The Other 80 Claudia Williams

The US is living through an affordable housing crisis - in fact, we are short millions and millions of affordable housing units. During the pandemic, homelessness flattened with an influx of resources to help keep people housed. But, those resources have long expired and now we are seeing an uptick in homelessness across the country. Jeff Olivet, the director of USICH (United States Interagency Council on Homelessness), says the problem is complex – but the math isn’t. We need more affordable housing. 
We discuss:
Biden’s proposed budget, which includes guaranteed vouchers for every low income veteran and person aging out of foster careThe new frontier; pairing emergency response such as shelters with robust prevention strategiesHow prevention starts with helping families through periods of financial crisisWhat happens when heat crises turn deadly for people who are homeless
Jeff reminds us that the people affected most by the affordable housing crisis are those who have experienced trauma and domestic violence:
“50 years ago, we still had domestic violence, we still had addiction, we still had mental illness, and we didn't have perfect systems to address that – but we had enough housing for everybody, and we did not see homelessness on the scale we see it today. So when we're responding to homelessness, it's critical to individualize support for people to make sure they have access to the care they need in terms of health and mental health and recovery and all of those important things. But if we don't solve the underlying structural stuff, the lack of affordable housing, the ongoing discrimination that people of color and LGBTQ people face in jobs and trying to buy a home or rent a home in the criminal legal system, in education, if we don't solve that underlying stuff, we're gonna keep seeing homelessness for a very long time to come.”

Relevant Links
Jeff Olivet testimony to Congress on strategies to reduce Veteran homelessness
Federal actions to increase housing supply and lower housing costs 
HUD-VASH vouchers to support homeless veterans 
USICH guidance document for healthcare
Article about the SCOTUS ruling 

About Our Guest
Jeff Olivet is the executive director of USICH. He has worked to prevent and end homelessness for more than 25 years as a street outreach worker, case manager, coalition builder, researcher, and trainer. He is the founder of jo consulting, co-founder of Racial Equity Partners, and from 2010 to 2018, he served as CEO of C4 Innovations. He has worked extensively in the areas of homelessness and housing, health and behavioral health, HIV, education, and organizational development. Jeff has been principal investigator on multiple research studies funded by private foundations and the National Institutes of Health. Jeff is deeply committed to...

California is the latest state to address healthcare affordability through cost growth targets. Elizabeth Mitchell – President and CEO of Purchaser Business Group on Health  – Joins us to discuss the nuts and bolts of the 3% cost growth target recently adopted by the state. Healthcare affordability is a big issue across the country. More than half of us skip or postpone care due to cost and medical bills are a leading cause of bankruptcy. Reining in medical costs is also how we’ll  free up resources for what we know works to build health in America: prevention, addressing the social drivers and fostering health in communities.
We discuss:
Two proven strategies to reduce healthcare costs: advanced primary care and effective specialty referralsWhy better consumer “shopping” is not the path to healthcare affordability How price transparency gives employers new tools to negotiate, and reveals troubling facts about purchasing intermediaries
Elizabeth reminds us how troubling it is that we don’t have clear prices in a sector that makes up 20% of the economy:
“The idea that you can't find out what something is going to cost before you agree to it is outrageous. Name any other industry that refuses to show you a price. It is incredible to me that we are still fighting about transparency when it is 20 % of the US economy. I mean, this is a multi-trillion-dollar industry who feels no accountability to show pricing. So, I just think it is incredible that we do not have meaningful transparency yet.”
Relevant Links
California’s Office of Health Care Affordability sets cost growth target
Federal hospital price transparency requirements
Purchaser Business Group on Health (PBGH) website
PBGH white paper on advanced primary care
US Department of Labor clarifies the fiduciary responsibilities of self-insured employers purchasing healthcare
About Our Guest
As President and CEO, Elizabeth Mitchell advances Purchaser Business Group on Health’s (PBGH’s) strategic focus areas of advanced primary care, functional markets and purchasing value. Mitchell leads PBGH in mobilizing health care purchasers, elevating the role and impact of primary care, and creating functional health care markets to support high-quality affordable care, achieving measurable impacts on outcomes and affordability.
At PBGH, Elizabeth leverages her extensive experience in working with health care purchasers, providers, policymakers and payers to improve health care quality and cost. She previously served as Senior Vice President for Healthcare and Community Health Transformation at Blue Shield of California, during which time she designed Blue Shield’s strategy for transforming practice, payment and community health. Mitchell also served as the President and CEO of the Network for Regional Healthcare Improvement (NRHI), a network...

The scope, scale and timeline of what California is trying to do with CalAIM is truly breathtaking. Two years after the launch of the ambitious program, which offers integrated medical and social care for California's 15 million Medicaid members, Dr. Palav Babaria joins us to discuss how it’s going and what comes next. Dr. Babaria is a primary care physician who leads quality and population health management for California’s Medicaid program, Medi-Cal. 
We discuss:
Which community supports are used most, or least? One of the big learnings from CalAIM: the enhanced care management models that work for adults dont work for childrenHow Medi-Cal is leveraging health plans as the organizers of social care because that’s where the members areThe soon-to-be-released population health management service will address two big issues: standardized and equitable approaches to identifying high risk members and integrating state level benefits data, like for WIC 
Palav reminds us that CalAIM was built through listening:
“Not everyone may know this, but CalAIM was generated from a statewide listening tour. Our previous state Medicaid director went around the state and literally asked communities… rooms full of plans, members, providers, what do you need from Medi-Cal that isn't working today? [The]  smorgasbord of recommendations is what turned into CalAIM … Listening to the community and responding to the community's needs is in the core DNA of this program.”

Relevant Links
Listen to our related episode “Reflecting on Year One of CalAIM with Jacey Cooper”CalAIM dashboard Population health management policy guide California and other states require managed care plans to reinvest in local communitiesNY waiver summary

About Our Guest
Dr. Palav Babaria was appointed Chief Quality Officer and Deputy Director of Quality and Population Health Management of the California Department of Health Care Services beginning in March 2021. She was formerly the Chief Administrative Officer of Ambulatory Services at Alameda Health System. In that capacity, she operationally and clinically oversaw 26 specialty clinics, four large primary care FQHCs, specialty and integrated behavioral health, and is responsible for all outpatient value-based payment programs. Prior to that role, she served as Medical Director of K6 Adult Medicine Clinic. She also has over a decade of global health experience and her work has been published in the New England Journal of Medicine, Academic Medicine, Social Science & Medicine, L.A. Times, and New York Times. Her areas of interest include ambulatory transformation in resource-limited settings, shifting to value-based care, and issues of gender in medicine. Babaria received her bachelor’s from Harvard College, as well as her MD and Masters in Health Science from Yale...

To achieve whole person care, we can try layering new social services on top of medical care. But Dr. Rishi Manchanda believes we should move further upstream and ask, what will it take to actually improve health in communities? From founding Rx the Vote to HealthBegins, Rishi is committed to building community social capital in America. 
We discuss:
Why he created HealthBegins, which is now halfway to its goal of transforming equity in 250 communities by 2025How California is making practice transformation a foundation of whole person careRx the Vote and the important role of health organizations in voter engagementKaiser Permanente's health, housing and justice initiative
Rishi thinks all public health students should study and know how to shift the political determinants of health:
“I think we can recognize there's ways to… get the dollars out the door, get the services out the door, get the access that we need while [also building] local governance. And I think that's what I see as a really interesting opportunity for us in California… There are opportunities here for public health schools, including Berkeley, to [help] public health students… understand the political determinants of health and then understand their role [to]... address them and improve them.”
Relevant Links
HealthBegins website
Rishi’s book The Upstream Doctors
Rishi's TEDx Talk: "What Makes Us Get Sick? Look Upstream."
New collaborative community health planning model in California
Policy requiring California Medicaid health plans to invest 5-7.5% of profits into local communities 
California Medicaid investments in practice transformation
Kaiser Permanente's health, housing and justice initiative
Oregon CCO model
An interview with Rishi Manchanda

About Our Guest
Dr. Manchanda is Founder and President of HealthBegins, a social enterprise that provides training, clinic redesign, and technology to transform health care and the social determinants of health. Dr. Manchanda is a dual board-certified internist and pediatrician, a board member of the National Physicians Alliance, and a fellow in the California Health Care Foundation’s Healthcare Leadership Program. He is the lead physician for homeless primary care at the VA in Los Angeles, where he has built clinics for...

June 18th is “Maya Petersen” day in San Francisco, in honor of her work building disease models that guided the region through the early days of COVID and saved countless lives. 
With projects spanning from developing HIV prevention strategies in East Africa to shaping new Medicaid models in California, the UC Berkeley epidemiologist is building a future where local public health leaders have the tools and data to ask and answer complex policy decisions in real time. Now that’s a world I want to live in.
We discuss:
How much better our pandemic response would have been if Public Health had access to integrated and linked dataHer work to bring sophisticated data tools to the point of decision in East AfricaHow California is building population management infrastructure
San Francisco’s Director of Health, Grant Colfax, taught her an important lesson about showing up and helping:
“I remember… saying, ‘You know what? You really need to find somebody who's an expert in this, I'm not an expert in this.’ And he said, ‘Okay, Maya, but if you're gonna find me someone it needs to be in the next 24 hours, because I need help.’ And it was just a reminder that, you know, you're not always going to be an expert, sometimes you just need to show up, do your best… be clear about your uncertainty and communicate well, and that can be… a big service”
Relevant Links
Local Epidemic Modeling for the San Francisco Department of Public Health
San Francisco’s COVID strategy
Multi-sectorial Approach to HIV in East Africa
Maya Petersen Day in San Francisco
Maya’s UC Berkeley page
About Our Guest
Dr. Maya L. Petersen is Professor of Biostatistics and Epidemiology at the University of California, Berkeley. Dr. Petersen’s methodological research focuses on the development and application of novel causal inference methods to problems in health, with an emphasis on longitudinal data and adaptive treatment strategies (dynamic regimes), machine learning methods, adaptive designs, and study design and analytic strategies for cluster randomized trials. She is a Founding Editor of the Journal of Causal Inference and serves on the editorial board of Epidemiology. Her applied work focuses on developing and evaluating improved HIV prevention and care strategies. She currently serves as co-PI (with Dr. Diane Havlir and Dr. Moses Kamya) for the Sustainable East Africa Research in Community Health consortium, and as co-PI (with Dr. Elvin Geng) for the ADAPT-R study (a sequential multiple assignment randomized trial of behavioral interventions to optimize retention in HIV care).
Source: https://publichealth.berkeley.edu/people/maya-petersen
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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email a...

If there’s one thing politicians do little of these days it’s change their minds. But, that’s exactly what North Carolina’s General Assembly did in 2023. Ten years after the ACA was passed, and in a historic bipartisan move, they changed their minds and voted to expand Medicaid. NC Secretary of Health & Human Services Kody Kinsley joined us to talk about what it took to get this done and how it’s been going so far. 
We discuss:
How to get stuff done in a politically divided stateOne move that would dramatically increase access to healthy food in America - automatically enroll all Medicaid beneficiaries in SNAP Why NC Medicaid has gone deep on peer to peer support for prenatal care and mental healthThe importance of building a better narrative about the role and value of public health
Kody points out NC’s strategy of investing in community organizations is creating  both health and economic opportunities:
“75% of our community based organizations are minority or women owned throughout those 33 counties. So, this isn't just about getting good access to what drives health in the long run. This is also about building that infrastructure and having a financing model that sustains it that is in the balance, a good value for the taxpayer.”
Relevant Links
NC enrollment dashboard
Crisis warmline
Healthy Opportunities pilots
“NC Launches Additional Phone Support for People Experiencing Mental Illness or Substance Use Disorfer” [RELEASE]
About Our Guest
Kody Kinsley serves as North Carolina’s Secretary of Health & Human Services, overseeing a department with over 18,000 staff and a $38 billion budget. With experience centered on health policy and operations, Kinsley worked on digital healthcare transformation, national education and labor policies, and served as COO and CFO of the U.S. Treasury. 
Secretary Kinsley’s three priorities for the department include: Investing in behavioral health and resilience, improving child and family well-being, and building a strong and inclusive workforce. Under his leadership, North Carolina expanded Medicaid and received the largest investment to bolster the mental health system in over a decade. Kinsley grew up in Wilmington, earning his bachelor’s degree from Brevard College and his master’s in Public Policy from the University of California at Berkeley. 
Source: https://www.ncdhhs.gov/about/leadership/kody-kinsley
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For more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams...