Our Community Innovation Fund project aims to address the health and health-related social needs of our African Heritage communities during the COVID-19 pandemic. The project involves collaboration between our healthcare professionals, our community representatives, and our social service providers from and to the African American, Eritrean, Somali, and Ethiopian Oromo-speaking communities in King County. Our  project focuses on promoting cultural humility, whole-person health, and access to healthcare and health related social services.

We served our African Heritage communities, specifically African American, Eritrean, Somali, and Ethiopian Oromo-speaking communities in King County. Our communities faced significant health disparities and health-related social needs, compounded by the ongoing COVID-19 pandemic. By focusing on our specific populations, we aimed to address the unique challenges we face and provide targeted support to improve our health outcomes.

The need was to address the impact of the COVID-19 pandemic on our served communities. Our communities faced multiple challenges, including inequitable exposure to the virus, negative healthcare outcomes, limited access to healthcare services, and systemic and medical racism within the healthcare system. There was a pressing need to mitigate these disparities and ensure equitable access to quality healthcare and health-related social needs services. Additionally,  our communities required culturally sensitive care that respected our unique needs and experiences.

Our process of establishing partnerships involved a collaborative and inclusive approach. We engaged healthcare professionals, community representatives, and social service providers from and who served our communities. We held regular meetings and discussions to build trust, foster understanding, and identify shared goals.

Through open dialogue, we developed strong partnerships and collaborations, emphasizing cultural humility, respect, and inclusivity. We actively sought input from community leaders, faith organizations, and our underrepresented sub-groups to ensure that their voices were heard and their perspectives were incorporated into the project. This collaborative approach allowed us to leverage the expertise, resources, and networks of various stakeholders to address the complex health and social needs of our communities effectively.

Success for this project was defined by several key indicators. Firstly, we aimed to improve health outcomes and access to healthcare services for our served communities. This is measured by tracking the increase in client enrollment and monitoring their progress in achieving improved health indicators and outcomes. Additionally, success is also defined by the establishment of strong partnerships and collaborations between our healthcare professionals (e.g. physical and behavioral health), community representatives (e.g. business owners and workers, Health providers and faith leaders/stakeholders), and social service providers (e.g.. Community Case Managers and Health Workers) . The effectiveness of these partnerships is evaluated based on the level of collaboration, shared decision-making, and collective impact in addressing the community members identified physical and Health Related Social Needs. Furthermore, community engagement and empowerment is integral to the project’s success. We strived to ensure that community members actively participated in decision-making processes, have access to relevant resources and support, and felt empowered to advocate for their own health and well-being.

I see the single most valuable achievement resulting from this innovation project was the significant reduction in the Covid-Long-Covid severe illness, and death rate among our African Heritage populations. By working together collaboratively, we successfully reduced the disparity in death rates between our community members and White majority individuals. This outcome showcased the effectiveness of our efforts in addressing the acute and chronic health-related needs of community members, particularly during the challenging times of the COVID-19 pandemic. It highlighted the importance of trust, cultural humility, and access to high-quality healthcare information, treatments, and support from families, friends, and neighbors. This achievement demonstrated the positive impact of our collective work in improving health equity and saving lives and livelihoods within our communities.

Sisters In Common’s background, mission, and vision align closely with this innovation project. As a non-profit community-based organization, Sisters In Common (SIC) is dedicated to reducing Social Determinants of Health (SDoH) disparities and empowering individuals, families, and communities in crisis. Our organization’s mission to re-introduce cultural values, traditions, and history that promote healing and empowerment resonates with the goal of addressing the health-related social needs of our served populations. The innovation project focuses on providing community-informed and culturally competent services to address client SDoH needs. SIC’s commitment to hiring directly from cultural and ethnic communities ensures effective communication and understanding of our clients’ cultural context and language. Our approach aligns with our organization’s mission of cultural empowerment for families in crisis. Additionally, the services offered by SIC, such as client screenings, consultations, referrals, counseling, and case management, directly contribute to the project’s objectives. By identifying problems related to trauma, social determinants of health issues, and family dysfunction, SIC plays a crucial role in assessing the needs of individuals and families and providing appropriate support.

The driving force behind this project was the pressing need to address the Social Determinants of Health (SDoH) disparities and promote healing and empowerment for individuals, families, and communities in crisis. Witnessing the profound impact of SDoH on the overall well-being and health outcomes of our communities, it became evident that a targeted and culturally informed approach was essential to address these challenges effectively. As an organization committed to serving our communities, we recognized that traditional healthcare approaches often fell short in adequately addressing the underlying factors contributing to health disparities. We saw the need for a comprehensive and holistic approach that considers the social, economic, and environmental factors impacting the health of our individuals and families. Our mission to re-introduce cultural values, traditions, and history that promote healing and empowerment provided the guiding principles for this project. We understood that by incorporating cultural competence, community engagement, and tailored services, we could make a meaningful difference in the lives of those of us facing crisis situations. The driving force behind this project was the unwavering belief in the power of community-informed solutions and the urgent need to address the root causes of health disparities. We were driven by a passion for social justice, equity, and a deep commitment to ensuring that our clients receive the support they need to overcome challenges and achieve optimal well-being. Through collaboration, partnerships, and leveraging the need for emerging to evidence-based practices, we seek to create a sustainable model that not only provides immediate support but also empowers individuals to take control of their health and navigate the complex social and healthcare systems that influence their well-being.

Our project innovation focused on addressing Social Determinants of Health (SDoH) disparities and promoting cultural empowerment in the face of crisis. It encompassed various issues and areas of focus that are critical in achieving equitable health outcomes for our individuals, families, and communities. Some key areas of focus included: Access to Healthcare: The project aimed to improve access to quality healthcare services, particularly since we are underserved and marginalized communities. It sought to address barriers such as lack of insurance, limited healthcare facilities access, race bias and cultural incompetency within the healthcare system. Health Related Social Needs (HRSN): Our project recognized the significant impact of social factors on health outcomes and worked to address HRSN, such as exposure to the health hazard, (e.g. Covid-Long-Covid exposure), issues with basic needs ( e.g. food insecurity), access to health care ((e.g. transportation barriers), Behaviors (e.g. Covid-Long-Covid risk taking Lifestyles), psycho-social, (e.g. Covid-Long-Covid stigma, emotion dysregulation and isolation), and Biology (e.g. negative Epigenetics) . By connecting individuals and families with the necessary resources and support, our project aimed to mitigate the negative impact of these social determinants. Cultural Competence: Cultural competence was a fundamental aspect of our project. Recognizing the diverse backgrounds and experiences of our communities, our innovation sought to provide culturally sensitive care and services. This included hiring staff from the same cultural and ethnic communities, incorporating cultural practices and traditions into interventions, and promoting cultural empowerment as a means of achieving positive health outcomes. Community Engagement: Our project emphasized community engagement and collaboration. It worked closely with community, CBO organizations, faith-based groups, and networks to raise awareness, build trust, and ensure that services were tailored to meet the specific needs of our communities. Engaging community members as active participants in the decision-making process and service delivery was essential to the success of our innovation. Holistic Approach: Our innovation took a holistic ( whole person) approach to address the multifaceted nature of our health disparities. It integrated physical, mental, and social well-being in the interventions and emphasized the importance of whole-person health. By considering the interconnectedness of these dimensions, our project aimed to achieve comprehensive and sustainable improvements in health outcomes. Overall, our project innovation focused on tackling SDoH disparities, promoting cultural empowerment, and adopting a comprehensive approach that addressed various social and health-related issues faced by our individuals, families, and communities in crisis.

We identified the need we were trying to meet through a comprehensive assessment of the communities we serve and are members of, coupled with input from our community members, stakeholders, and data on social determinants of health. Our approach involved multiple steps to ensure an accurate understanding of the specific needs and challenges faced by we as individuals and families in crisis: Community Needs Assessment: We conducted a thorough needs assessment by engaging directly with community members, organizations, and stakeholders. This involved listening to their experiences, concerns, and aspirations related to health and well-being.

Through our lived experience, surveys, focus groups, interviews, and community meetings, we gathered qualitative and quantitative evidence and data to identify the pressing needs and priorities. Data Analysis: We analyzed existing evidence, data and research on social determinants of health to identify key areas that concerned us. This included examining demographic data, health disparities, access to healthcare, education, employment, housing, and other relevant factors that contribute to inequities in our health outcomes. By analyzing this information, we gained insights into the specific needs and disparities prevalent in our communities. Stakeholder Engagement: We actively engaged with stakeholders, including healthcare providers, community-based organizations, government agencies, and advocacy groups. Their expertise and perspectives helped us understand the broader systemic issues, gaps in service delivery, and opportunities for collaboration and resource sharing. Cultural Considerations: We placed a strong emphasis on cultural competence and understanding theunique needs of our diverse communities. We engaged community members from our different cultural backgrounds to ensure that our services were culturally appropriate and respectful of their traditions, beliefs, and values. By combining these approaches, we were able to identify the specific needs and challenges faced by individuals and families in crisis. This process allowed us to develop targeted interventions and strategies that directly addressed the identified needs and worked towards reducing social determinants of health disparities in our communities.

The work we undertook through our innovation project differs from traditional approaches to addressing the problem in several keyways: Community-Centered Approach: Our work is grounded in a community-centered approach that actively involves community members in the design, implementation, and evaluation of our services. We recognize that the community members themselves are the experts on their own experiences and needs. By valuing their input and engaging them as partners, we ensure that our interventions are tailored to their specific contexts and preferences. Cultural Empowerment: We prioritize cultural empowerment as a fundamental aspect of our approach. We recognize the importance of cultural values, traditions, and history in promoting healing and empowerment for individuals, families, and communities. By integrating culturally sensitive practices and hiring staff directly from the communities we serve, we foster a sense of trust, understanding, and relevance in our interventions. Holistic and Whole-Person Approach: Our work goes beyond addressing individual symptoms or challenges and takes a holistic and whole-person approach to health and well-being. We recognize that social determinants of health are interconnected and influence one another. Therefore, we address multiple dimensions of individuals’ lives, including their physical, mental, emotional, and social well-being. Collaboration and Partnerships: We actively seek collaboration and partnerships with diverse stakeholders, including healthcare providers, community organizations, educational institutions, and government agencies. By forging strong partnerships, we leverage collective expertise, resources, and networks to create sustainable and impactful solutions. Evidence and Data-Informed Decision Making: We utilize evidence-based and emerging practices, as well as data analysis, to inform our decision-making process. By collecting and analyzing evidence and data on social determinants of health, community needs, and services outcomes, we continuously evaluate and refine our interventions to ensure their effectiveness. Overall, our work challenges the traditional top-down, one-size-fits-all approaches by prioritizing community engagement, cultural empowerment, holistic approaches, and collaborative partnerships. By embracing these innovative strategies, we strive to create lasting change and improve the well-being of our individuals and families in crisis.

Our project is innovative for several reasons: Cultural Empowerment: One of the key innovative aspects of our project is its focus on cultural empowerment. By recognizing the importance of cultural values, traditions, and history, we incorporated them into our interventions to promote healing and empowerment. This culturally sensitive approach distinguished our project from traditional approaches, ensuring that our services were relevant and meaningful to the communities we serve and are members of. Community Involvement: Our project placed a strong emphasis on community involvement and engagement. We actively sought input from community members, incorporated their perspectives, and involved them in the decision-making process. By valuing their expertise and lived experiences, we ensured that our interventions addressed the real needs and challenges faced by the community. This community-centered approach fostered a sense of ownership and sustainability.

Holistic Approach: Unlike traditional approaches that often focus on addressing specific symptoms or challenges, our project took a holistic approach to individuals’ well- being. We recognized the interconnectedness of social determinants of health and addressed multiple dimensions of health, including physical, mental, emotional, and psycho-social aspects. This holistic perspective allowed us to provide comprehensive support and promote overall well-being. Collaboration and Partnerships: Another aspect that made our project innovative was its emphasis on collaboration and partnerships. We actively sought collaborations with various stakeholders, including healthcare providers, community organizations, and government agencies. By leveraging the collective expertise and resources of different partners, we were able to create a comprehensive network of support and maximize the impact of our interventions. Evidence-Data-Driven Decision Making: Our project also utilized evidence- data-driven decision making to continuously evaluate and improve our interventions. We collected and analyzed evidence and data on social determinants of health, community needs, and services outcomes. This evidence-data-driven approach allowed us to make informed decisions, measure the effectiveness of our interventions, and adapt strategies as needed. Overall, our project’s innovation stemmed from its cultural empowerment focus, community involvement, holistic approach, collaboration with partners, and evidence-data-driven decision making. These elements collectively distinguished it from traditional approaches and contributed to its effectiveness in addressing the needs of our communities.

Our project enabled us to achieve several things that we couldn’t do before: Tailored and Culturally Relevant Interventions: Our project allowed us to develop and implement interventions that were tailored to the specific cultural values, traditions, and needs of the communities we serve and are members of. By directly hiring staff from our communities and ensuring services were provided in our languages, we created a culturally sensitive environment that fostered trust and engagement. This level of customization and cultural relevance was not possible in traditional approaches. Comprehensive Approach to Social Determinants of Health: Our project enabled us to take a comprehensive approach to addressing social determinants of health (SDoH). Instead of focusing solely on medical interventions, we recognized and addressed the broader factors that influence our health outcomes. This included addressing psycho-social and family dysfunction, advocating for accessible healthcare services, promoting mental health support, and addressing financial barriers. Our project’s scope and integrated approach allowed us to have a more significant impact on overall well-being compared to traditional approaches that often focus on specific aspects of health. Community Engagement and Empowerment: Through our project, we were able to actively engage the community and empower them to take charge of their own health and well-being. By involving community members in the decision-making process, we provided them with a voice and agency in shaping the interventions and services offered. This participatory approach empowered individuals to be active participants in their healthcare journey and fostered a sense of ownership and pride in their community. Collaborative Partnerships: Our project facilitated the establishment of collaborative partnerships with various stakeholders, including healthcare providers, community based organizations, and government agencies. These partnerships brought together diverse expertise, resources, and perspectives to collectively address our complex social determinants of health. Our project’s collaborative nature enabled us to access resources and knowledge that were beyond the reach of a single organization, enhancing our capacity to make a meaningful difference. Overall, Our project enabled us to provide tailored and culturally relevant interventions, take a comprehensive approach to social determinants of health, actively engage and empower our community members, and foster collaborative partnerships. These capabilities were transformative and allowed us to make a more profound and sustainable impact on the well-being of our individuals, families, and communities we serve and are members of.

Planning our budget for Sisters In Common’s project involved careful consideration of various factors and the involvement of key stakeholders. Here’s an overview of our budget planning process: Assess Project Needs: The first step was to assess the specific needs and requirements of our project. This includes identifying the target segment of our populations, understanding the scope of services to be provided, and determining the resources and infrastructure needed to deliver those services effectively. Identify Revenue Sources: Next, it was important to identify the potential revenue sources for our project. This may include activities, partnerships, or funding that would not make us a bunch of “Black share-croppers” ( “Slavery By Another Name”). Each revenue source was evaluated based on its suitability, sustainability, and alignment with our project’s mission and goals. Cost Estimation: Once the needs and revenue sources were identified, a thorough cost estimation was conducted. This involved determining the costs associated with personnel/staffing, infrastructure, supplies, training, outreach, program evaluation, and any other relevant expenses. It was crucial to consider both direct costs (specific to our project) and indirect costs (overhead, administrative expenses). Stakeholder Involvement: Our budget building was a collaborative process involving key stakeholders. This included the Board of Directors approval, project team, Legal experts, financial experts, program managers, and organizational leadership. Each stakeholder brought their unique perspectives and expertise to ensure a comprehensive and realistic budget. Consideration of Sustainability: Long-term sustainability was a major factor in budget planning. It was essential to evaluate the project’s potential to generate revenue or secure ongoing funding beyond the initial phase. This involve exploring partnerships, establishing fee-for-service models, or seeking reimbursement from insurance providers ( we now have contracts with the 5 MCOs Contracted to providing health insurance coverage to the millions of Washington state residents on Apple Health) . Review and Iteration: Our budget-building process involved multiple rounds of review and iteration. Stakeholders review our budget proposal, provide feedback, made adjustments, and ensure alignment with our project’s goals and financial constraints. The duration of our budget-building process varied. Given the complexity of our project, the availability of evidence/data and resources, and the decision-making processes within the organization, it took several weeks. Daily communication and collaboration among our team members helped streamline the process and ensure a well-informed and realistic budget.  Note: Typically, it may take you several weeks to a few months to develop a comprehensive budget that considers all relevant factors and stakeholders’ input.

Sisters in Common recognizes the importance of incorporating equity into our budgeting process to ensure fair and just resource allocation. Here’s how Sisters in Common incorporated equity into our budget: Equity Lens: Sisters in Common adopted an equity lens throughout our budgeting process. This means intentionally considering the impact of budget decisions on our marginalized and underserved populations, such as low-income individuals, racial and ethnic minorities, and others in our disadvantaged communities. Needs Assessment: Sisters in Common conduct a comprehensive needs assessment to identify the specific needs and challenges faced by our different communities. This assessment included input from community members, stakeholders, and those directly impacted by the services to be provided. Our budget then prioritize allocating resources to address these identified needs. Resource Allocation: During our budgeting process, Sisters in Common ensure that resources are allocated proportionally based on the identified needs and the principle of equity. This may involve directing more resources to our community members that have the most emergent and emergency need. We considered factors such as income disparities, geographic location, cultural considerations, and access barriers when making resource allocation decisions. Mitigating Disparities: Sisters in Common aimed to mitigate existing disparities and inequities through budget decisions. This included allocating additional funding to services that specifically target our most disadvantaged populations, providing subsidies or sliding-scale payment options for those with limited financial means, and investing in outreach and accessibility measures to ensure equal access to services. Continuous Evaluation: Sisters in Common would regularly evaluate the impact of budget decisions on equity outcomes. This includes monitoring and analyzing evidence and data related to service utilization, outcomes, and satisfaction among our different populations. By assessing the effectiveness of budget allocations in reducing disparities, Sisters in Common made adjustments and improvements to promote greater equity, in real time. By incorporating an equity lens into our budgeting process, Sisters in Common promote fairness, inclusivity, and equal access to resources and services for all our individuals and communities we serve and are members of.

Needs Assessment: Sisters in Common conduct a comprehensive needs assessment to identify the specific needs and challenges faced by our different communities. This assessment included input from community members, stakeholders, and those directly impacted by the services to be provided. Our budget then prioritize allocating resources to address these identified needs. Resource Allocation: During our budgeting process, Sisters in Common ensure that resources are allocated proportionally based on the identified needs and the principle of equity. This may involve directing more resources to our community members that have the most emergent and emergency need. We considered factors such as income disparities, geographic location, cultural considerations, and access barriers when making resource allocation decisions. Mitigating Disparities: Sisters in Common aimed to mitigate existing disparities and inequities through budget decisions. This included allocating additional funding to services that specifically target our most disadvantaged populations, providing subsidies or sliding-scale payment options for those with limited financial means, and investing in outreach and accessibility measures to ensure equal access to services. Continuous Evaluation: Sisters in Common would regularly evaluate the impact of budget decisions on equity outcomes. This includes monitoring and analyzing evidence and data related to service utilization, outcomes, and satisfaction among our different populations. By assessing the effectiveness of budget.

YES. Sustainability was an integral part of Sisters in Common’s budget building process. Here’s how sustainability was incorporated: Long-Term Financial Planning: Sisters in Common engaged in long-term financial planning to ensure the organization’s financial sustainability. This involved forecasting future expenses, revenue streams, and funding sources to establish a pathway to a solid financial foundation for ongoing operations. Diversification of Funding Sources: To enhance sustainability, Sisters in Common diversified its funding sources. Rather than relying solely on one funding stream, such as grants, we sought to secure multiple revenue streams (i.e. Cost reimbursement contracts). This also included seeking government sub- contractor contracts, fee-for-service arrangements, partnerships with other organizations. Cost- Effectiveness and Efficiency: Sisters in Common carefully considered cost-effectiveness and efficiency in budget planning. This involved identifying areas where operational expenses could be minimized without compromising the quality of services. We sought ways to optimize resources, streamline processes, and eliminate unnecessary expenditures to maximize the impact of our budget. Building Reserves: Sisters in Common prioritized building financial reserves to create a cushion for unexpected expenses or potential fluctuations in funding. By setting aside funds for reserves, we aimed to maintain financial stability and mitigate the risk of financial challenges that could threaten sustainability. Services Evaluation and Outcome Measurement: Sisters in Common implemented robust services evaluation and outcome measurement strategies to assess the effectiveness of our initiatives. By gathering evidence and data on program outcomes, impact, and cost-effectiveness, we could make informed decisions about resource allocation and prioritize sustainable programs that demonstrate positive results. Collaboration and Partnerships: Sisters in Common actively sought collaborations and partnerships with other organizations and stakeholders. By leveraging collective resources, knowledge, and expertise, the we could enhance sustainability by sharing costs, accessing additional funding opportunities, and expanding the reach of our services. By integrating sustainability principles into our budget building process, Sisters in Common aimed to ensure the long-term viability and effectiveness of our services, ultimately maximizing the impact on the communities we serve and are members of.

Sisters in Common faced several specific challenges related to budgeting. These challenges included: Limited Funding: One of the primary challenges was limited funding. Like many non-profit organizations, Sisters in Common operated within a constrained financial environment, relying on limited revenue streams. This created the need for careful budget planning and resource allocation to ensure all essential activities could be adequately funded. Fluctuating Funding Sources: Another challenge was the fluctuation of funding sources. Grants government funding sources can vary from year to year, and securing consistent funding posed a challenge. Sisters in Common had to navigate the uncertainty and potential gaps in funding by seeking diverse revenue streams and developing strategies for financial stability. Cost of Program Expansion: As Sisters in Common aimed to expand our services to meet the growing needs of our communities, we continually face the challenge of balancing the associated costs. Service expansion often requires additional resources, including staff, materials, and infrastructure. Budgeting for these expansions required careful consideration of available funds and potential revenue generation. Rising Operational Costs: Operating costs, such as staff salaries, rent, utilities, and administrative expenses, presented an ongoing challenge. These costs can increase over time, potentially exceeding the available budget. Sisters in Common needed to monitor and manage these rising costs to ensure financial sustainability. Impact of External Factors: External factors, such as changes in government policies, economic conditions, or funding priorities, significantly impacted Sisters in Common’s budget. Adapting to these external factors and proactively adjusting the budget became necessary to maintain financial stability. Balancing Services Priorities: Sisters in Common faced the challenge of balancing services priorities within a limited budget. We needed to make strategic decisions about resource allocation, weighing the impact and effectiveness of different services to ensure the most critical needs were addressed. Overcoming these budget-related challenges required careful financial management, strategic decision-making, and a focus on sustainability. Sisters in Common needed to seek creative solutions, diversify funding sources, and establish strong financial planning practices to navigate these challenges effectively.

Yes, the innovation funding provided to Sisters in Common was flexible funding. This flexibility allowed Sisters in Common to achieve several outcomes that restricted funding would not have allowed. The flexibility of the funding enabled the organization to: Respond to Emerging Needs: With flexible funding, Sisters in Common had the ability to adapt and respond to emerging needs within our communities. We could allocate resources to address urgent and evolving challenges promptly. This agility allowed us to provide timely support and services, ensuring we were responsive to the changing needs of the population we serve and are members of. Support Innovation and Creativity: The flexible funding provided Sisters in Common with the freedom to explore innovative approaches and creative solutions to address social determinants of health disparities. We could implement new services, pilot initiatives, and experiment with novel strategies to improve outcomes. This flexibility fostered a culture of innovation within the organization and empowered us to think outside the box. Invest in Capacity Building: Flexible funding allowed Sisters in Common to invest in capacity building initiatives. We could allocate resources towards training and professional development for our staff, enhancing their skills and expertise. This investment in capacity building strengthened our ability to deliver high-quality services and expand our impact in our communities. Collaborate and Leverage Resources: The flexibility of the funding enabled Sisters in Common to collaborate with other organizations and leverage additional resources (e.g. Contract BIPOC physical health professionals). We could form partnerships, pool funds, and coordinate efforts with like-minded individuals and entities to maximize our impact. This collaborative approach helped Sisters in Common to reach our deep dive community members and extend our services beyond what restricted funding alone would have allowed. Note: While the innovation funding provided flexibility, there are always opportunities to enhance its flexibility further to suit our project services.

Additional flexibility could include allowing for reallocation of funds based on emerging needs, reducing administrative restrictions, and providing more autonomy to our organization in determining resource allocation. Flexibility could also involve longer funding cycles or multi-year funding commitments, providing greater stability and continuity to support long-term service delivery.