Interview with Lynn Dorroh,
Executive Director of Hill Country Community Clinic

What was your original vision for the clinic, before it even existed?

For one thing, we wanted to create a place where people could get the kind of health care that we had always wanted. That included alternative health care, but even from the beginning, we wanted more than just a health clinic. We wanted to provide a gathering point and a focus for interested people in the region—which has always included Oak Run, Montgomery Creek, and Big Bend, as well as Round Mountain—where they could come together and make friendships and do something good for the community. We wanted a place where local people could have good jobs so that they could live fully in the mountains and not have to look to Redding as the source of all economic livelihood.

At the time, there was no medical care in our neck of the woods, and we were fortunate in that, among that original group of friends, there was a family practice doctor who wanted to try to implement such a big idea. We all volunteered our time at first, and then worked barely above minimum wage until the clinic got on its feet.

I guess it was just a serendipitous meeting of enough people to form a critical mass, to say, “We don’t know if we’re going to succeed but we’re going to try.”

How has that vision changed over the years?

It actually hasn’t changed, but grown. All that was true when we envisioned Hill Country Clinic remains true, but it has gotten much bigger. It’s also taken much longer to implement the complementary services that we always wanted to offer and integrate them with the primary medical care that we offer.

But over the last twenty years, the clinic has indeed become an important center of the community where there is more human energy and activity here on a daily basis than anywhere else in the area.

Funding is a challenge for complementary health services; but in 2004, we became a funded Federally Qualified Health Center, and one of the fundamental tenets of a federally supported community health center is that you respond to the community. From its beginning, this program has been very consumer driven, and a large portion of the folks who live this area are already consumers of alternative health care services and really want them to be offered here. That has appeared in every patient satisfaction survey we have done. In Hawaii, traditional native Hawaiian healing is funded. In Arizona, traditional Native American healing is offered. Here, we will work with the Bureau of Primary Health Care to have the program support the alternative modalities our patients want, including such things as acupuncture and massage. It is a uniquely responsive program.

If your current vision is fully realized to the greatest extent, how do you envision the new Health and Wellness Center operating in the community, for the patients you serve, and for the staff who work there?

When I close my eyes and imagine what I want it to be five six seven years after expansion completed, it’s a place where patients/community members can come and get a variety of human needs met. When I first became Executive Director, one of the things I noticed was that for many of the patients we were serving, especially the patients who are our heaviest users of services, they were coming so often not because they really had a medical condition that needed weekly treatment. What they really needed was human contact with someone who cared about them and knew them and would give them their full attention even if it was just for five minutes. The new Wellness Center will be a place where this can happen in a broader variety of ways. There will be a kitchen, not with a printed menu or waitress, but a place to get something simple to eat, or a cup of tea or coffee. You can sit down and talk to someone else waiting for an appointment, or the person who is volunteering to run the cafe. If you’re lonely, you can just come and hang out for a while.

Senior services are increasingly important as the people North State age. Hopefully, two to three days a week, we will have a Adult Day Health Care staff here who can take care of an elderly or disabled patient really well while the caregiver goes to town, shops, or gets some rest. It will enable people to stay in their homes for longer and to have a much higher quality of life. I envision a number of volunteers who will want to play a board game with these folks or tape their stories or quilt a square. There will be a variety of ways in which people, not just staff, are interacting with each other and can get the meaningful human connection that we all need.

For the staff, I imagine a wonderful, enriching, and satisfying place to work, where you’re treated with appreciation and respect, and where there exists an opportunity for them to progress into new positions. A number of people who started here answering phones are now licensed medical professionals. We currently have three intern positions filled with high school and Shasta College students who have part time jobs. We are willing to flex around their school schedule so that they can work here. Two of them will be going into health care and will have good jobs that will allow them to support themselves and their families.

The building project also has a teen center, and there are going to be a number of ways in which the kids at the teen center and the folks in the adult day care program can interact. We want to do a better job of channeling the volunteering energy we have among our patients. There is a lot of research about the positive effects of community service. A volunteer program will not just help the clinic, but can deeply enrich the lives of the volunteers.

What contribution do you see HCCC making to the larger area of which it is a apart?

I like to think that over the years, we’ve been a little bright spot on the map in the North State of creative, forward thinking folks who have consistently put the well-being of our community and the environment first. We will continue to play that role. The fact that the project is going to be the first LEED-certified project in Shasta County is a big deal. The expansion and pursuit of LEED status creates an opportunity for us to say that we really do care about the health of the whole—not just the health of human beings but health of the environment and how humans relate to the environment. We want to attract, as our community grows and new people move in—and in fact, there are several new developments in the planning stages—people who are excited about what we’re doing and putting in place. We want to give the message that we’re looking at the big picture in terms of creating community, that we’re doing our part to create a vibrant downtown that serves as a magnet for people who want to make wonderful things happen. We want people to see our community as one that would be as appealing to young families as it is to people in mid-life as it is to retirees.

How will the Wellness Center be different from other clinics that exist?

Besides the LEED certification, one of the things that is the most unique to The Wellness Center is the fact that we will have both mainstream and complementary health care under one roof. And they will be integrated; all types of practitioners will be talking to each other about patients’ care.

It can be hard to integrate even mainstream medical programs such as medical and dental, let alone mainstream and alternative care. We have to actively work hard to make sure that the providers in all those departments are talking about shared patients and that information is flowing adequately in order to get the best advantage to our care. As we add complementary services like acupuncture, massage, chiropractic and substance abuse treatment, they will all be fully integrated into our primary care as well. This is a unique model of care, not just in Shasta County, but anywhere nearby. Everything here will be organized by a collegial staff truly working together for the maximum benefit of the patient, incorporating some treatments like acupuncture and massage that are not always easily accessible to everyone.

Tell us a little bit about each new, expanded area of the clinic.

We currently offer primary medical care, dental care, and mental health. Our dental program is the most impacted. It takes six months for someone to obtain their first appointment to get a cavity filled. Access to dental care for low income people is extremely difficult. When we started our dental care program, we had people coming from as far away as Eureka and Susanville because they so desperate for care. It’s gotten better but the wait at other places that provide dental services regardless of ability to pay is just about as bad as it is for us.

So, we will add three chairs, which will allow us to add a full-time dentist and full-time dental hygienist. We are very excited about this! It’s an extremely difficult position for the staff to have patients calling for care, knowing that no one else can provide the services we provide, and have to tell them they’ll have to wait six months. It’s scary if their pain is due to an abscess because the wait could be fatal. We try to get them in as soon as possible under these circumstances, but with our additional chairs, we’ll be able to serve far more people in a much more timely manner.

As far as our mental health services—for last year-and-a-half, Shasta County as a whole, the county mental health system, community-based organizations, consumers, hospitals, health care providers, etc., have been working very hard to improve mental health services and make them more accessible to everyone. We’ve needed to do nothing short of a complete redesign of mental health services in our county. Currently, access to mental health services is much better for someone on Medi-Cal than someone in the middle class. Hill Country Clinic has a strong commitment to mental health services in general and for children in particular because we believe that early intervention can reduce the impact of serious mental illness later. In our new Wellness Center, we will have a larger room for group counseling, and our mental health services will be integrated with our substance abuse treatment program. We hope to be enhancing county services with some extra treatments that we are exploring that involve acupuncture and nutritional treatments. Substance abuse is a crisis throughout the county so we feel that it’s very important to address it in every way possible.

Our medical services will expand to include the new complementary services, and we will create more space so that we will be able to offer specialties such as orthopedics, podiatry, and OB-GYN to our patients once a month or more.

On the community end of the Wellness Center, there will be a large room adjacent to a commercial kitchen, and there will be cafe seating through the library. These rooms will be used for a number of purposes, including our Adult Day Health Care program, where medically fragile folks who need long-term care can have a place to go two to three days a week. It will be staffed by an R.N. and social worker. On call, as needed, there will be occupational therapy and physical therapy to maximize the functionality of disabled and senior community members so that they can continue living in their own homes for as long as possible. This program will also provide their caregivers a much needed break.

It’s going to be a beautiful room, and it will allow us to do health care trainings as well. Someone might even want to get married in the adjacent landscaped garden. We’ll have a casual, comfortable seating area outside the cafe area where folks can just hang out. We have a van that provides transportation for patients who need it. Folks are often waiting for an hour or two when they use this service, this will give them something to do. We’ll also have computers with free Internet access available, lots of access to health information in the library and good things to read.

The teen center will be in a separate building. Everyone at Hill Country Clinic is really committed to positive youth development because we think that is where health starts, with a good self-concept, completing your education, and developing healthy habits. Kids tend to disperse for various schools once they reach high school and about half of the children in our service area are home-schooled. The teen center will give all of our kids a place where they can get together on a regular basis, where they can do school projects and community projects. We wanted to have some youth input about the building project and about our programs, so HCCC has a Youth Advisory Board. We meet monthly in our board room. About forty teens participate in the YAB. We want to increase the involvement of young people in our community and hope that some of them may be able to stay in the area when they graduate from high school or college and make a good living here.