Culturally humble integrative primary care.

2004

In July 2004, our clinic was established by health professionals from the medical system, promotoras with the Kalpulli Izkalli organization, and community volunteers. We shared the vision of creating a clinic that offered affordable, high quality, holistic health services to anyone in need. Maintaining the dignity of both the patient and the clinician were essential aspects of our shared vision. We initially named our clinic Topahkal, (“house of medicine” in the Aztec language) by the suggestion of a founding member. The medical clinic began in a small, two bedroom casita on Ann Street, located in the heart of the South Valley of Albuquerque. We offered límpias, reiki, massage, herbs, and medical consultation. Our clinic grew by word of mouth, particularly in the Mexican American community. Many patients and friends helped us remodel the house and turn it into a disability-accessible clinic.

2005

In 2005, we received our first service contract from the NM Dept

of Health to provide a full spectrum harm reduction services to

opiate/heroin addicted individuals. We also received a one time

Con Alma Foundation grant to help us initiate our substance

abuse treatment and recovery program. We have now become

one of the most accessible medical clinics for opiate addiction

treatment with buprenorphine (suboxone) medication services,

and we offer a full spectrum integrative care, including

acupuncture, herbs, reiki and massage.

Also in 2005, we initiated a fair-priced ultrasound service with

the support of our community. The $25,000.00 machine was

purchased with funds raised by grants and private donations,

and it continues to be used today to provide high-tech imaging

services at low-tech prices.

 

2006

In December of 2006, the clinic moved to its current location at 1608 Isleta Blvd SW, beginning a wonderful partnership with the building’s owner, the Rio Grande Community Development Corporation (RGCDC), a local nonprofit organization. The move came after we had begun to outgrew our small casita, both in numbers of patients as well as the increasing complexity of the disease treated.

 

With only one month to relocate, and in the middle of an epic winter snow storm, we received amazing support from our patients and friends. They helped us to renovate the new building to ensure that the quality and feel of our working environment matched the care we give to patients; volunteers laid tile, painted, dug ditches, planted and planned. The design of the current clinic is deliberate, in particular the use of bright colors instead of sterile whites, the creation of the altar room as a sacred space for healing and traditional medicine, and especially the lack of a front desk. The latter was done intentionally in order to avoid the intimidation and separation that having a front desk can cause to uninsured patients who are often filtered away in this space. Instead of this, we developed the position of Greeter, a person who welcomes patients regardless of their income or insurance. This first impression sets the context for trust and dignity.

 

As the project grew and evolved, some of the founding members separated from the clinic in order to focus their energies on the priorities of their own organization. The name Topahkal was kept by the Kalpulli Izkalli and we went through a name change. Staff and clinicians brainstormed many options and then asked our patients to vote. They selected Casa de Salud Family Medical Office.

 

 

 

 

 

 

 

 

 

 

2007

In 2007, we received our first service contract from Bernalillo County which allowed us to provide health literacy services to our patients. We also began providing women’s health services through the Breast Cancer and Cervical Screening Program (BCC), which offers qualifying women free breast exams, mammograms and paps smears.

 

2008

In 2008, we welcomed a full time Doctor of Oriental Medicine, as well as a reiki master and massage therapists.  We implemented a customized electronic medical record and happily left paper charts behind.  Our patient base

continued to grow: we served approximately 8,000 patient visits.

 

2009

In 2009, we completed our application for 501-c-3 status and became an official non-profit organization known as Justice, Access, Support, and Solutions for Health (JAZZ for Health).

Jazz for Health was a recipient of a three year Pathways grant which funds community health workers who assist highly impacted patients in navigating the complexity of the health care and social service systems. A year later, in 2010, our navigators  saved patients over $700,000.00 in medical debt.

We added one full time physicians to our staff and served over 9,000 patient visits.

 

2010

In 2010, Casa de Salud was recognized when one of its founders, Dr Andru Ziwasimon, was nominated and selected as one of ten individuals nationwide to receive the Robert Wood Johnson Community Health Leader award. Funds from this award were applied to two projects, improving our student apprentice program and expanding our medical debt reduction services.

We added one full time physicians to our staff and served over 11,000 patient visits.

 

2011

In 2011, the Association for Healthcare Research and Quality, a federal agency, highlighted Casa de Salud’s work in its Healthcare Innovations Exchange, as an example of a community clinic that is working to improve quality and reduce disparities.

The WK Kellogg Foundation also recognized the South Valley Healthy Community Collaborative, and funded each of the five organizations involved in it, including Casa de Salud. Funds from this award are being applied to strengthening the collaborative as well as developing leadership and programs at Casa de Salud.

In addition, Casa de Salud is expanding its current building, adding several natural therapy treatment rooms and a large classroom, as well as enlarging the waiting room area. This is happening thanks to funding from the McCune Charitable Foundation and private donors, and assistance from our partner and landlord the Rio Grande Community Development Corporation.

 

2012

· We provided over 13,000 patient visits in primary care, acute care, acupuncture, reiki, massage, women’s health, at an average “fair price” cost of $40/visit, and donated over $50,000 in charity care services.

 

· We saved our patients over a million dollars in medical debt from hospital and emergency room bills by helping them navigate the hospital and collections systems.

 

· We trained over 30 health apprentices — college students and volunteers who dedicate time with us, learn medical-assistant skills, serve the community, and prepare to become the future healthcare workforce leaders of New Mexico!

 

· We provided comprehensive and effective holistic treatment services for drug addiction.

 

2013- 2014

We kept demonstrating that healthcare does not have to be expensive and

that it can still be high quality and hassle-free. With this success, we outgrew

our building and decided to expanded it. Thanks to the generous support of

the McCune Charitable Foundation, we had $175,000 committed towards

the expansion effort.  Our goal is to raise an additional $125,000 from our

community of patients and supporters.

Casa de Salud’s building expansion is an excellent opportunity for you to

dedicate a tax-deductible contribution to your local non-profit medical clinic. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2015-2017 (to come) 

Casa de Salud went through a significant transition, during which the organization lost significant financial resources and underwent a leadership transition. The organization rebuilt with a more independent board of directors, and hired a new Executive Director, Anjali Taneja MD MPH (who previously worked at Casa de Salud from 2009-2012). More clinicians were hired, the health apprentice program went through a restructuring and bolstering of infrastructure, and care continued for community members. (More to come).

 

2018 

 

REIMAGINING HEALTHCARE AND HEALING

In 2018, Casa served our community and patients with over 12,000 visits for low-cost primary care, acute care, counseling/therapy, acupuncture, massage, reiki, curanderismo, and Indigenous-based healing circles. In 2018, 80% of our visits were for patients without health insurance. We provide care that is accessible, low-cost, transparently priced, holistic, thorough, and, above all, grounded in love. At a time of great fear in the community around healthcare and public services, Casa is a safe space for those who are most marginalized in our country. Casa works to center and uplift marginalized communities — those who either have been traditionally othered by the healthcare system (immigrants, monolingual Spanish speaking patients, LGBT/queer community members, and community members struggling with addictions). There are few models of truly integrative care such as ours — with western/conventional American medicine working hand in hand with Eastern medicine and traditional healing medicine, and behavioral health clinicians, for community members who otherwise would not have access to these modalities. Recognizing that emotions and trauma are stored in our bodies, we intentional treat our patients as whole beings and use a mind/body/soul approach to ensure that we provide healthcare that heals.

In 2018 we also invested in a new and powerful open source electronic medical record that will grow with the organization, will serve as a powerful resource for team-based care and will be internally supported, giving us the flexibility to provide the best care and dynamically iterate and improve our work. What we learn from this work will be shared worldwide with the international open source community, to support others building internal electronic medical systems.

 

TRAINING THE FUTURE HEALTHCARE WORKFORCE OF NEW MEXICO

Casa de Salud has a robust health apprenticeship program, with 32 current apprentices. Casa’s health apprentice program trains the future healthcare workforce of New Mexico and beyond. Bilingual (English/Spanish) high school and college students from the surrounding community serve for 8 hours a week for a year or more.  Apprentices commit 500+ volunteer or work-study hours in a year and many continue for two or three years, as senior health apprentices.

Health apprentices learn and perform medical assistant skills such as drawing blood and performing EKGs, at the same time that they learn about soft skills and cultural humility in working with our community of patients. They develop confidence and leadership, and receive mentoring and support. Health Apprentices also learn about the community and structural factors contributing to health and illness, and are deeply committed to serving their community in the future. 80% of our apprentices are young people of color and 80% are women — and many come from immigrant families or families without great privilege or access to resources.

Health Apprentices also learn about the community and structural factors contributing to health and illness, and are deeply committed to serving their community in the future. As part of our effort to educate and mentor Health Apprentices, 20 members of the health apprentice team experienced and participated in the international Social Medicine Consortium  in Gallup, New Mexico.

Our 200 health apprentice alumni are community leaders and clinicians and are transforming healthcare. Apprentices who go on to medical school and other schooling generally stay in New Mexico — a state with a critical shortage of primary care clinicians — and serve underserved communities. This program is truly transformative, as students see what is possible in an integrative community setting before entering institutions of medical training. And those of us in healthcare have a responsibility to shift privilege and access in our professions.

 

GROWING OUR TEAM, OUR CULTURE, and LEADERSHIP

Casa de Salud is a woman of color led organization, with an all female board of directors, and an all female executive team. Fully 1/3rd of our staff identify as LGBT/Queer. 50% of our staff are people of color. 80% of our health apprentices are women, and 80% are young people of color. 90% of our staff are bilingual (English/Spanish) and 100% of our health apprentices are bilingual.

2018 has been a year of growth and culture building for Casa de Salud -- to respond to the increased desire for our services and to multiply and amplify the effectiveness of our work. We invest in our dedicated staff, in terms of leadership development and financial/benefits support. We know we can do this important work in the community and support our team. From weekly all team meetings, to space for integrative healing discussions and processing among transdisciplinary clinicians, to a cultural humility that each staff member brings to our organization, we know we can grow together and know our work can be achieved better together.

We have also grown our staff by 33% this year. This year we brought on two new clinicians (one from another state, who was excited about Casa’s model of care!), two volunteer specialist physicians, and have also increased our capacity of clinicians able to provide gender affirming hormone therapy for transgender patients, and buprenorphine (suboxone) medication for opioid addiction treatment. We currently have two physicians, two nurse practitioners, two physician assistants, two massage therapists, an acupuncturist, a reiki master, and a curandera on staff as clinicians. We were able to provide bilingual counseling/therapy with a clinical social worker for most of 2018 (she just had beautiful twins and we will be looking for another amazing counselor/therapist!). We hired on a Health Coach for our Strong Roots opioid addiction treatment team, a Health Apprentice Program Developer, and tripled our case management team. In addition, several of our staff members are former health apprentices. We continue to work with the Jesuit Volunteer Corps program and have a full time JVC serving a critical leadership role at Casa de Salud. And we further developed our creative and committed clinical operations team, and  our former Operations Manager, Elizabeth Boyce, took on the new role of Director of Operations. Lastly, we were able to expand days and hours at Casa de Salud, and are open for patient care five days a week and two evenings a week. We aim to open Saturdays and more weekday evenings in 2019.

We are grateful to the clinicians and staff who transitioned out of Casa de Salud this year, for educational and other pursuits. Each staff member who has touched this organization has brought so much lasting improvement to it.

Below are a sampling of the leadership work of our staff team:

Our nurse and clinical manager, Alejandra Casarrubias, who was also a health apprentice at Casa almost 10 years ago before attending nursing school, was featured in the Albuquerque Journal  for her work with as a Sexual Assault Nurse Examiner (outside of her full-time work at Casa!) 

Our patient and community leader Joshua Moya and our Executive Director Anjali Taneja spoke at a public event held outside Casa de Salud, supporting the 53rd anniversary of Medicaid and Medicaid and calling for strengthening these programs. They spoke alongside now Congresswoman Deb Haaland, American Medical Association President Dr Barbara McAneny, and Chief Medical Officer of True Health, Dr Mark Epstein. 

Our family nurse practitioner and curandera Lorraine Cordova (and a co-founder of Casa de Salud) was selected for the esteemed Jeanne Gauna Social Justice Spirit Award, for her lifetime of incredible service and commitment to healing our community. She joins two other clinicians from Casa de Salud in receiving this award in the last four years.

Four of our clinicians at Casa de Salud -- Dominic Villanueva DOM (our acupuncturist), Katherine Porterfield PA, Lorraine Cordova FNP, and Anjali Taneja MD MPH -- are 2016-2019 Robert Wood Johnson Foundation Clinical Scholars leaders along with Bill Wagner PhD LCSW from Centro Savila in representing Albuquerque and our innovative work in addictions treatment and recovery.  We spoke about Casa de Salud's model of care and our vision, as well as our Strong Roots opioid addiction treatment and recovery program, to 30+ Robert Wood Johnson Foundation Health Policy Scholars from around the country. We were also honored to hold a Clinical Scholars information reception, with over 40 attendees from around the county and national program staff from the RWJF Clinical Scholars program, at Casa de Salud.

Our acupuncturist Dominic Villanueva serves on the Bernalillo County Community Health Council (BCCHC) Prevention Strategy Group, and our director Dr AnjalI Taneja serves on the Bernalillo County Addiction Treatment Advisory Board.

Casa de Salud hosted two workshops at the New Mexico Public Health Association conference  this year! Our health apprentice leadership staff presented about "Improving Health Provider Workforce Diversity through Health Apprentice Model"  [Myra Murillo, Public Ally Fellow; Miquela Wiegel, Clinic Flow Coordinator; Joe McDonald, Clinic Flow Coordinator/Special Projects; Alejandra Casarrubias, Nurse and Clinical Manager]. And our Strong Roots/Raices Fuertes team presented  about "Raices Fuertes- Building Strong Roots to Address Opioid Pain Pill and Heroin Addiction in Bernalillo County" [Lorraine Cordova, Nurse Practitioner and Curandera, Joshua Moya, community leader and patient; Anjali Taneja, Executive Director; and from Centro Savila, Executive Director Bill Wagner and Counselor Irini Georgas].

 

REDUCING HARM, RESPONDING TO GENERATIONAL TRAUMA AND ADDICTIONS

We fiercely stand with our community. We believe that addictions and at-risk drug use are complex issues that are rooted in structural inequalities, generational poverty and trauma, and lack of social capital – and are further complicated by a lack of access to holistic and evidence-based treatment.

We work to meet people where they’re at -- embodying the concept of “harm reduction” in drug use and treatment. Our harm reduction approach means we’ve run a busy syringe exchange, and have provided access to effective, integrative treatment for opioid/heroin addictions, since 2005. We see addictions as a structural issue, not an individual problem, and our response involves providing shame-free humanized treatment as well as engaging our community in leadership/civic engagement opportunities to decrease social isolation and increase connectedness. We also work actively to shift policy and practice at the local and county level.

In 2018, we exchanged over 1 million syringes (to folks who brought in used syringes) with dignity and respect, so that community members can use more safely, reduce the spread of HIV and Hepatitis C, train others on the same, and if ready, they can transition to treatment for addictions with us or others. We also provided training for the life-saving antidote to opioid overdoses, narcan, to hundreds of individuals. Many have shared with us that the narcan they received from Casa de Salud helped save their life or the life of a loved one.

For 6 hours a week, we provide free drop-in ear acudetox (five acupuncture needles at key points around the ear) and relaxation opportunities for community members struggling from cravings, withdrawals, sleep problems, anxiety, stress, and more. We are grateful to the New Mexico Department of Health for the resources to provide these critical services in a community setting.

And for those who seek treatment for heroin and opioid pain pill addictions, we provide rapid access to integrate evidence based medication treatment with suboxone, with integrative healing of acupuncture, reiki, massage, and indigenous based healing circles, as well as health coaching and peer support, and therapy/counseling. Patients are also supported in their strengths, and we pursue creative approaches to civic engagement and collective healing -- the focus in this program is personalized but the approach is a community one.

This work is nationally recognized and we are currently supported by a Robert Wood Johnson Foundation Clinical Scholars three year funding and leadership opportunity to strengthen this work and to work in partnership with nearby Centro Savila, a community based behavioral health organization. 

 

STRUCTURAL CHANGE AND COMMUNITY COLLABORATION

We know we must build power with our community, and for the last almost 15 years, Casa de Salud has been supporting and leading efforts to address structural barriers to our community’s best health. In 2018 our VIDA team now encompasses direct services to address structural determinants of health, as well as health coaching and advocacy support to make change on a larger level. We continue to provide medical debt navigation (for uninsured patients with overwhelming hospital and emergency room bills), and are actively supporting efforts to shift attitudes and expand treatment opportunities for addictions in our county and state. We are also a member of the campaign to develop a Medicaid buy-in option for those in our state with private insurance or without health insurance.

We work in partnership with the Santa Fe Dreamers project, who provide a free drop-in legal clinic for DACA applicants and for others dealing with immigration issues. This service has been incredibly important for many of our community members, and we are grateful to SFDP for this ongoing partnership.

We work hand in hand with ACCESS NM and Centro Savila, two organizations in walking distance of Casa de Salud, as part of the EleValle South Valley Healthy Communities Collaborative -- doing work together that none of us can do alone. As EleValle, we are building tools for peer to peer education around important structural issues that affect our health. We build together on advocacy and service. We speak at community events, most recently to 80 home care providers, about recognizing and reframing addictions in the community, an event hosted by the South Valley Early Childhood Group. We also work in partnership with the Rio Grande Community Development Corporation, in supporting this work.

Our clinicians Kate Porterfield and Dominic Villanueva led efforts to collaborate with the Wellness Referral Center as an important wellness resource for our patients, and Kate Porterfield and health apprentices led our partnership with La Cosecha Community Supported Agriculture (for very low-cost fresh produce for our patients).

We held a voter registration drive at Casa de Salud this year, and were able to provide information to many patients including our immigrant families and returning citizens (recently released from jail or prison) about their voting rights and process. Several of our apprentices signed up to vote too!

And we collaborate with the UNM Community Engagement Center, South Valley Academy, and other organizations in matching excellent health apprentice candidates with Casa de Salud.

We are grateful for collaborations with several foundations and with Bernalillo County, the City of Albuquerque, and the NM State Department of Health.