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During the early 1980s, AIDS reared its ugly face in the Sacramento community, as it did in many other cities across the country. AIDS was a disease that ravaged communities that had been marginalized in America: gay men, injection drug users, sex workers, transgender women and African Americans.
Clearly, this disease needed to be addressed with a concerted effort. In 1989, our community joined forces to address the epidemic in a resounding way. Community advocates, along with the help of UC Davis Health Systems, CHW Mercy, Sutter Health and the County of Sacramento, formed the Center for AIDS Research, Education and Services (CARES) to serve people with HIV/AIDS. A few years later, Kaiser Permanente joined the effort. These early founders set the tone not only for who we were in 1989, but also for all the years to come.
While some doctors refused to care for those with AIDS, and a few politicians even advocated for quarantining people with HIV, CARES remained fearless of public opinion. We made our cause known in Sacramento and continuously advocated for compassion and increased services for our patients. Our model of care was envied by many in the HIV world as an innovative and practical solution that offered our patients everything under one roof. Services ranged from medical care to case management, from a full-service pharmacy to rental assistance, and from mental health care to nutrition counseling. CARES committed itself to having everything that someone with HIV would need to stay in care.
For more than two decades we have devoted ourselves to the cause and care of people with HIV/AIDS. These efforts often extended well beyond the walls of our facilities and beyond basic medical services. We enrolled people in research studies to help improve treatment of the deadly disease. We advocated for needle exchange programs as a preventive social service. We battled for social justice, supporting equality for everyone, regardless of their personal choices and behaviors. With our help, old wounds were healed between gay men and those in the religious community, and people were reconnected with the families that had previously rejected them. From the beginning, we were committed to the whole person, not just the snapshot of the person who showed up in an exam room.
We also did our best, and continue to do our best, to end new infections of HIV in our community. For example, CARES took over Sacramento County’s STD testing when the county could no longer afford to operate their clinics. We also led a five-year initiative to end HIV, known as Are You the Difference?, and when it expired, we started another long-term effort known as Zero Together. There is no question that CARES was the leader in HIV/AIDS care in the greater Sacramento area.
As HIV research and care progressed, those infected were assured that they could live a normal life span. What was once an epidemic, became a chronic disease. As an organization rooted in our community, it was essential that we continue to grow and change with it. This meant helping people manage their comorbidities, which often included substance abuse and mental health issues, as well as diabetes, high blood pressure, Hepatitis C, and asthma. We became primary care providers, treating the whole person, not just HIV.
With the passage of the Affordable Care Act, came our biggest change of all—opening our clinic to everyone in need of care, not just those living with HIV/AIDS. Because of the changes being made in healthcare, it became apparent that the funding we had relied upon for so many years was likely to decrease dramatically. We needed to become a federally qualified health center (FQHC).
In 2011, as part of the process to become an FQHC, we opened our doors to everyone and we now have more patients without HIV than we do with the disease. To mark that change we renamed ourselves Cares Community Health and in late 2017, changed our name to One Community Health.
This change expanded our reach in the community. With HIV, 4 out of 5 patients were men and all were over 18 years of age. Expanding our scope means we see many more women, women who may be struggling with domestic abuse or who need pre-natal care. We see young people, homeless teens, foster children, children who have experienced trauma, and kids who just have an earache. We see more seniors who suffer from multiple chronic diseases and need to move to assisted living. We added specialty care including podiatry, chiropractic, and gynecology. With these changes many more people of all ages have access to comprehensive, compassionate, respectful and empowering care.
The change in the disease status of our patients does not, nor will it ever, change our essential values. Whether CARES or One Community Health, our organization still pushes for equality for all and for social justice for those on the margins. Our doctors and health care professionals continue to treat people with compassion, without judgment for their personal choices and behavior. We still provide the same menu of services to everyone in need, and we continue to advocate for public awareness of such issues as the stigma surrounding mental illness and the need for healthcare for everyone.
Our expertise in cultural competency, especially related to sexual orientation and gender expression variance, continues to provide a safe haven for many. We understand the impact of trauma on one’s health and are working to help people heal those wounds. When we see suffering, we try to heal it whether it be an individual in pain or a group in our community.
At One Community Health, we understand that a person’s health is influenced by a variety of factors, including the environment in which they live, work, and play.
If a neighborhood is unsafe, getting outside to exercise may be a problem. If transportation doesn’t exist, getting to work can be an issue. Eating healthy can be impacted if the only nearby grocery store is a convenience store lacking in healthy affordable foods. If we as an organization and a community are serious about improving health outcomes, we have to look at everything that impacts a person’s ability to achieve a healthy life. Collectively, these issues and conditions are known as the social determinants of health. The solutions to these social determinants of health are not easy, but communities across the country are coming together to tackle them. One Community Health is committed to tackling these tough issues as well.
For nearly three decades, our passion and beliefs have not changed. If someone were to ask us why we do this work, our answer remains the same. Healthcare isn’t a privilege; it is a human right. Everyone must have the opportunity to achieve optimal health. Then as now, we’ve made it our job to help individuals and the community reduce the barriers to wellness.