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North Sound ACH

North Sound Accountable Community of Health

Equity

Network Dispatch: The Way Station

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Before the pandemic, people experiencing homelessness lacked access to primary medical and behavioral health care, and services we don’t always think about: toilets, showers, and laundry. COVID-19 created even more barriers to accessing these services. The Way Station provides a safe place to recuperate after a medical event, access to hygiene services, and comprehensive medical and behavioral health services that are currently lacking in our community.

The Way Station facility manager, Don Cook. Photo provided by Unity Care NW.

The Way Station celebrated its grand opening on November 12 – open Monday to Friday from 7 a.m. to 3 p.m. in downtown Bellingham, 1500 N. State St. Partners instrumental to this facility include Unity Care NW, PeaceHealth, Whatcom County, and Opportunity Council, in addition to North Sound ACH Collaborative Action Network funding.

“We recognize that good health extends beyond the walls of our hospital and clinics,” said Chuck Prosper, chief executive at PeaceHealth St. Joseph Medical Center. “By investing in these community organizations, we are helping address the impact of social drivers of health and creating pathways to a healthier, more equitable future.”

Conversations about this idea started at Unity Care NW in 2017, and the project partners came together in 2019. The planning phase included site visits to similar facilities in other communities, and they recently hosted a group of representatives from Langley BC, WA Representative Joe Timmons, and Whatcom County Executive Satpal Sidhu to learn about The Way Station. 

They have stayed consistent to the original vision for The Way Station based on their 2018 needs assessment, with some additions to the services planned, including a hot box for cleaning items affected by body bugs, and providing clean socks, shirts, and underwear. PeaceHealth is working on advocating for Medicaid reimbursement for respite services (they will be the referrer; Opportunity Council will manage those services at the Way Station). However, they are facing challenges finding funding for ongoing operations: many funders want to support launching new programs, fewer will help sustain work that is ongoing and will be transformative in the long term. Unrestricted operating support is the most pressing need, especially for hygiene supplies. 

Rachel Lucy, director of community health for the Northwest Network of PeaceHealth, said supporting The Way Station aligns with PeaceHealth’s core values of respect and social justice, and the facility meets a very critical need in northwest Washington. “There are few circumstances more morally distressing for our health care workers than knowing that someone they just cared for in the hospital will be returning to life on the streets or unstable housing,” she noted.

The Way Station is located at 1500 N. State Street in Bellingham. Photos provided by Unity Care NW.

“In Whatcom County, this is the reality for patients experiencing homelessness following a hospital stay. This was the driving motivator” that brought PeaceHealth and its partners together to establish the new facility, she said.

Unity Care NW led public engagement through listening sessions and panel discussions with businesses and residents located around The Way Station site, helping them see the facility as one of the solutions to the challenges they expressed about the concentration of unhoused folks in the neighborhood. For example, Unity Care NW staff explained that The Way Station will offer a private and dignified place for folks to use bathrooms, reducing requests from individuals experiencing homelessness for use of businesses’ restrooms.

There will be acute walk-in care at The Way Station (addressing immediate health needs onsite and then refer them to a regular provider for primary care), as well as substance use disorder treatment. Don Cook is the new facility manager; a Unity Care NW employee of 20 years, who has built a great rapport with his clients and is highly skilled at de-escalation.

Network Dispatch: Mobile Mama Grows Internship Program

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Recently celebrating 10 years in the community, the perinatal therapy practice Mobile Mama is growing thanks to community support, such as the Collaborative Action Network Review Committee. Mobile Mama provides counseling services from conception through motherhood.

In 2017, a group of partners in Whatcom County formed a perinatal mental health task force to build community capacity to support families during pregnancy and the transition to parenthood Mobile Mama Therapy, Whatcom County Health and Community Services, Bellingham Center for Healthy Motherhood, and a parent advocate. Becoming fiscally sponsored by Whatcom Family & Community Network in 2021 allowed the task force to apply for and braid funds for a variety of specific projects. One project is Mobile Mama’s Master’s Level Clinical Counseling Internship in Perinatal Mental Health. In 2023, the ACH CAN and the Mount Baker Foundation funded the expansion of this program from a one intern pilot project to three internship slots. In 2024, the Healthy Children’s Fund contracted directly with Mobile Mama to support three more interns over the next two years. Read more about this program at Whatcom Talk [click here].

The recent grant from the ACH includes funding to conduct a feasibility study on replicating the Mobile Mama internship program and expanding the perinatal mental health workforce to other areas in Whatcom County and into Skagit, and San Juan counties. These three counties share perinatal mental health capacity-building work with support from Perinatal Support Washington and the Department of Children, Youth, and Families, as well as have access to PeaceHealth infrastructure, including hospitals, clinical practices, and community benefit grant opportunities.

The internship program directly increases access to care by developing a local mental health workforce skilled in addressing perinatal mood and anxiety disorders who work with Medicaid enrollees.

2024-2025 Interns shown here – Meredith LaPlante, Melody Eastman, Aliya Qadri, Rachel Jones. Photo provided by Mobile Mama.

At a recent visit by ACH staff, Mobile Mama shared the internships are going well –each intern provides intakes and counseling for up to 12 clients per week, and receives advanced training in perinatal mental health and supervision hours each week. Applications for this internship have “skyrocketed” as word has spread! Mobile Mama hopes the upcoming applicant pool will include more students culturally and linguistically matched to the community.

Because there are more clients than capacity to serve, Mobile Mama continues to seek sustainable funding to support the internship program, as they cannot bill insurance providers for internship services.

Mobile Mama is looking to partner with the Managed Care Organizations (MCOs) and others, to better understand how to advocate for Medicaid changes, negotiate rates, and support programming, as well as being part of discussions on navigating the issues around credentialing, reimbursement rates, and billing for interns under the supervision of trained clinical supervisors with MCOs. To connect, reach out to Michelle@MobileMama.com.

Equity: Important Now More Than Ever

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Last summer we were getting ready to launch our first communities of practice, and had several conversations that retrenchment was just around the corner for investments in equity-focused work. A lot of organizations added DEI staff after the murder of George Floyd in 2020. By early 2023, many of those organizations were already walking back some of those commitments, either eliminating positions or asking DEI leads to add other responsibilities like strategic planning, HR, and other business practices to their roles. 

I carry a lot of curiosity about whether organizations who committed to equity, actually knew what they were committing to in the first place. Equity is much more than a trendy term to use in communications, a banner to wave to show that one is responding to a crisis, or a current event. Rather, it is (or should be) a body of work that will strengthen organizations and our communities if we put the required investments of time and dollars in. There is nothing easy about this, and there is no single strategy that will ‘achieve’ equity. There are too many long held beliefs, barriers and roadblocks in the way. That said, it is also possible to make visible and lasting progress. 

A close friend, Diana Bianco, introduced me to a term almost 20 years ago – “to what end?” I can’t count the number of times that I say that out loud. If you don’t know what you’re after, how will you know if you ever get there? 

I read an article this week about several large companies who are reducing or eliminating their commitments to DEI, including companies whose products we use every day. My intention is not to call them out here; they are not alone in making decisions to remove references to equity. They are simply examples of why the work we do is so important – equity is more than a word. 

  • “We’re going to lead with inclusion, because we need a world where inclusion is front and center. And that means inclusion for all, not some people. Everyone has a right to feel that they belong in the workplace and that they are included.”  They further stated “By putting inclusion first, we aim to address the existing flaws in DE&I programs, which have caused societal backlash and increased polarization,” then emphasizing its continued commitment to promoting equity within its “inclusion” strategy. (SHRM)
  • “True systems-change work associated with DEI programs everywhere are no longer business critical or smart as they were in 2020”, while in another spot they said “our commitments to DEI remain the same.” (Microsoft)

How can your commitments remain the same when you cannot say the word out loud? 

This is beyond disheartening or disappointing. I understand that companies don’t want anyone to be uncomfortable. Inequities are present every day – not just in the past, but perpetuated today and will continue into the future if we don’t name what needs to be changed. That’s why they need diverse leaders, who are tasked with leading those initiatives and deep systems change. But having a group of diverse leaders is a visual representation of hiring practices; having teams who are tasked with advancing equity is a whole other matter. It means that you value the work itself.  

Large companies have the power to change minds, and when they are faced with discomfort they should use that opportunity to educate, not backpedal; leaning into discomfort instead of stepping away. (Well, they could be using it as an opportunity for education if not for two things – they’re reducing their DEI staff, and the IRS tax laws make it illegal for a for-profit company to take any action that could reduce their market share or return to shareholders.) 

Equity is about everyone – and if there are people who feel left out, it is a lack of understanding about what an equitable approach can accomplish to better the lives of all community members. We have to know where we are headed (the ‘to what end’) and then we can lay out the steps we’ll take along the way. We cannot just begin taking steps and think they’ll get us to some  unstated goal. The word ‘equity’ is not the reason people are uncomfortable; the notion of change that will somehow leave them out or give them less is scary. So let’s address that. 

I’ll end with something my oldest said to me when he held his first job after graduate school. He was lamenting how much technology he had access to in his graduate program that was not accessible in the firm where he was working. As a young architect he didn’t have 3D printers or a device that he could take into the field as he was managing a project. “Mom, they only have desktops!” After he described the scenario I asked why that was and his response stayed with me, “the principals of my firm were taught by professors who were born at the turn of the last century.” I had to sit down and do the math to catch up. That is how structural racism stays in place – it is not about the long ago history (that some want to bury), all that history is sitting with the leaders we have today, including me.

If we want a future that embraces us all, we must be brave enough to build new structures, not continue to rebuild what made sense in the early 1900s. 

I’m glad to be with you on this journey and look forward to seeing you in August. Registration for the Partner Convening is open! 

Be well –

Network Dispatch: Cultural Alimentos Project

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Community-Centered Solutions: Cultural Alimentos Project

About to launch phase two of this project, the collaborating organizations – Bellingham Food Bank, Northwest Agricultural Business Center, and Refugee and Immigrant Services NW – have made great strides to increase food security for Black, Indigenous, and People of Color (BIPOC) and refugee, immigrant, and migrant (RIM) populations!

Approved for funding by the North Sound ACH Review Committee last year, the Cultural Alimentos Project focuses on expanding knowledge about food security needs and simultaneously building strategies for longer term investment in food systems that support BIPOC/RIM community members.

North Sound ACH team members visited the Bellingham Food Bank site in May 2024, meeting with Mike Cohen and Stephanie Sisson (Bellingham Food Bank), Steve Bader of Agape Food Bank, Alex Perez (Northwest Agricultural Business Center), and Van Kuno (Refugee & Immigrant Services NW).

Steve Bader of Agape Food Bank, and Stephanie Sisson and Mike Cohen of Bellingham Food Bank.
A sample of food available at the Bellingham Food Bank
Seen at the Bellingham Food Bank
Bellingham Food Bank Executive Directory Mike Cohen shows the warehouse.

Bellingham Food Bank surveyed their clients in 2022, asking about cultural food preferences, ease of locations, and to find out which populations were missing from utilizing their services. This project builds upon those survey results, and led to creating advisory groups composed of community members from the BIPOC communities they intend to serve.

Project leads said they’ve learned the importance of not rushing the process when it comes to building trust within the community. They recently hired a consultant to help them hear and learn from BIPOC communities. As a result, they’ve noticed a rise in the number of people joining the advisory groups, including members from Afghanistan, Ukraine, Pacific Islands, Vietnam, Pakistan, India, and various Latino and indigenous communities.

They’ve recently learned of key transportation barriers, residual fear of federal immigration policies that were never passed or have been rescinded (that threatened to penalize immigrants for accessing benefits), and continued lack of services tailored to BIPOC and RIM communities.

One significant finding was that people from Pakistan, Afghanistan, and Pacific Islander communities consistently reported a lack of services tailored to them. Often, they received written information and were then turned away. This issue was a common theme during advisory group meetings with these communities.

Stay tuned for more updates!

CORRECTION: Agape Service Project Food Bank is not a part of the Cultural Alimentos Project. They are a food bank that works closely with Bellingham Food Bank, especially around sourcing culturally relevant foods. They were also not a part of the 2022 Bellingham Food Bank client survey mentioned in the previous version of this post. The writer apologizes for the error.

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We’ll be sharing more Network Dispatches in the coming months, about the projects created by Collaborative Action Network members.

Apple Health extended coverage to end

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During the COVID-19 public health emergency (PHE), the Health Care Authority (HCA) extended coverage for all Apple Health (Medicaid) clients. This extension is now ending due to the Consolidated Appropriation Act (CAA) of 2023, and clients’ extended coverage will be affected. The HCA estimates 300,000 clients around the state may no longer qualify for Apple Health, but may be eligible for other insurance coverage.

HCA is resuming normal eligibility beginning April 1, 2023. Clients will receive a renewal notice prior to the end of their renewal period sometime over the next 12 months, based on a client’s renewal date.

Anticipated timeline for the end of the extended coverage:

  • Now – April 2023: clients can report a change (status, income, address, etc.)
  • April 2023 – April 2024: the HCA processes redeterminations
  • June 2023 – May 2024: some individuals and families will transition to other medical coverage.

If you receive Apple Health (Medicaid):

  • Make sure your contact information is up-to-date at www.wahealthplanfinder.org
  • Watch for renewal notices and take timely action to keep your coverage

Find a free Navigator at these locations:

  • Sea Mar Community Health Center https://www.seamar.org/open-enrollment.html
    • Skagit: Concrete Clinic and Mount Vernon Clinic
    • Snohomish: Everett, Marysville, and Monroe clinics
    • Whatcom: Bellingham and Everson Clinic
  • Skagit Valley Hospital and Cascade Valley Hospital
  • Unity Care NW
    • Bellingham and Ferndale clinics (360) 788-2669
  • Community Health Center of Snohomish County
  • Providence Health and Services (425) 261-4009
  • Resource Corporation of America (425) 263-8750

If you are a healthcare or community-based organization:

The HCA is seeking community organizations and influencers to act as volunteer Apple Health ambassadors. Ambassadors will work to ensure that Apple Health clients have the information and resources needed to maintain coverage at the end of the continuous coverage requirement period.

How can you spread the word? You can share information at work with coworkers and clients, at your next church service, community event, or school event. You can use their social media toolkit (https://www.hca.wa.gov/assets/free-or-low-cost/end-of-phe-social-media-toolkit.pdf) with approved posts you can share on platforms like Facebook and Instagram. North Sound ACH is also developing a social media tool kit that you are welcome to use.

  • March 27

The HCA is hosting monthly webinars for Ambassador updates – find dates and registration at https://www.hca.wa.gov/about-hca/programs-and-initiatives/apple-health-medicaid/apple-health-ambassador-program

Find more information at these links:

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.