I am happy to report that 2022 was a year of great growth for Chapa-De Indian Health.
While we faced challenges in workforce shortages and a particularly difficult cold and flu season, we made significant strides in advancing our mission and meeting the growing needs of our communities.
I am honored to work with such an outstanding team who continues to go above and beyond to provide our patients with the very best high-quality, compassionate care.
We have much to look forward to in the months and years ahead as we continue to expand our services by adding a third clinic site in Rocklin. I am proud to highlight some of the many accomplishments that we achieved together in 2022.
Thank you to all who support Chapa-De Indian Health and best wishes for a prosperous 2023!
Lisa Davies, MPH
Chief Executive Officer
At Chapa-De we are committed to providing quality healthcare services. We track a variety of data metrics to help us understand how we are performing in areas such as preventive care, chronic care management, and more. We are in a recovery phase as we emerge from the COVID-19 pandemic. Disruptions to daily lives and the healthcare industry reduced the frequency that patients sought routine care. Still, Chapa-De excelled in these areas in 2022 on the Healthcare Effectiveness Data and Information Set (HEDIS):
90th Percentile: Diabetes Management – A1C Control
Nearly 73% of Chapa-De patients who have been diagnosed with diabetes had an A1C test under 9 in 2022.
50th Percentile: Controlling High Blood Pressure
Over 65% of Chapa-De patients ages 18-85 had a blood pressure below 140/90 in 2022.
50th Percentile: Diabetes Management – A1C Screening
Over 90% of Chapa-De patients diagnosed with diabetes received an A1C screening in 2022.
The Chapa-De Team also came together to focus on improving outcomes in two key areas during 2022 – Women’s Health and Well Child Checks. These areas were of top concern because preventive care services saw the biggest declines during the pandemic.
Our medical care teams made it a priority throughout the year to talk with and educate patients about the importance of breast and cervical cancer screenings.
Mammogram Breast Cancer Screening
Chapa-De improved to 54.9% of eligible patients receiving a breast cancer screening in 2022 (nearly meeting our pre-pandemic rate of 59%). This improvement was a direct result of the focused effort of our medical teams. We also hosted mammogram events at our health centers, and partnered with Sierra Nevada Memorial Hospital and the American Cancer Society on a free mammogram event at Sierra Nevada Memorial Hospital. Thanks to these special events, 67 Chapa-De patients received mammograms and we were able to successfully identify two patients who are now receiving treatment for breast cancer.
Cervical Cancer Screening
In addition to the ongoing focus on women’s health throughout the year, Chapa-De medical providers entered into a challenge during the months of October and November to see who could achieve the most improvement in the number of patients screened. As a result, we saw a 10% improvement in cervical cancer screenings from 55.5% to 61.0% in just five weeks, and we ultimately exceeded the HEDIS 50th percentile with 65.9% of eligible patients completing a cervical cancer screening in 2022.
To help our patients prepare for the start of a new school year, we held back-to-school events at our Auburn and Grass Valley health centers. We served 62 patients ages 11-17, that were due for a well-child visit, by providing well-child checks, sports physicals and immunizations. We also gave out backpacks filled with school supplies to participating children. The giveaway was made possible by a grant from California Health & Wellness (Health Net).
These special back to school events helped us to improve to 46.7% of patients age 3-21 receiving a well child visit in 2022, this rate had dropped as low as 20% during the pandemic.
In 2022, Chapa-De purchased a parcel of land off Highway 65 at Stanford Ranch Road at Wildcat Boulevard in Rocklin. This will be the home of our third health center. This new location will be more convenient for patients who travel from the southern end of Placer County or beyond to get care at our current sites in Auburn or Grass Valley.
The new health center will offer Medical, Dental, and Behavioral Health services upon opening. Added support and services will also be available for women, infants and children and for clients living with diabetes. A Care Coordination team will be available to address social navigation and case management needs. We will add an in-house pharmacy and optometry services as the patient population at this location grows. The site is anticipated to open in 2025.
Chapa-De Indian Health is now a Tribal FQHC provider, which means we have more flexibility under Medi-Cal in the types of visits we provide on any given day to one patient, and it allows us to provide and bill for services outside our four walls. This exciting change is part of our commitment to evolving and ensuring we meet the needs of our patients and communities.
As a Tribal FQHC provider we are establishing a specialist network for our patients to more easily access the services they need. By contracting directly with specialty providers, we are able to streamline the process for staff and patients and reduce the length of time patients wait to obtain specialty care. After reviewing our most common referrals, we chose to start with Physical Therapy and have a contract with Family Physical Therapy who is serving Chapa-De patients at their office in Roseville.
We plan to continue to grow this service, and are working to contract with a dermatologist soon.
April Moore served 26 years as a Board Member and Chair of Chapa-De Indian Health. She spent her life working to advance the American Indian Community and helped make Chapa-De the robust and compassionate native directed healthcare system that we are today.
We are very proud to support these bright American Indian/Alaskan Native students in their educational journeys:
Amanda Barnes attends California State University, Chico and is earning her bachelor’s degree in Communication Design. A descendant of the Rumsen Ohlone/Costanoan Native American tribe, she plans to use her education and creativity to communicate to the world the uniqueness of her tribe and to give exposure to her native heritage. She believes her talents are brought forth from her ancestors and she dedicates her work to those who have come before her.
Leah Ellis is studying Psychology at the University of Nevada, Reno. She ultimately hopes to attend graduate school to become a licensed Marriage and Family Therapist and to return to her hometown of Grass Valley. Her goal is to help people live a happier and healthier life – she especially hopes to work with minorities and people who struggle with addiction and unhealthy lifestyle habits.
Noelia Davila attends Santa Rosa Junior College and is in the Nursing program. Growing up on an Indian reservation, she saw firsthand the desperate need for health care resources and indigenous health care workers. Her goal is to become a Registered Nurse and to travel to Indian Health Clinics around the U.S. to help Native people combat issues like diabetes and heart diseases.
Zachary Hatten attends Sierra College and is also pursuing Nursing. Following in his grandmother’s footsteps, he hopes to positively contribute to people’s health journeys by becoming a Registered Nurse. Knowing that minorities often face healthcare disparities, he plans on using his career to save lives in the American Indian community.
At Chapa-De, we are always looking for ways to be there when our patients need us the most. One of the factors in providing our patients with convenient access to high-quality, compassionate care is through our hours of operation. We understand that there are limitations to the Monday through Friday, 8 a.m. to 5 p.m. model and, in 2022, we wanted to explore the desire to make changes to our hours of operations in the future.
With this in mind, we surveyed our patients and community partners in September and October about our operating hours. Through this survey we learned that current and future patients are interested in expanded hours, especially later hours on weekdays.
Our internal operations teams will launch pilot projects throughout 2023 to test extended hours. We are also now exploring employee interest in alternative work schedules that could make it possible to expand our hours in a sustainable fashion. Thank you to all who participated in this important effort!
After three challenging pandemic years, we were excited to bring back our annual in-person Elder’s Christmas Party. At the beautiful Ridge Golf Course in Auburn, we started the party off with a prayer. The space was decorated with holiday decor and Elders’ laughter and conversations filled the room. We passed out gifts, ate delicious food, listened to festive holiday music, and shared stories of our people’s rich history. The room had a spot that was decorated for picture taking and we were even graced by Santa.
While it was technically a Holiday Party, it felt more like a family reunion. There were many people who hadn’t gotten together since before the pandemic and were able to reconnect at this gathering. Being able to reconnect, hug each other, and share stories honors our people in a meaningful and fulfilling way. Stories about early Chapa-De were also shared– mentioning how even despite our growing pains, our health centers have affected so many lives for the better.
We thank everyone who attended and made it such a wonderful event. The sharing of stories and wisdom is not only important to us, but to future generations as well.
Patient had at least one visit in the last three years
Patients are using
Free Care (AIAN)
Under 100% FPL
100-138% of FPL
139-200% of FPL
201-400% of FPL
Above 400% of FPL
*Data is based on feedback from patient surveys conducted in the medical department during one month each quarter in 2022.
Amazing facility that offers medical, dental and their own pharmacies! I love the Nevada County location due to the amazing customer service and staff. Everyone that has helped me in both the medical and dental offices are super kind, well knowledgeable and extremely helpful. Thank you Chapa-De Indian Health for offering wonderful healthcare.
Always treated Kindly! Labs are always done so quickly. Never too long but wait for your doctor's visit. Artwork is beautiful.
I continue to have outstanding service from the Auburn clinic office staff. I am so impressed with their professionalism.
To me, they have been a blessing, both dental and medical. I've gone there for years.
Fantastic experience! I can’t say enough wonderful things! The staff was lovely and helpful and the Doctor was so caring and had fantastic bedside manner. Such wonderful people!!
This year, we added a new member to our Care Coordination Team. We now have a Community Health Representative dedicated to assisting Latin@ patients!
Care Coordinators are staff members at Chapa-De who help patients with barriers that affect their care and wellbeing. They work directly with patients to connect them to a wide range of programs and services. This can include housing, food, transportation, and more. Our providers give patients the healthcare they need at our health centers and our Care Coordinators help make sure that patients have basic necessities and are getting the help they need in their daily lives.
Our Care Coordination Team now includes two Patient Care Coordinators, a Community Health Representative dedicated to American Indian patients, and a Community Health Representative dedicated to Latin@ patients. We also have a new Care Coordination Program Manager to help further strengthen our navigation and case management programs.
The Power of Care Coordination: One Patient’s Story
Patient Care Coordinators at Chapa-De often go above and beyond to help our patients. In 2022, Patient Care Coordinator Donna Jenkins was able to help a longtime Chapa-De patient secure safe and stable housing after learning he was experiencing homelessness. This was no easy feat and took 5-months of Donna’s constant attention with support and collaboration with the patient, AMI Housing and FREED.
After another team member recognized the patient’s need for housing and services, Donna stepped in to help. She personally contacted AMI housing and got the patient registered for the coordinated entry housing system through 211. The patient was also connected with a caseworker at FREED.
After not seeing a lot of progress after several weeks, Donna dug deeper and learned that while the patient was connected with the right housing resources, he wasn’t getting the help he needed so she stepped in to assist. Donna helped the patient fill out a section 8 housing voucher packet and arranged for the patient to get copies of his birth certificate, social security card, and bank statements which were required to complete the process.
Once the paperwork was completed and approved, Donna helped the patient secure housing that accepted a Section 8 voucher. The patient was incredibly grateful to everyone who helped him get off the street and especially Donna who he continues to visit each week.
Our Prenatal Care and Baby Luv programs in Auburn and Grass Valley:
The Baby Luv program helps educate soon to be mothers about what to expect during each trimester, as well as helping mothers after birth, by planning for the future. Our hope is that through this program, we are empowering mothers to be confident and educated in their pregnancy.
“Babies of mothers who do not receive prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do obtain care. While the statistics are concerning, I am happy to share that there are many resources readily available to expectant mothers in our community. Receiving early and regular prenatal care improves the chances of a healthy pregnancy for all individuals.”
Karina Gookin, MD
Community support is an important part of programs like our Maternal Child Health (MCH) program, creating access to critical resources for those who need it. In partnering with First 5 Placer, we are able to do just that for our patients.
First 5 Placer is an organization dedicated to supporting the healthy development of children during their first five years of life. Under the Road to Resilience Initiative led by First5, Navigators from partner organizations including Sierra Native Alliance, KidsFirst, and Granite Wellness Center visit Chapa-De’s Auburn health center on a weekly basis to meet with Prenatal/OB patients and parents of medical patients who are under age 1. These Navigators are coordinators and advocates certified by their programs to assist patients with housing, SUD(Substance Use Disorder) treatment/management, mental health services, education resources, and cultural and family resources for Native families.
We are thankful that our team has been able to partner with many important organizations in the Auburn and Grass Valley areas.
Our communities have experienced an alarming increase in the number of accidental overdoses and overdose deaths due to fentanyl. Fentanyl is a powerful synthetic (lab-made) opioid that is used to treat severe pain related to surgery or complex pain conditions. Although FDA-approved, fentanyl has been made and distributed illegally in increasing amounts over the past decade, leading to a dramatic rise in drug overdose deaths in the United States.
With this information in mind, Chapa-De is working to educate our patients about harm reduction strategies. We also provide free resources to empower community members in an attempt to prevent overdose. Chapa-De patients can get Narcan, which is a potentially life saving medication designed to help reverse the effects of an opioid overdose, as well as free fentanyl test strips at both our Auburn and Grass Valley health centers.
In 2022, Chapa-De gave out 5,700 free fentanyl test strips within our health centers and at community events. These test strips can alert community members if fentanyl is mixed into a product.
Click here to learn the signs of opioid overdose.
After renovating more than 17,000 square feet within our health centers in 2021, we broke ground on our new 10,000 square foot Administration Building in Grass Valley. Staff moved into the new building in July 2022.
This new building offers:
Adding this building was important in order to maximize space for patient services within our health centers. We are proud to be able to offer our staff comfortable places like these to help further their support for fellow coworkers and patients.
Dr. Glenn Gookin
Dr. Julie Garchow
Associate Program Director
Through a partnership with CommonSpirit Health (formally Dignity Health), we have worked to create a rural residency program for Family Medicine – the new Sierra Nevada Family Medicine Residency Program.
This is a multi-year training program, for physicians after they complete medical school, to focus on and further their work and education in family medicine. This allows those physicians to become eligible for a board certification.
The residency program is led by Chapa-De’s Dr. Glenn Gookin (Director) and Dr. Julie Garchow (Associate Program Director). Over the last three years, Dr. Gookin and Dr. Garchow, and various Chapa-De Leadership members, have been working closely with teams from CommonSpirit Health and Sierra Nevada Memorial Hospital to lay the groundwork for the launch of this important program. The rural residency program will bring medical residents to Grass Valley for specialized training in delivering quality healthcare in a rural setting. The residents will receive two years of primary care training at our Grass Valley location and will also spend time at CommonSpirit hospitals in Sacramento and Grass Valley.
“In Northern California, and throughout the United States, rural communities experience health disparities that are tied to a lack of healthcare services. It is much more difficult to recruit providers to practice in rural areas – something we know all too well based on the time it takes to fill open positions in Grass Valley. The goal of our new residency program is to attract doctors who want to make a difference in rural communities. They will get to experience the unique challenges and rewards of providing whole person primary healthcare to underserved populations in locations that do not have immediate access to large hospitals or a robust network of specialists. Our program will train highly skilled physicians who will learn from the Chapa-De team about the barriers faced by our patient population and who will develop the cultural competence to make a difference in Grass Valley and other similar communities.”
Lisa Davies, CEO Chapa-De Indian Health
One of our many success stories. With the support of her Chapa-De Primary Care Provider and the Diabetes Program, Julie has lost over 30 pounds and is feeling more comfortable with herself.
Diabetes care and prevention continues to be one of Chapa-De’s core focuses. With many in the AI/AN community and wider community living with diabetes, our team of lifestyle coaches, registered nurses, registered dietitians, and program staff consistently strives to provide the best quality care and create new support systems for these patients.
In 2022, Chapa-De’s Diabetes Prevention Program (DPP) was recognized by the CDC for our outstanding quality and outcomes, receiving CDC Full Plus Recognition. This award is reserved for programs who meet very strict quality and outcome standards. Full Plus Recognition means our program had at least 60% of DPP participants finishing a whole year-long program and meeting the below criteria:
– At least 5% weight loss 12 months after the cohort began, or
– At least 4% weight loss and at least 150 minutes per week on average of physical activity reported 12 months after the cohort began, or
– At least a 0.2% reduction in baseline HbA1C (recorded within one year of enrollment).
The DPP Program is free and is proven to help patients avoid the onset of diabetes, to live healthier, and to feel better while doing the things they love.
Chapa-De Indian Health has a longstanding record of serving our community. In 1974, our founding mission was to address the lack of healthcare services for American Indians living in our area. We aimed to create a space for native individuals and their families to receive appropriate and welcoming care within the community. While our mission has expanded to offer care to more underserved neighbors, our first priority remains to deliver high-quality and culturally informed healthcare services to American Indian people.
Chapa-De continues to expand and grow throughout our region. New developments and renovations allow us more space to serve our patients. We are able to expand our team, facilities, and patient service areas. However, we prioritize honoring our foundation in all that we do. We acknowledge that Chapa-De is located on the traditional lands of the Nisenan, Miwok, and Maidu people. We look at the land’s history with gratitude and will honor the land and the Nisenan, Miwok, and Maidu people in the present and in the future.
Throughout all of our changes and growth, we remain committed to ensuring that American Indians feel comfortable and at-home in our health centers. Chapa-De offers a wide variety of free and low-cost services to verified American Indian patients. We know the importance of offering culturally competent care and are continually evolving to respond to the needs of our community.
One of the many ways we check-in with staff is through employee engagement opinion surveys. These surveys help us to stay in-tune with the needs of our team and communities.
With a score of 81, we are proud to share that Chapa-De has excellent employee engagement that is well above the industry average.
We are also happy to announce that approximately 90% of Chapa-De employees agree that we are fulfilling our mission and 9 out of 10 employees (91%) agree that Chapa-De is dedicated to providing high-quality care regardless of financial situation or ethnicity.
88% of our employees are also “very” or “extremely satisfied” with the benefits provided by Chapa-De, which is 31% higher compared to industry standards, and 90% of team members feel that Chapa-De responded very well or extremely well to the COVID-19 pandemic.
95% of our team members reported that they are proud to work at Chapa-De and over 90% of employees said their work was enjoyable, interesting, and contributed to the overall success of the organization. Furthermore, we met or exceeded healthcare industry and U.S. benchmarks on almost all measures in our survey. The feedback we gathered this year helps to provide us understanding on what works well and what we can improve on.
Thank You Chapa-De Team! We are so proud of these results. Our staff are the foundation of Chapa-De. We are so lucky to have such amazing and talented individuals come to work with us every day. No matter how difficult, stressful or trying, our employees are ready to make a difference in our patient’s lives.
In 2022, we were proud to welcome Alexandra Wilkins, FNP at our Grass Valley Health Center, where she provides adult and pediatric medical care.
Education: Received Master of Science in Nursing, University of Southern California
Board Certification: American Academy of Nurse Practitioners
Languages Spoken: English
Alexandra is proud to be a provider at Chapa-De and believes that all people, regardless of their financial position, are deserving of high-quality, compassionate care. She is happy to have the opportunity to work in a clinic that serves Native Americans and other underserved populations.
“I love to care for others. My goal in providing care is to meet the patient where they are and try to educate them in how to help themselves medically and non-medically. My hope is that my patients feel empowered to care for themselves.”
Alexandra Wilkins, FNP
We are always looking to hire highly-engaged individuals who have a passion for helping others. We offer competitive salaries above market rates, generous paid time off and robust career opportunities.
At Chapa-De, We believe that you should have time and energy to enjoy the people and activities that you love most. We very much value work-life balance, which drives us to ensure employees have manageable workload and schedules.
We update the Careers page of our website regularly with all open positions. Go to www.chapa-de.org/careers to learn more.
Chapa-De Board Chair
UAIC Tribal Member
Chapa-De Board Secretary
UAIC Tribal Member
Chapa-De Board Vice-Chair
UAIC Tribal Member
Chapa-De Board Member
UAIC Tribal Member
Chapa-De Board Member
UAIC Tribal Member
Chief Executive Officer
Chief Financial Officer
Chief Operations Officer
Chief Information Officer
Chief Administrative Officer
Behavioral Health Director
Director of Nursing
Director of Quality and Patient Engagement
Medical Practice Manager
Dental Practice Manager
Dental & Orthodontic Care
Behavioral Health Services
Prenatal Care & Baby Luv Program
Diabetes Prevention & Care
Phlebotomy / Lab Services
Medication Therapy Management