Savvy Over 60: Sheila Kee

Few Western New Yorkers have led a hospital and fewer have been women. Then there is Sheila Kee. She has led three local hospitals, the Community Health Association of New York State and the Western Region for the state Health Department. Since September 2008, she has served as Vice President and Chief Operating Officer at Niagara Falls Memorial Medical Center, where her imprint can be found on many transformational initiatives. However, her career sprung from one of the most important periods in American politics.

What was your first professional job?

I majored in Political Science and in my sophomore year of college, I interned for the Democratic National Committee, when at the same time it was being bugged during the Watergate episode of our American history. Very, very interesting. I, of course, worked in one of the executive wings of the White House and it was wonderful. Then in my junior year, I went back and worked for one of the congressmen who sat on the Judiciary Committee and worked with his staff on the articles of impeachment for Richard Nixon, with a focus on illegal wiretapping.

From there, they referred me to Joe Crangle, who was Chair of the (Erie County) Democratic Committee, and I finished up my B.A., worked for Joe, then started working at the Erie County Legislature and I became Chief of Staff in a year or two. I became County Director of Budget and Management for 10 years, went to ECMC in a leadership position. From there, I went to the Community Health Association of New York State, which serves as a lobbying group and a service group for 52 federally qualified health centers in the state, went back to help Sheehan (Memorial Hospital) get out of bankruptcy - which we did, but unfortunately, later on it got back into bankruptcy and never came out - worked for the state Department of Health as an Associate Commissioner and now I'm here. I've had a very fun career.

Have you ever experienced sexual harassment in the workplace?

Interestingly, no. I never had an issue with that - and when I started working for the Democratic Party, I was usually the only woman in the room, the only woman doing research, the only woman running major campaigns. I guess I was just lucky, thank God.

What similarities are you finding between politics and health care?

You know, I was in politics for 30 years and there are so many similarities. One of them is: How do you reach your constituency? In the area of politics, everyone knows grassroots, knocking on doors, phone calls, that kind of thing. Health care today is becoming very similar to that because our mission is to reach out to people who've been disengaged from health care and the only way to get to them is the old-fashioned knock on the door, call them, text them, you name it. I particularly like they way it's developing into community-based health care.

I'm very happy to tell you that we are administering four innovation projects for DSRIP (Delivery System Reform Incentive Payment) projects, under the guidance of Millenium Collaborative Care. These innovation projects are fantastic. They're going out, knocking on doors, talking with people with serious mental illness and working with them to bring them in for screening or get them in for an appointment, so they can stay healthy both mentally and physically.

We have an outpatient mental health clinic. We serve about 1,200 people in it. But then there's this other population of people with serious mental illness who don't go to clinic, don't go to the ED (Emergency Department), don't go to the hospital and don't go to primary care. I call them isolationists because they are isolated and either they don't want to go for treatment or they just want to stay in their homes. So trying to reach out to those folks is very dificult. We actually provide therapeutic visits in the home and our patients love it. Sometimes that home visit will give them enough - what do you call it? - courage to go to a clinic. It opens doors to treatment. We're really pushing home visits now.

Credit Niagara Falls Memorial Medical Center

We had two Hot Spotter, or High Utilizer, programs sponsored by the New York State Department of Health: one for inpatients with four or more hospital stays in 12 months and an ED Hot Spotter program, where people have 10 or more ED visits in 12 months. On the inpatient side, we've come up with some techniques to find out, Why are they really here? Because when you really dive, it's usually not a medical or behavioral health issue, even though they have conditions. It's bad housing, their utilities have been shut off, they need legal aid, there's a food issue - all the issues what we the social determinants of health. When we find out what's really driving their behavior, we can fix that.

For our ED program we had 150 people with 35 or more ED visits in a year - and of that group, we've graduated 19 and of those 19, zero ED visits in recent months. So they go from 35 or more to none because I feel we've invested a lot of time and energy to really find out what's the issue and how to fix it.

Both Buffalo and Niagara Falls are poor communities, but are there significant health care differences you're seeing between the two?

There are some startling differences from what I saw in Buffalo and what I see up here and, I hate to say this, but often times up here, you don't have the level of family involvement with a patient that I saw in Buffalo. Maybe because families are poor themselves, they're faced with so many issues, they can't grapple with another one. So part of what we grapple with every day is, How do we support these folks? Many of them live alone. In fact, Niagara Falls has the highest rate of people who live by themselves - way higher than the state average. I call it the "loneliness factor": they come to the ED just to be able to talk to somebody. So, yes, the problems here are very deep-rooted and are going to take a long time to address properly.

You're a person who creates change, a changemaker, but the secret is how?

Everybody has said since I was a kid that I have this crazy imagination. I like thinking about innovating. So I do a lot of reading - journal articles and research studies - and when I do that, I try to apply what I'm reading to everyday life up here in Niagara Falls for health care delivery. So a lot of the things that we've done here is just based on things that's coming out in the literature. We've tried to stay ahead of the curve with some of our approaches.

When I was in politics, some people would call me a lightning rod. I thought I was just doing my job. Now if a man were working like I was, they wouldn't call him a lightning rod. So there was a double standard. Is it still evident today? Oh yeah. But I like being a lightning rod. You gotta shake it up sometimes.

What advice would you give women just starting their careers?

I, fortunately or unfortunately, always put work in the center of my life. I work very, very hard - you know, weekends, night and day. I'm not asking kids of today to do what I did, but I think they need to know that putting a lot of effort into something really makes a difference in terms of their ability to progress. I think they need to be innovative as to the way they approach things, don't be afraid to speak their mind - you might need to work around some rules to get something done - and really enjoy what they're doing. I've always been lucky to have jobs that I really love. If you're doing something that you don't like, have enough oomph to move on.

I'm at a point in my life when I think I have a lot more teaching to do, sharing what we've learned with others. I try to do that every day. I love history. I love politics. So I throw some of that in as I teach. I think it gives people a worldly view of, Why are we doing this? Then people will say, "Yeah, I'll do that." The biggest thing that I failed to do is keep a log of all my experiences. Had I kept one, I would have written a best seller because some of it, you couldn't invent it if you tried.

Flats or heels?

As flat as I can get them.

NOTE: Content has been edited. Details can be found in the audio clips. Listen Wednesday mornings throughout March on WBFO and watch online for more "Savvy Over 60." #SavvyWomenOver60