Podcast: Speaking of Quality: Wealth Management Insights with Hank Smith
Season 3 Episode 4 Title: Leading with Compassion: Why Access to High-Quality Healthcare is Essential to Community Growth

Episode Transcript:

00:05 Maxine Cuffe

You’re listening to Speaking of Quality: Wealth Management Insights with Hank Smith, a podcast by the Haverford Trust Company. On Speaking of Quality, Hank chats with authors, influencers and wealth management experts to bring a sense of clarity and calm to the complexity and stress of personal finance. And now, here’s your host, Hank Smith. 

00:26 Hank Smith 

Hello, and welcome to another episode of Speaking of Quality: Wealth Management Insights. I’m your host, Hank Smith, Director and Head of Investment Strategy at the Haverford Trust Company. On this podcast, we explore topics ranging from quality investing, retirement resilience, stock market trends, estate planning, small business ownership, behavioral psychology, and more. 

Today, I’m excited to interview Maureen Tomoschuk, President and CEO of an organization called Community Volunteers in Medicine based in Chester County, Pennsylvania. Maureen has been working in the healthcare industry for more than 35 years, with a distinct focus on philanthropy and community-based care. She’s been with Community Volunteers in Medicine, or CVIM, for nearly 20 years, stewarding its mission of providing access to high-quality healthcare for everyone in Chester County. Maureen, thank you for joining me on today’s episode. 

1:28 Maureen Tomoschuk 

Thank you, Hank, for having me. I look forward to the opportunity to talk with you about CVIM. 

1:33 Hank Smith 

Well, that’s terrific. But before we do that, why don’t we start at the beginning? You’ve spent your entire career in the healthcare industry, holding roles at Mercy Health Systems and the American Red Cross before joining CVIM in 2008. What inspired you and drove you to pursue a career in healthcare? 

1:52 Maureen Tomoschuk 

Well, I started out in my professional training as a social worker and was immediately drawn to the healthcare field. Everyone needs to access healthcare, and I felt like it was the place for me to spend my professional career. I started out in hospital social work. I did some time in psychiatric social work, but I really found my passion in hospital care and healthcare and recognizing how important that was in the community. 

2:21 Hank Smith 

You spent seven years with the American Red Cross, one of the most well-known humanitarian nonprofits in the country. Can you talk a little about that experience and what you learned during that time? 

2:32 Maureen Tomoschuk 

Well, I had the opportunity to step away after many years in direct social work practice in a healthcare setting to go to the American Red Cross. It was post 9/11, so the vital role that the American Red Cross played at that time was even more heightened, Hank. In the post-terrorist attack environment, the American Red Cross’ role was even more elevated. Being at the Southeastern Pennsylvania chapter, one of the largest chapters in the country, situated between New York and DC, was an incredibly heightened time to focus on the need to be prepared. So, it was an incredible opportunity, the organization, as you said, is very unique, very special in the communities. Every night in your community, there are volunteers who get up and go out in the community to respond to people impacted by disasters, typically residential fires, and there are volunteers that go out at all hours across the five-county region where I was serving as the head of emergency services.

But we were also focused on large preparedness activities, which the American Red Cross always had a role in, and we were responsible for mass care and disaster situations. A lot of the time, it was hurricane and storm-related, tornado-related. So, looking at terrorist attacks brought a whole new light. So, we had to have our daily volunteers who went across the five counties and went out for fires. We had to have a large-scale response for the region for impacts like flooding and hurricanes. But then we also had to look at deployment for preparation for a terrorist attack.

My fondest work there is really the opportunity to work with volunteers. We grew the volunteer roles to thousands – people who were willing to deploy for large-scale incidents and really bringing the awareness for how to be prepared both individually in your family for the impact of something like a disaster, but also to your community and then to the county and then to the region – so it was all about preparedness. My passion for working with volunteers really took on a whole new level.  So, that’s where when this opportunity came along to put volunteers and back in healthcare together, it was kind of like a dream job that was made for me. 

5:06 Hank Smith 

So, it was a fantastic experience to prepare you for where you are now at CVIM, how did you get to CVIM? And for listeners who aren’t familiar with the organization and organizations of the same ilk? 

5:25 Maureen Tomoschuk 

I was actually just coming in from a disaster and was scheduled to speak at a fundraising event for the American Red Cross. I had been deployed out into the field for about two weeks and kind of came in right off the street to fulfill my commitment to speak about the response in the community and had the opportunity to sit with some of the folks at a Mercy Table, Mercy Health System, where I had come from before I went to the Red Cross. And I did sit with them that night, after two weeks in the field, and I said, “I really miss being back in healthcare.”

Well, the very next day, one of the folks, my colleagues there, was speaking with a recruiter who had heard about Community Volunteers in Medicine and their search for the new president and CEO and they mentioned my name to them; and the rest is kind of history – I was recruited for the role. When I got the call and they described the organization to me, I said, ‘I couldn’t have written a better job; of course, I want to talk to you about it.’ Community Volunteers in Medicine has been serving the community for 26 years. It was to respond to a community need, Hank. 

The folks around the table at Paoli Hospital heard Dr. Jack McConnell speak about the first Volunteers in Medicine that was started in Hilton Head about five years before CVIM was born. It was really the need for the individuals working in this community, low-income individuals supporting the community down in Hilton Head, and a retired physician who was hoping to enjoy golf and the relaxation of retirement, talking to the folks that he came in contact with every day in the community, asking them where they were getting healthcare. And what he kept hearing over and over again was that they had nowhere to turn. They were low-income, they did not have health insurance provided through their employer, and they had nowhere to go. And his solution was, hey, look at all these retired colleagues that I’m experiencing here, we could do something about this. And the first Volunteers in Medicine was born.

And then, Jack McConnell’s mission was to help replicate the model in other communities. The board at Paoli Hospital heard him speak and came back to the table and said, “We have the same problem here in Chester County where we are the wealthiest county in Pennsylvania, but we have low-income individual workers who are supporting the very fabric of the community who have no healthcare benefits, and they’re using the hospital emergency room for their access to care,” and that impacts the entire community. You know, we all learned during the pandemic how important access to care is. The overuse of emergency rooms is as big of a challenge today as it was 26 years ago, so the need for CVIM has not gone away; it’s only grown. Our model is unique, we rely on retired volunteers and professionally still practicing volunteers. That’s one of the progressions that’s happened since the model started. It initially relied on retired professionals, but now I’m happy to say that we have plenty of folks who are making the commitment to give their time even though they’re still working. 

8:52 Hank Smith 

And you have student volunteers as well that are in medical or dental school training. They are they part of the staff as well? 

9:02 Maureen Tomoschuk 

Yes, we cover the whole gamut. We have our retired professionals who had professional careers as specialists, some of the top names in our community who have committed their lives to be healthcare providers, and we also have the eager learning students who are in the schools in this area, developing their professional careers that need hands-on experience with patient care. So you are right, we have student nurses, student nurse practitioners, student pharmacists, medical students, and dental students who all need clinical rotations and internships that have the opportunity to come to CVIM to get mentoring from some of the very most special professionals in this area who’ve had long careers. 

It’s an incredible environment of learning, and the volunteers and the students love it because they’re taking care of the community. It’s a very rewarding environment because people are choosing to be here and to give their time. The students are learning from some of the best, and the professionals who are volunteering are in front of students every day who are learning the latest and greatest, so some of the most amazing conversations take place here in the hallways of CVIM. 

10:26 Hank Smith 

Tell us a little bit about how CVIM has grown over your 20-year career running the organization and what is different today? I’m assuming better but maybe not so better, compared to when you came in; I’m also assuming it was a much smaller organization 20 years ago. 

10:50 Maureen Tomoschuk 

One of the core other pieces of our model that we haven’t touched on yet is that we are 100% supported by the community philanthropy; the generosity of the community, individuals, corporations, and foundations make it possible for us to do this work. Our initial pillars that started the organization committed to developing sustaining funds so that CVIM has people who rely on us, their lives depend on us for their healthcare. We had to be a very strong nonprofit to take on healthcare in the nonprofit world. They build a sustaining fund, recognizing that we would need to secure a building for our future and that we would need to be able to respond to the community’s needs even during economic downturns where philanthropy might be challenged. I’m happy to report that that commitment to build a hope chest, if you will, is what’s allowed us to respond to growing community needs.

Our board is committed to making sure that we are continuously responding to the needs of the community and access to healthcare has not gone away. We can say that we have grown all our specialty services. We provide primary care specialists, from orthopedists to endocrinologists. We have full dental care here at CVIM. We serve children, seniors, and veterans, and we have an on-site dispensary that allows us to make sure that patients leave with the medication they need to be able to stay well, take care of their families, and fulfill their jobs so that they’re active members of the community. The commitment to that core model hasn’t changed, but we have grown the service offerings. We also offer wellness prevention services. We have a whole host of pre-diabetic patients who rely on us, and we’re trying to help them make commitments to lifestyle changes so that they can not necessarily become diabetic. The whole focus on prevention and wellness has been part of the growth that we’ve focused on.

We also have grown our services out in the community. We now have three dental sites out in the community, making it easier for people to access care at CVIM because we serve a huge geographic area. We have two medical microsites, one in western Chester County and Coatesville and also down in southern Chester County and West Grove. Our dental sites serve seniors and our Latino population in southern Chester County. We are taking our services to the community because transportation is a challenge sometimes for people to get to our main center, our healthcare center in West Chester.

13:49 Hank Smith 

You mentioned that the concept of Community Volunteers in Medicine started in Hilton Head, South Carolina. How many organizations are there like yours or similar to yours around the country? 

14:03 Maureen Tomoschuk 

CVIM is part of the National Association of Free & Charitable Clinics, and there are about a thousand clinics across the country that are part of that national model. And, we have some advocacy support through that national bringing attention to the work we’re doing in each community, but the number of clinics that follow a Volunteers in Medicine-specific model is about 90 across the country. And, I’m happy to report that CVIM has been involved in helping many of them get started from the San Francisco Bay Area to State College here in Pennsylvania, Space Coast down in Florida. There’s been a number of them that we’ve been involved in helping them get up and running, and they all are a reflection of their own community. Hank. Some of them are small and just starting to get the volunteers and the community philanthropy support they need to grow, and others are fairly large and able to accommodate a lot of the community’s needs. That’s really what it takes: the support of the community to make them strong and able to continue to grow. 

15:18 Hank Smith 

You’re servicing your clients or customers, if you will, who are employed or temporarily unemployed without insurance, so they would have nowhere to go other than an emergency room. 

15:34 Maureen Tomoschuk 

Absolutely. Yes, we do income verification, low income, and someone in the household has to be working to support the family. These are folks that are really looking for a hand-up instead of a handout. Really, they’re trying to support their families, and they just don’t have healthcare benefits offered through their jobs. We service landscapers, hairdressers, and school bus drivers. Anywhere that you stop in the community, you may come in contact, you’re likely coming in contact with someone who’s working but doesn’t necessarily have healthcare benefits as part of their package. They’re really just trying to make ends meet. 

16:18 Hank Smith 

Just to be clear, you are fully supported by private philanthropy and no government funding or state or federal funding – it’s all private giving.  

16:34 Maureen Tomoschuk 

Absolutely, 100% philanthropy and that’s hard for people to get their hands around because we have become a very large healthcare center, one of the largest in the country right here in Chester County. It’s only because of the support of this community that has allowed us to grow. Our surrounding counties do not have a free clinic like CVIM. We historically started with just serving patients who lived or worked in Chester County, but now we do take folks from Delaware County, Montgomery County, some parts of Lancaster County, and even Delaware that if they’re able to get to us with transportation, we don’t turn them away because there’s really nowhere else for them to go. 

17:24 Hank Smith 

One of the big hats that you must wear as CEO is fundraising, just like any nonprofit CEO has to get their hands dirty and get out there and ask for money.

17:40 Maureen Tomoschuk 

Absolutely. That work is ongoing; it’s never done. Just like our recruitment of volunteers for the future, those are the two things that we always must have our eye on, making sure the support is sufficient. When we recruit a medical director, we have a paid medical director who manages over a hundred licensed credentialed professionals. To be able to have them here working, they do have to have the supervision of a medical director. So, for us to be able to recruit a top-quality medical director, we have to be able to assure that person that we’re going to be able to continue to pay them. The philanthropy, our fundraising model, has to support our work, so we have a top-notch fundraising team. 

Our board is committed to helping us raise awareness in the community, making sure that folks realize what we’re doing and helping to tell our story so that individuals in the community are interested and willing to step up and support CVIM. I’m happy to say that we have generous individuals like yourself and Haverford Trust, corporations that support us. And then family foundations. We are applying for grants all the time to make sure that we have the stable fundraising to continue to run this large healthcare center. 

19:08 Hank Smith 

Full disclosure, my colleague and the Chairman and President of Haverford Trust, Joe McLaughlin, introduced me to Maureen in late February of 2020 at an event in your facility in Chester County. I was so impressed with not just you, Maureen, but your entire team and organization that I joined Haverford Trust and now, I am an annual supporter of your mission, and it truly is an incredible mission.  

Let’s talk about maybe one of the toughest challenges you’ve had. I mentioned I was introduced in late February of 2020 and we all know what happened 3 weeks later when the entire country shut down and I am assuming that had a big impact on how you delivered to the community that still needed healthcare.

20:10 Maureen Tomoschuk 

Absolutely. One of the key challenges we were immediately faced with when everything shut down was, we lost over 300 volunteers who were coming in here and donating their time. They had to stay home. The core staff kept CVIM open every day during the entire pandemic. As I said, the focus on access to healthcare and the need to send people to the emergency room that were critically ill and needing emergency room care became very heightened during the pandemic for everyone in the community. CVIM’s goal was the same as it was every day: to keep people well, give them access to the medication they need to stay well, and not have people use the emergency room unless they really need to. 

We immediately set up a COVID call center with a dedicated case manager to take those calls, helping people identify their symptoms, manage their symptoms, and determine when we needed to bring them in to see them. We launched into telehealth, a platform that, pre-COVID, not many people had even heard of, and now most of us have all had one or many telehealth appointments with a healthcare provider. We had to open that service immediately in order to be able to determine which patients needed to be brought into the healthcare center to be seen in person, and which ones could be managed through a telehealth appointment.

We were open to serving dental emergencies. The last place someone needed to go when they were in dental pain or dental crisis with an abscess was to a hospital emergency room. We worked at the state level to be able to be open and serve dental emergencies, but we had to redeploy our paid staff; our dental assistants and hygienists became pharmacy assistants because we dispense over 40,000 prescriptions out of our dispensary to keep people well, and we had to make sure that people had access to their critical life-saving medicine. Our patients were picking up medicine in the parking lot and not coming into the healthcare facility to try to preserve the distancing and things that were very critical during the height of the pandemic.

So, we had to very much alter our model, but the goal was always to stay open and take care of the patients who relied on us. CVIM became approved to be a state provider of vaccines, so when we did receive the vaccine, we were able to vaccinate our patients as well as the community at large. We were doing large vaccine drives to make sure people got access to that. We were able to provide a lot of education to a very vulnerable population, and many of our patients were essential workers who were still out working. Making sure they understood how important it was to get the vaccine to protect their family was critical. A whole lot of education around the need for vaccines as well as making sure that people had access to it on a regular basis. Fortunately, we were able to get our staff and volunteers vaccinated early on as essential healthcare workers, and so we were able to gradually start to bring back our volunteer forces and get them back into providing specialty care.

23:55 Hank Smith 

So, four years later, would you say that things have pretty much normalized with respect to COVID-19 and all the subsequent variants that occurred after that, or is that still a challenge from your perspective? 

24:21 Maureen Tomoschuk 

We are still facing some challenges in terms of the workforce, like everywhere else in healthcare. There are a lot of folks, particularly in some areas more than others, that lost large numbers of healthcare workers who were either burnt out, or just unable to continue in those roles. With the ability to recruit healthcare workers, our volunteer numbers are almost back to the pre-pandemic level, but we are still heavily focused on recruiting professionals, nurses, physicians, primary care physicians, and specialists, dentists and dental hygienists in the dental industry to support our model. We could talk for a long time about the impact on the number of professionals who were impacted in private practice and were never able to return back to their level pre-pandemic.

CVIM is not alone. The whole healthcare industry has been impacted, particularly in the workforce of professionals in the post-pandemic world. It was a very trying and traumatic time for people working in healthcare. Seeing the suffering of individuals, people in healthcare are caregivers, and that’s their nature, and it was very, very, very difficult. And so, there’s been a lot of burnout. Folks who went through that and are stepping away from their full-time role we’re finding a few that are saying instead of going to volunteer in their retirement, they need a break so it’s an area of concern. We are continuously working on recruiting professionals, and just like anyone else, we must build the pipeline for the future.

We go out and talk anytime we can about CVIM in the community. We talk in the hospitals and at their staff meetings to plant the seed for the future because someone who’s working full time right now in healthcare may not have the time to give right now, but as they start thinking about maybe cutting back a little bit or stepping away, we want them to know that there’s a place for them to give back in a very meaningful way right here in this community. They don’t have to leave to go out of the country to serve an underserved population. It’s really right here in their community, and there’s a meaningful way for them to do that.

We would like to say that everybody we talk to becomes a Community Volunteer in Medicine ambassador. Once you hear about us, you may not be able to volunteer yourself, but you’re certainly able to go and spread the word. And truly, when we do ask our volunteers why they’re doing this, they always tell us they get back far more than they give. When you come into CVIM, the culture here is a very, very positive one. People are here because they’re moved to be here, and it’s a very passionate feeling that you can feel when you come through the walls of our healthcare center.

27:42 Hank Smith 

If our listeners are interested in supporting CVIM’s mission, either from a philanthropic standpoint or a volunteer standpoint, how can they get involved? Where do they go?

27:55 Maureen Tomoschuk 

The easiest place is visit cvim.org. We have a volunteer tab and a donate now tab. So, all of those should be pretty easy for folks to do. We always encourage people to come visit us here at the Healthcare Center. It is a community organization. Our doors are open. We welcome the community to come in. We rely heavily on partners. Our healthcare systems in this community, Chester County Hospital, Penn Medicine, and Main Line Health are very much our partners in making sure that we offer the full continuum of care. We have other, as we mentioned, organizations and universities that are our partners that send students to us and rely on us. Part of the key from day one was developing all the community partnerships that we would need to sustain this organization and grow it to the next level. 

The doors are always open, and we encourage people to come by. We like to spread the word through all of our volunteers, encouraging them when we have open houses to bring folks in to get a tour of the facility like you shared; that’s how you got in here from one of your colleagues. We just had an open house last week where we encouraged our staff and volunteers to bring their friends and family in. It was a wonderful evening, Hank. Some of the volunteers who had been coming here for years brought their spouse or their children in, and they said, ‘Well, now I know where they go and spend their time and why they come home and talk so much about CVIM. Our doors are always open; we love to share our healthcare center with the community and tell our story. 

29:43 Hank Smith 

Well, some of my listeners in previous podcasts have heard me say this. One of the secret sauces of what makes this country great, exceptional, and unique is philanthropy. We do it like no other country in world history has done it. We do it not just by the Rockefellers and the Fords and the Gates and the Buffets and what have you; it’s just the average everyday person gives back to their community either through community foundations, civic organizations, their churches, and it’s astonishing how much money and volunteer time. I’ve got to say that you and your colleagues at CVIM are the embodiment of that exceptionalism, and I just want to say congratulations.

30:41 Maureen Tomoschuk 

Thank you, Hank. We couldn’t do it without the community, the support of our donors, the support of our volunteers, and we only are here because of that, and that’s how we’ve been getting it done for 26 years. I just also would like to add that because your whole focus is on quality, CVIM, most people, when they come in, think of a clinic, but they don’t realize that we’re a healthcare center that’s focused on quality. We track benchmarks like cancer screenings against the national standards, and our goal is to exceed those, and we often do. And that’s our commitment to providing quality healthcare, not just access to healthcare.

31:29 Hank Smith 

Well, thank you for including that. And Maureen, thank you so much for joining us on Speaking of Quality. Your story and that of Community Volunteers in Medicine are genuinely inspiring and great examples of how supporting your neighbors is the key to a prosperous and thriving community that benefits everyone. I have no doubt that the stories you shared today touched many of our listeners. 

Thank you for listening to this episode of Speaking of Quality: Wealth Management Insights. Our next episode will be released shortly. In the meantime, please send suggestions or questions for me or the Haverford Trust team to marketing@haverfordquality.com. And don’t forget to subscribe, rate, review, and share this podcast. Until next time, I’m Hank Smith. Stay bullish.

32:17 Maxine Cuffe

Thanks for listening to this episode of Speaking of Quality, Wealth Management Insights with Hank Smith. To hear future episodes of speaking of quality, please subscribe on Apple podcasts, Spotify, or wherever you listen to podcasts. To learn more about the Haverford Trust Company, please visit www.haverfordquality.com.

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