Rural Health Network Development Program: Mendonoma Health Alliance

The Georgia Health Policy Center recently spoke to Micheline White, executive director of the Mendonoma Health Alliance (Gualala, Calif.) about how the organization continues to evolve and grow its network to meet the needs of a frontier community, especially during COVID-19. 


To date, what has been the biggest accomplishment or win in your network development?  

One of the things that has made us successful is being able to professionally develop our workforce. We have community health workers and one of them is a Promotora, so she works with our Spanish-speaking population. Having her on board, we were able to start expanding our care coordination program. We also have a care transitions program, which is like care coordination, but the main difference is that it is a 30-day program for people who are discharged from the hospital back into our community, while care coordination is for anyone who needs help navigating health care and essential resources and is not limited to 30 days. Our community health workers help people access resources like pharmaceuticals and durable medical equipment, coordinate specialty care and follow-up appointments or labs, and help with any other kind of needs, like behavioral health or addiction care.  

One of our other successful programs is health screenings, which we provide in our office and mobile throughout a 60-mile region. We started with blood pressure in year one in our first grant and have added screenings for cholesterol, A1C, HIV, and hepatitis C, and we just began offering COVID 19 screenings. Since we are a community-based nonprofit, our test results are non-diagnostic, but they are highly accurate. The screenings are a great way for people to get an overall snapshot of their health and if they test positive or have readings considered out-of-range we refer people to primary care providers. We have one Federally Qualified Health Center with no other care, outside of emergency services, for 60 miles in any direction.  


What is a tip you would share with an organization seeking to build a network?  

We will partner with anybody. We do not say no to a partnership. Collaboration is the most important thing in our organization. It has allowed us to be successful and sustainable. It is so much better to have access to all the knowledge that partnerships bring than to try to do things on your own.  

Something important to address in thinking about collaboration and partnership is that there are always going to be elements that are challenging. It is really important to be the neutral partner in situations. If everybody’s real purpose is to improve the health of the community, then the most important thing is to take a step back and just say, ‘I don’t have to own this program, but I am going to help you do it because it is what is right for the community.’ That is what will make your partnerships and your network flourish.  

Also, do not give up. At the beginning, it is going to be hard. But what happens at the end is beautiful. You end up seeing such an impact on the community and all the people that you are serving. Try to do the best of your ability to make partnerships work because every organization that is serving the community has a purpose and a reason. You have to sit down at the table, and you have to not beat around the bush about anything. No elephants in the room. If there is something going on, talk about it — no matter how uncomfortable it gets. You cannot solve problems and move forward unless you talk about it. Do it in a nonconfrontational way, and just say, ‘This is how I’m feeling. This is what we are seeing. What are you seeing and feeling?’ Once you come to that common ground and really understand each other, you will see that the problems are not that big and are always resolvable.   


How do you see participation in the Federal Office of Rural Health Policy’s Network Development Program impacting your broader health improvement efforts? 

Being involved in these grant opportunities through the Federal Office of Rural Health Policy has been incredible for our community. It has broadened the experience and professional development that my staff has access to. Our technical assistance provider’s advice has been incredible.  

Being a grantee holds you to a higher standard. No matter how much of a pain a deliverable is, get it done and do it with the intent of using the plan. The marketing plans, the strategic plans —they helped set us up for our future and launched the trajectory of our organization and network forward. The deliverables set the structure of your organization and network up for success.  


How will your organization emerge stronger from the pandemic? 

The biggest lesson is to be prepared for the unexpected and try to plan for the unexpected. Some organizations in our network have emerged stronger, while other parts of our network are still severely struggling. With the mandate on vaccinations and other pandemic-related stressors, the medical workforce at our partner organization has been reduced drastically. The pandemic taught our organization that even when we feel the chaos of what is happening operationally, that’s not as big as what people are feeling at home. We learned to look outwardly to see how we can help the community in ways that align with our goals and mission. We learned to turn to the community and ask them what they need and then plan to meet those needs based off what we heard. 

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