Latest / The Advancing Healthcare Innovation Show / E183 | Foster Care’s Hidden Health Crisis ft. Michelle Turner

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E183 | Foster Care’s Hidden Health Crisis ft. Michelle Turner · The Advancing Healthcare Innovation Show

0:11
Hello and welcome back to the Advancing
0:13
Healthcare Innovation Show. I am your
0:15
host, Michael Stamatinos, and uh if
0:18
you're new to us, welcome. It's great to
0:20
have you here. You know, we're having
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we're just really excited about a lot of
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things, but we're having some really
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fantastic conversations with real
0:26
leaders that are painstakingly
0:29
reshaping the future of care and
0:32
healthcare. And we're passionate about a
0:34
few different areas. We're very
0:35
passionate about healthcare innovation,
0:37
leadership, access, and and honestly,
0:40
the adoption of those innovations. So,
0:43
if it's your first time tuning in, let
0:44
me just let me just take take a quick
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step back here and just kind of give you
0:48
the lowdown of what we're really trying
0:49
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0:51
bringing real stories of innovation and
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leadership to life. Not just the stuff
0:56
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1:00
really innovating and getting stuff
1:02
done. Uh, and not only just sharing the
1:04
wins, also sharing some of those
1:07
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1:09
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1:34
Uh really excited about today's guest.
1:36
But before I kind of dive in, I just
1:38
every night in this country, in the US,
1:40
a child is placed with a new family, a
1:44
new home, new school, new rules. Um, and
1:48
almost always
1:50
no medical records, no doctor, no
1:53
continuity of care, just a kid, uh, a
1:56
family trying their best and a health
1:58
care system that, you know, was really
2:00
never really designed to follow them.
2:03
And most people in healthcare, they they
2:07
they actually don't really know about
2:08
this. So, this is a conversation that is
2:10
very near and dear to me, uh, because my
2:13
mother-in-law is actually really
2:15
involved in this, and we'll talk about
2:16
that in just a moment. But that this
2:17
gap, huge gap exists and today's guest
2:22
decided to close it. So Michelle Turner
2:26
is the founder and CEO of Here Now
2:29
Health, the first virtual healthcare
2:32
company built exclusively for children
2:35
and families uh impacted by the child
2:39
welfare system. So before she was CEO,
2:43
she was a foster parent to more than
2:47
40 children like 40 children. She also
2:53
uh served as a court adjourn I'm sorry
2:56
courtapp appointed special advocate. She
2:59
ran an FQC. She led a global teleahalth
3:02
nonprofit like rock star. She's she's
3:05
seen healthcare from the clinical side,
3:06
the operational side, um, and even the
3:10
sort of kitchen at midnight side when
3:13
uh, a child in your care is sick and the
3:16
only answer uh, anyone is offering is
3:19
the emergency room. So that is the
3:22
moment that here for now health was
3:24
built for. We get to geek out on a lot
3:28
of different things today, but
3:30
traumainformed virtual care is something
3:32
that is needed. continuity across
3:35
placements is needed. Um, they have been
3:38
purpose-built for a population that's
3:39
been invisible to most of healthcare for
3:42
far too long and today we get to shine a
3:45
light on someone that is doing something
3:47
that is very noteworthy. So, Michelle,
3:50
awesome to see you. Welcome to the show.
3:53
>> Thank you, Michael. I'm so excited to be
3:56
here. Thanks for having me and thanks
3:57
for that incredible introduction.
4:00
>> Well, um, it's a pleasure. It is being
4:03
recorded. So now you get to have it. So
4:05
um when people want to know who you are,
4:07
you just pop in the recording and like
4:08
here's who I am.
4:09
>> Giving my I'll stop giving my own
4:11
introduction. I'll just I'll
4:12
>> Or you just have me MC I'll just MC for
4:14
you and every time you go somewhere
4:16
we'll do that.
4:16
>> All my calls. Yes.
4:18
>> All right. So before we talk about here
4:20
now health, which is important. I want
4:21
to I want to go somewhere first. Um you
4:24
have fostered more than 40 children. 40.
4:29
Most people hear that number and I just
4:32
don't think that they can compute it.
4:34
Um, so I want to start there. When the
4:38
first child came through your door, um,
4:42
what was that moment actually like?
4:46
>> That that's a really good question. So,
4:49
um, my husband and I became foster
4:51
parents in the state of Georgia in 2013.
4:54
Um, we had two biological children at
4:57
the time and we actually started our
5:00
fostering journey with a a very kind of
5:04
um limited idea of what it was going to
5:07
look like. And that for us started with
5:11
we thought we were going to adopt one to
5:14
two children
5:16
>> and we didn't think we could be foster
5:17
parents. We thought it would be too
5:19
hard. All of the things that you hear
5:21
why people don't become foster parents,
5:23
we kind of believed at the beginning and
5:26
we went through the process. We got
5:28
certified and our home sat open for
5:31
about a month and a half. And this is a
5:32
time, just to set the stage for you,
5:34
this is a time when Georgia's foster
5:37
care system was in crisis. We had 18
5:40
foster families in our county and 110
5:43
foster children. So, if you do that
5:45
math, that is not enough homes. And here
5:50
we were with two open bedrooms waiting
5:53
thinking we are only going to take
5:55
children that are adoptable because it
5:56
would be too hard to love children and
5:58
let them go. Um so we waited for about a
6:01
month and a half and realized how
6:03
ridiculous this was and my husband and I
6:06
conversation. We said all right we'll
6:07
we'll give it a try. So I called our
6:09
case worker and I said we're open to we
6:12
want to be open to respit care. So
6:13
respit care is essentially temporary
6:15
care. We thought we could probably do
6:16
that. Right.
6:18
>> Right. So, the very first placement, the
6:21
very first child that came into our home
6:22
was a seven-year-old boy who came
6:25
>> for one week because his foster family
6:27
was was going out of state and he
6:29
couldn't go with them. And we got
6:31
through that week, Michael, he went back
6:34
to his his long-term foster family and I
6:38
immediately called my case worker like,
6:41
"Send us whoever you have. This is we
6:44
this is just He was a seven-year-old
6:46
boy. He could have been the kid sitting
6:48
next to our daughter in elementary
6:50
school.
6:51
>> And it just it it it, you know, just
6:54
gives you that stroke of reality of what
6:57
are we doing worrying about our own
6:59
feelings more than the children in our
7:01
county who we know don't have a a bed to
7:03
sleep in at night.
7:04
>> And that essentially, as they say, like
7:08
>> open the floodgates. And over about five
7:11
years, we had over 40 children in our
7:13
home. Some stayed for two nights. Four
7:16
of them stayed forever. Four of our six
7:17
children are adopted out of foster care.
7:19
Three are biological siblings. We had
7:21
everybody from itty bitty babies to 17
7:24
year olds who are about to age out of
7:25
the system. Um, one teen that came to us
7:28
with an ankle monitor. I mean, you know,
7:29
like the all the whole gamut and a
7:32
probation officer. And it really shaped
7:35
the reality as you mentioned of here now
7:38
health which is over five years
7:40
recognizing that even though I was
7:42
working in the health care system every
7:44
day, I failed over and over to get kids
7:47
the mental health care they needed, even
7:49
though I was probably the best suited
7:51
out of anyone to get that care to them.
7:54
>> And I knew we had to do something about
7:55
it.
7:56
when when you saw these gaps, these
8:00
lapses, I'm just because you've seen
8:02
this from the inside. I mean, were what
8:05
was your initial feeling like? Were you
8:06
angry?
8:08
I was I was angry and I was confused
8:10
honestly Michael because I I had this
8:13
idea which a lot of people do is that if
8:16
a state decides they can be a better
8:19
parent than a child's parents and by
8:22
that meaning they they take them into
8:24
custody and essentially when that
8:26
happens it means the state becomes the
8:27
child's parent
8:29
>> that they're actually going to do it
8:30
that they're going to make sure they
8:31
have the resources the tools that the
8:33
the adults they put in charge of these
8:35
children have everything they need to
8:37
make this child's life better.
8:40
>> And what I found that a lot of people
8:42
already know is just because a child
8:45
comes into state custody does not mean
8:48
that their needs are now being met. Um
8:51
we have a much higher level of
8:53
accountability and we should be
8:56
providing those needs but oftent times
8:59
if not most of the time that child is
9:01
just in a new home and their needs are
9:03
continuing to not be met. And so it did
9:06
it made me uh frustrated. It made me
9:08
angry. Um and it also made me feel like
9:13
I was letting down the kids. I that I
9:15
was not doing my job properly
9:18
even though I knew that there was
9:20
>> there was almost no way to do it. Um you
9:22
know, in the county that we were in in
9:24
Northwest Georgia,
9:26
>> we had less than a handful of therapists
9:29
that accepted Medicaid, most of which
9:32
did not understand the child welfare
9:34
system. or had weight lists of six
9:36
months or longer.
9:38
>> I knew I knew that reality and
9:43
you know that that again is is really
9:45
the basis for why here now health now
9:47
exists because it's what I needed. It's
9:48
what we needed.
9:51
>> You know I have uh spent a long time
9:54
talking with innovators talking with
9:55
founders and um there's there's
9:59
something that makes a founder to say
10:03
unreasonable. not reckless,
10:06
unreasonable.
10:08
You know, founders that
10:11
who build something real, you know, are
10:14
ones who like you can't not do it.
10:20
That's you.
10:22
>> It is. I Anyone who's known me over the
10:25
last decade
10:27
>> Yeah.
10:28
>> has probably heard this story. I for a
10:31
very long time I tried to get other
10:32
people to build it. I just knew the
10:34
world needed it. This was not here now.
10:36
Health doesn't exist because Michelle
10:38
Turner wanted to be a CEO or a founder.
10:41
Um I would talk to almost anybody who
10:44
would listen about how this was not only
10:48
needed, but it actually made sense. Um
10:51
it's a population that's 100% covered by
10:53
Medicaid. You know, we have all these
10:55
structures in states where it allows us
10:57
to to actually scale
10:59
>> Yeah. healthcare for this population and
11:02
kind of nobody just nobody was doing it.
11:04
Nobody was innovating and
11:06
>> I mean because you had a career I mean
11:08
you had a life uh you you could have
11:10
easily just kept going.
11:12
>> Yeah.
11:14
>> I'm just like what made you feel like
11:16
you couldn't leave this problem for
11:20
somebody else?
11:22
I I spent almost six years helping to
11:25
build a company called Hazel Health
11:27
which is the largest provider of
11:28
school-based tele medicine and it
11:32
honestly it it gave me the startup
11:35
chops. that gave me the the
11:38
understanding of the health care system
11:40
at a macro level that I honestly I
11:42
didn't I didn't understand when we were
11:45
foster parents and when this you know
11:46
this idea was just starting
11:49
>> and it it it really gave me the tools I
11:51
needed to launch here now health and
11:55
>> so when I left Hazel you know on very
11:58
good terms and and my you know my
12:00
colleagues and my leaders at Hazel were
12:02
honestly some of my biggest champions it
12:04
was kind of like you said because I had
12:07
talked about this so much and I knew if
12:10
it it was already too late but you know
12:13
this should have existed years ago.
12:15
>> Yeah.
12:15
>> And I'm one of the you know the few
12:17
people that deeply understands not only
12:20
pediatric Medicaid but also the child
12:22
welfare system and how they fit together
12:25
and don't fit together. Um but those are
12:28
you know that's that's really the
12:30
crossover that was needed and not a lot
12:32
of people in this country understand it.
12:34
is to walk me through the exact moment
12:37
that you decided to build here now. Not
12:40
not the idea is that it sounds like that
12:42
that had been simmering for some time
12:44
like the decision.
12:46
>> Where were you and like what happened?
12:48
>> So it's an interesting story. I was my
12:51
my first funer is Healthwork Studios out
12:54
of DC.
12:55
>> Okay.
12:56
>> And I say I I I accidentally pitched
12:59
them. Um, I two summers ago got in
13:03
contact with their team about a
13:04
completely different
13:07
reason, one of their other portfolio
13:08
companies. I talked to them about it.
13:11
Um, and we got to the end of the call
13:13
and they said, "Well, you you seem to
13:15
know a lot about Medicaid and we're
13:17
looking to launch a few companies in the
13:19
next year in the Medicaid space. Um,
13:21
where do you see whites space? Like if
13:23
you were going to build in the Medicaid
13:25
area, you know, like what what would you
13:27
build?" which is like catnip for me
13:29
because I was like
13:31
again
13:32
>> anybody that gave me an open door is
13:35
what I would talk about and this was not
13:37
a setup they were genuinely asking.
13:39
>> So I in the last less than five minutes
13:42
of that call I kind of accidentally
13:44
pitched them on what is now here now
13:46
health. I said if I was building a
13:48
Medicaid 100% I would do it for the
13:50
foster population. We spend 10x on the
13:52
behavioral health spend for this
13:54
population. They're 100% covered by
13:56
Medicaid and you know in x number of
13:58
states they're covered by one health
14:00
plan and those health plans are looking
14:01
for innovation because this population's
14:03
been I just I I did my spiel and I
14:06
thought I would never talk to them
14:07
again. Like this was just
14:09
>> hey take this idea and run with it. They
14:12
thought it was really interesting and so
14:14
they called me back up and they said
14:16
will you come actually teach our kind of
14:18
our our team about child welfare? We we
14:21
want to know more. So I met with their
14:23
broader team for an hour and just shared
14:26
my heart and and my knowledge. Um again
14:30
full well giving them this as hey you
14:32
can take this and run with it.
14:33
>> Yeah.
14:34
>> And they decided this is not just a a
14:36
huge need and a great mission but kind
14:38
of like I've been sharing this is
14:40
there's really interesting business
14:41
drivers behind this population. This
14:43
could create a great company. And so
14:46
they did diligence over the next several
14:48
weeks to months. I kind of supported by
14:51
being the subject matter expert in that.
14:53
>> Yeah.
14:54
>> And um a year ago this past fall, they
14:58
called me up and they said, "We want to
15:00
invest in this area. If you will come
15:02
lead this company, we will be the first
15:04
check." And that is that is when that
15:07
decision was made. And I accidentally
15:10
>> raised my first um investment check.
15:14
>> Wow.
15:15
Yeah. So I mean you just knew so much
15:17
about the problem. you illustrated it so
15:20
clearly that naturally they're like,
15:22
"Well, if this subject matter expert
15:26
knows so much about this problem, she
15:28
she's going to figure out the answer.
15:31
It's just a matter of, you know, funding
15:33
and who like who who else are you going
15:34
to talk to?" Because you mentioned about
15:36
just the complexities of it. I mean,
15:38
because
15:40
Medicaid is notoriously hard to build a
15:42
business on.
15:44
>> It is. Um, but when you when you drill
15:48
down to what Medicaid
15:51
managed health plans care about where
15:54
they spend a lot of money for terrible
15:56
outcomes and then some other interesting
15:59
things um with this population around um
16:02
something called soul source plans. So,
16:03
I know you're in Chicago. Illinois
16:05
actually has one where um the state
16:07
actually has one health plan that um
16:11
primarily covers any child that has a
16:13
foster care connection because going
16:15
back um the children in foster care,
16:18
those adopted out of foster care until
16:20
they're 18 and youth who age out of
16:22
foster care until 26, they are
16:24
guaranteed Medicaid. It is not based on
16:27
their parents' income. It is not based
16:29
on work requirements. it is because of
16:32
their connection to the foster care
16:33
system. Again, the state is saying they
16:36
can be their parents. And so, it's it's
16:38
like the state is essentially giving
16:40
them health insurance as their parents.
16:42
>> And so, um, a lot of this is really
16:45
built around that concept of we can take
16:47
your highest cost population, finally
16:50
prioritize them with highquality care in
16:53
the way they almost never get, but we
16:54
know they need.
16:55
>> Right. Right. And instead of
16:56
overspending on terrible areas like the
16:59
emergency room, hospitalizations, and
17:01
residential care, which is where kids
17:03
end up, oftentimes because they don't
17:06
get the care when they need it most and
17:08
they end up in crisis, we can we can
17:11
shift that spending to lower cost,
17:13
higher quality early services. We will
17:16
get these kids in care within 48 hours.
17:19
We will keep them in care because our
17:20
care model is built around their
17:22
realities. and will help you save
17:24
dollars and improve your outcomes. That
17:26
is what Medicaid managed care companies
17:29
care about and that's what drives that.
17:31
So I h I I had this thesis that yes
17:36
Medicaid at large is hard to build the
17:38
business and model around. But if you do
17:40
what's right for the highest cost,
17:42
hardest to engage population,
17:44
>> we can build a great business and we can
17:46
also finally do right by these families.
17:49
>> Okay, I want to I want to kind of
17:51
contextualize this. Let's just say for
17:53
example, waving a magic wand. I am a
17:56
foster care parent. Okay, paint I want
17:58
you to paint the picture for me. So, um
18:01
I get a kiddo.
18:02
>> I get him on a Friday night. No records,
18:05
no history, no established doctor. What
18:09
happens next
18:11
um with Here Now Health in the picture?
18:15
>> Yeah. So, um the child comes into care,
18:17
they get placed most likely with a a um
18:21
an unknown, you know, foster family and
18:24
um they may have no idea what diagnosis
18:27
they have, um what triggers they have.
18:30
And so, we have an intake form, a
18:33
referral form essentially, that takes
18:35
less than three minutes. We don't
18:37
require it. We know they're covered by
18:38
Medicaid. Most of the time, that foster
18:41
family is not going to get a Medicaid
18:42
card. They may never get it, but they're
18:44
definitely not going to have it by
18:45
Monday morning, right?
18:46
>> Um, that child really needs to be seen.
18:49
And so, we will take whatever
18:51
information they have. Maybe they've got
18:53
two forms and they've got two different
18:55
birth dates. They're not sure which one
18:56
is correct. We'll take both of them. So,
18:59
we have that um that intake form
19:02
submitted. Maybe it's by the caseworker.
19:03
Maybe it's by the foster family. We
19:05
schedule an intake within 48 hours with
19:07
a therapist who understands child
19:09
welfare. they understand not to ask that
19:12
child when do you get to go home or who
19:15
are your real siblings and are they
19:16
living with you? These are real
19:18
questions I've heard from therapists. Um
19:20
and so every one of our therapists here
19:23
now is not only experienced with with
19:25
professional and lived experience, but
19:27
they also have training from us to be
19:30
able to handle these difficult
19:32
situations appropriately,
19:33
>> right? And we start we have that intake
19:36
with the child and their new caregiver
19:38
within 48 hours. And we start to build
19:41
trust and we also start to guide that
19:43
caregiver and how to stabilize this, you
19:47
know, brand new child in their home's
19:49
reality. Um
19:51
>> like how often do you interact with
19:52
them? Is it like multiple times a week?
19:54
Is it, you know, is there like a um an
19:57
urgent care hotline that they can call?
19:59
Like what? I can only imagine some of
20:02
these things pop up.
20:03
>> Right. Right. So we um we are it's based
20:07
on acuity and need. Um and so we we
20:11
average seeing um each child and their
20:13
caregiver one to two times a week as
20:16
kids stabilize. Sometimes that need
20:17
becomes every other week and that's fine
20:19
with us. We we want to be as present as
20:21
needed. Um, you know, we have several
20:24
youth who are seen two to three times a
20:27
week themselves and their caregivers
20:29
being seen by the same therapist. It's
20:30
one of the unique things about our model
20:32
is we built in caregiver support. We
20:35
know that that is the number one factor
20:37
of stability for kids within the child
20:39
welfare system.
20:40
>> Consistency
20:41
>> is the consistency and the stress level
20:44
of their caregiver. Because if you think
20:46
about it, Michael, kids don't make the
20:48
decision to disrupt their placement. Not
20:50
usually. It's the It's the adults. And
20:52
you do that when your stress gets to a
20:54
level that you don't feel like you can
20:56
manage it anymore.
20:57
>> Maybe it's because you know this the
20:59
middle schooler who um was just brought
21:02
to you a month ago comes home from
21:04
school every single day and destroys
21:05
their room. Maybe it's because bedtimes
21:07
are so horrifically
21:10
um difficult that you and your spouse
21:12
are not getting sleep and you don't know
21:15
how to manage a child um who screams for
21:19
4 hours every night. you don't know what
21:21
you're doing wrong. If you don't change
21:23
the reality for that caregiver, they're
21:26
going to disrupt. And what that means is
21:28
they call up their caseworker and they
21:29
say, "I can't do this anymore. Find them
21:31
a new place to live." And that is
21:33
>> the outcomes decline rapidly for that
21:37
child. Every single time they move, they
21:40
lose most of their life. They lose their
21:43
providers. They lose their schools. They
21:44
lose their teachers. They lose their
21:46
mentors. Lots of times they actually
21:47
lose their case worker if they're moved.
21:50
you know, outside the county and they
21:52
have to start fresh. So, think about as
21:54
an adult how hard that would be. Now,
21:56
imagine you're a 12-year-old.
21:58
>> It's just trauma after trauma after
22:00
trauma.
22:00
>> Trauma after trauma. Yes. And and we
22:03
wonder why
22:06
that is the first indicator of a
22:08
child's, you know, outcomes
22:11
declining is that move because they lose
22:14
every bit of themselves. And so, um,
22:16
what we really want to do is we, you
22:18
know, we we support the caregiver so
22:20
that doesn't happen.
22:22
>> And if it does have to happen, we stay
22:24
with that child to to be that transition
22:27
and that continuity.
22:29
>> And so the the youth doesn't lose their
22:32
trusted provider even if they do move,
22:34
planned or unplanned.
22:36
>> So you stick you stick with them.
22:39
>> We do. We do. We continue that therapy.
22:41
We continue.
22:41
>> Is that is that hard to be able to stick
22:43
with them knowing that they're moving? I
22:44
mean, do they because it just seems like
22:47
there's a lot of drop off points that
22:48
can happen.
22:49
>> Yeah.
22:50
>> Because they they go to a new foster
22:51
parent, that new foster parent doesn't
22:54
know anything about the older foster
22:55
parent.
22:56
>> Is there like a system of record where
22:58
all of this stuff is kept? And are you
23:00
guys that system of record?
23:02
>> So, we aren't the system of record and
23:04
the system of record is is ever changing
23:06
and unfortunately oftentimes flawed. But
23:08
what we do is we make human connections
23:10
with every single person we possibly
23:12
can. the care manager at the health
23:14
plan, the case worker in the foster
23:16
system. We engage biological parents
23:18
even if the child's not not placed with
23:20
them. Um, and we fight to stay with that
23:24
child. We do the things that other
23:25
behavioral health companies just aren't
23:27
built to do. So, I'm going to give you
23:29
an example. We were um we were sent a
23:32
referral a few weeks ago for a child who
23:34
was in a foster placement here in
23:35
Virginia.
23:36
>> Okay? And um before we even did their
23:40
intake, they were moved to a kinship
23:42
placement. That's kinship is is a family
23:44
placement. So in this case, um I believe
23:46
it was the child's aunt.
23:48
>> Well, when we got on to do the our
23:49
therapist got on to do the intake, they
23:51
realized that that kinship placement was
23:54
actually in West Virginia.
23:55
>> So the child left the state and our
23:58
therapist was not actually licensed in
23:59
West Virginia. But we knew how important
24:02
it was that this child have therapy
24:05
start as quickly as possible to to make
24:07
this placement successful.
24:08
>> Right?
24:09
>> So in 24 hours, our clinical team
24:12
contacted the board of social works in
24:13
West Virginia, insisted that our
24:16
therapist get a license in West Virginia
24:17
because of how important it was that
24:19
this child have continuity care during
24:21
that move.
24:22
>> Wow. Um, we found a very sensitive
24:24
person in the the social work board who
24:26
believed in what we were doing and
24:27
understood the importance of that
24:29
continuity for kids in the foster
24:30
system. We got a West Virginia license
24:33
and within 24 hours we started seeing
24:35
that child and their new caregiver
24:36
again. And again,
24:38
>> that's innovation. That's like that's
24:41
that is amazing.
24:42
>> It's it's what should be done. It's just
24:44
it's doing what should be done to make
24:47
sure kids would get what they need when
24:49
they need it most. And that's what we're
24:51
built to do.
24:52
Wow.
24:54
I I want I want to ask you a question
24:56
that maybe most don't ask. Um
25:00
>> because you fostered more than 40
25:01
kiddos, you're building a company.
25:04
>> I think most people would pick one of
25:08
those things as their life's mission and
25:11
you're you're doing both. How did those
25:15
two versions of Michelle like talk to
25:19
each other? Does does the does the
25:22
foster parent make you a better CEO or
25:25
does the CEO make it harder to be
25:29
present as a parent?
25:33
>> Depending on the day, depending on the
25:34
hour. Um I I believe being a mom makes
25:39
me a better CEO. It makes me a better
25:41
founder. Um it I believe very strongly
25:46
it makes me better at every aspect of my
25:48
life. I've learned more from my
25:49
children, both my forever children and
25:51
my my former foster children um than I
25:54
ever live learned in school and a
25:56
graduate program in previous roles. It
25:59
hands down makes me better um at
26:03
building this company and I al also
26:06
believe it makes me better at
26:07
prioritizing my time. Um I do not have
26:10
the flexibilities that some founders
26:12
have. My kids will always come first,
26:15
but they come first in a manner that
26:17
actually makes me again, I believe, a
26:19
better leader and a better CEO and um
26:23
more thoughtful um
26:26
um colleague, you know, to my staff and
26:30
>> I, you know, I I I believe very very
26:33
strongly in that. I still take stories
26:37
from the youth that were in our home and
26:40
let them guide what we are building. Uh,
26:43
and I'll you I'll give you an example.
26:45
We had a teen foster daughter. Yeah. A
26:47
teen foster daughter in our home. And I
26:50
remember sitting with her, going over
26:52
the plan. We had had a meeting that day
26:53
while she was in school with her
26:55
caseworker. And um, you know, she had
26:57
given me some some things that were on
26:58
her case plan that she needed to do and
27:00
a timeline for um, the goals for when
27:03
she was going to be going back home. And
27:05
I was going over this with her and I
27:08
remember her staring kind of blankly at
27:10
the page and I got done and I was like,
27:12
"Okay, so what do you think?" And she
27:14
looked at me and she said, "No one ever
27:17
asked me what I think about this. Nobody
27:20
ever asked me what I think should be in
27:21
my case plan." And this is a 15-year-old
27:24
girl who had, you know, goals and ideas
27:27
of what she wanted to do post high
27:28
school. she was smart enough and
27:31
intelligent enough and mature enough to
27:34
contribute to
27:37
what was needed for her, what what
27:39
safety looked like for her to return
27:40
home and nobody was asking her. And
27:43
I've, you know, and it's just one
27:46
example of what I've taken into building
27:48
here now of we center the voices of
27:51
those who have been impacted by the
27:52
system most.
27:54
The number one voice we listen to are
27:56
kids and families that have been most
27:57
harmed by the foster care system. We
27:59
want to build what they want to interact
28:02
with, what they want to engage with, and
28:05
what would support them first and
28:07
foremost. And we believe by doing that,
28:10
we're not just building the type of
28:12
company that I want to be proud to lead,
28:14
>> but we're building what will naturally
28:17
be engaged with and and therefore will
28:20
help us meet
28:21
>> the health plan goals and the foster
28:23
system goals.
28:24
>> Yeah. And so, um, so yeah, I know it's
28:27
kind of a long-winded way to answer that
28:29
question, but I I I try to take every
28:32
story, every interaction that I've had
28:33
with, um, you know, children and the
28:36
families in the foster system that I
28:38
honestly was honored enough to have a
28:40
part in.
28:41
>> Yeah.
28:41
>> And I and I use it every day.
28:44
>> Yeah. Yeah, it's a very real way of
28:45
answering the question and like
28:47
grounding it in, hey,
28:50
these kiddos are basically sharing their
28:52
soul with me and the one thing that we
28:55
can provide to these kiddos that costs
28:57
nothing is like giving them dignity and
29:01
like you said asking them what they
29:03
think about it and asking them for feed.
29:05
Interesting that no one had ever asked
29:06
her that before. That's like pretty
29:08
fascinating to me. Why do you think that
29:10
is like why has healthcare been so
29:14
willing to um I don't know like look the
29:18
other way around you know on this group
29:20
like this is a it's a very niche
29:22
problem. It's it's a pervasive it's a
29:23
big problem but you don't really hear
29:25
about too much
29:27
>> because she didn't have a you know an
29:29
MSW or an MBA. She didn't she she didn't
29:33
have a title that allowed her to decide
29:34
what a case plan should look like. Um,
29:38
and
29:40
you I and I think we get that wrong a
29:42
lot in health care. Decisions are made
29:45
by those who oftentimes don't need the
29:48
care themselves.
29:50
>> And and then we are, you know, we we act
29:53
so confused when whatever we build
29:57
doesn't work. Um, and and I you you hear
30:00
often times that there are populations
30:02
that are hard to engage, right? and and
30:05
kids and families in the foster care
30:07
system are are high on that list. They
30:10
don't want to engage in healthcare is
30:11
what we hear all the time. And I believe
30:13
that is 100% false. We have built
30:17
systems that don't make a large
30:21
percentage of the population feel safe.
30:23
We have built health care systems that
30:25
don't actually work in the lives of the
30:28
kids and families who need them most.
30:30
And then we blame them for not engaging
30:32
in these systems. I mean, if you think
30:34
about it,
30:35
>> you're basically shaming them for
30:36
nothing.
30:37
>> Exactly. Exactly.
30:39
>> And then what do they do? They hide
30:40
further. They they don't engage even
30:41
further more.
30:42
>> Exactly. And so if you build something
30:45
that is wanted and needed and you build
30:48
it alongside or with them as the leaders
30:51
making the decisions, this is what we
30:53
want. This is what we need.
30:56
>> They naturally engage and that is what
30:57
we're seeing. 90% of our referrals we
31:00
turn into care. That is an incredible
31:02
number for any Medicaid population.
31:04
>> What what what's what's I guess what
31:06
would be acceptable? You said 90% which
31:08
is amazing, but what's what's typical?
31:11
>> And in typical Medicaid, it's usually
31:13
around 50 to 60%. And that's not
31:16
accounting for the fact that we are
31:17
actually serving the hardest, you know,
31:19
again, quote unquote, hardest to engage
31:22
population within Medicaid. There's so
31:24
there's not really clear numbers, but we
31:26
know it's it's definitely sub 50%. And
31:28
we are getting 90% into care simply
31:31
because oftentimes the our therapists
31:33
do, you know, they they call our aged
31:36
out youth before their appointment and
31:39
tell them they're so excited to meet
31:40
them. We don't require any login for our
31:45
virtual sessions. Every single thing we
31:47
do is done by SMS text. We meet families
31:49
where they are and with what they're
31:51
using most. Logins are actually a huge
31:54
barrier. You think about that. If a
31:55
child's had three caregivers in the last
31:57
month, do you think they passed on their
31:59
EMR login to to the next caregiver?
32:02
>> Of course.
32:03
>> No, of course not. And we face this all
32:05
the time. I, you know, I could never I
32:07
could never get into a child's um you
32:10
know, their their EMR for their
32:12
pediatrician or whatnot because the
32:13
login was lost three placements ago. So,
32:16
we made that very very you know, clear
32:19
decision early on. Everything we do is
32:21
done without a login.
32:23
>> And it's hard. Technically, it's hard,
32:24
but it's worth it.
32:26
>> Yeah. And I'm just thinking, so if you
32:28
could sit across from a managed care
32:30
executive right now and someone who
32:33
controls billions in Medicaid spend
32:37
>> and you had
32:39
60 seconds to tell them what they're
32:42
missing, what what do you say?
32:45
I would let them know that the thing
32:47
that they are spending the most on
32:50
is causing the most harm and we can fix
32:52
it because that that that's two things
32:55
in one. One, we're spending money that
32:58
doesn't need to be spent
33:00
>> and you're doing it in a way that
33:01
doesn't just harm your members, it harms
33:04
your business.
33:05
>> Yeah.
33:06
>> And we can do it better. We're we're
33:08
we're not curing cancer here. We are we
33:11
are taking innovation that already
33:12
exists and we're we're placing it in the
33:17
in the area that needs it most with
33:19
families
33:22
>> who need it and want it. And so let us
33:25
help you. Um and we're going to do it in
33:28
a way that actually makes makes life
33:31
better for for our families and kids who
33:33
need it most. And so I've had this
33:35
conversation with, you know,
33:38
multiple health plan leaders.
33:40
>> How do they react?
33:40
>> And
33:43
>> what's that?
33:44
>> How do they react?
33:46
>> The ones who understand the problem most
33:50
are immediately interested. They know
33:52
they're overspending on really bad care.
33:55
They have to, right? Because of the
33:57
level of accountability for these kids.
33:59
They can't say no to care. And because
34:02
community-based providers typically have
34:04
really long wait list and other
34:06
behavioral health companies will never
34:08
prioritize these kids, they're stuck
34:11
paying for emergency room visits, kids
34:15
sitting in the hospital beds when they
34:17
shouldn't be and ultimately residential
34:20
care um because all of the adults in a
34:22
child's life have given up on them and
34:24
it's the only bed for them to sleep in
34:25
and they have to have a bed for them to
34:27
sleep in. And so the ones who really
34:31
understand the problem
34:33
um are immediately interested. I
34:35
remember early on in in my journey as a
34:38
founder, I was in front of a health plan
34:40
and you know again sharing this and I
34:44
remember she said we're so tired of our
34:46
kids being an add-on. That's what we
34:48
don't want. We have behavioral health
34:49
companies come to us and say we'll serve
34:52
you we'll serve those kids too. And what
34:54
they mean by that is we'll throw them at
34:56
the back of the line and we'll give them
34:57
>> Right. Yeah.
34:58
>> Giving everybody else. Right.
35:00
>> Yeah. Right.
35:01
>> And they're tired of it. They know that
35:02
these kids deserve and need different
35:06
um and the very best care, but nobody's
35:09
willing to prioritize them. And so I let
35:12
them know more than anything we are
35:14
prioritizing
35:17
only kids and young adults impacted by
35:20
the foster care system because they
35:21
deserve it more than anybody else. And
35:23
we can we want to this with you. We want
35:25
to be your partner. We don't want to be
35:26
a vendor. We want to be your healthcare
35:28
partner for the child welfare system.
35:30
And they the ones who really understand
35:32
it are immediately engaged and
35:34
interested.
35:35
>> Yeah. You're you're in their top five
35:37
favorite people of all time. Um, how how
35:40
do you how can people I mean before I
35:42
forget I mean how do people how can
35:44
people follow you know what you guys are
35:46
doing? Give us like a commercial so that
35:48
people can go to like a website
35:50
something just so that we have it here
35:51
and that they can you know engage with
35:53
further.
35:54
>> I'd love to chat further especially with
35:56
health plans as we are we are Medicaid
35:58
funded first and foremost. We want to
36:01
you know we believe healthcare dollars
36:03
should be paying for healthcare
36:04
services. Um I'm pretty active on
36:07
LinkedIn. It's a great place to, you
36:09
know, follow along. Um, Michelle
36:12
here.alth is my email. I would
36:15
absolutely love to to talk through, you
36:17
know, where your needs are, where your
36:19
gaps are, and how we can partner to help
36:21
fix those. We are we are live in the
36:24
state of Virginia and Missouri in
36:25
partnership with the Medicaid health
36:27
plans in those states. Anthem Healthers
36:29
here in Virginia, um, Homestate Health,
36:32
Show Me Healthy Hit Kids in Missouri,
36:34
those are the plans that cover foster
36:36
connected lives. We'll soon be
36:38
announcing another state in the next
36:40
month or so. Um, but our plan is to
36:42
launch into three to four more states in
36:44
2026. We we know it's needed and you
36:49
know, we we'd love to chat through how
36:51
we can how we can partner with your
36:52
state
36:53
>> on helping to meet these needs.
36:56
>> That's amazing. Um, I know we're kind of
36:59
wrapping up, but I've just in my mind
37:00
I'm just kind of percolating just the
37:02
last question because you're building
37:05
something
37:07
that has never existed before. It's it's
37:10
so exciting. Um, at the same time, it's
37:14
it's also terrifying. Um, and it takes a
37:18
certain type of leader and leadership to
37:20
be able to kind of guide your team
37:22
through that. And I know you're really
37:24
in it right now, but if you had to like
37:27
peek out 10 years from now, and and I
37:29
know we're just guessing right now.
37:31
We're just guessing. And it's um 2036.
37:36
And if and I'm hoping this happens like
37:38
a lot. If here now health worked, and I
37:42
mean like really worked,
37:45
what changed for these kiddos? And what
37:51
does that world look like that you've
37:55
built toward?
37:58
If we look that far in the future and
38:00
we've been successful,
38:02
um it is never a question that
38:04
healthcare access
38:08
would keep families apart. Number one,
38:12
>> um believe very very strongly that
38:15
healthc care, the lack of health care
38:16
should never be a reason we rip a family
38:18
apart or we take a child into the foster
38:20
care system or keep a child in the
38:21
foster care system. And number two,
38:24
every stakeholder in the country, case
38:27
workers, court staff, CASA volunteers
38:31
know that if a child within the foster
38:34
care system needs help, we are the ones
38:36
they can turn to to get that
38:38
>> yeah,
38:39
>> help quickly and appropriately and
38:42
support the whole unit of that child.
38:45
>> And I think those are the, you know, I
38:47
would say those are the two main things.
38:48
If we've been successful, um, that is
38:50
what we're building to be. We are we are
38:52
not just building to provide therapy. We
38:54
are building to be the health care
38:56
partner for the child welfare system. We
38:58
want to do this handinhand with them and
39:01
we we want to do it better than anybody
39:04
else has ever has ever done. And so that
39:07
you know that would really be my goal.
39:10
>> Yes. And throughout this whole
39:11
conversation, the one thing that I've
39:12
and you've, by the way, just your whole
39:14
story, all the different, you know, and
39:16
I know you've got sort of a your
39:18
husband's in the military, so uh tours
39:21
of duty. You've done these really unique
39:23
tours of duty that have prepared you for
39:25
this. And while also being a foster
39:29
parent and just the words, the two words
39:31
that continue to come up in my mind
39:33
throughout this whole conversation were
39:35
consistency and stability. And it's
39:38
like, hey, if you want to build
39:41
a kiddo that's going to have like a real
39:44
good foundational life, you need to be
39:46
consistent. You need to be stable, and
39:47
you need to build systems that embody
39:50
those two things throughout their entire
39:53
like journey. So, I'm just grateful that
39:57
you joined today given that uh you're a
40:01
mom, busy CEO, and um you were super
40:05
intentional and just very rigorously
40:07
honest uh about just your answers. So,
40:10
thank you for that.
40:12
>> Absolutely.
40:12
>> And sharing the journey with us. And I'm
40:15
I'm excited for you at some point in the
40:18
future. We always keep the door open for
40:20
guests to come back and share more uh
40:23
about what's going on in this next few
40:25
few chapters. But for for those that
40:27
have if you tuned in and if you found
40:29
this conversation to be particularly
40:31
helpful uh revealed anything, please the
40:35
best way to be able to support would be
40:37
to either comment, share it, uh even
40:42
reaching out to Michelle directly. That
40:44
would be really really meaningful. And
40:46
if there is a topic that you want us to
40:49
explore further or even a leader that
40:53
you'd like to hear from, you know, drop
40:55
us a note, leave a comment. We do read
40:57
them. For me, this is a platform that um
41:00
it's not just about content. It's not
41:01
just about like real conversations. It's
41:03
actually about community. It's a it's a
41:04
living breathing ecosystem. And if you
41:06
want to eat from it, you have to feed
41:08
it. And that is our way of feeding it.
41:10
So drop those comments. So thanks for
41:12
listening. Uh keep building with
41:14
purpose. And uh we'll see you next time
41:16
on the Advancing Healthcare Innovation
41:18
Show.