Paul Enderson, Executive Director, North Carolina, Youth Villages

In an interview with Invest:, Paul Enderson, executive director for North Carolina at Youth Villages, shared the organization’s recent milestones, including significant growth in service capacity, the impact of inflation on operations, and the importance of holistic care in addressing the needs of children and families.

What were the most significant milestones and achievements for Youth Villages in North Carolina over the last 12 to 18 months?

When discussing milestones, it’s always helpful to start from the beginning. Youth Villages is a large, multistate organization, and we’ve been in North Carolina for about 20 years. We started small, very local, and have grown significantly since then. We’re now statewide, with 10 locations across North Carolina.

When we look at milestones, we consider how many children, families, and young adults we are serving. Currently, we’re serving more kids on a daily basis than ever before. We measure our capacity through an active daily census, and this past year, we reached a milestone of serving over 900 youth on any given day. Over the course of the last year, we served over 2,500 youth and young adults.

We also provide ancillary services, such as medication management and assessments. Including these, we’ve served nearly 5,000 people in the past year. These numbers are significant milestones, marking high points in our 20-year journey in the state, and we’re incredibly proud of them.

What factors have contributed the most to achieving this level of success and these milestones?

About 30 years ago, we evaluated our programs and identified a need to offer more services to families and communities. We realized that solely focusing on facility-based or office-based interventions missed the critical influence of family, community, and school environments on children.

We began by assessing research, developing concepts, and testing them. Once confident, we subjected our programs to third-party evaluations, ensuring they became outcome-based or evidence-based. The success of our programs lies in knowing what works.

For children living with their families, the family component is essential. Strong families lead to long-term success. Our interventions shifted to empower families so that when we leave, they can handle challenges differently. Success is measured not just at discharge but a year later, showing if we’ve influenced the family environment enough for them to manage problems on their own. The goal isn’t to eliminate problems but to equip families with tools to solve them more effectively.

For young adults transitioning from foster care to adulthood, it’s crucial to ask, “What does success look like for you?” We focus on helping them succeed in the community by supporting their personal goals, whether in education, employment, or housing through the LifeSet program. Our young adults consistently tell us that being asked about their aspirations is one of the most meaningful aspects of the program.

How have factors like inflation, interest rates, and overall uncertainty impacted your operations and funding models in North Carolina?

Inflation has affected everyone, and it simply costs more to do everything now than it did a few years ago. The most noticeable impact for us has been on our workforce. We are a people-driven organization — our mission is to help people, and if we don’t have the staff, we can’t fulfill that mission. Inflation impacts basic living costs, and the only way to address that is through compensation.

In our industry, we can’t just raise prices like a business selling a product might. Instead, we rely on our funders and supporters who understand these economic challenges. To secure more funding, we have to demonstrate the value of what we do. We show that our programs produce outcomes that prevent cycles of recidivism and reduce the need for ongoing intervention.

By helping people stay independent, remain in their homes, and avoid homelessness, we save money in the long run. These outcomes have value, and we can communicate that to our funders. Despite rising costs, we continue to deliver evidence-based services that achieve desirable outcomes. The state of North Carolina and our funders have been excellent partners throughout this process, showing strong support not only to us but to our industry as a whole. This collaboration has been incredibly beneficial.

What trends are you observing in the mental and behavioral health needs of children and families, and how are you adapting to these needs?

The biggest trend we’re seeing is a shift toward addressing the whole person. In North Carolina, there’s a move to allocate Medicaid funds in a way that focuses on holistic care. Historically, different aspects of care — social services, juvenile justice, mental health, and physical health — have operated in silos. Now, there’s a growing recognition that people are more than just their behaviors or diagnoses.

This holistic approach involves considering social determinants of health, which means looking beyond measurable factors like test results. We’re now paying more attention to a person’s environment, the impact of trauma, and how these elements contribute to their overall health.

By viewing physical and behavioral health as interconnected and addressing environmental factors, we can better understand and treat individuals as whole people, not just a collection of symptoms. This broader perspective allows us to implement interventions that address root causes, leading to more effective and lasting outcomes.

How are you leveraging technology, and what role does it play in the delivery and management of your programs?

Technology, especially from a data perspective, is crucial. If we had this conversation ten times, you’d hear me say repeatedly that you need data points, you need to track outcomes, and you need to know what works and what doesn’t. It’s essential to be prepared to adjust based on that information. The best way to achieve this is by collecting data and understanding how to use it effectively.

We have extensive internal systems in place that focus on gathering and analyzing data so we can make informed decisions from a programmatic standpoint. This allows us to adapt, focus on successful strategies, and adjust areas that might be struggling. Technology is vital for this process.

Another aspect of technology that gained prominence during the pandemic is telehealth. Historically, telehealth faced challenges due to bandwidth limitations, but as technology has improved, we’ve discovered new ways to engage with families remotely. Telehealth has been particularly useful for maintaining connections during concerns about infectious disease transmission and for reaching rural communities or individuals who have difficulty accessing facilities. There’s a lot of potential to continue exploring how technology can enhance the delivery of services over distances.

How is Youth Villages preparing to address the needs of North Carolina’s youth over the next two to five years?

North Carolina’s behavioral health system is undergoing significant changes. As I mentioned, Medicaid, for example, is shifting its focus toward a more rounded approach, connecting behavioral and physical health in a more integrated manner. As this progresses, funding will be allocated and managed differently, which naturally brings some anxiety but also presents opportunities to improve how things are done.

Navigating these changes requires clear messaging and confidence in what works. We need to be able to explain how our programs fit into the evolving system and ensure that we are communicating effectively. Partnerships are also going to be increasingly important. The future isn’t about individual providers working in isolation on what matters to them; it’s about collaboration. If the system is moving toward breaking down silos and focusing on the whole person, then it makes sense for the provider network to do the same.

Ultimately, we need to know what works, how it works, and how to communicate that effectively. By doing so, we can help ensure that our services remain aligned with the evolving needs of North Carolina’s youth.