Jamie’s Place 

The Georgia Health Policy Center recently spoke to Raleigh Bowden, M.D., a physician and member of the board of Jamie’s Place, and Rana Clark, R.N., executive director of Jamie’s Place, about the need for a network to address elder care issues in the Methow Valley of Washington. 


To date, what has been the biggest accomplishment or win for your network planning?  

Rana: We determined right away that the caregiver workforce issue was something we needed to address in multiple ways. To enhance our caregiver workforce, we have done caregiver trainings throughout the local community. We tapped into the local high school, and we graduated our first class of high school home care aides. Additionally, we provided a bridge program to certified nurse assistants (CNAs) so that some of our caregivers who already are home care aids can complete an accelerated program to become a CNA. It not only improves their education and knowledge, but it also provides the possibility for career advancement as well.  

We are not only in a rural area, but we are in a recreational community, so rents are very high, and inventory is low. One of the issues that we have in keeping and recruiting caregivers is finding places for them to live. We realized that we would need to do something creative, something quick, and something that would get to the heart of the issue. We purchased two tiny homes and put them on our property at Jamie’s Place, so that we can have a stable housing option for our caregivers. 

Raleigh: One of our partners is a home membership organization that develops programs for seniors to age at home. We are working with them on the Silver Nest project, which is trying to get older people with big homes and more space than they need to house some of the workforce around the valley through home sharing. That is just getting off the ground, but it is very exciting. 

We have a pretty aggressive partnership network. We have three or four primary partners and eight next-level partners. Pulling them together for monthly meetings and quarterly meetings has been an amazing success. By that I mean, people keep showing up. What we are doing is interesting to them.  


What is a tip or early learning that you would share with an organization launching a similar network?  

Raleigh: Partnership is the key building block. I cannot emphasize that enough. It is hard work and it takes time. Rather than run out and start doing projects, I would advise others building a network to spend time on the relationships. I am a hurry up and get it done person; but I am learning to have patience. In the long run, it is the partnerships that will provide each of us moral support and the ability to problem solve. 

Rana: If you have an issue or know of a problem in your community that you want to tackle, start with a needs assessment so that you have a solid foundation and a clear vision of what you want to do and so that you can make sure that all the partners in the area with a stake in what you are doing, in our case caring for our aging populations, have their voices heard. That needs assessment really set the foundation for this grant and all that we are doing going forward. 


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

Rana: Even though this is a one-year planning grant, we are not looking at it as a one-year planning grant. We are looking at it as building a sustainable network that is going to continue to work on these issues from here to forever. We are building real, integrated partnerships with people who are dedicated to the work that we are doing, and these issues are not going to go away in a year. Within 50 miles of here, there is nothing else but our 12-bed adult family home for long-term care. Our next step is looking at how to best provide that care for the seniors in the valley. 

Raleigh: The population here of those 65 years and older is the most rapidly expanding piece of our valley. We anticipate 35% more people in that age category in the next few years. While the planning grant really does focus on our valley, which is a piece of the county, we are already setting the stage to go countywide for many of our efforts. 


Do you have an example or story that illustrates the value of planning for a rural health network instead of a single organization at the helm?  

Rana: Jamie’s Place is really an army of two employees and a very active dynamic board of directors. It was imperative for Jamie’s Place to enlist partners. We are fortunate to have an active social service network in our community. In a rural setting, you need to support each other for the common good. 

Raleigh: I belong to the Lookout Coalition. It is one agency that is caring for a 97-year-old woman who has mostly done okay at home, but now she is turning toward death. She just cannot get out of bed. She will not eat and drink, and our agency is involved in communication between her clinic and the caregiver community. So, I helped find a caregiver and I talk to the caregiver via text every other day. And now, hospice has come on board. She does not want aggressive therapy. She wants to die at home. So, these three partners have gotten together to help provide that safety net. The wishes and care for this patient illustrates the need for a network of partners.  


What will your network members be doing more of or differently to emerge stronger from the pandemic? 

Raleigh: It is clear that Zoom and texting and quick electronic forms of communication beats the office visit in many situations. My 97-year-old patient cannot leave the house, she cannot go into the clinic. Increasingly we are working on HIPAA-compliant communication tools. We do not want to go back to the old way. I can see many more patients more quickly if I do not have to get in my car and drive an hour. 

Also, I think we need to restate the value of being nice to health care workers. Because people were treating health care workers so poorly during the pandemic, we are losing our caregivers and our health care provider workforce. We can all thank health care workers. Be nice to them and protect them from angry patients. We need to remember that the caregiver workforce is burning out partly because there are not enough of us. Even though COVID is kind of quiet, the shortage is not, and it takes a huge toll. 

Rana: COVID really ripped the blanket off of a lot of the issues that were already there and highlighted them, putting them in all caps with an exclamation point. COVID laid bare for all to see the elder orphans who are out there without any support. In our community, our elders who need to be transported to a facility because they can no longer be at home during the pandemic had nowhere to go. This grant is critical to the long-term health of our community. The network we are building provides the foundation we need to meet the next challenge head on!

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