Gratitude for the Leaders Who Are Holding Communities Together

This year, I have been thinking a great deal about what it means to lead during hard times and what it means to support the people who shoulder that responsibility every day. Community health center CEOs and senior leaders are carrying an extraordinary load. The federal changes that took effect this fall did not simply alter guidelines. They sent shockwaves through the safety net. Families lost food assistance. Essential benefits tightened. Community health centers were left absorbing the human impact of decisions made far from the communities they affect.

Through all of this, CEOs and senior teams keep showing up. I’ve seen leaders trying to shield their staff from burnout while also trying to prevent patients from losing access to the care they rely on. I’ve seen executive teams face painful realities brought on by these federal shifts and still find the strength to act. I’ve seen board members step up with seriousness and commitment while balancing complicated lives of their own. This year, leadership was not theoretical. It was personal. It was human. It was heavy.

My advisory work has been placing me in the rooms where these pressures are the most visible. The retreats, the strategy sessions, and the quiet conversations behind closed doors are showing me the true heart of leadership in a policy environment that keeps changing the rules and punishing our most vulnerable people. I sit with CEOs and senior teams navigating decisions with no perfect answers, all shaped by the cascading effects of the federal changes. We talk about values, mission, fear, responsibility, finances, and the human consequences behind each choice. Their honesty and courage are staying with me.

Through my work with leaders this year, I’ve seen exhausted CEOs regain clarity after absorbing yet another directive or policy shift. I’ve seen teams move from feeling overwhelmed by federal requirements to identifying their next right step. I’ve seen boards and executives align around unenviable decisions rather than avoiding them. These moments are quiet, but they are powerful. They are how systems move forward.

I am grateful for all of it. I am grateful for the leaders who kept showing up when retreating would have been easier. I am grateful for the trust they placed in me when uncertainty was at its peak. I am grateful to witness courage in its most grounded and practical form.

We must get through this crisis. We can, with the right leaders and the right support for those leaders. We can emerge with the strength and clarity needed to make true systems change.

Systems change grows from steady and determined leadership. It grows from mission-driven people who stay with the work, even when they are tired and the policy environment is stacked against them. It grows from CEOs and boards who refuse to let vulnerable communities bear the full cost of federal decisions made far away.

As we close out 2025, my gratitude is deep and sincere. Thank you to the CEOs and senior leaders who are carrying far more weight than anyone should have to carry this year. Thank you for the clarity, honesty, discipline, and compassion you are bringing to impossible situations. Thank you for continuing to lead when the path is far from easy.

I am grateful to work alongside you. And I remain committed to supporting you, in my work and in my writing, as you continue to protect the communities you serve. Together, we can work toward building a stronger and more equitable health care system in the future.