In the aftermath of Crozer-Chester Medical Center’s abrupt closure last spring, the Chester community has been left without a central hospital. The closure occurred almost ten years after the hospital was acquired by Prospect Medical Holdings — a private equity company — which filed for bankruptcy earlier this year. The Crozer Health collapse displaced over 3,000 healthcare workers and deepened long-standing healthcare inequities in the city, forcing many to seek care at sometimes dangerous lengths. At the center of the city’s response is Dr. Kristin Ball-Motley, Chester Health Commissioner and founder of the nonprofit Health Educated and Health Care Solutions Delaware Valley, who has worked to connect residents with healthcare resources, advocate for health needs, and reimagine what local healthcare could look like in Chester.
This transcript is a condensed version of the original interview, broadcast on July 31 from CMP Radio in Chester.
Ella Walker: I’m here with Dr. Kristin Motley today, the Health Commissioner of Chester. This interview will focus on the current health landscape in Chester, with particular attention to the closure of Crozer Health and its impact on emergency response in the area, as well as the role of local leadership and community initiatives. Could you start by introducing yourself and your role as Health Commissioner?
Kristin Ball-Motley: So I’m Dr. Kristin Motley, born and raised in the great city of Chester, PA, and I have a wonderful opportunity to join the city of Chester and the Bureau of Health as Health Commissioner, a role that I was honored to be offered, and a role that I had a good understanding in terms of what I wanted to do when I started this job.
But, things changed fast when Crozer started to deteriorate. And so it’s been interesting. It’s a lot of work. I’m a Bureau of Health of one, although I have an amazing group of people and organizations around me that have supported me in a number of ways. And so I’m not doing it all alone, but it does feel lonely sometimes.
EW: As a Chester native, how have you seen the city’s healthcare system evolve over your lifetime, and how does that compare to the developments in the past year with the closure of Crozer?
KBM: Crozer Health has been a staple in the community for decades. I was born in Chester at a former Crozer building, and they were the go-to place. We had all the top specialists, we had the burn center, we had a great community of health care providers, some who have been working at Crozer for years, for decades, especially their labor and delivery team; those nurses have been there for 30 to 40 years.
We had providers that knew the community, that knew the needs of the community, and that were able to meet the needs of the community, and so it’s just really heartbreaking to see what has happened and what has been allowed to happen.
EW: You are the founder of two prominent healthcare organizations in Chester: Healthcare Solutions and Health Educated. How has operating these two foundations been since the hospital’s closure?
KBM: Healthcare Solutions of Delaware Valley is a for-profit. I started that over ten years ago, mostly to help people who could not afford their medications. And so that has evolved into a consulting firm. Now, I mostly work with organizations on employee health and wellness, employee engagement strategies, and do some DEI work in that space for employers.
Health Educated is a nonprofit that I started during the pandemic. During that time, when COVID came on the scene, there was a need to educate the Black and Hispanic communities about COVID and vaccines. I was tapped by a number of organizations to help with those efforts, and that’s how Health Educated was born.
It is all about educating the community about health topics so that they can make informed decisions. We educate health care providers on how to take better care of people from marginalized communities, and we also expose young people to advanced careers in healthcare, because we know that you can’t be what you can’t see. We want to give young people, especially those from marginalized communities, an opportunity to see themselves through healthcare.
EW: With the absence of a major healthcare provider for the community, what resources have you been directing the community to for support?
KBM: Most of my work has been done through my role as Health Commissioner before Crozer started to crumble. Mainline Health had reached out to me when I became commissioner to ask: How can they support Chester?
Even when Crozer was here, we didn’t have enough primary healthcare providers to meet the health needs of the community. And so knowing that, I wanted to address the environmental issues that are plaguing this community, and I also wanted to bring in more healthcare providers in pediatrics and for adult medicine. We have a dismal infant mortality rate, and so we were working to even look at a newborn clinic. Crozer Pediatrics closed a few years ago, so that took away a number of pediatricians who were here to care for children.
I also wanted to bring in volunteer healthcare providers who could help to serve the primary care needs of the community. I was looking to start a clinic or a volunteer-based community service. And then we got the announcement that Prospect may be filing for bankruptcy.
It just derailed everything that I thought I was going to do in this role.
Once they filed for bankruptcy, I was already in conversations with Mainline Health. They described to me Together from West Philadelphia — an initiative to get people from West Philly connected to health care providers — I said, “We could do something like that in Chester.” Then we started Together for Chester.
Now, through Together for Chester, we help people get connected to health care providers throughout the region, since we historically haven’t had any. It was going to get done regardless of whether Crozer closed or not. But once Crozer started to crumble, we expedited the process.
EW: Beyond pediatric care, what are some of the pressing healthcare needs of Chester?
KBM: Chester is home to a number of polluting industries. On top of that, we deal with pollution from a number of other sources: fuel emissions from I-95, as well as an industrial highway with emissions that run through Chester. We are also home to a number of chemical manufacturing firms. We have the country’s largest trash incinerator.
And so that comes with pollution. It comes with toxic air pollutants. You have to breathe to live, and you can’t see these things, but you see the results of them. You see the infant mortality, which is five times the national average. You see the disproportionate rates of cancer, heart disease, and kidney disease for Chester residents.
The other thing is lead. A lot of the homes in Chester were built decades ago, long before lead paint was banned. And so lead is still prevalent in our community, and its impacts are devastating. As long as our children are exposed to lead, I don’t see the plight of Chester improving.
EW: Even before the closure, do you think Crozer was adequately meeting the needs of the Chester community?
KBM: That’s a good question because the hospital closed about three months ago, but we still led the state [before then] in pediatric asthma and infant mortality. I think that there was still a lot of work that needed to be done. People were not getting the care and education that they needed. That drove a lot of the numbers that we saw.
The pollution is causing the problem. So if you are not doing anything about the pollution, then you’re not going to do anything about pediatric asthma, right? Air pollution is a big part of what is driving the health outcomes in Chester.
If we’re not doing anything to protect our air, then we are not doing anything to protect our people.
EW: [Pennsylvania Governor Josh] Shapiro recently proposed legislation to rein in private equity in healthcare, aiming to prevent the abrupt closure that happened with Crozer. How effective do you think legislation like this will be in avoiding catastrophes like Crozer?
KBM: Unfortunately, it didn’t help us, but it will help other communities around the state and prevent them from the torture that we are currently going through in Chester. It’s a step in the right direction.
[Prospect Medical Holdings has] a playbook that they have used around the country. They capitalized on all the assets that Crozer had to offer. They did it in a beautiful way that did not break any laws. It is so unfortunate that it came at the sake of our lives.
EW: What do you think it would take to restore healthcare in Chester for the long term?
KBM: I think it’s going to take people who care. I don’t see Chester existing without a hospital. We can’t be the home of the state’s environmental polluting agencies and be expected to exist without a hospital.
There has to be a hospital. We’ll just have to build it ourselves.
I reached out to the governor’s office about this. I requested that we have a seat at the table when decisions are being made in terms of which health care provider will be coming to this area. We talked about them helping us to rebuild the healthcare infrastructure. I also asked for a feasibility study so that we can learn what healthcare infrastructure we need to have here in order to take care of the specific needs of the community.
What I’ve seen over time, and not just in the healthcare space, is that decisions are being made about people who live in Chester, and there’s no one from Chester at the table.
EW: You’re operating in a dire landscape in healthcare. What gives you hope in your work on a day-to-day basis in your efforts to rebuild healthcare in Chester?
KBM: I know as long as I’m working and I have the support of people around me, we can get something done together. The mayor has been very supportive. I’m not sure if he knew what he was getting into when he asked me to come on board. But every idea I bring to him is met with a “yes.” I’m really fortunate to have a great team behind me at work and the support of the community.
EW: How do you spread that hope to members of the community?
KBM: Just know that as long as I’m around, I am advocating for Chester, I am fighting for Chester, and I am asking for resources. I am doing everything that I can in my power to do something.
