NORTHAMPTON — Eliza Lake remembers the first time she needed the services of Hilltown Community Health Center.

It was before her family moved to Massachusetts and her parents had just bought a house in Worthington.

“I was 11. I got bitten by a dog, and I went to the health center to get treated,” she said.

In fact, she said, the community clinic was one of the things that drew her family to Worthington.

More than 40 years on, Lake, 52, is stepping down as executive director and CEO of the health center after almost nine years at the helm. Under her watch, the number of centers and the number of people served in Hampshire and Hampden counties have grown significantly, as have the number of employees needed to meet those demands.

Michael Purdy, the chief clinical and community services officer, has been appointed interim CEO, beginning July 31, while the board conducts a national search for Lake’s replacement.

With a background in health policy, Lake was the first legislative aide to Rep. Stephen Kulik of Worthington, who died in December, which she remembers as “an amazing experience” that inspired her to move to Boston and to get a master’s degree in social work. She began her involvement with the health center as a board member before she joined the staff as director of community programs and grant writer.

“Eliza has personified the vision and culture of the Health Center,” board Chair Lee Manchester said in a statement, praising her “steady and wise guidance.”

“Her constant focus on prioritizing the delivery of quality health services to our patient population has enabled HCHC to survive and thrive in a health care environment that is constantly changing,” Manchester said.

Lake, who also helps her husband, Bart Niswonger, run the farm on which she grew up, where they keep Highland cattle for certified grass-fed, humanely raised beef and manage a grove of sugar maples, said she has no immediate plans for her next venture.

Her mother still lives in Worthington and her father, Anthony Lake, who was national security adviser in the Clinton administration and more recently executive director of UNICEF, lives in Washington but still visits regularly, she said.

Growing mission

One of 36 federally qualified health centers in Massachusetts, and the only one in Hampshire County, the Hilltown health center has expanded staffing by 47%, from 101 to 148, as its budget has grown from $6.5 million to $11 million during Lake’s tenure. Five years ago, the organization opened a new clinic, the John P. Musante Health Center in Amherst, to expand access to those facing barriers to medical care in the Pioneer Valley.

“Eliza Lake is a phenom,” said Ellen Story, a retired Amherst state legislator who served on the task force that brought the Musante Center into being. “She’s so smart, she has such energy, and she has so little ego that she is a joy to work with.”

“She’ll be a real loss,” Story said.

In addition to the Musante Center, the organization operates clinics in Worthington and Huntington, as well as a health center at Gateway Regional High School and a community center, both in Huntington. In 2022, the health center served 9,458 patients from 28 communities in Hampshire and Hampden counties.

“I’m incredibly proud of the work we’ve done,” Lake said this week.

Being federally qualified means the health center has to accept all patients, regardless of ability to pay. The board of directors must be at least 51% patients, and the clinics must offer an array of health services, including dental, optometric and behavioral. In return, Lake said, they get roughly 20% of their budget in government support and free malpractice insurance — and have to adhere to numerous regulations.

As for insurance, she said the clinic’s patient pool is approximately 40% private, 30% Medicaid, including MassHealth, 20% Medicare and 10% uninsured.

A new reality

When the COVID pandemic hit in March 2020, everything was upended.

“We had to totally change our model of how we did things over a single weekend,” Lake said.

In-patient visits were out, and staff and patients had to adjust to the idea of telemedicine. Demand for behavioral services soared.

“Telehealth has been transformative,” Lake said.

Patients’ lives are complicated, she said, and many found telehealth made it easier for them to keep their appointments. While not practical for all treatments, the transition to telehealth for behavioral services was easy.

At the same time, the state turned to community health centers for help with distributing COVID test kits and vaccines.

“We’re a public health service,” Lake said. “Our role is to meet people’s needs. We’re here to fill in the gaps.”

Those needs never seem to diminish, which Lake acknowledged is a fact of health care in the U.S.

“People are never going to be the priority in a system run on the insurance model,” she said.

More expansion coming

The Hilltown health center is now expanding its operations in Northampton, providing care to the unhoused one day a week at the Manna kitchen at St. John’s Episcopal Church, Lake said. Future prospects include involvement with the city’s Resilience Hub and a second school-based health center at Smith Vocational and Agricultural High School, for which the center recently received a $1 million state grant.

With a number of small sites in a rural area, Lake noted, there are no economies of scale, and recruitment of medical and dental professionals is challenging.

“Transportation is a huge issue,” she said, both for staff and patients.

She said the health center has set up in-house training programs for medical and dental assistants and stepped up hiring of community health workers, who work with people in the community, helping them to navigate health services.

As Lake prepares to move on, she offered praise for the staff and pledged to ensure the transition would not be abrupt.

“Michael Purdy is the perfect choice to fill in for the interim,” she said in a statement. “I have every confidence in Michael’s ability to step into my position, but at his request I will be available to him for at least two months after my departure in an advisory role.”

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