Roots Community Health Center's Mission and Organizational Description. Located in Oakland, California, and incorporated in 2008, the mission of Roots Community Health Center (Roots) is to eliminate Oakland's health disparities by providing culturally informed, comprehensive healthcare, mental health, and wraparound services, resulting in improved health, patient self-sufficiency and community empowerment. Roots offers a unique blend of primary care and complementary services through a whole person approach to health that challenges entrenched social determinants, including poverty and dependency. Roots' programs integrate healthcare with life stabilizing supports for people ... read more Roots Community Health Center's Mission and Organizational Description. Located in Oakland, California, and incorporated in 2008, the mission of Roots Community Health Center (Roots) is to eliminate Oakland's health disparities by providing culturally informed, comprehensive healthcare, mental health, and wraparound services, resulting in improved health, patient self-sufficiency and community empowerment. Roots offers a unique blend of primary care and complementary services through a whole person approach to health that challenges entrenched social determinants, including poverty and dependency. Roots' programs integrate healthcare with life stabilizing supports for people surviving trauma caused by violence, racism, marginalization and poverty. We prioritize services for African American men, homeless residents, the formerly incarcerated, and those with substance use and mental health issues. Our programs and services honor the "roots" of culture, heritage, and tradition, and offer easy access to services that are shaped by listening to our patients/clients so that approaches match their needs, and are enhanced through strong partnerships that build a more efficient continuum of care in Oakland. Roots serves nearly 10,000 East Oakland patients at our primary care clinic and pediatrics clinic. We recently opened a third primary care clinic in San Jose, and added services in the Crenshaw district of Los Angeles. We also operate a mobile clinic for the homeless, which just received the esteemed Opus Award for 2017. Roots has spearheaded the design and implementation of workforce development programs coupled with peer-led service navigation and case management initiatives that are supported through primary and behavioral care. Over the past nine years, staff has grown from 2 volunteers to 48 full-time staff, many hired from our community; 85% of patients are MediCal recipients; 1500 access wraparound services. To broaden our impact and create a new model for whole health in Oakland, Roots launched a social enterprise - Clean360 - where we train clients to make and market natural soaps and related products. Clean360 clients are mostly reentry residents who have barriers to stability removed through case management, receive physical and mental health support as needed, and learn skills that build their employability, all keys to long term health. We recently opened two new storefronts to market Clean360 products, including our newest location at our clinic in East Oakland. Roots' patients and clients face many obstacles to a healthy life. An African American child born in East Oakland can expect to live 15 fewer years than a White child born in the Oakland hills, barely five miles away. Inequity because of race, class and neglect by governing bodies are key in creating this difference. East Oakland has one of the highest rates of poverty in the country, and across Oakland 20% of the nearly 400,000 residents live below the poverty line, and 30% of African Americans versus 6% of Whites live in poverty. More than a quarter of residents over the age of 17 lack a high school diploma. Violent crime rates are high, and the numbers of supervised individuals (parole, probation) are among the highest in the state. Gentrification is worsening poverty levels and opportunities for stable lives, leading to greater health disparities, a lower quality of life and shorter life expectancy. Roots' health care and services challenge these conditions, responding to the whole health of its patients and the entire community. Building a clinical team whose majority is composed of community members is a key strategy that results in culturally informed medical care, empowerment for our community, and an accessible training ground for East Oaklanders who want to serve their home community as health professionals. Peer-led Case Management. In 2013, we launched the training and hiring of Roots Health Navigators, recruiting reentry individuals who complete Community Health Outreach Worker Certification and provide case management and wraparound services for their peers, many of whom have chronic behavioral and physical health conditions. Thirteen full time Roots Navigators provide ongoing case management and support, some working with reentry clients, to promote effective community reintegration and improved life stability. Navigators also specialize to assist specific groups such as teen parents, clients with Hepatitis C, the homeless, etc. Navigators co-design a health plan in which the patient/client identifies priorities and decides how to proceed in dealing with her/his health needs. Dismantling barriers to social, emotional, and financial stability is a fundamental step in achieving life stability and whole health. Barriers include legal issues such as probation/parole status, criminal history, IRS liens/levies, etc.; psychosocial/health barriers such as physical/mental health, substance abuse, housing, food etc.; and competency barriers such as math, reading, communication and computer skills. Workforce Development. At the same time, Roots expanded our whole health model by launching our soap-making factory, Clean360 to train and employ low-income and majority formerly incarcerated African American community residents who participate in workforce development through the Emancipators Initiative. The Emancipators Initiative offers Roots apprentices a comprehensive workforce curriculum and paid, on-the-job training with whole-person support so that they are able to meet basic needs while gaining work experience at Clean360 or in partner employment settings. Over 30 months, 44 participants have graduated from the program, and 41 have successfully reintegrated into Oakland neighborhoods: 30 are in long-term, stable employment; 7 are in temporary employment; 4 are in school full time; 2 are in substance use rehabilitation programs; and only 1 has returned to prison. All participants are current on child support, restitution and probation/parole terms. Street Outreach. Implemented in 2015, Roots also supports a Street Team Outreach Medical Program (STOMP) that brings a medical team to homeless people across Oakland three times a week and offers benefits enrollment, linkage to services and treatment, and medical care. In the past 24 months, 823 homeless patients have received treatment; over 1900 face-to-face doctor visits have occurred; care and over 2400 basic needs supplies have been distributed. STOMP meets people "where they're at" in each encounter - both physically, and in terms of their readiness to engage in their own health and well-being. By building long-term relationships and reducing harm, we reach homeless residents who are marginalized from traditional healthcare, while improving the health of our community overall. Because the STOMP patient base has rapidly expanded, we now offer a weekly walk-in clinic at Roots' main site in East Oakland. Roots values and theory of change. In the clinical setting, in service navigation, and in workforce development, we are guided by our theory of change: empowering those who have been marginalized with skills that enable them to engage positively with themselves and their communities in the context of wraparound services delivered in a safe and therapeutic environment improves morale and self-efficacy, and ensures successful involvement/reintegration into society. To achieve whole health outcomes, we respond to chronic disempowerment; lack of positive/pro-social community engagement; lack of employment opportunities; unstable family relationships; low self-esteem and poor relationship skills; and attitudes/beliefs that lead to poor decision-making. Our care team partners with patients to identify and manage these risk factors, including their readiness to address them, through implementation of our multi-disciplinary, wraparound approach. Roots' leadership recognizes that the medical system must engender trust and demonstrate commitment to dismantle the barriers that exist for marginalized individuals - this is especially true for the formerly incarcerated. Meaningful engagement with services for this group is contingent upon access to culturally grounded, compassionate, and trauma-aware care, which facilitates opportunities for healing and self-empowerment within the clinical setting. Our clinicians are trained to recognize the broad-reaching impacts of trauma, using the primary care medical home as a place for healing. Community partnerships. Roots is committed to partnerships that ensure a broad and efficient continuum of care to increase collective impact, sharing best practices and protecting the safety net. These partnerships also help us evaluate our effectiveness and adjust our methods as needed. In designing innovative "system of care" models that better serve marginalized patients, Roots spearheaded a coalition of community-rooted providers in the East Bay (the Community Rooted Provider Coalition) to align similarly committed, independent safety net providers who share strategies and support each other in better serving historically marginalized residents. Roots was also recently selected to become the hub institution for East Oakland Building Healthy Communities, a ten year place-based strategy across California to improve the quality of life in low resourced communities. Roots participates in Alameda County's African American Behavioral Health Steering Committee, and engages with systems partners including probation, parole, Santa Rita Jail, etc. We have strong relationships with public officials and agencies in the City of Oakland and Alameda County. We partner with community colleges our health navigators and navigator interns attend, to ensure that concepts taught in school are reinforced through day-to-day service provision and on-site training.
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