Women Leading in Central MA: Healthcare Leader Janice B. Yost

Monday, May 27, 2013

Susan Wagner, GoLocalWorcester Contributor

A leader on many health and human services fronts in Central Mass: Dr. Janice B. Yost.

"In January of 2011, The U.S. Interagency Council on Homelessness named Worcester as the largest community in the country to essentially eliminate chronic adult homelessness."

When speaking with Janice B. Yost, Ed.D, it becomes immediately obvious that The Health Foundation of Central Mass is significantly changing how the issue of health is addressed in the region. The Foundation has played a key role in essentially eliminating chronic adult homelessness in Worcester and focused on multi-year projects that have achieved substantive public policy accomplishments such as improving preschool children’s mental health, preventing shaken baby syndrome, increasing access to dental services and mental health services, reducing hunger, guiding prisoner reentry and reducing recidivism, and moving public housing tenants toward self-sufficiency.

In 1999, Dr. Yost became the founding president of The Health Foundation of Central Mass. The grant-making organization emerged from the sale of Central Mass Health Care. She facilitated the Board’s creation of the Foundation’s grantmaking avenues and has worked to scale up evidence-based strategies through systemic change. Since offering its first grant in 2000 The Health Foundation has awarded nearly $25 million.

Dr. Yost has been recognized for her contributions with Health Care For All’s President’s Award for Outstanding Leadership in 2008, the Community Health Connections Family Health Centers’ Community Health Champion Award in 2009, the Massachusetts Shelter and Housing Alliance’s 2011 Cornerstone Award, and the Katharine Forbes Erskine Award in Social Service and Government by the YWCA of Central Massachusetts in 2012.

A Conversation with Dr. Yost

SW: I read that The Health Foundation approaches health in the broadest sense and uses the World Health Organization's definition of health, which is "a state of complete physical, mental, and social well-being." Can you explain how you have been able to work within that broader definition to successfully become a catalyst for change in Central Massachusetts?

JY: The rest of the world sees health in a much broader sense than we do. Until recently, we have always treated people who are sick but given little thought to cause or prevention. As a result, despite having a very expensive healthcare system we don’t have better health than a lot of other countries.

We took a look at our assets of $60 million and the fact that we could allocate between $2M and $2.5M annually. That would be a drop in the bucket if thrown at the healthcare delivery system serving the almost 1 million residents of Central Massachusetts. We decided to focus outside the medical delivery system.

In the broader context of health, mental health and oral health are closely related to physical health. Adequate housing, food, good lifestyle choices are all part of the equation. Prevention is the key. I personally get great satisfaction out of fixing broken systems and preventing tragic consequences.

SW: With $25M in grants awarded since the foundation’s inception in 1999, the Health Foundation has obviously had a major impact on the region’s health concerns. You have been a driving force in addressing chronic adult homelessness in the region. How have you been able to provide the support systems needed to address this issue? Are you seeing results from existing programs?

JY: A lot of our work is in housing. If you are homeless, your health is severely impacted and it causes premature death and numerous chronic diseases. Housing is fundamental to good health. A collaborative of area homeless service providers came to us and wanted to get 122 frequent users of PIP shelters from sheltering to housing. A concept called Housing First was sweeping the nation, yet there seemed to be local opposition to it. We funded a project called Home Again to test the House First concept in Worcester. After a 21 month testing period, an independent evaluation showed that providing housing, coupled with case management and services, to individuals who have been chronically homeless is effective in ending their homelessness and improving their health status. It is also far more humane.

Since case management was the key to getting people into housing and then helping them stay there, we put $2M into case management. We worked with MassHealth and Medicare to cover case management when the grant ended. In January of 2011, the U.S. Interagency Council on Homelessness named Worcester the largest community in the country to essentially eliminate chronic adult homelessness.

SW: You become an advocate for your programs to insure that they continue without your funding even if it means changing public policy. Besides Home Again, can you give another example of how that process works?

JY: In 2000, the Foundation was approached to help with the oral health crisis in Central Massachusetts by expanding access to dental service for vulnerable populations. To address the lack of access to dental care for many residents of North Central Mass, we helped create a dental clinic at the new health center in Fitchburg with satellite clinics in Leominster and Gardner. In Worcester, we helped double the dental capacity at the Edward M. Kennedy Community Health Center and at Family Health Center. In addition, we also look at how to create a positive end result that will allow these dental services to exist without our funding. To that end, we worked with the state legislature and Health Care For All to improve MassHealth dental benefits and how they work with dentists in private practice in the community.

With the assistance of Senator Harriette Chandler, we were able to change the state’s antidiscrimination law to allow dentists in private practice to only take on a MassHealth caseload that they could handle. We were also able to have MassHealth outsource dental benefits administration to become consistent with other insurance companies and to have somewhat more competitive fees paid to dentists. It has been so satisfying to grow from a starting point at which virtually no dentists in the Central Massachusetts accepted MassHealth patients to where we are now, with more than half of the region’s dentists accepting them.

SW: How do you encourage innovation and creativity in your funding programs? Can you give us an example of a project that demonstrates how your process works?

JY: One example is in the field of early childhood education. We had care providers approach us regarding the growing problem of children with behavioral problems being shuffled from one day care center to another without any of their underlying issues being addressed. Care providers wanted to bring behavioral health specialists into the centers to see if the challenging behaviors could be treated before children began school.

We supported Together For Kids, a pilot project that was implemented some day care centers and not others. The consistent management of behaviors made a dramatic difference. The children were tracked through second grade where they continued to move forward and show tremendous academic progress. For a relatively small amount of money kids were able to get on track and sustain their development. We took Together For Kids to the state and the service is now funded through the Department of Early Education and Care to address behavioral health in preschool settings with the long-term goal of preventing students from dropping out of school.

SW: How can the community help with your efforts?

Many of our projects have partnering organizations. We encourage the community to come forward with health concerns in Central Massachusetts. We start with a planning grant followed by a pilot grant. Then the program benefits from three more years of funding and evaluation that will provide the metrics and tools for further funding. We stay with the project until results and sustainability are achieved.

With more than 25 years of leadership experience, Susan Wagner is known for driving events, initiatives, launches, and openings for the healthcare, sporting, and entertainment fields through her company Susan Wagner PR. She consults in the development and execution of a broad range of outreach programs & public relations initiatives that effectively educate, inform, and build relationships with targeted stakeholder groups. In this challenging economy, Wagner also offers affordable start-up packages to new and emerging businesses and non-profit organizations.