The Critical Role of Advocacy in Improving Children’s Healthcare with Ellen Mazo

Released: 4/4/2023

In this episode of That’s Pediatrics, our hosts talk with Ellen Mazo, former (retired) director of Government Affairs at UPMC Children’s Hospital of Pittsburgh.

In this episode our experts discuss:

  • Ms. Mazo’s path to her role as director of Government Affairs for UPMC Children’s Hospital of Pittsburgh (2:25)
  • An example of how Ms. Mazo took reporting of information to the next level by becoming an advocate for children (2:59)
  • Providers and researchers as the front line of advocacy for the children we serve (4:37)
  • Some recent policies that UPMC Children’s has worked on including the TiPS program, the SMART Choices program, the LEND leadership training program, and many others (6:07)
  • How UPMC Children’s Government Affairs identifies priority areas for advocacy and then work to educate lawmakers on the value of the services UPMC Children’s provides (9:33)
  • An example of how, in 2009, telemedicine provided an example of seamless access to care that influenced a new focus for advocacy and eventually brought about changes to Medicaid coverage (11:12)
  • How UPMC Children’s Government Affairs encourages and empowers all community members to be an advocate in their own way (20:05)
  • The single most effective way for anyone to get involved (22:33)

Meet Our Guest

Ellen Mazo Ellen Mazo is the former (retired) director of Government Affairs for UPMC Children’s Hospital of Pittsburgh. In that role, Ellen oversaw local, state, and federal endeavors for the creation and shaping of policy to benefit the health and well-being of all children. In addition to engaging stakeholders in policy issues and developing advocacy programs, Ellen focused on securing government funding for the hospital’s programs and services. She created, edited, and produced UPMC Children’s former award-winning parenting magazine, Promises: Your Guide to Raising Healthy Kids, a lively 100,000 circulation quarterly with informative health-related stories for parents of children from birth to 18.  She is an award-winning government and health journalist who wrote for several newspapers. Writer and editor for the women’s health book division of Rodale Inc. (Prevention Books), Ellen was the lead author of The Immune Advantage (Rodale, 2002). She also has written for Encyclopedia Britannica’s annual health publication and several magazines. She is author of Rodef Shalom Congregation: 150 Years of Jewish Learning (2007). Ellen serves on the board of directors of Pittsburgh’s Mattress Factory Museum.

Meet Our Hosts

Amanda Poholek, PhDAmanda Poholek, PhD, is director of the Health Science Sequencing Core Facility at UPMC Children’s Hospital of Pittsburgh and an assistant professor of Pediatrics and Immunology at the University of Pittsburgh School of Medicine. She earned her bachelor’s degree from Fordham University and her doctorate degree in cell biology from Yale University. She also completed a post-doctoral fellowship at the National Institute of Arthritis and Musculoskeletal and Skin Diseases at the National Institutes of Health. Dr. Poholek’s lab at UPMC Children’s studies immune cells and how transcriptomics and epigenetics contribute to health and disease.

Arvind Srinath, MD, MSArvind Srinath, MD, MS, is the Pediatric Gastroenterology Fellowship program director at UPMC Children’s Hospital of Pittsburgh and an associate professor of Pediatrics at the University of Pittsburgh School of Medicine. He received his bachelor’s degree from Johns Hopkins University and his medical degree from the University of Pittsburgh School of Medicine before completing a residency at Johns Hopkins Hospital, a fellowship at UPMC Children’s Hospital of Pittsburgh, and a master’s degree in medical education at the University of Pittsburgh School of Medicine. Dr. Srinath’s areas of interest are curricular development, functional gastrointestinal disorders, and telehealth. Find him on Twitter: @Srinath_Arvind.

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Transcript

Voiceover: This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgements when advising their patients. Patients in need of medical care should consult their personal care provider. Welcome to "That's Pediatrics", where we sit down with physicians, scientists, and experts to discuss the latest discoveries and innovations in pediatric healthcare.

Dr. Arvind Srinath: Hello, and welcome to That's Pediatrics. I'm Arvind Srinath, Associate Professor of Pediatrics in the Division of Pediatric Gastroenterology. And I'm your co-host.

Dr. Amanda Poholek: I'm your co-host, Amanda Poholek, Assistant Professor in Pediatrics and Immunology.

Dr. Srinath: Today, we have the pleasure to work with Ellen Mazo, Director of Government Affairs. As Director of Government Affairs at UPMC Children's Hospital of Pittsburgh, Ellen oversees local, state and federal endeavors for the creation and shaping of policy to benefit the health and wellbeing of children in Western Pennsylvania, Eastern Ohio, Northern West Virginia, and parts of New York and Maryland. In addition to engaging stakeholders in policy issues and developing advocacy programs, Ellen focuses on securing government funding for the hospital's programs and services. She created, edited and produced Children's Hospital's former award-winning parenting magazine, Promises: Your Guide to Raising Healthy Kids, a lively 100,000 circulation quarterly with informative health-related stories for parents of children from birth to 18.

She's an award-winning government and health journalist who wrote for several newspapers, writer, and editor for the Woman's Health Book Division of Rodale Incorporated. Ellen was also the lead author of The Immune Advantage. She also has written for Encyclopedia Brittanica's annual health publication and several magazines. She's the author of Rodeph Sholom Congregation: 150 Years of Jewish Learning, in 2007. Ellen also serves on the board of directors of Pittsburgh's Mattress Factory Museum.

First of all, we can't tell you how much we appreciate the enormous impact you've had in advocating for children locally, regionally, and nationally. So, thank you. Can you tell us, Ellen, about your path to becoming the advocate you are today?

Ellen Mazo: Well, thank you so much for your kind words. Our successes are because of collaboration with everyone, and we at Children's Hospital as well as with the UPMC Government Affairs Department, led by Alison Beam, former acting Secretary of Health for the State of Pennsylvania. So, we are very fortunate to have the resources to be able to do this.

You're asking me about how I got here. And so as a longtime journalist, I covered everything from politics to healthcare to government. And so as I moved into government affairs at Children's Hospital on behalf of UPMC Children's Hospital, I welcomed the opportunity to do more than just report the information. What is important is to be able to go to the next level by advocating for our providers, our patients, and their families. And I have an example.

Dr. Srinath: That'd be wonderful. Thank you. Thank you.

Ms. Mazo: I have an example. So, in the early 2000s, a number of years before we opened our doors here in Lawrenceville, we applied for US Department of Defense funding for diabetes, endocrinology and metabolism research. This is funding that enabled Dr. Silva Arslanian as the primary investigator to continue intervention programs to help improve children's weight and morbidities. For me, this was an amazing opportunity to not just learn about the phenomenal research our scientists were involved in, but how this research has an immediate impact on the health of our patients. And that's what we're concerned about.

So, for example, thinking back, there was an early internet based weight management awareness program, offering our kids and their families online access to weight intervention and prevention techniques. Think of the technological advances we've made since then. We've been enabling our patients to take charge of their health in many advanced ways since then, and we can talk about this later, but about telemedicine is part of this, but to me, it started that.

So, who are the advocates? Right? The providers and the researchers. You all are the advocates, advocating for these children to improve their health, and how? By providing these substantial, wonderful resources that we have to give them. And so, what I like to tell all of our providers when I work with you on issues that are important to you about legislation and policy, is that you advocate every day. This is what you do. And how do you do it? You educate your families and your patients. You inform and advise. And you give them the tools they need to improve their lives and their health. And that to me, is advocacy. You also, it's a give and take, you learn from them. And it is what you do that helps my colleagues and me, and all of us at UPMC Government Relations to pursue the legislation and policy issues that are important to you, your patients, and your families.

Dr. Srinath: That's just amazing. Thank you for-

Dr. Poholek: Yeah. Really, that's amazing. And thank you so much for making sure to really include so many people in what is really a huge challenge and so many people have to be involved in that process. Can you tell us about some of the recent policies that have been put in place that you and the hospital have facilitated and perhaps some policies that are in the works?

Ms. Mazo: Yes, I can. There a number of areas that we've been working on. I would say that over the years we've had a number of programs such as our Successful TiPS program. Let me just say this, I'm about to use a lot of acronyms.

Dr. Poholek: That's fine.

Ms. Mazo: Oh my gosh-

Dr. Poholek: That's fine.

Ms. Mazo: ... one acronym after another. Our Successful TiPS program, that's the Pennsylvania Telephonic Psychiatric Consultation Service. This gives pediatricians access to our psychiatric specialists for immediate support for their patients.

Dr. Srinath: Wow.

Ms. Mazo: There's SMART Choices. Another acronym. Substance Misuse and Referral to Treatment program is a support program for adolescents who have substance use concern, as well as for their parents or other caregivers. And then those programs are really important, because they involve our providers really working with our patients and helping them. Then with the department, there's another program that I think has been just phenomenal and was with the University of Pittsburgh, UPMC Children's continues to be awarded US Department of Health and Human Services funding for the LEND program.

Now, you all may know this, but LEND stands for Leadership Education and Neurodevelopmental and Related Disabilities. But what does it do? It trains our future providers and other healthcare workers to support individuals with disabilities and to support their families. I mean, these are phenomenal pieces of work that we've been doing.

Dr. Srinath: Yeah.

Ms. Mazo: What else? I have more.

Dr. Poholek: Yeah.

Ms. Mazo: We have been working on ensuring Medicaid funding because of expansion of Medicaid. Almost 50% of our patient load, as you know, is on Medicaid. It's very important to us to be able to ensure that all kids are able to get the care that they need and deserve. Then we have Children's Hospital Graduate Medical Education program, it's another acronym, CHGME, which pays for ... Which helps to pay, shouldn't say pays for, helps to pay for the education of our residents and fellows. And we continue to advocate with the National Institutes of Health to support the next generation of diverse pediatric researchers. We've been advocating for gun safety. We've been working with Allegheny County for lead screening legislation. The list goes on.

Dr. Poholek: Yeah, I mean, I'm struck by the comprehensive role that this advocacy has to take. There's so many different areas where you need advocacy. And so, I guess, jumping off of that idea, how do you then engage stakeholders in policy issues and developing these advocacy programs? How do you identify areas where advocacy is needed and then find those stakeholders and engage them and move that process forward?

Ms. Mazo: You start by working with you, with our providers and finding out what is important to us, to our patients, to our families, and we look at those areas. You tell us what areas there are. For example, with gun safety, with the area, we have a timely example is that in the state senate right now, there's a bill that would ensure access to donor milk by requiring public and private health insurers to cover and reimburse for medically prescribed, pasteurized donor human milk. And why is this? How do we know that this is important? Because of you, because of the neonatal physicians who are working with our families and working with moms, and that they know that our medically at-risk infants who don't have access to their own mother's milk, need this care, need this kind of thing, milk. So, we worked in that respect.

Again, I go back to education. That we are continually educating our legislators, our lawmakers. It's not just showing up and saying, "Pass this bill." Or, "Do this for us." But it's making them understand the value of these services that we provide. I'm trying to think. Telemedicine, for example. I gave the early example of the kind of support that we were able to give.

This is phenomenal to me, in the early 2000s, even before we were at UPMC, at this hospital, we started thinking about, "What is it that we need to do to advance healthcare?" Right? And when we moved into this campus in 2009, we had with us, we had brought on a number of doctors who were from South America, and I think you probably remember this, and this would've been in 2009. And because they had moved here, they were still able to help their families they left in South America, by providing care. How did they do it? Via telemedicine.

Dr. Srinath: That's amazing.

Ms. Mazo: That they were able to do that. And there were our cardiac intensive care physicians. And this struck us, this is seamless access to care. And to be able to see their patient and work with the provider who was there, and to talk with mom and dad, and to be able to help them, help their patients. So, we said to ourselves, "If we can do this halfway around the world, why can't we do it in Pennsylvania?"

Dr. Srinath: Right.

Dr. Poholek: Right.

Ms. Mazo: Go outside of Pittsburgh, very rural state. So the thing was, at the time, we found that Pennsylvania's Medicaid program did not include telemedicine, but for just a sliver of services. And so, we knew that without the government's imprimatur, that we would not be able to move forward without this support.

So, the challenges were formidable and what did we do? It was a matter of educating. We began by educating our lawmakers, our administrators in the Department of Human Services, and our doctors and our patients, because telemedicine was new to a lot of people. And as we conducted more and more telemedicine visits, very early on, we had reimbursement for ... You have to get paid for what you do. Reimbursement came largely from grants. And we can thank the UPMC Children's Hospital Foundation for that, who were able to get us grants for that.

But the message began resonating, and especially as patient families increasingly embraced this seamless access to care. It was really an interesting process, but to go back to your question, it was engaging, educating, and continually doing that and providing the background information that we could, and this patient stories of patient families being able to tell us how this benefited them. So, it took us three-and-a-half years of this kind of education, to get the Department of Human Services to expand what it's known as its bulletin, Medicaid bulletin, to include telemedicine.

Dr. Poholek: Wow.

Dr. Srinath: Oh my goodness.

Ms. Mazo: But it was worth it.

Dr. Poholek: Yeah. Yes.

Ms. Mazo: It was worth it. Because in that time ... Oh, I'm sorry.

Dr. Srinath: Oh, go ahead. Sorry.

Ms. Mazo: In that time and beyond, throughout UPMC, telemedicine, as you know, has grown exponentially. And this is the thing that's so interesting to me, that especially in these past two-and-a-half years of the pandemic, now we've had even more patients and families coming to understand what it means to have seamless access to care. And that is via telemedicine visits.

So, what happened was when the pandemic hit, I don't know about other health providers, but we at UPMC Children's Hospital and at UPMC, we were prepared, because we had been working on this for a long time, and we were able to be able to help our patients immediately with this. Hundreds and hundreds and hundreds of patients. And one area that absolutely, that really stood out was in behavioral health.

Dr. Poholek: That was a wonderful, wonderful example and I really appreciate you taking us through the details of that example, because I think it really highlights exactly how you go from identifying a problem, engaging stakeholders, but then also most importantly, how it can really have far reaching effects that you don't necessarily even realize at the time, that you pick this particular topic to advocate for. And absolutely, as you were talking about that, I thought, "Oh my gosh, where would we have been during COVID if you had not done all of that work in advance?"

Ms. Mazo: Well, you all did the work. I didn't do the work. You did the work.

Dr. Srinath: So, you clearly are identifying needs, and you and your incredible team were amazing at advocating and securing means to help people address their needs. So, my question is a little bit even more granular. So, who do you go to and what resources do you have to identify those needs? And my second part to that question is, what if I'm a pediatrician in the community and I have a need that I think should be addressed. How can I connect with your team? Or, how can I reach out? Or, how can I make myself visible for that?

Ms. Mazo: That's excellent question, because that is something that we work to make sure that everybody throughout UPMC Children's and throughout the system, know that we're here to do that. As time has gone on, I think more and more of providers have learned that we're here to be able to reach out. We learn from you. You've come to us with examples of legislation that should or should not go through, should not be passed, should be passed. And so, what we've done is worked with you. You've been able to come to us. I think that that is probably the most effective way of doing this. Many of you have your own specialty organizations in your field, right?

Dr. Srinath: Right. Right.

Ms. Mazo: And many of those groups do a lot of advocacy and go to Harrisburg and go to DC, to advocate for and against pieces of legislation. And that's fine, to be able to do that. I think what helps all of us is if we also know that you're doing this, so that we can help advise and help provide even more information. By learning from you, we then, as the messengers, go to the lawmakers and give them background and help them. So that when you go there, when you go to speak to people, it's not just walking in cold, but they have an understanding of the kind of work that you do.

Dr. Srinath: Got it.

Ms. Mazo: That is really important. I have found that very important to always update them on the work that we're doing at UPMC Children's.

Dr. Srinath: So, do you have regular meetings, for example, with organizational leaders here within Children's or with the community physicians, to identify additional needs? Or, is it more that they contact you?

Ms. Mazo: It's both.

Dr. Srinath: Got it.

Ms. Mazo: It's give and take. And I think that, that's even more important. This gives me an opportunity to tell you too, that UPMC Children's Government Affairs has really been working to make sure that everybody becomes an advocate in your way. Not everyone, for example, has a Twitter account. I'm not sure. Okay. I know you're laughing about that, but I recommend that you do for this very reason. We have an account called UPMC Policy Matters. It's @UPMCpolicy, one word, and that account provides regular updated information on patient and community advocacy.

Dr. Srinath: Excellent.

Ms. Mazo: And UPMC Children's Hospital, we have an account @ChildrensPgh, @ChildrensPittsburgh. Again, provides this kind of information. It keeps you informed, it keeps you updated on the work that's being done within the system, within the hospital, as well as in the community. It provides updated information and news, and it can be very helpful as you think about wanting to become more involved.

I often learn more from you. I'm thinking like, "Oh my gosh, why didn't I know about that bill? Why didn't I know about what was going on? Why didn't I know that a gun safety bill was coming up?" Or, "Why didn't I know that there's a tweak to the telemedicine legislation?" It's because of you, that you're able to tell us and able to inform us. So, it's the give and take that is so very important.

Dr. Poholek: Fantastic. So, that was @UPMCpolicy?

Ms. Mazo: It's @UPMCpolicy. One word.

Dr. Poholek: I'm going to add that, because I do have a Twitter account.

Ms. Mazo: Oh my goodness.

Dr. Poholek: And so, I'm going to make sure to follow that account, so that I can stay updated on all of the amazing-

Ms. Mazo: And also, @ChildrensPgh.

Dr. Poholek: @ChildrensPgh. Fantastic.

Ms. Mazo: P-g-h.

Dr. Srinath: That's super helpful. Yeah, that's likewise, too.

Ms. Mazo: Yes. I learn a lot from this and we have a really excellent social media team that really keeps this up to date for us.

Dr. Poholek: Fantastic. This has been really informative. Yeah.

Ms. Mazo: I have one thing to say.

Dr. Poholek: Fantastic.

Ms. Mazo: I have one thing. The best, most effective way to get involved for any of you, all of you, is to register to vote.

Dr. Poholek: Yes.

Dr. Srinath: Yeah.

Ms. Mazo: Encourage everyone you know to register to vote. And then what do you do? You vote.

Dr. Poholek: Yes.

Ms. Mazo: You have a voice when you vote. And voting is the highest form of advocacy.

Dr. Poholek: I agree. Thank you for that. Thank you for that final closing. That's so important. Thank you.

Dr. Srinath: Yeah. Well, Ellen, it has been a huge pleasure and opportunity to speak to you. And the wealth of information and the wealth of advocacy and just the true service you provide to Children's is just so appreciated and we appreciate these tangible means to get our audience members to reach out to you, to identify issues for you and your expert team to work towards. And what you've done is just truly incredible. Thank you.

Dr. Poholek: Thank you.

Ms. Mazo: Thank you. Thank you.

Voiceover:  You can find other episodes of That's Pediatrics on Apple Podcasts, Google Podcasts, Spotify and YouTube. For more information about this podcast or our guests, please visit chp.edu/thatspediatrics. If you've enjoyed this episode, please be sure to rate, review, and subscribe, to keep up with our new content. You can also email us at podcast.upmc@gmail.com with any feedback or ideas for topics you'd like our experts to cover on future episodes. Thank you again for listening to That's Pediatrics. Tune in next time.

Disclaimer

This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgements when advising their patients. Patients in need of medical care should consult their personal care provider.