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Private Equity in Disability · Why We Do What We Do

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  Speaker 1: You're listening to Why we Do what we Do. Welcome
• 0:16
  Speaker 1: to Why We Do what we Do. I am your
• 0:18
  Speaker 1: privately funded host Abraham.
• 0:21
  Speaker 2: And I'm your Scrooge McDuck host Shane Greedy. Greedy Greedy.
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  Speaker 1: We are a psychology podcast. We talk about the things
• 0:28
  Speaker 1: that humans and non human animals do, and sometimes we
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  Speaker 1: talk about capitalism. But specifically, we are in the middle
• 0:36
  Speaker 1: of a suite of episodes in which we are taking
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  Speaker 1: on topics related to and surrounding ability, disability and accessibility
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  Speaker 1: and various concepts therein. Now, all of these episodes are
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  Speaker 1: intended to stand on their own, but we figure we
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  Speaker 1: wanted to talk about disability and accessibility and there's just
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  Speaker 1: a lot to say about the various aspects of those
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  Speaker 1: that topic, that the considerations in there and whatnot, and
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  Speaker 1: we decided that we would just do a whole bunch
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  Speaker 1: of episodes back to back. But if you haven't heard
• 1:08
  Speaker 1: the other ones, then that's totally fine. You can you
• 1:11
  Speaker 1: be able to follow this one with no problems, although
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  Speaker 1: we may reference them a little bit here and there,
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  Speaker 1: But also if you wanted to go back and check
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  Speaker 1: those out, they will set up a little more context
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  Speaker 1: for some of our discussion in here. But as I said,
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  Speaker 1: these are really intended to stand on their own, and
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  Speaker 1: I think that they do so.
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  Speaker 2: Yeah, and I think at the end of the day,
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  Speaker 2: we could do an entire I mean, we could start
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  Speaker 2: a podcast on disability alone.
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  Speaker 1: Yeah, that's true.
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  Speaker 2: I think that that's just because it's so in depth,
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  Speaker 2: so complex, and so we are really like in this
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  Speaker 2: suite we are just kind of introducing these these topics
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  Speaker 2: and giving you a little bit of a deep dive
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  Speaker 2: on that specific topic to some degree, maybe like maybe
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  Speaker 2: middle dive, but like it's really important to note like
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  Speaker 2: this is an ongoing discussion. It's a complex discussion, It's
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  Speaker 2: a deep discussion, and something that we're not going to
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  Speaker 2: be able to accomplish in a single hour or an
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  Speaker 2: hour and a half or even in the minies that
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  Speaker 2: we do here and there. Like it's going to be
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  Speaker 2: just it's a largely complex and unique tapestry of systems
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  Speaker 2: and people and culture that all come together and create
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  Speaker 2: these unique discussions.
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  Speaker 1: And it's something that is very apropos of the work
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  Speaker 1: that we do. We both are professionals working in the
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  Speaker 1: space of ability and disability and accessibility, and so we
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  Speaker 1: feel like we're well versed to take on some of
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  Speaker 1: the sort of related topics in there, and that is
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  Speaker 1: you know, worth pointing out that we have looked into
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  Speaker 1: a lot of things that are a little outside of
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  Speaker 1: our comfort zone here, but it's all very related to
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  Speaker 1: the kinds of things that we do and work that
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  Speaker 1: we've done in training that we received. But if you're
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  Speaker 1: joining us for the first time, then welcome. We hope
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  Speaker 1: that you enjoy what you hear in this discussion and
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  Speaker 1: you'll probably leave a little bit upset and raged because
• 2:52
  Speaker 1: we can be like John Oliver sometimes in that way.
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  Speaker 1: If you are a returning listener, then welcome back. We
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  Speaker 1: are so glad that you have continued to check us
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  Speaker 1: out and listen to episodes the things that we have
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  Speaker 1: to say about whatever we have to say. Either way,
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  Speaker 1: if you have not already supported us and you would
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  Speaker 1: like to, you can join us on Patreon, pick up
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  Speaker 1: some merch leave us a rating and a review like subscribe,
• 3:14
  Speaker 1: tell a friend, and I'll talk more about those things
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  Speaker 1: at the end of this discussion. But if you're listening
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  Speaker 1: to this on the day that it publishes, it is
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  Speaker 1: December tenth, and that means it is happy Dewey Decimal
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  Speaker 1: System Day for you book nerds out there.
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  Speaker 2: Yeah, you nerds. I actually love to do decimal System.
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  Speaker 2: It is kind of a great thing.
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  Speaker 1: Yeah.
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  Speaker 2: It's also the Festival for the Souls of Dead Whales.
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  Speaker 1: Su Yeah, okay, Yeah. It's a human rights Day. Hooray.
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  Speaker 1: Humans should have right hey, agreed.
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  Speaker 2: It's also International Animal Rights Day. Y, animals should have
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  Speaker 2: rights too.
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  Speaker 1: I love it. Perspect for life, all right. It is
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  Speaker 1: Jane Adams Day.
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  Speaker 2: It is. It's also National Day of Animal Rights.
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  Speaker 1: So international and national day great recognition.
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  Speaker 2: Uni.
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  Speaker 1: It is National Lagger Day. Drink responsibly or not at all?
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  Speaker 2: Yes or not at all. It's Nobel Prize Day.
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  Speaker 1: M okay. It is Computer Science Education.
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  Speaker 2: Week, it is. It's also Human Rights Week.
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  Speaker 1: That makes sense. It's you know, human Rights Day, and
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  Speaker 1: then week and then probably month, year, decade, millennia, forever.
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  Speaker 1: It is Logger Beer Week, so again also makes sense.
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  Speaker 1: Logger Day is in the middle of beer Week.
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  Speaker 2: Yeah. It is National a Plastic Anemia and MDS Awareness Week.
• 4:35
  Speaker 1: And it is National ground Water Awareness Week. That's where
• 4:39
  Speaker 1: a lot of people get their water mm.
• 4:41
  Speaker 2: Hmm, yeah, not puddles. Just so everybody's aware of that
• 4:43
  Speaker 2: it's a very different experience. It's National hand Washing Awareness Week.
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  Speaker 1: Oh do that thing? Very good? Yes, And relatedly, I
• 4:49
  Speaker 1: guess it is National Influenza Vaccination Week.
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  Speaker 2: Yay, yay, I love it.
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  Speaker 1: Yeah, go be vaccinated.
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  Speaker 2: Happy December tenth folks.
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  Speaker 1: Yeah, that's what I mean to say. That's where we
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  Speaker 1: landed is on that. So, but that's not what we were
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  Speaker 1: planning to talk about today in depth. In instead, we
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  Speaker 1: have an episode about money and specifically how money plays
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  Speaker 1: a role in the systems of care that exist in
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  Speaker 1: the spaces of disability and accessibility, and primarily in this case,
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  Speaker 1: disability and impairments. And so we're to do our best
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  Speaker 1: in here to be as nuanced and charitable as we can.
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  Speaker 1: And you're going to find out soon why that's difficult.
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  Speaker 1: And let's start with the fact that supports for people
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  Speaker 1: with impairments, those supports are not cheap. Private companies can
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  Speaker 1: afford to invest in innovations, they can expand businesses, they
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  Speaker 1: can create national networks and hire a lot of people,
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  Speaker 1: and they can further the research and design of supports
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  Speaker 1: for various impairments. So that is a thing that might
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  Speaker 1: be afforded by by having private money pay for supports
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  Speaker 1: in the disability space.
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  Speaker 2: However, part of the issue with the private industry is
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  Speaker 2: often this discussion of what's called the bottom line, and
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  Speaker 2: the bottom line is to make profit, which is sometimes
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  Speaker 2: achieved by cutting corners, price gouging, and monopolizing the industry
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  Speaker 2: to stifle competition and other innovation.
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  Speaker 1: Yes, and that controls the sort of movement and growth
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  Speaker 1: of assets inside of that, because if you can control
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  Speaker 1: how quickly the industry evolves, then you can always have
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  Speaker 1: like the next product to sell that's a little better
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  Speaker 1: than the last one, even though you could go much further.
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  Speaker 1: It's like you go just little baby steps because then
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  Speaker 1: the next advancement that you've already done, it's like ready
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  Speaker 1: to go, but you could then release that a little
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  Speaker 1: bit later. Is the new advancements, then people are replacing
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  Speaker 1: the old one. Yeah, and that could be sort of
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  Speaker 1: how the model works. So we'll describe some of the
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  Speaker 1: considerations around the world of private equity and supports for
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  Speaker 1: people with various and parents and again try and do
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  Speaker 1: so in a somewhat nuanced way. But also there is
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  Speaker 1: a heaping amount of evidence that shows where this doesn't
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  Speaker 1: work very well. To put it as nicely as I can.
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  Speaker 2: That is, I think a really great way to set
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  Speaker 2: everybody's expectations for this.
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  Speaker 1: Cool.
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  Speaker 2: We are going to approach this as best we can,
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  Speaker 2: but the evidence points to m you know, so if
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  Speaker 2: that's all sanding, all right, let's go ahead and get started.
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  Speaker 2: So there are at least ten million people in the
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  Speaker 2: US who have an intellectual or developmental disability IDDD. These
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  Speaker 2: people depend on a variety of services to function and
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  Speaker 2: kind of like get their needs met. They include supported
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  Speaker 2: living services, behavior analysis services, lots of different ways that
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  Speaker 2: this goes about. Some of them require system technology such
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  Speaker 2: as wheelchairs, communication devices. Others use support such as group
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  Speaker 2: homes or in home support staff, physical therapists, occupational therapists,
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  Speaker 2: behavior analysts, among others. There's lots of different services that
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  Speaker 2: exist in this space, well beyond what people see on
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  Speaker 2: a day to day basis consumable medical supplies, nutrition is, dieticians,
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  Speaker 2: transportation services. There's lots of things that exist in this space.
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  Speaker 2: That is, it's a complex network of services and providers
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  Speaker 2: that work to support many folks with these types of diagnoses.
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  Speaker 1: And vocational services, which is kind of its own thing
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  Speaker 1: too to talk about at some point because there's a
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  Speaker 1: lot to impact there. But anyway with that, so we
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  Speaker 1: have these ten million people, and in the past, the
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  Speaker 1: way that this has looked as that these people were
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  Speaker 1: like institutionalized. And as the United States and much of
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  Speaker 1: the rest of the world has moved away from this
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  Speaker 1: model of hospitalization and in institutions for people with various disabilities,
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  Speaker 1: there has been like those people still exist, and so
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  Speaker 1: there has been an enormous increase in the need for
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  Speaker 1: supports for in home care or in some cases group
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  Speaker 1: homes or community services in which there's a small number
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  Speaker 1: of people with disabilities they live together what twenty four
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  Speaker 1: to seven support staff or the small community where they
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  Speaker 1: live where they have sort of twenty four to seven
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  Speaker 1: support staff and care that are on the ground with
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  Speaker 1: them at all times. And not that the care the
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  Speaker 1: staff live there. They work in shifts, but they will
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  Speaker 1: be with them throughout the night and throughout that like
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  Speaker 1: someone will be there at all times of the day
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  Speaker 1: and night, even if they they switch each other out
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  Speaker 1: to be in the place. We've moved away from having
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  Speaker 1: people locked up in padded rooms and instead now they're
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  Speaker 1: out in these homes. But that means that they need
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  Speaker 1: those staff to be on call and available for them
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  Speaker 1: all the time right in.
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  Speaker 2: Many of these services started with usually locally run small
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  Speaker 2: businesses with less than twenty employees or even you know,
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  Speaker 2: around that, but sometimes less. I've worked in group homes
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  Speaker 2: where there's no more than ten yeah, and you've got
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  Speaker 2: a rotating staff, and it's like that is like I
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  Speaker 2: mean you're talking skeleton crews here. Yeah.
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  Speaker 1: Yeah, and you can have more like there could be
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  Speaker 1: like you know, forty people, but like they're small, they're
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  Speaker 1: small businesses.
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  Speaker 2: They're small, yeah, a small business. Usually it's like one
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  Speaker 2: group home. Yeah, and sometimes it's like just the family
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  Speaker 2: that runs it, so yeah, or they run through faith
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  Speaker 2: based organizations. Sometimes they grew to be fairly large companies
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  Speaker 2: with upwards of one hundred employees and still fairly small
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  Speaker 2: potatoes next to the large national companies that do exist now.
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  Speaker 2: I do think it's an important caveat. Like I will say,
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  Speaker 2: if you're listening to this and you know where I work,
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  Speaker 2: I do work for a large national company, and we'll
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  Speaker 2: talk and unpack that a little bit more, because I
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  Speaker 2: think that is just one and as a behavior analysis provider,
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  Speaker 2: like I work for a larger company that's going to
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  Speaker 2: play a role later in the conversation when we start
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  Speaker 2: talking about the money part of it.
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  Speaker 1: Being a large company is not inherently it doesn't inherently
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  Speaker 1: mean anything really in terms of quality of our services
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  Speaker 1: or things like that. But what we'll be talking about
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  Speaker 1: as we move through this is different than just at
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  Speaker 1: being a large company, because a company can grow to
• 10:49
  Speaker 1: be quite large and maintain it's its own internal structure. Yes, anyway,
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  Speaker 1: thinking about this, like, the reason that a lot of
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  Speaker 1: this exists is because there is money in this space,
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  Speaker 1: and a lot of that money can come from federal
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  Speaker 1: funded sources. So Medicaid, the United States program that provides
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  Speaker 1: low cost or free services for millions of low income families,
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  Speaker 1: spent over four hundred and fifteen billion dollars billion with
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  Speaker 1: a B like Carl Sagan billions and billions, four hundred
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  Speaker 1: and fifteen billion dollars in long term care and supports
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  Speaker 1: in twenty twenty two alone, And that's a representative number,
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  Speaker 1: Like that is a way that that system, the kind
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  Speaker 1: of money that moves through that system.
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  Speaker 2: Right, And because this is a government funded program that
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  Speaker 2: serves such a substantial number of people, it's considered extremely safe, reliable,
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  Speaker 2: recession proof, and lucrative for private investors. And this is
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  Speaker 2: where the tables turntables turn.
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  Speaker 1: So we're getting into now, like what the what we're
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  Speaker 1: talking about, and this has to do with private equity
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  Speaker 1: and investment firms like ads are for us, all right,
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  Speaker 1: we're back. ADS are not the same thing as private equity.
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  Speaker 1: This is going to be a whole thing. But okay,
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  Speaker 1: so as we said, like, we have all of this
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  Speaker 1: money that exists in the space that is paying for
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  Speaker 1: and that's not the only source, it's just one of
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  Speaker 1: the biggest, but there is money that's being paid out
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  Speaker 1: for these services that are like in home care and
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  Speaker 1: support staff and that sort of thing. And then comes private.
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  Speaker 3: Equity and private equity, and specifically private equity firms are
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  Speaker 3: companies that collect money from wealthy individuals, institution investors such
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  Speaker 3: as pension funds, and other entities as well, and they
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  Speaker 3: use this pooled wealth to acquire.
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  Speaker 1: Those smaller businesses. So they go around and I've seen
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  Speaker 1: euphemistic words like gobble up or snap up or in
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  Speaker 1: whatever way they buy out these company. They go to
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  Speaker 1: small town America and they find this little provider that's
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  Speaker 1: got ten people working there where they're doing in home
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  Speaker 1: services for some people with disabilities, and they will purchase
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  Speaker 1: that company and say, you belong to our larger national
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  Speaker 1: conglomerate of companies. Now you work for us. Here's our manual,
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  Speaker 1: here's our handbook, here's all of our trading materials, et cetera.
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  Speaker 1: And that's essentially what they do. And they go around
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  Speaker 1: doing this a lot.
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  Speaker 2: Yes, Also, conglomerate is such a word, like it's a
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  Speaker 2: great word, but also like it just evokes so many
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  Speaker 2: emotions to me, and like conglomerate it does.
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  Speaker 1: That word was used a lot at like nineties cartoons
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  Speaker 1: to represent the villainous entities of sort of corporations. I
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  Speaker 1: guess if you will.
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  Speaker 2: Guaranteed it was set in Rockhill's Modern Life in reference
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  Speaker 2: to mister Bighead's work, like it.
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  Speaker 1: Had to have been yeah, yeah, I think so, yeah yeah.
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  Speaker 2: So what they'll do is they'll merge these companies together,
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  Speaker 2: purchase and rebrand companies, unite them under a national, multi
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  Speaker 2: state conglomerate. Well, and often the purpose is to eventually
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  Speaker 2: resell the business for a significant profit. So the idea is,
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  Speaker 2: you take all these resources, you take all these companies,
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  Speaker 2: you put them together, you restructure, you resize it, you create,
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  Speaker 2: you create a profit margin, and then you sell it
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  Speaker 2: because you go, hey, look we did this great thing.
• 14:18
  Speaker 2: Now we're going to sell it to We're going to
• 14:19
  Speaker 2: sell it off and we're going to make money. They're
• 14:21
  Speaker 2: basically like the people that flip homes, but for businesses.
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  Speaker 1: Yeah, that's actually that's a good comparison. Yeah, good analogy,
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  Speaker 1: because it is cheaper for them. Like they'll spend less
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  Speaker 1: money acquiring the businesses than they can make by selling
• 14:36
  Speaker 1: those businesses. Yeah, because the conglomeration of businesses that they
• 14:41
  Speaker 1: have acquired is worth more than any like each one
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  Speaker 1: split up individually, if that makes sense. Yeah, And so
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  Speaker 1: that's kind of the plan in a lot of cases,
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  Speaker 1: is they acquire them all and then they sell them
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  Speaker 1: off for a giant profit. It's really just as you said, like,
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  Speaker 1: it's a flip scheme. It's that's the whole point.
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  Speaker 2: Yeah.
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  Speaker 1: And so we're going to try to be as charitable
• 15:02
  Speaker 1: as possible to these companies. And you might hear this
• 15:05
  Speaker 1: and say why, And it's because I want to be
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  Speaker 1: nuanced and complex in our discussion and give like the
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  Speaker 1: benefit of the doubt, where I can, but the evidence
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  Speaker 1: is like overwhelmingly damning. So let's paint the nicest picture
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  Speaker 1: that we can of private equity before we then have
• 15:26
  Speaker 1: to enumerate their breath takingly long list of crimes against humanity.
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  Speaker 2: Yes, yes, Also just a quick call back to the
• 15:34
  Speaker 2: word conglomerate. The evil business the mega corporation in Roco's
• 15:39
  Speaker 2: modern life was called conglomo.
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  Speaker 1: So you nailed it. Yeah, that's exactly right.
• 15:45
  Speaker 2: I knew it. I knew it as a child of
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  Speaker 2: the nineties. Okay, So going back to private equity, here's
• 15:50
  Speaker 2: the good. Private equity can greatly expand the resources and
• 15:53
  Speaker 2: capacity of smaller organizations. They can hire more people, purchase
• 15:57
  Speaker 2: more state of the art technology and equipment, and get
• 16:00
  Speaker 2: those the folks that need it, that are working kind
• 16:02
  Speaker 2: of the day to day basis, the day day work
• 16:04
  Speaker 2: that they're doing.
• 16:05
  Speaker 1: Yeah, there's a lot there's a lot of money in there,
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  Speaker 1: so they can technically spend that money in a lot
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  Speaker 1: of different ways that could improve a variety of things
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  Speaker 1: about how that service works. Private equity can sometimes circumvent
• 16:18
  Speaker 1: overly restrictive bureaucratic red tape and provide much more efficient
• 16:23
  Speaker 1: and streamline services. It could do that. It can do that.
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  Speaker 2: Yeah, Yeah, and because they become national, like a national brand,
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  Speaker 2: they can or could provide a recognizable brand with continuity
• 16:35
  Speaker 2: of services across many states. This can actually create streamline
• 16:38
  Speaker 2: databases for services as well.
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  Speaker 1: So yeah, I mean there are things to think about
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  Speaker 1: as what could be afforded by opening up private equity.
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  Speaker 1: And I saw some videos basically saying, like, you know,
• 16:53
  Speaker 1: there were businesses where they just couldn't hire that many
• 16:56
  Speaker 1: people because they just didn't have the resources to do it,
• 16:59
  Speaker 1: like there was a demand for their services. But once
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  Speaker 1: they got private equity, they could expand their services. They
• 17:04
  Speaker 1: could hire more people, they could provide a lot more services,
• 17:09
  Speaker 1: all afforded by private equity. So like it's it could
• 17:12
  Speaker 1: be a thing that happens, and maybe in some spaces
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  Speaker 1: it even does. Does it do most of those things? Sometimes?
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  Speaker 1: Rarely sure? But sometimes actually there have been many, many,
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  Speaker 1: many many many lawsuits and documented cases of fraud, abuse, neglect,
• 17:31
  Speaker 1: and death that have occurred over the years in spaces
• 17:34
  Speaker 1: where private equity took over.
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  Speaker 2: Yes, so, most recently, a twenty twenty five report identified
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  Speaker 2: the private equity firms have acquired a whopping one thousand
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  Speaker 2: businesses in the last twelve years, while also acknowledging that
• 17:47
  Speaker 2: because there are few requirements for reporting and because many
• 17:50
  Speaker 2: of these acquisitions happen with different names, this count is
• 17:54
  Speaker 2: likely a significant underestimate of the actual acquisitions that have
• 17:59
  Speaker 2: occurred in this time. So I would say, specifically in
• 18:01
  Speaker 2: behavior analysis, we have heard this term private equity so
• 18:04
  Speaker 2: much because all of a sudden, there's been a huge
• 18:07
  Speaker 2: interest in businesses inside of behavior analysis, and so you know,
• 18:11
  Speaker 2: I am sure that some of those businesses were not
• 18:13
  Speaker 2: reported just because of the reporting processes.
• 18:15
  Speaker 1: Very much so. Yeah, And so it's hard to say
• 18:18
  Speaker 1: how much more than a thousand it is likely, But
• 18:22
  Speaker 1: because I'm not beholden to anyone, I'm just going to
• 18:25
  Speaker 1: say I would guess it's way more than double that. Yeah,
• 18:29
  Speaker 1: I think I think it's pretty far beyond a thousand. Yeah.
• 18:34
  Speaker 1: I could be very very wrong. Maybe it's only a
• 18:36
  Speaker 1: thousand and one. Yeah, but there's been about a thousand
• 18:39
  Speaker 1: that they've identified, and it's probably most likely way north
• 18:44
  Speaker 1: of a thousand, Yeah, easily. Okay, So why is private
• 18:47
  Speaker 1: equity all of the sudden really interested in snapping up
• 18:51
  Speaker 1: all of these local businesses purchasing them creating these spaces, Like,
• 18:55
  Speaker 1: what's the point Because, as we said, the purpose of
• 18:59
  Speaker 1: an investment firm is to make money. When you have
• 19:02
  Speaker 1: a for profit business model, the point is to have
• 19:05
  Speaker 1: a profit is to have as much money as possible.
• 19:08
  Speaker 1: Why would you go to group home services for people
• 19:13
  Speaker 1: with disabilities as your sort of cash cow? Like, why
• 19:16
  Speaker 1: would you look there? Well, for one thing, it's a
• 19:19
  Speaker 1: low risk investment with a high potential for profit. So
• 19:22
  Speaker 1: those are like two those are kind of the basic
• 19:25
  Speaker 1: ingredients to get investors very interested. One of the reasons
• 19:29
  Speaker 1: that this is possible is because of the nature of
• 19:34
  Speaker 1: there being a lot of small, disconnected and fragmented services
• 19:38
  Speaker 1: spread all over the country. They're small, and there's a
• 19:41
  Speaker 1: lot of them, and they're not united in any particularly
• 19:44
  Speaker 1: meaningful way, so they're relatively inexpensive to acquire, and there
• 19:49
  Speaker 1: is like a steady growing demand for these services. There
• 19:53
  Speaker 1: are over seven hundred and ten thousand people waiting for
• 19:56
  Speaker 1: Assiste of Care, and these companies, many of them, if
• 20:00
  Speaker 1: not most of them, truly do not care about idd
• 20:05
  Speaker 1: about intellectual and developmental disabilities or the people that are
• 20:09
  Speaker 1: in those spaces or work in those spaces. They really,
• 20:12
  Speaker 1: really don't care. What they see is this is something
• 20:15
  Speaker 1: that we can buy for relatively cheap and make a
• 20:18
  Speaker 1: lot of money on. They're not like, let's go out
• 20:20
  Speaker 1: and help people. Now there maybe there are some firms
• 20:23
  Speaker 1: that like that's what their jam is, and like they're like,
• 20:25
  Speaker 1: let's go out and help people by investing a lot
• 20:28
  Speaker 1: of money into these places to make them awesome. That
• 20:30
  Speaker 1: maybe that exists. That's not most of what I found,
• 20:34
  Speaker 1: or any of what I found, really, but the overwhelming
• 20:36
  Speaker 1: majority of the time, I would just broadly say ninety
• 20:40
  Speaker 1: nine percent, even though it's not based on real numbers,
• 20:42
  Speaker 1: but like it's often enough to assume it's pretty much
• 20:45
  Speaker 1: all of the time, Like they don't care. They don't
• 20:47
  Speaker 1: care about the people who work there, they don't care
• 20:49
  Speaker 1: about the people who are being served. All they care
• 20:51
  Speaker 1: about is that they can use this system to make money.
• 20:54
  Speaker 2: Yeah, So if you are one of those companies it
• 20:56
  Speaker 2: does care about this population or the employees and stuff
• 20:59
  Speaker 2: like that. To us, so we can call you a
• 21:01
  Speaker 2: liar because most of the time it's very unlikely that's
• 21:04
  Speaker 2: the case. So you know, it's just it's it's one
• 21:08
  Speaker 2: of those things where I've never I've never in my experience,
• 21:11
  Speaker 2: heard that somebody is coming in with the value of
• 21:13
  Speaker 2: I want to make money actually caring about the well
• 21:16
  Speaker 2: being of people, like that's not those usually don't go
• 21:19
  Speaker 2: hand in hand there. I'm sure, like you said, there's
• 21:22
  Speaker 2: probably a rare case here and there, but I would
• 21:24
  Speaker 2: say that's less than one percent of the of the
• 21:26
  Speaker 2: companies that are out there doing that.
• 21:28
  Speaker 1: You have a hard time finding investors where your pitch
• 21:31
  Speaker 1: to them is like, I'm going to start a business.
• 21:33
  Speaker 1: I would like you to help me pay for that business.
• 21:36
  Speaker 1: I don't plan to make any money. The investor is like, hmmm,
• 21:40
  Speaker 1: I'm going to pass this time.
• 21:42
  Speaker 2: Yeah, and there and they're listen, there are people out
• 21:44
  Speaker 2: there that I am sure that it's like you can
• 21:47
  Speaker 2: do both right, Like you can care for people and
• 21:49
  Speaker 2: I can and I can still make a profit caring
• 21:51
  Speaker 2: for people, like there are people out there like and
• 21:53
  Speaker 2: there's actually science of support that like. The better that
• 21:56
  Speaker 2: you take care of the people that work with you
• 21:58
  Speaker 2: and for you, and the people in your care and
• 22:00
  Speaker 2: your customers, the more likely you are going to make
• 22:02
  Speaker 2: more money if that's your goal. But that's not what's
• 22:05
  Speaker 2: happening here in this space. What's happening here is like
• 22:08
  Speaker 2: these private equity companies are coming in and we'll kind
• 22:10
  Speaker 2: of talk about how this works. Right, They come in,
• 22:12
  Speaker 2: they find these small businesses, and then they make them
• 22:15
  Speaker 2: play ads on their podcast over and over and over again.
• 22:26
  Speaker 1: We're back. I do want to really quickly preface, and
• 22:29
  Speaker 1: I think people might hear this and say, private companies,
• 22:32
  Speaker 1: there are a lot of private companies who really care
• 22:33
  Speaker 1: about those people. And you're absolutely right. There are a
• 22:37
  Speaker 1: lot of private companies who legitimately care about their employees
• 22:40
  Speaker 1: and the people that they serve. We're not talking about
• 22:43
  Speaker 1: private companies. We're talking about private equity, which are investment
• 22:47
  Speaker 1: firms who are like, they're not firms who are ever
• 22:50
  Speaker 1: started in any capacity to get into the helping professions.
• 22:55
  Speaker 1: They were a group of people who said, we can
• 22:58
  Speaker 1: make money by investing money in things that we think
• 23:01
  Speaker 1: will return a profit. Yes, and in some cases that
• 23:04
  Speaker 1: turns out really good products and really good services. And
• 23:07
  Speaker 1: some of those companies they'll set their eyes on among
• 23:10
  Speaker 1: their many investments that they have some of these service
• 23:14
  Speaker 1: providers and say ooh, we can make money over there too,
• 23:18
  Speaker 1: and they'll go scoop them up. And it's not to
• 23:20
  Speaker 1: say that they hate the people who are in those spaces,
• 23:22
  Speaker 1: but they don't really care about the topic. They don't
• 23:25
  Speaker 1: care about the issues. And so the way that it
• 23:29
  Speaker 1: works is what they'll do is they'll purchase all these
• 23:31
  Speaker 1: smaller companies. They don't cost very much for them to acquire,
• 23:35
  Speaker 1: relatively speaking, Like for that company who they bought it from,
• 23:39
  Speaker 1: that might be a big time payout where they get
• 23:40
  Speaker 1: like a huge sum of money, like a million dollars
• 23:43
  Speaker 1: or two million dollars or five million dollars, But to
• 23:45
  Speaker 1: the investment firm, they're like, yeah, whatever, that's the cost
• 23:47
  Speaker 1: of doing businesses, right, we're working in the billions of
• 23:50
  Speaker 1: dollars space, a couple million here and there is not
• 23:52
  Speaker 1: a big deal. Anyway, they'll go and they snap up
• 23:55
  Speaker 1: these companies and then they borrow massive amounts of money
• 23:59
  Speaker 1: so that they can pay dividends to their investors. Right,
• 24:02
  Speaker 1: and then what happens is they're now massively in debt
• 24:05
  Speaker 1: and they will to maximize profits and to move that
• 24:10
  Speaker 1: debt around, they will cut everywhere they can in those businesses.
• 24:16
  Speaker 1: They might call it streamlining, they might call it efficiency,
• 24:19
  Speaker 1: but the costs in this are extreme. They will cut training,
• 24:23
  Speaker 1: completely in some cases, or just reduce it so that
• 24:26
  Speaker 1: they'll basically onboard a staff and say you work now
• 24:29
  Speaker 1: so that you have billable hours. And there's like very
• 24:32
  Speaker 1: little training that prepares them for that work. They're just
• 24:35
  Speaker 1: doing the work. They will cut staff and staff hours,
• 24:38
  Speaker 1: they will cut supplies and any other resources they can.
• 24:41
  Speaker 1: Wherever they can cut anything that they're paying for, they
• 24:45
  Speaker 1: will try to cut. They will move to like the
• 24:47
  Speaker 1: cheapest alternative version of it so that they can maximize profits.
• 24:51
  Speaker 1: And after they've spent about two to three years amassing
• 24:55
  Speaker 1: debt and cutting costs, then they do that thing where
• 24:59
  Speaker 1: they try and sell off the company that is now
• 25:01
  Speaker 1: an organization consisting of many different places all under the
• 25:06
  Speaker 1: banner of that company, and they will make a substantial
• 25:08
  Speaker 1: profit because they can report how much revenue that company
• 25:13
  Speaker 1: is generating relative to the overhead and also like how
• 25:17
  Speaker 1: many different businesses exist inside of that network. And so
• 25:21
  Speaker 1: they sell it off for you know, they purchase all
• 25:23
  Speaker 1: of them for a handful of millions of dollars and
• 25:25
  Speaker 1: sell it off for billions and make a gigantic profit.
• 25:29
  Speaker 1: They pay off their investors, and they move on to
• 25:31
  Speaker 1: the next scheme.
• 25:32
  Speaker 2: Right and it's actually a fairly common scheme among investment
• 25:35
  Speaker 2: companies in general. This is not just in disability services.
• 25:38
  Speaker 2: This is something that happens across the board. They will
• 25:41
  Speaker 2: trade debt around to pay people off, simply moving millions
• 25:44
  Speaker 2: or even billions through those various entities. And while this
• 25:47
  Speaker 2: is successful at reducing overhead, it comes at a significant
• 25:50
  Speaker 2: cost to the recipients of these services in programs and
• 25:53
  Speaker 2: employees and the people that are kind that are involved
• 25:57
  Speaker 2: in the day to day mechanations of the these companies.
• 26:00
  Speaker 2: It is there's such a huge impact. So we should
• 26:03
  Speaker 2: probably talk about that part because I think that that's
• 26:05
  Speaker 2: the thing that people don't realize is really the disgusting
• 26:07
  Speaker 2: part of this.
• 26:08
  Speaker 1: Yeah, the impact of this is it's a lot. I
• 26:11
  Speaker 1: feel like it's not to the point of like issuing PSA,
• 26:13
  Speaker 1: but we are going to tell some stories of things
• 26:15
  Speaker 1: that have happens to people. So I guess if you
• 26:18
  Speaker 1: are queasy just about even hearing that, like bad things
• 26:21
  Speaker 1: happen to people, then this next part is going to
• 26:23
  Speaker 1: be maybe you want to skip the rest of this,
• 26:25
  Speaker 1: I don't know, but yeah, we're not getting you know,
• 26:27
  Speaker 1: illicit anything. We're not We're not getting er explicit. I
• 26:29
  Speaker 1: mean we're not getting into the realm of actively describing
• 26:33
  Speaker 1: terrible things happening. Yeah, but terrible things happened, and they're
• 26:37
  Speaker 1: they're horrendous to the point of being nauseating when you
• 26:39
  Speaker 1: read about them.
• 26:40
  Speaker 2: Yeah.
• 26:40
  Speaker 1: For one thing, one of the most common things I
• 26:42
  Speaker 1: saw across all sources was understaffing. Like it is just
• 26:46
  Speaker 1: they are chronically understaffed, with their frontline staff sometimes working
• 26:51
  Speaker 1: sixteen to twenty four hours straight in a single shift,
• 26:55
  Speaker 1: resulting in fatigue, stress, burnout, high turnover. And like if
• 27:01
  Speaker 1: you've been working for twenty four hours without any pause
• 27:04
  Speaker 1: in that whole twenty four hour period, like how good
• 27:07
  Speaker 1: of a service can you possibly be providing at that point?
• 27:11
  Speaker 1: Not very That's part of like even where like the
• 27:14
  Speaker 1: eight hour work day came from. Is like at a
• 27:16
  Speaker 1: certain point, like your productivity just drops lower and lower
• 27:20
  Speaker 1: and lower and lower until you're paying for like someone
• 27:23
  Speaker 1: to do basically nothing. Yeah, and so it was actually
• 27:26
  Speaker 1: more economical than not have people work all day because
• 27:29
  Speaker 1: you've got the lower quality output from your workers. Pay
• 27:33
  Speaker 1: them for the eight hours, not the twenty four or whatever,
• 27:37
  Speaker 1: and then you would get the sort of maxim amount
• 27:39
  Speaker 1: of output that you're going to get.
• 27:40
  Speaker 2: Yeah, I mean, and this is like in a field
• 27:42
  Speaker 2: where in disabilities, where anywhere between fifteen and eighty percent
• 27:45
  Speaker 2: of the field there's a high turnover rate because of
• 27:47
  Speaker 2: the burnout rates.
• 27:48
  Speaker 1: Yeah.
• 27:49
  Speaker 2: Like it's one of those things where the folks that
• 27:51
  Speaker 2: we're serving cannot afford to have high turnover rates, the
• 27:54
  Speaker 2: employees cannot afford to be exhausted like this, Like that
• 27:57
  Speaker 2: is such a significant thing that we don't talk about, Like,
• 28:00
  Speaker 2: don't even get me started on self care. Oh, in
• 28:03
  Speaker 2: the systems that make it difficult. So the thing here
• 28:06
  Speaker 2: too is it's also made this type of system has
• 28:09
  Speaker 2: made it difficult to find enough people that want to work,
• 28:12
  Speaker 2: or any workers to hire for these types of positions. Understandably,
• 28:15
  Speaker 2: they're overworked, they're underpaid. Staff might misappointments, they might be late,
• 28:20
  Speaker 2: they might fail to bring their patients to scheduled appointments
• 28:22
  Speaker 2: or social engagements. As a result of missed opportunities, their
• 28:25
  Speaker 2: performance drops significantly because they are so strained in this space,
• 28:30
  Speaker 2: and they're oftentimes in the group homes I've worked in.
• 28:32
  Speaker 2: I don't know if you've had this experience, but in
• 28:33
  Speaker 2: the group homes i've worked in. Oftentimes, they're responsible for
• 28:36
  Speaker 2: people for twenty four hours a day. They're getting paid
• 28:38
  Speaker 2: minimum wage. They're getting beat up because they're working with
• 28:41
  Speaker 2: folks that have behavior concerns. They're managing medication, they're managing
• 28:44
  Speaker 2: their money, they're dealing with caregivers and guardians, they're dealing
• 28:47
  Speaker 2: with state overviews. They're private companies that are contracted by
• 28:50
  Speaker 2: the state, and so all the staff are just kind
• 28:52
  Speaker 2: of like they're just trying to get through the day. Yeah,
• 28:54
  Speaker 2: and they are fried because of this, and.
• 28:56
  Speaker 1: They've had very little training to prepare them for how
• 28:59
  Speaker 1: to get through the day. Part of the reason they
• 29:01
  Speaker 1: get beat up is because they're not trained how to
• 29:04
  Speaker 1: manage a system where you don't end up with aggression
• 29:07
  Speaker 1: like and violence toward one another. And like they're burned out, fatigued,
• 29:12
  Speaker 1: and they were not even really taught what to do
• 29:13
  Speaker 1: in the first place. Like that's tough, Like that's a
• 29:16
  Speaker 1: horrible sort of situation to be in.
• 29:18
  Speaker 2: Yeah.
• 29:18
  Speaker 1: Absolutely, there's some examples of things that have happened. There
• 29:21
  Speaker 1: was a company called Help at Home and they're going
• 29:23
  Speaker 1: to come up again. There was a patient in Indiana
• 29:26
  Speaker 1: who died of malnutrition of malnutrition of all things. They
• 29:30
  Speaker 1: weighed only seventy one pounds, which is thirty two kilograms
• 29:34
  Speaker 1: at the time of their death because they were so underfed.
• 29:37
  Speaker 1: And this again was due to staff shortages and lack
• 29:40
  Speaker 1: of resources being paid to ensure that person was getting
• 29:42
  Speaker 1: the adequate nutrition that they need. In Iowa, a patient
• 29:46
  Speaker 1: was left alone in a liquor store. Oh wait this one.
• 29:48
  Speaker 1: Maybe it was in Indiana. Now this is this is Iowa.
• 29:51
  Speaker 1: The person who died in malnutrition was in Indiana and Iowa.
• 29:55
  Speaker 1: It was a patient who was left alone in a
• 29:57
  Speaker 1: liquor store. They drank three quarters of a bottle of
• 29:59
  Speaker 1: vodka because they were just left alone sitting there. Yeah,
• 30:03
  Speaker 1: this is a person with an intellectual disability, Like they
• 30:06
  Speaker 1: did not have the skills to navigate the story very well,
• 30:10
  Speaker 1: and that happened to them. One facility in South Carolina
• 30:13
  Speaker 1: had one hundred and fifty calls to police and seventy
• 30:16
  Speaker 1: incident reports in a two year period, such that the
• 30:19
  Speaker 1: police department advocated that their license be taken away because
• 30:22
  Speaker 1: they were getting so much like the police were just
• 30:25
  Speaker 1: constantly there.
• 30:26
  Speaker 2: Yeah, I think it's really important to point out that,
• 30:29
  Speaker 2: like these are spaces where private equity has come in
• 30:31
  Speaker 2: stripped resources. This is not yes, this is not just
• 30:34
  Speaker 2: standard practice. This is a situation where they could have
• 30:36
  Speaker 2: done well with the right resources and with the money
• 30:39
  Speaker 2: that could have been invested, but the money was not
• 30:40
  Speaker 2: invested in the care of these people and as a result,
• 30:43
  Speaker 2: people were hurt.
• 30:43
  Speaker 1: That's a good, yeah, good reminder, because yeah, the whole
• 30:45
  Speaker 1: reason we're talking about these examples is because we're talking
• 30:48
  Speaker 1: about situations that have arisen because let's not say because
• 30:53
  Speaker 1: after private equity came in and purchased those businesses and
• 30:57
  Speaker 1: took over running like management of those resources and staff
• 31:01
  Speaker 1: and training and everything.
• 31:02
  Speaker 2: Yeah. So a facility in Utah had a two star
• 31:05
  Speaker 2: quality rating and has been fined multiple times for quote,
• 31:08
  Speaker 2: failing to prevent abuse, neglect, misappropriation of resident property, and exploitation.
• 31:14
  Speaker 2: And they did not ensure that the alleged violations evolving abuse, neglect,
• 31:18
  Speaker 2: exploitation or mistreatment, including injuries of unknown source and misappropriation
• 31:22
  Speaker 2: of resident property were reported immediately end quote. And they
• 31:26
  Speaker 2: had multiple payouts for allegations of abuse, neglect, intoxication, and
• 31:29
  Speaker 2: an obscene lack of compassion, which is a direct quote
• 31:32
  Speaker 2: from these reports as well. Yeah, further reports found that
• 31:35
  Speaker 2: patients infirms owned by private equity were fifty percent more
• 31:39
  Speaker 2: likely to be prescribed anti psychotic medications because they don't
• 31:43
  Speaker 2: have to pay as many staff to look after those
• 31:46
  Speaker 2: people if they are sedated most of the time. Now,
• 31:51
  Speaker 2: I get really frustrated because I work in crisis spaces,
• 31:54
  Speaker 2: so like this over prescription of medication. By the way,
• 31:58
  Speaker 2: just as another fact for everybody here, when it comes
• 32:00
  Speaker 2: to folks with disabilities, up to ninety percent of people
• 32:03
  Speaker 2: who are on psychotropic medications are never even told why
• 32:05
  Speaker 2: they're on the medications. Usually it's a caregiver that's told.
• 32:08
  Speaker 2: And in most of the time, these types of anti
• 32:10
  Speaker 2: psychotic medications or just any sort of psychotropic medication is
• 32:13
  Speaker 2: often prescribed for its side effect of lethargy insedation, So
• 32:16
  Speaker 2: in private equity spaces it makes sense make sure they're
• 32:19
  Speaker 2: on more medications. Fifty percent are more likely to be
• 32:22
  Speaker 2: prescribed a type of medication because it's easier to it's
• 32:25
  Speaker 2: quote unquote easier to manage the behavior because they're sedated
• 32:27
  Speaker 2: barely moving.
• 32:28
  Speaker 1: It's cheaper to pay for the drugs and keep them
• 32:30
  Speaker 1: just laying there not doing anything than it is to
• 32:33
  Speaker 1: pay for the staff to be there actually creating a
• 32:35
  Speaker 1: supportive space.
• 32:36
  Speaker 2: And let's talk about that for a second. Because if
• 32:39
  Speaker 2: these are private equity companies, they're coming in and buying
• 32:41
  Speaker 2: folks that buying businesses that are working on Medicaid services.
• 32:44
  Speaker 2: The medication is covered by Medicaid, so it's not out
• 32:47
  Speaker 2: of pocket for the private equity company who is in
• 32:50
  Speaker 2: there investing what they're doing is there. Actually it's a
• 32:52
  Speaker 2: win win for the private equity company. Not only do
• 32:54
  Speaker 2: I have to not pay for the medication, now I
• 32:56
  Speaker 2: don't have to pay for staff either. And now when
• 32:58
  Speaker 2: I build for those services, I get the range of
• 33:00
  Speaker 2: that billable time. Yeah, because I do not have to
• 33:03
  Speaker 2: expend any money on medications because it's all Medicaid.
• 33:06
  Speaker 1: Yeah, just just streamline that the Medicaid money straight back
• 33:09
  Speaker 1: to the investors.
• 33:10
  Speaker 2: Ooh, cur eating.
• 33:14
  Speaker 1: It really is like it's really hard to listen to
• 33:16
  Speaker 1: and like just sit here and be like, yep, this
• 33:18
  Speaker 1: is the system as it currently exists, Like this is
• 33:20
  Speaker 1: more often the case than is not. Yeah, Yeah, it's
• 33:23
  Speaker 1: just it's tough and it's really frustrating. Like they actually,
• 33:26
  Speaker 1: if you haven't heard this before, like people listening. It's
• 33:28
  Speaker 1: called a chemical restraint. Is prescribing medication such that people
• 33:33
  Speaker 1: can barely like operate or function that they're unlikely to
• 33:36
  Speaker 1: do very much because you have drugged them to the
• 33:39
  Speaker 1: point where they just kind of lay their passively letting
• 33:42
  Speaker 1: life pass them by. Yeah, and again it's cheap to
• 33:46
  Speaker 1: do that, but it is definitely not in their best
• 33:49
  Speaker 1: interest absolutely, much like playing ads is not the best
• 33:52
  Speaker 1: interest of podcast listeners. But it is going to happen.
• 33:55
  Speaker 2: It's going to happen.
• 34:03
  Speaker 1: All right, we're back. Maybe those were ads for sedatives,
• 34:07
  Speaker 1: but either way, so who knows anymore? Who knows?
• 34:12
  Speaker 2: It's a wild card on that side, Like, please tell
• 34:14
  Speaker 2: us if we get something weird down there.
• 34:16
  Speaker 1: Okay, so this starts to get again, Well, it starts
• 34:19
  Speaker 1: to we've already been in some dark places. It starts
• 34:22
  Speaker 1: there's some more weird stuff that happens that you might
• 34:24
  Speaker 1: not think about right away, which is that like there
• 34:27
  Speaker 1: are sometimes states will try and pass legislation that will
• 34:32
  Speaker 1: make it difficult for private equity to change services such
• 34:36
  Speaker 1: that it results in any kind of harm or loss
• 34:39
  Speaker 1: of quality for the people who receive them, and if
• 34:41
  Speaker 1: that becomes expensive for the investment firm. They'll just close
• 34:44
  Speaker 1: them down. Yeah, it's fine, it's gone. They've got businesses
• 34:46
  Speaker 1: operating in many other states that are a lot more
• 34:48
  Speaker 1: friendly to their overtures of harm and don't care as much.
• 34:52
  Speaker 1: Then we will list some of them. But anyway, what
• 34:55
  Speaker 1: that means sometimes is that homes are sometimes closed with
• 34:58
  Speaker 1: little or even no warnings sometimes to the individuals receiving
• 35:01
  Speaker 1: services in those places, and there's no options for them
• 35:04
  Speaker 1: to get anything else. They just one day, their staff
• 35:07
  Speaker 1: don't show up, Yeah that's it. Or like they are
• 35:10
  Speaker 1: not taken to the place they normally go, and they
• 35:13
  Speaker 1: are often not told about what's happening. It's just all
• 35:15
  Speaker 1: of a sudden, it's gone. And the companies that used
• 35:18
  Speaker 1: to provide those services have been bought up, so there's
• 35:21
  Speaker 1: no alternative for them anymore. Like the company that was there,
• 35:24
  Speaker 1: that was owned by this larger national company they bought up.
• 35:28
  Speaker 1: All the competition, Like everybody that could provide services is
• 35:31
  Speaker 1: now out, and now these people have just nothing. There's
• 35:33
  Speaker 1: just nothing.
• 35:34
  Speaker 2: Yeah, this happened to my town. This happened with adult
• 35:37
  Speaker 2: day train services, where multiple work sites were bought up
• 35:40
  Speaker 2: by a company and then when they realized that they
• 35:42
  Speaker 2: weren't making any money. They closed them all down, and
• 35:44
  Speaker 2: so you had hundreds of people with disabilities, adults with
• 35:47
  Speaker 2: disabilities who relied on being able to go to work
• 35:48
  Speaker 2: for social situations where they had their friends, they had
• 35:51
  Speaker 2: their communities. They lost it all overnight and these facilities
• 35:55
  Speaker 2: just completely shut down. It was awful. It was completely awful.
• 35:57
  Speaker 2: Which also too, like, I think it's an important thing too,
• 36:00
  Speaker 2: put an additional strain on their residential facilities because during
• 36:03
  Speaker 2: the day when they weren't home, they had less staff
• 36:05
  Speaker 2: during the day. So now they had to add more
• 36:07
  Speaker 2: staff during the day to make sure that the folks
• 36:09
  Speaker 2: that were going to work who were never home. Now
• 36:11
  Speaker 2: they had full staff in twenty four to seven, which
• 36:13
  Speaker 2: wasn't the case before. So now it added an additional
• 36:16
  Speaker 2: strain on top of the quality of life impacts that
• 36:19
  Speaker 2: it had for these adult learners. So like, it just
• 36:21
  Speaker 2: was a horrific situation. And those facilities never opened up again.
• 36:25
  Speaker 2: Yeah that was ten years ago and they still never
• 36:27
  Speaker 2: opened up.
• 36:28
  Speaker 1: Wow. Yeah, I mean they just sort of passed the
• 36:30
  Speaker 1: buck onto Like someone somewhere will probably try and take
• 36:33
  Speaker 1: care of this, but it's not our job. We're out.
• 36:35
  Speaker 2: Yep, yep, exactly exactly. Now, these groups also do this
• 36:38
  Speaker 2: other thing which I think is really awful. They lobby
• 36:41
  Speaker 2: against a right to repair law or right to repair
• 36:43
  Speaker 2: laws that would enable people to fix their own equipment,
• 36:46
  Speaker 2: such as medical equipment, stuff like that when it becomes
• 36:49
  Speaker 2: broken or damaged, and instead they will drive proprietary components
• 36:53
  Speaker 2: so that they can be the only person that provide
• 36:55
  Speaker 2: support for said equipment. So not only do they say
• 36:58
  Speaker 2: you're not allowed to fix your own equipment, they say
• 37:00
  Speaker 2: you're not allowed to fix your own equipment. And if
• 37:02
  Speaker 2: you want to fix your equipment like your beds, your hoists,
• 37:05
  Speaker 2: your stuff like this, you have to come through us
• 37:08
  Speaker 2: and pay us as the company so that you can
• 37:11
  Speaker 2: get your stuff fixed.
• 37:12
  Speaker 1: Yeah, proprietary screws where it's like the only they're the
• 37:15
  Speaker 1: only person who sell that shape and size of screw
• 37:18
  Speaker 1: with the specific head, so that only they know how
• 37:21
  Speaker 1: to do it, Like how things are structured, Like there's
• 37:23
  Speaker 1: no manuals for how things are put together, so that
• 37:26
  Speaker 1: if you wanted to try to fix it yourself, you
• 37:28
  Speaker 1: couldn't pull it apart. There's like all these proprietary components
• 37:32
  Speaker 1: that they own that make it so that you can't
• 37:35
  Speaker 1: fix your own stuff. You have to go to them
• 37:37
  Speaker 1: and pay them to do any repairs on your thing
• 37:40
  Speaker 1: or buy new ones again through them. And there has
• 37:43
  Speaker 1: been a huge push in the sort of right to
• 37:46
  Speaker 1: repair space because a lot of companies have done this,
• 37:48
  Speaker 1: Like almost every car manufacturer now makes their own individual
• 37:52
  Speaker 1: parts like individual screws, individual straps, individual clamps that only
• 37:56
  Speaker 1: they make that you have to then go to them
• 37:59
  Speaker 1: if you want anything fixed, because it allows them to
• 38:02
  Speaker 1: just continue to make more money and maximize profits off
• 38:04
  Speaker 1: of those things. And that's what can happen in private
• 38:07
  Speaker 1: equity is they will also do the exact same thing.
• 38:10
  Speaker 1: And I think I actually wrote down right to repair
• 38:12
  Speaker 1: laws as an episode topic for the future because of
• 38:15
  Speaker 1: I knew that we were gonna have a lot to
• 38:16
  Speaker 1: say about that, and there's lots to talk about. It
• 38:19
  Speaker 1: is interesting that the people write to repair laws fall
• 38:22
  Speaker 1: pretty squarely inside like the libertarian viewpoint of things like
• 38:27
  Speaker 1: this is the people should have the ability to be
• 38:31
  Speaker 1: independent from these companies if they want to. A lot
• 38:34
  Speaker 1: of libertarians might disagree with me on that, but it's
• 38:36
  Speaker 1: funny is that like being able to do things independently
• 38:41
  Speaker 1: for yourself is a value often espoused by that group,
• 38:44
  Speaker 1: And then they hire people, they vote in elect people
• 38:46
  Speaker 1: who make it harder to get right to repair laws
• 38:49
  Speaker 1: passed because Republican politicians tend to fight against right to
• 38:53
  Speaker 1: repair laws and a lot of a lot of the time. Right,
• 38:55
  Speaker 1: And they're like, well, but what about this company's ability
• 38:58
  Speaker 1: to make money. I'm like, I think they're I think
• 38:59
  Speaker 1: they're doing I think they're plenty of money. They need
• 39:02
  Speaker 1: that extra two dollars they're making from this, So.
• 39:05
  Speaker 2: The CEO is making four hundred times the amount that
• 39:07
  Speaker 2: their entry level workers are making, so like, yeah, they're okay.
• 39:10
  Speaker 1: Yeah, and three hundred times their next highest paid employees, right,
• 39:14
  Speaker 1: like right, a lot. So anyway, that's just one of
• 39:17
  Speaker 1: the issues there. Another one is that, again the cost
• 39:21
  Speaker 1: cutting thing that happens. So frontline workers such as licensed
• 39:24
  Speaker 1: nurses saw their hours reduced by three percent compared to
• 39:27
  Speaker 1: the industry standards. And you might also look at this
• 39:30
  Speaker 1: and be like, well, they're cutting costs that allows them
• 39:33
  Speaker 1: to streamline and make their services more efficient. No, that's
• 39:36
  Speaker 1: not what happens though, They're just cutting cost Homes owned
• 39:39
  Speaker 1: by private equity will actually charge upwards of ten percent
• 39:42
  Speaker 1: more for the same services that were being provided by
• 39:45
  Speaker 1: previous providers, So it's more expensive for the consumer and
• 39:49
  Speaker 1: you get a lower quality. And the surveys I saw
• 39:53
  Speaker 1: these multiple surveys where they would aggregate data on here
• 39:57
  Speaker 1: from like third party people would go through and just
• 39:59
  Speaker 1: ask and sometimes government agencies do this too, where they'll
• 40:02
  Speaker 1: serve the consumers who receive those services, and showed that
• 40:05
  Speaker 1: the ratings for the quality of care decrease substantially after
• 40:10
  Speaker 1: private equity acquires the original providers, instantly dropping about forty percent.
• 40:14
  Speaker 1: So there's a pretty large range of like how people
• 40:18
  Speaker 1: reported the quality, but it was on an upward trend overall,
• 40:23
  Speaker 1: and then the private equity firm would come in and
• 40:25
  Speaker 1: purchase this company and the quality just plummets into absolute garbage.
• 40:31
  Speaker 1: People are super unhappy, and I can imagine some naysayers
• 40:34
  Speaker 1: out there who try and argue that like, oh, they're
• 40:37
  Speaker 1: just mad that it was bought by private equity and
• 40:40
  Speaker 1: they just liked their people or whatever. I'm like, so
• 40:44
  Speaker 1: you're essentially trying to argue then if that's the place
• 40:48
  Speaker 1: you're coming from, that like you think they're just mad
• 40:50
  Speaker 1: that they liked their people and they switched over that
• 40:53
  Speaker 1: what happened is the private equity came in and made
• 40:56
  Speaker 1: their lives better in every way. They had better care
• 41:00
  Speaker 1: and more services and everything was awesome for them, and
• 41:03
  Speaker 1: they like had better equipment, and they're still and they're like,
• 41:07
  Speaker 1: I want to go back to the lower quality of
• 41:09
  Speaker 1: life because the other company. I'm like, nobody's nobody's doing that.
• 41:13
  Speaker 1: Come on, pull your head out of your ass, right,
• 41:15
  Speaker 1: that's not the move that's happening here. So that doesn't
• 41:18
  Speaker 1: even logically make any amount of sense, Like nobody's gonna
• 41:21
  Speaker 1: even if some people were upset, Like you wouldn't have
• 41:24
  Speaker 1: a complete shift of all people surveyed tick downward forty
• 41:28
  Speaker 1: percent if in the situation, like some people don't even
• 41:32
  Speaker 1: really understand what it would mean that a private company
• 41:34
  Speaker 1: came in and they're still reporting a lower quality of care. Right, So,
• 41:37
  Speaker 1: like this that argument just doesn't hold any water. I
• 41:39
  Speaker 1: know that if anyone is making it, But I could
• 41:41
  Speaker 1: hear the naysayer is saying something like that.
• 41:42
  Speaker 2: Yeah, yeah, yeah, you know something that I was thinking
• 41:44
  Speaker 2: about too, And I'm so glad that we bring up
• 41:46
  Speaker 2: homes in this space, because like, here's the thing that
• 41:48
  Speaker 2: a private equity company could do, Like I want you
• 41:51
  Speaker 2: to picture this for a second. We've already talked about
• 41:53
  Speaker 2: home suddenly closing. Here's what happens when a private equity
• 41:57
  Speaker 2: company comes in and they buy like a let's say
• 41:59
  Speaker 2: a group home. When they buy a group home, they're
• 42:01
  Speaker 2: often buying the company, which also means they're buying the
• 42:03
  Speaker 2: mortgage on the house because the group home that they're
• 42:05
  Speaker 2: living in, they're purchasing property. So it's not just they're
• 42:09
  Speaker 2: buying the company, they're purchasing the property in which the
• 42:11
  Speaker 2: group home is owned. Because it's very rare that you're
• 42:13
  Speaker 2: going to find a group home residential space that is rented,
• 42:18
  Speaker 2: it's often owned by the company that is running the service.
• 42:21
  Speaker 2: So here's what happens. Privaty equity comes in. They're not
• 42:24
  Speaker 2: happy with the services, they're not making profit margins, they're
• 42:26
  Speaker 2: not doing all those things. They can fire everybody that
• 42:28
  Speaker 2: works at that place. They can revamp the house, they
• 42:31
  Speaker 2: can actually like read like, they can actually like remodel
• 42:34
  Speaker 2: the house and then just sell the property and then
• 42:36
  Speaker 2: make all the money off of that. So like they're
• 42:38
  Speaker 2: making hundreds of thousands of dollars. Whether you're there or not.
• 42:42
  Speaker 2: So that's another thing that people don't realize is like
• 42:44
  Speaker 2: they can just flip the house. They can literally flip
• 42:46
  Speaker 2: the house when the when the business doesn't work, and
• 42:49
  Speaker 2: so they make all that money off of that too.
• 42:51
  Speaker 1: Indeed, it's unbelievable.
• 42:52
  Speaker 2: I'm sorry, I get really I get really worked up
• 42:54
  Speaker 2: about this because I've watched this happen and We're going
• 42:56
  Speaker 2: to talk about a company that I've seen has happened
• 42:58
  Speaker 2: with and I've got a story about this. Okay, So anyway,
• 43:01
  Speaker 2: we're gonna talk about these guys. Oh, I am on it. Oh,
• 43:05
  Speaker 2: here we go. I'm I'm actually you know what, because
• 43:06
  Speaker 2: I'm on such a role, I'm gonna take these next
• 43:08
  Speaker 2: bullet points. I'm gonna get on a soapbox for a second. Okay. So,
• 43:11
  Speaker 2: one of the biggest companies, or at least one of
• 43:12
  Speaker 2: the most commonly cited for numerous finds, licensed revocations, and
• 43:16
  Speaker 2: filed complaints is Saveda, who is owned by center Bridge
• 43:20
  Speaker 2: and Vistrea and owns a variety of companies across Oregon, California, Iowa, Florida, Colorado, Massachusetts, Utah,
• 43:28
  Speaker 2: South Carolina, Texas and other states. Like many states, I
• 43:30
  Speaker 2: believe you said before we started something up towards of
• 43:33
  Speaker 2: like forty states or something like that.
• 43:34
  Speaker 1: I think it was forty states that are around. Yeah,
• 43:36
  Speaker 1: so it's like most of the United States.
• 43:38
  Speaker 2: Yeah, yeah, so they own Neurorestorative, one of the most
• 43:41
  Speaker 2: commonly cited offenders for lots of problems, as well as
• 43:45
  Speaker 2: help at Home which we mentioned, and Mentor Network, but
• 43:48
  Speaker 2: there are other companies separately that are doing similar things. Specifically,
• 43:51
  Speaker 2: I want to talk about Mentor Network. When I first
• 43:52
  Speaker 2: started working in group homes in Florida, Mentor is all
• 43:55
  Speaker 2: over Florida.
• 43:56
  Speaker 1: Yeah, they were big in Florida.
• 43:57
  Speaker 2: They were big in Florida. They still and they're still around.
• 44:00
  Speaker 1: Yeah.
• 44:00
  Speaker 2: The one group hoom I worked in was a small,
• 44:01
  Speaker 2: little group home. It was a behavior focused group Palm,
• 44:04
  Speaker 2: which meant that everybody lived in the home had a
• 44:06
  Speaker 2: higher level of behavioral concerns than a standard group home,
• 44:09
  Speaker 2: and the staff were there twenty four to seven, highest
• 44:12
  Speaker 2: turnover rate I've ever seen in a group home. Everybody
• 44:14
  Speaker 2: was getting paid minimum wage. There were people getting chunks
• 44:16
  Speaker 2: bitten out of them, like severe aggression, severe fecal smearing,
• 44:20
  Speaker 2: lots of behavior problems. One of my favorite staff, she
• 44:23
  Speaker 2: was this feisty old lady and she was just I
• 44:26
  Speaker 2: loved her to death. We did not get along when
• 44:28
  Speaker 2: we first came in, but we ended up aligning really
• 44:30
  Speaker 2: well because we were like, hey, we're here for the
• 44:32
  Speaker 2: same reason. We're here to do the same work. Yeah,
• 44:34
  Speaker 2: she was making so little that she was having to
• 44:36
  Speaker 2: pick up extra overtime work. She's having to pick up
• 44:39
  Speaker 2: extra shifts. She had a fucking heart attack while she
• 44:42
  Speaker 2: was working and died in the group home because she
• 44:45
  Speaker 2: was working so much. She was exhausted. They ran her ragged. Wow,
• 44:49
  Speaker 2: and it was unbelievable. I could not believe it. She
• 44:52
  Speaker 2: died while she was on shift with her clients, by herself,
• 44:56
  Speaker 2: because she was understaff during that time. And it was
• 44:59
  Speaker 2: absolutely a result of the type of work and structure
• 45:03
  Speaker 2: and systems that were in place by these types of companies.
• 45:07
  Speaker 2: And this was before I realized this was private equity.
• 45:09
  Speaker 2: This was just these systems. Yeah, this was this was
• 45:12
  Speaker 2: not caring for your employees. And and I think about
• 45:15
  Speaker 2: Miss Debbie all the time because she was she was
• 45:18
  Speaker 2: as the kind of person that you needed to have
• 45:20
  Speaker 2: in this field. And this is what types of things
• 45:22
  Speaker 2: happen with private equity. Showing up. This is how they
• 45:25
  Speaker 2: care for their employees. It's it's unbelievable. So like when
• 45:28
  Speaker 2: I get worked upbout it's because of stuff like that.
• 45:30
  Speaker 2: It's like you've lost this person who shouldn't have lost
• 45:33
  Speaker 2: their life over a fucking job, but they lost it
• 45:35
  Speaker 2: because they were being just just work to the bone
• 45:39
  Speaker 2: so that somebody could go off and sell it for
• 45:41
  Speaker 2: you know, a couple hundred thousand dollars or a million
• 45:43
  Speaker 2: dollars or a billion dollars.
• 45:45
  Speaker 1: Yeah, yeah, yeah, there and there were so many, so
• 45:57
  Speaker 1: many things as like I honestly I kind of thought about,
• 46:00
  Speaker 1: like I should just go through and list all of
• 46:02
  Speaker 1: the various atrocities and lawsuits and complaints that have been
• 46:06
  Speaker 1: filed because there are so so many, and just to
• 46:09
  Speaker 1: like help give a scale picture. But I really felt
• 46:13
  Speaker 1: like I didn't want people to just get bored hearing
• 46:16
  Speaker 1: that list. But know that the numbers are out there,
• 46:18
  Speaker 1: and like you can certainly look into this, and if
• 46:20
  Speaker 1: you're curious about learning more, like just start googling around
• 46:22
  Speaker 1: like about private equity and disability, and like you will
• 46:24
  Speaker 1: find some horrifying stuff. It is a very very dark
• 46:28
  Speaker 1: and gross space. Absolutely that is out there, So really
• 46:32
  Speaker 1: taking all this together, when private equity enters the disability space,
• 46:36
  Speaker 1: quality of care, individualized care, appropriate supervision, training, all of
• 46:40
  Speaker 1: that decreases significantly most of the time, like very often
• 46:44
  Speaker 1: it is the case that you have a substantial decrease
• 46:49
  Speaker 1: in quality across the board and every facet of how
• 46:53
  Speaker 1: that business is supposed to operate. People suffer more. They
• 46:57
  Speaker 1: are treated with less dignity and rest and compassion. They're
• 47:01
  Speaker 1: over medicated, the staff are overworked. They have much higher
• 47:05
  Speaker 1: mortality rates. Like you have people dying at a much
• 47:08
  Speaker 1: higher rate when they are owned by a private equity
• 47:11
  Speaker 1: firm than when they are not. Because again, they are
• 47:14
  Speaker 1: cutting corners about things, and like nobody says boo, because
• 47:18
  Speaker 1: what are they going to do? Like right, they're technically
• 47:21
  Speaker 1: following the procedures, and yeah, they get fined and they
• 47:24
  Speaker 1: maybe get a slap on the wrist and they maybe
• 47:25
  Speaker 1: have their license challenged or something like that, but like
• 47:29
  Speaker 1: what do they care? Like their point is to just
• 47:31
  Speaker 1: make some money, so like as long as they can
• 47:33
  Speaker 1: end up with a profit in the end, Like the
• 47:36
  Speaker 1: worst case scenario, if they're like threatened with a fine,
• 47:37
  Speaker 1: they might just sell it early. You know and just
• 47:39
  Speaker 1: get a get rid of the asset.
• 47:41
  Speaker 2: Yeah, yeah, because at that point in time, they don't
• 47:43
  Speaker 2: have to. They don't have to they can go, well, well,
• 47:45
  Speaker 2: we can still make some money off of this and
• 47:46
  Speaker 2: cut our losses. They monopolize access to assess the technologies
• 47:50
  Speaker 2: and devices. They take over spaces so thoroughly that they
• 47:53
  Speaker 2: can't even be gotten rid of. So in Florida, Mentor
• 47:55
  Speaker 2: Group mentor specifically Mentor Network, but they weren't shut down
• 47:58
  Speaker 2: despite overwhelming evidence of fraud, abuse, and neglect because there
• 48:02
  Speaker 2: were no other alternatives for people receiving their quote unquote services.
• 48:06
  Speaker 1: Yeah, so even though people tried to shut them down,
• 48:08
  Speaker 1: they sort of realize it, if we close down Mentor
• 48:11
  Speaker 1: Group in Florida, there won't be other providers, Like there'll
• 48:14
  Speaker 1: be nothing for those people. So like even if they're
• 48:17
  Speaker 1: getting substandard quality and their care, at least they're getting something,
• 48:21
  Speaker 1: and they just kind of accepted it. So like there's
• 48:24
  Speaker 1: and that's happened in other spaces too, because they monopolize
• 48:27
  Speaker 1: those spaces, like they're almost impossible to get rid of
• 48:29
  Speaker 1: because they've taken over everything. Yeah, it's really a broken system,
• 48:33
  Speaker 1: Like it's it's really rough that should just not ever
• 48:36
  Speaker 1: be the case. And what's crazy about all this too,
• 48:39
  Speaker 1: is like technically most of like the human rights abuse
• 48:43
  Speaker 1: things are obviously not legal, but all the business stuff
• 48:45
  Speaker 1: that they're doing that's super shady technically is completely legal,
• 48:48
  Speaker 1: completely legal. They're working within the system that exists to
• 48:52
  Speaker 1: do all of this, And so people try and pass laws,
• 48:55
  Speaker 1: but then those laws get repealed or changed, or like
• 48:59
  Speaker 1: they just find new loopholes to move through, or they'll
• 49:01
  Speaker 1: just close down the business there and then leave everyone
• 49:04
  Speaker 1: stranded and they'll just move on somewhere else to make
• 49:06
  Speaker 1: money there.
• 49:07
  Speaker 2: Yeah, and if we go want to keep going forward,
• 49:11
  Speaker 2: administrations that tend to lean to more conservative spaces that
• 49:14
  Speaker 2: are actively looking to make money. Our current administrations right now,
• 49:19
  Speaker 2: they are actively dismantling the protections that are in place
• 49:22
  Speaker 2: to prevent these types of things from happening. Yeah, So
• 49:24
  Speaker 2: when we talk about things like fraud, neglect, abuse, all
• 49:26
  Speaker 2: those things, they're dismantling such systems to make that even
• 49:29
  Speaker 2: more legal. So those things that we're concerned about that
• 49:32
  Speaker 2: are illegal, the dismantling of systems and protections for people
• 49:35
  Speaker 2: with the IDDD diagnoses are going to be gone. Those
• 49:38
  Speaker 2: protections are going to be gone, and as a result,
• 49:40
  Speaker 2: private equity is going to just boom. It's just going
• 49:43
  Speaker 2: to make so much money because those barriers. The current
• 49:45
  Speaker 2: administration is actively removing those barriers.
• 49:48
  Speaker 1: Yep, yep. They can exploit the system as hard as
• 49:50
  Speaker 1: they want to and no one can stop them because
• 49:53
  Speaker 1: the all protections that did exist, well, many of the
• 49:56
  Speaker 1: protections that did exist will have been remove or weekends
• 49:59
  Speaker 1: to the point where they have no more enforcement power yep.
• 50:03
  Speaker 1: So that leads us to sort of what can we
• 50:05
  Speaker 1: do about this? Well, advocates who work in this space,
• 50:09
  Speaker 1: they argue strongly for greater transparency and the owners of
• 50:12
  Speaker 1: idd services and equipment providers and manufacturers that're going back
• 50:17
  Speaker 1: to the right to repair laws, they push those for
• 50:19
  Speaker 1: those right to repair laws, and they also really push
• 50:22
  Speaker 1: for greater regulations and stricter requirements for staffing and medici
• 50:26
  Speaker 1: oversight and quality audits and harsher punishments for violations of
• 50:31
  Speaker 1: the basic standards and human rights. Like they're really just
• 50:34
  Speaker 1: and honestly, that feels like they're not asking for very much.
• 50:37
  Speaker 1: Is like, can we have like somebody actually pay attention
• 50:40
  Speaker 1: to what's happening here? So that people aren't getting abused,
• 50:43
  Speaker 1: and like just check in periodically to see if things
• 50:47
  Speaker 1: are going the way they're supposed to be going. Yeah,
• 50:49
  Speaker 1: if they're actively causing people to suffer and die, then
• 50:53
  Speaker 1: like that should be something that has a punishment associated
• 50:56
  Speaker 1: with it. That's not like it's not okay to do
• 50:58
  Speaker 1: this sort of thing. Like it does feel like they're
• 51:01
  Speaker 1: asking for very little in a space where they it
• 51:03
  Speaker 1: would be reasonable for them to be asking for a lot.
• 51:06
  Speaker 2: Right right now, the Biden administration issued a rule that
• 51:09
  Speaker 2: required greater oversight of home and community based service providers
• 51:12
  Speaker 2: and require greater competition for workers. Which that's part of
• 51:15
  Speaker 2: the big problem that's happening when we talk about minimum wage.
• 51:18
  Speaker 2: We're talking about like some service providers are building out
• 51:20
  Speaker 2: at less than minimum wage and they haven't even updated
• 51:23
  Speaker 2: those rates in twenty years. So like there's a lot
• 51:25
  Speaker 2: of problems with this system and there's not a lot
• 51:28
  Speaker 2: of oversights. So the Biden administration issued a rule that
• 51:30
  Speaker 2: we could do that all of which all of these
• 51:33
  Speaker 2: things greatly reduces fraud, waste, and abuse, all those things
• 51:36
  Speaker 2: that are a problem. However, of course, current Republicans hate
• 51:40
  Speaker 2: this and have pushed for Trump to reverse these rules
• 51:42
  Speaker 2: because they are the architects of fraud, waste, and abuse.
• 51:45
  Speaker 2: At the time of this recording, Trump has already announced
• 51:48
  Speaker 2: that he's going to try to dismantle every single decutive
• 51:51
  Speaker 2: order or every single rule that Biden had made that
• 51:54
  Speaker 2: he signed with an autopen So like this, could this
• 51:56
  Speaker 2: is part of that dismantling these structures and opening it
• 51:59
  Speaker 2: up for these these egregious human harms.
• 52:02
  Speaker 1: Yeah, yeah, I mean the laws that the Biden administration
• 52:04
  Speaker 1: or the rules, the rules that they issued, would have
• 52:08
  Speaker 1: reduced fraud, waste and abuse and what to have protected
• 52:12
  Speaker 1: workers and what have protected recipients of those services, and
• 52:15
  Speaker 1: it would have made there be greater oversight for the
• 52:18
  Speaker 1: use of those resources so that we're not opportunities for
• 52:21
  Speaker 1: people to abuse the system and not as many opportunities.
• 52:24
  Speaker 1: And of course the current administration is reversing all of that.
• 52:27
  Speaker 1: They're like, no, we want the waste, we want the fraud,
• 52:30
  Speaker 1: we want the abuse, because then those very wealthy people
• 52:33
  Speaker 1: can become even more wealthy. Yeah, it's just it's insane.
• 52:37
  Speaker 1: So one thing you can do is we can vote
• 52:39
  Speaker 1: for competent people who will pass legislation that supports people
• 52:42
  Speaker 1: with intellectual and developmental disabilities and other disabilities and impairments,
• 52:46
  Speaker 1: and who will close the loopholes for abuse that have
• 52:49
  Speaker 1: been propped up by stupid excessive for profit privatization rhetoric
• 52:54
  Speaker 1: and like, do not fall for their stupid bulk that
• 52:57
  Speaker 1: they tell you in terms of like this make things cheaper,
• 53:01
  Speaker 1: it makes things more efficient, it makes things more streamlined. No,
• 53:04
  Speaker 1: it doesn't. It actively does the opposite. Like when private
• 53:07
  Speaker 1: equity comes in, things cost more and are less efficient
• 53:10
  Speaker 1: and the quality goes down. It's like the lose lose
• 53:13
  Speaker 1: losiest of all losing situations.
• 53:15
  Speaker 2: If you hear synergy run, if you hear them say
• 53:18
  Speaker 2: Synergy run, if you hear conglomerate get out of there.
• 53:22
  Speaker 1: Yeah, so I you know, in some of these spaces
• 53:25
  Speaker 1: it would be really difficult. Like I don't really bigrudge
• 53:28
  Speaker 1: at all. The companies who sold to those major companies,
• 53:31
  Speaker 1: like they're very likely were pressure campaigns to force them
• 53:34
  Speaker 1: to sell. They could have been that those companies set
• 53:37
  Speaker 1: up competition that ran them into the ground because it
• 53:39
  Speaker 1: was cheaper. Those people did whatever they had to do
• 53:42
  Speaker 1: in the situation that they found themselves in. It's the
• 53:44
  Speaker 1: private equity firms that should be stopped, like they're the
• 53:46
  Speaker 1: ones who are causing the problem. It's and more than anything,
• 53:49
  Speaker 1: like we just need better regulations and enforcement of those
• 53:52
  Speaker 1: regulations to ensure that there's not an incentive to even
• 53:55
  Speaker 1: go into the space and cause that harm in the
• 53:57
  Speaker 1: first place, and then make it easier for the people
• 54:00
  Speaker 1: who are doing good work, which does include a bunch
• 54:02
  Speaker 1: of private companies by the way, yeah, who have done
• 54:05
  Speaker 1: a lot of really great work for people with various disabilities,
• 54:09
  Speaker 1: like to clear the way for them to do their
• 54:12
  Speaker 1: job and do it really well and do it profitably
• 54:14
  Speaker 1: so that they can continue to work. Sometimes there is
• 54:17
  Speaker 1: not a blanket approach that totally works for everyone. I
• 54:19
  Speaker 1: think there just will need to be some room for
• 54:21
  Speaker 1: nuance and consideration. But like I'm not saying that like
• 54:25
  Speaker 1: private industry doesn't work in this space. It totally can.
• 54:29
  Speaker 1: But these private equity investment firms like where everything they
• 54:32
  Speaker 1: touch turns to like so fast the most of the time.
• 54:37
  Speaker 1: And again, like there could be some exceptions to this,
• 54:39
  Speaker 1: but most of the time where we've looked at this,
• 54:41
  Speaker 1: like when private equi got involved, everything fell apart. Like
• 54:45
  Speaker 1: they are just they they cause so much harm and
• 54:49
  Speaker 1: they make just a few people a little bit richer.
• 54:52
  Speaker 2: That's it. That's it, And there's data to support that, Like, yeah,
• 54:55
  Speaker 2: this is not us being like hyperbolic earning like that.
• 54:58
  Speaker 2: There are plenty of cases, there's plenty of data, plenty
• 55:01
  Speaker 2: of research studies of support exactly what we're saying.
• 55:03
  Speaker 1: So, if you live long enough to acquire a disability,
• 55:05
  Speaker 1: because if you live long enough, you will, or if
• 55:08
  Speaker 1: you know somebody who has any kind of disability, like,
• 55:11
  Speaker 1: then this affects you. And the people for whom that's
• 55:14
  Speaker 1: relevant is like one hundred percent of humans. Yeah, because
• 55:17
  Speaker 1: everybody knows somebody who has a disability. Everybody who lives
• 55:20
  Speaker 1: long enough will have a disability themselves. So like, this
• 55:23
  Speaker 1: is a space that whether or not it affects you
• 55:26
  Speaker 1: right now, it will affect you in the future if
• 55:28
  Speaker 1: you stay alive. Right, So let's try to fix the
• 55:31
  Speaker 1: system now before it becomes your problem and your kid's problem,
• 55:34
  Speaker 1: and your kids and your grandkids problem and everyone else's problem.
• 55:37
  Speaker 1: Like we just can't keep.
• 55:39
  Speaker 2: Going on like this, right exactly?
• 55:41
  Speaker 1: All Right, Well, I think that's all we have to
• 55:42
  Speaker 1: say about private equity in disability. It is bad most
• 55:46
  Speaker 1: of the time, maybe there's a couple of good ones
• 55:48
  Speaker 1: out there, and again, you can write to us so
• 55:49
  Speaker 1: we can call you a liar if you think that
• 55:51
  Speaker 1: that's not true. But yeah, again, I'm willing to accept
• 55:54
  Speaker 1: that there are going to be some private equity investment
• 55:56
  Speaker 1: firms that like, do have their hearts in the right
• 55:58
  Speaker 1: place and try to do this probably maybe probably not,
• 56:00
  Speaker 1: but that might exist somewhere. I just didn't find it
• 56:03
  Speaker 1: in looking through this, and I did want to find
• 56:06
  Speaker 1: silver lining. Matter of fact, I specifically was searching for
• 56:09
  Speaker 1: things that was like benefits, like right. I was like,
• 56:13
  Speaker 1: I had to get down to like simple things like that,
• 56:15
  Speaker 1: like tell me good things. It's like, uh, people get rich.
• 56:19
  Speaker 1: I'm like, that's not that doesn't sound that we're That
• 56:24
  Speaker 1: was not it. Matter of fact, literally all I could
• 56:26
  Speaker 1: find were like, here're the benefits for investors. I was like, race,
• 56:30
  Speaker 1: that's much worse. Yucky, you made it worse. Okay. Anyway,
• 56:35
  Speaker 1: you can tell us your thoughts by emailing us directly
• 56:37
  Speaker 1: infowwdwwdpodcast dot com. You can also reach us on the
• 56:41
  Speaker 1: social media platforms, and we do look forward to hearing
• 56:43
  Speaker 1: from you if you would like to support the thing
• 56:45
  Speaker 1: that we do. Actually hold on before I do that,
• 56:47
  Speaker 1: we are about to read through the credits and like
• 56:49
  Speaker 1: some information about supporting us, and all of that's fine,
• 56:51
  Speaker 1: it's good, it's whatever. I think you'll uh, it's worth
• 56:54
  Speaker 1: doing every episode because we that we depend on it
• 56:57
  Speaker 1: to be a podcast. And then after all of that
• 56:59
  Speaker 1: is done though, which is brief, we'll get through it.
• 57:01
  Speaker 1: Then we're going to recommend some things, and that's where
• 57:03
  Speaker 1: things get really fun. I think, well, I think this
• 57:06
  Speaker 1: whole thing was fun, but yeah, I think it's a
• 57:08
  Speaker 1: fun time. We just recommend some things and you can
• 57:10
  Speaker 1: take that and use it as you will. But we'll
• 57:13
  Speaker 1: get some recommendations first. Let me get through those credits,
• 57:16
  Speaker 1: which is again speaking to you. If you would like
• 57:17
  Speaker 1: to support us, you can join us on Patreon. If
• 57:19
  Speaker 1: you do that, you will get bonus content, add free episodes,
• 57:22
  Speaker 1: early episodes, all kinds of stuff like that. You get
• 57:24
  Speaker 1: to join our community of lovely humans that have taken
• 57:27
  Speaker 1: that leap, and you help us keep being a podcast,
• 57:29
  Speaker 1: and all of that's really wonderful and so a giant
• 57:31
  Speaker 1: thank you for the people who have made the leap
• 57:34
  Speaker 1: to support us. Thank you to Mike m Megan, Mike T. Justin,
• 57:38
  Speaker 1: Kim Brad, Stephanie, Brian, Ashley, Kiara, and Charlie for continuing
• 57:42
  Speaker 1: to provide your support and help us keep doing a
• 57:44
  Speaker 1: podcast thing.
• 57:45
  Speaker 2: You're so great.
• 57:46
  Speaker 1: Thank you so much to my team of people without
• 57:48
  Speaker 1: whom I could not make this podcast writing and fact
• 57:51
  Speaker 1: checking from Shane and myself. Thank you for recording with
• 57:53
  Speaker 1: me today.
• 57:53
  Speaker 2: Shane Hey, thanks for having me.
• 57:55
  Speaker 1: Our social media coordinator is Emma Wilson, and our audio
• 57:58
  Speaker 1: engineer technician who makes all of the sounds work and
• 58:02
  Speaker 1: sound like podcast episode is Justin. If we didn't have Justin,
• 58:05
  Speaker 1: you would not be able to tolerate or what sounds
• 58:08
  Speaker 1: we make.
• 58:09
  Speaker 2: If I didn't have just in my life, I would die.
• 58:13
  Speaker 1: Wow. Not to be dramatic, it's great, but of course
• 58:20
  Speaker 1: thank you all to listening for listening. That is very
• 58:22
  Speaker 1: important and we need you here as well. So I
• 58:25
  Speaker 1: think that is what we have to say for credits
• 58:27
  Speaker 1: before we get to our recommendations or is anything that
• 58:30
  Speaker 1: I missed?
• 58:30
  Speaker 2: No, I think that covers it.
• 58:32
  Speaker 1: I let's recommend some things.
• 58:33
  Speaker 4: Yay recommendations.
• 58:50
  Speaker 2: Okay, I'm gonna recommend a book. I am only about
• 58:52
  Speaker 2: one hundred pages in, but it is completely gripping. This
• 58:56
  Speaker 2: book is called Code Talker, the first and only memoir
• 58:59
  Speaker 2: by one of the original Navajo code talkers of World
• 59:02
  Speaker 2: War Two. It's written by Chester Nez, who was one
• 59:05
  Speaker 2: of the original twenty nine Navajo code talkers. And I
• 59:08
  Speaker 2: think it's pronounced schiss avila. Now, if you're not familiar
• 59:11
  Speaker 2: with this story, which I'm not completely familiar with this story,
• 59:15
  Speaker 2: so I'm kind of learning essentially, one of the things
• 59:17
  Speaker 2: that was essential for winning World War Two, or at
• 59:21
  Speaker 2: least having victories in World War two, we'll say, cause
• 59:23
  Speaker 2: I don't think anybody wins in war, but having the
• 59:25
  Speaker 2: essential battle victories in World War two was the use
• 59:28
  Speaker 2: of Navajo language as coded messages to communicate across American battalions.
• 59:34
  Speaker 2: And they enlisted Navajo peoples to join the Marines and
• 59:40
  Speaker 2: join different military branches and to develop a specific Navajo
• 59:44
  Speaker 2: code that was used to share messages. Now, for those
• 59:47
  Speaker 2: of you don't know, Navajo language is historically an oral history,
• 59:51
  Speaker 2: oral language, not written, so it was impossible to crack.
• 59:54
  Speaker 2: It was never cracked during the war, and that is
• 59:57
  Speaker 2: a huge, huge thing about this. So chester Nez is
• 1:00:01
  Speaker 2: somebody who is Navajo. He grew up on Navajo land
• 1:00:04
  Speaker 2: on some of the reservations and grew up in spaces
• 1:00:07
  Speaker 2: where he practiced a lot of Navajoa traditions. One of
• 1:00:09
  Speaker 2: my favorite things about this book is it's not just
• 1:00:11
  Speaker 2: like here's this battle, here's how we want it, here's what,
• 1:00:13
  Speaker 2: because you'll gets that sometimes with like World War two stories.
• 1:00:16
  Speaker 2: This is like about his life and his upbringing and
• 1:00:19
  Speaker 2: like history and traditions, and you get this really rich
• 1:00:21
  Speaker 2: description about Navajo traditions and belief systems and things like
• 1:00:25
  Speaker 2: the Dney who come in in the people that were
• 1:00:28
  Speaker 2: created by the gods who live in the glittering world,
• 1:00:30
  Speaker 2: which is the world that we live in, and like
• 1:00:32
  Speaker 2: that's part of like some of the belief systems that exist.
• 1:00:34
  Speaker 2: It's it's really incredible. And so if you're somebody who's
• 1:00:37
  Speaker 2: interested in vigenous peoples in American history, it's it's just
• 1:00:40
  Speaker 2: a really great read. And it's told from his perspective.
• 1:00:43
  Speaker 2: Cool it's his stories. It's not it's not an autobiography.
• 1:00:46
  Speaker 2: It's not a biography if somebody else, it's him specifically
• 1:00:49
  Speaker 2: sharing these stories in his life, and it's it's just incredible.
• 1:00:53
  Speaker 1: It also sounds like for people who are interested in
• 1:00:55
  Speaker 1: World War Two, like his team type stuff. We've actually
• 1:00:58
  Speaker 1: had on the list to do one about the code
• 1:01:00
  Speaker 1: talkers at some point because it was such an interesting
• 1:01:03
  Speaker 1: piece of history and used such an incredible part of
• 1:01:07
  Speaker 1: human behavior that's really fun to talk about. So yeah,
• 1:01:10
  Speaker 1: I think that would be a great episode in the future.
• 1:01:12
  Speaker 2: Yeah. Absolutely. And he doesn't pull any punches too. He's like,
• 1:01:15
  Speaker 2: the American government was terrible to us, like and he
• 1:01:18
  Speaker 2: tells stories about how awful it was. I like, how
• 1:01:21
  Speaker 2: like awful they were. So like, I think that's also
• 1:01:23
  Speaker 2: really important to like have that dichotomy of like this
• 1:01:26
  Speaker 2: guy who grew up saying like, hey, these really terrible
• 1:01:28
  Speaker 2: things happen, I still fought for what I believe in,
• 1:01:31
  Speaker 2: and I still participated to support these things. Like it's
• 1:01:34
  Speaker 2: really facetting. It's like a really complex thing. It's super
• 1:01:38
  Speaker 2: super interesting.
• 1:01:39
  Speaker 1: Man, I need to add this one to the list now.
• 1:01:41
  Speaker 2: Yeah, I am way totally hooked, all.
• 1:01:43
  Speaker 1: Right, I'm recommending something much less serious. I recently saw
• 1:01:49
  Speaker 1: the newest I guess this is the sequel. So it's
• 1:01:52
  Speaker 1: the movie Wicked for Good. So one of the most
• 1:01:54
  Speaker 1: popular movies in the country right now. Of course, this
• 1:01:57
  Speaker 1: is the sequel to the first movie, Wicked, and both
• 1:02:00
  Speaker 1: of these are based off of the Broadway musical called Wicked. Yeah,
• 1:02:04
  Speaker 1: for those of you who are not at all familiar
• 1:02:06
  Speaker 1: with the story, it's essentially it's sort of a prequel
• 1:02:11
  Speaker 1: ish set up to tell like the story of the
• 1:02:14
  Speaker 1: Witches of Oz, so of Glinda of the Wicked Witch
• 1:02:18
  Speaker 1: of the West, and they sort of give their origin
• 1:02:20
  Speaker 1: stories for how they came to be, and it goes
• 1:02:23
  Speaker 1: up to and through the events of the Wizard of
• 1:02:26
  Speaker 1: Oz movie, which I think came out in the nineteen thirties.
• 1:02:28
  Speaker 1: But again, you really get like you get to see
• 1:02:32
  Speaker 1: Dorothy and her crew come on the scene a little bit,
• 1:02:35
  Speaker 1: but they're literally like off in the distance most of
• 1:02:38
  Speaker 1: the time.
• 1:02:38
  Speaker 2: Yeah.
• 1:02:39
  Speaker 1: Really, what you see for the majority of the movie
• 1:02:41
  Speaker 1: are the evolution of the relationships of the wizards and
• 1:02:46
  Speaker 1: how they relate to Oz, the Wizard of Oz and everything.
• 1:02:50
  Speaker 1: And so it's and it is a musical. There's a
• 1:02:53
  Speaker 1: lot of singing, but it's I don't know, it was
• 1:02:55
  Speaker 1: just it was a really, really good time. I really
• 1:02:57
  Speaker 1: enjoyed it. I'm typically not a huge and of musicals,
• 1:03:00
  Speaker 1: but I thought this one was really good, and I
• 1:03:02
  Speaker 1: thought the sequel was was just lovely and very well
• 1:03:05
  Speaker 1: done and some really really complex singing. The music in
• 1:03:09
  Speaker 1: it is beautiful. So yeah, Wicked. And then my recommendation
• 1:03:12
  Speaker 1: really is the sequel, Wicked for Good, because that just
• 1:03:14
  Speaker 1: came out. They're a year apart with one another, but really,
• 1:03:17
  Speaker 1: really I really enjoyed it, so I think other people
• 1:03:20
  Speaker 1: will too, and of course other people are because it's
• 1:03:23
  Speaker 1: doing extremely well at the box office.
• 1:03:24
  Speaker 2: Yeah, yeah, yeah, it's a phenomenon.
• 1:03:27
  Speaker 1: Yes. Anyway, if you haven't already, go check it out.
• 1:03:29
  Speaker 1: And if you have already, then you're probably like, yeah,
• 1:03:31
  Speaker 1: I recommend it too. This is gonna be I guess. Yeah.
• 1:03:35
  Speaker 1: All right, So that's Wicked for Good the movie. It's
• 1:03:38
  Speaker 1: currently in theaters. And then Code Talker, the memoir for
• 1:03:41
  Speaker 1: one of the original Navajo code talkers, which is really cool.
• 1:03:44
  Speaker 1: And is there anything you like to add or anything
• 1:03:47
  Speaker 1: I forgot before we sign off?
• 1:03:48
  Speaker 2: No, I think that covers it all.
• 1:03:50
  Speaker 1: Right then? Yeah, Happy International Animal Rights Day?
• 1:03:54
  Speaker 2: Yeah, December tenth, Just going back to it.
• 1:03:57
  Speaker 1: This is Abraham and this is Shane. We're out.
• 1:04:00
  Speaker 2: Ziya.
• 1:04:02
  Speaker 1: You've been listening to Why we do what we do?
• 1:04:04
  Speaker 2: You can learn more about this and other episodes by
• 1:04:07
  Speaker 2: going to WWDWWD podcast dot com. Thanks for listening, and
• 1:04:12
  Speaker 2: we hope you have an awesome day.