E42: Revolutionizing Healthcare: Chanda Hinton’s Fight for Accessible Integrative Care

In this episode of the United in Accessibility podcast, Chanda Hinton shares her journey as a spinal cord injury survivor and her role as a leader in healthcare accessibility. Chanda discusses her vision for integrative care and the significant impact of her advocacy work, including the successful passage of Colorado's Spinal Cord Injury Medicaid Waiver. 

Transcript

00:04 Speaker  

Welcome to the United in Accessibility podcast. Today, we are honored to have Chanda Hinton, founder of the Chanda Plan Foundation, and Senior Executive Director of the Chanda Center for Health with us. Following a spinal cord injury at age 9, Chanda transformed her personal experience into a pioneering mission to enhance healthcare accessibility for individuals with physical disabilities. Her leadership resulted in the groundbreaking passage of Colorado's Spinal Cord Injury Medicaid Waiver, expanding access to integrative therapies such as acupuncture and massage. Through her work, Chanda is reshaping healthcare policy, creating a more inclusive system, and driving meaningful change. Join us as we discuss her vision for accessible, integrative care and the lasting impact of her advocacy on the United in Accessibility podcast.

00:59 Christopher Michael Lee  

Chanda, it is wonderful to have you today, and we're excited to hear a little bit about your story and some of the amazing work that you have done. So, I'm looking forward to hearing your story. You want to stop and tell us a little bit about yourself and about your journey?

01:13 Chanda Hinton  

Yeah, so I'm the executive director and Founder of a nonprofit in Denver, Colorado, where we provide integrative health care to folks with physical disabilities. And so, what that looks like is all underneath one roof. We provide acupuncture, massage, chiropractic, physical therapy, care, coordination, behavioral health to individuals with spinal cord injuries, brain injury, MS, CP, spina bifida, all those various neurological disabilities, and truly, the primary reason for all of it is to ensure that upon being diagnosed with a disability or having an injury, that we are already in a place where we're looking at our healthcare and we're addressing it from a proactive and preventative way rather than having people take too much medications, and we come to reliant on them, or as a result of over utilizing medications, other complications occur. And so just taking something that's complex, it's going to be with us for the rest of our lives. It doesn't go away, but when we have proactive and preventative services that redo some of those things I just mentioned, are also able to thrive with our disabilities. Because oftentimes we don't think that disability and wellness can coexist, but it absolutely can, and we just need the right things and have access to the right things in order to do that. So that's a little bit about me, and I know that we're going to go and do a lot more. And I'm really happy to be here with you today as well. 

02:47 Christopher Michael Lee  

Great. Thank you for that. Yeah, there was so much to unpack there. I love the fact that you've got behavioral health as a piece of it, because not only do you have the physical health, which is so important, but the mental health is so vital. I noticed just in doing a little bit of research on you, your story is fascinating and traumatic in a sense, but very fascinating, and how you have reframed what happened to you when you were nine is just phenomenal. And do you mind sharing a little bit about that? 

03:20 Chanda Hinton  

No, I would be happy to I think that it's, you know, the story behind why the center exists, and why we're doing what we're doing, right? So absolutely happy to share that with you. So, when I was 9, I was accidentally shot in the back of the neck between c5 c6 and so it severed my spinal cord at the C level. So, I'm a quad spinal cord injury. I function from a power wheelchair. I have a modified vehicle, all of those pieces in terms of my daily, you know, activities. But you know, being so young and injured with such you know, traumatic event, the biggest struggle for me my entire life was my health care. I couldn't stay healthy, and so I had lots of complications with urinary tract infection, you name it, any health thing that was a secondary condition to my spinal cord injury. I experienced it. When I turned 21, I started having a lot of chronic pain. So, I go to my physician and it's like, oh, that's just another secondary condition. Here's a narcotic to address it, right? And so while I use the medical intervention when I was shot to save my life, it was really ironic to see that the over utilization of a model that saved my life basically became the detriment to my life actually like I was on my deathbed from the over utilization of medication, and so from having that chronic pain, using that Percocet, became bed bound, I was at 59 pounds, was hospitalized, was being fed intravenously, had a feeding tube put in. It was kind of failure to thrive. And at that point I was like, "wow, I'm using medical intervention to save my life", but from a different perspective, or from a different angle. And from that moment when you know the medical intervention saved my life, it was like, okay, well, go back and do what you were doing. And I was like, no, I'm not going to go back and do what I was doing. I'm going to really redefine the way that I approach my spinal cord injury by looking at other options, of pain management, of other options to address some of my ongoing conditions, because I want to live with, you know, being from a place of being, you know, thriving, versus being sick all the time. And I think that oftentimes we see that people with disabilities don't participate in life or social activities, or all the various things that all of us should have access to, but we don't, because we're not healthy or we have complications all the time, and so I really wanted to eliminate that for myself, but because it felt like such a hidden secret that I had to find out on my own. Even though I was surrounded by all kinds of medical, you know, individuals, I wanted to make sure that what I did and how I fought for myself, I would eventually make sure that I made that available to others.

06:15 Christopher Michael Lee  

You know, it's crazy how we focus on one area, the medical model. And this is the way the medical model should run, and this is the way it looks like, right? And nothing outside that medical model regarding data, health, or, you know, the acupuncture, the other aspects, the massage that you are pushing for, is part of that plan, in a sense, right? Maybe at the very beginning, from a rehab standpoint, you know, you have a little bit of that, but it doesn't go much further than that. And so, I love the fact that you reframe this in a way that is so it's just so sensible, right? It makes a lot of sense. So, there was a spark. There was a spark when you were, I'm assuming I'm 21 or something, that you were like, okay, something's got to change. And I believe it was your sister that was doing something. Can you share a little bit about that? When that spark happened? 

07:04 Chanda Hinton  

Yeah, yeah, it was, it was definitely an aha moment, because my sister, who had studied yoga her entire, you know, like, probably last 15 years at that time, she's the one that really stepped forward and said, like, let's try something else. Let's try, you know, acupuncture, massage, chiropractic, all the things that our bodies, like blood circulation, lymphatic drainage, like movement, like, you know, all of those things like you just said, is so sensible, makes complete sense, but it's not at all what is being recommended, right? And so, when she recommended those services, I went ahead and tried it. And I always tell people I'm sitting here having this conversation, because I truly believe that by blending, you know, the medical model with a more preventative model, such as acupuncture, massage and chiropractic, like that's why I'm alive, I truly 110% hands down, tell people that is why I'm still with us today. And for me, it was just that first time I did even acupuncture, like, I was kind of going into it being like, what like, are these things really going to work like? Because, I mean, even today, like, after 20 years of having our health center, people that are newly injured coming to get services with us, it's so cute to see that same or to see that, you know, curiosity of like, what like? Why is this going to work? And the fact that we have to kind of reeducate ourselves? Because, you know, I think about, I will around in the world, and I see people that are being so unconscious and so disconnected from their bodies that upon injury, it's either you connect with your body deeper and want to really understand, like, these are the ways that I have to sustain wellness, or you remove yourself further from it. So, it makes sense that sometimes when folks come in after an injury, they're like: "So how is massage going to help me?" And it's like, oh well, it's, there's this thing called blood circulation, and there's this thing, like, it's so weird that us as humans actually forget how our bodies work, right? And so, it's been a really amazing thing for myself and so many others, but it's also been amazing thing for us to advocate and educate about, because it's not just simply direct services. It's like, yeah, it's great. We're going to give people access to these services, but it comes with more unpacking around. How do you make that sustainable through proper coverage? How do you make that more understandable through ongoing education? Because, you know, it's not as though these services are today, well accepted. We still come through situations where we have to explain to people why these are so, so essential for people who are going to live with a disability for their entire lives.

09:54 Christopher Michael Lee  

Wow. I mean, it's just yeah, to me, it's just it doesn't make a lot of sense. I mean, since it's right in front of us, and it should be part of it. So, what you're doing with your center is really expanding that education. You're letting people know, hey, massage does work, and this is why it does work, and why it's appropriate in this situation. I mean, think about just, you know, athletes like the Paralympics are coming right here in front of us, right? And how Paralympians are able to do the level of expertise and athletics that they do, and a lot of their plan deals with the things that you're working towards to reach at the highest level. So, it there's a lot of just some great stuff that's has shown already that people can do so much more with the right preventative care of that. So, I want to back up a little bit you talked a little bit about, you know, some of the accommodations that you use, you modified vehicle, modified chair, the assistive technology around how you get through your day. Can you talk a little bit about that? How was it that you'd found out that the toolkit that you use, which is the yoga, all the other things that you do to keep your body in check and your mind in check. What other kinds of strategies that you use to get through your day?

11:08 Chanda Hinton  

Yeah, and I think that one of the pieces about when we're talking about kind of that toolkit of getting through the day is that oftentimes we know that those with some pretty significant physical disabilities. Getting through the day can be quite sometimes difficult because of the lack of accessibility, and not only from just day to day in terms of our vehicles and getting in and out of places such as general grocery stores and things like that, but one of the things that I've noticed pretty significantly is that our health care has not been very accessible to people with disabilities. And so, you know, not only are we giving folks with disabilities not this proper level of preventative care in the health care world, but there’s also this whole other component about just physical access. And I'll give you a couple examples. So, at the Chanda center, in addition to like, directly serving individuals, advocating educating, we made sure that in order to navigate through the day, we wanted people to show up with not necessarily having to have their toolkit with them when coming to the Chanda center. And so, what that looked like is that when you see our front like parking lot, it is like we have more accessible parking spots than any of the other spots. So, it's like, this is, this is the anomaly, right? This is where you get to feel as though you totally are meant to be in this world. Because so often you run into those barriers and you just simply think, well, I mean, goodness, we're in the 21st century, and I still don't see the level of change that I should around accessibility. All of our doors are automatic, like they you come through, there's no thresholds. There's a reception desk that's very low, so eye level contact, you're not being forgotten by having yourself hidden behind this high-level reception desk. All of our bathrooms, not only do they have the auto button to get in, but there’s also a button that once you're in there, you press the button and it locks it for you, right? So, this dignity around like I'm coming to the center, I don't have to ask someone to open my bathroom door, because accessibility and equitable use of a bathroom should be what everybody has. And then you go into a treatment room, and all of our staff and providers have been trained to transfer our participants to the treatment table. We have ceiling lift to help people that maybe need more extra assistance than just being transferred by two person or by themselves, because we really believe, again, that when you're coming to healthcare and you want to massage, you should get out of your chair to get a massage. Like, nobody should be required to sit in a wheelchair to get a massage like, because one, it's just not appropriate, quite frankly. But number two, it gives you the best benefits of that service. And so, these are just some of the things from a, you know, a toolkit component that I noticed and saw in my own life. And I wanted to make sure that, as we created the health center, we made sure that we even broke down some of those physical barriers that just prevent people from, you know, at some point, even running away from healthcare, because if you show up to healthcare and they're unwilling to accommodate and unwilling to like be accessible, you run away from it. Who wants to keep going somewhere that's not accessible? So, then our folks usually end up going to the ER or going to the urgent care because they're not showing up in places that are accessible and willing to accommodate so therefore their situation worsens, the condition. Maybe they were there once going to the physician, for was only minor, but now has become, you know, significant. And so, all of those variables are things that we've had to really think about from. And a day-to-day perspective of our population, and just making sure that we, we break down some of those, you know, accessible barriers.

15:09 Christopher Michael Lee  

Creating a kind of a space that has equal access for all, right? And that takes a lot of energy and time to do that. And things change and shift. And your clients shift and change, so you have to make sure that you continue to stay on top of that. You know, I love the fact that that you removing barriers like that, because I always think about the fact that a lot of people that may not work with people with disabilities, no matter what the disability may be, they don't realize what I like to call the fast track, with all the frustration, that anxiety, the stress and the tension that people with disabilities go through every day that they don't even realize right, like getting into the building, getting onto that table, get into the car and out of the car, getting to the grocery store. That there's so much that they carry beyond just what they have to do in order to get through that door. So, I appreciate you sharing that. So, can you tell us a little bit of what has been the most significant challenges in advocating for integrating therapies for people with disabilities, some of the challenges that you faced? 

16:10 Chanda Hinton  

Yeah, I think it's kind of going back to reminding that the healthcare community can embrace acupuncture, massage and chiropractic without it having some sort of level of, I don't know, violation against their own level of service and practice. I think that's been a challenge, because I would say that, and it's gotten better, but in the very beginning, having to educate people why massage wasn't just a luxury, it was actually a basic healthcare human right to have good blood circulation like that. You know, it was because there were people that would just be like, well, a massage is like, something that you go to do to relax, and it's a luxury. It's like no for us it means that, because I, you know, we can't go into a gym and work out because we can't move our bodies, even if we go to a gym, we have to make sure that we have assistance there to help us work out, like at Adaptive gyms. And so these are ways that because our body was no is no longer to be able to do what it did before we really had to educate. And that was always the, you know, the hardest thing to do, I think over time, it's gotten easier. A couple things is that you know physicians, I would ask them, well, why don't you recommend these Why don't you refer these services to folks with disabilities? And I think the other you know challenge is that not all insurance companies would cover these services. And so, the challenge around the misunderstanding about the service and the impact and the financial benefit to being proactive, that was one piece, but then ensuring that if people are going to refer it, it's got to be covered, right? Because a lot of physicians are like, oh my goodness, I would love to refer massage for my patient, but that's not covered. So oftentimes I'm left with the reality that I have to prescribe them a medication because their insurance is going to cover this medication, but their insurance is not going to cover a massage. So, our healthcare system is even today, putting physicians in a really difficult spot. I know some physicians have even started their own practices where they don't have to be so, you know, specific to the level of coverage, or they've come up with different membership packets because they're like, I went into healthcare because I wanted to help people. I now feel as though I'm in healthcare because I have to, you know, be, you know, part of a system that's not really providing the services in which I feel is most, most ethical as a provider, right? And so, we just, unfortunately, have kind of flipped a little bit when it's come to our health care. And I just hope that those two levels of coverage further over time, will become more available, and that people will understand these services to be essential for folks, rather than a luxury. 

19:12 Speaker  

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19:49 Christopher Michael Lee  

So, there's a lot of, I hear it in your voice. I hear it in the passion about advocating and obviously the center is the structure that you're using to do that, but I would assume that you lobby quite a bit to try to change things within the healthcare arena. Can you tell us a little bit about, you know, just what you've been doing and how you were involved in the waiver, the Medicaid waiver, the CIH waiver in Colorado, and how that works exactly. And do other states have similar waivers?

20:24 Chanda Hinton  

Yeah, absolutely. So, one of the biggest things after I realized that these services were so beneficial, I knew that I wanted to break down that barrier of physicians not having another ability to tell their patients with long term disabilities that these services were covered, and then obviously getting them covered. So, while I advocate and do various levels of you know, different legislative things, this one was really essential to us. This was the first you know bill that I ever ran at the Capitol here in Denver, Colorado, and it was around ensuring that under Medicaid, folks with long term physical disabilities would get access and coverage of acupuncture, massage and chiropractic. And so that was in 2009 when we passed the original bill, and it's now continued ever since then, and has even expanded to the entire state. Because when we first passed it, it was smaller, it was a pilot for a little bit, where it was narrowed only to specific disabilities in the Denver Metro area, whereas as of today, it's multiple disabilities and across the entire state of Colorado. And so, it's been really amazing to see in the primary reason outside of just ensuring that the service was available and that physicians could refer other pain management options. Is that I as a nonprofit, as a founder of a nonprofit that was delivering these services, I always thought about, oh, my goodness, what if one day something happened and we were no longer around, like, where would that leave all the people that we were serving? And so where we landed is that we believed that our healthcare system needed to give these services because it means it's sustainable, like it means that if I go away, or the center happens to go away, which I doubt that'll happen at this point, but we wanted the system to be accountable for proactive and preventative services, rather than this small, little grassroots organization, because over time, it creates the sustainability of people getting access to those services for as long as Medicaid covers it. And so, we always look at what we do from a programmatic level, and we make sure that when we see the problem, we're always advocating for it on a more systemic, higher level, through whatever. You know, government program is maybe not doing it as it should. 

22:54 Christopher Michael Lee  

So, I'm curious. I mean, this is, first of all, it's remarkable, and I can't believe it's 2009 that you started with that pilot, and that way you're at right now of expanding across the state. But it makes me wonder, you know, other states have other states adopted this type of framework? 

23:11 Chanda Hinton  

Yeah, so what's really interesting is that federal really dictates the basic Medicaid, Medicare stuff, right? And then state by state, we get to identify some of our own we get to, you know, create waivers or adopt services independently from the federal government. And so, what happens is, like we see that as in being a good thing, and then sometimes we see that as a detriment to the folks in that state, for example, I would say that our example and our waiver. It's the only one of its kind. It's only in the state of Colorado. We've had other advocates from other states reach out to us and ask, "When are you coming to our state and creating this?" And I usually say, "well, you're an advocate. You go run the bill and make it happen. I've got the playbook. You can have my playbook for free. Go make it happen." We haven't seen that become reality yet, and so our board of directors are as we create our strategic plan, we are trying to identify what is the best way for this waiver to not be isolated, and only Colorado because we know we serve people that have come out of Craig Hospital, which is one of the really well known rehab hospitals in the country, and they're with us for a short period of time, and then they may go back and live at the state in which they their injury was and at that time, they are now losing all these amazing benefits, because at the time of their discharge, they were on Colorado Medicaid. But then as life, they want to maybe get back to their families. They want to get back to like, where they came from. And so now it becomes this really weird, you know, situation where people are even choosing to live in certain states because of Medicaid benefits, and how progressive some states are in other states aren't, which, I mean, that goes with the landscape with a lot of other things, not just this in itself, but we do this see, we do see this as a problem that we've noticed, and we're trying to identify what's our role in the resolution of it, knowing that it would be impossible for us to go to every state and do it. But we're also wondering, do we have conversations on a federal level to make it a part of the federal menu so that states can be educated more and adopted into their own state, much easier than it would be to then have to fight individually, state by state. And so those are just some of the conversations about where we want to go next with that, just as we keep evolving as a nonprofit and an organization.

25:55 Christopher Michael Lee  

Yeah, I'm just thinking that, you know, from a strategic partner standpoint of some of the advocacy groups out there, and you think about tied to federal and state, like the Silk Independent Living focus, I mean that that, to me, would be one area that you could lean into, and maybe even the assistive technology area to slightly where you could pull together partners, you know, from like ATAP, which are the assistive technology groups that deal with a lot of different strategic partners out there, as well as independent living, maybe some other the DD councils and different states, that there could be a coalition pulled together to help, from a federal standpoint, lobby to change things, because this does need to be, you know, nationwide. There's no question about it.

26:39 Chanda Hinton  

Yeah. And I do hope that, you know, one of the things that we've always hoped for is that some of those federally known organizations would pick up on us and come and say: "Hey, let's, let's get this done right?" Because I feel like what we've been noticing is that those the individuals that need these services, that may be represented by some of those coalitions, they want it, but it's kind of like we're knocking on the coalition doors every once in a while, because we hear it from their constituents, but yet, we haven't gotten the knock on our door yet. But again, we're sharing. We're doing more outreach and communication. We're available, I know that there's going to be an alignment at some point in that area, but I think that we just, you know, I'm one of those people that it's going to happen when it's going to happen and I do think that we have started to start heading down that path even further, especially as we prolong, or, you know, we've been around for much longer than the not so I I'm excited about it.

27:42 Christopher Michael Lee  

Just curious, I know, diverging from some of the questions I'm going to try to circle back around to them, but this is, this is great stuff, and it fascinates me as a nonprofit. How long have you been around as a nonprofit? 

27:53 Chanda Hinton  

It'll be 20 years next year. So, we've been around for a while. So, I think that, you know, in the very beginning, as you were talking about challenges earlier, as we've, you know, gotten older, we have a deeper reputation. You know, we have a within our community, with our foundations, our grants, all of that. But even within the other peers, other coalitions, that when we were in our infant stage, it's kind of like, let's let them get let's let them figure it out a bit. Because, yeah, I mean, I think that, but, but now I feel as though some of those more organized national coalitions are willing to listen to us, or come and seek our advice, because we, we now have a bit of a track record. 

28:39 Christopher Michael Lee  

Well, I was just kind of thinking as you were talking just about, you know, the advocacy piece of this, just the importance of having research data that supports what y'all are selling, which is so important. And I'm just wondering the center has moved that direction. That's why I was asking about the term in which the center has been opened. Have you done some work or collaborate with research grants, federal research grants, or state to collect data and if it's out there, what would some go to to find that.

29:08 Chanda Hinton  

We've done one that's as we all know, there's a there's some differences in what we all identify, as you know, research versus evaluation, right? And so one of the things of the CIH waiver is that when we passed that we did ask for dollars from the state to ensure that they did an independent evaluation, to ensure that what we were proposing to them, that the utilization of these three services would have validity to it would have dated a backup that one, it was improving the lives of people, but that too, we would see the cost of the population on that waiver get reduced in terms of like, reduced hospitalization, reduced pressure sores, or reduced urinary tract infection, so the state has been able to kind of compare and contrast the folks on their prior during the time that they're on the waiver, and look at those true claims of those individuals. Now granted, it doesn't mean that everybody on the waiver is not going to have some isolated incidences, right? That are going to be the outlier of the data, but those we you just have to account for. Now when it comes to like other actual research with principal investigator that various stuff, we've just started to have conversations about that, because we do believe that we, we see a lot of research around integrative health, like acupuncture, massage, chiropractic, when it comes to the general population, but we do not see very much or any study when it comes with those modalities and disability. And so, we've really need to be providing some more specific research on that piece of it. I've always been, I'd love to hear you think about this, because I think research and data is so compelling, and it can oftentimes drive change, and then it's so interesting, because I've had so many people say: "Well, in order for that like research to be really valid, you've got to have so many people", you know, in the study, you've got to have, you know, so there's a lot of variables about, you know, around research being so valuable. And then oftentimes, when we show research the level at which somebody can pick apart all those variables to not make it valid, is something very interesting that we've experienced as well. And so, it's kind of a catch 22 a little bit, you know.

31:52 Christopher Michael Lee  

It really is. And you make a really good point. I mean, that's why, you know, I always lean into universities and some of the research grant that they do, because what you're dealing with is, is private, in a sense, you know, from a HIPAA standpoint, from an IRB standpoint, so having the right partner to do that is critical, where it can't be picked up and in the sense of just picked a part, meaning, so I think, I think that has something that is so needed. I love the, you know, where you went towards, you know, the other disabilities, and pulling that into, I mean, this would impact anybody with any type of disability. The center of what you're doing would be something that would be helpful for, for all. 

32:38 Chanda Hinton  

Oh, absolutely. And I love that you said that because I tell people like, yeah, we as a nonprofit, we decided to focus on disability because we knew that that was the most underserved, you know, highest disparity because of lack of access to healthcare and these services, just because we've focused on that population does not mean that these services are critical and should be available to everyone, like the Chanda center should be. I always tell people: "It's the model that we should be doing everywhere in healthcare, where we have providers that are collaborating together underneath one roof for the sake of the end user, and that it's coming from a perspective of, you know, therapeutic, proactive, preventative, collaborative". It's just the nature of healthcare that I hope that we get to see on a larger scale, but, I mean, I don't know, because there's just so much stacked against so many of us about what are the true underlying drivers of healthcare? You know, there's the unfortunate, yucky part of all of it that, like, you know, you just wonder if we'll ever be able to break through some of that. 

33:55 Christopher Michael Lee  

So, on that note, this question is perfect. I mean, how do you envision the future of healthcare accessing people with disabilities?

34:03 Chanda Hinton  

I would love to see more centers like ours for folks with disabilities, but I would also like to see that there be primary care inclusive into those centers, because I truly believe that primary care, you know, one of the things underneath, you know, most folks with disabilities are reliant on, you know, government assistance, whether it be Medicaid or Medicare, and most the states. And so, what I'd love to see is that there's more of these services in centers where they're all underneath one roof, but that we're ensuring that we're bringing what we would consider, I don't really like to be the western and eastern models. I'd love there to just be an integrated model where we get away from separating them, and that it's very collaborative. Because right now, you know, we're representing an accessible Clinic for people with disabilities, for all the services I've told you about. We're still advocating in our state to ensure that our basic health care services are accessible. Like right now, there are very few individuals with disabilities that can one find a physician that'll take Medicaid if they do, they are not educated in disability. Oftentimes, you'll come into their office and they're like, they don't know what to do. They don't they don't know how to transfer us. They don't have an accessible table. There are all of these things. So, like, you're not getting your annual physical screens, like, so we're not even getting basic health care services, let alone the preventative ones. And so that is why, finally, the National Institute of Health had put a true or, you know, finally documented that healthcare was finally a dis or that disability was finally a disparity group which was not there for the longest time. And so, I think that there's a lot for us to do in healthcare around disability. I already wish today it would it was better than it is, and so I can only keep hoping that it's going to increase to what I foresee the future to be, and that we as advocates have to just continue putting pressure on those areas, even though I tell a lot of people, like having a spinal cord injury is a full time job like that alone and the barriers going through the community or going through life, that's your other part time job, you know. And then so adding advocacy on top of that, and I mean, sometimes that can be another part time job. So, it's like, you end up, you know, with so much, so much on your shoulders. Because it's just, you know, you'll always, in my perspective, I'll always keep things optimistic and I'll always keep things as bright as I can, but I'm also never going to dismiss that. You know, none of this is easy. It's, it's hard, right? It's like, and I think that sometimes it's really okay to talk about that, because I've seen people like sensationalize disability, or, you know, take it to a level of inspiration, and it's like, yeah, it can be all those things. But guess what? It can be really damn hard, too. 

37:17 Christopher Michael Lee  

Yeah. I mean, yes, there's layers on layers and layers, right? I love the fact, though, I mean, I guess I love the fact that you have a model, and I wish that model was shared more. I'm so glad that we all help you do that at some small level. And I can just think of all these advocacy groups like the world and people with disabilities and others that could be you could take this and really run with it, and I would love to be a part of that if you're ever interested in exploring the advocacy side from a national standpoint, on top of the other jobs that you had.

37:54 Chanda Hinton  

I am in. It's been one of my I have now shifted into fully doing advocate work and fundraising. I don't really deal with the daily operations anymore, so I'm really in a great place to do that. And so, you know, Christopher, absolutely, I think that it's, you know, we've come into that time where it like, the more there's been more outreach we've got to make some changes in that area, because it's just so needed, you know. And I think that there's been times where I'm like, oh, you know, I've done, I've done a lot. I'll let somebody else jump in and do it, and it's like, at the end of the day, I just know that there's going to be places and times where you know you're, you're not going to be satisfied. I want those people that could not be I can't be sedentary. I, you know, I will always be fighting and advocating for some goodness within this population, for I mean, forever. I mean, it's just my nature, right? It's my personality. 

38:55 Christopher Michael Lee  

Well, I, you know, I love hearing about the center and about your story. You have a framework, and you've had a framework that's worked and expanded for 20 years now. That says a lot, and congratulations on that. Truly, it's remarkable. And I can't imagine all the people that you've helped over the years, just to end off, is there anything else that you'd like to share with us to our listeners?

39:21 Chanda Hinton  

No, I just, I really thank you again for having me and like you said, it's you know me speaking more and sharing more is when community gets to hear about things that maybe they otherwise didn't. And so, I would only just say that if people are really interested in seeing that their state or there are, you know, anyone that has any idea or wants to connect, they're always welcome to connect with us. And we have a playbook, like you said. We have a model that we have no proprietary ownership of. We believe that these should be things that we all do together to make healthcare better. And so, I would just, I would leave with that we want, we hope somebody does it better than us, that feel that would be awesome, right? And so that's what I would leave with. 

40:11 Christopher Michael Lee  

Thank you so much for your time today, and I look forward working with you and spreading the word and the great work that you've done. Thank you. 

40:20 Chanda Hinton  

Thank you so much too.

40:23 Speaker  

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