- (female announcer) Production funding for Behind the Headlines is made possible in part by the WKNO Production Fund, the WKNO Endowment Fund and by viewers like you, thank you.

- The new leader of Church Health, tonight, on Behind the Headlines.

[intense orchestral music] - I'm Eric Barnes with The Daily Memphian.

Thanks for joining us.

I'm joined tonight by Jenny Robbins, the CEO of Church Health.

Thanks for being here.

- Thank you for having me.

- Along with Bill Dries, reporter with The Daily Memphian.

I mentioned at the top that you are the relatively new leader.

I think it was last summer that you started, and we'll talk some about that.

But let's jump into Church Health, and then we'll come back to your background, and all that.

The biggest challenge you all face right now, it's a strange time for a lot of the work you all do.

So, give me the quick answer to that.

- You know, it is a strange time.

We've got our patients who are fearful, funding questions all of the time with federal funds, private donations.

I mean, we are a not-for-profit that is largely funded by Memphians, and folks who just want to help make Memphis a better place.

So we really just need to make sure that we can keep our doors open, keep our volunteers active, keep our patients healthy, just to make Memphis a better place.

- We talk about patients being fearful.

I think I know, but for those, and we'll do a little bit more about all the work that Church Health does, 'cause even for people familiar with it, I'm always struck by there's, "Oh, that program, and that program and that program."

But the patients who are fearful of what, and who are they?

- Yeah, I think just the political climate, and you can't turn the TV on, or go to anything on social media and not see somebody upset about something, and something going away.

Of course, the undocumented issue is a huge concern for our patient population.

Most of our new patients these days are Spanish-speaking.

So there is always the fear of, "Will I be profiled?

"Will something happen at Crosstown?

Will something happen when I'm seeing my doctor?"

And we just have to make sure that we are a trusted resource and someone who can help overcome any fears by just taking care of the person who is in front of us.

- We'll stay on immigration, because we don't do a ton of national stuff, but it has big local impacts.

This happened when some orders originally came down a couple months ago that there was rumors and some substance to the fact that Hispanic families, Latino families were keeping their kids outta school, because they were afraid of roundups and pickups.

And it was never clear how much that was happening, but it was clear that it was happening to some extent.

Do you all experience that?

That people who need healthcare, or care of some sort, are not coming to you because they're afraid to?

- We haven't seen a huge decline in our patient visits.

Sometimes there is the correlation when you can look at the, I guess, social media rumor mill, things that are happening that sometimes we might have a dip in something, but folks are still coming to us.

We have had a couple of anecdotal stories from our medical director and other providers who say that, you know, patients were scared in the room, or fearful, didn't maybe want to go to the emergency department.

But for the most part, folks are still coming to us.

We're a trusted place for people to be.

- Let me bring in Bill Dries.

- There's also been a lot of concern about measles outbreaks, things like that.

What's the situation at Church Health on that?

- So actually, our medical director and chief operating officer have been on top of that.

We are making sure that everybody has good documentation, that all of our staff is having vaccinations and that everything is current.

But we haven't seen any cases in our clinic.

I think there's been one case in Shelby County.

But like all medical protocols we adhere to the standards that we need to adhere to and we're ready if we have to have any kind of situation.

But so far so good.

- Are people coming in for the vaccinations?

- Not that I'm aware of, no.

You can go to the Health Department, the shot nurse, but we don't.

In our pediatric departments, we will vaccinate for that.

- Right, right.

What have kind of been the lessons, or maybe the legacy of the COVID pandemic in having these type of discussions?

- So I think COVID, you know, it wasn't all bad.

I think there were a lot of opportunities that we were able to take advantage of with how we are doing the same thing every day.

Just a little bit differently.

Whether it is, you know, telehealth visits folks, you know, our nutrition kitchen and our dieticians, they have been able to have telehealth visits with some of our patients in their own kitchen to be able to see what's in their pantry.

Some of our behavioral health specialists really did find that a lot of patients did want to have some telehealth visits, but it just really allowed us to figure out how to build a better mouse trap, be efficient with our patient scheduling and use of our volunteers time.

- Right.

Because I think people who may not know Church Health might have this image that, "Oh, it's a clinic to drop into," and it's so much more than that.

It involves wellness services, preventative healthcare, those kind of things.

So that's a big part of your work.

- Correct.

We build our model of care, based on the model for healthy living where, you know, medical is just a portion of what we do.

Nutrition, friends and family, work life, faith life, everything that we do, we wanna keep things in balance for the patient.

So, you know, Dr. Morris will say fifty percent of the time the patients that he is seeing in our walk-in clinic, they might not necessarily be sick, but something else is bothering them.

And so, we have an opportunity in through our medical clinic to start identifying places where we can help bring patients together through our other outreach programs.

- All right.

How do you think Memphians use this magnificent healthcare system that we have?

I mean, is there such a thing as using it correctly or not taking full advantage of it, I guess?

- Well, I suspect we all have that issue with, "Do we use our doctors appropriately?"

But you know, we are a primary care health clinic.

We've been open since 1987.

Dr. Scott Morris was our founder.

And it truly is, we are looking for the called people to help make Memphis a better place.

And so, you can be a patient of Church Health if you are working in a low-wage job, underserved or uninsured Memphian, or part of a family member who has that sort of situation.

And we do wanna take care of the whole person and the whole family.

Continuity of care is very important to us.

So, you know, we have our primary care clinic, we have subspecialty clinics on our second floor.

We have dieticians, nutritionists.

So, you know, if you come into Church Health, we're gonna find ways to get you whole, get you healthy.

Some people take care of it, some people, you know, it takes them a little while.

- For people who have seen in Crosstown in the west atrium, the kind of scale and understand how much of that is Church Health.

They may think that's all of Church Health, and that's really impressive.

But it's also this network.

I don't know how you'd term it, but the volunteering of a lot of medical professionals all across the city, right?

- Correct.

- And really more care is given that way than in the clinic.

- Absolutely.

So we have 65 exam rooms at Crosstown, and we mostly use those for primary care clinic by staff doctors.

But we have a network of 1,000 volunteer providers, whether they are, you know, primary care, subspecialists, hospitalists, who will treat our patients if there is something outside of the walls that we can't take care of.

And this is just the community of Memphis coming together to help serve those who make our lives better.

- Of all the services you provide, goofy question, but what is the service or services that people are most unaware of?

Because there's a whole lot that you do, and you've touched on a bunch of them.

- Gosh, I think probably our nutrition kitchen, our Make-A-Meal programs, the diabetic classes that we teach are probably some of those preventive care measures that we have that folks don't take advantage of that much.

But we have opened up an eye clinic, and that has been a huge expansion of care for us to help parallel our primary care services to diabetic care, to take care of the eye health as well.

- Shifting a little bit the scale, I think I looked, the budget for Church Health every year is about $24 million, give or take.

You're the former CFO, you're the right person to ask.

So, that comes the breakdown I think is something like, what, $22 million in donations, three to four million in government grants, is that- - Actually, so government grants are a very small part of what we do.

Primarily we are funded by the private community, private businesses and private foundations here in Memphis.

We do have some government funding, a HRSA grant or two, some state funding with the safety net.

That is a huge part of our budget, I think.

About two and a half million dollars every year.

But we do have patient revenue coming in.

We are not a free clinic.

Everybody has, you know, a little skin in the game to take care of themselves.

Nobody wants a handout.

They want just help.

- So how does that work?

You just sort of, what can you afford?

I mean it's almost the honor system, or is it more formal than that?

- No, it's more formal than that.

We have a sliding scale that, you know, we match patients' income, based on what the affordability could be.

So, that brings in a decent amount of revenue for us that we are able to put back into patient care.

- I should have mentioned at the top, we're taping this.

When this airs, we taped it a week ago.

I'm not sure that anything came up, but I did wanna talk a little bit about the government grants and the state grants, and the legislature is in session, so I should mention that this is a week delayed.

Go back to that, the state funding, and then there's been talk, it doesn't seem like it's gonna happen this year, but Medicaid expansion and then at the federal level, potentially Medicaid expansion by Tennessee has been talked about a little more over the last few years.

It was a very controversial decision, not to take it back when Obamacare was introduced.

Some Republican red states, southern states have taken Medicaid expansion since Obamacare was launched.

But where do you see Medicaid expansion going?

What kind of state funding do you get?

And do you worry that any cuts to Medicaid at the federal level will drive more people to Church Health and your Church Health network?

A lot there.

- That is a lot there.

We will always have patients, there will always be somebody in need, and there will always be a line at our door.

So we can't solve 100% of the problem.

Memphis is a community of partnerships.

So we have a lot of folks who are gonna help us take care of those who are at our door.

Safety net funding is a state piece that our clinic and you know, about 100 clinics throughout our state that look like Church Health take advantage of.

That is a huge portion of, you know, our budget, and some others as well.

That is in the governor's budget.

We believe that it will pass.

The legislature has always been incredibly supportive of Church Health and the work that we do.

And now that we're part of a network that has the ability to advocate for, you know, the rural communities just like Memphis, Nashville, Knoxville, is pretty impressive.

So I'm not worried about that funding going away.

The Medicaid expansion, you know, Washington can't take care of the problems in Memphis, and they can't solve all of our healthcare issues.

That's something that we have to do here, which is why we need the support of so many people, you know, time, talent and treasure.

And whether Medicaid expansion helps or hurts the state budget, you know, I'm not in those rooms to know, but we are ready if it expands to see more folks, and we are ready if it shrinks to be able to take care of those who can't.

- Yeah.

Midway through show.

Bill.

- How much of what you do and what other institutions do, how much of an opportunity is there for collaboration or for planning?

Because there is some element of competition in there, but from what you just said, you're also looking at what the other guys do, so to speak, to see where there are opportunities to coordinate.

- Yeah, so I think Crosstown Concourse says it best that we are better together and if we are all sure of what we do well, and we know who does other things equally as well or better, we can use each other as referral and resource systems.

Memphis has a great network of partnerships with Christ Community Healthcare Services, the Memphis Health Department.

So we can take care of a lot of folks who are in need.

Throughout the state, I think what we have found with the Tennessee Charitable Care Network is that we truly are a better network of like clinics to be able to, you know, use each other as resources and ask questions like, "Gosh, have you seen this?

I don't know what to do."

Or, "Who is the person in our general assembly "that we need to talk to to help us advocate for this issue or that?"

- As Eric said, Medicaid expansion has been talked about.

But it sounds like you don't wanna put too much weight on that or some of the other things that might be controversial or that might not happen, right?

- Correct.

The payer system through Medicaid is not something that Church Health is going to solve, but the people who may have Medicaid will need someplace to go.

And we will need to make sure that we are equipped to be able to help those.

Because if Medicaid expansion happens, where folks who are up to 138% of the poverty level or 200% of the poverty level, if those numbers shift, we're already taking care of those patients.

If Medicaid expansion comes in, we can't say, "Oh, I'm sorry, we're not gonna take care of you anymore."

That's not what we would do.

That's not who we are.

So we have systems in place where if we have to take some of those folks, we will.

If we can pass them to a provider who is taking new Medicaid patients, we will help them get there.

But we are ready if Medicaid expansion comes in to take care of the folks who we've been taking care of for decades.

- You talked about the statewide network of community health clinics.

Is that the right way to phrase it?

- The Tennessee Charitable Care Network.

- Okay.

And so one thing that I think sometimes gets forgotten is that many of the challenges that Memphis has, and that any city has, exist in rural America, right?

Whether that's a fentanyl crisis, or that's people who are underinsured or not insured.

I mean, there are undocumented.

I mean these things, they may be at a smaller scale, but they are still very, very present.

And there's also been a lot of closures of rural hospitals around the country and in Tennessee.

And so, when you talk to your peers or people in these other communities, I have a feeling certainly politicians would be surprised at the commonality.

'Cause there's always this sort of framing of, It's Memphis, or Memphis and city of Nashville, and maybe Chattanooga and maybe Knoxville against the rural communities.

And that does happen.

But this is a place where the issues and needs and demands are really in alignment, right?

- Correct.

Yes.

I mean, it's about the person who's in front of you and who needs help today.

And the Tennessee Charitable Care Network, I mean, we are truly the safety net of clinics.

So, obviously Church Health is the biggest clinic in the state and the country that is taking care of the uninsured and underserved.

But all of these smaller clinics, whether they're in the bigger cities or the rural areas, I mean, we're all seeing the same things.

People are scared.

We don't have enough resources.

There aren't enough donors or doctors to help us take care of the people.

But you know, it is a great support network, because we are all seeing the same conditions.

You know, diabetes, obesity, hypertension, you know, all of those problems exist, whether you're in a city or in a rural area of our state.

- You talked about the volunteers you have.

The volunteers are everything from maybe we still call docents, or people who meet and greet, you'll see them in Crosstown, to healthcare workers, right?

Nurses, doctors, - Yes.

- On the nurses and doctor side, and the healthcare worker side.

I mean, there's a shortage of healthcare workers in the country.

We've written about it, we've had folks on talking about it.

People entering the profession are coming out of school with tremendous demand, but often tremendous loads of debt.

And you all are saying in the face of that, you're gonna work 16 hours, you know, at Methodist or Baptist or wherever, and you're gonna spend all this time, but we really want you to volunteer your time with us.

The people who say yes to that say yes why?

- I think people get into medicine because they want to help other people.

I don't think it's because they want to get rich or something.

I think it's because they wanna help the person who's in front of them, who's making their life better.

And for our medical professionals, we work really hard to make it as easy as possible for a doctor or a nurse or you know, a provider team to see our patients, whether they come to Crosstown and see folks at one of our night or weekend clinics, whether it's a specialty clinic like our hand surgery day, or a cataract-athon, or if it's, you know, just folks letting us send patients to their offices, just to see a few more people.

You know, it's everybody doing their part.

"Can you see one patient?

Can you see 10 patients?

Can you see 100?"

We are grateful for whatever our volunteers are wanting and willing to do.

- One more, and I'll go back to Bill.

One of the programs you have is you have healthcare for small businesses.

That may be where the restaurant workers are under that umbrella now.

Or is that a separate program still, that restaurant workers who very, very rarely have health insurance from their employer, for a whole host of reasons, could get care from you all.

Where does that all fit now?

- I'm glad you asked.

That's called the Memphis plan.

And when I started working at Church Health 18 years ago, I came to run the Memphis Plan.

So that is a managed healthcare system for, you know, using our volunteer networks for small businesses who don't have insurance.

So, it's sort of the low wage worker, hairdressers, self-employed folks, people who work at gas stations, probably your favorite server at one of your favorite restaurants, maybe your child's daycare worker.

So we're gonna take care of those folks.

But the plan is through the employers.

And so, we're looking for those benevolent Memphian employers who want to help, you know, value added for their own businesses.

- So they're putting a certain amount of money in on behalf.

- Yes.

- And then there's a discounted services to the employee.

- Yes, so it's $50 a month to be on the Memphis Plan.

So 40 of it could come from the employee, ten dollars of it must be paid for by the employer.

And it's just a managed care employee employer system.

- Bill.

- I've heard a word I didn't think I would hear in this discussion.

A cataract-athon.

- A cataract-athon.

- Bill's heard a lot of words too.

So, Bill is not often surprised when we have these conversations.

- But I think it speaks to a kind of approach of meeting people where they are, and rather than saying, "Well, you really need to get this checkup."

It's like, "We're having a cataract-athon.

You think you got them, come on in, let's have a look."

Is that the basic concept?

- Ish.

But there's way more planning, and obviously procedural issues.

But in partnership with Mecca, the Southern College of Optometry, the Hamilton Institute, we work with a host of folks to allow us to come in usually two Saturdays a year where we will find patients, whether they're our patients or the Lions Club patients who have a need for a cataract surgery.

And I think we had one a few weeks ago, and we did I think 35 cataract surgeries in an afternoon.

So, it is a great partnership.

- So, that's an outpatient procedure?

And people may not know that.

They may think it's a lot more involved- - It is an outpatient procedure.

Remember, he mentioned I'm the CFO.

I am not a doctor.

So, let's not confuse all of that.

- Okay.

- Thank you.

So, if we can identify patients in our clinic and decide that they need additional care, and so it is outpatient, you have procedure early in the morning and then you come back for a post-op check, and then we do all of the follow-up care back in our clinic usually about a week later.

- All right.

And talking about the Memphis Plan, I remember us having a discussion here with some restaurant owners during the pandemic, and kind of wondering aloud if maybe that model of employment was going to change as a result of some of the things learned during that.

You're meeting people where they are, but are there times when you kind of think there's a better way to do this?

- Yeah, and we sort of touched on this earlier with COVID, and how do you just change some adjustments to processes.

Meeting people where they are to make sure that they've got the care that they need is utmost of importance to us.

And with the Memphis Plan, there are changes in the business community and economy of scales with, you know, how much are we gonna pay folks, and how much do folks need to pay for the Memphis Plan or healthcare in general?

But the Memphis Plan is not going away.

We have worked a little bit to change how we can bring the Memphis Plan to other employers or self-employed people, you know, but we wanna make sure that we exhaust all opportunities and work with the employer about if the employee can afford a traditional insurance plan, or do they qualify for Medicaid, or do they qualify for Medicare?

How can we help be that value added to put them onto a traditional plan?

- Right.

Because you don't want to be a health insurer.

- Right.

We are not a health insurance.

There is a law on the Tennessee State rolls that say that we are not health insurance, but we want to guide people to care.

But the Memphis Plan is a great way to take care of that.

- With just a couple minutes left, I mentioned at the top, you're the new leader.

You've been at Church Health for 18 years, I think you said, but you followed Scott Morris.

So Scott Morris, the founder, Dr. Scott Morris, been on the show, friend of The Daily Memphian.

Coming up on 40 years, 1987, that Church Health was founded.

What is it like?

I mean, Scott is a bit of a bigger than life figure.

He's probably watching.

Hopefully, he's watching, - I'm sure he's watching.

- I'm sure he's watching.

But he is.

I mean, he has been an advocate for this, not just in Memphis, but around the country, and arguably around the world, of leading the charge on the necessity of this.

That's a lot to fill and follow.

- Yes, it is.

- By the way, he'll get mad at me in the hallway of Crosstown if I don't add: he is still with Church Health.

He just has moved from the CEO position.

That I need to make sure I say, so I don't get you or me in trouble.

- Thank you.

I appreciate that.

Third party validation.

Scott, he is playing the role of the founder.

He says, "You need to do what brings more joy in your life, "more love in your life, and being driven to something higher than you."

We call it God at Church Health.

And he loves to see patients during the day, and he loves to tell stories in the afternoon.

Why would he stop doing that?

So that is what Scott is still doing.

You know, I have been with Church Health for 18 years, and so I've taken several different roles in my time there.

So, it was sort of a reluctant, natural fit for me to come in and take the helm.

You know, I do appreciate that Scott is kind of down the hall around the corner, so when I do have questions or things, he is always right there.

But he loves to see our patients in the morning, and that is what he still does every day.

- And you came from a background in banking?

- Yes.

- Local banks brought you here.

- Yes.

When I moved to Memphis in 1999, I started in banking and loved it and, you know, was ready for something else.

I was looking for my own calling, but I didn't realize it at the time.

And I wanted to go work at a not-for-profit, and have a baby and slow down a little bit.

- Did you slow down?

- Not close.

- I was gonna say.

- Not even close.

- That was not really a slowdown, but- - No, but that's sort of the magic about Church Health.

Everybody can find their place to be, and to help, and I don't wanna leave, so.

- Yeah.

Yeah.

All right.

Well, Jennie Robbins, thank you very much for being here.

We really appreciate it.

Thank you, Bill.

And thank you for joining us.

I should mention, if you missed any of the show today, we have the full episode online at wkno.org, or on YouTube, or you can search for it on the Daily Memphian.

Recently had Police Chief CJ Davis on, we had Reginald Coopwood talking about similar issues.

He's the CEO of Regional One, different but similar kind of crossing over.

All those, again, are available online.

They're also available as podcasts wherever you get your podcasts.

Thanks very much and we'll see you next week.

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