SDOH in the Community
Dan Crogan: Hello and welcome to season two of ProspHire Soaring to New Health podcast. This episode is SDOH in the Community. I’m Dan Crogan, joined by my co-host, Chris Miladinovich. Today we’re talking about how environmental factors have a profound impact on overall development, future health and the critical needs to our youth.
Chris Miladinovich: Thanks, Dan. Today we have a very special guest, Stephanie Meyer of Pennsylvania Department of Human Services and Special Assistant to the Secretary with a focus on housing. And Chris Watts, the CEO of the Boys and Girls Clubs of Western Pennsylvania. So glad to be joined by you today.
Chris Watts: Thanks so much for having us.
Chris Miladinovich: Why don’t we start out a little bit about you guys telling us about your organizations, your mission, the populations you serve, and kind of how that ties into Social Determinants of Health. Why don’t you start, Chris?
Chris Watts: Love to start. And thank you, Chris and Dan, for having me. And Stephanie, it’s a pleasure to be here with you. I like to start talking about the Boys and Girls Clubs. Just saying that it’s an incredible organization that I’m really proud to be a part of. It’s an organization here in Western PA that’s been around for 135 years and nationally it’s around for 160 years. And why we are started is really the same reason why we exist today, is to help kids meet their potential. How we’ve done that has evolved quite a bit over the years, if we learned a little bit of what really kids needs and communities needs and will always continue to evolve, but the core tenets have remained the same as we provide safe places and dedicated mentors and relevant programs to help kids prepare for success and careers in life.
Right now, in Western Pennsylvania, we serve almost 7,500 kids a year primarily in Allegheny County, but more recently we’ve expanded in the Somerset, Westmoreland, Fayette, and Beaver County. But the core part of our programming is really trying to provide that safe, fun and inclusive, the environments, the experiences and relationships that we know and the Boys and Girls Clubs knows is what helps kids prepare best for success. With those kind of core tenets we try to help, what we think of those components that help kids prepare for success are in academics, whether you’re in preschool K 8 program or teen program, trying to make sure that kids are prepared to graduate on time and providing, primarily math and literacy support in those capacities character and leadership development skills and so making sure kids are prepared to have positive relationships with their peers and kind of have healthy decision making when things are tough. The third component is around healthy lifestyles. Boys and Girls Clubs because we run incredible sports programs that we’re well known for, but also the social, emotional components of health and preparing kids to understand kind of how they can handle some things that they may not be prepared for and how to do that in a positive way- it’s something that we’re really focused on. And the fourth component around the career and life readiness is making sure everyone has a plan. It’s whatever your plan is post-graduation, we want to help guide that for you, provide the inspiration or the opportunities or experiences for help those kids that may not have access to some things in their communities, help them understand what’s open and what meets, matches with their potential and interests.
One thing I do want to clarify and I think it’s really important about the mission, is, we do these incredible programs that are really focused on, really kids and communities that need us the most, because I think that’s where, where we do our best work. And unfortunately, Pittsburgh and Allegheny County and throughout the surrounding region where there’s incredible opportunities, but there’s disparities in communities that those opportunities aren’t distributed equally. And, a lot of the communities at the Boys and Girls Clubs have really spent a lot of time in and developed relationships with the ones that have those health disparities and Social Determinants of Health that we’ll get into, but also other conditions that make it just harder for kids to reach their potential and that’s something that we really focus a lot on and make sure that we’re bringing the staff and building relationships with communities that really understand that so we can, responsibly kind of help kids kind of get to that next level.
Chris Miladinovich: Okay. Wow, thanks for sharing. You guys do a lot of great stuff for the community and the impacts are very tangible. So thank you. Stephanie, thanks for being on the show and tell us a little bit about what you do at the Commonwealth.
Stephanie Meyer: Happy to do so and a pleasure to be here. I’m a licensed social worker and I have the pleasure to serve in the Shapiro administration as special assistant to the secretary, Undersecretary Val Arcush. And she is a phenomenal public health advocate, a physician and leader of our team. We provide direct supports to over 3 million Pennsylvanians through the state Medicaid program, our administration of the Supplemental Nutrition Assistance Program, Temporary Assistance for Needy Families and a whole host of other resources, programs and initiatives to help Pennsylvanians get the care that they need and the resources for a thriving Pennsylvania. So we really aim to provide a lot of supports and those are just really the direct programs we have through our array of other services. We actually estimate we serve over 9 million Pennsylvanians in some way. We touch their lives.
So out of a Commonwealth that has 12 million folks, we’re really interacting with the vast majority of the communities and the people that we’re all engaging with every day. We also have the privilege of overseeing the Office of Child Development and Early Learning, which we partner with the Pennsylvania Department of Education on a lot of critical supports and resources to children, youth and families. And we talk a lot about the fact that for families and especially families who are working moms, dads, caregivers, knowing that there is a safe place for their children to be is foundational. It’s really hard to concentrate on your work and all the things you need to do in your day unless you know you have that safe foundation and that you have high-quality program where your children are safe, where they’re well cared for. So I had also shared with Chris that I happen to be a parent of a Boys and Girls Club participant. My daughter attends one of their Great Futures preschool programs.
Chris Miladinovich: That is a big mission you have to fulfill and think about that impacting over three million people. That’s just amazing. Well, let’s have a joint conversation on something that’s very special to you both, and that’s this housing barrier. Why don’t we talk a little bit about what the state’s doing and then what the Boys and Girls Clubs are doing to kind of help the constituents through this particular barrier.
Stephanie Meyer: There are so many ways to approach this question. I’ll start out with, if we’re talking about the Boys and Girls Club, we’re often talking about children, youth, and families. And our colleagues with the Pennsylvania Department of Education, they oversee the Education for Children and Youth Experiencing Homelessness Program, otherwise known as ECYEH. And in the last fiscal year report, they identified over 40, 000 children in Pennsylvania who are experiencing homelessness or housing instability as defined by the McKinney Vento Act. So that’s quite a lot of families where they might be doubled up unsustainably, staying in an emergency shelter and don’t necessarily have that safe foundation. We talk about the fact that housing really has been under-invested in for decades, so it has been a perennial challenge where a lot of families don’t always necessarily have access housing has gotten far more expensive over the last few years. We just took a look and the rising rent prices have really outpace a lot of families income and ability to pay for it. So in an era of rising prices, inflation, we’re doing a lot of things to try to help where we’ve increased the benefits available through our supplemental nutrition assistance program. We have Overseen the administration of the Emergency Rental Assistance Program, or ERAP. And in ERAP, we’ve provided over 1 billion in rental assistance and housing stability services to over 200, 000 Pennsylvania families and households who’ve experienced financial hardship related to the COVID-19 pandemic and so many folks had situations where maybe they had a job loss or a loss of hours and we were able to provide really critical supports to stabilize them at that time in their lives. We work with the Pennsylvania Housing Finance Agency. I serve as the secretary’s designee to seek to build more housing that is available to folks at a range of incomes. Chris made a note about how there are communities where they’ve really experienced pretty profound inequities over time. And these are often due to a variety of factors, including structural racism. And we talk a lot about the fact that Pittsburgh is a most livable city and we really want to make sure that it’s a most livable city for all of our neighbors, not just some of them. So we really try to have a variety of resources and ways in which we support families to help them meet their basic needs and also increase access to housing and services.
Chris Miladinovich: So we talk a lot about homelessness, and can you define that for our listeners? Because we say the word, but we don’t think about what it actually means. Paint us a picture of what a homeless child looks like. Because then, now it becomes really real. When we can visualize it?
Stephanie Meyer: Yeah, that’s a big question and often one that gets some debate to it. For good reason. And so, many of the conventional definitions are established by the U. S. Department of Housing and Urban Development. And, often we say that there’s one where we talk about folks who are actively homeless. So they might be staying in an emergency shelter, staying outside, somewhere not meant for human habitation, in their car, things of that nature. There’s also what we call at risk and at risk may have situations that are untenable. So maybe it is someone who’s staying with someone, but they know if I stay here, it’s going to jeopardize my mother-in-law’s lease and she could be at risk to lose her housing, so I can’t stay for more than a couple of weeks. So with at risk, there may be somewhere temporarily to stay, but it’s not able to be sustained over time. And the McKinney Vento Act, which is the act that really has jurisdiction over the education and rights of youth in education has clear components for that doubled up as far as how that is addressed. And it also includes some foster youth as well.
Chris Miladinovich: And Chris, you probably see a cohort of this population. How does Boys and Girls Clubs of Western PA address these disparities?
Chris Watts: Well, I think from a fundamental perspective is that we’re here to try to support people. The families and kids that we serve as best as possible. We feel that our commitment to the kids, communities, and families that we have is to be there for the long term. And so I wanted to note something that Stephanie mentioned I think is really important is that what the state provides as it relates to licensed program and access to subsidies for those that really need it. That helps us ensure the sustainability of our programming because, we don’t want to turn any youth away, regardless of their ability to pay or have access to our program. And the unique programs that Stephanie was alluding to, that the state provides to programs like the Boys and Girls Clubs, are essential to providing reimbursements for kids that qualify and that allows us to hire the staff that are trained and reinvest in those programming. Especially in areas that may not have Philanthropy corporate other type of support to help subsidize. And so a lot of the state programs that Stephanie alluded to are beneficial to a whole host of community-based organizations, but particularly with you serving organizations like the Boys and Girls Clubs as it relates to how to serve families that truly need us that are experiencing whether it’s home and security or other type of challenges is that I really feel that any decision that we make, we really are trying to reduce barriers to participating in our programming and trying to lead with our mission. And it’s really hard because this is a large operation is a business at the end of the day, and we got to make a commitment that we can be sustainable. But that said, our commitment to reducing those barriers. How can we make sure the cost for those that may not be eligible to pay? How do we make sure that we can say, Hey, no, we got you. We’ll figure that out. We’ll work with you.
And that’s effort on our side to see how we can work on the back end there. Another big barrier, particularly as it relates to getting kids to our programs and home from our programs is transportation. And as I’ve experienced and we’ve experienced in organizations since COVID, that challenge has only been even more significant as some programs have consolidated across the state and particularly Allegheny County. There’s not as large of access to providers and so families are looking for different opportunities. So transportation now is a part of our business model that before a lot of kids could just walk to the club and right now because of a multitude of reasons we need to provide that access to there.
And another barrier, which is unique and you may not think of it at the top of mind, is process. One of the things that we really pride ourselves, as Stephanie mentioned, is quality. And quality relates to safety and ensuring that you come to a Boys and Girls Club. You’re coming with providers and staff that have gone through all their clearances and training and background checks and ensure that your peers have gone through your peer children and families are appropriately have the supports they need and the process to ensure that we have a safe environment. But sometimes those processes are tough. And it’s tough for families that may not have the time or capacity to go through sometimes significant paperwork to go through there. And so we’ve invested in some technology and other tools and staff resources that help families ensure that they can go through those paperwork processes that some of the incredible programs that the state and others have to offer.
Stephanie Meyer: If I may add, I think that one of the things that we think about all the time is that especially in health and human services as we’re thinking about bringing services and resources to people or alternately we’re thinking about bringing people to the services and resources. And those are so often the challenges that we’re all facing so it’s really wonderful when you see organizations stepping up and saying the community has changed. So much has changed since the COVID-19 pandemic and really wrestling with like, what does it take to get people where they need to be so that they can bring children to and from the clubhouse to get this high-quality programming to get that connectivity to their peers to learn. So it’s, incredibly valuable and I think it’s well, we all need to think a little bit differently since things have shifted so much in social service delivery and in health care delivery in the last few years we’ve had telehealth and so many other things come up that we’ve really weren’t quite as familiar with and to go back briefly to what you were saying You noted about quality. One of the things I wanted to highlight. So the child care works program that we offer where we help participants who are involved in certain programs. So folks who are in employment and training programs, folks who may be experiencing that homelessness or housing instability, and we help them get connected to this high-quality childcare preschool programs and able to get that.
We are working in the Shapiro administration to increase our rates. This new budget for 24 25, we’re increasing to 75 percent of private pay rates, which is something we’ve never been at before. So we’re really excited to make this investment in the health and well-being of our childcare infrastructure and to support families in this way. And one of the things I want to give some credit to, to Chris, I had a chance to tell him just before we started this. One of the things that I’ve seen the Boys and Girls Club do, we have an accreditation program called Keystone Stars. And it’s one of the ways that parents and caregivers, when they’re looking for a child care provider, can see this as a testament to quality. So child care providers that are licensed can work with us to get up to the highest, which is four stars. And I said to Chris before we started, that was one of the things that really impressed me about the Boys and Girls Club Great Futures program is that they pretty quickly committed to and got my daughter’s facility raised up to being a tier four star facility pretty quickly. So that’s a testament to the fact that you’re investing in your staff. You’re investing in making sure they have the training so that children are being supported. Well, there’s great early learning happening so, it’s really something where I value it and I’m grateful every day is a parent who does go to work.
Chris Watts: No, I appreciate that and we recognize that kids have choices parents have choices Funders have choices on where they’re going to support, and our commitment to quality helps ensure that we’re investing those time and resources that our stakeholders are supporting us are going to the highest quality use and so we have seven licensed programs right now in our portfolio, and right now, four of them at star four quality rating. We’re on trajectory for the remaining three to work through there, too. There’s infrastructure limitations, staff limitations that and materials that we’re working through. I would, I could assure you that the, the programming that was offered all at the highest level, but there’s some infrastructure developments that I think we’re investing in that are going to help us meet star four quality across the board. But I think that’s an important piece for us is our commitment to the community and what we want you to expect of a boys and girls club. It’s not just come to a safe place. It’s like, no, we’re coming and helping you learn from the best practices of youth development and whether it’s an early childhood or out of school time for K to 8 or teen programming that we’re going to help your kids prepare for a great future. And so that’s a part of that, that ecosystem that we’re, that we’re committed to. And it’s right of the, what the Boys and Girls Clubs have been pushing us is to ensure that we can and as I mentioned, the competition, You hate to say that and you don’t think in youth development, there’s competition and we’re incredible collaborators. And again, as I mentioned earlier, we benefit from collaboration with so many, but us lifting each other up and ensuring that that quality level is there so we can maintain and sustain for our families and communities is so important.
Dan Crogan: It’s truly amazing what both of the programs which you all are leading. I’d be remiss not to ask with everything that’s in front of you, there has to be 10 million things going on behind the scenes to make this all possible. How do you manage and prioritize? What’s the most important thing to drive forward?
Chris Watts: We developed a simple framework to start because again, there’s a million things we can focus on, but what are the most important? And the three things that we identify are the most is one, our staff. We cannot do anything we’re doing without an incredible team. And social services and youth development and education. We know staffing is such a challenge across the board. Folks are leaving that sector and it causes a limitation on what we can provide for our communities. And so I really wanted to make our differentiating factor for the Boys and Girls Club is big. We want to have an awesome team and we want to make it great for them to work here and invest back in that. And so we’ve really focused on creating that strong experience for our team, ensuring that we’re having a great culture, that we’re investing and prioritizing in DEI initiatives, knowing that those who need us the most need to have staff that reflect them in our leadership, in our board, and we’re working through that.
The second piece is on our mission. As I mentioned earlier, reducing those barriers is something that has been a significant priority. When we make decisions about programming, we want to think about how can our programming support those that need us the most. And so focusing on ensuring that, how can we reduce costs or make it easy for folks who really need us. How do we ensure that those who rely on us for transportation, we have the relationships with the school districts, or the appropriate transportation bodies, that we can provide that access there. And with process, again, we’ve invested in technology and resources to make registration process not just easier for our parents and families, but also for our staff, and how you acknowledge and process on the back end.
The third piece has to do with, I think we know that Boys and Girls Clubs not just means something to the kids and families that we serve, but it means some of the communities that we operate in. And not just even in the short term, but for decades. I mentioned 135 years, but there’s so many incredible alumni and people that have benefited from the program that care so much. And that’s one of, like, my favorite part of this job was hearing the stories and hearing folks that the club made a difference in their life. And that they want, they could do anything we want to help support it moving forward. And so being very cognizant of the impact that the club has in community and building those relationships with local stakeholders, whether it’s municipalities or the school districts that we operate in, or the relevant community partners that offer wraparound services or things that can help our programs be more effective. And so being at the table and actively engaged in community discussions and planning efforts and how can we step up and things that are a little bit. But potentially outside the box responsibly to open our doors to different community purposes. And so those are the three things that really ground ourselves on strengthening our team, delivering our mission, and our commitment to community.
Stephanie Meyer: So from my perspective, I often note as a social worker that I’m people driven, but data informed. And sometimes you hear a lot of people talk about data-driven decision making especially for us being the Department of Human Services. We are the largest commonwealth agency. We have over 16, 000 employees, a very large part of the Pennsylvania budget.
We are laser focused on ensuring that we are good stewards of the taxpayer’s funds and that we’re really supporting people with their health and well-being in a cost-effective and responsible way. So we think about getting upstream in terms of some of our investments in infrastructure right now to address health equity, health access, the ability to have the resources to live a good life, to be able to go to work, to be able to thrive.
And I think as a social worker, one of the things I talk about, I might have mentioned, I have a little bit of a background in community mental health as well. And I think it’s really important these days to think a ton about that. And that’s something that the Shapiro administration has absolutely made a very big commitment in this year’s 24/25 budget. We’ve put over a hundred million dollars into mental health supports, as well as increasing our County mental health-based funding. We really want to make sure that Pennsylvanians have access to the resources and services they need to be well and address their needs. And I think here, there’s some points I want to make that I think are really critical. So one of the things we’re doing is we are proposing a new teen waiver to the federal government to provide some new services and Medicaid. So we’re proposing to add some new housing services, food and nutrition supports, reentry supports, and multi-year continuous eligibility for young children, and that’s a very wonky way of saying that when a child in Pennsylvania, a baby is born and is eligible for Medicaid or medical assistance. Once they’re determined eligible, we’re proposing to keep them covered through the first month of when they turn six when they turn six.
So that’s something that is new and historic. It first got approved for two other states, but we know that gaps in care, that young critical age can be really hard and maybe is a reason that a family doesn’t get to the pediatrician, doesn’t get that wellness checkup, doesn’t get a vaccination. That can be part of requirement to go to high-quality childcare. So we’re really excited to get upstream and invest in children and families and set that strong foundation for a healthy childhood and well-being. And in our housing supports, one things we’re doing is actually proposing to add specific housing supports to pregnant and postpartum people, new moms, babies, families who might be experiencing homelessness and help them get back in track to find that housing stability.
One of the things I know, and this is some national research, there is some national research that came out that eviction lab really just talked about, and it showed the fact that, the person who’s most likely to enter an emergency shelter is a child under the age of 12 months. So in essence, babies, which is really sad and we can do better for all of our neighbors and all of the children across the nation. And we know that adverse child experiences such as homelessness, housing, trauma can be really hard and end up so that children might need increased behavioral health service, increased risk of needing specialized education services once they’re school age. So we really want to support families and give them that strong early foundation to prevent trauma, help them be stable, be well so that they can have those bright futures and really thrive in Pennsylvania.
So those are some of the things that we are thinking about. And one of the ways in which we’re doing this is we’ve set up a new social care platform called PA Navigate. PA Navigate is new. It just launched in January 2024. And in that, what happens is when folks go to the doctor, we do ask that our providers screen for Social Determinants of Health at least once every year. So if you’re going to the doctor more recently, they may have said, do you have enough food in your home? Are you feeling safe? Do you have a housing issue? Tell me more. And what they can do is In the past, they would say, okay, great. And I can maybe give you some phone numbers to call. We’re creating a new social care platform called PA Navigate, where those healthcare providers will actually be able to directly make referrals to community organizations that can help with those issues. So folks who know who are the experts, and they’ll be able to provide feedback on the outcome of that referral. Yes, I was able to get this person connected to a food pantry. I was able to get them connected to an employment training program. So we’re really excited to build that infrastructure to help that be another way that health can really be more connected to all the things we need in our daily lives.
Chris Miladinovich: Everything that you guys are doing is just incredible. And like you guys said earlier, there’s so much to do. You can’t do everything. Talk to our viewers and listeners about the obstacles. that you guys face in your organizations that prevent you from doing the interventions to tackle Social Determinants of Health?
Chris Watts: Two answers to that, because that’s, in our DNA, we know that there are going to be barriers. And that’s why we exist, is to go through those obstacles. And so, oftentimes when we’re going to have, as Stephanie mentioned, our kids and families and, frankly, staff are sometimes of adverse experiences that we have to go through and support in different capacities. For me, when we have a kid going through those experiences or a family that might be more challenging to work through with whatever reason. That’s the work and so I think that’s what us, that’s why we exist, and so I try to, and it’s like we have to embrace that, it’s really hard in trying to support our staff through that, but embracing some of those challenging environments, because that’s really why the Boys and Girls Clubs exists. We’re not just the childcare provider, although we provide critical services for families who rely on us to be able to work and provide for their family. But we’re here to help families that really need us. And one of the biggest barriers that Stephanie just alluded to is that also has an impact on those, those, those challenges on the mental health of, our staff, and has challenges in the mental health, and experiences that our families and kids are having in their communities or at home or wherever and are having an impact on them as well.
Last year Boys and Girls Club of Western Pennsylvania, the opportunity to host the U. S. Surgeon General, Dr. Vivek Murthy, at our clubhouse in the Stellis Campbell Clubhouse in Lawrenceville. And that was right around the time when the Surgeon General’s office released the advisory on the youth mental health crisis that exists right now, and as we know, the pandemic has exacerbated a lot of challenges that have existed prior to that and has only accelerated them for those that are already going through some, some pretty, pretty tough situations. And as that kind of convening illuminated is that we need as an organization to be able to not just provide those program interventions that we talked about is that we need to figure out how do we help prepare our kids for those programmatic interventions. How do we make sure that we’re meeting them where they are and offering that type of support for them? And also, our staff, who brings on the weight of that trauma, it’s heavy, and not all our staff are licensed social workers and have all the tools to go through that process. A lot of them just care about kids and want to do the best they can and so how can we provide those additional supports and so I will say that we’re, we’re very fortunate and pleased with the Shapiro administration’s proposed budget investment in mental health because we’ve benefited from that in previous years and we received a significant grant from the Pennsylvania Commission on Crime and Delinquency last year to invest in mental health, both services, mentor, mentorship programs and stipends for our teens to participate in our programming and providing mental health supports. So we have licensed therapists that are accessible in our facilities. We have group sessions at some of our facilities, especially those that need us where they might not have the opportunity to have those conversations in any other part of their environment. But that helps kind of create the space for those hard discussions and conversations and then can prepare for our programming. The service provider that we’re working with when we are gone through some really hard situations, we have conversations with them and we said can we offer your services to our staff? And that was a game changer that now some of our staff that are now working through some of these challenges with our youth. Now have access to free supports and a licensed therapist that we know the backlog of providers, particularly for youth, is pretty significant. And so being able to offer that as a resource for our teens and our staff has been quite significant.
Dan Crogan: And it’s amazing the initiatives that go into this, but as we can imagine, The individuals, the families, the communities that are having these obstacles and need your services. I would imagine there’s a lot of education. Some of them may not even know that this is an option. I’m sure a priority is where are we going to sleep tonight or how are we going to get food on the table. Could you talk to us a little bit how you connect with the member, the individuals, the families? Not only how you educate the staff and the providers on what you can provide to the people, but how do you connect with the members and get to the communities?
Stephanie Meyer: I’ll start from, from a high level. I think there’s a few ways to answer this and I’ll answer both from my Pennsylvania Department of Human Services hat and then briefly put on a hat from my past experience working for Allegheny County. So. I mentioned PA Navigate. That’s one of the new, newer ways where we’re really seeking to build that platform and have it be a really integrated way that folks can receive and learn about community resources.
In the early childhood space, one other thing that I will note we do have what are called Early Learning Resource Centers. And these are something that we fund throughout the state. There’s one locally here in Allegheny County. And the Early Learning Resource Centers, or ELRCs are there to help families understand child care quality options, but they can also have other supports. And here I happen to know because I used to work for Allegheny County Department of Human Services for a while before I moved to the state. There’s also a lot of different family navigators and there’s different folks there who can help them identify and connect to resources. Allegheny County really has some great infrastructure. So I’m sure folks can contact them. The Allegheny link, if they’re experiencing homelessness or housing instability, still have the number memorized 1(866)-730-2862. The Allegheny link is a fantastic resource for folks who are experiencing a housing crisis or instability locally. And there’s also the United Way and 2-1-1. So there’s a few different places where folks can go to try to learn about and connect to community resources. We’re all doing a lot of big thinking about trying to figure out how can we make it easier. And as Chris alluded earlier to like a lot of paperwork, a lot of ways that folks access resources currently we’re aware, like they can be fairly bureaucratic and they can be tough. So they can be hard. So we’re always trying to think on our end, are there ways that we can try to reduce our processes, make it so that facilities get licensed quicker so that we can reduce how much paperwork have to do, or folks can do things electronically, have someone help them over the phone. So we’re trying to think about the folks that.
There’s a variety of ways that people choose to access resources. We also think about older adults who may be interacting a little bit differently. So they may be interacting with their area agency on aging locally. There’s a fantastic senior line and folks who are part of the, the PA linked, the Aging and Disability Resource Center. So there’s a lot of ways that folks can try to learn about these resources.
Chris Watts: Another piece that I think is really important on how we kind of understand what our families need and support them, of course, we do surveys on an annual basis, and we get information on intake, on income level, and other disparities or things that we should be aware of, but really what it comes down to is the relationship from our program staff and our families, because that’s when you get to know the stuff. And sometimes they don’t feel comfortable sharing stuff on paper for every reason that you can imagine. One of our facilities in McKeesport, we just opened a new teen center with the collaboration and partnership with UPMC McKeesport and UPMC Health Plan. And when situations come up that we need behavior health supports or other types of supports, we can lean on them as a partner and ally there, and that’s the type of relationships that we’re looking to foster across our organization. And that’s not some institutional relationship that we could go up the chain, it’s just the program director at our facility knows the right person to call to get the help we need, which is, which is a testament to the partnerships and the commitment of our staff to get to know our kids and our families.
Stephanie Meyer: I would love to share a related resource here. So one of the things that I really like to share and make folks aware of is we partner with the Pennsylvania Key. The Pennsylvania Key is the PA Head Start State Collaboration Office. They offer a variety of supports and resources, phenomenal newsletters, they’re always talking about grant funding, opportunities, conferences and one of the things that’s a big priority of the Office of Child Development and early learning is we wanna provide supports that help to not interrupt care for, for preschool and for young children. And we know that that can happen for a variety of reasons. So we have something called Infant and Early Childhood Mental Health Consultation available completely free. Not of charge through the Pennsylvania key through our licensed child care providers and locally. There’s a lot of great supports through the Allegheny Intermediate unit as well as some school age support to the school districts to help assess needs and I’m gonna go into my like now I’m in my parent hat again.
My kiddo is five and Anyone who’s worked with five year olds strong wills They’re figuring out who they are in this world lots of opinions as we all are at the different You Parts of our Sagent for children, youth from infancy, toddler getting to school age, and then those teen years. There’s a lot of things to be figured out and all parents and caregivers are all just doing the best we can as our caregivers with complicated situations. And one of the things that I think is so helpful there is that they really are set up so that they can try and assess, give resources, help connect the the parents to tips and resources. Maybe you need to understand a little bit about what’s happening, like why is Johnny going wild at 3 pm every day and suddenly smacking so and so. Maybe there’s a precursor here and we can try to figure out some ways to problem solve together. Or I’ve done consultation myself. Maybe a child has, have a developmental delay. Maybe they need some speech services. Maybe they need some occupational therapy. And it can help tease out, what is, what is developmental? What might be mental health background? And there’s a variety of different resources to do this at different ages, but I really love the Pennsylvania Keys Infant and Early Childhood because I think it can be so valuable for providers, for parents and for children when you’re trying to figure out. And it helps reduce the risk of having children be terminated from care. If maybe they are having an incident like, oh, someone’s a biter, what are we going to do here? So there are some great ways to try and help everyone be set up for success. That I really just love the Pennsylvania Key so I try to tell as many people about it. And then there are the wonderful supports that Chris talked about as children get older and as we have our teens. These days, you mentioned you hosted the U. S. Surgeon General, which is a tremendous honor that the Boys and Girls Club was chosen to highlight. And they were really talking about the needs of adolescents and teens around mental health supports and these days, ensuring that our teens are connected, that they have resources, that they have care and treatment if they need it, is just so incredibly vital.
Chris Miladinovich: Well, thank you guys for so much for sharing the resources and your stories and, and everything that we’ve discussed about this important topic. We’re going to take a quick break, but when we come back we’re going to talk about the vision for your organizations. And then how our listeners can help. Whether you’re a payer, provider, or government entity, social determinants are a critical component of healthcare today, and play a key role in addressing health equity.
COMMERCIAL
Chris Miladinovich: Welcome back to Soaring to New Health. We’re joined by Stephanie Meyer and Chris Watts, and we’re having a great discussion about the Social Determinants of Health. Let’s talk about the vision for the future for your organizations. You guys are doing a lot of great stuff. But what’s on the docket? What’s the innovation in the space?
Stephanie Meyer: I talked a little bit earlier about what we’re building with PA Navigate a social care platform and our development of an 1115 waiver to provide some new supports in our state Medicaid program. We’ve really been working with our managed care organizations those are the healthcare insurers who provide services through our Medicaid program to over 3 million Pennsylvanians, and we work with them to do that assessment of Social Determinants of Health needs, and there’s a variety of ways in which folks may be able to help or may be able to drive change. And we know that a number of different entities one of the things I always say in these spaces is to make a difference, it takes collaboration and partnerships. As Chris has said really well, we can’t, none of us can do this alone. And it really takes sometimes investments from all levels of government. I do say this from federal on down. So I pay because we’re working with the allocations that we have at the state level, but we’re also thinking about drawing down resources from federal partners, working with local municipalities. I often say, working in different communities, one of the things I come up with, and I’ve been doing a lot of work with rural communities throughout the state too, even beyond western Pennsylvania, and really once you get outside of the city center, you hit some rural communities relatively quickly. And we often find that there are these fabulous community-based organizations and non profits doing great work, but they’re just, they don’t have a lot of capacity.
So we’re doing a lot to think about helping those organizations build capacity to be able to be part of these social care platforms. And that in turn could make it so that maybe healthcare entities we ask for them to have what are called value-based purchasing contracts. So we say, we want you to address Social Determinants of Health, and over the course of years we want you to increasingly partner with organizations that can help meet these needs. We have things called community-based care management and this is a place where really, our managed care organizations can be fairly creative. Locally, we’ve seen them do some great work around eviction prevention with some of the folks like the Allegheny County Housing Authority and mediation. There might be programming that is more general to the community or accessing food, accessing. So there’s a lot of different ways in what this might look like. I think one of the things that’s really special and unique around Western, Pennsylvania is we do have incredible philanthropic partners. We’re in we are the city of Mr. Rogers, so I think there’s a really great commitment to meeting the needs of our neighbors and honoring all of them. So for us, we’re thinking about building capacity making it better possible for a lot of different community organizations to take advantage of resources and building these partnerships that make it all possible.
Chris Miladinovich: Thanks for sharing that. And Chris, how about the Boys and Girls Clubs?
Chris Watts: Well, I think what Stephanie just mentioned does inform and inspire our vision forward is that we are blessed to have incredible philanthropic History and current support here and Mr. Roger’s perspective on being a good neighbor is something that we fully embrace and I think for us, there’s some math behind it, and then there’s some kind of what we do best. And so the math is that in Allegheny County, there’s 230, 000 children who are 18. And that vast majority of them are not being served in quality out of school time programming. And that’s not just due to one factor.
There’s many factors that do it, but the biggest factor is just access. There’s not programs out there. And so as we think, how can we, the Boys and Girls Club as one of the largest, the lead largest provider that has a platform, how can we help ensure, whether it’s in a Boys and Girls Club facility or not, how can we help ensure that the kids are being met in a way that meets our mission? And that’s something that I really care about and I think we’re working towards in the future. Alluding towards kind of what we talked about before is that as we look through, okay, supporting and ensuring that we have a business model that is resilient and sustainable as times evolve, that’s not going to be the model of the past and so the brick and mortar Boys and Girls Clubs that has full service everything that Stephanie and her family have experienced in Lawrenceville may not always be what works for communities you need to think through access and those factors that limit those barriers we mentioned before. And so, whether it’s in schools, whether it’s in housing complexes, whether it’s access to public transportation those are kind of the places that are, make it easier for families to engage in our types of programming as we think through partnerships and collaborations. Those are the types of things that I’m thinking about and filtering through as we make decisions on where we should be offering our services. Types of, so what we’re thinking about as an organization and where we want to go is that as I mentioned, we’re only providing resources to 10 physical locations across the region and there’s all is opportunities for expansion that we’re thinking through, but that’s that responsible operating model to ensure that we can sustain because the one thing that I know, based on, coming into the Boys and Girls Club and hearing the stories that I alluded to is that it means so much to the kids that have gone through it, but the families that rely on it, and so I want to make sure wherever we go, we can sustain and commit to the long term. And so thoughtful decisions and honest decisions with our funding partners and collaborators on what it’s going to take because you can do the math, too, on what it takes to sustain a program when you talk about staff and resources and materials, operating costs, facilities, maintenance, all of this type of things. I, of course, we feel that investments is worth it.
But right now, there’s limited state budget line items that go to support that directly. And so, trying to think through the creative matrix of funding partners that can help support that in places that really need us is stuff that we’re thinking about. So for us, we’d likely continue to prioritize as we think through any type of expansion opportunities or the highest need communities that have that sort of potential operating model that allow us to be sustainable to support there. But I see coming through COVID and coming through some evolutions there, we’re well positioned to have those conversations now. And we are at the table with a lot of those discussions. And I feel privileged that folks are calling the Boys and Girls Clubs and saying, we need you. How can we be there and whether that’s elected officials or municipal leaders or kind of school-based organizations, or just parents, people that care. And I wanted to make sure that we’re prepared for those conversations and that we can responsibly engage in discussions. And I’m excited about some of the, the, the future locations we’re considering.
As one of the locations we’re considering right now, I’ll allude to is an expansion in downtown Pittsburgh. And so downtown Pittsburgh, you may think like that’s a place for business, but there’s 2, 500 kids who go to school there every single day, about double that transfer through on public transportation, on way home from school. And we did not design a place for kids, I’ll tell you that. And so you are dealing with the downstream repercussions of that. And there’s not really places for kids to thrive, and so we’re really in active discussions with other service providers or stakeholders on how can we provide a proactive place saying, hey, you are welcome here, and this is a great place for you to kind of meet your potential or get access to different programming. But, can you imagine, downtown Pittsburgh, real estate prices, despite the conditions, are still what they are. And so, to meet the need, because transportation’s there, the hub and spoke model of the region, you can get people there to lower barrier entry, but providing those services could be a little bit more challenging. But that’s just one example that we’re considering now, that is meeting the need of the region. In a way that we feel the Boys and Girls Club can add value to that for a whole collection of stakeholders. Most importantly, the kids that really deserve the support.
Stephanie Meyer: Yeah. That’s such an important point. I think one thing that we don’t talk about enough in society, and we’re starting to talk about it more for adults, but our third spaces and how we think about places where we live, our home, we think about work, we think about school, but third spaces really just play places for people to be, to socialize, to engage, and that’s something I think that is so critical for our youth, because sometimes it’s like, oh, if I’m spending too much time at a mall or wherever it is, like, I’m loitering, am I causing trouble, et cetera, et cetera. And so I think giving youth these safe spaces to be is just so critical, and you have that opportunity to engage in STEM and STEAM programming, arts, education, and math, science, tech, career possibilities, social supports, athletics, like there’s so much. So I love that. I hope that that happens.
Chris Watts: Working on it with behind the scenes stuff that hopefully will come out soon, but it’s a, it’s a need and whether it’s us or a collection of partners, it needs to happen. And like, as I mentioned, the kids deserve it. Because I think we’ve designed out some of those passive places that used to exist in some spaces. And so we try to kind of bring that back and provide some more active spaces.
Dan Crogan: Well, it goes without saying, but what you both are driving and what your organizations are doing is absolutely incredible. And you have grand, grandiose ideas for continuing to innovate and continuing to help those communities and these members. What I’d love to ask and hear more about is, how can we help? How can the communities help? How can individuals help? What can we do to help bring your vision to life?
Stephanie Meyer: That’s such a great question. I think a few things come to mind for me and I’ll note again like my background and what I focused on most of the time at DHS is housing and homelessness and housing instability and how many, too many of our Pennsylvania neighbors are facing that housing instability every day with rising prices. I’ll note in that space, I do think being supportive of housing and a range of types being built. Sometimes they talk about the NIMBY or not in my backyard philosophy that happens a lot and what we really know that we need in Pennsylvania and in a lot of communities including Pittsburgh is we just need housing. A lot of it because we need to make up for decades of disinvestment. So becoming someone who’s pro-housing and who is for affording to fund that as well as reducing barriers. So they might be things like permitting, permitting reform, zoning reforms to make it possible to build a variety of types for folks at all different levels, family size, needs as folks age.
We have an increasing gray older adult population in Pennsylvania, so thinking about their needs is going to be really critical. So just making it possible to do that I think is really viable and that’s something that folks can do through letting their legislators know that it’s really important to them and folks can think about investing in that. Maybe that helps meet community health investment requirements. We know that a lot of our managed care organizations have done some really phenomenal pilots and programs where they’re investing in health locally. UPMC in particular has one called the Cultivating Health for Success Program. I’ve known others that do similar ones and I’ll note for this that a lot of times we hear that it takes six plus months to find housing for people because we just have the supply issue. So addressing that the root cause here is going to be really helpful. And I would note here like getting to know your legislators voting like that’s really important that that helps drive our priorities, drives our decisions and the strategic investments that are going to support Pennsylvanians and all of our neighbors.
Chris Watts: I will do my part to help continue to support and advocate for the awesome work that you’re doing, Stephanie, at the state and the Shapiro administration is leading, because it makes a difference to programs like ours, because we do need the support. As I mentioned earlier, the Boys and Girls Club is an organization that thrives from the generosity of the community and, and the support that we can receive. And so the things that really make a meaningful difference to us, number one, is that we’d love for you to come work for us. And so, folks that care about this mission and supporting kids and community, we’d love to have you explore some of the open positions we have available right now because it makes a difference. Second, we’d love to have your kids enroll in our programming.
I mean, we have awesome programming across the region whether it’s preschool or after school programming or summer camp or team programming or sports where, you experience the Boys and Girls Clubs, regardless of your background, income level. We’d love to have you and that’s part of the beauty of what we do. We bring a whole collection of folks together to experience something that’s unique and be able to understand and reflect and empathize with your peers and understand different backgrounds, helps you prepare for success and so we’d love to have your kids as a part of our program.
And third is contribute. I think what really makes a difference to us is folks that care about our mission. And I’ve been very fortunate to build a relationship with our folks at ProspHire here that have been incredibly generous over the years that make an impact on what we do. And resources and partnerships like that allow us to provide access to kids that really need it. And so, for folks who want to support our work whether it’s through scholarships that we can provide to our kids and allow us to be flexible for the families. And some of the funding streams and resources that Stephanie alluded to, the Child Care Work Subsidy Programming, of course, there’s going to be strings attached to those and process you have to go through.
But sometimes families can’t wait for that and so, we want to be able to be flexible and families need some support, that’s where those contributions and scholarship resources really help us. Additionally, if you’re interested in programmatic partnerships and alignment we have a whole host of activities that we do that we’d love to kind of ingrain a deeper partnership in. As I mentioned earlier, we have a wonderful relationship with UPMC and UPMC’s health plan, but we also have an incredible relationship with Highmark Wholecare that helps us really think through how to support families that really need us in creative ways. And so, there’s different ways that we can work with partnerships, whether it’s within the healthcare community or community based organizations that really care about our mission. I think the last thing which I wasn’t planning on mentioning but I will reiterate which Stephanie shared is advocacy. And so if you have a platform that you have access to elected officials or folks that you want to get in their ear about the importance of some issues. Think about the importance of youth development and childcare. I mean, that is not just providing access for a safe place to for kids. It’s helping families sustain their success by allowing them to work, but it also allows our employers to provide flexibility for their employees as well. And that’s what we hear. Oftentimes is that man, we’re trying to find employees, but our staff, perspective staff, can’t find child care or they need more flexibility with their life in order to deliver on the requirements of the job. And so programs like the Boys and Girls Clubs provide those families and employers the flexibility to help be successful.
And so for those that want to support in any different way, our website’s bgcwpa.org and you can find all the resources you need to help support and we’d love to get in touch with you.
Chris Miladinovich: Thank you guys so much. Thank you, Stephanie, and thank you, Chris, for your valuable insights about how environmental factors have a profound impact on the overall development and future health. As we wrap this episode, we extend a very large thank you to our listeners for joining us on this journey through SDOH in the community. Whether you are a healthcare professional or someone passionate about the quality of care, we hope this episode has inspired you.
Dan Crogan: Thank you for tuning in to Soaring to New Health. If you enjoyed this episode, don’t forget to subscribe, rate, and leave a review.