Alumna Took Unorthodox Path to Leading Local Health Care Staple

Alumna Took Unorthodox Path to Leading Local Health Care Staple

By Brian Hiro

An error occurred while preparing your download

Michelle Gonzalez was a Cal State San Marcos student only about a month away from graduating in 2003 when she started working for an organization then called North County Health Services.

Her degree (communication) was unrelated to health care, and Gonzalez had no intention of staying in the field. The main appeal of the job was that it was close to her home and the university.

Beginning her journey as a program assistant in an entry-level role, Gonzalez quickly developed a fondness for the local nonprofit and its high-minded mission: providing quality health care and wellness services to underserved communities, regardless of income or insurance status. Her early connection to community health mirrored CSUSM's commitment to accelerating social mobility through leaders who serve with purpose.

What Gonzalez imagined to be a brief pit stop instead turned into a rewarding career, and over two decades, she climbed the rungs all the way to the top - she was appointed president and CEO in 2020, the same year that North County Health Services was reborn as TrueCare.

With Gonzalez at the helm, TrueCarehas expanded into a regional force with 21 health centers and five women, infants and children (WIC) locations, covering a footprint of more than 42 miles, from Encinitas to Ramona. Her leadership has driven key advancements, including the opening of new health centers, expansion of the mobile fleet and specialty services, implementation of an advanced electronic health record system, rebrand of the organization, and launch of a successful doula program supported by a $2 million federal grant.

Question: This year marks the five-year anniversary of you becoming the leader of TrueCare. What does that milestone mean to you?

Michelle Gonzalez: I think it's a reminder of how quickly time flies and how quickly things can change and evolve. It's hard to remember that we were in this worldwide pandemic. It feels like it's been a couple lifetimes. We've had a lot of growth for the organization, and I think at this five-year mark, it just underscores how resilient we are, how much people matter at the core of everything we do - whether it's providers, whether it's patients, whether it's the community, our staff. It's a culmination of the strength of the organization and everything that we've accomplished, which is a lot in the last five years.

Q: How would you sum up the growth and changes that have occurred since 2020?

MG: We've expanded our footprint. We've opened new sites, we've added new service lines, we've added acupuncture, we've added podiatry. We've really stabilized our workforce during a time of a lot of shortages and uncertainty. I'm proud of the fact that our provider retention rate is over 90%. We continue to hire at an accelerated pace, and I start there because everything we do, all the growth and all the accomplishments, it always starts with people. Without a solid workforce, we wouldn't be able to achieve anything.

Our patient population has grown significantly as well. We had a slight decrease post-COVID, but we're back up to almost 70,000 patients. We've rendered more than 350,000 visits in this last year. Our workforce continues to grow. We're over 800 employees now and close to 160 providers. And then our budget has grown significantly, by almost $55 million in the last five years. We've tripled our mobile fleet. In all the areas of the business that you would expect to continue to progress, we're not only progressing, but we're thriving.

An error occurred while preparing your download

Q: How did your appointment as CEO come about?

MG: My predecessor went on a leave of absence in January 2020. The board asked me if I would be willing to step in on an interim basis. They were initially planning to do a national search, which I was fully supportive of. I didn't have any aspirations to be a CEO. I sometimes say I'm an accidental CEO. I was working in that interim capacity for several months, and then COVID made its presence known and we had the stay-at-home order. By April, the board had unanimously appointed me to maintain the position full term. After a lot of conversation and some prayer and reflection, I decided to pursue the position, and it's been a fantastic journey, in large part because I have such a great team around me.

Q: What was the biggest challenge in taking over just as the pandemic was heating up?

MG: There was so much uncertainty and fear. At one point, we had to close more than half of our clinics, probably 75-80% of our sites, we had to furlough staff. You think you can sort of ease in to becoming a CEO. There was no ease-in period. I remember talking with colleagues in the industry and saying, "How are you handling this? What are you doing?" And I realized very quickly that there's no playbook and everybody was truly figuring it out as they went along. Very early on, I made a conscious decision that I would be the type of leader who was always grounded and surrounded by strong advisers. We offer health care, but I'm not a clinician, so I made certain that we had strong clinical leadership on our team. It was about trying to understand what was unfolding in the world around us and how TrueCare plays an important part and ensuring that we were keeping our workforce intact. We're back on track now, but it was an incredibly stressful time.

Q: How did TrueCare pivot during that time and how does the organization look different now than it did in 2020?

MG: Before the pandemic started, we had pieces of a telehealth or virtual health program. We realized very quickly that it would be crucial to continue to offer services to patients. For many patients, we are their lifeline, and cutting off their health care was not an option. So we were able to stand up a virtual health program in three days. It started off with telehealth visits and as soon as we were able to, we migrated to a video visit platform. We essentially worked around the clock to make sure that we didn't cut off access for patients, but it also gave employees a sense of purpose. And we've continued to build on that virtual health program while staying true to the traditional methods that you would expect to render medicine.

We also had to pivot when it came to figuring out what our workforce was going to look like. We had to put people on furlough, but we made sure they still got a salary. We really believed that we needed to take care of our people, and a lot of funding from the federal government helped to shore us up. We laid off less than 15 individuals, and we were able to provide them with a severance so that they landed on their feet. I'm proud of that.

An error occurred while preparing your download

Q: How would you characterize the change in you that turned TrueCare from a short-term job to more of a calling?

MG: What I found was that people who worked here were very connected to the mission. They weren't here for the money. They were here because they cared about the people and patients that we were serving. The more I learned about the organization, the more in love I became with it and the more I realized, "My gosh, we have to make sure more individuals in the community and more community-based organizations know about what we do because there are so many people in need."

There was a misconception about people who were accessing care at community health centers, that they deserved less or they were just poor. I discovered that these are individuals who work very hard and who don't understand the importance of preventative care, and a lot of times don't feel like they're worthy of having access to care. What became a cornerstone of the work I did early on, and has carried on throughout my time here, is making sure everybody understands that access to health care is a right, not a privilege, and we don't care about your walk of life, where you come from or your circumstance. We want to make sure we help everyone who walks through our doors to the very best of our ability.

Q: Tell me about your background.

MG: I was born in Virginia, which is where my father is from. My mother is from Guam, and my parents met there while my dad was in the military. I'm half-Chamorro and half-white, and my husband is Mexican. We were childhood sweethearts who met when I was 12 and he was 14. I've had a lot of exposure to his family and culture over the years, and I think that's something that has benefited me very well. Though I'm not Mexican, I'm not Latina, I have such an appreciation for the culture and the people who we serve, which is the predominant background of our patients.

My family traveled a lot while my dad was in the service. We moved to Vista when I was in third grade, and I've lived in North County pretty much my whole life. I'm also the youngest of seven children and the first in my family to go to college. So I'm a first-generation college graduate.

Q: Did your parents not encourage college among your siblings?

MG: We came from very humble beginnings, and I don't think we always understood that college was something within reach. My parents did the best they could to work and provide for us, but it was really the mindset of, you go to school and you get a good job. But my mom would say to me, "You're too smart, Michelle. You need to think about college." I told her we couldn't afford college, but she said we'll figure it out, we'll find a way. For most of the time that I was a student, I worked two jobs to put myself through school. I was also an AmeriCorps member, so I was able to receive a grant. But none of it came easy and none of it was without sacrifice or hard work - not just for me, but those around me who supported me.

An error occurred while preparing your download

Q: What I'm hearing is a story of social mobility.

MG: Oh, one thousand percent. I think that's why Cal State San Marcos and TrueCare are such great partners. We see health care as a right, not a privilege, and we think it's fundamental and foundational to everything. I think it ties in beautifully with social mobility. And there's so much good that is happening at Cal State San Marcos. There's a lot that we do together, and social mobility is a big part of that.

Q: One of the main areas in which TrueCare and CSUSM have partnered in recent years is mobile health clinics. How did that come about?

MG: Once I became CEO and started serving on the University Council, I learned about CSUSM's interest in having a mobile health unit. I connected with (nursing lecturer) Matt Mincey early on and said, "You don't have to go on this journey alone. We have mobile clinics. We're right here, let's partner, let's figure out how to do this together." What started out small has expanded into working not just with the mobile team, but also with the School of Nursing, public health, the entire College of Education, Health and Human Services. It's a great opportunity to give exposure to students and help them understand that health care doesn't just come in a traditional hospital setting, that there's this whole other life of community health. There's a ton of overlap where our interests align nicely with what CSUSM is doing. We go to the same community events, and CSUSM students are able to do outreach, blood pressure screenings, things of that nature. Then, as they move farther along in their studies, when appropriate, they're also able to do internships at TrueCare.

Q: How would you summarize TrueCare's model in terms of providing health care?

MG: One of the things I want to emphasize is that TrueCare will not refuse services to anyone regardless of their ability to pay. What we're focused on is the individual and the family who presents and what services you need, and how we can either provide those directly or connect you with somebody who offers them. At TrueCare, we provide high-quality, compassionate care. Like we always say, "Health inside, welcome in!"

Q: That seems like such a valuable service in the community - health care you don't have to pay for.

MG: In today's day and age, it sounds like something very novel. Does that really exist? And the reality is that it does. When you believe in your core that health care is a right and not a privilege, you fight to make that a reality. And that's what we're doing. We're growing in all possible ways and we're maximizing wherever we can, in terms of the revenue we're able to generate. We take that and we pour it right back into the organization so that we can continue to expand our footprint. We put a lot of emphasis on making sure we can get people enrolled in coverage because we know that if you have coverage, that's a reduced barrier and you're more likely to access health care. But that's not the only barrier you will have to face and figure out. We also spend a lot of time and resources and energy in cultivating a fantastic culture internally. We believe that people who are joyful at work are more likely to do a better job and will pour that energy back into our patients and community. We make it a priority to care for our workforce, to really give them opportunities to advance, to grow and level up. What we find more and more often is that our patients are a direct reflection of our staff, and our staff is a direct reflection of our patients. Pouring into one is pouring into the other, and we're proud of that because health care is daunting - not just for the patient in terms of navigating, but it's also really hard work. One of our VPs many years ago said, "Michelle, we do noble work." And I was like, "Yeah, this is noble work." That's exactly what we do.

Media Contact

Brian Hiro, Communications Specialist

[email protected] | Office: 760-750-7306