ABOUT ALEX PLUM:
Rev. Alexander Plum, MPH, MBA, CHES, is the Executive Director of the Corner Health Center, Michigan’s oldest and largest integrated adolescent health practice. An ordained deacon in the United Methodist Church, he centers his work on the margins of society to achieve just, equitable outcomes in health and wellness.
In over 15 years of international and US-based health development and health system strengthening, Alex has prioritized the values of humility and reciprocity in his work. He has been principal investigator on multiple health services and health research grants exploring, among other things, the impact of water shutoffs on health; learned masculinity on health outcomes; food insecurity and hospital utilization; and facilitators and barriers to global learning.
Alex is a Salzburg Global Fellow, a former Paul D. Coverdell Fellow, and a Returned Peace Corps Volunteer (Micronesia, 2008-2011). He is a 2023 alumnus of Wayne State University (MBA, Global Healthcare Supply Chain) and a 2015 alumnus of the Rollins School of Public Health at Emory University (MPH, Behavioral Science & Health Education), which honored him that year with the Emory University Humanitarian Award. Alex graduated Phi Beta Kappa from Michigan State University (BA, International Relations & Political Economy) in 2008.
RESOURCES:
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TRANSCRIPTION:
David Fair: Welcome to Washtenaw United on 89 one WEMU. This is our weekly exploration of equity and opportunity in our community. I'm David Fair, and while we have one of the most technological and research advanced medical communities anywhere in the world, the United States, in many ways, has a broken health care system. It's not accessible to everyone. It's out of reach of too many. And even when free care is offered, there's often a sense of mistrust that keeps people from walking through the door. It's still a work in progress. Meantime, the need is real, and, fortunately, there are people and organizations working to overcome some of these obstacles and provide services in underserved areas. That includes The Corner Health Center in Ypsilanti. Its stated mission is to inspire 12 to 25-year-olds and their children to live and sustain healthy lives by providing them with judgment-free, affordable health and wellness care and education. Our guest today is the center's executive director, Alex Plum. And thank you so much for joining us, Alex.
Alex Plum: Well, hello, David. And thank you very much for having me.
David Fair: Now, clearly, there's a philosophy behind focusing on 12 to 25-year-olds. What exactly is it?
Alex Plum: Well, I'll tell you that the Corner is Michigan's oldest and currently largest adolescent health center. Our forebears began the organization 43 years ago to address what was really then a crisis in despair at teen pregnancy rates in our community. What we've seen over the last 43 years, thankfully, is teen pregnancy rates have gone down. We've seen increasing disparities and many other outcomes across the life course for people who live in Ypsilanti and Ypsilanti Township here in Washtenaw County. And we recognize that you have to start young. You have to get them early if you're going to make the kind of investments and changes that are necessary to ensure a long, meaningful, healthy life.
David Fair: The Corner Health Center says it is not only youth-driven, as you've just pointed out, but it is youth-led. What exactly does that mean?
Alex Plum: Well, in the nineties, late nineties, the Michigan Legislature changed the law, so that public boards and agencies in the state could allow young people to join their boards as part of the governance system. And the Corner was one of the first health care organizations to follow that lead--in fact, advocated for that change. So now, on our 15-member board, two young people have seats. They're full voting members of our board of directors. They influence the hiring of the executive director. And they set the strategic parameters of the organization. But more importantly, they provide us a window into the thinking of young people today as we organize ourselves to be relevant and effective in the work that we lead. And beyond just the board, we've invested in a youth leadership council, and these young people are promising and aspiring young folks from around Washtenaw County who review our policies and who undertake an impressive array of their own independent research projects to help seed new programs and initiatives that help us stay on the cutting edge of delivering adolescent health services.
David Fair: How has it shifted policy or service care at the center, having utilized the services and perspectives of these young people?
Alex Plum: In health care, and generally, we talk a lot about the protection of health care workers and have increasingly become in tune with the need for a patient bill of rights. And so, in health care, we've moved in that direction. But we hadn't really thought about an adolescent patient bill of rights. What does it mean for adolescents to have a say in their rights when they come in and receive health care? We know that many health care services still require parental approval. That's changing. You know, we're moving in the direction that 16, 15 and even 14-year-olds can consent to different elements of their care. And that's important. It respects their autonomy and ensures equity in decision making. And it puts young people in the driver's seat of their own health care.
David Fair: This is 89 one WEMU, and our Washtenaw United guest today is Alex Plum. He is executive director of The Corner Health Center in Ypsilanti. And, you know, "affordable" is a rather subjective term. Maybe it always was. But what may be affordable to you and me, Alex, may be completely out of reach for others. So, how do you define affordable health care at The Corner Health Center?
Alex Plum: The Corner is really proud to not and to never turn any patient away for an inability to pay. You're only going to find that in health care if you go to a social safety net hospital. And even there, their purpose is to sustain immediate life. It isn't to do anything else. The Corner is different. And so, our mission is to ensure that young people have access to whatever form of health care they need to live their best life. And in the US health care system, that is simply revolutionary. The Corner gives away about $1,000,000--they've had, last year, just over $1,000,000--in what we call uncompensated care. It is care services that will not be reimbursed by insurance companies, and it's care that our young people are unable to afford themselves. We're still a lean organization. We will bill insurance when we can when young people come in and if they're covered. And we work hard to enroll young people who are in our service area in in the affordable Medicaid plans, when they qualify for those. We navigate all of those services. So, you know, we don't want to ever leave money on the table. But the reality is that health care services are expensive, and with inflation and other forces in the US health care system, those prices continue to rise. We deploy a really great multidisciplinary care team. It utilizes a high-level physician for specialty services when it's necessary, and then we deploy more efficient, affordable resources, like advanced practice providers, nurse practitioners, to deliver a lot of our primary care. And then, we involve folks in medical assistance iand nurses. We even have doulas. Some of these services now are able to be reimbursed.
David Fair: Certainly, we probably don't need to point this out to anybody, but racism and discrimination has been and remains a plague in so many areas of our society, and health care is no exception. As a result, there are many people of color and members of the LGBTQ-plus community that mistrust the system. How does The Corner Health System apply its mission of being judgment-free in its service offerings?
Alex Plum: And the fact that phrase "judgment-free" really stood out to me when I was recruited to come work at the Corner. I think that there is...well, there's a lot to say about that, David. The first is we're an anti-racist organization.
David Fair: A lot of people say that.
Alex Plum: Sure, sure. And maybe it's easy to say, I don't know. What I know is my staff, over 50% of the folks that work at the Corner are people of color. About a third of our staff are LGBTQ, including myself. What that means is we have a deeply seeded identity in this organization. And so, when we say we're anti-racist, what it means to us is we work to systemically interrogate ourselves, our policies, our practices, things from the way we deliver care to where we purchase our inputs, our goods, our supplies, how we deliver the care, the hours of our operation, whether we're truly accessible. And we pay so close attention to the patient satisfaction surveys. Do our patients feel like they've been affirmed? Do they feel like they belong? Or have they experienced an incident of bias or something that they perceive to be bias or discrimination? So we do this because we recognize that the historical legacy of the U.S. health care system has been to prevent and undermine how people of color access care and achieve their best outcomes. We're really proud today that we are kind of on the forefront of how we partner with organizations in our community to address some of these disparities. We've been partnered with the Washtenaw County Sheriff's Department and the Department of Public Health on an intervention, including I'm sorry, with the county prosecutor and the trial court, so that we can help young people who have been arrested or charged with a crime. We are the place where a lot of these young people for nonviolent offenses can be referred. We then become kind of a care team for them, getting them connected to primary care services, behavioral health and wraparound social support. And when we do that for them and they complete that program, they no longer have a criminal record. They're actually discharged from that criminal system. It's a sort of an alternative justice kind of track. It's approved by the courts and the prosecutor's office. So, we're excited about that because we know that there is a disproportionately high number of people of color who wind up in our jails and who wind up in our criminal justice system. And we want to be on the front end of that. The last thing I might point out, particularly, is that we were the one organization awarded by Washtenaw County with an LGBTQ services grant that came directly from county government because of the work that we're doing, particularly in our care system, to address the rights of young trans individuals who are seeking gender-affirming health care services. And we do this because we know that if young people feel safe, if young people feel seen, if they feel hurt, that they will continue to be champions in their own care and this, ultimately, refocusing the power in individuals. That's what it means to be anti-racist. And I think that's what it means to be centering young people despite their background or despite their community.
David Fair: Once again, our Washtenaw United conversation on WEMU continues with Ypsilanti Corner Health Center executive director Alex Plum. As you mentioned, Alex, the Center is Michigan's oldest and largest adolescent health practice, entering its 44th year of existence. Would you say the need for the Center has grown over those four-plus decades?
Alex Plum: It's grown, and it's changed. But the need to center young people in all facets of our life remains consistent. The truth is young people will always be with us. And that's a good sign of a thriving society. But how that society centers those young people in their voices is, I think, a mark of its moral characteristics. So, I mentioned that at the start of the Corner's legacy, teen pregnancy was sort of our animating purpose. Well, now, 43 years later, teenage pregnancy hasn't gone away completely by any stretch. But we don't see the same number of 15 and 16-year-olds that come in pregnant. Now, what we're seeing is a really high rate of behavioral health and mental health conditions. Young people reporting high levels of anxiety and stress, suicidal ideation and depression. And so, we want to be present for those young people and their needs. And we see that these behavioral health conditions, by the way, cut across primary care needs. A young person might come in with a flu that won't sort of go away or a bad cut on their forehead. And as we tend to that issue, you know, our staff gets talking and then they find out there's been some trouble at home or they kind of get kicked out or they're struggling in school. And it opens doors to conversations, so that we can get those young people connected to the other resources that exist at the Corner, so we can ramp them around with the needs that they have. Just last year, we began offering services for fathers as well. It takes two to tango, and if you're not including the parental figure in the equation, then we're not really thinking about the whole family's needs. We had a young dad come in, and he had done a kind of a primary care check. And our nurse practitioner had said, "ou know, have you ever gotten anyone pregnant?" Now, we knew he was there for another situation. But that question--have you ever gotten anyone else pregnant?--it opens the door and he sort of stood up really proud and said, "Yeah, I've actually gotten two women pregnant." By the way, this is a 17-year-old. And we said to him, "Okay, tell us about the kids. Tell us about them. Like, are you involved in their lives?" And what was this prideful sort of posture with his shoulders back, kind of his confidence, "yeah, I've done that," immediately changed. And he started to slouch. He put his head in his hands, and he began to cry. He said, "No. Both women actually terminated the pregnancies." No one had ever asked him about the impact that had had on him. And so, there's these opportunities when we're really willing to take the time to ask questions and open doors. Now, this young man then got connected to one of our behavioral therapists, who was a Black man like he is, and the two of them were able to establish a relationship. That is a meaningful entrance into what I hope will be an episodic moment of care for that young person. And then, he'll get back on to his life. And we've been a friend to him, and we've put him on his path, and that is essential to the mission of the Corner.
David Fair: Well, as you just pointed out, sometimes, it can be as simple as asking a question. And yet, the health care system has become a volume business, and doctors are simply, not a lot of the time, to take much time other than to treat a symptom. So, you work in the middle of it and have characterized the American health care system as fundamentally broken. Do you see a fix?
Alex Plum: Hmm. Oh, we don't have time, David. We don't have time. I will say that there are fixes. You know, there are many fixes, and the fixes almost always begin on an individual level. Our physicians and our providers at the Corner are the biggest advocates for systemic changes in our delivery of care. Because at the end of the day, they're the ones in the room with the patient. They're the ones who know what's going on. Oftentimes, what I'm told as an administrator is to get out of our way and change the rules of the game, so that we can deliver the care that we do. What does that look like for the Corner? It means a really healthy source of fundraising. In fact, like many nonprofits, we do year-end fundraising goals. Actually, on Leap dDay on February 29th, we're going to be having a special event, a fundraiser event, a three-course celebratory centering our efforts to prioritize youth nutrition and healthy lifestyles. Folks can find out more on our website, Corner Health dot org. There's my one shameless plug. But we have to prioritize that fundraising. You know, about a third of our income comes through grants and through the benevolence and the generosity of supporters of the Corner who have been with us for 44 years. We receive some federal grants. And then, of course, as I said at the outset, we do a lot of billing when we can. We have to have these multiple varieated streams of revenue, so that we don't have the competitive pressures that so many of our peers in health care have. The Corner is trying to be at the forefront of how we achieve value instead of focusing exclusively on volume.
David Fair: Well, thank you so much for taking time to talk with me today. And thank you for sharing your insights. I appreciate it.
Alex Plum: Well, thank you, David. If I could just say one last thing on the way out, young people are incredibly smart. They're dialed in to the world around them, and they want to be healthy. There's a ton of competing pressures with social media and everything else, but the Corner is a place where they, I hope, will feel safe and they will come. And we hope that more folks will join us in this mission. I'm grateful to you and WEMU for having me on today.
David Fair: That is Alex Plum. He is executive director of The Corner Health Center in Ypsilanti. For more information, visit Corner Health dot org or check out our website at WEMU dot org. And we'll get you everywhere you need to go. Washtenaw United is produced in partnership with the United Way for Southeastern Michigan, and we bring it to you every Monday. I'm David Fair, and this is your community NPR station, 89 one WEMU FM, Ypsilanti.
UWSEM STATEMENT:
Recently, The Corner Health Center has received a $15,000 award from the 2024 cycle of United Way for Southeastern Michigan’s Opportunity Fund—a resource for local organizations and groups whose efforts address poverty, racism and trauma: root causes of systemic oppression that hold opportunity at bay for all people in Washtenaw County.
With this investment, Corner Health has institutionalized a Professional Development Plan for its staff members. This plan will ensure staff retention and a lower turnover rate to better service their client base, which includes: communities of color, youth who are from ALICE households, and unhoused youth.
WEMU has partnered with the United Way for Southeastern Michigan to explore the people, organizations, and institutions creating opportunity and equity in our area. And, as part of this ongoing series, you’ll also hear from the people benefiting and growing from the investments being made in the areas of our community where there are gaps in available services. It is a community voice. It is 'Washtenaw United.'
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