When Katrina Clark, M.P.H. ’71, took the helm of Fair Haven Community Health Center 40 years ago, it was a walk-in clinic open two evenings a week in a local elementary school that provided 500 visits during its first year. When she retired in June, Clark was the executive director of a federally qualified health center housed in three buildings that provides 65,000 visits a year.“What I really feel proud about is that we’ve been able to serve generations of families in the Fair Haven community,” said Clark. “We’ve delivered children of some of the folks whom we delivered, so we’ve been able to provide intergenerational family care over the years.”The clinic has grown, Clark said, because of both a greater need and its location in a New Haven neighborhood that is isolated from the city’s hospitals and other health care providers. Under her stewardship the clinic, whose patient base is largely made up of Spanish-speaking immigrants, has grown to encompass a range of services that includes prenatal and preventive care, management of chronic diseases, social services, and education about nutrition and health. “I think we provide care that really helps patients negotiate the entire health care system,” she said.During Clark’s tenure the clinic has collaborated with Yale through such activities as the School of Nursing’s Minding the Baby® initiative, a home visiting program for first-time young mothers, and the School of Medicine’s HAVEN Free Clinic, a student-run free clinic for the uninsured, which is held at Fair Haven every Saturday. She also oversaw the implementation of Epic, the electronic health record system adopted by Yale-New Haven Health System, to enable seamless transitions among the clinic, the hospitals, and Yale Medical Group.In June, Clark handed over the leadership of Fair Haven to Suzanne P. Lagarde, M.D., HS ’77, FW ’80, who is beginning a new chapter in a career in which she has often helped those in need. As a gastroenterologist in private practice, Lagarde nurtured a passion for issues related to access to care. For five years she traveled quarterly to southern Mississippi, where she worked in a large health center treating uninsured patients with gastrointestinal problems. That led to her role in starting Project Access-New Haven, a local chapter of a nationwide program to provide specialty care to the uninsured. “I became frustrated with my inability to effect change on a much broader scale, so it became increasingly clear to me that I needed to change my career path to see if there was something I could do that would impact larger numbers of people instead of one-on-one care,” she said. Last year, Lagarde enrolled in Yale’s Leadership in Healthcare M.B.A. program in order to obtain the skills needed to run an organization. At the time, she had no idea where it would lead her. She is halfway through the program, but already sees how she can apply the principles she’s learning to her new job.“Fair Haven is a clinical gem, and its hallmark is clinical quality,” she said. She wants to preserve this quality while strengthening Fair Haven to meet changes in the health care delivery system. She intends to take a critical look at such innovative models as Accountable Care Organizations and patient navigation to determine if they make sense for Fair Haven. She also intends to work closely with Connecticut’s Department of Social Services to find ways of increasing the number of specialists participating in Medicaid, which covers more than half of Fair Haven’s patients.When Clark came to Fair Haven in 1973, there were only three staff members; today there are about 200. While Lagarde’s experience may not include such explosive growth, she hopes it will bring the same spirit of innovation.