Leadership Interview: Cristina Gair

Cristina Gair is executive director of the West Mountain Regional Health Alliance (WMRHA), a community alliance committed to create an integrated physical, behavioral and oral health care system in Eagle, Garfield and Pitkin counties along the Western slope of Colorado. Its initiatives focus on improving access to care and addressing the social determinants of health so people can become healthy and have an improved quality of life.
 
Ascent: Tell me about the value of the Accountable Health Community Model (AHCM) and how it aligns with your organization's goals.
 
Gair: WMRHA was created to help ensure that people were getting access to care they need, and from there it moved to work that aligns providers and advocates for important policies that the Alliance felt were needed to support that work. Even if you have access to health care, there are other factors that impact whether someone can get and stay healthy, like housing, food insecurity, transportation and social isolation.
 
When we became a lead for the AHCM, it brought a more formal focus on social determinants of health and our work to bring together the health and social services partners in the region. Before, those groups may have been working together at some level, but now it’s at a deeper level. 
 
Ascent: WMRHA spearheaded the AHCM's care coordination survey, working with the medical, behavioral health and non-profit social service organizations. The results helped inform the work among other health alliances in the region. What were three key takeaways from that survey?  
 
Gair: First, the survey gave us a more clear picture of where people were concentrating efforts and where they might benefit from shared training, so care coordinators working with all these different entities can speak a shared language and support each other. Each region in the AHCM received results from their own care coordinators so they can analyze their own needs and customize support.
 
It also gave us a more clear picture of what was actually happening on the ground. We know that we have a lot of strengths in some areas, but weaknesses in others. Knowing that enables us to do better planning in care coordination for Region 1 and gives us insight to better support care coordination. We’re moving forward with Bridges Out of Poverty and cultural competency training, as well as coordinating no- or low-cost training in other areas, too, like motivational interviewing.
 
Finally, we have a better understanding of how to more effectively connect care coordinators with providers—we can really connect those dots. Care coordinators call themselves many different names, like navigators and case managers. Now, medical providers can recognize who they are and have a better understanding about their role, especially with community-based organizations. 
 
Ascent: What are next steps for WMRHA to advance health care access?
 
Gair: We had two organizations piloting the AHCM social needs screening tools this spring to initially work out the kinks in administering it. 
 
At the same time, our Public Health departments in Eagle, Garfield and Pitkin counties identified our top priority issues as healthy housing, mental health and behavioral health. Housing is a real concern in our region. Many people pay 50 percent of their income for housing, and our vulnerable population is really struggling. We’re looking for ways to take some concrete action. We brought together a housing and health summit in April and have another scheduled for July. Housing and health organizations don’t always chat with each other, and we’re trying to create that opening so they can start talking. 
 
We’re excited to partner on this effort. We’ve been fortunate to have some positive steps in behavioral health integration and access, and this next step will entail becoming more intertwined with organizations focused on social determinants of health—and we hope that will result in more positive outcomes for our community.