As with so many overlooked aspects of daily life, Covid-19 brought into focus the importance of robust and accessible healthcare. Dr. Jason Cunningham, CEO of West County Health Centers, said providing that care poses a worthy challenge.
"Healthcare, it should be different," Cunningham said. "So we're not just traditional medical providers anymore, seeing somebody in the office."
"We're talking about people who are going into the community, doing street work, community health workers, resource managers, in addition to behavioral health. We're doing addiction services, we're doing wellness services. So providing excellent care is no longer a simple provider or medical visit; and then also there's a little bit of a risk because you have that many more types of staff to hire and that type of staff to train and retain."
The health center in Guerneville, which will be receiving federal dollars for a solar array and the landscaping of an outdoor healing space, recently underwent a set of separate renovations and opened in August, after struggling to find the necessary funding due to natural disasters and inflationary pressure, said Cunningham
"We had an arson fire back in 2015 that burned down our health center," Cunningham said. "And again, we serve about 4,000 of our most vulnerable patients in our county who really have difficulty going elsewhere, and it really impacted our ability to provide care, including our dental clinic, which we had to relocate to Sebastopol."
"Now we've built it where how we want it to be built for our care, and most of healthcare, particularly for the vulnerable, has to do with teamwork and collaboration and care coordination and going upstream and figuring out what are the underlying causes for addiction and causes for mental health."
He said the aim of community based healthcare is to incorporate it into daily life, and said the renovated Food for Humans building on 1st Street in Guerneville will hopefully provide that space.
"We see primary care and community health being partly as a facilitator of community collective action," Cunningham said. "So when we're dealing with our homeless population or we're dealing with a mental illness for our kids, or we're dealing with any number of these entrenched multi-generational issues, it requires all of us to figure out how to do it together. So that collective action; and we're excited to be able to offer that space to our community for free."
One challenge not just for Cunningham and the West County Health Centers, but for healthcare networks around the country is meeting staffing needs.
"The deep work of relational primary care and really being part of another person's life in the most intimate way is profoundly interesting and rewarding," Cunningham said. "It's also quite difficult and the way that our health system is structured, it's not often rewarded financially as you would if you were and in other parts of the health system."
"So being able to do work in our most vulnerable rural communities and paying our staff wages they deserve and having that longevity is the risk. So that staffing is our most important asset. They are what create the relationship and the secret sauce, if you will, and it's also the most difficult to have sustainable part of our organization."
Despite the work’s challenges, Cunningham said, "It really is, I think, the work we all wanted to do, which is really being authentic with others in a relational way, recognizing that we aren't just a physical, but our health and our behaviors are informed by our community, our environment, our social structure, and also can be hindered by barriers, social determinants, and you know inter-generational transfer of trauma, how we learn from others, and it's not a 20 minute office visits anymore," Cunningham said.
Cunningham said for him, there’s nothing quite like healthcare work.
"Particularly in primary care, you’re in the front seat of humanity, and it can be incredibly rewarding and it can be life changing," Cunningham said. "If we do it right, it can be life changing for us as providers too."