Columbia Gorge Collective Impact Health Specialist

Description

The rural Columbia Gorge region in north-central Oregon and south-central Washington faces significant health challenges. In 2012, several community partners, including Providence Hood River Memorial Hospital, noticed that the Gorge community was missing out on important grant opportunities. The community lacked the resources to track grant opportunities, convene partners, design responsive programs, and complete applications on tight deadlines.

In response, Providence Hood River Memorial Hospital committed itself to funding a full-time position designed to fill these capacity needs: the Collective Impact Health Specialist (CIHS). Originally intended to serve as the "community grant writer," the CIHS works with community partners across sectors to help identify community needs, convene appropriate service providers to design initiatives to address those needs, and pursue funding to support those initiatives.

The CIHS position has capitalized on the Community Health Improvement Process (CHIP), a list of community members' needs written by community members. The CHIP divides these health needs into three categories:

• Social Determinants
• Direct Healthcare Services
• Health and Healthcare Ecosystem

Services offered

The CIHS can engage in an initiative if the initiative meets two criteria: 1) it falls under the CHIP and 2) it involves at least two community partners. Once both criteria are met, the CIHS:

• Identifies and convenes appropriate partners
• Facilitates conversations to design need-focused initiatives
• Seeks and secures funding to support those initiatives
• Works to connect and align local funding sources to support local initiatives
• Shares grant writing resources, including funding opportunities and common data

In addition, the CIHS role has evolved from .5 FTE to 1.75 FTE and plays a leadership role in the Healthy Gorge Initiative. The team has completed a year-long evaluation of the model through a Ripple Effects Mapping exercise and identified the impacts, results, and effectiveness of the CIHS model.

Results

Since the CIHS position began work in 2014, the model has helped develop over 120 new collaborative initiatives that have in turn created 60 full-time jobs, trained over 100 community health workers (CHWs), and secured $35.4 million so far.

Some highlights include:

• Funding for five years of afterschool programming
• Development of co-location facility as hub for community-based mental health services
• Launch of local workforce development needs assessment and planning
• Increase in community partners' interest and capacity to collaborate
• Alignment of local funders, beyond pandemic response, in order to better address local needs and leverage more "outside" funding

Providence Oregon, the healthcare network that includes Providence Hood River Memorial Hospital, replicated this model in rural Clatsop County, a region along the coast in northwest Oregon. This work has supported 8 new collaborative initiatives and helped secure over $6 million in grants.

In addition, the CIHS role has been critical to creating a culture of collaboration across historical geographic, sector, and population boundaries. The Gorge has received the following recognition for its work: It was named a 2016 RWJF Culture of Health Prize winner, was selected as a Blue Zones Demonstration Community, and received a visit from former Oregon governor Kate Brown and former Centers for Medicare & Medicaid Services (CMS) administrator Andy Slavitt.

Challenges

The biggest challenge is changes in the nonprofit and grant-funding sectors.

Policy change is the next challenge: The bulk of the programs launched have been intended to address immediate needs (downstream conditions), not the cause of those conditions. In order to create lasting change, the CIHS and community need to change the policies that result in those conditions.

Replication

At its core, this model is simply a community resource shared by community partners. This model builds on, works with, and coordinates assets already available in the community. Collaboration is built on relationships, which are based on trust. That trust is built on shared experiences based on shared goals and needs.

Collaboration is the key activity of the model's success, and that collaboration is built on trust. The willingness of community partners to work together across sectors and other historic barriers has led to community-identified needs as well as community-identified solutions. These two components make it easier to secure funding and make any program stronger. Trust helps partners think differently – and more innovatively – about potential solutions.

Neutrality is key for both the funder and the CIHS's day-to-day work. The funder should not dictate the content of the needs or the solutions designed by community partners. It should be noted that Providence has not received any of the $35.4 million in funding that has come into this community.

The CIHS must also remain neutral in designing the initiatives that address those needs. While the CIHS convenes and facilitates those discussions, this neutrality keeps the focus on the need itself and creates the space to design the best program regardless of organizational politics, personal agendas, and "the way we've always done it" mentality.

Contact Information

Paul Lindberg, JD, Collective Impact Health Specialist
Healthy Gorge Initiative
541.490.2340
paul@hatcreekconsulting.com