Lou Fragoso is president and CEO of Children's Hospital New Orleans, the largest free-standing full-service hospital dedicated to children in the Gulf South. He sat down with Deputy Editor Arnessa Garrett recently to discuss the hospital's major initiatives and its future. This conversation has been edited for length and clarity.

Garrett: Thank you so much for taking the time. I know it's a busy season too for you guys. So tell me what your average day is like.

Fragoso: Well, we have over 200 kids that are in the house right now. We have about 700 that come through this hospital on a daily basis, through the clinics, and another 200 that will come through the ER.

Today, I greeted 40 new employees that are joining the family. I think of the 40, 30 of them were nurses. I meet every new employee. I interview every physician.

Garrett: It sounds like you're growing.

Fragoso: In the last six years, we redid the entire campus. We have 17 acres, and we put $350 million in to just redo this entire campus so we can take care of more kids. But even probably more important than that is in the last five years, we've onboarded 200 new physicians, 1,000 [total] staff. Our footprint is across the entire state of Louisiana, Mississippi, Alabama and the panhandle of Florida.

But I think one of the things that makes us really unique as a children's hospital in terms of growth is the stuff that we do out in the community. One in five kids suffer from a behavioral health disorder. Right here, we have a 51-bed behavioral health hospital just for kids. It's the second largest in the country.

We went across the community [with our ThriveKids outreach program], specifically in schools in Jefferson Parish and Orleans Parish, where, across 180 schools, we have nurses and social workers focusing on behavioral health.

Garrett: You've also been doing a lot in the community as regards to gun violence. How did that come about and what has it meant?

Fragoso: We see in this hospital, on average, one gunshot [victim] a week. Our surgeons were like, "We're seeing these kids, then we're performing surgery, but what can we do to not have them come in?" And as you know, guns are a very polarizing conversation in this country. And we took the approach of, "Look, I think we can all agree that we don't want a kid to get a hold of a gun."

And so we went out to gun owners, and we said, "Hey, this is what we're seeing. What are you willing to use to safely store your weapon and not allow a child to get hold of it?" And they first started telling us what they didn't like using: "Well, we don't like using these gun cable locks. The whole point of having a gun in the house is for safety, and if I have to take 10 minutes to take the lock off the gun, then it's of no use to me. But we would be willing to use a biometric gun safe."

And so we said, "Alright, if you're willing to use a biometric gun safe, we'll give you that." Now, the difference is $2 for a gun cable lock versus $150 for a biometric gun safe. But we said, "Let's test this theory out." So we gave away 1,000 biometric gun safes, the ones where you put your fingerprint on it, it pops open and your weapon's in there so you have access to it immediately.

And were they using them? 90% were using them, and 100% felt like their kids were safer in the house.

Garrett: How did you get into healthcare? What drew you to the field?

Fragoso: My parents would be the easiest way to put it. So 53 years ago, my parents immigrated from Mexico to Chicago. And then 52 years ago, I was born.

Just to be super direct about it, these kids that we take care of, I was one of them. I grew up on the south side of Chicago. I was one of these kids that needed the community support. My mom used to take me to the Boys and Girls Club. My dad worked at the same old school Chicago meatpacking company for 52 years. It put three boys through school. My mom started her own not-for-profit to help underserved families. They both became citizens. This whole school program idea, I totally stole that from my mom. It was her idea. She started in Chicago. She's been doing that work for 22 years now. So the ThriveKids program is something that's my mom's.

My parents were a great example for me of hard work, work ethic, all of that. They obviously had huge struggles. My first language was Spanish. My primary care doc used to be the ER. And so for me, it's very personal when I see these kids.

Garrett: You've worked in Chicago hospitals. You've worked at Texas Children's in Houston. What drew you to New Orleans?

Fragoso: I was in Houston for about six years. It was great professionally. Texas Children's is an amazing hospital. But there's always a moment in time that's kind of this decision point. I remember being in a meeting. And we spent 30 minutes talking about how people with their Bentleys and their Porsches and their Mercedeses didn't want their cars parked by the valet because they didn't want them scratched. They wanted them left on the ramp. So there were the optics of these super high-end cars blocking the entrance to a children's hospital, where normal people then couldn't get in, and I'm like, "Are we really having this conversation?" And we did for 30 minutes, and I thought to myself, "This, this isn't right."

I believe everything happens for a reason. I got a call then from [then-CHNO President and CEO] John Nickens in January of 2018, and he said, "I want you to come to New Orleans with me." And I said OK. And he's like,"These people need us. We can do a lot of good."

The campus hadn't been rebuilt yet. It looked a little beat up. And he's explaining, "Here's what we're gonna do. We want to do this." And I remember stopping him. I said, "I got it." I could see it. I could see this was going to be the most beautiful children's hospital campus in the country, and it is.

And I mean, the people, the mission -- when you walked in, you felt it right away.

The people that we serve, they're kind, and they're grateful. I love that my doctors, they know you don't ever have to ask for an insurance card. We run it like a mission. We don't run it like a corporation. And I think that's special.

When people ask, "What do you do here?" I say, "We stand in the gap for kids." And then somebody says, "Well, what does that mean?" I'm gonna tell you what I mean.

There's a little girl named Stephanie. She was in school, and she was failing, but we were in that school with our ThriveKids program. Our social workers were going through a list of kids and saw she had failed a hearing and an eye exam. She had missed 90% of her appointments here, and we said, "Why did she miss them?" We checked. Both parents work. They had transportation issues, and they had a language barrier. So we got an interpreter, we scheduled transportation, we got all our appointments scheduled with all the specialists she needed.

She came in, she got glasses, she got hearing aids, she got everything she needed, and she went back to school, and guess what? She's doing well in school. We stood in the gap for that child. Those are the kids that fall into the societal cracks we talk about. What I like to think we do is that we go there, and we pick up that child out of that crack, we patch it up, we put them back on their path.

Garrett: We hear a lot about the difficulties with rural healthcare. How much reach do you have in places where there's just not a lot of good children's health care?

Fragoso: From an infrastructure perspective, we have clinics in the northshore, Baton Rouge, Lafayette, Alexandria and the Mississippi Gulf Coast. I think we serve kids from all 64 parishes. Abby, our helicopter, allows us to get to wherever we need to to get them. One of the reasons we partnered with Baton Rouge Children's Hospital, Our Lady of the Lake's children's hospital, is exactly because we said, "How do we come together to make sure we have a farther reach and so kids are getting care closer to home?"

Garrett: You know there's this push by Ochsner to create another children's hospital in New Orleans. How do you think that will work for the people of Louisiana?

Fragoso: One, I wouldn't call it a children's hospital. Just because you put up a building, and you put "Children's Hospital" on it, it doesn't make it a children's hospital. I would call it a boutique department of pediatrics that's run by an adult hospital.

I would say I'm a little disappointed, mostly because, you know, you don't compete related to kids. That's not something you should do. You should figure out how to support each other. We're all helping kids. I would have been really excited if when they came out with their announcement, they said, "You know what? We are going to make a difference in this community, and we're going to invest in behavioral health because we know that's a crisis. We're going to do more stuff out in the community to try and create a proactive approach to medicine." And that's not what they said. They said, "We're going to put up a new building to house the things that we already do, all the things that make money." You're not tackling any of the hard issues. You're not running towards any of the problems.

Garrett: But some would argue that competition will make everyone better.

Fragoso: People have to remember that in Louisiana, there's only a million kids. If you think about a heart program, how many kids are actually going to require surgery? Maybe a couple hundred. It doesn't create better outcomes or better health when you have multiple heart programs for a population of only a million kids. You want all of that going to one area. That's when you'll have your best outcomes because you've got all of your specialists and in one location that are seeing all those of kids, instead of splitting resources or duplicating resources.

Garrett: Next year Children's Hospital New Orleans turns 70. What do you see for the future?

Fragoso: In the last five or six years, we've made some significant investments. And in a lot of ways we do feel like we're just getting started. We've rebuilt this campus. Along the way we've also built a Ronald McDonald House on this campus and a Hogs [for the Cause Family Center]. We have 40 families living with us on this campus at any given time. This year medical history was made because we take care of the most kids that have sickle cell disease. And we are now one of only a handful of children's hospitals in the country that has a cure for sickle cell. It's an incredibly painful disease. It predominantly impacts African Americans. And to now have access to a cure ... We have a bunch of kids lined up for that. And then related to that, there's our cancer and blood disorders program. Last year, we did 19 bone marrow transplants, which was the most we'd ever done. This year, we'll do 27, to give you an idea of the growth of that program, which is another reason we need a new cancer and blood disorders floor. In the last five years, with our ThriveKids program, we were in 180 schools helping 100,000 kids with behaviorial health. ThriveKids now has 100 employees and has funding for the next 10 years.

So when I think about some of the things that are next just based off of that, one of the things we really need is a new NICU. We need a new Abby. Abby has been saving lives since 2011, so we need a new transport helicopter. We need to continue to double down on the community piece.

And I want the whole country to know what happens here. A lot these community programs that we've gotten national recognition for, I want to share that with other children's hospitals because I think it is a national model that could be used to support communities in a bigger way.