Justice, Access, Support & Solutions for Health

(Photo above: Several Casa de Salud team members photographed alongside Bernalillo County Commissioner Steven Michael Quezada).

Friends of Casa de Salud,

As we enter 2024, we wanted to share a bit of what we’ve been up to - and what’s on our plate for the year ahead. We invite your generous support for our community rooted, anti-racist, and independent healthcare and healing work.

At Casa de Salud, we fiercely believe:

That healthcare is a right.

That anti-racist care, harm reduction, and cultural humility are guiding values.

That true access to care means affordable, trusted, dignified care.

That healing goes beyond healthcare.

That healthcare has a responsibility to build power with community.

And that health worker voices - in solidarity with community voices - are powerful.

“Casa de Salud is one of the most adventurous attempts to make healthcare genuinely for the people.”

- Dr Pritpal Tamber

Casa de Salud’s model of care primarily lifts up and centers primary care for immigrants, low-income and uninsured New Mexicans, queer/transgender community members, drug users, and people seeking recovery and treatment for addictions. We see healthcare from a lens that understands histories of inequalities, oppressions, and structural forces. We see the strengths of our community members, as well as the cultural richness that exists around us. It is with this historical analysis and appreciation for the power within our community that we build towards collective wellness and liberation. We situate ourselves in the community as a change agent, developing models for advocacy for patients and organizing for health rights.

Below are a few highlights of this past year, in service to our community:

Our clinician and staff team supported our community with more than 7000 patient and case management visits. Over 75% of our patients are uninsured, the majority of the rest have Medicaid. We do this work independently, as a nonprofit organization that is not a federally qualified health center and does not receive federal funding for our work - while providing fair-priced care and sustaining a staff of employees with benefits.

This year, several incredible and caring physicians and nurse practitioners joined our team, including physicians, nurse practitioners, and our first Reimagining Healthcare and Healing Clinician Fellow. Learn more about our fellowship, we are recruiting for our second class of fellows!

We provided critical harm reduction services during a worsening opioid epidemic - meeting people where they are with dignity and respect. We engaged with 6348 community members for syringe exchange, safer use supply services and fentanyl test strip distribution. And we distributed over 566 boxes of naloxone, or narcan, the lifesaving opioid overdose reversal medication. Of those, clients reported using 157 of these doses out in the community, to reverse overdoses and save loved ones’ lives.

Our team supported 15 Health Apprentice Fellows this year, through our rigorous, nationally recognized Health Apprentice Fellowship. Our current health apprentice fellows will join over 330 alumni of the health apprentice fellowship network – a wide range of leaders, primarily young people of color, serving their communities whether as healthcare professionals or leaders in other areas.

We re-launched our VIDA Health Leaders Network of health workers and community members and are excited to build community together and organize together around our main focus areas of 1) Healthcare access, 2) Addictions, and 3) Community Safety.

Casa de Salud is proud to serve on the steering committee of the New Mexico Together for Healthcare campaign (along with New Mexico Center on Law and Poverty, Strong Families Forward Together, and Health Action NM - fierce partners in this work).

Casa team members and the VIDA health leaders network helped support two historic bills in the 2023 New Mexico legislative session. One is Medicaid Forward, which would allow for the state to study and to propose options to expand medicaid to more, or all, nonelderly New Mexico residents. Check out the powerful study that the Urban Institute published on Medicaid Forward in New Mexico. The second bill that passed ensures provision of evidence-based medication treatments for addictions, in jails and prisons in New Mexico. Both of these were huge wins. We are also working to ensure full implementation of the Healthcare Affordability Fund, the Patient Debt Collection Protection Act, and more legislation that was passed in recent years.

Our community health workers (CHWs) organized Casa de Salud’s first ever float in the Albuquerque Pride Parade, and Casa’s CHWs also organized a massive community event in June. In addition they engaged with thousands of community members about COVID and other health education issues, and we continue to distribute rapid home COVID tests kits to individuals and families.

Our Strong Roots / Raices Fuertes comprehensive opioid addiction treatment and recovery program supported many patients with low-barrier access to the life-saving medication buprenorphine. And our case managers intensively supported over 60 clients with significant needs relating to structural determinants of health – many monolingual Spanish speaking community members, and many people with co-occurring mental health and substance use issues.

We continued to advocate for more high quality and compassionate medical and behavioral healthcare at the county jail, the Metropolitan Detention Center. This is something we have been actively working for, over the last few years. This year, there was a huge win as University of New Mexico Hospital took on medical care after years of out-of-state for-profit correctional care companies providing below standard medical and behavioral health. Casa de Salud is helping to lead efforts for smooth coordination and transition of care from the jail to community clinics.

We expanded partnerships with the City of Albuquerque, Bernalillo County, and the NM Department of Health; with local and national foundations, and with community partner organizations. We are grateful to Community Catalyst, Foundation for Opioid Response Efforts, Con Alma Health Foundation, NewMexicoWomen.org, the Elevate Initiative, Albuquerque Community Foundation, Santa Fe Community Foundation’s Envision Fund, St Anthony’s Foundation, and the McCune Charitable Foundation, among others, for support for programs and operations.

We expanded benefits for our hardworking staff team - many of whom have been working on site at Casa de Salud during the entire COVID pandemic.

And, some wins and shoutouts about Casa de Salud team members:

Casa de Salud’s Clinical Manager, Alejandra Casarrubias RN, who was also a former Health Apprentice Fellow – was selected for the prestigious national Bloomberg Fellowship this year, receiving a full scholarship for a Masters in Public Health at the Johns Hopkins Bloomberg School of Public Health (announcement here).

Casa de Salud’s Executive Director, Dr Anjali Taneja, was appointed to the University of New Mexico Hospital Board of Trustees, by the Bernalillo County Commission.

Our new staff physicians and NPs this year include Andrea Vanderwoude NP (our clinician fellow!), Estela Gonzalez NP, and Marion Cook MD (a former health apprentice fellow and former staff member). They join our staff physicians Dr Anjali Taneja MD and Dr Heather Greene MD. And several Casa locums clinicians have been so helpful for ongoing coverage needs at Casa - Lorraine Cordova NP (also a curandera and a founding member of Casa), Dr David Parajon, Dr Jessie Rogers, and Dr Wendy Johnson.

Two health apprentices joined our staff as Clinic Flow Coordinators – Fabian Martinez and Carolina Rios. This makes 11 former health apprentice fellows who are now employed at Casa de Salud, in the roles of: Family Physician, Clinical Manager and Registered Nurse, Clinic Flow Coordinators, and Health Apprentice Fellowship Developer!

Two Clinic Flow Coordinators at Casa de Salud (and former health apprentice fellows), Diana Medrano and Ariadne Calderon, were accepted to and are enrolled in the first class of the University of New Mexico accelerated Bachelor of Science in Nursing program. And we are awaiting news from several apprentices and staff members who have applied to medical school and to physician assistant (PA) school!

Casa’s Executive Director traveled to Tucson, Arizona in February to speak about Casa’s model of care, at the Andrew Weil Center for Integrative Medicine. And this year, she served as co-host of this year’s New Mexico Ethics in Business Award, after receiving the award last year.

Casa de Salud’s Director of Operations Elizabeth Boyce was appointed to and represents Casa de Salud on the New Mexico Opioid Overdose Prevention Council.

Casa staff and health apprentices presented at the New Mexico Public Health Associationconference this year. The workshop “Health Apprentice Fellowship: A Model for Transforming and Diversifying the Healthcare Workforce“ was coordinated by Health Apprentice Fellowship Developer Andrea Romero, Clinic Flow Coordinator Rocio Sanchez, Clinic Flow Coordinator Yuri Munoz, and health apprentice fellows Jose Herrera and Kira Lotz.

Eight of Casa’s hardworking employees qualified for and received the Bernalillo County Premium Pay Grant, as part of the county’s efforts to support employees who were critical to care during the COVID-19 pandemic. Thanks to County Commissioner Steven Michael Quezada for reallocating a portion of his District-directed American Rescue Plan Act funding towards the grant for businesses in his district, which allowed for more employees to receive the grant.

Our new community organizer Alejandra Cruz Blanco is continuing our tradition of supporting uninsured New Mexicans with overwhelming hospital medical debt, helping to improve access to our safety net public hospital, University of New Mexico Hospital. She is also working to organize patients and health workers statewide to expand access to critical healthcare and move forward innovative statewide healthcare policies.

Next year, Casa de Salud celebrates our 20th anniversary! In 2024, we aim to continue all of our work above and expand our care beyond our South Valley location (more forthcoming!), expand our staff with new positions, continue to serve uninsured individuals and families in New Mexico, and build out creative innovations in care for our uninsured patients and patients with Medicaid. We are also working to build out a dignified continuum of care for people being released from the county jail, develop community events and health political education, and restore and strengthen our integrative healing options at the clinic. We will continue working to transform care locally and statewide, while building power with community and among health workers.

Below are some ways you can support our work and spread the word!

Please consider a donation to Casa de Salud here. The Casa team spirit is so beautiful, our team members work nimbly, creatively, and with so much love for our community. We do this work with so much resourcefulness towards finding sustainable, diverse approaches to funding – and with little overhead. Your support will go a long way towards this goal, for the year ahead.

Would you help us get the word out and help us find excellent clinicians and team members so our organization can best serve our community?

Know anybody who may be interested in our Health Apprentice Fellowship?

Join our VIDA network of health workers and community members moving together on healthcare access, addictions, and community safety issues.

Do you have other ideas or suggestions? Want to reach out? Don’t hesitate to email us.

Please follow us on social media: Facebook, Instagram, and Twitter

One last point. As Casa turns 20 years old, we are aware that this is no small achievement in this healthcare industry, where clinics such as Casa de Salud are working against many forces shaped by the evolving healthcare industry. With the COVID pandemic accelerating this trend, over 70% of all physicians in the United States were employed by a hospital or a corporate entity, including private equity firms. During the COVID pandemic, corporate entities’ acquisition of independent practices grew by 84% and this trend is only expected to continue.

Help preserve independent neighborhood based, accessible community rooted healthcare that is relational and that works to provide high quality care to those most in need, while building power to transform the structural determinants of health and the larger ecosystem of care.

With gratitude – and in solidarity with health workers and marginalized communities in the US, and internationally,

-- The entire Casa de Salud team, including our clinicians, staff, health apprentice fellows, leadership team, and board of directors.

Casa de Salud ofrenda for Dia de los Muertos.

Alejandra Casarrubias RN, Clinical Manager at Casa de Salud and national Bloomberg Fellow, at the Bloomberg American Health Summit, Baltimore MD, Nov 2023.

Alejandra Casarrubias RN (Bloomberg Fellow), Anjali Taneja MD MPH (Executive Director, Casa de Salud), and Bloomberg Fellows Kate Vander Tuig and Miguel Angel Vazquez, at the Bloomberg American Health Summit, Baltimore, MD, Nov 2023.

The Casa de Salud team setting up our float, at the 2023 Albuquerque Pride Parade.

Casa de Salud at the 2023 Albuquerque Pride Parade.

Casa de Salud at the 2023 Albuquerque Pride Parade.

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Please see below for much more on our work.

REIMAGINING HEALTHCARE AND HEALING

Casa serves our community and patients with visits for low-cost primary care, acute care, counseling/therapy, acupuncture, massage, reiki, curanderismo, Indigenous-based healing circles, ear acudetox, and syringe exchange/narcan distribution. Over 75% of our visits are 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 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.

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Photo Copyright William Widmer. Used with permission from the Robert Wood Johnson Foundation.

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Photo Copyright William Widmer. Used with permission from the Robert Wood Johnson Foundation.

TRAINING THE FUTURE HEALTHCARE WORKFORCE OF NEW MEXICO

Casa de Salud has a robust health apprenticeship fellowship program, in existence for the last 18 years. Casa’s health apprentice fellowship 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 320+ 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.

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Health apprentices at the international Social Medicine Consortium in Gallup, NM. In total, 28 clinicians, staff, and health apprentices participated in this inspiring consortium.

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Social Medicine Consortium screenprinting opportunity with Dr Chip Thomas (@jetsonorama), artist and physician with the Indian Health Service in Arizona. Health apprentices hold up t-shirts they made, saying "No to Racism"

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GROWING OUR TEAM, OUR CULTURE, and LEADERSHIP

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

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 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.

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.

We have historically exchanged over 1 million syringes a year (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 provide 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.

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 were previously 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. See our work here .

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Joe McDonald, Clinic Flow Coordinator & Special Projects; and Maranda Perez, senior health apprentice, arranging syringes and other materials for the syringe exchange at Casa de Salud. Photo Copyright William Widmer. Used with permission from the Robert Wood Johnson Foundation.

STRUCTURAL CHANGE AND COMMUNITY COLLABORATION

We know we must build power with our community, and since its inception, Casa de Salud has been supporting and leading efforts to address structural barriers to our community’s best health. Our VIDA health leaders network inspires and engages health workers around the state to address structural determinants of health, help move critical policy and legislation forward, and build power together to make transformative change in healthcare access issues, addictions, and community safety.

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

INVEST IN OUR WORK FOR AND WITH OUR COMMUNITY!

We currently do all of this work, and employ more than 20 employees and work with more than 15 health apprentices, while caring for those most in need -- with an operating budget of $1.5 million. We invite you to invest in us, support us, as we aim to meet the healthcare and healing needs of our community and build power with our community. Please share this crowdfunding page with friends, family, and others interested in innovative community-rooted and creative models of care. Please share this on social media, pass it on by email, and please give, no matter now small or large a donation.

Thank you! Casa love!

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Health Apprentices (most of them) and several members of our Clinic Flow/Health Apprentice staff and supervision team.

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