Angelica Arevalo of Brewster, Washington, has always been a go-getter. She earned her certified nurse assistant license, worked at a nursing home, and then moved on to a hospital. Along the way, she also secured a phlebotomy license. In 2014, she found a job at a local clinic and made sure management knew she was eager to learn new skills.
A year later, Arevalo grabbed the opportunity to apprentice at the clinic to become a medical assistant. However, the typically enterprising Arevalo was having a hard time. Her father, for whom she had been caring, had died and she was grieving. And she was stretched, juggling the demands of homework with caring for a young child.
But things have turned around for Arevalo. She successfully made it to medical assistant, and she’s also teaching and coaching new apprentices in the program she completed, known as InReach Career Pathways.
The apprenticeship program, in a clinic that provides healthcare to a low-income, diverse population, is one of several initiatives funded by the Siemens Foundation, the philanthropic arm of the German conglomerate Siemens, to bolster its work in health equity and workforce development.
“It was a beautiful grant for us, not only because of health equity,” Siemens Foundation Chief Executive Officer David Etzwiler told IP. “We know such clinics are understaffed. We know that building trust within community means having members working at the clinic from the community.”
Arevalo, who grew up in Brewster, says her own roots in the community make a difference, particularly for community members who are isolated and frequent the clinic even when they have no particular physical complaint. “There’s this one particular guy, he just likes to talk about his garden and what he’s growing in it, and he brings us food from it,” Arevalo said, ticking off a list of his offerings: cherries, apricots, tomatoes. “People like him just want some kind of interaction, and they need that for their mental health,” she said.
Funding through COVID
The Siemens Foundation’s health equity work sprung forward during the COVID-19 pandemic, at a time when clinics that receive federal funding and serve low-income populations were struggling. “We recognize such clinics are the backbone of our healthcare infrastructure, they serve populations who are greatly in need. And we just knew that government funding wasn’t coming fast enough,” Etzwiler said.
The foundation provided a total of $2.7 million in emergency grants to clinics around the country and funding toward COVID vaccination efforts in the first year of the pandemic.
It also gave $1,330,000 in grants to Choose Healthy Life, a nonprofit network of Black churches whose leadership includes Sen. Raphael Warnock and Rev. Al Sharpton. The grant helped the group develop a curriculum and train community health navigators about building trust regarding COVID vaccines and healthcare. As one reverend put it, said Etzwiler, “We are a paranoid community, and we have every reason to be.” (The Tuskegee study is a prime example of why there’s such mistrust among African Americans. During the decades-long experiment, researchers lied to Black men with syphilis, luring them into the study with the false promise of treatment, which they never received, resulting in the deaths of many.)
The foundation has also provided $1,530,000 in grants to the National Alliance for Hispanic Health in support of health equity work around COVID testing and vaccination, as well as a program to promote exercise.
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“It’s a floor to a career, not a ceiling”
With the worst of the pandemic in the past, the Siemens Foundation kept up its focus on clinics in underserved areas. A multi-year grant of $2.35 million issued in 2023 to the Washington Association of Community Health (WACH), which oversees the InReach Career Pathways program, has allowed it to build a coaching program for apprentices, which is part of Arevalo’s job now, and to expand into other states, according to WACH’s Director of Career Pathways Alyssa Burgess.
Because it’s on-the-job training, the InReach program also freed apprentices from the need to seek additional training at a community college. “Some of our health centers are in such rural areas that they don’t even have a local college that trains medical assistants,” Burgess said. The Siemens Foundation grant has also supported a $200 stipend for apprentices that can be used to travel to an offsite lesson and pay for child care.
Some 1,200 people have been trained as medical assistants and dental assistants since InReach’s 2014 launch by WACH, after state-level certification requirements changed, requiring medical assistants to receive additional training, according to Burgess.
Beyond building trust in underserved communities, Etzwiler says, roles like Arevalo’s with InReach tap into what the Siemens Foundation believes is essential to a democracy: addressing wealth disparities with jobs that provide living wages. “It’s a floor to a career, not a ceiling, and those dollars are spent, by and large, back in the communities from which they were generated,” he said. The average starting hourly wage for a medical assistant this year is $20.54, according to data provided by WACH. That is $4.26 more an hour than the state’s minimum wage.
Human decency, pandemic lessons
Arevalo said she has been able to carry forward the kind of support that helped her navigate through a trying time. She described an apprentice she worked with recently who struggled with a learning disability. “She would be in tears sometimes because she was afraid she wasn’t going to pass the test,” Arevalo said. She’d bring her kids over to Arevalo’s house and Arevalo would help her review the material. “I always told her, ‘You know the material. It just takes you a little bit longer to process things, but you’ll do fine.’”
The woman passed the medical assistant test. “Afterwards, she cried and said, ‘I’m so grateful that I had you to work with,’” Arevalo recalled.
For the Siemens Foundation, the InReach program represents a map of how it sees health equity and workforce development working in tandem and scaling up. With the foundation’s support, InReach has expanded to 80 employers in Washington, Oregon, Idaho and Montana. WACH has plans to expand the program further.
Siemens Foundation’s Etzwiler said that its work in this area comes down to human decency, but there are also lessons to be learned from the pandemic. “What happens when you don’t have a healthcare system that is shored up and ready to respond to the big healthcare needs of the day? And if we think [COVID is] one and done, we ought to be thinking again about that.”
“Even if you have a stone-cold heart, you have to understand this is the best path forward for the country to invest in each other, to take care of the overall health of the country, to think about folks earning a living and paying taxes, as opposed to the opposite,” he said. “Understanding that if you train folks in one sector, that means that there are more opportunities to train folks in other sectors, as well.”
