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North Sound ACH

North Sound Accountable Community of Health

Cultural Humility

Desfibrilador y Primeros Auxilios – Lopez Island features CPR class in Spanish

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In winter 2023, Lopez Island Family Resource Center (LIFRC), United General #304, and La Cima Lopez hosted a Spanish language CPR/AED/First Aid training on Lopez Island.

The Hispanic community on Lopez Island shared with Karina E. Cerda Aguirre, who works with LIFRC, that there was a great need to have this type of knowledge, due to events that had occurred.

“This course was a great success since all the people who took it here on López are very happy and grateful since some of them wanted to have it before, due to their own incidents, family or friends, and having taken it gave them great security and confidence,” Karina shared. “We believe that these courses make all of us and our community stronger!”

A student practices CPR at the Spanish class at Lopez Island Family Resource Center. Provided by LIFRC.

After obtaining support from the Lopez Island Family Resource Center, organizers wanted to include the La Cima youth leaders since they speak both languages, and because they showed great interest in taking the course and helping people too. Gabe Evenson of United General #304 was the instructor.

Most Hispanic families on Lopez could not take other CPR classes, due to lack of 100% understanding of the English language, but if it were offered in Spanish, they would be happy to participate and learn important skills to keep our community safe and healthy. It also provided confidence and empowerment to Hispanics knowing that they are included in this type of opportunity.

LIFRC hopes to offer another class on Lopez, and involve people from other San Juan Islands.  They hope that someone on Lopez will become a certified CPR trainer in Spanish so more people can be trained.  And that they will have bi-lingual, bi-cultural, Spanish speaking community members work for Lopez EMS someday.


Karina added her thanks to North Sound ACH and our network of partners. “Without your help, we cannot carry out many of our projects with the Latino community of Lopez.”

A student practices CPR at the Spanish class at Lopez Island Family Resource Center. Provided by LIFRC.
Students practicing CPR at the Spanish class at Lopez Island Family Resource Center. Provided by LIFRC.

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.

Sadness and anger on racial violence – we must speak up

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Shanon R. Hardie, Board Chair

The tragedy in Buffalo still weighs heavy on my mind and heart alongside the shootings in Tulsa, Laguna
Hills, Uvalde and 14 other sites over the Memorial Day weekend. I know it is not new; acts of violence
and racism are inflicted upon our Black friends, neighbors, co-workers, families, and communities every
day and traumatize them further. What is hitting me so hard is that despite so much more focused
attention on racial injustice, there continues to be such regularity of it; the cumulative effect, the
seeming acceptance of it as ‘normal,’ and that in the Buffalo case, it was an 18-year-old that carried out
this evil act. How does an 18-year-old develop such hatred and bias? We accept that we have so much
work to do with older generations raised in an environment with biased and racist cultural norms. But
how, in this day and age, are we still raising children with that hatred? I guess I have been naïve in
thinking that we are raising a new generation that is more aware, more tolerant, more empathetic,
more inclusive. My hope for the future was in the next generation. Expecting they would help us lead
REAL change. I know this is just one young person but if there is one, there are others.

Life is hard and there are so many risks out in the world that can harm and devastate any family. Every
parent worries about their kids. However, I can’t imagine the kind of fear, stress, and anxiety that Black
mothers and fathers have to live with and manage each and every single day. Beyond worrying about
the things all parents worry about – stranger danger, car accidents, being hit by a car, drowning, etc. –
they have to worry that any person their child interacts with will harm them solely because of the color
of their skin. A worry that those of us with white privilege never have to think about. Never having to
ask ourselves…Will they see and appreciate how important my child’s life is? Will they see my child as a
person of value and worthy of kindness and respect? Will they see that my child is as loved and precious
to our family as their own children are to them? Will they see that my child has hopes and dreams just
like their children do? Will they understand and have empathy for my child’s wariness and fear because
of a pattern of inequities, bias, violence, and trauma that they’ve seen happen time and again?

I struggle between heartbreaking sadness and full-on outrage. As a white woman of privilege, I am still
on a learning journey and am committed to increased awareness, adding my voice and taking action. I
am still not always comfortable in sharing my message and voice. I know what I feel in my heart and
what message I want to say but can’t always find the right words to say it. I know many of us of privilege
are in the same boat. However, if we stay silent for fear of saying it “wrong,” then nothing will change.
So, I am working at taking the risk of saying it anyway and knowing that I will get better at it through
humility, owning my missteps and doing better next time. I also know that I will be extended grace for
having my heart and intentions in the right place. I encourage you to join me in taking the risks…. for
that is the only way toward REAL change.

Gratitude and Celebration

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November is Native American Heritage Month, proclaimed by Governor Inslee as a time to “honor the unique heritage of this continent’s First People and reaffirm the commitment to respect each tribe’s sovereignty and cultural identity.”  We give thanks for the leadership of the tribes and their approach to whole person care. Our team continues to learn from them and aim to grow those practices in other parts of the North Sound region.

While the media focuses on the day after Thanksgiving as “Black Friday” we hope you will join us in two other (more important) ways. First, Washington is one of several states that celebrates the day after Thanksgiving as Native American Heritage Day, naming it a state and school holiday. But the holiday is only one part; the proclamation also calls for educating students about the history achievements, and contributions of the tribes. Washington is rich in its 29 tribes and you can learn more about each tribe at this link. Spend at least part of your day learning about the Washington’s tribes, their history and culture.

Second, the day after Thanksgiving is a day where we are called to Opt-Outside. You can #optoutside or check out this link at the Nature Conservancy to find ways to get out and connect to the outdoors. The tribes we work with have known the connection between nature and health since time immemorial, and continue to show leadership in positioning the health of our communities, ecosystems, and wildlife as inextricably linked. They might encourage us to ‘Opt Outside’ every day to find the path to our wellness and wholeness. 

We wish you wellness and gratitude this week, and hope you will celebrate your connectedness to others who were here before us, are here in our communities now, and the amazing land that surrounds us. 

Liz

Cultural Humility: A model to learn from

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Evidence based practices and models strive toward better health outcomes and efficiencies, but they don’t always allow for the differences among individuals, cultures and beliefs. We came across a great article on the Robert Wood Johnson Foundation website highlighting an example of how to move from cultural competency to cultural humility and its potential for impact. Check out the article here.

See our October 2018 newsletter at .