The Catalyst Podcast

Mental health and substance use disorders are behind a shocking share of pregnancy-related deaths across Missouri – indeed, nationwide - and many of those deaths were preventable. Joining us to discuss this are Charisse Montgomery, Family Services Coordinator with Chestnut Health Systems, and Lindsey VonDras, Perinatal Care Coordination Manager for the Missouri Hospital Association. Charisse and Lindsey break down what the data really says about pregnancy, postpartum risk, foster care disruption, and why so many families never get connected to the support they need.You’ll discover why nearly 40% of pregnancy-related deaths happen after delivery, how stigma and access barriers keep people from asking for help, and why Missouri’s maternity care deserts make the problem even harder to solve. We also get into what actually works: family-centered care, individualized recovery pathways, peer support, doulas, and coordinated wraparound services that keep mom, baby, and family in the picture. Charisse shares how Chestnut Health Systems supports parents through pregnancy and postpartum, and Lindsey explains Project STORK, a new Missouri framework promoting real connection, recovery support, and ongoing care.If you care about maternal health, behavioral health, child welfare, or better systems for families in crisis, this conversation is essential listening.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

Starting January 1, 2027, changes to Medicaid eligibility requirements will leave millions without coverage. Dr. Timothy McBride, the Bernard Becker Professor of Public Health at Washington University in St. Louis and a leading health economist, breaks down these provisions and explains how they threaten to strip coverage from people who are already working.We discuss the new twice-a-year eligibility checks, the end of self-attestation, and the extra documentation now required of caregivers, pregnant women, and medically frail patients. What sounds simple on paper quickly becomes a maze of mailed forms, state-by-state implementation differences, missing paperwork, and delayed doctor sign-offs. Key points include:How administrative hurdles—not just the policy itself—will drive millions off coverageWhy the new rules may be especially punishing for people with disabilities and caregiversHow managed care companies, state agencies, and providers could get squeezed in the processWhy the fraud narrative is often aimed at the wrong part of the system (beneficiaries rather than the providers who actually commit fraud)Dr. McBride also outlines the broader stakes: rising uncompensated care, higher medical debt, added pressure on rural hospitals and safety-net providers, and a likely increase in uninsured Americans as coverage rolls back month by month. For a clear-eyed look at what these changes mean for patients, providers, and the healthcare system, this is essential listening. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

In a recent article on our Catalyst Substack, titled. “A Growing Trend in Modern Policing: First-Responders in Mental Health Emergencies,” we examined how police officers have increasingly become the default first responders to behavioral health crises, and how law enforcement is partnering with mental health providers to more effectively respond. That article focused primarily on the law enforcement perspective and was informed by a podcast we did with Edwardsville, Illinois, Police Chief Michael Fillback, and how his department is transforming responses to behavioral health emergencies via its partnership with Chestnut Health Systems. This podcast shifts the lens to the mental health provider’s viewpoint, thanks to our guests, Julie Brugger,  Director of Access & Crisis Services at Chestnut Health Systems, and Kara Wardein, a Recovery Specialist also with Chestnut. We discuss: How law enforcement and mental health professionals are collaborating in real-time during crises – how the relationships are structured, the respective roles are defined, and the cultures are aligned.The benefits of ride-alongs: building trust, reducing stigma, and improving outcomes.The state of crisis response laws like Illinois’s Community Emergency Supports and Services Act (CESA), and how they pave the way for 24/7 mental health support.Why most calls to 911 involve behavioral health issues, and how expanding crisis teams can free up police bandwidth.The challenges of bridging two very different cultures—policing and mental health—and how trust and familiarity are closing the gap.While it’s not currently a pervasive model, why it will be more broadly adopted in the years to come. The one thing they’d change to improve these partnerships. Embracing these models creates a future where mental health crises are managed with compassion, expertise, and collaboration. It’s a conversation – and topic – that ought to start a broader conversation among policymakers, law enforcement officials, mental health advocates, and community leaders eager to pave the way for a more empathetic, efficient, and effective crisis response system.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

With respect to the great Sly Stone, this episode of the Catalyst is a family affair. We spoke with three members of the Koehne family, all practicing dentists: Dr. Annie Koehne, who has been practicing at Chestnut Health Systems for just under three years, her mom, Dr. Diane Metrick, who has over 30 years of experience in general dentistry and public health, and the family patriarch, Dr. Michael Koehne, who has been a general dentist for 42 years.  The Koehnes are all committed to improving community health, from making oral health more accessible to underserved populations to spreading awareness of the connection between oral and physical health. We discuss the importance of holistic, integrated care and the role of innovation in overcoming access issues — especially in high-need communities. They share real-world solutions like mobile units, collaborative outreach, and workforce expansion strategies. We discuss Annie’s work with Chestnut and what makes Federally Qualified Health Centers (FQHC) uniquely positioned to address dental disparities.  You'll learn about emerging tools like AI diagnostics, 3D printing, and tele-dentistry that are poised to revolutionize care in ways that were unimaginable a decade ago. The Koehnes share insights into the trends—technology, workforce models, policy shifts—they think will have the most impact on dental health in the next 5–10 years…and close with thoughts on what makes their work so rewarding.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

Edwardsville Police Chief Mike Fillback reveals how his department is transforming responses to behavioral health emergencies, emphasizing the power of specialized training and community partnerships. Discover why even small towns are leading the way in compassionate, effective policing that prioritizes safety, dignity, and long-term support over quick fixes. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

Value-based care is about connection, community, and innovation – the true metrics of success, as evidenced by the lives this approach is transforming across Illinois. Joining us to discuss this important topic is: Gilbert Lichstein is the CEO of the Illinois Health Practice Alliance, a behavioral-health-based Independent Practice Association operating throughout the state of IllinoisMolly McVey is the Integrated Behavioral Healthcare Director at Chestnut Health SystemsAnnette Frawley is a  Certified Alcohol and Other Drug Counselor and Certified Peer Support Specialist in the State of Illinois. She currently serves as an IHPA Outreach and Engagement Specialist for Chestnut Health System’s IHPA teamIn this episode, discover how value-based care goes beyond invoices to prioritize real results—like reducing emergency room visits by over 80%, helping unhoused individuals access primary care for the first time, and increasing engagement through community-driven, relationship-rich approaches. We discuss how a trauma-informed, Lived Experience-driven model is changing the entire narrative in behavioral health, empowering providers to break down barriers and build genuine trust with clients. Annette shares how simple acts, like sharing a bag of chips or being physically present in the moment, forge bonds that make a profound difference. Molly explains how strategic use of data systems aligns payer and provider goals to improve patient outcomes without adding burden, while innovative tools like just-in-time scheduling lower access barriers for transient, high-need populations.Embracing a future-proof, flexible, and compassionate model offers community organizations the opportunity to not only meet the growing demand for mental and physical health integration but to truly revolutionize care at the grassroots level. Perfect for healthcare providers, policymakers, and community leaders eager to turn data into lives transformed, this episode is packed with strategies to drive meaningful change now—and redefine what “value” really means in healthcare. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

Jamelia Hand, CEO of Vantage Clinical Consulting, advises healthcare systems, corporate organizations, and advocacy groups in their efforts to reduce the national emergencies of opioid addiction and drug overdose via strategy consulting, training, technical assistance, and Program Development. Her areas of expertise encompass behavioral Health, digital health and AI integration, compliance, and health equity. Among the topics we discussed:   1.   Her remarkable career trajectory, taking her though through just about every sector of substance use treatment—from direct clinical services, to corporate/private organizations, compliance, to digital health. 2.   Her “secret shopper approach” in evaluating treatment organizations before formal engagement. 3.   The critical gaps between the treatment business and the business of treatment (billing, regulatory compliance, revenue operations) and how treatment organizations can fill those gaps.  4.   Why organizations struggle with digital and AI adoption, and what leaders can do to promote tech/AI literacy and adoption. 5.   Her weekly LinkedIn “In the Field” posts – what she covers and why it’s been so well-received by people in the field. Whether you're a healthcare executive, clinician, or policy advocate, this episode is your essential guide to navigating the complex world of behavioral health, digital transformation, and organizational resilience. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

This is a special Catalyst podcast. First, because it’s the first one that includes a co-host, Ms. Cayla Epstein, a third-year medical student at the University of Miami, who brings a deep understanding of the issues we explore in this episode. It is also notable because of our three guests, who were among the co-authors of a study that was the subject of a recent Vox exclusive that received massive attention, RFK Jr. and the White House buried a major study on alcohol and cancer, which was amplified by contemporaneous stories in the New York Times, STAT, and other prominent media organs. Drs. Priscilla Martinez, Katherine Keyes, and Timothy Namei joined us to discuss their study, the Alcohol Intake and Health Study, which was commissioned in early 2022 by the US Department of Health and Human Services under President Joe Biden. The authors told Vox that they were informed last month that the Trump administration did not intend to publish the final draft of the study or its findings. Our conversation focuses on their study, its salient findings (including the link between alcohol and breast cancer), its ramifications for our nation’s public health, and the need to find alternative channels for disseminating important health information.Guests: * Dr. Priscilla Martinez, Scientist, Deputy Scientific DirectorAlcohol Research Group | Public Health Institute.* Dr. Katherine Keyes, epidemiologist at Columbia University. * Dr. Timothy Namei, Director, Canadian Institute for Substance Use Research; Professor, University of Victoria. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

Dr. Douglas Smith, Director of the Center for Prevention Research and Development at the University of Illinois, discusses the perceptions and definitions of recovery among youth. Drawing insights from the Illinois Youth Survey, Dr. Smith explains why only 5% of surveyed Illinois youth consider themselves in recovery, compared to the 8% national average for adults. We discussed why mobile apps have proven to be relatively ineffective for mental health treatment for adolescents, and how schools, communities, and healthcare systems can support diverse recovery pathways. He also shares insights from his new book, "Motivational Interviewing with Families," offering a fresh perspective on supporting youth in their recovery journeys. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

When former lit prof Molly Robey was teaching the works of the relatively little-known late 19th-century writer Charles W. Chestnutt - among other English writers equally and/or more prominent - she couldn’t have imagined the extent to which it foreshadowed her current work with Chestnut Health Systems. Dr. Molly Robey, Chestnut's Director of Employee Experience, joins us to discuss her transition from over a decade as an English Literature professor to leading employee experience initiatives, and how her academic background informs her work. Dr. Robey shares insights on creating inclusive work environments, supporting mental health initiatives, and developing retention programs with measurable results. The conversation covers her strategies for supervisor development, new employee orientation, and helping teams navigate organizational change while maintaining resilience in mission-driven work.We also discuss her training on "Why are we afraid to talk about religion at work?" which addresses one of the workplace's most challenging topics. She explains how this training fosters thoughtful, non-divisive conversations about religiosity's role in career choices and workplace well-being while providing practical guidelines for true inclusivity.This episode offers valuable insights for leaders, HR professionals, and anyone interested in building supportive workplaces that honor both individual identity and collective mission. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

We spoke with Matt Mollenhauer, Chief Clinical Officer at Chestnut Health Systems, where he’s been for the past 33 years. We discussed:* What a CCO does, and a sense of the scope of clinical programs within your purview as CCO.* Matt’s leadership philosophy - how he keeps staff engaged, motivated, and at the top of their game.* Matt points to two programs that best exemplify Chestnut’s innovative approaches in delivering successful outcomes.* He cites the top 3 challenges in today’s uncertain climate and what Chestnut is doing to overcome them.* What he learned from his days with Chestnut Global Partners, an international EAP, that he applies to his work today. And since he’s a diehard Green Bay Packers fan, we couldn’t resist sprinkling in several apt football references. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com

In this special episode of the Catalyst, we visit with Dave Sharar, the CEO of Chestnut Health Systems. After a remarkable 36-year career, Dave is stepping down from his post to begin a new chapter at the Lighthouse Institute.Dave reflects on his journey from camp counselor to CEO, sharing the pivotal moments that shaped his leadership philosophy, which emphasizes inclusivity, autonomy, and strategic direction. He delves into his pioneering work with Employee Assistance Programs (EAPs), the development of the Workplace Outcome Suite, a tool that revolutionized how EAPs measure their impact on productivity, and his role in pioneering the "glocal" model of international EAP delivery. The conversation also explores the challenges and achievements of his tenure—from navigating service line integration and the pressures of the pandemic to addressing widespread workforce shortages. As he transitions to his new role, Dave reveals his mission to tackle critical issues in workplace behavioral health, including access to care for the working poor and the persistent challenge of labor shortages.Join us as we celebrate Dave's legacy and look ahead to his next chapter of innovation in the behavioral health field. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thecatalyst2.substack.com