Unpacking Inclusivity in Healthcare with Julie Liebo

By | HEALS Pod, News

HEALS had the pleasure of interviewing Julie Liebo, a skilled nursing administrator, who shared her experiences and insights on inclusivity in healthcare. Julie discussed the historical challenges faced by the LGBTQ+ community in healthcare settings, highlighting the lack of acceptance and discrimination in the past. She emphasized the importance of creating a welcoming and inclusive environment for all patients and staff members, sharing examples of how she has implemented changes in her facility to support diversity and equality.

Julie’s personal experiences, such as supporting a same-sex couple in her facility and advocating for their rights, showcased the progress that has been made in healthcare towards inclusivity. She also addressed the need for ongoing education and awareness among healthcare professionals to ensure that all individuals are treated with respect and dignity.

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Full Transcript

DIEGO TRUJILLO:
And welcome back to another episode of the HEALS Pod, where we unpack the different services, the different service lines, facilities, and the people that make up our community here in Las Vegas to be able to tell a story of the thriving healthcare community we have here. I’m very excited to have a special guest I’ve known for many years in the community of her. And this is the first time we’re going to get to know each other and kind of unpack what skilled nursing is, what it looks like, and how to build a culture that’s successful and really impact people’s lives. So without further ado, my guest today is Julie Liebo. How are you doing today, Julie? I’m fine, thank you. It’s a pleasure to be able to have you on. Thank you for having me. I remember your name came up when I was back. I was just becoming a chaplain since you were at Lakeview Terrace. So this was back before you moved into skilled nursing. Yeah, this is a while back. I know it feels like I’ve been in health care for like a year or three. Sometimes I’ll tell that story. I’ll tell people, oh yeah, we’ve known each other for three years. She’s like, yeah, I have a friend. She goes, you were at my daughter’s eighth birthday and she’s 18 now. I was like, oh. So yeah, time flies when you’re having fun. So how long have you been in health care?

JULIE LIEBO: I’ve actually was in healthcare prior to Lakewood Terrace. I was in skilled care as well and worked for the same company. Just took a little bit of a breather. I thought I was ready to go away. But once you’ve been in skilled care, you just you just can’t leave it. Yeah, you have a passion for skilled care. I had to go back and it’s a you know, it’s very different than it’s ever been and it changes every day.

DIEGO TRUJILLO: What would you say, because, so again, when I met you, you were in assisted living. Right. It would seem that it would be much more difficult, cumbersome, and I’m just shooting from the hip here, right? When it comes to skilled care, you’re dealing with a lot more regulations, patients that, you know, are a lot sicker, going through a lot harder of times. It would seem that some people would want to move easier in their career, but you have this passion for skilled care. What is the main difference? What do you think drives you to that?

JULIE LIEBO: You know, there’s so many different things. When I was in assisted living, but prior to that I had been in skilled care my entire career, whether I was a CNA, got my license, grew up in skilled care. And what I get out of skilled care every day I go in there is the dignity and the understanding that, you know, we’re there for more than just caring for the patients. For example, in my building, we have a vent unit. These people have gone through so much tragedy prior to even getting to College Park Rehab.

DIEGO TRUJILLO: That’s a really good point. I’d never even considered that.

JULIE LIEBO: Yeah, and so, you know, normally what happens is families are in that acute phase when they go to the hospital, and what we forget so much is that, you know, they have doctors, everybody around the clock, and when you get that day, kind of that one-on-one care and an acute care for a week or whatever, maybe with a vent a couple weeks, And then all of a sudden that family’s thrust upon the skilled world. And, you know, where they’re sharing a room now with somebody potentially. There’s lots of very, very sick people nowadays in a skilled care. Doctors aren’t there every day, the nurses, the eyes and ears. And so we have to be that person and those eyes and that person who understands that family and that family member.

DIEGO TRUJILLO: That’s a really interesting perspective when you mention that. And I’ll say this because, you know, people used to ask me, so I fell in love with hospice. I had never been exposed to healthcare. That’s how I kind of, my foray into healthcare was through hospice. And it wasn’t until like my second visit, I walked out of a patient’s home and I was just, you know, the sister was there and she was like, thank you so much. And I’m watching her tear up and just, That feeling of gratefulness, for me, it melted me. I was like, man, I could do this forever. And I realized, you know, when people would ask me later on, I was, you know, I eventually moved into marketing. And what I would tell them is, you know, for me, it’s not the marketing piece, because that could be a grind and you could sell anything. But the idea that someone’s just been given the worst news of their life, right? Your mother, you, you know, this is a disease process and there’s nothing else we can do. Typically, human beings, and I would explain this to people, tend to shy away from that. And for me, it was a privilege to be able to step in, to kind of help the family get control, ground themselves, and figure out what is our goals, what are our priorities, what are we here to do? And for me, there’s no words to describe that. It feels like every other problem you solve, I don’t know if you… I always do this every time I get very stressed out, is I’ll watch a Zoom out on YouTube of the universe. And it really puts in perspective how small you are, right? And you’re like, yeah, and you’re only here for 70, 80 years, right? It’s very humbling. But when you can impact people’s lives like that, it feels eternal. I’m very grateful for the opportunity and having the personality that was able to endure that. And it sounds like you’re very much the same way with skill. I’ve never heard anyone describe skill nursing like that.

JULIE LIEBO: Yeah, I feel like, you know, like even before COVID, we realized during COVID, well, I believe I realized a lot before COVID, but like, for example, during COVID, families couldn’t get in for the longest time. And I would read and read and read things on the news or read things in the paper, read things in the news, whatever. that families were not sure what was going on with their loved one, because they weren’t allowed to go into the front door of a skilled setting for the longest time. And then, this is so ironic, but I also heard many facilities decided at that point, well, now’s a good time. We’re going to become a non-smoking facility, and we’re going to do this, and we’re going to do that. Now, I’m not a smoker, and I don’t advocate it, but when you just entered a nursing home, and your life is going to be there, really, the smoking is the least of our concerns. So I thought, even something as simple as that, no, we’re not taking that away and we’re gonna find the time to help them and assist them out the door. This is where we’re at right now. But during COVID, we took it a step further and I said, they have to see it’s our loved ones. So we set up around the facility, luckily I’m a one story, and we set up around the facility, FaceTime TVs and chairs and coffee and everything around the whole building so they could sit outside the window and look at their loved one. And if they were not in town, then we would set up FaceTime or Zooms and different things to be able for them to look at. So that’s how I utilized my activities and my social service department during the COVID four years that we were not able to have families in.

DIEGO TRUJILLO: That was a very difficult time, and I couldn’t even imagine what that process would have entailed. I mean, you tell it really briefly in 45 seconds, but implementing a plan like that cannot be easy. But I think you draw on a point, and it’s very easy for us to become… I had a boss one time, someone that mentored me. And I remember the company we worked at, she came in and she was very firm. And, you know, everyone started like throwing a fit and like having a problem. And I was like, well, I don’t know enough to know whether I like her or not. You know what I mean? She seems very strict. She seems very stern. And I’ll never forget one time she walked into the office. She called a meeting because she heard all the people had been, all the chatter. And, uh, and we all sit at this table. She pulls out a whiteboard and she, uh, this was back in hospice. And she starts saying, hey, you know, do you guys know the difference between patient-centered care is? And everyone just kind of sat quiet for a second. She goes, listen, at 7 p.m. on a Friday, nobody wants to run a referral. I know you guys are just like me, none of us want to go and be there. We try to push it off for Monday, we try to push it off for Saturday, on to the weekend nurse, you know, we’ll do whatever we can.” She goes, but because you don’t want to get up and take an hour or two of your day to go help these patients, she goes, you have to stop to consider that these people are now sitting there for 24 hours, if they’re lucky, if you’re going to come the next day, they’re now sitting there for 16, 20 hours wondering what is going to happen. They’re going to be in anguish. They’re going to be in agony. And then she finished it up. So just to be clear, we are not a family here. We are a group of professionals that are here to serve these people that are going through this moment. And it was really funny because afterwards people are still angry. And I was like, I’m fully on board with this, guys. I don’t know what you’re talking about. So maybe I lucked out and my very first administrator was kind of like that. But again, it’s what are you going to prioritize? Sometimes we don’t want to take the extra step. I mean, we’re human beings and we tend to go the path of least resistance. That’s just human nature, right? So no one says, hey, do you want to set up a bunch of chairs outside in the heat? No. But if you taking that extra step means so much for people, why not do it?

JULIE LIEBO: They need to see them. They needed to, you know, all of a sudden the door was slammed. So we had an obligation to come back. And we have very, nowadays in skilled care, they are very sick. Like I said, they would be in the hospital and then all of a sudden, wham, bam, they’re in another facility where they don’t know anybody or whatever. And some of these people are transferred late at night, different things, you know, unfortunately for the healthcare system that we’re in, those things happen. So we do have to jump to the music. And I know I’ve spent the last number of years at College Park making sure that that occurred, that people were on board and trained at every level. And, you know, when I think about this, Diego, I think the biggest issue that I see out there right now is, you know, whenever we advertise skilled care, it doesn’t matter who’s advertising it. It doesn’t matter if it’s CMS. It doesn’t matter if it’s an oxygen company, whoever. Whoever advertises skilled care, if you look at all of the advertisements, it shows people in a way that are probably photoshopped some ways and some places not, but it shows the people playing jumbo board, playing cards.

DIEGO TRUJILLO: It’s like a resort.

JULIE LIEBO: Yeah. And the real issue in skilled care is just so far from that. And, you know, I think when families see that and then they get into a nursing home or skilled post acute setting and they see people, I mean, we have people in our facility that, literally were homeless prior to entering a hospital and come in to us, and we still find ways to discharge them appropriately for the first time ever into an apartment if they’re ready to go out of the skilled setting. We just had a thing that showed that our facility and most facilities around town right now, average age is more in the 50s and 60s, so we see a drastic change as well. They’re not all elderly anymore that are in the facilities. When you’re talking about the high-level care that the CNAs and the families give, my heart always goes out to that pulmonary care, that ventilator care, especially in a state like Nevada where there’s 120-degree weather. But we have, unfortunately, people do go through tragedies, from gunshot to botched surgeries to whatever. Those units are, we are it for those families. We’re the eyes, we’re the ears. They hug them, and you know what? We see no lack of care. We don’t see people being worse off. In fact, we actually win people to go home. The staff, what I tell them is we don’t even use the word can’t, because there just isn’t anymore. I don’t know what that referral is going to bring the next day, because everything is so different. But we have begun to educate ourselves to whatever we can expect. And it’s getting quicker and quicker from the hospital to a skilled setting. And what we need to do, not to mention all the different regulations and things today that we’re encountering with change. But I’ve been doing this, so my first lie My first license was back in 1991, so God knows I’ve seen everything over the years and the changes, but there’s still a surprise every day. What I tell my staff, and it never fails, after all of these years, when I walk in that door, I smile. I am happy to be there, and if my staff’s not happy to be there to support the families and the community, then we’re in the wrong place.

DIEGO TRUJILLO: I think that attitude, your point there, it’s very interesting you mention that. I moved over from my position right in marketing, and I took on the role of CEO. And it was very funny. It was very interesting to me the way that people would approach me. And even old friends would all make a joke and be like, oh, Mr. CEO. And they would crack jokes. And it really took me to reflect on why. Why is that joke so pervasive? And I really think that, fundamentally, it goes on the reason that you’re there. And I would tell them, I was like, look, I know you think that CEOs in modern culture are very much seen as people of privilege, people that get all of these benefits. And, that’s not been my experience. And even if it was, I very much feel that this role that I ended up here, and I find myself in a place where I can impact healthcare statewide and really make changes and really drive something in the community. And I feel like I have a duty, right? If I’ve been given this opportunity, that I have a responsibility to live up to that opportunity, not just name drop and, you know, and all of these things, I very much don’t view it as a position of privilege. It’s very much to me as a position of responsibility. What do I owe my community? And I know, I mean, you’re going back, right, you went to 1991. When I was back in the 2000, 1999-2000, I actually, my sister at that time was about 18, 19, and we were playing tackle football at the park. And I was playing with her. She had a three-month-old baby. She was newlywed. She had a three-month-old baby. And sure enough, her husband got tackled. Well, he rolled to the ground, kind of banged his head really quick, got up. We played a couple more. We did a couple more plays. And then he said, hey, my head feels really funny. And then he kind of rubbed it, went off to the side, and then dropped to the ground, started convulsing. Ambulance came. He died on the way to the hospital. I think I sat outside at UMC. It felt like four to six months. We were there for a while. And then back then, because they were young, it was Medicaid. And so it was just denial after denial. And we ended up at Horizon, right by Valley Hospital. And I remember going in there and the treatment. My sister still stays in contact. He was there for about two years and a half before he finally succumbed to pneumonia. But the entire time, I, the way the staff would bond, right? And you would, people are sometimes very quick. I would say this with Desert Springs Hospital back in the day when we’d take my father and be like, Desert Springs, you know, why not Summerlin and why not? I was like, you know, it’s an older building, but everyone’s been there a long time. Like their, their teams are teams. They understand because they’ve all worked alongside each other. And it always brings me back, like I mentioned, back to 1999, when we would walk in, there was nicknames, because she would always bring my niece in. She basically grew up in that rehab, just going on a daily basis. And you think back at those times, the people that took the time to smile, right? It’s misery in there. Nobody wants to go, because it, right, unlike the advertisements, it’s not a resort. If you’re there, it’s because something bad happened. It’s not anything you desire, right? It’s not like they installed a new limb or a robotic leg and you’re going to be faster. I mean, you’re there because something negative happened. And so I very much agree with you. It’s the attitude. And I believe it starts with the administration, right? One of the things I worked with looking at workforce development and workforce pipeline, right, is the difference of what a culture can mean. And the amount of administrators and HR directors that will be, well, people just jump for 50 cents an hour. While sometimes true, that’s not what the data reflects. And, you know, I will bring up studies and say, well, you know, well, no, but that’s what they’re telling me. No, I understand that’s what they’re telling you, that they’re paying them 50 cents, you know. And for me, I stuck with my company. Back then, I was at the same hospice for like six or seven years because of the leader that I had. It really is what kept me there. I got offered more money, but I just really appreciated that. I always felt like my leadership looked after me, not the company’s agenda only.

JULIE LIEBO: Right. And like at my last all-staff meeting, I do a monthly all-staff meeting to make sure that we’re up on all the different regulations and things. That’s the other point is, whether they’re doing the dishes or whether they’re the RN charge nurse, this is their career. They all need to understand what’s going on. So I do a lot of education that way while we do some quick stand-ups on a regular basis every day. I feel there’s a need to bring them real quick and do a 10-minute stand-up. or we do an all-staff, but you know… Like a restaurant, right?

DIEGO TRUJILLO: Yeah, exactly. We do a wine tasting. Not quite that way, but actually… Right, but it bonds the team. It brings people together. It makes us feel like we’re a team. Exactly. Not random individuals running around the hallway.

JULIE LIEBO: Exactly. And the last all-staff meeting, not this last one, but the one before, I gave away, talk about people having a culture I believe we have a wonderful culture. I gave over 15 certificates and boss certificates to my CNAs, my housekeepers, my nurses, everybody who had been there more than 15 years. And then there were an additional five or six that were there over 25 years and the longest serving was our charge has been 31 years. I’ve been at it about 20 years. So there’s a lot of longevity in my building and I do believe it’s because they have a tough job and because of my caring for them as well, and I will do anything to care for that staff, because that staff is the one who’s accepting that 8 p.m. Venn patient needs us at the last minute, like you were talking about earlier, and not saying, no, we can’t do it or wait till Monday. We don’t. We’re constantly moving people that we have to accommodate people and to work with the community, with the hospitals. But what works for me is, We do this a lot, like all of our meetings will be with managers, or all of our QAPIs, or quality improvement projects, all that. It’s like, for whatever reason, we seem to have managers. I absolutely make sure the line staff’s involved in every meeting so they can be consciously involved in what, why I’m making this decision, or why all of a sudden are we having to take these heavy care patients, and things like that.

DIEGO TRUJILLO: It drops that us versus them mentality. Oh, totally, totally. And it helps them to understand. I mean, even for some that, you know, there may be people whose roles require them to look forward to earning calls and, you know, those kinds of things, that’s the job. But when everyone’s kind of involved in what that, of what that looks like, I think there seems to be a buy-in from people a lot more. And I mean, I don’t even have to say it seems, right? You just mentioned all the certificates you gave out for people that have been there a long time. It makes them feel valued, important, and you never know. It gives people an opportunity to give an idea that you may never have had.

JULIE LIEBO: Absolutely, and they do matter. They’re the ones doing the hands-on care. The other thing I did to make sure, speaking of hands-on and being out there, is about seven years ago or so, I walked out and I realized, wait a minute, my key managers, though, that can help communicate appropriately to the families and to the residents, you know, are scattered throughout the building. So I moved everybody. So when you walk in my building, I’m first, and the door’s open, and they see the administrator. Like, our eyes meet the minute they walk in the door. The next door is the director of nursing, who’s right there in the front. The next door is the social service director, who’s right there in the front. And so we, all of us are, and I tell them, absolutely without exception, our doors remain open. So many times you go into facilities and you know, you have to walk through a hallway to get to the administrator or, you know, another hallway to find the director of nursing. I think that’s exactly why it’s incredible where I work because people can, and they feel freedom enough because when we tour them or we say here’s where we are, this is where you find everybody. And then when you want to speak to the direct care nurse, here’s what the wings look like. Everybody is there for a reason. You know, we can get so caught up in paper pushing, and there are a lot of regulations, and certainly we have to do it.

DIEGO TRUJILLO: Yeah, I mean, that’s the nature of it. That’s our punishment.

JULIE LIEBO: Right, but we’re really there to listen to them, and honestly, I believe it cuts down on so many concerns that if they know, you know, I put my email specifically and phone number, and it’s never been that abused over the years to families because, you know, we are in a different situation. They’re more long-term. They have, you know, they don’t, you just don’t have the closest and it’s understandable in an acute setting until they get to us where, you know, like what’s going on. I mean, I had a family conference last week with 14 people came, which is really unusual.

DIEGO TRUJILLO: Wow, the whole family, yeah, right?

JULIE LIEBO: Yeah, well, they were Filipino. Okay. And they came in from the Philippines, they came in from Hawaii, whatever, and everybody’s like, I said, no, you know, first of all, that’s very cultural and it will be okay. And it was. But they were looking for so many answers, you know. And honestly, when they left, they left thank you notes for everybody and did fine. But just that few minutes of being able to sit down with everybody and let them know, you know, we can’t tell you yes or no, but what we can tell you is people in this condition have done this or, you know, whatever. So to give some hope as they leave long distance. I think the communication, and a lot of times, you know, I will always introduce the certified nursing assistant. I will introduce the nurse on the floor. This is the person you can go to. And the staff are not the same. The staff might be different on a weekend, but they’re not different. They’re our staff, but somebody works, because we have 12-hour shifts, they’ll work Monday, Tuesday, Wednesday, or Friday, Saturday, Sunday, or whatever. So they know that that’s staff that’s current and on board, and they will see all the time.

DIEGO TRUJILLO: Well, it helps. I think it helps a couple ways, right, from the patient side. And I can relate to this, again, being in hospice. You know, sometimes it feels like you’re being told what’s going to be done. That’s typically, through medicine, it’s like that. One of my favorite selling points on hospice was letting families know, we meet as a team. On these days, our doors are open and you are more than welcome. Or, you know, you talk to a family member and they’d say, I just don’t want them to take this medication and blah, blah, blah. Because they’ve always felt that someone walks in the room and says, OK, you’re not doing this, this, this. You’re now doing this, this, this. So they don’t feel like they know who to listen to. And more importantly, they feel disempowered. Right. Disempowered? Unempowered? Right. It was the lunch, is what we’re going to blame. But they don’t feel empowered, is the point. And giving them the ability to say, hey, when you talk to your RN case manager, bring up what meds are important. Before you ever sign paperwork, make sure that you’re good with these medications and with the changes they’re suggesting. We typically don’t bully, and you’re involved in the plan of care. And that goes a very long way. I know for me, every time I worked with a Hispanic population, because I’m Colombian, that was one of the first things that would that I would bring up because they just felt, again, like they were always being told. Not like they were being interacted and they were working alongside them. And at the end of the day, it’s their life that we’re working with, right? Their loved one, etc. And then the second thing that I was going to bring up that, you know, listening to you discuss that, right, is it’s kind of the idea that the general is always in the front. It’s a very different feeling when the general is leading the army versus when the general is sending a letter saying, yeah, tell them to throw their bodies at it. You know what I mean? It’s a different type of commitment and showing your face and being up front and being there, right? I know I would always pride myself as a marketer because whenever I had someone call to complain, I would say, hey, I’m right near your building. Can we hang up? And I want you to say this to my face. I’m not going to run. If we made a mistake, if there was an accident, please let me know what we did wrong so it never happens again. And it was just always showing up and showing face. And that goes a long way for people. We’d all make mistakes. We’re human beings, and I mean, this is the nature of the world that we live in. And so, for me, it was very important that people felt heard, that they felt understood, and that I wasn’t running. Right? And I think your team sees that. Circling around, and I know we wanted to touch on this because we’re coming up on Pride Month, right? And we’ve, a couple of the things that you mentioned as you were speaking really kind of push towards inclusivity, right? Not pushing to put people outside of populations where you feel like you’re another, but you’re a part of that community. I’ve observed you over the years, right, on social media, and it’s always been very interesting because of your push for inclusivity. And so I wanted to delve a little bit into those topics, right? I would like to look at historically, because people that are never a part of a population typically go, well, why are they complaining? What’s the problem? I don’t see what the problem is. And like, well, really? You don’t see the problem as a, you know, as a person not from that community. Whereas when we’re from communities, right, we tend to notice certain things. For me, it was always like, yeah, if you get pulled over, son, roll down all the windows. It just makes the police more comfortable. And it wasn’t until a friend of mine that was American, he was just like, huh, that’s really interesting. I never thought about it. I was like, yeah, I thought that’s, I always did that. And honestly, it’s a smarter thing to do. They’re very on edge. So just roll your windows down and keep them calm. But I never realized where that comment came from, right? And so, I want to ask you, uh, things historically of how they may have been different and what you have pushed to change. I was thinking on how to unpack this, right? And we could sit here and say, what do you do now that is amazing? But I’m sure that this is something that not only has unfolded, but is continuing to unfold, right, as our, as our culture progresses forward, as we look for better, um, just merely for the, for the point of better outcomes. So can you tell me a little bit in the 90s what that may have looked like when we looked at, right, the inclusivity? I wanted to show a little bit of progress, hopefully, right? Hopefully. And I’m sure the world was very different then. And so, yeah, I’d like to figure out what were things like key things that you would see or you might notice or observe that were kind of irritating that you thought, you know, when I grab the helm, I’d like to see things differently.

JULIE LIEBO: Right, well, obviously it was virtually unknown in the 90s.

DIEGO TRUJILLO: It wasn’t something you do. It was a don’t ask, don’t tell was the policy.

JULIE LIEBO: Yeah, you don’t come out and say whatever. But I’ve actually felt, even as an administrator, I felt that discrimination in a company early in the 90s where I have a wife of 30-some years, 35 years. You know, she ends up having a one-time bad illness and, you know, it comes into focus that, why are we paying for this woman? And, you know, it brings up this, oh, they’re gay. And all of a sudden, my numbers weren’t right. I’ve always been a very successful administrator and I lose my job. We all knew it because I’ve been there before and we all knew it was very subtle, but it was because, you know, something was influencing here and it wasn’t my performance. Whatever, you move on. But from the 90s, I would say it wasn’t in most of the handbooks even where we don’t discriminate on sexual preference or same gender, however you want to put it, wasn’t even there. And even in the company I work with, which is pretty progressive actually, and I’m very proud to say I work for Fundamental because they really did take a look at it early on with me. Like, what can we change? What can we do? And we did, we did some, you know, they added to the employee handbook, which was fantastic, you know, finally way back when. Now there’s a lot of programs and we see, you know, under CMS new rules that are acknowledging that there are same sex couples that are entering nursing homes, things like that. I did a subtle thing like just all of a sudden one day I took out the male and female bathrooms and made them gender free. And no one ever, ever said another word. They’re gender free. And also when you walk in the door, I put up a very unassuming equal rights sign on the door of the facility. And we have proudly given our brochures out with a pride flag on it at different things because the company has also supported that. But along with all of that comes, and so if I bring it internally into my building.

DIEGO TRUJILLO: If I may interrupt really quick, so what year, for example, the manual that you mentioned, at what year? Because I’m assuming in the 90s, coming out of the 80s, must have been a pretty difficult time. Yeah. Coming into the 90s, it was maybe a little easier, but it wasn’t that much easier, I’m assuming, right? Yeah, we’re talking 2000, probably, you know, 10 maybe. It took a while.

JULIE LIEBO: And then now we’re You can’t force that, and I think sometimes people, we look at our main tool, the MDS right now, now we have to all of a sudden say, what do they prefer to be called? Who are they? What are they doing? I remember years ago, this is a very interesting story. Years ago, I had a woman in my facility. This would have been a little bit later on. I had a woman in my facility that was very sick. And after going in, and it wasn’t, we didn’t even have to ask people that. We didn’t have to acknowledge it. Nobody cared whether somebody was gay or not. And in speaking with her, we found out she had a partner in a facility in town here in Nevada, one in Henderson, and she was in my building. Come to find out they had been together for 20 years and had not seen, they were in separate nursing homes. They’d never seen each other, and they were bedridden. So I worked with that administrator at that point. I mean, there’s a lot involved in it, but I worked with that administrator and brought that person to my facility. And I have to tell you, because back then, now they’ve both since passed away, but back then, even putting two women in the same room was… It was like a nightmare for everybody. I’m like, no, this is this is her because same-sex marriage was not legal either at the time Okay, this is their partnership of 20 years. And yeah, that’s very true.

DIEGO TRUJILLO: Everybody If you had a dog if you had a friend for 20 years, they’re gonna be a pretty big part of your life Let alone if now dad Romantic relate, you know what? I mean pretty significant significant individual.

JULIE LIEBO: Exactly. And when we moved the beds together, oh God, that was really pushing. And I said, why? What’s the problem? Again, before they entered nursing homes, they had all these years together. So we’re going to give them those years before they die. And we did. But that was probably the most tragic thing I had seen. But I know some of that still goes on because people haven’t taken the time to ask or to get to know. But moving fast forward to more recently in the last few years, I did work with, at the time, Comagine, and I worked with CMS, and we worked together to put a pilot program together, and I helped consult on that. Unfortunately, COVID hit right about that time as well. designed pins that if they went through this whole training and they understood what to look for with both gay, trans, lesbians, whoever, that they would look and know what to ask. Example being, you can get, and I have this in my building, you can get a trans individual in your facility that has not completely transferred, or has not completely finished that transition. So instead of, you know, we realized in that video that the first time, it happened to be a physical therapist, helped to assist with removing their pants to help them. get cleaned up, and of course, seeing the fact that there was maybe a male autonomy and a female on this person still, they went, you know, like, oh my God, what do I do? And not to laugh, not to do anything, but to understand was very critical. And so, and everybody’s thinking it won’t happen. I have two people in my facility right now that have not finished transition because of illness. So we deal with that every day. And I know that there are other places in our community that that’s happening. I remember recently when I had two guys, they were married, and I had two guys, and I happened to go into the room to introduce myself because I hadn’t met the husband yet. Now picture this, Stigl, this is even more current, so we still have a little ways to go. So here’s the husband sitting in a chair in the room, talking to the patient in the bed, right? And the nurse is facing the patient in the bed, and I’m watching this whole conversation, and never once kind of turned over to bring the husband into the conversation. So when she walked out the door, I just followed her out. Great nurse. And I just said, I just want to point out one thing to you. I said, do you know who that man was in the chair next to him? Yeah, that’s his partner. I said, it’s his husband. I said, you never acknowledge the husband during the conversation. So this is what we’re going to be training. But if that was, think about this, if that was a heterosexual couple and the husband was sitting in a chair and the wife was in the bed, you automatically would be turning and bringing that husband into that conversation. So we have to learn to observe and to look. So now we try to find a little bit more of that up front so that people know. You gotta remember, the majority of us, myself included, after 35 years, I had said earlier, when my partner got sick years ago, I couldn’t get past the door of the ER. I could not get past that door. Like, are you family? Yes. But we weren’t legally married yet. We had documentation, but we weren’t legally married. And it wasn’t until I was, because she was very ill, and it wasn’t until I practically screamed at the top of my lung that a pastor came out of God knows where and helped me to get through the door and to see her. But we’ve certainly come a little bit further, but I can’t tell you how many times people will walk into a place and they’ll go, who’s the real mom? Who’s the real dad? We have two children that we adopted years ago. Who’s the real mom? Well, we’re both real moms. But, you know, we see that when they walk in the door. We try to find out, well, currently I have three gay couples in my facility and two trans, and they need that care. And they remain in that facility because they’re acknowledged for their relationship. And we actually offered to have, because my wife happens to be a pastor, we had even said we could marry them to help them financially, because they didn’t know. But even bigger than that, that’s why my staff stay. This is the other thing. I have several staff that have come out in the facility, just have never worked anywhere where I’m accepted, and I’m not going anywhere. I can provide this care for you, because you acknowledge who I am.

DIEGO TRUJILLO: Yeah. I mean, from the get-go. It’s unbelievable. Yeah. It’s unbelievable. We live in a world, and I’ll say this, because I am, and I tend to be a little bit more man’s man, and when I, I say that in a traditional sense, right? But at the same time, I was very close with my sister growing up. So people are like, well, how do you understand? I just know my sister, and I understood her and saw the struggles she would go through, and I tried to put myself in her shoes. And then, right, when I was a little bit, I want to say middle school homophobia was a little more popular. It started kind of phasing out. One time I was in high school, I was like, yeah, this is kind of terrible, right? to go to that extent. And it feels like we’re very much in a reactionary world. And it always reminds me, there’s an expression, right? Talking is the cost of being heard. And unfortunately, everyone’s been giving a microphone. So now nobody’s listening to each other whatsoever. And we’re all just trying to tell everyone, you know, they’re going on recently about this, this football player that made this speech, and I don’t want to get too political on this podcast, but But one thing that is blowing my mind is how it’s just, I’m watching these two sides form. And I was like, guys, first of all, right, because then you have the women that are like, oh, women shouldn’t just be. And I was like, if that’s what she wants to do, like, why are we telling other people what to be and what to do? If you want to be a stay-at-home mom, great. The football player’s mom’s a physicist. Great. I mean, everyone should be able to reach for whatever potential they want to aim for. And I would feel in a health care setting, and this came in mind, one of my, I want to say my fourth patient, was fascinating to me. This is back when I was a chaplain. He had no family. When his spouse died, he walked out of the front door and left everything there and went to Brazil. So he lost everything. Now, as I started unpacking, now he was living in a studio apartment by himself. He had been with his partner for about 60 years. And so I remember talking to him and being like, what is Like, I can’t imagine what being gay is in 1950 in Brazil, right? And for him, it was kind of funny because he was like, actually, it was a very pleasant experience. I did a really good job in the military. And I was like, wait, you were in the military too? So he had a good, uh, a good, uh, he had a, he would share a lot of insight on what his experience was. And he had a lot of video. They, they, they did very well. And he came from a very, very well-to-do family, which was the tragedy. When he walked out, there was paintings from the 1700s. from the 1800s. I mean, he really had, he was like, yeah, I left all of this. And so it was very interesting how it really hit me hard how badly hospice had let him down. Because his husband had died and he was in a different, anyone that would have spoken to this man could have seen, hey, he’s a very high risk, bereavement risk. Like we really need to stick with him. And they just kind of let him go. And I think this crosses over all bounds, right? Because we have this on the one push, the push for equality for women for all four. And then there’s now this push for like, yeah, men don’t have friends. And as I’ve grown older, I see this, that the loneliness that exists in men and I start Sometimes we try to outdo each other with what we’re going through. And I’m just sitting here thinking like, hey, do you guys not realize we’re all going through something? Like, this is precisely the point. And for me, what must have been really hard looking at the examples that you’re giving, I put myself in the world that I grew up in, which wasn’t as hostile. I couldn’t imagine growing up in the 50s and 60s where we had to lie about our relationship our entire lives, and now I’m bedridden. How much more vulnerable can you be as an individual? I’m dependent on these people. What a great opportunity to be able to give them a chance to be seen. probably for the first time in their life, at least very much in healthcare, if someone would have just asked, for 20 years they live separated, right? And I think it speaks more to the issue of not just how we’re treating a specific population, but really how we’re treating all patients from a point of understanding and comprehension, right? And just learning to listen. Which is a little hard, you know, again, we’re very busy. Like I always joke, right? I don’t see healthcare workers like bored sitting around. It’s like a social worker. They’re all very busy and they’re all going through things, etc. All these things are happening. And so to be able to take that time and to be able to guide your staff, do you ever have staff that are resentful when you say things like that? Is there a pushback?

JULIE LIEBO: I have not had any pushback to be quite honest, but I do go to orientation right away and I let them know what our goals are and what we do. I do place, there’s some signs throughout my building and the break room and other areas too that say we accept all. I have everything I can up there that says we celebrate our diversity. I make sure we do all kinds of parties for every potential person that comes into the door that’s an employee so that we recognize who they are. And so I think as we continue to do that kind of thing, they do stay because they do feel like people know who I am. And so I haven’t really felt resentment, but I do let them know in orientation. I said, I’m really sorry if this is a problem. We could talk about this, but this is who we accept, and these are the kinds of patients, and these are the staff that we accept when they come out. We have a staff person that transitioned completely in our facility, and she’s very, very happy. I believe in my heart and heart she couldn’t have done that anywhere else with the dignity that happened there. So I think we’ve still come a long way, or we’ve made a lot of good strides. We really have. The problem’s going to be, and like you say, it’s people in general, and the problem’s still going to be that health care, it’s about getting better, and it’s about accepting the family. So we have to, whether we want to hear the answer or not, we have to hear about it. We have to ask. We have to say what about them. And in a lot of cases, families are a little bit still embarrassed by what, you know, who this person is or how they live their lifestyle.

DIEGO TRUJILLO: Well, because they still have that mindset. Again, just because we’re here now today doesn’t mean I was raised like that for 40, 50 years. I had the one, actually, this patient that I was telling you about, I remember one time I brought up and I was like, hey, look, they legalized gay marriage. And he goes, Oh, no, no, no, no, no, no, no. That is unacceptable, unacceptable. I was like, you were with your partner for 60 years, right? And unfortunately, I mean, progress is slow, but we sometimes have this attitude that recognizing someone else means ignoring somebody. And I just, that’s where I get frustrated in today’s culture. I get very frustrated because it’s always a, well, you know, um, an either or. Right? It’s never the and. And like, oh, also there’s these people that need to be seen as well. And I don’t know if it’s just my life trajectory because I, again, going through the, on the issue with trans people, uh, as I was speaking with, I had a friend and, uh, and one time they sprung the news on me and I was like, huh. And so, and it really just led to me asking a tremendous amount of questions. And as I was learning, it would really help me, oh, okay, I see where you’re coming from. Do we agree on everything a hundred percent? No, not necessarily. And she would get sensitive. She’d be like, well, I just think, and I’d joke and pry and be like, oh, they’re definitely giving you too much estrogen, right? And we’d have fun with it. But it was always, again, going and circling back, hey, you know that I love you as a friend, that I care about you, and I want what’s best for you. And if you think this was what’s best, and sure enough, I mean, what she’s blossomed into versus who she was back before she transitioned, it was a night and day difference. And so I’m just like, yeah, if this is what has given you fulfillment, as opposed to being suicidal and wondering why you’re here all the time, I mean, what is the alternative, being forced into this mold. And so again, going back to that, just that approach of understanding and also the inclusivity, which for many people, again, if you grew up in San Francisco, you’re going to think, well, I don’t know, why is everyone complaining about discrimination? It may be a little different if you’re from Dayton, Ohio, right? It’s very different lives. And I would hear people sometimes I had a friend one time that said that, well, I just don’t understand what all the protests and the problems with race that’s going on. And I was like, really, as a blonde-haired white girl, you wouldn’t see what the problem with race is, even for me growing up in Las Vegas. It’s a lot more diversified. I went to seminary in Dallas, and it really put it into perspective. I was working alongside a food runner who was much older than I. And he told me I mean he made a comment I was like, huh and he goes yeah I remember when you know They would put the white people in the front and then us Mexicans would ride in the middle and the black people would go in the back and it was always history to me it always happened like so far back and I was like Wait, you saw that? I mean I which I should have known because I know the dates and I enjoy history But it really just brought that to like to life it added color to a painting and I realized wow This wasn’t that long ago Right? We might think that because we’re learning about it in a book, but this man is telling me, no, that’s how it was and this is how we treated each other. It’s just very interesting. Again, circling back to that, to the comprehension and understanding and listening and again, acknowledging populations. What areas do you think we could work on as a community in general? You’ve implemented some pretty great things. I know there’s people that may be listening. There may be even people rolling their eyes and being like, oh, here we go again. And I want to leave, Right? That’s why I wanted to focus on the history first to understand, you know, we’re coming from somewhere. It’s not like we just decided to complain all of a sudden. Right. What do you think we can, what small steps do you think that other administrators, buildings, health care workers, staff members, you know, offices, what small steps could we take to help to further that?

JULIE LIEBO: Yeah, I think, you know, it really helps probably to sit and talk with your staff first. I think you’ll find that a lot of staff in your building probably are gay or are, to be honest, are trans. We’re in every building. They’re in every building. And once they kind of understand what they go through, I think we can understand what the patient population will be going through. But it’s going to be very small steps. And this didn’t happen overnight. We’ve come a long way, like I say, from not acknowledging same-sex couples to today being open on a referral that says this person is trans or this person has a husband.

DIEGO TRUJILLO: You know that or a wife that yeah, you know is you brought up that acknowledgement piece I so honestly, I never even took that into account now that you bring that up I’m like combing through my history. This is my stories thinking, huh? Yeah, did I ever do that? Because it’s again we have this behavior that it’s just in us We’re not thinking about how we’re interacting with every person right each one of us is kind of the way we are Sometimes we have to take that step back and be a little more conscious about how we’re engaging, right? That was a very interesting poem, a very interesting story, because, yeah, I wonder if there were moments, right, where I just was going about the average? Because I know, for example, so my father died from kidney disease. He ended up having kidney failure. He had a rare disease that shut his kidney down. There came a point where we had to make a decision. Now, for a Hispanic to go on a hospice, you’re already fighting an uphill battle because they will tell you, I’m not giving up. I’m not giving up. That’s not what we do. And then number two is we’re not sending them to some place, right? And so I remember The first thing I’d always bring up, if I was dealing with a Hispanic family, I would say, okay, so hospice is not a place, it is a service where you are. It allows, you know, and then I would explain that to them. And if it ever turned into the, if I ever looked, right, and you looked at, it was kidney failure and they weren’t gonna do dialysis, I would walk in and say, hey guys, I can give you this big, long speech on what hospice is, and I feel like it’s very important. I’d like to give you literature, but just, you know, so we’re not here for one hour entertaining ideas. If you choose this service, he will have to stop dialysis.” And the family would be like, absolutely not. Okay, I wanted to save us. There will come a point where you have to make that decision. Let’s get that out of the way. I’m not here to sell you anymore because you already told me you will not, you’re not willing to discontinue dialysis. But here’s what the future may look like. There may come a point where he’s too tired, where it’s this, and I would kind of explain it. I would approach it completely different than I would, you know, people from other cultures because I had an understanding of what, right, I was raised Hispanic. So it’s very interesting, again, when we start thinking of different, of different people from different backgrounds and learning how to connect with them. which we see statistically the benefits, the outcomes that we have in patients’ lives when we do that. We just see better results in people. And at the very least, if you don’t care about any population and all you’re worried about is that, is those end of the quarter calls where you’re looking at your earnings, it very much will impact your bottom line. I mean, if you’re treating patients better, if they’re being seen, if they’re being heard, and again, this goes, I was sharing with you before we started the podcast, there was a new study that came out, that as a woman, if you have a female provider, you will have much better outcomes. So these things are not too distant. They’re not too far from home. We all have a sister, we all have a mom at the very least, right? So having an understanding, there is a lot of benefits to this. It’s not just simply a burden. It’s not simply that. But the outcome is a better world. And I don’t think a better world’s ever been forged easily, right? I don’t think the people that landed after crossing over the Atlantic was like, well, that was really simple. What if we just push west, right? It always required optimism that change could happen, that we could get somewhere better. And then it took a lot of blood, sweat, and tears to make that happen. And I feel like we’re still at the early ages. You know, it’s really funny you brought up gay marriage. Yeah, I saw that happen, and it still feels like it was a really long time ago, and it wasn’t even a problem. I always relate to a story. I remember a physician calling, and there was a couple inside of the ICU. He was yellow. He was jaundiced. She goes, he probably has a few days to live. I’ve called eight chaplains, and they all refuse to marry him. And I was like, but what do they need? Well, just someone to come fill out the paperwork and do the ceremony. I was like, wait, really? And everyone was worried about what their needs, wants, desires, everything. I was like, at the very least, just for the ease of the legal paperwork and everything that the partner is going to have to go through, I say partner because eventually they’re a spouse. So I went in there, and I got a little nothing but cake, because you couldn’t have a wedding without a cake, right? And I was just like, come on, man. It just seemed very heartless to me. Right? You’re already dying. And you really got to stick it to them one last time, huh? Just to prove your point. I mean, have some humanity. At the very least, it seems like, uh… When an eight-year-old is dying of leukemia, you’ve got to come and tell them, hey, Santa Claus is not real. You get what I’m saying? It just seems like cruelty to a certain point. You’ve got to set yourself aside and your own feelings aside to be able to serve. What else do you see towards the future? What are you excited about? What is your outlook? I mentioned that there’s one of my favorite expressions is, optimists build the future. So we have to remain optimistic. What are you optimistic about?

JULIE LIEBO: You know, I’m optimistic that, always optimistic and believe that we will be a world of peace. I really believe at some point we’re going to learn to respect each other, every culture, everything. I really do in my heart of hearts believe that. And as I see, like even something as simple as when we changed our mission packet to read you know, person one or person two, not husband and wife or child or whatever, you know what I mean? Son, daughter, whatever. I mean, little things like that matter 100% when you’re looking at, you know, paperwork and you’re looking, it gets people thinking a little bit of, you know, what are we doing? Who’s out there and who are we representing? So I’m very optimistic and at some point, we’ll have enough education behind us that people will understand the types of patients that they are taking. and who they’re bringing in and not do any laughter. I mean, I had a, this was a really interesting one, story. I had a trans individual who got shot here in Vegas in a bar, and she had, she was a dancer. In training the staff, which we do all the time about diversity and whatever, she and she gussied up every day. I mean, she and her friends would come in and it really, the facility was a blast. The therapy department was so great after education that they actually taught her to dance in heels. You know when she was getting her they were doing all the gait exercises and everything not just to you know be able to stand up and walk 10 feet down the hallway but no this person’s going to do some high kicks again or go into the bar and whatever and it was a it was so fun to this day she’s actually moved now to the Midwest but I I still stay in touch with her on Facebook all the time, you know, how she’s doing and whatever. But I think if we can get to that point where people have that kind of fun and acceptance of people’s lives and want an interest in learning who they are, obviously somebody saw that, like you said, women being cared by women might change the outcome. Well, the more staff that can relate to patients, too.

DIEGO TRUJILLO: Yeah, I think in general, I mean, that study happened to study women, but it just feels, again, you’re being seen and heard.

JULIE LIEBO: Exactly. And so if they can walk in and even me, I mean, there’s been several times where, you know, we’ve been chosen as a facility because of who I am. It’s like, well, I’ll feel comfortable going into that facility because there’s going to be an understanding of who we are.

DIEGO TRUJILLO: I won’t be another one of those, right?

JULIE LIEBO: But it’s the same thing. You know, we take people of major size. And so I, when I started that years ago too, I said, look, We want to continue to take these people, and we can’t take one. I want to take, you know, three or four at any given time, because nobody wants to deal with people that kind of size. And we have now built that program within the facility as well. And so there’s a dignity behind that. There’s a dignity behind being trans and being in that facility, or gay in that facility. Very important. You know, that’s, in most cases, that becomes their home. We’ve got to understand who we’re caring for inside and out. Otherwise, they’re just laying away the way that they were before. If they’ve got nothing left but living in that type of facility, why should they go on more years to come without being able to come out and say who they are? I don’t know how to explain that, but it’s the saddest thing in the world when you’re closeted. Your life just goes by, and you want to share who you’re in love with, or you want to share who shares every moment with you like any other partnership, and you can’t. So we have to look. I tell all administrators, you have to look. You have to want to teach.

DIEGO TRUJILLO: I agree. I agree with you 100%. And I think that one of the major things, which it’s really funny now, I always show it to people when people are kind of When I see them as stubborn or where I see them as like really firm on their positions I’m like, hey, let me I don’t know if you’ve ever seen this video There’s a video from the 70s where they made it illegal to drink and drive And I and I always tell people I’m like if you don’t know right I saw this with like the mask Oh, you’re not gonna tell me and there is a video of a news station interviewing people And there is literally a woman with a beer in her hand and a baby in the front seat right in the in the strap And she’s saying well, you know now they want to come and tell us that we can’t drink and drive and but you know if a man is right somebody else like well You know if a man wants to put in a hard day’s work and have a beer on the way home What’s wrong with that? I’m like Yeah, that’s how people used to be. You’d sound pretty dumb if you said something like that, right? And so we have to hope that some of this will stick and slowly things will progress and things will change. So I very much admire your optimism in what you just said. It does sound I find it frustrating that it has to be a naive statement or come off that way, because I don’t think it is. We have to hope for something. But if not, what are we doing? Right? There has to be a better future. We need to pay for ourselves. And unfortunately, the tribalism that kind of comes in us, maybe it can go towards other things, like, you know, people on other planets. No, I’m kidding. We can get it against them. They’re, they’re, no. But that we can learn to kind of unite and bring those things together. For me, I always drive home the point to be just, just listen. Just listen to where they’re coming from. And if you ask the right questions, you know, typically you don’t have, now there are some people that are just, you know, they’re just trying to outrage and bait for those things. But if you really listen to where people are coming from, it seems to make sense. We’re all shaped differently. And so our experience are different and you’re always going to be better off. You’re never going to be worse off for having more knowledge on how people or how the world is. So at the very least, even if you disagree at the end of that, at least you can kind of come together on the fact that you have learned a little bit more and you know a little bit more, and you’re more educated on your position if you choose to, you know, continue to hold that. Maybe you’re going to tolerate now and accept later. Who knows? But just remember the 80-year, right, the 1980s alcohol video. You can YouTube it too. God, it’s so funny to go back. I still continue to go back and watch it. I’d be like, wow, people really used to argue that. They got upset about big government telling them that they couldn’t drink and drive. Yeah, exactly. We have come a long way. Well, thank you very much for coming on. I told you it would only be about 45 minutes and we went well well over that but this is a very interesting conversation and more importantly I think it’s a conversation that needs to be had on a more frequent basis. I really appreciate it. I always tell my guests it’s very interesting the way you kind of connect over a podcast with people. You wouldn’t think it because you’re like, well, what is he gonna ask, right? And I’m thinking what am I gonna ask? Yeah, exactly. But I like when the conversations come out natural like this and we just kind of find out a little bit. I didn’t dig into your past, but you mentioned something right as a CNA and working in skilled nursing. So I appreciate you being able to share a little bit about your experiences and what you’re doing to pave a better way in our community to be able to serve the people in our community. Thank you. Thank you for having me. Thank you very much for coming in, ladies and gentlemen. Thank you very much for tuning in for another episode of The Peels Pod. Have a wonderful day.

Unpacking Stem Cell Research and Regenerative Medicine with Dr. James Utley

By | HEALS Pod, News

In this episode of The HEALS Pod, we had the pleasure of interviewing Dr. James Utley, who joined us all the way from Panama City, Panama. Dr. Utley shared his journey of starting a stem cell regenerative medicine clinic called Origins in Panama City after conducting independent research in Las Vegas.

Dr. Utley discussed the process of using mesenchymal stem cells from donated umbilical cords at Origins, highlighting the ethical sourcing and transparency in their manufacturing process. He emphasized the importance of evidence-based treatments and the differences in regulations between Panama and the United States.

The conversation delved into Dr. Utley’s background in the United States Navy and his experience in blood banking and transfusion services, leading to his passion for life sciences and stem cell research. He also touched upon the potential of stem cell treatments in various medical conditions, including osteoarthritis, injury recovery, autoimmune diseases, and autism.

We explored the challenges and opportunities in bringing stem cell therapies to the United States, with Dr. Utley expressing optimism about the future of cellular therapy and genetic engineering. He highlighted the need for more research and evidence-based practices to ensure safe and effective treatments for patients.

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Full Transcript

DIEGO TRUJILLO:
Ladies and gentlemen, welcome to another episode of The HEALS Pod. I am your host, Diego Trujillo, really excited about what’s going on in our city, all the innovation, all the change and everything that’s happening. And sometimes, you know, when we’re trying to innovate, when we’re trying to create new things, we can kind of run into some walls, some difficulties. sometimes were stifled by regulations and things like that. My guest today is very interesting because they started it based here in Las Vegas and they had to expand, right? To be able to push the type of research they were looking to do. And I really want to unpack a little bit about it because I know a lot of us have questions when it comes to stem cells and what stem cell treatments do, how they work and what the differences are. And with me today, I have a very special guest that is calling in all the way from Panama City, Panama, and I’m very excited to be able to interview Dr. James Utley that joins us today. How are you doing today? I’m doing well. Thanks for having me. Fantastic. Well, I would have loved to have gotten you out here to Las Vegas, but I know that your work has you down there in Panama City. But I think what you guys are doing is fascinating. I’ve been kind of keeping an eye ever since this was an idea. And eventually, me and you knew each other here in Las Vegas from different events and different processes. I’m sorry, different events and different organizations. And then all of a sudden, you kind of came up with, hey, yeah, I’m moving to Panama City. And I’ve been taking it back like, okay, what is it about Panama City? Why Panama City? And then kind of wanted to unpack that. So what are you doing down in Panama?

JAMES UTLEY: Yeah, so I guess that’s a good place to start. Yeah, I think when we first met, yeah, it was already seeded, the idea of what was happening down here. There was a there was actually research being done at the lab there, but it was independent research by myself, right? And it was really kind of looking at, you know, different cellular function, the way we could stain cells, culturing techniques, etc. And then it resulted in, you know, the movement to Panama here and opening Origins, which is really a stem cell regenerative medicine, you know, clinic and center that provides mesenchymal stem cells for clinical application for different, for broad use. And that’s what kind of makes Panama the ideal place for this type of one research into clinical application. But yeah, it started in Las Vegas. And now that was the whole, that was the whole thing. Of course, no, there’s no patients. It was all just independent research that happened, which was really taking the start of what we call the explant culture method. And then And then kind of refining it and just understanding and learning it, perfecting the craft, if you will. And then, you know, ready for bring it to prime time to, uh, down here in Panama.

DIEGO TRUJILLO: So taking it, taking it a step back, right. Cause I wanted to unpack this and I was thinking on how we do this by stages. I’d love to kind of get into your background. What, what gave you this, uh, this passion for, for life sciences and what you started exploring and how you got to this, this place you are now.

JAMES UTLEY: Yeah, it was actually kind of serendipitously that I arrived here. I had always been kind of fascinated with this specific cell line, and it was really kind of tipped off in the work that’s been done in graft-versus-host disease, right, and that type of research. So that’s kind of like the teaser of why I was like, oh, this is an interesting These cells are interesting, right? But, you know, long before that, I most certainly cut my teeth in the United States Navy, you know, and I worked in blood banking and transfusion service, you know, basically all through the Navy. And that’s where, you know, all the training and background comes from. Yeah, yeah, that’s where, that’s where it kind of all started. I, for nine years, I worked for Banner Health and then this group called Laboratory Sciences of Arizona. I don’t know if, so I was the technical director there for the last five, which was for all the blood banks and transfusion service, which really kind of broadened, you know, it’s, it’s Banner operated six, 30 hospitals over six states, etc. We just kind of hosted all the you know, procedures and protocols and everything for them. So that’s where a lot of the technical work came here.

DIEGO TRUJILLO: COVID happened. That was your foundation. Just out of curiosity, that was your foundation kind of getting you set up in the life sciences in the lab space. But up to that point, had you done any research? Did you look to innovate? Was there any innovation in your process?

JAMES UTLEY: Oh, uh, let me see. I want to make sure I understand that question.

DIEGO TRUJILLO: So, so currently you’re, you’re doing a lot of innovation, right? When it comes to stem cells and what you’re talking about, um, as we discuss these, these mesenchymal stem cells, you said there was an interest there, but when you were working in the lab technician, that was more, most in the blood banking, that was more in, in lab processes. There wasn’t innovation in that space or was there also?

JAMES UTLEY: Oh, no, no. Yeah, no, there’s tons of innovation. I could think like even just right before, you know, right before I left that space, we were working on sorrel and treated platelets, which is a way to treat platelets for, you know, the mitigation of bacterial contamination. Then I think kind of like my one of this like prime project that I always hang my hat on. was this one with a vendor called Hemanetics. That’s when I was in the Navy. It’s a glycerolization, meaning providing the ability to freeze and unfreeze red blood cell units. So that’s a, which was, you know, this is like 2005, I believe. And that, so we ended up putting all these frozen units on all the naval ships and then four deployed during the, you know, the time of the war. But that was an innovative piece there. So there’s always been kind of like for me, I’ve always kind of been pushing the envelope in terms of innovation. And then, you know, I I kind of really got deep into some genetic engineering and some CRISPR technology. That’s kind of in the last four or five years or so, which is definitely surprisingly. So, yeah, it was just surprisingly easy, you know, and part of that really, I guess it was called a biohacker community there. So there’s a lot.

DIEGO TRUJILLO: I mean, there’s The first deployment of CRISPR actually. So my father had a very rare disease called amyloidosis and the very first deployment of CRISPR was against that disease. There was no cure. There was no really treatment. Even during our treatment, one of the oncologists looked and said, yeah, it looks like everyone else was just taking a shotgun approach to see what would work on this. Like, you know, they were doing chemo and, and different things, but nothing seemed to work. So I remember it was about a year after his passing that they deployed CRISPR and sure enough, they had very good outcomes with a patient with amyloidosis.

JAMES UTLEY: Yeah, for sure. There’s a whole frontier in front of us as well here. this technology relational to the computational improvements of AI. We have a crazy future of innovation in front of us.

DIEGO TRUJILLO: It seems like a very exciting time when we hear a lot of the quotes.

JAMES UTLEY: I think it’s the most exciting time because this is the first time in human history that we have the ability to edit our own genetics here purposefully. So yeah, it’s crazy.

DIEGO TRUJILLO: So what was it then that made the connection to Origins where you are now, right? So you mentioned that you were working with Banner after the Navy. Where did the connection to Las Vegas come from? Where did that hit?

JAMES UTLEY: Well, I mean, at the time I was living in Phoenix, like the connection to Las Vegas is my family lives there. And then there was just like I said, it was kind of a happenstance event where there was an alignment of like minded people that, you know, I had met along the way. And this was an idea that hadn’t materialized. But it’s kind of one of those, if you’re you know, maybe, maybe you’re destined to walk this path. And that was the because, you know, I mean, I was a self therapy guy, you know, we’re, you know, I’m making, you know, developing and pushing self therapies, you know, and that’s essentially what what I do. And, and this having this opportunity, which was never apparent, you know, like it was never in the plan, right? It just, it was it was a series of folks with some ideas. And then input the right background and some good research that happened probably a year prior to this endeavor, you know, year, year and a half. You know, because, you know, other things is, you know, I completed the AABB cell therapy program, you know, these are all things are just manufacturing, like lots of different cells, right? Like, but, but that’s how it kind of arrived here where There’s this whole movement in regenerative medicine, and it was just kind of an alignment that is hard to explain, but it just happened.

DIEGO TRUJILLO: A little bit of luck, huh? Right place, right time, and you had the right skillset.

JAMES UTLEY: That’s about most things in life.

DIEGO TRUJILLO: Yeah, you’re just prepared and something that you’re passionate about and it just turned out they need to do. So tell us a little bit about origins. What is origins? What do you guys look at? You know, I hear about stem cells all over the world and people, you know, a while ago were, oh yeah, I’m going to Tijuana. And I remember seeing stem cell billboards everywhere. And now I’m seeing them in the US, they’re advertising stem cell therapy. So I want to kind of explain to the people that are listening today, what is the difference? What was it about Origins? I’m sure you are aware of stem cells already, right? This is nothing new. Oh, yeah, for sure. So what was it about Origins that really caught your attention that you said, huh, this seems like something worth pursuing? What was the goal that was different here?

JAMES UTLEY: Okay. Yeah. I mean, so there’s a couple of ways to divide that question up. I think the first one is what, I mean, first is what is origins. Of course, we are, you know, a stem cell clinic here in regenerative medicine center, as I mentioned, um, we harvest our MSCs or mess. We’re going to, we’ll use that term, um, uh, from Wharton Shelly, right. From donated umbilical cord from Wharton Shelly. Now, in my opinion, that’s probably the most rich source of MSCs. And there’s no ethical concern because these are all donated, right? They’re donated under informed consent from a program that we have here at a local hospital that sits right next to our center. So it’s perfect. So you have, now, you have the ability, so these, so that’s one part of it. That’s what we do, right? And we operate here in Panama because, I mean, people believe that it’s kind of like the wild, wild west and there’s no laws or regulations, which is far from the truth. We have, they have, They actually have some pretty strict regulations. It’s just they have carved out this piece of the law here that you can use this cell therapy for, you know, a broader application, right? So it would be equivalent to using something in the U.S. as, you know, all based on all evidence-based, based on literature, etc. But it you can you can you can use it. So there’s no there’s no hiding or anything like that. What I fear, so now we’ll stop there. That’s just the beginning part of the amazing things that happen at Origins, right? But to transition to the next part of your question is, yes, you do see stem cell clinics that are all over the United States to include in Las Vegas, you know, for one is those are harvested from the person from self, their colitologous donation, right? So there’s different ways to do that from bone marrow or fat. Um, and so they’re, they’re harvesting the mesenchymals or the MSCs and those cells are as old as the patient, right? So, you know, there’s a kind of a common sense theory that, um, you know, if, if, if something is, is aged as, as old as you are, right. Um, then there’s a probably, you know, there’s, there’s less opportunity for function, even though the literature kind of argues that back and forth. Right. So there’s some opportunity there. Um, my biggest concern I think is, the FDA has some really strict verbiage around, you know, regenerative medicine clinics in the U.S. and the use of stem cells and or exosome products. And it’s all over there. It’s all over the website. It’s for consumer protection, et cetera. But still clinics are offering that, right? And so they Now, by doing so, I think it gives rise, and this is my own opinion, to kind of some black market behavior, if you will. Because if you’re a patient and you’re asking the next, like, okay, well, where did this come from? Because you do see, aside from the autologous cells, they used to have ones that are harvested from different tissue sources, right? amnio or placenta, etc. So, but you want to ask like, where did this, you know, and even in the exosome world, right, with exosomes, which are, you know, a secretum factor of an MSC, right? So it’s what, it’s what the cells secrete. You asked where do they come from and things like that? And I don’t think that the patients there in the US they don’t get really clear answers because there’s not a Really kind of a logistics train. That’s very clear, right? right, and so what what it does is it opens up the the window for What I’ve been coining as some black market behavior. Yeah now here in Panama completely different We have our laboratory is glass. It’s from floor to ceiling. It’s glass. We have every section of the process. It’s all mapped out. And when the patients come here, here to Origins here in Panama, they get to see everything that’s happening from a manufacturing standpoint. And it’s full transparency and audit. That’s everything with the Ministry of Health here and this organization, which is like an FDA like, um, so there’s all of that, you know, it’s complete, complete transparency where you get everything from raw source materials to the end product from, you know, we say from, from vein to vein, right. Which means from the donation to the infusion, it’s, you can look at every step and audit every step, which is, that’s what makes this place different. Now that’s from a, like a manufacturing or what they call continued good manufacturing practice. Now, then you move into this kind of this argument of whose cells are better, right? And that’s where there’s, of course, there’s a debate, but we know that the function of these, you know, cells that are donated from Wharton Shelly is pretty much evidenced in the literature that they are superior to any that would be in any cell, any other MSC that’s harvested from adipose, etc. So people might argue that we just, we know that from our patients as well as the research we do.

DIEGO TRUJILLO: And I’m sure that, like you said, some of it’s anecdotal, right? A cell that has been around for 40 years collecting radiation from the sun and just the environment and contaminants and things like that. And correct me where I’m wrong, because I’m not studied in this, but it would seem that a brand new cell would probably have more potential to have a positive impact than one that’s already been affected throughout its life as it’s being created and as it’s being regenerated, no?

JAMES UTLEY: Yeah, that’s like, that’s a, that’s a fair analogy. You know, there’s a couple of ways to look at it. You can look at some, the cytogenetic portion of like, so what’s the ability that way. And you can, you know, it’s, it’s, it’s all of those, but we do, we harvest from mortgage jelly. So we know that there, uh, those cells are optimal. Um, And I think that it’s, I mean, it’s evidence in the literature, but it’s also, we look at, you know, the patients that we track here, and I think… Right, you’re able to observe that.

DIEGO TRUJILLO: Well, I mean, I always find it interesting, I think the gentleman’s name was Thomas Midgley, or Midgley, he invented leaded gasoline and ended up lying about inventing, they think he is probably responsible for more death on this planet than anybody else. because he invented leaded gasoline knowing that it would be putting lead into the air. So for about 30 years, people everywhere around the world were breathing in leaded gasoline. And it’s really interesting. You look at the data and the statistics on like violent crime during those years and how they went up, up, up, up, up until they cut the leaded gasoline. And obviously there was huge settlements and lawsuits around that because it wasn’t as inert as he had kind of exhibited. And they were able to test people that were alive during that period just by the level of contaminants within their body. So I mean, again, the assumption that that being in an environment and add to that, like atomic testing and things like that, that just contaminate our environment, I would assume that the cells would be affected by that as well. The things that we’re drinking and eating versus again, the brand new cells that are collected from the jelly, like you mentioned.

JAMES UTLEY: Yeah, it’s an environment. So me personally, I know that I’ve, I’ve spent some time kind of like, uh, talking with folks and, you know, trying to be collegiate around this debate here. And what I have found is that some of the regenerative medicine like stem cell centers in the US, because they’re you know, it’s like, it’s, it’s like religion, you know, they, and which is really meaning that they don’t want to are they they have a belief system, which is, yeah, is great. So I haven’t, you’re gonna knock down their framework, and I’m gonna push you into picking a side here.

DIEGO TRUJILLO: All right. No, I’m just kidding. No, it’s, it’s very interesting to see that. I mean, and I think it’s, it’s reflective. Again, when you just look at the pricing on things, um, and, and the cost of what things are. I know there’s another manufacturer, a drug manufacturer here in the U.S., right, that makes, uh, semaglutide. And their biggest concern is they’re like, yeah, you know, typically this is the cost. And there’s people that are getting this from China for, you know, and administering it for $200 a shot. There’s no way they can know what the quality is, what they’re getting, right? And unfortunately, even though it’s not a legal generic, these doctors are able to obtain this, they’re able to give it to their patients, and it’s just a matter of time before a bad batch comes in, we see some negative effects, and it just kind of takes the entire thing. Whereas having the ability to say, yes, that hospital right there, is where we source our product, where we source the stem, the product, the stem cells, right? The umbilical cords, this room right here is where we extract. I mean, the entire process is overseen and like you mentioned is transparent.

JAMES UTLEY: Yeah, that’s the most important part, I think there, because you, you know, and if there’s a, like a call to action for patients is that if you’re looking at these stem cell clinics or the regenerative medicine clinics that are using stem cells in the U.S. Just first do a quick Google search on the FDA website. You know, they have warning letters and these type of things. And there is a lot of them. So it’s, you look, it’s really easy. It’s like clinic and then write FDA warning and then it’ll provide, you know, either they’ve inspected them, they’ve warned them, you know, this is all public record. So I always just say like, Hey, you know, you don’t have to take my word for it. Just do a little googly and you might find it.

DIEGO TRUJILLO: Yeah. Okay. All right. That’s fair. So what is it about this process that you guys do there that you can’t do here in the United States out of curiosity?

JAMES UTLEY: Well, I, the true essence of it is really kind of unknown, but we’re the, uh, now what we know is that it’s the culture expansion. So that’s made from taking one, making many, that is actually the part that’s in, uh, restricted in the US, because if you do that, then it falls in a category that’s called more than minimally manipulated. And if you do that, then you have to go down a regulatory pathway, which is an investigation of a new drug, et cetera. And so that’s the key. So there’s people that try to work around that so they’re not like technically, they’re not crossing that barrier of however that’s defined of more than minimally manipulated. then they can have some more laterality. But again, it’s like, it’s just loophole type stuff. Yeah, it’s great. And so that’s the, that’s the whole thing. That’s why they exist. I’m, I’m sure of it. Um, but having some real clear interpretation of what you can and cannot do, um, through that’s like from end to end from, through the whole process, um, kind of like, kind of like figured out, it’s like, it’s the culture expansion. They don’t lie. Maybe they, maybe, maybe it’s been termed in an FDA guidance as unnatural. Um, so therefore, you know, but, uh, it’s really, it’s one of those things where it’s like, there’s got to be more layers to the rationale, which probably has interest of, you know, not to be sound like a conspiracy theorist, but has the interest of, you know, big pharma or someone else that really kind of keeps everything in place. So that’s, that’s my that’s my best deception, my best description of Why, for sure.

DIEGO TRUJILLO: So yeah, there’s not like an actual, here’s the science behind why we don’t do this. It’s just kind of been, well, this is the way we’ve always done it, and we will continue to until there’s enough pressure or people find out, or I’m assuming until enough success stories happen. And I’ve been hearing a lot of success stories coming out of Origins. There was a podcast Hughes actually sent me. It may have been you or another gentleman named Dan that had sent me the podcast to listen to, and I gave it the full listen to, and it’s pretty incredible to listen to the outcomes that these patients are having, which has got to be extremely motivating for you guys.

JAMES UTLEY: Yeah, it’s very powerful. I mean, it’s the purpose. So I think if there’s like two really broad purposes for me, you know, is that one, to help people, that’s, you know, two right is that we can provide enough evidence that can be used to open window you know open access for everybody right because it’s not it’s not super complicated to be honest with you it’s it’s biology treating biology um and that’s really the the essence of it and so you know and the way I feel about it is if you’re if you want everybody should have the, you know, the information. So if you’re a patient that’s gone, you know, kind of thinking about like, should I get surgery or not? You know, and there’s this option here that could probably help you. You know, in some regard, right? Yeah, you should just be aware of it. You can so you can make that decision yourself. That’s just my thoughts on that.

DIEGO TRUJILLO: And I know a lot of people sometimes are a little bit nervous when they hear, oh, South America and Central America. It’s funny, because I’ll talk. I recently was talking to somebody about plastic surgery. And as they were talking, I mentioned, yeah, in Colombia, it’s very common. A lot of the plastic surgery tourism is very big. And their face kind of said everything. Now, full disclosure, I am Colombian. So I remember seeing their face like, what? In Colombia? Going in to get surgery? And I was like, you know, it wasn’t until I shared with them, which is the fact that I was very surprised, they have five Jayco accredited hospitals in Colombia, which is the same accreditation body here in the United States. So these are not subpar hospitals. You’re not in an alleyway here. These hospitals are on par with what is being done in the United States.

JAMES UTLEY: Yeah, that’s that’s that’s that’s very true. The health care delivery, I mean, here in Panama and in Latin America is it’s actually pretty good. You know, I would say that like even for us here, you know, we have a federal, that’s US federal, deemed status organization that we work with to help accredit the laboratory. And that’s the same steps you take in the US. And it’s actually written in the law that you have to seek these deemed status organizations, one or the other, you have to go. And so that’s why people think that it’s kind of like the wild, wild west. Well, okay, it’s the wild, wild west in terms of applying it, right? But when it comes to manufacturing the product and all the safety involved, You have to follow all the rules whether you’re here or you’re in Tennessee. It’s really the same. to do it right. Now that’s to do it right and that’s how we do it here. When we were building this place and all these ideas were coming, we brought folks to certify our clean rooms, we brought the folks from the U.S. here, we flew them here, they did all the certification, so there’s really no difference. There’s no difference of what happens here versus what happens in the United States.

DIEGO TRUJILLO: The quality is the same.

JAMES UTLEY: Yeah, I would say that because we have the support of, you know, being able to operate freely here, in terms of the way that we apply the cells that, you know, you just, like I said, you don’t, you don’t fall in that trap of, of regulatory worry, because you’re, and then that there are no, there’s no black market behavior.

DIEGO TRUJILLO: And how do you feel your outcomes are? When you, when you weigh the outcomes, I’m kind of curious, right? Because we knew each other before you had gone and done this project. Was there any doubt in your mind? Like, huh, I wonder if this will work or it should work. Right. And then versus now you’ve been open for roughly about a year, year and a half. Yeah. And so as you go in the year, how have you felt with your expectations versus the outcomes that you’re seeing?

JAMES UTLEY: Yeah, no, there was for me, of course, as a scientist, I have, you know, I, I only look for evidence there, right? But, you know, this right here, believe it or not, this, this cell line or this, these MSCs, they have so much literature, right? So it’s, you know, it’s decades worth, you can just look back and you know of course if you’re you have to be wise in what you’re reading you know to make sure that it’s uh but you know all the theoretical makes sense and then you take that the theoretical and then you’re looking at okay what other people you know because we’re you know we’re not the first people to do this and when you look at some of the evidence that’s been promoted uh you know that’s uh in the body of knowledge. And so, you know, it’s just like, it’s just like anything. So, you know, going into it, it’s like, okay, well, you know, I, uh, I follow the protocol or the recipe here and we work on everything that’s already evidenced. You know, we’re not, there’s no, there’s not really, I mean, there’s no experimenting here. Right. And so we have a snapshot of what is an expected outcome and all of them are, you know, in, in the realm of positive. Now we, you know, of course we look at what, uh, thing, you know, all the risk, uh, you know, the risk assessment assessments were assessing the risk at appropriate levels to ensure that, you know, and that’s, I think that’s probably if there’s things, I mean, there’s two things that I know that we do better here at origins or what I feel. Um, and that’s what also translates to real, you know, positive outcomes is that of course we follow all the rules of, uh, you know, of, uh, of anything that, you know, for any high potency medication, you know, um, we of course do that. We also spend time and characterization to make sure that there is, that is the exact cell, you know, and there’s nothing different. So we do a lot of work there to make sure that it’s really a pure product. And when the doctors here, they evaluate all the patients, right? They look at, you know, the patient in terms of pathology or what they’re seeking. And then two, they kind of look at all the other risk factors of their, you know, immune system, immunogenicity or tumorigenicity. And then we, you know, really calculate in terms of how dosing these patients, you know, and that’s all based on evidence. And so all of those, I mean, it’s really static. It’s really controlled. And doing that, it’s easy to measure all the way around, all the way through the continuum, and then be able to assess.

DIEGO TRUJILLO: So nothing’s really like trailblazing here. These are all practices that have been around and been observed and been recorded and, you know, okay.

JAMES UTLEY: It’s like a really novel, but you know, the reality of it is it’s, it’s not, uh, it’s, it’s just, I think what makes it novel is a supplied correctly here at this location, you know, at this institution. At other places, it’s not. There’s a lot wilder of an application that I’ve seen in this network, which then, you know, so who knows?

DIEGO TRUJILLO: So you really think it’s in the final delivery, the process that you guys are executing that you feel is novel and very different is the deployment of these cells within other people, within patients, correct?

JAMES UTLEY: Yeah, that’s what happened. I mean, once you’re provided as a dose to a patient, you know, and then so you’re looking at you’re assessing therapeutic gain. So that therapeutic gain is contrasted with what your expectation is. And the expectation is what has been published in the literature. And that’s really it.

DIEGO TRUJILLO: And what results have you been seeing in people’s lives as you work with patients?

JAMES UTLEY: Well, I think that we’ve been seeing a lot of really positive feedback, you know, there has, we have a population of patients, we call them super responders, which we invest in trying to understand, you know, what what makes a super responder, meaning the phenotype of the patient, whether it’s age, whether it’s, you know, kind of the makeup, if you will, of their immune system, or, you know, what, what, what is it, whether it’s the, you know, the injury or pathology in which we’re seeking to treat. So it’s those, those type of things, right. So, and we get a lot of really great outcomes. Now, we have some, you know, the patients that they, while they’re here, you know, because they’re only here for a snapshot of time, they have, you know, they’ll, they’ll have kind of like an outcome. It’s like, okay, so it’s not as pronounced as we would say, as the patient class of super responder. But then it seems that some weeks to, you know, 90 days or so, they have, they have some, you know, really positive gains. So that’s it, you know, are there patients that are not responsive? Well, it’s hard to say if somebody is non responsive, because we look, we try to observe all these, you know, so we have some biomarkers, you know, all these objective signs. So It’s hard to say that now, when it kind of translates to the subjective or what they’re telling you, like they may not be aware, but the benefit is usually a matter of increments, right? So that’s why we have to be very careful when we measure these to make sure that we’re assessing the baseline and any shift in that baseline.

DIEGO TRUJILLO: Okay, that’s perfect. That gives you some like objective results to be able to say, okay, these were the outcomes and there has been something. But everyone seems to respond at least a little bit,

JAMES UTLEY: Yeah, because I mean, paramountly, the product, the product is safe. That’s, that’s what’s paramount, right? So, you know, it’s not meant in the application of like, say, like treating, like a disease for an end state, right? Like, if you’re thinking of it that way, right, because we have this, it’s more of a holistic treatments, biology, treating biology. So you never, I mean, what we don’t see, we don’t see is that, you know, that there’s like, like no gain right it’s just kind of a matter of increment we have to like measure it very closely and we do that for everyone um and some people just they they were in a worse state meaning let’s just give an example of pain they were in a worse state of pain and then they impeded their pain profile so therefore they’re very vocal like oh this is this is uh very beneficial to me um but we still we take that what they tell us and we put it contrast to kind of the objective evidence there to make sure that we have a you know real clear picture.

DIEGO TRUJILLO: Well, and that leads me to my next question, which was what is the direction? What do you guys treat? What do you look to do? You know, you mentioned pain right there. Is pain one of the things that you specifically try to treat, like neuropathy? Or how do you guys go about this?

JAMES UTLEY: Well, the application, because there’s actually a really kind of a broad spectrum in terms of application, if we were to break it down into kind of our main one is osteoarthritis, I think that was kind of a point is the primary application is patients with osteoarthritis. Now, of course, the rejuvenation, you know, for in terms of injury, injury recovery, That meaning like helping an injury recover, right? Whichever. Um, that seems to be kind of, um, there’s a lot of athletes, uh, that come here for, for that, you know, kind of speed to recovery.

DIEGO TRUJILLO: What kind of athletes are you talking here?

JAMES UTLEY: Yeah, I mean, I think the majority of them, well, we have all sorts of athletes. But I’d say the majority of them are NFL players. We have kind of come here for some rehab, you know, they have a tough line of work. But we’ve had, you know, cricket players, we’ve had tennis players, you know, kind of the the broad, the gamut of athletes, which I think, if we’re talking in kind of two categories, which is performance, as well as injury recovery, right, you kind of, that’s, there’s a strong application for that, you know, just makes that just makes perfect sense for the, for a cellular therapy, for the cellular therapy. But, you know, autoimmune, there’s a big body of literature that supports the use of MSCs with autoimmune. And then there’s a body of evidence that supports the use of MSCs in autism. And, you know, we have my colleague here, Christian Diaz, Dr. Christian Diaz, He has a lot of experience in that. So you see that there’s kind of a broad application because they really, if we’re, we have to look at like, okay, what do the cells do? They do two things really well. They modulate your immune system or make your immune system do something that is beneficial to you. Um, or they work in, uh, uh, to reducing inflammatory response or the anti-inflammatory nature of it. So, uh, if you have, if you have a pathology or a disease state and, or injury that has those components, then the cells have the high probability of being very beneficial to you.

DIEGO TRUJILLO: Okay. So that’s it. So there are certain diseases where you feel a little more confident in the results than others.

JAMES UTLEY: Yeah, it’s all based on the literature, because it’s not, you know, for us, it says if somebody comes to us with a disease, like sub pathology, that is, I’ll say we’re it’s not so common, right? Then we dig, we do research here, all the physicians here, we do research to make sure that it’s been evidenced somewhere. And that can be globally, that can be, you know, China, you know, and then we kind of look at that, right? And then we bring it to this, we have a group that we bring it to, and we all kind of talk about it and say, hey, is this the right therapy for this patient, et cetera? And we do this on a weekly basis. And then we inform the patient, right? So say, Hey, this is what the literature supports. We have evidence doing this, maybe not exactly what you’re looking for. But we have evidence that, you know, whether it’s trial data, whether it’s some studies, et cetera, this is what now. So now here you go, patient, you can make, uh, uh, the most informed decision as you can. Yeah. But. There’s a lot of patients that we actually don’t treat. We just say, hey, listen, we don’t, either what we’ll do for you won’t, won’t really help where you’re at. So if you have an injury where you’re like, okay, surgery is destined for you, and we’ve evaluated that, then we, you know, we tell you, oh, sorry, we’re not the, we’re not the best place for you because, you know, surgery is the best place.

DIEGO TRUJILLO: What percentage of inquiries do you feel that you guys can’t serve or that you’re having these conversations with?

JAMES UTLEY: I think it kind of ebbs and flows, um, in terms of, um, I think earlier on, we had a lot more complicated cases that, um, that kind of needed some, uh, some guardrails, if you will. Um, but you know, I’d say it’s, you know, it’s, it’s a small, it’s a small percentage now, because I think most of the, most of the folks that, that actually make it, you know, through the, through the evaluation period, they’ve already been there. Uh, they’ve been screened.

DIEGO TRUJILLO: Yeah.

JAMES UTLEY: They’ve been screened.

DIEGO TRUJILLO: They’ve been screened appropriately. Is there any that you’re looking forward to, or you’re looking towards kind of trying out new and maybe publishing your own data? Do you guys do any of that research?

JAMES UTLEY: Yeah. So publishing our own data, of course we have, uh, we have the preclinical stuff or the in vitro lab stuff. Um, so we have some, we have some studies that are ongoing off in that. uh in that realm um and then of course the there different case studies have been broken up into different cohorts and those those will make it um you know those will be those will be reviewed and hopefully published here I would assume very shortly um I know that there’s uh one organization um they have an annual conference that is very interested in uh having us present so we’re trying to wrap that up but yeah so it’s kind of a a traditional type, I guess, laboratory, uh, research, if you will, there’s that avenue. And then there’s case studies, which is, um, which is a patient, patient centric there.

DIEGO TRUJILLO: How exciting to be a part of this. I can’t imagine the feeling, um, when, when you guys push forward and as you look to publish and kind of, is there ever hopes to bringing this to the United States?

JAMES UTLEY: I hope so. Like that’s the whole goal. I, um, I know that, All the preparation work that we’ve done this far thus far is really to meet that need. Um, which means that we just go through and, uh, all the design and studies and all the research is really based to, uh, build a, you know, build a body of knowledge to then, uh, bring it to the U S. Um, yeah, that’s, that’s the goal.

DIEGO TRUJILLO: And if you had to guess how far away are we from that, from bringing that kind of stuff to the United States?

JAMES UTLEY: Yeah, I get this. But I get this question a lot. I used to be kind of like more definitive on the answer. I would be like, oh, five years, you know, but now I don’t. Now I’m not 100% sure that So I know the end point exists, like it will happen. It’s just how do we get there is a little fuzzy in my mind, which used to be more clear. Now, I think with the progress and to include the stuff that we, the research that we do here around an A, the A cellular product, which is the exosome product from mesenchymal stem cells or MSCs, I think they have probably a better shot of application in the US market, under some regulatory framework, then let’s say mesenchymal stem cells organically by themselves. So I know that’s kind of a, but I think technology is going to outpace. And so we’re just gonna have a different product, it’s going to be the same, it’s just gonna be a different iteration, provide the same benefit, just a little safer, meaning that Acellular products have zero chance of attenuating immune response versus a cellular product that has the has the probability, right? So yeah, I don’t know. It’s a it’s kind of a tough one to go.

DIEGO TRUJILLO: But very interesting. You’re pushing forward anyway.

JAMES UTLEY: Yeah, first of all, I think for the essence of this podcast, I’ll still say five years.

DIEGO TRUJILLO: Yeah, right. Okay. Just give us a number. That’s all we wanted, right? You satiated our desire to know. No, it’s very interesting, especially when there’s not a clear marked area. And again, sometimes it’s frustrating to think, I believe it was the percentage, there is a conference that we had here regarding innovation and they were talking, right? When it comes to innovation, some places are really playing catch up, but when you’re that far behind, Um, the curve on innovation, sometimes you’re able to make a leap forward. And so it’s not, it’s not even catching up. You could just full on skip this step of catching up and get ahead of a lot of other people. And so, you know, that’s my hope that we can do that.

JAMES UTLEY: That might just happen. That might just happen. I, uh, I think that might happen. Now, if you were to ask me, kind of when we were a year ago, if you asked me a year ago, I would say that we were behind being like the U S was kind of behind on this. But now I don’t think so. Now I’m interested to see what the future brings.

DIEGO TRUJILLO: That’s fascinating. What do you think is the most exciting part about what the future may bring regarding this technology?

JAMES UTLEY: Oh, I mean, of course, you know, I’m a cellular therapy guy, so I’m a cellular therapy nail, and I only see whatever that analogy is. Everything is self-therapy. Yeah, I’m a cellular therapy hammer, only seeing a cellular therapy now. Okay, but with that said, I think as these tools in genetic engineering, they advance me, meaning that in terms of computation and in the world of AI, as that matures, which it’s daily changing, it seems like, that we will have the ability to engineer the cells to provide a function, which in my mind would be secreting exosomes and then being able to harvest those. So I think that’s kind of the future. That’s an exciting future here that we’ll probably realize.

DIEGO TRUJILLO: And so you’re hoping within five years to be able to bring this to the United States and ideally, hopefully Las Vegas. I would like to think that if groundbreaking research is being done out of town, you know, there’s a push here in Las Vegas for the life sciences. You know, there’s various collaboratives that are coming together. Um, to look at, you know, whether it’s workforce within the life sciences or just bringing life science companies in general, there’s definitely a focused effort. And so the opportunity to be able to interview you guys, not just for the podcast and not just in regards to life science, but really people that are pushing forward innovation and doing new things. Right. People that, that aren’t willing to just sit on their hands and wait for them to be given the opportunity, but finding a way to be able to execute on this. What percentage of your population would you say come from the United States?

JAMES UTLEY: Oh, in the high 90s, or maybe 95% or so. Yeah, they’re all US.

DIEGO TRUJILLO: Americans are interested in these types of treatments. It’s just the regulations that are holding back the delivery of these treatments over there in the United, or over here in the United States.

JAMES UTLEY: Yeah, maybe it’s, maybe I’ll ride at 90% of the folks that come here are US clients, or coming from the US, and or Canada. So, but yeah, no, the demand, the demand is, is great. It’s kind of like where, where, where would you like to go? And that’s where, cause you have these, you know, different centers that are located all over the world, whether it’s Dubai or Tijuana or, you know, or even Columbia. Right. So it’s kind of the, where, where, where do they land now? You can argue all day, which one, which one is better. Right. And I think that where I, where I sit, I viewed most of them, and of course, some Google Intel work. I say, okay, I know that what we’re doing is safe, and I know that the way that we characterize our product is unique, not done at other places. Maybe it is, maybe it isn’t, but I know that That’s, that is a testament of why the outcomes are, are good.

DIEGO TRUJILLO: Right. So how can people find more information on Origins? If they’re interested, they’re listening to this podcast and they’re thinking, huh, can this therapy work for me or for my loved one? Where would they be able to go get more information?

JAMES UTLEY: The website is a great source of, uh, information. Yeah. So it’s like www.origins.com.

DIEGO TRUJILLO: And that is spelled A-U-R-A-G-E-N-S.com, correct?

JAMES UTLEY: Yeah, that’s the website. I’ve also published some books that you can find wherever books are sold, or I think the easiest way is on Amazon. Then, you know, we have that kind of the words in the name title there, but if you’re to Google, you know, if you put that in the Amazon search, you’d find a And we kind of go over the whole gambit of the different applications, which is, you know, autoimmune for athlete repair, excess home harvest, like kind of everything we talked about here today. Cellular Assurance, that’s my favorite one, but it’s a, that’s around the immunogenicity and tumorogenicity of the product, right? So we wrote those and they’re not, they’re not too super long. There’s parts where they’re pretty technical, but the goal was to make them kind of shorter and not just like this one long reference type book. so that people could use them as they’d like, you know, in the application which they see is fit, and be able to, you know, spread the knowledge all the way.

DIEGO TRUJILLO: Yeah, to be able to share. Well, I want to thank you very much for coming on the podcast and sharing. I know you’re, uh, you’re very busy down there. Um, like you mentioned, the hospital’s right next door, so it’s, it must be a constant flow of, uh, extraction and processing. And then the patients that are coming in to get treated. Um, I want to thank you for your time and being able to share with us. Again, I’m very excited. This is technically born out of Las Vegas, even though you guys are not right now in Las Vegas, but I’d love to see you guys. Yeah. Pretty sure. I would love to see you guys be able to make a return and to make an impact and start putting Las Vegas as a city on the map for life sciences.

JAMES UTLEY: Well, I mean, everyone that, uh, you know, this, this endeavor was born, uh, out of Las Vegas. And so all the brain power is, uh, Las Vegas, uh, you know, Las Vegas fueled.

DIEGO TRUJILLO: Yeah. Well, it’s fantastic. Well, thank you very much for coming on. Is there anything else you’d like to leave with the listeners today?

JAMES UTLEY: Yeah, thanks for having me, for sure.

DIEGO TRUJILLO: All right. Well, excellent. Thank you very much for coming on. That’s Dr. James Udley coming and speaking to us from Origins down in Panama City, Panama. The website for that, if you’d like some more information, is A-U-R-A-G-E-N-S dot com. That is Origins dot com. And you can find out what treatments they offer, what are the different diseases that they are targeting currently and, you know, maybe even find out a little bit about your situation. It might not be on there, but to be able to find out if there is any possible benefits that you can receive from this treatment. Thanks again, Dr. Utley for joining us today in this conversation and sharing with the Las Vegas community a little bit about what you guys are doing down there.

JAMES UTLEY: Perfect. Thank you.

DIEGO TRUJILLO: Fantastic. Well, ladies and gentlemen, that is another episode of The HEALS Pod. We want to thank you for joining us. Stay tuned as we expose all the different and interesting companies, services that are happening here in Las Vegas, and now even abroad, um, as we look to expand into, into what sciences, sciences are being pushed forward here from the Valley. Thank you very much for tuning in and we look forward to seeing you again on The Heels Pod. Have a great day.

 

 

Evolution of Specialty Courts: A Look into Las Vegas Justice Court with Judge Cynthia Dustin Cruz

By | HEALS Pod, News

Diego Trujillo, the host of the HEALS Pod, welcomes Judge Cynthia Dustin Cruz from Las Vegas Justice Court Department 5 as his guest on the latest episode. Judge Cruz specializes in adult drug court and DUI repeat offender court, which aim to connect treatment and wraparound services with judicial oversight to help individuals struggling with substance abuse and mental health issues.

During the episode, Judge Cruz shares insights into the evolution of specialty courts in Nevada and the impact of grant funding on court programs. She discusses how the funding has enabled the court to provide essential services like housing, medical care, and identification assistance to individuals in need. By removing financial barriers, the court can create a stable and supportive environment for individuals to focus on their recovery and rehabilitation.

The conversation delves into the importance of peer support and community involvement in the rehabilitation process. Judge Cruz emphasizes the role of accountability and guidance in helping individuals navigate their recovery journey. The funding has allowed the court to expand its services and offer more holistic support to those in the justice system.

Listen to the Podcast.

Full Transcript

DIEGO TRUJILLO:
And I’m Diego Trujillo, the host of the HEALS Pod, recorded here in Black Fire Innovation Center at UNLV. Very excited for another episode of Heels Pod. We’re very interested in being able to explore the topic today. I have a very interesting guest that has joined me. We recently connected at an event. It was an absolute pleasure, and we’ll get into the story of how that connection went. But with us today is joining us Judge Cynthia Dustin-Cruz from Las Vegas Justice Court Department 5. Did I get that correct? You got it correct. I know it’s a bit of a mouthful. Not the name, but rather the specific court where you serve.

JUDGE CYNTHIA DUSTIN CRUZ : Oh, the name is a mouthful too. I usually just affectionately go by Judge Cruz, but… Judge Cruz.

DIEGO TRUJILLO: It does make it a little simpler. It makes everyone feel a little more positive, like it’s going to go smoothly, right? Yes. It has a good name. Well, excellent. Thank you for coming on the show today. It was, uh, we had a very interesting connection at an event where I wasn’t expecting to have a run in. And for, for those of us listening, right, we’re setting up these different town halls and we’re trying to get, um, the voice of healthcare in front of our elected representatives. And, and sure enough, I go to this event and you walked up and you’re like, Hey, I’m running for judge. And I had brought up to the group that we’re planning all these events. I was like, what about judges? And they’re like, no, judges don’t really, you know, there’s not a lot. And that’s why I gave you the answer I gave you. Right. Because typically it’s very hard, right, for a judge, at least when it comes to health care. Well, normal, not normal judges, sorry, judges of other courts that are looking at different types of cases. And in your case, you are like, actually, you may be interested. So tell us a little bit about Justice Corps’ Department 5.

JUDGE CYNTHIA DUSTIN CRUZ : So the Department 5 always throws everybody because everybody’s like, is that my district? What does that do? And Department 5 just means there are 16 judges on Las Vegas Justice Court. And you have to figure out where you’re going to assign cases to go. So that’s how they came up with departments. And so I’m one of 16. And then whenever there’s an election cycle, certain departments are up on the election cycle rotation. So that’s all that means.

DIEGO TRUJILLO: Okay. Fantastic. And what kind of cases do you specialize in? We’ve connected on this. You made the connection. I want our listeners that immediately go, well, hold on. Why does he have a judge on, right? To make the connection for healthcare, because your answer was tremendous. And I, uh, I don’t have a history. I have been there before and was blown away at the work that that was being done at the court. And so I mentioned to you, I was like, well, you know, we’re really more healthcare focused and you, and you mentioned that you do a couple of interesting things that may impact healthcare here in the Valley.

JUDGE CYNTHIA DUSTIN CRUZ : So right now, um, I, I’m the chief judge of the court. So I handle all the administrative duties, but I also do keep two specialized dockets and they are what’s called specialty courts. And one of them is an adult drug court and the other one is a DUI repeat offender court.

DIEGO TRUJILLO: And in both of those, I think, I mean, it goes without saying for everyone listening impacts the lives of all of us that live here in Las Vegas.

JUDGE CYNTHIA DUSTIN CRUZ : Absolutely, because what a specialty court does is connect treatment type care with collateral wraparound services with the oversight of a judge, a district attorney, and a defense attorney. And we hold people accountable because sometimes there’s something that’s going on in their life. A lot of times it’s a substance abuse problem, it’s a mental health problem, and it’s causing them to get involved in the criminal justice system. Yeah. So our specialty courts are a way to get them to hopefully use treatment and our afferent services to not be involved in the court system anymore.

DIEGO TRUJILLO: Absolutely. And I’ve, I’ve known, and just to, just to share with the listeners, because I had heard of drug court, right, uh, growing up and younger, and I’d kind of had some very, very distant connections. I’ll never forget one time someone from church, Uh, there was a gentleman that needed volunteer hours, and he was like, yeah, I’d like to volunteer, and he was in drug court, right? And so he started explaining a little bit about it was, what it was, and I was like, wow, this is a little in-depth. I thought you just, it’s a court, but they require drug tests, was basically it, right? Um, and- and that was my understanding of it. And I’ll never forget when he came very proud, he goes, hey guys, I’m graduating, I’d love to have you come out to my graduation. I was like, okay, yeah, we’ll- we’ll show up, thinking like, here’s your certificate, and… And I have never been so touched, um, emotionally by the legal system. I-I could not believe what I was witnessing. Um, typically, from my understanding growing up here, right, everything is very punitive. So, you’ve-you’ve done wrong. Here, sit in this cell, or this is your-this is your slap on the wrist. Um, and for the first time, all of a sudden, I saw a partnership between people and between the judges. And I’ll say this, very specifically, because as people are giving testimonials, right, I’m watching, you know, they show the before pictures, and this is what they look like when they came into the court. And then they would call the person up to give them their certificate, and at one point this gentleman comes up, and he goes, you know, and I forgot who was the judge at the time, he goes, you know, I was so furious with you when you sent me to this program. And he even started saying, I started looking up your address. I mean, everyone was like, all our hair kind of stood up like, wow. And he started tearing up and he goes, what you have done for me, you have changed my life and given me another. There wasn’t a single person in that room that wasn’t crying. I mean, and he just really documented the anger that he felt and everything. And the judge, I didn’t realize she was standing there. He was speaking to her. She was in the back of the room. She comes running to the front and gives him a hug. And again, I’m watching this, could not believe what had happened. And she just said, Hey, I’m so proud that you made it through. And again, he’s wiping tears away from his face. And just, it’s something I never expect. I was sharing with you before we started the podcast when I was a child, my dad, my dad was a court interpreter. And so sometimes, you know, my dad would take me along to court, I’d have to sit in all the different courts. And for me, right, it was always we were sharing earlier, the municipal court at 6 a.m., which was very early and very boring. It was the same infractions over and over. Everyone just kind of talked like it was very rote. Um, not a lot of emotion. I’d get excited because at 11, that’s when we’d go over to federal and then I’d get, oh, hey son, be quiet, but this is what the trial is about, right? And you’d see the intense cases and people testifying. And so it was always more exciting for me. I had never seen anything like this where the justice system was, uh, Again, it was almost as partnering, right? It didn’t feel like, hey, you messed up. You know you shouldn’t have done it. Here’s your punishment. But rather, hey, what’s going on? How can we fix this issue? And I think for the first time, you know, I watch documentaries on prisons in Norway and just different approaches. um, approaches to justice and rehabilitation, right? We want people to come back better as better citizens. And, you know, again, working in the community for a very long time, you saw a lot of people that would go away and they wouldn’t come out better. They just had more skills and more knowledge and more connections. It didn’t feel like there was actual rehabilitation. And for the first time in my life, I began to witness that. Has that been your experience as you’ve served? What was your interest? How did you delve into that?

JUDGE CYNTHIA DUSTIN CRUZ : So, um, Prior to becoming on the bench, I did, one of my areas of practice was criminal defense. And so I would see people that were my clients and they would come in and I would listen to what these people were saying. And I started noticing, you know, okay, this person’s kind of fallen afoul of things because of a disease. And when I got on the bench, the judge at that time, so I got on the bench at the start, January 1st, 2013. And the judge that was presiding over that would occasionally have me cover because you can’t just sit there and say, oh, let me just get any body. You have to have somebody that has an understanding. And then that judge was planning on retiring. So, there was a discussion about me taking it over. And so, I started going to some a little bit more in-depth training because you can’t just walk into this and just be like, hey, here I am. Yeah, ready to go. It’s kind of like somebody saying, hey, here I am. I just want to jump into the medical field. Right. You have to have some training. And so, I started doing the training.

DIEGO TRUJILLO: Well, it seems like it would require obviously an understanding of the legal system, but also you kind of need to delve out to specialize what is substance You know, substance use disorder, how are the different programs, what works, what doesn’t, etc.

JUDGE CYNTHIA DUSTIN CRUZ : Absolutely. And you have to understand, I mean, and so now we’ll hop into the medical aspect. You have to understand what’s going on with somebody’s brain. And you have to understand, you know, substance use addiction, it’s a disease. And once you start understanding how these pathways get opened up in the brain and It’s nothing different. I mean, you have people that are diabetic and, and there’s something with their body that it doesn’t produce certain things and it doesn’t do things in a certain way. And, and you’re going to have a similar issue with somebody that has an addiction. And, and so yes, I’ve, I’ve gone into the deep dives where they’ve brought in like neurologists and doctors to talk about. And there used to always be this mindset that it was completely abstinent based. You had to teach people to not use at all. And there’s really been an evolution of that to realize that there are certain addictions that really medicated management treatment can truly help somebody. And it’s not about, hey, we’re going to have this person, they’re going to be high. I mean, it’s the same thing when you see somebody with a mental health disorder. There are certain medications that can help them manage this. It’s just like any other disease.

DIEGO TRUJILLO: I would, and I would draw that same way. I was going to draw the correlation, for example, to Ozembic or these weight loss drugs, right? A lot of people are using them. They’re seeing great results, et cetera. Some people get upset because there’s kind of a cheap, but whatever that may be. I mean, people are achieving a lower weight in the same way. Um, and some people don’t believe whether, whether it’s biological or not, you know, our environment, whatever it may be in our nutrition growing up has affected that. And now there’s a medication that can help us manage that weight. It’s, it’s the same thing in this case, I would feel.

JUDGE CYNTHIA DUSTIN CRUZ : It is. We have people that are, I mean, they’ve been addicted to a type of opioid for years and trying to get off an opioid when you’ve been addicted for years, sometimes you need an additional tool in your toolbox because they just white knuckle it for so long and then you have a relapse. And the problem is, is that when you start talking about opioids, A relapse can be even more deadly because if you want to go back and use the same dose, because a lot of times that’s what they go back to, now their body’s tolerance may have dropped and now you’re running into definitely a critical care situation with their system that they’re ODing and you don’t want to see that. You have to find that happy Marriott between where medicine intersects because yes, I do have people that are in my court that are very good manipulators and very good on the criminal thinking aspect. Right. But and getting Doctors and our medical care teams that work with addiction medicine understanding this populace is a little bit different. They do have drug seeking behavior and they’re going to be really great to tell you how many symptoms they’re having when they’re seeking something. and understanding, you know, hey, we have to work collaboratively and we have to have that the medical care team is reading what the rest of the treatment team’s notes are so that we can holistically treat this person. So when they’re telling this group A one thing but they’re telling group B something different and group C is something completely different and they’re telling me a whole different story. It’s always good because we work collaboratively together so that our teams are able to see what all these different stories are and then you’re able to know the whole picture and work better on treating someone.

DIEGO TRUJILLO: Well, and I think the tool that you guys have in your toolbox, that is an incredible tool. And I’ll say this because there’s a person that I’ve known that was a 30-year methamphetamine user. He had learned to be a functional methamphetamine user. Eventually, you know, every six months would end up, you know, going on a bender and losing their job. And they found themselves in this constant mouse wheel. And it wasn’t, they would try to quit and I’m going to try to go clean and this and that. And it wasn’t until the, the, there was that issue with child support. And so he went to the court within the child support and the judge just asked him, Hey, do you, would you want to go to drug court? And at that moment that, that he was asked, he was living off Boulder Highway in like an RV, um, kind of hit the bottom of the barrel. And so, the question just came at the perfect time, and he said, yeah, sure, I’ll go to drug court. Again, thinking, yeah, it’s just, you know, it’s court, but with required urine screenings, right? And so, once he ended up going, I mean, he was able to quit using drugs, uh, he got clean, he’s been clean for about seven years now, and it just completely transformed his life. And you realize, Because you mentioned, right, a lot of people, we have this antiquated perspective on what, you know, they just need stronger character. They need to make the decision to, and I’m saying this as a Hispanic, because my God, I deal with this attitude a lot. And I would tell people, hey, you know, the drug use is a symptom, right? What you’re describing is a symptom of a deeper problem. And so while you want them to just quit using drugs, you’re not addressing the root problem. What is wrong? And you have this very unique tool in drug court where you have forced accountability, which I think is the number one. You know, when I talk to addicts working in the community, there’d be a lot of people that would get recommended to me working in church. They would bring them, and I would say, well, you know, you need to get clean. Look at these negative outcomes. And it was very interesting that they would just, yeah, no, I know I could get clean. I just, I cannot go to sober living. I cannot, I can do this on my own. I don’t need rehab. How many times have you tried to get clean? Oh, it’s probably 14 or 15 times. Okay. How has that worked for you? Right? Well, it hasn’t worked. I was like, the only thing that there, I was like, well, what are they doing there to you in there? And this was always my line of question. Are you being tortured? I mean, they must be doing some horrible things that you are just so dead set against going to a rehab. Well, no, not really. I was like, yeah, they’re making you wake up early. They’re making you take time to write down in journal. They’re making time for you to have a devotional. I mean, really all they’re doing is wanting to give your brain structure and you are fighting with everything in you to oppose that structure. But it’s not like they’re forcing you into labor or anything like this. I mean, all it is is, yeah, everybody wakes up at this time. You need to follow the rules. The minute they start giving you this structure, their brain just, it really wants to resist that, right? Especially after many, many years of continued use, you know, there’s not a steadiness in their life. And I’m giving you anecdotal information. I’m sure you have many studies, and as you’re researching in your role, and you’re watching this play out on a daily basis, no?

JUDGE CYNTHIA DUSTIN CRUZ : Oh, absolutely. I think probably the way that I can dial this in, not that I’m saying that we would do this, is how many people have been like, you know what? I want to lose five pounds, and I know I need to eat better, right? I need to stop eating these bad things. I’m just as guilty of this. But imagine if we sat there and said, Diego, every time you eat over a certain amount of calories, we’re going to know. And then we’re going to hold you accountable for that. And we’re going to start off with like, hey, you’re not able to and you’re going to come and tell me. I can do this on my own, right? And then pretty soon you keep going over that. And we finally are like, Diego, we, we’ve exhausted like every resource that we possibly can. Like we’re making your meals. Now you’re sneaking other foods. Like we’re working on all of it. And, and now you’re starting to exhibit lying and you’re exhibiting all these other behaviors. So I’m going to do something called, I’m going to put you in jail. to get your attention.

DIEGO TRUJILLO: We will definitely be able to manage.

JUDGE CYNTHIA DUSTIN CRUZ : Right. You know, that’s kind of, I mean, it’s a very simplistic way, but that’s what the threat is. It’s a carrot and a stick approach. And when people come into the drug court, they will start off and they are a lot of times saying they will take anything because they think the minute that they plead to say, I’m going to go do drug court, I’m going to get out of jail.

DIEGO TRUJILLO: Yeah, they think it’s a get-out-of-jail-easy card.

JUDGE CYNTHIA DUSTIN CRUZ : We have a lot of get-out-of-jail. And then I tell people, I am going to ask you to do some of the hardest things. I know what I’m going to ask of you is hard. And they’ll all be like, oh, no, I got it. I got it. I got it.

DIEGO TRUJILLO: As long as I’m not in jail. That’s all I think of, right?

JUDGE CYNTHIA DUSTIN CRUZ : As long as I’m not, I call it, you know, we’re anti-blue outfit, anti-orange slipper shoes. And I tell everybody as I’m rolling them out of jail, like, unless you really like those orange slipper shoes, stay with the program. Because we do frequently have to roll people out. Everybody coming out into our program is on some form of electronic monitoring initially. OK. Because we tried it wherever they weren’t on electronic monitoring. You need a nice officer sometimes that wants to come and knock on your door at three o’clock in the morning and say, what are you doing out and about? So we have that accountability piece. Or if I do have to put them in sober living or residential treatment, it helps with that initial phase. And just like how you told me the story of people like um, the drug court that you watched. I have a lot of people that are very mad at me at the start. Yeah. Um, I have people that, you know, they want to try to see how much more they can try to outsmart us. And, and usually what causes people to end back in custody is either you, um, you either started not following rules or you started lying or it’s a behavior thing, or you just kind of tried to, wander off and not show up. You know, we usually don’t put people in custody for use, but I’ve had a lot of people tell me when I’ve had to put them in for like 24 hours, they’ll tell me that was the first time I went to jail sober. And they said, oh, it’s a big difference. It’s a lot worse. When you’re not drunk or high and you’ve got to do that, apparently it’s much worse. But that is, I mean, it’s a kind of treatment based and we’re more holistic on keeping an eye on people a lot more than sometimes. hey, I went in to do drug treatment on my own, outpatient, and I’m hopping into one, you know, two groups a week and one individual, but then the rest of the time I’m off on my own. And it really takes a community to help people in certain circumstances. Now, I’m not saying that there’s not other people that can make it happen on their own, but there are, unfortunately, some people that need that community to make that difference.

DIEGO TRUJILLO: Well, and I think, again, right, so you have that saying, no man’s an island. And I think it exists for a reason. I mean, we’re social beings. And for a lot of times, there’s been failures in people’s lives, right, whether that be family. Again, I would work with young people, so I would always have the, you know, hey, my son’s punching holes in walls, and I caught, you know, I found a pipe in his room, and this and that, and they’d bring him to church on a Friday, and I’m like, You know, and they’d say, hey, is there anything you could do? And I was like, you know, I can’t undo what you didn’t do for the last ten years. I mean, I know you want a magic cure here, but, you know, when he was throwing fits and he was four years old, that’s when you should have addressed it. Now he’s a lot bigger, so it’s ending up being holes in walls. Um, and I would always tell them, you’re gonna find a limit, and it’s gonna be the hospital, it’s gonna be the morgue, or it’s gonna be the judicial system. But there is a limit to everyone and everything. And really, it’s just learning to have that self-accountability. And unfortunately, some people haven’t had that. And when they have the community of people, for me, when it comes to addiction, right, there’s a lot of failure rate. It’s very, very high. If medicine, right, I used to listen to a lot of Dr. Drew. This used to impassion me a lot. And so I just, you know, for entertainment purposes, would just learn a lot about addiction. And as Dr. Drew would always talk about the accountability portion, he would talk about what it was like for a person that was an addict. And I would use those descriptions to tell parents, right? Hey, what would it take for you to rob from the person that you love most on this earth? Oh, man. And they would say, oh, I would never steal from my mother. No, I know. What would it take for you to do that? Oh, it would be an extreme desperation. Correct. That’s what they’re going through, right? And trying to take them to a place of empathy. And because of the failure rate, I mean, you look at how much modern medicine has progressed. Um, and then when it comes to addiction and recovery, that’s why I would always get into those talks about rehab. I was like, guys, uh, as much as modern medicine has progressed in every level in treatments of diseases and things like that, 12-step programs and, you know, rehab, um, stepping out and getting that accountability, learning to put limits on yourself so that they’re not placed on you. I mean, those are all very, very intense. I-I’m… I think as you, uh, as you work in the court with these individuals, it’s something that you must consistently see.

JUDGE CYNTHIA DUSTIN CRUZ : Absolutely. We do tell people, like, I frequently say, you know, I’ll get a lot of people, well, you’re doing this to me and you’re doing this to me. And I go, no, I’m not doing anything to you. Your decisions are what’s causing a reaction. So I tell everybody, you’re driving the bus. I’m going to hold your hand and I’m going to try to help, you know, guide you while you’re driving the bus. But you’re the person who’s in control. So if you want to take charge, you know, I’m going to give you every tool. We’re going to build a great bus. We’re going to give you a great engine and we’re going to help teach you how to most effectively drive that bus down the road. But if you want to just kind of, you know, stare off into the wild blue yonder, you know, if we’re working harder than you, then maybe this isn’t where you’re ready yet. And so many of the people that come into any treatment court, I hate to use the word baggage, but there is, they have a lot of learned experiences. And there is a lot of trauma. There is a lot that’s triggering them. And then what’s really kind of disheartening was that we have people that, you know, the more that I interact and the more that I talk to people, and I will have people and they’re doing great and suddenly they’re not. And I’m like, what’s going on? You’ve been doing so well. You, you know, you come in and you’re positive. And I have people that will literally sit there and say, yeah. And I felt guilty because I was happy. I felt guilty that things were going on good for me because I know people that it’s not. And I said, you know, so now we’re really starting to look into, you know, on that treatment aspect, you know, do we need to roll in almost like kind of a quasi survivor therapy because a lot of these people have almost like a survivor’s guilt. I also have people that have lost a sense of self-worth and that we need to tell them that they are worth a lot of this. And this is stuff that’s really started coming out in my treatment courts that is we’ve really started talking to people. I’m going to say probably in the last two years, we’re starting to hear it a lot more. And I don’t know if it’s just as treatments evolved, whether I’ve evolved as to what questions that I’m asking. You know, we do a lot of motivational interviewing, but it’s kind of me and like, hey, you know, one minute you’re standing in front of me and I’m going to start asking some weird questions here and there. But we really have discovered that, you know, I’ve never figured out and it just boggled my mind as to how people could have guilt or shame for being happy.

DIEGO TRUJILLO: Right. Well, you know, there’s a really good book I remember reading called The Body Keeps the Score. I don’t know if you’ve ever read the book. I’ve heard about it. Phenomenal book. And in it, he gives an example, right, of mice that were raised. They did an experiment on some mice that were raised in very harsh environments. They would have very little food, but they would have the option of going to a nice warm place where they could stay with lots of food. And they would put them in the cage and they would let the mice out. Some of the mice were raised in those more hospitable environments. And they noticed something. It is when a trigger would occur, when there would be a stressor, the mouse would run to what’s familiar, not what’s best for it. And I think sometimes especially as walking, you mentioned community, and some people can do it on their own, they may have the community themselves, but for people that are lacking that community, and I’ve worked with a lot of people, I’d say, hey, the brain has this way of telling you, I’m okay, I’m in control now, I’ve conquered this. It’s lying to you, it absolutely is not, you have not. And the moment you hit a stressor, that’s really the moment of, okay, that’s where the growth opportunity happens, because that’s where the hurt is. And I always teach my boys this, right? Everything on earth grows through suffering and pain. Right? If you have a tree, I’ll never forget when a gardener says, no, no, you got to loosen the tree because we had a little sapling, right? And it was growing. And I was like, well, shouldn’t we secure it a little more? It’s kind of loose inside of. And he goes, no, no, no. It has to be able to wiggle in the wind. If not, it will never develop a thicker, a thicker root system. And it won’t. I totally forgot the name of the center part of a tree. The stalk.

JUDGE CYNTHIA DUSTIN CRUZ : The trunk.

DIEGO TRUJILLO: Yeah, the trunk. Oh my God. Yeah, the trunk won’t, won’t thicken. You need to allow it to wiggle and suffer a little bit in the wind. You can’t let it loose completely, but as, as that tree would grow, he’d give it a little more autonomy to be able to bend in the wind. And with that, it would eventually be able to establish the roots. And I think as people, you know, the stories that you’re, you’re sharing right now, right? People feeling that survival’s guilt, they find themselves in a place where they, they’ve never been okay. and all of a sudden being okay, it’s just an odd place. It’s definitely not familiar to them. And so having that support system to say, hey, this is what life can be, you know, and as you grow, you can also turn around and help people out. I think that’s where the peer-to-peer really kind of comes into play. And I would see it, I would always liken it to people. So I did bereavement, I was a bereavement coordinator in hospice for a long time. And it was very interesting. A lot of people in the community would know what I do. And one of the things would be, you know, you lose your mom, you lose your, you lose a sibling, things like that would happen in life. But then you’d have people that, you know, maybe there was a violent act. or a child that would die, and once they passed, it was very hard. You could sit in a group, but the brain would work the same. You could go to a group, I could sit here and give you counseling, I could sit here and tell you everything, but I haven’t lost a son. And at the end of the day, you’re always gonna be in the back of your mind, no matter what I tell you, you’re gonna say, yeah, I get that, that sounds logical, that sounds reasonable, but you haven’t gone what I’ve gone through. and that disconnect, right? And so I immediately learned with people that had lost children to immediately link them up with a group, a support group for people that have lost children because when they speak to you, it’s going to carry way more weight than anything that I could say because I simply have not gone through that experience.

JUDGE CYNTHIA DUSTIN CRUZ : We do that. Peer support is so key. And, you know, you always it’s always been there. So when you look at the 12 steps and I’m going to pull on AA and NA. You know, they always talk about a sponsor. You know, you talk about your home group. These are people that have lived experiences, and that’s what a sponsor is. It’s somebody that’s going to hold you accountable, help walk you through in that learning process. And they’ve developed an entire profession, and it’s licensed now, and it’s a peer support specialist. And so not only is it critical and key and enormously helpful within the drug court realm, but they’re also having that in things like mental health courts, veterans treatment courts, they have mentors. It is, you know, everybody’s called it different things, but we’ve been all doing it for a long time, but they actually now, underneath the uh, legislature, they’ve actually codified the profession of peer support specialists now.

DIEGO TRUJILLO: Yeah, I mean, you think of the human, the human experience, right? We’re going back, let’s say, 8,000, 10,000 years, right? There’s always been that example of someone that has more experience going before me and then taking me there. You look at that within trades, right? You always have the journeyman. And this goes back, even the famous artist Michelangelo, you’d always start out as just a helper, and this person would help to guide you and help to shape you. And sometimes, right, you take that down to childhood, our mother and our father, right? And if those examples weren’t there for us in a very solid way, they can really damage our ability to be able to follow somebody else. And so it’s really retraining everyone to, again, going back to that primal sense of being led, being guided, people that could say, hey, I’ve been in this, I’ve been through this experience. And this is the way that you push forward through this. As you hit those storms, or those challenges, or those triggers, the person can tell you, hey, everything that you’re wanting right now is bad for you. And you know it’s bad for you, and it’s going to lead to negative outcomes. But there’s a better way to do things, right? And so it’s making that conscious choice and helping to shift. That’s why I think this is, again, I would hear this a lot. And I used to live in Nicaragua. So again, you would always hear, well, you know, I just wish he had a stronger character. And I would sigh and be like, there’s a lot more to this. You think he just hasn’t thought of making the decision? Look at the situation he’s in. So being able to be able to support there, again, watching the court system do this to me was completely eye-opening to what kind of change was possible through the legal system. How easy has it been to lead this court? Are you guys pioneering? Is there a lot of precedent and experience that you guys can follow?

JUDGE CYNTHIA DUSTIN CRUZ : So we are, I’m proud to say, I sit on a state committee and I’m proud to say we have a vast amount of specialty courts throughout the state of Nevada. So we’ve been doing this for a while. It’s evolved. We all evolve as we learn, you know, as we learn as to what’s going on. So, for example, Las Vegas Justice Court, adult drug courts, like the oldest specialty court in Las Vegas Justice Court, and it originally started off, it was like a six-month program, and back then Judge Lemon would, like, run it, and he and Judge Smith, and they’d yell at you. They’d like yell at participants. And I mean, we’ve evolved so much more, even from when I took the court over in 2016. We’ve really evolved. I mean, we’re almost, what, we’re eight years? Where we started off, I came in and there were new best practices and evidence-based principles, and we revised the treatment court when I took it over in 2016. And now there’s new things on the horizon that we’re looking at, just some of the things that I’ve talked to about pulling in that stronger, formalized peer support, pulling in to realize some of these other things that are causing people to struggle and not be able to move through due to that survivor guilt, that lack of self-worth. And just as we keep evolving, it’s great to say that I’ve got my court. I do a DUI repeat offender court. We’re rolling out and just starting to go in with a mental health court. We’ve got a community court.

DIEGO TRUJILLO: How exciting is that?

JUDGE CYNTHIA DUSTIN CRUZ : Veterans Court, we have a lot. And I mean, that’s just at my level. And then you go up to district court and you have all those courts, plus you have more. So we’re constantly looking at ways that the court can intercede better and find ways to rehabilitate people. That doesn’t mean that there’s still not some people that, unfortunately, you are going to have to move down the stream. But even in the correctional system, they are starting to reevaluate how they’re doing things. And I’ve had discussions with the deputy chief of the Clark County Detention Center, and underneath where the sheriff’s role and the sheriff’s viewpoint is, is even looking at things differently for people that are in our jail system that are serving out shorter term sentences, not a prison sentence, and how to approach things differently there.

DIEGO TRUJILLO: And I think, I mean, you talk about evolving, right? And I think we as human beings are constantly doing that with knowledge. I would deal, again, with a lot of Hispanic communities here and even living in Central America. For me, corporal punishment was a part of growing up. I got spanked. And for me, I got spanked a lot, right? And, uh, and I was talking with a sibling, and sometimes we’re very judgmental of the past. And it was talking with a sibling, and they’re like, yeah, well, you know, I don’t spank, and you shouldn’t have been spanked. And I was like, you know, at the same time, my father grew up in Columbia. To be able to get to the farm, my great, uh, my grandfather had a farm. Had about 150 workers. It was a rather large farm there. They’d grow sugar cane. You had to ride horses for about six to eight hours to get to the farm. And I remember telling her, because sometimes she was like, yeah, you know, it just seemed unjust. And I shared, I was like, you know, I really thought about this. I really thought about this. They didn’t have time on a six-hour horse ride to tell you, hey, stop rustling around, right? Stop. Because if you fall down four hours into a ride and your bone is sticking out of your body, the consequences are going to be very dire. We didn’t live in the society that we lived in now, so it was very important the children would listen. You really need to pay attention because any mishap is really going to lead to some serious consequences. as a result with my children, right? I don’t believe in corporal punishment because I have more tools available. I have more understanding, right? And so I think in the same way, as we gather more knowledge, you know, some judges may have come from the older school like, hey, be hard because they’ve never had, you know, but one hammer doesn’t build an entire house. There’s different tools that are available. And at the end of the day, we need to be focused on outcomes. not how hard can I be on this person because look what they’ve done to society, um, but rather how do we get a better outcome here for society? How do we get an individual that begins to contribute, to view their life different, that, that’s willing to, you know, go back into their children’s lives, that is willing to make an impact and really change who they are? So as you’re, as you’re pioneering, you’re, you’re talking about all these specialty courts. You had mentioned that you had received some money, you had gotten some funding, or I believe it was over $3 million in new funding for the Las Vegas Justice Court. How does that mechanism work? I wasn’t even aware that, you know, the courts would apply for grants. I was like, wait, what? That was very interesting.

JUDGE CYNTHIA DUSTIN CRUZ : So when I took over adult drug court, to say that I was squeezing blood out of a rock would be kind of a narrow thing.

DIEGO TRUJILLO: Because you’re an entrepreneur, too. Yeah. Yeah, right?

JUDGE CYNTHIA DUSTIN CRUZ : We had, you know, and just the way that the billing system was going on. And I just was meeting these other judges. And they were talking about all these other things that they were doing in their court. And I’m like, I’m struggling as to how to get people, you know, with their treatment paid for and all of that. And I’d never written a grant before. And I said, all right. And I got told, you know, you’ve got to look at grants.

DIEGO TRUJILLO: It took a weekend course. You’re ready to rock.

JUDGE CYNTHIA DUSTIN CRUZ : It was a little bit more than that. But the good thing is I am an attorney. And so I’ve learned to make persuasive arguments. I’ve learned to write persuasively. And I said, if I can write an appeal, I should be able to write a grant. The first time that I applied, I was not successful, and I went back and I read what the reviewers’ notes were because, yes, I could write persuasively very well, but there were certain things that I needed to learn how to do better. Here’s $1.2 million. Oh, wow. Over a five-year turn.

DIEGO TRUJILLO: Then my third attempt— Were you expecting that on the second one?

JUDGE CYNTHIA DUSTIN CRUZ : No.

DIEGO TRUJILLO: Or were you expecting a bunch of notes and to learn a little more?

JUDGE CYNTHIA DUSTIN CRUZ : I was not, and so we got that one, and then, you know, it just started the ball rolling, and then the next one was for $300,000, and then we got a $400,000. It’s just being able to, you know, once you know how to get your message there and following through with the message, you know, that’s how you get there. And that made it that we could do so much more to help people.

DIEGO TRUJILLO: And what did this funding go towards? Typically, what do you seek funding for?

JUDGE CYNTHIA DUSTIN CRUZ : So, you know, the other thing that I also worked on is, you know, we’ve got the Affordable Care Act. So I pulled on the Affordable Care Act because we did. We needed to figure out how we were more cost effective. Because the one thing that insurance is there for is to help pay for treatment. So we were working on making sure everybody was getting enrolled in insurance so that we could use the affordable care to pay for treatment. Then for my people that were unable or they were underinsured, now we could step in and help out with that. We’re able to help out with housing now. Peer support services aren’t covered, so we’re able to pay for peer support services. We’re able to pay more for bus passes. We’re able to pay more for transportation. We’re able to pay more for when people need identification again. We’re able to pay when there’s Limitations as to people’s insurance, we’re able to pick that up. For medications, some of these medications are somewhat expensive. I mean, if you’re talking about Vivitrol or Suboxone, you’re starting to move in on these 30-day shots. They’re expensive, and sometimes certain insurances don’t cover them. So we’re able to do so much more now with that additional funding, and we’re able to help more people. And that’s what this is all about.

DIEGO TRUJILLO: Have you seen the funding directly impact the outcomes? Absolutely. So that’s something that’s directly, uh, the correlation is clear there.

JUDGE CYNTHIA DUSTIN CRUZ : Well, I mean, if I’m, if I have somebody, so here’s what we know. If somebody is homeless, we know that they’re, you know, there’s an 80% chance that they have a substance abuse problem, a mental health problem or both. Um, so you have to find some form of stable housing. Well, the one thing that insurance doesn’t cover is housing.

DIEGO TRUJILLO: Right.

JUDGE CYNTHIA DUSTIN CRUZ : So if I have people that in the first 90 days so the first 90 days of moving into a treatment program that first phase you’re trying to stabilize people right if they’re so worried about Am I going to be able to stay at this location or I only have 30 days at this location and I have to figure out how to pay and I’m not even at a job yet. Like they’re not going to be able to stabilize because you’re triggering them. So if I can sit there and say listen I’m going to get you placed somewhere that you’re not going to have to worry about that financial component. We’re going to cover your housing. then now I’ve eliminated one thing that could be potentially a trigger and I’ve provided them with a safe, sober, and supportive environment. So, and it’s safe. So that’s like number one to be able to start dealing with a stabilization process. And when we have grant fundings like this, that gives us the tools to be able to keep making this momentum. I have people that they haven’t seen a doctor in years. And you know, drug use isn’t nice and warm and fuzzy on your body. So we make them go see a doctor. And I can’t tell you how many times I’d have people like, I can’t afford to do that. I had people that were being injured and I’m like, you need to go to the doctor. And they’re like, I don’t have money to go to the doctor. And that shouldn’t be, you know, you shouldn’t have because you can’t pay just to see. So we’ve also collaborated with some low cost clinics with wonderful physicians here in town to be able to see them because People need these wraparound services to get them where they next need to be. And how about this? I have a lady in, of course, a lot of times when you’re homeless, you lose all of your identification. So, you know, you have to go through different steps of things. And a lot of times it’s paying these little fees to be able to get them to have identification. And then let’s say I’ve had people that, you know, they were here lawfully here in the United States, but they’re not a U.S. citizen. And to try to get the additional documentations for that, you know, you’re having to pay hundreds of dollars. And if you’re homeless, you don’t have that money.

DIEGO TRUJILLO: Yeah, it’s not on your list of priorities.

JUDGE CYNTHIA DUSTIN CRUZ : No. And so, we have, that’s what the funding has done. I mean, there’s a lot of oversight as to what we can and can’t use it for. But that being said, the doors that having funding provides makes or breaks what enables somebody to do it. Now, I know people that they’re, you know, and I’ve had people when we were struggling with money that You know, we worked very collaboratively to find every resource we absolutely could do for them, but I did see sometimes that, you know, they were worried and they had additional stressors and this kind of eases that piece.

DIEGO TRUJILLO: Yeah, I agree. I saw a presentation. His name was Dr. Jeffrey Brenner. He won a MacArthur Award for a technique called hotspotting, medically. So they would look at readmissions in hospitals, and they would notice, huh, the last five days of every single month, there was a lot of people of There’s a lot of people, and I was telling this story to my sister over the phone inside of a grocery store, and so he goes, yeah, they were looking, and they were noticing the last five days the amount of people that would come in for ketoacidosis or their blood sugar level just wasn’t managed. And so he’s looking at all these Medicaid readmissions. This was in Arizona. and what that cost was. And then he thought, well, what if we give these people $30 food cards that they could use for food? And so they started giving him $30, and I mentioned this in a grocery store, and a guy goes, oh, more handouts, like he wasn’t even paying attention. But they started noticing these $40,000 readmissions to the hospital begin to drop. And after he did that, the insurance company, it was a very large insurance company, he said, hey, will you allow me to buy an apartment complex, and we’re just going to give these people a place to live? We’ll give them a social worker, and we’re not going to charge them anything for one year. And they, well, what are the conditions, and this and that? They can drink, they can use drugs, that’s, we’re not going to limit that. This is their apartment, this is where they could live. And he showed a video of what it would go like, the interviews, the rate of recovery, how it increased. Not just that, but I’ll never forget, while they were going through somebody’s apartment, he goes, please, he paused the video, he goes, please take note of how this woman keeps her things. She’s been in this apartment for six months, and all of her things were in bags in the closet. because she wasn’t used to unpacking that stability, right? And you look at Maslow’s hierarchy of needs and what we need to be able to self-actualize and break out of those cycles, um, where we just feel hopeless. There’s no way out. And so when someone gives us that chance, that dollar can go a really long way, um, for many people to be able to break out of that cycle. Are there any cases or memorable experiences that you’ve presided over as a judge that have kind of jumped out at you or really stuck with you? I’m sure you have some very interesting stories.

JUDGE CYNTHIA DUSTIN CRUZ : So I love to tell the story about one of my former, he graduated, but he came in and he first got sent to the court and we released him and he left.

DIEGO TRUJILLO: And we were like, OK, so I’m going to issue this before the ankle bracelets or the electronic monitoring.

JUDGE CYNTHIA DUSTIN CRUZ : Yes. And because he came to me when he wasn’t in custody. And and so we put him somewhere and he left. And I was like, OK, well, issue the warrant. And you know what? I want to say like two to three weeks later, he comes in the door and he’s I will never forget. He’s wheeling in a purple suitcase. And he comes into me and he says, I don’t want to live that way anymore. He’s like, I know how to do this. I can run. I can dodge the system. And, you know, I can wait until Metro finds me and runs my name and puts me in jail and I serve out. He’s like, I can do six months in jail standing on my head. He goes, but I don’t want to live like this anymore. And he stood in front of me with his purple suitcase crying. He’s like, I just need help. And I said, OK. I can help you. But you’ve got to be ready to try to do this. And we put him in a sober living facility called Freedom House. And this young man who went from living in a tent in a desert that his entire, all of the things that he had in his life was in that purple suitcase. Um, no idea, no nothing, no job. He now, um, not only does he have a job, not only does he have a car, not only does he have a house, uh, not only does he have an ID, um, you know, I get, uh, I get messages from him and he’s like, I went to Indonesia.

DIEGO TRUJILLO: Oh, wow.

JUDGE CYNTHIA DUSTIN CRUZ : You know, he’s like, I can travel. I don’t even blink. He’s like, I don’t blink when I give people my ID. There’s no issues. He’s like, I, I remember him showing me pictures at his graduation. And we talked about the purple suitcase and he would show me pictures of before he, before he got into recovery. And I always would joke, and I’d be like, OK, that’s your rib cage? Because you’d be like, I’m fat now. I’m like, that’s your rib cage. That’s your intercostal muscles. That’s not like that. That’s your visceral organ. That’s not it. And when we looked at every smile, I said, do you notice the difference between your smile today and smile then? And I said, there you look like you’re baring your teeth, and now it’s like genuine. And I tell that story, and I just had a young man that I graduated last Thursday. And he thought he had no problem. He thought everything was okay. The mother of his child had separated from him. He had no visitation. He didn’t see himself as being homeless because he would go and couch surf. He got very serious charges against him, and the district attorney must have seen something in him, or he had a defense attorney that argued. He graduated last week with me home. His ex-wife came to the graduation. He has the co-parent now together. He has his kids. He has, he has a wonderful job. He has like everything. And you just watch these stories of people. I mean, I have another graduate and she just got married and she’s in Bali right now. Wow.

DIEGO TRUJILLO: So it’s like watching people’s life come to fullness and they’ve just accepted this bare bone existence. And all of a sudden it just, you see it come to life.

JUDGE CYNTHIA DUSTIN CRUZ : I’ve had people who tell me at graduation that they were so angry with me that I made them go into somewhere like a sober living facility, which was a roof over their head, a functional bathroom, food, because they thought that living in a tunnel with other people that were around them, with no bathroom facilities, no running water. I mean, you were living in a sewer tunnel that you thought that was OK. And it wasn’t until I forced them to go into something else that they realized that was not OK, and they should have never realized that was acceptable.

DIEGO TRUJILLO: How eye-opening. And I would feel like it’s something that’s so unique to your line of the judicial system, right? I’m sure other judges don’t feel like this about their job. You know, I thank you for the seven years in prison. You realize, I’ve realized that that tax fraud that I committed, you know, was a mistake and you’ve made me a better, right? Here’s an update of how I’m doing. This is very unique to your line of work, huh?

JUDGE CYNTHIA DUSTIN CRUZ : It is. I mean, and I’m sure there’s a lot of people that intersect into our justice system that probably are in that similarity. But a lot of them aren’t ready to kind of take the chance to do this, or they don’t want to. They’re not ready. And it’s an unfortunate thing that there’s a lot of times, and we’re revisiting, you know, as to, you know, if you failed out, you know, when we think it’s appropriate for you to come back, because it used to be that, you know, we didn’t want to keep pulling on taxpayer resources to try again and again and again. And we also didn’t want it to be a situation of like, OK, well, you didn’t make it this time, but you know what? You can come back in three months and pick up another crime and come back. But we are having discussions about that because we do know sometimes people just aren’t ready.

DIEGO TRUJILLO: Yeah. Yeah, there’s kind of a sweet spot to really make that come to fruition. It’s kind of tough. How do you balance then, and let me ask you this, we’ll shift a little bit, because when we met, you handed me your card, and you said, I’m up for election, right? How do you feel when the election year comes up, right? Because now you’re focused kind of on two things, because there’s work you’ve been doing, and I’m sure you’re passionate about it. If you’re writing these grants personally, you’d like to see them executed and deployed. You want to see the outcomes on that. What is the dichotomy there within you on how much attention you give to each?

JUDGE CYNTHIA DUSTIN CRUZ : It is that I joke that my re-election campaign is a second job now, so I am working two jobs. And some of the things that are unique and they intertwine together. It’s just like how I walked up to you at a networking event and introduced myself in hand card and like, hi, I’m running for re-election. And you just looked at me and you’re like, I’m really nice to meet you, but you know. Right, not a lot I can do, but I’ll vote for you if you want. Yeah, right. But it’s like having this intersection. OK, yeah, I’m running for re-election. I met you. But now I’m doing my job as a public servant because my job as a public servant and my job as chief judge of the Las Vegas Justice Court is to talk about what we do. The storytelling. and how we intersect and how we help improve not just our community but it is public safety that we’re talking about also. So it also allows me to blend and have that I’m doing sometimes wearing two or three hats because I’m also a chair of what we call here’s a big long word the Clark County Criminal Justice Coordinating Council which is a whole bunch of people sitting in the room talking about systemic criminal justice issues and how we fix it. So a lot of times, um, I may have a meeting with somebody like you and I may come in to be like, Hey, I’m having, I’m sitting down with coffee with you to talk about my reelection campaign. But somehow that translates into, I’m not talking about my reelection campaign. I’m talking about what we do in Las Vegas Justice Court for specialty courts. And you know what? I’m also now going to talk about how does that intersect with my role as chair of the CJCC because how about if we find a way to diminish that pipeline going into the jail and into the courts and where do we intersect with the community to help out with that and where does that Fall into with what you can do and that’s where you know, sometimes, you know, I joke that I’m like, okay I might be working two jobs, but and I might be talking about three different things but it’s all with having my eye in the windshield as to what’s going on because that’s what That’s what being an elected official about is doing public service.

DIEGO TRUJILLO: Yeah, and it would seem the tie-in, the role that you play and how you need to be tied into the community. I mean, this is different than maybe other courts where they’re not so actively engaged with all the social services and everybody else, right? The support system isn’t needed as much. maybe he’s a little more punitive or whatever it may be, just by nature, it seems here, you would not just have a vested interest in seeing these people rehabbed, but hey, now that I have this passion and I’m building, you know, I’ve worked on this baby that I’ve helped to raise, how can I make sure this baby has the best chances? And how do we make sure people never even come into this court, right? How do we really start partnering up Because, again, I think our country had an idea of what addicts were and what addiction was, and all of a sudden that really shifted. In the last 30 years, in the last 40 years, we began to see, you know, people injured at work that all of a sudden hears a prescription, or in a car accident hears a prescription, all of a sudden gets pulled, and the only thing they’re left to do is, well, where do I go to now to get this, right? And so, I think as that, as that, as addiction began to touch more, you know, suburban America and people start to see the face of this and understand it, we really see the collaborative nature that’s required to pull ourselves out of this. And so, I can’t imagine, in your case, where you’re, it’d be like running to maintain the business that I’ve built, right? And so I’ve worked hard on this business for six years. I’m watching the impact it does. And, hey guys, can I keep my job? Can I continue to do this? Right? Which is, it’s kind of the, the, the nature of, of what you do. Uh, what do you feel distinguishes you from your opponent? What do you try to focus on as you’re, as you’re going into the community with this storytelling and sharing what it is that you do?

JUDGE CYNTHIA DUSTIN CRUZ : A lot of it is my track record. So, I mean, specialty courts is just one thing that I’ve been working on since I got on the bench in 2013. So, you know, my slogan is experience matters. And we’ve talked about this when we talked about people with learned experiences and people that had to apprenticed and people that had journey. I mean, I’ve been doing this. I’ve been an attorney for over 20 years. My opponent is a very, very bright young lady, but she’s only been an attorney for five years. So, I keep trying to tell people, like, listen, you know, experience matters. I have a good track record, and I have that it hasn’t just been like, hey, I just go in and I, you know… Yeah, I’m milking it. I jump on the bench and I do my job as a judge on the bench and I preside over cases and then I get off the bench and I take off my robe and I, you know, go home and turn it off. It’s definitely been more than that and it’s, you know, it means that I’m in places and I’m in meetings on Fridays and on Saturdays and on my days off because sometimes that’s when community partners and stakeholders, that’s when people are available to do about that or it’s writing a grant and thinking about things a little bit more outside of, it’s more than what I do just sitting on the bench.

DIEGO TRUJILLO: This is community work, what you do. I mean, the community work that you do is just in a completely different setting than the rest of us out here trying to connect the dots and trying to make it happen and the wraparound services and everything. You just play a different role within that community.

JUDGE CYNTHIA DUSTIN CRUZ : Right. I call it being a collaborative stakeholder because that’s what it is. We can’t, yeah, we’re, you know, we’re a different arm of the government, you know, the whole nine yards. But that being said, you know, I had somebody say to me the other day, I was in a meeting and they said, My goal is to put your treatment court out of business.” And I said, bring it on. That’s awesome. Because if you put my treatment court out of business, it means that you are getting to people that have need before they ever run into a police officer, before they ever go into the Clark County Detention Center, before a case ever comes into thing. So please put me out of business. Put my specialty court out of business because of what you’re doing so far down the road. But in the meantime, let’s figure out how we work on this journey together.

DIEGO TRUJILLO: A hundred percent. I’m with you. You know, you mentioned the experience thing. It always reminds me. There’s a saying that Hispanics mom will tell their children, which is, you know, the devil knows more for being old than for being the devil. Right. And so what mom? But it means I’m older than you. I know what’s happening, right? They kind of share that experience with us. You reminded me of that when you mentioned it. So if people want to find out a little bit about more, a little more about your campaign, a little bit about what you’re trying to achieve and what you would achieve if elected again, where can they send their friends and family? Where can they go and look?

JUDGE CYNTHIA DUSTIN CRUZ : So I have a website. It’s cruz4judge.com. So that’s C-R-U-Z, the number four, judge.com. Um, I am also on, uh, social media. So, uh, I believe my, my, uh, I’m reelect judge Cynthia Dustin Cruz on Facebook and then on Instagram. It’s, uh, I think judge Cynthia Cruz on Instagram.

DIEGO TRUJILLO: Okay. And that way they can follow in all the updates of what you’re doing now and also for the reelection as well.

JUDGE CYNTHIA DUSTIN CRUZ : Yes. So, you know, as I’m running around in the community taking lots of smiley pictures. Right. Seems to be. But yeah, it’s definitely, you know, I think the public struggles because You get these names on the ballot for judges and no one knows what’s going on. And so that’s why I also think it’s such a critical thing, even as my role, not just, hey, I’m in campaign reelect me mode, but as the chief judge of the court to keep working and educating our public as to what we do in Las Vegas Justice Court and why it is important to figure out who your judges are, especially if they’re going to be elected.

DIEGO TRUJILLO: Yeah, I agree with you. Well, I really want to thank you for coming on. I think that we’re definitely going to have to have you on with, uh, as we go, we’ve been exploring and putting on these panel for opiate response. And there’s a lot of really interesting things happening in the community. I love highlighting them and spotlighting it. And again, I think it’s us working together as a community, uh, when it comes to healthcare, when it comes to homelessness, when it comes to mental health, when it comes to substance abuse disorder and, and all these different areas, I really look forward to being able to sit down and speaking with you, uh, hopefully when you win more grants. for the court system, no, to see these outcomes and see what changes we can make to be able to make an impact in our society. I really want to thank you for coming on and being able to share with our audience. For everybody listening, that was Cruz, C-R-U-Z, the number four, judge.com. That’s cruz4judge.com, and they can get more information. And then, as you mentioned, it was Judge Cynthia Cruz on Instagram? Yes. And then I’m sure if you look up Judge Cynthia Cruz on Facebook, it’ll also come up.

JUDGE CYNTHIA DUSTIN CRUZ : Sure. A lot of times it comes up as either Judge Cynthia Cruz or re-elect Judge Cruz. Re-elect Judge Cruz? Yeah. OK. I’ll be on the November ballot. And underneath the full, long name, Cynthia Dustin Cruz, because that’s my full name. But I don’t make people do that. It’s a mouthful on court. Right.

DIEGO TRUJILLO: It’d be a little trickier. Well, thank you very much for coming on and sharing with our audience, for everyone that’s listening. Uh, this is The Heals Pod where we try to highlight all the amazing programs and all the amazing people in our community to be able to share the story of a thriving healthcare system here in Las Vegas. Thank you very much for tuning in and make sure to visit Cruz for Judge. That’s the number four, cruzforjudge.com. Thank you very much for coming on with us, Judge Cruz. Um, and we look forward to having you on again.

JUDGE CYNTHIA DUSTIN CRUZ : Thanks so much for having me.

DIEGO TRUJILLO: Have a wonderful day.

The Impact of Organ Donation: A Conversation with Christina Gilbert of Nevada Donor Network

By | HEALS Pod, News

Our goal with HEALS Pod podcast is to shine a light on the companies and leaders that serve our valley to help us get to know the ins and outs of our current medical system and what can be done to improve it. Here is our conversation with Nevada Donor Network’s Christina Gilbert. Click here to listen.

Full Transcript

DIEGO TRUJILLO:
Ladies and gentlemen, welcome to another episode of Heals Pod. It’s a pleasure to be able to have you join us today as we get into a very interesting conversation. My guest today is Christina Gilbert from the Nevada Donor Network. And we’re very excited to discuss not only what this organization does, but also what she does in her participation and how is it that organ donation works? What is the process? And just shedding a little bit of light on what that looks like because many people aren’t informed. Welcome today, Christina.

CHRISTINA GILBERT: Thank you so much for having me, Diego. It’s wonderful to be here.

DIEGO TRUJILLO: You said you weren’t nervous, so it should be very comfortable. Well, the nice thing is we try to take a lighthearted discussion to be able to keep it enjoyable and entertaining for everybody. So no pressure whatsoever. Great. But we did want to dig in and find out a little bit about Nevada Donor Network. You know, they are a well-known organization here in Southern Nevada. They’ve done a good job at branding. But we want to kind of delve in a little bit, maybe about things people don’t know and kind of clear up some misconceptions and things like that. So thank you for joining us on this journey.

CHRISTINA GILBERT: No problem. I’m happy to be here.

DIEGO TRUJILLO: We’re hoping you’re going to make it good. Right? But as we start today, so how long have you been with the organization?

CHRISTINA GILBERT: So I will have been with Nevada Donor Network for seven years this month, and let me just tell you, it has been the most amazing adventure I have had in my professional life. Personally, I’m very passionate about the mission and bringing awareness to our cause because organ, eye, and tissue donation truly does save and heal lives every day, and it’s a very beautiful thing to be a part of.

DIEGO TRUJILLO: Absolutely. And I think one of the things that I was excited on this podcast, actually, as we were discussing, because it’s one of those things that people nod and go, yeah, absolutely. But they really don’t know anything about it. And I know, you know, the Nevada Donor Network has been a member of HEAL, so I’ve been around a few of the employees and kind of talked. I remember going when they did the grand opening on the laboratory. That was very exciting. And just learning the depth of what it involves and the lives impacted. I know I’ve had people in my life that I have known that have been severely impacted by organ donation, not just in their personal life and needing a transplant, but some of them having to relocate their whole family to Sacramento just because the 14-year-old needed a kidney. I wasn’t a kidney, actually. It was a different organ for her. I had another friend that had a kidney transplant, and luckily she was able to do it here in Las Vegas. So what does Novada Donor Network do?

CHRISTINA GILBERT: So Nevada Donor Network is the federally designated OPO or organ procurement organization for a majority of the state of Nevada. We are responsible for recovering organs and tissues for transplant to help save and heal lives all around the world. So it is just at the core of our mission to be able to bring awareness to that as well because obviously we would like Nevadans to get registered, understand the process, understand what goes into it and how important it truly is.

DIEGO TRUJILLO: And do you see that as a large challenge? Is it something that you feel like, OK, we’re 70 percent there, we’re 80 percent there, or is it just an ongoing battle of education and, you know, getting people signed up and getting people on board?

CHRISTINA GILBERT: So I’m happy to share that Nevada has 64 percent of our state that is currently registered. The national average state by state is 54 percent.

DIEGO TRUJILLO: So we’re above the national average. I’m going to start touting that.

CHRISTINA GILBERT: Yes, I know it’s something to brag about. And I think that, you know, it’s a matter of having that conversation that can be really tough. All of those different conversations in life. It’s hard to think and speak about death and dying and that’s, you know, a part of what we deal with every single day. And I think it’s more so just being comfortable enough to share your wishes, to share why this means a lot to you and why it is something that you want that truly does move the needle. and spread that awareness and education about organ and tissue donation.

DIEGO TRUJILLO: Well, and I know that this is something, again, when you discuss it and you’re talking about the families that are looking to have that discussion, I mean, there’s a few discussions. And just to clarify for the people listening, when you talk about organ donation, there’s multiple conversations you’re having, I would guess, right? And correct me where I’m wrong. The first conversation is, are you an organ donor? And what there’s have to be different misconceptions around each one of those conversations because even I talk to people and they’re like, no, so the paramedics can leave me there dying so they can donate my organs. I was like, wow, that’s not at all how that works, right? It’s not like someone sitting there with a timer like, okay, we’ll give him five more minutes. And then at that point, you know, if he doesn’t, then we’ll harvest organs, but that’s not the case, correct?

CHRISTINA GILBERT: Absolutely not. So that is the most common myth and misconception that we hear is that if someone knows that I am a registered organ and tissue donor, they won’t do their best to save their lives. Well, we know that HEALS especially supports the first responders in our community, and we know the medical oath that they take to save lives first. And how I view donation is a light at the end of an incredibly dark tunnel for them. It is sort of that peace and solace for the heroic donor families when there is nothing else, life-saving measures, are no longer effective, there’s nothing else that can be done, then donation becomes a conversation. So I think that’s where the line has to be drawn, is to understand the process and that nothing can happen until all of those life-saving measures have been ended and are no longer possible.

DIEGO TRUJILLO: Yeah, it’s no longer viable. And then at that point, you know, once you’re seeing that nothing else can be done, okay, let’s have the next conversation. That’s when the organ procurement conversation comes up.

CHRISTINA GILBERT: Exactly, yes.

DIEGO TRUJILLO: Right. And so some people are somehow afraid that it’s going to intervene with their care. And I noticed very much in dealing, I worked in hospice for seven years. And so when you’d have that conversation, even being people right there, many times you’d bring up, hey, you know, you want to discuss final arrangements, and you would be shocked at the percentage of people that would not respond. Absolutely. I worked, remember one night at the hospital, we did a, you know, final, final arrangements day and we had the, you know, the five wishes and we’re handing them out. And we had nurses walking from trauma and saying, ah, no, you know, we did. Hey, have you had your final arrangements? No, not right now. I’ve been really busy. And we’re like. Man, you see all the wild accidents that happen, all the crazy things. I mean, we always assume that death is very far off. Regardless, even if they said, you know, you only have six months and people will still, you know, that part of denial where we’re just pretending that it’s, it wouldn’t happen to us or, you know, we’re not a statistic, whatever it may be. But with organ procurement, do you find that same challenge when you’re having that discussion or people that immediately standoffish or no, no, no.

CHRISTINA GILBERT: I think that the conversation really does take two different paths. It’s a matter of the knowing what your loved one and your hero wants, or it’s having to try to figure out and understand them as a person and understand, is this something that they would have wanted? So I think in the time of grieving, and anyone that’s out there that’s listening knows that feeling of loss when you’re in that grief so heavy and when it’s fresh, right? happening at that moment, it’s hard to understand what decision to have to make. So if that decision is already made, there’s a sense of peace. And so when you have that path of the conversation, knowing and understanding, it just makes things a lot easier for all of the loved ones that are involved.

DIEGO TRUJILLO: No, I agree with you on that. And I’ve always been very clear, like, yeah, no, absolutely. I’m an organ donor. And if anything happens, yeah, they’re there. Because I think, you know, when you’re dealing with death and you’re dealing with a lot of questions, I had found when working with families is that it’s always the why. Why is this happening? Why? We’re trying to make reason and trying to understand where these things happen. And one thing that I did see amazing, we actually had a very good friend whose son was tragically struck on a motorcycle. And we remember when it all happened. And then, you know, the questions are going to remain there and there’s not an answer. You’re not going to find an answer. And so when the choice is my favorite line from A Man’s Search for Meaning, right? When the choice for suffering has been removed, how we respond is really what it comes down to. That’s the only choice we have left. And for me, that was always very impactful because the person’s been lost. There’s nothing you can do at this point. That’s already happened. And so how we respond to that, and I think that, and this is just a little, I’ll give you a little plug, I think that was the most beautiful thing about watching the entire donation process, is taking something that seemed meaningless, it seemed chaotic, it seemed like it was just, why could this have happened, and all of a sudden turning it into a beautiful story, and not just one beautiful story, but multiple beautiful stories.

CHRISTINA GILBERT: Absolutely. And I think one of the most beautiful ways that our family services coordinators have described it to me and the way they share with loved ones of heroic donors is that your loved one’s story can end with a period or it can end with an and, an ampersand. It can continue on through donation and the ways that you impact other people’s lives. And I just found that to be incredibly beautiful. And, you know, with my own personal connection to donation, obviously I’m very passionate about the mission, I also see how it impacts loved ones and family members to have that knowing that their legacy of their loved one lives on.

DIEGO TRUJILLO: And do many people want to know what happened?

CHRISTINA GILBERT: I think that it really is just dependent on personality types. I think it’s kind of cut right down the middle. There are people who really want to understand and know and take in. be around a recipient’s family and the recipient and know them. And then there’s some people that this loss is still too profound for them to communicate about and speak about that they maybe will accept a letter or they’ll send a letter, but they don’t want any further communication. So it does have to be mutually agreed upon. And everyone’s grief journey is different.

DIEGO TRUJILLO: Yeah, that’s completely understandable. I mean, I could not I wouldn’t want to put myself in a situation where I’d have to make that consideration. So I definitely don’t want to judge anybody on their decision when it comes to those things, because it’s highly personal. And again, everybody’s story is very different. Every relationship is very unique. So it’s always very important to kind of remain nonjudgmental and just understanding. I mean, people have their process of going through what they’re going through. Exactly. Have you found or have you found that many families find a rewarding reward in maintaining that communication? Because you mentioned it was split. Are there any people that that kind of go through that and think, you know what, never mind, I don’t want a connection or I don’t want contact?

CHRISTINA GILBERT: I think what I have really noticed is and from the words of a heroic donor mother is that they have found a purpose after their son, specifically Courtney Kaplan, and the loss of her son, Mikey Sigler, you know, she always says, now I found my purpose. My purpose is to bring awareness to organ, eye, and tissue donation. She is connected with his lung recipient, double lung recipient, as well as received a written communication from his liver recipient. And she welcomes that. And she’s open to it. And, you know, she really hopes to hear from more of his recipients because he had a couple more as well. And I think, you know, we’ve just recently within the last couple of weeks have had a husband as well as a daughter that met a heart recipient out in Utah, which we will be sharing a video during this month as well on our Facebook page. But I just think truly it does give them. when you’re searching for that sort of meaning, it can give you that.

DIEGO TRUJILLO: Yes. And then all of a sudden you understand when a family can come and say, hey, thank you, because of what you went through, I’m able to now have this. This is the way I’ve tried. And you brought up Courtney. That was a friend I was talking about, because we knew her for even a few years before the accident had happened. And that was, again, watching her process for me has been something… I don’t want to say beautiful, because it sounds… It’s making the most out of something that is very unwanted, right? Yeah, it’s a tragedy that just shook everyone. And all of a sudden, we have an opportunity. And this is something very unique. I mean, this is not something humans could do a thousand years ago. No. Right. And so this is a unique opportunity to really take something, make something out of something that was completely lost and allow it to create a blessing for others or to be able to impact other lives positively.

CHRISTINA GILBERT: Exactly. And I think there is really something that’s special about that to see it grow as well as see how someone has that journey through their grief and why we You know, have services like our aftercare team, our family services coordinators that walk alongside our heroic donor families to make sure that they have the resources that they need.

DIEGO TRUJILLO: Yeah. And again, the correct perspective, because sometimes we shift right in those moments and it’s very hard to maintain a perspective. I would do that. Excuse me, I would do that with many families. What does a chaplain do? They would assume it was always religious, and I would tell them, no, some people are not religious at all, and I’d still spend time with them. My role was really maintaining perspective. When someone would tell me, yeah, you know, my mother’s dying. And this is just heartbreaking. I can’t continue.” And I’d say, you know, while that’s true, it’s the evidence of love. It’s because you’ve had something that you’re feeling a loss. There’s some people whose mother passed, and they don’t think twice, because their mother was never involved, or there was never that connection, or their father, or what have you. the grief that you feel is the evidence of love. And when people would shift perspective, it was very powerful. I’d be in rooms, you know, and a family would go from being devastated and crying about a father on a ventilator, and they would just shift, and I would watch this family give thanks for the dad that they have before they unplug them. And so for me, it was very important to be able to help people maintain perspective. Because that’s very hard. And I know I’ve had to have people, you know, when you run into problems, you’re just focused on frustration and anger and everything that comes around that, right? And there’s people that step into your life to, you know, ask certain questions where like, no, you’re right, right? You know, that it was a blessing having him or, you know, it was a huge impact. And so as you have those discussions, it helps you to remain focused.

CHRISTINA GILBERT: Yes, that’s a very powerful point.

DIEGO TRUJILLO: It’s incredible. And I’ve always thought that amazing about your organization, right? There’s not just a person out there trying to go procure organs, right? There’s an entire team that steps in on every way. I noticed this even in the laboratory, because I had seen laboratories. I had never thought about how complicated it would be to, hey, we need to test this. We need to make sure that it’s all clear. And we need to do this, like, now. Yes, it’s very timely. You don’t have three months to get a result back.

CHRISTINA GILBERT: Yeah, and there’s so many people that are a part of the process. We obviously have our local transplant center here at the University Medical Center of Southern Nevada, UMC. But then we’re also working with transplant centers to find that perfect match, the United Network of Organ Sharing, who ensures that, you know, everyone who is in desperate need of a transplant is listed and they are able to receive that perfect match, which that’s something I would like to share. There is a huge need. There’s over 100,000 Americans that are currently waiting desperately for an organ transplant, and almost 700 of them are Nevadans.

DIEGO TRUJILLO: And that’s what I wanted to ask you, right? Regarding that need, I’d like to unpack that a little bit. What does the need look like, aside from 100,000 just in the United States, but you also trade organ. I don’t know if trade is the right word, so correct me where I’m wrong, but there’s also, it’s international.

CHRISTINA GILBERT: So we work with organ transplantation just within the United States, but outside of the United States, there is, for example, we do work with different ophthalmologists around the world to help bring the gift of sight to people through corneas. Going back to your experience in hospice care, this is another common myth and misconception is someone will count themselves out. They’ll say, I’m too sick. I have this disease or I have this going on with my health, so I’m not able to be an organ donor or my age, whatever that is. And I always say the gift is saying yes. When you say yes, you bring hope to those people that are waiting, but also you can give the gift of sight through your corneas. You can give the gift of healing through tissue, that’s bone grafts. different types of tendons, ACLs, you know, different things that can help give people their lives back in not maybe the way we traditionally think of from an organ transplant perspective, but it does heal them and it gives them their life back.

DIEGO TRUJILLO: Yeah, absolutely. I mean, functionality, it definitely makes an impact. And again, what you’re saying, right, that the gift is the willingness. It’s just instead of discounting yourself as to why I’m not good enough, we all need to be proud of the organs we have. They’re all useful in some way or the other.

CHRISTINA GILBERT: And the desire to give. I mean, that to me is such a reflection of your character, and it inspires others as well. By having the conversation, I think that surprises people a lot and why we love to share stories and tell people always, share your why, because that really can inspire someone. And like you shared, we think even when a doctor tells us six months to live, well, we don’t know what tomorrow holds. I could be driving home after this, and I don’t know what could happen. So I think at the end of the day, it truly is about sharing your wishes to not only know that your loved ones understand what means the most to you, but even aside from that, to inspire others to also want to give back.

DIEGO TRUJILLO: Right. And I have different, again, I agree with you very much on one side, right? For me, while I don’t I don’t believe we live in a society that necessarily there’s not a reason why someone should be generous, right? Because everyone has their own belief systems and values. For me, generosity is a very, very important character trait that I pay attention to and something I try to exercise in my life. But just from a completely utilitarian standpoint, So if you argue philosophically, and I’d get in these arguments with people, I’d say, you have something that’s useless, and you can make something very useful for a lot of other people. This is kind of a no-brainer, unless you hate efficiencies in the universe. But, uh, it just, it would seem that, yeah, we cannot change the circumstances. I would understand if we were like, hey, you know, you either have the option that your dad lives, or you donate the tissue. Okay, well, you know, That’s a tough choice to make, and if anyone were to ever make that decision, good on them, and kudos for being generous there. But on this one, there’s no other benefit. The circumstance is what it is. The situation has already occurred. And again, from a utilitarian standpoint, this is the most good for the most people. Something could come out of this. And for me, it’s a pinnacle and a testament to humankind and what we’ve been able to achieve. Something that we couldn’t do a hundred years ago. Yes, it’s beautiful. The fact that death was it. You got there and that was that. I mean, everything was lost and all of a sudden we figured out a way to be able to salvage that and to be able to make an impact on other people.

CHRISTINA GILBERT: Yeah, and things have come so far. Speaking to, you know, my personal connection to donation, when I was only five years old, my grandfather actually passed away at 51, waiting for a heart transplant. And he was here locally at Sunrise Hospital. waiting to get medevaced out to Salt Lake City to get listed for a heart transplant and unfortunately he was sick and he had many years of fighting. He had a congenital genetic heart defect and There was nothing he could do. He was the healthiest person. You know, I think that was in my mom’s side of the family, constantly swimming, running, eating healthy. And unfortunately, those were just the cards that he was dealt. But still, even knowing that and knowing that he wasn’t able to receive his gift, he still was registered. Of course, my whole family, we’ve always had conversations about donation, but he was able to give the gift of sight to others through his corneas. Locally, they ended up staying, and then my grandma actually received two thank you letters from his recipients, and just that gratitude is what got her through a really, really dark time.

DIEGO TRUJILLO: And I completely understand. That’s what I was talking to a little earlier, right? I can’t even imagine as a donor what that feeling has to be getting that letter. Again, there’s nothing there but a loss. And all of a sudden it becomes a thank you. Something beautiful comes out of that. And that’s got to be a very incredible experience.

CHRISTINA GILBERT: It truly is. And I mean, now we’re talking, you know, not to age myself, but 30 years later, and my grandma still brings it up. She’s in her mid-80s, and it’s still something that means so much to her. So I think that ripple effect that it creates, it’s just truly immeasurable.

DIEGO TRUJILLO: So digging into that a little bit, right, what is the impact? When you think of one person donating, what is the impact that one person could have with donation?

CHRISTINA GILBERT: So when one person says yes and gets registered to be an organ, eye, and tissue donor, they can actually save the lives of eight others through organ donation. and heal and enhance the lives of 75 or more through tissue donation. So that’s a very large number. I mean, can you imagine? And with tissue donation, the gift can be preserved for a longer period of time, just depending on what the tissue is. And so that can continue to give back over several years and make an impact on so many others. So I’ve seen people who have gone on to, you know, impact a few hundred lives through their tissue donation.

DIEGO TRUJILLO: Yes. So it’s not just simply one organ from one person to the other. There’s a huge impact here.

CHRISTINA GILBERT: Yes, there truly is. And imagine how you change things, right? When we were talking about, you know, Courtney’s story, Harold, Mikey’s lung, double lung recipient, he was able to be with his son when he you know, got married and then became a grandpa and all of these things that happened. And he was being told, had he not received that gift, I mean, he maybe had days to live. Yeah. So imagine how different that story would have been. And because Mikey said yes and made that decision, it completely changed the lives of all those people.

DIEGO TRUJILLO: Yeah, it changes a huge story. Absolutely. Again, from the utilitarian standpoint, to me, this is a no-brainer. So hopefully we can convince some people that are listening today, and hopefully to make the choice. I think sometimes these are the kinds of things we’re apathetic about. But again, and we think, well, tomorrow I’ll do it, or I can do it on a later date. Yes, I’ll deal with it when it happens. This is something, again, none of us have any writing on the wall that says, oh, this is how long, or a barcode on our neck. I think that was the number one question I’d get asked when meeting with a family, right? When you meet with a family, they just receive the worst news they’ve ever had. They would always, well, do you have any questions? After I would explain, yeah, do you know how long he has? And I would always tell them, you know, unfortunately, none of us do. You may have pancreatic cancer, but I may leave this building and get T-boned at a stoplight. And that’s that. I didn’t have time to call anybody, reorganize my priorities, nothing. I mean, we really fool ourselves, in my opinion, on a constant basis. We live in a very sanitized world where we’re just not exposed to death. It’s not something we see a lot, and it’s always in the back of our minds way back there without realizing how close we are constantly. I say this as an avid outdoorsman. I really love hiking and anything that has to do with outdoors, backpacking. And it’s very interesting when you begin to take people back, having to explain people or you take them out and you think, hey, you have to remember how meaningless you are to this mountain. So one poor decision on your part, the mountain will not be phased in the least bit, right? And all of a sudden it’s brought… Yeah, we’re not in a city where you could just get rushed to a hospital. We’re looking at 12 hours before you’re even rescued on a broken bone. And that’s not if it’s sticking out. Right. And so I think people live in this very sanitized world. You’ll see this sobering look come on people and be like, wow, this is this is. Yes, I know we’re outdoors, but it is it is very, very dangerous. And you need to be aware of that. Right. Yeah. So. Your involvement with the organization, what did you do before you had worked with Nevada Donors?

CHRISTINA GILBERT: So prior to working with Nevada Donor Network… I’m curious as to your journey, right?

DIEGO TRUJILLO: Yeah, my journey. You’re a wonderful speaker, right? And you have the life experience. Thank you. The connection. But when you unpack it, what was it that drew you in?

CHRISTINA GILBERT: Well, basically, I had a very corporate America start to my marketing career. And I worked with GES, Global Experience Specialist, does all the large trade shows in town. And I enjoyed it. I had a great team. I mean, I think what I really felt was the need to use what I’m really good at and my skills to give back in some way. It’s just who I am and a part of the core of, at the center of who I am and what I love doing. And so I ended up working with Whole Foods Market for some time after that, getting into the retail space. But what I really got to do there that I loved was partner with a ton of nonprofits. And I’m like, I’ve got to find this.

DIEGO TRUJILLO: That’s what pulled you in. You were like, wait, there’s rewarding jobs out there? What?

CHRISTINA GILBERT: Something that I can do and be passionate about. And I had no experience in the medical side of things but I think what I brought to the table obviously my own personal experience with the mission but aside from that it’s passion right? I think that’s what beautifully pulls together the people who create our team is these are people that will sit down on the floor in a hospital room and cry with a donor family you know and their son who’s just lost his older brother I mean I’ve seen so many stories where you can just the passion just really exudes from each of us. And so I randomly saw this position and I shared it with my grandma and she goes, well, you know who that is, right? And I was like, no. And she was like, well, that’s who, when your grandfather passed away, he donated his corneas. So this again, back in 93. That drew the connection in and you’re like, okay, this isn’t just a random. This is moving me to where I should be. And I went through the interview process and I just completely hit it off with the team. I’ve never looked back since seven years almost this month, and what a beautiful month to start as well because it’s National Donate Life Month, which is our big observance that we celebrate each year to bring awareness to organi and tissue donations. So yeah, it’s just very, very meaningful to me.

DIEGO TRUJILLO: Yeah, it sounds like it was the place where you needed to be. Yes. Right. Well, good for you on your journey. Thank you. So and when you’re dealing with families to be able to connect and even people that are considering donation to be able to tell your story must be very powerful. Does the entire team share that? Does everyone have that background or is there a connection typically?

CHRISTINA GILBERT: I think there sometimes is and there sometimes isn’t.

DIEGO TRUJILLO: Not that one is better than the other.

CHRISTINA GILBERT: Totally. Yeah, there’s a little bit of both. I think definitely when you are able to have that empathy to understand, of course you can meet a heroic donor family where they are, but I think our team is so empathetic. You just have to be a certain type of person to be able to be a part of our team. And I think that there is just that character and quality that we have and it’s beautiful and if anyone listening is interested in joining our team I highly encourage you nvdonor.org slash careers and please check us out because I think that, you know, anyone in the healthcare realm of a professional totally looking, but we also are just looking for the right member for our team.

DIEGO TRUJILLO: That’s a big part of our culture. Because it’s a very rewarding job. I remember, and again, coming from hospice, it was very funny because I’d have people that would try to, Hey man, you’re a really good talker. And you know, could you do this? And they, they tried to get me to switch over. And it was really funny because, uh, Whenever people try to sell you things, they always sow that doubt. But, you know, are you ever tired of that grind? That nine to five? And they make me, like, ask me these questions. I’m like, no, not at all. I mean, yeah, I cry with families on a monthly basis. This is the most rewarding work I’ve ever done. Having people tell you, you know, the death of my mother was the worst experience, and you made it the best it could possibly be. There’s no compliment or anything that someone could say. I mean, that feeling of going into work was not, it wasn’t a drudge for me, at least. Oh, totally. And so once you find that position, you’re just like, wow, this is it.

CHRISTINA GILBERT: Yeah, it truly is. And I have had that come up so many times for me personally over the years. I had a best friend who lost her younger sister, and I visited her the night before she passed to be there for the family. And she was at Nathan Adelson Hospice. Her mom said, well, I would love for her to be a donor, but I just think she’s too sick. And I was able to have her connect with her nurse who then communicated with our team and she was able to give the gift of her heart valves, her corneas. So that right there was like It’s just, there’s nothing, like you say, that can meet that or pull you in or just show you, like, this is where I’m meant to be.

DIEGO TRUJILLO: It’s a very human connection. It’s very hard to describe. I could tell. I could see it when you’re talking about it because it’s something that’s very hard to describe to people because typically we’re generated, well, how about what’s your income yearly? What’s your, you know what I mean? The things that we typically shallowly value. But in a moment of death, they’re valueless, right? Those things are not important. Your television, for me, that was always probably the greatest gift for hospice, when I’d look at what hospice did. And even in my own, because everyone says the same thing, well, you know, I just want to go to sleep one night, and then that’s it. And I was like, not me. You know, after working in the hospital, I very much would like for someone to say, hey, you only have about six months left. Stop worrying about all that stuff that is not important. Stop all of it. All the things that you, you know, you feel like you’re lacking or missing or this. And it’s time to refocus on who is around you and what do you want to do with the last days of your life. For me, it was, you know, at first, because I was one of those, I was like, I want to go in my sleep till all of a sudden, like, no, I would love to be able to know. to be able to, you know, what would, I always thought if I got in an accident, right? Because we drive a lot marketing. And so I would always think if I die in a car accident, which is not unlikely, seeing how drivers in Las Vegas are now, I won’t shift the blame to them. It’s everybody else that moves in. But seeing how drivers are and just how dangerous those things can be, right? People really seem to undervalue. And I’d always think to myself, if I were to die, what was my whining for the last five days? What did I complain about or what things were wrong in my life? And are they really that important? Right? I do a lot of refocusing work, I like to call. And that was definitely one of my exercises. And this isn’t something I follow. I just started doing this because I… I would start watching videos whenever you’re having a really bad day. I would watch videos of like a zoom out of the galaxy. I don’t know if you’ve ever done that. No, I haven’t. Yeah, just go on YouTube and type in, uh, type in a zoom out and it starts in like a city, then it zooms out to the state, then it zooms out to the country, then it zooms out to the planet, then it zooms out to our galaxy or to our solar system, then it zooms out to our solar system being part of a smaller galaxy, which is then a part of the Milky Way galaxy, and all of a sudden you think, yeah, my problems are not that important, right? Whatever I feel is like the end of, yeah, it’s not that. We are a blip, and so it would always help me to refocus, and I would always do that in my gratitude. What would be my complaining for the last five days, and is it really that important that I’m letting it occupy my mind? And then through my, and this is something, again, working in hospice that I would tap into continuously. And I’m sure you experience that as well, right? How many complaints do you want to have a day where you might get in an argument with a partner, or you might get in a fight with a relative, and then you go to work and think, wow, it really can be a lot worse. And this is not important. We used to have our office on the first floor of a building, and on the third floor was a child’s oncology. up center here in Las Vegas. And I remember, you know, I’d be flustered and I’d walk in and, you know, busy because I have real problems and they’re really, really important and I’m important and I need to take care of. And I’d see four young kids sitting in a chair with mom and dad because when someone has, you know, a child has cancer, it’s the whole family that has to kind of deal with it. And I just immediately would stop and just be grateful as soon as I got to my office and think, all right, slow down and just handle the problems you have because it’s not the end of the world. Right? It could always be a lot worse. So as you’re going on a day-to-day, what does your day-to-day look like?

CHRISTINA GILBERT: So really it just depends by the day and truly another reason I love this role is we could be out doing an education for an organization that wants to have us. We have someone that educates our youth population as well as, you know, going to schools, doing all those things. Heading out to the Nevada DMV, over 99% of registrations come from DMV offices.

DIEGO TRUJILLO: Those are the key players of the organization, all right.

CHRISTINA GILBERT: Yes, you know, different people like that. We have partnerships with hospices.

DIEGO TRUJILLO: What does that look like out of curiosity? I’m just, I’m kind of curious now.

CHRISTINA GILBERT: Sure, like the DMV education. Essentially, it’s a lot of gratitude. Clipboard in the parking lot? Well, it’s more it’s a lot of gratitude. It’s you know, I think that they are our front line. We truly view them as that because they are required to ask that question to you know, give you the opportunity to receive that heart on your license. But, you know, there is such this attitude when people walk into a DMV, I don’t want to be here, it’s something I have to do.

DIEGO TRUJILLO: I think everyone feels that, right? The ones that are there and the ones that work there.

CHRISTINA GILBERT: There’s some incredible people that work there and there’s people also that work under those roofs that have been impacted by donation and are passionate. So really it’s about awareness and them obviously having such a short interaction with people who are making that decision, but understanding, hey, you don’t have to be the expert, but we provide resources like brochures and, you know, there’s just branding about the mission within DMVs that they are supportive of. In September, we celebrate them through National DMV Appreciation Month. And I think it’s really just saying thank you and then allowing us the opportunity to, you know, just have that education and share more about donation.

DIEGO TRUJILLO: And it’s being able to transmit that passion. Because I can tell you, did you fill out box eight, check yes or no, versus, hey, would you like to be an organ donor? And if, you know, No, I don’t want them taking my body just because, but that’s not that way that works. And having them take the time, they don’t have to explain it. Yes. And so being able to transmit and motivate another individual to be able to carry your message effectively has be, uh, must be somewhat challenging, especially again, when you work at the DMV, cause they’re dealing with all of us and having lived with all of us, right? We know how frustrating we can be sometimes. I include myself in that. Because it’s all of us. Totally. We always had a joke when we were in school that, you know, you know, people, what was it? We would always say people are dumb and we’re people too. So we really need to take a step back whenever we want to be judgmental of someone else. Cause we make some comments or might make an opinion or whatever it may be, but it’s important to be able to network. So what other positions? So how, how else do, do people fill in?

CHRISTINA GILBERT: So we also liaise with different partners around the state. So whether that’s a funeral home, a hospice, we work with law enforcement agencies, fire, of course, our local coroner’s offices as well, which help facilitate donation on a different side than, of course, our hospitals, who we also work with as well. We have an entire hospital services team who is out doing those educations and ensuring that they understand what, you know, they need to do in order to get in contact with us, all those different things. I mean, there’s so many moving parts consistently on a daily 24-7 basis of our mission that, again, as we discussed, death happens when it happens at any point. And so we always do have a team member that’s available to go out and be there for a family, work with a nurse in a hospital, Just be there to continue to make the donation process move forward.

DIEGO TRUJILLO: It’s a pretty large operation. It is. So seeing this, how big is the need then? And when I say the need, obviously everyone needs to be educated on this. You guys are doing a great job. The number was 64% you said? Correct. Okay, so fantastic kudos on that. The marketing team is doing very good at getting the message out there. What is the need as far as procurement? I mean, are we talking every hospital ten times a day? What does that look like?

CHRISTINA GILBERT: There’s no exact number, but obviously aside from the numbers I shared with you about the national transplant waiting list, our local waiting list, there’s also the actual, you know, every day, 17 people pass away waiting for the gift. So even though there’s that over 100,000 people waiting, those are people coming on and off of the list, right? Because they’re too sick and they pass away. There’s also every eight minutes, someone’s being added to the list on average. And so there’s just a lot of dynamics that the more people that are registered, the better. We all carry, depending on what our race or ethnicity is, unique genetic markers that make us the perfect match for someone else. So it’s incredibly important for people in multicultural communities to get registered. Over 60 percent of the national waiting list is someone with a multicultural background.

DIEGO TRUJILLO: Do you find a challenge culturally?

CHRISTINA GILBERT: I think from a cultural perspective, it revolves less around the generosity of donation and more around the death conversation, the maybe distrust in the medical system. You know, it’s more of those types of things. I am Cuban as well as Middle Eastern. And then my grandmother, she is English-Irish Welsh. So I’m a little bit of a mix of everything.

DIEGO TRUJILLO: Yeah, you got all the challenging cultures. No, I’m kidding.

CHRISTINA GILBERT: So my grandma on one side, who lost my grandfather very young, she’s had her funeral planned down to what music is playing since he passed away.

DIEGO TRUJILLO: And this is what each of you will read.

CHRISTINA GILBERT: Yes, literally. She does, you know, over at Davis, where my grandfather is buried. But then on the other side of things, my Cuban side of the family, the day that someone passes away, the funeral is then getting planned, things are getting figured out. It’s just a matter of making those conversations more normalized and being the change. We say that every time during National Multicultural Donor Awareness Month in August, be the change.

DIEGO TRUJILLO: See, and I asked that, so both my parents are Colombian. So I am 100% Colombian, but manufactured here in the U.S. And yeah, it’s crazy. I’ll tell people, it’s very funny because you grow up here, Hispanic, and your parents will always complain and be like, oh, well, you know, sometimes you just think so American. I’m like, well, yeah, I didn’t ask you guys to raise me here. So on some parts, I’m very American. On some things, I’m very Hispanic. And that was one that always killed me was the lack of planning. You know this is coming, you’re on hospice, and yet afterwards we’re all, where are those documents? Where did they leave this information? Would they have wanted this? All of the things that we easily could have had a simple conversation about, that now we, you know, and it’s not just left to guess, like, where’s this paper? But a lot of them are very, very deep questions. Would they have wanted this? Am I going to live with regret of making this decision? Totally. Right? And I think that’s a big fear. When I would talk with families in hospice, I would tell them, you know, the biggest thing with hospice coming in is you have a team of professionals that deal with this on a constant basis. And having that next to your side allows you to make much more informed decisions. And it takes away the fear of walking that unknown path, which I think a lot of people have. And sometimes, I would find that when you’re specifically speaking with Hispanics, I can’t speak to Middle Eastern and all that, but when you’re dealing with Hispanics, it was a very, well, we don’t give up. No, we don’t give up. We don’t even talk about giving up, right? That was kind of the mentality. In the case of my father, he had kidney failure, so there was, I mean, there was going to come a point where you were going to choose, I don’t want dialysis anymore, unless something else would have happened suddenly. Um, but eventually it did come to that point where we had to have that discussion and, you know, I had a physician come that was a friend of mine at the hospital and, you know, she stepped out of the room and she goes, hey, do you want me to hit him direct or do you want me to sugarcoat it? And I was like, no, he needs to hear it. And she walked in and said, listen, you will die by yourself in a chair. I cannot believe they’re dialyzing you. You will die in a chair by yourself in a cold room, or you can go home and be with your family today.” And he just said, I want to go home, right? It was a really powerful moment, but he had to hear it. And so sometimes, again, we live with these blinders on. So I always think culturally, especially when it comes to organ donation and that distrust of the medical system and, well, you know, they’re going to say, oh, here’s a good one, right? As if a doctor has a lead or is getting, you know, $25 for every organ they donate or whatever that may be. To be able to discuss that’s why I was curious as right culturally as you engage if there is a constant shift depending on the population and I think for me personally you know now being a part of the mission.

CHRISTINA GILBERT: sitting down, having a conversation, talking about my work, my abuelita, 86 years old, bless her heart, she randomly is like, Cristina, we’re watching her telenovelas.

SPEAKER_01: And she’s like, you know, I don’t know that anything in my body is good, but I’ve been registered as an organ donor for 25 years.

DIEGO TRUJILLO: And I was like, wow. I got what I got. If you want it, it’s here.

CHRISTINA GILBERT: Yeah, she’s like all about it. And it was literally because I am now in it. So she felt comfortable speaking about it. And hearing that, I was like, Wow, that’s really all it takes is just continuously bringing it up, being inspired, being passionate, and anyone could be that way.

DIEGO TRUJILLO: It kind of like, it drops the stigma when it’s brought up in discussion on a regular basis, right? So I always had this, I know, no, let’s not talk about this subject. And I’m like, mom, we’re all going to face this, right? We’re all going to come to a point where we hopefully where we, you know, can choose hospice. Some of us won’t, but this is a conversation. We’re all gonna die. We’re all guaranteed this, and yet we want to avoid this conversation as much as possible. We’re just adding a bunch of pain into everybody else’s life and difficulty and things that are unnecessary. We’re already having to deal with your loss, and now we have to say, well, what are we gonna do here? What are we gonna do there? So it’s very interesting as you have those discussions. Culturally, I’m sure the difference is a lot. I remember talking about hospice with some physicians from the Middle East, and they’re like, no, you know, we… One of the physicians said, because I don’t know if it was reflective of all, he goes, no, no, no, we always give people good news. We never tell people the bad news, right? Going back to if a bride asks you, you know, is she the most beautiful bride? And she is absolutely not. What do you do? Do you lie or do you tell the truth? And so he’s like, you know, we always want to give people hope. And so that conversation would kind of stick there. And I was like, oh, I don’t know if I’d want to live that, right? I think I would want a clear picture to at least make the best decision. Yes. And so I think with organ donation, it’s the same thing, right? The subject’s a little icky, but we’re all going to die. This is an inevitable fact. That’s like us having to do taxes yearly, and no one wants to talk about taxes. You’re not going to get too far. Totally. So it is very important. So where can someone now, now that we’ve convinced the 20,000 people that are listening today, Now that we’ve discussed this, how can somebody register?

CHRISTINA GILBERT: So it’s incredibly easy. So a lot of us know about, of course, going to a Nevada DMV office, checking yes to the organ donor question, receiving that show of support, that heart on your license. But aside from that, if you don’t have an appointment at the DMV for a long time, you can actually go to nvdonor.org, get registered at registerme.org. And it’s incredibly easy. It can happen in literally 30 seconds.

DIEGO TRUJILLO: How do you check? They can look at their license and see if they’re registered or not.

CHRISTINA GILBERT: So essentially, we do not. And this is something that I’ve also commonly found with heroic donor families. When they share and they do educations, Actually, no one is looking for your license in that moment. Again, the first responders are responding to the medical crisis that’s going on, you know, doing their best and absolute best to save your life. But aside from that, it’s actually we have access to a registry. So that’s why the communication has to happen with us. And then we can confirm that registry, whether you register online or at the DMV. So if you’re still and I share this with people, you’re still like, you know what? I just really don’t want to have a heart on my license. I don’t feel comfortable. Completely fine.

DIEGO TRUJILLO: That’s why the online registry was created So you can know that that is the decision you made and then share it with those closest to you And then the decision is made if there’s people that are sticking to their guns thinking no I don’t want this on my license because the paramedics are gonna immediately just let me go There’s the option to not get it on your license and still register as an organ donor

CHRISTINA GILBERT: Yes, exactly. So if you are an iPhone user, there’s actually an option within your iPhone health app as well. But registerme.org is incredibly easy and you can do it literally right now within 30 seconds.

DIEGO TRUJILLO: And what about for people that are not, they’re not in the position to, or let’s say they already donate, is there something more that they can do?

CHRISTINA GILBERT: So if they are already registered, there is the option if you are very passionate about donation and our mission, you can actually become a living donor as well and you can donate one of your kidneys. There’s also the option. I have seen people to donate a portion of their liver because your liver does regenerate to full size. And so you can actually give that living gift as well. So if you are passionate about being a living donor… What do those positions pay?

DIEGO TRUJILLO: So there’s… You’re kidding, right? You’re like, sir, sir, we do not… Yeah, right.

CHRISTINA GILBERT: Yeah, no, it’s illegal to sell organs and tissues in the United States. But yeah, there are ways to give back through living donation. I mean, A kidney is the most weighted on organ in the United States. So you can do an altruistic donation if you don’t know anyone. But if you do know someone that is listed, desperately waiting for that gift, go get tested through their transplant center. They can give you their information to their social worker. And they can make that happen. And you can live with one kidney. We all only need one kidney to live.

DIEGO TRUJILLO: OK. And that’s a guarantee?

CHRISTINA GILBERT: That is what is medically possible. There are some people that are only born with one kidney.

DIEGO TRUJILLO: I like the caveat you gave there, right?

CHRISTINA GILBERT: Yes. So yes, it is a way to give back. And I have seen people thrive. And really, really beautiful stories that have come from living donation. A woman, we shared this story on our Facebook page, that shared her niece by donating a portion of her liver.

DIEGO TRUJILLO: Oh, that’s incredible. Yeah. So the last and final question I wanted to ask you today, right, is how can people get involved with National Donate Life Month? You mentioned that there is a month dedicated where we recognize donating life. How do people get involved?

CHRISTINA GILBERT: So it’s incredibly easy. We have a whole webpage of resources that they can actually access at www.nvdonor.org slash april. And from there you can see ways to share more about our mission via social media. We have our annual Hope Glows, which is our fun run slash walk that’s going to be at the end of this month on the 27th in Mountain’s Edge at Exploration Park at 5 p.m. There’s so many different ways to get involved, so I would encourage you to check out that page.

DIEGO TRUJILLO: What does that event look like for those that have families and are looking for something fun to do?

CHRISTINA GILBERT: Oh, it’s so much fun. So essentially how I view it is it’s really like a visual image of what donation represents. Glowing a light, you know, it’s at night. We host it. Everything is glowing. There’s just a lot of good energy It’s very family-friendly DJ food trucks and it’s just to celebrate the gift that organ I and tissue and bringing awareness, right?

DIEGO TRUJILLO: I’m sure everyone begins to have the conversation some people might be attracted just by the event but be able to find out because I think I feel like when you share that, people think, well, you know, I’m probably not good enough or I smoked for 20 years. We discount ourselves from the ability to be able to participate in a more meaningful way than we even know.

CHRISTINA GILBERT: Never count yourself down. The gift is saying yes.

DIEGO TRUJILLO: Do you guys turn people down and say, well, you’re too sick?

CHRISTINA GILBERT: So, of course, there’s a medical evaluation that does occur, but that is not something that anyone needs to worry about.

DIEGO TRUJILLO: Right. Don’t do that at home. Yes. Allow the medical experts.

CHRISTINA GILBERT: Let the medical experts and professionals make your wishes come to fruition and just say yes.

DIEGO TRUJILLO: That’s fair. Well, I want to thank you for coming on today, Christina. Of course. This was very, very fascinating. Thank you for coming and sharing both from your experience and the rest of your teams and what everyone goes through there. How can people get, can you give us the website again if they want more information?

CHRISTINA GILBERT: So if you just want to learn more about organ, eye and tissue donation and figure out ways that you can get involved with Nevada Donor Network, head to www.nvdonor.org and we have plenty of resources and different things that you can connect with us to be able to learn more about our mission.

DIEGO TRUJILLO: And then they can also go to that website forward slash April if they want to go to the Hope Glows event.

CHRISTINA GILBERT: Yes, exactly. And learn more about different ways that you can get involved with National Donate Life Month all month long.

DIEGO TRUJILLO: This is incredible. Well, thank you very much for coming on. Of course. It’s been a pleasure being able to interview you today, and I think there’s a lot of guests that listening to this definitely learned something. I know that I did, and I’ve interacted quite a bit with Nevada Donor. I feel like every time I hang out with someone, you guys are so resourceful. There’s always more that I learn. Thank you so much. Thank you very much. We had not had the pleasure of meeting though. Yeah. So yeah, after this experience, I feel like I got a new friend out of this podcast. Definitely. Well, thank you very much for coming on. And, uh, and we look forward to interviewing in the future when you guys get new news to be able to share on your lab and new developments that are happening because we, and this is another number I really like, we are one of the top organ procurement organizations now.

CHRISTINA GILBERT: Yes, we are. And we continue to have a number that we can. So I don’t have the exact numbers specifically, but I do know that our team continues to be and we love to share this the best in the universe. And through the supportive Nevada community that does believe in organ and tissue donation, we continue to make our mission.

DIEGO TRUJILLO: We could take it to 70%. Yes, exactly. Hopefully, if we all participate. So at the very least, at the very least, if you want to help out, tell your neighbors, tell your friends, say, hey, this is something, have that conversation with them. Again, I think you’re right, Christina, bringing that up and having that discussion around death and who we are afterwards, I think is very important. I think it kind of helps us reflect on our humanity and be able to share that. And I think that’s a conversation that everybody should have. Yes. So, thank you very much for coming on once again. And ladies and gentlemen, thank you for jumping on and listening to another episode of The Heels Pod. My name is Diego Trujillo, your host. Thank you very much. Have a great day.

 

The Journey of Building a Health Information Exchange in Nevada with Michael Gagnon

By | HEALS Pod, News

In this episode of The HEALS Pod I had the pleasure of speaking with Michael Gagnon, the executive director of the Health Information Exchange in Nevada. Michael shared insights into the challenges and importance of building a comprehensive health information exchange network.

The conversation delved into the complexities of connecting various healthcare providers and the critical role of the Health Information Exchange in facilitating seamless communication between different medical facilities. Michael highlighted the need for standardized protocols and the challenges of interoperability in the healthcare system.

We explored the history of the Health Information Exchange in Nevada, its inception, and the funding challenges it has faced over the years. Michael emphasized the value proposition of the HIE, citing real-life examples where access to shared medical records has saved lives and prevented medical errors.

The discussion also touched on the evolving role of the Health Information Exchange in the future, including the potential for leveraging AI and data analytics to improve healthcare outcomes. Michael stressed the importance of data privacy and security in the context of sharing sensitive medical information.

Furthermore, we discussed the need for public policy support and funding to drive the success of the Health Information Exchange. Michael highlighted the potential cost savings and efficiency gains that could be achieved through a well-integrated healthcare data network.

Listen to the Podcast.

Full Transcript

Diego Trujillo:
Ladies and gentlemen, welcome to another fantastic episode of The Healed Spot. I’m very excited today to be able to share with a friend of mine that I think carries a very noble goal, one that I wish would accelerate a little bit quickly that it has. But he is the executive director, if I’m not mistaking, of the Health Information Exchange here. Michael Gagnon joins us today. How are you doing today, Michael? I’m doing great. Thank you, D.A. It’s wonderful to be able to have you with us, to be able to share with the listeners. I know that the Health Information Exchange has been a passion. Uh, every time I talk to you, you, uh, not only do you know a lot, a tremendous amount about the health information exchange, but the, the delicate nature of what building and, uh, something that would seem very obvious, uh, at least from, from my point of view, knowing nothing with health information exchange. And so I wanted to have you on today to kind of dig in a little bit and find out, well, why, what is the hangup? What are the challenges? What are the arguments? Um, you know, for me, when you talk about a health information exchange, right, I would just say, well, yeah, it’s just a way that all the medical records and all the doctor’s offices kind of speak with each other, right? That’s correct. I don’t know if that’s an oversimplification.

Michael Gagnon: No, not really. It’s, uh, it’s actually quite- Is that pretty spot on?

Diego Trujillo: Yeah. But it seems a lot more cumbersome when I hear you guys talk about it. It, uh, and when I say cumbersome, I mean, yes, we’re not gonna, running a USB cable from one computer to the other, right? This is, this is, uh, very interesting the way that all of these systems kind of have to come together. How do they share the information? Can you tell us a little bit about, uh, the Health Information Exchange here in Nevada for those that haven’t heard a lot about it?

Michael Gagnon: Sure. Healthy Nevada is a non-profit that’s been in business for about 12 years. Uh, we manage the Health Information Exchange for the state. No, it is not as simple as just connecting two cables together because the standards just don’t really exist, um, out there and really only honestly aren’t really adopted enough to make them really work well. So it takes an organization like ours to kind of be the middle man in the middle where in the system to make those things work and to take in the information from all the records and then make it useful for other providers.

Diego Trujillo: So what is the size, just for people that are listening that have no idea, right? So our Heals listeners come from a variety of backgrounds. So some of them might not be familiar enough with technology enough to call me out and say, hey, you can’t just connect two computers with USB. You’d have to use an ethernet cable or another system. But what is a way that you can kind of explain what it is that you guys do and how this idea originally came to be?

Michael Gagnon: So it all started back when the Office of the National Coordinator was formed back in around 2009, and they started to realize that they were going to put electronic health records in all the provider offices and hospitals, and they needed a way to connect those organizations together. And so there was funding through something called the HITECH Act to make that happen. And we were not actually one of the recipients of some of that money, but instead got a grant from Southwest Medical Associates and UnitedHealthcare to get our network started in Nevada.

Diego Trujillo: So this was federally, they were funding different projects for this. That’s correct. And Nevada wasn’t included in that.

Michael Gagnon: Uh, Nevada did get some money, but the state started to create their own health information exchange at the time, and it just didn’t make it.

Diego Trujillo: Okay.

Michael Gagnon: Um, was it uncommon that that happened in other states? Um, but Healthy Nevada was a private organization that got started around the same time, and did actually make it, and, uh, and was successful in getting, uh, hospitals and providers connected.

Diego Trujillo: What do you feel is the key differences that led to the, the private entity succeeding, or at, at the very least, right, uh, still existing?

Michael Gagnon: Yeah, I think partly it was the organization that was behind it at the time, which was Health Insight, which was the quality improvement organization for the state. And then it really came down to the management and the board and the hospitals that were supportive of making it happen. I think they were the real key reason that it worked for Healthy Nevada, but did not work for the state of Nevada.

Diego Trujillo: Okay. And it’s very key when people think about this. One of the things that I think is kind of often overlooked is the different talents that kind of have to come together to make this happen, right? You don’t simply need an MBA to run a good business as far as the entity goes. There’s also the technical side. How are they communicating, the political side, and how are they going to engage? organizations, the outreach and the marketing that’s necessary. Have you had a lot of trouble bringing all of those pieces together? Do you find it difficult? Or when you stepped in, how did you begin to engage with all those different areas?

Michael Gagnon: Yeah, well, I had the distinct advantage of having helped the network get started in Vermont many years ago. Oh, okay. And so I learned a lot about how that Hall was going to work from a business perspective. I already knew a fair amount about the technology, although I’ve learned a lot more over the many years I’ve been working in this field.

Diego Trujillo: What year was that? Just so everyone can get an idea.

Michael Gagnon: It started in about 2003 in Vermont and became incorporated in 2005. Okay. And you were there from the ground? From the very beginning. So almost 20 years in the business. What were you doing before then? I was working in a hospital as the director of infrastructure. So I did software development and databases and ran the whole network for University of Vermont Medical Center.

Diego Trujillo: Okay.

Michael Gagnon: So that was useful background, but really wasn’t sufficient, honestly. You have to have the right leadership team. You have to have the right technology knowledge. You have to be really good at working with your state governments, particularly Medicaid. There’s just a variety of different things you need to be good at to make this happen. And then you have to be extremely flexible in your approach because it’s challenging work.

Diego Trujillo: And even talking with you, yeah, I’ve noticed that. I mean, just any one of those one areas, your ability to be able to pivot and navigate is essential, right? Because, you know, you have one plan and nope, that’s not the plan we’re following or this didn’t come through. Exactly. Now bringing all of those people together to try to figure this out seems like it’d be a lot larger of a challenge.

Michael Gagnon: Yeah, getting the organizations to participate and contribute into the network is also really important, right? So you have to be really good at relationship management with the hospitals. You have to be really good at relationship management with nursing homes and with the provider offices and getting them to recognize the value proposition of them sending their data out of their system to someone else. so that it comes back around to them when they do need to see that patient again. And that’s an interesting challenge as well. And then if you don’t get much support from your state, you’re running a non-profit, but it’s a high-tech non-profit. So where do you get your capital to really build out your network?

Diego Trujillo: Which means you’re flush with cash, right? Yeah, exactly. Just so much money as a non-profit.

Michael Gagnon: So much money in that, right, exactly. And so, you know, it’s kind of an interesting challenge in that regard. If you do get your seed funding from your state to make it happen, then you do subscription services, you need an important sustainability plan. You got to have a lot of different business knowledge to pull off something like this. And then there’s a specialized technical knowledge to understand what it means to build interoperability in the state.

Diego Trujillo: And what does it mean to build interoperability? Well, just for those that are listening, sometimes we use technical language and forget everyone. Exactly. When you’re talking about interoperability, what do you mean by that?

Michael Gagnon: Honestly, it means that your medical records can get to the right provider at the right time.

Diego Trujillo: Okay.

Michael Gagnon: And so that if you’re being treated in an emergency room, that information from the previous hospitalization you had or from your physician office gets to that emergency room doc so they know what medications you’re on. They know that you’ve had a previous procedure. They know what your diagnoses are. And so that’s just really important in continuity of care.

Diego Trujillo: So it would seem that it’s kind of, and this is what really struck me the first time I’ve heard about the Health Information Exchange. Back then I was in marketing, we were having Vegas Healthcare, you know, we’d have our meetings and someone came to a meeting and I asked them, well, what do you do? And they said, well, you know, I work for this organization called Health Information Exchange. And I was like, well, what is your job? Well, my job is to go let people know that there’s a central repository of information that people can contribute to and then pull from. And the concept seems so overly simple to me. And when I say simple, I mean the buy-in on, hey, do you guys think it’s a good idea that we all exchange information so that we can provide better care? It seemed like that would be an obvious yes, but it seems like that hasn’t played out that way in the community.

Michael Gagnon: It’s an interesting dilemma. And everyone gets it, and everyone believes that it’s the right thing to do. But then getting people to contribute and participate and recognize that everyone gets the data out, but they don’t always want to push the data in. And if pushing the data in costs several thousand dollars from your electronic health record vendor, then that tends to be this natural barrier to participation.

Diego Trujillo: It reminds me of the story of the little red hen. Yeah, exactly. Who will help me bake this bread? And everyone’s like, oh, no, I’m sorry. I’m really busy.

Michael Gagnon: Everyone wants to eat the bread, but not necessarily bake it or collect the wheat and mill it and all those things. Absolutely. A little bit.

Diego Trujillo: So everyone sees the value you were saying. Everyone sees the value and how important this is, yet somehow there’s a disconnect there.

Michael Gagnon: Well, think of it like when we build interstate highway systems. Someone had to decide that we’re going to build the interstate highway system and then you build the on and off ramps and that’s where the communities get their value. So think of the docks or the hospitals as being more like the on and off ramps into that. But who’s going to build the highway? Well, then that’s where the government, that’s where the states typically come in and say, no, we’re going to build the highway. We’re going to build the core mechanisms to make this work. And then you get the value proposition because you can put your gas station or your convenience store off of your on and off ramp. And so we’ve been building the on and off ramps but haven’t really built the interstate highway system is kind of the way I view it.

Diego Trujillo: That’s a wonderful way. Honestly, we’ve spoken multiple times and that explanation you just gave right there was probably the best example I’ve heard of where the challenges lie then. So here, oddly enough, it’s like everyone has the infrastructure. We have the gas stations. We have the shopping centers. We just have nothing to connect them.

Michael Gagnon: Right, and we’re using old roads and dirt paths to get between them now at this point.

Diego Trujillo: And what do you feel when you talk to the state about this? I mean, it would seem like the state takes a priority on highways, as we all driving in Las Vegas know.

Michael Gagnon: No, there’s been a lot of construction. We’re great at infrastructure here, but when it comes to health infrastructure, we’re just learning. And honestly, the state took a big step forward this last year in passing a statute called AB7. And AB 7 is going to lead us, I believe, to the point where the state does start to invest in creating the interoperability framework that literally everyone in the state will benefit from. Every hospital, every provider, every nursing home, and honestly every patient will benefit from this being in place.

Diego Trujillo: Yeah, and I could see. Can you give an example of patients that have benefited from this? I know there’s been a couple that you guys have shared in the past. I just don’t want to butcher the story in repeating it.

Michael Gagnon: Probably one of the best is the patient that came in with a stroke at UMC. And Dr. Young there, who was a big advocate of ours, treated this patient. and saw them come in and knew, obviously, that they were unconscious and having a stroke. But when you have a stroke, it could either be a clot or a bleed. And the CT scan that they ran on the patient wasn’t obvious about what it was. And he paused for a minute and said, we better go check the health information exchange just to be sure. And he found a military ID in the person’s pocket, pulled it out, looked at, it just had a first and last name on it, went to the Health Information Exchange and found that that person had had a stroke, a bleed stroke, hemorrhagic stroke at Centennial Hills just a couple weeks before. And they were just about to give that patient a clot buster, which would have made that bleed even worse. And so it’s things, it’s stories like that that really kind of frame what the value proposition of the HIE really

Diego Trujillo: Right, and if you’re that patient or his family, I’m sure they understand the importance of that, right? It literally saved their life most likely.

Michael Gagnon: Yeah, it certainly saved them from harm. And if it wasn’t for the fact that they, you know, that Dr. Young is just a really great user of the HIE, that wouldn’t have happened.

Diego Trujillo: And how much time does it take away for a physician to go and do that? Are we talking about a two-hour period that he had to go and research this person, or are they pulling it up immediately?

Michael Gagnon: He pulled that, once he found the military ID, it took him like five minutes to pull up that record.

Diego Trujillo: So it works pretty quickly, the way people can tap in and draw information and kind of educate themselves to make better decisions on patients.

Michael Gagnon: Yeah, now he’s the kind of user who’s willing to log into our portal and do that. And there’s other mechanisms you can get to get to that information directly from your electronic health record. But he was very good at it. He’s been good at it. He’s been a supporter of ours for over 10 years. And he found that information and it’s a testimonial he’s done for us before. And it’s just one of those stories that we tell because it just does show the value proposition.

Diego Trujillo: Yeah. And, and how do you feel the role of the health information exchange will evolve in the coming years? Um, in other words, where, where do you see this going? Or do you think, I mean, this alone is, is an amazing value proposition, right? Uh, where do you see this expanding to provide more value? How are you guys trying to kind of capitalize on what the future may look like? I know AI is a big, a big deal, right? I’m sure companies across the country are tying to tap into these records to be able to kind of research and gather information. Is there any kind of monetization that will help sustain this kind of model? Or is it just simply you’re expected as a physician to kind of pay money to be able to share the data and receive the data?

Michael Gagnon: No, I would say what you’re mentioning is very important and probably the future of where it’s going. So think of it as being more like for medical research or for population health where you want to know what’s going on with your diabetic population in North Las Vegas. Or for, you know, improving care because you’ve got artificial intelligence based in this. You can do clinical decision support or you can do medication administration based in knowing all the information on a patient instead of just what you have in your local electronic health record in your practice. So I think the future is actually bright. This is something that we can do. It doesn’t require a lot of change in the actual provision of medical services to make this work. Um, but it does influence the way it can work. And it can really help by saving lives and saving costs. And it’s probably the way we’re going to make value-based healthcare work.

Diego Trujillo: And when you have large vendors, and I agree with you, right? If you want data now, you have to go to the MCOs, you go to the managed care organizations. They’re the ones that really carry it. Do those organizations communicate with each other or not typically?

Michael Gagnon: They often do not because they compete with one another, but they do get data from us. So all the Medicaid, Medicare organizations are part of our network, and they get clinical information from us daily. We send them real-time alerts when their patients are being seen in the emergency room or we get admitted to the hospital. But I mean real time within minutes of that person actually showing up.

Diego Trujillo: Wow, that is pretty quick. And how quickly, where do you feel the largest pushback is? So once again, I mean, I think as we explore the value of this and we discuss, it’s seemingly obvious to anyone listening that how could we improve health care? And I say this because I get interviewed all the time. Well, how do we improve health care in Southern Nevada, right? And it feels like they ask the question just to ask the question, not to listen to actual answers that will help to solve this. And this seems to me like such a low-hanging fruit for everybody. I mean, if you think of what one thing can we do that will lead to the largest amount of impact immediately, Medicaid rates, right? Raising Medicaid rates will have a large impact. Aside from that, I mean, the Health Information Exchange seems like it would be one of those things that would have an incredible community to the outcomes of our health care here.

Michael Gagnon: Yep. And yet each state views this differently. Some have embraced this and fully made it work, and they create public-private partnerships, and those are highly successful. And others simply are a little bit behind. And I think Nevada’s been a little bit behind. One of the wild west here. In many of its healthcare aspects, right? And it may not have been ready for something like this before. And it also took us getting electronic health records in all the practices first. Like that had to happen as a precursor to making this happen. And now that it has, it’s an ideal time to really jump into it and really fund it. And it’s not inexpensive, I’ll tell you that. It’s kind of like building a broadband network where someone’s going to put up towers and put up, you know, equipment.

Diego Trujillo: But we see the government investing billions of dollars in that, right? Exactly. You see the value and you see the return on doing these things. Right. How do we share that sense of urgency? How do people understand how important this is?

Michael Gagnon: You know, I think partly it’s just getting the word out. It’s partly letting people know what the value proposition is. It’s partly working more closely with our state Medicaid department who has access to a lot of the funds from CMS, from the federal government, to make something like this work. And it did take us working closely with our state government partners to make this happen. It seems like the regulation is just about ready to go in terms of making that a reality. And some of the funding, there’s actually $3 million in funding.

Diego Trujillo: Do we get an announcement podcast? Is that what that means?

Michael Gagnon: We certainly will, I think, pretty soon, I’m hoping. But right now, we’re kind of right on the cusp of really embracing it. And there’s other states, California, which recently embraced the same kind of thing. Montana, which recently, I mean, some of us are a little bit late to the party, but that doesn’t mean we can’t make this happen.

Diego Trujillo: What would you say is the, I mean, there’s good and bad to that, right? Sometimes you feel like we’re late to the party. There’s probably some states that were trailblazing here that really learned some hard lessons.

Michael Gagnon: And spent a lot of money to get things done and wasted a lot. And I don’t mean that they wasted it on purpose. They just didn’t know how to get it going. In the early days of when I worked on this, there was a lot of money thrown at this just to figure out how to get organized, just to figure out what the technology should do, just to start to get people connected. A lot of money spent on consultants. I mean, I think all of that was a precursor, though, and was necessary. The one thing about Nevada is being a little bit behind like this, we can be very efficient. The fact that we already have a structure in place and we can incrementally build on top of it, that means we can move ahead very quickly with a more modest amount of investment. Now it’s still not inexpensive.

Diego Trujillo: Yeah, we didn’t say it’s little.

Michael Gagnon: No, it’s probably $4 million in state funds that will generate $40 million in federal match. But that’s the other part of it, is there’s so much matching funds out there from the federal government that it also is one of those things that when you mention that to people, you go, for $4 million in state funds, we can have a fully meshed network that, you know, connects almost every provider in the state. It’s another thing that people think is kind of, why aren’t we done this already?

Diego Trujillo: Yeah. I know that’s something that definitely kind of hit me very hard. It’s like, wait, how does this not exist, right? All of these companies knew they were developing software for hospitals, for doctor’s offices. They’re all somewhat familiar. And I’m assuming, correct me where I’m wrong, I’m assuming that for them, it must have been important that they would be able to communicate with other systems. They wouldn’t design their system in a way that when it spits out data, it’s incredibly difficult to parse through. So they all had to have this in mind. Do you get a lot of support from those organizations? Are they interested whatsoever in the interoperability of their systems? Or do they just build their systems the way they build their systems and that’s it?

Michael Gagnon: No, it’s amazing recently how many vendor products come to us to be the source of their data, to make their systems work better.

Diego Trujillo: When you say vendor products, what do you mean by that?

Michael Gagnon: I mean anything that could be like a health app for a patient, or when you need to get life insurance and you need your medical records collected, or if you’re trying to do diabetes care. Those organizations are now coming to us because we’ve aggregated this information for 10 or 12 years and we have it in a repository and if they have the right rights and approvals from patients and provider groups, we can give them access to that information. We’re becoming more and more of an asset in the community for the health data.

Diego Trujillo: I think that data in general, and I’ll be very honest with you, I became friends with somebody that had studied research for data and that are data analysts, and that’s what they had gotten their master’s in. I think you know her as well. And as we’d go on hikes, I guess data was one of those things I knew existed, it floated out there. I never valued the importance of data. And it wasn’t just through casual conversation. When you have someone that’s passionate about data saying, look at what you can do with this, this, this, this. And it just, it kind of began to blow my mind how much would be possible just by knowing things, right? And having that information recorded and being able to make it make sense. The way you need to, I don’t know if I phrased that correctly.

Michael Gagnon: No, that’s a great way to phrase it. And if we want to make our healthcare system in Nevada better, we’ve got to be able to look at data, analyze it, understand where the most cost-effective use of our resources are. We want to be, you don’t want to waste money doing things that are not going to be effective. You want to recognize where the value comes. And if you’re looking at data, that’s another thing you can do with it. Not just give it to the providers to let them do better care, but also analyze data, like I was saying earlier, about, well, where is the best use of our resources? Because our diabetic population in this area is different, or our heart disease issues are here. And so you can use geographic coding of things as well to kind of understand how to best use your data for that purpose.

Diego Trujillo: Yeah. And, and I think as a society, right, when you look at, and you’re talking just about health data, I think if you would have asked people 15 years ago, how important is data? They would have kind of shrugged their shoulders and been like, uh, kind of. I think, uh, as we’ve seen social media grow and as we’ve seen media and tech companies take off and, and we started realizing as a population, well, hold on, these people figured something out with this data. It’s very important, right? Google gives you all of these things for free. What are they trying to get here, right? Well, what is the privacy? And again, data begins to kind of come up, data on privacy specifically, with Cambridge Analytica. And the way we watch these companies in such a targeted way be able to collect information and know how to kind of guide populations in general is, it seems that data has kind of come to the forefront. Right. Which means you’re in a good position right now, right? as people realize the value of, wait, oh, yeah, we could see how it helps when I’m browsing the internet, while I’m using different things, right? I talk to people sometimes, because they’ll talk about privacy and cookies, and they’ll complain, and I’ll be like, man, we had to grow up, I grew up in a world where I would, right, it was like, you had to watch television, and that’s how you get your cartoons, and then you got fed seven commercials, so you always had to run to your mom and dad and tell them, I need this G.I. Joe toy, right? And they’d plant this urge in me. But now all of a sudden, and I would tell people, I was like, you realize that now they know kind of what you’re into. You get served ads based on the data they have on you that are more relevant to you. As a person that, listen, I don’t think as a society we’re going to get away from advertisements. But if I have to deal with them, I’d rather deal with advertisements that are more relative to me. Uh, if that makes sense, right? Absolutely. So for me as a 39-year-old man, right, that drives or is interested in these seven things, right, if you’re gonna advertise any hiking stuff to me, I’m gonna immediately watch your ad. Right. Um, however, if you’re talking about Charmin or, you know, uh, dish soap, I might not be so interested. It might not be so effective. Now, we all see how this has changed our lives for the better in those areas. You mentioned it with, as a patient, right? There’s life-saving implications, but now you’re talking about the actual public health using it to understand diets, to understand what’s affecting us specifically. I’m sure they may be able to start picking up on trends. Um, especially with the advent of, uh, of AI and the integration of AI, where now the machine can automatically say, hey, something’s happening here. You know, there’s 37 people in the last two weeks that have shown up with this very rare or not typical, uh, condition. Right. Is that something you could see happening with the data as well?

Michael Gagnon: Yeah, we’re already doing that with Southern Nevada Health District, where we feed them information regularly, and they can look at patterns in that data to tell that, for example, a sinusitis infection is happening in the area, and what does that mean, and what’s the implications of that, and how do they treat that?

Diego Trujillo: Did you just pull a random example, or is that happening right now? No, that’s an actual one we’re working on. I know, I just went last week, and I was like, okay, what a coincidence, sorry, and somebody else called me, and they’re like, I swear I’m not lying, I’m sick. I was like, no, no, no, is it nasal? Yeah, I just went through that.

Michael Gagnon: Let me address, though, the privacy and security aspect. So health information exchanges take that extremely seriously. And it’s more of a closed network. It’s not really as open a network as the other things you do on the internet. We only allow certain providers and certain groups in. We only have certain connections to those organizations, and those are all privatized over. They flow over the internet, but they’re all through virtual private networks so that they’re all private. We then have the highest security accreditation that you can get called HITRUST. And we have a very small staff that’s highly trained. And I was the privacy and security officer for a large medical center in Vermont. And the thing that kept me up at night were my 6,000 employees. A very small percentage of them might want to do something malicious, but another percentage would actually potentially do something accidental. But when you have a small team, highly trained, it actually helps with the security and privacy of the information because they’re very attuned to what they’re doing and why they’re doing it. And that goes a long way. And then being very cautious about who you give access to it, under what conditions. We just recently added what’s something called multi-factor authentication. This is where you have to use your phone and you get a code, six-digit code you have to put in. So we’re like tightening up it even more. And we did that because of the things that happened with the change healthcare thing that happened with Optum. So we need to stay in front of that. We always stay in front of it. No HIE in the country has ever been breached. So many other organizations have been, but no HIE in the country, not in any state, has ever been breached. And it’s partly because we’re just so attuned to how important this is.

Diego Trujillo: Yeah, that’s what like 90% of it has got to be, because I’m assuming the number one hang-up on people wanting to participate on this is, yeah, but how secure is the data?

Michael Gagnon: Partly, and partly they want to make sure that it’s private and only shared, but when we explain all that, that it’s really going to someone treating them, or it’s another doctor or it’s another hospital treating them, and now they don’t, might not have to have lab tests repeated or get stuck again for a blood draw, or might not have to have an imaging exam repeated. They’re all really for it. The vast majority of people, 95% of people opt in and say they want to participate. And then a small number of people simply want their data to be private, and we honor that as well.

Diego Trujillo: Yeah. So it’s not automatic. Each patient individually would have to sign a consent to participate.

Michael Gagnon: That’s correct. That’s the way it’s set up here in Nevada, that everyone has to what’s called opt-in or give informed consent to participate.

Diego Trujillo: Okay. So if you want to stay off the grid, you’re good. Yeah. Right? Until you need it. Then you say, how come you don’t have my info? Yeah, exactly. We always used to joke around because we’d work in secondary services. So you’d have a case manager call and say, hey, do you know a home health that can go? And they would name the most random places in Nevada I had never heard of in my life. And I’m born and raised in Nevada. And I was like, well, no. And they’re like, there’s nobody that goes out there? And it was funny how they would be shocked. And you’re like, well, you know how you chose to move away from society? Yeah, it turns out that you accomplished that goal, right? Successful. And then you get upset when there’s not companies that service that, right? No, that’s very interesting. As an HIE, what was it that drew you the most to this project? What do you say kind of fuels you? And I say this honestly because you’ve shared a little bit in the past about how big of a struggle. Again, I felt like this would be an alley-oop, slam-dunk. You know, someone threw the ball up, Michael grabbed it, slam-dunked, everyone’s on board, let’s get this going. And it seems to not have been this way. Nope. There has to be a vision in you, something that really pushes you to say, okay, we cannot give up on this, it’s too important. What is that, if you can explain it to the audience listening?

Michael Gagnon: Honestly, it’s been a passion of mine since I first saw the opportunity for what this could do. There’s no downside to it, honestly. You know, it’s just the sharing of information in this way is just all positives. And once I started to understand what needed to be put in place, I studied computer science, and so I said, this is something I know that we can do, and it has to be done. I’ve become jaded at times because of how complicated it is to do, but I’ve never lost my sense of the mission and vision that this has to happen, and it can really be the driver for improving the value of healthcare, and it can help patients. We feel like we are the only patient-centered service in the state, and I don’t mean that other organizations don’t care about their patients, they do. I mean that no one else collects all the data in a single place, and aggregates it and makes sure you’re the same person and makes it available to everyone else.

Diego Trujillo: That’s a key thing. Seemingly, there’s no way that that could ever happen without an organization or a convener that actually brings that together.

Michael Gagnon: That’s exactly how it has to happen. You have to create a network above the individual provider organizations to make that happen. It’s the same way banking did with ATM cards. When each bank didn’t connect to every other bank, they created something called an interbank network that connected all of them together, and that’s how they shared data so you could get your money in any place. What we are is like an interbank network, but for providers.

Diego Trujillo: Yeah. And so where do you feel the greatest challenges currently right now? If you could name one thing that you’re like, you know, as an organization or as a community, this is the largest hang up we have on making this happen.

Michael Gagnon: The only thing that’s holding us back, Diego, is the funding right now. You know, I’ve been in this long enough. We have an excellent team. We know exactly what technology would put in place. We are following in the footsteps of others who’ve been the trailblazers, so we don’t have to invent new things. And yet, we probably could invent new things and make sure that they’re unique to Nevada. But honestly, it’s just the capital funding to build out this network and knock down those barriers we talked about earlier.

Diego Trujillo: And following that up then, what can I as an average citizen, you know, as Diego Trujillo that just, you know, works his nine-to-five job, what can I do to help push this forward or to make these things happen?

Michael Gagnon: Well, we may reach out to all of you to sign some kind of petition or to become much more aware of the fact that, you know, we’re around and that this exists and this is a value proposition for every citizen of Nevada.

Diego Trujillo: Yeah. I think the, the awareness, I agree with you on that. Again, when I heard about this, I was like, wait, this hasn’t been done? How has this not been done yet? Right? It seems so obvious. Um, but getting people to actually mobilize and engage sometimes can be a little bit difficult. How has been the feedback with legislators over the years and up until now? Do you, do you sense that? So we talked earlier about that, that kind of change in perspective towards data, right? Where now people are like, Oh, what you have is very valuable. Are you seeing that same, that same knowledge or that same feeling within the legislation?

Michael Gagnon: I think it’s flipped here in the last legislative session, and that’s a good thing. I think the federal government pushing what’s called the trusted exchange framework and their cooperative agreement has caused us to realize that we have to do something about this. And so some of the state legislatures have gotten involved with that and started to push it forward and started to create the framework and the statutes that would push for the regulations that make this happen. And so that’s been good. It’s been a challenge up to now, but I think it’s finally coming around. Honestly, the national networks are really important, but not sufficient to meet all the needs. You need a local network and you need national networks both. And it’s the same way, like I said, with banking ATM cards. You have national networks and then you have international networks.

Diego Trujillo: Who runs the national networks out of curiosity?

Michael Gagnon: Well, there’s several organizations. One called the Sequoia Project has been around the longest. They were funded by the federal government to create something called the eHealth Exchange. But there’s others, Commonwealth, Care Equality, Epic has its own network. All of those are useful. All of those are necessary. They do interstate connectivity. And that’s valuable, but you still need your local connectivity. You still need to know what immunizations have been done inside your state. You still need to know what’s going on in the emergency room so you know how to look for public health issues in your state. So there’s some state-based things and there’s some national things.

Diego Trujillo: Zooming out real quick to the national, it would seem like forcing from a national standpoint that the government should be the one kind of running this. And I say this only because some of the companies you named are vendors, right? They have a very specific interest on being number one and, you know, competing better than everybody else and making sure that the other guys don’t succeed, right? And that they do just because of the shareholders. So how… How do you kind of get over that? I’m trying to think about without nationalizing it, which is a very, right, everyone’s scared of that word. But, uh, but really without it being something that is nationally ran.

Michael Gagnon: Uh, I think it really needs to have national standards. Like we, we don’t impose like, uh, TCP IP networks across the country. We let individual organizations do that. So you can privatize that part of it, but you have to have the national standards in place and the rules of engagement and what you want to get accomplished. And then you can let the private sector kind of be involved with making that happen. State governments are very good at policy creation, but often not so great at running, especially complex networks like this. Yeah. You know, and so it’s kind of isn’t even, even our, you know, electrical grid is run by a private company, but with public oversight. That’s kind of the ideal model we want to see in Nevada is let the, let one you know, kind of network us, Healthy Nevada, run that network for the state. But we’d welcome the public oversight. We’d welcome the public opinions on this. We’d welcome, you know, public meeting law and make that happen.

Diego Trujillo: So you would see this functioning as a utility?

Michael Gagnon: Pretty much. And as a matter of fact, there’s federal language now to define something called a health data utility. And it’s recently passed as part of the Labor H Bill and was signed by the president. And so now it’s not yet something that’s coded into law. It’s more of a recommendation. But the CDC and the Office of the National Coordinator and CMS are all starting to promote the concept to say this is a logical way to build out your network in your state.

Diego Trujillo: Now when you mention funding, what would it look like? Are we, are you not able to draw some funding, for example, by letting AI companies have access to data or allowing some of these companies to look at this data? Are you able to monetize? Again, keeping in mind that this is a nonprofit, right? So it’s not for Michael Gangman’s new yacht. But this is rather for the ongoing mission of the organization, right?

Michael Gagnon: That’s certainly something we could consider, but that’s something I would ask the governance, like I ask my board those kinds of questions. Okay. And make sure that they are comfortable with what we’re doing in that regard because some things can be considered, you know, kind of safe, like medical research, and other things maybe not so much. You’re kind of just trying to privatize the information or selling… Marketing diabetic materials. Yeah, we’re not really into, like, you know, kind of selling the data. We’re there to make sure that the, you know, and we actually welcome governance of that because I think that’s where the state needs to play a role. They need to play a role in understanding what’s something allowable for this data, you know, what our citizens really want. Now, if a private citizen signs a release form, that data can go anywhere it wants to. That was a federal law passed called the 21st Century Cures Act. They can have their data go to an app on their phone. They can have their data go to TikTok if they really want to. Now, we wouldn’t necessarily promote that, but we would also be required by law to do it. So, I think there’s some rules that we need to put in place, policies, usefulness. In Vermont, we had a board that did this. It was called the Green Mountain Care Board. They governed what was allowable for data to be used in that health information exchange. We’d welcome that same thing in Nevada. It gives us the guardrails to work within, and I think that’s an important thing for the government to do. not necessarily to run it, but to give us the flavor of what’s allowable, what’s reasonable, what helps the citizenry, what’s considered something that’s allowed.

Diego Trujillo: And I agree with you. It feels like this almost needs to become like a partnership with the legislature and kind of engaging them. And I would venture to guess, right, as we get younger politicians in office that kind of understand, this has been one of my frustrations, and I don’t know if I should vocalize this on the podcast, but I will. No, of my frustration of watching a 70-year-old man asking the CEO of Google if his iPhone can blah, blah, blah. You know, well, how come when I look up on my iPhone, he goes, yeah, we don’t make the iPhone. It just… And I say this for this example. We used to revere within human beings, right? Going back thousands of years, we’d sit around the fire. And why was a old person so revered? Because they had experience. They would be able, they knew more about the world than anybody else. They could share more and they would be able to advise and tell stories that would help to shape. And it feels like with technology, that really got flipped on its head, right? You look at a 15-year-old on a cell phone versus a 70-year-old person on a cell phone and the way that they engage with that. And I don’t say this as a criticism. There are some 70-year-old, I will include my mom in that, very much admire the way she adopted technology and really pushed to learn. But some people were always very resistant to it. Well, I’m just not good at those technological, you know, I wish we could have said, hey, I’m just not good at that algebra stuff. And our parents would have been like, oh, then don’t worry about learning it, right? However, this has real-world implications in how we build our society. I know there’s even criticisms, to the way that we handle our privacy and data here versus like Europe and the way the European Union takes its approach on privacy, right? Yes. And it seems like they’re much more awake and alert at least to the value of data, to how to protect data, and then how to shape the society they want to live in. Where it feels here, as a population, we may be more flippant, and maybe not knowledgeable enough.

Michael Gagnon: A little too independent, maybe, in terms of that regard. Like, there’s some things where it doesn’t work to have everyone control everything uniquely, but you need to have some kind of underlying capabilities, right?

Diego Trujillo: Yeah.

Michael Gagnon: And you’re right about the age of people are more comfortable with the information sharing, use of iPhones, use of any kind of cell phone, smartphone device. And that’s starting to change. And I think that can be a good thing. Yeah, we still need to worry about privacy and security, like we said before about these things. But really it takes one champion who gets that this saves lives and this saves money. And if you get that one champion and they’re powerful enough in the state government, they almost always pull it forward. That’s another theme we found and we did a little research study with UNLV actually about what makes for a successful health information exchange. And to begin, it needs to have public policy and public funding. That always takes one champion, someone pushing it forward, because it’s so esoteric a kind of capability that it just takes one person going, no, we’ve got to do this for this reason. And they don’t have to understand how it works. And then you have to also build trust. Someone like I have to gain trust of people that I’m going to do the right thing. Right. And that it’s going to be the right mission and we’re not going to sell this information. We’re going to do it for the right reasons. We’re providing a public service. That’s the way we view it. And once it flips to that, That’s when you start to make progress and you get the investment. And it’s not, like I said, it’s not a small investment. So it does take people going, okay, how important is this? By the way, we think that for a $40 million investment, we would save $153 million per year. in savings, just in hard costs, just in things like non-repeated tests, just in things like non-repeated imaging exams.

Diego Trujillo: And this is not just a random number you pulled out.

Michael Gagnon: This is actual data you have. This was a study that was done in New York, and we just adopted that and changed the dynamics and the numbers to be adopted into Nevada. And because New York is actually a little bit more mature health care market, that number is probably actually higher here. Wow.

Diego Trujillo: Yeah, they’re not making as many mistakes as we are here, or repeated testing, or whatever it may be.

Michael Gagnon: Yeah, and they’re just a little bit more integrated networks and such, you know, versus us where we’re a lot more independent, especially in Southern Nevada. And that means then that the data sharing is even more important.

Diego Trujillo: Yeah, no, and I’d agree. I would say the biggest challenge, I mean, just listening to your story, right, is just, you show up as a new kid on the block to tell everyone, hey, you can trust me, we’re building something good here, and we need government money for it, right? And everyone’s like, uh, who’s this guy?

Michael Gagnon: I tried that with Director Whitley in the first few weeks I was here in the state, and it didn’t go over so well. Yeah. Honestly, you know, you just gotta build trust, and the relationship we have now, yeah, is much better. I’ve been here for nearly seven years doing this. We’ve built up some credibility over that time. We’ve accomplished some things. We did pull off one small project a few years ago where we connected several underserved hospitals and the state public health lab and such. And we started connecting to the Southern Nevada Health District at the time. And now we’ve built upon those incrementally, a little too slowly as I would want it to go, but made incremental progress. And so now it’s starting to flip around. I think, you know, Director Whateley feels like he has an edict from this AB7 statute that was passed to do something about this. And I think we’re going to see this change a lot in the next two or three years.

Diego Trujillo: Well, and the exciting part is you’ve also, again, you’ve worked for seven years to demonstrate you’re not a flash in the pan, that you are committed to this vision, that there is integrity in, you know, behind this project. You have the momentum with that trust. Now all you need is for it to be a priority, and it seems like that’s what’s happening.

Michael Gagnon: I’m really excited about it. I think the future in Nevada for this kind of stuff is just about to hit, and we’re gonna see tremendous change. In the next legislative session, I expect we’ll see several bills to try to fund really important projects like maternal child health, like chronic kidney disease, like connecting up the jails and prisons, of which most of those end up on Medicaid after they’re out of that, or have substance abuse issues. I think we’ll connect up mental health, All of those things are incredibly important to this marketplace.

Diego Trujillo: Just solving one of those alone. Yeah, one of those alone could be tens of millions of savings. Just one of those would be a huge savings. And the fact that you have one system that can benefit all of those is a tremendous impact. Well, you mentioned that, uh, you know, you have to, I can very much relate with that, having to build trust and saying, yeah, I know I’m a new guy, but this is what I’m about. And right. And that takes time. Right. And I hope that the people listening to the podcast, uh, will, will at least have a little more trust after this podcast, understanding a little bit more about you, your background. Um, is there anything you could leave with the listeners today of things that they can do that may listen to this and say, yeah, this is a great idea. What needs to be done? Or is there an email list they can be put on so that, you know, when it’s time to mobilize or to let our legislators know, hey, this is a very simple, you know, a very simple solution that can benefit a lot of areas. How can people stay connected? How can they stay informed?

Michael Gagnon: Yeah, if you’re a provider, we’re on healthynevada.org. You go to our website, you can actually participate in many ways, but the most important way might be go on and sign up for who you think you need information from. By the way, we’re going to be coming out with a survey here pretty soon too, and we’ll make sure that the listeners and others in the community get that survey. And it will help us understand what we’re doing well and what things still need investment and where to best spend our dollars, should we get them, to make things better for all the providers in the state and all the patients in the state.

Diego Trujillo: That’s excellent. And for everyone listening, that is HealthyNevada.org. H-E-A-L-T-H-I-E, Nevada, N-E-V-A-D-A.org. So make sure to get on, stay up to date on kind of what’s happening with the Health Information Exchange. I think this is something that everyone could support. Again, going back to the beginning of the podcast, the first time I heard about this, well, this is an obvious, like, yes, this would benefit for many reasons without anyone even explaining it to me. I definitely want to encourage our listeners to be able to stay in touch and to kind of know what’s happening as the legislative session gets a little bit closer to see what we can do to really move the needle on this and begin to make an impact. I think you’re at a very pivotal moment. And I know you’ve stuck around this for a few years, but I think the priority on data and understanding what this can really do for our society and how transformative it can be is a concept that a lot of people are understanding. And I’m very excited for what Healthy Nevada will become.

Michael Gagnon: Well, thank you for having me here.

Diego Trujillo: Well, excellent. Well, ladies and gentlemen, that has been another episode of The Heels Pod. We thank you for joining us today. Again, make sure to check out HealthyNevada.org. H-E-A-L-T-H-I-E-N-E-V-A-D-A.org. And thank you very much for tuning in again. Have a great day.

 

Nurse Corps: Revolutionizing Home Healthcare in Las Vegas with Terri Bruesehoff

By | HEALS Pod, News

In this episode of The Heals Pod, I had the pleasure of interviewing Terri Bruesehoff from Nurse Corps. Terri shared her journey of moving to Las Vegas and her extensive experience in the healthcare industry, spanning over 40 years. She discussed her background in nursing, starting as a CNA at the age of 16 and progressing to various roles in hospitals, school nursing, public health nursing, and home healthcare.

Terri highlighted the importance of home healthcare, especially in the current trend where individuals prefer to receive care in the comfort of their homes. She emphasized the need for coordination and continuity of care, especially in complex cases involving ventilators, trachs, and G-tubes. Terri also discussed the new concierge care program at Nurse Corps, catering to the needs of adult patients and offering personalized, high-quality care.

The conversation delved into the challenges and rewards of home healthcare, the importance of building relationships with patients and healthcare providers, and the significance of integrating Western and Eastern medicine practices. Terri shared her passion for problem-solving and putting together the pieces of the healthcare puzzle to ensure optimal patient outcomes.

As the Director of Concierge Services at Nurse Corps, Terri discussed the future of home healthcare, including potential expansions into transport services for private jet travelers and hotel guests needing specialized care. She also touched on the role of AI in healthcare, emphasizing the need for a balanced approach to medicine and the integration of alternative therapies.

Throughout the episode, Terri’s dedication to providing exceptional care and her commitment to innovation in the healthcare industry shone through. Listeners were encouraged to reach out to Nurse Corps for more information on their services and to benefit from their expertise in home healthcare.

Listen to the episode

Full Transcript

DIEGO TRUJILLO:
Ladies and gentlemen, this is Diego Trujillo for another episode of The HEALS Pod, here with Terri Bruesehoff that has come to be able to share a little bit about the organization she works for and also a little bit about you. How are you doing today, Terri?

TERRI BRUESEHOFF: I am fabulous. How are you today?

DIEGO TRUJILLO: I’m doing excellent. You know, we always like to dig into, as we do the interviews, it’s not just about the companies, because no one’s trying to listen to a 45-minute commercial, but the people behind the companies, right?

TERRI BRUESEHOFF: Absolutely.

DIEGO TRUJILLO: The people that are delivering. I’ve known you for about three years now, five years. I give these short dates and then people remind me how long and I’m like, wow, time is flying.

TERRI BRUESEHOFF: Listen Diego, it’s been 50 years. What do you mean?

DIEGO TRUJILLO: How dare you? How dare you? So you’ve been in this community for how long? Tell us a little bit about Las Vegas. What brought you here? What was the choice? What was the scenario?

TERRI BRUESEHOFF: Oh my gosh. I love it here. I started off in Philadelphia 20 years and then I moved to California for 20 years. Then Hawaii for 18 years. Okay. Where I lived on a sailboat and blah, blah, blah. And then I moved here five years ago.

DIEGO TRUJILLO: So you went from the ocean directly to the desert. Yes. And what is your favorite of all four? Oh man, everyone.

TERRI BRUESEHOFF: And why is it Las Vegas? Everyone is different. I love Las Vegas because I love to sail and boat. I love the hiking. I love the mountains. There’s so much to do here for free. Yeah. And you can really connect and get grounded here because there’s a lot to do. The desert is just mysterious and marvelous all at the same time.

DIEGO TRUJILLO: You know, we recently went on a night hike. It was very funny as we’re like going on this hike. We went to the hot springs. Oh, yes. Gold Strait hot springs.

TERRI BRUESEHOFF: At night? Yeah.

DIEGO TRUJILLO: Wow. Oh, it’s gorgeous at night. And I have LED lights we lay out. And so we’re going, we’re hiking in and we run into these two young men that are going in as well. And they ask, so what time do they close here? I know, and I was like, you guys don’t hike very much, do you? We are fortunate. I was like, yeah, they don’t close it. It’s the desert. It’s a wonderful thing.

TERRI BRUESEHOFF: It really is.

DIEGO TRUJILLO: And I would be honest, growing up here, I really don’t feel, but this might be a personal bias thing, obviously, because I like hiking, but a lot of people don’t really appreciate the nature that is around here.

TERRI BRUESEHOFF: Some people don’t even know.

DIEGO TRUJILLO: Yeah, I travel a lot. Every time we travel, right, in Ecuador and the Galapagos Islands, we’d go hiking, and people would be like, well, so where’s your favorite place to hike? Gold Strike. Well, where’s that? It’s by Hoover Dam. It’s a 30-minute drive. People don’t know. They’ll see pictures and be like, where did you take that picture? Oh, that’s only an hour away.

TERRI BRUESEHOFF: And then we’re tromping in the snow, you know, I’m tromping in the snow five feet up to my waist because we have so much snow. We are so blessed.

DIEGO TRUJILLO: Yeah, I agree with you on that. I really, after getting into outdoor sports, and like I tell people, my vice is hiking in the outdoors. Anything that has to do with that, getting away, there’s no better feeling. We recently got back from Death Valley, and we had a friend that came from San Francisco who grew up here, and he goes, you know what? I never thought I’d say this, but I really meant the desert. He goes, there’s something different about the desert than all the trees. And I say, yeah, they’re called no insects.

TERRI BRUESEHOFF: No, insects. Just the coyotes and the snakes and the turtles.

DIEGO TRUJILLO: Listen, coyotes all run. When people ask me, because I’ll night hike a lot, and they’re like, well, what about the coyotes? If you manage to see them, they’ll run away. Though I think we’ve been stalked twice by a cat. We’ve caught its eyes at night. I’ll have to show you after. So you came to Las Vegas, and what did you do during this entire time period that you were traveling in different places?

TERRI BRUESEHOFF: I have been in health care since way before you were born. I started off when I was 16 in 1977 as a CNA, working in the hospitals, and then I got my RN-BSN degree, and I started off in the hospitals, ICU, CCU, ER, became hospital administrator, and then I went into, after that, I went into school nursing at a private school in Hawaii, 1,500 kids, and then went into public health nursing, and then into home healthcare.

DIEGO TRUJILLO: Wow, so you’ve seen a variety of nursing. I have. And you’ve gone, it’s very interesting listening to your answer right now, right? You started out in private care, direct patient care. Yes. You moved away from that. Yes. And then you circled back. Can I ask you why? What made you circle back? What was it about the home care?

TERRI BRUESEHOFF: This is what’s going on about home healthcare. This is the trend. Everybody wants to, stay at home, be at home, die at home. They want to be near their family. We can make such an impact having the right nurses and CNAs in the home to give people the biggest impact, the quality of life, and make them as independent as possible.

DIEGO TRUJILLO: Yeah, you know, and I agree. There used to be, I don’t know if it was generational. I believe I was listening a while back, right? The generational attachment to, for example, big chains. So the old generation used to be very attached to these big chains, Applebee’s, you know, Sizzler. And the larger the corporation, well, they must be doing something right. And younger people went the complete opposite way of that, right? And I think as the care comes home, pardon the pun, but as the care comes home, I think one of the main drivers for that, I mean, we see it with COVID infections within facilities. Sometimes I’ll talk to people and they’ll be very frustrated and be like, well, you know, my grandmother went into this facility and she got MRSA or C. diff. And I was like, well, that’s where sick people go. That’s where you’re going to gather all the sickness because they’re all in the same place. So having that kind of, not just isolation, but not being around as many infections, but being able to be in the comfort of your home. A lot of people fight for that a long time.

TERRI BRUESEHOFF: We had a big influx of patients coming home during COVID, and it was amazing to hear people would call us and say, my mother is in the hospital and we can’t see her. She’s in the nursing home. She’s in a long-term care. And literally, We would go outside the window crawling along the dead rats so we can knock on the window and say, hi, how are you? Because they weren’t allowed to go in. And they found that their parents were dying because of lack of touch.

DIEGO TRUJILLO: And I, you know, I think a lot of people, the automatic assumption is they have more equipment and tools here. It must be safer for me here should anything happen. Do you ever experience that as you’re speaking with people and you’re discussing that with families?

TERRI BRUESEHOFF: Yes. When we were, when these families were asking if we could take their loved family member home on a ventilator, trach, and G-tube. Many of the facilities didn’t understand that we were capable of doing that. They said, oh no, you have to be in the facility. So it was a great time to educate facilities and the long-term care facilities about what we can do at home and work together to get that patient home safely.

DIEGO TRUJILLO: Well, and I think with technology, right, those things have all changed. If you went back to when you first started your career, you talk about taking someone home on a ventilator. That might have seemed a little bit difficult, but it seems like those circumstances may have changed now.

TERRI BRUESEHOFF: Absolutely. We can do ventilators, trachs, G-tubes, wound care, and it really takes a collaboration, though. of all the different entities, of your doctors, your nurses, your case managers, your respiratory therapy. It doesn’t take one person, it takes the group of us to get a person home safely and being in compliance.

DIEGO TRUJILLO: You do a lot more than just simply put a nurse there then. It sounds like you guys are orchestrating, you’re quarterbacking, you’re trying to kind of bring everyone together around that.

TERRI BRUESEHOFF: That’s what I love doing. I was just going to ask you that. I love putting together a puzzle.

DIEGO TRUJILLO: Is it that, yeah, sometimes the chaos, I don’t want to say chaos, but chaotic nature of trying to organize an orchestra, right, and bring everyone together to where it comes off on perfection.

TERRI BRUESEHOFF: Absolutely. We just had two scenarios just recently. The patient was going home, He wanted to be at a certain place. Can you make it happen? We need 24-7 nurses around the clock. They’re going to need IVs, this, this. They need a dietician. He wants a life coach. And I go, just bring it on, because I love putting the pieces together and saying, we can do this. Let’s work together. And we’ve been able to take quite a few patients home. and give them that full care, not just the nursing piece, but the PT, the OT, the ST, a dietician, a nutritionist, whatever they’re looking for. That is what we’re developing this concierge program. We call it concierge, giving them what they want and working together with them to give them peace of mind that we can do that.

DIEGO TRUJILLO: And the organization you work for now is Nurse Corps. Yes. So concierge care is a separate branch of what Nurse Corps is offering.

TERRI BRUESEHOFF: Yes, because Nurse Corps has been here for 15 years. Predominantly, we’ve been known for the pediatrics line. We can take pediatric patients home on ventilators, trachs, and G-tubes. We can do the hourly care. We can do visits, IV visits, wound care. pick lines, all that stuff. So that’s been our bread and butter. We’ve been known for that. And then we branched out since 2019. And especially during COVID, we branched out to bring more people home, more adults home, and provide them this, what we call a concierge service. Basically, tell us what you want and we’re going to make it happen for you.

DIEGO TRUJILLO: That’s really interesting because you’re really being able to cater people. You know, again, my background was always you got to meet the patient where they’re at. You got to meet them where they, and that’s literally what you’re doing on a constant basis.

TERRI BRUESEHOFF: Exactly.

DIEGO TRUJILLO: Listening to them tell you this is where I want to go and then making that happen.

TERRI BRUESEHOFF: Right. We can transport patients to another state. We just got a request for that this morning. We work very closely with your hospice entities because they do the visits, but we can do the continuity of care. We can do it. We call out here. private duty nursing, that’s hourly care. We can provide that piece for the hospice that they cannot provide, and we work closely with them. We’re partnering with a lot of hospices and PCA companies because we provide the CNA, the LPN, and the RN.

DIEGO TRUJILLO: So you do everything else. So you’re figuring out this formula. How new is this concierge care program?

TERRI BRUESEHOFF: It’s very new. The brochure you’re looking at is about two weeks old.

DIEGO TRUJILLO: Oh, okay, so it really is coming fresh off the press.

TERRI BRUESEHOFF: Fresh off the press, and I’m visiting concierge doctors, and we’re partnering with PCA companies, concierge physicians, our facilities, and I have very good friends in this community because we do a lot of networking. I have good friends that have the same type of business, that are in the same type of business, they’re marketing, we’re in the same role. We meet for coffee and we get together because there is not enough. There’s enough for everybody. We must do continuity of care. We must do coordination of care. If I can’t provide the service, I’m going to call my good friend over here and say, maybe you can do a better job.

DIEGO TRUJILLO: Seeing you’re one of those, when we used to talk in marketing back in the day, right? I would always make a joke, right? There’s certain people that are just pen droppers. They just come into the office and here’s an item for you to remember us by. And those people that really get out there and try to be a resource, not just knowing all of the different resources that exist, but you are one of the people that, hey, Terry, do you know somebody that can blah, blah, blah, blah, blah? And if I didn’t know them, you would definitely know them, right? And I love doing that. Yeah, you fill in. It really helps us become stronger as a community. In the very end, who wins?

TERRI BRUESEHOFF: The patient wins. The patient wins. And we sleep well at night knowing that we’ve made a difference. Absolutely. And when I lived in Hawaii, I started a staffing and home care agency, and my boss always said, Terry, go out there and you have to form the relationship first before you get the business. That’s the Hawaii way. Yeah. And I’ve carried that here. I love networking with friends, becoming friends, networking, becoming business partners. Health care, as you know, is low on the list here. We’re like number, I don’t know, 48th? We’re 48th. That’s kind of scary. And we can’t retain physicians. We can’t recruit enough. So we must build up our health care system. The only way to do that is working together and advocating for better health care.

DIEGO TRUJILLO: Seeing recently, I was listening to a study, because everyone always assumes it’s Medicaid rates, Medicaid rates. And I do believe that they may play a part, right?

TERRI BRUESEHOFF: Yes, they do.

DIEGO TRUJILLO: But one of the things that was very interesting, recently on a graduating class of physicians, the one reason they didn’t want to stay here wasn’t Medicaid. It was too difficult to coordinate care.

TERRI BRUESEHOFF: Coordination of care.

DIEGO TRUJILLO: And I was like, wow, that’s not a grant issue. That’s not a funding issue. That’s just us simply getting along with each other and working together for better outcomes for our patients.

TERRI BRUESEHOFF: And I will tell you, when I used to, if I go, let’s, for instance, when I would go into an NICU to bring a baby home, the first thing I did was come up with a discharge planning tool. And everybody was aware that we needed to have the doctors and the case managers having a team meeting, and I would start talking to the parent about what we need to do, their go-to bag, what’s gonna happen when we go home, visit the home, how are we gonna set up, do you have enough electricity, where are you gonna put the ventilator? And so as the patient knew and the family knew that they were going to be discharged, I started coordinating this with different people. And it makes such a difference. So on the day when the ambulance shows up, we’re all ready to go. And it’s not just a half-baked discharge.

DIEGO TRUJILLO: Yeah, absolutely. Things are done thoroughly. And again, you bet those better outcomes. And I’m sure working as long as you have now in the community, you’ve heard the stories. Yes. I remember one time hearing a story of a patient being transported home on hospice, and there was no one there. By the time the nurse from the company got there, the patient’s spouse was dragging the person across the front entrance, trying to get them back into the car to take them to the hospital.

TERRI BRUESEHOFF: Horror story.

DIEGO TRUJILLO: And it was just heartbreaking to me to think that no one would be there to just say, hey, everything’s OK. This is part of the process. This is what we do. Not dragging, right? But getting them settled in at home. There’s something nice to being relieved. A lot of people, especially us in health care, sometimes we forget how scary it can be when you don’t know what’s happening. Right. We walk these experiences on a day-to-day basis, working with patients. And sometimes people forget that they’re not used to this. So for us, it’s, oh, this isn’t a big deal, right? That’s just the sound they make. Or that’s what it sounds like when you do this. But the families don’t know that. And they’re not only dealing with the stress of what’s going on, but the fact that it’s all unknown to them.

TERRI BRUESEHOFF: Yeah. One of my favorite things to do is I’m the ambulance chaser. So I’m at the hospital at the point of discharge, and then the family goes and I go, I’m going to chase you home. I will be there. So when you’re bringing in your mom, home. I’m going to be there and I’m going to walk you through it. I’ve got your water bottles. I got some food bars for you because you haven’t eaten all day. Now we’re getting you home and our admissions nurse will show up and do the admission. Our clinical supervisor or clinical director and then our nurse taking care of that patient’s going to show up. So now someone’s taking care of the patient, the admission’s taking place with the paperwork, and I have now passed the baton over, and we’ve given them tools to succeed instead of them turning around and going back to the ER within 24 hours.

DIEGO TRUJILLO: It allows them like a type of continuity. Yes. Right? It’s not just being kind of tossed like a football, but rather hand it off, like you said, like a baton.

TERRI BRUESEHOFF: Yes.

DIEGO TRUJILLO: I love doing that. So, and this is your full-time job. What do you do with Nurse Corps specifically?

TERRI BRUESEHOFF: Oh, I’m the Director of Concert Services. So, Director of Marketing. So, you’re building out this program. I really am.

DIEGO TRUJILLO: It’s not simply a program they rolled out and handed to you.

TERRI BRUESEHOFF: Oh, no.

DIEGO TRUJILLO: We’re rolling it out, yes. Oh, okay. All right. And you’re the one that’s kind of heading the charge here. I am. And how are you feeling the feedback from clients? What are you feeling from the providers as you’re approaching them on this? Is this something common here in Las Vegas?

TERRI BRUESEHOFF: No, it’s not common. There’s probably one other agency that’s doing the concierge. It’s not common. But what is common is more and more concierge physicians are rising up. More people want to pay out of their pocket for good quality physicians that can come to the home. So we see a big trend, especially with the affluent. They want it all in the home. They want people to come to them to do the work, and they don’t want to go to a doctor’s office. They don’t want to go. So we’re seeing this trend, and this is a great place to roll this program out.

DIEGO TRUJILLO: Yeah, and how’s the reception been then? They’ve been very excited?

TERRI BRUESEHOFF: Yes. Yes, and we’re training our nurses. We, you know, they all wear black scrubs. They all look professional. So it’s a training thing.

DIEGO TRUJILLO: Is there an apprehension among the providers as you guys are going out and exploring this?

TERRI BRUESEHOFF: Well, the only apprehension is they know us as pediatrics and handling adults. So this is something new. They do know during COVID, we were the nurses that worked 24-7 at Cashman Center. We got the contract. So we got some great exposure during that time. And then we traversed into doing concierge care. So far, it’s being very well received.

DIEGO TRUJILLO: So COVID kind of threw you guys into it, and then you realized, hold on, we can do this, right? It’s true. So you grew from it.

TERRI BRUESEHOFF: We really did. That’s fantastic.

DIEGO TRUJILLO: It’s very interesting to pulling out and extracting those positives. And you know, now that this is being offered, one of the things that I always tell, because people will bring up, well, you know, 48th in the country and 48th in the country and 48th in the country. I was like, well, At least it’s easier to go from 48th to 30th, to 25th. We can move on the way up, yeah. Going from 5th to 3rd has got to be kind of a tough spot to be able to nestle in, but I think we have an opportunity. We do. Being able to move the needle on what we are as a healthcare community and what we can do for our community working together.

TERRI BRUESEHOFF: And thanks to HEALS, Diego, because we have those task force for the workforce solutions and for the physicians and for jobs, and we are working together. We have such a great group of people that want to make a difference here.

DIEGO TRUJILLO: I do appreciate the shout out. I try not to shameless plug nonstop because people are like, yes, we get it, right?

TERRI BRUESEHOFF: But it’s a lot of people don’t understand how much you do and do to put this program together so we can do coordination of care.

DIEGO TRUJILLO: Well, and for a feeling of community. And I think that sometimes people very much underestimate the importance, right? And I’ve heard it a couple of times. People say, well, you know, heels mixers are just people getting together for a couple of drinks after work. And I was like, you know, for me, it’s frustrating because, as you know, I don’t really drink.

TERRI BRUESEHOFF: I don’t drink either.

DIEGO TRUJILLO: If you ever offer me a drink, I’m like, yeah, that’s not why I’m going. But the feeling of community, of the identity, not just of Diego’s trying to fix healthcare and so is every single person independently, but being able to come together to find solutions, running into new people, sometimes old friends you don’t really see on a continuous basis. But that’s a very important part, again, going back to what I was mentioning on coordination. how important it is to coordinate. Could you imagine not knowing any of your nurses? Not knowing any of your OTs or PTs or these relationships?

TERRI BRUESEHOFF: No. And, you know, if you don’t have the relationship, they’re not going to call you. They’re not going to trust you. Yeah. So building relationships is key in this business. Yeah.

DIEGO TRUJILLO: Or any business. And I think it’s, especially in healthcare, it’s very give and take. Because I used to see It’s sometimes you have to take it. When I would have service failures, and I’d have a case manager call me upset, and she’d be like, well, why did this happen with this and this patient? I’d say, you know what? Are you available? Yes, I’m available right now. Let me drive right now. I’m going to go right to where you are. I want you to tell me what went wrong. And they’d always get surprised. And I was like, well, listen, nobody’s going to ever be able to promise you a perfect execution of services. You know, there’s going to be service failures. There’s going to be problems. What I’ve boiled it down to is how do we respond to those challenges and to those problems? Did we make a mistake? Let’s own up to it and see how we can fix those things. So it offers a very unique opportunity to be able to do that. How do you guys function or divide between the concierge service and the other traditional lines of service? Did you guys completely break it up? Is it two separate offices?

TERRI BRUESEHOFF: No, no. Same office, just different lines of business. We have different supervisors working on certain, you know, what we call the Medicaid or the insurance population versus the concierge. So we have different people that have identified that want to be in the concierge program. Okay. But with any employee, we vet everybody. We do fingerprinting. We do urine tests. We do drug testing. We really make sure they are trustworthy. We do in-services. We have a little skills lab that we put them through to make sure they know what they’re doing.

DIEGO TRUJILLO: So you’re continuously really making sure that your employees that you’re sending out, yeah, you really can’t play around.

TERRI BRUESEHOFF: No, you can’t. And we shadow people and we have a new grad program which we developed. Because of COVID, as you know, people have stopped working. I don’t know what they’re all doing to make money, but a lot of nurses have left the industry. And now we are accepting new grads. We’ve come up with a new grad program, which includes shadowing and training. And we were so excited about this because new grads are looking for work and we certainly need more nurses every day.

DIEGO TRUJILLO: You know, I love hearing that because the amount of times that you, as you know, I have the nursing group, the amount of times that they post saying, where can I go as a new grad? And just the limiting factor where we’re desperate for a workforce, yet we make it very difficult for them to get in. And so it doesn’t seem to make sense, right? We all understand that there’s going to be challenges with bringing on new people, but hey, there’s the benefit of being able to mold them the way that, you know, hey, this is the way that we work and this is best practices.

TERRI BRUESEHOFF: And we don’t have to accept their bad behaviors. We can mold them into good behaviors. I wasn’t going to go there because I don’t have a nursing license. It is an expense and it is a lot of work, but we are willing to do that.

DIEGO TRUJILLO: Yes. Yeah. In the end, what do you come out with?

TERRI BRUESEHOFF: We come out with a nurse that is reliable, is loyal, and is trained the way we want her to be trained.

DIEGO TRUJILLO: You took a chance on that nurse, and you never know. Some nurses might go off and be able to get another position. It’s a contribution to the community at the very end, right?

TERRI BRUESEHOFF: Yes.

DIEGO TRUJILLO: Because not everyone is willing to take these risks and not everyone is willing to take the weight on to be able to do this. So let me follow up on this. So your lines of service, right, are the concierge care. What else do you guys offer? You mentioned pediatrics.

TERRI BRUESEHOFF: Oh, yes. Our largest line is pediatrics. So we take all the Medicaid insurances, and some kids have 112 hours a week of service. There are ventilators, trachs, and G-tubes. We have a lot of visits, like wound care and IV therapy. So we’re not home health, which is just visits. We are considered home care. Okay. Even though we are a certified home health care agency. Oh. So we’re certified home health care because we chose to abide by the higher standards. Right. But we predominantly do different insurances and then now the private pay piece. Okay. We always have an RN on call every day. Somebody answers the phone 24-7. If you called at two o’clock in the morning, our gal, Patty, is going to answer. And it’s pretty good. And we We excel on figuring out those crazy puzzles, because I love doing that. That’s you, right? That’s me.

DIEGO TRUJILLO: That’s the corporate culture. And how’s the feeling around the office when you guys are working throughout the day? It sounds like everyone likes solving the problems then.

TERRI BRUESEHOFF: Everyone loves solving the problems. If we had more nurses, of course, we all say the same thing. More nurses would make everyone’s life here easier.

DIEGO TRUJILLO: But even there, it sounds like you’re solving problems as well. Hey, we’ve got to figure out a way to be able to get more nurses.

TERRI BRUESEHOFF: Yes, so we’re taking in new grads, which is a big thing for us.

DIEGO TRUJILLO: OK, that’s fantastic. And everyone knows, you know, it’s very interesting. Sometimes I’ll hear the complaint, well, you know, these nurses want to get paid all this. Well, yes, you as a business are not trying to overpay for employees, right? Why would the employees on the other side not come back and say, well, you know, I’m trying to get paid the best I can for the work that I do. That’s just how it works in a supply and demand economy. And it’s very interesting when people don’t want to help with the supply and then complain about the demand driving up the costs.

TERRI BRUESEHOFF: And you know, a home care nurse has to be courageous, has to be very independent, and needs to be brave. Because if a trach comes out, you have three seconds to figure it out in the home care. situation. If a trait comes out in the hospital, you could just push that code blue button. You can figure it out. In the home, it is you and you alone. So you must be more stronger, courageous. It is no longer the little old lady with the walker. Home care has to do with IVs, wound care, social, what’s going on with the rest of the family, the dynamics, the siblings, other people in the home. There’s so many things a home care nurse needs to encompass. and embrace in order to get along with that family and to provide the service.

DIEGO TRUJILLO: So for a new grad nurse, how long do you feel like until they kind of find their rhythm within home care?

TERRI BRUESEHOFF: Oh, we have a specific program where they’re shadowing, doing the education, they’re working alongside with an RN, and then they really have to pass the check-off system before we let them go to the next step. Okay.

DIEGO TRUJILLO: And how long does that take normally do you guys?

TERRI BRUESEHOFF: A couple months. Okay. Yes. Some nurses, you know, it’s a scary thing to go in the home and be there by yourself. Yeah. I mean, the comfort of the hospital, right? You have all the supplies.

DIEGO TRUJILLO: All the machines.

TERRI BRUESEHOFF: Yeah.

DIEGO TRUJILLO: If something goes wrong, there’s a lot of backup. Whereas here, I really need to be efficient.

TERRI BRUESEHOFF: Correct. And that’s why we have an RN and call all night long because at two o’clock in the morning, we want to make sure that nurse knows that she can call us to get advice.

DIEGO TRUJILLO: That there’s going to be some backup for her even.

TERRI BRUESEHOFF: Yeah. Do I need to send him to the ER? What do I do? We always have an RN ready to help our nurses.

DIEGO TRUJILLO: That’s fantastic. And how long has Nurse Corps been in business here in the Valley?

TERRI BRUESEHOFF: Oh, we’ve been here for 15 years. Okay. It’s been quite a while. And we have 25 branches throughout the country.

DIEGO TRUJILLO: Okay. Is it a franchise or is it an independently owned

TERRI BRUESEHOFF: Independently owned and they’re based in Texas. Okay, fantastic. Yeah, it’s not a franchise.

DIEGO TRUJILLO: And was that the first place you worked at when you got to Las Vegas?

TERRI BRUESEHOFF: This was the first place. They recruited me from Hawaii to move to Las Vegas.

DIEGO TRUJILLO: Okay, so they’re the ones we can thank for bringing you out here. Yes. Right, not blame, because you’re doing a great job.

TERRI BRUESEHOFF: Not blame, no. Not blame.

DIEGO TRUJILLO: No, I love it. Fantastic. And where do you see this going in the future? Now that you’re seeing more reception from people, when it comes to home care. Where do you see that headed in the future? What things are you looking out at on the horizon and how to expand or what the next steps are?

TERRI BRUESEHOFF: Oh, I think we’ll be doing more transports. There are a lot of people here who have their private jets and they come in town and then they need service or they want to fly to another Utah or something, but they need nursing care. on the plane, so I could see transporting becoming more of a big thing here. And then, of course, all the hotels. There are people that fly in that will need some IV therapy or wound care, or they’re a quadriplegic and they want to be here for a week. So we’ll be expanding out as our program grows to those specific things when people come in from other states.

DIEGO TRUJILLO: Yeah, you have to figure out how to accommodate people as the needs shift. Yes. So you really allow the needs to be able to dictate which way you guys grow. That’s true. And what do you think is a favorite part of what you do, aside from the problem solving? I mean, working in this concierge side, it must be a little bit different than pediatric care and what you were doing before. What draws you to the concierge side that you really enjoy?

TERRI BRUESEHOFF: Like I said, I like putting the puzzles together. I just met a mobile dentist who can join our team to go. I can recommend them. I love meeting the people. When you meet people that are doing concierge, they’re usually somebody in the business that you go, oh my gosh, you know? And of course, we don’t have real names. We just admitted Jackson Brown, and we just admitted a, you know, Yeah, John Smith. John Smith, and it could be their their street name, so we keep very tight reins on who we take care of. Yeah. And we signed NDAs. We are very careful on who we admit.

DIEGO TRUJILLO: Yeah, and how you’re servicing, right? They have very specific needs, so having that understanding always helps you to perform better in what you’re doing.

TERRI BRUESEHOFF: Yes.

DIEGO TRUJILLO: Well, that’s fantastic. Where do you see the future going then immediately? Do you see any incorporation with AI? I’m kind of curious as far as any innovation to see what’s happening technologically. Because, I mean, some of these machines and some of these patients and complexity of patients, when we think of what it was, again, 40 years ago that you can bring a patient home, on event, that’s drastically shifted because of the type of technology that exists and what’s able to happen. What are things around the horizon that you’re excited about or you’re like, hey, this might be around the corner and no one would have thought it possible?

TERRI BRUESEHOFF: Oh, absolutely. You know, AI can be a very good thing. It can be a very dark thing. So we have to be very discerning. And I see AI is helping with checking the plan of cares, making sure things are complete, doing telehealth medicine is a big, big trend to incorporate.

DIEGO TRUJILLO: Thanks to COVID again, right?

TERRI BRUESEHOFF: Absolutely. And AI can be very beneficial because it can check things. Did you finish this? Did you complete the goal? It can help you with coming up with treatment plans. It’s a little assistant to make sure that you’re staying on task.

DIEGO TRUJILLO: Yes. I agree. I remember a while back that as people would document, they were showing it as the… This was a software for hospice. And as the hospice nurse would be documenting, the machine would automatically prompt them, well, have you thought of this medication, right? So it looked for certain triggers, and then would offer recommendations, at which point the nurse could either choose yes, no, but at least those pop-ups were there to make sure, because it’s very easy to expect people to behave like machines and operate perfectly at all times. However, not even machines do that, right? And so being able to have someone that can, you know, after your 14th visit in one day, make sure you’re still executing as exactly and precisely as you should be, as the first visit. It’s very, very interesting to see how those assistants are coming along and how that’s all happening.

TERRI BRUESEHOFF: Right. And you know, I’m working on getting my functional medicine nursing certification. I’m a big proponent of alternative medicine and combining Western with Eastern. And integrating, and I truly believe that if we do integrative medicine with our patients, we can make some recommendations for the nutritionist and for that person, for the chef who can prepare a healthier meal. And I think our patients will benefit from that. And I’ll never just say all Western medicine or all alternative, because I think you have to have a good combination of the two. And integrative medicine, functional medicine is becoming the new trend to integrate medicine with alternative ways.

DIEGO TRUJILLO: I’m hearing a lot of that. You know, it’s very interesting. I was having this conversation recently as we were camping in the desert, and we were talking about these funny supplements that sometimes people take, and sometimes it gets a little wild. Oh, wild, yes. And while I was, I think we were actually talking about coffee enemas, and I was like, yeah, I cannot believe people would try this. Thousands of years of evolution, your body kind of knows what it needs, right? As long as you’re eating a rounded out diet, for the most part, your body’s going to get most of what it needs. It’s not like nature forgot one very simple part or one very essential part. And I think that we kind of moved away. Again, you look at traditional medicine, things that got us to where we were. And so we kind of threw the baby out with the bathwater. There may has been wisdom there because immediately we go into the scientific method and, you know, looking for proof on everything and then circling back and finding out, well, hold on a second. this might actually be, there may be something here. And my thing is, if an animal, or if they’re drawn to something, typically it’s for a reason. As animals evolve, they figure out these little advantages that they can get through nature, and I’m seeing that happen more and more with the alternative medicines and different approaches.

TERRI BRUESEHOFF: Yep. And that’s a whole other podcast, you know. Yeah, right.

DIEGO TRUJILLO: Because I could talk about that for years. You know, it’s just funny because I remember growing up and then someone telling me that, oh, yeah, I remember, I don’t know if it was in the 70s or 80s, they used to tell women, oh, yeah, no, you need to buy formula because formula is better than breast milk.

TERRI BRUESEHOFF: Yeah.

DIEGO TRUJILLO: I was just thinking in my head, hold on. I know. Somebody in a lab came up with something better than what brought us here after thousands of years.

TERRI BRUESEHOFF: I know. In the 60s, we were not breastfed. It was not cool. I was a bottle-fed baby. And of course, I breastfed my kids. So things come circling around. And we are products of our environment. Our environment is not as healthy as it was with our grandparents. It’s a different world. It’s a different world, so we really need to look at both sides.

DIEGO TRUJILLO: Yeah, and even the things that we do, you know, I was looking at, yeah, I don’t know if you know, I cut out sugar back in like 2008. And people would ask me, why did you stop adding sugar? I just completely, I went completely dry on sugar. I would not eat desserts, would not. And all it took, I probably did that for about six, seven years. Now I’ll dabble a little bit because of the gym. I need the carbohydrates. But even then, I try to get them from fruit. And it was all due one time I was listening to when YouTube first came out. And I was like, oh, wow, they have different professors giving presentations. And all I did was watch an endocrinologist that wasn’t making any claims aside from, this is how much sugar we used to eat, and this is how much sugar we’re eating. And so just off of that, there was one sentence in there And he was sharing, he goes, you know, our great-great-grandparents used to eat about 12 grams of sugar, and that came from fruit. That’s on an average day. And I remember thinking back when I was a kid, and there was like 55 grams of sugar just in one can of Pepsi.

TERRI BRUESEHOFF: Or a bowl of cereal.

DIEGO TRUJILLO: Yeah. And then things that we have traditionally thought, oh, this is fantastic. This is good. This is what I should be doing.

TERRI BRUESEHOFF: And it really has no basis in reality.

DIEGO TRUJILLO: I mean, sugar is more addicting than cocaine. I always tell people that. My kids, it’s very funny because they’ll try, oh, no, no. But they like it. Well, of course they like it. Of course. It’s a jam pack full of sugar. Yeah. And it’s not, I never thought I’d be that parent. I’m going to be honest with you. But I watch it very much and I think, well, just why do you need that much sugar? What is the point? Of course, you’re going to like it. Of course, they’re going to smile and say thank you and ask you for more. But we really need to have a little consideration of what we’re putting in and why we’re putting it.

TERRI BRUESEHOFF: I mean, look at the pictures from the 70s, the 60s, and the 50s. Nobody was obese. Yeah. And now we have an obesity problem.

DIEGO TRUJILLO: You know, he made that connection as well, along with corn syrup.

TERRI BRUESEHOFF: Yeah. Terrible.

DIEGO TRUJILLO: And he actually used the case study of Japan, because Japan didn’t grow any sugar. And so he started looking at the obesity rates in Japan when it started, once we started trading corn syrup over to Japan, the change that happened in their population. And so like we were mentioning, right, I think there’s a lot of changes in the world around us. And sometimes we end up circling back, you know, what at one point was home care and then eventually went to hospitals and these, you know, these institutions where people would go when they were sick. And all of a sudden we’re circling back to home care and people wanting to be home and being taken care of at home. It’s very interesting to see very thoughtful people developing strategies within our community. And I’ve always admired that about you because it wasn’t, for me, Nurse Corps was Terri. Anytime I ever thought of Nurse Corps, and I remember the little red logo, I always thought Terri was on my brain. Oh yeah, Terri works there, right? And it was very interesting as I was talking to you, finding out all the other things you do. You had shared a little on this concierge care program that you have. at one of the Heels event, and I got very excited because I think we’re pushing new frontiers. We are. And I like watching innovation. I like watching these boundaries be pushed and thinking of different ways to be able to care for people aside from, well, this is what we’ve always done. Yes. Right. And so, yeah, I’m very curious to see what you come up with next time.

TERRI BRUESEHOFF: Good.

DIEGO TRUJILLO: Yes. Now that you’ve been here. And I appreciate your kind words at Heels. Again, I’ve worked very hard to bring the community.

TERRI BRUESEHOFF: Oh, I love it. I love it.

DIEGO TRUJILLO: And I’m glad that you guys have remained members and been faithful. I know I had a challenging time jumping in during COVID, but Nurse Corps has always supported Las Vegas Heals, and we’re very appreciative, not just because of what Heals is and because I’m doing it, but because of the vision we’re trying to accomplish. I truly believe that a community here will help provide better health care to the residents of Las Vegas. True. And Lord knows there’s a huge shortage. There’s a lot of work to do.

TERRI BRUESEHOFF: Yes, there is.

DIEGO TRUJILLO: Well, thank you very much for coming on to the show today, Terri. Is there any last words you’d like to leave for people? How can they get more information? Contact me.

TERRI BRUESEHOFF: You can call our office number 702-458-1137. My cell phone is 702-861-8604. And I’m Terri B. Or you can look us up at nursecorps.com. And it’s N-U-R-S-E-C-O-R-E.com. Thank you so much. This was so much fun.

DIEGO TRUJILLO: Absolutely. It was a pleasure having you in. Again, every time I interview someone, even though we already knew each other, you get to know people in a very different light. It’s very enjoyable. So thank you very much for coming on the show. Ladies and gentlemen, as she had mentioned, you can go on Norsecore.com. That’s N-U-R-S-E-C-O-R-E dot com. Or you can always call in to the office at 702-458-1137 with any questions you may have. And from the sound of it, Terri, it sounds like even if they have challenges that they have not been able to find answers, you guys may help them with that as well. We’re going to figure it out. Excellent. I love that attitude. Thank you so much. Absolutely. Well, thank you, ladies and gentlemen, for another episode of The Heals Pod, tuning in and learning about the services that are in our community.

TERRI BRUESEHOFF: All right. Aloha.

DIEGO TRUJILLO: Thank you. Have a great day.

TERRI BRUESEHOFF: You too.

Navigating Financial Challenges in Healthcare: A Conversation with Mahesh Odhrani

By | HEALS Pod, News

In this episode of The HEALS Pod, I had the pleasure of interviewing Mahesh Odhrani from Strategic Wealth Design. Mahesh shared his journey from growing up in Dubai to moving to Las Vegas and becoming a financial advisor. With over 20 years of experience in the financial services industry, Mahesh specializes in working with healthcare professionals, particularly physicians and dentists.

Mahesh highlighted the unique financial challenges faced by healthcare professionals, such as high student loan debt and the lack of financial education during their training. He emphasized the importance of creating a comprehensive financial plan tailored to each client’s goals and evolving needs.

One key aspect Mahesh discussed was the shift in priorities among healthcare professionals, with a growing emphasis on work-life balance and quality of lifestyle. He shared insights into the generational differences in financial goals and the importance of aligning financial decisions with personal values.

Throughout the episode, Mahesh emphasized the role of financial advisors as educators and time-savers for their clients. By simplifying complex financial information and providing tailored advice, advisors like Mahesh help clients navigate financial challenges and achieve their long-term goals.

Listeners were encouraged to seek professional financial advice and to prioritize working with advisors to ensure their financial well-being and peace of mind. The episode provided valuable insights into the intersection of financial planning and healthcare professions, shedding light on the importance of strategic wealth management in achieving financial security and freedom.

Listen to the Podcast.

Full Transcript

DIEGO TRUJILLO:
Ladies and gentlemen, it’s a pleasure to have you today on The HEALS Pod. Thank you for tuning in. I have a very special guest that joins us all the way from Henderson, Nevada. Is it Henderson?

MAHESH ODHRANI : I live in Henderson, yes.

DIEGO TRUJILLO: He lives in Henderson, all the way from Henderson, Nevada, from Strategic Wealth Design. Our guest today is Mahesh Adrani.

MAHESH ODHRANI : Thank you, Diego. Thank you for having me.

DIEGO TRUJILLO: Did I pronounce that correctly?

MAHESH ODHRANI : Yes, you did.

DIEGO TRUJILLO: Okay, fantastic. Well, it’s great to have you on the show. How long have you lived in Las Vegas?

MAHESH ODHRANI : Or in the Valley, I should say. You just said Henderson. Yeah, in the Valley. I moved here back in 1999. So I’ve been in Las Vegas for, this year was my 25th anniversary. It was just last month. And I moved here from Dubai. That’s where I grew up.

DIEGO TRUJILLO: You grew up in Dubai?

MAHESH ODHRANI : I did, yes. Fantastic. Now, I know, I’m seeing the look on your face when I say Dubai. But it was not anything like that when I was growing up. It wasn’t that Dubai. It wasn’t that Dubai.

DIEGO TRUJILLO: Fair enough. I always ask people, right? So one of the missions with HEALS as we work with organizations is to try to attract talent. So for me, it’s always the important question of, well, why did you move here? And you know, I always say this to the people that get resentful, because Las Vegas natives are all, oh, you’re born and raised in Las Vegas. And they get very excited. And people go, man, you make us feel left out. And I was like, listen, we were all stuck here. You chose to move here. So I ask you right now, what made the choice? What was the choice that brought you here to Las Vegas?

MAHESH ODHRANI : That’s a great question, Diego. My story is unique, because I started studying, when I graduated from high school, I started going to an American university in Dubai. And after the first tuition bill, my father said, I’d rather you go to the US, get the same education, but get a different experience. So circumstances, I picked Las Vegas because we had some extended family here. Now that extended family has since moved to Dubai, but Vegas has been home. And the joke always is when I tell people my story, it’s coming from one desert to another desert. The only difference is the humidity.

DIEGO TRUJILLO: Yeah, right. And we’re all trying to be luxurious deserts, is that right?

MAHESH ODHRANI : Yes. Yes, we are.

DIEGO TRUJILLO: We’re the oases, each respectively to their own areas. Well, fantastic. And so you went to school, you went to college here. What did you go to school for?

MAHESH ODHRANI : I went to UNLV. I graduated with a degree in finance and MIS, and joined the financial services industry immediately after I graduated. So back in 2003 is when I started in the financial services industry.

DIEGO TRUJILLO: Okay, fantastic. Where was your first job, out of curiosity?

MAHESH ODHRANI : So I started in the financial services industry with a company called Wealth Strategies Group here locally and as a financial advisor. OK. And I was with them for about 17 years. And in between, they had a merger with another company. And 17 years into the business, I finally transitioned out and went independent. And we joined a independent broker dealer. In our world, it’s basically an independent firm that gives advisors a lot more flexibility and control in how they want to build their business.

DIEGO TRUJILLO: So you kind of got pushed out of the nest.

MAHESH ODHRANI : Uh, I kind of did, I kind of grew up, uh, and all those changes happened in 2020. Okay. So, so it definitely felt, uh, nerve wracking making that change while in the midst of a pandemic, but it certainly allowed us to grow and, um.

DIEGO TRUJILLO: Gave you that flexibility to kind of build it the way that you thought, right?

MAHESH ODHRANI : Correct. It gave us a lot of, a lot of flexibility, but just not knowing how we’re going to, what’s our next move going to be. But over time it just gave us a lot more confidence that It’s as you said Coming out of the nest.

DIEGO TRUJILLO: Yeah. Yeah, that’s true And sometimes, you know, we need that fearful push as we talk on leadership principles seeing that the L and heel stands for leadership Sometimes stepping out of that net. I know for me I was actually I had a boss tell me hey, you know, I think this is it We’re not gonna be able to continue and I remember freaking out I was pacing around in my house thinking, oh my God, what am I going to do, and should I get another job? And someone mentioned to me, they’re like, hey, you know, you’ve been wanting to get out of the cage for multiple years now. You’re out of the cage, and you’re looking for another cage to go jump in. And I immediately was like, yeah, you’re right. I mean, that fear of entrepreneurship and stepping off the ledge, like, immediately hit. And now that years have gone by, and I find myself in the position I’m in, I’m very surprised how I’ve been able to navigate, and you just learned to swim, right? But if you don’t get that push sometimes, I know that, you know, people will sign up and be very loyal to companies and be very happy with the company and then a merger happens. So it’s nothing, there wasn’t a leadership change per se or there wasn’t any negative intent or nefarious intent. And then all of a sudden you find yourself in, okay, well, what am I going to do, right?

MAHESH ODHRANI : Yeah. And you mentioned something about, um, like going out and feeling nervous, right? One of my mentors always said is, is having faith and taking the leap of faith. Is is just knowing yourself and sometimes we just don’t know how things are gonna work out Yeah, but just having sometimes things are going to work out and taking that leap of faith

DIEGO TRUJILLO: You know, I was reading a book, now that you mention that, I was reading a book regarding relationships and finding meaning in a digital world. And he mentioned, there was a phrase there that has stuck with me that you just, you kind of mentioned. He goes, you know, we’re growing up in a world of convenience. We spend more time worrying about what can go wrong instead of ensuring that things go right. And that one was like a punch in my stomach. I was like, yep, he’s right. Like what keeps me up at night? Not what the fight is going to be, but it’s what am I going to do? What am I going to do? What am I going to do? And what if this goes happens? And what if this right? But you kind of figure it out along the way. Sometimes people want like a very clear path of what steps they should take in life is just not that way, right?

MAHESH ODHRANI : Unfortunately, it’s not.

DIEGO TRUJILLO: You take the path that you feel conviction for. And you make sure that that is the path that you need to take. And you make sure that it works out. So you got pushed out of the nest, so to speak. And you find yourself. So what made you think of the name, Strategic Wealth Design? Or did you just use a random name generator?

MAHESH ODHRANI : How did everything come about? How was the birth? It’s funny. I did use a random name generator to get some ideas. OK. But then what we did was, when we came up with the name. And Strategic Wealth Design has been around for eight years now. OK. Now, that was already in play while we were with our previous firm, because we were allowed to market and have our own firm name and own branding. Now, strategic wealth design came about because, of course, I use a name generator. We came up with the idea of about 10 names that I felt close to, and then we send it off to clients for a survey. And majority of the clients picked strategic wealth design as the number one choice. And that’s what we went with. Pretty much took feedback from our clients and that’s…

DIEGO TRUJILLO: They’re like, all right, just listen to the people, right?

MAHESH ODHRANI : Just listen to the people, exactly.

DIEGO TRUJILLO: That’s a smart choice. That’s a smart choice, serving customers and listening to them. Well, so you take this step. And I wanted to kind of preface this episode because there’s some comments that kind of come up sometimes in regards to our mixers and things like that. And I wasn’t sure maybe five years back what Heels may have looked like. As you know, right, I took over as CEO around three years ago. And And since then, I really try to keep it consolidated to the healthcare industry. And people would ask me, and they’d say, so is it just a bunch of realtors and wealth managers that all come to the heels mixers? And I remember like bringing up, well, no, no, no, we have mainly industry. However, I think there’s an important connection. And that’s one of the reasons I wanted to record this podcast. Because as I started speaking with you and exploring, right, the decisions in life, Everyone knows what a wealth manager is. You know, they help with your investments, retirement, planning, things like that. But I wanted to unpack the importance of your role and how you see your role within the healthcare industry. Because while you are not directly, you know, a provider, you’re not in healthcare, I think the decisions that you help people to make can really set up for success and for failure. And I even say that when I was in school for theology, right? So we’re learning about theology and they’re talking about, You know, we’re taking all these counseling classes and all these educational courses. And during the course, one of them was financial planning. And I remember thinking, what does financial planning have to do with how I’m going to apply my degree? And I’ll never forget in that class, the reason, the first thing they go, you know, you’re probably all wondering why you’re here. But if you don’t learn to make good fiscal decisions right now, you can put yourself in a corner that you’re not going to be able to get out of. And you’re going to be locked into the position you’re in simply because of bad, poor financial decisions or poor foresight, right? Even sometimes, because I do watch American Greed, Um, even sometimes, you watch some people get backed and make unethical choices because of earlier choices that put them in a corner, and then unfortunately on American Greed, they fang it out. They figure out, wait, did I get away with this? Maybe I can get away with it a little more. And, you know, they keep pushing it down through the envelope. There’s always a story that sticks with me of this company that makes fruitcake in Texas. And this guy must have embezzled like $27 million from a fruitcake company over like eight years. No one saw it coming. And all it did was he had to make like a car payment. He wrote a check from the company, and no one questioned him on it. So he continued to do that for years on end, and it just got more and more. So for me, fiscal responsibility should be the basic for everyone. And this is just my explanation. I’d love for you to add to this. that kind of dictates what decisions we make, the freedom and the liberties that sometimes we give ourselves. Otherwise, again, we have responsibilities, we find ourselves cornered, and we can make unwise decisions for that. So explain to me how you see strategic wealth design in the connection with healthcare and what your service is, you feel, to the healthcare community.

MAHESH ODHRANI : Yeah, and so our strategic wealth design is a wealth management and financial planning firm. So we offer financial planning services for health care providers. We work with a ton of physicians, nurses, and other health care executives in the industry who also have A lot of work that we do is also in the dental community as well. Okay. So, for our healthcare professionals, the challenge that healthcare professionals face, I mean, you were lucky to have a financial planning class when you were going through your education.

DIEGO TRUJILLO: There are some horror stories within religious circles, as you can imagine. And so, my school really wanted to make sure that no one from their school played out into those. That’s why they kind of focused on it. Again, the character and the integrity that comes with the role. But go ahead.

MAHESH ODHRANI : Yes, and unfortunately in the medical space or the dental space, there’s zero education when it comes to personal financial planning and how doctors and dentists can actually take care of their finances and grow their wealth over time. And know enough, at least, to not be taken advantage of. So that’s one aspect. And I grew up with a lot of friends and clients in the health care space. That’s what came natural to me over time.

DIEGO TRUJILLO: So you’re somewhat familiar with their struggles already.

MAHESH ODHRANI : I’m very familiar with their struggle. We do a lot of speaking at dental schools and medical schools and residency programs. And we do hear it consistently based upon the questions that they ask. that they don’t have any education when it comes to the life part of it, the financial planning, the personal financial planning, but also on the business side of things, the business of medicine, understanding how to run a practice or how a practice is actually run. So that was one aspect. The other aspect of it is our motto in our firm is to help clients build financial freedom and financial security. Now, That goes far beyond because money is one of the number one causes of stress. And it causes stress doesn’t matter who you are, if you’re wealthy, or if you don’t have enough assets or income, it causes stress across the board. So I know in the healthcare space, there’s conversations about not only taking care of your physical being, but your mental and as well as your financial well-being as well. So both the health and wealth sort of go together, and that’s, we help on the wealth side, so at least hopefully, hopefully with the work that we do, reduces their financial stress, so they can focus on what they love to do the most.

DIEGO TRUJILLO: And I think that’s what it comes down to, right? So they have a calling to medicine and to be able to serve the community, but if you don’t have the money or if you’re misappropriating or mismanaging or whatever it may be, that’s going to put a barrier to what you can do because you’re worried about your house being on fire, you know? So it’s very interesting. How long have you been working specifically with healthcare? Was that a target with Strategic Wealth Designs from the beginning? You said, you know, we can step in and really provide a service.

MAHESH ODHRANI : Yeah, pretty much from when I started in the business 20 years ago. Did you have a lot of friends in med school? I did have some circles in the medical space, primarily through just social connections, being involved in the community. And that’s where we started off being in the healthcare space. And then eventually, we just got into speaking at some residency programs here locally, even across the country. And we speak at a ton of dental schools as well. So I think the work that we do, the word got out, and we were invited to come in and speak at different programs. Because we do a lot of education, financial education for doctors and dentists. So that’s, it was not intentional, It was something, I think, just over time I stumbled across, and existing clients that are in the medical space, physicians referring their physician friends, and that’s really how it all grew over time.

DIEGO TRUJILLO: But it was not intentional. It may have been you witnessing your friends make poor decisions when you were younger, and you’re like, man, if someone would just give these guys advice, right?

MAHESH ODHRANI : I have seen that as well, yes, yes.

DIEGO TRUJILLO: So that’s great. And what do you think is the most attractive, or what do you enjoy the most, I would say, about working with health care professionals? Is there something about that market specifically? Are they more demanding, less demanding, more education, and you enjoy educating? What part of it do you think is the most attractive?

MAHESH ODHRANI : I think our clients are quite diverse. Personally, myself and my team members enjoy the education part of it. And I think because we do a lot of speaking engagements around education and going and teaching in residency programs about just financial awareness, education, how to achieve financial balance and financial freedom and security and all those topics that we cover. And I think at heart, all of us in my team, at least all the advisors, are educators at heart. Because we want to make sure the clients understand the decisions that they’re making. And sometimes we are known to talk a little too technical just because we want to make sure they understand. But our number one goal is, I think we just saw the need there. Now, my personal practice, even though we have other advisors, has evolved where I work closely with the entrepreneurs in the medical space. So I would work with the practice owners And I work closely with them. All the risk takers. All the risk takers, yes. Because I just have, over the years, I’ve just built a liking towards working with business owners, practice owners. They just think differently. They’re wired differently. They’re taking risk. And we want to make sure that we help them, not only in the personal side of things, but also help them on the business side of things, understanding how their business and their practice is functioning and what improvements can they make, essentially, to better the output, essentially, which will help them raise their income and their wealth.

DIEGO TRUJILLO: Yeah, and I feel, you know, I had thought about that question when I asked you regarding the educational portion of it, right? When people think of finance, some people like the numbers, some people like beating odds, some people like outperforming in the competitiveness. You’ve always been a person that, as I’ve been around you, education just kind of oozes off of you, right? You can tell when people read and when people like learning because they always have interesting facts or whenever you say something they can add, and you’ve always been one of those people. Oh, thank you. And in addition to that, um… In addition to that, your ability to be able to kind of emphasize with those people that are struggling, those entrepreneurs that are pushed out of the nest, because you’ve been there, right? So as you’re watching these people take the risks, again, hey, I understand your fear. I understand where you’re at, being able to identify. But I feel like the pleasure and the satisfaction really comes from them learning and saying, man, thank you very much for taking the time to show me these things, right? So all of a sudden, you’re seeing the effects of you as a teacher improve people’s lives directly. And it doesn’t hurt that, you know, they invest with you and you help them perform and, you know, that also puts a smile on your face, I’m sure. What financial challenges do healthcare professionals typically face? How does your firm address these challenges?

MAHESH ODHRANI : I think one of the first challenges that physicians face when they’re getting out of their medical school or residency programs is the fact that they have a ton of student loan debt. So we come across a lot of physicians, they’re graduating out of residency programs, they’re finishing up residency programs, and now they have a mortgage without even owning a house. So they’re graduating with a ton of debt that’s gonna take them time to repay, and the laws and the rules around the student loan repayment are quite complicated as well. So we do a lot of consulting around that piece. The second challenge that I see them face is, and this is more about habits. What happens is they’re used to making $50,000 to $60,000 a year while in residency programs. And now they jump to making almost $250,000 to $300,000 per year. And that becomes a huge challenge because They’ve not been used to it. They’ve not had incremental increases. Yeah. So going from making $50,000, $60,000 up to $250,000. Many times we notice people face challenges in terms of keeping up with the Joneses. So, next door neighbor bought a new car, I gotta get a new car. And we see them overspend in the first few years of becoming a doctor, or coming out of residency program and start earning that larger income. So, those are two challenges that we notice quite common with physicians when they’re just starting off. Now, as they’ve been practicing over the years, let’s assume they’ve been doing a good job with saving and investing and protecting their wealth. Now, we notice that a lot of times some of the challenges that people face, physicians face, is that they have advisors that they’ve used over the years. But many times those- A friend told me or actual advisor? A friend, yeah. Yeah, they listen to advice on social media. Nothing wrong with advice on social media. I would say some of it is good. Majority of it does not provide the full information. It’s good, but they’re not providing the full information. So a lot of times, they’re listening to their friends. They’re listening to what others are doing. And they become very transactional, which is unfortunate. Very successful physicians, I’ve noticed, rather than trusting a handful of advisors, and crafting a bigger picture strategy for their financial life, they become very transactional in buying products and services from multiple institutions. Again, nothing wrong with that. But what we see is when those things happen, then there’s gaps that start building up over time, where things are not working together. So how we solve for that, because that was the other question that you asked, how do we solve for some of these challenges? The first thing that we do with every single client that starts working with us is putting a whole plan together.

DIEGO TRUJILLO: This is where the strategic part comes in.

MAHESH ODHRANI : This is where the strategic part comes in. Yeah, they’ve been working on wealth design, right? That’s a good point.

DIEGO TRUJILLO: That’s a good point. OK, now let’s add strategic to that.

MAHESH ODHRANI : So when we did the client survey I mentioned, several clients said that. You’re very strategic, so you need to have that word in there. But I always use the example of going to the mall.

DIEGO TRUJILLO: Ladies and gentlemen, just so you know, this is where Mahesh really lets out the wisdom. Go ahead. The example of the mall.

MAHESH ODHRANI : When you’re going to the mall, and when you first walk into the mall doors, generally what do you see?

DIEGO TRUJILLO: For me, it’s the food court, because that’s why they would drop me off, right?

MAHESH ODHRANI : I was going to say the map of the mall. The map of the mall, yes. So you see the map of the mall. And generally, you would say, hey, I want to go here. And then you’ll figure out the best way to get there. So same thing when it comes to financial planning. It’s without knowing where you want to go, it’s very hard to create that map and the roadmap. But if we know where our clients, where the physicians, where the practice owners, where they want to go with their wealth, their finances, their practice, then we can come up and craft that map to get there. So to use an example of the mall is one of the challenges that people face is not having that roadmap, but two, not putting the effort into it. And that’s what we offer is that financial plan is to put that roadmap together to help them accomplish their financial goals.

DIEGO TRUJILLO: Well, it would seem, too, that, you know, to be able to achieve something great, there needs to be hyper-focus, right? You need to be kind of zoned in. So, you go back to these people’s lives, typically, when I say these people, right, physicians’ lives, the calling for physicians starts a little younger. So, at 11, 12, 13, they start feeling this, right? At 18, OK, now I got to pick my college career. But it’s all been driving towards one goal, and all of a sudden, you cross the finish line, and they had never followed that up with. Okay, once I cross the finish line, what does that look like, right? And it brings back the memories of those posters they put in your classroom. If you don’t know where you’re going, you’re going to end up somewhere you don’t want to be. So it seems like that’s step one is just, okay, let’s look at your goals. What do you want to end up as? What are the typical answers you’re hearing when people, do they have clarity in that? Do they have some clarity? What do you find in most people that are finishing their residency programs and now are hitting, I want to say lottery ticket, it’s not, right? It’s delayed gratification manifesting all at once, right? Which is not always fantastic because you didn’t have time to build the discipline to be able to help manage those things. So that’s where you start out. What percentage do you feel have never thought of that or what do you experience as you’re stepping in with clients? I’m sure there’s an expectation when you say, OK, this is where he’s going to go. And 80% of the time, they go that way. And then you need to kind of re-educate and redirect. What do you find?

MAHESH ODHRANI : Yeah, so we find when we’re working with clients, generally, we try to segment their goals into three buckets, short-term, mid-term, and long-term goals. And obviously, being in the financial world and being a financial planner, They always start with, oh, here are my financial goals. I want to move into a bigger house. We need to buy new cars in a couple of years. We have young kids, so we’re going to start thinking about saving for college. Eventually, that long-term goal is going to be a retirement. Some of them are going to have, I want to start a practice or own a practice at some point. And what does that look like? For a lot of individuals, we have to dig in further as to what are all the other soft emotional goals that they’re looking at accomplishing.

DIEGO TRUJILLO: Can you expand that? What do you mean by soft emotional goals?

MAHESH ODHRANI : So, what I mean by that is, okay, in terms of, let’s talk about college. So, yes, we want to do some college planning. And where would you want your child to go to college? Now, a lot of them, if the kids are under five, they probably have no idea if they want to go, where do the kids want to go to college? The parents may say, You know, yeah, we want them to venture out or travel somewhere. But you never know, depending upon how life evolves. We’ve had clients, when the kids are closer to going to college, when they’re in their teens, then parents are a little bit more objective as to, OK, we want them to stay closer to home. In Dubai. In Dubai, yes.

DIEGO TRUJILLO: And then all of a sudden, you know what, actually, maybe you should go to Las Vegas. That happened to you, is what you’re describing.

MAHESH ODHRANI : That happened to me, yes. So things can evolve over time. But when I talk about soft emotional goals, we want to get into the why behind some of the goals that they have and what they’re looking at accomplishing. So one of my close friends had a goal of eventually paying off his home, as an example. And interest rates were very low. Now, this is not advice for the audience, so this is an example.

DIEGO TRUJILLO: It’s not advice. This happened to somebody, and you’re just oral history here.

MAHESH ODHRANI : Oral history. So was very attached to paying off their home. And interest rates were low. It just didn’t make sense from a financial standpoint. And I talk about financial planning as both science and art. The science of the mathematics behind everything that we do. The art is all the emotional part of it. So in this example, was they were quite attached to paying off their paying off their mortgage, even though financially, scientifically, this was just a goal they had since they were children.

DIEGO TRUJILLO: I say this is as a Hispanic, that’s like the number one thing is like, Oh, you got to pay off your house, you got to pay off your house, that and this is not financial advice either. And you wouldn’t want to listen to me on this. But And then someone explained to me, well, that’s not always the best decision, because you can write off some of that interest. You know, if the interest is low, it’s not worth it to pay off. You can grow your money somewhere else faster. Don’t know how accurate that is. You should speak to a wealth planner if you’re curious. But I remember hearing that advice. But that was just very common. It was like an emotional sentiment, until people started saying, well, buying is not always the best way to go. Sometimes leasing is better, because it allows you this flexibility, et cetera. So, go ahead.

MAHESH ODHRANI : So, in that specific example, the client and the friend was very attached to paying off the house. It had to dig into further versus say, okay, let’s put that as a goal, let’s make that happen. We had to understand what’s the why behind that. So, just digging further into it and having a conversation with the client about it, found out that when the client was a child, unfortunately, his parents, lost the home to foreclosure because they could not pay the bills, and the father had lost a job. Something had affected them, and there was trauma around it. And they’d stayed with a friend’s house for a few days until they found their feet again and went into another apartment. But that trauma stuck with this client forever. And their number one goal was they don’t want to put themselves or their family in that situation ever again. So they were very hyper-focused on paying off their loans. Now, the challenge that we faced was, yes, they were hyper-focused on that, but they were at the expense of other decisions in their financial life. They didn’t have the right amount of rainy day fund. They were not protecting the family appropriately. So there were a lot of other things that had gaps in their financial plan that they were not addressing. But understanding that why the soft emotional goal was important for us, so now we can do a better job and coach them through that process. Yes, we want to accomplish that goal. We understand your why behind it. Now let’s focus on can we take a look at the other aspects, fill those other gaps first, and then refocus on these goals that you mentioned.

DIEGO TRUJILLO: Yeah. So your role really takes on a secondary role, which I thought in case you want to expand to strategic wealth design and therapy, because you kind of have to explain to people, hey, I understand where you’re coming from. This is math. You know what I mean? And so when you start explaining the math, they still have the emotion. And so they might not see it clearly. Am I getting that right?

MAHESH ODHRANI : Yes, I mean, compliance would not appreciate me saying this, but many times I do feel that we do act like part-time therapists. I’m not a licensed therapist, but it’s just conversations, just letting people, letting our clients speak up, letting our clients share with us their why and what’s the thought process behind some of the decisions that that they have made and they want to make in the future.

DIEGO TRUJILLO: Yeah, and I do say that just for clarity, right, just half-jokingly. I would notice it. I think there’s a lot of crossover. And really, we use the word therapy, but this is just human beings bonding with other human beings, right? Correct. And being able to have conversations and understand. I would see it a lot in hospice. I would meet with families. And again, my job was in marketing. My degree was in theology. And one thing that I learned working as a chaplain in hospice was stay within your scope. If they ask you a question on medications, don’t answer it. Even if you know it, that’s not your role. Tell them to speak to the nurse. And I had a family that I remember they came, they signed their dad onto service. These two daughters loved their dad. and they kept calling me to ask me questions about a wound. And they’re like, you know, the nurse is telling us to use this, this honey, uh, meta honey, but, you know, we found this other product online. And I was like, you really need to talk to the nurse about this. All I’m going to do is call the nurse. And after the third time of them calling me in one week, I realized that in their moment of crisis, I was the first person that stepped in and began the solution process. And as they were facing these challenges, right, with their father declining, the wound wasn’t healing as quickly as they would have liked to see, really, they called me. It was the third time that they called me. And instead of calling the RN case manager to say, hey, they’re complaining about the wound, I said, hey, you might want to get the chaplain involved a little bit, because they just want to hear a familiar voice. And that’s when, you know, sure enough, they did that. They never called me again. But people, you know, we tend to latch on to people that are giving us advice. And, you know, especially when it’s Sage and Wyve advice, they’re paying you for your advice. So it is very important. But it’s also equally as important for you to listen. You don’t have to. Like you said, it’s math. So you could just send them to a YouTube video to educate them on the math of it. But this is where the human element of, right, of, I don’t want to say wealth design, but it’s wealth management kind of comes in. is truly understanding your client so you can see how you can lead them to make the best fiscal decision for their goals.

MAHESH ODHRANI : Yeah, and in our business, it’s all relationship-based. And there is transactional business, but unfortunately, our firm, or fortunately, our firm stays away from most of that. So most of our business is very relationship-based. And one of my mentors, and I trained this to advisors joining our firm, that clients need to know, like, and trust you. They can know about you, so through social media, through being introduced by a friend, but eventually they need to like you. They like you as a person. And rather than just focusing on the math, is bring out the personality, bring out the emotions, because that’s really what people are attracted towards. And eventually, if they know you, they like you, now the trust has to be built. We still have to be competent to build that trust and be confident in what we do. So those are the three things that I train a lot of new advisors on. That’s your corporate culture. The know, like, and trust.

DIEGO TRUJILLO: Yeah, that’s part of it. How do financial challenges, like student loans, right, what you mentioned right now, the emotional, do you feel like it’s different for healthcare professionals? Do you, if someone steps out, finishes, you know, an MBA, and they have $150,000 in debt, do you feel like it’s very different, or do you, is it the same approach, or is there some difference to healthcare specifically? So, um… And I say this for people listening that may be going to school that are doing this, that they can hear it and be like, huh, I had never considered that, right?

MAHESH ODHRANI : Yeah, that’s a great question. So if you look at the different occupations, different fields, anyone in the business world probably would have had some education and more knowledge around student loans as they’re going through the process and going through school. Because in the business world, they do talk a lot about finances. That’s true. Unfortunately, for physicians in the health care space, There’s not a ton of education that takes place while they’re going through the residency programs with the medical school when it comes to personal finances. So that’s one distinction in terms of the education that they receive while they’re in the program. But also the amount of student loan debt is generally much higher for physicians, and especially if they end up going into fellowships and additional education beyond that. The other thing to consider is The programs that are available in the marketplace, I have yet to find any type of government assistance or program where they would help with student loan repayment for a business graduate. So, however, there are a ton of states, a ton of programs available out there now where they are subsidizing. If you’re working in underserved, if the physicians are working in underserved areas, the state has some grants to pay towards the student loan debt. So, for example, in California, I don’t remember the name of the exact grant, but there’s a grant available where the state of California will pay, I think, the numbers are about $40,000 or $50,000 per year towards the student loan debt if they’re working in an underserved area. And even here in Nevada, I believe there’s a new one that’s launching. Again, I don’t remember the exact name of it, but there’s a new one launching here in the next year or so, if I’m not mistaken.

DIEGO TRUJILLO: So it’s not just simply about making better choices towards the future. There’s opportunities you could be missing out on.

MAHESH ODHRANI : That is correct.

DIEGO TRUJILLO: As a physician, there’s things, right? There’s fruit on your tree you didn’t even know you could eat.

MAHESH ODHRANI : Correct.

DIEGO TRUJILLO: So you’re stepping in and say, hey, did you know that there’s this benefit or this that you could be taking advantage of? Because you have a good point. With the amount of debt you’re coming out of medical school, compare that to hospitality and other areas, you’re probably going to be a little more in-depth. You’re going to want to take every opportunity you possibly can.

MAHESH ODHRANI : Yeah, and take every option that’s available to you. And many times when they’re finishing up residency programs, if they have two or three different opportunities available to them, either to go into a private practice or into a corporate environment or a big provider, But they’re the benefits are all going to be different from provider to provider that they join the company to company or practice to practice So so what we do one of the things that we do is when they’re looking at those opportunities Yes, you want to take a look at which one’s going to be the best fit for them? But when it comes to the financial side of the money side which was going to be the best fit for them for their career growth, but on the financial side, we can help them evaluate and compare those benefits between different providers. And there are a lot of employers now in the medical space that are also offering student loan forgiveness programs, where if you join them, they would help you pay off your student loans too. So again, that usually does not exist in other industries.

DIEGO TRUJILLO: So that’s very interesting, because at that point, so you need to make the decision, because everyone’s wanting you to come over, right? So as you’re being swooned, you need to figure out which one really benefits you the most. I mean, I would think that your personal goals are going to be incredibly important to where you want to end up, you know? Because you could make a choice that seems like the easiest choice now, but 15 years down the road, you’re really going to be regretting it. And if you didn’t put any foresight into that, you might be hurting a little bit, yeah?

MAHESH ODHRANI : Correct, yeah. It takes some time to actually evaluate those. And as I shared before, it’s about one which is going to be the most appealing for your career growth standpoint. But the second thing to look at is the financial side. Sometimes, it’s not just about the dollars and cents, which one’s going to pay me the most. It’s about, okay, if this one provider is paying me the less, but I have better quality of lifestyle. I have better quality in terms of the number of patients that I see in a day. I’m still able to get out by five, six o’clock and be able to be at home with my family. So yes, there’s less pay, but you get better quality of lifestyle. So it’s evaluating those two things and saying, okay, which one’s going to be the best fit for the client?

DIEGO TRUJILLO: See, you bring that up, and I was going to do this as a follow-up question, and you kind of touched on it right there, because you’re mentioning two value systems that are very different. I would say the previous generation’s value system was make as much money as you possibly can, and at the expense of everything, right? Your kids grow up. They never saw you. Now, I speak to some older physicians, and they’re like, oh, these young kids just don’t want to sacrifice. They say they want to, you know, be at their kid’s baseball game, and they want to. And I was like, well, yeah, why would you want to live a life to earn money and not live a life, right? To say you made the most money, it seems like the values are very much changing. As you look at that, do you see the difference generationally? In other words, when you were doing this 15 years ago, do you get very different answers when you probe clients to what you’re getting now? Does that shift?

MAHESH ODHRANI : That does shift. So I probably read some research, and this was in our industry research that some companies had done, like a focus group, probably about 10 years ago, maybe a little bit longer than that. And back then, the research showed that most individuals coming out of medical schools and residency programs, and even dental schools, because it was a combination of both dentists and physicians, they want better quality of lifestyle. And they would prefer working for an organization where they did not prefer starting their own practice, but they would prefer working for an organization as a perhaps a W-2 employee where they have limited number of patients that they see. They’re still able to get out and spend time with their family, go to the baseball game. So that’s what the research showed. This is probably about 10, 12 years ago now. But you’re right. We do see that generational gap where some individuals that have been practicing, some physicians that have been practicing for many years, they are very much into hard work and working long hours, owning their own practice. And we have seen that shift take place. However, now we’re seeing the pendulum swing again. individuals are getting burned out because these large corporations have, they’re just squeezing them to see more and more patients.

DIEGO TRUJILLO: They enjoy that hard work ethic and they’ve tapped into that.

MAHESH ODHRANI : Yes, yes. And so what we’re seeing is now more and more physicians coming out of medical schools or even residency programs, they do have some goals of starting their own practice. We actually have seen some of our clients leave the large corporations and go out on their own, start their own practice, because they were just getting burnt out. And burnout is real in the medical space, in the healthcare space. especially in this town because we’re so understaffed. Yeah, everyone’s working hard. Everyone’s working hard. So we’re seeing that pendulum swing again to where, and I’m talking about practice ownership.

DIEGO TRUJILLO: Yeah, how you choose to practice as an employee versus being an employer or being a business owner. Correct. And they’re finding that being a business owner is allowing them a little more flexibility to have quality of life.

MAHESH ODHRANI : It’s having… Not always, but… Not always. Okay, yeah, I know. It’s, it’s, the grass may only seem greener on the other side, right? Yeah. So, so we have, we do see individuals it’s better quality, they have more control over it. And what they’re recognizing with the tools and technology that they have access to today, they have better control over the quality of care that they can offer to their patients, as well as the number of patients that they manage in their practice. Yeah. So versus being forced to seeing 40, 50 patients a day.

DIEGO TRUJILLO: And what area do you think is the most often overlooked or where focus should be placed on? Is that all dependent on goals?

MAHESH ODHRANI : So it all depends upon goals. It depends upon where they’re at in their career and their life. And the crazy thing is that our goals evolve.

DIEGO TRUJILLO: So that’s a reality. That’s a truth. I still have my 13-year-old goals. I don’t know what you’re talking about, Mahesh.

MAHESH ODHRANI : Yeah, no, of course we evolve. So we do have those. Those are long-term goals. But our goals evolve. So yes, the advice, the challenges, and as those goals evolve, we want to make sure that we’re there right by a client’s side to help them accomplish those goals as those goals come up. And same thing as I shared my story, right? I was in Dubai thinking I was going to be there, and my goals changed, and I was in the US.

DIEGO TRUJILLO: You said, this place is getting too nice for me. I’m out of here.

MAHESH ODHRANI : No, I’m kidding. Yeah, it was getting too big for me at that time. It was still small when I moved out. But that’s what we see, is where the goals evolve over time, and we want to make sure we’re there with our clients, giving them advice along the way.

DIEGO TRUJILLO: This is where it’s important to not just have boilerplate answers. Anyone can go online and research information and know things, right? But the human element of having an actual strategist that’s working with you on this, even as your goals evolve, so that they can help you to pivot. Do you have any clients that just drive you absolutely nuts, that are just bouncing back and forth? Or have you in the past?

MAHESH ODHRANI : Yes, yes. We’ve had them in the past and we also have a few of them currently. I think part of, one of the things when clients ask us why should they hire us, and my number one answer is because of time. Time is is all of our precious resource. And it’s getting more and more limited. Of course, someone that finishes residency program and starts working, perhaps they’re single, perhaps they’re married and no kids yet, they may have more time on their hands. And certainly, all the data, all the research, everything’s available online now. That’s the great thing about where we’re at in society today. There’s so much information available. Yeah, the access to it. The access to the information is very easy now.

DIEGO TRUJILLO: That’s also a downside, though, I would think, right? It’s like doctors—I’ll make the connection—it’s like doctors saying, oh, let me guess, you went on WebMD and this is what you have, right? They get frustrated because, oh, he accessed information. They call him Dr. Google. Yeah. So they get frustrated there. Do you have that? We have that as well.

MAHESH ODHRANI : It sounds like that’s what you’re describing. Okay. We have that as well. But we’re educators at heart, so we want to make sure Many times the information, especially in our world, yes, information is available. It’s readily available. There’s a ton of it. We want to make sure we simplify it and help our clients understand when it fits in their goals or not. So where I was going with that was there’s a ton of information available. They can do it themselves. Our premise is we want to be that time for our clients. We want to create that time. That’s a great expression. Once they know and like and trust us, we want them to reach out to us for any financial concerns. And our goal is to help them solve, answer their questions, solve their problems, so that they can focus more on what they love doing the most. Spending time with their family, taking care of their patients, taking care of their practice, and enjoying what they do most.

DIEGO TRUJILLO: Yeah, so it’s like a chief financial officer, but for your life, right? So, yes, you can sit down and research this for 13 hours. Or you can ask me, and I’ll spend my time doing it, and then, you know, give you the bullet points in 10 minutes, 30 minutes, and save you the time of having to research all that. Correct. Okay, let me ask you this, then. Can you highlight any common financial mistakes? Is there things that you see healthcare professionals do over and over again that you’re just, oh, man, you really need to rethink this? Is there something you can offer the audience as advice on that?

MAHESH ODHRANI : I think, so yes, so one is not spending time with their professionals. So I do see that physicians work hard. They take care of patients. They save lives. But unfortunately, they don’t spend enough time with their professionals, with their accountants, attorneys, their advisors, to take care of their financial life. The reason I say that is because we do see, at many times, there’s gaps in in our clients’ financial lives where they haven’t addressed several needs or several recommendations that professionals have given them, but they just don’t take the time. They’re just busy. They’re just busy. For whatever reason. They’re just busy. And so that’s one. The other common mistake I would say is what we talked about before is transactional. We do see a lot of physicians make financial decisions because their friends are doing it or someone just came by the office and was representing a financial product and they just went ahead and bought it. Again, nothing wrong with that. But what physicians end up missing out on is understanding the big picture. And many times, without understanding the big picture, I noticed that they do end up either purchasing or making mistakes with their finances, which becomes either very expensive to fix later on, just because they’re just too busy taking care of their patients.

DIEGO TRUJILLO: Like buying a two-seater sports car when your wife is pregnant.

MAHESH ODHRANI : Right?

DIEGO TRUJILLO: You’re just like, oh, I might not have thought. Yes, you want to drive the sports car, obviously, right? It’s very fun. But then when you start getting into the practicality of it, you’re reminded as soon as you get home, excited to explain why it’s important for you to have 550 horsepower and thinking, wait, this is illogical. This doesn’t make sense with my life, right? So I’m sure you’re seeing people make those mistakes.

MAHESH ODHRANI : We have seen this, yes. Okay.

DIEGO TRUJILLO: And then do you scold them or you kind of hit your head against the wall on trying to get them? No, but you’re not understanding.

MAHESH ODHRANI : We want to sympathize. We want to empathize with them. We try to listen. And we certainly, you know, all we can do is give our advice and give our opinion around that. So the clients pay us for their advice. Right. Now, we hope that they listen and actually take action. But what they’re paying us is for the advice. And our job is to advise them, to coach them. And certainly, if they would reach out to us before they make some of the financial decisions, we can help them save a lot of headache.

DIEGO TRUJILLO: You know, this is really bringing a lot of memories of marital counseling and things like that, where you talk to people and you’re like, yeah, but we just keep getting in a fight. Have you guys discussed what your common goal is? Well, she wants this. Yes, you need to come up with a common goal, because once you’re both signed up to the goal, then he’ll come and say, yeah, but look at this 85-inch TV, and it’s so discounted. And all you have to do is say, yeah, but does it meet our goal? Remember we came up with a goal together? And then immediately he’ll be like, yeah, you’re right. It doesn’t work towards our goal, right? That’s the importance of goal setting. Because then you’re going to remind them as the financial spouse. You’re going to remind them as a financial spouse and say, well, you had said that this is your goal. Is it still your goal? You can buy all the TVs you want and sports cars. I can’t tell you what to do. But is this still your goal? Because you’re not working towards it by doing this, by making this decision.

MAHESH ODHRANI : Correct, yeah. And many times, you’re right, it’s just reminding them of the goals that they put together. But also, what I’ve noticed is many times they’ll have those goals, but they’re just scared or they’re concerned about making those decisions. A great example just recently, we had a client, spouse needed a new car, they just finished their residency program, just started earning income, and they were very concerned about making like bad decisions with their money. Right.

DIEGO TRUJILLO: So they didn’t want to go and— They realize they won the lottery, and they know what people do when they win the lottery, so they’re a little tentative on decision-making.

MAHESH ODHRANI : Exactly. They’re very cautious at making decisions. But the spouse needed a new car, and they’re like, uh, it’s on its way out. And I said, what car are you looking at buying? And let’s say… Porsche GT3 R8, no. No, no, it wasn’t that. It was a, I think it was a Toyota Camry RAV4, one of those cars. And we looked at the price and I said, you guys can afford this today. And you can either pay cash for it because you’ve done well, you’ve been very cautious, you’ve been saving up a lot of money since you started working. So you can do this today or you can finance it. How are you going to do it? But we’re having this conversation, and I know I’m your financial advisor. I give you permission to spend the money today if you need to. So they were not looking for my permission, but I think internally they were. You’re addressing the fear.

DIEGO TRUJILLO: They feel there’s a fear there of making the decision. And am I going to make a mistake and regret this? It’s nice having an expert that in finance say, this is absolutely not a mistake. You can make whichever way you want to make this decision, you’re in the position to make it.

MAHESH ODHRANI : Correct, yep. So it was that simple, but I think they were just looking for validation.

DIEGO TRUJILLO: Yeah, that’s fair. And that’s what you’re paying for, right? And that’s the human element of what we were discussing earlier. We use the word therapy, though technically it’s not therapy, right? However, you’re just looking to know that you’re making a sound decision. Correct. And having that feedback from a professional, it’s saying, yeah, it’s sound.

MAHESH ODHRANI : Don’t worry. And if they wanted to buy the Porsche GT or something else, That would have been a different conversation. But I think with the price point they were at, it was great. And it was a good feeling as an advisor, too, where the clients are looking for that validation. They’re listening to advice. They’re taking advice, and they’re acting on it.

DIEGO TRUJILLO: Yeah, that’s the educator in you, right? Yes. Because there’s nothing worse than educating someone, them saying, wow, that’s a really good point, and then going do the complete opposite of what you just suggested they do. How can healthcare professionals effectively manage their finances and find time for financial planning when there is a shortage, right, when you are busy, when you’re trying to keep everything afloat?

MAHESH ODHRANI : That’s a great question. So the first thing is what we talked about before, is know, like, and trust. So biggest thing is building trust with the right professionals in their lives. And with that, the three professionals that we always recommend that physicians have in their lives is an attorney from asset protection and estate planning perspective, a tax accountant who can come up with effective tax strategies, and a wealth advisor. And essentially all three of these individuals should know each other and should work as a team for the client’s benefit or for the healthcare provider’s benefit. As far as creating the time, that’s If they’re working with the right team and essentially working with great professionals that they know, like, and trust, they can make the time to meet with them at least on an annual basis. And the perfect strategy would be is to get all three of them in one room once a year for an hour just to be able to discuss the client’s life and look at all the strategies from a tax standpoint, legal standpoint, as well as financial standpoint. and see how everything is working and having all three professionals be on the same page. But once you trust them, then the professionals can leave that meeting and act on behalf of the client to make sure the client’s goals are taken care of.

DIEGO TRUJILLO: And I’ve seen this kind of in play. It almost feels like the three branches of government keeping checks and balances. You have three professionals, right, that don’t necessarily, they don’t work for the same company. They work for the same client. They can overlook each other to make sure the other one’s doing their job. And really, when they come together effectively to work towards those goals, to make sure that those goals are being worked towards. Which gives you a little more trust in a team, right? Because if there’s going to be a failure in one, the other two might catch it and say, hey, we’re noticing this. We’re not getting this paperwork or this information, etc. How do people make the choices? What should I look for? The guy that hands the nicest card, that drives the nicest car? How do I choose my attorney? How do I choose my wealth manager? How do I make these decisions?

MAHESH ODHRANI : That’s a great question. So the first thing is the personality. So again, I’m going to go back to that no like and trust. I know I’ve said that multiple times.

DIEGO TRUJILLO: You know what’s funny is you’re saying this, but I have the personality that runs any detail-oriented person, drives them insane. And my accountant is very detail-oriented. So it’s very funny how I’m like, oh, thank you. I’m always apologizing. She’s like, yeah, I know, but you need to make this a priority. I know, I will, I will. And then I get back on it. But go ahead.

MAHESH ODHRANI : I was going to say that no lie can trust, right? But then the second thing is the trust aspect comes from are they complimentary to you? So, you’re not detailed, Diego, but you’re, you said you’re an accountant, right? Absolutely. Your accountant is detailed, and you need the accountant to be detailed. But if the accountant was just like you, then there would probably be a lot of mistakes on your tax returns.

DIEGO TRUJILLO: Yeah, three me’s would be a mess, right? I need the skills that I don’t have, and I need to pay somebody that has very good of those skills, right?

MAHESH ODHRANI : Correct, and all those three professionals, one is they need to know their craft. So whatever world they’re in, they know their craft, they need to have the experience. But when you ask that question, how do you pick? So one is the personality, is making sure that you’re the right fit. Two is validation. So do they have other clients that you know that are working with those professionals? And in our business, more and more research is showing that most of the time, clients find their advisors by asking their friends and family. That’s one of the top ways clients find advisors. So asking your friends and family who they work with. And are they happy with them? And the third thing would be competency. Do they have the right credentials? Are they furthering their education? How long they’ve been in the business? Have they experienced part of it?

DIEGO TRUJILLO: And are they the best, right? Are you picking the best? It’s like looking at a resume. Yeah, someone’s it’s yeah, you’re my first client, man. I’m gonna we’re gonna find out right? That’s kind of scary versus, you know, yeah, I’ve been doing this for 15 years. I go to these conferences annually. So it’s okay. Do people ask you that? What do what do you do for your continued education?

MAHESH ODHRANI : Yes, we’ve had we’ve had few individuals ask us that question. But I think at Like, if you look at my business card or my name online, you’ll see I’ve got about, I think, four designations. I’m losing count at this point, four or five designations. So for each of those designations, unfortunately, I have to do continuing education requirements every year.

DIEGO TRUJILLO: Oh, you can’t just pay for those designations, huh?

MAHESH ODHRANI : No, unfortunately not. So, and in fact, I’ve got We’re sitting here in March, and I’ve got one due at the end of April, another one due at the end of May. So I’ll be doing a lot of continuing education over the next 60 days.

DIEGO TRUJILLO: Also being busy. Well, I think it’s important to interview people, again, find that. Do you ever find that when you ever sit down with a client, they may be successful, they may have wealth to manage, but there’s just not a personality click, and you let them know, hey, I don’t think I’d be the best fit for you?

MAHESH ODHRANI : Yes, we’ve had that, where we know we’re not a good fit for them. And it’s also been where, over time, Maybe initially we thought that we were a great fit, but over time we realized that we’re not a good fit anymore. So we’ve had to excuse ourselves from that relationship as well. So we’ve had those conversations, tough conversations with clients as well.

DIEGO TRUJILLO: I think it’s important. I noticed that in consulting, is that some people would pay a good amount of money for your advice and then not listen to any of your advice. And then I remember being kind of frustrated at first, and then it kind of clicked for me. I was like, wait, their plan is going to fail. That’s why they hired me, because it’s already failing. They’re not listening to anything that I’m suggesting for them to do. So when that fails, the only difference is, instead of blaming themselves, they’re going to blame me for executing their own plan. So they’re just paying me to get mad at me, right? And so I was like, yeah, this might not be the best fit, right? You’re paying me a good amount of money. Yes, absolutely I am. And then I would say, well, you know, if you don’t listen to me, then what are you paying me for? I mean, think about it logically. I’d love to just take your money if you’re just looking to give it away, but we need to be clear on expectations because I feel that your plan’s not working based on the fact that you hired me. You wouldn’t need me if your plan was working and then kind of working outwards from there, right? And kind of explaining it to them. They’re like, okay, okay, well, we’ll try it this way. And if it doesn’t work, we switch it up. But again, it’s probably the same with you.

MAHESH ODHRANI : Yeah, it’s exactly the same with us as well. Our number one goal is to consistently add value to our clients’ lives. And if we’re not doing that, and we’re just collecting fees or getting paid, then we want to excuse ourselves from that relationship. But our number one goal in terms of all my training with all my team members, that’s what we talk about is if we’re not adding value, then we’re not the right person for that client.

DIEGO TRUJILLO: Yeah, absolutely. So we talked about other people’s success, right? And what they would like to see and how you achieve them, their goals. What is your goal with strategic wealth design? What is the outcome that really makes you feel good about what you do? Not just clients making money, but are there outcomes that you ever see in clients’ lives where you just feel like you did your job to the best possible way to see those outcomes in their lives?

MAHESH ODHRANI : Yeah, I think from, and I’ll talk about strategic goals here in a moment, but the outcome, every single day that we work with our clients, our goal is to help them prepare for whatever their financial goals are. For many of them, it’s the ultimate retirement. But there’s all these short-term, mid-term, and long-term goals. And that’s what gets me up every single morning because we’re helping them accomplish their short-term, mid-term, long-term goals. Like the example that I talked to you about with a client just going out and buying a car. That was a great feeling when they were in communication with us and they booked their car. They knew the day they were going to go pick it up. and they sent us a picture that they picked up the car. So that’s great, right? And so that’s a short-term goal. Other goals, when clients have, when they listen to our advice and they save up for sending their kids off to college. That’s where it’s valuable when that child is eventually going off to college and their college education is fully funded. So that’s a great feeling.

DIEGO TRUJILLO: It’s like planting a seed and then all of a sudden you see the fruit on the tree and they pick it and they take a bite and they say, wow, this is delicious. Yeah, I’m really glad you listened and planted that seed 10 years ago, 15 years ago, et cetera.

MAHESH ODHRANI : And for many of our clients now, as their kids are going off to college, they’re having conversations with us about their They don’t have any finances, they’re just going off to college, but we’re educating them about finances and how to manage their finances while they’re in college. And what this college fund can do for them, because they’ll be one of the few, perhaps, that will graduate without any student loan debt. And then getting clients to their retirement. or working with a practice owner that eventually sells their practice and goes into retirement. So those are all just moments that we get to enjoy that makes me get up every single morning and go to work. Now, you asked me the question about strategic wealth design goals. Those goals, one of our goals, internal goals, is to touch 2,500 families. So we’re probably at about between 600 to 700 families right now. I didn’t look at the exact count this month. But we’re probably about 600 to 700 families right now. So we know we’re at four advisors in our firm currently. We know that our growth goal is to grow to about 20 advisors in the firm. and approximately each advisor serving approximately 100 to 150 families in the healthcare community. So that’s our goal as to where we want to go with our firm, but with the premise that our passion, what we’re all about is to enrich the lives of people we touch. We do it through the world of finance and financial planning, but that’s the number one goal is to enrich the lives of people we touch, and our goal is to get to 2,500 families.

DIEGO TRUJILLO: And you said something key, because sometimes when you talk about the financial planning aspect, again, people just think, they’re just thinking of getting richer. They don’t understand when people meet these, you know, these personal KPIs or these personal metrics in their life where you see these moments. You mentioned something really that caught my ear when you talked right now. which is not just the strategic wealth design, but start turning it into strategic generational wealth design, right? Where now you’re educating kids and say, hey, your college is paid for. Do you want to just flub that? Or do you want to take advantage of that and really take it to the next level, right? I always used to say it to younger people, carrying the flag further than your parents did. Or just, are you just going to live out their life, but once again, not that they didn’t succeed, but you have an opportunity that wasn’t afforded to your parents. You may be able to take this a little farther. Do you ever engage on that level?

MAHESH ODHRANI : To a certain extent, yes. I probably never say it as eloquently as you did. But yes, we do talk about a lot of the kids’ goals, what do they want to accomplish. What’s interesting is just this past week, we had a client at the office and they brought their child who is in high school, about to go to, so will be a senior in high school next year, so about a year to, actually, no, they’re a senior right now, so they’ll be graduating. this coming fall, and we’re talking about college plans, what do they want to study. But one of the goals is to go to Europe next year for education for a year. Okay. And the parents are not thrilled.

DIEGO TRUJILLO: You didn’t hold that up within quotes, you just said education, right?

MAHESH ODHRANI : Yeah, so didn’t hold that up in quotes. Good child and I think has a good head on her shoulders. She’s already starting to make some financial decisions. So has already been working and wants to start taking a look at educating herself on investing. So it’s a good child, good head on her shoulders. What the parents did, we’re just concerned about the child being so far away from them.

DIEGO TRUJILLO: That’s unique to only that family and only those parents.

MAHESH ODHRANI : Every other parent is complete opposite. Yes, only unique to that family. Every other parents, yeah. But in that conversation, we talked about education, finances, and everything else, but that was her goal. And part of me was encouraging her to go to Europe because that’s what I did. And what’s interesting, This family’s also, the father is an immigrant as well. So the father has gone through the process of being, of traveling away from home and being away from home and building his business. So in this case, it was, I was very encouraging of the child to travel and experience, but I was also encouraging and assuring to the parent to consider that because it will just open up the world for this child to get that experience.

DIEGO TRUJILLO: Absolutely. You know, it’s funny you say that. There’s a lot of crossover. I used to work with a lot of young people, and I’d always tell parents, listen, no one’s going to come when your child turns 18 and is going to tell you, hey, everything you used to say used to be a command. Now everything you say from here on out is going to be a suggestion. You can’t get resentful. You already let go of the arrow. You had 18 years to aim the bow and arrow, right? You’ve released the arrow. Now you’ve got to trust everything you’ve done for the last eight years, which is a very scary prospect. And I only say that because my son’s 12 and nine years old. So the thought of, all right, now you’ve got to do it on your own, right, is kind of scary. But you need to release. If you don’t release, they’re never going to fly.

MAHESH ODHRANI : Yeah, and at some point, they have to take the risk, they have to make the mistakes, and that’s how we all learn as human. Yeah. Yeah, it’s, I’ve made a ton of mistakes, but even not listening to my parents, and it’s one of those, you know, I have to, no regrets, but that’s what made me, that’s what makes me who I am today is because I’ve learned from those mistakes.

DIEGO TRUJILLO: Yeah. You know, I tell my boys, and I learned this from somebody, and I thought it was such a great, you know, because they had exited and made a tremendous amount of money. And I was like, so what do you think about your boys? Because he had boys, too. And when I started asking him, he goes, you know, I want my kids to suffer. I just don’t want them to have as many scars as I do. And I love that explanation. I don’t, I’m not, I don’t want to solve your problems. I don’t want to make everything easy. I want you to kind of suffer a little bit because you, you have to kindle that fire within yourself. I just don’t want you to have permanent deformations from the burns that you get. Right? And that’s, uh, I never thought a financial planner would have to step in that way, but you have a very good point on that. And luckily you’re worldly, so the child probably really appreciates that you said, yeah, move away. It sounds like a great idea. Well, Mahesh, I want to thank you very much for coming on the program. I hope that this has been enlightening for our audience. I know it’s been enlightening for me. One of the things that I’ve learned in podcasting is just getting to know people in such a different way because I have to be very targeted and extracting, getting people to talk a little bit. But you’ve made me think about quite a few different things as we’ve been talking. What is something that people can walk away with and do today, right? They listen to the podcast and think, yeah, where is my finance? Where, you know, I don’t have an attorney, a financial planner, Do they wait until they’re making a good amount of money? What is a step they can take immediately that you would leave them with?

MAHESH ODHRANI : But first of all, thank you for having me on this podcast. This was a lot of fun. I’ve known you for several years and I was excited that when you started this podcast and thank you for asking me to be on this channel. So what I would say is where do you start is start by conversations with financial advisors. Try to maybe interview three advisors and try to find the best advisor and financial planner that fits with, again, your personality and what you’re looking at accomplishing. even if you’re not ready, most financial advisors at least do a free initial consultation. So at least go out and talk and research as to who would be a good fit. And then once you find the good fit, they can help you put the other players together. So if you don’t have an accountant, they’ll help you with that. If you do have an accountant, we can obviously ask your accountant for any recommendations for a financial planner and estate planning attorneys. But lean on your existing professionals or friends and family and ask them, who do they work with? But certainly if you start with any of one of those professionals first, ask them for recommendations and start interviewing to build that relationship. Because again, it is a long-term relationship, but certainly start somewhere. The number one thing after I’m done doing any talk at a medical school or residency program, I always say, Do something. You’ll forget 90% of everything that I said today, but I want you to take one thing and take some action. That’s all I care about. Be it, yeah, maybe meet with a professional, but it could be, it’s one of the things that we talked about is to start saving the right amount of money, start investing in your retirement plan through your employer, whatever that is, but take some action.

DIEGO TRUJILLO: You know, I really, really appreciated your answer, because so many people don’t play to win. I noticed that. And so they’ll say, well, you know, once we’re large, then we’ll implement those systems. And I would always reverse it and say, well, do you think those companies got large because they implemented those systems? In other words, pretend like you’re going to succeed and start making those decisions. You don’t have to have a million in the bank to then begin having the discussions, because then you hit that point you mentioned earlier, where you hit the lottery. What are you going to do, right? Because If you look at it statistically, make a lot of mistakes is going to be the answer. But start planning like you’re going to succeed. And then as your success, you can start interviewing these people, asking questions, so that when you begin to succeed, there is a game plan. An alternative one, right? Looking at more at the negative aspect, again, working in hospice. I would always tell people, it’s okay to learn about these things. You don’t shop for car insurance after your car’s flying off the cliff or rolling down the hill, right? Correct. Shop when it’s calm, where those problems haven’t began yet, so that you can make the best possible decision. So that, right, in this case, when the money starts flowing, there’s already a plan. And you’re not going to end up with, you know, an impractical car or a poor decision that you’re like, oh, I really should have just asked this beforehand, right? So that’s, it’s really good. That’s interesting. I want to thank you again, Mahesh, for coming on the show today. I had a really good time interviewing you and learning about strategic wealth design. How can people reach out to you if they want to find out a little, if you want to be one of the three, or they want you to be one of the three?

MAHESH ODHRANI : Absolutely. They can go, um, they can Google my name. They can go to, uh, our website, strategicwd.com. And, um, on our website, there’s an initial consultation link as well. They can click on that. Uh, but they can certainly Google my name and they can find our website and find me on LinkedIn.

DIEGO TRUJILLO: Okay, fantastic. Well, ladies and gentlemen, that is strategicwd.com. Or you can look up Mahesh Adrani. That’s M-A-H-E-S-H-O-D-R-A-N-I. O-D-H-R-A-N-I. So close. Fantastic. I was trying to pull that one off. But yeah, look them up and reach out and ask questions. Like I said, plan to succeed in your life. Start asking the questions early on because more often than not, they’ll be able to give you advice right at the very beginning that will help you get to that success a little bit quicker. So lean on experts that know a little bit more than you do. And thank you very much again for coming on, Mahesh. Thank you, Diego. And we look forward to more podcasts, to get more information, and to be able to educate the community to make the best possible decisions for their lives. And I agree with you on one thing that you said. People don’t realize how financial decisions can impact their stress, their emotions, how you are as a husband, as a father, as a wife, even as a child, right? What decisions you can make that are going to lead to you being the best person? that is able to make the clearest decisions possible. So thank you again for coming on to the podcast. That is another episode of The Heals Pod. And we want to thank everyone that has joined us today to listen. Have a fantastic day.

 

Meeting Community Needs: A Conversation with Kenneth Moskowitz from JFSA

By | HEALS Pod, News

Diego Trujillo, the host of HEALS Pod, welcomes Kenneth Moskowitz from JFSA for an insightful conversation in this episode. Kenneth shares his journey of moving to Las Vegas and taking on the role of CEO at JFSA, a social service agency established in 1977. The discussion delves into the various programs and services offered by JFSA, ranging from adoption services to behavioral health support for individuals of all ages.

Kenneth highlights the importance of addressing the unique needs of the Las Vegas community, such as addiction support in a gambling-centric environment and assistance for the homeless population. He emphasizes the agency’s commitment to identifying gaps in services and expanding programs to meet those needs effectively.

The conversation also touches on the challenges faced by families, misconceptions about adoption, and the importance of providing comprehensive support for seniors, including companionship programs and services for Holocaust survivors. Kenneth discusses the agency’s approach to individualized care, focusing on the client’s needs and creating a supportive environment for both clients and staff.

Furthermore, Kenneth shares the agency’s recent initiative to establish a breast cancer support program, showcasing JFSA’s dedication to addressing critical issues in the community. The episode concludes with a discussion on future plans, including the development of additional addiction support services and a comprehensive social services network to streamline assistance for individuals in need.

Listen to the Podcast

Full Transcript

DIEGO TRUJILLO:
Good morning or afternoon, ladies and gentlemen. This is Diego Trujillo, the CEO of Las Vegas Heels, here for another episode of HEALS Pod. Excited to have with me Kenneth Moskowitz from JFSA. How are you doing today, Ken? Good, good. Thank you, Diego. Thanks for having me. It’s a pleasure to have you, not just here, but in the community. I have known of the work you do, though we have not actually met in person, so it’s a pleasure to be able to have a conversation, find out a little bit more about JFSA and what you guys are doing in the Las Vegas Valley. How long have you been in Las Vegas?

KENNETH MOSKOWITZ: The agency’s actually been around since 1977, so quite a while. All right, longer than me.

DIEGO TRUJILLO: I was born here in 1984. And how long have you been in Las Vegas?

KENNETH MOSKOWITZ: I’ve been here since 2015.

DIEGO TRUJILLO: All right, I’m curious, what brought you to Las Vegas? What was the plan?

KENNETH MOSKOWITZ: Yeah, I was actually working in South Florida, where I was running a JFS agency back there, and then went into a private practice, and then got connected with a headhunter, basically, that they were looking to bring in a CEO to the agency out here. And I came out here, it was just a great opportunity, and I’ve been here since then.

DIEGO TRUJILLO: How do you feel compared to Florida?

KENNETH MOSKOWITZ: It’s a little cooler here in the winter than I’m used to, but I’ve adjusted. A lot of work to do. Yeah.

DIEGO TRUJILLO: A little bit as a community. How do you find the comparison now that I bring up Las Vegas versus Florida as far as the organization? What did you do in Florida before coming?

KENNETH MOSKOWITZ: yes so uh… you know i was actually i was the ceo of uh… j f s which is a similar family service agency in south florida on broward county area the fort lauderdale area on similar type of organization similar type of services tried to meet the needs in the community for people that were struggling and uh… when i came out here uh… it was really uh… taking the agency that was in existence and building off of that and looking to continue to expand it to uh… meet those gaps for people

DIEGO TRUJILLO: It’s always fun. So you already had the CEO experience running the organization per se.

KENNETH MOSKOWITZ: Oh yeah, I’ve been in the field for the nonprofit field for many, many years.

DIEGO TRUJILLO: My curiosity lies then, what were the differences you noticed moving to Las Vegas? What were any key needs or shortages that you see here as opposed to Florida? At least with the families and the population that you serve?

KENNETH MOSKOWITZ: I mean, to a certain extent, it’s similar. You know, the needs across the country are pretty similar as you go from community to community. There may be various changes. For example, here, like addictions is a big thing. In the gambling mecca of our country, you know, you see a lot of people that are struggling like that. You know, big homeless population here, people that are out on the street and are struggling just to survive.

DIEGO TRUJILLO: Yeah, absolutely. And I guess the challenge for us is always, right, the paradox of this CEO is how do we navigate this with very limited budgets, limited resources, and how can we make the largest amount of impact? Right. All right. Well, fantastic. Well, welcome to Las Vegas. Tell us a little bit about JSFA here in Las Vegas.

KENNETH MOSKOWITZ: yes so i’d say if i say as i said you know was uh… has been around since nineteen seventy seven uh… started out as as a smaller organization providing a minimal services working with seniors uh… some emergency assistance and counseling uh… you know just trying to fill some gap in the community it did initially start out from the jewish community as a need to meet some of the needs within the Jewish community and over the years it has really expanded and grown to go well beyond that where we are here to really service anybody that’s in need.

DIEGO TRUJILLO: That’s amazing to hear. So you started kind of ultra focused and then expanded your vision from there.

KENNETH MOSKOWITZ: Absolutely, absolutely. You know, as an organization that gets support from a variety of sources, we get a lot of government funding. You know, it opened up that door for us to really be able to identify what are some of the gaps and needs in our community that weren’t being served. And that’s really what we, you know, we focus on is really identifying that and growing from there.

DIEGO TRUJILLO: Right. And looking to do the gaps because sometimes here in the Valley, we can really duplicate services quickly.

KENNETH MOSKOWITZ: Exactly. That’s something we try not to do. We really try to assess and determine where their needs are not being met, develop and build programs off of that, as well as if there are some services being offered, there may be parts of our community that are not getting that assistance, so we’ll see if we can jump in there and do something as well.

DIEGO TRUJILLO: Yeah, I remember even in my own personal life, actually, I took, there was a time I was delivering food, and it was kosher food deliveries, and I never had thought about it. When I went to go pick up some food, it was a part of a WhatsApp group from some friends of a friend that would go and play paintball and do different activities together, and one of them was like, hey, there’s these families in need. And when I asked them, I was like, well, isn’t there food banks? Because I would have to drive to North Las Vegas with a box of food, and they go, yeah, there is, but it’s not kosher, so the family can’t really, and they need to have it on a specific date. which is why the delivery dates were on Wednesday. So it was very interesting to see. I had never considered that very unique need within that community. And so it’s very interesting. I’m sure that informs you of the needs that you guys may have had as a community in expanding outwards, being able to identify those very specific needs of the different communities, which is important. I think here in Las Vegas, one of the differences that I’ve seen greatly, and many people have kind of given me feedback on, is the way that we’re very transient. A lot of people end up here. Right? Not a lot of people are born and raised here. And I realized this working in hospice, the amount of patients I would have that are like, yeah, you know, once I pass, just call this number and they’ll come and cremate me and that’s it. And I remember thinking, man, how sad that it would just end like that. And people, when I’d share this would say, wow, how often would you see that? Thinking I would say like once or twice a year, it was on a monthly basis. I would run into seniors that were going through this. So how are your programs segmented? How do you guys divide up the workload or the targets?

KENNETH MOSKOWITZ: Yeah, great question. Yeah, so what’s really, I think, unique and special about our organization is we provide services across the age continuum, really trying to fill those needs for people in all age groups. For example, we have an adoption program, which we work with both birth mothers that are looking to give up their child for adoption and making those connections to families that are looking to adopt. That program’s been around for about 20 years.

DIEGO TRUJILLO: How does it differ from what CPS does out of curiosity?

KENNETH MOSKOWITZ: Are you working with those different fostering agencies? Yes, so the difference is we don’t work within the foster care system. So basically what we do is there are young women that have a baby and feel that they’re not in a position to really raise that child and want to give it up for adoption. So they would come to JFSA and we would, you know, we would meet with the birth mother and then we would, you know, get information, speak with them about what their desires are, trying to understand, you know, to make sure that this is exactly what they want to do and feel comfortable doing that. And then when they are in that place where they’re ready to give up their child for adoption. We then also work with families that, you know, for their own desires to help them prepare and, you know, we go in, we meet with the adoptive families, we do a whole background assessment to just determine to make sure it’s a safe a good environment for a baby to go into, and then pretty much, a lot of times, women even come to us before they give birth. So they’re already in the process of thinking about adoption once the baby’s born. So we, a lot of times, we’re working with the birth parent while they’re pregnant, as well as the adoptive family during that period of time.

DIEGO TRUJILLO: That’s a very unique situation. How many? So it’s not even working in tandem. You guys are an addition to what already exists, at least on behalf of the government. You’re working because I know they’re overloaded. I mean, they’re swamped as well, so I’m sure they can benefit off this use. But being able to step in at the time that you do to ease the transition to prepare both parties. I have personal friends that have gone through very similar situations. that have adopted this way. And actually, they’re like, yeah, you know, their son is 14. They’re like, yeah, they’re going to go spend a month or two with their birth mother, and they’ll still go back. They maintain touch. So it seemed for a lot more fruitful of a transition for both parties, I guess, in the way they were able to work it out, at least. Do you find this with the families that you work with, or is everybody different?

KENNETH MOSKOWITZ: You know, I mean, each situation is different, so it really depends upon what relationship is developed from the adoption, whether or not they’re going to continue to have, the birth mother’s going to continue to have contact in some respect with their child. that they’re giving up for adoption. You know, some choose to have that and they work with the adoptive family. Others choose not to have that kind of relationship, you know, and sort of that’s the end of it once they give the child up for adoption. So we work with on both ends. We work with the, as I said, the adoptive family as well as the birth parent, trying to see what’s the best fit for everybody.

DIEGO TRUJILLO: And what do you think is the greatest challenge for families that you see or a misconception? Maybe there’s a family that’s listening that’s kind of considering, hey, I’d like to do this or this is a goal that they had set in mind. What do you think are some of the misconceptions that people might have regarding this or challenges they might not expect?

KENNETH MOSKOWITZ: Yeah, so one of the things, you know, that we look at when we’re meeting with adoptive families, you know, what is their reason for wanting to adopt? You know, it’s not like, well, we lost a child, so we want to sort of replace the child we lost or something like that. You know, we want to make sure that the reasons and their motivations for wanting to adopt is because, you know, for some they may not be able to uh… you know have a child of their own uh… you know one of the things for example as we were the first agency in uh… the state of nevada to do same sex adoptions so you know couples the same sex couples are looking to adopt as well uh… so what we think is that our goal is to really make sure it’s a good fit that the child is going into a healthy atmosphere that the reasons why they’re looking to adopt or or you know for a good Right, the proper reasons. Make sure they’re in a good place, a good foundation. Exactly, exactly. You know, they have the security, be able to provide safety and security for a baby and a child.

DIEGO TRUJILLO: That’s very, very interesting. What other services do you guys offer aside from that?

KENNETH MOSKOWITZ: You said the whole gamut, right? Yeah, we do. So then we have a very comprehensive behavioral service department, which has really grown over the last few years. And that consists of a number of programs. So we have a counseling program where we provide therapy to individuals, families, groups, from kids all the way to seniors that are struggling with dealing with some mental health issues or basic anxiety, stress, depression. In today’s modern world? Yeah, right. Can you believe it? It’s amazing, right? Yeah, so what we do is we offer services for people that are looking for that. We take a lot of different insurances. We also have a sliding scale because we understand that sometimes people may not have insurance or can’t afford to pay if you go to a private practitioner. So we try to work with people understanding their financial situation as well.

DIEGO TRUJILLO: Yeah, it can be a little tough. I don’t know. I was just recently going over the numbers provided by UNR and the state on the mental health. Over 80% of people in Las Vegas live in a health care professional shortage area for mental health. And I don’t think people understand these numbers. So when you start seeing situations play out in schools, play out at jobs, There’s a lot of stress. There’s a lot of stressors. Um, and even among younger people, right? The worries of, you know, the future they saw is very different than someone growing up in the sixties might see. Um, just the changing in the world, the changing of the job market, of the, just how tense everything is around the world. It feels like within the last year, um, and just that uncertainty that people are dealing with on a constant basis. What percentage of, of the behavioral health or mental health, what percentage of your services are focused on that? Do you guys kind of calculate where your, your resources are directed?

KENNETH MOSKOWITZ: Yeah, I mean, you know, as far as, like, our programming across the board, we have, you know, the majority of what we do is kind of broken out between, you know, like, young, the behavioral services, then we have emergency services and senior services. So there’s a good portion. I mean, we are in the process of growing our counseling program. But, you know, for example, one of the biggest things that we’ve been involved with, you know, with all this stuff happening out there in the world in our local community, these shootings, this nutty stuff happening, we have been really actively involved in stepping in and doing crisis intervention, kind of helping people that have experienced trauma and have gone through things like that. When we had that whole tragedy on the Strip a number of years ago, we went into one of the hotels and we did a lot of crisis intervention with the staff where it took place, providing support,

DIEGO TRUJILLO: Do you constantly, are you constantly finding a deepening need or do you feel like you can keep up? It would seem with most mental health providers that I speak with now, I mean just keeping up with the demand and staffing, it kind of feels like you’re fighting against the ocean sometimes.

KENNETH MOSKOWITZ: Yeah, I mean the challenge is getting qualified professionals, you know, that are available to provide that service. So that’s why I said we’ve really grown the program where we’re now, we have, you know, a number of licensed practitioners and we’re starting to expand looking at how we can also bring that service out into the community is one of the things we’re looking at. So if people cannot access our location, you know, going to the home if need be, you know, see, these are things we’re looking at to try to make it more available for people. And it is, it is a challenge out there, you know, from the more severe situations people are experiencing to people that are just, you know, having some challenges living day to day.

DIEGO TRUJILLO: Yeah. And I know I would run in, again, working. I, when I first entered healthcare, was a chaplain in hospice. And, and the amount of calls that I would get to senior facilities where they couldn’t really get out to get therapy or counseling. And they would just be people, again, we’re not talking about someone that’s a little, a little sad and they’re, you know, cause they’re 18, they haven’t figured things out. They’re 90 years old saying, everybody that I know that was alive is now dead. Why am I here? And I would find myself challenged on, well, what good answer do you have? Right? Well, you know, You know, what’s the purpose at this point?

KENNETH MOSKOWITZ: And so being able to have someone that would come in I know that that’s great need in our community Yeah, I mean you bring up, you know, you bring up a loss and and bereavement You know when you mentioned earlier that more and more people are moving out here and what we’re finding is this You know, this is becoming a retirement area. A lot of people are retiring to the Vegas area and And, you know, as they get older, those losses start happening. So, you know, really trying to identify what we can do to help those people, you know, live out their lives and deal with the challenges that they face just from aging in itself and then loss and stuff like that. So that’s a big part of what we try to identify when we’re reaching out and letting people know we’re available to provide support.

DIEGO TRUJILLO: Yeah, let me know when you’re ready to target the senior living facilities. That’d be a great… I know that’s a much-needed resource.

KENNETH MOSKOWITZ: Yeah, we definitely, you know, it’s one of the things when we look at what going forward down the road, housing, especially even with senior housing, is a major challenge in our community. Affordability, just availability, and that is something that, you know, we continue to identify where there’s a need, and our goal is to get more involved in trying to identify housing, affordable housing, different level of care housing for seniors, as they age, you know, trying to get people to age in place.

DIEGO TRUJILLO: You know, that’s the ideal. And it’s scary when you’re on, I see the world now, right? And I, there’s sometimes concerns on my part. I’m thinking, Oh my God, I’m 39, but I’m still 39. If I needed to put in a little extra hustle or grind, I have it in me. I couldn’t imagine for some of these people that are going through this on a fixed income. If you and I can complain about inflation and complain about how expensive things are. I can’t imagine if, if we were just set on $1,400 a month and that’s all we have.

KENNETH MOSKOWITZ: and that’s what we see a big part of in addition to the emotional challenges you know with the seniors uh… senior services that we provide you know we really see that that the you know making that decision do i buy food or do i pay for medication uh… you know how am i going to pay for my electric bill and still put food on the table and uh… you know these are challenges many people face but we see it so much more so in our seniors uh… you know and again health issues you know uh… as they get older and The idea is you don’t want to have to go into a living care facility or a nursing home if you can avoid it. Living in place, staying in one’s home is the ideal. So what we try to do from various programs that we have is really try to help people sustain and maintain themselves in their homes for as long as possible.

DIEGO TRUJILLO: Yeah, and I feel like community is a huge part of that, that’s sometimes lacking here. I was born and raised in Las Vegas, and yeah, that sense of community. Even when I went to go live in Central America when I was younger, it was funny. I’d tell people, I was like, wow, that’s so different. At the end of the day, everyone would pull their chairs, so they’d have either plastic chairs. They’d all bring them to the front of their house, and they would put water in the trees because it was so hot and humid. So they would just get the hoses and spray the trees down. It would cool the weather around, and all the neighbors would sit out and talk.

KENNETH MOSKOWITZ: which of course comes with its own challenges right uh… they they have a saying in spanish small town big hell but uh… but there’s also a lot of benefits to that absolutely you know that’s a great point you’re bringing out because community many uh… many individuals as they get older become isolated they they can’t get out as quickly as often so so they’re living in their homes also or or they’re cut off from social contact and we all understand how important it is to have that social interaction with other people. So, you know, a lot of our senior service programs are geared towards that. You know, for example, our senior companionship program, where what we do is we work with seniors that are volunteers, and we’re able to also pay them a stipend, because a lot of times they’re financially challenged, and what they’ll do is they go into homes of other seniors that may be a little more needy, Spend, you know, time talking, playing cards, you know, having, developing friendships like that because it’s serving a dual purpose. It’s keeping people that are our seniors that are active and also helping them through the stipends we’re able to pay while also having those shut-ins have some context.

DIEGO TRUJILLO: I mean, it sounds wonderful on every side. I mean, that’s very beneficial, even when people, and I always say this, right, when people are going through a loss or they were depressed, I would always tell them to kind of try and reach outside of yourself. I know you don’t want to, but if not, you’re going to sit there and meditate on your loss. If you focus on giving back to others, even when they’re, or especially when they’re in worse situations, it really brings a sense of gratefulness. I had a friend a long time ago tell me, you know, I asked him, what are a couple of lessons you learned through life? And he was a lot older than I, he goes, don’t ever wonder if it can get worse. It can always get worse. He goes, don’t ever. He goes, one time I challenged, I was like, all right, what else are you going to do to me? How bad can it get? And boy, did it get bad. And so I think that sense of companionship alone, I mean, giving people the meaning, that was one of my recommendations I would always give to people when I would have to go speak with seniors. I have a stack of Viktor Frankl’s book on a man’s search for meaning. I’ve almost forgot the title. And I would always tell people to read it, right? Because I believe it draws into a sense of purpose that each of us have, that we’re all created with, something that we need to respond to, even when situations feel very hopeless and there’s nothing left for us to do. And a big thing, a big part of that, right, is connecting to the community, is finding out what the needs of other people are. Because we could sit here, I mean, we could do a whole hour podcast on your problems and my problems, right? And we could all complain, but that does no one any good, right? But when we begin to step out of ourselves, begin to connect with other people that are in need, and the fact that you even provide a stipend for allowing people to do that, for me it was always fascinating as a younger person working with seniors to just hear the stories. I, as I mentioned, my degree is in theology, so I love history, and so to just hear people tell me stories was absolutely fascinating, because they were from all over the world, so I’d find out what it was like to grow up in the Midwest during the Great Depression, and and hearing stories about how this gentleman and his brothers used to go steal potatoes and how that’s how they had to survive to be able to make soup. And then hearing people from other parts of the world, right? Growing up in Brazil in 1950, what that was like. And I think it’s, you know, for chaplains, one of the things that CMS dictates that you have to document, right? And so as you would document, one of the things that we would do that was a recognized service we would provide was called life review. So just giving the opportunity of asking someone, so what was your life like? What was it growing up? And being able to extract gems, not you as a person coming in as a participant, but having them do that. That alone would be very therapeutic for people. And I realized early on, it helps to shift perspective, not on what you don’t have, but what you have had. Because again, it could always be much worse. And so that’s wonderful that you guys do that. How long has that program been going on? How big is that program?

KENNETH MOSKOWITZ: We’ve had that for a few years. We were really doing well building it up and then COVID hit, which I think we all realize.

DIEGO TRUJILLO: I took over a week before lockdown as CEO. That was my first gig.

KENNETH MOSKOWITZ: I can do this. So, so, so COVID, you know, was a period of time where, especially with seniors, you know, a lot of them were not going out. So, so the program kind of, you know, and we had, we had another, uh, uh, senior program, uh, same kind of thing with a volunteer, uh, what’s the grandparent program, getting seniors out into the schools, working with kids and supporting teachers. So during that period of COVID, it kind of took a step back, uh, just because people weren’t going out.

DIEGO TRUJILLO: People weren’t connecting with anyone.

KENNETH MOSKOWITZ: Right, so we’re back now, we’re building up again, we’re getting more seniors, we’re looking for seniors that are financially struggling themselves and are looking to do something but also maybe get a little support in helping to do that. So there is that opportunity for seniors out there that feel that they want to give back, they themselves can help another senior or get involved in the schools. A lot of retired teachers, sometimes they would get involved in being part of our Forced to Grandparent program. They have a lot to give back. Absolutely. A lot to give back. Absolutely. So it’s a really great volunteer driven program.

DIEGO TRUJILLO: Yeah, I’m 100% in favor of that. And just, I mean, when you think about humanity and oral tradition and what has been the entire history of human existence is listening to somebody older than you tell you stories, right? And the growth that comes from that as a younger person. And then again, the ability to be able to recite your life story and to be able to grow from that. What a really interesting program. I wasn’t even aware that you guys had that one. Yeah. And much needed. I don’t think there’s anything similar in the community that I know of.

KENNETH MOSKOWITZ: No, we are right now, we’re the only organization that provides those two programs, you know, the Foster Grandparent, you know, and the Companionship Program geared towards that.

DIEGO TRUJILLO: Yeah, I’d love to be of service. However, I can connect you if you need volunteers, whatever that is.

KENNETH MOSKOWITZ: That is amazing. This is something we definitely would want to support. Yeah, we’re always looking for seniors that are interested in giving back and also that can receive some assistance on their own. So we’re always looking for volunteers.

DIEGO TRUJILLO: What other senior services do you offer?

KENNETH MOSKOWITZ: So we have a Holocaust survivor program where there are Holocaust survivors living in our community that are aging and getting older and need help with in-home services, you know, help bathing, cleaning, shopping, also home care. We were able to provide home care where we have people going into the homes providing support to them and case management. So we’re sitting down, we’re meeting with them. We provide socialization activities, luncheons for them. You know, just again, you know, the whole idea is to age in place with any of our seniors. So we do that. We work with Holocaust survivors.

DIEGO TRUJILLO: Do you take part of the story? You just brought this to my mind. When I was in Israel, we were touring the museum at the Holocaust Museum. They were going over there’s a program where they had, where if you had survived, they wanted to record your story. Do you participate in that program, helping to record those stories and make sure that they get recorded?

KENNETH MOSKOWITZ: Yeah, we, we, you know, for, for a long time, we’ve been working with, you know, that organization that comes in and, um, you know, a good, good majority of our seniors and our survivors have already, you know, given their testimonials. Yeah, yeah, yeah. And, and if there is somebody that hasn’t, you know, we’re always trying to do our best to connect them up to, to be able to leave that legacy and explain, you know, their situation and what they went through.

DIEGO TRUJILLO: So you’re definitely not a sole mission focused organization. It’s very interesting to hear how robust you are and how you look to connect.

KENNETH MOSKOWITZ: Yeah. So what I was saying, you know, in terms of like, for example, going back to some of our behavioral services, we have a program which is called our Center for Assessment and Educational Services. And what that focuses on, you know, there’s a lot of kids that are struggling in the schools and, you know, need psychological testing, need to identify what the problems are, need plans in place so they can do well in school. So we offer a program where we work with the county schools, the juvenile justice system, the charter schools of the Clark County, where we provide psychological assessments to identify what may be the challenges that the child’s having. But what’s unique about us is we also do educational assessments. So what that means is not only do we look at the, from the developmental issues or challenges, ADHD or behavioral problems, we are also looking at what does that child need academically to be able to perform well and do okay in school. So between the two of that, We then meet with the families, we’ll meet with the schools, you know, we’re available to put a very nice comprehensive plan together and nobody else really does that. You go to a psychologist privately, plus not only will you pay more for a psychological assessment, but that’s all you’ll pretty much get. So, you know, we provide, you know, a much more competitive price. If somebody needs testing, it’s more affordable, plus we add that educational component.

DIEGO TRUJILLO: So you’re able to bridge that gap for people. I noticed, I think it was for me growing up here, my father was Colombian, and my parents were, the one thing they taught me as a son, the only thing that can’t be taken away from you is your education. So they would hammer on me nonstop. And my father would always set up, you reminded me right now, parent-teacher meetings. and I would always find out that they’re coming because the teachers would immediately start, all right, Trujillo, what did you tell your dad? And I was like, what are you talking about? Why does he want to meet with me? I don’t know. My dad just does this, right? And we’d walk in. It was very interesting. I just went through this experience with the teacher, which, I mean, for me, it’s sad because it’s reflective of the way of the world sometimes now. But I would sit and as I would talk to them, I sat with the teacher, and she did exactly what my teachers would do, which she came in with a binder and started saying, well, you know, Mr. Trujillo, I’ve been a teacher for 26 years, and I try to do this, and I try to do this. And I noticed her get very defensive, and I was like, listen, I’m not here to—you’re doing my job. My job as a parent is to educate, and you have partnered and taken over a very large role. The very least I can do is say, how can I help you, right? And she was very, very grateful. And it was the same thing when my dad would talk to them and, you know, they’d pull open this binder and start kind of going over everything. He’s like, what can I do as a father to help you? And immediately they’d close and be like, what? Because how many people weren’t doing that? Do you find, are you able to track the data on how students do afterwards? Because you’re doing a very important assessment. And then you’re also making that connection to, hey, here’s where they’re lacking. This is the, you know, the social detriments or the social problems that may be occurring. And this is how it could be course corrected. Am I correct?

KENNETH MOSKOWITZ: Yeah, yeah, yeah. I mean, you know, and we obviously we get feedback and from the parents, you know, in staying, you know, in touch as far as if there are continued ongoing challenges or things are not going the way they would have liked, you know, we’re certainly available to want to continue that relationship. in being there as an advocate for the child and for the family, if that’s the case, and really working with those teachers. And a big part of our program also is one of our staff in that program actually goes in and does training into the schools. You know, it’s available for the teachers if they want on looking for certain signs, how do you deal with certain challenges. So again, that program is pretty comprehensive. And not only is it available to, like I said, we have relationships with the school systems or whatever, but people privately They can contact you directly. They can contact us directly if they want their child tested, if they feel there’s some information they need. And again, what’s great about us is we approach it from a number of different ways, plus affordability, what we would charge for an assessment to get that taken care of is a lot more competitive than you may if you go privately.

DIEGO TRUJILLO: And how long would it take to, if I called today, about how far out are you on assessments?

KENNETH MOSKOWITZ: Not very long, you know, probably within a few weeks, getting that initial intake information, finding out what the issues are, what the challenges are, setting up the appointment with the psychologist. So, you know, you’re not looking like months and months and months down the road.

DIEGO TRUJILLO: Yeah, I mean, sometimes that’s what it looks like here in Las Vegas, or you hit the barrier. Sorry, I don’t take that insurance, or sorry, it’s too expensive. You guys are able to kind of remove those barriers.

KENNETH MOSKOWITZ: Yeah, we are. Like I said, our goal is to try to quickly identify with all our programs and services what the need is, what the challenges are, and do what we can as best as possible to step in and fill that gap and meet that need. Now, whether it’s us doing it or trying to find, if not us, who else in our community is in a position to do that. We collaborate with a lot of organizations and agencies. Our goal is to avoid saying no. Right. You know, being available and trying to do what we can for a person to resolve their challenges.

DIEGO TRUJILLO: And let me ask you this, circling back to you a little bit and finding out more about Ken, is this what you saw yourself doing when you were younger? What were the dreams and the aspirations? Yeah. Nonprofit CEO was up there in third grade.

KENNETH MOSKOWITZ: Yeah, exactly. No, you know, it’s interesting. I guess I was that kind of person when I was, you know, when we were kids that my friends would come to and speak to and talk to me about. You know, I would listen, and that’s something that I kind of fell into. Although I was excellent at math, you know, I was considering, do I want to go into mathematics, architecture maybe? I like drawing, stuff like that. And I just ended up gravitating towards the human service arena. I have my master’s in social work. I’m a licensed clinical social worker. both here in Nevada as well as in the state of Florida. I’ve done a lot of therapy and counseling, have always been in organizations or positions where I’ve given back and working with people on helping to improve their lives. And then I got my PhD in addictions counseling. So not only when I look at things, I look at it from two perspectives. I look at it from the perspective of helping that person, that one-on-one, what do we need to do to meet the needs that that first person’s challenged with? But I also have the experience and years of running an organization, looking from it, from that administrative perspective, doing it in a way that’s ethical, doing it in a way that’s fiscally responsible, and always making sure that we do it with respect and dignity in how we treat people. So I’ve had that, I believe that good balance of both the clinical or the direct service as well as the administrative.

DIEGO TRUJILLO: I agree. And working at different companies, I mean, you could definitely tell the difference. I’ve had companies where one of the places where I worked, right, would be led by a marketer. And it was very interesting working under someone that had moved up in marketing because the way that they viewed meeting the patient where they were, the way that they viewed going out and getting into the community was very different than somebody who had never been through that process. So I’m sure your background in social work and actually working with patients and resolving problems and helping them, their thought processes should very much inform the way that you dedicate your resources and how you allocate them.

KENNETH MOSKOWITZ: Yeah, and I think again, we really take the perspective at JFSA that, you know, it’s not taking that person and fitting them into our model, our mold. You know, which a lot of organizations and a lot of businesses do. You know, this is the way it is. This is the way we developed it. You either fit into it or take it easy.

DIEGO TRUJILLO: I always say jamming the solution down their throat like you’re fitting that square peg into the round hole.

KENNETH MOSKOWITZ: Where our perspective is, look, each person has their own individual, unique challenges and needs. And what we try to do is figure out what we can do to adapt what we do. to meet those individual components that a person comes to us with. You know, you can’t always do it, but we really try to put the person’s needs first rather than the agency’s needs first.

DIEGO TRUJILLO: Yes. I think it comes down to perspective, right? And that starts with leadership at the very top, is how are you going to shape your teams? Is it shaped towards how many numbers have we gotten through? How many people? What does the bottom line look like? Or is it going to be shaped more by your vision and what you’re trying to achieve? And I think what you end up with are two very different organizations if you only focus on one or the other. And so one of them will survive because they’re watching their bottom line, but may not be as impactful. But when you can walk that fine line in your leadership, to be able to keep the heart of the organization at all times. And even then, it helps people become fiscally responsible. When you have a leader that really cares about what they’re doing and demonstrates that, it really helps to add to the culture of fiscal responsibility, of doing what’s right at all times, right? And having people under you that aren’t scared to do the right thing because they may, oh, well, sorry, no, I told you you can’t work more than this, or these are the limits, right?

KENNETH MOSKOWITZ: Yeah, and absolutely, you know, and again, you know what, you’re hitting on such an important point as far as what I consider to be a successful nonprofit social service agency, you know, is certainly identifying the challenges that the person comes to with, setting up an atmosphere within your organization where the staff feel comfortable, where they feel that they can, you know, utilize their experiences and their own backgrounds in helping to work with somebody and not fearing repercussions. Having that dialogue, it’s not just from the top down, it’s across. And having that ongoing conversation and really a team. We focus on, we’re a team, and it starts with our board of directors, which we have a phenomenal board of directors, with myself, my management team, all the way down to the person who’s driving the vehicle, providing the service directly to the client. We really try to set that family-like atmosphere because the more comfortable you feel in your job, the more you feel content with it, the more passion you’re going to develop and the better you’re going to be able to help meet the needs.

DIEGO TRUJILLO: You know, I’m reading a book, and now that you mention that, you’re exactly right. In the book, they go over the employee experience. And it just focuses on, you know, we’ve been so focused on our revenue, and our revenue comes from customers, which means that we need to do whatever we can to bend over backwards for customers, that we have forgotten about the employee experience. And as a result, our bottom lines have taken a hit. And that’s one of the authors, that’s the thing they were mentioning was, you realize your employer’s the one that are delivering on the promises that you’re making. Um, as a leader. And if we don’t if we don’t have happy employees, they’re going to do very poorly on delivering on those promises, which reflect back on us.

KENNETH MOSKOWITZ: And you’re also going to have turnover. You’re going to have an over the revolving door. People are going to be continually coming and going, coming and going. You know, look, if you don’t take care of the people that are doing what the mission of the agency is, you know, you can’t say, let’s take care of the client without also keeping in your perspective that you need to also be available to do the same for the people that work for you. Absolutely. And I think it’s that emphasis, it’s that focus that allows us to be, I believe, as good as an organization that we are and as successful as we are in meeting the needs.

DIEGO TRUJILLO: And let me ask you for future plans. If you could wave a magic wand and open a new program, what needs are you identifying right now that you would say, you know, this would be a wonderful program?

KENNETH MOSKOWITZ: yeah well uh… i mean what do you have a few well yeah i think there’s always a few on one thing i just want to mention so speaking of needs just to let you know so uh… this within the last seven or eight months we we started a brand new program our breast cancer support program uh… and i bring that up because this kind of ties into the question you just asked is that somebody came to us that you know in a community that was going through her own experiences through breast cancer treatment and you know she was she was in a in a good position so she wasn’t struggling as much but when she was going for for her treatments, whatever, she noticed that there were a lot of people that were struggling, you know, financially having problems, a lot of emotional challenges. So she came to us and said, hey, this is what I’ve been seeing. Do you think this is something that JFSA can kind of look at developing a program to step in to provide help to these people? So we sat down, we did our analysis, like I said, we looked at it from all perspectives. Can we do this? Can we do it? Can we do it financially? Can we do it not duplicating? And we felt that there was a place for what we can do. So we developed a program where we provide case management, financial support to people that are struggling with going through breast cancer treatment. As a matter of fact, our last major fundraiser in November highlighted that program. We honored a couple of the cancer organizations out there, and we’re continuing to build and grow that. I mean, within six, seven months, we have like 25 people that have come to us. You know, we provide group, we provide the counseling. If somebody is struggling financially, we’re able to help in a certain respect doing some of that. It’s like I said, people that are going through cancer are struggling and challenged with not only the emotional, but a lot of concrete things. And our feeling was, we looked at it as what gaps were there and how can we help these people. And so far, it’s been great. And again, that’s sort of what drives our organization, is where is there a need out there that maybe isn’t being effectively Met by other agencies or we can do it. We felt maybe, you know, even more, you know unified and comprehensively Impactfully and that’s what drives how we determine services. So one of the things as I mentioned earlier We’re in we’re in a gambling Mecca. We’re in an addictions, you know, addictions is big you celebrate our vices Absolutely. Now, there are a lot of programs out there that provide addictions treatment, you know, no doubt. But we also feel that, you know, with our experiences, our background, we feel that there may be a place to develop, get more involved in that, developing some more addictions focused treatments. You know, I look at things that, you know, how can we comprehensively meet those gaps? You know, people like, for example, you talk about psychiatric services, You talk about counseling. You talk about financial assistance. A lot of times people have to go from one place to another place to another place. Well, my goal is to make it as easy as possible for people to get help in one place without having to run through all the red tape all over. So when we look at it, so we’re looking at possibly developing some of our services and programs where we can provide all of this in-house and what’s great about us is with all our departments and programs a lot of times somebody will come in door A and we’ll identify that they have a lot of other issues and then a lot of our other programs can help meet those needs and they don’t have to run around from here to here to here. Should be like a comprehensive social services network absolutely and we do a lot of that now like I said our emergency service department you know we have a you were one of the bigger food pantries in the community were able to provide crisis financial assistance of somebody is struggling to pay a bill mortgage rent. utility bill. We have a huge program now that we’ve developed called Second Step, which is getting people that are homeless transitioned back into their reintegrated back into housing. We’re one of 11 in our community that the county has identified to try to address this homeless issue. So we’re one of the larger organizations doing that.

DIEGO TRUJILLO: You certainly came into the community and took on some responsibility.

KENNETH MOSKOWITZ: Hey, that’s what it’s all about. You know, look, we have to really see, you know, what we, people, everybody has their own thing and their own struggles. Some of us more than others. And, you know, being able to provide that, that hand to lift somebody up is, you know, what I believe is what it’s all about. You know, helping our neighbors, you know, help neighbors, helping neighbors. being there to really help people’s lives that want a better life, doing what we can to provide assistance and guidance when necessary to help them get there.

DIEGO TRUJILLO: Yeah, I’m 100% on board with you, right? Our obligation to the common man, our obligation to society, and it doesn’t matter, for me it’s very interesting, right? With my theology background, there’s an obligation on a religious side, but even when you look at secular philosophies, it’s just awakening to the idea that we all have an obligation one to another. And I think when people kind of take that attitude a little bit more, I always mess with people, because Human beings are very interesting in that. If you ever ask somebody, are you a good person? They’ll always say yes. I have not come across a person, no, I’m a terrible person and I’m committed to it, right? It doesn’t matter who you ask. Everyone feels self-righteous or justified in their decisions. And then I always hit them with the, well, are you a generous person? Oh yeah, absolutely. Why? And just waiting for that. And it doesn’t even have to be financial. You may not have money to give, but many of the services you described, companionship, that pays you to donate a little bit of your time. And sometimes very small acts on our behalf as human beings can make such a large difference in people. And sometimes even knowing we’re not alone, both my mom and my sister are actually breast cancer survivors. And watching, I try to think about it as a man, because I’m very practical about it. But then stepping out of myself, right, seeing as my sister was going through the double mastectomy, of how that change was affecting her as a woman. And I’m thinking very utilitarian and practical, like, well, you already had children, all right, well, they’re gone, and you know. But obviously, it was a lot deeper than that. I’m not that insensitive. But I think it’s something that, unless you have gone through it, it’s very hard to identify. It’s the same thing with the loss of a child. You could have the best therapist, counselors, anyone step in. They’re always going to have a wall thinking, yeah, but you haven’t been through what I’ve been through. You have no idea what you’re talking about.

KENNETH MOSKOWITZ: You’re absolutely right. I think we all have that tendency to think we are the only one who has experience. Nobody can understand that. To a certain extent, that’s true. But when we try to look at it that there are resources, there is support, and people start realizing, you know, maybe there are, maybe not identically what I went through, but we can share similar things. It helps people get through that challenge, get through that grief, whatever it is that they’re dealing with. And that’s a big focus of what we try to do through the various services. And we’re very volunteer driven. A lot of, like I said, we have food. One of the things with our food pantry, just to kind of circle back real quickly, is that not only can people come to us for that, we bring it out to the community. We deliver all over the community. If somebody can’t get out of their house, whether it’s a senior or a family that’s struggling, You know, all they need to do is reach out to us, and, you know, we will do that where we can reach out and bring food to them, and that’s a big part of what we do.

DIEGO TRUJILLO: Let me ask you a question. This is probably the most important one for everyone listening. You’ve mentioned various times how easy it is to reach out to you guys to be able to find these services. How can people reach out, whether it be to volunteer or whether they’re going through need?

KENNETH MOSKOWITZ: Yeah, I mean, the easiest thing is if they go to our website, which is JFSALV.org, you go on there, you’ll see all the services and programs. You can send an email through our information on there, and we’ll get that if you’re interested in volunteering, if you’re interested in helping support the agency in whatever way that is. Also, if they call our number directly, 702-732-0304. and you just call up, say, I’m interested in doing this, that, or the other thing, and that information will get to the right person, and we’ll do what we can to connect you and hook you up.

DIEGO TRUJILLO: That’s amazing. Yeah, right? We’ll put you to work.

KENNETH MOSKOWITZ: Right? There’s plenty of work to do, right? Exactly. Just roll up your sleeves and dial the number. 100%. You know, as I said, for us as an organization, yeah, we do provide services. We do charge fees for various services here and there. We do get donations. One of the biggest things we’re now looking at is trying to branch out into the corporate arena, corporate sponsorships. you know, giving back to the businesses, giving them their opportunity to show the community what they can do, what they’re willing to do for the community, while also helping an agency like JFSA to, you know, be able to take those funds that they may support us with through a sponsorship and give back to the clients that we serve. So we’re really looking to branch out within the corporate, the private, you know, donor Because, like I said, support for a non-profit is so important. Sometimes people don’t even realize that. Even the smallest amount, just giving back, it makes you feel good. Plus, it makes such a huge difference for those that really need the help.

DIEGO TRUJILLO: Absolutely. And I think a lot of people sometimes are hesitant with so many non-profits popping up. So, I’m sure the history, you mentioned 1970. 1977. So, 47 years. You know what you’re doing at this point.

KENNETH MOSKOWITZ: Yeah, yeah. I’m willing to go on record to say I’m pretty confident that You know, any support we get, you know, you look at nonprofits, you know, in terms of, you know, how their money goes out into the community, you know, based on the dollar, what percentage actually goes back out. Well, 88 cents on the dollar, 88 cents to 90 cents of a dollar goes back directly to the client. to really help provide that support. Many, many non-profit and organizations can’t say that, you know, because more goes into just, you know, running or the overhead, things like that. Yes, every non-profit needs that support to keep the doors open, the lights on, the people, you know, working to do the work, but yet most, the majority of the funds we get in go directly back out into our community, and that’s what I think people who want to donate and give, you want to make sure that you’re giving to an organization that they can comfortably say and show that, yes, the money you give is going to go work back into the community. Is making a large impact, right?

DIEGO TRUJILLO: Absolutely. And I agree with you 100%. I mean, it’s the same thing with investing. If I said, hey, you can invest in this place and you’ll make $0.10 on the dollar, or this one will make $0.90, it’s the same thing when it comes to how far of an impact is my money having, right? And so knowing that there’s an organization that’s been around since 1977 that has been making an impact and that is still continuing to expand its services, it doesn’t sound like you’re slowing down, Ken.

KENNETH MOSKOWITZ: No, no. As a matter of fact, we were able, fortunate enough to buy a building a couple of years ago, and now we’re looking to expand beyond that. You already outgrew. That is great. That is good news. It’s not great, but… It’s a great problem to have. As I said, we’re doing it in a responsible way. We’re doing it by making sure that the services are going to continue to be of high quality. making sure that we’re doing it fiscally responsibly, but we want to continue to do what’s needed to fill those gaps where there are challenges and problems out there.

DIEGO TRUJILLO: I’m not going to lie to you. I knew some of the services that you offered. It wasn’t until this conversation that you really began unpacking, I realized how in-depth you guys are. I mean, and you’ve had time to think about which way do we want to grow, but that is incredible to hear you guys, the impact that you’re making in the community. I just wanted to, before we close out, just remind everybody If they wanted to look up JFSA, it is JFSALV.org, and then you can click on services to find out what services, or you can get involved. Click on the button that says get involved, and get involved as a volunteer. It doesn’t always require money. A lot of times, it’s just people that are volunteering, and from what it sounds like, Ken, there’s a lot of people that do that.

KENNETH MOSKOWITZ: Absolutely, and we’re always looking for volunteers. We’re always looking for people that want to give back, you know, in whatever way they feel they can. We’ll put them to work. Yeah, we’ll never turn down. We’ll find something for you to do. There is a need.

DIEGO TRUJILLO: Right. That is great. And the phone number for that, ladies and gentlemen, is 702-732-0304. Well, I want to say thank you very much to our guest today, Kenneth Moskowitz, that has come and joined us from JFSA. Really did a wonderful job explaining all your services and kind of sharing the way that you guys are headed. I’m very, very excited to know that you’re in our community, continuing to make an impact. and building out these services that are making a difference in people’s lives.

KENNETH MOSKOWITZ: Yeah, again, thank you for helping me. Thank you for helping me. Thank you for offering me the opportunity to come speak today. And as I said, you want to find more about us, please reach out. I’ll be more than happy to go have a cup of coffee with you and tell you about the great work we’re doing. And yeah, we just really appreciate the support we get and we hope we continue to do so.

DIEGO TRUJILLO: Excellent. And so you heard, ladies and gentlemen, if there is a company, if you own a company and you’re interested in supporting on a larger level or getting involved, there is opportunity for involvement, or even if you’re just an individual that would like to give back a little bit of time. It sounds like JFSA could put you to work and could put you to work effectively, from the sound of it.

KENNETH MOSKOWITZ: Right. And also, if you are a company, you’ll get that opportunity to put your name out there to show how you support the community. So we understand partnerships, collaborations, working together.

DIEGO TRUJILLO: That is wonderful. Well, thank you very much, Kenneth. I appreciate you coming on the show today. It’s been a wonderful pleasure speaking to you today.

KENNETH MOSKOWITZ: Thank you for having me and I really appreciate it. Thanks.

DIEGO TRUJILLO: And with that, ladies and gentlemen, we sign off today. Thank you very much for joining us on another episode of The Heels Pod.

Empowering Healthcare Leaders: A Conversation with Kimberly Grana

By | HEALS Pod, News

In this special episode of our podcast, I had the pleasure of interviewing Kimberly Grana, the Vice President of Valley Oaks Medical and the newly appointed President of the Healthcare Leaders Association of Nevada. Kimberly shared insights into the formation of the Healthcare Leaders Association and its focus on local healthcare efforts.

We delved into the importance of community in healthcare, discussing how collaboration and communication among healthcare providers can significantly impact patient care. Kimberly emphasized the value of having a strong network of healthcare professionals who are dedicated to putting patients first and working together towards a common goal.

The conversation also touched on the significance of creating a positive work culture within healthcare organizations. Kimberly highlighted the importance of leadership, transparency, and accountability in fostering a supportive and engaging work environment. She shared her experiences in managing teams and emphasized the role of effective communication and resourcefulness in problem-solving.

Additionally, we discussed the upcoming “Beating the Odds” annual conference hosted by the Healthcare Leaders Association. The conference aims to bring together industry leaders, subject matter experts, and healthcare professionals to discuss key topics such as billing, culture, staffing, and industry trends. Kimberly expressed her excitement for the event and highlighted the valuable insights and networking opportunities it will provide for healthcare leaders in the community.

Listen to the Podcast

Full Transcript

DIEGO TRUJILLO:
Ladies and gentlemen, this is Diego Trujillo, the CEO of Las Vegas Heels, here with a special episode, a good friend of mine that is joining me from Valley Oaks Medical. She is the vice president, Kimberly Grana. How are you doing today?

KIMBERLY GRANA: Very good. Yeah. A longtime friend and Las Vegas native, much like you.

DIEGO TRUJILLO: Las Vegas native. You know what’s funny? I just, the last person I interviewed was also a Las Vegas native, but we always get very excited.

KIMBERLY GRANA: My, my family, my children are the third generation born and raised.

DIEGO TRUJILLO: So funny thing. We said the exact same thing because he was first generation. I was like, you know, you never meet anyone that’s a Las Vegas native. He goes, and when I told him, I was like, when you do, they have three, four generations here. And we started laughing and sure enough, what lands into the studio? Well, it’s fantastic having you here today. How has, uh, how’s your morning been? Your commute went well?

KIMBERLY GRANA: I’m right down the street from you, so it’s actually lovely.

DIEGO TRUJILLO: It’s wonderful. Have you been a lot of stress? We have some announcements that we want to discuss today, right? Because we saw something pop up regarding the Healthcare Leader Association of Nevada. It is. And so we saw your recent appointment as president. Is that correct? Yes. And I immediately thought, hmm, I don’t know anything about this. I would love to learn more. And I figured if I knew about it, I’m sure people would like to learn a little bit more about what the Healthcare Leaders Association is. when it was founded, what you guys do, and kind of digging a little bit about what you guys have cooking along.

KIMBERLY GRANA: Thanks for bringing me in. I appreciate it. The Medical Group Management Association, the MGMA, has a national organization and then we had a small local following. They’ve kind of taken a pivot where they’re going away from local and they’re focusing more on national and organizational memberships. And so as an organization and a local, I was the president of the Nevada MGMA, we felt that really local healthcare and having that local presence is so detrimental to what we do on a day-to-day basis, that we actually broke away from that and started the Healthcare Leaders Association of Nevada. And we just view this as an incredible, just incredibly exciting opportunity for us as healthcare leaders to step to the front and come together as a profession to lead our community. We have decided to make this change because Healthcare is local, and it’s important to keep education and efforts at a local level.

DIEGO TRUJILLO: And I couldn’t agree with you more, especially when you’re talking about Las Vegas. And you’re born and raised here. We have a different mentality culture kind of growing up, but when it comes to healthcare and just the industry in general, it’s always very interesting to watch people come in from the outside. because they’re very confident, rightfully so, because we dominated Texas, and then we went into New Mexico, and then we hit Arizona, and they just come and make a splash, try for two years in Vegas, and just, what’s wrong with this place, right? And it’s not that there’s anything wrong, we’re just very localized. There’s a lot of preferences, people, et cetera, of how we operate. So having grown up here in Las Vegas, do you feel that gives you insight into how that looks? How did you end up at this position? I wanna take a step back with the healthcare leaders of America.

KIMBERLY GRANA: Association. Geez, it’s like three degrees of separation. It’s a very, very small healthcare community here in Las Vegas. There’s what, over three million people, but a very small healthcare community. And I think people have long memories. And when you have proven that you are good at what you do, that you can prove that you’re going to do what you say you’re going to do, that resonates and having that trusted partner that you can rely on is invaluable. I think that’s anywhere.

DIEGO TRUJILLO: Is this something that as a child even you were like, you know what, I need to be a person that does what they do. What was your formation in that? How did you land in this role? What did you find yourself? We mentioned earlier, right, the vice president of Valley Oaks. Is that where you started in healthcare?

KIMBERLY GRANA: Oh, absolutely not. I was going to change the world. I was going to be a doctor. I was going to save everybody and everything. And then I was working at St. Rose Hospital, DeLima, because that was only St. Rose open way, way back in the 90s. And I was working bed control and admitting.

DIEGO TRUJILLO: Was this your first job in health care?

KIMBERLY GRANA: It was my first job in health care, and I was studying for my MCATs that weekend. And an OB-GYN came in, and she was sobbing. And she was like, I never see my family. She’s like, do anything else in health care. You saw the cost. Like struggle.

DIEGO TRUJILLO: Yeah. Is there another way to save the world?

KIMBERLY GRANA: Yeah. So I pivoted. I went into ultrasound. My degree is in ultrasound. I started working for, um, at St. Rose hospital. I worked into ultrasound for many years. I worked there for, um, for 13 years and then I worked for a cardiologist for, um, 18 years and I just, I grew up through healthcare.

DIEGO TRUJILLO: At what point—so you’re now the president of the Leaders Association, the Healthcare Leaders Association. At what point did leadership become something that you either found an interest or a talent or a knack? At what point did you start realizing, huh?

KIMBERLY GRANA: It was so funny because I was just doing ultrasound in someone’s office and they’re like, you have it together. You’re raising your family. You have these great kids. You can run my practice. That’s just an easy transition. You can just go from running your home to running a medical office. But I jumped in with both feet. And I’ve always kind of been extra. If you’re going to do something, do it 110%. Go for it. So I just took that in. And I right away joined the MGMA, the HFMA, the ACAG. And I formed my community. I’m like, if I’m going to do this, I’m going to need resources. I’m going to need family. I’m going to need a community. That’s very interesting.

DIEGO TRUJILLO: So you immediately identified the need to have that support system in place to help you grow.

KIMBERLY GRANA: Absolutely. And so I started on this journey and I went and I found subject matter experts. I went to people who are industry leaders already. How did you do that? What do I do here? What do I do in this situation? And they really helped mold me into the leader that I am. And I think that our Healthcare organizations as a whole, the Nevada Healthcare Forum, I’ve been on that board for six years. They have an incredible organization. They do a wonderful event every single year. They bring the community together and they help educate and kind of create just the next leaders in healthcare in Las Vegas and I appreciate that.

DIEGO TRUJILLO: And I think that community is incredibly important. I mean, and aside from the, it’s lonely at the top, and all those, right, more traditional sayings, when you’re shaping a community, right, you typically have two groups of people. The ones that will, you know, complain about it, right, which we’ll see. I think it’s funny, we were just talking, someone posted something on Facebook, like, doing nothing but complaining, and someone shared it to me. And I was like, wow, I wonder what they’re actually doing, aside from making a post, right? So all you’re doing is kind of complaining in public. And there’s people that go, man, something has to be done, right? And kind of roll up their sleeves. And you find yourself frustrated. I know for me, sometimes I feel like the little red hen, just asking, who will help me pick this weed? Who will help me? And then it’s just, who will help me eat the bread? Oh, yeah, yeah, we’ll help you eat the bread, right? And so it gets a little frustrating, but being around like-minded people, what environment did that create for you? Where do you think that really started? Did it change your thought process, your mentality? Was it the resources? What do you feel was the most important at connecting with those communities?

KIMBERLY GRANA: I’ve always been the kind of person where there’s a problem, there’s a solution for every problem. There just is. We just have to figure it out. And if you get really bright people in a room, you can sort through. I really don’t think there’s anything you can’t work through. So I have always believed that. And having this forum full of really bright, intelligent people who are problem solvers, who know the landscape, because healthcare becomes, you know, putting out fires. And I want to, and while that’s necessary, there’s also a point where you can be proactive and learn from people who’ve already been there, done that. And I’m big on, Especially in Las Vegas. Yeah. I don’t want to make my own mistakes. I want to learn from your mistakes. I’m going to make my own. I know it.

DIEGO TRUJILLO: What was the expression? A wise person. What is it? A fool learns from their own mistake. A wise person learns from other people’s mistakes. Correct. So it’s good to be in that environment. At least you’re able to learn from those experiences. So what landed you eventually at Valley Oak? So you’re telling us, right? You were for 18 years in a cardiology office?

KIMBERLY GRANA: Yes, and then I went and I started consulting on my own. I moved around a little bit and I had a very, very good friend named Sherry who decided to take on this private equity group. Someone had just gone and bought a bunch of medical practices with You know, just thinking that’s how you do it. You just go and you buy medical practices, right? There’s no standardization. There’s nothing that has to go into it. They’ll run themselves. No. So she brought this incredible team together and we dug in and really cleaned it up and then that individual sold. Valley Oaks to Apollo Medical Holdings, which is a billion dollar company that’s publicly traded out of California. They have IPAs mainly. So they’ve been in that market. And we were their first like clinic group.

DIEGO TRUJILLO: And IPAs for everyone listening that might not recognize what an IPA is.

KIMBERLY GRANA: Good question. It is an independent physician association. So it’s a group of physicians that come together and create a small, narrow network to provide really great care. Some people would refer to these as HMOs, but common ones here in Nevada, just as a basis of comparison, would be like P3. Optum, and so you have the certain providers that are within that network, and you stay to your network. It’s like a referral.

DIEGO TRUJILLO: What’s the benefit of staying within that network out of curiosity? Some people find frustration in that, right? They find it limiting, and I want to have choice, but there are benefits to having that network, correct?

KIMBERLY GRANA: 100%.

DIEGO TRUJILLO: Well, what are some of those benefits?

KIMBERLY GRANA: So the benefits are, so we participate in value-based care. And everybody talks about value-based care. What is value-based care?

DIEGO TRUJILLO: We only have four hours for the podcast.

KIMBERLY GRANA: No, I’m kidding. I’m joking.

DIEGO TRUJILLO: You’re like, let’s dive in. No, but this is very important stuff.

KIMBERLY GRANA: So value-based care? So the government, for so many years, had done this fee-for-service, where you’re sick, and you go to the doctor, and they’ll reimburse you for whatever services you provided. that’s

DIEGO TRUJILLO: For me, right, my parents are both Colombian, and I was around a lot of Hispanics, and there was always this perception of, yeah, all they wanna do is just treat you, treat you, treat you, treat you, and I would, even now, they’ll bring that up, I’ll be like, yeah, that may have been the case in some places at some time, this is the reason why value-based care is kind of changing that, and I’ll explain, right? The incentive is, did they get healthy? Do they need to come back every week for a Band-Aid? Something’s wrong, why is it not healing, right? So a lot of questions, get asked, instead of treating patients would being the incentive, the main incentive shifts over, right? Where it starts focusing more on what are the outcomes? What are you doing? Do you find that to do much easier in a group?

KIMBERLY GRANA: Oh, absolutely. Especially having the backing of, you know, your corporate partner. We’re opening an innovation clinic just down the street.

DIEGO TRUJILLO: That sounds very exciting. We just did an episode on innovation mentality here in Las Vegas.

KIMBERLY GRANA: I love it.

DIEGO TRUJILLO: And we’re having, they’re bringing in an innovation expert. from Sweden to come speak on the mindset that it takes to be innovative as a city, as a society, as a culture, and as a business.

KIMBERLY GRANA: Just now that you bring that up. So I already love the name. Yeah, I will definitely be part of that.

DIEGO TRUJILLO: And this is recorded at the Blackfire Innovation Center, right?

KIMBERLY GRANA: Nice! Okay. That’s exciting.

DIEGO TRUJILLO: So what is your innovation clinic? I’d love to hear more about this.

KIMBERLY GRANA: So what we did is we took our corporate office of Valley Oaks Medical Group, all the primary care clinics, the MSO, this supports services for the clinics. We provide billing, medical records, prior auth and referrals, things like that, the services to take out the administrative burden from the office. So we provide that at our corporate office. And then we also have a clinic. And so let’s think of something. Oh, we had this company who was like, we can help you provide this incredible service to your really, really high risk patients by putting devices in their home that listen to their habits. It’s not, we’re not looking, there’s no cameras, they’re nothing. They’re just microphones that listen to how many times they flush a toilet, that listen to their cough and listen to the cough progress. And then they notify us and we take action immediately, almost like a chronic care management to the next level or something. And they use smart home technology. to do all these incredible things and help improve longevity and improve patient outcomes.

DIEGO TRUJILLO: must be a little challenging seeing that older generations read the book 1984. So you want me to put microphone. I think once you explain the benefits of it, they’re like, okay, this actually makes sense.

KIMBERLY GRANA: Well, that’s just something like we’ve been fed. There’s all these really cool, innovative ideas. That’s just something else. There’s also scribes where it’s AI listening to you do your notes. So you literally are just focusing on your patient, talking to them, having a conversation, and then AI is generating your note and closing those gaps.

DIEGO TRUJILLO: So you’re just executing on new technologies.

KIMBERLY GRANA: And new technologies and then also automating things. There are so many things we do in life that can be automated.

DIEGO TRUJILLO: Yes. You know, there is someone I’ve been working with for a while and I kept telling him about technology. There was kind of a fear and apprehension of like wanting to learn the technology. I was like, look, if you just learn, I know just watch a 12 minute YouTube video and just look up tips and tricks on this application. And sure enough, the person calls me the next day and they go, oh my God, you’ve been telling me this for months. I just watched the video. I’ve been copying this over three different times and writing it down and blah, blah, blah. And I was just like, yeah, technology can make your life a lot easier. I think everyone’s learning that with AI.

KIMBERLY GRANA: I think so. And I think there’s that unknown factor there. And I think I like to explain it to people where I’m like, OK, remember the very first time you got a smartphone. And every time you get a new smartphone, and there’s that intimidation factor, but like after a few weeks, you’re like the pro of that smartphone. You have mastered everything. You’re constantly finding new tips and tricks, and it’s just, that’s how everything will be.

DIEGO TRUJILLO: So I do that every time a new iPhone comes out. Every time the operating system updates, I’ll look up tips and tricks videos, and people are like, I didn’t know the iPhone could do that. Yes, you know they’re paying people billions of dollars to make this thing better constantly, and you’re trying to use the two-year-old version of it. So that doesn’t make sense. Right. So you’re applying this mentality then, right? This innovative mentality. What are new technologies? How can we make patients’ life safer? How do we make it easier? How do we provide better care by listening to how many times they flush the toilet? Which may sound like something very inert, but there’s a lot of things you can do with that data.

KIMBERLY GRANA: Yeah, kidney disease, renal disease, you can tell their volume overload, they’re having to run to the bathroom, you can save them before. There’s so many things, right? And so many ways that you can help improve something.

DIEGO TRUJILLO: Is there anything like this in Las Vegas right now?

KIMBERLY GRANA: No, not that I’ve ever heard of before. That’s why you have the name Innovation Center. How exciting. It’s just, that’s just one thing. And there’s tons of things. Honestly, we get approached by multiple companies and we get fed people through our corporate offices that are like, oh, I heard about this thing. And they’re at the East Coast and they’re nationwide. So they’re all over, and to be honest, Las Vegas is like 10 years behind the time, or the Wild West out here for sure. I’ve always heard that.

DIEGO TRUJILLO: Yeah. You know, this is the one exciting thing, and I will make this, because people always bring up the low numbers, and well, you know, 48th in the nation. I’m like, you know, the nice thing in knowing that is a very small effort will really move the needle. I mean, getting from 48th to 30th is a lot easier than getting from 7th to 3rd, right?

KIMBERLY GRANA: Yeah.

DIEGO TRUJILLO: And so it’s very interesting because you have these new technologies that you’re kind of getting fed from around the country, being able to apply them. I’m very curious to do a follow-up in a couple of years to see what the data is reflecting and what you guys are showing in your patient population. That’s got to be very exciting to kind of pioneer that.

KIMBERLY GRANA: It’s so exciting. We’re looking forward to all of the innovation and bringing these things on. And having that one clinic where you pilot it, you don’t just set it out for all of your 20 clinics all over the Valley. You pilot it in this one. You really get some feedback. And it takes a special person to be at our innovation clinic who’s willing to work with us and give us the feedback. And we want to do what’s right for our patients and for our employees and our physicians, everybody as a whole.

DIEGO TRUJILLO: So do all of your clinics refer a specific patient with a need? Do they try to tell them, hey, you know, we have an innovation clinic. If you’d like to try that out, they have this new technology? Or does the innovation clinic work with all your clinics?

KIMBERLY GRANA: Kind of both. I think all the things. We have a really cool integrated health model where we have doctors and mid-level providers who really specialize in different things. And so we advertise that all over our website and let them know, hey, if you need women’s health services, we have somebody who loves that and specializes in this. If you need joint injections and trigger point injections and knee injections, we have a doctor who loves doing that. And so you can pinpoint what you need, we can have referrals from within, or you can just look at the clinic that’s closest to your house and we have amazing providers.

DIEGO TRUJILLO: That’s got to be one of the exciting things about having this IPA that you had mentioned, right? This group of providers is that each one of them can specialize in a different area or push in a direction. And not just that, but as we learned in Las Vegas, right? How do you communicate that to other people? Do you need to pay someone $75,000 a year to run around and drop off flyers? Will that be effective when there is a really good solution? It’s easier to just have that network and let everyone know, hey guys, I’m doing this now. If you have any patients that can do this, right, they’re able to get the information out. It makes it more effective and more efficient.

KIMBERLY GRANA: Absolutely. And then being able to communicate that via online portal, like just you have your website, you have Instagram, you have LinkedIn, and you’re getting out the awareness. You’re making sure that the public knows about you, knows where you are, knows the services that you offer. It’s not just everybody kind of offers some things, but who offers specific things? If you don’t know, you end up going to, you know, A jack-of-all-trades. Yeah. Or some very expensive specialist for something very small that could have been done at a primary care clinic. Like, oh, I have to get this. I have a skin tag, and I want it removed. A lot of primary care doctors can do that. I could just walk in. And we have some that love cryotherapy, and they’re doing all these cool different things. But how would you know that? Yeah. And then besides letting people know how all the services that you offer, getting the feedback from them on how they like the services. And technology has arranged for… Look up our clinics. We all have 4.8 Google star ratings and hundreds and hundreds of them. People like the services.

DIEGO TRUJILLO: Where can they look up your clinics?

KIMBERLY GRANA: Well… Let’s do that shameless… Let’s do the shameless flag. We are at valleyoaksmed.com.

DIEGO TRUJILLO: Valleyoaksmed.com. That’s where they can find out about all these technologies, the innovation center, the locations of the clinics.

KIMBERLY GRANA: Absolutely. And actually Valley Oaks has been super supportive of the MGMA and the HLA and they host events. So we have monthly meetings at the Valley Oaks conference rooms. You can come on up. and get free education for healthcare leaders and executives, managers, supervisors about lots of different healthcare topics. We just went over HIPAA compliance and security at our last meeting, and we had an incredible subject matter expert come in and just speak to everybody. Scare everyone? Yeah, it’s true.

DIEGO TRUJILLO: Everyone’s like, wait, yes, it’s that serious.

KIMBERLY GRANA: I know, I never thought of this. And it’s so great because there’s so many people participating that they’re like, oh, I did this. And you’re like, oh my gosh, I never thought of that. Just so many different things. I’ll give you a for instance, just for anybody listening. For those of you who don’t know what a business associate agreement is, you should have business associate agreements with everyone. And we went through. People didn’t know they should probably have one for even the drug reps that come in their office because when you’re talking to your physician, you’re going to say something about one of their patients that they happen. So get the business associate agreement with them. Get it with your IT company. Get it with your cleaning crew. Get it with all these different things. You can never be too safe.

DIEGO TRUJILLO: Yeah, and it helps to protect. And I think the nice thing about subject matter experts is they kind of paint sometimes the worst, because they see the worst stories on a continuous basis. So things that would never occur to you. And they’re like, well, actually, there was this doctor in Michigan. And then you go through and you’re like, oh, my God. Yeah, I don’t want that to happen. And it’s very small things that you could do that could really improve the safety of your operation.

KIMBERLY GRANA: Absolutely. It’s those things. And then it’s just learning tips and tricks for just medical group management and just being part of a medical group or a small doctor’s office to help manage it better. Because you’re surrounded by a community of people who’ve been there, done that for years and years. So you can benefit from their knowledge and the things that they’ve been through.

DIEGO TRUJILLO: And what you were saying earlier, for the people that are just starting early in their career, right? To be able to get connected to a community of people that really face the same problems, just because you’re new doesn’t necessarily mean that you don’t know what you’re talking about or you don’t have any good ideas. We all learn from each other, and I think that’s kind of the critical part.

KIMBERLY GRANA: Absolutely. I love that. I love when somebody comes in. Well, in school we talked about, really? I never learned that in school. I had to learn it on the job. Now we’re teaching. Yeah, it’s pretty great.

DIEGO TRUJILLO: So you guys have an event coming up. You mentioned that Valley Oaks has supported you with your work inside of the MGMA, which is the Medical Group Management Association, as well as the HLA. Now that the HLA is kind of pushing, I’m seeing you guys had an event. And that’s what kind of sparked. I was like, well, you should come talk about the event and share. Yes. For the people listening. So you have the Beating the Odds annual conference that’s coming. Tell us a little bit about the conference.

KIMBERLY GRANA: Oh, it’s pretty amazing. We have subject matter experts in all aspects of leadership and healthcare and the things that you should know. And there’ll be vendors there giving away prizes and getting to network with local healthcare leaders all over. There’ll be incredible panels of industry leaders. And we’re very, very excited. Yeah.

DIEGO TRUJILLO: Is there any specifics that have really caught your interest? You were very excited. What is one speaker or someone that, well, we’ll say within the top three so you don’t single anyone out. Is there any subject that you’re like, oh, this is very exciting. We have this person sharing.

KIMBERLY GRANA: Yeah. Billing. I think anytime you hear about billing and collections and things like that, that’s always a big draw. People want to know about that. I’m talking, myself, I’m a speaker, talking about accountability, culture, and staffing. So then you do have a favorite speaker. Right. No, not myself, for sure.

DIEGO TRUJILLO: No, you mentioned culture. Sorry to interrupt. Culture, staffing.

KIMBERLY GRANA: And then we have an industry panel. I’m super excited about that. So we have Senator Fabian Donate is going to be on the panel. And we have another CMO that we’ve invited. I can’t say who yet. And a hospital CEO who will probably be on it. And we’re going to put together this incredible panel for you just to know what’s going on in this health care, this local health care community.

DIEGO TRUJILLO: Yeah, I think that’s where the key is, right, is what distinguishes us because we can go online and there’s a tremendous amount of resources, but we’re not in those places. I think one of my most frustrating, you know, when you look at the legislative sessions move and they go, well, you know, California has the cap set. And I was like, well, Do they have the same challenges as us? Like, I understand we want to base ourselves off someone, somebody else here. You know, we don’t want to pioneer brand new laws. But at the same time, are we taking into account the differences in our community, the challenges in our community? You mentioned while you were speaking that you were speaking on culture. And I’d like to dig in a little bit because I’ve dedicated the last three years of my life at Workforce Pipeline. And along the way, one of the challenges that I have seen is just the cultural and generational change in values when it comes to jobs. And so for me, and I always explain this to people, for me growing up, every job always felt like, well, you’re very lucky that we give you a paycheck. All right, you’re very blessed to have this job, so you don’t want to mess this up for yourself, right? And I feel like the younger generation doesn’t seem to have that same value. I mean, we see that with the great resignation. We see that in a lot of younger people just disengaging as a whole. You mentioned culture. That has to play a huge part. And I see the culture. I mean, when you post photos and the teams and everyone, how important is that? Give us a little teaser of what you’ll be talking about.

KIMBERLY GRANA: So culture can make or break your organization, to be honest. So many people have come and gone in organizations, and it’s because they don’t provide that culture. Within our organization, we pride ourselves in our retention rate. So the national health care retention rate is about 22%. at Valley Oaks. We were 4% as we’ve grown and gotten so much bigger. We’re now at 6% but that’s still an incredible retention rate. People want to work there and I think that to provide a place where people just want to go to work and they want to be involved in what everyone else is doing and they feel that leadership is very transparent and that you’re all here for, you know, the betterment of the community, of providing a good, like, work-life balance and kind of family culture. Again, I’m big on community. And that’s just, so it’s from the top down, our CEO, our CMO, myself, and it’s just creating that community where we have our big corporate office that’s like the aunts and uncles and cousins and then each individual you know medical clinic is your own little tight-knit family because at the end of the day you’re with your work family more hours of the day than even your home life. So make those important, make those meaningful.

DIEGO TRUJILLO: And I think like something that you said, right, is creating the family environment. Because I used to get very bothered when companies would say that and be like, you know, we’re like a family. I’m like, okay, do we all share in the profits? Are we all eating off of this? Yeah, no, we’re not. We’re not being included, right? I never was able to buy in because they were just saying it. They weren’t creating an actual environment. And there have been other places I have worked at where there was that loyalty stemming from the leader. that would really show that not just with me, but with every employee would share that interest. And just to, you know, it’s funny that you bring that up, because I do have some data on that. On this book that I was reading called Connectable, they were talking about the isolation and disconnection. And it makes your team seven times more likely to disengage, five times more likely to miss work, three times more likely to underperform, and three times more likely to quit. And that’s just because you did not create an environment. And sometimes when I consult with different companies and speak with them and you ask them these questions, it’s always put off on the employees. And the frustrating thing for me, I think the leader always takes responsibility. It should always be that way. Someone walks away, even if it wasn’t your responsibility at the end of the day, if they didn’t follow you, then you didn’t lead right, right? And so there’s always a lesson to be learned as a leader. And sometimes that could be a little rough. I don’t know if you’ve gone through that.

KIMBERLY GRANA: Absolutely.

DIEGO TRUJILLO: Yeah, you have people walking when you’re like, but why are they? man, I really messed up in this. Maybe I was too demanding, or I didn’t create that environment. And so, they talked about team belonging. At this conference, I was, or in the book that I was reading, and as they were discussing, right, with recruitment, 167, when they engaged their team, 167% were more likely to recommend their employer to work. They had a 56% increase in job performance, 75% reduction in employee sick days, and 313% had less intent to quit their job. And this is fascinating because as I’m speaking with we started a human resources task force within heels because I realized. If I’m going to build a pipeline from the school district right and the post-secondary educators to the workforce and the employers catch the ball and fumble it nonstop and so I started putting the group together and I kind of asked. As I was building the strategy, it was very funny to me. I was speaking with one of the facilities, and the HR manager goes, why would I want to hand off my employee to somebody else? And I was like, you know, the fact that you would even refer to them as if they were a possession that you own, I think that from right there, your attitude, you’re starting from the wrong place. Why wouldn’t you incentivize them to stay with you over anybody else, right? And then there was arguments. No, well, people will leave for a $0.25 an hour raise. Will they? Because the data doesn’t really reflect that, right? And the person came back, no, no, they tell me for 25 cents more, they have to leave because they make more money, 25 cents more. And we’re like, we understand they tell you that. Yeah, that’s what they’re saying. So you’ll be delving into all these things in culture. I think for me, this is probably one of the greatest challenges in the city. And I’m very excited to hear you address this. Because I realized early on, someone needs to work with the different people within HR. We need to reframe our perspective and the way we’re approaching, because we’re leading a completely different generation.

KIMBERLY GRANA: Yeah, I’m really excited. I’m actually on one of your committees or task forces. Yeah, you are in the HR task force. Yes, I’m super excited. They’re incredible leaders on that. We had some great discussions and one of the moderator who was kind of running the whole meeting was like, why is this important to you? Why would this matter? And I sat there and I was like, These are my future people. These are my team members. These are the people that I’m going to bring into my organization. And when I see they’ve gone through your training and they’ve actually been part of this program, I’m going to pluck those people out so fast because those are the people that are dedicated to making a better health care community.

DIEGO TRUJILLO: And there’s something to be said for creating a leader versus hiring a leader. And that in hiring a leader, you become a step in somebody’s path, in their career path. But when you develop a leader, there’s a loyalty there that goes very, even if they leave the organization, they’re still very loyal. And I say that because I’m still that way. Yeah, I had one one boss when when I was younger and I still to this day, right? I’ll write her. Hey boss. How you doing? I’m not your boss anymore. Yeah, I know but you always cared about my interest and there came a point she would always tell me, you know, if you ever get a better job offer at least give me the opportunity to try and match it and one day I walked in I said, hey somebody offered me this she read over the letter and she said hey you’re a single dad, this is an incredible opportunity, I can’t match this, you need to take this opportunity. And that told me everything I needed to know, which is why I’m still loyal to that person. If I ever had to go back, absolutely, I would join that team. And so when you look at being able to empower those employees, and not just empower, because HR is not simply hiring, and their job is not necessarily empowering, their function within an organization can be very, very critical. to that corporate feel. For me, as a younger person, as a millennial, I, for me, I was always, yeah, do not trust HR. HR is just there to defend the company from anything that you could ever do. And that was the perspective that I always had, which is why I realized we really need to shift the perspective. And this is something that I read on an online forum one time. So I was like, yeah, that is kind of how they are. And, uh, I realized that we need to retrain HR to start appearing or working as an ally with employees and understanding that you’re standing in the gap, that you’re a bridge. It’s not just a one-way road. Have you experienced those struggles as you’ve worked?

KIMBERLY GRANA: Yeah, absolutely. And I think that creating the conversation that HR just makes recommendations. The HR laws are set up actually to protect employees. Oh, we’re going to clear it up here. All right. From their organization. They just are. And as health care leaders, we rely on HR to help make recommendations. So that’s all they do. The HR doesn’t say, oh, this is how it has to be, or they say, Here are my recommendations in my organization. This is what I recommend. We can take those or we can go out. I mean, there’s a lot of you take it to your board of directors or your leaders in your organization and say, okay, here’s what the laws are. Here’s what HR’s recommendations are. What do you think? And you can decide to, you know, go with what they recommend or you can choose your own path, but then stand by that. And now you’ve set a precedence and now you just be consistent with whatever you’re doing.

DIEGO TRUJILLO: Have you ever been frustrated in an HR position after you made recommendations?

KIMBERLY GRANA: Oh, 100%. Absolutely. We won’t make you name names. No, but you’re trying to do what’s best for the organization and you’re trying to do the right thing and then they’re just kind of fighting against it. Sometimes they don’t see it. Yeah, or maybe don’t realize you know, that’s okay for right now in this one instance, but you have to think about five years from now, and now you’ve set a precedent, and things like that.

DIEGO TRUJILLO: So even in HR, you have to lead the leadership, yeah? It’s how you present the information, how you guide them.

KIMBERLY GRANA: Yeah, you have to be fair, and you just have to think about, you have to really put that non-partial kind of hat on that, okay, I don’t know this person. This is, you know, someone walking on the street, What would I tell them if this person worked at Albertsons? What would I tell them? How would I instruct them on what to do? And just not be partial and really be fair.

DIEGO TRUJILLO: Okay, and how are you going to prevent yourself from going crazy organizing this event and then also being a speaker at the event?

KIMBERLY GRANA: I have an amazing executive assistant. She’s absolutely wonderful and she helps keeping me on track. And you know, just again, community. Community. You lean on the right people. Yeah, my husband, he’s a retired fire chief. OK. And he helps me out at home while he’s going through pilot training. He wants to be a pilot. Good for him. Yeah. All right. I commend him on that. Super exciting. And so he supports me at home. Then I have my incredible team at work. They just are. We have a bunch of just the A-team, high performers that we don’t micromanage. We just appreciate them, let them loose, trust that they’re going to do their job, and they do, and they do what they say they’re going to do.

DIEGO TRUJILLO: That’s a wonderful attitude. Again, talking about leadership, right? People want to do a good job. They want to be empowered. There’s nothing like snipping your wings like a micromanager, someone being on top of you. Even with my teams, I can tell when people come to work on a team, They’ll come to work on my team, and when they work with me, well, should I change this font? Listen, I don’t care about the font. Whatever you feel is best. If you make a drastic error, please let me, like, we’ll sit down and we’ll discuss it. But other than that, just do what’s best and make sure that if I ask you, well, why did you make that decision, that that’s justifiable, that you were making that decision for the good of the company or the organization or whatever the vision is. And so it’s important when you have that, it’s very difficult to let go if you’re a perfectionist. But once you find that rhythm and you start seeing people reach their potential, it’s even more exciting than doing everything perfectly yourself. In addition to being able to actually scale. So how did you convince your husband to be a pilot?

KIMBERLY GRANA: Right? We see what the real angle is here. Oh, he loves it. He just loves it. And I love it. I’m the paparazzi. You’re documenting the trips. Yes, I document everything. I love flying with him. It’s just wonderful.

DIEGO TRUJILLO: Do you feel like your attraction has grown since he’s been a pilot?

KIMBERLY GRANA: I’m going to sell everyone on aviation. Absolutely. I mean, come on. He was, listen, he drove fire trucks. He had the whole suit and everything, and that was hot. Okay. This is the next level.

DIEGO TRUJILLO: Oh, I also fly planes.

KIMBERLY GRANA: Yes. I mean, come on.

DIEGO TRUJILLO: Yes. So you got to work on yourself. We’re giving some relationship advice now as well, right? If you work on yourself, then the relationship will improve.

KIMBERLY GRANA: I think so. I think that, again, having your community and having everybody that’s good at something. Everybody has to be the boss. So I’m the boss of my area. You’re the boss of your department. My husband’s the boss of our home. He’s our event coordinator. He takes care of things. He’s the CFO and the CEO there. And then I have my work, and I’m the master of this domain. And I think everybody having their thing that they’re responsible for, they take ownership of, and they do what they say they’re going to do, and that’s how you become successful.

DIEGO TRUJILLO: I think that’s the key. I mean, you really hit on something. I almost want to ask you, at what age you realized that? Because when it comes to problem-solving and doing what you say you’re going to do, so those were things that I just kind of figured everyone did. I even remember an email signature. Someone would send an email. At the end, they would always put, I was put on this earth to solve problems. And in my head, I would kind of roll my eyes and go, well, that’s kind of dumb. Like, weren’t we all? And then I started meeting other people, and I was just like, wow. Like, well, yeah, but I can’t do this because of this one barrier. Okay, well, then do it this way. Oh, okay. Or not even when you have the solution, I would tell them, well, I hired you. All I’m going to do is Google it and then give you the answer, or you could just Google it. And then they’d be like, all right, all right, I’ll look it up. I’m like, yeah, solve the problem, right? People hit these challenges and immediately just freeze.

KIMBERLY GRANA: I think it’s part of your leadership style, right? You’re confident in saying, okay, everybody, come on, Google. We have Google, we have Alexa, you have Siri, you have all these things. You have resources at your fingertip, but you’re creating an AI community. It all comes back to your community.

DIEGO TRUJILLO: It’s something that’s very interesting, and I agree with you fully. So when we founded Vegas Healthcare, the other organization that I run, that was the one thing that was, you know, bringing community back into healthcare. It didn’t, at the ground level of the healthcare workers, it didn’t feel like there was a community. It was competition and, you know, If four marketers went on a referral, they would stand outside of the room, the patient’s room, and just scowl at each other the entire time, until each one would be called in one at a time. And I thought, this is ridiculous. This person’s dying. Whoever provides the service that they need, that this family, not everyone does the exact same thing, that’s the person that should take care of them. It would make sense. I mean, we’d all, you know, and I would find the irony in talking to people, and they would be like, oh no, this company that I’m working for now, this is the best company. I have ever been. And then they were in another company six months after, and I’m like, oh no, but these guys are just incredible. I’m like, could it be that multiple companies do multiple good things, right? That we have differences? And so it was very eye-opening to me once you saw the community begin to function when it came to coordination of care. And we’re talking on a more lower level, right? Not so much the leadership that we were talking about earlier of developing vision and strategies and how do we want to develop health care in our city. But this is looking at it from a different perspective of right on the ground level, the coordination of care, but it all comes down to just human beings working together. I mean, I recently read a study that, or a report that the reason physicians, the residents didn’t want to stay in Las Vegas for the first time, it wasn’t the Medicaid rates, it wasn’t reimbursement, it was coordination of care. And for me, I felt like I was getting punched in the stomach. as a native-born Las Vegan, because that’s not a grant issue. That’s not that they haven’t funded it enough. We just need to know each other and know what everyone does.

KIMBERLY GRANA: It’s a shortage issue, and again, that’s the benefit. We talked about having IPAs. We talked about narrow networks. We talked about having your referral community. That’s the benefit of that. Any one of my doctors or even my front desk could call a cardiologist and be like, oh, so-and-so has this patient. They need you to get in. I mean, they need you to see them right away. And they’ll get them in. And so having that, having those people, having those partners that are just dedicated to putting patients first and doing the right thing.

DIEGO TRUJILLO: And they all know they have the same goal and objective of doing what you just said, right? Putting patients first, and they know what their lane is. Hey, this is about where I get. If you go to this person, he can help you a little bit more. And being able to have that communication, being able to have that discussion, being able to call the other doctor, text them, hey, this is the issue. This patient came in and said, you said this. Oh, no, no, no. What’s happening is, right, having that clear explanation, because sometimes it’s not so clear. So then doctors are just kind of trying to guess, well, what did the other guy mean, right? When I have a cell phone number, I can just ask them, what did you mean by this? It makes it a little bit easier. I’m assuming, right? I’ve not been in your role.

KIMBERLY GRANA: 100%. I always tell people, because I’ve had people ask me, how did you get here? How do I sit in your seat? And I’m like, I’m not the smartest person in the room. I never, ever, ever claim to be at all. But you have Google. No, I’m kidding. I am resourceful. Yeah, absolutely. You’re right. That’s not a joke. It’s absolutely true. I am super resourceful.

DIEGO TRUJILLO: And I’m the same way. So I grew up building computers, and people are like, man, you’re just so good with computers. How do you know this? Well, I just type whatever the problem is into Google. Really, and that’s it? But what do you write? What is it doing? That’s what I write. And they’re just, they’re blown away. I’m like, you realize, again, this company spends billions of dollars to give you the right answer. So even if you mess up on the question, more than likely, you’ll be able to find the right answer, or at least know how to ask, right?

KIMBERLY GRANA: Absolutely.

DIEGO TRUJILLO: So it’s being resourceful in that area. And a lot of people, They just hit that wall and they just don’t know where to where do I get the information. And it’s always good to be around resourceful people, not because they always give you the answer, but because they teach you to be resourceful. They teach you to go seek out the answer and how to filter through answers. How exciting. I’m really looking forward to this conference. Again, ladies and gentlemen, it’s April 12th. This is the 2024 annual conference called Beating the Odds. by the Healthcare Leaders Association of Nevada. And with us today was President Kimberly Grana. Thank you very much for coming on.

KIMBERLY GRANA: Thank you.

DIEGO TRUJILLO: And what day are you going to be speaking all day? You’ll be there all day.

KIMBERLY GRANA: Yeah, I’m the keynote speaker and I opened the conference.

DIEGO TRUJILLO: Fantastic. So make sure to get there early and stay till the end, ladies and gentlemen. Is there anything else you’d like to tell the audience today as we say goodbye?

KIMBERLY GRANA: We’re always looking for healthcare professionals to join in support of the organization, volunteering for a position on our board or one of our committees. Everyone is welcome. We want you to be part of improving the local landscape of healthcare in Nevada. So please join us, join us at the conference, join us at our monthly meetings. We meet the second Wednesday of every single month and you can look at our website www.hlanv.org

DIEGO TRUJILLO: Fantastic. And that’ll have all the contact, the LinkedIn, all the information will be there for everybody.

KIMBERLY GRANA: Correct. Thank you so much for having me, Diego. I really appreciate it.

DIEGO TRUJILLO: Thank you very much for coming on, and I definitely want to go on the plane when I get a shot. Absolutely. No, that’s very exciting for me. Thank you very much for listening, ladies and gentlemen, and we will see you on April 12th at the Beating the Odds conference. Have a great day.

 

Bridging the Gap: A Conversation with Stavan Corbett on Workforce Development

By | HEALS Pod, News

In this episode, I had the pleasure of interviewing Stavan Corbett, the Executive Director of the Division of Workforce at the College of Southern Nevada. Stavan, a Las Vegas native, shared his personal journey and insights into workforce development in Las Vegas.

The conversation delved into Stavan’s background, growing up on the east side of Las Vegas and his experiences working with marginalized communities. He highlighted the importance of empathy, systemic thinking, and amnesty in leadership, emphasizing the need for inclusive and supportive leadership styles.

Stavan discussed the shift towards skill-based hiring and the importance of bridging the gap between education and employment. He shared the innovative programs offered at CSN, focusing on healthcare, manufacturing, business, and IT, to meet the demands of the evolving workforce landscape.

The discussion also touched on the challenges of engaging individuals in educational pathways, with a focus on building relationships and providing services to support talent development. Stavan highlighted upcoming workshops at CSN, including resume writing and CPR courses, aimed at fostering connections and empowering individuals to explore career opportunities.

Listen to the Podcast.

Full Transcript

DIEGO TRUJILLO:
Ladies and gentlemen, thank you for joining us today. This is Diego Trujillo, the CEO of Las Vegas Heels. And I’m here to interview a very special guest that is a Las Vagan that has been working in Las Vegas for quite some time. He’s currently with the College of Southern Nevada’s Department of Workforce. And it is Stevan Corbett that is joining us today, the Executive Director of the Division of Workforce. How are you doing today, Stevan? I’m great. How are you, Diego? Excellent. How’s everything been going so far?

STAVAN CORBETT: So far so good, as you know, a lot of opportunities here, so we’re all busy.

DIEGO TRUJILLO: Yeah, a lot of work for us to develop. So we want to unpack your story a little bit, and a little bit about your program, to know what you guys offer, and, you know, kind of delve into that a little bit. But we want to find out a little bit about you, you know, your background. How long have you been here in Las Vegas?

STAVAN CORBETT: Yeah, well, my whole life I was actually born here. I love it. I know I felt good about you. So, you know, in my age bracket, there’s not as many. When you probably get into the 30s, there’s even more. And so, yeah, I’ve been here all my life, born and raised, and it’s an amazing place, and it’s why I continue to be here.

DIEGO TRUJILLO: For the other locals, what side of town did you grow up on? I’m curious.

STAVAN CORBETT: Well, not only grow up, but still live on the east side. East side. Went to Eldorado High School and still within probably about two and a half, three miles of that high school.

DIEGO TRUJILLO: Okay, no kidding. So I was Chaparral. Oh yeah, okay. So I’m born and raised here. I did Woodbury and Chaparral. And when I meet people, and you are correct, so I’m 39, and yet you don’t meet a lot of people our age. And then when you do meet the other people that are born and raised here, they’re like, yeah, fourth generation. And you’re like, wow, my God, you got me beaten heavily.

STAVAN CORBETT: 100%.

DIEGO TRUJILLO: So, Eastsider also, though, you know, growing up here in Las Vegas, what was your experience? What were you aiming to when you were growing up? Did you see yourself as an executive director of workforce development?

STAVAN CORBETT: No, not at all, right? And so growing up, my stepfather was a carpenter and worked on projects like Cashman Field and Thomas and Mac, and of course, several of the casinos. My mother up until a couple of years ago worked in the casino and was in the cage, going way, way back into what is now Main Street Station, which was the International. She just retired a couple of years ago, and so my first job out of high school was a dishwasher, and I thought I was in heaven making eight bucks an hour. Everything else kind of just happened and here we are.

DIEGO TRUJILLO: $8 an hour. I think I was at $5.15 at Peter Piper Pizza. And then I would choose to wash the dishes because I could listen to the music in the back as I would do it. Absolutely. You did better than me. You did better than me for your first job. Well, that’s excellent. So what brought you to that? Where did you see yourself growing up? What did you want to work in? What were things that gave you passion that kind of make the connection to where you are today?

STAVAN CORBETT: Yeah. So, you know, growing up, it really wasn’t a future orientation that, you know, it was more like, hey, this is what I do. This is life. And, you know, first generation in terms of going to college, first to even graduate high school in my family. And so some of that territory was uncharted. It wasn’t until later on that I got into youth development. and start making the connections about social enterprises and talent and working with marginalized or disenfranchised communities and then looking at what are the resources that are available that not everyone is always accessible to or has access to nor has a knowledge base of it.

DIEGO TRUJILLO: So did you always see yourself in workforce or then that was more from the employer side that you saw the challenges that existed?

STAVAN CORBETT: I think it’s an and, right? It’s definitely from the employer side and also working with communities and recognizing the different disparities of generational progress, social mobility, and things of that nature.

DIEGO TRUJILLO: That’s really interesting, you know, as you bring that up, I remember working with young people, so my degree’s in theology, right, and I wanted to serve the community, I’d always felt that calling in my heart, I always was like, man, I want to change the world. And when I got out of school, I was working with young people, and a lot of them, it was a Hispanic church, a lot of them would end up here, right? They were either first-generation or they were brought very young, and it was very interesting to talk to some of these kids and see their their vision would go as far as their parents. And what I mean by that is I would ask them, like, so what do you, uh, what do you want to do? Well, you know, my dad’s a carpenter and I want to be a carpenter. And it would blow my mind until it kind of clicked one day. And I would say, Hey, what did it take for your dad or your mom to get here? And they would tell you the story. Oh man, they had to do this and this and take the train. I mean, really terrible stories, overcoming a lot of obstacles. And I would tell them, so after everything they did, you want to do the exact same thing they did, they do now? It seemed a little low effort to me. And when I worded it that way, there was always an aha moment. I was like, if they push this hard, why don’t you advance the flag? So it’s great hearing your story, right? Those first steps that you take. And then seeing the disconnect. I went through CCSD as well. And I always tell people when I talk about workforce, it’s very interesting. I’ll always ask the question in meetings, did anybody grow up here? Because I always want to know, well, who went through CCSD? There was a lot of frustrations that I experienced. And seeing what they do now is incredible. I didn’t have that back then. So you met with the school counselor like once a year, quick, what do you want to do, boom, here’s a sheet, and then that was it. But I’m watching the community kind of take a more focused look at this. And I think the program that has impressed me the most has been your program at CSN. I was very excited to do this interview. And I’m not just saying this because you’re in front of me.

STAVAN CORBETT: No, absolutely.

DIEGO TRUJILLO: Um, but really the, how quickly, when I first started hearing your programs and saying, well, what if we need this? Oh, we can deploy it in a month and a half, two months. We could just put it together. And just, uh, how quickly you can, you can move into the needs of the community and the needs of the employers to develop that. Do you feel that there is a change in Las Vegas and the mentality of, of what jobs should look like, what workforce should look like? I mean, having grown up here, you probably have the same experience I have, if not something similar. Mm-hmm.

STAVAN CORBETT: No, I, I would agree with that, Diego. There, there’s, You know, 20 years ago, diversifying our economy was a buzzword that nobody really could explain or define. It was just something cool to say. And I would say it’s probably only within the last 10 or 15 years that we’ve actually begun to see some of that implementation, where there are different industries coming to Vegas. You know, we’re a very tax-friendly, business-friendly structure, which has somewhat inadvertently created the demand, and rightfully so in terms of economic development. What does that look like for the city? How do we broaden our portfolio? How do we broaden our city’s personality of what it is that we offer? And so in the last 10 or 15 years, you know, I’ve been in workforce since about 2006. And back then it was just WEA, W-I-A, and it was a Department of Labor program. It isn’t until probably the last 10 or even five years where there’s more understanding about workforce development, how does that support economic development, and then how do you deploy those as a equitable strategy across the communities and to ensure that there is a concert of growth and a concert of opportunities for not just those who have always engaged in those practices, but also again, as I shared earlier, this diversification and workforce is bringing possibilities to communities that maybe not have been thought of in the past.

DIEGO TRUJILLO: Yeah. And where did you see that disconnect? You mentioned having worked, right, seeing it both on the employer and on the workforce side. What was your first step, right? So you graduated. What is your degree in? Educational Leadership and Management. Okay. So you already had your side on that, right, and the educational side. What was your first aha moment in thinking, hey, something has to be done here?

STAVAN CORBETT: Well, it was even before that, right? I’m a late bloomer in terms of going to college and achieving that. And so I already had been in the space. And so really, my experience perpetuated my choices in education. And so what that did for me is now just be able to have a credential to be able to move within the space, right? And so it really was first the experience with the families, with the employers, within the education space that really inspired me to push and go on with my education.

DIEGO TRUJILLO: And what was your following step as you were connecting these dots? It’s very interesting, because I’ve never met anyone. And when you talk about these abstracts, like workforce pipeline, well, I work on workforce pipeline. What does that mean? And so having to explain that to people. And it was something, when I stepped into Las Vegas Heels, I had never thought about workforce. It had never been something that had crossed my mind. When I took over Las Vegas Heels, I had to start surveying the community. I’m like, OK, what are the needs in the community? And that one just jumped out. And it’s very funny, because I get invited to speak on workforce development now, and I’m thinking, like, oh, man, I’m the expert, right? Which I don’t consider. Within my small space, I have learned quite a bit. And, you know, being able to find partners that have helped to educate me and explain things. For you stepping into that, what were the huge gaps that you, when you took this step, right? You wanted to move forward. What were the steps that you saw, the glaring gaps where you were like, you know, this needs to be closed?

STAVAN CORBETT: Yeah, again, sounding like a broken record. The drive was really identifying that there were workforce development opportunities, that there was diversification of our economy, but there was still a large community that was not being brought in to participate in those pipelines.

DIEGO TRUJILLO: And where were you working at the time when you started seeing these things?

STAVAN CORBETT: At the time this was, I was at actually Nevada Partners. Okay. And I was a youth workforce development specialist and work with adjudicated youth and out-of-school youth. And so that’s kind of when it was like clear that going back to what you had shared that there are these young individuals with phenomenal talent, transferable skill sets, but weren’t being guided or provided the opportunities of how to connect those and develop that future orientation. When we talked to the employers, The employers had already a fixed mindset on certain groups and talents and what they could or could not bring. And so that was just seen as a challenge. It was kind of like an opportunity to play this matchmaker where it was building and taking a systemic approach of making connections for individuals, employers that would have a macro impact. in terms of the workforce and the diversification of it, along with the economic development.

DIEGO TRUJILLO: So you were heavily involved, right, looking at all the dots, starting to see how to connect it. And for those people that didn’t grow up in Las Vegas, it’s kind of automatic, just gaming and hospitality. Correct. I mean, when I talk about workforce here in Las Vegas in different meetings, it’s incredible to me how many people will bring it up. maybe because they haven’t gone through the system here. And, you know, the first thing I mentioned in healthcare, I think even when we met, was, you know, I can name 15 jobs at a casino. I can name two in healthcare in high school, right? Nurse and doctor. I don’t want to do either of those things. And I think there is a lot of career options that are left unexplored. So at what point did you transfer to CSN? When did you take that role on?

STAVAN CORBETT: So it’ll be three years in April, and there was a long journey in between, always in the space of education or workforce I at one point had worked for and actually served on the local workforce boards board going back to about 2011, 2012. And then in about 2019, 18, I transitioned off the board and became an employee with Workforce Connections. And so from there, had a, what do they say, a offer I couldn’t refuse when Dr. Zaragoza reached out and said, hey, I’d really like you to consider, you know, to come work for CSN and serve in a capacity at the Division of Workforce. And so that was in April of 20, 2021.

DIEGO TRUJILLO: Was that the first step towards an educational institution?

STAVAN CORBETT: No, I had previously actually worked at, I actually worked at UNLV in their, what they call gear up. So after school programs, math and science, STEM. I also worked at Nevada State University and built FYE programs, first year generation programs in that space. And so all those were components of workforce, but this going into the workforce board and then CSN is much more intentional about what that looks like.

DIEGO TRUJILLO: Yeah, and it seems that now this time you got the reins. So instead of building out a program, it’s overseeing the build out of programs. Is there a huge, you know, HEALS stands for, the L in HEALS stands for leadership. Yeah. How big of a transition was into that leadership role?

STAVAN CORBETT: You know what, so I’ve been very fortunate, right? One of the things I’ve had the opportunity to do is served in an elected capacity as well back in 2010. And so served on a state board, served on a local elected board. And that’s my response when you talk about leadership. Sometimes it’s not always there in those spaces, but that is the first thing that comes to mind. And I’m very fortunate. Do I have the reins? I think that’s open to interpretation, but do I have the responsibility? Absolutely.

DIEGO TRUJILLO: That’s what I was going to, you know, I always say that to people when I took the title of CEO. And people would always tell me like, oh, wow, Mr. CEO. And at first I was like, oh, you know, and then I realized very, very early on, you know, I, I have kind of landed in this position. My life has guided me to this. I very much see it as a responsibility. It’s not a position of privilege. It’s just, we need outcomes for our community. That’s right. I see the nursing community and the way they struggle. I see the hospitals trying to staff and the different facilities and all of the companies in between. And then I see that the healthcare failures that working in healthcare, you hear about quite often, right? Um, when there’s a horror story big enough, you’ll hear about it on the outside, but within healthcare even, um, you see the burnout rate, and it, you know, I see a maelstrom forming that is even more terrifying. I mean, I don’t know if we, when you look over the numbers that Dr. Packham releases from UNR, and you look at the needs of what our community actually needs, just to meet the, the average, nationwide, it’s very intimidating. I also have a nursing group with about 5,000 nurses and I tell people, I mean, it’s almost at this point about every two weeks someone will post, I’m just burnt out being a nurse. I’m just tired. I feel overworked. I don’t, I feel underappreciated. I’m ready to just leave nursing in general. And those posts really scare me because, you know, not only do we have a shortage, but the ones that we do have that are carrying the load are starting to kind of give up. And I think that, uh, As we see the diversification, I think this is where, you know, as I took over, you know, we started setting out goals as a city. How do we want to grow as a city? And right, the two pillars that came up, education and healthcare. And so I was the only one in the room where everyone’s looking at me like, healthcare, what are we going to do? And I was like, ah. Let me become an expert real quick.

STAVAN CORBETT: Yeah, of course.

DIEGO TRUJILLO: So looking to fill those gaps, as you stood over, right, this position that you assume now, what do you think are the greatest lessons that you brought to that position? Where do you feel that you had learned? I mean, we all have good leaders and bad leaders in our life. I say they’re only bad leaders if we don’t learn, right? Yep. So there’s people that have said in our lives, I’ve worked in kitchens with old French, French chefs where it didn’t matter how they spoke to you. If they made fun of your mother or your family, all you could answer was yes, chef. Absolutely. So you learn to bite your tongue, but you learn about how you don’t want to be. What leadership lessons do you feel that you bring? What experiences informed you and how you wanted to build this out?

STAVAN CORBETT: Yeah, you know, the first thing that comes to mind in a sounds textbook is going back to what you were saying about individuals who are burnt out. And I think what that shares about you is your empathy. And empathy is a significant ingredient when you talk about leadership. It’s a significant ingredient when you look at using empathy to look as a filter when you’re looking to solve problems, when you’re looking to support individuals. And so that’s probably been one of the greatest lessons is empathy. Also, you know, for more of a technical piece, it’s always also, what’s the big picture? How do you take a systemic approach? We can all build things individually and then you put them together or you can put them together and then go into, you know, different iterations and design thinking and making sure that you’re an inclusive leader, right? That’s significant. And also, I think the biggest opportunity when you talk about how to move these mountains, so to speak, right, that we’re all kind of pushing towards, it’s also amnesty, and how do you practice amnesty for yourself? How do you practice amnesty for others? How do you make sure there’s a support system? So as you talk about looking at mistakes as lessons learned, not taking a punitive approach, taking more of an asset-based, mind-based approach to those opportunities, going back to again, because it’s our responsibility.

DIEGO TRUJILLO: Yeah, I always, I think it’s Marcus Aurelius in Meditations that wrote, be strict with yourself and be forgiving with others. And I always take, you know, early on as I was practicing leadership in different roles, I remember speaking to somebody and saying, hey, Try to be the type of follower that you would want if you were a leader. And that person’s attitude completely shifted. They used to come over all the time and say, hey, sorry, I can’t be here on Wednesday. And then I had to solve a problem. After that conversation, they began bringing the problem and saying, hey, I can’t be here Wednesday. But I spoke to, you know, John, he’s going to cover for me. And then as you lead, and I will say this, and fail in leadership, right? Because it’s happened to me. Every time someone walks away, you could blame them, but who’s the one in charge, right? The leader is the one, and if they’re not following, then you didn’t lead right. So I take a lot of responsibility in that, but when you start looking at it that way, I think you start becoming more forgiving of people underneath. And I think the world has kind of shifted to where instead of demanding perfection, it becomes letting people grow, right? And learning to feed them and learning to say, hey, what do you need? What do you need to succeed? And my job as a leader is to make sure you have all those tools and the guidance to be able to kind of self-actualize and to grow into your position. Do you feel that you’re able to do that in the position that you’re serving in now?

STAVAN CORBETT: You know, it’s interesting you say that. I think yes, right? The reaction is yes. The balance is how do you do all that, but then also recognizing the critical points of success and the critical points of integration and support that come in line, right? And so when you talk about the burnout, yes, you want to practice all that that you talked about. You want to deploy empathy, and then you want to balance that with how can you still drive the talent? How can you drive and support the solutions that are team-based and take a team approach to address those opportunity gaps. Because somebody’s being affected by them, right? Yeah. So you really have to kind of take this multi-dimensional vision of where you deploy yourself, where do you deploy the team, where do you allow yourself to be deployed based on managing and supporting the system that’s to address all these opportunity gaps. but for it to be optimal. And it’s kind of, you used the word failure a couple of times. It’s so much of an important ingredient. I would say it’s almost like not adding salt to a meal. That’s how important failure is sometimes, right? It may not seem like it at the time.

DIEGO TRUJILLO: It’s miserable. I talk to my children. My son goes, dad, have you ever failed? Are you kidding me? And I could still, my late father, I could still hear his voice saying, son, you need to be consistent. You need to be consistent. because you want to give up. But yeah, that failure really becomes a part of your recipe.

STAVAN CORBETT: Right, right. And so, you know, as you know, you know more than most, you’re balancing the internal and the external opportunities. And you have to sometimes come to realization, you may just be a baton passer. You may not finish the chronicle. You may not cross the finish line. Maybe your role is just to pass the baton so that the next person that takes that work is not starting where you started, but you’ve moved the starting line.

DIEGO TRUJILLO: Yeah. And I think it’s leaving that the legacy of systems, right? Yep. Where you have figured it out, because what we’re trying to solve here is extremely abstract. Yeah. There’s no clear, like, one, well, here’s the template. Just follow this template and you’ll succeed. Um, if not, that person would be teaching all over the United States.

STAVAN CORBETT: 100%.

DIEGO TRUJILLO: Because I don’t think any workforce board has quite figured it out. No. And even if they did, the challenges would shift, you know, decade to decade. And again, seeing it here in Las Vegas, you look at the push 15 years ago, 20 years ago of what Las Vegas was versus what we’re trying to be now. I think our goals are ambitious and aggressive, and I’m really proud of the city and the way people are coming together. And I think, you know, you mentioned, right, driving these teams. For me, it’s always making people feel like they’re included, right? even in my other businesses, it’s always letting people know, hey, I don’t view you as you work for me, right? There was this old attitude that kind of existed, and you should be very grateful that I’m giving you a check. And I think that mentality has really shifted. People want to buy in to that vision. And when you can provide that vision, they start becoming creative. They start coming out with solutions. If you’re expected to take that leadership role and say, all right, Stevan, give me the 25 things we need to do to succeed, that’s a lot of pressure. But when you start putting it on your team, That’s where I think things begin to flourish. And not just that, regardless of who you are, after a length of time, your vision is going to start kind of getting honed in and you’re going to miss out on new ideas. 100%. And I think recently I was listening to Jeff Bezos, who was being interviewed. And as he was being interviewed, he was like, yeah, I’m typically the last one to speak at a meeting. And I thought they were going to say because, you know, If you have two ears and one mouth and give the typical the answer that we already know and one of his things was we always start in order of seniority and what he meant by that was in reverse. He goes we start with the most junior engineers because if I come into the room and speak. as the leader, they’re all going to change their opinion and say, oh, yeah, what he said. But if we let them speak first, not only do they feel like they’re a member, they’re contributing to the ideas. But in response to that, they’re able to get their ideas out and sometimes bring some very fresh perspectives. I don’t know if you’ve seen that where you’re at in your position.

STAVAN CORBETT: Oh, yeah, most definitely. Right. And, you know, one of the things that comes to mind is, again, it’s an and not an or. Right. And when you talk about situational leadership, You’re flowing through all those different, you know, sometimes you have to be directive. Sometimes you’re collaborative. Sometimes you’re more hands-off, right? And it’s going back to what are you doing? How are you leading yourself first? What is your self-leadership look like? Ooh, I love that. There you go. What does your own self-leadership look like? And that’s based on the investments you’re making to yourself is going to be evident in terms of what you’re putting out.

DIEGO TRUJILLO: Yeah, you have to, it has to flow through you. And as you build yourself as a leader, you build those around you and the team underneath and allow them to function and to flow. I think the idea of, again, one person having the solution and needing 30 people to execute, that doesn’t happen. And if it does happen, it’s not quite as successful as when you let an entire group of people flow. And to be honest with you, there’s a beautiful thing. I don’t know if it’s ever happened to you. So for me, I kind of battle with perfectionism a little bit. And everything that I do, I want it to end up good. I want to do well. And sometimes I would kind of pass that on. And I noticed I would intimidate the people working on it. Well, I don’t know if I should do that. And then I eventually became, just do it. Do whatever you can to the best of your ability. And if it comes around, we’ll just have a conversation and see how we can do it better. And then all of a sudden I see my team start coming together, even recently with my podcast team, because putting these podcasts together, there’s three podcasts I’m recording. What is that workflow? What about the cover art? Where are we uploading? How are we getting the show notes and all the scripts? How are we, right? All these different steps that was a tremendous amount of work that was on me. And then we just had one meeting with the team. Next thing you know, I’m watching them get published on their own. I get excited when my team starts, you know, working and working excellently.

STAVAN CORBETT: Absolutely.

DIEGO TRUJILLO: And putting things forward. There’s a really proud moment, right? Don’t disagree at all. So you see that coming together. So tell me a little more about CSN, right? So you stepped into CSN’s role. Where do you feel the strengths are in your program? Again, I’ve identified different strengths as I’ve kind of engaged, but I’d love to hear your feedback, right? Leading the organization, what would you say you’re most proud of that you’ve been able to put together, or the direction?

STAVAN CORBETT: Yeah, the direction is significant, right? You know, our current president, Dr. Zaragoza, has an international reputation and workforce. He built probably the, I’m not going to say probably, he built the workforce system at the post-secondary level in San Antonio. It’s one of the reasons why they brought him here. And so his vision for the college in the last five years has been significant where he’s been ahead of his time. and him focusing on, listen, going back to it’s an and, not an or. One of the biggest things we’re most proud of is recognizing that there are training opportunities for individuals who are not thinking about a degree. They are economically not in the space they want to be. They’re working two jobs. They’re burnt out just by surviving, right? And so the divisional workforce is really built for that community that says, listen, I may at one time wanted to go into a degree pathway, but I have a family to feed. I’m barely surviving. And so what the divisional workforce offers is, hey, come take this short-term training. It’s taught by, it’s developed by subject matter experts. It’s nine times out of 10, we have employer input. into the curriculum and design. So it’s meeting the needs of the employer. And I can testify to that firsthand.

DIEGO TRUJILLO: I was blown away when your team, I gathered like 10 employers. Yeah. And they gave immediate feedback and they said, okay, we’ll change it. So yeah, that was incredible.

STAVAN CORBETT: And that ecosystem is so important, right? And so we recognize that our main two assets are the student and the employer. We’re there as a bridge to connect them. And so we work with the student on their customized learning styles. and we work with the employer on their customized training needs and connect the two. And so again, going back to Dr. Zaragoza, he’s really put a significant emphasis on recognizing what is called the one college model. And this one college model is something that’s emerging across the United States where there’s no longer an academic affairs and a non-credit. Everything is integrated because it’s a systemic approach of how do we get folks into a space where they’re being engaged in and experiencing generational wealth, generational progress, breaking those barriers that potentially they resided in before and get them into a space where they can think differently and look differently about their future. and be proud about the skills that they didn’t know they were capable of. And now they’re in a position to say, you know what? I do want to go on and get a degree because I took this PCA class. I took this dialysis technician class. And now that I know I can do it, I’m going to get into the nursing program. I’m going to get into XYZ program.

DIEGO TRUJILLO: Yeah, and I feel you’re right, right? So a lot of people, when you speak to them, I notice with education, and this can go even as simple as learning to use new cell phone features, people’s minds tend to shift in adulthood where they don’t like learning anymore, or they don’t think, or they become intimidated. And sometimes when you spark that little switch, even if it’s a 16-hour course, it doesn’t matter. Once they reach that accomplishment and get their brain in the right mindset, then the sky’s the limit. That must be incredible to be able to witness. I’m sure you see that in students all the time.

STAVAN CORBETT: Oh, 100 percent, Diego. You know, it’s, you know, to see individuals who are exactly in that mindset sometimes because their lives are stress-induced. They’re just trying to make it. And so, you know, it’s that part of the brain that some of us have the opportunity to explore because we’ve worked our behinds off and now in a place where we can get downtime, where we can enjoy life. A lot of these individuals are not really enjoying life. They’re surviving, right? And so their brain doesn’t allow them to develop these type of thoughts. And so they lock in. to, hey, I’m just going to go into this pattern. And so to your point, absolutely. It’s an amazing opportunity to be a part of a team and to be a part of a college that is looking at everybody and wants to make sure that there is social mobility, not just for some, but for all, and that there’s a system in place in collaboration with the employers to make that happen.

DIEGO TRUJILLO: So tell me, because I know the playing field has kind of changed, right? Where there was a heavy emphasis on four-year degrees and in those different areas. Even then, we’re seeing a lot of changes now. I speak with employers and, you know, things that were required previously now become, hey, I just need them to do what I need them to do. Right. Yeah. As long as they could do that. I don’t care what degree they have. Like the piece of paper doesn’t matter. Can they get the job done?

STAVAN CORBETT: Yeah, absolutely. So I’m sure you’ve heard the phrase, the paper ceiling, right? The paper ceiling referring to employers traditionally saying, listen, if they don’t have this degree, I’m not even going to look at them. And now what we’re seeing is really a migration of employers. because there’s so many tremendous talent gaps, saying, we’re going to go on to a skill-based hiring arena. What does a competency-based approach look like? What are the assessments out there that are going to allow me to know that this potential team member can do the job. And what does that look like? And it’s, again, it’s not an or, it’s an and. The four-year degree, all of our data tells us, is still very important. There’s still higher socioeconomic success, right? There’s still higher quality of life. And so the skill-based hiring, what it does is just an equitable approach on how to widen the net make sure that we’re taking into consideration everybody’s skill sets that are sometimes not documented by a piece of paper.

DIEGO TRUJILLO: Right. Right. And sometimes, like, sometimes you need to unlock people’s potential for growth, like you mentioned. So while their priority may have never been a four-year degree, they find themselves with a 16-hour certificate, they’re working in a new field, and then thinking, huh, I wonder if I could move to the next step and and you’ve kind of again unlocked that that idea that maybe I should maybe I should push on yeah that is very much my story to be honest with you as for me as I went to a school that was you didn’t receive college credits for it because it was a seminary but I remember finishing that and saying well I did two years here right You know, I learned all these, but none of this is transferable to university. I might as well finish off. I’ve already started. Right. And so by that point, next thing you know, I had done another two and a half years and, you know, um, I had finished off my degree and now all of a sudden, yeah, I can enter a graduate program and I can, and I can use those skills. Back then I was very motivated. I was like, all right, I’m going all the way to my PhD or my master’s of divinity. And then I was like, yeah, I’m good with my bachelor’s, right? At this point it’s time to work. But I think again, it’s, it allows people to know what they don’t know and what they’re capable of. Yes. which sometimes, and more often than not, they very much underestimate what they’re actually able to achieve. Absolutely.

STAVAN CORBETT: So what programs do you offer specifically? So right now our programs, predominantly we pull from the Governor’s Office of Economic Development. We pull from, you know, the workforce, LVGEA, Chamber Blueprint, Workforce Blueprint. We know that healthcare, manufacturing, business and professional services, CIT, IT. These are all our major in-demand occupations. These are the occupations that are going to bring a diverse economy into fruition, right? And so right now, our two most robust, I would say, is healthcare manufacturing in terms of the short-term training. We have over 60-something degrees, two-year degrees that we offer, about 13 to 14 four-year degrees that the college offers. And it still varies, right, from liberal arts We have a robust, we’re building a robust CTE program to meet that, to meet those talent gaps that exist. And CTE for those that… Yeah, Career and Technical Education, right? So when you and I were in CCSD, I forget the name of it, but it’s now… I think they call it now SECTA, but that was the only school. Yeah, yeah, yeah. It was Votek. Votek, right. Back in the day, yeah, on the Hill. Exactly, right. And so now, you know, you can say what you want or think what you want, but our CTAs, you know, within the Clark County School District are some of the top in the nation.

DIEGO TRUJILLO: It’s incredible what they’re doing at the school district.

STAVAN CORBETT: Top in the nation, yeah.

DIEGO TRUJILLO: And I think sometimes it’s overshadowed when people look at the school district, because I hear a lot of criticisms. And I’m, listen, I always think before I criticize an organization, would I want to be the leader? And if the answer is no, that seems like a very difficult job, then I’m very careful with my criticisms, because it’s, you know, that’s like me watching a football game on a Sunday and saying, well, I should have done that. Like, hey man, can you run as fast as he can? Yeah, you can’t even do the basics of what he can do. No, 100%. So maybe you’re not calculating. But with CCSD, I hear that. I mean, even for me, I think it wasn’t until I was like 25 that I realized how large our school district is here. But that is something that I am very proud of when people bring it up. Now our magnet programs, our career and technical education, I mean, they really are putting some incredible efforts into it.

STAVAN CORBETT: Absolutely. I mean, yeah. And so that that’s a support system. And so at the college, we’re always that’s talent, like that’s talent that is being produced at its highest levels. How do we maintain that? A lot of those individuals go on to other states. And so we lose out on a lot of that talent, that brain drain. Right. And so what is it that we’re doing as a college system to recruit individuals that have been homegrown and come into the workforce, go into the training force, and contribute to these opportunities.

DIEGO TRUJILLO: See, and that’s one of the things that I examined when you look, right, Las Vegas, and we always tell people this, in healthcare, is very different. Because companies will come and say, oh, we dominated Texas, and we dominated, you know, New Mexico, and then Arizona, and now we’re moving into Las Vegas, and we’re here to set a name, and then they’ll last two years, and then withdrawal. Yeah. Just because Las Vegas is so unique, and when it came to workforce, Um, so a while, when I first started getting into this, I, I formed a think tank. There was someone that was very, very smart when it came to workforce, and I knew I didn’t know about workforce, but I knew about healthcare. And so, we would grab coffee once a week, and I, you know, as we were exploring ideas and challenges, um, he would kind of guide me, and we identified one huge magnet here. And it was, for me, A little frustrating because you have kids that are graduating. I’d go speak at Desert Rose. Yeah. So I’d speak to the kids coming out of the CTE program. I would ask them, okay, so you want to be, you’re going to graduate as a medical assistant. And all these kids would raise their hand. So where do you want to work as a medical assistant? And they would just kind of shrug their shoulders. And I realized right then there was a problem, right? Well, in a doctor’s office. Well, that’s kind of obvious, right? That’s where you’re going to end up. But what kind of doctor’s office? If you end up at pediatric oncology, and you have a younger brother and sister, and now you’re watching children die all day, it starts becoming very depressing. It’s not a very fulfilling job or one that might make you happy. And so you think, you know, I’m going to get another job. And you get one at a wound clinic, thinking that you’re going to put Band-Aids on cuts. And it turns out wounds can be very, very disgusting. Yeah, sure. And so next thing you know, you turn 21. What just opened up for you? Right. So I was like, we invest all this time and all this effort into training the young kids. And we have this gigantic magnet sitting right there that offers immediate gratification. Do you want to make $400, $500 a night? And so it’s very hard, especially as a young person, to say, no, you know, I really want to, you know, put off all the nice things I can own right now and look forward to the future 20 years from now. But that’s a goal. How do you reach out to those kids? How do you kind of incentivize them to not focus right at what’s right in front of them?

STAVAN CORBETT: Yeah. So, so great. Well, I don’t think anybody’s figured that out yet. Yeah. Right. I know I’m on it.

DIEGO TRUJILLO: I was hoping you would share that with me because I need to apply that.

STAVAN CORBETT: No, right. So, you know, you, you, you know, you always work one. It’s you. When I was in, uh, when I started out in workforce and I was a case manager, right. We would go door-to-door in communities, and knock on folks’ doors, and leave flyers, and hold info sessions.

DIEGO TRUJILLO: Do you feel that gave the results that you wanted? Not criticizing, I mean, you have to do something, right?

STAVAN CORBETT: So it evolved it, right? Now, was it optimal? No, of course not, right? And so there was definitely some, you know, there was definitely evidence that what we were doing was, one, different than what we had always has done. had done, and we did see an increase in our enrollment. So that was… There was an impact. Right. And so even now, one of the things, going back to outreach, going and tabling for us, the conversion rate is very low when we table sometimes. And so what we’ve begun to do is switch to a workshop model. And so in March, we’re going to be deploying mental health, free mental health workshops, free CPR courses, free resume writing, in an opportunity to say, listen, let us provide a service. Come and let’s start building a relationship so that we can have those conversations. Oftentimes, you know, somebody said something to me a long time ago, and they said, hey, rules without a relationship equals rebellion. And so when nobody’s coming to your program, it’s because there’s no relationship in place, right?

DIEGO TRUJILLO: That’s a really good saying.

STAVAN CORBETT: Rules without a relationship equals rebellion. I love that. been fortunate enough to have a team to say, let’s move in this direction. Let’s start the relationship being service-oriented and offering a support, offering knowledge, offering a service. And now when we get individuals who attend those workshops, we have a space to talk about career and educational pathways. We get a space to begin the conversation that didn’t begin before. And so, you know, that’s kind of how we’re pivoting. to make sure that we’re recognizing and securing and developing relationships with all that talent that’s untapped and doesn’t know how to connect their talent to the resources and the opportunities that exist.

DIEGO TRUJILLO: Yeah, and I think you’re right. That was a great expression that you used right there because while everyone at the college might not have the right heart, People on the outside might not have been around those environments, so they may say, well, yeah, of course you want me to go to your school, because you charge a tuition, or you want, you know, you want people in seats. But that’s not necessarily the case. And so the relationships are what’s going to help to bridge that gap and let them know where your heart’s at, saying, hey, look, we have this for you, whether you choose it or not. We’re still going to be here to serve you and to help you.

STAVAN CORBETT: The opportunity for us is, it’s kind of like knowledge, right? If somebody chooses not to go on that path, we want to make sure it’s not because they didn’t know.

DIEGO TRUJILLO: Yeah, that’s really good. Yeah, it’s an actual choice, but not a result of ignorance. So you said these programs are launching in March.

STAVAN CORBETT: Yeah, we’re starting out with resume writing, you know, how to do a cover letter. We’re supporting some mock interview workshops for individuals to come in. And, you know, we’ll have a strategy on how that goes out and how that information is shared.

DIEGO TRUJILLO: And we’ll have that in our newsletter as well, working at CSN. So if you get the HEALS newsletter, you should be seeing information. Keep an eye out for that in March.

STAVAN CORBETT: And that’s exactly right. It’s a service that we want to offer going back to responsibility, right? We’re the third largest community college in the nation, 33, 34,000 students. And there’s no community college as well positioned as CSN to support the opportunities that are before us when it comes to workforce and economic development.

DIEGO TRUJILLO: It lets you set the template. Yeah, 100%. I think it’s always very exciting when we look at, you know, sometimes bad news can be somewhat intimidating. And so when people will talk about health care, for example, the 48th in the nation, right, as far as primary care, and you look at these very negative numbers, and my thought’s always like, yeah, but with a very little effort in the right direction, we can really move the needle. Going from 48th to 30th is probably a lot easier than going from, you know, 6th place to 3rd place. And so I always get excited at those daunting tasks and those negatives, because I think we’re in a very unique position to turn them into positives. And like you said, right, we’re not going to figure this out.

STAVAN CORBETT: No, not overnight.

DIEGO TRUJILLO: Yeah, not overnight. But we can get started in the right direction and leave this for younger generations that could start figuring it out more. But I do like the perspectives, right? When you talk about serving leadership, when you talk about connecting with the community and being a resource to people, as opposed to, here, we need this, right? I think people begin to respond differently. And culturally, our attitudes towards these things begin to shift. We become more accepting to it, right? Because when one of the people that have gone through your program, when they speak to their kids, who might not see a way out, it’s a very different conversation because they’ve been in that area. That’s right. And so it’s kind of like when you were a kid and you’d have a friend or a relative that, you know, their parents would be an expert in one area and they’d help to break it down. Everyone needs that gateway in. Oh, yeah. Right? And removing those barriers. Right. And so it’s incredible to be able to speak with you today. I want to thank you very much for coming on and sharing and, you know, sharing your story, finding out that you’re a Las Vegas native as well.

STAVAN CORBETT: Yeah, right.

DIEGO TRUJILLO: Not wanting to exclude anyone that wasn’t born and raised here, but it’s very rare when we run into each other.

STAVAN CORBETT: No, it is.

DIEGO TRUJILLO: So we always get excited, right? Indeed. That’s excellent. Well, thank you very much for coming on. How can people find out more about your programs? How can they get engaged?

STAVAN CORBETT: Yeah, so, you know, definitely going to the CSN website. We have a plethora of information on there. You know, we can do the old school 6514747 is the number to reach. That’s a catchy number, right? That’s a catchy number. So that’s there. But, you know, it’s with today’s technology, always just reach out, right? Call, email, go onto the website. We have social media channels as well. We have partners that we collaborate with that you can track through to us. But, you know, we want to make sure that we’re out there. If there’s opportunities that we’re not in a space or that resources can be provided, let us know. You know, again, we haven’t figured it out completely, and we always keep an open mind.

DIEGO TRUJILLO: And just to let everybody know that’s listening at home, it’s not just for people wanting to go through these courses. If you’re an employer that is really struggling with employment, correct?

STAVAN CORBETT: Correct, yeah. So we do have a business development team who goes out and meets with employers, and we literally just look over, hey, where are your talent gaps? We can customize a training for you. We can serve as your pipeline, right? If there are gaps in there, we work with Blue Bunny Wells. We work with even the school district, where we’ve taken customized training, embedded it as part of our ongoing portfolio of courses, and recruit for those employers to make sure that the talent and the curriculum matches the job description and matches the needs of the employers.

DIEGO TRUJILLO: Yeah, the lines have to meet. Otherwise, you’re just training people that can’t get hired anywhere, right?

STAVAN CORBETT: No, these are not cookie cutter out of the box, right? 95% of the time, if not more, is our subject matter experts working with the company’s subject matter experts. And they’re exchanging drafts of the curriculum. And until the employer says, that’s it, that’s what we end up delivering.

DIEGO TRUJILLO: So as an employer, you can jump in to help shape the programs the Department of Workforce is developing.

STAVAN CORBETT: 100%, right? That’s a service.

DIEGO TRUJILLO: I think sometimes people don’t know that. They don’t know that they can, I wouldn’t think that you could just call a university and say, hey, can you please teach this? I need this.

STAVAN CORBETT: Yeah, no. But that’s very much what you do. That’s exactly what we do. And that’s what the division, that’s why the division of workforce exists is to take those customized, personalized, just-in-time training approaches and make sure that what’s being delivered, the SMEs on the employer side, has their handprints all over it.

DIEGO TRUJILLO: Fantastic. And I want to finish off today. I want to ask you a question. What is one leadership lesson that you’ve learned that is the one thing that you pass on to every person that you lead?

STAVAN CORBETT: Yeah. I mean, the first thing that comes to my mind, so I’m going to trust it, is that empathy. It’s so important, right? And balancing what is in this work. We’re in some mission-critical work, right? Like, there’s a lot of stuff that’s happening, and it’s impacting lives. And you still have to practice that empathy with your team, with yourself, and again, going back to balancing and meeting that critical mass, what’s needed, but making sure that you’re supporting the team that’s going to get it done. Otherwise, it’s just not going to get done. It’s not going to happen. No.

DIEGO TRUJILLO: Well, Stevan, I want to thank you for coming on today. That’s Stevan Corbett, that is the Executive Director at the Division of Workforce at the College of Southern Nevada. Sorry, when I was younger it was the Community College of Southern Nevada.

STAVAN CORBETT: I knew what you were talking about. It’s still in my head.

DIEGO TRUJILLO: I want to thank you for coming on today. It was really interesting, and I think we do need to do some quarterly updates on what’s happening on workforce. I think it’s important that people understand, because I think as employers hear this, and they understand that there’s people that are listening to their feedback and pivoting to their needs, we get more engagement from employers. And really, to solve this problem, it’s not going to be just your department. We need the employers. We need the different conveners. We need everyone working together on this. Um, which has been somewhat of a challenge in Las Vegas in the past, but I think our mentality is changing and I’m very excited to see that. I think we realize all that now that the growth is coming. Yep. Um, it’s right here. If we fumble the ball, this is on us. Yeah, a hundred percent. I, uh, I’m very excited to have you in. Thank you very much for sharing your experience, um, and how you got where you are and the leadership lessons. Thank you very much. And thank you to everybody that’s listening at home. You have listened to another episode of The Heels Pod with Stevon Corbett from the College of Southern Nevada.