Care. Systems. Practice.
Perspectives is a space for exploring the questions, lessons, and lived realities that shape the work of health equity. It brings together what I notice in systems, what I learn from people, and what it takes to turn care into practice. It examines whether our systems are truly built for the people they serve.
From that starting point, I write about the intersection of human behavior and organizational strategy: the place where intentions meet the structures that either support or undermine them. These reflections are part inquiry, part accountability, and an invitation to consider how change actually takes hold.
The Impact Canopy™ is part of that work. It uses available information to offer a practical look at how a healthcare initiative is showing its effect so far, with the understanding that the picture can change as more is learned. This direct view is applied across different initiatives to notice what is emerging and where added focus could help, particularly for the organizations and communities I support.
The Evaluation Scale
🌱 Emergent: The commitment or funding is in place, but the community impact is not yet felt based on what is currently known.
🌿 Ascending: The structure is coming together and progress is visible, but the benefit has not yet reached its intended depth or scale within the community.
🌳 Established: The system is steady, reliable, and doing what it promised. People can feel the difference in their daily lives, not just in plans or announcements.
Status: 🌱 Emergent
Image courtesy of Unsplash
News Reference: House Votes to Renew ACA Subsidies 🗳️
The start of a legislative session always brings a mix of emotions. This year, the feeling is especially layered. There is the nervousness that comes with renewal, and there is also a quiet spark of hope.
For so many families, programs like the enhanced ACA tax credits are not abstract policy choices. They are the difference between stability and uncertainty. When these programs approach an expiration date, the anxiety is real. It is the weight of wondering whether the care you rely on today will still be there tomorrow. Naming that fear is part of responsible stewardship.
Even in this uneasy moment, something meaningful is happening. Legislators from different backgrounds are choosing to work together in ways that put people first. This kind of movement is not about winning or losing. It is about recognizing that the lived experience of families should guide the decisions that shape their access to care. When leaders choose that path, they create more than policy. They create a sense of security.
The hope in this moment comes from the possibility of moving from an emergent state to something more reliable. Renewing these initiatives is not just a procedural step. It is a commitment to building a foundation that supports health equity for everyone. When accountability is paired with compassion, the trajectory of care can change for all of us.
Status: 🌿 Ascending
Image courtesy of WVTF / Radio IQ
News Reference: Patrick County hospital to reopen first week of January 🏥
The reopening of Stuart Community Hospital in Patrick County marks an important step forward for a region that has gone without a local source of care. On Monday, January 5th, the doors are expected to open again. For residents who have spent years traveling far for even basic services, this moment carries real weight. It is a milestone worth acknowledging.
The building provides the structure, but the community defines the work. They know what was lost and what must be rebuilt. A facility offers the location, but the neighbors give the health system its meaning.
As the doors open, the real strength lies in medical staff and neighbors coming together to build something different. When local voices and care teams guide the effort together, it becomes more than a place to receive treatment. It becomes a steady presence that offers trust, continuity, and peace of mind.
Status: 🌱 Emergent
Image courtesy of Unsplash
News Reference: CMS Announces $50 Billion in Awards to Strengthen Rural Health🏡
Virginia’s $189.5 million federal award from the Centers for Medicare & Medicaid Services is meaningful, and it deserves recognition. It is part of a broader investment to strengthen access, improve care coordination, and support the communities who have waited the longest for relief.
Funding is an essential first step, but the real impact is realized in how those resources reach the families who have lived with this absence. The caretakers, patients, and families who navigate these systems every day understand the realities better than anyone. Their experience is a necessary guide for the decisions ahead.
Sound strategy begins by understanding the perspective of those closest to the work. It means bringing counties into the conversation early, grounding plans in real needs, and giving the people on the ground the authority to lead. When we strengthen the voices in the community, the entire system becomes more capable and more resilient.
Status: 🌱 Emergent
Image courtesy of Unsplash
News Reference: 2026 Life Sciences and Health Care Industry Insights Report 🖥️
Deloitte’s recent analysis on virtual first care shows how quickly digital models are expanding, especially in rural areas where distance often makes care hard to reach. Technology has its place, but no tool can replace the trust that comes from being in the room with someone who is caring for you.
As organizations adopt virtual care to meet new demands, the challenge is ensuring these digital frameworks support the human connection at the heart of the system. A screen can help people connect, but it cannot offer the reassurance of an in person conversation or the understanding that comes from true presence.
Innovation should make it easier for patients to reach their providers, not create more separation. For families facing complex health journeys, that physical connection is what builds a real safety net. The guiding question stays simple: does this strengthen the relationship between the patient and the care team?
About the Author: Donna Harvin-Graham is the Architect of Accountability™. Her work brings systems and care into alignment, shaped by an MBA from the College of William & Mary and a BS in Psychology from Pennsylvania State University.