Checking in on ProMedica’s $20M investment in a southeast Michigan city

Frank Nagle, director of community impact, ProMedica


In February 2022, Toledo, Ohio-based nonprofit health system ProMedica committed to fundraising $20 million over a 10-year period to invest in Adrian, a small city in rural southeast Michigan, to drive community development and end health disparities.

The investments would be centered around education, housing, financial and social services, policy, and community infrastructure, director of community impact Frank Nagle said at the time. The project is modeled after ProMedica’s $50 million investment in Toledo, which began in 2016. A year into the Adrian initiative, Modern Healthcare caught up with Nagle about the progress the organization has made.

What were you able to accomplish in the first year?

We started by doing community planning sessions. To be able to facilitate them, we pulled some data reports on health, jobs and finances; on education and training; and on housing. We compared the census tracts in East Adrian with the county data, and it really helped stakeholders and residents see the disparities that people experience. Some of the [factors] that popped up were [ability to access] preventable health services or median household income disparity.

Anywhere from 10 to 12 residents joined those sessions and shared their lived experience [and] their expertise. It helped us to be able to assess: What are the key priorities we need to focus on? And how do we need to tailor some of our partnerships and programming compared with how the model looks in Toledo, which is more of an urban community, so we’re addressing the rural health needs we’re seeing in Adrian?

Following the community planning sessions in May and June 2022, we formed a partnership with the Adrian Dominican Sisters. They have literacy programming and dollars they’re allocating toward the technology center and [the expansion of] access to digital literacy. We worked with some of our community organizations to detail ways to mobilize financial coaching, community health navigators and some other evidence-based programming into the neighborhood.

The key thing we’re looking at is how [to] start offering some programming and services now, since the need is there. And how do we do that while we’re also doing the fundraising to [reach] the full $20 million to invest over the next 10 years? We are looking at temporary locations we can operate out of while we work on establishing a permanent center [which will be known as the Adrian Ebeid Center]. We know some of the renovations and securing a building and some of the fundraising around that might take some time. So as we get into a temporary space, our goal is to start offering some of those programs and services and to keep collaborating to develop that continuum of resources to address the community’s needs.

How do you work with community-based organizations?

Many of our nonprofit partners and different stakeholders attended those community planning sessions. We were able to identify that many organizations are offering programs and services that could address the needs being identified. But there are barriers to accessing those services.

Those community planning sessions really helped to bring partners to the table to hear feedback directly from residents about what some of those barriers are. A lot of it came down to access and cost. Residents had a hard time navigating some of the complex systems in the community and they were just looking for some guidance and support—being able to make sure they were going to the right agency, for the right resource.

By combining those under one roof in the Adrian Ebeid Center, the goal is to help with that navigation and to work hand-in-hand with those residents. One of the biggest fears for residents is taking the time to go to multiple agencies for a particular support and making an error that automatically results in them not being able to get that care or service they’re looking for. [Our aim is] to coordinate those services and, ultimately, build more collaboration so we don’t duplicate what’s already existing in the community.

ProMedica made a similar fundraising commitment in a more urban area in Toledo. How do they compare?

There are differences around some of the drivers that cause unfavorable health conditions or that cause barriers. The one that stood out the most to me was, in our rural community, people are having to travel longer distances to access certain agencies or to access the services they provide. We heard some firsthand experiences where residents would use public transportation to go to a particular agency. They would have to spend a whole day going to one or two appointments because of their transportation barriers.

In rural areas, we need to be able to take programs into the neighborhoods and to the community of focus and look at ways we can create more access through online programs or workshops for the rest of the county. Those three census tracts we are focusing on [in East Adrian] had significantly higher social vulnerability indexes from the Centers for Disease Control and Prevention. There is a need across the county, but we’re looking at how we invest in the neighborhood that has more disparities and inequities compared with others. [We’re also looking at] how we create that broad-based access through digital applications or through mobilizing services.

How do initiatives like these benefit healthcare organizations?

It ties back to the organization’s community health strategy. For nonprofit healthcare organizations, it’s a great opportunity to align some of these efforts with their community health needs assessments. Take a look at the county-level data in community health assessments, and then take a deeper dive into internal data to look at the most prevalent readmissions or emergency department utilizations that could be avoidable. Or even [examine] which inpatient setting or ambulatory care admissions are correlated with some of the more pressing community health needs.

Other organizations could look at those data pieces and then consider the ways they could mobilize some of their screenings or some of their education to vulnerable portions of the community, or how they could collaborate with community agencies that provide some of those services. They might be able to link patients presenting to the emergency department or any other care settings to community resources, so that when they leave the four walls of healthcare, they’re supported by the local resources that are addressing the majority of the factors that determine somebody’s health and well-being.

This interview has been edited and condensed for clarity.

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