2016 Public Health Grand Rounds 11/04

PUBLIC HEALTH GRAND ROUNDS Linking Research to Community Health Improvement Jointly sponsored by the Department of Public Health Sciences & URMC Center for Community Health

(people chattering)
- Okay. (sighs)
All right, looks like we're filling up here.
This is good.
I'm gonna go ahead and get started.
Welcome, everybody.
Thank you for coming to Public Health Grand Rounds,
appreciate your attendance.
Most of you should have picked up on the way in
an evaluation form.
I'm encouraging you to please complete the evaluation form.
We do read them, we give feedback to the speakers,
and most importantly, we look for future topics
from suggestions from you all.
So please complete those
and leave them with the folks on the way out.
This is Public Health Grand Rounds,
put on jointly between the Center for Community Health
and the Public Health Sciences Department
here at University of Rochester.
We put on these Public Health Grand Rounds to bring to light
important issues that are important
not only to clinical delivery and healthcare delivery
but also to the community and the health of the community,
and really try to talk
about that intersection between the two.
Today, we've got a very exciting talk
from the folks at the Center for Youth.
Thank you all for coming.
We have three great speakers.
Because there's three,
I'm just going to read the brief bios here
instead of trying to be creative.
So thank you, all, again.
We have Doctor Richard Kreipe here today.
Doctor Kreipe is the Doctor Elizabeth McAnarney
Professor of Pediatrics at the University of Rochester.
He is board certified in pediatrics
and in adolescent medicine.
He co-edited the first textbook on adolescent medicine,
published in 1992,
and the American Academy of Pediatrics textbook
on adolescent healthcare, published in 2011.
Doctor Kreipe received the 2012
Society for Adolescent Health and Medicine
Outstanding Achievement in Adolescent Health Award
and the 2014 Academy of Eating Disorders Leadership Award.
He directs the University of Rochester's site
in the New York State Department of Health's
Center for Excellence for Assets Coming Together for Youth,
a public health long-term statewide community-based effort
to promote positive youth development.
Amazing career.
Thank you so much for being here with us.
Doctor Elaine Spaull is the Executive Director
at the Center for Youth
and likes to say that this job is her hardest ever
because the stakes are so very high.
Her background in education as the Dean of Students at RIT
and as a professor at the University of Buffalo Law School
and her legal background as a corporate tax attorney
at Nixon Peabody prepared her for this position
at the Center for Youth,
as the challenges facing our children and youth
and their families often require much advocacy.
Doctor Spaull has an undergraduate degree
from George Washington University,
a Master's degree from Georgetown University,
an Executive MBA from RIT, a PhD in Philosophy,
Organization and Education from University of Buffalo,
and a JD from University of Buffalo, as well.
So that's pretty outstanding herself. (chuckles)
Then Faith Davignon is the Program Director
of the Crisis Nursery at Greater Rochester,
a program of the Center for Youth.
Her background is in residential care,
reflected in her work for over 10 years
at the Villa of Hope.
That was in the Teen Mothers program.
Miss Davignon has an undergraduate degree
from SUNY Fredonia in Psychology.
Her work at Crisis Nursery is by far
her most rewarding as well,
as it offers immediate relief and support to families
and addresses the needs of the entire community.
Excellent.
Please join me in welcoming our speakers today.
Thank you.
(audience applauds)
(Dr. Kreipe mutters to himself)
- Okay, I had the slides here.
That's them there.
Let me click on that button there.
Excellent.
I appreciate the introduction.
I'm glad to see everyone here.
The title that we have now, though,
Because Not Every Family in Crisis Has a Village,
Rochester has a Crisis Nursery,
I apologize if I offended anyone in our community.
I offended at least one person
who sent a note to Nana Bennett
that the text that we had talked about
was a macro aggression.
I apologize if anyone feels that there was macro aggression
or any kind of insult to anyone.
Let's just kinda talk about what we're,
the next talk, (mumbles) okay.
Again, apology for any insensitivity
or perceived aggression.
I tried to reach out to that person,
but that person didn't get back yet.
But I'm hoping we can establish a conversation.
How many folks here are familiar with Public Health 3.0?
Oh good, there's a couple of people that are aware of.
I mean, a lot of people are aware of it, that's good.
I just learned about this two weeks ago.
I think it really helps provide a frame
for what we're gonna be talking about
with respect to the Greater Rochester Crisis Nursery.
What I wanna talk about, again, Public Health 3.0
as a framework, Greater Rochester Crisis Nursery
is now mergered with the Center for Youth Services.
We're gonna hear from Faith especially
some of the stories of the GRCN families.
Then, finally, the discussion is,
how do we bring the Crisis Nursery concept to scale,
and especially possibly being able
to make it a broader experience.
This is Public Health 3.0.
It's on the line.
It's actually a very well-done presentation.
I think the Surgeon General we now have,
Surgeon General Murphy, I believe he is
the best Surgeon General since David Satcher,
who actually trained here in Rochester.
He really seems to understand, in my mind,
what the Surgeon General is all about.
In Public Health 3.0, it's a pretty simple concept,
is what we do together as a society
to ensure the conditions in which everyone can be healthy.
Different than Public Health 1.0,
which was basically 1800s into most of the 20th century,
it's a comprehensive public health protection
from primary prevention through treatment,
becomes possible for the first time in history.
We didn't have this even available to us.
And development of an astonishing array
of health protecting tools
and capacity with increasingly sophisticated techniques
for ensuring sanitation and food safety.
So that's Public Health 1.0.
Then Public Health 2.0, late in the 20th century,
there was tremendously uneven public health capacity
at the local levels.
We would talk about, late in the 20th century,
I trained in pediatrics down in Philadelphia,
St. Christopher's Hospital for Children, in the mid-1970s.
It's amazing, when I talk to interns and residents
about the treatment of asthma,
the medicines that they had were not available to me.
I mean, the stuff that we used,
and they said, "You really used that?"
"Well, it's the best we had."
So I think we have seen a lot of advancement.
But what we start to see here also
is that there's a governmental public health comes of age
in, again, with today's health department
accreditation movement.
This is where we get the Public Health 3.0,
the social determinants of health
are the conditions in which people are born,
live, work and age.
I think it's an appreciation of that
where I wanted to put that in the context
of where the Crisis Nursery has a role
and where the Center for Youth Services has a role.
We see there's economic opportunity, housing,
environment, education, food, safe neighborhood,
transportation, all come together.
I think if you were to ask most people,
"Economic opportunity, that has nothing to do with health.
"Housing, that has nothing to do with health.
"Environment, that has nothing to do with health,
"especially since there is no global climate change.
"Education has nothing to do with health.
"Food, well, yeah, maybe.
"Obesity, that can be a health problem.
"Safe neighborhoods, ah, that's not health."
The point is, health is determined by all of these things,
possibly more than the other things
that we used to consider the main determinants of health.
That's where I think the Crisis Nursery comes in,
again as a public health intervention.
Again, Public Health 3.0, it's a significant upgrade
in public health practice to a modern version
that emphasizes cross-sectional,
environmental, policy, and systems level actions
that directly affect the local determinants of health.
What we're looking for is local public health leaders
as the chief health strategists.
Kind of a completely different way of looking at things.
We're not talking about, well, we've got
a Commissioner of Health at the state level,
we've got a Commissioner of Health at the county level.
That's not what we're talking about.
We're talking about people at a really local level,
maybe even in their own neighborhoods,
with Public Health 3.0.
So, just kind of in graphic form,
one was increase the use of clinical preventive services,
which was primarily focused on healthcare,
innovative clinical interventions in Public Health 2,
and now we're talking about community-wide prevention,
implementing interventions that reach the whole populations.
I think the key components that our Surgeon General
and the Office of the Assistant Secretary of Health,
they talk about leadership and workforce,
essential infrastructure, strategic partnerships,
data with analytics and metrics,
and then flexible and sustainable funding.
In the end, it all comes down to funding.
Everything that we do in public health
comes down to funding eventually.
The picture doesn't show it real well,
but you can see that there's the public health agency
in the center, but then there is all of these other dots,
and they're all interconnected.
This is like a, you may not be able to see it very well,
but this is, it's like a spider's web,
with that, the central being the public health agency.
But really, I just wanna give you the concept.
Exactly what the nodes are are not as important
as the concept of that the public health agency
in a local community.
This could be, for example, our Center for Community Health,
our Department of Health, et cetera.
Here's the thing that I find.
They talk about there's five different kinds of issues.
And one of the recommendations is
that funding for public health should be enhanced
and substantially modified,
and innovative funding models should be explored
so as to expand financial support for Public Health 3.0,
style, leadership and preventive initiatives,
blending and braiding.
I love this, 'cause the new word that I'm hearing now
that's been made into, I'm not sure,
is that a gerund or something like that, it's "pivoting."
See, when I was voting, back when I was younger,
it was always called you were "flip-flopping."
If you went from one thing to another,
you were called a flip-flopper, and that's a bad thing.
But apparently being pivoting is a good thing
because you can go from one idea to the other idea,
but it just shows how flexible you are.
So it's always kind of interesting
how things evolve over time.
I hope everybody is going to vote on Tuesday.
This is a very important election.
So blending and braiding of funds from multiple sources
should be encouraged and allowed,
including the recapture and reinvesting
of generated revenue.
Funding should be identified to support core infrastructure
as well as community-level work
to address the social determinants of health.
This is where the United States is moving forward,
in Healthy People 2020,
which before long it'll be 2020,
and we'll be looking at Healthy People 2030.
Okay, so that's Public Health 3.0.
Let's look at the concept of a crisis nursery.
Well, what's a crisis nursery all about?
Well, it provides emergency housing and daycare
to families facing a self-defined crisis.
They assist family with meeting short-term needs resulting
from unanticipated medical and mental health crises,
including sudden family death and illnesses.
They also help with referrals to communities.
It also, they can provide information to other communities
attempting to create a crisis nursery.
This is why I think things like,
the term community pediatrics, where was that coined?
What city was that coined in?
(man speaks off-microphone)
Rochester, New York, exactly.
And what was the first, where did United Way start?
You can't answer, Andy.
(audience laughs, woman speaks off-microphone)
Rochester, New York, was called the Community Chest
under George Eastman.
So I think we have a long history of saying,
"You know, we've got to work together as a community."
I think there's lots of opportunities here
to kind of be able to really move Public Health 3.0 further.
I don't wanna talk too much about this
because we have really the important people
that make this run, Elaine and Faith.
Here's the picture on Genesee Street.
It's a beautiful house.
It was founded in 2002.
In 2011, the Center for Youth
and the Crisis Nursery of Greater Rochester
had an asset-less merger in 2011,
meaning there wasn't any change of money
or anything like that.
Just, we work together.
It provided emergency daycare for families in crisis,
medical, domestic abuse, housing and security, et cetera,
for kids zero to 14 years.
Well, I don't think zero.
I don't think there are any in utero.
Have we had any in utero moms come?
(audience mutters) No? Yeah, okay.
(woman speaks off-microphone)
We had a three-day-old, but we could take a one-day-old.
But that's probably cutting it a little bit.
I think the word that probably
doesn't fit very well is nursery,
'cause I think people think of nursery as little babies.
But it's kind of more the concept
of taking care of somebody who needs nurturance.
The Crisis Nursery is having really increased usage.
This is one of the pictures.
It's a beautiful place.
Makes you feel like you just wanna hang out there.
Another picture of the bedrooms.
Of course, a nursery.
They do have younger kids there,
so they have all this equipment.
And a lot of this stuff, the building of this,
where local tradesmen and things like that,
they donated things.
It was really a wonderful kind of an opportunity
to have a positive effect on your community by giving.
The administrative data regarding this,
the hours of childcare has really increased,
from 6,000 in 2014 to almost 10,000 in 2015.
The most common reasons for people using the Crisis Nursery
of Greater Rochester last year was medical
or respite or Department of Social Services,
or other kinds of things, as well.
The reasons, again, were not mutually exclusive.
A lot of times, there are several things
that all come together.
Top referring agencies to the Crisis Nursery,
Strong Memorial Hospital, Ronald McDonald House,
the Willow Domestic Violence Center.
And then of course, there's also things like DSS
and lots of other things that Elaine and Faith
can tell you a little bit about.
But I think it's basically, what we're realizing is
that the Crisis Nursery is really of this community.
It's over in the 19th Ward.
It's a great building, you ought to go out and visit.
But it really is, that's why it's important
to have, I think, a strong foundation at the medical center,
because as a pediatrician, training in Philadelphia,
we often had patients who were admitted
who were called "social admissions"
because the dad was in jail and mom was something or other,
and the kid didn't have any place to stay.
So the kid comes, gets admitted to the hospital.
This will avoid those kinds of things.
The kids don't have to be hospitalized
because the family's in a crisis.
We see here the childcare, how it's really kinda
just going up and up.
And that trend continues up.
Again, the reasons for seeking things,
we see respite, homelessness, CPS,
Department of Social Services, medical,
domestic violence, and other,
which can be lots of other kinds of things.
And then again the agencies here, Strong.
Then also the Center for Youth and Child Protective.
I think the thing that I wanna talk about today is
how people thinking about, how do we take this to scale?
How do we make sure that, whenever we have a crisis nursery,
it's a location for best practices
and actually research, public health research?
There's obviously already a link
with the University of Rochester,
but also with other academic institutions,
to become a training site for a host of professionals
working with youth.
Be able to apply for a grant, not yet explored,
foundation grants, the CDC, lots of other kinds of places.
What Elaine's vision is to see a house
in at least every quadrant of the city.
So Elaine, as a city councilwoman,
she thinks in quadrants and things like that.
I think it's a great idea because there is a big difference
between being on the northeast side of town
and being down on Genesee Street.
There can be a world of difference between those two.
So I think the neighborhood kind of gathering around,
also makes sense having it in the same area.
But also to be able to expand the capacity
to increase utilization, explore per diem reimbursements,
assess city and county dollars,
and then to find partner agencies.
That's kind of, I want people to be thinking about now
for the rest of this hour.
Public Health 3.0, we've got this Crisis Nursery,
it does great things,
the Center for Youth does great things,
and how can we really see this as a public health model
that we need to not only encourage and support
but also replicate and disseminate.
With that, I'm gonna turn it over to.
So, thank you, questions, comments, we'll wait for those.
We'll turn it over to Elaine.
- All right, well, thank you so much.
I'm hooked up.
Can you hear me up there?
I promised I wouldn't wander too far.
The young man who mic'd me said, "How far will you go?"
I said, "I promise not to leave the building."
So I'm gonna be here with you guys.
Thank you for lunch, by the way.
We always love it when people feed us.
So we're grateful for that.
And so grateful to see so many of you.
We are in this together, my friends.
We are in this together.
Doctor Kreipe referenced my city council,
I am a city councilwoman in my ninth year.
I promised my husband I would have one term.
I'm in my third, so, you know.
I also thought I would be married to him
for three to five years, we would see how it goes.
We're in our 45th year of marriage.
And I don't like to say it out loud
because people do the math
and they realize how old I am.
I'm trying to pass.
But we're here, and my job today
for about five or 10 minutes really only
is to segue between the public health conversation
and all those issues that you face in your training
and your being in part of this amazing institution
that's helping our community so much,
to segue into how this got involved with
and attached to and connected to the Center for Youth,
which is in its 45th year, just like my anniversary.
I don't know why I'm talking about that.
But anyway. (audience chuckles)
So 45 years we've been at this.
And always the first 30 years before I got there,
I've been there 15 years,
the first 30 years were almost always 12- to 21-year-olds.
That was our target.
It was all about those kids 12 to 21.
That was because you could not take into a runaway
homeless shelter, under federal law, anybody under 12.
So it was 12 to 21 and 12 to 21,
and how did we decide that we wanted to work with babies
and families and now, of course, our span,
and Doctor Kreipe is right.
We should say "birth," birth to probably,
our oldest customer at the Center for Youth is 23 now,
so birth to 23.
At the Crisis Nursery, the majority of our children
are under the age of eight.
You'll hear about that more from Faith.
I'm gonna talk to you a little bit
about why, when Doctor Kate Cerulli,
who is really the brains and beauty,
and if you know Kate, you know how she rolls,
got this started.
Kate is not with us.
He mother died earlier this week
and she's dealing with family issues.
So we send her our love and condolences.
But it was really Kate's vision to say,
"I wanna live in a community that never leaves anybody out.
"I wanna live in a community that has a huge safety net.
"And if I," and she will tell you herself,
"I as a mom, with resources, with money, with friends,
"if I as a mom felt a little bit unsteady
"when I had my first child and didn't really know what to do
"and could have really used some help,
"if I felt that way, how must other people feel
"who don't have the support systems,
"who don't have the resources,
"who find themselves completely, how do they feel?"
So she and a group of amazing women,
I hate to say this, Rich, but it is really girls who rule.
Is that o-, we love men.
(man speaks off-microphone)
Your mother taught you that?
There's men in the audience, we love you.
We're not trying to diminish you in any way.
But we will say that it was the women who got this going,
and it was because they said, "What do you do
"when you're faced with tremendous, tremendous crisis
"and tremendous choices?"
So, you might have to leave your child
with a neighbor you don't know
because you have to go to work and you had no childcare,
or you might leave your child, honestly, this is true,
in your car when you go for an appointment for an interview
because you don't have any money for babysit.
Or you might have to reuse a diaper.
Now, when I first heard this, I was completely freaked out.
"What do you mean, you might have to reuse a diaper
"because you don't know if you're gonna have any,
"'cause you have to decide between paying your rent
"and taking care of your children,
"between paying your rent and feeding them,
"between paying your rent and paying for childcare?"
So the brilliance of the people
that started the Crisis Nursery was that,
"We wanna live in a community, don't we,
"where there is this amazing, compassionate,
"safe, effective, efficient, loving, caring,
"professional environment where you can ring the doorbell
"on Genesee Park Boulevard and say, 'I need your help.'"
Faith is gonna talk with you about some of our families.
We struggle.
As Doctor Kreipe said, I've had a million different careers.
At one point, people thought I couldn't keep a job.
I actually had never been fired,
but I had moved from being a teacher
to being the dean of a college
to teaching for the law school, and now this.
It is really, I think, the most difficult work that we do,
and that's because, if we don't do it well,
we will lose people.
And I am not, I am a hyperbolist by nature.
If you know me, I'm a big exaggerator.
But I promise you, I am not exaggerating when I say
the Crisis Nursery saves lives.
Some of you have had the great pleasure
of coming to see us
in our little house on Genesee Park Boulevard.
You're all welcome.
We do have an open house on the 9th,
where people come and they bring everything
from Windex to diapers.
It's how we fund some of what we do.
But I wanna tell you a little bit more
about why I think at this point in our community
and in our world we need the Crisis Nursery.
You know, the Dalai Lama says,
"What is the best way to live your life?
"The best way to live your life is to,
"if somebody comes to you and says, 'I need help,'
"and you can help them, then you do it.
"And if you can't help them,
"at least you don't make it worse."
Now, that's a pretty simple way to live.
But I have to tell you, the first part of that theory
is what we do at the Crisis Nursery.
We are the place that you can pick up the phone
and say, "I need help."
It's the most unusual environment.
It is in some ways the most pure form of justice.
Not just charity.
There's a difference between charity and justice.
Charity is doing really good things.
Justice is doing the right thing.
It's different.
And at the Crisis Nursery, we believe in social justice.
That means that when somebody comes to the door
with three children that are filthy, dirty,
wearing old clothes, and their mom is homeless,
we do not judge.
We bathe them, we feed them, and we give them new clothes.
And when a mom comes to us completely battered,
being abused by her husband, and says,
"Please keep my children because I'm not safe
"and they need to be safe," we take them in
and we don't judge.
This is the purest form of justice.
In anything I've done in my long career,
and it's been long, and I'm much older than I wanna admit.
But you know what?
This is the form of justice that you are all being trained,
I hope, in this beautiful institution to be part of,
to say, the first thing you ask is, "How can I help?"
Because we live in a world right now
where people are suspicious, they're afraid,
they don't trust,
they don't know who to turn to,
they feel overwhelmed, they feel sad,
they feel frustrated.
And what happens when that happens is
our families fall apart.
And guess who falls through the cracks?
Our children.
So the Crisis Nursery became a part of the Center for Youth
because we realized that if we didn't take care of families,
many of those kids would end up in our shelters at age 12,
they would end up in our school programs.
We run 35 different school programs
alternative to suspension, keeping kids safe in school.
If we didn't do the Crisis Nursery and start early, early
and help families stay together,
then we would feel something later.
We would have a aftershock.
We would see the children later,
in a way that was much less positive.
It is a joyful, happy place.
Kids come to us sometimes in tremendous crisis.
Terrible things have happened to some of them.
Faith's gonna talk with you.
We're dealing today with a very personal crisis
of a family or two that we've dealt with
and she'll talk with you about.
If we cry, don't get sad.
We do cry.
Sometimes it's healing.
It's hard work, and we do cry.
We've been crying a lot this morning about a loss we faced.
But I'm here to tell you that we're in it for the long run
and we need your help.
We need your prayers.
We need your time.
We need your support.
We need to spread the word.
I really, truly do believe, and my poor staff
doesn't wanna hear this, I really true believe
that we would end some of our poverty issues
and some of our crisis
if we could have a crisis nursery in every quadrant.
If you didn't have to try to get from Clifford Avenue
in Bay, which is part of my city council district,
all the way to Genesee Park Boulevard on a bus with a baby
in a certain kind of time, because if you don't get
to DSS by the time of your appointment, guess what happens?
You get sanctioned for 45 days.
How do we help our families get what they need?
We are the people who will say, "How can I help?"
And that's what you do here at the university.
So God bless you, thank you.
I may go out the back.
It's not because I don't love you,
and I'm not trying to get another wrap,
although I like the turkey one.
Thank you (audience chuckles)
for that, Doctor Kreipe.
It's because I have another presentation
to make over at the convention center.
But I am gonna turn this over to the brilliant Faith.
I wanted to change my name to Faith
because I thought it was such a great,
and she's, like, "No, that's my name.
"You have to stick with your name."
God bless you and than you,
and I wanna introduce you to Faith Davignon.
(audience applauds)
- Can everybody hear me?
I am not synced with a mic.
My role today is to really get you guys to understand
what the Crisis Nursery looks like,
the families and the children that are with us,
what they're facing.
And I'm hoping to spark some questions in you
that we can answer, as well.
Our little house on Genesee Park Boulevard,
I have been blessed to be the manager at the site
for three and a half years.
I'm gonna talk a little bit about, to kinda story tell
so that you guys can really get a picture
of our families and their situations.
Some things hit home to me when Doctor Kreipe
was talking about Public Health 3.0
and how many different factors can prevent our families
and our children from getting the care that they need,
whether that be medical care
or care for their mental health,
which has a huge impact on the families.
When someone is in need, for example of medical care,
mom ends up in the emergency department,
she's there with her two-year-old.
And the doctors have assessed and they decide
that mom needs to be admitted.
And she's calling everyone that she can think of
to come for her two-year-old.
And Doctor Kreipe mentioned social admits.
I know the hospitals are trying to get away,
do away with those.
The social workers get in contact with the Crisis Nursery
and they will ask us to take in the child.
We partner with them, we partner with you,
to help these kids.
The way that looks is, the Nursery has taken in children
for up to eight or nine days at a time, 24/7 care,
also providing the families with supports
with the school-aged children,
who I'm gonna talk to you about,
to get them to school each and every day
that they're with us,
to make sure that their needs were met.
If there were medical needs that happen with the kids
while they're in our program, we're taking care of that,
and getting them the care that they need.
One family who Elaine spoke of is very dear to our hearts.
We met them about two years ago.
Mom was pregnant at the time
and had a seven-year-old daughter.
She has sickle cell anemia.
She was having a sickle cell crisis and needed care
in the hospital.
So we helped this family during these situations
where mom had no family support,
no safe friends to rely on, and she was seriously ill.
The other part of what mom was facing was
that she has pretty significant learning disabilities,
and because of that, she had a lack of understanding
about her medical care.
She wasn't certain how to even get her prescriptions filled
or to organize her medical appointments for prevention.
So mom would end up in the hospital
literally a week out of every month.
She would be admitted.
And for about 16 to 18 months,
the Crisis Nursery took in her child
each and every time she was admitted.
During one of the times, this family has a sister,
the mother that I'm speaking of had a sister
who also suffered from sickle cell anemia.
We cared for her son, as well.
And that mother died while the son was in our care.
That was a very traumatic event, as you can imagine.
But we stuck with the family, we helped the family
with respite care.
When we say respite care, we're talking about
taking care of the needs, the emotional
and mental health needs of the parents
so that they can parent well and be healthy.
We kept track of this family,
trying to provide this mother with supports,
over the last, it's probably been about 10 months
since we've heard from them, which to me is a good thing.
That means they don't need us,
that they've got the other support someplace.
And I found out this morning
that the mother I'm speaking of, she died.
She leaves behind a two-year-old
and her eight-year-old daughter.
The father of the girls contacted me this morning.
He also has sickle cell.
What he said to me was, this stuff occurred
about four weeks ago.
I said, after talking with him through that, I said,
"Can you tell me what you need today?
"Do you need anything today?"
He said, "Faith, I have sickle cell,
"and I'm not gonna let this happen to me."
So we took in the two-year-old today
so that he could preventively seek medical treatment
for himself and to go to his doctor's appointments,
to pick up his prescriptions, that sort of thing.
So we're kind of, now we're helping
a third person in the family, or trying to intervene there.
So that's just one example of pretty intense situation
that the Crisis Nursery has been dealing with.
Again, there are no limits to how often a family can use us.
We hope always to make a plan for them
to have more concrete supports.
But in the case of this family,
when there is no other supports,
we're the ones that are there.
And what the families, when they describe us,
they describe the Nursery as a family,
like the family that they don't have.
It allows us to be able to intervene
in a huge array of ways.
The other story I wanna tell you about
is a woman I met about two months ago.
She called with a referral from a social worker
here at Strong's Partial program.
She was gonna be taking part in the Partial program here
for her mental health for about two weeks.
She needed care for her two-year-old daughter
during the day while she was here.
So we were able to provide that support and get mom there
so that she could take care of herself in that way.
It's amazing how, when a parent is asking a stranger
to care for their baby, how quickly they become
engaged with you and how quickly they trust us.
So that's what we see.
What we didn't realize about this mom was
that her mental health issues stem
from a much bigger problem,
that she was, one, ashamed to talk about,
and two, afraid to talk about or to let people know.
And the more we partnered with this mom
and the more we were able to provide safe
and loving support for her daughter,
she let us know that she was a victim of domestic violence,
that she has three children,
two school aged and her two-year-old,
that they are victims of domestic violence.
And when their father turned the violence and abuse
on her children, that mom said, "Enough"
and contacted the police.
There's order of protection for all the children,
including mom,
and that she was just trying
to piece her life back together.
So she allowed us to be a part of this journey with her,
and we're able to help her more.
When I say more, she's continuing
to seek treatment for herself.
There are still physical, medical appointments
that she needs to go to,
based on the abuse that she endured.
For example, she goes to physical therapy
from some broken bones and things like that
that she's still healing from.
She also is able to take her older children
to a therapist twice a week
because they're really struggling.
So we're able to kind of approach it in a very open way.
There aren't lengths of time that we're willing to help.
Our program is extremely low barrier.
What I mean by that is,
if a mom or dad, like this morning,
finds themselves in a crisis
and they have no one to care for their children,
they can call us.
We're not going to ask them anything else.
We're not gonna ask them how much money they make,
we're not gonna ask them if they have DSS benefits,
we're not gonna ask them to provide a birth certificate
when they come, or unreasonable documentation
that, in a crisis, you would not be able
to yourselves provide for someone.
So we're just able to get these families in.
The trust that is built is just remarkable.
There's other situations
that I had talked with Doctor Kreipe about
that we've helped with continuously.
Ronald McDonald House, as you could see,
is one of our major referral sources.
The issue that they have and they face every day is
that they do not have childcare onsite.
So if a family comes and there's multiple children
in that family and one of the children
is admitted to the hospital
or having treatments at the hospital,
a lot of times, those other siblings
are not allowed in the unit,
they're not allowed up at the hospital.
There's just a lot of different things
that can go on that can prevent that,
or to prevent a mom and a dad to come together as a team
and to actually be with their children together
in the hospital.
So what we do is, we take in the siblings
in those situations.
One family comes to mind, where mom had a baby last August
that was born with a serious cardiac issue.
He faced multiple surgeries from birth.
And mom had an 18-year-old little baby boy.
I'm sorry, did I say 18-year-old?
Yeah, no, he was not.
We do not take in a senior in high school.
He was 18 months old.
The Golisano Sibling Clubhouse is awesome,
but you have to be two to go, to be cared for there.
So we were able to take this little guy in.
Mom was here in Rochester from out of town
for four months.
So we were able to provide care for her son
while she was in the hospital, visiting and making sure
that her baby was getting the proper medical care,
being able to talk with the doctors,
being able to bond with him.
And he passed away in December.
What we were able to do in the middle of the night
for this mom, and I don't know if anyone even said this,
that we're a 24/7 program.
So there isn't a holiday, there isn't an hour
in the middle of the night that we're not gonna respond.
And this mother had c- (chokes up) at 3:00 a.m. and said,
"I got the call.
"They told me I need to rush in and say goodbye."
We were able to get staffing in to our program,
we were able to get mom to the hospital within an hour,
so that she was able to be there for her child.
So, I guess another situation that is very intense
in what we do, but very needed.
Now, for example, this mom,
she doesn't struggle financially.
That's not their crisis.
I think I worked really hard
to try to have people understand
that the families that we're serving,
yes, we serve a lot of families who are poverty-stricken,
a lot of homeless families, that kind of thing,
where we're trying to help people get back up on their feet.
But there's a lot of families that we're servicing
that they have very stable incomes.
It's just that crisis has hit them
in a way that they found themselves with no support,
or they found themselves in a situation, for example,
where a family member was dying and in hospice.
Huge Italian family, right?
Lots of family and friend support.
But it was not a healthy environment
for their nine-year-old son,
who just wanted to get his homework done
and wanted to be around some people
that weren't crying, that weren't grieving,
and he needed to get his own needs met.
So those are other people that we're partnering with.
We're partnering with hospice.
We're just able to pull kids out of situations
that kids should not have to be in.
I'm gonna speak of the domestic violence situation
that Eileen started to tell you a little bit about.
We had a woman show up at our door
with three children, three girls.
Her youngest was about 16 months old.
She was beaten so badly that she couldn't see the paperwork
that we were asking her to sign
to get her children in the program.
So we helped her with that.
She talked to us about how she had been beaten
by her baby's father for a very long time.
But it wasn't until that morning,
when she was walking home from the store
with her baby on her hip, and he approached her
and he beat her with the baby in her arms.
When she saw her baby fall to the ground,
she said, "Enough."
We were able to help this mom and this family,
one, mom had intensive medical issues.
She was admitted to the hospital that day.
She had to go for extensive followups.
We provided her with a referral
to the Willow Domestic Center.
They actually deemed her unsafe to stay in the county.
So we helped her to be able to relocate to Dansville.
We were able to stock her kitchen for her.
We were able to give her bedding and supplies.
And we were able to stay with them
and kind of see them through this whole nightmare of sorts.
We were able to make sure that the girls got into counseling
for the things that they had seen and been through.
So we were able to do a lot of things
and fill in the gaps in a way that a lot of other programs
don't have the ability to do.
Part of that is because we're so unique.
We lack a lot of funding because of that.
We're the only program in New York State like this.
So when people call me and say, "If you're full,"
we have a capacity of just six,
"what's the other option?"
There is no other safe option,
yet. - Yet.
- I was just gonna say, Doctor Kreipe,
that is why it is really important
to think together as a community.
Without the support of the community already,
we have 50 active volunteers in our program
who help us.
We have donations dropped off daily.
Elaine talked about the great attendance
at our open house that we have every year
and how that helps sustain us.
It does take a community, it certainly does.
So with your help, in your minds,
we're asking you to kind of think
how to expand, how to get this going.
I see families that have an eight-hour work shift,
like Elaine said, across town.
They will need to leave their children
at the Crisis Nursery for 12 hours, half of the day,
because they're taking the bus,
and because the bus route doesn't allow
for them to get back to their children.
So it's a struggle.
A struggle.
So thank you, thank you for listening
and thank you for opening your minds to this.
(audience applauds)
- I'm sure we were gonna save time for questions because--
- [Richard] And answers, I want answers.
I don't want questions.
- I want solutions.
Are we gonna make 'em write a check?
This is not church. - No, no, no.
- I do have to run.
But you know, when I say we're in this together,
I mean that because we all have different assets,
we all have different things that we bring to the table.
Some of you may have a connection to a realtor
who wants to give me a house, and I'm happy to have it.
Or some of you may say, "You know what?
"I would love to volunteer."
We're always looking for support,
specifically during the holidays.
Is there anything on your mind that you want me to know
before I let off?
Faith, as you can see, she is a treasure.
Honestly, I don't know.
There are other places in the agency, (mumbles) big agency,
I know other places where people are saying,
"You think Faith--"
I'm, like, "Don't talk about Faith.
"Faith is off the record."
I shouldn't say that on your behalf.
But she's off the record for anything else
but the Crisis Nursery.
We need this kind of compassion and understanding,
(audio fades out) background.
But anything on your minds for me before I run off?
Doctor Kreipe is also a great (mumbles) of the center.
(audio fades out)
So he knows about our program.
But anything you want me to know before I (audio fades)?
Well, then you can ask Faith and Doctor Kreipe, right?
- [Richard] And we'll have a conversation.
- You'll have a conversation, okay.
God bless you, thank you.
- Thank you, Elaine.
- I'll see you guys. - Take care.
I'll turn it in for you.
(Elaine speaks off-microphone)
(audience chuckles)
- [Elaine] Thank you all so much.
- Anybody have any thoughts about this all,
especially, you know,
it seems like it's a pretty worthwhile endeavor.
It's something that certainly fits into Public Health 3.0.
I mean, it couldn't come at a better time,
with the launching of Public Health 3.0.
But what are your thoughts about what might be
some solutions to how to keep,
not just keep the Nursery going,
but actually to expand it?
And then have it be kind of a laboratory in our community
for what works and what are the important elements
in a crisis nursery?
Obviously, you want somebody who's a program manager
who's dedicated like Faith.
But there's probably lots of other things.
So I'm just wondering what people's thoughts are,
and if you've ever been involved
in any kind of endeavor like this.
I think it's pretty exciting.
- [Woman] If you're evaluating at all,
I mean, (audio fades in and out).
How good you're doing, right?
- Right.
We keep statistics on all of our demographics
of the populations that we're serving,
all the people in the community that know us.
And just by one of the charts that you've shown,
our numbers just keep growing and growing.
Because of that, we only can take in six children at a time.
I think I said that.
We have to triage our crisis situations very thoroughly
and to make sure that we're always saving room
for real serious crises.
Which is hard.
It's really hard to turn someone away and say,
"I'm sorry, but your crisis is not as serious
"as this next person's crisis."
And that shouldn't be.
So when we're talking about our community needs,
you know, we should live in a community
where every crisis matters
and everyone's gonna feel that support around them.
But we absolutely are keeping track of all that data.
- I think (mumbles) kind of lead-in to the thing,
"Wouldn't it be neat if we could have other Crisis Nurseries
"and maybe do different interventions
"and be able to compare (mumbles) other outcomes
"and things like that?"
Yeah, Wendy?
(woman speaks off-microphone)
- Oh, awesome.
- [Woman] I think what would be really cool,
(audio fades out)
how do we get a lot of these things, programs, together?
(audio fades out)
How do we work together
so we're better supporting each other
in the messages that we share with our families,
the messages that help to benefit them.
(audio fades)
- Those who couldn't hear, Wendy Lane from Child Life said
we all need to work together to make this happen.
We do need more.
And I think that you're absolutely right, Wendy.
I would just say one more time,
November 8th is a way to ensure.
I think we know who cares about children and who doesn't.
So I think the ability to reach beyond the normal silos.
You know, it's really infuriating.
Elaine and I were on the governor's
Children's Cabinet Advisory Board for four years.
It was just wonderful, 'cause we said,
"We have to break down these boundaries,"
because there are some institutions in New York State
that says, "You have to do this."
And there's other ones, says, "You can't do this
"if you're gonna get funding from us."
So there's all of these things
that are kinda cross-referencing each other.
I think you're absolutely right.
We need to be talking, we need to be having people,
especially people who experience the problems come,
"Look, I went to some (stutters).
"Why did they end my,
"why did I have to go on penalty for 45 days
"because I didn't do something as far as DSS goes?"
I think we need to have a mentality
of how we can all work together on this.
Again, the village concept rather than,
"Well, sorry, you didn't get your (mumbles) in, next."
Yes?
(woman speaks off-microphone)
Yeah, good question.
The question was, how do the neighbors take this?
- I can tell you that at our site,
that it's been the same site on Genesee Park Boulevard
since the beginning, since 2002.
Our neighbors are incredible.
Elaine had actually spoke to me about this yesterday,
about the right way to kind of expand,
the right way to start a program
in a neighborhood like this is
that you talk to the neighbors first.
Of course, the city councilwoman would say that
and bring that to the front of everyone's mind.
But that's the right way to be transparent.
We have never had a safety issue on site at all.
We have wonderful neighbors.
We had a neighbor just buy a home
right next door to us, so he's new.
Wasn't really sure what our program was about,
and I talked with him on Wednesday.
And he asked me politely if he could buy a puppy.
And I was, like, "Um, I think you can do what you want."
And he said, "Well, do you think
"that that would upset your kids,
"or would you allow me to let them play with the dog?"
I mean, they're just, like, really awesome.
- Anybody from pet therapy here?
'Cause I'll answer that question if he (mumbles).
Oh man, there's nothing like pets.
- Anyway, we have nothing but kind (audio skips) us.
I think that's because they connected
with the neighborhood first.
We're a part of the 19th--
- I think you need to know that the Genesee Park,
I mean, it's a beautiful, wide street.
When you're going to the airport, you probably go by it.
The houses are all nicely kept.
So it fits in, and I think that's an important question of,
location needs to be really well thought out.
(woman speaks off-microphone)
- The locations would be picked very carefully
and really talked.
The 19th ward has an association.
We are a part of that.
We do a lot of functions with them,
where we'll set up a table.
So we're really active in that community, which is nice.
- Anybody live in the 19th ward?
It's a great community.
I had a lot of friends that used to live there.
They still live there, actually.
I just haven't talked to them in a while.
- That was a really good thought.
- Other ideas?
Yes.
(woman speaks off-microphone)
- I was just actually having
a conversation today about that.
- What role would the student nurse have in this?
Excellent.
- I was actually just talking,
when I got here this morning, I was a little bit early
and I was talking to, I believe,
the head of that department, who's outside.
I don't know if she's still here or not.
But we were talking about collaborating efforts there,
as well, so that we can,
we take in a ton of different interns,
we have occupational therapy interns,
we'd be more than willing to, and bless,
to have student nurses here
participate in that kind of thing.
- You can contact me
and I can give you the contact information.
- We also discussed having the student nurse population come
and do maybe some trainings for my staff
around certain issues.
So we were gonna kind of collaborate in that way.
- Great idea, thank you.
Yeah. - Yeah.
(woman speaks off-microphone)
- Yes, yes.
(woman speaks off-microphone)
Do you want me to repeat-- - Yeah.
- That question?
She was asking if we get United Way funding.
The Center for Youth absolutely does.
I can speak about the Crisis Nursery.
We get a $25,000 grant from them every year,
which is awesome.
That helps to sustain the program.
(woman speaks off-microphone)
- For those of you who aren't familiar,
the New Beginnings is for males
who have been disengaged from society in one way or another.
They're not in school.
They're great young men,
but they're not headed in a good direction.
And there's a house where they go,
they get to college.
We had one kid, I think one of the first kids actually
who went through that.
He was not in school, he was a dropout.
He actually graduated from the New Beginning school
and now is a student at RIT.
(woman speaks off-microphone)
Demonstrating.
(woman speaks off-microphone)
Yeah, I agree, thank you.
Go ahead.
(woman speaks off-microphone)
Excellent!
(woman speaks off-microphone)
- That would be awesome.
- And we know from the work
that Doctor (mumbles)'s group did that,
when kids in school pick their own books
that they're gonna read over the summer,
they don't have nearly as big of a drop-off.
I mean, it's really sad to hear that a kid who,
Rochester City School District gets done in the end of June.
By the time, if that kid gets back in September,
he's two or three months behind on reading.
So this is a great idea.
Yeah, anything anybody wants to think about
how we can do this, we can,
I'll give you a card, too, so you can get in touch with me.
But this is great.
Well, we have, yeah?
(woman speaks off-microphone)
- Absolutely. - Yeah.
Thank you very much for all your ideas.
- Thank you, guys, very much.
(audience applauds)
- [Woman] Don't forget your evaluations on the way out,
and thank you, all, for (volume drops out).
- Let me turn this thing off.
I like the fact that it's got a mute button.
So it's not, it's.