Community and Care: Addressing Mental Health Challenges in Las Vegas with Dr. Sid Khurana

By | HEALS Pod

Episode Description

n this episode of the HEALS Pod, I, Diego Trujillo, CEO of Las Vegas HEALS, had the pleasure of interviewing Dr. Sid Khurana, one of the co-founders of Nevada Mental Health. Our conversation delved into the pressing issues surrounding mental health care in Las Vegas, particularly the challenges of access and the ongoing shortage of healthcare providers.

We began by discussing the inspiration behind Nevada Mental Health, which stemmed from a personal encounter Dr. Khurana had with a handyman seeking mental health resources for a family member. This moment highlighted the lack of accessible, insurance-based mental health care in the community, particularly for those who fall in the middle-income bracket. Dr. Khurana shared his journey of moving to Las Vegas and how he has witnessed the city evolve over the past 12 years, noting its family-friendly aspects and the abundance of outdoor activities that often go unrecognized.

As we explored the current state of mental health care in Nevada, Dr. Khurana pointed out that despite some progress, the state still ranks last in the nation for mental health access and disease prevalence. We discussed the interconnectedness of mental health, substance abuse, and homelessness, emphasizing the need for a holistic approach to these issues.

Dr. Khurana elaborated on the mission of Nevada Mental Health, which focuses on providing quality, patient-centered care without the common practice of double booking appointments. He emphasized the importance of building a strong therapeutic relationship between patients and providers, which is crucial for effective treatment outcomes. We also touched on the significance of patient engagement and the need for reeducation to foster a collaborative approach to mental health care.

A significant portion of our discussion revolved around innovative treatment options, including Transcranial Magnetic Stimulation (TMS), a non-invasive procedure that targets specific areas of the brain to treat conditions like depression and anxiety. Dr. Khurana explained the science behind TMS and how it offers an alternative for patients who may not respond well to traditional therapies.

We also addressed the broader cultural context of mental health in Las Vegas, including the transient nature of the population and the impact of individualism on community support systems. Dr. Khurana highlighted the importance of resilience-building in children and the role of supportive family structures in fostering mental well-being.

Towards the end of our conversation, we touched on the potential of psychedelic-assisted therapies and the need for ongoing research to explore their efficacy in treating mental health conditions. Dr. Khurana expressed his openness to integrating new scientific findings into practice, emphasizing the importance of curiosity and evidence-based approaches in mental health care.

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Transforming Healthcare Delivery: Lessons from Hospitality with Stowe Shoemaker

By | HEALS Pod

Episode Description

In this episode of HealsPod, I had the pleasure of interviewing Stowe Shoemaker, a renowned figure in the hospitality industry who has made significant strides in bridging the gap between hospitality and healthcare. Stowe shared insights from his book “Hospitable Healthcare” and discussed how principles of hospitality can be applied in healthcare settings to enhance patient experiences.

The conversation delved into the importance of incorporating hospitality principles in healthcare, emphasizing the need to treat patients as “loved family members” rather than just customers. Stowe highlighted the significance of empathy, reliability, and responsiveness in creating a positive patient experience, drawing parallels between the hospitality industry and healthcare.

Stowe introduced the “payer model,” a framework designed to prepare, anticipate, engage, evaluate, and reward patients throughout their healthcare journey. He emphasized the role of empathy and tangible experiences in making patients feel comfortable and valued, even in challenging situations like emergency room visits.

The discussion also touched on the implementation of the payer model in healthcare settings, with Stowe providing examples of how hospitals like MD Anderson have successfully integrated these principles to improve patient care. He encouraged primary care providers to consider adopting elements of the payer model to enhance patient satisfaction and attract more patients to their practices.

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Empowering Women in STEM: A Conversation with Rosemary Brock

By | HEALS Pod

Episode Guide

In this episode of the Heals pod, I had the pleasure of interviewing Rosemary Brock, the founder of the Nevada chapter of the Association for Women in Science (AWIS). Rosemary shared her journey and the mission of AWIS, which focuses on supporting women in STEM fields. She highlighted the importance of closing the “dream gap” for young girls and empowering women in their STEM careers.

Rosemary discussed the challenges women face in STEM fields, such as gender biases and career interruptions. She emphasized the need for mentorship and support to help women advance in their careers. The conversation also touched on the role of storytelling in communicating science and the importance of casting a wide net in workforce development.

The episode highlighted the upcoming event hosted by AWIS Nevada, where a panel of top women in STEM will share their career journeys. The event will also introduce a mentorship program to support women at various stages of their STEM careers. There is excitement about the event and we encourage listeners to attend and support the community-building efforts of AWIS.

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Embracing Evidence-Based Medicine: Intermountain’s Commitment to Excellence with Mitchell Cloward

By | HEALS Pod

Episode Description

In this episode of the Heals Pod, I had the pleasure of interviewing Mr. Mitch Cloward, the president of Intermountain Health’s Desert Region. The conversation delved into Mr. Cloward’s background, his journey into healthcare, and the values that drive Intermountain Health as an organization.

The episode started with Mr. Cloward sharing his early experiences in healthcare, beginning as a housekeeper in a trauma hospital and how that shaped his perspective on the importance of every caregiver in the healthcare system. He emphasized the significance of compassion, kindness, and human skills in addition to technical expertise in providing outstanding patient experiences.

Mr. Cloward highlighted Intermountain Health’s commitment to quality, safety, and evidence-based practices in healthcare delivery. He discussed the challenges faced in the healthcare industry, particularly in addressing mental health needs and chronic disease management. The importance of community partnerships, continuous improvement, and engaging with patients on a personal level were key themes throughout the conversation.

The episode also touched on Intermountain Health’s recent expansion into the Nevada market through the acquisition of Healthcare Partners of Nevada, focusing on senior care. The organization’s approach to integrating evidence-based practices and tracking outcomes to ensure the highest standard of care for patients was a central point of discussion.

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Breaking Down Stigmas: The Evolution of Addiction Treatment with Dr. Partida Corona

By | HEALS Pod

Episode Description

In this special edition of the HEALS Pod, we continue our Southern Nevada Opiate Response Series, focusing on addiction and substance use disorders. The host introduces Dr. Partida Corona, an expert in the field of addiction medicine, to delve into the science, diagnosis, and treatment of addiction.

Dr. Partida Corona discusses the scarcity of addiction specialists in Las Vegas, highlighting the need for more healthcare providers in this area. He shares her journey into addiction medicine, starting with his residency at UMC Hospital, where he observed the prevalence of chronic pain management leading to substance abuse.

The conversation shifts to the definition of opioid use disorder, emphasizing the biological changes in neurochemistry that drive addiction. Dr. Partida Corona explains the importance of medication-assisted treatment, such as buprenorphine, in managing addiction and reducing harm.

The host and Dr. Partida Corona explore the stigma surrounding addiction and the need for a shift in mentality towards treatment. They discuss the effectiveness of peer recovery navigators and the power of human connection in aiding recovery.

The episode concludes with a call for collaboration, understanding, and empathy in addressing addiction as a chronic condition. Dr. Partida Corona emphasizes the importance of recognizing the humanity in patients and meeting them where they are in their recovery journey.

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Navigating Estate Planning and Business Succession: Insights from Shane Jasmine Young

By | HEALS Pod

In this episode of the podcast, I had the pleasure of interviewing Shane Jasmine Young, a successful estate planning attorney based in Las Vegas. Shane shared her journey of starting her own law firm with her husband and the pivotal moments that led her to specialize in estate planning. She emphasized the importance of comprehensive estate planning to avoid probate, protect assets, and ensure smooth transitions for families. Shane also discussed the challenges and rewards of entrepreneurship, highlighting the crucial role of support from loved ones in pursuing one’s passion.

The episode delved into the intricacies of estate planning, including wills, trusts, and the significance of having a clear plan in place to avoid conflicts and ensure the smooth transfer of assets. Shane’s personal anecdotes and professional insights provided valuable guidance for listeners on the importance of proactive planning and seeking the right expertise to navigate the complexities of estate planning.

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Full Transcript

DIEGO TRUJILLO:
Ladies and gentlemen, this is Diego Trujillo. Welcome to another episode of the HEALS podcast. I am very excited to have a very special guest today. And also, I’d like to consider a friend. We’ve been watching each other from afar for a while. We met not long ago at a women’s conference, and I learned a little bit about what she did. And I’m excited to have you here with us is Shane Jasmine Young. How are you doing today?

SHANE JASMINE YOUNG: So good. Thank you for having me.

DIEGO TRUJILLO: I always need to really double check myself to make sure I don’t mispronounce the name. No, you got it. You know, it happens occasionally. So thank you very much for coming in. I know we had reached out a while ago. I had been sharing with you how we kind of dug into hospice and we were talking about hospice and final arrangements. I was like, you know, we unpacked it briefly. And in this podcast, I’d kind of like to unpack a little more on the final arrangements, right? on the wills, the trusts, the states. But before we dig into that, I’d like to kind of find out a little bit about how you’ve been doing. How’s the law firm going?

SHANE JASMINE YOUNG: Yeah, it’s been going great. So as you know from us being friends, my husband and I grew up here. He’s born and raised. We’re high school sweethearts, actually. And we went away to college but came back here to Las Vegas because this is where our home is. Our families are here. And we started our law practice in about 2017. So yeah, seven years now. And our focus is estate planning primarily.

DIEGO TRUJILLO: And was that always the goal? So when you guys grew up here in Las Vegas as a little girl, I’m kind of curious, what side of town?

SHANE JASMINE YOUNG: I grew up in Henderson.

DIEGO TRUJILLO: So I went to Green Valley High School. I went to Chaparral. So it’s always like the kids on the way. He went to Eldorado. Fair enough. I like you a little more now. Both of you.

SHANE JASMINE YOUNG: That’s great. So we grew up here. He’s born and raised. I grew up here. Well, I moved here when I was nine. And I didn’t always know that we were going to start our own practice. And he’s not an attorney, by the way, but he runs the business. He’s the CEO, COO, handles all the marketing, you know, that type of thing. But when I went to law school, he had started talking about having our own firm and, you know, what the plans would be.

DIEGO TRUJILLO: And in mind for you, you always wanted to be an attorney.

SHANE JASMINE YOUNG: I did. So when I was growing up, my dad was an entrepreneur, and he started his own airline, and he used to work for another company, decided to start his own business, and it ended up going south because he was taken advantage of, essentially. And some investors, including an attorney, took advantage of him and took control of the business. So this happened when I was very young, and they ran it into bankruptcy. So my family had a lot of financial hardship. There was a lot of up and down, you know, growing up, a lot of uncertainty. And my dad instilled in me, my parents instilled in me, you know, the importance of being able to be educated and make proper decisions and rely on the right people. So he had said, you know, you got to go to law school, so this doesn’t happen to you.

DIEGO TRUJILLO: Because even then, it’s tough. I mean, people don’t have an understanding a lot of times on, you know, these shotgun clauses, the way you can push different partners out. I mean, it really can be rough. So it’s something that you experienced and witnessed at a young age. Right. So what pushed you towards, was it in law school that you said, you know, I want to do estate planning?

SHANE JASMINE YOUNG: You know, it didn’t come until later. So after I graduated from law school, I was an attorney at in big law. So I worked for a really big law firm. They actually didn’t do estate planning. But my first pro bono case where I was volunteering as an attorney was a probate matter. And I saw firsthand how this family had relied on an estate plan, you know, the father that passed away. had a plan, he had a trust, but it wasn’t done correctly. And the family ended up fighting, you know, with his ex-wife and it had to go through probate and, you know, taxes and all these things. So as a first-year attorney, that’s what really piqued my interest. And then ever since then, I had done pro bono cases. And then I got more experience doing estate planning through the years and also working as the general counsel for a financial services company.

DIEGO TRUJILLO: See, and I think a lot of people, you know, sometimes we don’t see how south it can go. And I’ll be very honest, and I’ll get kind of cultural on this, because we’re Hispanic, and I’ve talked about this on the podcast before, and it very much matters, the cultural impact of it. It’s very interesting when approaching it, especially, for example, when you talk about hospice, end-of-life care, and you bring that up to, you know, my Hispanic parents, oh, no, no, no, we don’t want to talk about that. There’s a conversation we need to have, like this is very important. So this is what we were discussing when Karen Rubel was on from Nathan Adelson Hospice. And, you know, we’re talking about these cultural approaches. And when it comes to final estate planning, it was very interesting for me and eye-opening working in hospice. I have some absolutely horrible stories that could have been solved by a conversation. Some of that could have been solved by an attorney. I remember, I’ll never forget one time I walked in, we were trying to discharge this patient. The case manager, well, let me find out if the person has, you know, any income so that they can pay monthly. They had probably between three to six months to live. And I remember, you know, they checked in, the kids were on board, but the wife, which was not the children’s mother, had control and said, well, I don’t know if he’d want to spend his money on that. Yeah, and we just looked at each other in shock like what what else would someone want to spend their money on than a place to live, right? It’s just and I didn’t I hadn’t developed that malice yet It wasn’t till the social worker was like, hmm. I wonder what she would want to spend it on right? And I was like, oh my god. Yeah, she totally seized control. He had not made any arrangements any plans I’ve seen this there was a patient one time with his wife and like glioblastoma, so she had tumors growing in her brain, and she lost the ability to be able to communicate. And I’ll never forget, they were the sweetest couple, I’ll never forget going through the paperwork to sign the hospice paperwork and getting to the DNR, saying this is a DNR, this says that, you know, should your body, should her body stop, that, you know, that we’re not going to do any kind of life-saving measures or anything like that. And it was a conversation I had had a hundred times. I mean, really repeated over and over. So for me, it was kind of rogue going over the explanation. And I could see as I was explaining the weight of this decision come on this man and he tears up and he goes, how can I make that choice though? I feel like I’m the one killing her. And I just, right. And I explained, I was like, look, sir, it’s not you. It’s the disease process. And unfortunately where you’re at. I realized, I remember I went home and said, mom, dad, you guys need to have a conversation at the very least of what do I do at this point? I just felt so bad for this man. And I’m sure this is things that you see play out on a constant basis.

SHANE JASMINE YOUNG: We do. And, you know, you have seen the worst of it in real time, right? Where these people are trying to make these decisions last minute, you know, in your presence, having never thought about them, having never had conversations. And we see it also, you know, unfortunately on the, you know, the law firm side where we will often get calls from frantic family members saying, you know, my parent or my grandparent, you know, they’re sick, they’ve got, you know, this condition, they’re in hospice, and they don’t know what to do. And so that’s definitely where we don’t want to be planning, you know, last minute.

DIEGO TRUJILLO: I always, and I would always say it, it’s like shopping for car insurance after your car has gone off the cliff. Right. Like, you know, that’s not the time to shop. It’s when you’re calmly at home and you can really look over all of your options. I would always tell people this.

SHANE JASMINE YOUNG: Yes, exactly. And that’s the thing that we try to get out there in the community. You know, thank you for this podcast, by the way, because having these conversations now and getting people thinking about these things is so important. Because when it’s too late, there’s limited options that we have available. If you don’t have capacity to be able to make decisions, we’re definitely much more limited or there’s another course that involves court that people don’t realize they would have to go through. Yeah, it gets a lot more complicated. Or a conflict within the family as you shared. Here’s one person on one side saying, nope, this is what they would have wanted.

DIEGO TRUJILLO: They wouldn’t have wanted this to spend money on that. Yeah, and everyone’s clearly seeing what the end goal here is. Yeah, no, I can’t imagine the frustration dealing through those situations on top of the fact that you’re losing a loved one. I mean, you’re already going through an extremely difficult time. It’s hard enough. And having to plan funeral services and having to pick all of these things out. I remember repeating a million times, and my sister was always very good with my father on, hey, you know, get all of the documents in one place. And even then, there were still some floating around.

SHANE JASMINE YOUNG: Right, and that’s why it’s important, you know, that, you know, we tell clients and the community, plan while you can, you know, plan while you have the ability to make these decisions while you’re alive and well, you have the capacity, you can have the conversations, put the proper planning in place now so that there’s not a conflict, there’s no question as to what would she have wanted or what would he have wanted or What are we supposed to do now? Or, you know, of course, ending up in court or worse.

DIEGO TRUJILLO: Yeah, even worse. Yeah, where now people are fighting over it and now there’s siblings involved. I would always explain this to people. I mean, people always have this assumption where, you know, when a loved one is going to pass, that everyone comes together. And I’d love for it to be that way. But 90 percent of the time, there’s a lot of emotions. There’s anger. There’s bargaining. There’s, you know, people are going through the stages of grief and everyone handles it completely different.

SHANE JASMINE YOUNG: And that’s often where you see the worst of people come out. I mean, in my own family, I’ve seen it where someone passes away and they may or may not have had any planning in place. And, you know, it’s the grandchildren, it’s the children that are fighting over things. And it’s just not a situation that you want to be in.

DIEGO TRUJILLO: Yeah, there’s ways, especially when you can avoid it, right? Yes. I mean, this is like going mountain climbing and then like, you know, looking for rope after you’re halfway up on the mountain or slipping off, right? This is something you could have planned for and something you could have looked into. And for me, it really spoke to, uh, you know, this, this weekend, I had an epiphany. I was out hiking in a rainforest up in the Northwest. And, uh, and it was really interesting to me. I never explored that kind of forest. I’ve been in jungle. I lived in Central America, but I’ve never been through a forest like that and watching the way these, these giant trees would fall. And as soon as they’d fall, you’d see all these other trees spring life from them, right? So the term is nurse log. And I thought, am I going to be one of those trees when I fall? Like eventually I’m going to be gone. Am I just going to take up space and rot away? Or are things going to grow from what I’ve left, right? And I think like family planning, especially when it comes to estate planning and things like that, I mean, do you, Do you want to let the state figure it out on your behalf? How efficient are they at doing these things, right?

SHANE JASMINE YOUNG: And what a picture you paint, you know, through that, you know, that analogy, that metaphor, right? Where, you know, I don’t think people want to think, number one, they don’t want to think about those things oftentimes. And we see it, you know, culturally, as you mentioned, you know, different cultures, different communities. have a harder time by dealing with the death or dealing with planning for those types of situations.

DIEGO TRUJILLO: Or the thought of death, right?

SHANE JASMINE YOUNG: Yeah. Or they think that by talking about it or by planning that they’re going to bring it on. There’s all these misconceptions, all these myths. And so I can tell everyone that’s listening. You know, by planning, we have never seen, you know, that cause be the cause.

DIEGO TRUJILLO: Do you have the data? Do you have the data? Okay, we need hard numbers. How many of your clients have spoken with you and passed within a year? Right. It just doesn’t happen that way. I think it’s part of a sanitized society that we live in. And I’ll never forget one time, I was reading this book by an Anglican philosopher. And it was really brilliant. He was like, you know, I always push families to do an open casket. And he goes, I know it sounds very crazy, right, that I would insist on this, but we live in a world where we never see death. It’s just not something that we’re exposed to. And you could tell by the way people drive. I mean, people really don’t realize how, like, you are at the edge at all times. You can fall off a little two-step ladder in your home and that’s it, right? And we act like death is just this concept. It’s so far away from us. It’s so distant because we live in a world that’s so sanitized. He goes, you know, every time we would do a funeral service, I would always insist. He goes, no, right. There’s certain exceptions. He goes, but I’d always push the family because there’s a part of being human and standing over that loved one and facing our mortality. And it really leads to us as an audience living different lives as a result of that.

SHANE JASMINE YOUNG: It’s so true. It’s so true. And I think that’s just another common misconception that you brought up is people think, you know, I’m not old enough. You know, I’m not close enough to death to require an estate plan or another. Another one is, you know, I’m not wealthy enough. People think that you have to have you know, millions of dollars to be able to plan for, you know, that time. And an estate plan really should be a plan that anyone puts in place that’s over 18 that, you know, deals with that.

DIEGO TRUJILLO: So unpack that a little bit. Let’s kind of dig in now that you kind of touched that subject, right? So when you’re talking about estate plans, you’re talking about wills, you’re talking about trust, can you break it down for the audience just so we have some clarity? I know we all know everything already. But for everybody else.

SHANE JASMINE YOUNG: Just so we have some clarity. So the common thing when people hear estate plan is you think of, you know, a will or a trust. Sometimes I hear life insurance, right? So those can all be components of an estate plan, but your estate plan really should be a comprehensive plan. that addresses all types of contingencies. So some of these examples that you know you’ve brought up. If you’re in an accident, if you are incapacitated, if you’re in the hospital, who can step in immediately to be able to talk to your doctors if you can’t speak on your own behalf? Who can make those decisions as far as medical care, end-of-life decisions, without any conflict, without family members fighting or disagreeing as to what you would have wanted? who can step in and actually make those decisions for you legally, you know, be authorized to do so, who can go and handle your financial affairs.

DIEGO TRUJILLO: Which is, yeah, the medical power of attorney and the financial power of attorney. So you could even separate your estate among the people that are to kind of have responsibilities.

SHANE JASMINE YOUNG: Exactly, because there’s different roles, right? There’s, you know, the medical side and then there’s the financial side. So financial powers of attorney are important if you’re incapacitated. So if you haven’t passed away and you need someone to go to the bank for you, Because you can’t handle your financial affairs, you can’t pay your bills, pay your mortgage. You want someone that you trust as a fiduciary, as a financial agent, to be able to go and handle those affairs for you while you’re still alive. So that’s a financial power of attorney. Now, after you’ve passed away, now it goes into, do we have a will? Do we have an executor? Do we have a trust? Do we have a successor trustee? Those are different roles there.

DIEGO TRUJILLO: So and you do this analysis with every client that comes in?

SHANE JASMINE YOUNG: Yes, so what we do is we invite everyone, including the audience, to schedule a complimentary family wealth planning session. So this planning session normally is $750, but when you come through, you know, someone like Diego, you know, this podcast.

DIEGO TRUJILLO: Thank you very much. I mentioned Las Vegas Heels. Yes, please. And this is a one-on-one meeting? It is.

SHANE JASMINE YOUNG: So they’ll have the opportunity to schedule a one-on-one meeting or, you know, if it’s a couple, you know, with an attorney, a private meeting. And we go through and we talk about where things are. You know, what are your concerns? What are your family dynamics?

DIEGO TRUJILLO: What are the typical questions do you ask? I guess people, I’m kind of curious, right? Walk us through a little bit. What are the questions? Where are you trying to get immediately to kind of start putting this picture together?

SHANE JASMINE YOUNG: Sure. So before clients come in for a family wealth planning session, we ask that they watch a webinar. So there’s a 60 minute webinar on our website. It’s younglawlive.com. And it’s, the webinar goes into more, a little more detail, but still it’s kind of like estate planning 101. What is a will? What is a trust? What are these important decisions that we want to make? How do people often make mistakes that end up with their plans failing? How do we avoid those mistakes? So, and it gives a good sense of, you know, who we are as a firm, because we do approach things differently than the traditional estate planning firm or, you know, estate planning lawyer, where we want to make sure that all of the bases are covered and it’s comprehensive. So, when they come in for the session, before they come in for the session, They complete a family profile that gets them thinking really about what is important to me. So it’s almost like a questionnaire. Are you concerned about X, Y, Z? Is it probate? Is it protecting your young children? Is it your pets? Is it your spouse? Do you want to avoid taxes? Are you a business owner? All these different dynamics go into how we guide clients through the planning process. It also helps the benefit of the family profile and kind of going through this process is it allows them to become financially and legally organized. They’re gathering this information, they’re thinking about these things, so that… Which otherwise would just, the family has to go rifle through everything and kind of put these pieces together. Yeah, and you’re always missing something when that happens. Okay. So it allows us to start the process of gathering the information and making their plan as comprehensive as they want it. So when they come in for the session, we talk through, you know, those items in the family profile. I’ll ask about the family dynamics. You know, are they married? Are they single? Do they have young children? Do they have adult children? Do they have adoptive children? Any pets that they’re concerned about? You get very thorough. Yeah, so all of those family details. And then we also talk a little bit about the assets. So, do you have a home? Do you have bank accounts? Do you have investment accounts, retirement accounts, life insurance, you know, vehicles, personal property, like all the things in your home? Let’s take a brief inventory of these things because a lot of people don’t realize that if you have a home, if you have some of these assets, it’s a trigger for probate if you don’t have a proper plan in place.

DIEGO TRUJILLO: Okay. And probate being?

SHANE JASMINE YOUNG: Probate is the court process that we have to go through when a loved one dies, and they don’t have a proper estate plan. So they either have no plan, or maybe they just have a will, or they have a defective trust, a trust that wasn’t set up properly. So if you only have a will, for example, and let’s talk about the difference between a will and a trust. So a will really only deals with the disposition of your assets. It basically just says who gets what. And when you only have a will, it has to be filed with the probate court. So the probate judge is the one that’s deciding how quickly these parts of your estate are finalized. Creditors are the first ones that are able to make claims, and they are the first ones that get paid. including, you know, the government, the IRS. So taxes come out of your estate and your family has to wait during this process until it’s finalized and a judge basically issues an order saying… They kind of clear everything, basically.

DIEGO TRUJILLO: The role of the probate is to make sure all the creditors are paid, basically. Exactly, right. So they make sure everyone gets paid and then say, okay, you can have this stuff.

SHANE JASMINE YOUNG: Exactly. And it’s voluntary. That’s what a lot of people don’t realize. So if you don’t have a proper plan, you only have a will, then you’re opting your family in to probate into this process. And it’s a public process. A lot of people don’t realize it’s public. So anyone can go and see what’s in the estate, who the family members are, who the heirs are that are supposed to be receiving these assets. That’s how a lot of predators will prey.

DIEGO TRUJILLO: I was just going to ask you, you said that with a certain look in your eye, as if like, yeah, this is where they’re finding. What is happening there? What are people seeing? You mentioned predators and bad actors.

SHANE JASMINE YOUNG: Yeah. So are you familiar with Tony Hsieh, the former Zappos CEO? So he was based in Las Vegas. He was 46 years old when he passed away a couple of years ago now. And his estate has had to go through probate because he didn’t have anything in place, not even a will. So now his brother and his father were appointed as executors. One of them has since stepped down. But he had all of these properties where creditors were able to make claims, including his ex-girlfriend that said, you know, I have this contract that says I’m owed $15,000 a day for, you know, this and that, or I think actually it was $30,000. So all of these people have come out of the woodwork making claims on the estate because they’re able to see what assets he had, including real estate.

DIEGO TRUJILLO: So people just make up claims and just start showing up and saying, hey, I’m owed this.

SHANE JASMINE YOUNG: Yes. And some of his properties were actually fraudulently transferred because these bad actors were able to get access to information on his assets, Tony Hsieh’s assets. So they went and they filed these fraudulent deeds. It only came out after the fact where there were some other people involved in his estate on his side that were able to see that these things had happened. And otherwise, these assets would have been transferred to these third parties, and no one would have known.

DIEGO TRUJILLO: So this is one of your more money, more problems situation going down without some kind of arrangements or final arrangements made.

SHANE JASMINE YOUNG: Right. But even for people that don’t have extensive assets. These could all be headaches, even if you don’t have a lot. If you only have a house, which most people do. Even without a house, if you’ve got bank accounts, investment accounts, anything else that’s important. Nevada has a really low threshold. So any estates that are valued at over $25,000, There has to be a filing, a probate-related filing. Now, a lesser amount of assets is not going to take as long as something that’s a little more complicated or more assets, more value to it. But yeah, there’s a filing. So that’s what happens if you only have a will. So a will just deals with the disposition, just says who gets what. But ultimately, it’s a judge that decides how that happens and when it happens. Now, if you have a trust, it’s a much more comprehensive set of documents beyond just a will. So yes, it’s going to include… Does it include a will? It does. So when we do planning, we always include what’s called a pour-over will with a trust because if there is an asset that doesn’t get properly titled or retitled if it’s not in the name of the trust. And I can talk about that, what that means. Then we use the pour-over will to basically submit that to the court and say, hey, judge, we don’t need to do a full probate here. We actually have a trust. We have these other assets. This asset was just left out. Can we pour it into the estate?

DIEGO TRUJILLO: Oh, it just kind of covers whatever might not have been named. Exactly.

SHANE JASMINE YOUNG: Yeah, it’s just a safeguard. So yes, we still do a will, but really when you have a trust, that’s the centerpiece of your plan. And I’m talking about a revocable living trust. So the main purpose of a revocable living trust is that we’re able to avoid probate, we’re able to avoid taxes, we can keep everything private and handled immediately by the people that you want and trust. to handle things versus having to go through a public extended process, expensive process. That’s another thing a lot of people don’t realize, how expensive probate can be.

DIEGO TRUJILLO: Which is important. If you’re wanting to hide your assets, just keep it private. If you don’t want everyone to find out, this would be the vehicle to be able to do that.

SHANE JASMINE YOUNG: Exactly. Because everything can be handled privately with our guidance. We’re there to guide. But everything can be handled within the family, within the people that are legally authorized to step in. Everything is laid out, so there’s no question. There’s no conflict. Family members don’t have to go to court.

DIEGO TRUJILLO: And typically, yeah, I was going to ask, so who would challenge those kinds of things?

SHANE JASMINE YOUNG: Yeah, so if you have a properly set up plan, then one of the things that we include are provisions like a no contest provision. So if there is a potential beneficiary that tries to, or anyone that tries to make a claim or contest what’s set forth in the trust, then they basically are prohibited from taking anything. So it basically disincentivizes someone to cause trouble. And another thing that we offer to clients is our firm can serve as what’s called the trust protector, and that’s different than the trustee. So when you have a trust, you have a trustee, and that’s the person that manages the assets, makes sure that the assets go to the beneficiary or beneficiaries that you’ve chosen. The trust protector is really there to protect your intention as the person that set up the trust. So, especially after you’ve passed away, if there’s an issue between the trustee and the beneficiary, right, that the trust protector can step in and serve as a mediator, as a referee. We’re able to resolve the issue without them having to go to court. So, that’s the default if there’s a problem.

DIEGO TRUJILLO: And how often do you find yourself in those positions?

SHANE JASMINE YOUNG: So as a trust protector, we’re able to resolve any issue, and we can right the ship. So that makes it a lot easier. Do you find that happening frequently? It doesn’t happen very frequently. So it’s nice because, you know, it’s just that added peace of mind.

DIEGO TRUJILLO: Oh, correct. Yeah. But when it does, I’m sure it’s another headache, right? Right. Because then you just avoided everything for the government to get involved, and someone just came and basically started rattling the cage, and now the government’s involved.

SHANE JASMINE YOUNG: Right. And when you have a well-crafted plan that is comprehensive and it really covers all of the bases, then it minimizes the opportunity for there to be any type of challenge.

DIEGO TRUJILLO: Yeah, because it would seem the more clear a plan you lay out, the less ambiguity. We’re going to know exactly what this person was going for, right? And then you’re there as the protector to make, no, no, no, that wasn’t the intention. You know, you can read it right here, here, and here, and these other seven passages where it said this, right?

SHANE JASMINE YOUNG: Exactly. And because we drafted the documents, we know exactly.

DIEGO TRUJILLO: You spoke with the person, yeah, right? Yeah, exactly. You even know all the jokes they made in the back room.

SHANE JASMINE YOUNG: I take a lot of notes. That’s one thing that clients often, you know, see me doing. You know, when I’m meeting with them, I’m taking a lot of notes because, of course, I may not remember, you know, the exact conversations, right, 10 years later. But, you know, having notes jogs my memory and I can refer back to them as we are helping support the family moving forward.

DIEGO TRUJILLO: And this process that you mentioned, right? So you mentioned, you send them to the website, they go on, it was younglawlive.com? Yes. And then they take a webinar to get ready. Is this something, a process that your organization kind of established? Yes. This wasn’t taught in law school, this was you saying, okay, what is the young difference? Yeah.

SHANE JASMINE YOUNG: So we really try to make things as easy as possible because as we know, you know, with our own personal experiences and experience in business, It can be overwhelming for people that don’t understand the process. And we want to make sure that we’re supporting people that are wanting to make planning a priority. And we start by education, by providing resources, by being out in the community, you know, and speaking. By doing these things to be able to get all the information out. And so the website that you mentioned, it has our on-demand webinar. So we do a weekly webcast. It’s a live webcast we do every Thursday at 6 p.m. So if you want to be able to engage and you ask questions, you’re able to do so through a chat box.

DIEGO TRUJILLO: How hard is it, getting a little zoomed out, how hard is it to keep people tracked on that? And I ask this kind of curious because I’ll see it sometimes like a hospice company will have an Instagram and they’ll say, well, we’ll follow our Instagram. I don’t know if I want a hospice popping up all the time on my social media, right? All these negative things. How is the receptivity from the community? How are they responding to?

SHANE JASMINE YOUNG: You know, we get such great feedback because my personal Instagram and the Young Law Group Instagram, for example, you mentioned, you know, social media. There’s a lot of crossover. There’s a lot of overlap because I’ll post a lot of things related to planning on my personal page because we’re talking about these things. It’s our families.

DIEGO TRUJILLO: At this point, it’s who you are. So I don’t know how you and I connected. But at one point, we’re connected. And I was like, huh, who’s this person? I always notice families. I pay a lot of attention on social media because people get, in my opinion, get an opportunity to show the world what they think is important. Is that material wealth? Is it this? Is it that? And some people just play right into the shallowness of it. For me, I started in 2008 back in college. I had a lot of friends that went all over the world. So I’m able to track, hey, this is what Gary Botswana is doing. You know, this person went off to work at an orphanage in Ghana. And so, you know, I’m able to kind of stay up with our friends. Right. And for me, it’s always like I always share me, my boys, you know, trips. It’s kind of the thing that I’m into. And so I always observe what people post. And it was always you and your family. Yeah. I was like, man, what a beautiful family. They’re always so close knit together. Gigantic smiles everywhere. So it was. Yeah. And then the young law group was all over. You kind of have become like one. You are the young law family.

SHANE JASMINE YOUNG: And it’s funny because, so my husband and I, I mentioned, you know, we’re the owners of the business and then we’ve got five daughters. So our daughters, our youngest one, yes, our youngest just turned 13. So we’re like all like through the baby phase right now. But our youngest is Samar, she’s 13. And then Cameron is 14, Kaylin is 16. And then my twins, who I actually had just before starting law school, are now 23 and they just finished their first year of law school. So, they are continuing to be lawyers. They work with our firm. So, a lot of clients, after they meet with me, it might be one of our daughters or, of course, another team member that’s following up, you know, to gather information. So, it’s always nice to have that.

DIEGO TRUJILLO: That’s incredible. So, speaking, going back to that reference of the tree, right? When the tree falls, what are you going to leave behind?

SHANE JASMINE YOUNG: Right. And that’s part of our plan, right? You know, it’s part of my business succession plan, which is essentially, you know, an estate plan for the business, right?

DIEGO TRUJILLO: You know, what if something happens?

SHANE JASMINE YOUNG: And there’s so many contingencies that we as business owners need to plan for, but you know, what do I want moving forward with respect to my business? And it is for it to continue. It is for my family to continue to serve this community and continue to educate and provide resources because estate planning touches everyone. And that’s one of the beauties of being an estate planning attorney. You know, when I was doing business before only business, it was only a certain pocket of the population, right, that really, you know, was interested in that. But estate planning touches everyone. So I’m constantly able to integrate that with our normal life.

DIEGO TRUJILLO: And what was your aha moment? Was that case you were talking, that pro bono case, where you’re just like, wow, what a mess. Yes. I could help here.

SHANE JASMINE YOUNG: It was definitely multiple things that happened along the way. But that was that first time where I saw, oh my gosh, this poor family paid all this money. to avoid this issue. And now the children, who were adults, thankfully, but the children were going through, they were fighting with this ex-wife who we all know, the dad that passed away, we knew that he didn’t want her to inherit these things, but because he never updated his plan, it just caused all these problems. And then since then, I continue to do pro bono work, I continue to expand my practice to be able to serve clients on the estate planning side. And then, of course, when I started my firm, it was a no-brainer. Like, this is what we’re going to do. And it’s been such a blessing.

DIEGO TRUJILLO: Was your husband on board fully for the whole process? Oh, yeah. I’m sure you’re coming home and telling him these stories of like, oh, my god, you cannot believe this.

SHANE JASMINE YOUNG: Yes. And he, just because we are so family-oriented, he was just like, OK, well, when you’re ready to start the firm, because I was the one that dragged my feet on that.

DIEGO TRUJILLO: All right, all right.

SHANE JASMINE YOUNG: So he knew from the beginning, you know, we’re going to start a firm. We’re going to do this. We’re going to be able to, you know, like create more for others versus, you know, working in a confined setting. And so as I was telling him these things, you know, he was just like, OK, this is, you know, like, yes, this is this is part of our purpose, you know, being able to help other families who don’t necessarily have the information or access even.

DIEGO TRUJILLO: You know, you kind of fall into your role. It’s very odd to kind of say to people, and I say this because even when I think of where I was at 30 years old, and I’m 39 now, when I think of where I’m at, and I talk to some kids that are like, man, I’m already 31. I was like, man, I didn’t even know. Like, you know, I liked working in hospice. I think at like 31, 32, I got into hospice. I was like, you know, I really enjoyed it. No, I may have been around 30. Time flies. Yeah. No, I started getting into hospice. I felt a passion for it. But I had no idea where the road would end. Right. Right. Doors would open. I opened a Facebook group which somehow blew up. Right. And, you know, there’s things that we did to really bring it together and things that we push for. But it’s very interesting the way that the calling in life sometimes presents itself and you have the option to kind of respond. And I find it so fascinating that it wasn’t just you, that your husband was always there present. Was he always as sensitive? Yeah. To the direction of things or was he on his own business trip and then he said, all right, what do you want to do?

SHANE JASMINE YOUNG: Yeah. No, he was always very tuned in and you’ve met him before. Yeah, I have. So you can see he’s very much aware.

DIEGO TRUJILLO: You can see it through the pictures, I’m telling you. Yeah. There’s definitely a unity there. So I was just curious on that now that you brought it up because you said you were dragging your feet on it.

SHANE JASMINE YOUNG: Yeah, I was because I was scared. I was scared to start my own business. A hundred percent. What if I fail and we had a family. I was so used to the stability of having this really nice paycheck of working with these big firms.

DIEGO TRUJILLO: Which came every two weeks. Exactly.

SHANE JASMINE YOUNG: I could depend on it. Our bills were being paid. And so it was scary to think about letting that go and starting something new. You know, when I started the firm, when we started the firm, we had zero clients because I was coming from not a law firm, but being the general counsel for a financial services company. So I didn’t have a book of business. It was really starting from scratch.

DIEGO TRUJILLO: So what was that start like? I’m kind of curious. Was there like a day one you both showed up on a Monday and were like, well, here we are?

SHANE JASMINE YOUNG: Well, so when I, my last job that where I was an employee was for a financial services company called Provident Trust Group. So when they hired me, they actually hired me and my sister who’s also an attorney to be their legal team. And your dad really put it into you guys. It worked for two out of three at least. So we started there and the owners were very transparent. They said, look, we’re looking for the two of you to help us. get all of our legal affairs in order so that we can sell the business. So, you know, we were there to really do cleanup and also compliance and make sure that everything was being done properly with the business so that they could hand, you know, hand it off properly in this potential sale moving forward. So we didn’t know the time frames necessarily, but I was thinking it was going to be January of 2020, or sorry, 2018. was the time frame that we were looking at. But it ended up happening sooner in the summer of 2017. And I came to work one day and they said, OK, well, the buyer confirmed this and that. They want to basically take over.

DIEGO TRUJILLO: They shook your hand and said, thank you? Yes, thank you very much. Yeah. Oh, so this was the push out of the nest. That was what I needed. This was the push out of the nest, that crisis moment. Yes, yeah. Now, let me ask you this, and I want you to be very honest with me, because I experienced that. Did you immediately start thinking, where am I going to go get a job? Or were you immediately like, all right, well. The sign is clear. I got to be an entrepreneur.

SHANE JASMINE YOUNG: It’s so funny, because Charles and I, my husband Charles, had talked about what the next step would be. And so we knew that it was going to be starting our own firm. We just thought it was going to be a few months down the road.

DIEGO TRUJILLO: On your timeline.

SHANE JASMINE YOUNG: Yes. And so we already had a few things in the works. But really, it was just kind of the idea and the mission and the purpose, but nothing really hard set. Like I hadn’t set it up, set up the business.

DIEGO TRUJILLO: Yeah, there weren’t dates you didn’t have.

SHANE JASMINE YOUNG: Okay. Yeah, we had a website and that was about it.

DIEGO TRUJILLO: So it just turned into a scramble for you guys.

SHANE JASMINE YOUNG: It did. And I did think, you know, to be honest with you, I, you know, I went on LinkedIn. I was like, should I, you know, get another job at least in the interim because, you know, to continue to be able to start this business.

DIEGO TRUJILLO: Stability and security, right?

SHANE JASMINE YOUNG: Yeah. And I guess, you know, I really don’t remember how long that contemplation lasted, I think, I want to say it was like 30 minutes.

DIEGO TRUJILLO: It was pretty quick. Yeah, you panic for a second and then you think, wait, why am I trying to get back in the cage? Right, no, exactly.

SHANE JASMINE YOUNG: Like I need to utilize this opportunity. This is an opportunity. And I came home that day and I remember I walked in the house. My mom was there with my daughters and she came out. And she saw me unpacking my things. We had a big SUV, so I was unpacking all the boxes and multiple boxes. And so she was like, Shane, what happened? And I said, oh, well, today was my last day at the business. And she’s like, What? What happened? And I explained.

DIEGO TRUJILLO: She didn’t really know the background. You know the moms with the soothing tone right away. What do you mean? And what are you going to do?

SHANE JASMINE YOUNG: I don’t know. And so I said, you know, well, you know, she’s like, but you’re not upset. And I said, no, because this needed to happen. You know, the timing was, you know, it was a little scary. But look, you know, this is what needed to happen for me to really be full fledged invested in the next step. This is how it needs to be.” And I knew, you know, my husband was so excited.

DIEGO TRUJILLO: Was he ready, set, go? He was ready.

SHANE JASMINE YOUNG: The minute you told, finally, yes, let’s do this. He was so ready. So he was like, we could have done this 10 years ago. I’m like, well, you know, but we needed to go through, I needed to go through the process, you know. And so once, you know, we were still aligned with what we wanted to do, we immediately dove into creating the business. You know, getting our message out there. You know, we also do other things like business and personal injury. So we’ve done that from the beginning. And the company that I had left, Provident Trust Group, these new owners that came in basically hired me on a retainer basis to be their business counsel, their outside counsel. That was my first business client, and that was nice. Then they actually tried to rehire me to come back as a full-time employee with a new business. I was like, no, no, no, that’s okay. I’m going to continue.

DIEGO TRUJILLO: I’m already out. I already got the wind, I’m flying.

SHANE JASMINE YOUNG: Right. Yeah. So it all worked out the way that it’s supposed to. I’m so grateful for all of the experience, good and bad.

DIEGO TRUJILLO: Yeah, these steps are always very interesting. There’s a book I always recommend to people called The Road to Character by Charles Brooks. And in the first chapter, he talks about the way, right, we live in a society that’s very, like, you need to find the truth within yourself and, you know, you need to dig deep. And he was like, you know, And he disagreed in the discussion. And he brought up Viktor Frankl, the writer of The Man’s Search for Me. And he goes, you know, you talk to this man that just lost his wife, his parents, his children, all his wealth, to dig inside of himself and find his truth. Like, what are you talking about, right? It wasn’t inside of him. He responded to a calling that occurred outside of him. And we all have that choice to respond or not to respond, right? And I think it’s that panicky moment that you’re describing where you’re just like, You know immediately on the drive home like, you know, you kind of needed to go that way But am I ready and no and right all the reasons why maybe no and of course mom’s tone never helps, right? What do you mean what are you gonna do I don’t know but you have bill I know right we’ll figure it out they really play it up No, it’s good to have you know in your in your instance you had someone very important that was like hey, finally, right?

SHANE JASMINE YOUNG: Let’s go Yeah, and thank thank goodness because it can be it can be scary I see a lot of entrepreneurs a lot of business owners that have these dreams, but they’re not supported Yeah, and it doesn’t have to be a spouse, you know, it can be anyone that can write to support you But oftentimes it’s you know, it’s lonely

DIEGO TRUJILLO: Yeah, and people don’t understand the full scope of it, right? One, you have enough work just doing the estates. I mean, the actual, you know, the actual attorney work, let alone building a business and branding and how are we going to do this? And what are we going to go here? And how do we, you know, there’s a lot of strategy around it that, you know, hats off to those people that do, but typically they find people that are able to kind of build those things out.

SHANE JASMINE YOUNG: Right. And that’s what I advise all the business clients that I work with. Find them in high school.

DIEGO TRUJILLO: Yes.

SHANE JASMINE YOUNG: Well, that too. But, but yeah, it’s, you know, you have a specific skill set or a gift and you can’t do everything. You know, you’re not an attorney, you’re not a tax advisor, you’re not a financial advisor, you know, you’re a doctor, you’re this, you’re that. So focus on what you need to focus on and hire the right people to handle those things. And you’ll be so much happier. You’ll have so much more time to focus on the things that build your business.

DIEGO TRUJILLO: Right. Yeah. You know, there was an expression that I was kind of anti-everything. Because, you know, I was always like, my parents were always, you need to get straight A’s. And I remember at a conference one time, a guy, he was like, you know, I remember when, and I tell my kids the same thing, to be fair. Yes, we do. Because I went to school in Central America, and I was like, oh my God, guys, this is a cakewalk. Please, you need to get straight A’s. Yeah. But one of the things he said, if you only work on your weaknesses, the best you’ll ever be is mediocre. And that spoke to me so heavily, right? So what are my talents? And that was something that was never really taught to me in school. It was like, hey, and I always bring this up with like leadership, which for me was the bane of my existence until I was like 30, 35, where it kind of clicked onto, oh, how do I use this, right? Before then, leadership was always, you know, if I got in trouble, I’d get in trouble worse than everybody else because, Diego, you were the leader. I never asked to be the leader. Right? And so I never learned how to really utilize these tools, these skills, the giftings that I have and to kind of make an inventory and to start applying those things. And when it’s outside of that scope, to outsource it to somebody else.

SHANE JASMINE YOUNG: So true. And I wish that more people would realize that because they think that they’ve got to do all the things. Yeah. And you don’t. You can really focus on what, you know, the best use of your time and energy is.

DIEGO TRUJILLO: Yes. You know, and it was bringing that up even when, you know, my partner that I started Vegas Healthcare with, that has kind of been there through thick and thin. And people will ask us, so we had met when we were marketing. She came to market one time. She worked at a home health. I worked in hospice. We said, hey, you want to go market together? We just got along. We started this Facebook group, you know, so people can kind of post. could post different ideas and it wasn’t, we had a lunch one time with like five other people and I was like, you know, it’d be cool. What if like different organizations just film their own commercials on their cell phone and we see what skilled nursing facility, you know, can do the coolest commercial or what? You know, I just started saying, how can we interact and engage as a community? I started throwing ideas and the other people were like kind of bouncing back and she just had her head down on a piece of paper, just writing every single idea that I had. I would throw it out, she’d write it down, she’d write it down, she’d write it down and then at the very end she goes, okay, so how are we gonna get started on this? And I was just right. All of a sudden, I had an implementer that was just like, here are all these great ideas. Let’s do something with them. How can we start executing these ideas? And there were times where she’d say, oh, well, let’s run this contest or let’s do this. And I would tell her, I think that’s a terrible idea. I don’t think that’ll work. I think that’ll annoy people, blah, blah, blah, blah, blah. And I couldn’t have been more wrong. If I had tried to keep the control of the steering wheel the whole time, the growth, I mean, 3,000, 4,000 people would join at a time. Because of ideas she would have and for me, it’s always important to surround yourself, right? The people that are with you and in your case, I mean with your daughters, with your husband, who else is gonna watch your back better? Right, exactly. Exactly.

SHANE JASMINE YOUNG: And thankfully we have surrounded ourselves with others that have our back. You know, we work with the Regulus Media Group. So that’s, you know, the business that handles all of our marketing that you see, all of the media. So those are things. It’s a good plug for them.

DIEGO TRUJILLO: Yes. Yeah. All of your content’s incredible.

SHANE JASMINE YOUNG: It’s so good, right? And I get credit. Oftentimes people are like, oh, it’s so good. You’re doing all these things. And it’s not me. You know, I have a team that does all those things and so well supported, not just on the marketing side, but on the operational side. You know, we just have such a great. you know, dynamic with working with them. And it has resulted in me having to give up a lot of control, you know, when it just started with just me, you know, I was making all of the decisions, of course, you know, with my husband, but I was that main, you know, that focal point. It ended, you know, it started and ended with me. And so as our business has grown, I’ve had to learn to rely on other people, you know, that I can trust, of course, and let go of those things that I was normally,

DIEGO TRUJILLO: But you see how much better, if you would have been in charge of the branding and the image, right? How much further they were able to take it because you were able to let go of that control. Exactly. You found a trusting partner. And so circling back to the estates and things like that, what are the aha moments for you? What are the moments that make you feel like, wow, this is exactly, I’m exactly where I want to be?

SHANE JASMINE YOUNG: Every time I have a client come in where sometimes it’s with a couple, for example, we’ll often see that, you know, one partner is like full, fully vested, you know, they’re ready to plan. Sometimes there’s, you know, another, you know, the partner or the spouse that’s like, you know, I don’t think that we need this, or I don’t want to have this conversation, you know, whatever the objections or concerns might be. And then at the end of the session, where both of them, you just see this sense of relief, like, oh, I’m so glad that we were able to take the time that we, you know, got over that hump that we made the decision, you know, to put a plan in place and it’s like a weight gets lifted off of them.

DIEGO TRUJILLO: You know, I was just listening to a podcast with a divorce attorney and it was, you know, at first I kind of kind of I always told, because somebody recommended it to me, and they were like, well, let me know what you think. And at first, I’m thinking, like, of course, right? If you ask an attorney, everything is always the worst in the world, because they’re seeing the worst in the world, right? Going back to Nietzsche and, you know, if you stare into the abyss, the abyss also stares. That’s what you’re exposed to, and you’re seeing the worst examples of, like, slip and falls, just anything, right? You’re always seeing the worst. That’s why it’s in court. And so sure enough, I kind of go into listening to this attorney. The podcast was fascinating. And he starts talking about, you know, it was something I would tell, I would do pre-merit of counseling. I went to school, my degree is in theology. So when I’d meet with couples and that was one thing that I’d say, hey, okay, you guys are going to start a business. There’s like a 56% chance you’re going to fail on this business. And right in their eyes would open up. I was like, So it might be best to do your due diligence and really find out about each other right now And a lot of times we have these relationships we’re in and this is something the divorce attorney was talking about He goes people need to clarify these things These are just discussions they need to have and the host would push back and say yeah, you know We don’t really like having these he’s like you don’t like having them, right? Yeah, you think you’re going to enjoy the conversation down the road? There’s so many things in our life that we just keep pushing back and pushing back. But when we do have that clarity, I mean, if you think about what you’re doing, yes, you’re doing estate planning, but you’re helping two people with different opinions, different ideas, different ways. even though they’ve been married for 30 years and helping them to align in a specific way, which I never would have thought until you said that right now, right?

SHANE JASMINE YOUNG: And it’s true. That’s why, you know, like on my signature block in my email, for example, it says attorney and counselor at law. And that the counselor at law is a very common term that attorneys utilize, but really we are counselors. I am a counselor. I’m dealing with these very confidential, very private matters, you know, personal matters with these families. We’re talking about, you know, their money. We’re talking about Their children, their family members, their wishes.

DIEGO TRUJILLO: The ex-wives. Right. All the mixtures.

SHANE JASMINE YOUNG: The legacy. All of these things that are so important. I think that that’s another reason why I love what I do because I get to have these really meaningful conversations with clients and I get to guide them through some of the things that have held them back.

DIEGO TRUJILLO: They’re in a jungle. They’re literally lost in a jungle, and you’re just kind of showing them a path. Okay, here’s a way out.

SHANE JASMINE YOUNG: Right. And I’m not there to tell them, like, this is what you need. Here, sign here. I’m here to guide them. I’m here to educate them, empower them to make the best decisions that fit, you know, for their families.

DIEGO TRUJILLO: Right, and their circumstances. So it was the same thing. Anyone that’s… that does sales well and when I sell sales because I used to work in hospice and you think about selling hospice and you know I remember when I stepped in and I’d go in like have these conversations and I you know this is what we do and blah blah blah and I remember I had a mentor and she told me hey you need to shut up and I was like what are you talking about she goes you need to not talk for like the first 30 minutes Let them talk. And I was just like, huh? And she would say, yeah. And so, because I was very eager to get in there and, you know, look, I learned all of this material and it wasn’t about that. It’s just, just be quiet. What do you guys want? Where are you at now? And where are you trying to get? And then use all the tools that you have to help them get there.

SHANE JASMINE YOUNG: Right. And it’s so important. And that’s why, you know, going back to the family wealth planning session or the life and legacy planning session that we offer, that’s where I, you know, I’ll ask the question and then they’ll share the information with me, you know, because I want to understand what’s important to you. Sometimes it isn’t about the money. Sometimes it’s about these other decisions that are so critical, you know, they don’t really care about this or that. And so it’s, it’s unique to every, every client, every family has their own things that are specific.

DIEGO TRUJILLO: You’re always surprised to find out. And I’ll bring this up because I wanted to discuss this with you and get your kind of input on this. One time I was listening to a podcast with Mark Garagos. And Mark Garagos is talking. He’s represented many famous clients. And somebody asked him, if there’s one thing in the law that you could change What would it be and he said that there is no inheritance? Yeah, and the and the the host who was kind of conservative was like, what do you mean? What is the state gonna take it and blah blah blah and he goes no he goes and and Mark Geragos was very clear He was like I would say about 50% of people that come to my office in LA I just come in and say hey, I have a trust when I turn 30, but I’m only 23. How can I access it? He goes, and the amount of times I have to look at someone and say, hey, this is like locked. It’s ironclad. There’s no way you’re going to tap in. He goes, they will go home and sit on their hands for six or seven years until they can access. He goes, I’ve never seen a fire put out inside of a human being, like knowing that there’s a trust and they just can’t access it yet.

SHANE JASMINE YOUNG: And that’s where I think old school meets the new school. So when we talk about traditional estate planning, there are still estate planning attorneys that set things up that way. And in certain cases, it might be necessary, but that’s where having newer provisions, new changes in the law that are being incorporated, including things like the trust protector. Because if there’s a trust protector in that scenario, then we could potentially make some adjustments to achieve the intention or the intent of the person that set it up.

DIEGO TRUJILLO: Okay, so that’s where it would fit in. Not in a challenging way, but a more nuanced approach. So I’m kind of curious when, do you see this? Oh, yeah.

SHANE JASMINE YOUNG: Is it? Well, with like the trust fund baby type of situation?

DIEGO TRUJILLO: Yeah, where they’re trying to tap into trust a little bit earlier. What are your thoughts on that? I’m kind of curious.

SHANE JASMINE YOUNG: Right. Well, we don’t see it as often.

DIEGO TRUJILLO: But we’re not in LA, right?

SHANE JASMINE YOUNG: Right. And so it’s more so we’re focused more on the planning side of what does it look like moving forward with these clients that they’ve got children, whether they’re young or they’re well into their adulthood. What are the things that are important to the people that are setting up these trusts so that when they are no longer here, their children aren’t tied to something that doesn’t make sense for the family? So we are able to set up similar types of trusts. We call them lifetime asset protection trusts. But we can create parameters that can be very liberal or very restrictive or conservative.

DIEGO TRUJILLO: And how often are you seeing clients? Is this something so when Mark Ergo said that right? It really caught my attention and I was like, yeah, and so Hoping my kids never listen to this episode of the podcast, right? So I’ve always told my boys you guys are not getting a single thing You guys will fight for everything you have on this earth just like I have right and so uh, and you know I one time I told that to my sister’s like hey, that’s kind of cruel to you and I was like No, I mean I plan on leaving them something. I just don’t want them to count on it Right.

SHANE JASMINE YOUNG: And that’s where having, you know, working with, you know, a lawyer or a law firm that understands really what your goals are and what, you know, the values that you’re instilling.

DIEGO TRUJILLO: Because they’re interpreting kind of what you want. Yeah.

SHANE JASMINE YOUNG: All right. And that’s where, you know, we focus on the family values also. So, you know, if you came in and we talked about those things and, you know, you were a client that said, look, I do want to leave something. I want to leave a legacy, you know, for my children. But I don’t want them to have this sense of entitlement which stifles their growth or paralyzes them from being able to make decisions or work or create their own businesses, things like that. So we take all of those considerations in and we draft the provisions around it where there’s language.

DIEGO TRUJILLO: Can you give me examples of one? Yeah. Because my sister threw one out. She’s like, yeah, well, what if you throw them $25,000 when they get married? Or what if, are there other things? Well, I’m kind of curious.

SHANE JASMINE YOUNG: Yeah. So it’s really whatever you want. So whatever those provisions are, and you know, your sister, you know, gave a good example. If, you know, you want to be able to contribute to a wedding that they might have, and you’ve allocated a specific amount. Sometimes we have clients that will say, all right, well, I don’t want them to be able to access themselves. I don’t want them to withdraw money until they reach a certain stage in life. So it could be an age, you know, oh, when they’re 30, like the example that you shared. Or it could be after they’ve graduated from college or after they’ve achieved this, you know, because the parents want to encourage.

DIEGO TRUJILLO: They’re looking for an evolution, not necessarily a number, right?

SHANE JASMINE YOUNG: Right. And then we can draft in provisions that grant the trustee the flexibility to see, okay, well, is this now adult child, you know, are they making the proper decisions? If they’re not, say they’re, you know, they’ve got a drug problem or an alcohol problem, okay, well, then we can block them from being able to access the money until a certain point. Yeah, there’s so much flexibility that we can create with these types of trusts.

DIEGO TRUJILLO: Now, do you oversee that? Do you hire a law firm to be the the trustee?

SHANE JASMINE YOUNG: So the trustee is typically someone that the family appoints. So if, you know, husband and wife come in and they are creating their plan, they’ll agree on typically, you know, who would step in after both of them have passed away. So usually it’s a family member or a friend that they trust in that capacity. But if there isn’t someone or if they would prefer a third party, like a neutral, unbiased party to handle that part of it, It’s, you know, there are other firms or trust companies that typically serve and provide trustee services. So my firm doesn’t do the trustee services part of it, but what we can do is the trust protector. So that’s, you know, a little bit different than the trustee.

DIEGO TRUJILLO: You give them the tools so that the trustee can execute properly and you set them up for success and not battles.

SHANE JASMINE YOUNG: Exactly. And the trustee can come to us and say, hey, you know, I’m not really sure what to do in this situation or I’m having an issue with a beneficiary. What, you know, what do I need to do? And we’ll look to the trust and we’ll say, OK, these are the provisions. This is how the trust works. This was the intent behind it. And if we need to make adjustments to, you know, be flexible and with what’s, you know, what we’re being faced with and we’re able to do that.

DIEGO TRUJILLO: And how often do you think families should re-look at their trust in their estate planning?

SHANE JASMINE YOUNG: Oh, I love this question. So at least every three years.

DIEGO TRUJILLO: I’m sure. I’m sure. No.

SHANE JASMINE YOUNG: Yeah. So every three years, we do a complementary review for all clients that we work with.

DIEGO TRUJILLO: Oh, OK. I wasn’t expecting that. Yeah.

SHANE JASMINE YOUNG: So we do that every three years because we want to make sure that their planning stays up to date. Things change. The laws change. And that’s also the typical point of where certain documents, like financial powers of attorney or even medical powers of attorney, can kind of go stale. and become outdated or even expire on the financial side. So at least every three years, we also offer a VIP program where there’s a bunch of complimentary services that we offer to people that are part of it.

DIEGO TRUJILLO: So people can upgrade up front and be able to, you know, make sure it’s secure for the rest of their life, not just… And we do an annual review as part of that.

SHANE JASMINE YOUNG: So there’s a bunch of benefits with the VIP program. But an annual review is really what we recommend. You know, just like when you have a financial advisor, you know, you typically meet with your financial, your tax advisor every year.

DIEGO TRUJILLO: They’ll send you the business sheet at home. What are the expenses, et cetera. You kind of review it. Nothing’s changed. OK, cool. Or yeah, something major changed or whatever.

SHANE JASMINE YOUNG: Exactly. So that’s just another touch point that we offer. And we reach out to the clients and say, hey, Happy anniversary. It’s been a year.

DIEGO TRUJILLO: Has anything changed? Perfect. Perfect. So to wrap it up today, you had mentioned something that you were offering to the listeners today. Yes. To those people that have made it through the podcast and now have a better understanding.

SHANE JASMINE YOUNG: Right. So we are offering a complimentary family wealth planning session or life and legacy planning session, normally $750, but because they are listeners and supporters of the podcast, we will waive that fee. They’ll just complete a family profile ahead of time. And we do recommend watching the webinar, you know, that webinar, younglawlive.com, you can click the on demand button, watch it anytime. So that is an offer. And then anyone that is actually booking their session, if they book their session, you know, within, let’s say, 30 days, then we’ll offer $500 off their actual estate plan.

DIEGO TRUJILLO: Okay. And are you able to kind of give a range so people have an idea? Is this a $15,000 expense? Is it a $3,000 expense? What should it cost typically?

SHANE JASMINE YOUNG: It depends on the type of plan that they pick. So we’ve got different levels of plans, but our comprehensive plans start at $2,500. Okay. It could be more or less depending on, you know, if they’re going to scale back or if they’re going to be doing something a little more comprehensive.

DIEGO TRUJILLO: It’s very hard to develop a one size kind of fits all on this, right? Exactly. And you don’t want to do that.

SHANE JASMINE YOUNG: You don’t want to work with someone that has like a one size.

DIEGO TRUJILLO: But I was targeted on Instagram for a $99. I’m kidding. Don’t do it. I find it cheaper. No. Yes. Yeah, be careful. Yeah, I’m sure it can end up costing a lot more if you if you go that route. It does. So I really appreciate you taking the time today. I know this podcast has ran a little longer, but it’s definitely something, especially after we explored the five wishes, right? We were talking with Nathan Adelson and they have a very simple list of questions. It’s more towards end of life care that that answers, again, five simple questions. that help people somewhat with advanced directives. However, nowhere to the level of what you’re doing. And for me, it’s important for people to know this and to understand this. Again, circling back to what I said at the beginning of the podcast, sometimes we live in a very sterilized world where there is no death and no one ever dies and we’re shocked to find out that it happens to somebody. Um, even though it’s happening to people all around on a daily basis. And so it’s very important to kind of take a step back from our life and really examine what we’ve built. And again, I think that it really rang true in my mind when I, when I was walking through the forest and just looking at these trees that had fallen over and, and right again, these nurse logs. in these massive 200 feet trees that had started as little saplings on them. And I was like, wow, what a message, right? Who am I gonna be when I die? Am I gonna leave a mess for everybody and just here’s nothing but headaches for everyone? Or am I gonna leave, you know, I don’t wanna be a chore when I go. They’re already gonna be very heartbroken over my leave, no.

SHANE JASMINE YOUNG: It’s hard enough though, it’s true, it’s hard enough.

DIEGO TRUJILLO: There’s enough to worry about and enough emotion to go through it. It’d be a lot easier if you just had a set instructions of what they wanted.

SHANE JASMINE YOUNG: Right, it just makes it easier.

DIEGO TRUJILLO: And so I appreciate you coming on. I really do. Sharing and everything else you share with your family, with your husband, all of it. You guys have a very beautiful family. Thank you. And so it’s amazing to see you guys grow and do well and make the impact you are here in the city. I think anyone could just be an attorney, right? And I think you’ve chosen and responded to a calling to more to that.

SHANE JASMINE YOUNG: Well, I appreciate the kind words, and thank you for the opportunity to share this important information.

DIEGO TRUJILLO: Of course. Well, thank you very much, ladies and gentlemen, for getting on to another episode of The Heels Pod, where we kind of interview the different services and companies within our community to find out who we are and grow together. Thank you very much for listening. Have a great day.

Unpacking Inclusivity in Healthcare with Julie Liebo

By | HEALS Pod

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.

Kevin and Frank From Freedom House

By | HEALS Pod

DIEGO TRUJILLO:
Well, ladies and gentlemen, my name is Diego Trujillo, the CEO of Las Vegas heels here today to speak to some very special guests that have joined me from the Freedom House here in Las Vegas. We’re doing this as part of our conversation as we, you know, explore the Southern Nevada response to the opiate crisis that’s going on. And I’d like to introduce my guests today Kevin and Frank that have joined me all the way from Freedom House So, how are you gentlemen doing today? It’s good having you guys so we wanted to kind of have a conversation this morning and discuss a little bit about What services there are and what do services look like I think and I’ll speak I guess from my background I’m born here in Las Vegas. My parents were Hispanic, and even when I did my interview with Dr. Morgan, we were talking about just cultural approaches, right, to healing, and even then, when I’ll travel to Central and South America, and, you know, people will say, well, you know, if they were just stronger mentally, if they had a stronger will, and, you know, and I would explain to them, right, as I would, you know, speak to parents and travel. One of the things that I would always bring up to people is, what would it take for you to steal from your parents, right? And so, and I’d ask them that question, they’d kind of get taken back and I’d be like, no, really, think about what it would take for you to go into your mom’s jewelry box and to take jewelry. And then you’d see the shift on their face occur. And then I’d always say, whatever that line is, that’s what they’ve crossed, right? This is not about willpower. This is not simply a decision that they didn’t think, oh, I could just simply not do this. And so as we look at the opiate epidemic, which in a lot of times, I think at first, when you looked at drug addiction, it always affected certain communities. And all of a sudden, with the opiate epidemic, you see that start tapping into different communities that had never experienced that, right, and really seen the face of addiction. How long have you guys been working at Freedom House?

KEVIN: Well, Freedom House has been established since 2012 with the mission to be able to help people with their addictions, whether they’re coming from Nevada Department of Corrections or they’re homeless. And now we got to a component where now we have residential inpatient, which is a 90 day, a 90 day, was it a graduation?

FRANK: Yes.

KEVIN: And then they transition over to our transitional living. And since I’ve been there, I’ve been there over 12, about 13 years, I’ve seen over 5000 people come to our program through both genders. And our program now is such a big wraparound service to where it comes from residential inpatient to transitional housing with job development, case management. We help them with their vital documentations. They go to 12-step relapse prevention programs. They do treatment with us. And then from that phase on, they transition over to three-quarter housing, which is independent housing for people that cannot get their own place, probably because of their criminal background or they’re on parole or probation. So we have over 125 residents in our three-quarter housing. Some has been with us for seven years, and they’re just living a normal life.

DIEGO TRUJILLO: So taking it back to what I was mentioning at the beginning, Would you guys feel this is simply an issue of willpower?

FRANK: I definitely know it’s not. For me, from my experience with a person in recovery, as far as willpower, there’s no such thing, right? Once you get to a certain point, the drugs and alcohol, the disease of the drugs and alcohol, they take over. You know, so at that point, there’s no willpower to be installed.

DIEGO TRUJILLO: I think that’s the point. And I wanted to mention all that before I asked you guys about Freedom House, because it’s not like people are walking in and you guys are saying, hey, have you ever considered not using, right? Absolutely. These are very in-depth programs. So how was Freedom House started? What was the origin of it?

KEVIN: It was the vision of Jeff Iverson. Jeff Iverson was in an addiction. He went through a drug court program and had a passion to want to help those with a second chance. And it just grew from there. Most of the people that are in our program are mandated through drug court. It gives them another opportunity instead of going to prison. It’s an 18-month program, which they have to go through the whole drug and alcohol program, right? And then we have the men and women that come from Nevada Department of Corrections. You know, there’s over 375 people in absentia in parole that are in prison right now that are waiting on parole to get released. And they want to have the equal opportunity as everybody else at Freedom House. So there’s always this rotation of people coming in and out of Freedom House and want the equal opportunity as the next person.

DIEGO TRUJILLO: Okay, so and is there a waiting list? Yes. Oh, there’s no vacancy. So the need there is great.

FRANK: Yeah, absolutely. And essentially, like, our goal and our job is to continue elevating and continue expanding, continue beating recidivism by releasing participants from will essentially D popping them from prison or jail. And As soon as they get to our program, that is exactly where their journey starts. And so, yes, there’s a wait list right now, especially in Department of Corrections, as well as Clark County Detention Centers, North Las Vegas, City of Las Vegas, Nevada, you know, so all the jails and prisons, this is a high need.

DIEGO TRUJILLO: And this is a willingness on the participants to be able to step in, right? That’s correct.

KEVIN: Yes. I mean, so when we get them, we get them at ground zero. You know, they’re they don’t know what direction to go. They don’t know what to do. And we’re trying to walk them through the courses of being able to participate through the process of change. We want to get them to a point where they’re now a hero in their family’s life and being able to merge those bridges with their family and their children and go back to them. You know, some of them made a poor choice. They made a bad choice and the addiction de-escalated them down to the bottom of the homelessness. And so we lift them back up. You know, I think that right now our whole staff has the passion when we come in 100% to see the needs of someone that needs help. And that’s a big thing. You know, just a little story about myself. I went to prison at 15 years old in 1991. And I did seven years, five months in prison as a teenager. Kid got out when I was 21 years old, and I was still trying to adjust to color, sounds, and smells because I was institutionalized. But no structure, no reentry components to be able to allow me cognitively to make executive decisions in my life, reentering into the community. And so it was hard for me. It was hard. I was isolated. I was in discouragement. I was in depression. I had a lot of anger. I had no answers for any of it. And so when I got into Freedom House, it was as if I was doing self-clinical work on myself, seeing the next person, a mirror image. You know, so I was getting that clinical component with one-on-one conversations with people in the program. And that’s where we’re at right now.

DIEGO TRUJILLO: See, and there’s something that you bring up, because I always analyze this when we’re discussing, you know, young children and young boys. And, you know, we’re seeing Through social media, the change of technology, the change of the world, right, the parenting really shifts a lot because the world is a very different place. I think the first exposure that I got, that I can think of, of what you’re talking about, I remember watching the Shawshank Redemption. And I think for a lot of people, right, you never think, there’s a character in the show that spends 40 years Just living a very structured life within the prison system and then just gets thrown out and okay now go And eventually within the program. Yeah, he ends up taking his own life, right and And it really I remember watching that with my father when I was 13 years old and really taking a step back and thinking There’s something that you mentioned though. That’s really key here as I circle back to what I was talking about with with young children and just everyone in general is the ability to mentor the ability to guide. I mean, we see this since childhood. We all ideally should have a father to look up to that can guide us the details. Hey, don’t do that or do this. Unfortunately, some of us don’t have those. But even outside of that relationship, you look at trades that have existed for hundreds of years, whether it was a mason, whether it was a painter, you always had someone that would come in as an apprentice. I don’t know anything, and you know a lot more than me. And they would serve under that person, learning those skills, until eventually they would begin to paint. You look at Michelangelo, Leonardo. Anyone who accomplished any great work didn’t do it on accident and didn’t do them by themselves. It didn’t happen isolated. There was always someone to walk them along. And while we reference these masterpieces, again, the idea of a father being able to step back into his son’s life Being able to connect even if he may have made mistakes and gone down the road It’s going to take some mentorship to take a person to that level When you connected, what was it? Was there a resistance for you stepping into the program?

KEVIN: No, so I just want to go back to the institutional trauma just to define a little bit To put it in the simplicity of what that means is when a person gets incarcerated and they’re in and they’re in prison They’re like a block of ice and behind concrete and steel is like a refrigerator frozen. And all that happens in our system is that they do not get the golden nuggets, the diamond things to be able to change. And so when they release them back into society, they’re thawed out to save the same person, just a different date. So then a vicious cycle continues. You know, I don’t have no money. I’m broke, busted, and disgusted. What am I going to do? Then they’re going to go relapse. And then what happens when they relapse, criminal behavior starts kicking into effect. There they are, merged again, married, and honeymoon state. And it’s a vicious cycle. You know, with me, it’s taking the time to be able to table conversation sit with somebody one-on-one where they don’t have no restrictions or they don’t have the guard up to be able to not allow someone to penetrate with a little bit of prudence to help them through the walk of this life, right? Like right now as we speak there’s someone OD’ing out there in the streets right now with the homelessness that’s affecting the community right now. These are people’s family members, aunts, uncles, cousins, brothers and you know they’re so far gone like They have no more hope. They don’t have no hope. They’ve actually really accepted to be living on a six-inch curve of homelessness with a tent. You know, and it’s discouraging to see that, you know, in a greater sense because we’re trying to pull them out of there. You know, give them one little glimpse of hope, you know what I mean, and let them know, hey, we care to be able to say, yes, I want change. And that’s the key.

DIEGO TRUJILLO: What are the common themes as you’re speaking? I’m sure when you started in this, right? So you lived your experience. There must have been a point where something shifted and you began kind of looking at those coming behind you, right? And now all of a sudden, the lessons that were taught to you, you’re turning around and teaching. What are attitudes, behaviors, excuses, whatever, were there things that you pinpoint and you’re like, oh, here we go. You’re going, stop with the shame, stop with the self-pity, or what are things that you

KEVIN: When we first start seeing this, it’s a pattern, right? So when it’s a pattern, we right then and there, we cut out the gray area. It’s either yes, you’re going to get it or no, you’re not. We’re not living on gray. We’re living on either full coverage. Which is 100% and we’re not going to live on liability, which is 50%. We’re going to be 100 percenters in this and we’re going for we’re going for the gusto. So we’re going to take you from being ground zero to hero. And that’s where we’re going to get at. And once you get to that Dante’s peak of being a hero in the top part of a mountain. you made it. And now you turn that back in to doing community work to help save another brother and sister into the recovery component.

DIEGO TRUJILLO: I feel like giving is a huge part of that, right? And I say this because I almost feel like there’s so many human beings. When we were younger, jokingly, we used to call them extras. They just simply exist. You just exist to consume oxygen and put out carbon dioxide and then just churn the economy. There’s never a contribution to anyone around you. And I do both from a spiritual standpoint have a belief but even from a right on that we there is something owed to our common man and then from a secular point of view I feel like even as a species on this planet. There is something owed to our common man I mean in both ways right Marcus Aurelius would always say that you know, the tide raises all ships You can’t just look after one specific group of people we need to give back Is there a resistance to giving back or is that typically the fruit of healing?

KEVIN: I think it takes time, the food of healing. Because you got some people that want it and some people say I’m just using you as a get out of jail free card and I got one more run in me.

DIEGO TRUJILLO: So you have those like, those attitudes? Oh yeah, yeah. All the time.

KEVIN: How quickly do you pick up on that? Well when you see him, so say for instance somebody gets accepted into the drug court program. They know they can’t get an OR, which is an order of recognizance on their own release, because they’ve had too many FTAs, which is failure to appear. Then they can’t get bailed out because the family don’t want to invest financially for your life because you already burnt them. So now your next step is saying, hey, I’m going to go through Freedom House’s drug court. Oh, I’ll go to drug court. So now I’m going to get out of jail.

DIEGO TRUJILLO: So Freedom House is like, oh, this is my get out of jail free, basically.

KEVIN: So they have an ankle monitor on. Then for you know, just for movement they go and cut the monitor and take off back to the streets Now they’re back into warrants and they get picked up eventually and got get put right back in front of the drug court Judge and then either they’re gonna terminate them or they’re gonna put him in an inpatient site where Kevin works out and kind of touching on that

FRANK: The willingness is a key component, especially for those who are getting out of incarceration, right? The idea of 1%, maybe 0.5% of becoming willing when you opt into a program. Just like Frank said, a lot of them, they sign the dotted lines. For example, for me, I signed the dotted lines just to get out of the environment I was in. Within six months of that time frame, that’s when you start seeing people wanting to give back. They realize that what we do in the community is more impactful than being isolated and not growing. From my experience, being incarcerated for four years, I got out of prison and I realized I didn’t know nothing. I don’t know what people are doing. I had this sense of entitlement, this sense of attitude, and I did not want to grow. Okay, very comfortable with where what and exactly I was doing in life until I met Frank right the idea of of him the background that he came from installing that into me Made me want to open up my eyes, and that’s when I became willing so I three months for me I I became willing, and then my willingness just started to expand. And at a certain point in my life, I realized this is what I want to do. And since I’ve been at Freedom House, I see that day in and day out. The idea of change is so elusive until one sees that same particular person that they may have grown up with or they were in the same cell with.

DIEGO TRUJILLO: You know you mentioned something, this is something to come to what you’re saying, because I think pure navigation is a huge part and for those that don’t understand. Are listening when you talk about pure navigation it’s people that have lived experience. I used to see this in hospice I worked in hospice for many years, and it was the difference versus. you know, losing a parent and losing a child. If someone had lost a son at 10, 11 years old, unless you have gone through that, there’s really not a lot you can, there’s a lot you can say, but not a lot that’s going to really stick or land because in the back of their mind, they’re going to say, yeah, but you don’t understand. And there was a couple of cases where I, you know, had to deal with patients like that, And I would immediately refer them to, hey, you need to connect with a group with parents that have lost their child, because I don’t understand. And there’s always going to be a little 10%, 20%, no matter how good I say whatever it is, there’s going to be a percent that’s not going to stick. It’s not going to land. And so I feel like when the peer navigation, I was actually at a workforce conference. They were talking about people working in environment. And I don’t have the study pulled up. But there is a percentage. And they asked somebody how big they thought a mountain was. If that person was standing alone, they would estimate that the mountain was 30% bigger than it actually was if someone was standing next to them. Which means if you stood by yourself in front of a mountain and I asked you, how big do you think it is? And you answered the question, you would say, I believe it’s 10,000 feet. And if Kevin was standing, I’m sorry, if Frank was standing next to you, you would typically answer it’s 7,000 feet. So just our perception of how big a challenge or a mountain is, changes simply by having somebody by our side. I mean, let alone with the lived experience. Do you guys make it part of your program to give back? Or is that something that naturally occurs in people once they start climbing that mountain? Because I’m sure they they come in with an attitude, all of a sudden there’s there begins to be a shift, right? That ice begins to chip away if you’re able to connect on a peer to peer level and say, hey, I’ve been where you’re at. And I’m sure there’s people that have the worst story, right? Because everyone wants to outdo it and say, well, I did six years, well I did seven years, well I did, right? Is there a point where they naturally just start switching? Is this something that you teach?

KEVIN: It’s a culture change. It’s a culture change and they have to be involved with the community of recovery. And us as staff members, we have to stay humble. We have to stay humble. Today, someone’s going to have a bad day. Well, today is OK. Tomorrow will be a better day. And there’s some flux of different kind of personalities that are in there. I mean, we’re dealing with people that are co-occurring, that have mental diagnoses, and that are on all kinds of medications. And they don’t want to take heed to treatment. They don’t want to do nothing. They just want to sit there and give up. So we have to nurture them, you know what I mean? And there’s not everybody, there’s some, there’s some that are, you know, red flagged that we need to nurture more, you know, give them words of encouragement, you know, tell them, hey, you’re doing good right now, you know, you’re doing an awesome job what you’re doing, you know, these little buildups, these little nuggets get building up inside them. So they have motivation instead of lack of motivation. And that’s what we have to do. And so Again, staff members at work, we have to put on a million hats. A million hats, you know what I mean? We have to be everything, you know, at one time. And it’s a challenging population that we work with. But the good thing is that we come to work and we say we’re here to serve, you know?

DIEGO TRUJILLO: We’re here to serve.

FRANK: It has a lot to do with passion too, right? Like, one of the biggest things that Frank pulled me to the side in the very beginning of my journey was you have to have the passion for what we do. And for me, being able to be that mentor for other people in the program, It has a lot to do with my personal experience and my passion for why we serve, why we go out into the community, why we are at a war with a disease that, you know, we can’t beat, you know. And so the more people that have the passion, the bigger the community gets, the bigger the war will continue. And eventually my goal, my dream before I die, I hope, is that we are able to beat this disease, you know? And so it’s just not, you know, Freedom House, it’s other facilities out in the community, it’s other people that are on the ground, right? One thing about Freedom House is we do not do this alone, right? We have other community partners that come into play that we pivot, that help us help them, and it’s just a networking full team that is boots on the ground people who are, has that passion, who wants to see change, And a lot of participants that come through our program, they realize that throughout their journey. And they sit back to themselves and ask themselves, how can I install this change in my life? Where does it start for me? And it is the mentorship. It has a lot to do with pulling one aside and walking through the journey. My experience at Freedom House, when I was a participant there, was I had that one person that followed me around, that took me to drug tests, that took me to classes. Because it was a lot for me, the accountability component. If I was by myself, I would make unknowable decisions. And so with that one person that was next to me, I was able to ask that question of, hey, do you think this is a great idea? And that other person would say, no, it’s not a good idea. Let’s stay on the right path. And that is how I was able to succeed through this program, and that’s what I instill into the participants.

DIEGO TRUJILLO: When I worked in churches, that was one of the things that I would see. When you work on the accountability portion, and first of all, you make people accountable for their own actions. So I’m not here to baby you or to make you, you know, listen, tough things happen to everybody. That’s just kind of the struggle of every animal on this planet. That’s not exclusive to human beings. It’s these tough things happen to everybody. And one of the things that I would always, that I always touch on is the accountability to themselves and just listing out goals, right? There’s an author that speaks, right? You have to paint a heaven to run towards and a hell to run away from, right? So if you started making five poor decisions, Or the five vices or the five bad habits that you have because this isn’t just substance, right? It’s typically there’s a lot of other things you haven’t developed character integrity other areas of life that are very important. But if you let the five, if you let your five vices take control, and in five years, what would your life look like? Write that down. And if you had five virtues, you have five things that you’re unique at, good at, gifts, whatever those may be, and you really nurtured those and focused on those in five years, what would your life look like? And when you have people kind of paint that out and you realize, like, I’m not making any choice, because I’m sure you guys have heard, well, you guys are going to kick me out. Absolutely. Yeah. We’re not kicking you out. We gave you a list of rules. You agreed to the rules and you made your choice. So as far as that goes, right, it’s personal accountability. And circling back to what you guys were talking about giving, because it is really good. And that’s, again, working with youth for a very long time. And, you know, I’ve But sometimes go visit them in jail and and I think there’s there’s a reward that’s very difficult to describe to people Because it happens to me all the time. I was I were I was a youth pastor for many years and I worked with you with young people I’ll be out and about and I’ll run, you know, I’ll be out with my girlfriend We’ll go watch a movie or we’re doing and someone will walk up. Hey Diego. How are you doing it, right? Yeah. No, how hey, how’s your painting going? No, it’s doing really well Actually, they’re hanging some of my paintings and galleries and and that you know, they’ll share, you know Diego was the one that kept me motivated in doing it It was something that during the moment. I never you know, you never knew if it was gonna land I I couldn’t tell the future but you wanted to encourage people in to watch that fruit and come back and to watch people’s lives change just not even from a lot of what you did just little things like being there by being their their accountability partner by speaking with them helping them to make good decisions, because we all kind of do that, right? As you get older, you stop thinking with your frontal cortex, your prefrontal cortex, you start kind of rationalizing. I explain this to my boys all the time, because it’s, guys, if you jump off the dresser onto the bed, how could that go wrong? Well, no, we’re gonna land on the bed. Ideally, how could it go wrong? And when they really think it through, and with addiction, I would deal with people, I’d say, listen, you’re gonna go through a point, and then at month two or three, you’re gonna be like, man, I’m pretty strong. You know what? Probably have a grasp on this. I could probably that’s your brain lying to you. Do not listen to that voice You will not and you will end up right back where you’re at You know because it I had worked with many people that have gone through that even in personal experience There was always that point where I’m strong enough now. No, you’re not stop telling yourself that that’s that voice It’s just leading you down to you know Because then you do it once and oh, I’m okay. I haven’t lost my job. I’m alright, right? And then all of a sudden you see it kind of trickle down and lose control, which is addiction, right? It’s continued use in the face of negative outcomes and negative consequences and you find yourself at, you know, at ground zero. Okay, here we go again. Which is very demotivating. Do you have a lot of people that stick around or continue to give back even after?

FRANK: Yeah, we have it. So we have an alumni Center not even a center but alumni group of participants who completed the program who give back and so every 90 days We are always hosting alumni events. And right now we’re at a list of over 500 participants who completed the program Within the last few years who come back You know, not all of them come back at once, but every sections that come back and they donate, they give back, they meet with our participants. A lot of our participants have, they’re still on our three-quarter properties. They’re connected with me through social media, emails, text messages. One of my goals, because I’m also an alumni participant as well, is staying connected. It’s the biggest component, like what happens two years after completion? What are you doing three years down the road, right? Are you still sober? Are you still connecting with outside support groups, right? Are you still involved in what we instilled in you in the very beginning? You know, so we that is something we always will hype up as the alumni component of Freedom House.

DIEGO TRUJILLO: Yeah. And I mean, life’s a journey the way it doesn’t get lighter. Exactly.

KEVIN: And even when they transition to three quarter housing or their own housing, personal housing, You know, we do a continuum of care plan up to a year, you know, through Survey Monkey, where we send them the link and they answer like 10, 15 questions just to kind of keep them in the loop just so that we know and that we’re aware they’re still around and they haven’t engaged in any criminal behavior or are being arrested or relapsed. We have seven meetings a week at Freedom House, one at seven in the morning, one at seven at night. All clients are required to go to a minimum of seven meetings per week. If they have a job, they can go up to a 4, but we still encourage them to do 7 a week. And they have to be there on time. You know, if it starts at 7, they can’t be there at 7 or 1. We’re not feeding the flesh, we’re feeding the spirit, right? So they’re waking up and that’s just a morning breakfast. you know, the morning meditation. And I encourage every man to go inside that, and even the women, you know, because there might be one person that may share something in their testimony, and that one sentence might switch on and say, hey, I want change. I want change. I just needed to hear that one sentence. Everything else, I want change. And that’s it. And so it’s the surrendering part, right? Being humble to surrender and say, I lost. I lost to the addiction. I lost to criminal behavior. I lost to the homelessness. I want change. And that’s the Second Chance Act.

DIEGO TRUJILLO: There’s a point in life where things feel overwhelming. And I think it’s always encouraging when you have someone that’s fighting just as hard, right? Because you have the depression, the drug addiction, it kind of seems to kind of get you in the tunnel vision where it’s just you. Right where I’m the only one that is experiencing this I’m the only one that is that has this difficult boss or that just lost a loved one or that But it really is not we are we are all going through this on a constant basis and here Other people and sometimes it’s worse and you’re like, wow, how are they still going right that they have some fight in him? Excuse me. It leads to a little bit of They draw from within, listening to the strength that others have outside. Again, going back to that mentorship role model that we have seen throughout all of humanity, right? That guidance of people stepping in. I agree fully with what you’re talking about there, right? That one little sentence sometimes, because there’s always that voice, right? You think about the angel and the devil on your shoulders. There’s always that one little voice that’s saying, hey, you’re good enough, though. Why are you still coming to these? You’ve been sober. You’ve been all right. And all it takes is one slip to really fall back quite a bit and lose a lot of ground that you have gained.

KEVIN: Yeah. So, you know, I always say this when I come to work, it’s not for my glory. I’m doing the works of my Lord. And when I leave there humbly, I left doing his works, not mine. And I’m just a tool there. I’m a tool. He’s using me to help the next person. And and that’s just that’s just where I’m at, you know. And yeah, so.

DIEGO TRUJILLO: No, and that’s incredible. It retains the same mentality, right? Because you don’t start feeling like, well, I’m essential here and they need me and right, you kind of realize your role. And it helps to keep you humble throughout the entire process. As we try to tackle this as a community, you guys mentioned, I mean, you both laughed immediately when I said, you know, how many empty beds do you have? And you guys were like, no, there’s a wait list, right? So the need is vastly larger than what Freedom House can do or even the community partners that exist. What do you guys think from your perspective? What do you see that we need to do as a city? Because I, you know, you’ll talk to some people and just to fill, they’ll always say, well, we need to figure out how we can address homelessness, how we can figure out how to address drug addiction and how to, you know, address criminality or mental health. And we’re like, yeah, those are all lean.

KEVIN: Well, I think I think some of the legislation, the legislators that are in Nevada, they need to really look at the focus of housing. You know, there there’s no housing. You know, everyone has someone in their family under some kind of mind altered substance. Right. But they turn the cheek. It’s I’m tired of being taken advantage of and stolen from. We need housing. We need housing. We need people that are willing. And there is a lot of people out there willing to work for that component or that place, that program to save somebody. There’s no housing. There’s no beds across the town at all. You know, in the last seven years, like we are the only ones that have a licensed facility for women. You know, and it’s a SAPTA approved, just like Freedom House. In the last seven years, there’s been an increased flux of women getting incarcerated in Nevada apartment corrections than men. So what about them? You know, we have to be able to balance out the genders and be able to support both of them at the same level.

DIEGO TRUJILLO: That’s a very interesting point you brought up is you look at that. I didn’t know there was an influx. Oh, yeah. So definitely seeing that there is an influx again, Las Vegas is changing quite a bit. And I hate sometimes when we focus on the glitz and the glamour, we don’t look at all the other sides of what a community is and what it takes.

KEVIN: I mean, there’s acreage out there. There’s acreages out there that are just flat with sagebrush on it. You know, and you have all these hotels that are multi-billionaires, and if they would even just put in you know, a million a piece or something. I’m just throwing a number out there, but be able, because I know that there’s a lot of people that are owners of these places that have family members that undermine all the substance. The gentleman, a seagull from Westgate, his daughter passed away from opiates. And they have a celebration every year for her, you know, and it’s we’re trying to dive into that as hard.

DIEGO TRUJILLO: And I think now that you bring up the housing thing, even the hotels, there’s discussion of them saying, hey, we’ll match, right? I think that part of the challenge that we see as we try to navigate all this. is finding a cohesive system instead of this whack-a-mole. And for me, you know, I lead Las Vegas Heals. I also have a group called Vegas Healthcare. It’s just bringing together all of the providers and saying, what do we need? How do we work together towards getting in? And I have noticed a shift within the community.

null: It used to be kind of competitive, right?

DIEGO TRUJILLO: You have this like level of competition and I don’t know if this existed within mental health, right? But within health care in general there was this level of competitiveness Well, then we kind of realized and in the newer generation with the thought is bringing we’re growing as a city There’s no need to compete. We will all grow right and even when it comes to mental health, we have to work There’s not one group that can serve the entire community And so once we can we can figure out how to work together I think it’ll it will make it a little bit easier and and I think that the hearts of people are changing I think the attitudes of people are changing like you mentioned right people all of a sudden This is touching people’s lives who this is never of touch. It’s always been other people. It’s always been other communities But now it’s starting to draw a little bit from their own personal life and a lot more people are beginning to become engaged With the things that are occurring within their community What ways forward do you think we can bring to bringing those communities together?

KEVIN: Awareness. Don’t let it die down. Awareness. Get out there. Get on the front steps in front of people. The awareness. Don’t allow the conversation just to die down. You always got to keep it fresh in their head. The federal government gave a lot of money to Nevada for the epidemic of fentanyl. You know, and then so now you got county and city looking at what’s this look like? You know, they want to, you know, look at a $63 million facility, which it takes time to hit, it takes time to build. You know, we’re already an operational program that’s been well-established since 2012. It’s shifting and changing this. Hey, let’s get them going now. Because they want numbers. They want outcomes.

DIEGO TRUJILLO: For me, probably one of the greatest successes in hearing you guys discuss it, I think you guys hit the hitting nail on the head. It’s just peer-to-peer navigation. And that’s all it is. It’s just getting someone that has been through this to talk to me, right?

FRANK: Absolutely. I think with the awareness component, the biggest factor that I’m noticing in the community is we’re building buildings and putting people in the buildings. Right? There’s no programming going on. It’s just, hey, let me get you out of the off the street, getting high to put you in a solidified house for you to get high in this house with no program. You’re not tackling substance abuse. You’re not tackling mental health. You’re not tackling the human being as a whole. And I think raising awareness in the community. I attended a meeting last month with the president of Freedom House. And it was a front line where you know, the commissioner tick soccer bloom was there and we were talking about this, right? Like we were talking about how can we venture on a path of? Continue raising awareness to the community as well as installing more programs around, you know for me I was on the streets and I had no clue there was programs, you know, and so you’re right There’s a lot of changes in the community, especially in Las Vegas. There’s more people On the boots on the ground type of people, you know, help us out in Nevada. They have a more team who’s consistently out there day to day on the streets. You have shine a light who’s out there pulling people from the tunnels. You know what I mean? Placing these people on the streets into direct housings with substance abuse treatment, mental health awareness, right? Like tackling that component where I can address every barrier at one time. You know, and that’s the biggest key of success is how can we continue raising awareness in the community.

KEVIN: And I think the best part too is when you go up to somebody that’s homeless and you’re talking to them and you’re trying to draw them in to getting into a detox program and we already know that they don’t have no money. But don’t worry about the financials. Your financials will be taken care of. Don’t worry about the food and the hygiene. I mean, we get people from prison that are, I mean, from county jail or prison that are indigent, they don’t have nothing. To end up handing them some body wash And, you know, a nice deodorant and a shaver and some shampoo. It’s like the whole world for them.

DIEGO TRUJILLO: Yeah.

KEVIN: It’s literally the whole world for them. I mean, yeah. You know, like, oh, I could take a shower. I could take it. Oh, I don’t have to take a 10 minute shower. I can take a 20 minute shower. Yeah, go ahead. It’s hot water there. You know, and then we and then inside the courtyard, we do community things like we have a gym there. They have we have a pool. They barbecue over there. It’s like the safe haven when they get inside the gates there that they don’t have to worry about the outside of the world coming and attacking them. They just it’s all one big old recovery community. You know, we have a meeting room that has a big TV in it where they watch games and they sit down, they break bread together, and you know, it’s all healthy. It’s good energy, it’s good energy. And it helps them.

DIEGO TRUJILLO: I think the safety, right? You touched on the safety, and that’s something that I… Instead of jokingly, I was in the Galapagos Islands, and I had an epiphany. And this is back when I was, you know, life is very hard. I had new challenges, and I was growing this, and you know, and I kind of sometimes would be like, God, this is so hard on me, and why do I have to struggle? And I kept thinking this. And then I go to the Galapagos Islands, where the animals there, when they have a bloom, like an algae bloom, the populations will grow by like 95%, and within six months, 95% of them will die. Sea lions on average would have at least two pups because one of them will die. And I remember looking around at all these animals and all the different defense mechanisms and I was like, every animal on earth exists under threat, right? And you think something that we underestimate that we’re sitting in a room and we’re not worried if we’re going to be attacked right now. We’re not worried if something’s going to happen. People don’t understand that about homelessness, right, is you are not protected at any point in time, the level of anxiety that you are dealing with. So, I mean, you talk about a gate, just that gate shutting and saying, all right, there’s some order structure, I’m okay, I can watch TV, I can eat, right, I can have people to connect with and talk to. So I can kind of break away from that loneliness, right? Yes, there’s people around, that doesn’t mean you’re connected with them. And so I think that plays a massive part into it.

FRANK: I agree. And kind of touching on that, you know, January, the end of January, we hosted a community alley cleanup on Palos Verdes. And we offered, you know, five scholarships available for anyone who’s willing to come to our program. There’s this one girl who’s still with us in this program. We were able to direct her into the Lima Diversionary Program, who is based off of, you know, pulling people off the streets or before they go into incarceration. You know, they want to bring them into a structured program. And last week I was just sitting down with her and she said, you know, for me it’s the security component. I feel safe when I walk into your female location. I feel safe when I’m able to meet with my case manager knowing she has her heart and best interest. And I agree, the security is very important because I now know I have an environment that I can go to that I can call a temporary home until I’m able to establish my own type of security.

KEVIN: And she was living in a tent and she was pregnant. Pregnant.

DIEGO TRUJILLO: Wow.

KEVIN: Under 10, homeless. She took the offer and never looked back. And so that was one out of many that were there. And we’re going to be doing it again on the 28th of June, where we’re going to have Metro out there. We’re going to have a cleanup cruise. You know, we get out there and clean up all the homelessness. We offer them help. If it is, our transporter will take them to treatment, go to detox and get a medical clearance. If they need to stay there for five to seven days, they’ll do that. and then we’ll start the beginning process of change. You know, this is just something we do. You know, this is like, it makes us exciting. Like when me and Kevin seen her go, it just made my day.

DIEGO TRUJILLO: I can’t imagine what that success story is. You have a lot of failures and frustrations and a lot of times they’re just using you. But when you’re able to really make an impact like that in somebody’s life. She’s giving her kid a hope. Yeah. And think of the outcome of the child that’s coming afterwards. Yeah. Completely different destiny.

KEVIN: Just molding her to strength. Getting out of that depression and getting out of that discouragement and getting out of that anger, because all those little things right there will lead you down to homelessness and into a vicious cycle. Yeah. Releasing those out of her spirit. And now she sees hope. I have hope to be a mother. Parental guidance for my child. Without addiction. And all she has to do is stay away from the negativity. Stay away from negativity because mind you, anywhere in life where you go out there in the streets, there’s darts trying to shoot at you and arrows trying to shoot at you every day, especially over at Freedom House. That alley right there, by the time you walk to the bus stop, there’s like 10 people probably ask you for some drugs or if you had some. So you’re using the tools that you’re actually being taught through the meetings and through treatment to be able to place a protection and just say no. You know what I mean? And it’s a good look. You know, how we know this is because the clients come back and they say, hey, man, I’ve been mentally challenged twice, three times, four times right now. Let’s talk me through this. I said, OK, give me 10 minutes of your undivided attention. Let’s walk this from the basic fundamentals of what happened and where we’re at right now. And so when we talk about it and we table it, They’re, again, they’re doing that therapeutical change in themselves right then because now they’re hearing themselves what they just did.

DIEGO TRUJILLO: We’re taking time to, yeah, to really think things through.

KEVIN: Yeah, so now, oh, I just played a moment memory with action. Now I just did something. Accomplishment. accomplishment. That’s amazing.

DIEGO TRUJILLO: So if someone has a relative, family member, if they feel for themselves, how would they be able to contact you guys?

KEVIN: Yeah, so our main office number is 702-485-1300. They can call my number 702-328-2023 or they call Kevin’s number. My number is 702-931-7674 and you can always call me any time of the day.

FRANK: As far as the referral process goes, just give us a phone call and we’ll handle it from there. Whether you’re currently using drugs or you’re currently drinking, our goal is to just get you to the front door. And we’ll take care of everything else after that.

DIEGO TRUJILLO: Yeah, because that’s the hardest part is getting to that decision.

FRANK: Exactly. Someone calls and says, hey, I can’t get to you. I need a ride. We have transport that will go pick you up. I, myself, will go pick you up. Because it’s that scaring moment of the unknown, of like, where am I going to go? What does this program look like? And for me, it’s the idea of just make that leap, that leap of unknown. I understand. I totally get it. At the same time, you’re going to make a leap to an unknown place to make a successful impact on the world.

DIEGO TRUJILLO: Yeah, I agree with you. You don’t like where you’re at, right? Okay, well, you know that. Absolutely. So why don’t you take a chance on this? If you don’t like it, you’re in the same place you are now.

KEVIN: It’s definitely a hard one because they have that one foot over that threshold. And they’re like in the middle of that threshold, like, man, just take the next step. Put them both over that threshold. And once they do that, then they just start like, oh gosh, here it is, the process.

FRANK: And I’ve sat on the phone with people for hours, right? And recently I sat on the phone with a gentleman who recently completed our program and then called us and said, hey, I need to come back home. I need to come back to a secure location where I can get back to the basics. I lost something down the road. And I’m going to see if I can pick it back up at Freedom House. So I stayed on the phone with him. I sent my transport driver to go pick him up. And we got him into a direct detox location. And that’s why we lean heavily on the community, especially when it comes to moments like these. We’re able to pick up the phone, call a friend, and say, hey, I need a person in detox. Can you help us out? For me, my goal is to build partnerships with everyone that’s in the community. that the reason why because I want to direct contact you know if someone calls me and says hey Kevin I have two kids and a dog can you help me out I want to be able to pick up the phone call someone else and say hey this person has two kids and a dog can we get him to your location you know and that’s why it’s very important to understand it’s a community driven what we do it’s just not one for it takes everyone absolutely yeah we all have to lean on each other well gentlemen thank you very much for coming in today I really

DIEGO TRUJILLO: Glover and Frank Heath, the Director of Operations and the Program Manager for Freedom House and Freedom Behavioral Health. Thank you guys very much for coming in today. And if you need the main phone number for each of those facilities, just rewind a little bit. Each of them gave out their cell phone number. Thank you very much for giving out that contact info. Thank you. Absolutely. So if you need resources, feel free to reach out. I want to thank everyone for listening and being able to tune in to this episode of The Heals Pod. Thank you very much.

FRANK: Thank you, Diego.

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

By | HEALS Pod

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.

Listen to the Podcast.

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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

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.