My Professional Life

For those who do not know what I’m about, let me introduce myself…

My name is Annika O’Melia. I grew up in Rock Island, Illinois. I attended Eugene Field Elementary School, Washington Junior High School, and Rock Island High School. My fondest memories of high school are playing basketball with my teammates and falling in love with my husband.

Technically, my first job was at Circa ’21 when I was in sixth grade, playing the Pepper/Duffy swing in Annie.

In high school, I worked with a group of female athletes to bring a Title IX complaint against Rock Island High School—a place I loved dearly—to achieve more equity in boys’ and girls’ sports. That experience shaped me. I learned early that you can love a place deeply and still challenge it to do better.

My first real job was working for the Rock Island Fitness and Activity Center as a lifeguard and swim instructor. I worked summers and off sports seasons for the City of Rock Island.

I attended Northwestern University in Evanston, where I studied Human Development and Psychological Services. During college, I had the opportunity to work on public policy through Northwestern’s Institute for Policy Research, won a classroom award for my writing, and interned at Cook County Hospital during the last year the old building was in operation, working with children who had suffered extreme physical abuse that required hospitalization.

In college, I worked at the university’s aquatic center, lifeguarding and teaching adults how to swim. I worked at Giordano’s Pizza, as a server at the Kellogg School of Management banquet hall, and at Davis Street Fish Market (where I met “Norm” from Cheers).

During college, I interned at Robert Young Mental Health Center.

After college, I worked at Lutheran Services in Iowa with girls and young women who had interactions with the legal system.

After getting married in 2004 at 23 years old, I moved to St. Louis, where I attended Washington University in St. Louis and earned a master’s degree in social work with a focus on social and economic development. I took courses in economics, social entrepreneurship, healthcare policy, and more. Through practicum placements, I worked on urban planning in St. Louis and on Individual Development Account (IDA) policy with Dr. Michael Sherraden.

Upon graduating, I took a job with the St. Louis Juvenile Court, counseling and supporting victims of serious crimes committed by juveniles—armed robbery, murder, and assault.

In 2006, we emigrated to Vancouver, Canada, for my husband to attend Vancouver Film School. He had graduated with a degree in computer science from Augustana College, and after I finished my master’s degree, it was his turn to accumulate student debt.

When we arrived in Vancouver, it took a while for me to be cleared to work in healthcare, so I worked full time at a café called Viva and nannied for a private family. Vancouver is expensive—our studio apartment there cost more than our current mortgage.

Working at Viva was a trip. I was the only American. My bosses were newly divorced and didn’t speak to one another. The husband was from Germany; the wife from Africa. My closest coworkers were from Iran and Sri Lanka. The women in the kitchen were both from China—one spoke Mandarin, the other Cantonese. The coworker closest in age to me was from France and roller-skated to work. We made paninis together every morning, and I cherish the laughs, language barriers, and sense of community that came from being a foreigner in a not-so-foreign land.

Once I passed the health screenings required by the Canadian government, I was hired by the British Columbia Ministry for Children and Family Development. I worked as a therapist, primarily in a program designed for youth with behavioral challenges. Our program combined therapy, parenting groups, and school interventions to layer consistent strategies and scaffolding for kids across settings.

In late 2008, we moved back to the area, and I worked for Lutheran Services of Illinois with parents who had their children removed from their care through the Department of Children and Family Services.

In 2009, I took a new position as a behavioral health specialist at Edgerton Women’s Health Center (EWHC) in Davenport. Edgerton began as the Maternal Health Center in the 1970s and was a community champion for women’s health for decades, providing high-quality care. It was the coolest, best job I'd had to date.

In approximately 2014, I was named Chief Executive Officer of Edgerton. In this role, I was responsible for managing the nonprofit medical clinic and administering the Title X family planning grant and the Women, Infants, and Children (WIC) program—the second-largest WIC program in Iowa at the time.

This was one of the most challenging periods of my life. I was growing my family, working 60 hours a week, and constantly worried that the organization might not make payroll. I had to eliminate positions, restructure departments, and push a dedicated team of physicians and midwives beyond reasonable limits without being able to adequately compensate them or respect their work–life boundaries due to challenging reimbursement rates and lack of revenue.

In 2014, policy changes related to the Affordable Care Act meant that Federally Qualified Health Centers, like Community Health Care, began receiving enhanced reimbursement for maternal health services. These changes put Edgerton in a position where we were asking the community to fundraise for services that another local nonprofit could provide without the same burden. Around this time, funding for our Title X program also fluctuated depending on political conditions.

And then… I was sitting in a meeting with the Title X committee in Des Moines, discussing our 340B drug program, when I realized that our clinic had been billing for birth control incorrectly since the implementation of our electronic health record. I am confident this was not intentional, but rather the result of a pricing flaw introduced during the 2012 EHR conversion. At that time, electronic health records were still the Wild West—organizations across the country were learning in real time. Part of why I had become CEO was that I was one of the youngest people in the building with a master’s degree and a working understanding of how the EHR functioned.

Nevertheless, as CEO, I had signed Medicaid, Title X, and contract documents with both Illinois and Iowa certifying that I would manage those programs appropriately and ethically.

I drove home from Des Moines, pulling over to throw up because I was so upset. I understood the math: we would owe Iowa and Illinois hundreds of thousands of dollars. I also recognized that without that revenue, the organization would not survive.

Some advised me to quietly correct the issue and hope the states would never notice.

I called my dad and asked his advice. “You call a meeting, tell your board, and let the chips fall where they may.” Within 24 hours of learning this information, I shared it.

During this time, I started visiting RV parks and looking at campers, daydreaming about uprooting our two small children and traveling the country. In my imagination, I wrote novels while my husband found work wherever we landed. He was, understandably, not into the idea. Looking back, I see those daydreams for what they were—an escape fantasy born out of intense stress.

While at Edgerton, I worked alongside some of the most talented, evidence-based, trusted, kick-ass providers and staff in the women’s health world I’ve ever encountered. Protecting them—and the services women relied on—became my top priority.

Working with our board of directors and in partnership with Genesis and Community Health Care, we navigated a transition that ensured continuity of care for patients and employment for staff. Edgerton dissolved as a nonprofit only after paying every community vendor, from cleaning services to postal and printing contracts. Every staff member retained employment, and many went on to earn higher pay and better benefits. We repaid the state of Iowa in full for the billing error.

I remain deeply grateful to Doug Cropper, CEO of Genesis Medical Center, (since retired) and Tom Bowman, CEO of Community Health Care, for their partnership and integrity during that transition. Genesis absorbed the outstanding debt Edgerton owed to the hospital system to allow the transition to occur unencumbered.

By early 2016, I was pregnant with twins and actively working to put myself out of a job.

By the time the twins were born, I went from being a CEO—running the second-largest WIC program in Iowa and serving women on Medicaid—to becoming a mother on Medicaid myself, relying on WIC after the birth of my twins. During the pregnancy, I developed HELLP syndrome and was advised not to have any more children - I'm convinced the pressure of this period of life made me very sick.

As we prepared for this dramatic change, my husband pursued a new, more stable career. But just starting out, times were lean. There was no way we could afford daycare for three children, so I stayed home after the twins were born.

I wasn’t sure what I would do next professionally. I knew what I didn’t want. I never wanted to be in a position again where I couldn’t pay people what they were worth, where I had to squeeze productivity, or where financial instability dictated clinical decisions. I also knew I needed to make money. I was living near the poverty line with four children and a husband just starting a new career.

In 2017, I decided to start my own private practice. I began alone, in a 120-square-foot office on the third floor of the Northwest Bank Building.

I made the conscious decision to accept private insurance and cash pay. That choice wasn’t ideological—it was practical and protective. I needed to build something financially stable enough to support my family and, eventually, the people I would employ.

Over the past eight years, I’ve grown the practice into what it is today. Along the way, I’ve learned new therapeutic modalities, served hundreds of people, and grown deeply in my own sense of self. Most importantly, I’ve worked intentionally to create what I believe is an exceptionally healthy work environment—one where clinicians can thrive so they can serve clients well.

Today, we have two locations, and I employ or contract with 23 clinicians. They set their own hours, work as much or as little as they want, and are compensated appropriately for their work. I built this practice with the explicit goal of never replicating conditions that burn people out or devalue their labor.

It’s also important to name a basic economic reality: for providers who are not part of a hospital system, a nonprofit that fundraises its way to solvency, or a Federally Qualified Health Center, accepting very low-paying insurance often makes it difficult—if not impossible—to stay in business. That isn’t a reflection of values; it’s a function of reimbursement rates.

I am exploring onboarding Illinois Medicaid in the future at a measured rate. At the same time, I’m not going to contract with other insurance companies unless their reimbursement rates are brought in line with top payors. I won’t build a business model that depends on underpaying clinicians or controlling their productivity in order to survive.

To expand in Illinois and make Medicaid participation sustainable, I need a larger building in Rock Island. I’ve been actively working toward that end. Growth, for me, isn’t about scale for its own sake—it’s about creating infrastructure that allows broader access without sacrificing ethical employment practices or financial stability.

We have traditionally offered a graduate student intern program that provides no-cost or low-cost therapy to people who cannot afford insurance copays or whose insurance is not in network. I’ve overseen that program for years as one way of expanding access to care beyond what insurance alone allows.

That program is not active right now because I am on a sabbatical from my primary role so I can pursue Rock Island Line and other long-standing creative and civic interests. During this time, I have stepped away from seeing clients for the most part. My team is fully aware of this arrangement and continues to operate the practice day to day.

I’m deeply grateful for the clinicians I work with. They have been supportive and encouraging during this season—even when they don’t share my ideas or opinions. Their professionalism and autonomy are part of what I value most about the environment we’ve built together.

During the time I was building my business, I learned new therapeutic modalities—EMDR, Internal Family Systems, polyvagal theory, and more. I read constantly, journaled, and spent six to eight hours a day counseling people from the corner of my bedroom during COVID as we all navigated an uncertain world.

All that time spent with, mostly, women on healing journeys helped me heal too. It helped me see the ways I had often done what was expected of me, sometimes instead of what I actually wanted to do. I hadn’t allowed much space for creativity or for being with people the way I was in high school—in community, fighting for equity, part of something systemic.

As I helped those women define themselves, I was in an unconscious parallel process of doing the same. When I eventually told them I needed to do something different for a while, they encouraged me, and we severed our therapeutic relationship.

Why did I write this whole thing?

To give you a sense of my professional life. To help you know a little more about me.

But mostly, to respond to people coming for my business.

I have gone to great lengths in my life to do what I believe is right—even when it meant blowing up my own future and economic security while pregnant and about to have four children under the age of five.

I share all of this for one reason: if you think threatening my business or my finances will silence me now, you don’t know me.

Over the last several months, as I’ve shared publicly available documents related to Community and Economic Development funds and ARPA spending, the focus of some responses has shifted—from quiet warnings, to attempts to define who I am in this community, to scrutiny of my private business.

That shift tells me the work is being noticed.

Let me be clear: my private practice operates independently of my civic work and complies with all professional and legal standards. It is not the subject of my reporting.

This is the only time I will respond to criticism of my private business on this platform—or on any social media platform. If I choose to talk about my work in the future, I will do so intentionally. I will not engage with anonymous attacks; those will simply be referred to this article.

Anyone who wants to ask questions in good faith is welcome to contact me directly and openly—not anonymously. If there are factual errors in my reporting, I welcome them being named so they can be corrected.

I will continue to publish documents, ask questions, and focus on public accountability.

Silence is not on the table.