Today we’re talking about global healthcare. Mark Eastburg, president & CEO of Pine Rest Christian Mental Health Services, is here to share his perspective and insights. We’ll talk about barriers to care, serving rural communities, and gain some insights into today’s state of mental healthcare and of course, what it all has to do with rural health.
Follow Rural Health Today on social media!
https://www.youtube.com/@ruralhealthtoday7665
Follow Hillsdale Hospital on social media!
https://www.facebook.com/hillsdalehospital/ https://www.twitter.com/hillsdalehosp/ https://www.linkedin.com/company/hillsdale-community-health-center/ https://www.instagram.com/hillsdalehospital/
Follow Mark Eastburg on social media!
https://www.linkedin.com/in/mark-eastburg-13b0239/
https://www.linkedin.com/company/pine-rest-christian-mental-health-services/
Jeremiah Hodshire (Host): Well, it’s great to have in our mobile studio today because we are at the Michigan Hospital Association’s annual conference. Each year at the annual conference, I try to find 4 or 5 inspiring leaders to interview. The leader I’m going to introduce our listeners to next is a friend of mine, a colleague. I’m going to say a warrior in healthcare, because there is such a battle that we’re facing right now. It is great to welcome Mark Eastburg and Mark, you serve as the president and CEO of Pine Rest Christian Mental Health Services. That’s located in Grand Rapids, Michigan. And you have an incredible testimony and journey that you’ve taken to get to the position you are. 2500 employees. You span across—do you span across states even?
Mark Eastburg (Guest): No, we’re all in Michigan? We go as far north as Traverse City and as far south as Kalamazoo.
JH: So, Mark could you, and it’s Doctor Eastburg, but I’m going to call you Mark because you’re a friend. Could you share with us a little bit about your organization. What is it that you do. And you know, the patient centered care that you give and really talk about some of that work that you’re doing right now?
ME: Yeah. So actually, we started in 1910 by Dutch immigrants who came over here and they are from the Netherlands. They started schools, they started churches, they started orphanages, and they noticed that there were people in their community who had mental illnesses. And the only alternative were the state hospital systems. But the state hospitals at that time were more like prisons or jails, and they were also hostile to people of faith. They would take away their reading materials. And so, these immigrants got together and said, we want to create a different kind of place, a place where it feels more like a home environment and a place where if people wanted to talk about issues of meaning and purpose and value and faith and spirituality, they could; anything would be on the table. So, they purchased a farm in 1910, and because they actually kicked out of Grand Rapids, because the neighbors didn’t want those people near. And so, patients came from all over North America and from these little Dutch enclaves to come. And initially they came, worked on the farm. The idea was sort of a gentle work that that distracts the mind. And that’s how we got our start. So, long story short, we made it through the Great Depression and World War II. And then in the 60s and 70s, we really became an organization not just for one small Dutch community, but for the whole community. And so, serving now, kids from every county in Michigan and all kinds of different groups, our demographic of the patients we serve looks a lot like West Michigan.
JH: And obviously, the impact on communities like Hillsdale, where my hospital is located, is that we have a place to send our patients. And that is something that a lot of rural communities struggle with outside of Michigan is access. Access is a big issue, pediatric access. And so, you’re serving that need, I would assume your capacity most of the time.
ME: We are. So, over the years the continuum really built up. So, we have about 20 outpatient clinics throughout Michigan, Michigan. And then we have about 240 hospital beds. Now with the development of the pediatric center behavioral health and we have day hospitalization programs, we have residential services for people who need that longer, more extended care. So, it’s really the full range of services.
JH: So, you’ve been engaged in quite a few projects, which we’ll talk about in just a minute, but I want to get to your why, you know, Doctor Eastburg, you’ve got quite the history and you are brilliant man. I’ve enjoyed getting to know you. You could certainly be at many more places that would love to have you as their president and CEO. But the end of the day, you’ve chosen to do this. And I would claim that it’s ministry work for you. But I want to hear your why. What is your why?
ME: I decided late my college years that I wanted to be going to clinical psychology. So, after working for a couple of years, I went to grad school at Fuller Theological Seminary that has a school of psychology. And what attracted me was integration of faith and practice in that setting. And so, at the end of those five years, you do a six-year internship. And I; having lived in Grand Rapids for a little bit, knew a little bit about Pine Rest, so applied to do an internship. And then after that year we saw my wife and I saw Michigan is a great place to raise a family. And what drew me to Pine Rest was the commitment to clinical excellence. And as those early founders talked about and valued the holistic care, mind, body and spirit. So, I like to say I wouldn’t do this job anywhere else. This is a perfect fit for me as a believer, as somebody trying to follow God’s call in all parts of my life. And it does feel like ministry to me. So, I’m really fortunate to have a job that can make a tangible difference in the community. I’m so honored to be in that role and stewarded with that.
JH: You’re doing a phenomenal job? And if anyone that’s listening to this podcast knows Doctor Iceberg, you know that he is mission minded. And, I would say the second thing that I notice about you, my friend Mark, is that you’re a servant leader and, you know, it’s never about you. It’s about what great things are happening for your patients. A couple follow up questions. Is your location the same that it was when it started as a house?
ME: We’re still on the farm. Well, we don’t farm anymore. We sold the herd of cattle in 1957 and had a big auction for all the farm equipment, but we actually still have 40 acres that we lease out to somebody. But yeah, our campus people are usually really surprised when they come because it feels more like a college campus. So, we have buildings on about 100 acres of it. So, driving it around and different buildings
JH: Let’s talk a little bit about, you know, the patients that you receive are from throughout the state of Michigan. As we face some of the challenges today, we have Medicaid cuts. And I’m going to ask a perspective on that in just a minute. And some other challenges, reimbursement funding. You’re serving a very unique population. Most recently you’ve engaged in a building project. I would like for you to share with our listeners what that is. What does that provide access for Michigan patients? Can you talk to us about why it was created? What is the number? What are you looking at for throughput of patients, those types of things.
ME: So, to really tell a story of this, I have to go back to pre-COVID. We were we knew we had to struggle with wait times to see a child psychiatrist. That was sort of a challenge all throughout Michigan, five months, six months. Me as a parent, you as a parent, if your child is in crisis, you’ll do anything for them. I’ll get in the car and drive to Atlanta if that’s where the specialist is, and that’s what people are having to do. So, we knew we had to do something better for kids. Also. They were particular group of kids, kids typically with autism who would have a behavioral health crisis and they would get stuck in emergency departments. And we didn’t have good settings for them because we tend to cater to, or serve people, kids who are higher functioning. And they certainly didn’t do well in the children’s hospital. So, we start talking about maybe this is the time to do something big around kids. Then Covid hit, and as we anticipated, coming out of Covid, there was a mental health crisis really across all ages, but especially for kids, especially for our adolescents who lost a couple of years socially, lots of losses around school experiences and being disconnected, increased use of devices. We saw this sort of new pandemic of anxiety and depression. So, we said, maybe this is the chance to do a once in a generation project, a pediatric center of behavioral health. So, the result is a separate building on our campus. We have 66 inpatient beds for kids. We have partial hospitalization, which is day hospital programing, specialized clinics for eating disorders, substance use disorders and a psychiatric urgent care center, which was really a new thing for us and very few, if any in the state. And the philosophy of our team was if you’re having a behavioral health crisis, just come in and we’ll help you sort it out because it’s a whole different system. So, we opened March 23rd. We filled up the first week in inpatient. And we’ve served about 1000 families now in our urgent care from at least 40 counties. Just in a few months. And what the 40 counties part of it, you know, talking about rural health makes me really happy because we did not want this to be just sort of a West Michigan thing. As we talk to philanthropists. We talk to state representatives who were supportive of this project. We said we wanted this to be something for all of Michigan. So, Hillsdale Hospital would feel the benefit of this. So, families in the U.P. would feel like they had a new resource, so that 40 counties has been that’s been our goal. And we want to spend that even further. So, every kid in every county feels like we can be part of their solution.
JH: Great work to you and to your team, and for having the vision of what is needed in Michigan to fill this gap. And it’s a huge gap. I believe you told us today when we were in a previous meeting, that you’re and you’re finishing your budget year. Is that correct? Or starting your budget priorities for the next year?
ME: Yeah, July 1st.
JH: So, you’ve set priorities obviously for the new fiscal year. There’s a lot of changes in Michigan’s landscape and in the nation with changes to Medicaid and the average commercial rate, all of the challenges that we’re facing on top of the tax credit rollbacks, a lot of challenges financially. How are you navigating this today in your hospital? And what does that look like for you as a strategic plan for you and your board of how you’re going to continue serving this population?
ME: Great question. So, our patient pair mix is probably more like reverse of yours. We probably have 35% Medicaid/Medicare. And I know you have a high percentage.
JH: 72%.
ME: I’ve quoted that to a lot of people saying, it could be even more challenging because my friend JJ, look what he faces. What we’re concerned about is people losing their coverage. We’re concerned about people who just show up and say, I need care, but I don’t I don’t have any kind of insurance resources. And I lost my Medicaid last month. One of the things we’re focused right now is we’ve always had a patient assistance fund in our 115-year history. We need to take that up a notch because we know people are going to be coming seeking care. We want to be able to say yes to everyone. So that’s my focus.
JH: Mark, is that a community supported fund? Is that just an internal fund that you try to do it from general budget? How do you fund that?
ME: Yeah, in 1960, foundation was started an endowment I think it was the first hospital foundation Michigan. And so, it’s grown over time. And a big percentage of that goes toward our patient assistance fund. Of course, we raise money. We have a resale shop that produces a couple hundred thousand dollars a year for patient assistance. Yeah, mostly volunteers running it. And so that’s one area of focus. The other a little different piece for us is in behavioral health. Lot of that Medicaid funding flows through another system. And that’s the community mental health system.
JH: Talk to us a little bit about that.
ME: So, for let’s say for inpatient psychiatric care the money would come; this is oversimplification, money would come from the state of Michigan to a regional. Or prepaid inpatient health plan. And then they would become our payer. And so, depending on what the PHP that does that impacts us. So, whereas in most of health care, the payment comes directly from the state, there are these other layers that we’re managing. So, if we see cuts in one place, we don’t quite know how that’s going to trickle down to affect us. The other piece of this is, and this maybe really widens the lens. I mean, I would love to be able to work ourselves out of a job, especially on the inpatient side, if we can do more prevention work, if we can say, just come in to urgent care. If you make a family wait 60 days, they’re going to have a crisis that might need an inpatient or a much higher level of care. But if you say, well, come in this afternoon. So, thinking as a citizen, if we can invest our resources as a community into those prevention services, that will be a big help as we struggle with the funding shortages. I like to say too there’s this sense that we under invest in behavioral health. I believe that. If we invested, I think 1% more in Michigan, in Michigan’s Medicaid system, in the right place, we could bring down overall healthcare costs by 2%.
JH: Absolutely. Yeah, absolutely.
ME: I think for every dollar we spend in the right place and behavior in the right place in behavioral health, we can save. We can save the reduction on the other side. One of the challenges that in Michigan behavioral health is a carve out. An added expense in one area doesn’t necessarily doesn’t necessarily translate to the other area.
JH: So, there has to be some reform, you know. And if anybody can accomplish it though Mark Eastburg, you can do it because I have full faith in you that your advocacy efforts, I’ve watched you, your fierce. I watched you during some of the slope with the mental health dollars. You were fierce. You’re quite the advocate and it worked. And I’m going to encourage you to continue to do that for the right reasons. Patients that need access. You’re a man of remarkable character. I want to ask you two last questions. First of all, I want to ask you. You know what’s keeping you up at night as you think about your work and the task that you have, what really keeps you up? What are you worried about?
ME: So probably almost any hospital CEO you ask would say something to do with funding in behavioral health. Our margin is really slim. We don’t have some of the high margin procedures, and we’re always right on the edge. So, we’re all we’re always concerned about. Could something shift in Washington and Lansing that could negatively impact our ability to keep our doors open, provide care? So that’s one of the things I am concerned about. I think long term; the demographics of Michigan are not favorable for having an adequate workforce in health care. And so, will be able to find enough nurses. Will we find another therapist? And then maybe a third thing, that is something that’s really important to me. Access is incredibly important. But access to what? And after Covid, there are a lot of large for-profit entities that saw, oh, we have a behavioral health pandemic. Here’s a chance to make some money. And the quality has not been uniform across those. And so having lived in the behavioral health world now for 35 years, 36 years since I’ve been at Pine Rest, I have seen like really great quality and really poor quality. I hope that the market can differentiate that because sometimes just getting somebody in for a therapy appointment, isn’t that right? And for us it’s really personal because just about everyone on our team, my leadership team has been impacted by behavioral health. My family has used Pine Rest. And so if you stay focused on building the services that you would want for your neighbor in a Good Samaritan sense and your friends and family, then that’s a great North Star. Not can we make a buck over here because there’s a high demand.
JH: At the highest level of quality. That’s right. You can and you can deliver. It is a North Star. But that’s what the North Star should be. It should not be a profit margin. Absolutely not. Well, you’ve demonstrated that you have done a remarkable job at making it a mission. You know, the last question I went in positively. What are you looking forward to in the next year or two in your organization or even looking outside of your organization? You know, more globally. What are you looking forward to?
ME: That’s a great question. One of my dreams would be to be able to say, this is a very specific narrow one is, you know, five years ago we were talking a lot about emergency department boarding of kids. In 2000, let’s say 27. That hardly ever happens. That would be amazing.
JH: Would that be incredible? Yeah, we had one I called you about. We had a six week stay in the E.R.,
ME: That’s unconscionable. There’s a lot of good people trying to do the right things. And the systems prevent you sometimes, but that would be an amazing, happy vision for those families that could do that.
JH: If we could do that, we could pretty much close in prayer and shut the place down because we’ve achieved greatness. Well, the last item that we have today, and we ask this of each of our guest is to give us a rural health recommendation, because right now, across this country, we’re facing unprecedented times, challenges we’ve never, ever dealt with in our industry, young leaders rising up because right now, the turnover rate for CEOs and departure rates very high. So, you have young leaders trying to navigate all this stuff. Doctor Eastburg, you’ve been around for three decades. Give us a rural recommendation that you would give for an aspiring maybe there in the role. Maybe they’re soon to assume the role. What would you say to them as hope, as a piece of advice? Maybe it’s sage advice. Maybe it’s just, you know, a recommendation. But when we publish this on each of our weekly broadcast and we make this a segment because it’s important to have a recommendation for like, all right, you’ve just given me all the problems. Now, what are you going to do? What is the recommendation? What is your recommendation that you’d give someone?
ME: I would say learn how to partner. Learn how to work together with another organization. And having done this now for 20 years, their organizations that are wired for partnership, there are some that are not wired for partnership. You just got to move on from the ones. You’re not going to change their DNA. But in my experience, there’s there are plenty of organizations that have their North Star focus on what’s good for the community. Find those organizations, find those people in the organizations, build friendships with them, and you can accomplish great things. And especially if I’m rural and my resources are minimal in my surrounding area, find a great partner who is going to start to love your community as much as you do.
JH: Great recommendation. Obviously, in the challenging times that we face today, it’s good to know there are leaders who have walked this for three decades and who have done remarkably well. There’s hope. And I think if we don’t have hope, what do we have? And I really feel that that’s our greatest gift that we can give to our next generation of leaders, is that it’s a fight worth fighting and there is hope. And so, thanks for the great work you’re doing. Doctor Mark Eastburg, CEO at Pine Rest Christian Mental Health Services, located in Grand Rapids with 20 other affiliate Off-Site areas that you could receive care. And it’s great to have you on the podcast. I look forward to our future conversations.
ME: It’s been an honor. JJ, thank you very much.
JH: Thank you very much. And thank you to our listeners for tuning in to Rural Health Today! Catch our next segment, Rural Health News, to stay up-to-date on the current state of rural health every Monday wherever you get your podcasts. Don’t forget to check out the latest updates and resources from Rural Health Today at ruralhealthtoday.com and make sure you’re subscribed to the show so you never miss an episode. Until next time, remember rural health strong!
