2023 Year in Review
/Reflecting on 2023…
What a year!
2023 started with a fresh look at the renewal of Waiver 1115 for our state, and also provided us a unique opportunity to look back at our last 5 (ish) years of progress in our region.
Community remains at the heart of our work, as we are constantly reminded that better health starts together. Our priorities this year centered around 3 major themes: putting equity at the forefront of everything that we do, letting community voice lead in solutions for their own representative populations, and further investment in a community-based workforce that helps us provide resources that go beyond primary care to offer supports like food, housing, and behavioral health services, all which factor into making our region healthier and stronger.
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Putting Equity First
BHT has been on a unique equity journey over the last 10 years. We are constantly striving for health equity - where institutions support every individual in achieving their full health potential regardless of identity, environment, or lived experience.
A fundamental part of our equity journey is coming to terms with the understanding that we live in a white-dominant culture built upon patterns of behavior that positioned white people to dominate positions of power while perpetuating avoidable and unjust health outcomes for people of color for over 400 years. We acknowledge the presence of systemic racism and white-supremacy culture at play in the policies and culture that governs our work. We must be intentional in our commitment to support the voices of Black, Indigenous, and people of color or else we risk perpetuating patterns of white-supremacy culture.
When we look at the decision-making tables, we notice most of the leaders are white. When we look at who is most impacted by these agencies’ work, the data shows people of color carrying the unjust burden of the greatest barriers. This disparity tells us we are working in a white-dominant system. If we are not intentional about applying an anti-racist lens to everything we do, we are at risk for perpetuating white supremacy culture in behaviors such as perfectionism, defensiveness, and a sense of urgency.
In June 2020, the BHT Board approved the following position statement to guide our work (read our entire position document here):
Racism is not just when a person treats someone else differently because of their race.
Racism is a developed false idea used to justify a culture whose behavior has positioned white people to dominate positions of power while perpetuating avoidable and unjust health outcomes for people of color for over 400 years.
BHT is committed to building an anti-racist community and opposing oppression in all forms – not only to stand against systemic oppression but to invest in radical change and steward the process that will lead us to a better future.
We commit to critical analysis of how white-supremacy culture influences our decision-making and acts on opportunities to disrupt cycles of discrimination and oppression.
Our definitions of equity are ever-evolving, but we are centered and focused on dismantling white supremacy, serving impacted populations, and using our privilege to disrupt systems of power and oppression. Below are a few stories of how we did just that in 2023.
Spokane Public Schools Partners with CHAS and Unify to Ensure Equitable and Accessible Healthcare for Students.
Within the halls of Spokane Public Schools, a transformation took place to provide students with equitable healthcare, something they might not have had access to otherwise. Medicaid 1115 Waiver Funds supported a telehealth pilot program that spans multiple schools located in high-need areas.
In education, telehealth appointments become more than just medical consultations—they become lifelines. Often overlooked in underserved communities, students find themselves at the forefront of care. Students can consult via telehealth with physicians while simultaneously receiving in-person support from their school nurse, including medication administration and vital monitoring. Additional resources were allocated to ensure uninsured students have the resources they need to maintain their health after their telehealth appointment, including follow-up care at nearby clinics.
The telehealth pilot program is just the beginning of a quest to increase healthcare access among youth. BHT has allocated $600,000 in 2024 to support increasing access to care in rural Eastern Washington counties. Together, we're weaving a narrative of resilience, compassion, and unwavering support, ensuring that every student can access the care they deserve regardless of circumstance.
BHT Breaks Down Barriers to Provide Funding For By/For Organizations
In 2023, the BHT Community Resiliency Fund aimed to remove barriers for impacted community-led organizations and create opportunities to fuel systemic change. 55 organizations submitted Request for Proposal (RFP) applications, with requests totaling over $5M dollars.
RFP evaluators included at least three members from BHT BIPOC/Impacted Board members, BIPOC/Impacted Community members, and Health Care Authority (HCA) representatives.
22 evaluators worked over 16 hours to review presentations. At the recommendation of our evaluators, BHT awarded 20 community-based organizations* over two million dollars to serve their communities. All the organizations selected serve and/or advocate for persons with intersecting identities who have been negatively impacted by systemic and institutionalized racism.
Of the community-based organizations that were selected for funding:
13 focus on serving our Black, Indigenous, and Communities of Color in Spokane to prevent, mitigate, and repair the impacts of systematic racism.
Four focus on serving persons who are justice-involved.
Two focus on serving members of the LGBTQIA2S+ community.
One is an activist building and supporting organization, working against systemic and intrinsically racist policies.
Learn more about the Community Resiliency Fund RFP process
*with leadership, board, and/or staff comprised of at least 50% impacted persons
Vaccine Clinics Held at Lincoln County Schools Produce Notable Outcomes
With BHT Equity funds in hand, the Lincoln County Health Department embarked on a mission that would redefine community health. Recognizing the importance of accessibility, they brought vital vaccinations to events and schools where community members gathered. This initiative produced notable outcomes — a 10% increase in adult flu vaccination rates, alongside full vaccine compliance in two schools, all achieved with a total cost of less than $14,000.
The vaccination efforts resonated across Lincoln County. A total of 137 flu vaccinations, 24 COVID vaccinations, and 29 adult and childhood vaccinations were administered, marking a significant step forward in protecting the community's well-being. In Sprague, success was achieved as every student met vaccine requirements, showcasing the power of targeted interventions.
This wasn't only about numbers—it was a testament to dedication and innovation. These clinics didn't just contribute to the county's overall flu vaccination efforts; they became a cornerstone of community resilience, uniting neighbors in a shared commitment to create healthier communities.
Community Voice Takes the Lead
BHT was founded on the principle that when we step back and let the local community lead, we find the best and most sustainable solutions to some of our most complex problems. Here’s a few ways we led with community voice in 2023:
BHT Funds Community Linkages RFP to Address Health-Related Social Needs in the Region
In early 2023, BHT issued a Request for Proposal (RFP) totaling $3.6M, inviting submissions from organizations offering care coordination and services addressing health-related social needs. The aim of the Community Linkages funding was to identify entities showcasing a robust commitment to whole-person care through coordination and addressing social determinants of health. These services encompassed housing resources, food assistance, culturally sensitive care, transportation aid, employment support, and assistance for justice-involved populations.
The funding objectives were:
To strengthen infrastructure in community-based organizations that provide care coordination and health-related social needs.
To shift power by supporting organizations that represent the communities they serve.
The response was overwhelming, with over 40 applicants seeking more than $17 million in support. From this pool, nine recipients emerged through the diligent efforts of a dedicated community panel. Their commitment and hard work ensured the selection of deserving Community Linkages RFP recipients. Click here to view the recipients.
Quick tip! What are Health-Related Social needs?
BHT acknowledges there is more to health than primary care, it is also the access to social, physical, occupational, mental, and behavioral resources that make up the larger picture of what makes someone healthy. We recognize that all of these areas are interconnected and determine a person’s overall health.
Bringing Narcan to Community With a Free Vending Machine at Spokane Public Library
BHT received a $30,000 grant from United Healthcare to purchase Narcan vending machines, ensuring the life-saving medication is readily available to the community at no cost. BHT acquired two vending machines, with one placed in the South lobby of the downtown library for convenient access for all. Thanks to a staff member's suggestion, we were able to utilize the funds beyond Narcan, incorporating essential items like feminine hygiene products, first aid kits, ponchos, and condoms into the machines.
The community enthusiastically embraced this initiative in 2023, leading to significant utilization of the vending machines. BHT partnered with the Department of Health, which provides Narcan at no cost, and the West Spokane Wellness Partnership, which also generously donated Narcan to fill the machines. These partnerships have been instrumental in ensuring the availability of life-saving resources.
Looking ahead, we recognize the need for sustainable funding solutions. The demand for harm-reduction items is not only high but also profoundly impacts the well-being of our community. In the long term, we will need to creatively find ways to fund the additional harm-reduction items to continue meeting this crucial need. Our machines are now living at two community-based organizations who center around recovery services.
Care Connect Offers Impactful Services to Address Health-related Social Needs
Care Connect was a program born out of the response to the COVID-19 pandemic, but it has had lasting effects in jump-starting efforts in community-based Care Coordination. The current program is designed to assist individuals currently dealing with COVID, Long COVID effects, or any form of COVID-related impact. Recipients of services can engage with Care Coordinators for extended durations, facilitating connections to essential community programs or support services that their household may require. Case management is available to address various barriers across different pathways, such as behavioral health, mental health, physical health, employment, health insurance, financial assistance, and beyond.
In 2023, Care Connect experienced significant changes, including recruiting 20 new Care Coordinators. Additionally, four new Collaborative partners were referred through CCS, and the implementation of Care Connect 2.0 began in July 2023.
The Care Connect team has helped many households in the region get access to the things that help make them healthy, and have also grown in their own skills as well. Many have completed training programs such as CHW, Navigator, and Care Connect, in addition to pursuing supplementary training based on individual interests. Their collective efforts have positively impacted countless households spanning six counties.
SMILE Spokane Works to Minimize Health Disparities
Founded in 2017, Smile Spokane has a clear vision: to minimize health disparities within Spokane County. The team is dedicated to achieving tangible advancements in oral health equity by initiating systemic changes within the region's oral health infrastructure, thereby ensuring that everyone has access to improved oral and overall health outcomes.
The team has been working to support several outcomes, including enhancing access to school-based sealants, promoting the integration of medical and dental services, and improving equitable access to underserved populations. This report highlights the team's significant achievements over the past year, and BHT is excited to present it to you.
BHT Sponsorship Supports Community Events
In 2023, BHT offered one-time community sponsorships for local organizations to host events and run special projects. In total in 2023, BHT put $122,000 back into the community via this initiative!
Below are a few of our community sponsorship recipients:
Spokane Homeless Connect
Spectrum Singers
Our Place Community Outreach
Spectrum Center Spokane
Compassionate Addition Treatment
Ferry County Public Hostpital District
Terrain
Cool Spokane & Yoyot Sp'q'n'i
NE WA Educational Services District 101
Spokane Outreach Networking Group
Mujeres in Action (MIA)
The Way to Justice
Our Kids Our Business
Spokane Regional Domestic Violence Coalition
Peace & Justice Action League of Spokane
Inland Northwest Juneteenth Coalition
Glow Children Early Learning Center
Community Health Worker Coalition for Migrants and Refugees
Raze Development
Manzanita House
Martin Luther King Jr. Family Outreach Center
B & B Pro Video
Spokane Marshallese Community Advisory Committee
Mission Community Outreach Center
Latinos En Spokane
Spokane Homeless Connect & Innovia Foundation
A Woman's Worth
Sweetgrass Healing Arts Collective
Prioritizing Investment in the Community-Based Workforce
Our community-based workforce is the key to regional change and better care for all. We have had the opportunity to see time and time again how working with a care coordinator that is representative of your community and understands your unique needs gives you a better chance at being healthy. This year we focused our efforts in how we can train, support, and grow our Community Health Workforce to support our region.
Community Health Worker (CHW) Network and Training Program Takes Flight
Our HRSA CHW Training & Apprenticeship Program has made significant strides in empowering CHWs across our region in the past year. We successfully trained 36 new CHWs, providing them with essential skills in Adult Mental Health First Aid, Disaster Preparedness, and Medication Management. Additionally, we offered upskill opportunities to 40 existing CHWs, further enhancing their capabilities and readiness to serve our community.
Our efforts extended beyond training. Through robust community outreach and engagement with employers and partners, we raised awareness about the invaluable contributions of CHWs. Participating in over 20 regional events and delivering presentations at 25 meetings, both large and small, we highlighted the pivotal role of CHWs in enhancing community health outcomes. The guidance and support from our dedicated Steering Committee members have been instrumental in shaping our program's development, ensuring quality improvement, and selecting training participants.
Eastern Washington CHW Network Thrives
The Eastern WA CHW Network has also flourished, welcoming 20 new members to its ranks and achieving a milestone of 100 total members. Monthly meetings serve as vital platforms for CHWs to connect, share resources, and foster professional development. These gatherings have facilitated engagement with over 12 partners, who introduced new resources to support community members effectively.
Moreover, our network's influence extends to statewide leadership. Four of our members now serve on the State CHW Leadership Committee, advocating for CHW interests in training, education, employment, and policy. Their involvement ensures that the voices of Eastern Washington CHWs are heard at the highest levels of decision-making.
Through these initiatives, our CHW Network and Training Program continues to strengthen the foundation of community health across Eastern Washington, empowering CHWs and fostering collaboration for a healthier future.
Behavioral Health Forum Creates New Workforce Training Opportunities
In 2021, the Better Health Together Board allocated a portion of remaining Integrated Managed Care dollars to support behavioral health (BH) workforce initiatives. This included support for organizations with SUD and master’s level behavioral health staff to provide supervision so that staff can gain critical licensure.
BHT's Behavioral Health Forum gathered behavioral health providers and integrated primary care partners to get feedback about supervision needs and barriers. Based on this work, we designed an approach for expending the allocated dollars and distributed all $150,000 to eligible organizations.
As of July 2023:
15 organizations received $10,000 contracts
87 staff received licensure supervision and 21 completed supervision hours needed for licensure
14 organizations have applied for Round Two funding opportunity
More than $11,000 went toward licensure costs, including application and testing fees
Behavioral Health Workforce Initiatives: Funding Directed by Behavioral Health Forum
$45k in scholarship funds went to students for Bachelor’s in Integrated Behavioral Health program at SFCC - The first cohort is in progress!
$65k supported Certified Peer Counselor Training
$47k awarded to Eastern Washington CHW Network for community-based workforce training
$75k distributed to CHW Training Program to fill gaps by supporting participation when CHWs not eligible for HRSA funding
$45k in scholarship funds went to students for Bachelor’s in Integrated Behavioral Health program at SFCC - The first cohort is in progress!
BHT speaks to Dr. Ponce Gonzalez About Reducing Barriers to Training a Community Health Workforce
In August 2023, President Alison Poulsen and Chief Equity & Strategy Officer Hadda Estrada joined Dr. Ponce Gonzalez at the Community Health Workers Coalition for Migrants and Refugees to discuss reducing barriers to becoming a community health worker. The team discussed systems of power and their impact on migrants and refugees. BHT reinforced its commitment to center community voice and its deep appreciation for our community partners who help us amplify that voice. See the full interview: https://fb.watch/mzz3f7ngGT