Banking on KC – Patrick Sallee of Vibrant Health
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Kelly Scanlon:
Welcome to Banking on KC. I'm your host, Kelly Scanlon. Thank you for joining us. With us on this episode is Patrick Sallee, the president and CEO of Vibrant Health, a federally qualified health center located in Kansas City, Kansas, ensuring that thousands of people throughout Wyandotte County have equitable access to medical, dental, and behavioral health services. He's also the author of a new book that was published just a few months ago called The Solitary CEO: How to Overcome the Isolation That's Holding You Back. Welcome, Patrick.
Patrick Sallee:
Good morning. Thanks for having me.
Kelly Scanlon:
Patrick, how has Vibrant Health carved out its niche, especially within the healthcare ecosystem here in Kansas City?
Patrick Sallee:
Sure. Well, thanks for the invitation to be here. I appreciate the opportunity to visit with you and to talk about what we're doing at Vibrant Health. So you mentioned we're a federally qualified health center. We provide medical, dental and behavioral health services as well as a number of wraparound sort of social care coordination support services to about 18 to 20,000 patients, primarily in Kansas City, Kansas. So we have three locations in Wyandotte County currently where we offer those services. And our niche is generally most of our patients are 200% or below the federal poverty level. So community health centers like us, there are about five in the metro area. Community health centers like us primarily serve under-resourced families and residents.
Kelly Scanlon:
It got its start 30 years ago, but it was under a different name, Turner House for Children I believe. So tell us about its original mission and how it's evolved since you took the helm as CEO six years ago. I mean a lot of things have happened in that period.
Patrick Sallee:
We've done a lot. But it's interesting and we talk about the history a lot because we aren't able to do what we do now, if we didn't have volunteers of all types that got Turner House going 30-plus years ago. We were founded as an all-volunteer pediatric clinic in KCK. So very similar mission to what we do now, but focused on pediatrics and it was a free clinic, so we weren't charging insurances, we weren't charging copays, we weren't doing any of those sorts of things. So over time we grew to where we hired an admin team and started hiring medical assistants and nurses and staff and taking insurances over a period of time. And in 2016 the board decided they wanted to pursue this federal designation and really that designation is about helping us stabilize financially. There's a federal grant tied to it, and there's an increased reimbursement rate for Medicaid, but it was really about financial stability and more services to be offered.
So we started that process in 2016 as an organization and it was really a bold move by volunteer leadership that we can do this, we can pull this off. And I came on board in 2017 with the task of taking that to completion and we've just had a ton of opportunity in the last five or six years to grow through acquiring clinic locations and partnerships and a number of other things that when I started in 2017, we were 25 employees and about a two and a half million dollar budget with about 5,000 patients. Next year we'll be about a $19 million budget, 150 employees and contractors and approaching 20,000 patients that we provide care for.
Kelly Scanlon:
That is phenomenal growth. You're in these neighborhoods for the people that you serve and you are now seeing patients across the spectrum, not just children.
Patrick Sallee:
Correct. Yeah, great point. Now so it's kids, it's adults, a lot of chronic disease management and then we see back to school time, we see a lot of physicals and that sort of thing and it's all primary outpatient care. We refer to hospitals for anything specialty, but it is all primary care. And what's great about it is there's a referral directly to dental. So one of our main locations dental's on the second floor. We have medical on the first floor, we have medical on the third floor, we have a pharmacy on the first floor. So you can get all of those things in one trip to one place. Incredibly convenient.
Kelly Scanlon:
You talked a little bit before about these wraparound services and I know part of your mission is to treat the whole person. What are some of these wraparound services, and why is it important that you would offer those in addition to the health-related services?
Patrick Sallee:
It's important for a number of reasons. First, most of what happens and contributes to how healthy are we as a community or as individuals happen outside of what takes place in a clinic. So if you think about the factors driving our health, 80% of those factors are driven by decisions and things in the environment that happen outside of what a medical provider's going to do in a clinic. This leaves a good portion – 20% to happen in the clinic. But if we're really going to move the needle on health in Wyandotte County, which is our mission, we need to be concerned with the other 80% and see where we can support that.
So some of our wraparound services are, we have community health workers that will help provide access to food or utility assistance or those kinds of other support services that our partners provide directly, but we can be the connector and the referral source for that. But as we think about our future we are thinking a lot about how do we get involved in housing and food insecurity and a number of other issues where we think we can play a role using our connection to the federal government and support through grants to take on some of those issues as well because they are directly tied to people's health.
Kelly Scanlon:
So rather than wait until a condition becomes chronic and they need to see you at the clinic, you are trying to get ahead of that and address some of the issues that contribute to those kinds of diseases and health issues.
Patrick Sallee:
Correct. So think about one of our referral partners is Kansas Legal Services and this is a medical legal partnership. It is probably the most sort of stark example of where this hits home. If you have a family that's living in a rental property and the rental property has mold and let's say the eight-year-old kid comes in with asthma and we struggle to control it no matter what we do in the clinic. If we keep sending them home to an environment that has mold and is unhealthy for that asthma, it doesn't matter. The physician can't do anything about that at the end of the day.
But if we engage an attorney through a partner that can take on their situation and support the family to get that remediated through the owner of the property they rent, that's actually solving more of the problem than what we can treat in a clinic. And so we have to be thinking about all of the health of our patients through that lens of what are the issues in the environment. And I don't just mean climate, but what are the issues in their lived experience and their place that are driving their health.
Kelly Scanlon:
You also work with some local hospitals. Tell us about that relationship.
Patrick Sallee:
We've had really strong relationships with the University of Kansas Health System, KU School of Medicine, and then Children's Mercy Hospital. And those on the KU side go back to 2016 when we really were trying to bring this together. And then Children's Mercy is a more recent partnership in the last couple years, but essentially we engage with both of them to have physicians and nurse practitioners in our facility providing care. We have three locations as I mentioned.
And so one of those locations is all the providers that work there, the physicians and the nurse practitioners are employed with Children's Mercy and we contract for their time, but they spend their whole time with us, which means we get the benefit of the big system of Children's Mercy. And the same when we have physicians from KU, we get the benefit of these big systems and relationships that involve the quality of care and people that they hire into our world. And we think that there's a lot of opportunity to continue to expand what that looks like, bringing specialty medicine into our space that would be a reasonable accessible way as opposed to having to try to get into the hospital.
Kelly Scanlon:
As we talked about, you have been really busy the last few years. You've achieved several milestones. Given that track record, what do you see for the future? What's your vision?
Patrick Sallee:
We have a lot on our plate and a lot we're planning for. And I think the biggest thing is probably thinking about what our role is in a very targeted place-based strategy. And what we mean by that is we're in a number of neighborhoods, but thinking about a neighborhood and how we can impact housing and food insecurity and some of those issues that I mentioned before, but what's our role? And so how can we be a catalyst to do some of those things and create opportunity through a physical capital investment that can create opportunity for investment in small businesses and investment in housing and those sorts of things that trickle down from commercial development? So we're trying to find our lane and have an impact in neighborhoods beyond clinical care.
Kelly Scanlon:
Okay. So from the health mission you have grown to address some of the environmental need but then also the economic issues surrounding their lifestyles and opportunities that are available to them.
Patrick Sallee:
Correct. If you start unpacking any number of issues that are systemic and speak to health, almost every time you dig deeper it comes back to poverty. So all of us in sort of the social service world, the issues we're trying to tackle end up coming back to poverty. If we can help lift people out of poverty, we can help change their health, we can change a number of other things. I mean it is fundamentally, there's a 10 to 15-year difference in life expectancy if you're born and raised in Wyandotte County, then if you're born and raised in Johnson County. That's not a climate issue. That's not exclusively a behavior issue, it's a poverty issue. And so in order for us to move that we have to change the place and we have to invest in the place and help build up jobs and opportunities for people to be homeowners and build equity and all of those things that help people grow in advance. We've got to be worried about in trying to impact those if we really going to impact health.
Kelly Scanlon:
You've worked with a number of nonprofits throughout your career and you're currently on the board of several within the community Care Network of Kansas, the Children's Center for the Visually Impaired and many others. I could go on. What has motivated you to work within this sector?
Patrick Sallee:
I think the biggest thing is, there have been several points in my life where it's just been clear to me the difference between the life I've been lucky enough to live was very much dependent on the place that I was born and the family I was born into. I didn't do or choose any of that. I mean that was luck, right? And so if luck can have such a determining factor on our life outcomes and our opportunities, that feels like an injustice to me. And so it's really been this drive around how do we make things fairer for people and opportunities more equitable? So it isn't that intellect and ability is reserved for these pockets of our world. It's pretty equally spread. Opportunity is not and we've got to be, in my opinion, we need to be working to provide that opportunity more equitably across our community.
Kelly Scanlon:
You've recently penned a new book, I believe it came out in September. It's for C-Suite leaders and it's for C-suite leaders who've struggled with isolation specifically. It's called The Solitary CEO: How to Overcome the Isolation That's Holding You Back. And there's a personal story related to your own health behind the book. Would you mind sharing that and the reason you wrote the book, some of the highlights of it?
Patrick Sallee:
Sure. I think the purpose of the book really was yeah, I spent a lot of time thinking about my own personal choice in my own life, my own experiences and how some of the lessons I've learned through just 10 years of sobriety and some of the challenges that came along with that that you learn through the recovery process around engaging with people. Recovery can be isolating. And at a period in time when I was first getting sober, I spent some time in jail and I spent some time in solitary confinement in jail. And that can be pretty isolating as you might imagine.
And so some of the lessons that I learned through recovery and that experience that relates to how I think about the isolation of the job and people say it's lonely at the top, that cliche because it's true. It is true. So I'm not making the argument that it's not true, but I am trying to make the argument that there are some behaviors that leaders go through, myself included, that further isolate ourselves from the teams that we work with or the boards that we report to or whoever, our customers or our client, whatever it may be. And we sort of self-imposed some of that isolation. And so the main purpose of the book is to try to provide some opportunities or some perspective on how we limit that, isolating ourselves in leadership.
Kelly Scanlon:
Yeah. A lot of our listeners are entrepreneurs and they're business leaders in the community who I'm sure can identify with what you were just talking about. That decision-making in particular can feel like you're all alone when you do that and maybe don't have people that can identify with the sorts of challenges that you face every day. You mentioned that there are some behaviors that actually exasperate that isolation. What are some that maybe our listeners should be aware of that they can change?
Patrick Sallee:
I think some of it even comes down to thought process, thinking about they don't understand the challenges that I'm doing. They don't understand the problems, the decision I have to make and the seat that I sit in and all those things. And while that's true, we don't understand that the situation other people are in either. Just because we supervise them doesn't mean we understand all their pressures because we all come to work with not just the pressures of the job and the day, but the pressures of home and family life and whatever other situation we're dealing with that affects how we show up today. And I think there's time, when we spend a lot of time thinking about ourselves and thinking about the pressure we have further isolates us to be inward thinking and nobody understands my situation. And what I have found is when I get most in that place, because I didn't write this book to say I've solved the problem and I don't experience this.
It's more to say, I deal with this all the time and here's what I do to get out of it. And to me, those things are getting back to the basics of the job. I used to work in a food service organization, this was 20 plus years ago, but I was the director and I felt often like nobody understood, I've got to deal with this and nobody gets it. And when I felt that way, I would go back and kick the dishwasher staff, and dishwashing team out of that area of the operation and I would just wash dishes. And I just need to go back and do the basics of this to reconnect to what we're trying to do here.
Happens at Vibrant too. I think some of the most, the strongest connections that I get back to our mission are to go bother the medical assistants or go bother the front desk. And it helps remind that they're dealing with problems that I'm not dealing with and I couldn't begin to understand some of the pressures they have with patients coming in and you got different people on your case and whatever. You just need to connect. And so I find that often the behavior that's isolating ourselves is really when we become self-focused.
Kelly Scanlon:
With everything that you've done and with all that Vibrant Health is doing, when you look back and say 20 years, let's just pick a date in the future, 20 years out, what do you most want to accomplish?
Patrick Sallee:
I think the biggest thing that we could've accomplished is to have moved the needle on health in Wyandotte. Wyandotte County ranks at or near the bottom always as in health outcomes in the state of Kansas, the county that ranks at the top is Johnson County. So we're not talking about an issue of provider access in rural Kansas. We're talking, as we've said about poverty. And I think that 20 years from now is a long time to try to move the needle on that rankings. You don't go from, I don't think you go from the last to the top in 20 years, that's a 50-year plan just based on how the numbers work and where we are. But what you can do is move the needle on key indicators.
And if 20 years from now we were to look back and say, Hey was Vibrant Health successful? Were we successful in what we've done? To me, we've moved the needle on really important stuff. And it's not just about Vibrant. We work with a bunch of different partners who do a lot of the work and we are a part of that and we are a convener and I think we do a lot, but we also have, there's a community of people committed to doing work in Wyandotte. And I think that 20 years from now, if we're successful, that community is bigger in terms of people participating in this. The awareness of how we get there is broader and we've moved the needle on really some key indicators a lot around economics in Wyandotte. And it's not solely about what Vibrant Health do, but as a collective, what were we able to move the needle on?
Kelly Scanlon:
Patrick, thank you so much for being here today for all that you and your team and your affiliates are doing for the community. Its important work and it raises all of us up. Thank you so much for that.
Patrick Sallee:
Yep. Thank you for the opportunity. I appreciate it.
Joe Close:
This is Joe Close, president of Country Club Bank. Thank you to Patrick Sallee for being our guest on this episode of Banking on KC. As a safety net care provider, Vibrant Health helps ensure that residents in underserved areas of Wyandotte County have access to quality, affordable healthcare, close to home. Vibrant Health status as a federally qualified health center and its collaborations with area hospitals have been pivotal in allowing it to open multiple locations and grow its patient base from 5,000 to 20,000 during the past five years. But as Patrick points out, even with all that Vibrant Health has achieved, 80% of the factors affecting health outcomes occur outside of clinical care. Poor nutrition, lack of affordable housing, lack of access to good jobs and other factors contribute overwhelmingly to negative health outcomes. These are areas we as a community can help improve. They don't require a medical degree, but our efforts will add up to healthier communities in the broadest sense. Thanks for tuning in this week. We're banking on you Kansas City. Country Club Bank member FDIC.