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Becker’s Healthcare Podcast
Jessica Salem, Executive Director of the Center for Health Equity at Dayton Children's Hospital
00:16:46
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- [00:00]
A
Welcome to the Becker's Healthcare Podcast. I'm Chris Soso, your host, and today I'm thrilled to be joined by Jessica Salem. She's executive director of the center for Community Health at Dayton Children's Hospital. Jessica, thank you for joining us today.
- [00:12]
B
Thank you. I'm excited to be joining you.
- [00:15]
A
Jessica, are you here, of course, to talk about the kinship housing project, but before we get into that, could you let our audience get to know you a little bit better, introduce yourself, tell us a bit about your background?
- [00:25]
B
Sure. I am a. A lifetime member of Dayton Children's Hospital. I have worked here for over 18 years, and I am fortunate enough that I have been responsible really, for the majority of those 18 years for all of our community health work. So for, you know, the hospital audiences, I'm responsible for things like our community health needs assessment, community benefit, our community engagement strategies. If the word community is in it, it seems to kind of fit into my realm. So this project, which we'll talk about today, just fit so perfectly and fit my background, and I'm really just excited to be able to share about it with you today.
- [01:03]
A
That is so fantastic. All right, so without further ado, let's jump right into that. Jessica, so very simply, but can you take us through the inception and evolution of the kinship housing project? What do we need to know right off the bat?
- [01:15]
B
Sure. So several years ago, and I'll start out with the fact that a project like this takes many, many years of planning and thought. But I think we're thinking about 2019, 2020. We were talking to our community health workers here at Dayton Children's who were working specifically with kinship families. Those are the grandparents, aunts, uncles who are taking kin in instead of those little kids going into foster care. So really special people and special families. And as we were talking to our community health workers and understanding the barriers for this specific patient population, one of the highest needs that came out of conversations was housing. That many situations were that a grandparent wanted to take care custody of their grandchild, but they were living in senior housing, or their housing wasn't big enough for the teenager that really needed some room to grow. And over and over and over, this became a barrier. And a little bit backdrop, the backdrop here in Dayton at the time, we were in the epicenter of the opioid epidemic. So we had a lot of kinship families just being created overnight because of overdoses. And so this just really came to a head. We also had a tornado in 19 as well, and that hit the neighborhood not too far from the hospital. So just know that I think that's important background information of why this was such an intense need around housing and kinship families at the time. So I'm really grateful. Our president and CEO, Debbie Feldman, she had heard about the community health workers and what they had said about the kinship families. And you know, she said, let's just build housing. Then. I know it's one of those things, like not often that a CEO says let's build housing. But she is a very community driven person and also very much into community development. Her background is actually our county administrator. So she understood the systems of foster care and homelessness and all of those things. And so it was just kind of that perfect storm of all the right pieces coming together to say we should be doing this. So at the time we did some pre development, we had land not too far from the hospital, about two acres, an old school site that we were able to purchase and started on this journey of really just forming and norming this idea. So then a long story short, because that, you know, that covers four or five years, we were able to assemble an incredible team of, you know, an architect who listened to the neighborhood about what should fit in the neighborhood. This isn't a high rise. These are little duplex homes. Look and feel of old North Dayton, where we are located. We have a phenomenal contractor, the model group. They understood community development, they understood this type of work. They have a passion for this population. So they were our developer and general contractor. We knew that we should not be in the property management business. I know I don't want to get phone calls in the middle of the night for whatever it might be. That's just not my expertise or the leasing side. There's a lot of details with that. So we're partnering with Wallach Communities, who is our property manager. We have a local organization called citywide Development who really does a lot of boots on the ground, community development, really getting input from the neighborhood because we want families in this little neighborhood to feel like they are part of the neighborhood and not, you know, just that they truly are part of the community. So after assembling all of these partners, and of course you have to get the funding. And we were lucky enough to get some congressionally directed funding from our senator Sherry Brown at the time. That was really kind of $2 million that really got this going. We're like, we can actually get this done. And we were able to get some county funding, some city funding. And then this project is a 4% low income housing tax credit Project which will make a lot of sense to people that know housing. So you cobble together all those funders who also believe in the project. And here in, on October 27th, we were able to officially like open the housing, at least the first cluster of homes. And we are currently in the lease up phase.
- [05:17]
A
Jessica, thank you for covering all that ground. As you said, it's a lot, but I think you explained very well that there are a lot of moving parts here. I mean, whenever any sort of entity that's really not the government is going to take on such a huge undertaking. I mean, for example, you said, you know, we don't want to be in the property management business. So that might be a question that someone asked at, at the outset. Right. It's like, okay, are you going to be a landlord now? Like, how does that work? So, but yes, as you said that you're. It's not just Dayton children saying, okay, we are overseeing every aspect of it. We have partners who are helping with this aspect and that aspect. So as, as this is coming to fruition. I mean, you mentioned Deborah Felman's role and Sherrod Brown's role and just how much effort does it take on the part of the hospital and a leader such as yourself in terms of making all this happen? Does that make sense?
- [06:13]
B
Yeah, I've talked with Debbie quite a bit about this because it really does take, and I think this is the role that we have said that the hospital is taking is that we're really that convener and the group that it was great that we have the legal team that can do this and that can kind of figure this all out. But also at the same time, we know our limits as a hospital, but we really, we often say that we're like the sole organization dedicated to health in our community or children's health in our community. And this is children's health, this is their mental health and their physical health. And to really rally people around it. That's really been the role that our team has played. There's a lot of like little bits and pieces, like, you know, making sure that this T is crossed and I is dotted. I mean, it's amazing what goes into this. I never knew that when I, I said that I would do this. But yeah, it's a lift, I think, from a really technical standpoint of the hospital to say, how does this work? But then also to know this is where our boundary is, this is where our line is, this is where we can't cross, and this is where we really need to partner. And a lot of our community work, we're really committed to partnering with the right people who are the experts in that space.
- [07:25]
A
Perfect. I mean, on the other end of it, it has to be inspiring and uplifting from a morale point of view for Dayton Children's, where certainly we can say, as us healthcare providers, like, all right, if a patient doesn't have housing or, you know, proper nutrition, et cetera, then they're going to have these problems. So for a health system to be able to step in and say, you know what, we're going to take care of that, huge issue. Right. That way we can help everything else fall into place. Right. So, yeah, just given what you've had to do to do this, I'm just really trying to point out and just emphasize your point that this is not something that, like a lot of things in healthcare, it's not something someone who might be a silver physician to yours is gonna be saying, okay, six months from now, we're going to have this. Probably not, but it is possible.
- [08:17]
B
It is possible.
- [08:20]
A
Awesome. So looking ahead a little bit here, Jessica, how are you going to measure this project's success and how do you hope that it will grow in the next? Take whatever timeline, Sue State and children's, whether 3 years, 5 years, 10 years, etc.
- [08:35]
B
Sure. So, you know, and that's the best question, right? Like, what's the return on investment, in a way. And I know as a hospital, you have to think about that, and it is about children's health. So on the outset, you know, this project is 26 units, so 26 families can be served. We're prioritizing those families in the kinship situation and also families that might have a chronic health condition, a child in a chronic health condition, because you're only two blocks away from the hospital. And so ultimately, you know, 26 families having stable housing is, you know, one measure in itself. And we hope that we fill that by, you know, early 2026. So that's kind of the timeline that from getting people in the door. But it isn't always, you know, just about housing, but it really is about how do we ensure, you know, stability for the kids that probably have been moved around a lot, given their background, and frankly, stability for the kinship caregivers who may have been living in an isolated situation, you know, the only ones that are now a grandparent taking care of a four year old. I mean, I just really think about their different situations. So what our team is doing, we're not going to do any Formal research, at least at this time, because we don't have a good, you know, we don't have a control group to necessarily compare, you know, but we are going to be surveying the families and first of all identifying their, their home situation before, just to understand, you know, the pre and post, you know, short term, where were you living before, what was that situation and what's the situation now? These are all three bedroom, two bath, about 1400 square feet, big backyard. We have a shared playground for all of it. You know, so really a whole. Not far from school, it's not far from a bus stop, you know, all the things we really tried to think about. So, you know, there is that kind of immediate, I would hope for families an immediate restfulness that they're in a home that is just a bit more conducive to the kinship situation. I think longer term, as a hospital, we are going to be looking at things to the extent that we can. You know, families have to be willing to share their information with us. But are we able to see that their asthma is better controlled? I mean, we did. We intentionally made these homes with no carpet and kind of simple, simple features. And once again, not all, like kinship kids have asthma, but there probably are some health outcomes that we're hoping to impact through this. I think it's going to be the behavioral health, the mental health components, and that isolation piece. And we're going to be going back to the families on a regular basis, just kind of understanding and asking them those type of questions. And then also from a social support perspective, we're going to ask the families what, I mean, do you need food? What are the other social needs that you might have? Because the hospital has some resources for the general population as well as our patient population. How can we at least take advantage of those resources for these families as well? So, yeah, I think long term is just thriving children in this neighborhood. And that can mean a lot of different things from the health, like a true health care perspective all the way to our more holistic health perspective.
- [11:40]
A
Yeah, you raised some, some really great points there that for the one thing you're, you're just at the outset of this, so you have a ton to learn. But I'm sure you're also very excited to be able to help these children and their families to say, you know what, you know, yeah, you are only two blocks from the hospital and here's how we're going to help you see, okay, this condition that you have is getting better, whether it's asthma, as you mentioned mental health or behavioral health. So this is such a long term component that you don't necessarily see from a lot of hospital programs in general. Does that make sense?
- [12:14]
B
Right. Yeah. And we need the families to stay there too, because, you know, that's the other thing is if they've been moving around a lot, you hope that they do stay and then that allows for more stability for the kids and that helps with school absenteeism. I think it just is that holistic picture of health, that all those things matter and that's the type of things that we're going to be looking at.
- [12:34]
A
That's a whole other element in school is this. You mentioned it. The big thing here is stability. Right. It's going to start with that, looking at this whole thing from an operational standpoint, Jessica. So if you can give other health systems who might be thinking about this sort of project, and hopefully there are, hopefully there are others who hear this and say, you know what, we can do this too. So for anyone who is looking to take, undertake, I should say, similar effort. What advice do you have for them? And I know that can be a long list. So wherever you want to take that, please go for it.
- [13:08]
B
Yeah, I mean, I think it is one of those every state's a little different with the type of funding that's out there, every community. So it is kind of figuring out what's what population, what, you know, what makes sense for your organization. But I think for us, we. And it took us time and this, you know, it's always hindsight's 2020 and you're like, oh, we wish we would have included them earlier. Right. So from the outset, you know, we had, you know, here I'm in like the community health space. And of course our CEO was leading this effort and we already had some really good community development partners working in the neighborhood. We were already working and that's citywide development. So some of that infrastructure was already here at Dayton Children's. But I would say a really good community development partner is important inside the hospital. We've really leaned on teams like our facilities team. So, you know, and a facilities team probably in some spaces could lead this. But I just, you know, every hospital is a little different. But our facilities team has been absolutely incredible as far as, you know, helping to interview the property maintenance people and what, what about this and this and this and they. So they've been a really important part of our team. Our accounting and finance department has been very, very important just because of the way that we had to close on these deals and this housing tax credit. And this is an area that I know very little about. So that accounting and finance team, our legal team, was super important here. Again, this is something that a hospital might not normally do. So how do you set something up like this? So those are, like the key internal people. And then we really, you know, we went. Reached out to people like our security, for instance. We are not providing state and children security on this. You know, we said, nope, that's gonna be the property manager's job. But still can utilize the expertise at the hospital. And what I. What I really think has been neat about it is that you, you know, across a hospital, you can get different people excited about a project like this. And I think it does help employee morale, too, to say, you know what, this is something really cool our hospital's doing. And I'm proud to work at Dayton Children's. And we've seen that a few times when we did the open house for this, and we opened it up for staff to come in, a good 150 staff come through. And, yeah, it was a walk from the hospital. They had to take a little time away from work. And we intentionally wanted people like social workers and community health workers and others who would naturally refer families. But we have a wide variety of our staff come through, and I just. They were just proud. And I think that's really, really neat. So there's a kind of two sides of, hey, it's a great thing to do for families. But also there was a sense of pride for our staff.
- [15:42]
A
That is so cool, to say the least. Jessica? Yeah, I've certainly any number of us have read about projects where, for example, health systems are building more. More affordable housing for their own employees. And that's certainly a huge thing, too. If you live in a place where it's hard to forward live, that's a whole other issue that can and does need to be solved. And this just seems to me like you're taking it to a whole other level at Dayton Children's.
- [16:09]
B
I think we're trying. And I will say we've told our staff, if they are kinship caregivers themselves, they would qualify. And so we've had some phone calls from staff members, so hopefully in a couple months I can report. I just think it's just a neat connection, right, that we have staff that would be in a kinship situation and they would also qualify.
- [16:29]
A
Fantastic. Well, Jessica, thank you so much for coming on the podcast today, for lending us all your insights. I really can't wait until our audience gets a chance to hear them. And, yeah, she's looking forward to the next time at Passcross.
- [16:41]
B
Sounds great. Thank you.