History and Evolution

 

In the Columbia Gorge region of north central Oregon and south central Washington, our community is changing the way we identify and address some of our most difficult and historically entrenched issues. Through collaboration, common needs, and mutually reinforcing activities, we are building a collective impact framework that will enable us to meet the medical, emotional and social needs of individuals in our community, while also making systemic changes across multiple sectors.  In short, our vision is to create an inclusive health community.

A significant shift in our traditional approach to meeting needs occurred when Oregon moved to a Coordinated Care Organization (CCO) model of Medicaid funding in 2012.  (Note: CCOs are chartered by the state of Oregon to manage a region's Medicaid funding.)  With the development of the regional CCO, which is led by the Columbia Gorge Health Council, local health care and other leaders recognized an opportunity to identify our common needs and develop collaborative solutions.  

In response to this opportunity, The Health Council and community providers intentionally adopted a broad definition of a "healthy" community.  This definition includes traditional physical, mental and dental health while also including social determinants of health such as housing, food insecurity and transportation.  The inclusion of these typically "non-medical" issues by the local health care industry has proven to be a catalyst to truly unite local social service providers, medical providers, state agencies, nonprofits, private businesses, schools and others in their work across sectors through exemplary initiatives.  

As a Gorge community, we also shifted to deliberately amplify the voices of the end-users of safety-net services to inform programs every step of the way.  The first step was initiating the Community Health Improvement Process (CHIP), a region-wide effort to identify and prioritize needs faced by low-income community members.  The CHIP became the foundation for much of the work community providers are undertaking to create a culture of health.