Podcast Transcription

Saranda West: Welcome to the Accelerant podcast, where we are impacting thought leadership in the nonprofit community.

Hi there. Thank you for joining me on the show today. I'm your host, Saranda West. Today, I am joined by Gloria Winters. Gloria is the CMO of the YMCA of the Pikes Peak region. Now, for most of you, when I say CMO, I know you all think Chief Marketing Officer, but hold tight because Gloria is, in fact, the Chief Medical Officer.

We’re obviously going to dig into that. Gloria, thank you so much for joining me on the show today.  

Gloria Winters: Thank you so much for having me, Saranda.

SW:  So, Chief Medical Officer. Will you just start out and elaborate? What is that? What is your role and what do you do with the YMCA?  

GW: Yeah. As you said, I'm their Chief Medical Officer, now for three and a half years.  

I was in formal health care for 18 years. I had 12 clinical practices across the state of Colorado and was a practitioner myself. I have my doctorate in physical therapy. My expertise is in exercise and sports science, sports medicine, and all the things that go with that.

I was doing that and loved it for all 18 years, and then I really saw an exponential change in how our healthcare was functioning and the ability for patients to get access to get good care. And actually, even for providers to love what they're doing.  Because of all of the different federal requirements and insurance requirements, it just starts to consume the practitioner's time and make it challenging to treat patients in the way that we always had.

I knew that those were issues going into practice early on, but they seemed to escalate within those last couple of years that I was leading the practices, then practicing myself. I started to really look into how I could impact more of the health of the patient, and the CDC had put out years ago that 80% of what impacts a patient's health is the socioeconomic environment, the behavioral factors, and then the physical.

When you look at that, a place like the YMCA is something that is very, very specific to impacting all of those areas, and 20%, the CDC had named as being what the clinical practice affects the patient's health.

That's actually a small amount, and when you're looking at how to really do what we call whole person care, that component is really important.  

SW: That fits perfectly [with] the Y's mission and what has been the mission for years in terms of spirit, mind, and body. Really rounding out the full, the overall health of the person.  

Whole Person Care

GW: Yeah, correct. When you talk about whole person care, you're really looking at how you can connect that formal healthcare environment to the other things that affect it, and the Y really does that. I saw the Y as being a health organization, where I really was from the formal health care organization.

I had quite a few of my clinics within YMCAs, or positioned very close to them, so I knew functionally that that continuum of care could happen, whether it was for my cancer patients or my musculoskeletal patients, my Parkinson's patients. I could connect them to the YMCAs as an extension of my care.

Oftentimes they would say, “Hey, Gloria, your care was fantastic. It did exactly what we were hoping to, but the experience that I had at the Y with the relationships, those things were actually life changers for me.”  

That's a little bit of history of where I came from. I started talking to some different leaders about how we could work this and what impact we could have by actually having someone lead from the Y in this scope.

That's where it really came from. The intent of my current position is really to connect formal health care back to the Y and everything it does, and then enhance the things that the Y does. So many of our offerings, our diabetes prevention programs, or other chronic disease management programs, Parkinson's. It doesn't matter what age you are. There's probably some aches and pains that you have in your body  

Most people are walking wounded and are they actually getting that care that they need? Can we actually help refer back to formal health care and then back into our Y for the things that they need before and after that?

That's really the scope of how that developed. It's really been fascinating to see now in this new COVID environment, actually, how that's compressed and accelerated the need for the Y to be able to offer that whole person care as an extension of what the formal health care is doing and what they need help with.

SW: Absolutely. To give everyone some context: I think I know what day it is. It is May 6th, so we are right in the times of quarantine. Give us a little bit of the what's going on in your community right now, in Colorado Springs.  

GW: Yeah. I'm in Colorado Springs, and we went into Stay at Home in March and April.

Then, that was lifted to what we call Safer at Home just last week. Still with all of the social distancing, hygiene, and all the infection control measures that we can possibly have, but that means that retail stores can start to do curbside pickup and restaurants can do the same. Our facilities are still closed, and we will be having those announcements come out hopefully in the next couple of weeks of what the recommendations from our governor will be.

There's a few other states that are a little bit ahead of us and allowing opening of facilities, but we've been planning for that. We're going to be ready to go once we get the green light to be as safe and as healthy as absolutely possible.

SW: Yeah. I'm curious, and I definitely want to come back to the reopening, because I think there are a lot that people are trying to decide and figuring out. But with the programs that you help facilitate and going back to the like diabetes prevention, what has happened to those programs during this quarantine time?

Changes to Programs at the YMCA of the Pikes Peak Region

GW: Yeah, that's a great question. We were able to fairly quickly shift a lot of our programs to virtual. As we know in the formal healthcare world, tele-health has skyrocketed. There were a lot of perceived barriers for that before. I think it's the same for us in the virtual exercise world. We're such a relationship-centric organization, and that still felt like a barrier.

We moved very quickly into offering virtual programs for all ages: children, youth, adults, and specifically for our older adults.  

SW: So, really those programs, keeping the relationships and doing their workouts at home.  

GW: Yeah. Yeah. One of the examples of that is, we have a very specific diabetes prevention program for the Latino community, non-English speaking, only Spanish speaking.

We had developed that specifically for many of the undocumented Latino families in our community to have access to that, so they were becoming very comfortable coming into our facilities, feeling safe. When the facility is closed, that was a real disruption for them.

Not only were they losing jobs and kids weren't in school anymore, but now they had nowhere to go that they felt safe, so we were able to launch that into a virtual platform and then, as well, offer meals for them to come pick up at our facilities because both parents have lost their jobs or furloughed.

We've been able to see that continue, and they've actually continued to have weight loss and they're doing their exercises and they're sending us posts. And so that was one of the real pluses for me with it. The silver linings in all of the COVID pandemic is to see the communities really come together and have continued to have impact.

SW: Absolutely. One of the things I noticed on your website, the Y has also been offering childcare for similar situations, for emergency workers.  

Childcare for Essential Workers

GW: Yeah. We launched that immediately when we learned that the facilities were going to be closed and that the surge was happening. Healthcare workers were going to need to be in the facilities. What were the kiddos going to do?

We were able to launch that critical childcare right away and put all the measures in place. First, safety and health, and then allow for the physicians and nurses and first responders to get where they needed to be. I had quite a bit of outreach, one-on-one on the phone with them to see how that was going and see if what we were providing was everything that they needed.

The stories that came back from psychiatrists, from emergency medicine docs, you name it, of just saying, “We wouldn't be able to do this without having the critical childcare.”  

You're offering something good, but then when you really get in and hear the stories and the psychiatrist was an interesting story because it wasn't my first stop for a first responder type of position, but she said, “Gloria, the amount of behavioral health issues, the social isolation that this has caused has caused the fear that this has caused...” she said, “My caseload has gone through the roof and I'm working double time. I need a place for my kiddo to be safe and have good curriculum and activities and some consistency.”

SW: That is so great to hear.

You mentioned key piece of that is that the kids are safe too, because it's one thing to put yourself on the front line... Can you talk through some of what those processes are, what you've put in place specifically for the childcare offering?

GW: Yeah. Yeah. I'm sure anyone that's listening to this has done... if they're in business, they had to set up all kinds of guidelines and policies and procedures. So, the kiddos would come in and have a quick health assessment and temperature reading as well as all of our staff, hygiene, washing hands for 20 seconds immediately upon arrival. We do drive through drop-off, so the parents don't actually come in.

Less contact with less people means less potential. This came a couple of weeks down, but we moved into both staff and kiddos wearing face masks, and then just the cleaning and disinfecting procedures to the nil. Behind every single kiddo comes somebody that's cleaning. We map out our zones for our facilities so that there's less than 10 kiddos in each section and they don't just... usually they would go through some kind of rotation with their activities and engagement, and we had to shift and navigate all those things.

The Colorado Department of Public Health and our El Paso County Department of Public Health, we were on the phone with them two or three times a week to talk through those measures, as well as what to do when somebody comes down with COVID and we had plausible cases with staff, with kiddos, with parents, the parents being healthcare workers.

Those policies and procedures, we learned very quickly how to communicate with our public, how to communicate with the families and with the kiddos to make them feel safe in a time that's so unprecedented for them.

SW: Going back to the mental health piece. I think you have kids. I do as well. My five-year-old still can't comprehend what is going on and why we can't go to the trampoline park. Every other day, just helping them understand. I know that's gotta be a piece of that as well.

Summer Programs for Kids

GW: Yeah, our staff have been so phenomenal in creating a place of safety and trust and joy for those kiddos. We've had the Olympics. We were all expecting to see the Olympics this summer and that didn't happen, and of course, Colorado Springs is Olympic City. So, we've had Olympic athletes virtually call in and chat with our kiddos and talk about their disappointments and their struggles of not being able to go places that they wanted to.

Certainly not being able to compete when they've trained and prepared for something. We went into lockdown at spring break, so most of these kiddos had plans for spring break and that got disrupted. Really speaking to the disruption in their lives, we have quite a few of those things set up for the kiddos to participate in.

SW: That's fabulous. What does it look like? For reopening, sticking with the childcare theme, I know we're moving into summer. Schools are still closed. Are the same processes in place, or what are the conversations around opening up for summer camp?

GW: Yeah, I just got off a call here right before I jumped on with you to discuss those components.

We have set those into phases of potential reopening and that's all been mapped out, whether it's zones and rotation times and mapping for distance and all of those things at our Y we're looking into. We did actually already expand our critical care when we went from Stay at Home to Safer at Home.

Now, some parents need to go back to the workplace, so we've already expanded that just in the last week. We're continuing to plan for those camps, whether it's the day camps that we locally hold at our facilities. We're partnering very strongly with our school districts and that's been one of the beauties of this, a silver lining is that cooperation. The collaboration that occurs within our previous partners now have been elevated to a place of, “Man we're going to make this happen so that the community has access to, to whatever it is that they need. “

SW: Right. I wanted to go back to one small detail because I think it's what everyone's trying to figure out.

You're checking temperatures, asking for symptoms of the kids with like childcare. What does that look like? Even as you're opening back up, for gym facilities, what does that look like in terms of capturing that data and concerns about HIPAA compliance and anything associated with tracking any of that health information?

New COVID Procedures

GW: Yeah. For example, the process would be, if our facility was open, you would schedule a time to come in – These are all plans for reopening – We will wait for final guidance from the state in order to determine if we need to switch something, but the essence of it would be that you would schedule a time to come in, whether it's through a personal training or group fitness class, or to use a piece of machinery, and then you would actually walk in and go to the hygiene station where you would wash your hands or disinfect your hands, have your temperature check taken and then have a health screen done.

We have a technology that we'll be utilizing to gather that data. It's all HIPAA compliant. If we determine that we need to store that data, we're leaning in that direction. The easy button is to obviously just not store any of that information.

One of the reasons we're looking at going ahead and storing that for both staff and members is because of contact tracing. If that person were to come down within the next 48 hours with COVID, then we would want to trace that back to the persons that they were in contact with. That would be both for the sake of public health information, as well as what is best practice to controlling the surge of any of COVID.

SW: Again, Gloria, real quick. Let's go back to one of the things you mentioned: contact tracing. This is maybe not quite all fleshed out yet, and we've been working on different pieces, how we can track capacity of the facility and then also to the area. What are your thoughts in terms of what that looks like moving forward?

Contact Tracing

GW: Yeah, that's a great question. We are zoning all of our facilities, so there'll be a map of zones and we'll know which zones are active and when they're active and when cleaning and disinfecting needs to come into that zone. It's a whole developed process. You'll have to sign up for your class through GroupEx PRO or whatever else we're using in advance of coming to the facility so that we know how many are going to be on site.

You have to check in. You have to check out. We would actually know what zone you were in and what people that you were with. That's our phase one. Phase two, we'll expand upon that. Everything's zoned: the flow, the walkway where you're at. Did that answer your question?  

SW: Yeah, absolutely.

Can you talk me through like the hygiene station and then scheduling to come to the facility? What other plans are you still talking through to figure out what the other processes may include?  

GW: The facilities themselves are being structured for all the hygiene, social distancing and cleaning and disinfecting.

Those are the three big components that then you fall everything else underneath mapping out in all of our group exercise rooms, the six feet apart. How many persons can we have per square foot? What does the cleaning and disinfecting rotation look like? We have special machines that we've ordered that you can spray down that electrostatic cleaners.

They look like the ghosts or backpacks, so we can't fight a few good jokes about Ghostbusters right now. Everything that we can put into place that creates the most trust and safe and healthy facility, because there's really two spectrums. There's the side, probably even listening to this, that says, “No way, do not even open up until everything is a hundred percent secure.” Then there's the other side that's laid back and says, “Why not? Let's get our herd immunity going, right?”

You get very separate ends of the spectrum. What we want to do is come up with all of the guidelines, policies, and procedures that could put us in the best place to live life well. There's OSHA and there's HHS and there's your public health departments. Obviously, everybody knows now the CDC giving us all of these requirements and guidelines.

We're following those to the strictest letter of the law. We know that we've done due diligence to put everything in place, to be a functioning business. To that extent, we have to get back to a functioning business so that our economics can return.

I've never been in a situation where there's such a tight link between healthcare and economics, and this tight rope that we're walking, this cyclical effect. It’s one bouncing off the other. If we don't figure that out and get it right, there's not a lot of margin for error right now because of so many of the unknowns.

Those agencies that I just listed are doing such a good job to give us best practices. We're really going to be able to assure the community that they do need to get back and get exercising for their immune system and for their social cohesion and further life. They can do that in a safe place.

SW: One of the things that I've been sure, and I know the general public is as well, there's so much information coming at us at one time and not knowing. It's like, should you wear masks? Should you not? Should you wear gloves? Should you not?

Out of those agencies you listed, what is one that you use as your data, your truth of “This is what we're going to follow”?

GW: So first of all, CDC, because that's going to be your best regulatory agency for determining those ends of the spectrum.

Do I wear a mask? Do I not? That's a really good, consistent one where you're not going to get as confused. Then OSHA for the return-to-work guidelines and the CDC match up beautifully. Those are the two that I go to daily to see if there's any changes to check into. Then the third would really be your local public health agency.

We are seeing that health is run at a state level. Oftentimes, there's been now, if you look into any of the current blogs that are out there, or maybe even podcasts, there's this talk about local health and national health and then local health. There that's a whole other conversation to be had about how those three different ones, with the politics and with the guidelines, but at the state level, that's where we're really making our local decisions based off of what we see of our COVID cases, our curves, and how to make decisions.

That's the third entity that I check every day is both the state Public Health Department and then our County Public Health Department. I'm in conversation with both of those entities on an almost daily basis to see where we need to pivot and move in order to continue with our best practices for the things that we are currently doing.

SW: That's so helpful. How do you see reopening and putting the members at ease that they are coming back to a safe environment? How do you see the communication to members changing during that time locally?  

Reopening Plans

GW: I will tell you, our Marketing Department has been so fantastic with their communication.

If there could be a case of over-communication, that's what we're trying to do to make sure that we have full transparency to the public of what we're up to, how we're getting there and the services that we're providing. To really answer your question, I think trust is the main issue.

We have always been both nationally and locally at a trusted organization, and so that component. We are only furthering that by all of the steps that we're taking to make sure that when we reopen, we're safe and healthy. Fear is what is the preeminent atmosphere of the day. When you look at how to bring that back to a level of trust, there's a few different dimensions of trust that need to be focused on.

That personal, physical trust that I can trust my physical space. There's the economic/financial component. There's the socioeconomic component, so really looking at them, the core factors of what creates trust and coming back to that, and then making sure we're answering those questions in those categories, in those dimensions.

SW: Yeah, that's perfect. I guess mental health and the whole health. How are you staying healthy during this time? Cause I know it's been very chaotic, especially for you and your role with the wise. You've been figuring out these reopening plans and everything coming at you.  

Staying Healthy

GW: That's a great question. I did hear on some other calls, some people would say, “Oh, I've had a chance to reset and have some rest time.” That just really blows my mind because that's nowhere near where we've been at. I've just found, family of course, and a huge component of just my mental health and wellbeing.

In Colorado, we're just now getting to hopefully a beautiful spring here. Beauty is what really restores my soul and finding beauty, whether it's in mountain biking or the outdoors and having some moments.  

SW: So many say, “I got a chance to do a puzzle for the first time in however many years” or all of this exercise.

I'm like, “I've just been sitting at my desk,” but I think that's all for good. So, the Y in particular has been serving the needs of the community and evolving quickly as those have been ever changing in the past six weeks, eight weeks.

GW: There's so many painful stories right now both in our community, and we've had a really, some very close staff that family members and such have passed with COVID. Those are all reality. You don't ever want to sugar coat it, but there's quite a few different authors that I love that really speak to beauty, restoring the soul.

And When there's so many painful things and the trauma continues to occur over a long period of time, it's not one stressor that has occurred that causes our fight or flight, and we have our adrenaline run. Then we have three days to recover from that.

No, this is a sustained thing. The stressors are real over a long period of time. Whatever beauty it is that you find that restores your soul, go find that, do that, and allow that to fill up that space. That's been consumed with all of this.  

SW: So, Gloria, I know you have a lot of interim plans and still, as you said, taking in information daily to get to what the reopening plans for the whole, for all of the parts that the YMCA serves, whether that's childcare or people actually coming into work out.

Knowing that a lot of others are in that same, any final words or any other considerations that we haven't talked about yet?  

Final Words

GW: Yeah, maybe a couple of things. We didn't talk too much about our outreach to the vulnerable populations, to our older adults. We've made over 14,000 phone calls to our senior population to check in and see what they need.

The follow-up with that has been...we have gone to, I think as of today, it's probably over 300 deliveries, whether it's mood or someone needed a webcam for their tele-health visit, but they couldn't get it. We've done care packages, you name it. We've partnered with different food agencies to do hundreds and hundreds of food distribution and onsite help for those populations.

That's a really big component, not just the work that we're doing with seniors, but again, when you see the partnership and collaborating with these other entities, one of the research studies that I read from Deloitte was saying that two of the biggest drivers for our long-term outcomes of this pandemic will be the intensity that pandemic partnered with the ability to collaborate with other entities.

Like Daxko, like the food agencies, like our healthcare partners, the YMCAs. When we pull that together, really tightly that for our local area is going to decrease the overall impact of the pandemic. For me, when we're looking at what are a couple things that I can grab onto to really make a difference in the outcome of this pandemic, that's what I go to.

Otherwise, there's just a volcano of information and unknowns that you start to get lost in, in the overwhelmed zone. I kind of pull that back into, “Okay, let's look at who our partners are. Let's look how we can bring this together and then make impact.” That's what, to your point, what we're really seeing with the childcare.

We're really seeing with our vulnerable and older adult populations. It's making a difference, and I can tell you that that will have effects long-term. We'll be able to look back and see in our area that that changed the outcome of the pandemic.  

SW: I'm just so glad you brought up the senior population and the outreach there.

Maybe even expand that, because I know in terms of COVID like the seniors are more at risk, or those with preconditions. Having to decide for themselves a lot, you know, are they going to come back? What would your advice for those particular groups be? How do you see those?  

How do you see that outreach even continuing over the coming months until we get a handle on this?

GW: Yeah. I heard a couple of questions there, so let me pull them in. I would first say that we've always known that the chronic disease population is that at-risk population. Everybody knows that we've been talking more in the medical field and then in the public health field for the last few years about social determinants of health, which means really what's driving your health, what's actually impacting it.

Transportation, food access, these are things that have been taking a lot of notice in the last few years. Chronic disease and social determinants, and now we've added to that communicable disease. You add communicable disease to these other two, and these three are now going to be our permanent buckets.

A year ago, communicable disease, the flu, the cold people would have. Now that won't leave their language for years and years to come. We may have pointed the finger at somebody with the chronic disease and say, “Oh yeah, they need more help.” Or somebody that has transportation issues... “Oh yeah. They need more help.”

Now, it's even the healthy, active individual that says, "Oh shoot. Now I'm in this bucket with communicable disease. I have a chance of getting that.”  

So, now I'm living in this. It's not as actually segregated out anymore. We're all lumped into it. Those with chronic disease, actually, then you add communicable disease to that and social interaction so that they're even a higher need bucket than they were before.

All of that to say that those are really three areas that I think will now be permanent in our focus of health and how we address health. At the very beginning of our talk, I spoke about the CDC, mapping out that 80% of what affects our health care.

Those social determinants: behavior, physical activity, and 20% was clinical. I'm putting money on it that that's going to go towards 90/10. So, 90% of that will be communicable disease, chronic diseases, behavioral health, these things, and 10% will actually be what we can get in clinical care. That actually puts forward the need for organizations like the YMCA to be that much more face forward as a health organization to address these issues because the health care systems are going to need our help in creating that continuum of care, where they can treat the person, then send them to us.

Then we can finish that piece off with transportation and food and social interaction and exercise programs to encourage increase your immunity. That actually has ballooned out what I think that the Y's responsibility in this post COVID era will be.

Did I answer all your questions on that one?  

SW: Yes, sorry for the rattling of questions. I'm just trying to get my mind around it as well, because really what it boils down to, and what you're saying is, this has surfaced a problem that was already there, but it's brought it more to light, right?

Given the COVID pandemic and the Y has responded and has to continue to respond while then also trying to bring up and go back to what the Y was serving before, as well, and try to maintain both.  

GW: Yeah, exactly. We will have to find, and that's what we're working on, a way of keeping people safe and healthy, even more so than if they were to only stay at home because we need a place where they can exercise to boost their immunity

They can congregate in groups of 10 or less to have social cohesion and bring that component back. I mean, the loneliness of all age groups and what has the effect of that is, we haven't even seen the tip of the iceberg on that yet, those longer-term outcomes.

We will figure it out and then people will actually want to come to the Y for those places, maybe even more so than before, because we can't live in a bubble in our homes. We may need to for times if things surge up in search down, but not permanently. We've got to find a way to make this safe and healthy and workable for the long-term health of our communities.

SW: I just wanted to say thank you so much for all of the work that you have been putting in at you and your team and the Y and serving your community during this time. If someone wants more information about the YMCA of the Pikes Peak Region, what's the best place for them to contact you?  

Get in Touch with Gloria and the YMCA of the Pikes Peak Region

GW: Well, I'm certainly happy to give out my contact information, which is gwinters@ppymca.org. You're welcome to email me.  

Then also, of course, our webpage: ymca.org. There's all sorts of contact information that you can find there.  

SW: Great. Thank you so much for joining me today. I really appreciate it. Now, this will be so helpful for all that are trying to navigate and figure out the reopening and whatever this new normal is going to be.

GW: It's absolutely my pleasure.

SW: Thank you for joining us on this episode of the Accelerant podcast. To check out previous episodes, see the full list on daxko.com/podcast or your favorite podcast app.

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