Building Evidence and Sustaining Growth for an Elder-Led Model of Care 

Kílala Lelum Health and Wellness Cooperative

Program Design + Evaluation

Grants + Strategy

Kílala Lelum Health & Wellness Cooperative is an Elder-led health centre located in Vancouver’s Downtown Eastside community. Founded by physicians, nurses, Indigenous Elders, and Knowledge Holders, the centre provides a wholistic, culturally grounded approach that goes beyond Western models of clinical care. 

Rooted in the success of the Vancouver Indigenous Elders Partnership (VIP) program, Kílala Lelum integrates Elders into all aspects of care—strengthening relationships, restoring identity, and improving health outcomes. Evaluations of this Elder-led model showed measurable improvements in mental health, wellbeing, and reduced emergency service use, establishing Kílala Lelum as a national leader in Indigenous-led, decolonial health care.

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Challenge

Indigenous community members living in Vancouver’s Downtown Eastside face deep inequities in access to culturally safe, trauma-informed care. Kílala Lelum was established to change that by embedding Elders and cultural practices into every layer of care. 

Initially, Changemark was brought in to evaluate one component of this model and identify funding opportunities to sustain it. As findings revealed further system gaps, our role evolved: each evaluation informed a new program, a new proposal, and the next phase of growth. Kílala Lelum needed a partner who could link evaluation and funding strategy in a continuous cycle of learning, true partnership, evidence generation, and expansion.

Solution

Changemark worked alongside Elders, Knowledge Holders, and staff to co-design a decolonial evaluation framework that brought together Indigenous and Western methodologies and ways of knowing, turning evaluation into a tool for both learning and growth. 

By combining culture, wellness and healing with data-driven evaluation, Changemark supported Kílala Lelum to strengthen existing programs, secure new funding, and sustain operations through multiple phases of expansion. 

The project included:

Evaluation + Research Design

  • Co-development of a decolonial evaluation framework grounded in OCAP® principles and community priorities 

  • Implementation of multiple studies, including: 

  • Model of Care Evaluation – gathering staff, provider, and Elder experiences to identify system strengths and challenges 

  • Elder in Primary Care Study- assessing the impact of Elders working in partnership with Primary care teams to provide care for Indigenous people living with opioid use

  • Chronic Pain Management Program (CPMP) Evaluation – measuring outcomes using both clinical and cultural wellness indicators 

  • Integration of multi-methods approaches that balanced quantitative measures with Indigenous storytelling and narrative inquiry 


Funding + Sustainability Strategy

  • Creation of OCAP®-aligned data and reporting systems to strengthen accountability and community ownership 

  • Preparation of funder performance reports, renewal proposals, and evaluation summaries to sustain and expand programs 

  • Design of logic models, implementation plans, and communications materials to support ongoing funding strategy and program scaling 

  • Development of knowledge products and facilitation of community learning events to share insights and mobilize knowledge 

  • Securing of new federal and regional funding to expand culturally grounded health and wellness services 

Results

Over four years, this collaboration transformed a single evaluation into a multi-year, multi-program ecosystem of care and learning. 

We’re deeply grateful to continue walking alongside Kílala Lelum today, supporting their ongoing evaluation work, strengthening funding pathways, and helping scale this model across other Indigenous-led health systems. 

Impact Highlights:

  • Secured $1.9M in initial SUAP funding, plus four funding extensions totaling more than $4M 

  • Secured 3 funding increases and extensions to carry the program past the first allotted funding period 

  • Facilitated $800K from the First Nations Health Authority and new support from Vancouver Coastal Health 

  • Co-developed 40+ knowledge products and hosted community learning events 

  • Supported funding for partners including DUDES Club and RainCity Housing 

Through this partnership, Kílala Lelum built a sustainable, evidence-driven model of Indigenous health care, rooted in culture, strengthened by data, and expanded through community leadership.

Interested in Learning More?

Let’s talk about how we can help you turn evidence into funding, and funding into systems change.

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