Columbia Gorge Collective Impact Health Specialist
- Need: To address the specific health needs of north central Oregon and south central Washington.
- Intervention: The Collective Impact Health Specialist identifies community needs, convenes community partners to design initiatives that address those needs, and secures funding for health-related initiatives.
- Results: Thanks to the CIHS, the Columbia Gorge region has received $12.5 million since 2014.
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 Hospital, noticed that the Gorge community was missing out on important grant opportunities. The community lacked the resources to track grant opportunities or convene partners, design responsive programs, and complete applications on tight deadlines.
In response, Providence Hood River Hospital committed itself to finding 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
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 have been met, the CIHS:
- Identifies and convenes appropriate partners
- Facilitates conversations to design need-focused initiatives
In addition, the CIHS role has evolved into a leadership role of a larger project called the Healthy Gorge Initiative. Part of that project includes the CIHS overseeing two new grant-funded positions: a Learning Specialist designed to understand and improve the impact of the collective work through data and a Communication Specialist who works to share stories both inside and outside the community. All three roles collaborate closely with an Oregon Health & Science University-funded position called a Community Research Liaison, who connects local projects/partners with academic interests.
Since the CIHS position began work in 2014, the model has helped develop over 50 new initiatives that have in turn created 30 full-time jobs, trained 100 community health workers (CHWs), and secured $12.5 million.
Some highlights include:
- The region's first school-based health center
- Advocacy for and development of affordable housing units
- Several multi-partnered coalitions to address specific needs including food systems, health equity, and childhood obesity
- Development of a Learning Specialist position designed to understand the impact of the collective work through data
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, received a visit from Governor Kate Brown of Oregon and former Centers for Medicare & Medicaid Services (CMS) administrator Andy Slavitt, and is part of the National Academy of Medicine's Health Equity Incubator Model.
This video from the Robert Wood Johnson Foundation (RWJF) showcases the various Columbia Gorge initiatives:
The design and funding for the CIHS model has come exclusively from Providence Hood River Hospital, a small community hospital within a much larger Providence system. There were no real barriers to the project within the Gorge community. Partner organizations quickly recognized the value of the community-based role.
The largest challenge at this point is capacity: capacity of the CIHS role itself as the project expands, capacity of community partners to take on more work, and capacity to create long-term change.
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.
The CIHS position can be replicated in any geographic or issue-based community. At its core, it is simply a community resource shared by community partners. The two fundamental components to get the project started include:
- Willingness for community partners to collaborate
Collaboration is the key activity of the model's success – and the broader work – in the Columbia Gorge region, 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 $10 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.
Community and faith-based initiatives
Networking and collaboration
June 5, 2017
Date updated or reviewed
June 29, 2020
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.