The power of community: Case studies from Erie and Pittsburgh

Dr. Ellen Beckjord: Stronger communities begin with good health—for everyone. You’re listening to the “Good Health, Better World” podcast, presented by UPMC Health Plan.  

This season, we’re exploring ways to achieve good health in today’s complex world.

I’m your host, Dr. Ellen Beckjord. Let’s get started. 

Today we're discussing how community and connection can support good health with Dan Lavallee and Charles “Boo” Haggerty in this episode of “Good Health, Better World.” Boo is the president of the Hamot Health Foundation in Erie, Pennsylvania.

Boo, welcome to “Good Health, Better World.”

Boo Hagerty: Thank you. It is great to be here.

Dr. Ellen Beckjord: And Dan Lavallee is the associate vice president of community engagement at UPMC Health Plan. Dan, thanks for joining us.

Dan Lavallee: Thanks for having me.

Dr. Ellen Beckjord: I'm really excited about this conversation. This is a topic that's really near and dear to my heart. And I'd like to start with a general question. Boo, if I could ask you to respond first: What are some of the ways that we are both more and less connected than ever before?

Boo Hagerty: Yeah, more connected in a way that I actually think post-pandemic we are all much more aware of our health, you know? So from that standpoint, an awareness is really a good thing. Less connected, I think that there's a point in time where people are starting to lose trust. And I think trust is everything in health care. So, we'll talk today about some tools we're doing to build that trust. So, more connected in that we're aware of our health care, less connected that I think we have to continue as health care leaders to build trust with everyone we serve.

Dr. Ellen Beckjord: I love that observation. Dan, what are your thoughts about it?

Dan Lavallee: Yeah, I think it's all about trust. I think about how we build that trust, how we show up in our communities. And, you know, that's changed very much since the pandemic, of course. And there are people that have still been left behind, are still struggling, you know, and I think, each day if we make it a point to make sure we're showing up in a different community in the best way that we can—you know, with the entire teams that we have—I think we can make that change and make that difference. So, but it is all about trust. And Boo, I couldn't agree more.

Dr. Ellen Beckjord: Can you talk, Dan, about, how does community influence lifestyle or health behaviors like, and I know that's a really general question, but your thoughts on that. And then Boo if you could chime in too.

Dan Lavallee: Yeah, I think a beautiful thing in life is, you think about it like in our communities, there's a couple of major places that we all go, whether it's places of faith, community organizations, you know, that we might bring our kids to as well, or social service agencies that show up for those in need. I know my grandmother, when she was aging, had people that were there with her and were making a difference near the end of her life, after she had spent 60 years making a difference in her own community. So I think for us, the way we think about it is that we've got such incredible team members across the commonwealth [of Pennsylvania] in particular, who show up at those places.

And if we can empower those team members to continue to do that and build that trust, the first call that someone will have when they either need help finding a doctor, navigating insurance, or, trying to find a career, maybe, in health care will be to call that team member that showed up, you know, at that place of faith or at that community organization to make the difference.

And, of course, every community is different and has unique needs. Every impactful program that Boo and I get to work together on—whether it's our neighborhood centers or our Pathways to Work program or others—has come from communities asking for a different level of commitment and ways that we show up, you know, as an organization. And it's just a beautiful journey. And I know we'll keep—you know, continuing to move.

Boo Hagerty: Yeah. I think we have a challenge in health care that we are rich in data. We have so much data and you can pick up a journal and read research stories after research stories of what works, which is important, and then bridge it to when I call like the one size fits one mentality. We think we know what's great globally, but then how do you drill it down to that individual person?

And the best example I can think of that is in 2011, in Erie, Pennsylvania, where I’m from, we opened up a school-based health center. It was the first one in the state. So we put a primary care office in a school in the middle of a neighborhood that was completely underserved. Nobody in that school had a medical home. And we used all this great national data to say, if you build a health care center in a school, that's where people can get to, they can get to school, and they'll come to the doctor's office.

We opened it, we were open for one year and nobody came. Not one student, not one teacher, nobody. Some neighbors kind of started to trickle in. And then we realized we didn't ask them. You know, we said, well, this national data tells us this will work. And we never went into the school, talked to the parents, talked to the faculty. They knew we were doing it, but that trust. So that was such a great learning curve of how to bridge the great, rich data with what it means to that one person.

Dr. Ellen Beckjord: Yep.

Boo Hagerty: Learning from that mistake that I just told you, five or six years later, after we opened the school-based health center, our foundation, the Hamot Health Foundation, partnered with the UPMC Health Plan. And instead of assuming, now we went into the neighborhood, and we conducted a survey of 650 households, average 30 minutes talking to the people who lived in the neighborhood on their porches with the neighbors that we trained to be our surveyors. The methodology was beautiful, and they really gave us great input in terms of what they wanted to see. They said they wanted trusted access to health care. “We know there was an office there, but, you know, we don't really know anyone there. I want to trust them.” They wanted better opportunities for education. They absolutely wanted their neighborhoods to be invested in.

Ironically, that school that we put the school-based health center in closed; it was a K–8 elementary school that the school district closed. So it's an empty building. So our foundation bought it, and we worked with a lot of community partners. The collaboration was huge and we opened it up and it's now an education center, a learning center, the medical office is there now in a bigger footprint. And we started career training. We've graduated nurses out of that program. We've graduated medical assistants. So that was the—kind of the impetus behind when people give you information, don't do a survey unless you have every intention of taking the results and doing something with them.

Dr. Ellen Beckjord: That's a fascinating story. And a really wonderful observation.

I would like to hear from both of you about the really intentional investment that's been made in the new [UPMC Health Plan] Neighborhood Center in Erie, like as an investment in a community space.

I know at the time of recording now, in May of 2025, we’re actually just a few weeks away from its opening. But can you forecast for listeners what that space is going to be about and your perspective on that intentional investment in—in a physical space. And Dan, you could talk about the one we have here in in Pittsburgh too, if you like.

Dan Lavallee: Yeah, we're so excited to open our second Neighborhood Center in Erie here in a few weeks.

I think if we take it back, you know, where Boo was going, we had a very similar experience here in the East End area of Pittsburgh, right around the beginnings of the pandemic. We had an opportunity to listen a bit more to the community to understand what was needed in an area where we have thousands and thousands of individuals on Medicaid, individuals on Medicare, people that have, you know, other needs, job needs, housing needs, food needs.

And it was a place for us to make impact. But it all started with that type of listening that Boo was talking about, and that built kind of the foundation for why we opened this Neighborhood Center that we have here in Pittsburgh. I spent 18 months trying to show up [in] every last place, whether it was a group of one or a group of 500.

And, you know, all the feedback wasn't always the greatest. There were things that we needed to do to show up a little bit differently. And I took that to heart, and that was one of the reasons why one of the main service areas that we have in our neighborhood center in Pittsburgh is our [UPMC] Pathways to Work program and linking to organizations that will help people find life-changing careers with us and others.

There are other things I kind of learned in that process, too: how to make sure that we got ongoing commitment and ongoing feedback and understanding from the community, really how they felt, and that really drove us into Erie as well, in the very same tenet. We were very lucky and fortunate that Boo and his wonderful team had been showing up for years in this community, but we also knew it was an area that still persists with just challenges of accessing care and how social service needs link with those challenges as well.

And that's why we wanted to make sure that we're supporting the work that was already done in the Wayne School and out of the Erie Center for Arts and Technology and how the programing that they're doing in the community and just make it an open door for UPMC that you can come in and that you will—no matter what the question is, even if we can't answer that question right this minute—we’ll be there with that individual, that family, or that organization. We're here to listen to it all, no matter how challenging it might be so that we can make the change we all seek.

Dr. Ellen Beckjord: I am so excited about it. And it is such an empowering and inspiring idea. And Boo you said this really quickly, but I want to put a fine point on it. And, as a person who's done a fair amount of survey research in my career, the idea of training community members to be the interviewers and what sounds like is more than 300 hours of conversation that you had.

Boo Hagerty: Yeah.

Dr. Ellen Beckjord: What a tremendous thing.

Boo Hagerty: It was as rich an experience as we really could have found. And the—again, a lot, a lot, a lot of data. But then we had to break it down to, again, that individual person and what it meant to that individual person. And we have been grassroots. We have talked to, like Dan said, 1 person, 5 people, 200 people, many community forums. I mean, I’m making it sound simple, but this was hard work.

Dr. Ellen Beckjord: And using what you learned because I think not asking doesn't build trust, but asking and then not listening damages trust.

Boo Hagerty: Damages trust. So when they saw this school going up, they're like, OK, this is for real. This is happening. And our students that we’re serving inside the school live in the neighborhood. And the other thing that we know, which has incredible impact, is that this group of people will tell us they didn’t have any intention of leaving Erie. And when we started the nursing school—we have a nursing shortage in this country now, everyone knows that, it's crisis level in some points—the UPMC School of Nursing said, if you can help us invest in the capital, we'll do it.

And so that's where the fundraiser began, we got the capital, we put it in that building. And interestingly enough, 78 percent of the graduates work at UPMC Hamot. So it's feeding our own system. It's a 660 percent ROI in the first four years in terms of what we're saving on agency nurses to what we're putting into our hospital. Even though Hamot Health Foundation is a separate 501(c)(3), we are part of UPMC. We're very proud to be part of UPMC. And again, tremendous partnerships all the way around. But what was really great about it is we were one of the first hospitals in the 42 systems to not have an agency nurse anymore.

Dr. Ellen Beckjord: Wow.

Boo Hagerty: And not only is that costly, it's the best thing for the patient to have that nurse that they recognize and see every time they walk in. And we've diversified our workforce because 48 percent of our graduates are minority. So, so many boxes that we checked along the way. But back to your point of listening. We had to, or we would have completely lost that trust.

And are we there yet? Not even close. We've—you know, this is a great track record. The Neighborhood Center will be one more thing we're doing. We’d have another seven podcasts to talk about housing. So we're not going to get to that today. But that's a big next piece for sure.

Dr. Ellen Beckjord: Well, again, I'm so inspired by just how intentional and methodical but impactful the work that you're driving is because at a time when there seems to be more worship than ever of efficiency, you're talking about value.

And it's not to say that you weren't working efficiently. I'm sure you are. But some things just take time. Like it takes 300 hours to listen deeply to a community. And that was 300 hours incredibly well spent that's yielding this enormous return and everything else you're doing that that takes time. You know, it can take time in an efficient way. But there's just no getting around that. So I'm just so excited to hear about all these great things.

I'd just like to ask both of you if you'd like to share something that you're most excited about or hopeful at this point in time. Dan, what are you most excited about now? I feel like for you, there's a long list of things you're excited about, and I love that about you. You can share more than one if you need to.

Dan Lavallee: You know, where Boo was going, you know, around a job. Like, think about what a life-changing career means. And, this takes me back to the beginning of when we started our Pathways to Work program, which came from listening and came from partnering with organizations that were sharing with us that people in our communities were hungry to come join UPMC to make a difference in their communities and to stay, as Boo was talking about with the nursing program that they have up in Erie.

So what I'm most excited about is continuing to expand our work in helping people find life-changing careers. There is no more powerful community engagement tool than going into a neighborhood and helping somebody find a career that is good for us, too. Because people are staying. We see the same things. We just had a big milestone. Our 10,000th person hired off our own Medicaid plan over the past four years.

Dr. Ellen Beckjord: Wow.

Dan Lavallee: It's just unbelievable. I remember we were searching for one, you know, and it's like there is the difference of the one. But then when you can show that you can expand, we've expanded this across and scaled this across the commonwealth. We have a wonderful team member up in Erie, in central Pennsylvania, and we’ll continue to build.

And I think the thing that I have learned of why I'm so excited about this is because that's how you transform communities. And we've been able to prove too, Ellen—to your point that if we invest time in helping people find the right fit or helping people turn the experience that they have from work in customer service and retail into coming and serving our members here—we need people who have experience in having hard conversations to make people feel at ease and to help people get through challenging times.

And that is what is so special to me and what excites me now, of course, for the larger impact, of course, for the better retention that we have, of course, in these programs and that people that are able to stay, but I think about like, in my life, I have two daughters, a wonderful wife. And like, if I didn't have a job or I didn't know where the next meal was going to come or I wasn't sure how to provide for them, I sure as heck would not be worried about going to the doctor myself, or going to get whatever care that I need, you know? People are willing to work, they're ready to go, and sometimes we all just we all need a hand up to make the difference we all seek in our community.

So that excites me more than anything is how we can do this all together and what that means for us, for the individuals and for our members and for overall communities, you know, and it'll continue to be a wonderful journey.

Dr. Ellen Beckjord: That's fantastic. Boo, what about you?

Boo Hagerty: Mine’s somewhat personal that translates into the work we're doing now. In 2008, my wife and I were very, very lucky to adopt a little boy from Guatemala. And he graduated from high school, and [is] now in college, which is great. But in that journey, when we were in Guatemala, we thought we saw probably the worst poverty that we would ever see. And we brought him home. And kind of shame on me, I'm an administrator at UPMC Hamot in Erie, Pennsylvania. We sit in the boardroom all day and we talk about length of stay and we talk about our case mix index. And we talk about this and we talk about that, and we do a great job of taking care of people when they hit our hospital doors. But we really weren't paying a ton of attention to those who weren't hitting our hospital doors. And sure enough, this very school I told you about, my first entry into that school was when the principal of the school invited some of us to go over and read to the kindergarten kids. And some of us looked around and we could not believe the environment.

This school was seven blocks from our hospital. We’d driven by it all our lives, but because a lot of us were from Erie, we never really looked inside. And when you look inside, it was paint chipping off the walls. It was, it was just a horrible environment. The kids’ stories that the teachers were telling us broke your heart. And that's when we said, we've got to do more. So we started working with the principal of that school and said, how do we lean into this community? Incidentally, as we're working with him for a couple of years, I was fortunate enough to come to work for the UPMC Health Plan for a few years, and in that time learned a lot about the social drivers of health.

And that was a great evolution, because what I found out working here is, that is the poorest neighborhood that we're talking about in the state of Pennsylvania, some believe the country. I don't have that data, but we know from health care data it's the unhealthiest in the state of Pennsylvania. And we knew that from the Medicaid members that we serve, you know, from here, the Health Plan.

So what drives me is that we're actually making an impact. And what I'm most excited about is we're just getting started. We graduated from this school, now, about 45 construction trades graduates. So we're not just feeding the health care system. These are 45 people now who know how to be electricians, how to be plumbers, how to be roofers, how to be carpenters. And our foundation started a community development corporation, and we are now buying blighted homes and having those construction trades students work on the homes so we can, at a fraction of the cost, rebuild these homes and give quality affordable housing. We know that leaky roofs and broken windows and bad ventilation lead to illness. If in fact we can take 50, 100, 150 homes, renovate them and put them back in service in the community, people are going to be healthier. So I'm excited about that.

Dr. Ellen Beckjord: This is, it's just tremendous that you're figuring it out. You're figuring out the leverage point—

Boo Hagerty: With a lot of smart people around me.

Dr. Ellen Beckjord: —in the cycle to drive transformational change. And you figured out how to do it in a replicable way, learning as you go and refining. And we are so fortunate to have both of you and the teams that you lead and the folks that you work with.

Boo Hagerty: I love working with this guy.

Dr. Ellen Beckjord: And the collaborations you drive here at UPMC.

Boo Hagerty: I'm glad you said collaboration because a lot of people think it's cliche. It is so vital.

Dr. Ellen Beckjord: It’s necessary.

Boo Hagerty: Yeah. And so many that have driven us; I learned from some wonderful people.

Dan Lavallee: Yeah, I think that that is the best part about UPMC is that we have so many people that are every day, they are sharing their own experiences and are vulnerable and are—whether it's they're in someone's home trying to make sure that they get the right, you know, home modification to stay there, or whether they're talking to one of our Medicare members who has food needs or whatever it might be. I admire that so much. And I think that's the special piece. When you share your own journeys and own challenges and are able to be vulnerable. I think that's the number-one thing that makes a difference and makes connection.

Dr. Ellen Beckjord: Absolutely.

These are just an incredible set of initiatives that you've talked about. Opportunities that you and your teams and your collaborators are creating. What are some ways that folks can get involved, either to access some of what is available or to contribute in some way?

Dan Lavallee: Yeah, I think that's a beautiful question, Ellen. I know I can speak for Boo in this one, he and I are available at any time to talk with someone, whether they're in need, whether they have someone in their life who might be in need, or whether they have a desire to be a part of making a difference in these communities, so you can call us anytime.

I mean that, deeply. I was talking to somebody the other day who had been— who just got out of incarceration for decades, you know, and wanted to make a difference in their community. You would have thought that would have been an ask for maybe help. And it was an ask to be a part of something, you know, in their community. So we are open. There is no wrong door. Of course, you can come in our Neighborhood Centers. Boo's door is always open.

But I think for us it is just all about, again, how we show up and we're there and we mean that. There is no discussion or no topic we can't discuss. And, you know, we're right here. So please outreach to us at any point in time. There's more information, of course, on our websites about some of the programs that we have in our communities that you can learn a little bit more and read about it.

I will say, lastly, our greatest…so many programs that we've had have also come from our own incredible employees. We have almost 100,000 people working at UPMC and who, you know, might live in a, you know, live in a neighborhood that there's a need, you know, and that will show up and figure out how we can do that. So I think that's an incredibly powerful tool that we've had. And we encourage anyone who's listening who might be an employee to get in touch. And, you know, maybe we can build something special together.

Boo Hagerty: I got a text the other day from one of our nursing school graduates. She's, all it says, “Mr. Boo”...it's a whole ’nother episode, why a grown man’s named Boo…but “Mr. Boo, I got my, I got my W-2 and I made six figures last year because I worked overtime, extra shift differentials. I worked a lot of weekend shifts because I had some debt to pay off.” This was a person of public assistance before she graduated. And she said I just want to thank you for the scholarship because our foundation provides a lot of scholarships for these students so they can come out debt-free. We didn't even talk about that. There's not a lot of cost to these students either, because of philanthropy and grants and just kind, kind people want to see this.

Our website, HamotHealthFoundation.org, has a lot of information as well. We are accessible, and that's what I think makes the difference in terms of not hiding behind, you know, a big desk. We are out in the community rolling up our sleeves and trying to learn as much as we can.

Dr. Ellen Beckjord: Well, we will be sure to share the resources and contacts that you've so generously shared in the show notes.

Is there anything we didn't talk about or anything that you'd like to mention about communities and health before we close?

Boo Hagerty: I would love to punctuate one point if I could. And we talk about leadership—sometimes we tend, and I know I'm guilty of this, to think too small. And at a point where we're doing some of the work that I was explaining, it wasn't near to the scale that we're at now in my brain.

And I got a call one day from a person who's very well-known in this community named Bill Strickland. And Bill started the National Center for Arts and Technologies out of Manchester Bidwell. And Bill called me one day, and he says, I want that model in Erie, and you're going to run it. And I said, well, jeez, Mr. Strickland, we've only met twice, and you seem like a really nice man and you're very inspiring. Your story is great. And I said, but I'm running a foundation; I don't have the bandwidth to go start another nonprofit called, now, the Erie Center for Arts and Technology. And about 10 minutes later, my boss, who's the president of the hospital, calls me and says, whatever Bill Strickland just said, do.

And sometimes it's good to just be forced into something because you don't really have much of a choice. Best phone call I can tell you I've had. You know, I'm the king of hyperbole sometimes but, right up there. And I've become great friends with him. I am now on his national board called the Strickland Global Leadership Institute. I have benefited from meeting Bill and many people like him who lean in hard. But if he taught me anything, it’s you—just, whatever you're thinking, it's not big enough. So we got to think big.

Dr. Ellen Beckjord: I love that. What a great and inspiring idea. But you're right, it's just so…And sometimes I think that the longer you've been at something, in many ways, the better you get at figuring out how to solve the problems that you face. But you know all the ways things can go wrong or all the reasons that it's going to be a struggle and that can trap you. I think, you know, you're never better at doing what you're doing than you are today, the longer you've been doing it. But that piece of advice to not let that inadvertently trap you because you stop thinking big enough is such good advice.

And sometimes I guess you just—what a lucky and wonderful phone call.

Boo Hagerty: I'll say. I don't know how he got my number [laughs] but it's worked out and I love that man and I have tremendous respect for him, and he's taught me so much. And when I feel like quitting, I think of how many times Bill Strickland didn't quit. And again, many people around him and many people like him. So, there's no quitting [with] us. We're going to keep going.

Dr. Ellen Beckjord: Absolutely. That’s going to be what it takes.

Well, thank you both so much for taking time to talk on “Good Health, Better World.” Thank you for the work that you're doing and we can't wait to see how it continues to unfold and where it where it goes next. It's been a wonderful conversation. Dan Lavallee, thank you for being on “Good Health, Better World.”

Dan Lavallee: Thanks for having me.

Dr. Ellen Beckjord: And Boo Hagerty, thanks so much for being here with us.

Boo Hagerty: It's truly my honor. Thank you.

Dr. Ellen Beckjord: We hope you enjoyed this episode of “Good Health, Better World.”

Be sure to tune in next time, and visit upmchealthplan.com/goodhealth for resources and show notes.  

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Views and opinions expressed by the host and guests are solely their own and do not necessarily reflect those of UPMC Health Plan and its employees.