The Community Centered Health Home Initiative started from a relationship with Children First/CIS’s advocacy initiative, The Success Equation, to address policy issues related to the social determinants of health and received funding from Blue Cross Blue Shield of NC. It is based on a successful and paradigm-shifting model from the Prevention Institute that prioritizes engaging residents of a particular community in long-term leadership and relationship as they identify strategies and work together toward improving the health of their neighbors, making clinical changes based on resident feedback, and addressing policies that are preventing people from reaching their full health potential. The key to this initiative’s success has been using shared decision making which included many key partners in a Steering Committee: MAHEC, Pisgah Legal Services, ABIPA, resident leaders from Pisgah View and Hillcrest Apartments, Children First/CIS, the YWCA, Homegrown Babies, North Carolina Center for Health and Wellness, Buncombe County Health and Human Services, Buncombe County Government, CHIP, Nurse Family Partnership, WNCCHS, Community Care of WNC, Vaya Health, The Buncombe County Initiative originally engaged with women in Pisgah View Apartments, but it is now growing to be more of a county-wide “movement.” CCHH has had some major achievements over the past year:
- Six resident leaders of Pisgah
View Apartments and Hillcrest completed training to become birth doulas and are
working on their DONA certification through a training with
local organization, Homegrown Babies, to work with lower-resourced
African-American women who would otherwise not have
access to this kind of birthing support, now operating under the name
Sistas Caring 4 Sistas
- A group of women meet in Pisgah View Apartments once a month, Mother to Mother, to share ideas, create relationships and determine the best steps to creating the community capacity the community wants to see
- Five of the resident leaders completed training to be a Breastfeeding Peer Counselor
- Two of the resident leaders completed the Tobacco Cessation Specialist training
- One of the resident leaders completed the Community Leadership Essentials training through the Center for Creative Leadership
- Doulas entered into a contract with the YWCA Motherlove program to provide doula services to teen mothers
- One of the resident leaders, Nikita Smart, joined the CCHH Board
- Nikita Smart wrote and was awarded a Tipping Point grant from Buncombe County to further the ability of the doulas to serve more clients
- MAHEC joins with Pisgah Legal Services to have on-site legal advice and support for patients dealing with housing uncertainty, eviction, and other economic conditions that directly impact health.
- MAHEC providers and staff begin to be trained in the Racial Equity Institute's two-day anti-racism training, to address implicit bias and structural racism within the healthcare setting
- MAHEC will be entering into a redesign of the physical structure of the clinic to be more open and inviting
- Four resident leaders were trained
to provide Lamaze Childbirth Education classes
- Four Doulas became MAHEC PRN staff
members to provide more reliable way to compensate them for services.
- Doulas have had/currently 19 African-American clients and 13 high-risk women of other demographics for a total of 32 clients.
- MAHEC received a two-year implementation grant from BCBS, continuing the work CCHH started in 2015, that was a grant co-written by all of the partners engaged in the initiative over a 6 month period that prioritizes building community capacity, making clinical shifts, making environmental and policy changes, and creating a strategic communications plan to further this model.
The Home Visitors Collaborative includes participants from Nurse Family Partnership, CCWNC, Asheville Buncombe Institute for Parity Achievement (ABIPA), Project NAF (Nurturing Asheville and Area Families), Motherlove, and Verner's Early Head Start, Buncombe County Prevention Services. This group just formed at the start of 2017, so the first several meetings were devoted to participants learning about the various programs and establishing both the logistics and the shared vision for future meetings. The group has also researched and shared information on successful models in other communities (the Home Visitors Collaborative in Kalamazoo was the basis for this collaborative). They have broken their work into three areas with initiatives active in each:
- Customer Service:
- Exploring ways to collect information from mothers who have recently given birth about their prenatal and birth experience, social support, etc.
- Creating an inter-agency brochure/rack card with all the program's eligibility and referral information to educate providers and community about options.
- Awareness and Training:
- Supporting ABIPA in disseminating their recently-created preconception health presentation (targeted at teens)
- Identifying common trainings for all agencies with home visitors (including Racial Equity Institute)
- Sharing more ACEs/Resilience information with clients and community
- Data:
- Currently creating a "wish list" of data they would like to be able to get from other sources to inform their services and also their reach/impact (possible sources: MAHEC/Mission/Medicaid...)
- Identifying measures the home visiting programs currently collect that could be shared/aggregated to better measure their reach and impact
