming to Region

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Washington State has a long history of welcoming refugees to our communities, and with the recent arrival of Afghan individuals and families, in addition to the COVID-19 pandemic, Refugee & Immigrant Services Northwest (RISNW), based out of Everett Community College, has stepped in to play a key role.

Executive Director Van Kuno has been with RISNW for 30 years, starting as a volunteer after her own refugee resettlement from Vietnam. When she arrived in 1975, after the fall of Saigon at the end of the Vietnam War, she and her family settled in Minnesota, where she earned a degree in biochemistry. They then moved to Snohomish County, where she volunteered at the Refugee Forum of Snohomish County, which would later become RISNW. After a year, she got a paid position with the Forum, and soon after became its executive director.

Kuno said she wanted to partner with North Sound ACH because of our similar philosophies and mission statements. North Sound ACH provides RISNW support in three overlapping areas: the Community Health Worker/Promotores fund, the COVID-19 response fund, and the recently established Afghan refugee resettlement support fund. “Going through the red tape to get funding takes a chunk out of our busy schedule,” Kuno said. North Sound ACH helps with some of that “red tape,” which “allows us to do the job that we’re supposed to do,” Kuno said.

The COVID-19 response provides rapid testing kits, PPE, food and care kits; and the resettlement support fund is used for rent and housing help, bedding, clothes, and household supplies.

Courtesy of Van Kuno / Refugee and Immigrant Services Northwest

Through the CHW/Promotores fund, RISNW has hired a full-time navigator, who helps connect families to resources they need. This has been a great help since many of the Afghan families arrive with only what they can carry. The newly operating welcome center provides mobile dental, COVID-19 vaccines, hot meals, a worship leader from the local mosque, and staff to help families with housing applications, get children signed up for school, and whatever else they need. So far, RISNW has helped resettle 14 Afghan families.  

“When they meet with the navigator, they say what they want to talk about, what they need, then the navigator does research, provides that information back to them, and provides it in a linguistic and culturally appropriate way,” Kuno said.

Kuno said they let the clients direct what they need, but as a refugee herself, she is intimately familiar with the needs and struggles of newly arriving refugees and immigrants. About 10 years after she started working with RISNW, she noticed many Vietnamese and Cambodian refugee women struggling. Early resettlement efforts helped their husbands get jobs, and enrolled their children in school, but sometimes the women would be left behind. They weren’t able to understand letters in English, but many were also not literate in their native language either. They were isolated from their families and even each other.

Today, Kuno provides incoming women with laptops to get connected online –  to chat with family, friends, and local community; use email; learn English; help their children with school – and encourages them to get their driver’s license. A few years ago, she worked with Iraqi families to help the women get their driver’s license, explaining the benefits to both husbands and wives. To the husbands, Kuno would say they then wouldn’t have to leave work to help get the children to appointments, and to the wives, she would explain this would make it easier to go grocery shopping, take the children to school and the doctor’s office, and go see their friends. She employs the same methods with today’s Afghan families.

“If the woman is strong and healthy, the family will be strong and healthy,” Kuno said.

RISNW is open to all refugees, migrants, and immigrants in the area; they often help people from Somalia, Sudan, Congo, Iran, Iraq, Ukraine, Vietnam, Cambodia, Estonia, and Eritrea. There are 10 offices in the area, in Everett, Lynnwood, Monroe, Arlington, Mount Vernon, and Bellingham.

Their services include employment, English as a Second Language (ESL) resources and classes, education and social services, immigration and naturalization, interpretation and translation, and advocacy. Some of their other long-standing partners include the Employment Security Department, DSHS, and WorkSource. Learn more on their website https://risnw.org.

You may also donate to this fund at https://www.aplos.com/aws/give/NorthSoundACH