Building Vibrant Health: IEHP Foundation's Greg Bradbard on Equity, Advocacy, and Collective Action

Greg Bradbard, CEO of the IEHP Foundation, joins Erin to discuss building healthier communities through advocacy, nonprofit leadership, and place-based health initiatives like the Blue Zones Project. A powerful look at health equity, systems change, and the human side of healthcare.

Transcript

Erin Brinker: 0:00

Erin, welcome everyone to the making hope happen radio show. I'm Erin Brinker, do you ever just watch human behavior, either online or in person? When we were first married, my husband and I would go to public spaces just to watch people. And it was fascinating. Body language can communicate so much. We'd watch, you know, who was holding hands, kind of what people were wearing, you know, did they have kids, and what did that look like, and which stores were they going to? And it was really interesting. They have pets with them, etc. It was an, it was an interesting and fascinating way to spend a little time online is a different experience, but it can still tell you a lot about how human beings interact with one another. I was on X recently, and it was fascinating. The most innocuous of statements can bring vitriolic and profane responses. Most of them I ignore because there's an active percentage of the population that likes to set fires just to watch them burn. Occasionally, I'll make clarifying statements, and I did that yesterday, someone had posted a video from an airport that was largely empty, or of an airport that was largely empty. A man was sitting in his spot with his things around him, and another man sat down right next to him, not one space away, or two spaces away, or the other, you know, the other side of where the chairs were. He sat right next to him in a largely empty terminal, which is weird in the US, right? That's not the cultural norm. The original passenger responded with grossly outsized anger. Dude was mad. He was pretty bent out of shape. The second guy took a second and then backed away and that that, you know, kind of he looked stunned, mostly at the level of anger, but he didn't even see that what he had done was out of the cultural norm. So the two men were of different races, so the usual racist vitriol from posters on X ensued, as you might imagine, to me, the issue was a lack of observance of a cultural norm. To them, it was something more nefarious. And again, please keep in mind that some people will see that, because that's how they see the world. And there's nothing that you can say or do really, especially on that platform that's going to change their mind. They're going to set a fire and watch it burn. And I really I'm not interested in those people, because there's nothing I can do right where, at least I'm not sure what to do. I think that's a fair statement. So my statement made no comment about the flash of anger of the first passenger hat. I simply commented that I didn't think that anger was down to race another poster on X became enraged and defensive that I had the temerity to say that, you see, he thought I was calling him a racist because we disagreed. I wasn't, but he called me a few colorful names in his response, and for whatever reason, I had the presence of mind not to respond in kind. I acknowledged his point and said that I should have assumed his inference and been clearer. So his main point was, well, you didn't say that the behavior that you that you disagreed with the behavior of the first guy you know going off. Well, I didn't make a statement about his behavior at all. I was just making a statement about a cultural norm. But okay, I get that, and you're right. I see that. I can see why you would assume that that was my point of view, and I should have been clear. Then that's pretty much what I said in a short tweet. You know, he apologized to me, and we ended the conversation on a positive note. And it got me thinking, there is a there is tremendous power, rather, in extending an olive branch, and it really costs you nothing. If it's not taken or reciprocated, you're no better or worse off than when it was extended in the first place. If, however, it is well received, you are both better off and so is the other person, which is great, right? And perhaps they'll come to the next interaction with a little more kindness. So I'm grateful for kindness today, and I want to put it out there that maybe we're all a little too defensive. And I'm not saying we don't have reason to be that's true, but maybe we're all a little defensive, and maybe we really are wearing ourselves out jumping to conclusions, and we should probably stop that and remember that the other person, usually, sometimes they're bots, but a good you know, you have to assume at least some of the people that you're talking to online are actually people All right, now on to our guests. Well, I am very pleased to welcome to the show Greg bradbard. He is the CEO, Executive Director for the IE HP foundation. That's the Inland Empire Health Plan Foundation, and he's been a fixture in the Inland Empire for a long time, from the United Way to. Hope through housing national core to IE HP Foundation, if you've been involved in really moving the needle in the Inland Empire, you know. Greg bradbard. Greg bradbard, welcome to the show. Thank you so much. Erin, great to be here today. So I told him, I said a little bit about who you are, but why don't you? Why don't you tell our listeners, kind of who you are and how you ended up and how you made it to the IHP foundation? Yeah,

Unknown: 5:22

sure, well, well, first off, I'm a husband and a dad, and so that's, that's the important place to start and have two daughters, and that's, that's an important thing. But my, my, you know, my history was, I started, really was my degree in psychology and social behavior back at UC Irvine, and didn't know exactly where that was going to take me, but what I knew was that I wanted to help people. I wanted to do something that made a difference in my community and that made people, lot people's lives better, and I've been on this interesting path since then. And really my first job was actually I had done an internship while in school for an organization that worked with low income and homeless families, and there was a food pantry and counseling services and transitional housing. And as I was about to graduate, didn't know what I was going to do with my life, the executive director offered me a job, and that changed my life. Excellent, really, truly. And she ended up becoming a terrific mentor. Her name was Margie Wacom, and she was on the school board and was executive director, very connected in town and but really became a mentor for me, and introduced me to this idea of working in the nonprofit field, which I never understood before. I remember actually asking her early on, so like, help me understand this nonprofit thing, like, Is it government? Is it business? And she explained it to me, and I kind of came to the conclusion it's kind of

Erin Brinker: 6:44

someplace in between. I was going to say yes

Unknown: 6:47

to the same day. It's like running a small business, but where your mission is to change a life, rather than to turn a profit, right? Many of the same you know, principles and skills you need to run a business successful. You need in the nonprofit world as well. Anyways, fell in love with it and I worked, had the blessing of work in a number of different organizations, then an educational foundation. I worked with kids in the foster care system at Casa of Orange County for about nine years. Wow. Really powerful work there, if you know, providing mentors and advocates for abused and neglected kids in the foster care system. Yeah,

Erin Brinker: 7:24

and I want to, I so love their mission, because in family court, the parents are represented, the state is represented, or the county and the CASA volunteer. And they're volunteers who commit to a lot of training two years at a minimum. They are the they're the voice for the child in that courtroom where life changing decisions are being made.

Unknown: 7:47

You're exactly right, yeah. And what I saw was that those volunteers, many times, got to know that child better than anyone else. And to your point, Erin, what those kids also realize many times, is that that cost of volunteer was maybe the only person in their life who wasn't paid to be there, their social worker, their attorney, their foster parent, everybody else was getting a payment. But the cost of volunteer was there simply out of the kindness of their heart, and when those kids realized that the relationship and the bond that was formed was so powerful. So those cost of volunteers, you know, in advocating for those kids in court, was so powerful. So I was there for about nine years. Loved that time in 2010 was given the opportunity to run Inland Empire United Way. That was my chance to come back to the Inland Empire area. That's when I moved my family up to rancher Cucamonga area, and had the opportunity to run United Way, where I think we met initially, yes, and and there we did things like beating programs for hungry kids in schools. We had a school tools program that put school supplies in the hands of teachers in low income classrooms. We ran the two on one call center, which hopefully listeners know, is a 24/7 free community resource line. And then we did a lot around college career access as well, college readiness as well, to introduce kids from lower income communities who are maybe be the first in their family to go to college, for them to understand the benefits of going college, that there's dollars available to go to college, and to help them actually head down that path. And so, so

Erin Brinker: 9:19

let's talk about that. 211, for a second. And I sorry, I didn't mean to interrupt you. Were there when they really were putting this whole infrastructure together, if I remember correctly. And then, and this, the counties had kind of decided, and probably at the state's behest, to put together a number that could be called for any kind of resources from you need housing, you need food, you need, you know, rent, just rental assistance, or you need help with utility bill, or, you know, whatever. And you all that, all that infrastructure had to be built and created so that there would be something for there would be a network for families to call. And you were part of that developing that infrastructure, correct? Yeah,

Unknown: 9:55

to some extent, yeah. I mean, it was the the basic infrastructure was in place. I have to give a. Shout out to Gary Madden, who is the director of 211 at the time. And Gary, particularly in San Bernardino County, did a lot of work actually, to develop different kind of specialty areas. And so we had a program specifically around the re entry population. So those leaving prison, how do we connect them with the resources they need so they can be successful when they return back to their community, so

Erin Brinker: 10:20

they don't end up reoffending and going back to prison. Because nobody wants that. They don't want that. Society doesn't want that. We want them to become productive and have families and live a life. No, that's exactly true,

Unknown: 10:30

and unfortunately, we've also created a system that makes it very difficult for people to come back and be successful, so that to make sure that they have the resources to do that, we also had a Veterans Program that was specifically focused on meeting the needs of veterans, both those who had just returned from duty as well those who have been out of the service for, you know, decades. And what we did is we hired in both of those programs, hired peers to do that work, so as they understand exactly in the re entry population, it was people who had spent time in jail that understood, you know, kind of the culture and the mindset, and then the veterans as well. We hired veterans to answer those calls as well. But two on one's a great, you know, it's a great resource. Unfortunately, there are not enough resources in our community across the Inland Empire area to meet all the needs that exist. And so, you know, 211 is able to connect people with the resources that exist, but if the capacity is not there to provide those services, then two on one is limited, sometimes really to the services that are available.

Erin Brinker: 11:33

So from the Inland Empire United Way, you made another jump, yes.

Unknown: 11:38

So had the opportunity to work for the last seven years or so with national core and the hope through Housing Foundation. National Core is an incredible developer and operator of affordable housing, and they have about 100 affordable housing communities throughout Southern California, Florida and Texas. My role was running the hope through Housing Foundation, which was a separate 501, c3 that specifically provided the on site services. So while these families and seniors were on these properties, we provided things like after school programs for kids, financial management and job assistance for adults, health and wellness programs for seniors on those sites. So right on site where people lived, we provided those really fulfilling, but terrific organization. And then it was about a year ago that I had the opportunity to join IHP Foundation, incredible place, and I plan on being here forever.

Erin Brinker: 12:37

That's great. That's great. You found your spot so so talk to me about what the Inland Empire Health Plan is, and then differentiate it from the foundation your missions. How are they different?

Unknown: 12:47

Yes, yeah. So, so many people know IHP, which stands for Inland Empire Health Plan. And Inland Empire Health Plan is the primary Medi Cal provider in the counties of San Bernardino and Riverside County. So you might note the federal level, we refer to it as Medicaid, and Medicaid is typically health insurance for low income or those with disabilities. In California, just to confuse everyone, we call it Medi Cal. And

Erin Brinker: 13:15

they're getting cute, you know, it's branding.

Unknown: 13:18

They're there. It's good branding, though, but there's some enhancements there and what as well. So, so something that a lot of people don't know is that about 43% of residents in the Inland Empire rely on Medi Cal for their insurance. A full 43% of that IHP provides insurance and healthcare services for about one in three across the region, or about 1.5 million residents across San Bernardino and Riverside counties. And so that's IHP as a health plan, the health plan's job has a whole network of providers to provide the quality direct healthcare services, whether that's physical health, that's mental health, whatever the specialties are hospital services to their 1.5 million members. So

Erin Brinker: 14:05

are they also a Medicare supplemental provider? Or do or when people hit 65 and they've maybe they've had IHP, do they age out and they have to find another supplemental or another Medicare provider?

Unknown: 14:17

Great question. So to a certain extent, yes, there, are some people that that qualify for both Medicare and Medi Cal and so there's a small population where that is true. However, IHP currently does not have a Medicare Advantage Plan, which means it would be for those who are just on Medicare, who are 65 and over. So the great majority are children and families under 65 years old.

Erin Brinker: 14:42

So I'm reeling at that 43% number that just seems that seems unbelievable to me, that that such a high percentage of the population requires government assistance for basic needs, and health care is a basic need. And, you know, I just. Got to sit with that for a second, because, you know, ultimately, we want people to be, to be to gain affluence, and be affluent enough to be able to to not rely on the largest and as we're seeing largess of government, and we're seeing now with the changes in federal government and how they're spending money, and all of that that, all of that I assume, is at risk. So we can talk about that in a minute, and kind of what, what that means on a very, a very human level for the families who are facing this challenge. But talk continue, talking about the IHP foundation and kind of what your mission

Unknown: 15:33

is, yeah, so about three years ago, the leadership of the health plan had the wisdom of launching this foundation and said, Hey, look, we, in addition to the work we do directly for our residents, we really need an entity here in the region that's dedicated specifically to improving the health of all people across San Bernardino and Riverside County, regardless of insurance, regardless of income level. And this so they established this foundation. They funded it initially with about $100 million which is the initial endowment. And if you know how an endowment works, that doesn't mean that we have $100 million to spend, no capital sit there in perpetuity. And the beauty of that is those dollars will be retained for decades and potentially generations to come, and will grow over time as well and continue to work for the region. And what we are able to invest then is the investment return off of that initial endowment. And so the mission really is focused, like I said, across the region. How do we create a place? And this place being San Bernardin, Riverside County. How do we make it a place where everyone has the ability to experience what we call vibrant health, and vibrant health is full physical health, mental health, overall, well being, and it's really what all of us want for our families. And what we know is that, and the research tells us this, that about 60 to 80% of one's health outcomes are not simply what takes place in a doctor's office or in a hospital, and at the contrary, that's 60 to 80% of our health actually is what happens in our communities, our neighborhoods, in our homes, and it's our personal choices. So it's this combination of our environment and the personal behaviors and choices that we make that make up much of our health care. And the reality is, when we walk into a doctor's office, much of what needs to happen for us to be healthy has already happened or is happening in in our home and in our community.

Erin Brinker: 17:33

And that's huge, right? So we especially when you're talking about changing people's knowledge, their attitudes and their behavior, a lot of people know, well, you know, maybe a certain percentage of the population don't, but a lot of people know that you that you eat whole foods that you don't. You know you don't. You stay away from the package stuff that you need to get out and move your body every day, that you need to get enough sleep and drink enough water try to keep stress at bay, although my dad would say stress makes the world go round, but you don't. You don't want to be so stressed out that you're having a mental health crisis, and we know all of those things, changing the attitudes, and, more importantly, changing behavior, that is really hard. It

Unknown: 18:09

is, you know, it's interesting. So I was just having a conversation with a physician, and I was talking with him about what makes it difficult to treat patients sometimes, and he said, you know? He said, If we're not careful, what happens is somebody walks into a doctor's office, they present a certain issue, whether it's a headache or they have high blood pressure or whatever it might be. We look at what the medication is. We give them the mechanic medication. They go home, they take the medication. Nothing else changes. They come back. They're really not in any better place than they were previously. And he said, if we don't take the time to really understand their life circumstances and the other life and social factors. He said, we often miss out on he said what what really is impacting their condition is everything else. Yeah, and the everything else is. He said it might be that they're working two jobs. It might be that they just lost a job. It might be that they're a caregiver. It might be that they have unstable housing, or they feel unsafe in their neighborhood, and all of those things are impacting, you know, one's ability to take care of themselves, if they're not sleeping well, if they don't have a place to keep, you know, their medications, if they're in a stressful situation where they're not able to keep up with taking that medication on a regular basis, but all those things being a major factor. And he actually said he goes. You know, he goes? We make 1000s of micro decisions every day, which I've since learned the number is about 35,000 is what the research tells us. Holy

Erin Brinker: 19:33

cow. Seriously, a day i know i just

Unknown: 19:37

think about is that even when to blink my eyes, I don't know what the research says you make 35,000 day and and what we know is that our environment nudges us one direction or the other. Are we going to make a healthy choice? Are we not going to make a healthy choice? And so, Erin, to your point, it is really difficult, you know, to change human behavior. And what. Know is that it's one thing to know what the right thing is to do. It's something else to actually do it. And what the research tells us is that one of the keys there is you have to change the environment. You have to make it easy for people to make healthy choices. You know, create an environment where they're naturally going to they're going to have more healthy food options, for instance, or they're naturally going to walk instead of, you know, taking a car, taking the stairs, instead of that the elevator, for instance,

Erin Brinker: 20:25

you know it. It makes me think, you know, in communities, and you went to school in Irvine. So Irvine is completely walkable. Where people live, there are nice sidewalks. There are everything's well lit, there's, it's it's clean, there's not, you know, they're not people living all over the streets. They're not, you know, it's a very, very walkable space. And you go into lower income or more urban communities, and that's not at all the case. They may not have sidewalks there. It's just, it's just a completely different environment. And so consequently, people don't walk. They they're not out there with their kids. They don't feel safe in the parks. They don't you know, they're not out there experiencing the same way that in the higher end communities, people are experiencing life. Also in the lower income communities, you're much more likely to see fast food and mini marts and you know, all of the things that you know, if you're working 60 hours a week and trying to get your kid, you know, from here or there to school, make sure they're taken care of. And let's just say you're just working the 40 hours a week trying to get your kid here or there, and there's a McDonald's or a taco bell or whatever on every corner, and, you know, you don't have time to get home and cook, you're going to stop and get the Taco Bell.

Unknown: 21:37

Yes, yeah, and you're exactly right. It's about what's accessible to us, right? What's what's nearby. And you mentioned, you know, if people don't feel safe on their streets, if there aren't sidewalks, you know, it's, it's, we obviously have weather here during the summer where it gets very warm, very, very warm. Yes, when people can exercise is either early morning or late in the evening, when it might be dark as well. If you don't have street lights, then people aren't going to feel safe. And that also impacts, well, that whether they whether they exercise, and

Erin Brinker: 22:05

I'm not scapegoating the unhoused. They have their that's a population that has, you know, obviously, very a lot to deal with, and a lot of challenges in their own lives. And as a society, we could do a much better job in managing that, that challenge. But if you know, as if, from coming from the standpoint of a mom, if you're seeing, I've not been a single mom, but if I were a single mom, and you're having to make choices about what you can and cannot control, you know you're not going to take your kids out if it's not safe.

Unknown: 22:36

Yes, no, absolutely. Yeah. So,

Erin Brinker: 22:39

so the foundation is really focused on the all the things that lead to health. What are some of your art to good health? Because, like you said, ultimately, by the time you're sitting in your doctor's office with diabetes and high blood pressure, there's a whole lot of of things that could have happened before then, and they can treat those individual symptoms, but they're not going to treat the underlying problems without major lifestyle change. So kind of talk about what i, h, p, s, mission is, and, and you know what specifically you're doing?

Unknown: 23:06

Yeah, exactly. So. So the way we carry our mission, and the mission is to ignite and inspire health across the Inland Empire. So what does that look like, along the lines of what we've been talking about, you know? So first of all, you know, we have some priority areas. Those priority areas are specifically low income communities, those that are rural or remote, and those that have the greatest health needs in them. So we're focusing geographically on those areas where we need to know the needs are greatest. Secondly, we've identified a group of kind of priority issue areas that we're really interested in investing in. We'd love to be able to invest in everything, but we have limited resources. So we need, we need, we know we need to focus those resources. We do utilize the vital conditions framework. So Erin, you might know the vital conditions is a federal framework that's used by, I think, over 40 federal agencies and others, but it's really an easy way to talk about the social determinants of health, which is what we've been talking about. And there are three of those in particular that we focus on. The first one is basic needs for health and safety, and we've kind of two emphasis there. One is food insecurity. So how do we make sure people have access to nutritious foods, as we were talking about, which is critical. The second one is around access to health care, both physical health and mental health care as well. The second priority there is humane housing. And so this is focused on, you talked about homeless, but really access to quality housing, and that's both affordable rental housing, but also home ownership, because we know that one of America's greatest wealth building tools is home ownership. And so we also, you know, are really supportive of those programs that allow down payment assistance, that help build credit, that help get people ready to purchase their first home and build that generational wealth for their family. And then the last area is around what we call meaningful work and wealth. It's really focused on workforce development, and for us, that focus. Is on developing the pipeline of future healthcare professionals and social service professionals as the two areas we're really focused on are our nonprofit organizations and make sure we have enough physicians and other healthcare professionals to meet the needs of our region well.

Erin Brinker: 25:16

And that's a growing challenge right nationwide, having practitioners both in the physical health when you think of health care, and also on the mental health side, there are huge challenges, especially in lower income or rural remote areas, finding enough people to care for them. Yes, yeah,

Unknown: 25:35

absolutely. If you look at the numbers of our ratio of physician to residents in Inland Empire compared to San Diego, Orange County, LA, we have a much, well, I guess larger ratio meaning we have fewer physicians or professionals. And you're exactly right, not just physicians, but also mental health clinicians as well. My wife is a mental health condition, and I can tell you every day what she sees is that there are more people seeking services than there are available clinicians, and many people have to wait, you know, weeks or months in order to get in to get an appointment. What I

Erin Brinker: 26:09

think is interesting, and that certainly has the has to take a toll, first of all on the practitioners. I imagine that because of the number of people they're having to see and the quick way they have to chart, because they have to document everything in a very particular way. And and then they, they they're left, they're set, because they're human and they're empathetic humans. They're left with all of the things that have been given to them to to process with their patients. And then they have to take that somewhere and do something with it. And so then they need mental health professionals to support them. And so it is, it is, it's a lot,

Unknown: 26:42

yeah, yeah. Somebody was said to me, every counselor needs a counselor,

Erin Brinker: 26:46

indeed. Well, they absolutely do, absolutely do, to protect themselves, you know, from the burden. I actually thought about being I really, really thought about going into mental health, doing that. And my husband's like, Erin, you take every patient that you would take home, every single thing that ever you know, that they ever told you, because I would, I would, I would not be able to shut it off. And so my, my, my hats off to people who can't because they're desperately needed. No, it's

Unknown: 27:11

heavy, heavy work, but really important work. Indeed,

Erin Brinker: 27:13

100% not. I've mad respect for anybody who does that. So one of the challenge as you're talking about, there's, there's not enough mental health practitioners. But we've got medical school, a relatively new medical school at UCR we have the one that's at the Arrowhead Regional Medical Center. There's the the there's one in Pomona, an osteopathic medical school in Pomona, Cal State, San Bernardino has just fall. Will be there. Fall 25 will be their first cohort, of physicians assistance. There are nurse practitioner schools, I think, at Loma Linda, and a few other places. And also, Loma Linda, of course, has a medical school and allied health professionals. Is that enough? And can we incentivize and is there a place, and I'm putting you on the spot, is there a place for the IE HP foundation to incentivize people who graduate from these programs to get local residencies and stay Yeah,

Unknown: 28:04

great question. And so what I'll say is, and this is an area where the health plan actually makes much larger investments than the foundation and IHP is a health plan actually invests in pretty much every program you just mentioned by scholarshipping in students. And one of the things that we're really emphasizing is, first off, how do we recruit more kids from our region? So how do we make those sure that those coming into the program who are scholarshiping are from this, this place, because we know they're much more likely to stay here if they have roots here and have family here and then, and then many of those programs as well also require, if you receive the funding, you do have to stay for a certain number of years and serve this community after completing, after completing your residency. That being said, you know, what I've learned is that it's not just a matter of, I mean, one of all it, part of it is a number of, you know, the number of available slots in medical schools, and they are limited. I was just at California University for science and medicine, which is affiliated with AMRC, as you mentioned. And you know, they were sharing how many applicants they have from around the entire country and how selective they have to be. The very cool thing is, they really do prioritize local students into their programs, so that, you know, the kid from Fontana actually is a much greater chance of being accepted than the, you know, the rock star from from Virginia, for instance. And so they are prioritizing that that's great, very limited slots. The second piece is having enough spots, though, for residency so that once those students go through, I'm going to call it the Classroom program, that they need to be placed into local hospitals, and we do a limited residency slots as well, and really funding for those residency slots. So it's a bigger picture, but there are, there are many people. Focusing on that. There are some dollars flowing into that, the health plans investing in that as well, but a big one that we're slowly chipping away at. So

Erin Brinker: 30:07

one of the things that that you all have done in the last year is put together a cohort of nonprofit leaders that will be kind of shepherded and stewarded to be to tackle some of the most pervasive problems and impacting the social determinants of health. Why don't you talk about that?

Unknown: 30:26

Yeah, so really exciting, actually. And so, you know, one of the things that I really value is that, when I came on board, my board of directors said, Hey, Greg, one of the things we're interested in is non profit capacity building, which I absolutely love. You know, I spent the last 25 years running non profits, and what I learned through that is that there is no perfect nonprofit. Every nonprofit has challenges, and even as good as they are, there's room for growth above that. We also know across this region, we have many small to mid size nonprofit organizations that need just based basic development of nonprofit skills as well. And so first, what we did is we we developed a program in partnership with the care of answer I project, which provided a 10 session series of basic, you know, nonprofit business management training for smaller organizations, where those organizations would go through that program. This was specifically for organizations with the budget less than$500,000 many of them were founder led organizations. They'd go through that training, and then at the end of it, as a carrot, we provided a $5,000 grant. So no, it's great retraining, but they got a grant at the end of it, and we got fabulous feedback from that. So the program you were referring to, though, is actually a newer program, which we call our champions for vibrant health leadership network. This is a group of 40 organizations. We actually had about 120 organizations that applied for it. Very difficult decision, but we were able to whittle it down to 40 organizations. And each one of those 40 organizations, who are selected, nominated an Executive leader and an emerging leader to be part of it. So there's two leaders from every organization. And we did that really intentionally. You know, when I came on board, I did a series of listening sessions around the region. My board of directors and the staff who were here before me did a bunch of that as well. And we really have built our programs based on the feedback that we received from nonprofit leaders. And one of the things we heard was we need to invest in that next tier of nonprofit leaders in the region. How do we make sure we're building those folks who can be executive directors in the future? And so this program intentionally does that. You know, what we ask for is, who do you see in your organization that's talented has the ability to move up either in your organization or someplace else, because it might be someplace else, but in the region, what we would want to do, invest in the leadership of Inland Empire nonprofit leaders, and so it's a two year program. It's focused on first, leadership development. So we actually hired someone who ran the master's program in leadership at USC, oh, wow, building this whole Leadership Development Program. Secondly, they also get a grant. So each of those organizations got a grant. The smaller organizations got$25,000 the larger ones got$65,000 and they got that for the first year. They'll get that again in the second year as well. So it's a two year grant. And part of what we heard too from organizations was, hey, what we need is unrestricted, multi year funding. And so this was a step in that direction. We're gonna say at least it's a two year grant. It's unrestricted. It's intended to help you build capacity in your organization. What can you spend it on that's going to help prepare your organization to expand, to reach more people, to do your work better? But it's really up to the organization to decide what that is. And then the final component of this program is around public policy. And so one of the things we know is that our nonprofit organizations have the ability to lift their voices and to advocate for issues that are really important to the Inland Empire, and they're on the ground every day with children, with families, with those with disabilities, those who are unhoused, those who aren't working. And they know the issues, and they have the ability to raise their voices at this the the local level, county level, state and federal level as well. And so we built this program to really build the public policy muscle of that group. What's been really exciting, it was, it was kind of disheartening, but exciting at the same time is that of those 80 leaders in our first session, I asked them, How many of you ever been to Sacramento before or have ever advocated, you know, to to local leaders on behalf of your organization or an issue you care about. And only about 15 hands went up in that entire room, 80 leaders, 15 of them, many of these are executive directors who had never really advocated before, and so we have put them through a whole kind of advocacy training program about a month ago, we took them up to Sacramento. We took that whole group of 80 leaders. We walked the halls of what's called a swing space now, but it's essentially it's the capital where all the assembly and senators are for the state. They all did meetings that morning. They were all very nervous. You can feel the tension in the room. How nervous. Were to go meet with these important, you know, elected officials. And by lunchtime, it was really cool to see just this confidence. Oh, that's great in that they had done the meetings, and they're like, We can do this. It's just having a conversation. And these assembly, you know, members or the senators or their staffers, they're just people. They're people a lot of influence, but they're just people, and it's a conversation about issues that we care about and that these nonprofit leaders know a lot about as well. And so the idea is to build those skills so that those leaders will continue to advocate for whatever issues are most important moving forward.

Erin Brinker: 35:39

Lot of nonprofit believe, nonprofit organizational leaders believe that they can't engage in advocacy because it's seen as lobbying and as 501, C, threes. We're not supposed to endorse candidates. We're not supposed to, you know, have that kind of influence, except when you're advocating for the population that you serve. That is a different thing entirely. And we are absolutely able to do that. And we should do that, you know. So if somebody has their idea, and I had picked on the unhoused position before, so, you know, they assume that, well, all the unhoused it's they're just lazy, and they're just on drugs and it, and you say, Now, wait a minute, the fastest growing population of unhoused in the state of California are women over 50 years. Yeah, and, and so let me, let me disabuse you of some misconceptions, and we can move forward on what a solution might look like. And that is a very different conversation than you know then I support this candidate. You know what I mean? It's they're not all the same, and that's

Unknown: 36:37

considered education. And so nonprofits can do unlimited education. Lobbying is when we're saying, hey, specifically, we want you to vote no on this bill, or we want you to support this particular, you know program, you know, government program. And most of what we do, the lobbying is very limited. It's really more education. It's bringing and it's also bringing kind of the face and the stories of our community into those legislators offices. Because I think a lot of times we talk about these issues at this level, but to be able to bring it down to ground level and say, let me tell you specifically about Cynthia and her family, single mom with four kids, and the way that this program made a difference for her, and if it goes away, what that's going to mean for other families like her, and

Erin Brinker: 37:22

that is a beautiful segue into what we kind of teased at the beginning of the conversation about some of the changes that are happening on the federal level, and what that's going to mean for the 40 What did you say? 46% of California Inland Empire residents, 43% who are on Medi Cal. And for those of you not in California, just to remind you that's Medicaid, it's, it's, it's healthcare for people who who need a little help with their budget. And so kind of talk about what some of those changes are and what what you're worried about. Yeah,

Unknown: 37:50

so, so right now, there's pressure on Medi Cal or Medicaid at both the state and federal levels. So first on the state level, you know the bottom line is as we came out of COVID. As you can imagine, during COVID, a lot of people, everyone stayed home. They were not seeking medical services. And during that time, what that means is that there were many fewer services being used. As we've come out of COVID, people have obviously come back to real life. So they're using they're going to their doctor when they need to. We also have deferred I want to call it deferred maintenance now as well. So, you know, issues that probably should have been addressed. You know, 2020, to 2022, that were deferred. Now we have more of those people in the system who are really accessing services the same time, mental health, you know, pro and con. I think people have gotten much more comfortable with seeking mental health services, but that's also increased that pressure on the system as well. What all of that means is increased costs on the system, and so over the last two years across the state, the cost of Medi Cal has increased beyond what the state has budgeted, essentially, for that system. So the state is looking at, how do we reduce costs and make sure that we can continue to support Medi Cal moving forward? Now on the federal side, about 70% of funding into Medi Cal at the state level comes from the feds. It comes from the federal budget. And as we know right now, many changes being considered at the federal level, we know the federal government is looking at cutting about $880 billion out of the federal budget over the next 10 years, of

Erin Brinker: 39:29

money. I can't even, I can't even picture that amount of money. It's a lot.

Unknown: 39:33

Indeed, the portion of the budget that that, that 800,000,000,800 $80 billion needs to come from is the portion that includes Medicare, Social Security and Medicaid. And as we know, those services for seniors, Medicare is unlikely to be significantly touched Social Security as well, but Medicaid is one. That is being looked at. You know, the President and others have said, we're not going to cut Medicaid. However, there are some changes that are, you know, being considered in terms of eligibility, or the types of services that would be included, or reimbursable, which we know will will reduce those people who are eligible or those people who are able to have that insurance and the services that they're able to to take advantage of,

Erin Brinker: 40:26

and if you change the reimbursement rate. So right now, Medicare, meta, Medicaid, or Medi Cal, reimbursement rates are low, but if they're made lower, then fewer doctors are going to participate. So you've essentially taken away health care from people who live in that area. So say you're in Blythe and or, you know, not even necessarily that far flung you're but you're out in a rural area, and there's one Medicare or Medicaid, rather, Medi Cal provider, and the reimbursement rates are changed so that he can no longer survive out there, because it's not enough money per patient. And so all of a sudden that that the families that this this doctor was serving, they no longer have access to health care.

Unknown: 41:04

That's right, yeah, and, and so let's just play that out. If that was also a doctor who was serving 50% medical and 50% let's say employer sponsored insurance, and they now go, I just lost this piece or a good portion of it. I can't afford to, you know, run services that doesn't just affect those that were on Medi Cal, it's also affecting access to care for those that have higher incomes and that, you know, have employer sponsored so. So another layer of that is we know that when people don't have health insurance, they're not going to see a PCP or primary care physician, and when they have health care needs, where do they go? The er, er, exactly, so the emergency room, and that's the same emergency room that people with insurance are going to be using as well, except for now, you're not just going to have people with emergencies. You're going to have people with all kinds of other issues, but they don't have another place to go. And law says when you walk into an emergency room that hospital must serve you, regardless of insurance,

Erin Brinker: 42:04

so you break a leg, you might be sitting in there, or an arm you might be sitting in that doctor's emergency room for 1518, 20 hours waiting to get served.

Unknown: 42:13

Yeah, so Exactly. So it will impact everyone in the community in that way, not to mention it also puts the burden of cost on the hospital, because the hospital still has to provide that service, whether they're receiving any insurance reimbursement or not for that. And some hospitals, particularly those in more rural and remote areas, have said, we're not sure we can sustain that, which means that we might have to close and again, then it reduces that access for everyone across that community. And so Jared McNaughton, this, the CEO of IHP, often says it's kind of a, it's kind of a house of cards, you know, and you pull out one card, it doesn't just affect that one card of that one population. It affects the whole thing, because it's all, it's all, you know, the healthcare system. And if you look at hospitals or doctors, they rely on those multiple sources of funding. So if you reduce the medical or the Medicaid funding, it is going to impact those daughters, doctors, the quality of service and access for everyone else as well, and

Erin Brinker: 43:11

then you have more sick people in the community, right? So whether it's a communicable disease or not, they're they're out there in schools, and that's the example that pops into my head. I'm married to a teacher and work for an educational foundation. So you know that having sick kids in school is not ideal, but if they don't have any way to treat what they have you have, they have no choice to send junior to school, or he's not coming to school at all because he's too sick to come to school, where the infection, or whatever it was, could have been treated in a physician's office pretty easily with some penicillin or similar antibiotic. And that then creates problems in the education system. It creates problems in other infrastructure as well. So I mean this rule really, healthcare is a very basic need, and the system so far in California, although it we need more, it has been working, but disrupting that system, as you say, could cause a major collapse. Yeah,

Unknown: 44:08

yeah. You know, somebody once said to me, you don't have your health. You don't have anything. Indeed, I'm not sure I fully appreciated it at that time, but it's true, and it's exactly what you said. I mean, if you have a child who's sick, then that child can't go to school and learn and build their future. It means that they're that parent also can't go to work and earn, you know, a living to be able to support all the other expenses of food and rent and, you know, shoes for their child. And so it is. It's critical, it is to keep keep people healthy. So

Erin Brinker: 44:41

one of the biggest issues, and this is not it's it's part of the vital conditions. It's a social determinant of health, and it's an area that you clearly know a lot about because of your work with hope through housing, is is humane housing in the region. And then there are health systems that are working on this issue, dignity. Had this, these kinds of grants and others. What is IHP? What is the IHP foundation doing to address the housing crisis?

Unknown: 45:08

Yeah, so right now, and I'll tell you, in, you know, just to go back, I'm about, I don't know, 15 months in something like that. And so we are just, we're just getting started, and we actually the priorities I shared with you earlier, we just nailed down in December, so we're just beginning to roll out exactly in

Erin Brinker: 45:24

the framework you're doing the bedrock, the bedrock stuff. So

Unknown: 45:28

right, right now our investment in housing is really about investing in those organizations. We have a number of organizations that are part of the leadership network that are either investing in homeless services, transitional housing or long term permanent housing as well. So it's really investment in those organizations. In the future, we'll see what, what other areas we're able to, you know, be additive in. You know, one of our values as an organization is we really want to be a good partner in the community and be a partner to our nonprofits that we know we don't have all the answers, we don't have it all figured out, but want to come alongside and say, hey, where can we be additive to some of these efforts? And so we are really interested in some of the collaboratives that exist right now. We're working with inland So Cal housing collective, which you might know as a collaborative of housers, to see how we can support some of their work. So we'll see, we'll see that grow. But what I know, though, from my history working with hope through housing and others, is, you know, housing is critical, but it's also very expensive, and it's a it's a giant, it's a giant issue that no one organization is going to solve

Erin Brinker: 46:42

well, and I love your answer that that you want to lift up other organizations who are already in the space, rather than reinventing the wheel. And that's been a trend over the last, I would say, decade, and that in the nonprofit sector that people may not be aware of is this collective impact approach. And so we've seen collective impact initiatives around the state, but in our region, there's growing inland achievement. There's the IE So Cal housing collective. There's the micro enterprise collaborative. There are, you know, in each one, one small business. One is education uplift San Bernardino, which is hitting a lot of different little a lot of different issues. I know that you all do a lot to educate beyond the your grant, your grantees, you do a lot to educate the community. So I went to an absolutely fabulous crisis communications workshop, I want to say was late last year at IHP, and really talented people who work for your organization. I learned so much, and it's great networking, and it was wonderful. So thank you for that. Yeah. So we

Unknown: 47:42

have a series, which we call our vibrant health forums. And the idea of these are really to be educational workshops. We are fortunate that IHP has a really terrific conference space here, and so we can bring together about 120 community leaders at a time to focus on a given topic. And so last year, we did a couple. One was focused on the governor's May revise of the state budget to educate local leaders on what's in that budget and what they might need to be paying attention to. The last one that we just did come months ago was specifically focused on diversifying your funding base. And this was focused on nonprofit organizations, focused on building a stronger individual and major gifts program. So what we know is that many organizations in the Inland Empire rely heavily on state and federal grants, some county grants, and don't have a very strong individual giving base. And what we know is that individual giving does two things. One, it diversifies your your portfolio, if you will, just like you would an investment portfolio, you want a diversified funding base in a nonprofit, but it also provides that ongoing, recurring revenue that's typically unrestricted into your budget that can provide that base for organizations. And so we held a forum really well, received over 100 leaders in there, and one of the things we got out of that was, and, like I said, we try to be responsive. We did a survey and heard from everyone, you know, the those who attended, saying, what's the next step? How do we get more of this? Like, like, Okay, you convinced me here the things I need to do. How do I actually do that, though? And so we just built, we're offering, and the applications are open right now. It's our vibrant health training on major, I'm sorry, individual and major giving. We're going to choose just 20 organizations to be part of that, and it will be a combination of a series of workshops and then some individual coaching as well, from two individuals, Lisa Wright and Lana Wilson, who you might know, who are experienced development professionals in the region, and they're going to share their expertise very practically with either executive directors or development people in local nonprofits to help them figure out, okay, I have a basic base of individuals, how do I expand that? How do I grow that, and how do I take those donors? Being $100 donor to a $10,000 donor. You

Erin Brinker: 50:03

know, it's interesting, because in the in the Inland Empire, there are pockets of wealth, but there's also a lot of there are lots of pockets of need, and there's a perception that you the pockets of need that you don't want to approach them, except that they want to participate too. I mean, I, you know, as a development person, I have even my small gift, I have tremendous joy when I give. And one exhort organization that I support that's not in this area. It's called holding out help. And it's it. It is a safe haven for men and women leaving poly polygamous cults in in Utah. And so they come out. They lose their they leave this their family. They have nothing, everything that they've ever known. They're leaving it behind. And so they need a safe haven, and they need a place to be deprogrammed, and they need they need food and shelter. They need privacy. And I give it's like $25 a month. It's not a big amount, but I feel a love and ownership for the people that that we're helping, I say we and I, that is a gift. So the donor sitting on the other side, they want that opportunity too, even if it's $10 yes, they want to participate, and they want to feel connected that they're investing some in something important.

Unknown: 51:16

And that makes such a difference. And like you said, it's not a ton of money, and it could be $25 it could be $5 a month, but that adds up over the course of a year, and it provides that base where that organization knows, okay, every month, if I have 100 donors doing that, it's providing that steady revenue into my organization that I know I can rely on, that provides that stability, which is so incredibly

Erin Brinker: 51:38

important. So you know that if you annualize, and I think it's a if I did the math a long time ago, but if you annualize a $35 donation from 6000 donors, that's a lot of donors, but 6000 donors, the annualized revenue is $2.2 million

Unknown: 51:54

there you go. And right now, when we have so many organizations that are fearful of what might be coming, of lost revenue. For those who have state federal grants, some of them, many of them, are letting us know they've already received letters that they're losing funding right now. That means cutting programs and such. And if those organizations had a much stronger individual giving base, I think that they, they would be fair on the feeling it's never good when you lose those grants, but a little bit more secure. And would provide that base. And this is the time to go back to those organs, to those individuals, where you can say, hey, look, we just lost this funding for this particular program. We need your help. And if you can, can you step it up a bit, or make a special gift or make your $10 a month, 15 or $20 a month.

Erin Brinker: 52:43

Yep. And I'm thinking, you know, a lot of organizations that rely on that federal funding, a lot of more research, healthcare, universities, you know that kind there are small there are other nonprofits as well. But I'm thinking, if you're doing grand ground groundbreaking cancer research, and all of a sudden you're told that your next round of funding is not coming, how devastating that would be, both to the organization and the individuals taking part, being a part of that, but also to the science that's not being done, yeah and yeah, and the outcomes that are not being realized. So

Unknown: 53:15

we do have that application open right now for anybody who's listening for that upcoming training. And then we also have our next vibrant health forum, which is focused on narrative and storytelling for advocacy and fundraising. Great that one is scheduled for May 22 and both of those opportunities can be found on our website, which is IHP foundation.org,

Erin Brinker: 53:35

so we just have about five minutes left if you were giving an elevator pitch to the our listening audience. Now, of course, we've been on the air for a while, but to our listening audience, what are the most important things that you would say the IHP Foundation has, let's say, in the next 18 months, that they kind of summarize that for us. Yeah, well,

Unknown: 53:55

we talked about a little bit, and then there's a big piece that we missed. Was so a lot of it is building the capacity of our nonprofit organizations we've talked about and that that's going to continue to be a major focus. How do we help those organizations that are on the ground meeting daily needs that lay the foundation for our community to experience better health every day? The other side of the place, based side, you know, something that's a major initiative for us, not just over the next 18 months, but over the next five years, is the Blue Zones project that we're working on. Oh, that's huge Riverside, and so many people may might know the Blue Zones. There's a Netflix series called Live to 100 a great four, just four episode series. But there's a National Geographic researcher who did a bunch of research around the globe and identified five different communities where people live exceptionally, longer. Interestingly, one of those communities is Loma Linda, California, the only one in North America. Yes, the only one in North America. But he identified these, these four principles, very simply that say, Hey, look, it's about, you know how you eat, mostly plant based diet. Secondly, how you exercise, and having natural movement in your day every single. Day. Thirdly, being in community and having social, social connections. And then finally, having purpose, knowing why you get up every single day. I love that. It's very simple. What I would say is, there's simple concepts to understand. They're not always easy to put into place. And so we've been partnering with the Blue Zones organization. Just launched this effort. It's in the county of Riverside, in five specific communities, the city of Riverside, banning Coachella, Palm Springs and unincorporated of me that Mead Valley. And the idea is for us to reverse engineer a Blue Zone. In other words, how do we change the built environment, local policies, school policies, workplace policies, so that it makes the healthy choice the easy choice, that makes it easier for people to choose those principles we just talked about. I

Erin Brinker: 55:49

absolutely love that. And you know, it reminds me, have you seen the documentary called happy? No, but oh, it's fantastic. It's probably been out 20 years, and the documentarians go all around the world looking for the happiest people. And the happiest person was, I think, either in India or Bangladesh. He's a rickshaw driver. He's got nothing, but what he has is a family who loves him and that he loves, and he just exudes joy. He is just he loves his life. Now, of course, he's active because he's he's carrying people around in his rickshaw and but and he they, they clearly have, obviously there have some food, but it's not an overabundance of food. But he's surrounded by people who love him. The people who were the least happy are the ones that were essentially stuck in a rat trap. You know, the the in the United States was not very high in the list. Japan, I think, was the lowest as far as a happiness index. And one of the things that in that movie that they or that document documentary that they showed, was something called co housing, which we don't have in this immediate area, although I think there's a community being built in Chino, where it's an intentional community, where people decide now they have their own space, but there are also communal spaces, and they decide to have communal meals at least a couple of times a week, to do communal things, to celebrate together. They get to know each other and essentially act like communities used to act 150 years ago. And this intentional community, they talk to seniors and single moms who live there who are able to support one another. It was beautiful.

Unknown: 57:27

Yes, no. And maybe the next time we have a conversation, we talk more about mental health. We know are you? A Surgeon General has said loneliness is a national epidemic,

Erin Brinker: 57:36

and it's like smoking two packs of cigarettes, cigarettes a day,

Unknown: 57:39

so that connectedness and living in community is is absolutely critical.

Erin Brinker: 57:44

Wow. So well I am. I'm so grateful that you spent this time with me. We're just about out of time. Greg bradbard, thank you for the incredible work that you and the IHP foundation and IHP are doing in the community. How do people find and follow you on social media and where they where can they go for more information? Yeah. So the best

Unknown: 58:01

place is just go to our web our website, which is IE HP foundation.org, and on there, you can both sign up for our newsletter. And the newsletter, we push out all of our opportunities, trainings, that kind of thing. And then all of our social media handles are on there as well. All the social media handles are also IHP

Erin Brinker: 58:18

foundation. Greg bradbar, thank you so much for joining me today.

Unknown: 58:22

Thanks so much, Erin. Take care.

Erin Brinker: 58:25

Well, that is all we have time for today. You've been listening to the making hope happen radio show, and I'm Erin Brinker, for more information about the making hope happen Foundation, please visit www.makinghope.org That's www.makinghope.org Have a great week, everyone, and enjoy the warmth and beauty of spring. I'll talk to you next week.

Unknown: 58:46

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