A Network Approach to Understanding Well Being and Growing Vital Conditions

Thriving Together North Central Washington, previously known as North Central Accountable Community of Health (NCACH), was formed in 2016 to improve the health and well-being of Chelan, Douglas, Grant, and Okanogan residents as the region’s designated Accountable Community of Health. When NCACH was formed, its top priorities were improving health care access and quality of care and reducing per capita health care costs in the region.

With the end of the Medicaid waiver approaching, the NCACH Board adopted a revised mission statement and launched a strategy workgroup. Building on the momentum of the Medicaid waiver, NCACH began to broaden its scope of work to focus on whole-person health and health equity for all residents of North Central Washington. In early 2023, their governing board voted to approve a new name for the organization, and NCACH became Thriving Together NCW (TTNCW) to serve as the backbone for a more engaged, network approach. The rebrand more accurately reflects the work and goal of all people and places thriving, with no exceptions.

About the region: The North Central Washington region comprises Okanagan, Chelan, Douglas, and Grant counties and the Confederated Tribes of the Colville Reservation. The area is primarily rural and covers 13,000 square miles, with a total population of just over 250,000.

What is an Accountable Community of Health?

An accountable community of health is a network of organizations—both health and human service providers collaborating to improve the health and well-being of Medicaid populations through innovative approaches and addressing root causes. With a “Medicaid Waiver,” these groups can direct funding toward non-clinical interventions, including whole-person health, upstream factors, and preventative care of the Medicaid population.

The TTNCW strategy workgroup evolved into a stewardship council, creating an ongoing forum for community leadership and voice in shaping a change model and future investments. In addition, a group of community partners were invited to serve as part of a data workgroup, focusing on understanding current community conditions and measuring progress over time. These efforts are funded through organizational investments seeded by the state Medicaid waiver program.

TTNCW staff in partnership with the stewardship council and data workgroup, and with support from Community Initiatives, is building a community network and moving into action together. They are leading through a regional change model that uses the following three change levers to build a future for thriving people and places.

1. Convene Diverse Partners for Shared Understanding, Learning, and Action

TTNCW recognizes that no single agency or program can meet all their region's intertwined social and health-related needs and believes that power grows when it is shared. In response, TTNCW began the work of facilitating the development of a regional “network of networks” known as the Thriving Together Network (Network). The Network is composed of dedicated individuals and organizations who live, work, serve, and invest in the North Central region. As a Network they are committed to investing in upstream solutions to complement the region’s existing urgent services infrastructure—things like urgent care clinics, food pantries, and homeless shelters. They recognize that urgent services alone cannot create well-being for those who call the region home.

The opportunity to collaborate brings together diverse perspectives, resources, and strengths that address complex challenges. The Network unites around a shared purpose and is fueled by a deep-seated belief in the power of collaboration to effect meaningful change.

As a Network, they believe:

Our interdependence makes us stronger. We know that we are all interconnected and that we can’t achieve everything we want by operating as if we’re separate islands. By developing a shared vision and working together, we can become stronger, smarter, and more resilient.
Our region is a place where everyone belongs. North Central Washington is home to diverse communities, including cities, small towns, and a sovereign nation. When we understand each other’s perspectives and interests, we create stronger connections and increase our ability to solve tough problems.
Our communities know best. We want to harness great insights and innovations from around the country but believe that the people in our region know best what’s working in their communities – and what needs to change.
Our region is full of stewards. Stewardship is about finding a purpose that is larger than yourself or your organization – it’s about thinking in terms of the whole community. We believe in distributing leadership, sharing resources, and developing the mutual trust that allows us to build a better future for everyone.

2. Measure and Track Well-Being

The Network uses the Vital Conditions Framework to make visible the systems that shape choice in community, seek multi-solving solutions, and guide resource distribution towards solutions that address root causes. This framework presents an actionable, asset-based approach and emphasizes the importance of building up vital conditions that enable communities to flourish. At the heart of the framework and the network’s approach is an emphasis on Belonging and Civic Muscle. By adopting this approach, the network aims to build resilience and sustainability in the region.

TTNCW has created seven online data dashboards powered by IP3 ASSESS embedded on their website to build a shared understanding of vital conditions in the region and to drive community transformation—each report is dedicated to one of seven vital conditions for wellbeing. These interactive dashboards feature key community data indicators alongside stories of community assets, voices, and solutions ready to be amplified. Learn More

Adopting the Vital Conditions framework also guides how the network identifies relevant indicators of community well-being and measures and tracks progress towards their goal of all people and places thriving, no exceptions.

The Network recently applied The Science of Thriving and administered the validated Well-being Survey in the region. This equips the Network to track and measure well-being at the individual level, as well as the community level through aggregated data. The use of these well-being measures provides an invaluable, highly responsive complement to community needs assessments, population health indicators, and other social determinants of health that can take years to see measurable change.

TTNCW partnered with over 50 organizations to administer over 2,700 surveys during the summer of 2024. The data showed that nearly half of all respondents were either suffering or struggling. These data are a catalyst for change and provide a baseline for measuring the Network’s progress over time. Survey findings shed light on community well-being and will be the topic of a series of upcoming community dialogues. Community members will have the opportunity to discuss survey results and share their lived experiences to illuminate the stories behind the numbers. The growing number of community relationships and shared understanding strengthens the region's belonging and civic muscle—setting the stage for meaningful change.

3. Identify and Advance Opportunities for Collective Action

The Network is growing and actively working to enhance regional capacity for collective action to improve vital conditions. TTNCW serves as the backbone for the Network and recently hosted its first all-Network convening: the Thriving Together Well-Being Summit (2024). Nearly 150 community partners gathered to learn, connect, and build thriving communities. The purpose of the summit was to create and share space for the emerging Network to connect, learn, and discover opportunities for shared action, with an emphasis on building belonging and civic muscle.

The outcomes for Network partners included:

Deepening a shared understanding of the Thriving Together approach (Vital Conditions Framework and shared stewardship practices)
Share the results of the well-being survey and make meaning of emerging patterns
Build capacity for shared stewardship skills and practices
Begin to shape a living vision and collective interests for moving into 2025
Build a diverse network of individuals and organizations with a strong sense of community

Over the course of the day, Network members had the opportunity to understand what meaningful engagement with the Confederated Tribes of the Colville Reservation could look like. The Network heard about building a movement for thriving together, powered by a network from a fellow Washington ACH—North Sound ACH. They dove into the results of the regional well-being survey and conducted dialogue in small groups about belonging, multi-solving, stewardship, and data and story. The Network ended the day with a World Cafe exercise that allowed participants to imagine what was possible together and to name starting points for 2025.

Among the priorities lifted up was the interest in an ongoing tribal learning journey, energy around hosting community dialogues, creating spaces and practices for growing belonging and civic muscle, and multi-solving around food and mental health.

By connecting across local efforts and identifying shared priorities, the Network is building a foundation for sustainable, regional actions that strengthen community well-being. The Network has also identified agreed-upon success measures:

We will know we are living into our values and making a difference as a network when:

All community members see welcoming paths and accessible resources that enable them to lead their best possible lives.
Groups that have been confined to the margins feel that they belong, that their contributions are valued, and that they are shaping the decisions that affect them.
Partners from different sectors and backgrounds are no longer surprised to be in a meeting together. They understand each other’s perspectives, where they differ, and what they have in common.
Organizations integrate thriving into institutional practices – caring for their staff and the communities they serve and shifting internal culture to prioritize partnership and collaboration.
Local leaders bring questions to Network tables, knowing that the people there are the right ones to engage in co-creating programs and advocacy agendas together.

The story of Thriving Together NCW and their regional network of partners is one that is both still evolving and leading the way. As the partners leverage a shared framework, practice stewardship, center relationships, and seek opportunities for multi-solving, they build civic muscle and resilience for meeting their highest goal of all people and places thriving, with no exceptions. Explore the resources below to learn more about the tools and practices of the Thriving Together Network.