Arts&Culture

Tell me about 90 by 20 [a Davis plan for accomplishing a 90 percent high school graduation rate by 2020]. And why does it have to be ’20? Why not ’17? What happens between now and ’20?

You have to have high expectations, but expectations should be reasonable. So when we look at the work we’re doing or we look at the return on investment, it’s a do-able plan to chart off growth for graduation over time. Anybody that says, I’m going to get a 20 percent in graduation rate—I mean, I’d have to say you’re setting yourself up for failure. … But if you say, How can we get to a 90 percent rate over time? and incrementally we say three percent here, four percent here, and as we look at all kids, that’s a doable plan as we look at how we are revising the work we’re doing with special education, and we look at how we service gifted and talented, we look at the work we’re doing with ELL [English language learners] kids. To be fair, I think a good leader would say, Here’s the North Star—how do we get there? You’re not going to get to the North Star in a day. What would be do-able? So 2020 looked like a do-able plan over time to increase. If you looked at how the district has maintained its increases—and there’s a little push along the way so it’s not—I mean, I think 2020 is a little aggressive, but I don’t know anybody who rises to a low expectation. And when people push back at me about, Don’t you think 90 by 20 is a high expectation? then I return the question—Do you have low expectations of kids? Do you have low expectations of teachers? So you have low expectations of a superintendent? I’d rather a superintendent saying, This is our North Star to get the 90 percent and hit 88 than not have a high expectation for every boy and girl. But I believe the community does have high expectations, and I think it’s a reasonable plan and a well thought-out plan.

I think what I was trying to get at is over the next four years at a classroom level, what in practical terms is going to change? What do you need to have happen there?

To get to the graduation rate? I think there’s a lot of things. I think when you look at the work we’re doing—so, there’s academic gaps, but then we talk about the needs of students, and we talk about social/emotional learning and these other types of gaps as we continue to move this work forward. As you know, we received $13 million from Stacie Mathewson [Foundation, $1 million a year for 13 years to aid programs to close gaps that may undercut student success]. We’re talking about kids who struggle with mental illness, kids who struggle with substance abuse. We still educate those kids,- but if we never attack some of these gaps we don’t get long term improvement here. So if we look at the work we’re doing around social/ emotional learning, we believe that we have started to receive some increase in academics as it relates to us helping kids solve these problems. When you look at the work we’re doing nationally around parent teacher home visits, one of our big pushes is get into families. How do we help you help your kids? Parent university nights, like informing parents—having parents have strategies. Looking at the rigor in our curriculum. Making sure it’s relevant. And providing opportunities for a variety of kids so that they are engaged. I think those are the pieces that help us get to this 90 percent. It’s not just Can you pass a test? Are we helping kids deal with all these other skills that are related to social/emotional learning. And that’s the work that we’re doing—and engaging families so that we get to this pathway. Ω

School board Superintendent Traci Davis, a student and mom.

A Reno nonprofit community health center expands into a new location

Story and photos by Josie Luciano

RigHt: Radhika Siddharthan, left, gets a check-up from Northern Nevada Hopes Chief Medical Officer Reka Danko.

hen Jerome Edwards turned 70, he was diagnosed with HIV and AIDS.

“I’d lived a relatively good life,” he said. “I’d been married for 25 years until my late wife died. I was somewhat calm and fatalistic about it.”

Edwards’ nurse practitioner was less calm. “She was shaking,” he recalled. “She said, ‘There’s this organization called Hopes that you organization called Hopes that you need to see.’ I’d never heard of Hopes. need to see.’ I’d never heard of Hopes. … It was the best kept secret in town … It was the best kept secret in town if I may say so.” if I may say so.”

Now, eight years later, Edwards is Now, eight years later, Edwards is going on 79 and still at Hopes—offi-going on 79 and still at Hopes—officially Northern Nevada Hopes—as cially Northern Nevada Hopes—as both a patient and the current Board both a patient and the current Board

Secretary. But the clinic is no Secretary. But the clinic is no longer the secret it once was. longer the secret it once was. Founded in 1997, Hopes Founded in 1997, Hopes opened its doors near the corner opened its doors near the corner of Ralston and Fifth streets for a of Ralston and Fifth streets for a small group of HIV and AIDS small group of HIV and AIDS patients, growing its base in patients, growing its base in tandem with community tandem with community need, taking over an need, taking over an adjacent building, and adjacent building, and eventually adding eventually adding mobile units to mobile units to

Whether it’s a

medical goal,

a behavioral

health goal, a

housing goal,

getting food—

Whatever it is

We can help

With, We’re here

to listen.

Reka Danko chief medial officer

accommodate its growth. Last year, Hopes broke ground on a 37,500-square-feet facility next to its old address, and next week it will welcome the public at its grand opening on March 15.

HigHway to HealtH

In the process of going public with the new building, Hopes has expanded its services from existing programming like ChangePoint syringe exchange, HIV-AIDS treatment, and senior outreach, to primary care options like behavioral health therapy, pediatric services, and an on-site pharmacy. The move will also make it possible to more than double Hopes’ patient base from 4,700 to 10,000 individuals.

“Housing means health,” said Sharon Chamberlain, the CEO of Hopes. “Access to care means health. Having food is related to health. Having childcare so you can make it to appointments is a part of health.”

As someone who has struggled with both homelessness and drug addiction in the past, Chamberlain has an understanding of the issues that face Hopes patients—a cross-section of the community that the clinic dubs “underserved.” Seniors, LGBT individuals, uninsured and undocumented immigrants, substance users, the homeless—all are people that traditionally experience more barriers to health care than other populations.

Perhaps this is why every program at Hopes begins with the premise of meeting people where they are.

“If you come here and your diabetes is out of control, but your major concern when you walk in the door is that you haven’t eaten in two days, and you need something to eat, we’re going to help you find food,” said Chamberlain. “We’ll take care of that part first. And once you’re not hungry, if you want to talk about your diabetes, we’ll talk about your diabetes.”

Once a patient’s basic needs are met, the clinic can begin to address the longer-term issues that can make or break a community—issues like ongoing care for individuals and citywide population health.

Reka Danko, Hopes’ chief medical officer, believes that the key to lasting individual health is building a partnership with her patients to meet goals.

“Whether it’s a medical goal, a behavioral health goal, a housing goal, getting food—whatever it is we can help with, we’re here to listen,” said Danko. “The biggest part of what we do is, without judgment, move forward to help that person in whatever line of care it is.”

For senior patients like motherdaughter pair Marie Hutchinson and Cindy Higgins, their partnership starts with personal attention.

“We were seeing another doctor, and we were unhappy with the service we were getting,” said Higgins. “She would talk to my mom or to me and she never really said anything. I’ve had three heart attacks now, and after the first two, she never really addressed these issues.”

After switching to Hopes, Higgins has been able to keep up with her medications and lose the weight she needed to lose. Hutchinson, a former nurse, will be 102 years old in November (something no medical provider can take all the credit for).

For other patients, like Kristen Aaquist, primary care is specialized care from the onset. As a transgender woman who has undergone transition, Aaquist has hormone and emotional health protocols that some traditional providers aren’t always aware of.

“If you’re trying to approach a new doctor, and you want them to just treat you, you may not want to go through that extra step of educating your doctor about your needs—that’s something the trans community has experienced a lot of.” said Aaquist. “[Hopes is] pretty well educated in what the trans community needs.”

No matter what community individuals come from, all patients receive comprehensive care that includes a case manager, a behavioral health therapist, a psychiatrist, and medical providers. Though integrated facilities are nothing new, it’s a progressive choice for those on the fringe of traditional healthcare, especially those who do not have the time or resources to travel back and forth between primary care providers and specialists.

HealtH is otHer people

It may follow that if you have healthy people, then you have a healthy city. But, as Chamberlain alluded, health is more than the medical. It’s more than individual lab results, and it’s more than individuals, too. When tracking health on a broader scale, many facilities apply a “Triple Aim” framework—a term Danko defines as “quality care for the individual, in combination with population health, in combination with a cost effective strategy.”

Within a population, certain subsets of the group will follow different health trends depending on both clinical factors like disease and non-clinical factors like education or socioeconomic status.

For populations who choose not to access care because of cultural barriers—like the fear of getting arrested or deported for drug-addiction and uninsured-undocumented immigrant populations—education is the best medicine, even if it takes years to bring everybody in.

“It’s just taking time for individuals to be comfortable with the fact that they can come into a place and get free syringes and not be put on a list and not be followed by law enforcement officers,” explained Robert Harding, the Harm Reduction & Outreach Coordinator for Hopes’ ChangePoint syringe service program.

For populations where payment is a barrier, Hopes has different options like Medicare, Medicaid, private insurance, and some special exceptions.

“For the people that don’t have insurance, we have a sliding fee scale based on income,” said Chamberlain. “That slide goes all the way down to $10 for a medical visit, which is very affordable.”

On a city-wide scale, Hopes is able to have an immediate impact on problems like infectious disease outbreaks by working with community partners like Renown, St. Mary’s, and the Community Health Alliance to keep sick people, who could get care in a clinic setting, out of the emergency room.

And they’re starting a garden.

Although they won’t be able to grow enough food to move the meter on population health, patients are already looking forward to the 400-square-feet plot and the prescriptions that doctors will be able to write for families to eat from it. Of course, patients will also get to do some gardening, or as Edwards puts it, “take control of a situation, see things develop, and you know.” Ω

Northern Nevada Hopes’ grand opening will take place on March 15 from 11 a.m. to 1 p.m. at its new facility, the Stacie Mathewson Community Wellness Center at 580 West Fifth St. For more information, visit www.nnhopes.org.