Brick by Brick
This regional community affairs program is about exploring solutions to complex problems in Southwest Ohio. This podcast is a companion piece to our larger project. Visit https://www.cetconnect.org/BrickbyBrick/ to learn more.
Brick by Brick
Feeling the Pain of Medical Deserts
Millions of people live in a medical desert, meaning they have inadequate access to healthcare, both in urban and rural settings. There are a variety of reasons why, including distance to a hospital, lack of broadband internet, lack of transportation, and a shortage of healthcare workers. Despite these challenges, there are solutions. Brick by Brick examines workforce training and school-health center partnerships.
Interview guests: Ohio Governor Mike DeWine, Hamilton County Commissioner Alicia Reece, Chief Rural Correspondent KFF News Sarah Jane Tribble, Ohio Alliance for Population Heath Community Health Worker Lead Kerri Shaw, North Mason Fire Chief Beau Bakken, Retired Cincinnati Medical Director of School and Adolescent Health Dr. Marilyn Crumpton, Fayetteville-Perry Local Schools Superintendent Tim Carlier and Director of Curriculum and instruction Jennifer Spaeth Mullis.
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Ann Thompson:
Have you heard the term medical desert?
Sarah Jane Tribble:
They're basically places that lack healthcare providers, primary care doctors, nurse practitioners, and also behavioral health workers.
Ann Thompson:
According to a 2025 study, one in three Americans live in a medical desert and that affects the kind of care they receive. Many of these patients have lower incomes and are without healthcare insurance.
Monica Stobart:
Working in a setting that I do, I had just run into a lot of the patients that we were seeing. They were losing their lives because they didn't have access to healthcare.
Ann Thompson:
Medical deserts can be both urban, If you don't have transportation, and rural if facilities are too far away. Nearly 50 million people in the US live more than an hour away from a hospital equipped to handle major traumatic injuries. This small town fire chief recognized the problem and took steps to solve it.
Chief Beau Bakken:
The fire department was becoming the healthcare provider, not just emergency healthcare provider, but the overall healthcare provider.
Ann Thompson:
Another possible solution involves pairing schools with healthcare facilities. Ohio's governor believes schools can bridge the gap in healthcare.
Gov. Mike DeWine:
Instead of people having to drive 20 to 25 miles, they're going to be able to get healthcare right here and we know that's going to improve the quality of healthcare.
Ann Thompson:
That's state money. New federal money is also being pledged 50 billion over five years for things like workforce development and tech innovation.
Kerri Shaw:
That's funding that is going to help rural healthcare systems across the country, and it will be a competitive process to access those dollars
Ann Thompson:
On this episode of Brick By Brick Medical Access. Who has it? Who doesn't? And how can everybody get it? There are many possible solutions. We're focusing on workforce training and school-based health centers. Let's get into it. This is Brick by Brick Solutions for a thriving community.
Ame Clase:
Brick by Brick is made possible thanks to leading support from Greater Cincinnati Foundation, AES Foundation and George and Margaret McLane Foundation, with additional major support from Laurie Johnston, The Robert & Adelle Schiff Family Foundation, Murray and Agnes Seasongood Good Government Foundation and more. Thank you
Ann Thompson:
Hello, and welcome to Brick by Brick, where we're highlighting solutions for a thriving community in southwest Ohio. I'm your host, Ann Thompson. Lack of medical access continues to be an issue for millions of Americans. What can be done to solve it? Today we're focused on just a few slices. Workforce development as an effort to fill the shortage of healthcare workers and school-based health centers, which provide medical care not only to students, but also the community. The healthcare company GoodRx started tracking medical deserts in 2021 and since then has found the problem of inadequate access of healthcare has gotten worse in the last four years. More than 1300 pharmacies have closed. The shortage of medical personnel and hospitals has grown. Good Samaritan Hospital in Dayton shutdown in 2018. Cincinnati's Drake Hospital closed this year and faced with more expenses, hospitals are continuing to cut costs. Federally funded health centers remain at risk of closure, including three Montgomery County nursing homes and 10 in Hamilton County.
Planned Parenthood clinics in Springfield and Hamilton have closed. GoodRx says Preble County has the most healthcare deserts in southwest Ohio. Six with not enough pharmacies, primary care doctors, hospitals, hospital beds, trauma centers, and health centers. You can find the GoodRx map on our website at cetconnect.org and think tv.org. The State of Ohio has its own map. It shows types of health provider shortage areas. It recognizes the key is recruiting providers to those areas. The state operates 10 workforce programs, nearly all of which have a goal of increasing providers in those regions. Brick by Brick reached out to area hospitals to see what they were doing to improve medical access. We heard back from a few including Cincinnati Children's Hospital, which is expanding its regional sites of care, including a new medical building in Clermont County's Eastgate area, and it's added a new school-based health center in New Richmond. As we hear back from more hospital groups, we'll share it out. You might be asking What about telehealth? Sarah Jane Tribble is the chief rural correspondent for KFF News, a leading health policy organization, formerly known as the Kaiser Family Foundation. Tribble took a deep dive into healthcare deserts and its challenges
Sarah Jane Tribble:
During COVID. We heard a lot about telehealth. In fact, there was a lot of initiatives and funding put forth through Congress for telehealth, and it was sort of referred to as a solution for people who couldn't leave their homes and certainly a possible solution for people in rural America where there wasn't enough providers. But what we found was in today's world with telehealth, you often want to do video calls so the doctor can fully see the patient they're dealing with. You need high-speed internet for that, and many homes don't have that.
Ann Thompson:
This is particularly true in the Appalachian Southeast. According to KFF’s analysis, Ohio has a higher than average percentage of residents in rural areas. Nearly 24%. KFF found Adams Brown and Highland Counties lacked adequate broadband and is not just the presence of broadband, but how fast it's triple traveled around the country. Finding example after example. Leroy Walker was hospitalized in Alabama. The hospital had high-speed internet, but Tribble found it wasn't fast enough for the hospital monitoring systems.
Sarah Jane Tribble:
So I went into his room with his permission as a reporter, and I noticed he was hooked up to an insulin IV bag, but nothing else. There were no heart monitors on him and he had come in with shortness of breath and a history of high blood pressure, but there were no heart monitors on him and something started beeping and Leroy and I kept talking and we just kept talking because we expected somebody to come
Ann Thompson:
Because of the weak signal, it took some time for somebody to come and Leroy was ultimately fine. Proximity is also a problem. Statistics show more than 28 million people live over 30 minutes from the nearest hospital, and nearly 50 million live over an hour from a hospital equipped to handle major traumatic injuries and staffing shortages continue to complicate the issue. One assessment found in some primary healthcare deserts, there is only one full-time primary care professional for every 8,000 people. More than double the ratio recommended stretching healthcare access even thinner in those areas. On top of all that, millions of Americans are preparing for Medicaid cuts. Over the next decade, Ohio was estimated to lose 37 billion in funding the seventh largest amount among states in the us. Brick by brick will be following the effects. There is some potentially promising news. The federal government is taking steps to shore up medical access in rural America. It is introduced a $50 billion rural healthcare transformation program. Here's KFF’s, Sarah Jane Tribble again.
Sarah Jane Tribble:
So what's sort of exciting about that when I talk to the experts who are watching it is that it's a transformation program and they expect it to go to innovative ideas. And when you read the law, it talks about using technology to improve the health outcomes of people in rural areas. So the future could hold a lot of promise.
Ann Thompson:
The Ohio Health Department is applying to the program before the government shut down. The Centers for Medicare and Medicaid services was set to announce grants December 31st. We'll see if that schedule holds. The State of Ohio was announced $88 million to support public health and workforce development in Appalachia. One of the recipients is the Fayetteville Perry local school district in Brown County east of Cincinnati, brick by Brex Horns Legger Jr. Investigates, what a difference a new community health center can make
Hernz Laguerre Jr.:
Governor Mike DeWine stopped by the Fayetteville Perry local school district in Brown County, Ohio to see teachers sit in on lessons with students and to witness the development of the Rocket Community Wellness Center, director of Curriculum and Instruction, Jennifer Space Mullis and superintendent Tim Collier talk about how the community's needs aligned with the governor's vision.
Jennifer Spaeth Mullis:
Two of his big focus pieces in his administration have been literacy and rural healthcare, like the absence of rural healthcare, especially in the Appalachian area.
Tim Collier:
We're a small rural area. We don't have any type of health services, medical services in the township. So where are they going?
Hernz Laguerre Jr.:
And thanks to the Appalachian Community Innovation Center's grant program, Fayetteville Perry is one of 11 school districts to receive resources to provide a new school-based health center. According to the school board members, Rachel Ray and Merri Kay Atkins, this center will remove a major barrier to healthcare in the community.
Rachel Ray:
I know in the past 26 years that I've been here, it's been very little opportunities for people to receive care here locally, especially specialized care, occupational therapy, physical therapy, any kind of counseling, and that you're driving an hour no matter what, and that limits our families and our community as to what they can do and to get the care that they need.
Merri Kay Adkins:
We've been without a physician now for at least 15 years or more. This has been a long time coming for our community.
Hernz Laguerre Jr.:
The Rocket Community Wellness Center won't be complete until the summer of 2026, but Brick by Brick wanted to know how effective these centers are. So we looked at the school-based health centers in Cincinnati, retired medical director of school and Adolescent health. Dr. Marilyn Crumpton explained the unique history of the city providing primary care
Marilyn Crumpton:
In the beginning. It was done through city funding. In 2009, the city was able to get their healthcare approved as a federally qualified health center, which meant they were eligible for federal funding. The research that had been in process about school-based health centers and improving education and health outcomes for children really fit well into that opportunity
Hernz Laguerre Jr.:
Through a community-based effort and multiple health providers. About 25 Cincinnati public schools have a school-based health center, are in the process of getting one or have transportation to get to the nearest location.
Marilyn Crumpton:
When you've been to one school-based health center, you've been to one school-based health center model because they fit the people they serve.
Hernz Laguerre Jr.:
One of the shining examples of this program can be seen with the K through 12 or public school in lower price hill. We spoke to the nurse practitioner that served the school during the early stages of the center in 2006, Dilruba Rahman.
Dilruba Rahman:
So I came here. There was no setting but the principal at that time, Craig Huckberry, he put me in a little closet space in a room and that's how I started here
Hernz Laguerre Jr.:
Today with more funding along with the collaboration of community groups and medical institutions, Oyler now has a full functioning health wing with patient rooms for primary care. They also have dental vision and more as a result of these services in the school, attendance has improved.
Dilruba Rahman:
We try to keep the kids in school so they don't miss school days. I take care of anything, everything for them. The biggest problem in this community, parents have a transportation issue. They cannot leave their job. They don't have a transportation to come and pick up the kid and take the kid to somewhere else. We have a one-stop shop here.
Hernz Laguerre Jr.:
Students and faculty alike depend on Oyler’s Health Center like Senior Magia Seymour whose only primary care physician is Ms. Dilruba.
Meijas Seymour:
With physicals and stuff. I feel like they get it down like that. Our health clinic is very, very important to oiler. All our athletes come here to get their physicals and stuff like that.
Hernz Laguerre Jr.:
O’Nyai Moore, a sophomore who had multiple visits in Ms. Del Aruba's office for general needs over the years.
O’Nyai Moore:
Having a health clinic in your school, it helped with a lot. You don't got to keep going to doctors and to hospitals. You can just come here, come here for your checkups, come here for your physicals. Everything you need is here.
Hernz Laguerre Jr.:
Even principal Kayla Brunswick has benefited from the clinic.
Kayla Brunswick:
I know I had strep throat one time and she also got me in very quickly to let me know that I did have strep throat, so that was really nice too. The community definitely trusts what we have here in the health clinics
Hernz Laguerre Jr.:
And that trust is the foundation of these health centers. Governor DeWine says Trust is the reason why schools serve as the right location to provide more medical access to students and the greater community.
Gov. Mike DeWine:
We're doing this in a number of schools around the state and it really just boils down to people need to have a trusted place to go and there's no more trusted place than their local school. So putting it here in the school means school kids will have access to it, but also the whole community will have access.
Ann Thompson:
Thanks for that story. Hernz. We heard you list some of the examples of what these health centers can provide. What service do you see impacting the community the most?
Hernz Laguerre Jr.:
I think what will have the most impact are pharmacies. The folks at Fayetteville told me that they don't have a pharmacy nearby and that folks have to drive 20 to 30 minutes out, which leads to a lot of people toughing it out if they have an ailment, the center will bring more convenience by having a pharmacy right there. Similarly, Oler brings convenience by having medicine delivered to the school so parents don't have to leave work and students don't have to leave school in order to get the medicine that they need.
Ann Thompson:
Your story certainly points to the importance of having a school-based health center.
Hernz Laguerre Jr.:
And what's great is that is also self-funding. In the case of Oyler, they use insurance and Medicaid in order to fund their program. So not only is it good for the students in the community, it's also self-sustaining.
Ann Thompson:
Thanks Hernz. We'll talk to you on the takeaways.
Hernz Laguerre Jr.:
Sounds good.
Ann Thompson:
Ohio University has a good understanding of the lack of healthcare access because its main campus is an Appalachia in Athens, Ohio. 10 years ago, it applied for and received a grant from Medicaid to start a certified community healthcare worker training program benefiting 20 counties in southern Ohio. Carrie Shaw directs it and explains how having community healthcare workers can help,
Kerri Shaw:
I like to think of them as the connective tissue of our systems, so they're liaisons between the patients or clients that they're working with and all the healthcare and social services systems that are out there that they might need to connect to. And so having a real understanding of the needs that folks have and what gets in the way of them being healthier and really helping to eliminate those barriers to access for healthcare.
Ann Thompson:
Ohio University recruits all over the state for the free program and the only requirement is the student has a high school diploma or the equivalent. Monica Stobart has been an EMT for 14 years and decided to enroll
Monica Stobart:
Working in a setting that I do. I had just run into a lot of the patients that we were seeing. They were losing their lives because they didn't have access to healthcare or they didn't have insurance or they couldn't afford their medications or they just didn't have transportation to get back and forth to the doctor. So it was something that weighed heavy on me for a very long time and I was like, I'm just tired of being reactive to the problems. I want to find a solution.
Ann Thompson:
Stobart says, the Certified Community Healthcare Worker Program teaches things like resources, how to approach people, and where to bridge the gaps. Associate professor Kerri Shaw recalls a practical example.
Kerri Shaw:
We had a community health worker who was doing a home visit and realized that a gentleman didn't know how to prepare food except for it to deep fry his food, and so she helped him learn how to cook, how to grocery shop, how to read a recipe, and what all of that meant. And so he actually lost over a hundred pounds, threw away the deep fryer, and his A1C levels for diabetes dropped several points.
Ann Thompson:
More than 500 community healthcare workers have graduated from this program, which has also been funded by the CDC, the Ohio Department of Health and others to keep up with employment needs. Shaw says there's also a youth model and a class for new Americans in Dayton. These are students who have healthcare degrees or experience in their countries of origin, move to the US and are trying to get their foot in the door. Here we've been talking about responses to improve medical access in rural areas, but neighbors in our urban areas are also experiencing barriers. Coming up on Brick by Brick, a look at how the 5 1 3 relief bus is taking care on the road.
Commissioner Alicia Reece:
Hamilton County on Wheels, we've gone over 200 locations, we have over 30 plus partners, and we deal with a lot of different things
Ann Thompson:
And proof that model is working in another part of the country
Chief Beau Bakken:
Our mobile Integrated Health is taking folks out of the emergency system, keeping out of the ER, reducing our call volume, and then again providing a lot better outcomes for our patients out there in the field.
Ann Thompson:
That's ahead. When Brick by Brick continues,
Ame Clase:
Brick by Brick is made possible thanks to the generous support of so many, including Diane and Dave Moccia, P & G, The Camden Foundation, The Stephen H. Wilder Foundation, TJ and Susie Ackermann, Patti and Fred Heldman, a donation in memory of Frank and Margaret Linhardt, and more. Thank you. We couldn't do this work without you.
Mark Lammers:
Hey, we all have a different story even if we grew up in the same neighborhood or city, especially if we're talking about housing stories. Hi, my name is Mark Lammers, executive producer for Brick by Brick. Growing up, I lived on the west side of Cincinnati in a single family home, but I've also experienced apartment life in good and bad settings in a number of different cities. I learned a lot from those times in my life and from my journey as a whole. Now we want to hear about your housing story. That's the new audience question that's live on our show pages at thinktv.org and cetconnect.org. Log in and hit the green button to share your journey and what you learned from it. We hope to share some of your experiences and lessons as we move forward on Brick by Brick so we can all get smarter together. Thanks.
Ann Thompson:
Welcome back to Brick by Brick. Have you seen a big bus with the numbers 5 1 3 on it driving around Hamilton County. It brings medical care and a long list of other services to our neighbors. On this day, it was parked at an Avondale Health Fair.
Michael Dunham:
I had my blood pressure checked, my glucose. When I leave you guys, I'm getting ready to get a cancer screening.
Ann Thompson:
Michael Dunham says The 5 1 3 Relief Bus is a place to get your medical answers. That's what Hamilton County commissioner Alicia Reece likes to hear. It was the beginning of the pandemic when she was trying to figure out how to get COVID shots to people and heard of a successful effort on a bus at Virginia's Hampton University.
Commissioner Alicia Reece:
So I decided to get on a plane and go to Hampton right in the middle of the heavy part where they said, don't travel. When I got down there, I got a chance to see this huge RV and I said, man, this is it.
Ann Thompson:
The county partnered with UC Health to acquire a bus and medical personnel who drove around giving residents COVID vaccines. Since then, it's added dozens of other services with partner agencies serving more than 30,000 people since the beginning. The bus goes way beyond medical tasks to include rental assistance, birth and death certificates, unclaimed funds, expungement and help finding a job.
Commissioner Alicia Reece:
We still have ARPA funding and that is the primary of the bus funding, but we have modeled it in where this will now become a part of Hamilton County Services.
Ann Thompson:
Travina Adams runs the 5 1 3 Relief Bus.
Travina Adams:
So people are very grateful we get Thank you. We appreciate it. I didn't even know I needed this. We get how amazing it is to have all the services in one place.
Ann Thompson:
Katrina Davis is one of those people. She talked to Brick by Brick at the Avondale Health Fair.
Katrina Davis:
I would say for us the 5 1 3 bus look, get on social media and find out where they will be located because they pop up all over Hamilton County.
Ann Thompson:
The bus has been so successful. Commissioner Reece gets out of town calls about it.
Commissioner Alicia Reece:
I've had people call me all the way from Canton, Ohio, can you get that bus over here? We need it. And my response has always been like, oh, move to Hamilton County and you have access to it. But I would imagine others will be looking at us Model.
Ann Thompson:
Hamilton County is now looking for ways to include eye exams and dental care. Taking medical care on the road is also proving to be successful in a tiny town in the state of Washington. Belfair across Puget Sound is a medical desert. Residents used to just call 9 1 1 if they needed medical attention, even if it wasn't an emergency, and because of that, there was a 30% increase in the number of calls to the fire department. Chief Beau Bakken had to do something.
Chief Beau Bakken:
The fire department was becoming the healthcare provider, not just emergency healthcare provider, but the overall healthcare provider.
Ann Thompson:
That's when the department with funding from the local hospital started a mobile integrated health program. It hired a physician's assistant, a nurse, and a psychiatric nurse practitioner. It now asks residents to call the fire department before individual medical cases get out of hand.
Chief Beau Bakken:
So they can call here at the fire station or they can stop in. We have a little clinic space that's part of the fire station, and they can actually come in and or have our unit deploy and be seen out there in the field before the 9 1 1 system is even activated.
Ann Thompson:
And for the first time, emergency calls have started to go down. What do residents think of the service that began in 2023?
Chief Beau Bakken:
Where do I start? Tears, hugs, gift cards, notes of changing lives. It's the best thing that we've done in the 30 years that I've been done here. Like I said, I'd love to see this in every rural fire department in America.
Ann Thompson:
This model and others are seeing success. There are limitations money. As hospitals face their own budgetary challenges, will their partnerships continue? Hamilton County uses leftover COVID funds for its 5 1 3 relief Bus. Commissioner Reese is in the process of baking the bus into the budget. Fire Chief Beau Bakken pointed out something else.
Chief Beau Bakken:
Competition is one right dollars make the world go round, and if you all of a sudden start pulling patients from an ER for a hospital or from a local provider and whatnot, now we're starting to compete for dollars that are out there. That has not been the case in Belfair, but I can see that in other areas.
Ann Thompson:
Other limitations for creating greater medical access include lack of broadband internet service. The state of Ohio has announced a $50 million investment in support of broadband expansion in Clermont, Brown and Adams counties. State workforce training programs continue. Is it helping to ease the shortage? National government data shows 623 hospitals anticipate a critical staffing shortage and projections from the Bureau of Labor Statistics estimate US Healthcare Organizations will have to fill more than 203,000 open nursing positions every year until 2031. Some have hope. The new government Rural Health Transformation program that we mentioned earlier will make a difference. It focuses on sustainable access, workforce development, innovative care and tech innovation. Half of the 50 billion in federal funds will be allocated to states over five years. The other half will be distributed based on things like the percentage of rural communities.
If you want to learn more about medical deserts and ways to increase medical access, be sure to head to our show webpage on cetconnect.org and thinktv.org. That's where you'll also see related articles, a link to the podcast and Hernz and Emiko’s video stories as well as online extras. There are also a couple of big green buttons there for you to provide ideas and feedback. We'd like to hear from you. Speaking of the web, that's where we can drill down in a lot of the data-driven stories that we've told you about right here it is a lot of information, so let's take a few seconds, let it all sink in, and we welcome the team to the microphone. Hi to Emiko Moore.
Emiko Moore:
Hello
Ann Thompson:
And Hernz Laguerre Jr.
Hernz Laguerre Jr.:
Hello
Ann Thompson:
Hernz, what are your thoughts?
Hernz Laguerre Jr.:
Yeah, I think there's a couple of things that resonated with me, but the main thing was what one of the board members from Fayetteville shared, she's been living in Fayetteville all her life and for the past 60 or some odd years, and she said there's been a 20 year span where there hasn't been a primary care physician within a 30 minute drive from where that school is. So she said, being that people had to drive so far to get x-rays, blood work drawn and all that stuff, it created a culture of people seeing health as an inconvenience, seeing if they had an ailment or something, they would just wait it out as opposed to traveling so far in order to be seen and then
Ann Thompson:
It could go bad
Hernz Laguerre Jr.:
And then it can go bad. So I think having this health center is going to make such a difference to the lifestyle and the health of that community.
Emiko Moore:
And it sounds like the school is really the hub of the community, so it's a place that people know where it is. It's a trusted place for them to go. I think about the parents who have to take their children to a doctor. If you have to go 30 minutes to an hour away, that's half a day off of school for your student. They're going to miss a lot of school. Whereas if you had right on the premises, maybe that doctor appointment is 30, 40 minutes and you're back in class.
Ann Thompson:
Yeah, so true. And I want to call out Monica Stobart again, who you heard from in this episode. She had been an EMT for 14 years and decided to enroll in Ohio University's community health worker program. These are workers that can help bridge the gap and let patients know different programs that are available. For example, she said she was tired of being reactive to the problems and she wanted to find a solution, and I was so impressed that one of these workers was able to help a gentleman who needed to eat healthier, who only knew about fried food, and here they were able to teach him about how to grocery shop, read recipes and cook.
Hernz Laguerre Jr.:
That's pretty awesome.
Ann Thompson:
We realized that we focused on just two possible solutions for medical access and there are more. And so just know that we'll be drilling down on some more of those in the future.
Hernz Laguerre Jr.:
Sounds good. Cool. Looking forward to it.
Ann Thompson:
Thanks guys.
Emiko Moore:
Thanks.
Ann Thompson:
Coming up on the next Brick by Brick Food Insecurity part two, we look at the role food banks and food rescue organizations are playing.
Jori Novotny:
So when people do find themselves ultimately turning to us for help, they've tended to attempt every other thing they can think of to cope.
Ann Thompson:
The government shut down and changes to SNAP benefits. Make this episode even more relevant. Stay tuned.
That's our show. We hope you learn something and if you did, please share it out with your friends and family. And if you could please rate and review our podcast. We'll make it easier to find for Hernz Laguerre Jr. And Emiko Moore, I'm Ann Thompson. We'll be back soon with more solutions. Take care.
Our show is produced, hosted an edited by me, Ann Thompson with reporting and story editing from Hernz Laguerre Jr. and Emiko Moore. Our Executive producer of Mark Lammers. Audio sweetening provided by Mike Schwartz. Zach Kramer runs the lights and cameras. Derrick Smith is our production specialist and Jason Garrison is our production manager. Kellie May heads up our marketing and promotions, along with Mike Shea and Bridgett Dillenburger. Elyssa Stefenson handles the website and Josh Lusby and Steve Wright are our designers. Bill Dean and Andres Kruza are the engineers for the show and our Chief Content Officer is Colin Scianamblo. Our music is from Universal Production Music. Brick by Brick: Solutions for a Thriving Community is a production of CET and ThinkTV, Southwest Ohio PBS member stations.