Podcast Introduction (music playing): Welcome to Work Trends RU, presented by the Heldrich Center for Workforce Development at Rutgers, The State University of New Jersey. In this podcast, we speak with experts, policymakers, and thought leaders about issues affecting work, education, training, the economy, and well-being. Each episode of Work Trends RU provides insights into important topics like changes in the job market, economic challenges, and how artificial intelligence is shaping the future of work. Our guests share their thoughts and reflections on how public and private sectors can better address the needs of workers, job seekers, and employers. Join us as we discuss the evolving landscape of work and education on Work Trends RU. (music ends)

Carl Van Horn: Welcome to Work Trends RU. I’m Carl Van Horn, your host for today’s podcast.

Today, we’re very honored to have with us Tammy Murphy, who is the First Lady of the state of New Jersey, who has led important initiatives around nurturing families and mothers and children. And she’s going to talk about that and how it relates to workforce and improving our state and lessons for others in other states. So, we’re welcoming Tammy Murphy, we are so happy to have you with us today. And we are very honored to have you as our guest.

From the very beginning of this administration, I actually recall meeting with you during the transition. And you had asked me to prepare some suggestions for what your priorities might be as the First Lady of the state of New Jersey. And so, my colleagues and I put together a list and we were prepared to talk with you and we came and met, and you said I want to focus on improving infant mortality and childcare. And I said, okay, well, that’s a great idea. We’ll put ours in the wastebasket. And, of course, we knew you would focus on many other issues in your career. So, tell me what, now, almost seven and a half years later, would you point to as some of what you feel are the major accomplishments, and then we’ll talk about the future agenda. Let’s talk a little bit about what you feel you’ve accomplished so far.

First Lady Tammy Murphy: Carl, it’s going to be impossible for me to talk about one singular item or even a handful. So, I’m going to give you the big, broad, basket of things. I’m super proud of everything from the benchmarks that we have been able to share and to now be able to prove that we actually are making progress in this space. I’m really proud of just the creation upfront of Nurture NJ and all that that brings with it, family festivals and podcasts and Facebook live events. And I’d be remiss if I didn’t talk about the strategic plan we unveiled and we now made incredible headway on that. My husband, bless him, has signed over 70 pieces of legislation in this space alone over the course of seven years. And that’s ranging from everything from creating the first authority in the country that’s focused on maternal and infant health to Medicaid expansion across a whole range of areas. And then probably the singular piece of legislation that I’m most proud of and most excited about is Family Connects NJ.

But all of these taken together would not have happened without being able to go on a listening tour, raising community voices and making sure that…we have a saying in our office “not about us without us”. And, so, I’m really proud of that and I’m proud of what we’ve been able to do together and this whole huge movement that we’ve helped to create.

Carl Van Horn: So, I remember seeing a statistic that we were ranking sort of in the middle of infant deaths, for example. And, has that improved significantly or is that still not as good as we want it to be?

First Lady Tammy Murphy: Well, it’s not going to be as good as we want it to be until we’re number one. So, let’s just accept that up front. When we started out on this mission, New Jersey was 47th in the country for maternal mortality rates. And we now have managed to inch our way up to 28th. That’s still substandard. But saying that it proves that we can make a difference here. If we stay committed and we are dogged in our determination to fix this, what I would call a crisis, then we can actually become the safest state in the nation to deliver and raise a baby. But, you know, there’s not only just that one statistic, but there are quite a few others. We’ve moved from fifth to second in the nation for infant mortality, which is great. And we’ve moved from sixth to first for neonatal mortality. Just last year alone, we’ve improved a number of other rankings, going from 36th to 25th for breastfeeding and 32nd to 18th for severe maternal morbidity. So, there is absolutely room for improvement, but I do believe, again, with the steps we’ve taken and the number of partners we have activated across the state, truly around the country and the world at this point in time, we know what we have to do and if we are diligent, we can get there.

Carl Van Horn: So, I think a person not familiar with this might say, how could we have been in such a poor place because we’re one of the richest states in the country, right? So, was it a lack of attention? What was really missing that helped you move the needle so much? Because obviously there’s more to be done, but that’s a huge improvement from where you started.

First Lady Tammy Murphy: Yeah, if you boil it all down, this is inequity in care. This is systemic racism that has existed for ever. And it’s really just going in and tackling this head on and bringing other people with us. You know, we started out, it was just my little office trying to work on this. And what what we’ve been able to do is amass thousands of people across the state of New Jersey now who are not working in silos because I think that’s part of the problem is when people, you know, you try to tackle a problem and, especially this one, I mean we started out, just by way of example, with two of the departments and agencies within the administration working alongside us. I assumed upfront it would be Department of Health and Department of Family and Children’s. Today we have 22 agencies and departments working with us because it’s everything. It’s not just going to be checking a health outcome, it’s transportation getting to and from the doctor’s office. It’s having access to medical care. It’s having, you know, a birthing facility that’s accessible. It’s workforce development, as you rightly know. I mean, everything that we do and we touch in our lives impacts these outcomes. And so, everybody has to work together and pull their own share of the workload.

Carl Van Horn: Yeah, I’m glad you brought up workforce development because that’s obviously my area of interest and specialization. So, on that point, I mean, elaborate a little bit about that. What are the training and other educational initiatives that you’ve helped launch and supported through this initiative?

First Lady Tammy Murphy: Yeah, I mean, listen, we have expanded access to the entire perinatal workforce through Medicaid. A lot of this is through Medicaid. So, really hope that we can keep all of that in place, I have to admit, in this day and age. But we’ve expanded our doula care, our midwives, our community health workers. All of them have, we’ve improved access, we’ve improved repayments we’ve extended time that these different workers in the industry are able to focus on their clients. The community… The Family Connects NJ model is super interesting because we are now sending certified nurses into homes within two weeks of delivery, which means that… You know, in normal circumstances, a baby is seen at two weeks after being born and a mom is not seen for six weeks. So just by virtue of building up that one workforce, we are catching mortality, morbidity challenges up front. We’re checking on, you know, mental health challenges. We launched this program in January of last year, and as of today, we are now accessible to over half of the state. And just in the first year alone, of the 2,300 visits that were made by these nurses in just the first five counties, 17 % of those moms or babies were either referred back to their primary care provider or referred to the emergency room. And, all that means, as you obviously understand, is that those complications can be handled quickly and not make for a bigger challenge and a bigger cost to society, honestly, down the road. Then of the, you know, so 17 % sounds like a lot, but 75%, over 75% of the people who were seen were connected with additional resources. So, if you’d go back to my comment about having 22 partners in government who are providing services, whether it’s banking and insurance or Department of Environmental Protection or Treasury, all of these play a role here. And being able to refer moms and families for further resources that they might not know about, it helps everybody. I mean, Phil’s expanded paid leave; I mean, there’s so many pieces of the workforce development space that we have worked on and continue to work on here and now.

Carl Van Horn: Yeah, one of the other elements you’ve alluded to is some of the community-based organizations. And is this something where new organizations were created or was it bringing those along with you, the people that were in touch with their communities but needed to expand in this space?

First Lady Tammy Murphy: Yeah, you know, let me tell you, it’s probably both, it’s more, it’s more been about connecting people and making sure that they’re working together. And one example I will give you is in the very beginning, what we realized is that, you know, many communities didn’t have access to a lot of the government services, didn’t know about them. So, we created something called Family Festivals. And we’re about to have our 23rd Family Festival over the past seven years. Basically, a Family Festival, I think of it as kind of a cross between a job fair and a block party. We essentially bring the state, county, and local resources into communities that have had bad outcomes, have had bad outcomes historically, whether it’s infant mortality or low birth weight babies, you name it. There’s lots of ways that we can look at this. But we would take these, we created this festival where literally, we had tables set up, we offer free food and music, we, I would work with the faith community and the public school system and the local council and mayor’s office to make sure that the word got out that this is free and please join us. And I was worried because we set these things up for four

hours, the first one. And I remember the very first one. I was so gratified to see not just the help that was being administered on the spot, but also to see different providers swapping business cards and saying, “Hey, I had a client last week who could have what you’re offering here. Can I take that?”. So, I realized that what we were doing is creating, expanding the social safety net across the state. And so, the answer to your question is, think it’s really been just creating Nurture NJ has enabled a lot of these specialty, frontline, on the ground, grassroot movements to be able to come together, unite and lean on each other for support.

Carl Van Horn: Yeah, and connectivity and coordination are often underestimated when it comes to public policy. Everybody thinks first about money, but that is a question that I’d like to ask you, which is how much does it take? You alluded to Medicaid, of course, but incrementally do you have any idea? Is this really expensive? I mean, someone looking at this might say, well, that’s great, but, you know, we can’t afford it to do it in our place. Or is it more about intentionality and coordination and will?

First Lady Tammy Murphy: Listen, a lot of this costs money. I’m not going to, I’m not going to say it doesn’t. But, in my humble opinion, it’s basically being able to target people to understand the data that’s out there already and to coordinate. You know the Family Festivals, they they’re really inexpensive, but they are really impactful. I mean, we’ve helped over 15,000 families across New Jersey just by basically saying, can you show up on Saturday from, you know, eleven to three? I mean, it doesn’t take a lot. And we’ve had a lot of success leaning on a lot of foundations have helped us. But, you know, they’re really inexpensive to pull together.

Other things like the Family Connects NJ and Phil has put in, I think, 38, he has asked for 35.8 million in his budget to ensure that we can expand across the state. But I think at the end of the day, you have to look at supporting families. It’s making New Jersey healthier, it’s making people be able to be more productive in their lives. And it’s saving us all down the road so much in terms of healthcare costs and other challenges that we might face in society just by tackling challenges upfront. So, I guess at the end, the other piece that we are working on right now, which is pretty exciting, is we are, I talked about the authority, the first authority in the country. We are building in New Jersey, in Trenton, which is a birthing desert, which is a desert on many levels, you know, food desert. It’s really despite the fact that it’s our capital, as you know, it’s had grave challenges over time. And I’m really excited because this authority is actually going to be located in Trenton. And we are building an innovation and research center in Trenton, which will be the first of its kind in the country. If you think about all the cancer centers and all of the heart centers that are out there all across the United States, which obviously are needed, there’s nothing out there for moms and babies, nothing. So, this is going to be a real, not just a boost for New Jersey, but it’s also gonna be a beacon of hope, I think, for many. And we’re gonna share with anyone who would like to participate, you know, all the data, all the research that we’ve had so far. It’s gonna be an innovation research center, so we’re gonna encourage people to try and understand what certain innovative approaches can do to change this space. It’s going to be a perinatal training center, so there’s so much that’s going to happen there, and that is obviously going to cost money, but we’re on our way, and I’m really excited about that.

Carl Van Horn: Yeah, and you’ve already alluded to this, it saves money down the road and that’s the key point if you just take a fiscal perspective. Now, believe it or not, there will be another administration in a little bit. And you’ve already made a very good case of why they should continue that work that you and your colleagues have done. Are you feeling positive about that? That this is something we’ll endure? I’ve seen both. I’ve seen both happen in my career where people say not made here and they don’t want to do it and other people say, yeah, that’s fantastic, we’ll continue that.

First Lady Tammy Murphy: I’m sure I could go down the rabbit hole here and be pessimistic, but the fact of the matter is I am an optimist and I feel like we’ve been thinking about this. I’ve been concerned about what happens to this initiative since day one. Since we started seeing that we could make progress, I’ve been concerned about what happens when Phil is no longer the governor and where does this all go?

And that had led to creation of the strategic plan, which has 80 actionable steps of which we’ve already either completed or started over half of them. It led ultimately to what my vision was, which is this center that will be a convening place and a resource for everybody going forward. And, so, with the creation of this authority, which is pretty difficult to unravel, I think. I do believe, I do have reason to feel optimistic that this will continue. And again, I’ve sat in the well for dozens of Phil’s speeches, whether it’s the budget address or the State of the State. And I can assure you there’s a lot of things that are raised that are not bipartisan. And I can assure you that when it comes to maternal and infant health, everyone agrees. Both sides of the aisle, this is not a question of whether or not it’s a Democrat or a Republican topic. It’s just not. It’s healthcare and it’s moms and babies. So, I’m hopeful, Carl.

Carl Van Horn: Well, I’m sure you’ll be giving advice to whoever comes into the next administration about how to do that. And as a person who believes a lot in data, and I know you do, too, I think having the data to prove the progress is also critical because at the end of the day, yeah, you’re right. It is who can be against babies and moms? But on the other hand, having the data prove the long-term benefit and what you’ve already achieved is, I think will be very important.

First Lady Tammy Murphy: Yeah, me too. I’m hopeful.

Carl Van Horn: So, if you don’t mind, I want to switch topics to sort of a very fun thing, which is I like to have everybody that I interview talk a little bit about their first job. And your husband did that and that was a very entertaining answer. At least I found that most people remember that very well and got some important lessons from that. So, what was your first job? What did you reflect from that? And what do you think you learned in that?

First Lady Tammy Murphy: Yeah, well, first of all, aside from the random babysitting and leaf raking jobs or whatever they might be around the neighborhood, my first consistent job was actually doing odd jobs, I guess I would say, at my father’s business. My father was a small business owner. He was a car dealer back in the day. And, so, I did everything from answering telephones to helping in the service department or the parts department, counting objects. Not all of it was particularly stimulating, but at least it was rewarding in a couple of respects. So, that’s my first job. And I think what I would tell you I remember is, and has been most impactful, is first and foremost, my father always said, and I do believe this in my heart, that as the Woody Allen quote goes, “80% of success is showing up”. And, so, I have never forgotten that. I think it’s incredibly important, whether you’re in school or whether you’re in your job that that’s part of it. And then secondarily, I would say that, you know, not only the feeling of being able to give back and earn your own money, I’ve never forgotten the feeling of being a contributing member of something, of an initiative. And I believe in all of my heart that those who say that people want a handout, they’re wrong. No one wants a handout. Everybody wants to feel like they have purpose. And, so, I’ve always tried to make sure that those around are given the ability to step up or lean in or do whatever they can.

So, those will probably be the biggest takeaways.

Carl Van Horn: That’s great. Thanks so much for sharing that.

Well, Tammy, thank you very much for sharing all of your work and success with our audience. We wish you the best as you go on to the next phase of your career, which I’m sure will be full of additional impact and success. Thank you very much.

First Lady Tammy Murphy: Thanks, Carl. It was great to see you and thanks for having me today.

Podcast Close (music playing): Thank you for joining us on today’s episode of Work Trends RU, where we explore the issues affecting the future of work, education, and how the workforce can be better supported by both the public and private sectors. Tune in next time as we continue our conversations on the evolving landscape of work and education. (music ends)