Network Spotlight: Northeast Oregon Network

May 2017
Northeast Oregon Network (NEON)

Northeast Oregon Network (NEON) is a nonprofit rural health collaborative of providers, agencies, and community members from Union, Wallowa, and Baker Counties of Northeast Oregon.

Network Name Northeast Oregon Network (NEON)
Location La Grande, OR
Key Contact Lisa Ladendorff, Executive Director
Mission To increase access to and quality of integrated healthcare for Northeast Oregon residents by identifying system gaps, facilitating community-developed solutions, and advocating for health policy change.
Vision Improved health status for all residents of Northeast Oregon.
Lisa Ladendorff, executive director of NEON, was interviewed by the Network TA team to share information on the network’s characteristics, key learnings, accomplishments, and challenges.

Q: In a nutshell, how would you describe your network?

A: Northeast Oregon Network is a nonprofit health collaborative network. We serve five rural and frontier counties across a fairly large geography in eastern Oregon. We focus on improving health for residents in the communities that we live in, with the vision that all people in all the communities that we serve are healthy, happy, and thriving. We do that by working with community partners and community collaboratives to fill gaps in funding, capacity, and knowledge in the local systems that support health.

We’re a vertical network, with multiple providers of many different types and partners of many different types involved. We work with healthcare systems, social service systems, and loosely affiliated community groups that are working on community issues that would improve health. Most of our services are facilitations and technical services to partner organizations and community groups. In a lot of ways, we're an innovator, convener, and expert for community groups trying to provide what rural groups don't often have. 

Q: What benefits do network members receive?

A: For the closest partners that contract with us, there's actual funding that flows through to them. When we work on a project, rather than ramping up the network itself, we really try and contract with the already existing expertise and individuals in the community to deepen the collaboration. That's been an advantage and a strength; having between a fourth and a third of our business handled through contracting with partners is really an advantageous model that works well.

We also provide benefits to the people our members serve. One of the basic activities that we carry out is we've selected an evidence-based practice for health education, the “What To Do For Health” series. We purchase a substantial number of those materials every year and then make them available to partners to use with their constituents, provide them to Head Starts, to clinics, to parenting organizations, and as giveaways at outreach events. People are also served more in-depth through the programs that we offer ourselves, such as Pathways Community Hub, where we've currently worked with and served 170 very high-risk individuals in our communities.

As a network, we also help improve the success, efficiency, and products of members’ programs and outcomes. Some of the programs that we do are actually implemented not in our sites but in other program sites. We can help them start programs, find funding for programs, or provide technical assistance to make those programs successful. We also conduct a number of community health assessment activities. Partners benefit from having both qualitative and quantitative data sets ready and available for community health improvement planning. In the past, community health assessments came with membership because we had outside funding to do it. Recently, it's been a fee for service that folks can pay for, but we offer discounted service rates to our partners. 

Q: What types of organizations are you interested in recruiting for membership or partnering with more?

A: We have a pretty broad representation, but two areas that we'd really like to see grow are the local business community and financial institutions. We’re looking at including a local business and a local community-based bank within our board membership. One of our current board members is the director of the local economic development district. When you look at rural communities, economic development is a key issue.

Q: What challenges do you face working in rural health care?

A: There are oh-so-many of them sometimes it seems. The biggest challenges we're probably facing at the moment are the uncertain state and federal funding environments. Oregon is a Medicaid expansion state. Oregon has really worked hard and has reached coverage of 95% within the state, but we're going to have a terrible time maintaining that. The state legislature is grappling right now with what that's going to look like. That's going to impact us in a couple of ways, including our outreach and enrollment program or our support of services that meet the health-related social needs of patients to reduce the cost of care.

Whenever extreme threat comes, I think individuals and organizations in Oregon have one of two fundamental ways they can respond. One is they pull back and protect their turf. The other is that they say, "Hard times coming. Where are all the like-minded people? Let's gather together. There's security in numbers to figure this out.” Oregon has been going through massive change in the healthcare environment since probably 2011. That was a threat in the beginning, and there was a lot of pulling back into “turfiness.” In the last couple of years, we've really seen that moving to a lot more community collaboration. 

There have been some changes both in Oregon's public Medicaid market and in the early learning environment where the state actually mandated these community groups, community advisory councils. It took about two and a half to three years of finding people to come and finding ways to organize, but now they've really started to take off. People have had that experience of a set, stable, long-term, ongoing organized group for people to share information and solve problems together. 

Q: How did NEON achieve its name recognition and strong reputation in your communities?

A: It took lots of persistence and time. Our network staff members try and show up at every single advisory committee, collaborative meeting that’s related to us in the counties we work in: safety committees, early childhood committees, health care committees, and the list goes on and on. We make sure we’re prepped with messaging when we go to these groups, to explain who we are and why we’re there. Then when things come up, we can say, "We might be able to help with that," or, "Let's join together to focus on that,” or, "You know, there's this opportunity for that." It's a forum that makes it a lot easier for us to connect with people.

For example, one of our staff members was attending an early childhood meeting when they started talking about a requirement to have institutional racism training. This is one of the newer services that we can provide. Some folks at the meeting were bemoaning the fact that they missed the state training, and they didn’t know what they were going to do. Our staff member spoke up and said, "You know, we can do that for you." They said, "Really?" "Yeah, let's get you connected with Lisa. What do you need?" Our staff have gotten pretty skilled at recognizing those connector opportunities.

Also, we’ve adopted a strategy that when we pursue larger-scale grant funding, we approach partners to do it with us. We don't do any of our projects as a single entity. When we ask them to partner with us, we always make sure that there's money that gets paid out to them. That immediately shows people, “Partnership isn't lip service. We really want to work with you. Let's dive in together deeply. We're willing to ante up.” That tends to increase a lot of trust.

Q: What’s made your network successful in diversifying your revenue stream?

A: Our sustainability strategy is really pretty simple. First, get one funding source. Second, get two funding sources. Third, make sure you have a mix of state, federal, and foundation for grant funding sources. Fourth, get non-grant funding sources. We were intentional about having these steps in place right from the very beginning.

Grant writing is a continual thing. We're always looking for opportunities. I adopt the rule that if I have something that absolutely needs to be funded, I better have three grant funding opportunities out for it, given that an acceptance rate of 30% is relatively normal. We don't do anything that's not a community collaboration and a fairly in-depth one. All of our grants have MOUs, not just letters of support. Those MOUs are very specific about the contributions and involvement levels. We usually have very strong community coalitions. Finally, it's part of our strategic plan and our strategic value that every program that we're involved with utilizes an evidence-based practice. When you have strong partnerships, a strong research base, and strong grant-writing skills, and you’re constantly looking for opportunities, you’re going to have more success with funding.

We've really been growing our contract services work over the last several years. Part of that is, as we have worked with people through joint projects that are grant funded, they really begin to see what our technical skill is. After that project is over, they often choose to work with us, whether that's a training product, project management, program evaluations, quality improvement, or community health assessments. We want to keep growing that. We're probably going to have about 25% of our budget this year that's earned income, and that's really our biggest year yet.

The piece that we have not yet cracked is how to get ongoing investments that aren’t grants and aren’t earned income. For instance, getting hospitals to say, "This service is of such value that we're going to contribute this annual amount," or getting insurance payors to say, "This service is of such value that we're going to contribute an annual amount." We don't have that, which some other sites do. We've made progress, but that's still in our sights.

Q: Based on your experiences as a network leader, what advice would you give to a developing rural health network?

A: I would say figure out what your strengths are and capitalize on them. Quite honestly, one of our strengths is the passion that partners and staff have had around our mission and the values with which we work. That's a softer strength, but it's carried us through a lot of rough spots. For us, our core when we started was the strength of this vision that was really compelling to those involved and the passion of those involved about that vision. Our values have really dictated what it is that we need to do when push comes to shove and things get tough. I always say that our network has been a faith enterprise. There are clearly moments when we don't know what's going to happen next. We're sort of in one of those right now. A lot of networks are, I think.

I would also say to really hone your technical skills and be intentional about what you do. Any action that we take has multiple levels of impact, and we rarely do just one thing for the sake of doing just one thing. We're doing outreach and enrollment. That helps individuals, and it also helps serve an equity issue in rural health. We're addressing a population health equity issue. We're addressing an individual need. We're also addressing a partnership need—our partnerships need us and want us to do it. You take one activity that we're doing, and we've really got three or four different purposes for why we're doing it. Being intentional about that helps you get maximum impact from one action. We're low-resource entities. We don't have a lot of money. We're small, community nonprofits. It's going to be best for us if we can get maximum impact from what we do.


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