Patterns & Paradigms | The Pattern Podcast
Patterns & Paradigms | The Pattern Podcast
Season 2 Episode 09: Access Supports for Living with Ron Colavito
The mission is simple: Help people to live the healthiest and fullest lives possible. With 1500 employees, Access: Supports for Living supports 11,000 people in the Hudson Valley each year through a broad range of programs including behavioral and mental health services, substance abuse counseling and support, children and family services, services for individuals with intellectual and developmental disabilities, longterm residential services, respite care, affordable permanent housing, and employment services (to name a few!). This week we're talking about the challenges this incredible organization faced during the early days of the pandemic, how they pivoted, and how they're moving forward.
This week's episode features Ron Colavito, President & CEO at Access: Supports for Living.
We are experiencing a paradigm shift, a fundamental change in the way we usually do things. We are intentionally choosing to see the silver lining opportunity arises. We can shine a light on the things that weren't working well on those things that weren't really working at all, we can regroup reevaluate and re-engineer it's time to explore new patterns and paradigms those that inspire us to rise above the chaos and explore how the conditions of today and take us to a better tomorrow patterns and paradigms the pattern podcast from Hudson Valley pattern for progress. You're listening to season two episode nine, access supports for living with your host pattern, president and CEO, Jonathan Dropkin.
Speaker 2:Thanks for joining us for another episode of patterns and paradigm. Um, I hope you enjoyed our last one with Barry Roth bell. Barry's one of the truly accomplished members of the media profession. Um, I hope you enjoyed his insight. If you did, please remember to ask someone to take a, listen to one of our podcasts. You can find it on Apple or Spotify and wherever else you find your podcasts, this week's trend or bubble. I keep returning to this, this business of electric cars. So there've been a lot of announcements coming out of Washington from Ford, from general motors about what the United States is doing. So pattern and paradigm took a look at what was happening in China, Europe, Japan. And it's interesting some aspects of the search for that affordable electric vehicle that makes everyone happy are advanced. Tesla has been added for 14 years, but China's ability to throw money at this and their ability to automate. You know, they're not really worried about unions and we are because they're good wage positions, as long as we can protect them. This is without a doubt a trend. But if there is a race to find a variety of electric vehicles, Europe, Japan, China are going to quickly outpace the United States unless there is something really dramatically different in how we approach the creation of such vehicles. So this one's a trend, not a bubble it's going to happen, but we're going to need to be aggressive or imaginative in a way in terms of how to produce it. One of the point of, you know, China, for instance, supply chain, you know, the batteries they have, the supply chain issue completely figured out. They just don't have enough production vehicles yet. Let me ask, uh, what's up JD, and I'm going to ask myself, this question is what pattern is working on this week. I wanted to just briefly mention a large project that we're working on in orange County. It has a lot to do with conflict resolution. And I wanted to just clarify for our listeners who may know something about this project, it was designed. It had been five years in the making. And initially it was birthed out of the conflict between the ultra Orthodox population and the rest of orange County. This project is not going to solve that tension. This project is going to attempt to find a piece of that tension and create a pilot program for how mediation conflict resolution can possibly result in a better way than litigation or anger. Does it solve the big picture completely? No. And at the same time, we're still in the process of looking at one that is a piece of the social justice issues. And we're looking at a number of topics and we hope to have the second one of those settled on, we did find one involving water in the town of Woodbury. And that's what we're going to be looking at as a way to bring the ultra Orthodox or Haredi community to the table, along with the decision-makers in the town of Woodbury. Um, so more on that one to come this week, we're really excited to have Ron Colivida the president and CEO of access supports for living. Ron is a long time employee there. And in 2019 was elevated to be the president and CEO. For those of you that don't know access, it's a hundred million dollar organization. It has well over 1500 employees. It touches all nine of the counties and lots of Valley that pattern works on. They work with people with both mental and physical disabilities. And, um, I think you're going to enjoy the conversation with Ron as Ron really tried to look very hard at where they were before the pandemic, what the pandemic did to change their model for service delivery, and then what aspects of it might be in the future to remain. And that's very much the theme of patterns and paradigms. Hi, Ron, how you doing? And, and, and ha how have you been managing through the pandemic and your staff? You know, I'm just curious, like on, I ask all of my guests, hi, how are you doing?
Speaker 3:Um, well, well, thanks Jonathan. Thanks for having me. Um, I mean, I think we're, you know, we're doing where we've, we've pivoted, um, in a number of waves over the last several months, and I think things, you know, continue to adapt, but, um, we have a great team that's, um, that's working, I would say kind of beyond full speeds still. So, um, you know, everything from our frontline staff or who are right there in the trenches, leading the work to the leadership team is making sure, you know, we're getting resources and safety and now vaccine management, um, and, you know, access to vaccine available, um, to the, to all the individuals that we support as well as, um, you know, to our staff. So, I mean, I think, um, we're, we're doing a, I guess as well as can be expected, I think would be the, probably the best way. And in some cases, um, I would say better than expected, still, still growing and still finding opportunities.
Speaker 2:Well, and I think doing as well as could be expected or better than expected puts you well above many other organizations, so kudos to you and the whole team at access for, for doing that, um, for the benefit of our listeners, why don't we just take a step back and describe the mission of access and why don't you correct me? Because my natural inclination would be the people that you serve or clients, but that may not be the right term.
Speaker 3:Sure. So, I mean, just starting there, um, we just refer to them as people. Um, the, there are people like you and I, um, and they happen to utilize different, um, different supports and different services that the organization provides. Um, you know, tying to mission, um, access and mission is, is simply to help people live the healthiest and full of slides possible. So that happens in a lot of different ways and in a lot of different points along one's journey, but, um, that really ties to finding areas of unmet need and looking to fill them, um, throughout the Hudson Valley and, and, and beyond, probably in the, not too distant future.
Speaker 2:So you have a full array of services. When I was looking through the website there's mental health services, there's substance abuse services, maybe walk us through a little bit of, uh, all the different, because I don't think people have any idea of the
Speaker 4:Total, the vast array and even the size, I mean, you're a hundred million dollar organization. Yeah.
Speaker 3:So th so the organization from a revenue perspective is right around that Mark the a hundred million dollar Mark. So it's a pretty large organization. Um, we operate in nine counties, um, throughout the Hudson Valley, um, and with a wide variety of service areas, as you mentioned. So, um, and I, and I should mention in about 1500 staff, so quite large, a large number of staff supporting, um, supporting the work, but we operate on, we kind of break it down into a handful of core areas. So, um, you started to mention our behavioral health services, which focus on mental health and substance use. Um, so there's a number of things that, um, that we do there from counseling centers to programs, um, supporting, um, that early onset, um, first, first diagnosis of psychosis with individuals with schizophrenia, um, as well as, um, more intensive day programs, um, mobile, mental health, um, that happens in both Ulster County and orange County. Um, and then additionally, um, in Rockland County now for children. Um, and then, um, one of the newer services over the last couple of years, um, that kind of wraps around a lot of this is a 24 seven urgent care, um, for mental health and substance use. So those services are available 24 seven and, um, went virtual, um, um, right at the start of the pandemic and continue to operate, um, in a mixed model today, virtual available anytime, anywhere, but also some in-person, um, access to services. So that's kind of behavioral health in a nutshell, um, other, uh, Mo Mo most significant part of the organization, um, is services for individuals with developmental disabilities or intellectual and developmental disabilities. So those range from, um, residential settings to services in the community, um, and also services, um, supporting, um, employment and respite at times. Um, we also have children and family services. So those, um, are working, um, often with, um, preventive services for families, um, with youth at risk, um, but also support, um, there's programs that support expecting mothers, as well as, um, foster care and a children's diagnostic center, um, which is doing, um, court placed assessments, um, for children, um, you know, all in an effort to, um, for safe return home and if not, um, for stabilization, um, process until someone can return home. Um, the other parts of the organization focus on housing. Um, housing has been, um, uh, a service that's really grown with us over the last decade, um, including, um, I think we're on our 10th project now in affordable housing supporting, um, um, permanent housing for individuals with developmental disabilities and, um, homeless population. Um, there may also be, um, a mental illness, um, um, which is, which is common, but, um, also with that population to provide permanent housing and, um, the last area, which I, I, which is really goes back, um, to the, to the roots of the organization when it was originally named occupations, Inc, is around employment. Um, so we have, um, access business solutions is part of what we do, and that is where we, um, employ around 300 plus individuals, um, that have a disability. Um, and they work in a various settings. We manufacture products. Um, we provide service contracts, um, to government customers, to commercial customers from anything from food service to custodial, to facilities management, um, and on the manufacturing side, um, one of the larger areas we do is we are, um, a manufacturer of hearing protection, um, and a distributor of safety products. Um, some of which we do in partnership with, um, a little company called 3m out of Minnesota. So that's the, that's kind of the, the, the breadth, you know, quickly, there's a ton of services under the hood that make all that up though.
Speaker 4:Well, and, and, and that the full panoply of services, I think most people have no idea that it is so broad. So let's say a hundred million dollar organization, 15, roughly 1500 employees. And how many people do you think you touch? Have you ever tried to
Speaker 3:It's about 11,000 people a year? Um, the, the, the predominance of that is in behavioral health services, um, because that's where we're seeing many people, um, in shorter stays smaller visits, um, on the, if you were to look at the developmental disability side, um, a much more intensive service, particularly when you talk about 24 seven residential supports. So, um, you know, those are, those are costly services, um, but well, but needed for some, you know, individuals who are perhaps some of the greatest complexities, um, that we serve.
Speaker 4:So we're almost at March 12th and, and that's an important day for me, because that was the day that I said, that's it, I'm going home. I'm packing up, I'm leaving the office. Um, that was my aha moment. Do you reckon or recall when that moment occurred for you and you said we've got to do things dramatically differently?
Speaker 3:I, I believe, I believe it was actually the same day if I, if I recall, if I recall, I think that was a Thursday and it was a Congress and I was on a, um, a phone call, um, um, with Nyeem our, our chief program officer, where we were having a conversation around closing, um, our day programs and no longer having that and starting to, um, dramatically change what, how we occupied space and use space and started, you know, and, and conversations around PPE and all those things were just that, that was the conversation with that day. And, um, from that point forward, things have been, um, dramatically different. Um, you know, that was the first, I would say at that point, everyone was just scrambling. So there was like, you know, all those activities were happening. If I had to say the moment that kind of it's set in a bit more, and I probably don't remember the date of this, but, um, we had had our first couple, the first couple of people, um, that we serve, who were dying, who had a COVID diagnosis. Um, didn't if you remember, early on hospitals were overwhelmed and not prepared, and people were being sent home, um, in, uh, in, in health that they ordinarily would not leave the hospital, um, because there needed to be room for, for others who are much more acute. Um, so we had, um, in about a 48 hour period made a decision because we didn't have, uh, there was no other planning at that point from government to actually turn, um, part of our, the middle of our administrative building. So just down the hall from where I'm sitting today, um, into essentially a hospital step down isolation unit for, um, two of our individuals who are going to be released from the hospital, but we felt not, um, not strong enough and still, um, symptomatic, not wanting to return to, um, to their residences, um, for fear of infection of others and their own and their own health and safety. And we essentially created a little mini, you know, step-down ward, um, out of a day program space right here in the middle of our building. So, um, that being set up and staffing that, um, and having that happen, you know, down the hall, I would say was probably one of the more significant events that I can, you know, that I can recall as far as an aha moment. Um, you know, um, second only insignificance to those that we lost. We lost some staff, we've lost individuals we serve, um, as many have. So, um, those were the most challenging moments and continue to be as they occur.
Speaker 4:And I think that, um, for most people that don't understand the nature of your work, it is that there is a very large labor intensive, interactive nature to it. And there was no playbook for this. This was, you know, I know that you guys are really good at sort of thinking through the delivery of services, but at this moment in time, what was happening, where there, you know, crash meetings of all senior staff, um, I'm always kind of curious what, what happened a year ago.
Speaker 3:Um, there were, there were a lot of these types of, you know, like zoom and other meetings that were happening at, um, let's just say later hours than they may have normally been occurring, because particularly, I would say in the first two or three weeks, um, stuff was changing so dramatically within the course of a day, that being sure everyone was on the same page that evening was important to start the next day and what we were, what we were learning, including, um, you know, starting with safety because PPE was so hard to come by. Um, and we actually were procuring PPE, not just for access, but on behalf of some of our partners where we were able to, just because we do manufacturing and we do distribution, we had some, some, we had some different mechanisms and channels to, to resource that stuff, but that was, you know, that was constant as well as, um, ensuring safety, you know, primarily, most importantly with our residential settings, um, you know, we support about 170 people in residential, you know, group settings where those were the greatest risks and often, um, because of the need for that type of setting for the, for the individually support, um, there's other complicating medical factors. So not only is there the group nature of the living that creates, you know, potential exposure, there's also, um, the, the much higher risk around someone, um, acquiring COVID and what that would look like. So there was, there was, yeah, there was constant planning and meeting and adjusting, um, in addition to, um, much greater communication from, from my office with the leadership team, but with staff at general, um, you know, it was actually a great opportunity to be out there more with staff routinely talking, um, you know, multiple times a week at times with various groups to make sure everyone heard stuff. Everyone had a chance to ask questions and make sure any safety concerns primarily were pro right to the forefront.
Speaker 4:So a couple of things, first of all, um, you're owed a thank you for everything that you did with your masks, um, uh, your story about how you got that to not just access, but to other organizations and other people, you truly to be commended for that, but then let's divide this a little bit into, so you have 1500 employees, that's one set of issues. Then you have the people that you work with that have a completely other set of issues. So there's like your workforce while it might come into work, am I not coming to work? And then you have the people that you serve, you gotta serve, uh, I, this, this must have been an incredible period in which you had to think through the management of an organization, such as access
Speaker 3:First and foremost, you know, I referenced the residential population as well as people we S we support in the community, the, our, our direct workforce. Didn't miss a beat those on the front lines, you know, continue to work. Um, we did everything we could possibly to make sure they were safe and protected and supported. Um, but that's, that's where really all the, all the kudos and all the, um, you know, uh, all the celebration of the good work should be, um, you know, the rest, the rest of us did what we could to support them. So that that's first and foremost, and that network continued and continues to today. Um, you know, the different, you know, in a different area of supporting, um, on the behavioral health side and family and children's side in particular was, um, I guess, similar for both the people, um, and the staff, um, in that telehealth and tele and working with zoom and different types of communication really is what made the difference there. Um, that was a, you know, a rapid change, um, including procuring, you know, equipment that we didn't have, um, you know, making sure we got extra of things. So we were, we were fairly well prepared, but needed to do some more of that over the, you know, the first few weeks. And, um, that was, that was, I would say, a tremendous success. Um, we saw in our, in our still continuing to see about a 30% uptick in utilization of behavioral health services since the beginning of the pandemic. Um, and I can tell you that the changes in tele-health and, and the relaxed regulations have allowed people to, um, to continue to have those supports, um, when needed and, and have them more flexible than they did even pre pandemic, which I think is really important. Um, so we know we are looking forward to a time where, you know, as we're just starting to happen, as those things start to mix in, and we start to have a mix of in-person and telehealth, because there are still points of which in person are, are really important. Um, but tele-health is proven to reduce no show rates for people that, that really need to, you know, maintain schedule and utilize services. Um, and they're enjoying it. They're actually participating and sometimes engage better, um, in services when it's on their own WhatsApp when it's on their own, you know, schedule to some degree. So I think that telehealth was really a big one for, um, staff and for, um, and for people that we support. And then of course, um, the frontline staff that were out there all the time, it was really just, you know, main focus was, was safety and safety of them. And so that they could be safely, um, um, supporting those people that would live with us in some of our residential areas.
Speaker 4:So let's, let's talk about tele-health, which has been one of the themes of this podcast, which is this great, um, awakening to the idea that there are services that can be conducted through telemedicine. And yet at the very beginning, we were not equipped. I mean, people had to discover platforms. There was, uh, HIPAA issues. There were, um, insurance issues where insurance companies said, well, we don't reimburse for that. How did this all play out? And, and how did you manage to incorporate it into your delivery of service?
Speaker 3:So, I mean, the first thing was, you know, we've been, we've been fortunate through some federal, um, some federal grant funding through, um, through SAMSHA too, that really helps help create the urgent care. And before it even went virtual that created this urgent care model that wrapped around. So, um, when we went virtual on, I think it was the 23rd of March, so within a week or so of all this happening, we had the virtual model standards stood up and we, and we went that provided us, I would say the buffer for government to catch up with relaxed regulations that we had support that wasn't, you know, contingent on, on being able to bill and get paid per se, like we had, we had that buffer that really helped us balance that, but I would say, you know, um, to the benefit of government, they did add pretty quickly to reduce the burdens that had been in place for a long time, because the utilization in our field of tele-health pre pandemic, I believe, was in the single digits. So, you know, when we talk about, you know, how often it was used and that may even be being generous. So, um, you know, now it's, you know, to, to imagine, um, operating without tele-health now just about a year later is, um, almost just as hard, um, to, to think about. So that was, that was, you know, I would say that's how it kind of came to be, and then, you know, working out, um, you know, some of the other, some of the other people that deserve some credit behind the scenes and all organizations, um, you know, I think across healthcare are the people that are working behind the scenes, trying to figure out how to bill and get paid for all of this, because rules were changing, um, daily, weekly at best, um, for months. So, um, that process is still catching up with itself in a lot of areas. But, um, first and foremost, you know, we were able to have enough support out there and reduce regulations to get people the services they needed, um, despite, um, shutdowns and, and, uh, you know, the pandemic that was, you know, really, um, really heightened back in, you know, in, in March, April, may. Um, and then again, you know, near the end, you know, the end of 2020 into 2021,
Speaker 4:So pardon the pun access. So if we're going to talk about tele-health, even this morning, as we were getting online for our discussion, my broadband in Sullivan County was not cooperate. How have you found as we pivot to this world of telehealth, have your, the people that you serve did have the appropriate amount of access, or even the knowledge for how to get online and how did that work?
Speaker 3:Yeah, I mean, I think it was mixed, I think largely it was successful. One of the, um, the biggest things that we think remains out there because, well, so we could get on the soapbox around making sure everyone has adequate access to broadband, which, you know, should just be at this point. Um,
Speaker 4:That's not so Fox, it's a reality.
Speaker 3:I mean, that, that, that should be, you know, that that's clear, but until that happens, you know, one of the things that we think is important and advocating for is that telephone only based communication for some services needs to be allowed to continue because not everyone, as you said, has the ability, whether it's the, whether it's the connection being strong enough, whether there's the device and, you know, the affordability of having it, um, or the knowledge of how to use it, to be able to navigate all those things and have those expectations of people who may be utilizing services to support crisis events in their life. So, um, telephone, telephone only, um, still needs to remain, um, supported, um, in some of these cases, um, particularly, you know, if we have medical professionals, um, you know, assessing that that's, that that's effective and needed because, um, we're not there yet. I wish, I wish I could say we're there that everyone has, you know, adequate access to this, that that's not the case. And, and the Hudson Valley is a, is a great example of, um, how different access can be from, you know, five miles.
Speaker 4:Yeah. And you operate in a piece of nine counties, predominantly orange, predominantly others, but, and does the broadband connectivity vary greatly from community to community throughout the Valley?
Speaker 3:Yeah, I mean, Sullivan County, I think would be a good example of, um, where it's not where it's not the strongest, but you know, there's also rural parts of Ulster County in Duchess County where we serve, um, you know, so, and, you know, even, um, orange County where most of our services are there, there's plenty of, you know, you drive around here, but you're going to find some dead spots. So this is not, um, you know, this is not well covered, whether it's from a cell based signal or, or, um, you know, direct connections into, you know, into homes.
Speaker 4:Um, it, it's interesting that pre pandemic pattern does a lot of work in infrastructure. So traditional infrastructure, roads, sewer bridges, and then the infrastructure needed for broadband or 5g connectivity. Um, we just put to the top of the list and what has occurred during the pandemic has proven that that is no, you know, I think as you were saying, right, it's almost like electricity, every house has to have this. And especially for the people you serve, um, you know, in reading about access, one of the areas that is mentioned is that you are a metrics driven organization. So any, any examples, I mean, you've had a long history of working your way up to the position you have as the CEO of, uh, access. How do you use metrics? Pattern is a metric organization. So we, we love to talk about, uh, you know, wonky stuff like this.
Speaker 3:I, this, I thought you said, this is only 45 minutes, so no, um, no, wait, we are. Um, and, and actually, um, you know, we take pride in it and don't shy away from the fact that we, you know, we measure and we want to prove lots of things because, um, you know, we've, we know it works, what you, you know, what you measure is kind of what you do. Um, so, you know, to start with, so, um, but we, you know, we measure, I mean, there's hundreds of things, I'm sure they know, but there's, there's about a hundred and twenty-five or so like really formal things that we keep track of. But, um, the way that it's organized is we organize it through, um, a series of about 12 value streams, so different portions of the organization. So I've mentioned some today, things like behavioral health for adults or children and developmental disabilities, employment, housing, um, but all of those areas are how we're kind of organized. They all kind of cross, they kind of cross reference, um, different metrics and goals from everything from customer service to quality metrics, to, um, um, measurements around, um, um, financial matters. So revenue and cost and surplus, um, as well as safety and wellness for staff. So there there's many different things, but they, we, the one thing we've done is created some more like vision type goals that everything has to point to. So, you know, we were talking for just a bit, um, on access, you know, access to, you know, we were talking about, you know, tele-health and some of those services, but one of those core areas is, um, what we just call access 24 seven, how do we continue to evolve our services that are available whenever and wherever, um, they're needed? Um, so that that's a core area. You know, other core areas are around, um, reaching greater numbers of, of people, um, achieving employment. So today that that number with people we directly support and in the community is around 450. You know, our goal is a thousand. Um, we want to increase our donor base of people that know the organization participate in the organization. Um, we want to be, you know, both, um, known, um, more for the work we do and the work we do in public education, in the state and on a national level, those are, those are some of the areas. And then of course we want to be financially viable. So there's goals around, you know, financial metrics, but also one which, um, sounds pretty boring, but it's reducing our administrative rate because what we want is we want more dollars directly hitting program services. So if we continue to be more efficient with the administrative costs of the organization, um, that we can continue to, that we can continue to be better and better stewards of, of public dollars, that large enough to support the organization
Speaker 2:As we continue to move, um, in a positive direction, the infection rates going down more vaccines are getting out there springtime is hopefully arriving. How is the vaccination process working for you for your employees and for the people you serve?
Speaker 3:So, I mean, I think it's been mixed. Um, you know, it's obviously this is a, this is a challenge. I think, unlike any, any logistics challenge that's been faced. So, so, um, we were, we were fortunate our, uh, our team really worked early on, on partnering, um, with local organizations to get access for our, our, you know, our one, a priority one, a folks. So we actually, um, were very successful quickly in getting, um, our, our residential, um, individuals that we support serve or vaccinated. So, so that, that was strong to the point that, you know, today that group is in the, you know, over 90% has received their first, uh, first, uh, first shot. And I think we're actually probably close to like 70% having received a second shot. So that was, that was critical as it related to those that had the greatest risk of acquiring COVID and, and, um, you know, potential for really poor outcomes. Um, that said the staff that support, um, those individuals and frontline staff generally speaking have been, um, slower to adopt and be willing, not, not for necessarily a lack of access that we had early on, which is becoming harder now because other groups are mixed in. So now it's kind of more open, but, um, that's been, um, that's been the biggest challenge and, and a challenge that I think has been heard, not just with access, it's a, it's a not nationwide, um, issue around really, um, you know, and I, I thought a lot of it resides with, you know, um, generational distrust of the health system for a whole host of reasons that now is, you know, playing out. So, um, I'm hopeful. Um, we're starting to see a little bit of an uptick in participation in those areas. And, you know, I am hopeful that, um, things like the Johnson and Johnson vaccine getting approved, you know, with a single shot, um, may make this, you know, more, um, um, more likely to be adopted by others. But, um, you know, otherwise when we start to get outside of the core priority groups, um, then it's a bit, you know, then it's a bit more, it's a bit more challenging, you know, you're kind of, you know, trying to run from place to place and sign up here and sign up there. And someone's got five shots and someone's got 10 shots today. And, and how do you do it? Like that stuff is where I think, um, some of the, you know, the centralization of this could be, could be stronger, but, um, but we have seen really, you know, really strong efforts around larger clinics and things, including, um, direct clinics at some of our homes being performed through CVS, um, where they're actually coming out and do clinics on site. So, you know, a lot of it today is I think it's really about supply. So as we start to see the supply numbers, um, I think some of this will be, we'll be kind of in the rear view mirror, hopefully. Um, but the biggest, the biggest challenge has been, you know, uh, for, for portions of, of, of, of our staff, um, really, um, willingness to, to get the vaccine is probably the most important thing. So we've been doing everything we can on education around that, and, you know, providing updates and staff that are willing and have done a telling their story and why and why it's important. Um, but those are, those are, those are that, that's the number one issue, not the logistics.
Speaker 2:Um, so hopefully this brings us to what some might call a new normal. And, and what does the world look like host? Um, COVID I know we're not out of the woods yet by any stretch of the imagination. So one thing I was thinking is, you know, telemedicine or telehealth is one area that you've mentioned, are there others that you had to adjust to pivot to that you may say, you know, something, we weren't doing that before, but we should continue doing it. It, it, it actually is not a bad way for us to provide our services.
Speaker 3:Yeah. I mean, I, I think, um, just simply, you know, greater work from home or work from alternative sites, flexibility is important. Um, you know, attracting talent into our field is important. So the ability to have more flexible work schedules and arrangements across, uh, you know, a wide variety of, of positions that we have, I think if something that we're, you know, that we're figuring out what that looks like post pandemic, because it's not going to be the same as it was. And, um, nor does it need to be, um, that in turn also may allow us to have a smaller footprint as, as it relates to physical space, um, which is, you know, which is also important if we're not, you know, having the dollar spent on paying for those spaces, maintaining those spaces and all of those, all of the things that go with it, those dollars can drive back to, you know, to direct supports, um, you know, for services. So that, that to probably stands out as, as one of the, um, one of the key things. Also, I think some of the, um, the other things that just need to continue as a result of this, um, is the planning, the pre-planning the, how do you support people? You know, I mentioned the isolation center that we created, well, how do those plans, how do we keep those plans active so that if something happens, we're once again, ready to start that immediately, do we have stockpiles of PPE and things like that? And, you know, I think it's more kind of worst case disaster scenario planning needs to be more at the forefront because even if it's not, you know, we should all be fortunate that we don't need to pull out that playbook for another, you know, 50 years. But, um, the likelihood is, you know, the world is getting more crowded and more complicated. It's probably more than likely it's not going to be, um, you know, another hundred years between pandemics. So I think those are, those are important things that need to stay, but, you know, the, the things that have been learned that have been positive, I think really our use of space work can be done in lots of different ways and forums. And, and of course, um, of course tele-health,
Speaker 2:Let me just ask you that one magical question, which probably was a question before the pandemic, but maybe the pandemic has changed your priorities. So if there was this magic one and money was no longer the object, it was somehow flowing to you, where would you spend it? What would be the most effective use of found money or new sources of funding? Where do you think you'd put it if, if it came your way?
Speaker 3:So, I mean, I mean, I think it's the same pre pandemic and post it's just been highlighted to a greater degree. It's investing in the wages and salaries, benefits, and training of the frontline staff, um, not paid nearly what they should be for the work and responsibilities that they carry. Um, so I think that's, that's absolutely the number one, the number one use as far as, you know, if it's about different models and if, and if things could change is how we, you know, how we get paid and how we earn dollars for the work that we're doing. I think that would be the continued transition, um, with, with some speed, um, to moving towards models where we're being reimbursed for the quality outcomes that, that people are achieving, as opposed to often lots of regulatory things, checking boxes and forms and plans being done by some date or that somebody's, somebody's head within a bed as opposed to how is, how is their life going? How are there, how are their health outcomes, how are their, you know, their, their social outcomes? How are those things going? That's a dramatic shift from where we are today to really pay for value as opposed to, um, paying for kind of checking off certain requirements. So that would be the, you know, from, uh, just, uh, how it would happen. That would be number one, but the, you know, the open, the open, uh, checkbook, uh, question would, you know, I think it's definitely, you know, supporting the, supporting the frontline workers, um, in all the different areas of the organization, both in wage, but also, you know, in, in training, um, and making sure that they're prepared for the work, um, the best that they possibly can be.
Speaker 1:Ron, thank you so much for joining us on patterns and paradigms. We wish you nothing but, uh, success and good fortune and continuing to deliver the services that you do,
Speaker 3:Same to you, Jonathan. Thanks for having me.
Speaker 1:Thank you for tuning in to patterns and paradigms the pattern podcast. For more information about this episode, visit our website pattern for progress.org forward slash podcast.[inaudible].