I recently had the opportunity to speak with Aaron Atkinson, President and CEO of People Encouraging People, and to get an update on the organization’s work in Baltimore and across Maryland. The conversation was a reminder that community-based behavioral health is not simply a set of clinical services. For many people, it is the infrastructure that makes stability, recovery, and dignity possible.
People Encouraging People, or PEP, serves individuals facing serious mental illness, substance use disorders, disability, homelessness, and other barriers to independent living. Its continuum includes community treatment, psychiatric rehabilitation, health homes, targeted case management, homeless outreach, overdose response, outpatient behavioral health services, residential rehabilitation, supported living, and affordable housing. PEP serves people across Baltimore City and several Maryland counties, reaching thousands of individuals and families through highly individualized services.
Community based treatment of behavioral health is at the core of PEP services. PEP’s community-based services include Assertive Community Treatment (ACT), which brings multidisciplinary behavioral health support directly to people with serious mental illness in their homes and communities. Forensic Assertive Community Treatment (FACT) is a related model for individuals whose behavioral health needs intersect with the criminal justice system. These programs reflect PEP’s approach: meeting people where they are and helping them avoid hospitalization, homelessness, and incarceration.
One of the striking parts of my conversation with Aaron was the scale of infrastructure behind the phrase “meeting people where they are.” PEP’s work depends on outreach teams, a fleet of more than 40 vehicles, and a substantial housing platform. The organization owns and operates 75 homes, including residences tied to its Residential Rehabilitation Program, as well as other affordable and fair-market rental properties. This is mission-driven work, but it is also operationally complex and capital-intensive.
Aaron also described a difficult near-term challenge: Medicaid. Roughly $21 million of PEP’s income comes through fee-for-service reimbursement, while much of the remaining revenue is tied to housing-related grants from HUD and state and county sources. Medicaid rates have remained flat while staffing, clinical, transportation, housing, and operating costs continue to rise. At the same time, new Medicaid work requirements could cause some vulnerable people to lose coverage, creating gaps in care and reimbursement.
Organizations like PEP are essential community infrastructure. Their challenge now is to sustain that infrastructure while demand grows and the financing becomes more fragile. At Apollo, we are thrilled have PEP as a partner that benefits from Apollo fundraising and the generosity of our donors.