JANESVILLE, WIS. –
HealthNet of Rock County, located in Janesville, Wisconsin, is a charitable clinic that provides free medical, dental, and behavioral health services to low-income residents in need throughout Rock County. Since HealthNet doesn’t rely on reimbursement, it’s at liberty to create unique and innovative new models of care for public health interventions.
In 1994, in response to a Salvation Army assessment indicating that healthcare was one of the least affordable commodities in Rock County, a nurse assembled volunteers – including her husband, a doctor – to hold informal clinics for low-income residents. Over time, the clinic has expanded to provide medications, primary care, chronic disease management, vision referrals, and dental services.
Now, it’s expanding again as the community comes together to lend a hand in creating the future of HealthNet. From local volunteers to corporate sponsors, it’s truly a team effort.
We spoke with Ian Hedges, the CEO of HealthNet of Rock County, to explore some of the ideas and plans driving the project forward. This conversation has been edited for clarity and length.
What are some of the most significant benefits provided by HealthNet of Rock County?
We have found that there is a huge need for healthcare for individuals living on the margins, because health affects everything. It affects whether or not you can interview for a job well. It affects whether you get that apartment or not. People make judgments based on your smile, and it is hard to get anything done when you’re in significant dental pain. What we do helps people lead healthy and productive lives and participate in the community.
How is your vision changing?
Our new vision is that everybody who walks through our doors is able to get most of their needs taken care of in one cohesive space, and they ultimately become healthier. It is a lofty goal, but in reality, the biggest issue in healthcare is fragmentation. Also, as an industry, we have had to focus so much on production that compassion is not always the cornerstone of healthcare as much as it used to be, when we know that compassion is a major factor on whether individuals reach optimal health.
We are essentially doubling our space. That includes doubling our pharmacy space and tripling our dental spaces. What we have found is that our staff and volunteers are so compassionate, and they need a space that also reflects that. We want a space that feels like it is well maintained. I also think the design and space in this new facility creates a calming effect for our patients, and they feel like everything is beautiful. It also reflects a biophilic nature component which has a calming and healing aspect to it.
Understanding the goal throughout the design was to create an ideal and equitable experience, how does the new space support trauma-informed care delivery?
To be trauma-informed means that people suffering from psychosis, people who often feel that they are not listened to or heard, and people who often feel that the world is falling apart around them should feel like there is a place that’s going to accept them no matter what. It means the space will be sensitive to their needs and reassures them their problems will be addressed.
For starters, we do that using soft color tones. Everything we are doing has a soothing element to it. Even in our carpet, when we were picking carpet squares, we did not want carpet squares with rough patterns or even geometric shapes because sometimes those can feel sharp, as though you have to fit within a pattern, and that’s not an image that we wanted to give our patients.
We do not use sharp fluorescent lighting; we use calm, cooling lighting, making sure that it is dimmable as well. We’re also bringing in natural aspects. The healing thing about nature is that it is a predictable space for a lot of us. We know that when we get fresh air, we feel better. We see different colors that are soothing to us. We understand what we are going to get when we touch natural surfaces. That predictability helps our patients not feel anxious.
How does HealthNet reflect the diversity of the Rock County community?
HealthNet strives to reflect the diversity of our patients in our work and our environment. We have a mural that’s coming together outside, and one of our goals was to make sure that it reflected different people in different life stages and also people of different racial backgrounds and different circumstances. We are doing it in a very unconventional way right now that is ultimately meant to ensure that no one is excluded. Discrimination and exclusion can be a source of trauma for many individuals, so providing inclusive space helps make our space more trauma-informed.
How does the design help foster a sense of safety for staff?
We were very intentional about creating space for private reflection and escape when they are not working. There’s space to decompress. They should know their workplace values them and is going to provide comfort if there is a situation in which they are uncomfortable.
How does it help patients feel a sense of agency?
For one thing, there’s a separate business entrance. Anybody who wants to come to do deliveries, give donations, or come here for a meeting needs to use our business entrance so the patients can be left alone and feel like business is not interfering with their ability to feel calm. That was a very intentional thing.
In terms of architectural design, one important element is the flooring, making sure people won’t slip and fall and also making sure it has a common element to it. We don’t want people to feel guilty if they cause a spill. Those types of issues definitely came up in the planning process.
We also spent a lot of time discussing what the receptionist desk should look like, how the entry is going to have more of a privacy interface or more soothing and be a welcoming space when a patient comes in. That is the patient’s first impression, and that is important, especially if they are scared or anxious. We also talked about privacy between the patients checking in and those who are waiting.
At this point, we are double-soundproofing everything, making it feel as if no one in the world is going to hear anything that the patients have to say. That is important because, ultimately, we as providers have to communicate what is happening. For our providers to have private discussions out on the floor, the patient should feel protected, like no one is going to listen in on them and no other activity is going to interfere with their care.
You mentioned biophilia, our innate love of the natural world, and incorporating it into the new clinic. How else does nature come into play?
The tone around our reception is going to look like it’s made of wood all around. It is a different color that kind of looks like different barks, different types of wood, and there is a forest pattern in the background. The behavioral health reception area is going to have a wavelike pattern, so it has a water element to it. Water is also reflected in our group-therapy space, where we have a table that almost looks like a wave or a little river. Then, above you is the artificial skylight so that at all times through the year, you feel like you see an open sky and trees poking out. I cannot wait to see it.
For the colors of our furniture, we wanted to make sure all the medical exam rooms had a healing element to them. The plan is that we have these vinyl colors that kind of have a gradient in each room to represent a theme such as compassion, serenity, healing, with a photo portrait of a flower, to add touches of purple, yellow, soft blues, and greens.
This is a project that brings together the whole community. How did ERDMAN and other community partners participate?
The generosity of our donors and community partners cannot be underestimated. As our pro-bono interior design partner, we know ERDMAN serves a lot of healthcare institutions and hospitals. I think it is very important that those institutions know that you designed a space that was customized for people who have a lot of experience with suffering. The architectural firm of Angus Young is doing their work at a heavy discount for us, just because they believe in the vision of what we are doing. Area hospitals have also contributed financially because they see this as an investment in their future as well.
Our community’s therapists are so invested in this idea of a behavioral health clinic for people in need that they are giving their own resources and time to build up our behavioral health clinic. One clinic is giving us their electronic health record software that they personally developed, and it’s incredibly useful.
The sides of the building that are not covered by the mural will be painted by volunteers from United Way Blackhawk Region.
The design goes above and beyond to reflect our vision and serve the needs of this community, and that reflects well on everyone involved.