016 Roy Poillon from FamiliesImpactedbyOpioids.com
Roy Poillon joins us from FamiliesImpactedbyOpioids.com He talks about his system for educating families about the substance abuse journey, and healthy family dynamics including denial, enabling, and codependency. He talks about measuring successful recovery, support of families, and a nationwide presence of Family Solution Finder Learning Centers. Enjoy.
The Illuminate Recovery Podcast is about Mental Health, Mental Illness, and Addiction Recovery. Shining light on ways to cope, manage, and inspire. Beyond the self care we discuss, you may need the help of a licensed professional. Curt Neider and Shelley Mangum are a part of Illuminate Billing Advocates. They are committed to helping better the industry and adding value to the lives of listeners by sharing tools, insights, and success stories of those who are working on their mental health.
Transcript (no grammar): roy poillon joins us from families impacted by opioids.com he talks about a system for educating families about the substance abuse journey and healthy family dynamics including denial enabling and codependency he talks about measuring successful recovery support of families and a nationwide presence of family solution finder learning centers enjoy welcome to the illuminate recovery podcast we shed light on mental health issues mental illness and addiction recovery ways to cope manage and inspire beyond the self-care we will discuss you may need the help of a licensed professional my name is kurt neider i'm a husband father entrepreneur a handyman and a student of life i avoid conflict i deflect with humor and i'm fascinated by the human experience and i'm shelley mangum i am a clinical mental health counselor and my favorite role of all times is grandma i am a seeker of truth and i feel like life should be approached with tremendous curiosity i ask the dumb questions i fill in the gaps we are really excited to have roy poyon with us today he is the executive director and founder of families impacted by opioids he runs the family solution finder learning center and is a really great advocate in this industry roy thanks for being on today thank you for having me shelly hello kurt hey roy one of the things that i think is very helpful is to give a little bit of background roy of kind of where do you come from and how did you end up getting into you know opioid addiction recovery and and helping families um i get asked that question a lot so thanks for starting off with that where i started from was in the area of disease management i had the experience of working with one of the top home health care agencies back in the 90s and the topic of disease management wasn't really known what we were doing is we were wrapping around um a particular condition like asthma diabetes and we were providing more of a holistic approach which oddly enough include the family and because we had catch data cache collection tools we could actually start the uh the nuance of outcomes management and outcomes measurements with that we launched that across the nation to about 200 locations so we were working with both providers discharge planners ur managers as well as a heavy role with managed care the payers so we kind of saw this as our area our space and as we created it new models new new acronyms came from the work we were doing as well as oasis deciding from medicare standpoint to use our basically it was how we started a case and then measured it they were most interested in variance management and intervention from a disease management standpoint one of the things that we noticed was that when we educated the family but it wasn't just it wasn't just measuring the family in terms of did you listen to what we said our data collection tool actually allowed us to understand the level of comprehension and their ability to do it which was pretty much unheard of but as we gained measurements in that we could come back into that realm and say okay this person isn't doing well we're seeing on our early indicators that they're not doing well and they're going to head for a relapse is there something that we can do to intervene and then we might notice that it's nutrition okay well let's let's educate on nutrition as our intervention let's measure was that intervention you know helpful and did we end up doing financially better uh satisfaction better clinically better utilization better which was our four outcome measurement tools very common in health care today but not in the substance use disorders industry you know to be honest with you kurt shelley i'm sure you can relate to this we had to create the the vocabulary in order for this industry back then to understand the value of what we were doing and then they should pay us up front eventually we were able to go at risk for that so we were at financial risk for 35 000 member lives south south side of chicago for asthma you can imagine what that must have been like and so when we came back to our client which was humana and started to give them the data they were amazed and they said well how did you get to that performance level and we told them medicare requires that you fail before you're able to go to the next level and they'll reimburse that you paid us so we jump to the level that makes the most sense after the assessment so the driving tool was the assessment yes but no because we had to have unbiased accurate information in a timely way that we could respond to upcoming variances and just at the very beginning they start to sit there and think well does do we have this in substance use disorder actually we do we have three stages of relapse oh okay well what's the first stage self-care well where do you where would you ever find self-care registering on a data collection tool inside the assessment of severity data collection tool that's 42 line indicators and it goes from mild moderate to severe on each one of them and we can we can start to see collectively well how do you collect that i mean how would you ever get out to jack's place and meet with him on a quarterly basis and you sit there and think this is an industry right i mean we're gonna use all the tools here i'm assuming the home healthcare industry does this all the time they know how to make an appointment they know how to make sure sally's at home okay for this well you said then you're looking to just say well can can a home health care agency handle this they open a case based on a doctor's prescription managed care checks the eligibility and gives the authorization if it's a disease management model that the managed care is approved of they know the algorithms that we're working off of but we have to have the family involved that's the one thing we noticed back in the 90s that when they were involved we just didn't do as well so the way that i'm coming into this industry is with that knowledge that skill base so you look at the industry and say are they ready for this and the answer is no they're not i mean they don't even the family doesn't even have a face nevertheless a voice they're not invited to the table they're treated as more of a problem and an annoyance on all areas of our society this is really strange because when you look at it they go to jobs and family services and says my son needs a job but he's got a federal record from a drug developed problem he wasn't fortunate enough to go through drug court and he went to prison and he needs a job and then philly's jobs and family service is looking at them saying well how do you lose this other job well he was drunk like oh okay well we'll go out and find a job that we can you know qualify them for and get them into employment because the plan is important it's one of the characteristics of re-entry um and the family is looking at wow that's great and then they say good go away it's like well now wait a second the membrane of our society they just pinged off of them they are going to go away they're going to retract back into their house because they're embarrassed and the thing is but our society now knows that this family has an addiction and they have a brain disease inside the family and it's impacting all of the family and we just kind of told them to go away same thing happened for the coach down in a sports locker room where jane for example uh didn't play well and fill their history tests this week so now the guidance counselor and the coach knows that jane is failing but she's an a student she's a very good player on the volleyball team and so you sit there and you think okay well society just found out that this family because she said to the coach my family's been fighting every night for three weeks now up till five in the morning listening to this my life is an absolute wreck i hate my brother for what he's doing to my mother and father oh well okay um how does a guidance counselor handle that did we give them any tools to handle the family member not really same thing with a pastor the pastor knows how to help a family who's suffering they are in the business of nurturing through their faith practices families that suffer family members they're they're comfortable in that space do they know anything about substance use disorder living in the living in the family no well whose fault is this well to be perfectly honest with you it's the industry's fault because we are an industry it's the substance use disorders industry because we gave that family no face and no voice so that's what i've created a voice for the family well how are you gonna do that roy how about you get the heck out of them well okay so i think it's pretty incredible what you're talking about and and i don't disagree i agree that you can't you can't take an individual out of their family dynamic give them you know support recovery or you know whatever the tools are that they need stick them back into a dysfunctional family and expect that they're going to change because they were just put back into the same dynamic that and they're expected to behave a certain way and we haven't done anything with the dyn with the system so i i totally agree with what you're saying um i'm curious about application because not everybody i mean when i work so we work with a lot of substance abuse and mental health facilities and i know that they try and do family sessions they try and do family you know group stuff family day they do family sessions but i don't see it being near as effective i think as it should be or could be well let me take a moment and i'll describe for you the family solution finder learning centers this is that this is a new kind of new co it's a blue ocean it really fits into what is there but it really isn't there right now and so what we've done is we've taken 32 we reverse engineered the journey in the family and we've taken 32 of the issues that they're likely to experience living with substance use disorders now we've written a study guide that identifies three learning objectives for each issue okay now they know about the family as a system how because we told them about homeostasis but we didn't use the homeostasis word because it's intimidating it's a lot to say so we talked to them about the balance of the family okay they get it then what well the balance of the family is really the functionality of the individuals so let's talk about functionality but not just that let's talk about potentiality because jerry might be a really functional person in his own life but he's so mad at jack he thinks that jack should just hit rock bottom before he's gonna help well that means his functionality the potential being a part of the family dynamic and helping jack is practically non-existent so he gets kudos for being functional but he gets negative points for his potentiality well what happened there well there are three primary obstacles that interfere with our functionality and potentiality as a family member in a family dynamic of a family that's living with substance use disorders and that would be denial enabling and codependency they're probably the three most majors so why don't we tell the family this i mean really that wasn't very hard well how often uh let me ask you roy how often does the family go i don't want to hear this because it's not my problem it's their problem correct correct and what are you dealing with by stages of change right right okay so let's set up the learning module so that it mirrors five stages of change not just that let's add military's motivational interviewing so it's really powerful okay so to take your example what do you know shelley from oh sorry to do this to you in pre-contemplation we would do what we would give them an assessment so they could see themselves and then we would say this is what you could look like and then they would say i think i want to look like that and you're you're thinking no roy we do this for the patient we don't we shouldn't have to do this that's a nice word you shouldn't have to you have to now okay let's just say for example you have to well then how would we do it okay that's a better word so how you would do it is you would just do what i just said you would offer them a choice well that means that they're huh in pre-contemplation well how'd you get them there you used millionaire olympics motivational interviewing you knew europe you knew your pre-contemplation and now they're contemplation and they're at stage two and that's because you gave them an assessment well how do you get them to preparation well you know this i mean we know motivational interviewing you have a choice of how they would learn and they select one okay great now they're in preparation stage number three see what i'm doing we did that with this learning okay but all we've done right now is said this is homeostasis that's meaningless that's a that's a 62 second slide and i'm gonna move through 27 of these things in 45 minutes and i'm going to walk out that evening and think wow i really did this family justice and the answer is no you didn't and we've got to stop it it's already proven it doesn't work it doesn't work when all we do is run slides in front of a family and think we've achieved something great we have not and you're accountable now because you're in this conversation so what we're going to do now is we're going to sit there and say in a workbook take that information of functionality and which one of your parents is kind of like acting like they're not very functional how's that working and what's their potentiality well you're going to record in a book about your sister donna and your mother and your father you actually are because what you're gonna do is you're gonna then take that and you're gonna sit there and say i know what's going on and i know how it's impacting my family and you're still nowhere you can't do anything yet because you don't have coping skills you need a solution don't you because you've got an issue let's say the issue is enabling that is enabling really there's 10 types of enabling and when you take seminar number 10 you'll realize that enabling versus consequences of the 32 seminars but in 10 types of enabling you've identified that dad is actually problem solving that's his enabling because he keeps saying to jack if jack wouldn't hang out with those kids he wouldn't have this drug problem ah the problem is jack it's not the kids and the real problem is every time you say that dad you're a name like jack you're letting him up though so you gotta stop doing that do you think he's gonna listen to his daughter what's the solution well by answering the six questions in this book for every issue they will come up with a solution it's a solution finder model okay six questions for any issue you're facing in life pretty cool huh so then you take that and you put it into a decision-making model well we all know what that is okay but it's here that's coping skills number two okay you have a solution to the issue which is dad it is problem awareness which is enabling it's one of the ten and we've realized that that's part of his functionality and his potential to contribute so we're kind of working back through these seminars you can see and then you turn around and say now let's act on it okay well now you need a plan of action oh by the way that's the third of the three coping skills that's what this book is about now the reason it's 397 pages is because you do that for every one of the 32 issues in this book you've just written down a solution a decision a plan of action for how you're going to handle the emergency room why what did we learn well that was actually seminar number 14 emergency room intervention emergency services you knew what the paramedic was going to do in an overdose in your living room you knew what the er was going to do you knew about what is a 23-hour observation and what is a an intensive care advent you knew to ask as far as seibert is concerned the program receiver which everybody's ignoring it should be a standard model the fact is we need for that person to be hardwired into the next step when they leave the er or the hospital so at discharge they should have an appointment and be practically driven over to the mental health group to get started or the iop or whatever it is that they need sometimes they're going from there to jail because when they're when they're done medically it's they created a problem that's what started this whole intervention and now they've got the court systems to deal with how many families first time through understand the legal system [Laughter] okay well actually there's 12 steps to building a case before it goes to the prosecutor okay did you know that one of those reasons that you are at the er that you get an assessment is so you can quickly get in that to the prosecutor or you would if you took the seminar because that assessment tells the prosecutor this is not a criminal it's a person with a brain disease so he goes to drug court or at least whatever is called or titled their intervention program in the legal system in that county good okay he's got a fighting chance now hopefully he'll avoid a record and be able to get through this into an iop or a php program so what we're doing here is we're educating the family who follows the fit this person through all this i mean from the beginning of this first i think something's wrong here too uh i haven't seen him for 17 days and i'm worried to you know his first police interaction to an overdose uh stealing who's there from all this we need a case management company that we can connect them with there is none and there won't be anything for a long time to come you know the case managers are they're the family if we educate them because their family is with this person through the whole thing and i know what you're gonna say hey roy not everybody has a family family is defined by the person not us family could be the neighbor it could be the guy out of rehab who's ever this person's you know confidant and who's he's willing to listen to we all we all have that even we're in the judges of prison we still turn to somebody who we think you know could help us hopefully or thinks better than we think so with that in mind that's family so we want to educate family regardless of how you define it and that's what this does the fourth book is where they sit there and they say ahead of time uh i get a feeling we're probably going to end up in court i think i want to find a drug court lawyer now and find out how much he charges because in seminar number 23 we're going to talk to you as a family member about financial management it's expensive i don't care how wealthy you are you're gonna have to sell some of those mutual funds i don't care how poor you are you're gonna have to find a program that'll pay for this but either way you gotta pay the piper and the piper gets paid or this person doesn't get the care they need okay so we want to avoid that when families get educated let's educate them about how to manage the financial aspects of this too sounds like a lot i'm just getting started let's say i'm a family member how long does it take for me to get through this system well this is a chronic disease so it'll be with you for the rest of your life all right i don't mean that i mean the seminar i mean you're you're christian i know i know what you're saying that's a wise guy yeah there's 32 if you did one a month you'd have two and a half years worth of content however there's an on-demand curriculum builder with an assessment tool so with the assessment tool what you do is you take it and say what's most important to me right now these are not sequential so you're jumping jack just got arrested well you want to go to drug court what's drug court take the seminar okay i'll tell you what you need to know okay what happens after drug court take the seminar for uh treatment centers okay well what happens when he gets out take the re-entry seminar it'll tell you what you need to know about re-entry so it's a set of it's a set of um it's a it's resources i'm not i'm not attempting to become a certified family member is that correct correct yeah um you're not and nor will you be and you're you're not really you don't have to know these topics to present them we have about powerpoint and we have the powerpoint with slide voiceover so all you have to do is get them to sit down in front of this content now they can take it at home this is designed to be presented by a social worker let's say a social worker gets all of this because a local uh treatment center stopped by and gave them the copy of this and it's from social worker to family table okay okay this is 12 core competencies out of the 32 and we're going to give it to sally who happens to be a social worker down the local hospital er and she says boy this is great can you you're giving these presentations at your location every wednesday from 7 00 to 8 30. yes and we're also doing it on zoom and in some cases the the the family members take it at home on topics that they want to learn because something's happened recently that's important to them but she looks at it she says well can i go out and give these presentations as part of my speaking engagement the answer is yes we want you to so go to the kiwanis club sally and be the superstar that helps to spread the education that's exactly what we want so this can i give this to my family members here at the er yes please do i'll give you more copies so what have we done for the treatment center marketing okay now the treatment center is just sitting there saying give me your next referral they're saying sally i want you to know what the family members are going through because they're a vital part of this and we don't talk to them very much you can help us wow you just turned on sally remember that part of the membrane what if we did that with the coach oh i'm sorry that's what this says from coach's family table the family table is where we want to be that is the hardest place for a marketing person to get to they love to be the dialogue of the family table if you educate them on what's causing them the greatest amount of pain you will be at the family table okay great tool by the way for anybody who wants to build their referrals then there is this is why i said there's more so we've got these we got from police to family table from pastor family table from social worker from community agency we've covered the entire stakeholders of the local county here in lima ohio okay all the people now understand and can share with what they understand and we're doing this at our local treatment center this poor pack of books costs 38 that's about the price of a coca-cola when you look at the fact that there's 32 seminars so what we're doing now is we're saying would it be great if the churches had something because that's where families gather it's the only place where we can involve god because we're not going to be able to involve god in these other forums this is not appropriate for our society so the family goes to church to experience their faith and love of god and god's love for them and they're suffering they know that god's there but they're not quite sure because of all the confusion that's going on how to connect wouldn't it be great if my pastor or my priest had a ministry of people like me there i know they're here they're just not gonna raise their hand wouldn't it be great if we could do these programs there yeah you can okay and here's how we've got one for the catholic church and one for the protestant church is turkey ministry so that they can not only offer their faith practice but also education inside of a ministry so now we have a satellite bailey solution fighter learning center amazing this will kill stigma this will increase continuity of care from because now jobs and family services understands what the family is going through you know you said that you do what you're here knows what the family's going through you know foster care is out of all of us in the community probably understands the most about the family but even they have limitations because they're so they're so myopic and it's okay that they're that way it's just that's the way it is but if they just were given this information made it easy to learn they could sit there and say to the family jade are your family members involved in training on this uh family solution learning series because i think i want to make that part of our case management plan you guys need to get sparked what's going on here what if everybody in this society started to say to them sure we could give you that but i've got a question for you before i give this to you have you guys taken the family solution learning center series are you enrolled in the learning series because it really should be what if everybody started saying that to the family i'm not making any money on this that's not what this is about the content is free the books are free i'm doing this off of a disability check and that's how i'm kind of like this is this is kind of my ministry my way of giving back because i think it's horrendous that we're treating the families this way but i'm also kind of looking at the family saying why did you guys stay up for yourself and make the industry do for you you know this is like hiv aids your kids are dying in the streets we should get angry but get angry in a productive way get smart first so roy let me ask you a question um so how long have you been doing this [Music] um three years i've been i've been building it okay uh i started off with a very large uh conference called um addiction and family empowerment and um i used that as my focus group so that i could understand i had 42 vendors there i had 17 breakout sessions i had speakers keynote grand ballroom the whole works and the purpose was are you guys talking to each other let me get you into a roof and see how you interact and then from that i built this so talk about some of the organizations that you work with and and i've you've talked about how to utilize it but talk about you know how do you are you working with a substance abuse organization that's utilizing it are you working who do you work with and and how do you see them utilizing this because what i'm not sure i hear you saying and you probably are but how are we linking the family with that individual who's in treatment because i hear the families doing this and they're going to get wiser but we still have that relationship that we're trying to heal and that has in my head that has to be done together that's a very good question and it's probably the most critical aspect of the dynamic once the family is smarter to do it in front of that we've already tried it it doesn't work and you just make them a little bit aware you need to use the it makes me feel statement you know out of education you know this is enabling well you know this enabling is a meaningless word and what type of enabling so we're missing the mark with a lot of these you know treatment center programs god bless them for what they're doing they need to they need to dive deeper and they will say and i'm not so much opposed to them saying it that's not our world we can't bill on that and that's true okay but let's face it they're the decision makers and if you really are interested in brand equity of your organization you will want them to know who you are and how much you care you start educating these families they'll get it and that person is going to relapse several times well here's an interesting thing shelley when a family relapses did i say family or do they mean the person they're one of the same when they get out of the treatment center they're one in the same okay so when the whole process relapses we can cut that down almost by 65 empirical studies have proven this to be true by enrolling the families in a multi-dimensional family therapy at the least bo and murray bowen's family therapy samhsa's asking us to do this the nih is asking us to do this they know that this particular model works what i just said was we can cut relapses in half if the family goes into 12 sessions of family therapy so to answer your question i don't have a group right now up and running because i'm launching on june 1st but i've been piloting it up to now so the results are looking very positive and if you're a person that sits there and says roy i want to be i'm in my community i'm in the county i'm i'm down in marion uh county and uh we do have a drug problem i want to be the one with the family solution final learning centers and i will announce through adam's board and the department of mental health for the state and social media that on wednesday nights at 7 00 p.m we're running a schedule of one of these 32 and we'll have the books here for you okay and you come on in and um we'll we'll give you this education now i'm gonna go out to the community and i'm gonna call the coach and i'm gonna give him these books okay so that when he runs into a student it's just that it's obvious that this failing is in this disease he can give that to them and by the way by flyers inside of here so they'll understand to come to us and i'll do that with the police the pastors see what we're doing that's how they're going to connect okay now your question was specific how does the patient connect to the family member that's not my job and i stay in my lane and i think that's very important that each of us do that that's for the daily therapists to work with them on because every family is going to be a little bit different but the fact is that needs to happen deliberately you don't just educate the family and say well they should talk at some point you know now it doesn't work that way with a good family therapist they'll integrate this okay um you talked about outcome measures um and i know that outcome measures in treatment is um you know is being emphasized and required what what do you offer in way of outcome measures and can a facility utilize that the way that you know jayco or the insurance companies are asking or car for you know any of those accrediting bodies well fortunately i've got some experience in that area and uh because i'm treating this like it's a disease the other fortunate part is a very close friend of mine is on my board and she's written a book on advanced nursing epidemiology and she teaches public health research at a doctorate level so she'll be advising us as to different groups as they come to us what they can do to put in a study probably used for a grant a state grant but an answer your question the markers are going to be in terms of being able to capture data like utilization so that when we see variances take place utilization did change appropriately for the protocol the algorithm that was suggested and then we can move into you know what were the final outcomes clinically financially and and satisfaction wise which are typical measurements for jayco carf and other and other groups very very cool do you have that in a in a software type of a platform or is it something that would integrate into their own software platform i don't have that today the model is on paper right now it's called the abacus because it's the 42 on the severity scale and that's repeated so that's your touch point where you come out and touch with a blindfold on you say how are you doing you know on this issue how are you doing on that issue you let them tell you what you're experiencing and then you rate it mild monitor severe so that skill is easily a part of most managed care off the shelf in the public realm case management software so you can pick up that case management software i'm finding that a lot of groups have already incorporated case management as a concept they're using it a little bit differently while in care coordination i think of case managers as being much more kind of artificial intelligence uh probability of success is determined ahead something we know from past experiences that if we do this we 65 percent of the time we're pretty good but maybe it's that other you know 40 to 45 percent that we want to pay closer attention to as to why we're not to improve fantastic i can tell that you have put a lot of a lot of blood sweat and tears into this project and what you're trying to do and you're incredibly passionate about it and i can tell you've been incredibly detailed about every step of it and making sure that you have resources for every part of that community in order to get the information and the training and the understanding that they need to help heal not just a family but an entire community which i think is really powerful i think it's really powerful i'm imagining roy that as people listen to this podcast they're going to want to engage and um and and really you know take advantage of some of your resources or all of your resources how will they get a hold of you what's the best way for them to do that call me i'm very approachable and and all of this is valuable to who they are so it's kind of a cafeteria style put it on your tray if that's what you want if not put it back the fact is four four zero three eight five seven six zero five gets them connected directly to me and number again four four zero three eight five seven six zero five or you can go to families impacted by opioids dot com now i use the word opioids because it gets people's ideas to well what kind of family substance use disorder is too long a word for a website yeah that makes sense well and it's a big huge problem right now so fantastic resource i really appreciate roy you sharing um sharing all of this work that you've done and um and the and how it's affecting and can affect communities pretty powerful um i appreciate it i'll walk them through it and it's free that's incredible how do you sustain that in the long run because obviously you know the the disability check only only makes it so far so what's the future what's the future of the program how do you maintain sustainability you know is there a point where the books cost money or are you suggesting that you know people who want to open a local you know center go out and get you know grants and that kind of stuff and then that is helps fund your material what's that system look like well let's say i don't mean to be you know i don't mean to avoid the answer that you're looking for but i'd like to adjust it a little how do they sustain it because that's what's more important i'm not important in this others other is this organization it's just a conduit to get this to you you set up a county level family solution final learning center you create the collaborative you invite the players the stakeholders in they'll love it there's nothing like this nobody dies as deep a dive as this does and make it so approachable but in that same realm they could charge five dollars a session you have 20 people coming in you pay for that person's salary that is the instructor it's an hour and a half meeting you could do it on so you can charge the books we already said on amazon.com they would then pick up for 38 and that's their expense so or they could download it free on our website now the thing is this is 400 pages so good luck printing that i recommend double-sided uh pretty but the fact is i like to have a book in front of me personally when i'm taking a kind of course material like this it's shareable so that when you're in a support group because this is not a support group this is a solution finder learning center this is all about giving them everything they need to strengthen that muscle so they can be a solution finder family that's what our community wants we want a whole bunch of solution finder families in our counties that are dealing with the drug epidemic how great would that be our families in america are worth this they're worth every bit of what goes into this but more importantly they're worth the energies that local people stakeholders that take this on we'll be doing and they'll get the reward they're going to be the harvesters we're just going to plant the seed to answer your question directly kirk god is taking care of me and everyone has picked up my life i'm good i don't need the other and the fact is i don't expect that to change my concern is the county level and how well we can take care of them and i believe that this is one of many options let's fill the gap so roy i have one more question for you i hear your passion what's your story behind the passion how come you picked this and and put so much time and effort into it that's a very good question and this is another one that i get asked a lot it's kind of difficult to share um if if you don't understand where i'm coming from but i'll just put it out there um i i pray on a regular basis so i went with the uh marion fathers of immaculate conception out of stockbridge on a tour where we prayed the saints location of states throughout poland and i got back to cleveland and i asked i'm catholic so i asked the blessed mother why did you have me go out and do that i mean what was the purpose to that and i didn't i didn't have an answer to that but then one night and this is a true story i hear a slam at my door i've got french doors on my house and i thought this was a home invasion i called the police i grabbed my gun i went downstairs i'm in my underwear i opened the door literally on my door my storm door is blood and there's a woman at the end of my driveway underneath the street lamp screaming help me help me he's trying to kill me help me and i said well come on up you know she came up to the door and i made sure that she didn't see the gun and she said let me in and she's bleeding she has a knife in her hand and i said no no the police are coming and i'm thinking this still might be a home invasion or at a minimum i don't want the police to arrive she's bleeding i'm not my underwear i'm a single guy this isn't going to look good so i said just wait here and when they get here and they got there and they started their investigation well long story short she was on heroin she was loosening she was stabbing herself she thought her friend had died by this murder and she thought she was next and they took her off to the hospital and she was admitted into psychiatric word i found this out later so the next morning i said in prayer what was that all about no no more bodies i'm listening you know i i hear the news every day about these drug eggs and and what's happening to them and i'm thinking that these families just must be getting torn apart and that's generational because the little brother is experiencing this he's going to grow up one day we've got to stop this and that's when i found out about the families not being included well i was doing an alzheimer's center for family members on a journey with diminished and i would give three seminars where i would introduce and help families understand that their loved one is still there and they have to learn a new way of communicating with them so it's kind of already in that realm and what i heard in my heart was take what you did with the alzheimer's material and learn about the journey of the family and apply it there then take what you learned in disease management and the family and the care and the system and apply it into that and create and i'll guide you that's why i'm not gonna charge for it that's pretty powerful yeah that that'd be silly for me to sit there say oh great way to make money i've got what i need now the question is do you have what you need well the and i and i don't ask that from a judgmental standpoint you're talking to two medical billers right so right we understand the side of the business to say okay if if i'm a therapist and i just want to go out and i want to help everyone for free you've either got to be really good at collecting money on charity to support i mean it just costs money to do right or there are already systems in place for that right and that's where we come in to help therapists and facilities bill in order to cover their expenses because if they don't cover their expenses then it's not sustainable they can't help as many people as possible right and many of those people still choose to help a certain amount of people for free right they scholarship people they they still have you know whatever their version of a ministry would be in in just helping people sure um and so my question is not to say you know is this roy's get rich scheme but at the same time i'm looking at a lot of content right because that one book was 400 pages so that means like the whole thing is what probably a thousand a couple thousand pages or something like that that costs money right at the end of the day that book has to get produced and so i'm not asking it from a skepticism standpoint i'm i'm asking it from i think it's a super valuable resource i think it's an amazing work that you've done you do this by yourself yeah well i already told you no but yes i mean outside of the outside of the almighty you don't have like a team of writers on this no every every here is samsa nih clinical uh psychiatric papers boiled down to a level that really hits their understanding that they can use that's what's really important that's amazing so it's amazing i'd love to see it but but the but the actual books are purchased through amazon and reimbursement i get a royalty i get uh 22 cents on every book amazon gauges me for 60 uh and i want to keep the price tag down so um i just heard i i totally respect you you look like a very fine person and i'm sure um you did not mean to suggest that you know this this was something other than what i was presenting it to be but the fact is i do believe you can make money on it big money because if you're the only treatment center in town educating a majority of the family members they're going to come to your location that's a no-brainer i mean everybody would love to be at the family table with their brand being mentioned yeah this is a huge tool this is a huge tool for centuries yeah and it's a real problem so to go to add on to what you're saying i'm perfectly fine with somebody being super rich if they could get rid of the opioid problem right i mean that this is this is this is a there's people who get rich off of much much stupider things so um all of that comes from a from a a place of protecting the work that you've done right and having that get farther and farther and then the next step then becomes you've said you're launching in june launching in july what are those avenues how do you get the word out right how are you trying to grow i'm going to all the stakeholders in every county across ohio i've got 88 counties from that i'm going to learn an enormous amount and then about my vision is printed it's in i'll send you a starter guide book to anybody it's also on my website as a download but in there is the vision and it states what i'm doing in ohio and when i move into the united states but i do have a group in lancaster california i got another group that's piloting in just south of columbia missouri i got a group down in panama city and this by accident so once i started to queue up my social media which is just for the purpose of exposure i have a question for you and shelley hurt there's billables for educating on cessation of smoking there's billables for educating on um weight gain and weight reduction there's billables for a lot of education can any of these be used by a primary care or a drug specialty company in the area of educating that you're aware of is there a general education or something that might come close to what a manager would sit there and say that's worth paying for that's a that's a great question roy and and i think the answer to that question as satisfying as we might think in my experience there are billable codes for those services but very few of the commercial insurances are willing to pay for that sometimes medicare sometimes medicaid is willing to pay for those educational pieces if you um encase it in like a an iop and intensive outpatient or a partial hospitalization or residential program and put that education in there because obviously education's a piece that has to go be part of that then then you can you get the whole service paid for per diem or per day but you don't necessarily get that individual piece paid for i mean we're still having trouble getting biofeedback which is already been proven that it has amazing success with depression and anxiety and and and substance use and and a lot of that stuff and we're still having struggles getting that paid for people are still paying cash for those kinds of services so i would think that the educational piece unless you could tie it in with with therapy with process groups and things like that that it would be difficult to get it paid for how about on the mental health side uh same thing same thing they want to see it be therapeutic and not necessarily educational and not that they won't pay for it but that's got to be therapeutic is sorry the world is calling that's right the the therapeutic advantage inside of a disease management model allows you to do that and that's the nice thing about bundling if we don't if we don't come up with a better solution the managed cares will divert their local standard they'll start to bundle bundle means a blanket over everything the capital venture people out of san francisco new york you know north carolina boston there's they're starting to look at all of these industries and saying hey there's true cash here and they're right the problem is they're also going to look for blanket standardization of care we don't want that we want to keep this like cottage industry of individual treatment plan continuity of care continuity and the continuum of treatment being understood locally not managed out of you know some national center where that's what we do because that's what we get paid for right around a disease management model and take it to our local managed care medicaid groups we're going to get slammed on this and a lot of these i a lot of these iop programs will be merged and people will be coming in and there will there won't be a homogeneous nature to the growth of this industry it's going to be all mergers and acquisitions not quality i think we're already leaning that direction in many areas but i i don't disagree with you and i also think because of that because of what you just talked about that those you know those mom and pop residential treatment facilities and the community-based treatment facilities mental health as well are needed and we're going to have to work as a community to support them because i think that's where the best treatment happens anyway if we can get them to understand the value of the family it's going to be harder to just lodge agree from boston nope yeah it's a tough one but i think i love that you're fighting for it you know that's a big piece for me too is i think you can't separate a person from their family or even their support network right it's it's a huge piece everybody knows that and so i think there's got to be a lot more advocating for it so i appreciate your effort and what you're doing and and the fact that you know you're not after making a million bucks you're just after getting the word out there and getting people resources in people's hands and i think that's commendable thank you i appreciate that you need a book from private equity to the table the family table no i do a matter of fact i met with merrill lynch for just that reason would you like to help me to develop one i don't know enough about it to be much help what you were saying about the value to individual centers isn't diminished by private equity got somebody who's smart enough to say okay in my center i care enough about the patients and i want to see variety you know exist that i'm going to bring the family in and give the family all of these tools those national guys ought to be savvy enough to be able to say the same thing right this strengthens their brand right this strengthens the value that they add to their consumer um so other than some of the standardization of care issues um i think some of those people actually could be pretty good advocates for you right i hope so because they carry a lot of girth so to them i'm saying you don't have to repeat and that's that's the cost and efficiency you're repeating it in your 37 locations you could actually run a zoom meeting and on every wednesday night you're going through and everybody from all the different centers comes in and maybe a person from your center is following those people as a kind of a proctor you know mentor for the family but the true education is being pushed out from a cost efficiency from one location at the national location so the nationals do have a play in the family especially when they're asking the person to fly to another state would it be great at the same time they started educating the family members through zoom and they make that connection so that when they send them back this family really does understand enabling boundaries what to do when the police show up next time they have to go to the er the drug court system narcan suicide prevention i mean kind of a peer-to-peer re-entry process i won't list you all 32. [Laughter] well i'd like i'd like to read about all of them so i'm going to get on hand and get get my copies okay wait until june 1st i'm still editing the books well thanks for taking the time for us i think what you're doing is amazing um you know i think i think there's a huge void there right and i think this can really help um and once you once you've kind of tackled this then we need the 32-step series for addicts themselves right [Laughter] on disease management because a lot of it is about building yeah yeah happy to help we're happy to help and that's and that's kind of you know our our goal we're in this world we don't deal with patients directly right we're not um well shelley's a therapist but uh i'm not but together you know that's kind of really our goal is to help providers in these facilities be more successful that's kind of the way that we support the industry so well thanks for taking the time for us this is this is a great chat uh admirable everything that you're doing thank you it's very kind of you appreciate it