A Letter from the CEO
2025 was a year of historic change in the US by virtually any measuring stick. We at NWRPCA have been both deeply concerned by the magnitude of the challenges facing community health centers across the Pacific Northwest and so impressed by the extraordinary resilience, innovation, commitment and effectiveness demonstrated by our member organizations in addressing those challenges. Health centers are the backbone of primary care for over 2 million people in Washington, Oregon, Idaho, and Alaska—often in the most rural, underserved, and complex environments. This year tested that role, but it also reaffirmed the essential nature of our collective work.
The Nature of the Challenge
Health centers entered 2025 navigating a convergence of pressures—political, cultural, economic and technological--that strained systems and staff alike. Persistent workforce shortages—particularly among primary care clinicians, behavioral health providers, and dental professionals—continued to limit access and increase burnout. Rising operational costs, including wages, supplies, and technology investments, outpaced reimbursement growth, creating financial uncertainty for many health centers. And patient needs driven by housing instability, food insecurity, behavioral health crises, substance use disorders, and the ongoing impacts of climate-related events, such as wildfires, heat waves, and flooding, further exacerbated the situation, as did regulatory complexity, evolving payment models, and uncertainty around long-term federal and state funding.
NWRPCA’s Response and Strategic Direction
We at NWRPCA are proud that in the face of these challenges, we remained steadfast in our mission to strengthen community health centers and to advance health outcomes across the region. Guided by our Board-defined strategic priorities and despite these challenges, NWRPCA in 2025:
Looking Ahead
2026 promises to be as “fluid”, politically, culturally and economically, as the preceding year, with the path forward continuing to require uncommon adaptability, creativity, and courage. We know that the challenges facing community health centers are, in many ways, existential. We also know that in this crisis lies the opportunity to truly reimagine care delivery, strengthen community health systems, and advance health outcomes across the Pacific Northwest. We at NWRPCA remain deeply grateful to the health center leaders and staff who show up every day for their communities, to our partners who stand alongside us, and to our NWRPCA colleagues and board members whose dedication makes this work possible. We invite you to join us in addressing today’s challenges head-on in order to build a stronger and more effective community health system for tomorrow!
With deep appreciation,
Bruce Gray, CEO
Northwest Regional Primary Care Association
The Nature of the Challenge
Health centers entered 2025 navigating a convergence of pressures—political, cultural, economic and technological--that strained systems and staff alike. Persistent workforce shortages—particularly among primary care clinicians, behavioral health providers, and dental professionals—continued to limit access and increase burnout. Rising operational costs, including wages, supplies, and technology investments, outpaced reimbursement growth, creating financial uncertainty for many health centers. And patient needs driven by housing instability, food insecurity, behavioral health crises, substance use disorders, and the ongoing impacts of climate-related events, such as wildfires, heat waves, and flooding, further exacerbated the situation, as did regulatory complexity, evolving payment models, and uncertainty around long-term federal and state funding.
NWRPCA’s Response and Strategic Direction
We at NWRPCA are proud that in the face of these challenges, we remained steadfast in our mission to strengthen community health centers and to advance health outcomes across the region. Guided by our Board-defined strategic priorities and despite these challenges, NWRPCA in 2025:
- Provided high-impact training to health centers across the four-state region, reaching over 2,100 health center staff and board members through our three annual conferences and various webinar series. Through these convenings, NWRPCA created space for health centers to learn from one another, share solutions, and build regional partnerships. These connections are critical to sustaining innovation and collective impact across our diverse geography.
- Advanced regional and national advocacy efforts that helped protect and strengthen funding and policy support for community health centers. Specifically, NWRPCA staff convened forums with our federal and national partners advocating for sustainable funding, workforce investments, and policies that protect access to care for underserved communities. Our work ensured that health center priorities were clearly represented in policy discussions affecting Medicaid, Medicare, behavioral health integration, and emergency preparedness.
- Expanded workforce development and leadership programs, supporting emerging and established leaders in navigating change and complexity. NWRPCA’s entry-level and mid-level manager trainings supported 145 health center staff. Recognizing that people are the heart of health centers, NWRPCA’s workforce efforts, NWRPCA’s expanded workforce recruitment, retention, and leadership development initiatives helped health centers address burnout, strengthen leadership pipelines, and build more resilient care teams.
- Advancing health outcomes across all disadvantaged populations remained central to all our work. In 2025, through our Community Health Worker Institute, we provided training to nearly 400 CHWs, CHW supervisors and other key partners engaged in expanding care through innovative approaches outside the four-walls of the clinic. We also helped centers respond to climate-related health impacts and advance culturally responsive, community-driven care.
Looking Ahead
2026 promises to be as “fluid”, politically, culturally and economically, as the preceding year, with the path forward continuing to require uncommon adaptability, creativity, and courage. We know that the challenges facing community health centers are, in many ways, existential. We also know that in this crisis lies the opportunity to truly reimagine care delivery, strengthen community health systems, and advance health outcomes across the Pacific Northwest. We at NWRPCA remain deeply grateful to the health center leaders and staff who show up every day for their communities, to our partners who stand alongside us, and to our NWRPCA colleagues and board members whose dedication makes this work possible. We invite you to join us in addressing today’s challenges head-on in order to build a stronger and more effective community health system for tomorrow!
With deep appreciation,
Bruce Gray, CEO
Northwest Regional Primary Care Association
