Building Ohana

Transforming mental healthcare for our kids

Building Ohana

Unprecedented $105.8 million gift to transform behavioral healthcare for our children

Bertie Bialek Elliott wanted to do something transformational in the place she calls home. And she has — donating $105.8 million to Montage Health Foundation, the largest gift ever in Monterey County and one of the most significant philanthropic commitments in healthcare nationwide.

The extraordinary gift will be devoted exclusively to creating an innovative approach to child and adolescent mental and behavioral health. The hope is that elements of the model will be replicated elsewhere to address similar concerns throughout the nation.

The need is painfully apparent, anecdotally and statistically.

“Our kids really are neglected when it comes to mental healthcare,” says Dr. Eric Jacobson, medical director of Behavioral Health Services at Community Hospital of the Monterey Peninsula.

“Our kids really are neglected when it comes to mental healthcare”

Dr. Eric Jacobson, medical director of Behavioral Health Services at Community Hospital of the Monterey Peninsula


  • As many as 1 in 5 children and adolescents ages 9-17 in the U.S. may have a diagnosable psychiatric disorder
  • One study estimated the need for 30,000 child and adolescent psychiatrists but found that only 6,300 were practicing

In California

  • From 1995 to 2010, the number of inpatient beds for young people with acute psychiatric issues declined 40 percent
  • There are fewer than 1,050 child and adolescent psychiatrists to serve more than 9 million children and teens

On the Central Coast

  • From 2014–17, nearly 1 in 6 high school students surveyed in the Monterey Peninsula Unified School District seriously considered suicide and about 1 in 3 suffered depression-related feelings, according to the California Department of Education
  • Monterey, San Benito, and Santa Cruz — and 41 other California counties — have no child/adolescent inpatient psychiatric beds

Of course, the issue is much bigger and broader than the shortage of therapists and inpatient centers; there are needs all along the spectrum of care.

“You have to have a system with multiple levels of care and appropriate follow-up, with kids and their families,” Jacobson says.

That is the goal in Monterey County, under the program name chosen by Elliott: Ohana. The word is Hawaiian for “family,” in an extended sense — blood-related, adoptive, and chosen.

“It truly encapsulates the community we want to reach — children, adolescents, families, and those who care about and for them,” Packer says.

The unprecedented venture will include everything from an actual “Ohana House” to early intervention, comprehensive support for young people and their families, and partnerships with an extensive collection of existing community organizations.

“We envision a warm, welcoming center on Montage Health property at Ryan Ranch,” Dr. Steven Packer, President/CEO, Montage Health says. “But we see much more than bricks and mortar — a groundbreaking hub for comprehensive, innovative solutions, with concentric circles of care emanating throughout our community.”

Research and feedback from families who have struggled with behavioral health issues point to two key areas: what happens to a young person before they are in crisis or need urgent care, and what happens to them once they have received care. So often, families and children and adolescents are struggling, adapting, and trying to survive long before they reach crisis. And when that doesn’t work, frequently they turn to urgent or emergency care. Then, after that short-term solution, they often return to the same environment that contributed to the need for care in the first place, with no support for sustaining any gains made.

“That means we need to help them, their families, and those in their circles of influence throughout their entire journey,” Packer says. “What if we could follow them home?’ More directly, what if the extraordinary care they received through Ohana could follow them out into their everyday lives? Help them to continue a healthier way of living that gave them not only hope, but tools? That is what we want to build.”

The first step is a national search for an innovator in pediatric/adolescent behavioral health. A search firm has been engaged and is charged with identifying a clinical director who will create and maintain an unparalleled program of care.

Following that, over the course of the next five years, there will be the development of programs and relationships throughout Monterey County that involve the entire family, schools, pediatricians, community organizations, and others.

There will also be the construction of Ohana House, which is expected to include:

  • Up to 24 inpatient beds, with separate areas for boys and girls
  • Indoor and outdoor recreational and quiet spaces
  • An outpatient treatment wing
  • Rooms for one-on-one and family counseling
  • Space for community activities
  • Classrooms for inpatient youth and space for training and workshops

A significant portion of the gift will be placed in an endowment, to provide funding for Ohana into the future.

“Our goal is to use Bertie’s gift to develop a program that can be emulated by others throughout the nation,” Packer says. “We consider this an investment in the future of countless children and families, and we are committed to being the best stewards possible. We have always been committed not only to innovation, but to doing the right thing. This is the right thing. We are ready to go.”

"We envision a warm, welcoming center on Montage Health property at Ryan Ranch. But we see much more than bricks and mortar — a groundbreaking hub for comprehensive, innovative solutions, with concentric circles of care emanating throughout our community."

Steven Packer, MD, President/CEO, Montage Health

Elements of Ohana

  • Innovative care — adopting best practices where they exist, creating them where they don’t
  • Early intervention — developing approaches and outreach, with community partners, to engage early, before issues arise
  • Outpatient care — involving families, schools, pediatricians, community organizations; individual, group, and family counseling; ongoing treatment for substance abuse, if needed
  • Inpatient care — in a peaceful, healing environment
  • Emergency care — specifically for this younger population
  • Complementary care — including life coaching, athletics, arts/music therapy, peer counseling, pet therapy, education and career guidance, spiritual practices, when appropriate, etc.

"If you can help young people early, rather than waiting to rescue them later, how great is that?"

Bertie Bialek Elliott

Bertie Bialek Elliott:
Creating a place for families to turn through a transformational gift

Perhaps it all started with Grandpa Ernest.

When 3-year-old Bertie Bialek Elliott grabbed her dolls, a few of their clothes, and decided to run away that Sunday in 1936, she knew where she was heading. Two miles down the road to a man who understood family.

There was something about Grandpa Ernest Buffett. The way he understood Bertie. The way he treated members of his Omaha, Nebraska, community with each and every grocery delivery he made. “He was really important to me,” said Bertie, 84, of Carmel. “I always looked to him for affirmation. I felt loved by him, and that’s a gift.”

And so it is that, for as long as Bertie can remember, family and community have always seemed to not only go together, but to be the most important things in this life. It was in that spirit that in December she donated $105.8 million to Montage Health Foundation to transform mental healthcare for children and adolescents.

“I had been thinking about doing a project with Community Hospital because sooner or later, they touch almost everybody in the community,” Bertie said. “Steve (Packer, Montage Health CEO) brought me four ideas. Immediately after I read them, I knew.”

Just to be certain, though, Bertie individually asked her three daughters — Susan, Cynthia, and Carolyn — for their favorite. Each picked the same project.

“This is an unmet need,” Bertie said. “Young people need help at times. It’s not an illness that kids want to get. But because it shows up in behavior, there is more judgment from others. If you have a big enough family, it’s hard to say you’ve never been touched by a young person who needs help.

“I had the sense that this project would take a lot of money to get it going. It would take a chunk of money or it might not ever get done. Since I had money to give, I thought it was worthwhile. If you can help young people early, rather than waiting to rescue them later, how great is that?”

And then Bertie chose a name. It came to her almost immediately. Ohana. Hawaiian for family, roughly translated.

“It’s more than family,” explained Bertie, who frequently travels to the islands. “It’s friends who are like family. We don’t have a word for it in English. It’s about trying to make things work in the larger picture. It speaks to the cooperative nature of people, not the competitive nature. It’s really a beautiful thing.”

Bertie never considered putting her own name on the effort. She just isn’t one to name things after herself. She doesn’t mind if others do, but for her, it’s just calming to be some small part of a big universe. “Because we all go back there at some point,” she said smiling.

In fact, the only time Bertie did put her name on something — the Roberta Buffet Institute for Global Studies at Northwestern University (a $100 million gift) — it was for her brother, Warren. Yes, that Warren Buffett.

To Bertie, Warren is simply her big brother, her hero, and her protector. A man who doesn’t really put his name on things either. “I put the name Buffet on the global studies institute for my brother because he wouldn’t ever name anything for himself,” she explained chuckling.

Actually, her brother’s notoriety surprises Bertie sometimes. “I remember flying across the country to New York in the 1980s,” Bertie said. “And Warren had just been named by Forbes as the richest man in the country. I thought ‘How could this be?’ ”

It seems only yesterday when Bertie and Warren were playing ping pong and Monopoly. “He loves playing the game. And he always picked me to play with him because he could always beat me,” Bertie laughed. “He always won. I like to think I gave him his early training in winning. I made him a winner. I’m very proud of him and very close to him. Almost his whole fortune is pledged to be given away.”

Their older sister Doris is also a philanthropist. And Bertie, of course, has followed suit, consistently throughout her entire life, either financially or with her time. Particularly locally.

She first visited Monterey in the fall of 1962 with her then-husband Dr. Charles Snorf. The construction of Community Hospital had just been completed. “It was dazzling to me,” she said. “And Monterey is beautiful. It seemed like a good idea to come here.”

The perfect place to raise their family. They moved here from the Midwest in July of 1963. Her husband was building a thriving career as an orthopedic surgeon. Bertie was busy raising the children. But a decade later, in this seemingly ideal zip code, tragedy struck.

“We had a fourth daughter,” Bertie said. “She was born at CHOMP in 1968. But she died in 1975 of a brain tumor. Sally was only 7 years old,” she said, tears welling. “She was about to go into the second grade.”

A few years later, Bertie and Snorf ended their marriage. Eventually, Bertie remarried — Dr. Hilton Bialek — and they were together until 2002, when he passed away. In 2008, she married again, this time to David Elliott.

All the while, Bertie was a humble, familiar, well-loved figure in the community — in general and at Community Hospital, specifically. She was part of the Junior League in the 1960s and ‘70s, a member of the Monterey Symphony, Carmel Bach Festival, and Monterey Bay Aquarium boards, a president of Community Foundation for Monterey County, a founder of the RISE (Recruitment in Science Education) program at California State University-Monterey Bay — a program that helps students get through high school and then provides scholarship money for college.

“I’m lucky because I’m able to help,” Bertie said. “It makes me really happy. I have 11 grandchildren, and I like helping other people’s grandchildren.”

At Community Hospital, Bertie helped lead the capital campaign for the Comprehensive Cancer Center; was invited in 1997 to join the Board of Trustees, where she first met Packer; participated on the Women in Philanthropy committee (now known as Women’s Forum for Health); with her husband David made a significant gift for the Inpatient Rehabilitation Unit; and became part of a small, select advisory council at Packer’s request. She left that post in early 2017 to take care of Elliott, who passed away that April.

“I know the moment I decided I wanted to do a project for Community Hospital — it was when we knew David was dying, when they gave us the diagnosis: ‘He has a cancer that can’t be fixed,’” Bertie said. “The next day, I saw Steve (Packer), and I told him.”

Bertie makes contributions where she’s already certain the vision can be actualized. “I have every confidence in Steve and the people who work with him,” she said. “I gave it with no strings. They can take this and run with it.”

Bertie said she knows the gift will have worked “when Ohana opens its doors — the first time a family comes in and gets help. It’s good to have things that pull you into the future. Like planting daffodils and then getting to see them bloom. Something like this, like Ohana, well, it’s a wonderful antidote to getting older.

“For these families, just knowing they have a place to turn to…I know it’s going to help.”

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