In this special crossover episode with "In the Arena with NOW " from Vital Village Networks, we explore how the Petaluma Health Center team in Point Reyes and Bolinas is reshaping healthcare with a dignity-centered approach. We're joined by guests, Judith Bravo and Christina Gomez-Mira, as they share their journey of fostering equity, trust, and connection within their clinic and community through their work in CCI’s Resilient Beginnings Network.
In this Health Pilots x In the Arena with NOW crossover episode, we dive into the transformative work of Petaluma Health Center’s Point Reyes and Bolinas sites. Joined by Judith Bravo and Christina Gomez-Mira, this conversation unpacks their participation in CCI’s Resilient Beginnings Network and their collaboration with Vital Village Networks.
Together, they reflect on what it takes to build a more equitable, trauma-informed healthcare space—not just for patients, but also for staff. From addressing power dynamics within the clinic to deepening engagement with their rural Latino community, they share key moments of growth, learning, and challenge.
Some key themes discussed in this episode:
✔️ Defining dignity-centered care – What does it mean in practice?
✔️ Overcoming internal inequities – Navigating power dynamics and fostering a culture of mutual respect.
✔️ Building trust in historically underserved communities – Strengthening relationships with Latino agricultural workers.
✔️ Small changes, big impact – How small, collective actions are reshaping clinic culture.
🔗 Resources & Links:
💡 Listen and subscribe to In the Arena with NOW for more community-centered conversations
💡 Subscribe to Health Pilots on Apple Podcasts, Spotify, or wherever you listen!
___
🎙Podcast production services by Wayfare Recording Company
© 2025 Center for Care Innovations. All Rights Reserved.
Episode 57 teaser // Christina Gomez-Mira (guest):
If we're going to do equity work that has to span across all of the spaces that we are in — so that if we're going to work on equity, we want to try to address inequities within our community, it doesn't feel authentic to be doing that without even talking about the inequities within our own clinic, in our own— the walls of our clinic.
Health Pilots podcast intro:
Welcome to the Health Pilots podcast presented by the Center for Care Innovations. This podcast is about strengthening the health and well-being of historically underinvested communities. Every episode offers new ideas and practical advice that you can apply today!
Episode 57 intro // special crossover episode with Vital Village Networks:
We’re bringing to you a special crossover and collaboration with Center for Care Innovations’ Health Pilots podcast and In the Arena with NOW, a podcast hosted by the Networks of Opportunity for Child Wellbeing, powered by Vital Village. Stay tuned at the end of the episode for info on where to subscribe and get connected!
This episode features Ronda Alexander of the In the Arena podcast. Ronda serves as director of national partnerships at Vital Village Networks, who have been instrumental in facilitating the trauma and resilience informed journeys, partnering with pediatric care teams in CCI’s Resilient Beginnings programming. Vital Village uses a trauma-informed lens to support systems alignment and collaboration across community-based early childhood health and education efforts.
We’re excited to welcome Judith Bravo and Christina Gomez-Mira of Petaluma Health Center, who were also guests in a previous Health Pilots episode entitled, “Inherent Resilience, Shared Commitment: The Collective Strides Towards Healing and Equity.”
It was through CCI’s Resilient Beginnings Network that this care team at Petaluma Health collaborated and collectively learned with Vital Village -- and in this episode, you’ll get to listen in on the lessons, reflections, and deep learnings that emerged from this cross-sector partnership.
I’ll pass it on to Ronda to get it started.
Ronda Alexander (host), Vital Village Networks:
For our listeners, my name is Ronda Alexander. I serve as the director of national partners or national partnerships with Vital Village Networks. Vital Village Networks is an organization or collective of folks working here in the Boston, Massachusetts area, but also nationally focused on health equity and child wellbeing.
And so I'd love for each of you, uh, to tell us, introduce yourselves and tell us a little bit about your healthcare center and the community that you're a part of and that you serve.
Judith Bravo (guest), Petaluma Health Center:
My name is Judith. I am the patient navigator, for Petaluma Health Center at the Point Reyes and Bolinas sites. I've been here 6 and a half years — about 6 and a half years — and I serve everyone, every one of our patients, but mostly our Latino and Spanish speaking patients, or our underserved populations here in Point Reyes really try to bring equitable health care along with Christina to our patients who really, really need it— to everyone, but especially to those who really, really need it.
Christina Gomez-Mira (guest), Petaluma Health Center:
I'm Christina Gomez-Mira. I'm first and foremost, a primary care provider out in West Marin, and the medical director of our Point Reyes and Bolinas sites. I've been there about four years. And like Judith said, we're an FQHC, Federally Qualified Health Center, in an area called West Marin, which is a rural area along the northern California coast.
Even though we're about 60 miles from San Francisco, we still are rural. We call ourselves, we say it's over the hill to go anywhere. You know, outside of our area, so we face the same barriers that a lot of rural areas face, like transportation, lack of transportation, lack of affordable food, serious lack of housing.
We have a large agricultural sector, that's mostly Latino, and that's where, Judith was referring to our Latino community that we've been reaching out to, and she's been essential and so important in connecting with the community that works on the ranches out in the area that we've been trying to connect with more.
Ronda:
This team in Point Reyes and Bolinas, and you all have to let me know if I mispronounce anything, have been a part of the Center for Care Innovations (CCI) Resilient Beginnings Network — this learning program dedicated to advancing pediatric care delivery models that are trauma and resilience informed. Vital Village Networks was engaged through this learning program as both partners and faculty. So that's just a little bit about how we were connected and how we've come together.
When we began working together in the spring of 2024 the Point Reyes and Bolinas Health Center team was really hoping to get more of some targeted technical assistance and support.
What were some of the things that you were working towards? What did you want to get out of out of what we were doing together?
Judith:
We were trying to get a common understanding between the staff what exactly it means to be an equitable health care centered clinic— get a common understanding as well as maybe find what works, what that means to each one of us and how to really apply it to our everyday routines. So, dignified and equitable health care towards our staff, care towards our staff and general care, and then also to our community members, our patients who come in.
Christina:
So when we first started working with the Resilient Beginnings Network grant and introducing trauma informed care to our clinic site, we were at the end of the COVID pandemic; we’d just gone through a merger with the Petaluma Health Center.
So these were two very big changes that greatly impacted our staff, our patients and our communities. So we were, first of all, had to take time to heal from this and to start to define who we wanted to be as a group, which also meant letting go of who we were, which was hard for some and creating a new culture and a new definition of, who we were as a clinic, and I think at the same time we were also defining who our community was and who we served, you know, and when we said who are, we serve our community - “were we truly serving all of our community?” And, “who weren't we serving?” So, that was sort of the context of what we started with and we learned that there were different understandings and definitions of what “equity” means, different commitments to becoming a trauma-informed healing organization, and different commitments to anti-racism and equity. And so, another big moment came as we started to reach out to our Latino community who had not historically engaged with our clinic, and along with Judith, we connected with some of the ranches where our Latino patients lived. We went out, we visited them, we saw firsthand some of the deplorable housing conditions they were living in. At the same time, the county investigated, found sewage and petroleum products in the soil. And so, we brought all this back to our clinic, which surfaced a lot of complex feelings, biases, tensions among staff.
And that's where I think what, in reference to what Judith was saying, highlighted the need to better understand what it means to engage in trauma informed equity work. And also highlighted some internal tensions amongst our different departments, you know, where we have, um, power dynamics, different power dynamics, internal inequities, communication barriers that have kind of distanced our group.
So, I think that's the time that you guys came in, Ronda. And honestly, I don't think we were super clear on where we wanted to go! I feel like you came in and we were like, “Ooh, this is not where we imagined we were going to be, but this is where we're at,” and sort of felt like we couldn't, we couldn't actually work on trauma informed care or becoming an anti-racist, resilient entity without addressing those things, or at least trying to. So, I feel like you all took all that in, and then synthesized that, and kind of realized that we needed a little bit of healing, and a little bit of starting from a common place, which, which is where I think, where it was born, the idea of dignity-centered care.
Ronda:
And I think that sort of leads into my question around like, what were your hopes for not only how you wanted to show up for one another within the health center, but also for how you wanted to show up for the community that you were a part of.
Christina:
I think just the basics, I think what Judith was saying, starting from a place of respect amongst our different departments and teams, and open communication.Personally, I, or not personally, but I, you know, I think our RBN, Resilient Beginnings Network, group really had hopes - have hopes - that we can build a shared understanding and commitment of what equity means, of anti-racism, especially in the context of our community and then equities that are present there.
Judith:
I have to agree with Christina. I am, there has to be, you know, a shared I guess, respect for one another, understanding each other's roles, each other's responsibilities — what I'm trying to say is having a sort of understanding so that there's no power dynamics here. It doesn't feel awkward having to ask someone else to do something for you because you know that they're your coworker, they're your equal and they're going to be equally happy to help you as you would be happy to help them.
I think there has to be an understanding of what our patients go through individually as well. Not necessarily knowing exactly everything that they go through, but just having an understanding that they're humans too, that they go through things just like we do and having a shared empathy for each other.
Ronda:
Yeah, I think that's so powerful Judith. I think you said it beautifully, right? That we're leveling these power dynamics and that there's a sense of shared empathy. I think that was, that was super clear. So don't worry.
Christina:
Can I add to that, Ronda?
Ronda:
Yeah, go right ahead.
Christina:
I think also one of the things in - as we started to work in around our ACEs screening, our Adverse Childhood Events screening, I think there was not always an understanding of how, of the social factors that impact health, um, and how much they impact health.
And so, I think you've been sort of starting to have an understanding of how we are— how health isn't just the medical issues that a person's facing, but health includes like the social factors and the social environment in which a person is in. I think that was an important thing that we realized wasn't necessarily shared — we didn't have a shared understanding of that, or that we wanted to create a shared understanding of that.
Ronda:
Yeah, that makes a lot of sense. Yeah. So after, we had some conversations about that— I mean, I think that's really the first part of our work, and working together and our approach, coming from Vital Village Networks is really understanding, one: “Who are you as a community? Who are you aiming to serve?” And, “what are your hopes for yourselves and for the community?” And, “how do you want to be in relationship together?” So that was huge and really important for us. And it may have seemed like we spent a lot of time doing that, but I think that was really important for us to understand you all and understand your community.
And so, after we had a few conversations, we decided, to do a virtual workshop, sort of introducing the broader Point Reyes and Bolinas Health Center team to the Dignity Framework, a tool that we had also shared during the Resilient Beginnings Network program. So we did this virtual workshop and then we followed that up with an in-person retreat several weeks later. And the central theme of that retreat was, “What does it look like to show up for each other and our patients with dignity?” And so I'm going to ask you to take a minute, take a couple of seconds. You might want to close your eyes or whatever feels comfortable to sort of go back to that place...
What do you remember most when you think back on the virtual workshop and retreat, right? What images come to mind when you think about those time, that, that time together, um, for yourselves?
Christina:
Honestly, I think that I realized that was the first time I was in a room with all of our staff for that long and talking about things that were not just work related and that felt good. It felt like we were able to kind of see each other as more than just our different roles in our clinics, but as people, as colleagues — yeah, I felt like it was a space in which we could kind of just, sit back and get to know each other a little bit more in a way we never have time to in the context of our busy, rushed clinics, you know, so that was what I remember most.
I mean, I really appreciated our breakouts, and I feel like I got to have conversations with some of the medical assistants and, like, get to know things. And just understand each other, I think, in a different way than we just don't have time to. And I think, in reference back to what Judith was saying, it did-- it was a place in which I felt like we were able, we were creating something together equally, like as equal parts in that effort, and that felt really good and important.
Judith:
I noticed a lot of, even though we were in our breakout rooms, we were all, like, collectively working together, I think, for the first time, I don't know that I've seen and it wasn't exactly work-related or, you know, clinic-related, but more just us as a staff.
What comes to mind is just us when we had those giant, like, sticky notes on the wall, and Renee was asking us, I forgot exactly what we were talking about, but everyone was pitching in, you know, you heard from people who probably don't always feel comfortable speaking up. And so, that was, that's what's most memorable to me is just that we were all working together again even though we were in separate breakout groups we eventually, you know, it was towards the same goal. And, um, also the meditation— the meditation was really nice. The meditation and, um, kind of like “self-care five minutes” that we had, that was really nice. I think we need to do that as a staff more.
Christina:
Yeah, that was really nice. I had in one of our breakouts, I went for a walk with a staff member and we just had such a good talk and, and I, we got, I don't know, we kind of got down to, “what do you want— what do you want?” At the end, the staff member told me, “I want, I just want someone to ask me how I'm doing during the day.” And it was such a like revelatory moment where I thought, “gosh, we probably don't stop and ask each other: ‘how are you doing today?’” Um, so that's, that's a moment that I took with me, I remember.
Ronda:
Yeah, that's powerful. It sounds like there was some real deep, like, human connection, right? It sounds like the word that's coming to mind, I'm hearing, is “connection.” What elements felt the most useful, right? I think you've started to surface some of those, but, I guess what I'm wondering is what have been some, some bright spots since the workshop and retreat?
Or what had been some wins that, that you all have been proud of that you've been able to implement since, since that time together back in the summer of 2024.
Judith:
I think one of our goals was getting everyone here on time and getting our day started on time so that nobody else, I guess, gets behind on their day. And so I think we've all gotten better at being at huddle at 8:30, and giving our announcements, and getting our day started on the right foot.
Christina:
So I think for me, it's a small things and I'm seeing that like, um, Maria Romo in the front office bought a, a tea thing, like a, to put tea with cups and different types of tea in, in the waiting room.
Patients have loved that. And it's a small little thing, a small, it was an idea that we came up, that was came up, um, collectively within the retreat, and it's just one little touch that has made a difference. One of the things, I think people, even in the way we're coming up with ideas, it feels like there's more of a collective approach. One example is some of the funds that we have with the RBN, I just put it out there for, we just put it out there for any suggestions that people had to make our space in the clinic more inclusive and welcoming. And through that decision, someone threw out, “how about we paint a mural?” And then it came out that Alondra, one of the medical assistants, is a really talented artist.
And so then we got paints and now, um, Alondra's planning to paint a mural in one of the rooms. So that felt really exciting. Just like even the process of coming up with that felt more collective.
Ronda:
Yeah. I love that. And I think what I, one of the things I heard you say is like, it's not about the big things, right? It's, it's the small things and the little things that those are the building blocks. Those are the things that build community, that build relationship, that build trust.
Christina:
Can I add one other thing?
Ronda:
Absolutely.
Christina:
I think another one too, uh, you know, we, um, we sort of like never have time. We feel like we don't have time to add more meetings on, we always feel like we need more time to go over certain things, but we just don't have that. So one of the things that came up in the retreat was using our all-staff time in a different way.
And so, that's felt really big to me because we have two hours a month for our all-staff meetings, and it used to be more didactic presentations, updates, things like that. And now, what we did was we shifted to maybe having half of the time back and then the rest having sort of an open freeform – each department share some of the things that are coming up for them, or maybe that they're working on. And then we've come up with solutions together, which has been really, I think, really incredible because we're small enough space and team to be able to work on those things together. And that's— yeah, like at the end of each meeting, we have sort of a list of some to-do's.
And then everybody gets to hear some of the things that are coming up for other departments that we wouldn't otherwise know. SoI've really loved that. I think that's been really impactful and, and... impactful having people feel like hopefully feel like they have more autonomy and sharing the things that are going on rather than just being talked at during a meeting.
Ronda:
I love this. This is, this is so powerful. One of the questions that's coming to mind for me is: how did working with Vital Village Networks, so how did working with Renee and I, challenge you all as a team? I think sometimes we, you know, we, we want to focus on all the good things. And that is really important, right? Focusing on the growth and the wins - and that is really important. And we want to keep that in mind, but also sometimes it's important to name, like, what are the blocks and the barriers? And so, I'm curious to know, like, where were you challenged? And perhaps, what are some blocks and barriers that have come up since our work together?
Judith:
I think we're still, as a team, as a staff, trying to figure out exactly what dignity-centered care means. There's just not a common understanding, I guess, and there's some - I don't want to say backlash, but hesitancy, from staff members.
Christina:
No, I think you're explaining really well. I mean, first, like, to go back to what, I feel like when we came, when you came to us, Ronda, we just were like, I don't know what we're, we just didn't know, I don't know, we, I think, we didn't have a clear idea of what— we knew what the problem was, but didn't really know how to wade through that or even get to a different place. And so, I feel like you all challenged us to, to sort of pull back and think about what we really need that help us see that we really needed to just start at the base of coming together with a shared, some sort of shared empathy --I liked the way you said that earlier, Judith. So I feel like that was, that was really where you challenged us because, because I don't think we that was clear to us at all. And I agree with Judith - I think that there's a tendency to see change as bad.
I think that's universal. And I think it's especially true of our clinic. And I have to recognize that, that I came into the, you know, I came into that space after a merger, after pandemic, after these big changes, you know, and so I say that with empathy for understanding why that was the case, but I think it's really like, our hopes is to understand to get to a place where change isn't bad — change can be good and change is important and change is essential. And I think we're still in that process.
And I think another big barrier that's always a barrier is the frenzy of primary care clinic, we're just rushing to see as many patients as we can because of the system that we have in place. And it just doesn't leave time, like I said earlier, to necessarily sit down and just ask the person next to us, “How are you doing?” Or to even check in with ourselves. So I think we're always up against that. And then I think, you know, as we continue to sort of understand the importance of addressing the inequities within our own clinic in order to even start to address inequities outside, like we face the barriers of structural racism that are embedded in our own medical system and our own clinic and the power dynamics and hierarchies that are built in that, that are hard to level.
—Like to bring back what Judith was saying earlier, trying to have everyone feel like they're equally valued in a part of the team is hard when these structures aren't built to recognize that.
Ronda:
I love the amount of growth and the learning that you all are having as a team. I know you all have begun to highlight this, I'm just curious to know sort of what new ideas or ways of thinking are starting to emerge about you yourselves or about the folks that you serve and how you want to work together and be in community together.
Christina:
I think, reflecting back to what Renee said that, that we have to take things slow, that it'll take time to create a trauma informed, anti-racist, inclusive space. And that's, I think that goes for in our clinic as well as in our community. And I think for me personally, reflecting on the fact that if we are going to work, if we're going to do equity work that has to span across all of the spaces that we are in — so that if we're going to work on equity, we want to try to address inequities within our community, it doesn't feel authentic to be doing that without even talking about the inequities within our own clinic, in our own — the walls of our clinic.
Ronda:
It sort of reminds me of, um, that a phrase or saying, and it, and it may come from the Bible. So forgive me as I'm not particularly religious at this point, but essentially like— “pay attention to what's happening in your own eye before you point out what's happening with somebody else.”
Or, you know, what Grace Lee Boggs also says it really well, “in order to heal the world, like you have to heal yourself.” And so sort of starting from within, and in order to serve your patients, to serve your community, uh, Christina, what I hear you saying is that you all also have to pay attention to how you all are taking care of one another.
Is that what I heard you saying?
Christina:
Yeah. That and also, um, what parts we play in these, like, systemic inequities or systems of oppression. I think for me personally as a white person, I'm very aware of that and constantly growing and learning. In a community that's predominantly, that's majority white community, and I think a majority – a community that would identify as progressive — it's helped me really understand how that can lead to sort of the idea of white exceptionalism, that we don't need to talk about race or that doesn't exist, when in fact it does everywhere, and especially exists within our community and some of the responses that have come about with the Latino community specifically, and that pertains to our work - that pertains to our work, and I don't think every, that's not, that's not always understood. I hope that we can get to a place where it’s understood how that, how intricately connected it is to what we do and want to do.
Ronda:
Well, my very last question for you all is, what's on the horizon for Point Reyes and Bolinas Health Center? What's the story that you want to be able to tell one, two, three years from now, about your health center, and how you show up in your community?
Judith:
I would like to continue to tell the story about how we started working, how we got those grants with RBN, and how we started working with Ronda and Renee - with you, Ronda, and Renee, and - keep working with both of you. Hopefully, in the next two to three years, we've come a longer way than we are now.
I hope that the clinic staff has more of an understanding, or more of a shared understanding of what our goal is as a clinic. What it means to be anti-racist and trauma-informed care, and a dignified place to work, and a place that serves dignified health care as well. I want to be able to provide more resources to our patients here, like Christina said, in the beginning, we are a very rural site, even though we're so close to San Francisco.
We are very rural. Our resources are limited, so, I hope that in 2 to 3 years, we have more resources available to our patients, to our community in general.
Christina:
I want to be able to say that we have open communication and respect and care for each other. That we have time and space for self-care or to feel cared for within our busy clinic. I think a shared sense of equity, which you absolutely highlighted.
A commitment to anti-racism. And an understanding - and a shared understanding - of what that is and I think a shared, I mean, if we're dreaming, shared advocacy — that like shared commitments and collective, like commitment to advocacy within our community, within our clinic. Again, always coming back to what Renee said - the small things - and just continuing to like appreciate and cherish the small steps, and see them lead to bigger— bigger changes and bigger collective commitments. More trust, more trust amongst— all of us.
Ronda:
I can't wait to see what you all are doing in the next year, two, three years. I can't wait. And I hope that we're absolutely still working together. You all are doing such amazing work. And I think working together and serving and supporting and caring for children and families and communities from every angle is, it's big work.
And even the small steps and the big - it takes a lot. So really appreciate our time together. I appreciate having the chance to work together and appreciate you all, in this conversation. So, thank you so much for joining me today.
Judith and Christina:
Thank you.
Episode 57 outro:
Thank you for listening to this special crossover episode, a collaboration of the Center for Care Innovations and Vital Village Networks. Special thanks to Wayfare Recording Company for editing and production services.
For more information about the Health Pilots podcast and the Center for Care Innovations, to see what’s in store for programming, upcoming events, and funding opportunities – visit careinnovations.org
To learn more about Vital Village Networks, check out vitalvillage.org, and be sure to listen in on more of the In the Arena podcast featuring community leaders who are centering healing, power sharing, and narrative change in their advocacy efforts to create thriving, healthy communities.
Subscribe to both podcasts on Apple, Spotify, or wherever you listen to podcasts – and connect with us on our socials!
We appreciate you tuning in — catch you in the next one!