23: A Recovery Revolution
Grab a chair. Let's play second number quick. So why are we going to start with you or your great great great all over gray or disputes over all the didn't sleep well You know it's one of those another one wake up at four o'clock in the morning and it could get back to sleep you know and just you know filling a little stressed so if you had to guess where do you think. I am group therapy. Maybe a warm up an intro to theatre class. Nope I'm at a staff meeting. And this is daily ritual for this team. Today I am bread. Sparkley Coterie colored. Today I have been here since thirty Uber. We're could not sleep last night. Decided to get up through on Harry Potter. Search like okay. We'll do what we need to do today. That bright sparkly glitter fellow. Is Jack Register? He's the clinic manager here at Eleanor. Health and high point North Carolina. Jack starts each day by asking his team three simple questions. What color represents you today? Where yet and what do you need from the rest of the team? It's a quick way to get everyone on the same page which is important here because as Jack told us in the world of addiction things can change at any moment can i. Can we put you on tape for one second? Can you like it? Seems like there's some drama happening here. We're just we're just like see you pacing back and forth like on the phone and some member came in sick. What's ailing I'm Stephanie? Willis Wax Today. I'm turquoise or maybe a seafoam and this is last day the name Eleanor health ringing a bell. It's probably because heard it from last day. Fan favorite doctor and Zinger Harrison. She's a CO founder and chief medical officer of Eleanor Health and when we talked to her back in August. This place was just about to open. Its doors for the first time. Now it's up and running. There are four different clinics in North Carolina. So what is Eleanor Health? So health is a comprehensive Monta tutorials substance use disorder treatment program for individuals with opiate use disorders or other substance use disorders. That's well put another way. Eleanor health is a really innovative patient. Facility in Zinger is a doctor and she's about to throw out some clinical terms so quick refresher. The American Society of Addiction medicine outlines four levels of care level. One is outpatient. That's less than nine hours. A week of treatment level to includes intensive outpatient or partial hospitalization for nine to twenty hours a week level. Three's residential and level four medically staffed treatment at a hospital level. One Care but when we move into the communities that we're going into we're trying to create a part of the continuum that has been missing which is a place for people to come to after their level to for people to come to after their level three residential care or for those whose appropriate to come straight to us from detox. Our goal is to individually conceptualize. Each person that comes into our clinic and help them craft the formula that will quickly get them to recovery as defined by them because many of the treatment programs have been born out of the abstinence based model which means you can never use anything ever period again or else you cannot be in this program. You're not considered to be in recovery. Our Program Sets those goals with the patients. So if we have a patient who wants treatment for their opiate use disorder. But they had you know. A non hazardous drinking pattern. They want to continue to drink a glass of wine at night. We can set the goal to treat an opiate use disorder. And you can still have a glass of wine at night. Unlike other Abstinence based programs where it's like you have to be able to commit to absolutely nothing at all or you can't be here by providing this level of flexibility. They believe their members are more prepared to actually maintain recovery which is really the most important part right. Okay let's frame this. In a different way one. That will be very familiar to many listeners. So think about dieting. I can go on a Paleo whole thirty. Sugar is evil kind of Diet and say I'm never GONNA eat another car for the rest of my life but that will never happen. I am setting myself up for failure and I'm giving myself in out if it means that the moment I slip up and eat a cookie. I am a bona fide. Fuck up and my diet is over. Eleanor health doesn't make it so easy to quit and the way we do that is by unparalleled fussy so myself access to Mit. I know I know all last day. Roads lead back to but even if your sick of hearing it from us. There are many institutions. Who still haven't gotten the memo. The True Abstinence based program would even consider MIT unacceptable. And we know that about forty percent of subsidies treatment programs that are not accepting people who have part of their formula. We will get into this more next week but there are a shocking number of recovery programs that are providing extraordinary care but still have strict rules against people using medication assisted treatment from some AA groups to five star residential facilities. You can literally get kicked out for being on the difference between that approach and eleanor. Health approach is that we know that the value in maintaining our treatment relationship. Even if your urine drug screen is not turning negative supersedes the risk that we create by kicking you out of treatment so we don't kick people out of treatment. It just means we need to let the relationship grow. We need to consider a different intervention. That might be more effective for you. In this moment we need to identify something that you haven't put your finger on yet that we haven't put our finger on yet that's driving the continues and so it's a problem solving relationship. I type of approach as opposed to. If you don't stop using right now quote. You're not ready to be in treatment. That's incredible truly groundbreaking to last week. We got into why the thirty day model doesn't work for most people. Some places like the women's home are solving that problem by offering extended residential options. Eleanor health is essentially meeting a similar goal in a slightly different way. They provide a soft place to land no matter where you are in the recovery process just got outta residential and don't know how to get back on your feet. You are welcome here. You've never been to treatment before but no you need help. You're welcome here. They like to say they're level of CARE is for one hundred percent of people at some point in the illness they offer what's called a wrap around model which essentially means wrapping a comprehensive set of services and support networks around people rather than forcing them into a predetermined treatment parks so we enter into treatments using evidence based methods so everybody will get screened for depression anxiety trauma. We have our psychiatrists in house. You can get started on your Ma t no more than two days from your first contact with because we know it's critical to be there when the time is right we have a one year program which reduces in intensity as the symptoms of the substance use disorder reduces. But what's beautiful about? It is that let's say you're in phase three but some confluence of factors leads to an increase of your symptoms. Guess what we can increase the intensity of your service with us based on what you need at that time. We're really like aiming to just call out stigma and so we want people when they walk in our doors to fill a warm embrace to feel like they have joined a community that will always value them and always have their best interests at heart and proactively look for them. If they come up missing I tell my patients. You're the expert in you. I'm the expert in medicine. Each of these expertise is equally valuable and we put them together to come up with something amazing. So that's Eleanor Hill. Yeah I was GonNa say it seems like a utopia yeah. I'm glad that you said that the the idea that humans have around utopias that it's you can actually get there And then in this context you actually can. The funny thing about utopias is that they start in real places often real places grappling with very basic problems. What we're finding is that these communities are desperate. They're so happy we're say we're moving in. We'll do the hard work for you if you prescribe the meat will do. The wraparound services. People are so excited. The emergency departments we would get people started on suboxone but we don't have anywhere to send them when we started from the hospital. We're so happy that you're coming and so the reception has been overwhelmingly warm. The tree practitioners in the community want to be doing the right thing. The system just is not making that easy or possible right now and so. We hope to ease that pain point as we move into communities than the arms have been wide open so far eleanor. Health is a centralized hub with a very dedicated set of community partners. They don't offer every single service in house instead. They work with a network of providers residential facilities hospitals physicians. So if you really need patient care. Eleanor health can find that for you. Make sure it's in your insurance network and then stay in touch throughout your stay to make sure that you have a plan in place when you're done but it's important to mention that eleanor health is still in its infancy. They've been building their program from the ground up. An Zinger has been recruiting an army of staff members but she and her co founders are very picky about who's allowed to enlist we are not bringing people into our leadership who are not hard line or mission aligned. The first level screen has zero to do with medical skill zero. What I have told my person. Who's doing my screens for me. Is You talk to this person on the phone and you listen for productive language. You listen for explicit stigma. You listen for implicit stigma. You listen for lack of the harm reduction relationship I orientation and if you hear any of those things they don't make it past the first screen right because I can rain you to practice in May T- I cannot train you to have the heart and the compassion in the commitment that the people were serving need each and every one of us to have and this brings us back to the sparkly. Gentlemen we met up top Jack. He is heart compassion and commitment personified. And this is most obvious. When he's talking about the people he serves. We don't call them patients we don't call them clients their members and there are members for life. And that's the reason why we're here. That's why the doors are open. I actually got involved in a policy work as an advocate in lobbyists I with Trade Association Social Work And then in larger contexts and I frankly got really just hired of banging my head against the wall at one point. I wanted to be politically active but then I lost my mom in two thousand nine at the age of fifty six from her mental illness. when she should have been a grandmother she was suddenly gone and my family didn't even really know how to function at the moment when I was at my my social worker anymore. Walmart hiring Eleanor House called. And so what I'm able to do here is a combination of all my skills. A combination of all my experiences can bring my grief here the grief of the people that have lost and know that I can help somebody else not end up there. Jack's not in this alone. We also talked to community recovery partner. Bruce rate is the boots on the ground guy at eleanor health. Most of the people that work here they worked in other fields jobs and the hit like ceilings of what help they could provide. They the kid too much at the job they were. You know money's for giving a shit. Basically Bruce realized early on that these people do very much give a shit and that they run things a little differently around here. I never been to orientation with US Jay Z. As I was like maybe Oh man. It was in nineteen eighty six when I was coming of age. Ronald Reagan doubled down on the one drugs that had been started by Richard Nixon leadership team who was conducting Bruce's orientation played this short film it was produced by The New York Times and it's Jay Z. Doing the voice over about the history of the war on drugs and racial inequity in the criminal justice system. And there's an artist. Molly crab apple that is sketching it. All out as he speaks young men like me who also became so villain and drug addicts lack moral fortitude. I've watched this video. Dozens of times over the years. It is truly riveting and very informative then we had a discussion. They say it is GonNa make some people feel comfortable. But we'RE GOING TO BE REALLY TONOS. Lay offer this Joe. Excuse my French would say but could be. Arcade could say what I wanted to say. Could feel the way I want to feel when it was still value. Wasn't you know frowned upon? You know you could be self. You're a whole person. Yeah the whole person approach. We've heard variations of this idea. Pop up a lot lately last week. It was the women's home with their trademarked. Whole Life Model. Sometimes it feels like their recovery world's version of all natural organic a buzzword that may or may not be real but lens air of credibility but at eleanor health. Everyone from the staff to the people they serve embody the whole person approach which is to say they're human with their own backstories their own emotional needs and their own opinions and I come at this with lots of passion and lots of energy because I have personally lost lots of people care about and love and come out at one of those families that got beat up by mental health and addiction and I would prefer for people not to be beat up here. It's clear that Jack has empathy for the people who come to eleanor health. Looking for help and that help is truly unconditional. We believe in a incremental harm reduction approach. Because the minute that we come at you like a ton of bricks you're gonNA respond by getting flattened so if they decide to bail on us for bit okay. Our model is built in a four phase approach in phase. One you get tons of touches with us you might hear from US eight times a week if we gotta come to your house. We're GONNA come to your house right but the idea. Is We kind of really give you a lot of connection initially and then as you start to figure out what you need from us we start pulling back the pieces that you don't right? And that gives us the ability to scale and serve other folks and gives us the ability to uniquely be present to what folks are looking for. You keep using the word tach. How do you define a touch? Everything from phone call to a face to face to Meet you in the community coffee shop here where you are to formal meeting A session to meeting with one of our providers. All of those are considered touches. We want it to be what you need. We will do so. For example we have a story that one of our members lived in local tent city He was homeless and Shelby was able to meet with him and he kept saying. I'm worried about my tent blown away. I don't I can't talk to you my ten GonNa Blow Away S. Y. Shelby is the other community recovery partner at Eleanor Health. Sadly for us but awesome for her. She was on vacation when we visited eleanor health. And while we didn't get to meet her in person it is clear that this lady is mighty loved around here because she always goes above and beyond. She's like okay. What do you need to make that not happen? He goes well. If I could hammer it up against the you know the thing right the whole there then she's like okay so she went and got some hammer nails came back and handed them to him and he hammered up his stanton and talk to us. He's now in transitional housing. He's now he looks like a million bucks. He looks like a different guy. Every time comes in I don't recognize any comes up and gives me a bear hug. And he goes. It's bobby I know. You don't remember me because he doesn't even look like the guy that we met and he said I guess I have to be loved by. Y'All whether I want to or not that's what folks did hear sears. Used like removing barriers left. And Right. That's what we're all about. You'll hear that from every member of our leadership. Our job is to remove the barriers to get folks to the next place so if that's a little barrier or if it takes time and it's a big barrier that's what we're here for. You'll notice that a lot of this is the same thing. The women's home offers for the women they serve in Texas and while they certainly have their differences. The broad strokes are the same compassion connection community tools to help members cope with trauma for the long haul forever and these things do seem to be effective for members but they also inspire and motivate staff corps. Some time me because they put every angle they they really take away all excuses for ecause. No people have to be tied after. Be ready however they give you everything that you need to be successful place like that. Who Okay I know said up top that this is a real life utopia but all the employees were so over the top positive that I was starting to feel like I was stuck in the Truman. 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And if you're not happy with your counselor you may request a new one at any time for no additional charge. Best of all. It is a truly affordable option with financial aid available. For those who qualify. So why not get started today? Go to better help dot com slash last day. Fill out a questionnaire to help them. Assess your needs and get matched with a counselor. You'll love as a special offer for my listeners. Get Ten percent off your first month with code last day. Don't delay get help today at better. Health Dot com slash last day We're back I'm cindy ever Anaheim. Sixteen Years Cindy hobbled in for interview wearing a big black medical boot. She'd had a major accident a few months ago but muster up pretty good lander in the hospital and put her in close contact. With lots of high powered opioids. Cindy's injury set off the most recent and arguably the most intense cycle of substance abuse but our story is deeper and way longer than that. Look at the big picture and it goes back thirty years thirty five long time but then I went through a long period of time doing great in being married having children. You know running the business you know being the perfect mom taking the kids everywhere on their lunch and other Games Going to school and doing all that well the kids grow up. My husband left empty home. Move THE ATTITUDE. Just one bedroom. It's just me and struggling to figure out who me was. Everything was changed in Hong jumped back on that road make choices and not thinking. That was hurt. Anybody you know just me. I'm not hurting anybody. Nobody really knows but I saw what it was doing to me. Just couldn't continue to on that how to figure out who I am important on the help. A truck one month before we met Cindy in this tiny back office at Eleanor health. She decided to reach out for help. She called on a Thursday reuss picked up the phone and she realized she had no idea what to say or how to say it. Because I was afraid that if I said what was true but they would say he would say. You can't come here. And I was struggling for what to say and then I forgot how he said it but he basically said your current user and that was true. Just done drugs before called and I was like it's okay once comes as Tamar. Wow Okay I'll come. I came and You know sorry but I did drugs before came. Came in and Shelby and she was so kind and so understanding and so nice but she bought it that you know to drug test me and I'm GONNA fail the drug test already tell you so okay get worryingly okay just kept saying it's okay. Told her what she would find. That's what she found. She didn't say see instead of sending her away. Shelby Center over to Jack. You sat with her and talk to her and the whole time he was smiling. It all felt like a dream especially because she had just had the complete opposite experience at another treatment facility. If I didn't meet the criteria I don't know I wouldn't kit down enough or I was kicked down too much and I was just site. I can't even light cullman tra- all Cindy wanted was a chance to try. But she was knocking on the wrong door and like David Smith said a couple of weeks back. There shouldn't be any wrong doors. Cindy had a moment of clarity. And Eleanor health welcomed. Her with open arms walked in here and they were so nice to me and that people are talked to discuss more comfortable and more comfortable and when I left I said to my mom I don't even know if this is real it such the perfect place for me. I fell like Bingham scared that it's not really real ben still new and green and everything to it so everybody just makes feel really comfortable and I felt comfortable being open and honest and not like leaving things out about myself to not look so bad. How does that feel? It's different? Fill a whole lot different but in a way I do keep being surprised at how do feel because didn't expect Priscilla's good as I do and I do feel pretty good but I know I'm here and I have them and they continue to even when I'm not here. I hear them so what they said to me. In the way they treated me. That goes with me when I leave which I didn't expect that and expect to hear their voices talking living here. Even they're like call me anytime but I never picked up the phone and call him but it was like I picked up the phone and call them because they're talking to me so when you hear the voices of these wonderful people in your head saying here don't do that. Don't do that or if you do. It's okay or still going to be there for you but it's more important that don't do that. Do you. Hear how Cindy is essentially repeating all the things in Inga and Jack said that Bruce and shelby reinforced in that intake process. There is nothing she can do. That will make her on welcomed here and this is key because Cindy is very new to this. Even though she saw her husband go through a Cindy has never been to treatment herself at sixty years. Old This is her very first time. You know because I came in here and it was a drug addict. You're not a drug addict. After we talked to said you're substance abuser and explained to me me different clear definitions and talk to me about the brain and what different things do to your body and help makes you act in. Choose and make me look at things. Different must still can't look at myself without saying I chose to be like this and they are trying very hard to teach me. That didn't necessarily choose was still got the honestly at the beginning of the series. This whole addict for substance user issue felt really important but twenty three episodes in. We've heard from a lot of people who strongly and positively identified as addicts so labels aside. Whatever you call yourself. The thing that matters is reframing the idea that she chose this that to me is the beginning of the brain rewiring process and that process requires a lot of touch is in the beginning. So how often are you hear comments a week and then now that they're doing the group thing I come twice but they have let me know that I'm welcome to come any day and hang out with the sit in the lobby? Read a magazine talk to them on board or climbing the walls or anything. The doors open. Here don't talk to me. I'll be here. Pick up the phone call. We'll come get you WANNA get launch in a really really really conned nights and so far every day. I swear I thank God that they're here and afraid that their poof disappear and I'm so young and new alden aged but young in this you know I'm scared to it'll go away and I'm not strong enough yet. They go back can do what I was doing that now. Will throughout our interview you can hear the unbridled vulnerability in Cindy's voice and when we came back the next day. I asked Jack if that's something that concerned him. Yes when we talked to Cindy yesterday. I am questions specifically about her so like she seems like she is in such a vulnerable place right now and like this is where I believe in everything you guys are doing here. I'm so afraid for her like I am afraid that she's going to go home and use and relapse like A. It's like I wanted to follow her home like if I don't hear from her at least two to three days. We're going to call her and every time. I'm with her and Mike how you doing how you motivated but see. Here's the thing about eleanor health. Different if she relapses that's okay. It doesn't mean she's out of the program it just means we Redo the plan. Our corporate medical director. Dr Harrison has the same. If something happens it doesn't work. It's not the client's fault. It's the planes fault that means we step back and figure out what we need to do differently so with masonry. If something happens we're going to be okay. What do we need to do now right so while I worry for her too? She's a survivor and has been through hell and back right. And that's part of her story is that she was actually able to block her dealers whenever they called and said Hey. Do you want some free stuff? And she was able to do that on her own. Huge in early recovery coach. That is huge but I have to be honest. I was still a little terrified. Talking to Cindy we've never featured someone who is this new to recovery. It's still intense. Just listening to her tape but I did get to see how much this place means to her. It really is a life vest and after the break we get a glimpse of what it looks like when someone who's drowning shows up at eleanor health for the very first time. Lemon on a media the company that produces last day the company where I am the chief creative officer just turned one happy birthday to us and for our birthday. We have a brand new website so go check us out at. Www DOT lemonade media dot com here to get the www anymore. Just say limit on okay. Lemonade MEDIA DOT COM. Go check us out and this is particularly useful to you to you last listeners. Because on this new website you can find brand new conversation forms four last day where you can connect with us and each other about what you here. You can also find a lemonade media store with all sorts of last day. Swag right now to celebrate our first birthday with us. You can use the Promo code birthday ten to get ten percent off your entire order so visit lemon on media dot com and shot with our last day community and use Promo Code Birthday ten for ten percent off your swag order today. The next recommendation is a story for the Weirdos the loners and the ugly ducklings Dear Young Rocker is a raw music oriented audio memoir in this scripted narrative podcast listeners. Both laugh and empathize as the protagonist Chelsea struggles to feel cool enough to exist and finds a home in music. It's also a series of letters from older Chelsea to her younger self reminding us all that as alone as we may have felt at a young age there so many others out there who felt just like US executive produced by Jake Brennan of disgraced land. Dear Young Rocker is an Iheartradio podcast. You can find it for free on. Iheart or pretty much anywhere podcasts are. It's Day two at Eleanor. Health and EDSEL hectic. Can I can put you on for one second. Can you like it? Seems like there's some drama happening. Here's what we see you pacing back and forth like on the phone and some member came in sick. What's going on so this is sort of the perfect scenario so what we have happening right now is that we have a walk in member who is brand new to us who is not would shape. Our clinic scheduled. Today is already really packed with not much flexibility right so this is the downside of only having open doors people tend to walk through them sometimes unexpectedly so cue the network of providers and community partners so typically when our providers are not available here in this clinic. I then get online and say to the other clinics help I need somebody so we have another provider another clinic. Who's GonNa see our walk in person? So we're doing all of their intake paperwork here and then we're getting them ready to go online to see that person and so we come up with the best plan. Possible keep folks comfortable in. My job is to work. The magic connect the dots. Pull the strings what we need to do. What's happening this morning? So when you say members like sick what does that? What does that mean usually withdrawals usually that means they are in this Rosa withdrawal or as in our Watkins case. I'm ready for care today. Damn it mom and daddy are with us right so we get support system. We got person we are ready for. Care now wow and you can't turn that person away no ma'am and we won't. That's a critical moment. Yes ma'am of course. This is the critical moment. Cindy tried to get into treatment and she was turned away so she used right up until that first day at Eleanor. Health for OPIOID users. Especially knowing everything we do now about fennel that is throwing that person back into a life and death situation which is unacceptable. But obviously that level of high intensity stakes makes work-life pretty intense. I mean I guess I was just GonNa ask you like what's a typical day for you and that is what I was expecting cat. Yup Thank you for giving me that tape woman. Laughing at me is nurse Judy. As a refresher judy was the one who was gray and yesterday staff meeting and it was really hard to get her on tape today because she was being pulled in a million directions. You come in then. There are people that have walked in. You got to figure out how to fit them in and you WANNA turn people down. That are needing US especially someone that may be you know in crisis or almost in crisis you know you. WanNa turn them down so you just kind of jump through hoops. You Skip Lunch. You know. Hold your ds long as you can. I told him yesterday I was like look. I'm going to beat a day Old Lady. I got a lady Blackhawk after it sounds silly but that is the kind of practical consideration. You have to make when you work in a field with such noble intentions. I want to absolutely be available to someone in crisis but also I'm GonNa pee today. I mean that's part of the meet people where they're at and do you find that. The meeting people where they are is a harm reduction. Principle is true in medicine. Do you feel like that's a concept that you have had in your career. Is that something? That's specific to. Eleanor I don't think it's just eleanor. But it's done well by eleanor don well by eleanor. And I think that It's not as common as I would like to see it because so many times you know in medicine throughout these years and years for me. It's like you know you try to fit people into the box. That's already define you know. Yep Diabetes Care or smoking cessation or things you try to fit them into a box. You know this is how we do it you know. I'm an old school nurse. I've been a nurse since either of you were born before either. You're born and give us today. I've been under since nineteen seventy five. Wow I was born in eighty one. Of course she knew Judy's been around for awhile but at Eleanor Health. She's encountering some stuff for the first time it's interesting you said you're an old school nurse but eleanor does. All Telemedicine seems very progressive. Yeah that is and you know. Some of the newfangled ways to deliver the care You know I'm still kind of muddling my way through but the mentality and the approach at you know really helping and you know how we do that. Yeah I'm hands on if this is new to you as well. Telemedicine is where doctors patients essentially video chat online. They can see each other and talk to each other in real time. So it's like any normal appointment. And then Judy does all the hands on stuff like taking blood pressure. Vitals stuff like that. What are the pros and cons of telemedicine? I think the pro is definitely it's efficient. It's efficient The the practitioner gets a chance to see people without having to be here. I think it is efficient for them but as for us as well. You know if you can't get a doctor in at a certain time then you know. Dial up zoom boom there is. This is just one of many ways. That eleanor health is innovating to keep costs down while maintaining a high quality of care years. Inga again so the other thing. I'll say about substance use disorder right now like the rest of healthcare in America is overwhelmingly fee-for-service which means you go. See the doctor that their post or whatever practitioner they send a bill to the insurance company. Or if you don't have insurance to you and you pay for that service and it there's like a fee for that service. The problem with managing chronic medical conditions like that. Is that so much of what you need to do to support? People doesn't have code attached to it that you can bill for and so the system has been built such that. You literally can't do what you need to do and sustain your practice because we need to do is go sit in the Er and wait for someone to show up so that we can start the relationship immediately right there in the Er will we need to do when a person misses their appointments is send one about field workers out to their house and say. Hey we haven't seen you in a while. We just wanted to make sure you're okay. None of those have a fee attached to them that you can bill and so classically treatment providers are not able to do that. Eleanor health is actually negotiating with peer partners for value. Based care which is like when you come in our care. The payment is based on what we need to provide to help you get in recovery as quickly as possible and maintain it for as long as possible. So we're really looking to change the way substance use disorder care is delivered but also to change the way insurance is paying for substance use disorder care so that it can more closely align with what folks need. Okay Sounds Amazing. But how does this relationship with the insurance companies actually work? We talked to Corbin Pedro ending his business partner and CEO broke it down for us. I always say we're the only game in town. When it comes to a unique payment model that incentivizes recovery not relapse and when we go into a community like in high point where we are and we try to serve as many people in that community as we can go into a market estate in partnership with of Very Forward Thinking Health Insurance Company. Who has agreed to pay us in a certain way and so here in. North Carolina our partner is Blue Cross of North Carolina. And they've agreed to pay us a certain way and they want their members who are struggling with addiction to come to us and so that sort of has set the groundwork for our ability to sort of treat in our clinical model and so we're not paid for quantity were paid for the care and the outcomes that we get for our patients but in order for something like this to actually happen everywhere. Policy-makers need to get on board because as things stand now access is pretty uneven depending on where you live like North Carolina for example. You know it's now. One of twelve states that has not expanded Medicaid. You're in as well in Texas. And so there's a dramatic level of need over. Fifty percent of the people in the state who have a substance use disorder are uninsured. This is something we talked about with Andy Slavic back in Episode Eight. If fifty percent of people dealing with substance abuse are not insured. Their best bet is to show up at the ER which is inefficient and costly. So when you hear a politician claim to care about taking on the OPIOID crisis and saving taxpayer money. While also voting against Medicaid. Call them out on it because that does not add up. Eleanor Health has managed to create a business model that is actually efficient and warm. Oh and based on evidence which is what you would expect in a medical setting. Yeah and that's why I look at some of the models that exist out there and it's often somebody who's experienced addiction themselves and they're like well. This worked for me. It was moving to a new city and Marathon. And so they like start. This program are like walking through the woods or living in a beautiful place on the beach. And they're like this is what works for me so it must work for everyone and that's not actually evidence like we believe in evidence. We appreciate anecdotes right. And so we appreciate it but like we we follow evidence and we always you can tell our clinics warming welcoming like come and hang out here if you need to like. We're not a residential. We're not home but you know a place where you can feel comfortable income if you need a safe safe place to come which brings us back to Cindy. Found that safe place when she needed it most. She is at the very beginning of her recovery journey and that can feel daunting she still in that white knuckle phase of early sobriety. What Wilma described as walking around without skin? Which is literally one hundred percent exposed but in addition to feeling all the scary stuff. She's any better place than she's been in a really long time. You feel hopeful up very hopeful and like a or something. He medical look good. I feel good. I can't believe I said that. Out Loud Ashville good. I felt like taking a shower and shaved legs and put on clean clothes and put no makeup enrolling. My hair felt like doing that. Felt like Don that and months. That is impressive. That is impressive. Shaving your legs is impressive alone makeup and hair now your next level as the child of a very southern woman raised around very southern woman. I will tell you this is important. My mother does not leave her house without her face. On the way Cindy is describing her process of self care today. This is how a highly functioning southern woman shows up when I left here from this morning and I was coming back daughter. Texts me and mom got the mail out and handed me envelope and it was a letter from Fun Da. I got contacted by two of them in one day in that been like because I hadn't heard from him. Bouma hurt by the time I needed to hear from them. Looked up at thank you God. Because that's what it was. I read my letter. You haven't read it a habit because we were like in the car and get the mail out around mouth and she ended up to me and I was looking at it and I looked at her and she's a won't you read it after because you're gonNA be upset a good way but you don't WanNa go there and be upset Like you're right stuck up my bag so read it when I go home. Let's it'll be good. I'm sure if there is one thing cindy loves it is her babies who are all grown up now and in their absence there is this massive void inside of Cindy that she was used to filling with drugs. Eleanor health is offering her an alternative human connection. So I was sitting out there waiting for my mom. And Bruce was lieven Radio magazine and he was walking out the door he was leaving any stopped me turn around and he looked at me. He looked at me again. His gave your agenda. She's coming skyway. If you WANNA go for Rod and little sure on jumped in the car and he ran a couple errands in studying even get out of the car just went with them and then got back here. A few minutes later mom pulled up On so yeah. We're running errands Honestly I think it was a secret count playmate the call me unless talk back when you talk to me a lot and then blessing he said before we closed the doors when we were in the parking lot he gave me something did hit a suggestion on something. He thought I should try for myself. Hurry Day it was something like writing Kim Jung down a goal. They can't do that ten things a day week or make it five. Thanks today and it can be. You're not on your phone as much as you were something. Little Little Sandy. Not Big You. Keep thinking bad Control the world little McKay About it well. I see that you did five things today. You did your hair makeup. You put clothes on put earings in and then you came here. That's five things to six okay of sex things. There you go girl you want. Buyer literature got a letter from your son. And you got a text from your daughter now. Today's been a great age. That you're rock-n-rollers earlier. I thought I was going to have a great day. Felt like it mellows. Having a great morning ended up having a great great day. I really appreciate it. We've talked a lot. The season about the concept of one day at a time but this is such a beautiful example of what that looks like in real when you've had such an endless string of terrible days a great day is a gift and a great great day that is next level. Eleanor health is helping people. Like Cindy to experience this. But they're also serving members. Were in a totally different place in their recovery. Next week we meet Isaac who encompasses so many of the themes that we've been grappling with throughout this season. He is committed to the twelve steps tethered to an AA community. But there's something that he is hiding from them. I like to go to a meeting. Still I network in do lot with these guys. I got really tight with these fellows in their help. Must be having said that though I still have to keep the issue must have oxygen you separate from them because they Kinda WanNa get judgmental They Wanna be like doing extra stuff you know. They don't really understand. If I removed at pieces of puzzle. I will probably not succeed like I have been for the last almost five years and I it makes me feel kinda dirty. You know like I'm hiding something that I soon be doing when really. I'M NOT STARE. The ones with the problem. How to looking at it but they make me feel like it's my problem. I don't run into that here. Last Day is a production of lemonade. Medium our producer Jackie. Danza guard Nicole is our associate producer in our assistant. Producer is Claire Jones. He Gins them. As our technical director rank. Steer was our editor our executive producer Jessica Cordova Kramer and our music is by Hannah Brown special. Thanks TO WESTWOOD OUR AD sales and distribution partner and day. Very very special. Thanks to everyone. We spoke to eleanor health. Nikki and I were especially grateful for the bottomless snacks. Coffee and girl scout cookies. Y'All really know how to make a couple of hundred ladies feel loved? You can find US online at lemmon onto media that's Lemon. Oughta like L. E. An Ad and you can find me at whittle. Stephanie if you like what you heard today tell your family and friends to listen and subscribe rate and review us on Apple spotify stitcher or wherever you get your podcasts. I'm Stephanie Woodall's wax seal next week.