Latest / Becker’s Healthcare Podcast / Jessica Salem, Executive Director of the Center for Health Equity at Dayton Children's Hospital

Transcript

Jessica Salem, Executive Director of the Center for Health Equity at Dayton Children's Hospital · Becker’s Healthcare Podcast

• 0:00
  Welcome to the Becker's Healthcare Podcast. I'm Chris
• 0:02
  Oster, your host. And and today, I'm thrilled
• 0:04
  to be joined by Jessica Salem. She is
• 0:05
  executive director of the Center for Community Health
• 0:08
  at Dayton Children's Hospital.
• 0:10
  Jessica, thank you for joining us today.
• 0:12
  Thank you. I'm excited to be joining you.
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  Jessica, you're here, of course, to talk about
• 0:16
  the kinship housing project. But before we get
• 0:18
  into that, could you let our audience get
• 0:21
  to know you a little bit better? Introduce
• 0:22
  yourself, tell us a bit about your background.
• 0:25
  Sure. I am a a a lifetime member
• 0:28
  of Dayton Children's Hospital. I have worked here
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  for over eighteen years,
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  and I am fortunate enough that I have
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  been responsible, really, for the majority of those
• 0:36
  eighteen years for all of our community health
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  work. So, for, you know, the hospital audiences,
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  I'm responsible for things like our community health
• 0:43
  needs assessment,
• 0:44
  community benefit,
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  our community engagement strategies.
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  If the word community is in it, it
• 0:50
  seems to kinda fit into my realm. So,
• 0:53
  this project, which we'll talk about today, you
• 0:55
  know, just fit so perfectly
• 0:57
  and and fit my background, and, I'm really
• 0:59
  just excited to be able to share about
• 1:01
  it with you today.
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  That is so fantastic. Alright. So without further
• 1:05
  ado, let's jump right into that, Jessica. So
• 1:07
  very simply,
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  but can you take us through the inception
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  and evolution of the kinship housing project? What
• 1:12
  do we need to know right off the
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  bat? Sure. So several years ago and I'll
• 1:16
  start out with the fact that a project
• 1:18
  like this takes many, many years of planning
• 1:20
  and thought. But I think we're thinking about
• 1:23
  2019, 2020.
• 1:25
  We were talking to our community health workers
• 1:26
  here at Dayton Children's who were working specifically
• 1:29
  with kinship families.
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  Those are the grandparents,
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  aunts, uncles who are taking kin in instead
• 1:35
  of those little kids going into foster care.
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  So really special people and special families.
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  And as we were talking to our community
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  health workers and understanding the barriers for this
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  specific patient population,
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  one of the highest needs that came out
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  of conversations was housing.
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  That of many situations where that a grandparent
• 1:54
  wanted to take care custody of their grandchild,
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  but they were living in senior housing or
• 1:58
  their housing wasn't big enough for the the
• 2:01
  teenager that really needed some room to grow.
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  And over and over and over, this became,
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  you know, a barrier.
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  And a little bit, you know, backdrop the
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  the backdrop here in in Dayton at the
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  time, we were in the epicenter of the
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  opioid epidemic, so we had a lot of
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  kinship families
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  just being created overnight because of overdoses.
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  And so this just really came to a
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  head. We also, had a tornado in '9
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  yeah, in '19 as well,
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  and that hit the neighborhood not too far
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  from the hospital. So just know that I
• 2:31
  think that's important background information of why this
• 2:34
  was such an intense need around housing and
• 2:36
  kinship families at the time.
• 2:38
  So, I'm really grateful our president and CEO,
• 2:41
  Debbie Feldman. She had heard about the community
• 2:43
  health workers,
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  and and what they had said about the
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  kinship families.
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  And, you know, she said, let's just build
• 2:50
  housing then. I know it's one of those
• 2:53
  things, like, not often that a CEO says
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  let's build housing, but,
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  she is a very community driven person and
• 2:59
  also very much into community development. Her background
• 3:01
  is actually,
• 3:03
  our county administrator, so she understood the systems
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  of foster care and homelessness and all of
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  those things. And so it was just kind
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  of that perfect storm of all the right
• 3:11
  pieces coming together to say we should be
• 3:13
  doing this.
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  So at the time, we did some predevelopment.
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  We had land not too far from the
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  hospital about two acres, an old school site
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  that we were able to purchase
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  and started on this journey of really just
• 3:25
  forming and norming this idea.
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  So then a long story short, because that,
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  you know, that covers four or five years,
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  we were able to assemble an incredible team
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  of, you know, an architect who listened to
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  the neighborhood about what should fit. In the
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  neighborhood, this isn't a high rise. These are
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  little duplex homes.
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  Look and feel of Old North Dayton where
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  where we are located.
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  We have a phenomenal
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  contractor,
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  the model group. They understood community development. They
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  understood this type of work. They have a
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  passion for this population. So they were our
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  developer and general contractor.
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  We knew that we should not be in
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  the property management business. I know I don't
• 4:02
  want to get phone calls in the middle
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  of the night for whatever it might be.
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  That's just not my expertise. Or the leasing
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  side, there's a lot of details with that.
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  So we're partnering with Wallach Communities who is
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  our property manager.
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  We have a local organization called Citywide Development
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  who really does a lot of boots on
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  the ground community development,
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  really getting input from the neighborhood because we
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  want families in this little neighborhood to feel
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  like they are part of the neighborhood and
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  not,
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  you know, just that they truly are part
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  of the community.
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  So after assembling all of these partners, and,
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  of course, you have to get the funding.
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  And, we were lucky enough to get some
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  congressionally directed,
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  funding from our,
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  senator
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  Sherry Brown at the time. That was really
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  kinda $2,000,000 that really got this going. We're
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  like, we can actually get this done. And
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  we were able to get some county funding,
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  some,
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  city funding,
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  and then this project is a 4% low
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  income housing tax credit project,
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  which will make a lot of sense to
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  people that know housing. So, you know, you
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  cobble together all those funders who also believe
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  in the project.
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  And here in October 27,
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  we were able to officially, like, open the
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  housing, at least the first cluster of homes,
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  and we are currently lease in the lease
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  up phase.
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  Jessica, thank you for covering all that ground.
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  As you said, it's a lot, but I
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  think you
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  explained very well that there are a lot
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  of moving parts here. I mean, whenever any
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  sort of entity that's really not the government
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  is going to take on
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  such a huge
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  undertaking. I mean, for example, you said, you
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  know, we don't wanna be in the property
• 5:34
  management business. So that might be a a
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  question that someone asked at at the outset.
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  Right? It's like, okay. Are you gonna be
• 5:40
  a landlord now? Like, how does that work?
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  So,
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  but yes. As you said, that you're it's
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  not just Dayton Children saying, okay. We are
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  overseeing every aspect of it. We have partners
• 5:50
  who are helping with this aspect and that
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  aspect. So,
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  as as this is coming
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  to fruition, I mean, you mentioned Deborah Feldman's
• 5:58
  role and Sherry Brown's role. And just how
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  much
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  effort does it take on the part of
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  the hospital and, you know, a leader such
• 6:08
  as yourself in terms of making all this
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  happen? Does that make sense?
• 6:12
  Yeah.
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  I've I've talked with Debbie quite a bit
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  about this because it really does take,
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  and I think this is the role that
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  we have said that the hospital is taking
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  is that we're really that convener
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  and,
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  the group that, you know, it was great
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  that that we have the legal team that
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  can do this and we you know, that
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  can kind of figure this all out.
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  But, also, at the same time, we know
• 6:34
  our limits as a hospital. But we really
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  we often say that we're, like, the sole
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  organization dedicated to health in our community or
• 6:42
  children's health in our community.
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  And
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  this is children's health. This is their mental
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  health and their physical health. And to really
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  rally people around it, that's really been the
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  role that our team has played. There's a
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  lot of, like, little bits and pieces, like,
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  you know, making sure that this t is
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  crossed and I is dotted. I mean, it's
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  amazing what goes into this. I never knew
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  that when I said that I would do
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  this.
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  But,
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  yeah, it's it's a lift, I think, from
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  a really technical standpoint of the hospital to
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  say how does this work, but then also
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  to to know
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  this is where our boundary is. This is
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  where our line is. This is where we
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  can't cross, and this is where we really
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  need to partner.
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  And a lot of our community work, we're
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  really committed to partnering with the right people
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  who are the experts in that space.
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  Perfect. I mean, yeah, on the other end
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  of it, it it has to be,
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  inspiring and uplifting from a morale point of
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  view for Dayton Children's where I mean, certainly,
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  we can say as US health care providers,
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  like, alright.
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  If a patient doesn't have housing or,
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  you know, proper nutrition, etcetera, then they're gonna
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  have these problems. So for a health system
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  to be able to step in and say,
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  you know what? We're gonna take care of
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  that huge issue. Right? That way, you can
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  help
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  everything else fall into place. Right? So Mhmm.
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  Yeah. And Just given what you've had to
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  do to do this,
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  I'm just really trying to point out and
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  and just emphasize your point that this is
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  not something that's like a lot of things
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  in health care, it's not something someone
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  who might be a similar position to yours
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  is gonna be saying, okay. Six months from
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  now, we're going to have this.
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  Probably not, but it is possible.
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  Mhmm. It is possible.
• 8:19
  Awesome. So looking ahead a little bit here,
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  Jessica, how how are you going to measure
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  this project's success,
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  and how do you hope that it will
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  grow with the next
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  take whatever timeline,
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  Sue State and Children's, whether it's three years,
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  five years, ten years, etcetera?
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  Sure.
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  So,
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  you know, a lot and that's the the
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  best question. Right? Like, what's the return on
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  investment in a way? And I know it's
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  a hospital to think about that, and it
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  is about children's health. So on the outset,
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  you know, this project is 26 units.
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  So 26 families can be served. We're prioritizing
• 8:53
  those families in the kinship situation and also
• 8:56
  families that might have a chronic health condition,
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  a child in a chronic health condition because
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  they're only two blocks away from the hospital.
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  And, so, ultimately, you know, 26 families having
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  stable housing is, you know, one measure in
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  itself, and we hope that we fill that
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  by, you know, early twenty twenty six. So
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  that's kind of the time line that from
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  getting people in the door.
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  But it isn't always,
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  you know, just about housing,
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  but it really is about how do we
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  ensure, you know, stability for the kids that
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  probably have been moved around a lot given
• 9:24
  their their background, and, frankly, stability for the
• 9:27
  kinship caregivers who may have been living in
• 9:29
  an isolated situation. You know, the only ones
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  that are now a grandparent taking care of
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  a four year old. I mean, I just
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  really think about their different situations.
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  So,
• 9:38
  what our team is doing, we're not gonna
• 9:40
  do any formal research at least at this
• 9:42
  time because we don't have a a good,
• 9:44
  you know, we don't have a control group
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  to necessarily Yeah. Makes sense. That. You know?
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  But we are gonna be surveying the families.
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  And, first of all, identifying their their home
• 9:52
  situation before
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  just to understand, you know, the the pre
• 9:56
  and post, you know, short term. Where were
• 9:58
  you living before? What was that situation? And
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  what's the situation now? These are all three
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  bedroom, two bath,
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  about a 1,400 square feet, big backyard. We
• 10:08
  have a a shared playground for all of
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  it. You know? So really a whole not
• 10:11
  far from school. It's not far from a
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  bus stop. You know? All the things we
• 10:14
  really try to think about.
• 10:16
  So, you know, there is that kind of
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  an immediate,
• 10:20
  I would hope, for families and immediate,
• 10:22
  restfulness that they're in a home that is
• 10:25
  just a bit more conducive to the kinship
• 10:27
  situation.
• 10:28
  I think longer term as a hospital, we
• 10:30
  are gonna be looking at things to the
• 10:32
  extent that we can. You know, families have
• 10:34
  to be willing to share their information with
• 10:35
  us, but are we able to see that
• 10:38
  their asthma is better controlled? I mean, we
• 10:40
  did we intentionally made these homes with no
• 10:43
  carpet and kind of simple simple features.
• 10:46
  And once again, not all, like, kinship kids
• 10:49
  have asthma, but there probably are some health
• 10:51
  outcomes that we're hoping
• 10:53
  to impact through this.
• 10:54
  I think it's gonna be the the behavioral
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  health, the mental health components, and that isolation
• 11:00
  piece. And we're gonna be going back to
• 11:01
  the families on a regular basis just kind
• 11:03
  of understanding and asking them those type of
• 11:05
  questions.
• 11:06
  And then also from a
• 11:08
  from a social support perspective,
• 11:11
  you know, we're gonna ask the families what
• 11:14
  I mean, do you need food? Like, what
• 11:15
  are the other social needs that you might
• 11:17
  have? Because the hospital has some resources for
• 11:20
  the general population as well as our patient
• 11:22
  population. How can we at least take advantage
• 11:24
  of those resources,
• 11:25
  for these families as well? So,
• 11:27
  yeah, I think long term is just thriving
• 11:30
  children in this neighborhood,
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  and that can mean a lot of different
• 11:33
  things from the health, like, a true health
• 11:36
  care perspective all the way to start more
• 11:37
  holistic health perspective.
• 11:40
  Yeah. You raised some some really great points
• 11:42
  there that for the one thing you're you're
• 11:44
  just at the outset of this, so you
• 11:46
  have a ton to learn. But I'm sure
• 11:48
  you're also very excited to be able to
• 11:51
  help these
• 11:52
  children and their families, you know, to say,
• 11:54
  you know what? You know? Yeah. You are
• 11:56
  only two blocks from the hospital, and
• 11:58
  here's how we're gonna help you see. Okay.
• 12:00
  This condition that you have is getting better,
• 12:02
  whether it's asthma, as you mentioned, or mental
• 12:04
  health or behavioral health. So this is there's
• 12:06
  such a long term component that you don't
• 12:09
  necessarily see from a lot of hospital programs
• 12:12
  in general. Does that make sense? Right.
• 12:14
  Yeah. And and we we need the families
• 12:16
  to stay there too because, you know, that's
• 12:18
  the other thing is if they've been moving
• 12:19
  around a lot, you hope that they do
• 12:20
  stay, and then that allows for more stability
• 12:23
  for the kids. And that helps with school
• 12:25
  absenteeism. I think it just is that holistic
• 12:27
  picture of health that all those things matter,
• 12:31
  and that's the type of things that we're
• 12:32
  gonna be looking at.
• 12:33
  And that's a whole other element in school.
• 12:35
  It's just
• 12:36
  you mentioned it. The big thing here is
• 12:38
  stability. Right? It's gonna start with that.
• 12:41
  Looking at it, this whole thing from an
• 12:43
  operational standpoint, Jessica, so if you can give
• 12:47
  other health systems who might be thinking about
• 12:49
  this sort of project, and hopefully there are.
• 12:51
  Hopefully there are others who hear this and
• 12:53
  say, you know what? We can do this
• 12:55
  too. So for anyone who is looking to
• 12:58
  take under undertake, I should say, a similar
• 13:00
  effort,
• 13:00
  what advice do you do you have for
• 13:02
  them? And I know that can be a
• 13:03
  long list. So
• 13:04
  Yeah. Wherever you wanna take that, please go
• 13:06
  for it. Sure. Yeah. I mean, I think
• 13:08
  it is one of those every state's a
• 13:09
  little different with the type of funding that's
• 13:10
  out there, every community. So it is kind
• 13:12
  of figuring out what's what population, what, you
• 13:15
  know, what makes sense for your organization.
• 13:17
  But I think for us, we and it
• 13:19
  took us time. I mean, this you know,
• 13:21
  it's always hindsight is twenty twenty, and you're
• 13:23
  like, oh, we wish we would have included
• 13:24
  them earlier. Right? So Yeah. From the outset,
• 13:27
  you know, we had,
• 13:28
  you know, here I'm in, like, the community
• 13:30
  health space, and, and, of course, our CEO
• 13:32
  was leading this effort, and we already had
• 13:35
  some really good community development partners
• 13:38
  working in the neighborhood we were already working,
• 13:39
  and that's citywide development. So some of that
• 13:41
  infrastructure was already
• 13:43
  here at Dayton Children's, but I would say
• 13:45
  a really good community development partner is important.
• 13:49
  Inside the hospital,
• 13:50
  we really leaned on teams, like our facilities
• 13:53
  team. So you know? And a facility team
• 13:56
  probably in some spaces could lead this, but
• 13:59
  I just you know, every hospital is a
• 14:00
  little different.
• 14:01
  Right. But our facilities team has been absolutely
• 14:04
  incredible as far as, you know, helping to
• 14:06
  interview the property maintenance people and what what
• 14:09
  about this and this and this, and they
• 14:11
  so they've been a really important part of
• 14:13
  our team. Our accounting and finance department has
• 14:16
  been very, very important just because of the
• 14:18
  way that we had to close on these
• 14:20
  deals and this housing tax credit, and I
• 14:22
  this is an area that I know very
• 14:24
  little about. So that accounting and finance team,
• 14:27
  our legal team was super important.
• 14:29
  Here again, this is something that, you know,
• 14:31
  a hospital might not normally do. So how
• 14:33
  do you set something up like this?
• 14:35
  So those are, like, the key
• 14:37
  internal people. And then we really, you know,
• 14:39
  we went reached out to people, like, our
• 14:41
  security, for instance. We are not providing
• 14:43
  Dayton Children's security on this. You know, we
• 14:45
  said, nope. That's gonna be the property manager's
• 14:48
  job. But they can utilize the expertise at
• 14:51
  the hospital. And what I what I really
• 14:53
  think has been neat about it is that
• 14:55
  you, you you know, across a hospital, you
• 14:57
  can get different people excited about a project
• 14:58
  like this. And I think it does help
• 15:00
  employee morale too to say, you know what?
• 15:02
  This is something really cool our hospital's doing,
• 15:05
  and I'm proud to work at Dayton Children's.
• 15:07
  And we've seen that a few times when
• 15:09
  we did the open house for this and
• 15:10
  we opened it up for staff to come,
• 15:12
  we had a good hundred, hundred and fifty
• 15:14
  staff come through.
• 15:15
  And,
• 15:16
  yeah. And it's you know, it was a
• 15:17
  walk from the hospital. They had to take
• 15:19
  a little time away from work, and we
• 15:21
  intentionally wanted to think people like social workers
• 15:23
  and community health workers and others who would
• 15:25
  naturally wide
• 15:28
  variety of staff our staff come through. And
• 15:31
  I just they were just proud, and I
• 15:33
  think that's really, really neat. So, there's a
• 15:36
  kinda two sides of, hey. It's a great
• 15:37
  thing to do for families, but also there
• 15:39
  was a sense of pride for our staff.
• 15:41
  That is so cool to say in the
• 15:43
  case, Jessica. Yeah. I've certainly
• 15:46
  and a number of us have read about
• 15:47
  projects where,
• 15:49
  for example, health systems are building,
• 15:51
  more more affordable housing for their own employees,
• 15:54
  and that's certainly a a huge thing too.
• 15:56
  If you live in a place where it's
• 15:58
  hard to to forward live, that's
• 16:01
  a whole other issue that
• 16:02
  can and and does need to be solved.
• 16:04
  And this is just seems to me like
• 16:05
  you're taking it to a whole level of
• 16:07
  dating children.
• 16:08
  I think we're trying.
• 16:10
  And I will say, we've told our staff
• 16:12
  if they are kinship caregivers themselves, they would
• 16:15
  qualify. And so we've had some phone calls
• 16:17
  from staff members. So, hopefully, in a couple
• 16:19
  months, I can report. I just think it's
• 16:21
  just a neat connection, right, that
• 16:24
  we have staff that would be in the
• 16:25
  kinship situation, and they would also qualify. So
• 16:28
  Fantastic. Well, Jessica, thank you so much for
• 16:31
  coming on the podcast today, for lending us
• 16:33
  all your insights. And I really can't wait
• 16:35
  until our audience get a chance gets a
• 16:37
  chance to hear them. And, yeah, she was
• 16:39
  looking forward to the next time at Pass
• 16:40
  Cross. Sounds great. Thank you.