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Partnership Health Center's David Quattrocchi · A New Angle

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SPEAKER_02: This is A New Angle.
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SPEAKER_02: Conversations about how we're doing and where we're going.
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SPEAKER_02: I'm your host, Justin Angle.
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SPEAKER_02: This show is supported by the Headwaters Foundation,
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SPEAKER_02: First Security Bank, and the University of Montana College of Business.
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[music]
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SPEAKER_02: Hey folks, welcome back and thanks for tuning in.
0:32
SPEAKER_02: Today is our next edition of The Ripple Effect,
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SPEAKER_02: a quarterly series in which I speak with grantees of the Headwaters Foundation.
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SPEAKER_02: My guest today is David Quattrochi, community organizer
0:42
SPEAKER_01: at Partnership Health Center.
0:43
SPEAKER_01: So finding yourself in the fight,
0:45
SPEAKER_01: which I think good organizers do,
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SPEAKER_01: is framing things in a way that helps people understand this is about all of us.
0:52
SPEAKER_01: David's work illuminates that healthcare is much more than an individual issue.
0:57
SPEAKER_01: David, thanks for joining me.
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SPEAKER_01: Thanks for having me, Justin.
1:00
SPEAKER_01: I appreciate the platform here.
1:02
SPEAKER_01: Yeah.
1:02
SPEAKER_01: So tell us, where did you grow up and what did your parents do?
1:05
SPEAKER_01: I grew up in Southern California, San Bernardino County.
1:08
SPEAKER_01: My parents met at a banking job.
1:12
SPEAKER_01: They both worked downtown at the Bank of America building in Los Angeles.
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SPEAKER_01: My dad was an accountant and my mom more clerk duties.
1:21
SPEAKER_01: Yeah, and how did you make your way to Montana?
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SPEAKER_01: I just felt more spiritually at ease,
1:28
SPEAKER_01: however you'd want to say that when I'd visit the Northwest and wanted to get out of
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SPEAKER_01: the bigger city.
1:34
SPEAKER_01: I lived in Los Angeles proper before I moved here.
1:38
SPEAKER_01: I was working on a grant.
1:40
SPEAKER_01: We only had it for about a year for this housing justice coalition I was with.
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SPEAKER_01: And then a relationship and housing lease and everything kind of came up at the same time.
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SPEAKER_01: I was like, this is the time to do this.
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SPEAKER_01: And so I applied for jobs kind of sprinkled through the Northwest and interviews
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SPEAKER_01: with Partnership Health Center, which is where I work now, went really well.
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SPEAKER_01: And they offered me a job and I just thought this makes the most sense and feels
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SPEAKER_01: the most right.
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SPEAKER_01: Well, you mentioned partnership, your employer.
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SPEAKER_01: What is Partnership Health Center?
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SPEAKER_01: Why does it exist?
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SPEAKER_01: It exists because there is a deep need for affordable healthcare.
2:17
SPEAKER_01: Usually you'll see what's called a federal We have
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SPEAKER_01: a federally qualified health center,
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SPEAKER_01: FQHC, which is what partnership is, pop up in places of deeper need.
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SPEAKER_01: So we have things like sliding scale fees.
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SPEAKER_01: We employ social workers,
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SPEAKER_01: community health workers,
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SPEAKER_01: Tenancy support specialists to kind of bridge the gap
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SPEAKER_01: and help people understand what forms of payment,
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SPEAKER_01: Medicaid, whatever it is that we can work with.
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SPEAKER_01: Now we have clinics pretty diffuse throughout Western Montana.
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SPEAKER_01: It's explicitly created to meet the needs of lower income
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SPEAKER_01: and inaccessible health care elsewhere, but it is open to all.
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SPEAKER_02: Let's draw out this population that you're primarily focused on.
3:03
SPEAKER_02: How is it that those people are left behind by the current system?
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SPEAKER_01: How do you fill that gap?
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SPEAKER_01: Usually we can meet the basic kind of like primary healthcare needs, dental, behavioral health.
3:14
SPEAKER_01: It's more just like a low barrier, high accessibility kind of option for people.
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SPEAKER_02: And you mentioned the sliding scale.
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SPEAKER_02: That's probably a big part of it.
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SPEAKER_02: Sounds like a lot of what you all are able to do is just Meet people whose needs are different.
3:33
SPEAKER_01: Yeah, if you've ever heard the cliche, meeting people where they're at.
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SPEAKER_01: Yeah.
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SPEAKER_01: So we have people who will help the redetermination or renewal process on Medicaid.
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SPEAKER_01: Our approach there in an ideal scenario is that someone would come to help,
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SPEAKER_01: whether they're working in tenancy or community health worker or a social worker,
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SPEAKER_01: to help.
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SPEAKER_01: To get through kind of that arduous process of like how overwhelming that situation can feel.
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SPEAKER_01: I get a bill in the mail and sometimes I spiral.
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SPEAKER_01: So imagine like opening up a packet that you have to fill out that's going
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SPEAKER_01: to determine if you can get healthcare for the next year.
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SPEAKER_01: And encountering pages of that language without someone who hasn't gone
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SPEAKER_01: to social work school or been doing this for years or months.
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SPEAKER_01: So that's the support we try to build into the other services we provide
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SPEAKER_01: at partnership is make it accessible.
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SPEAKER_01: Meet people where they're at, like I said.
4:33
SPEAKER_02: Why would a medical center employ a community organizer?
4:39
SPEAKER_02: Most people just have a problem, they go to the doctor.
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SPEAKER_02: And I suppose before you get into that, let's just define what that term is.
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SPEAKER_02: It was a term that maybe rose to prominence in most people's minds in 2008 when- Obama.
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SPEAKER_02: Obama ran for president and some people embraced him as a community organizer,
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SPEAKER_02: other people disparaged him with that same title.
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SPEAKER_02: What is a community organizer?
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SPEAKER_01: Well- It's quite literally somebody who tries to organize the community.
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SPEAKER_01: Yeah, okay.
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SPEAKER_01: Good definition.
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SPEAKER_01: Yeah, next question.
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SPEAKER_01: Basically, communities can look differently.
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SPEAKER_01: So we can look at the whole community of Missoula,
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SPEAKER_01: very overwhelming, 80,000 people trying to get all on the same page.
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SPEAKER_01: Good luck.
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SPEAKER_01: But for me,
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SPEAKER_01: say if I'm working with people experiencing homelessness,
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SPEAKER_01: That's a community that's somewhat more...
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SPEAKER_01: It's not easy to reach by any means, but there's smaller, more focused population.
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SPEAKER_01: So I would work with them to,
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SPEAKER_01: quite frankly,
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SPEAKER_01: develop a voice,
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SPEAKER_01: a collective voice,
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SPEAKER_01: and try to build avenues to change policy or at least influence it,
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SPEAKER_01: at least mirror the reality back to community members who might be confused
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SPEAKER_01: when they're saying...
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SPEAKER_01: Where's my tax money going?
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SPEAKER_01: Some people know it as a social determinants of health.
6:01
SPEAKER_01: It's in the middle of a kind of a reframe period to social drivers,
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SPEAKER_01: lest we determine what someone's outcomes are going to be forevermore.
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SPEAKER_01: Sure.
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SPEAKER_01: And we should define just this concept.
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SPEAKER_01: If any of us kind of zooms out and thinks like, what impacts or drives our health?
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SPEAKER_01: Of course,
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SPEAKER_01: it's the things we eat,
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SPEAKER_01: it's the things we drink,
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SPEAKER_01: the air we breathe,
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SPEAKER_01: the DNA and genetic factors that might hold things that our ancestors dealt with.
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SPEAKER_01: But then the social driver is access to good food in the first place,
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SPEAKER_01: access to transportation to get us to our work,
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SPEAKER_01: to our appointments, to be able to go see nature, access to nature.
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SPEAKER_01: Access to social, our social situation, built environments.
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SPEAKER_01: All the things that enrich our lives and we're told,
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SPEAKER_01: self-care, you've got to make sure you're doing this and that for yourselves.
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SPEAKER_01: I think a lot of us who are on the spectrum of privilege that don't really have time
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SPEAKER_01: to carve out that in a day,
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SPEAKER_01: trying to make eight appointments by bus,
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SPEAKER_01: let's say, or walking in the rain, let's pour a little more on.
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SPEAKER_01: Sure.
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SPEAKER_01: The social driver of health that day is, I might just give up on my appointments.
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SPEAKER_01: I don't have a car,
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SPEAKER_01: you know,
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SPEAKER_01: and it's hard to navigate this town if you don't,
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SPEAKER_01: you know, have like speedy modes of transportation.
7:29
SPEAKER_01: But it's all these things that basically drives or impacts our health.
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SPEAKER_01: So you just think like, go out one layer.
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SPEAKER_01: And then the structural, this is something else.
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SPEAKER_01: A driver would be policy makers, laws.
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SPEAKER_01: These are the things that we can look at and say,
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SPEAKER_01: well, disproportionately under these, this, you know.
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SPEAKER_01: People of color are more impacted by these policy choices
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SPEAKER_01: because this neighborhood doesn't have a health center or a healthy grocery store.
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SPEAKER_01: It's just a gas station.
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SPEAKER_01: So it's access to those things and it's the meta level kind of stuff.
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SPEAKER_02: You're describing category factors that basically put stress on an individual
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SPEAKER_02: and put stress on specific communities as well and those stressors.
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SPEAKER_02: Whether they're explicit or implicit, have an impact on your health.
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SPEAKER_02: So as a community organizer,
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SPEAKER_02: knowing that there's this set of factors that we're now calling social drivers
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SPEAKER_02: of health,
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SPEAKER_02: how do you then interface with a community in order to maybe address some
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SPEAKER_02: of those factors?
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SPEAKER_01: A lot of it is outreach.
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SPEAKER_01: My approach,
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SPEAKER_01: based on good mentorship and people who are smarter than I
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SPEAKER_01: and been doing this much longer,
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SPEAKER_01: is to try to build some kind of structure where people can do work together.
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SPEAKER_01: What you're describing there...
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SPEAKER_02: I think a listener can easily see how that could translate to a community and
9:00
SPEAKER_02: the role of a community organizer.
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SPEAKER_02: You have to sort of pull the strings and get the right people in the room to give
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SPEAKER_02: that sort of energy
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SPEAKER_01: what it needs to take off.
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SPEAKER_01: Truly.
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SPEAKER_01: And that's, I think, a really good community organizer.
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SPEAKER_01: What I strive to do is kind of be a convener and a connector.
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SPEAKER_01: But I know that a lot of policy decisions that are made in our community,
9:24
SPEAKER_01: statewide,
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SPEAKER_01: nationwide,
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SPEAKER_01: Whether it has to do with criminalizing the use of public space or divesting
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SPEAKER_01: from public housing and social safety nets.
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SPEAKER_01: Those are things that will impact anyone who falls into it.
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SPEAKER_01: So I think finding yourself in the fight is what I call it.
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SPEAKER_01: I don't just want to be a consultant.
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SPEAKER_01: I want to make sure that anything I'm working on is set up,
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SPEAKER_01: maybe not to address immediate needs I need,
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SPEAKER_01: but I myself,
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SPEAKER_01: you or anyone I care about or that you care about would have this safety net here.
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SPEAKER_01: So finding yourself in the fight,
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SPEAKER_01: which I think good organizers do,
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SPEAKER_01: Is framing things in a way that helps people understand this is about all of us.
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SPEAKER_01: And that's when you hear another cliche,
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SPEAKER_01: my liberation is tied to yours, quite literally is an example of that.
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SPEAKER_02: And tell us a success story from this work in your current role.
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SPEAKER_01: One of the things we've worked on is working with a group called
10:25
SPEAKER_01: the Perinatal Substance Use Network,
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SPEAKER_01: which is a collection of parents who were either using substances,
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SPEAKER_01: you know, drug use during pregnancy after it.
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SPEAKER_01: So I've had a lot of really unsatisfactory encounters with agencies
10:43
SPEAKER_01: who were Might threaten to take the kids away.
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SPEAKER_01: It might jeopardize their ability to get into shelters.
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SPEAKER_01: Our job was just to convene.
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SPEAKER_01: And so we went through a really long process of what's called cutting the issue in organizing.
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SPEAKER_01: And that's to really understand over the multiple voices that we had in the room
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SPEAKER_01: as we were in these sessions.
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SPEAKER_01: When you hear patterns,
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SPEAKER_01: this is an overlapping thing that's likely happening to a lot of other people across
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SPEAKER_01: the state.
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SPEAKER_01: And from there,
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SPEAKER_01: we can start figuring out what a policy change would look like or what a training
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SPEAKER_01: for providers might look like to help them understand what
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SPEAKER_01: a parent who's using drugs might be going through
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SPEAKER_01: and what support would look like according to the person most impacted.
11:31
SPEAKER_01: Okay.
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SPEAKER_01: That's just one thing.
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SPEAKER_01: I think that group has been a pretty big triumph.
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SPEAKER_01: You can guess,
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SPEAKER_01: you know,
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SPEAKER_01: drug use is not always the easiest thing to organize around,
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SPEAKER_01: but the group has found its footing and has a really on fire core crew to it now
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SPEAKER_01: of parents with lived experience of this.
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SPEAKER_01: And I mean,
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SPEAKER_01: convening it and now they're on a little dissemination tour talking at conferences
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SPEAKER_01: and Starting to do that and next thing would be to try
12:02
SPEAKER_01: to actually change some things.
12:04
SPEAKER_02: Draw out the connection between your work and Partnership Health Center.
12:10
SPEAKER_02: Are you trying to get people aware of the services you offer and engage in them more readily?
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SPEAKER_02: Are you trying to put yourself out of business by preventing the sort of...
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SPEAKER_02: Ailments that people would come to partnership for in the first place?
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SPEAKER_02: What is the interface?
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SPEAKER_02: How does your role serve the institution?
12:30
SPEAKER_01: I mean, we quite literally have to be the bigger picture.
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SPEAKER_01: I think thinking of putting yourself out of a job.
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SPEAKER_01: It's not going to happen in my lifetime.
12:38
SPEAKER_01: Sure.
12:39
SPEAKER_01: I mean, unless something radically changes just, I mean, in so many ways.
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SPEAKER_01: But I think having that as a North Star or,
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SPEAKER_01: you know,
12:49
SPEAKER_01: the compass of your work means that you're going to do things a little differently
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SPEAKER_01: and not think about My career sustainability or my professional trajectory.
13:00
SPEAKER_01: I mean, I'd be playing drums and painting if we weren't bound to do tedious work
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SPEAKER_01: that is basically fixing up the world.
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SPEAKER_01: We'd all be probably doing much different things.
13:12
SPEAKER_01: Maybe not.
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SPEAKER_01: But I think there has to be a liberatory element in organizing for it to be effective.
13:21
SPEAKER_01: Otherwise, you're chasing funding streams, grant cycles, and I'm on one.
13:27
SPEAKER_01: You know what I mean?
13:28
SPEAKER_02: Yeah.
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SPEAKER_01: And I know it's not gonna happen in my lifetime most likely,
13:33
SPEAKER_01: but I think just having that in mind means you work in a way
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SPEAKER_01: that puts people most impacted first because it is stopping the bleeding.
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SPEAKER_01: We're gonna need health centers in perpetuity.
13:48
SPEAKER_01: We're always gonna need some place when we scrape our knee or get cancer or whatever.
13:53
SPEAKER_01: So we can't put ourselves too much out of a job.
13:56
SPEAKER_01: And there are people who enjoy serving their
13:58
SPEAKER_02: community that way.
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SPEAKER_01: Organizers will probably always be in vogue as well.
14:03
SPEAKER_01: There's always going to be work to do even in Utopia.
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SPEAKER_01: We always got to make it better, I think.
14:10
SPEAKER_01: But yeah, you got to be looking to take yourself out of the equation.
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SPEAKER_01: We're just here to do mutual aid work that builds systems that kind
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SPEAKER_01: of helps us navigate through the current.
14:23
SPEAKER_01: But we have to be building something what we call dual power.
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SPEAKER_01: In the organizing circles.
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SPEAKER_01: And that just means building systems concurrently with the systems that exist now.
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SPEAKER_01: So as those fail,
14:38
SPEAKER_01: since they are,
14:40
SPEAKER_01: hence we need all of these extra programs to fund healthcare
14:46
SPEAKER_01: and just all these intermedias and everyone making a little buck off our health.
14:52
SPEAKER_01: Once we get rid of all of that, we'll need something in place.
14:55
SPEAKER_01: We can't just tear it all down.
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SPEAKER_01: We'll be back to my conversation with David
14:59
SPEAKER_02: Quattrochi after this short break.
15:06
SPEAKER_02: A New Angle would not be possible without the generous support of
15:09
SPEAKER_02: the Headwaters Foundation,
15:10
SPEAKER_02: working side by side with Western Montanans to improve the health
15:14
SPEAKER_02: of our communities.
15:16
SPEAKER_02: And you can't do that sort of work without access to capital and education,
15:20
SPEAKER_02: two critical catalysts offered by First Security Bank and the University
15:24
SPEAKER_02: of Montana College of Business.
15:26
SPEAKER_02: Hey folks,
15:27
SPEAKER_02: I'd like to call your attention
15:28
SPEAKER_02: to Climate Smart Missoula's fourth annual Climate Solutions Week,
15:32
SPEAKER_02: running from September 26th to October 4th.
15:36
SPEAKER_02: This year's theme is Humming Along,
15:38
SPEAKER_02: and the week offers over 20 free events to learn, create, and connect.
15:42
SPEAKER_02: Check out missoulaclimate.org for more information.
15:47
SPEAKER_00: Hi, I'm Nora Sachs.
15:48
SPEAKER_00: I'm the host and reporter of Richest Hill,
15:50
SPEAKER_00: a podcast for Montana Public Radio, and you're listening to A New Angle.
15:58
SPEAKER_02: Welcome back to A New Angle.
15:59
SPEAKER_02: I'm speaking with Partnership Health Center's David Quattrochi.
16:03
SPEAKER_02: You used the word liberation a few times,
16:07
SPEAKER_02: and then you said people forced to live in abject poverty.
16:10
SPEAKER_02: Talk about this concept of liberation.
16:13
SPEAKER_01: Liberation here, basically, I mean the freedom to have your basic needs met.
16:21
SPEAKER_02: So is that a right to have your basic needs met in your conceptualization?
16:25
SPEAKER_01: Well, I think I can say that pretty confidently.
16:29
SPEAKER_01: Partnership has it as a slogan, healthcare is a human right.
16:33
SPEAKER_01: And that's more of a goal, I think, than an ethos.
16:38
SPEAKER_01: It's not yet.
16:39
SPEAKER_01: And some people say housing is a human right.
16:42
SPEAKER_01: And the same lawmakers who criminalize the use of public space will have these things.
16:47
SPEAKER_01: But those are goals.
16:50
SPEAKER_01: And I think anything we can identify as a need,
16:53
SPEAKER_01: food, basic shelter, healthcare, things that take care of us.
17:00
SPEAKER_01: And I think that would look pretty unique to every community and neighborhood.
17:06
SPEAKER_01: And I think the freedom to do that The freedom to be ourselves,
17:10
SPEAKER_01: whatever our identities are, however we choose to live our lives, whoever we love.
17:18
SPEAKER_01: These are just essential freedoms, essential liberatory elements.
17:24
SPEAKER_01: So that's all I mean is just the freedom to be yourself and to be a part of
17:28
SPEAKER_01: a community that takes care of itself.
17:31
SPEAKER_02: That word community, is that the entity that provisions these rights and freedoms in your view?
17:38
SPEAKER_01: Ideally, I mean, we're just communal social beings, right?
17:43
SPEAKER_01: So many people congregate to cities because the resources are there.
17:48
SPEAKER_01: And then even here,
17:49
SPEAKER_01: like over by our local shelter,
17:51
SPEAKER_01: the Pavarello, you'll see a concentration even denser, right?
17:56
SPEAKER_01: We're animals.
17:57
SPEAKER_01: We want resources.
17:58
SPEAKER_01: We need resources.
18:03
SPEAKER_01: Communities, and that's for us to define.
18:06
SPEAKER_01: Ideally, we'd have representatives if that's the form we'd want our community to govern itself.
18:14
SPEAKER_01: Who understand the needs of the community and are there more as bottom liners
18:19
SPEAKER_01: than guessing what might be best for people who have zero experience living
18:26
SPEAKER_01: in abject poverty or as a person who identifies in a certain way.
18:33
SPEAKER_01: We just need mass representation I think for that to become a reality.
18:37
SPEAKER_02: In our remaining time,
18:38
SPEAKER_02: let's bring it sort of back down to some more concrete things that you
18:41
SPEAKER_02: and your colleagues at partnership are doing.
18:44
SPEAKER_02: Like what are some projects on the calendar for this year and maybe in the short run
18:50
SPEAKER_02: that people should know about?
18:54
SPEAKER_01: Well, we're doing a monthly kind of know your policy workshop on some of
19:01
SPEAKER_01: the Medicaid changes coming up.
19:03
SPEAKER_01: So some people have heard the president referred to as the big,
19:08
SPEAKER_01: beautiful, It's more technically known as HR1.
19:13
SPEAKER_01: This bill has a lot to do with many social safety nets.
19:18
SPEAKER_01: In terms of Medicaid,
19:19
SPEAKER_01: there's just more frequent check-ins,
19:23
SPEAKER_01: so another packet to fill out now every six months instead of one year,
19:28
SPEAKER_01: more work requirements and volunteer requirements.
19:33
SPEAKER_02: So some would argue that these requirements make the system more accountable
19:40
SPEAKER_02: and operate more efficiently and effectively.
19:43
SPEAKER_02: Others would say this puts barriers between people in need and the resources they need.
19:49
SPEAKER_02: I think you could make a strong argument that both positions are correct,
19:54
SPEAKER_02: but in your experience interfacing with these communities,
19:58
SPEAKER_02: I'm sure you would favor the latter explanation.
20:02
SPEAKER_01: Yeah, I think professionally,
20:03
SPEAKER_01: I've got to say,
20:04
SPEAKER_01: I've just learned from people who do need to go through this determination process.
20:11
SPEAKER_01: Yeah, the more paperwork, the more problems.
20:14
SPEAKER_01: Yeah, harder.
20:15
SPEAKER_01: Harder.
20:15
SPEAKER_01: It's a reason to quit.
20:17
SPEAKER_01: You said it.
20:18
SPEAKER_01: And we saw that a few years ago with the sunset of the program coming up,
20:24
SPEAKER_01: and we ended up expanding it here.
20:27
SPEAKER_01: But thousands, tens of thousands fell off during that.
20:31
SPEAKER_01: Just the difficulty to keep up administratively has been a challenge for the state.
20:35
SPEAKER_01: And so this will create more work as well.
20:38
SPEAKER_01: And one of the things,
20:40
SPEAKER_01: there will be more frequent eligibility checks and enrollment barriers
20:44
SPEAKER_01: through state.
20:45
SPEAKER_01: The pausing of an implementation of recent federal rules that were designed
20:50
SPEAKER_01: to simplify Medicaid enrollment and retention.
20:53
SPEAKER_02: Wait, wait.
20:53
SPEAKER_02: So we're pausing a set of rules designed to make things simpler?
20:57
SPEAKER_01: Essentially.
20:57
SPEAKER_01: Okay.
20:59
SPEAKER_01: I'm sure there are arguments, like you say, either way, but those were paused.
21:04
SPEAKER_01: And like you said, it can lead to coverage interruptions, increased paperwork.
21:10
SPEAKER_01: And it's not ending anything per se, but some people will...
21:15
SPEAKER_01: As we've seen,
21:16
SPEAKER_01: I'm not making it up,
21:18
SPEAKER_01: have kind of self-selected, I'm not going to address this until it's a real issue.
21:23
SPEAKER_01: And no matter what we think morally of this person,
21:26
SPEAKER_01: choices like that that are made out of desperation will often delay care until
21:32
SPEAKER_01: the emergency room kind of issue happens.
21:35
SPEAKER_01: And that's a cost to the whole community.
21:38
SPEAKER_02: And I think it's something that Anyone can grasp.
21:42
SPEAKER_02: I mean, I've got things in my job that are administratively taxing, like travel, for example.
21:51
SPEAKER_02: It's part of my job to travel to conferences,
21:54
SPEAKER_02: and it feels like more and more they make travel a hassle.
21:57
SPEAKER_02: The forms, the way you got to pay for everything.
22:00
SPEAKER_02: Even though I'm in a position of pretty immense privilege relative to
22:03
SPEAKER_02: the populations we're talking about,
22:06
SPEAKER_02: it's still like I got to do all these extra things.
22:08
SPEAKER_02: It's a hassle.
22:09
SPEAKER_02: I'm not going to travel.
22:10
SPEAKER_02: I'm just going to tap out of that part and do other stuff.
22:14
SPEAKER_02: I think anybody can sort of identify with that administrative burden
22:18
SPEAKER_02: and why it's just a disincentive to do the thing you want to do or maybe need to do.
22:23
SPEAKER_01: And then imagine not having a home.
22:25
SPEAKER_02: Yeah, exactly.
22:28
SPEAKER_02: If you're struggling to meet basic,
22:30
SPEAKER_02: basic needs,
22:31
SPEAKER_02: the idea of filling out an additional form would be quite daunting, I would imagine.
22:36
SPEAKER_01: I mean, I've learned from people who do it.
22:39
SPEAKER_01: It is.
22:40
SPEAKER_01: And there's a lot of despair and morale plummet.
22:43
SPEAKER_01: I'm not here to paint a picture that everyone will be suffering and they're just
22:48
SPEAKER_01: so sad about this paperwork, but it's a pain.
22:51
SPEAKER_02: It would seem we need to just build more trust and humanity into the system.
22:57
SPEAKER_02: I don't know exactly how you do that.
22:59
SPEAKER_02: It's probably your job to figure that out.
23:01
SPEAKER_01: At least,
23:02
SPEAKER_01: if not trust,
23:03
SPEAKER_01: at least a way to bridge the misunderstanding of what this difficulty looks like
23:09
SPEAKER_01: for people.
23:10
SPEAKER_01: When systems are set up,
23:13
SPEAKER_01: it kind of rings true that there wasn't enough feedback
23:16
SPEAKER_01: from people People experiencing the thing when,
23:19
SPEAKER_01: I mean, you'll see so much pushback, you know, from advocacy groups.
23:23
SPEAKER_01: And I mean, it depends.
23:26
SPEAKER_01: There's tax codes and things you could go into and kind of learn where,
23:30
SPEAKER_01: you know, follow the money.
23:32
SPEAKER_02: Or just simply blind spots.
23:35
SPEAKER_02: We don't have to necessarily make assumptions about motives here,
23:41
SPEAKER_02: but our first edition of the Ripple Effect,
23:43
SPEAKER_02: we had the leadership from Ford,
23:45
SPEAKER_02: Montana on,
23:46
SPEAKER_02: and they were dealing with a housing issue,
23:48
SPEAKER_02: and the city of Bozeman was developing a survey about housing in the community,
23:55
SPEAKER_02: and they only surveyed homeowners.
23:58
SPEAKER_02: That leaves out a giant swath of the population.
24:00
SPEAKER_02: It's not necessarily ...
24:03
SPEAKER_02: It's not necessarily malign intent, but it's certainly negligence.
24:08
SPEAKER_01: Yeah, and like you're alluding to, it just leaves out a portion of us.
24:12
SPEAKER_01: So you
24:12
SPEAKER_01: don't get an
24:12
SPEAKER_02: accurate view of what the views and needs of the community are.
24:15
SPEAKER_01: At least on that end of the spectrum, right?
24:18
SPEAKER_01: We know what homeowners prioritize and need in that example.
24:24
SPEAKER_01: Everyone else, renters, people who don't have homes at all.
24:30
SPEAKER_01: Once again,
24:30
SPEAKER_01: and that's another part of my philosophy,
24:33
SPEAKER_01: if you'll indulge me,
24:34
SPEAKER_01: is in organizing is you got to work from the bottom up and not so much like
24:41
SPEAKER_01: the bottom of humanity,
24:42
SPEAKER_01: just the bottom of us who are the least privileged, have least access to resources.
24:48
SPEAKER_01: Otherwise, we keep creating things on top.
24:50
SPEAKER_01: We keep creating systems that work for people who have access to this or privilege for this.
24:57
SPEAKER_01: But if we keep doing that, it's a great world for everyone above that certain poverty line.
25:06
SPEAKER_01: And so the systems we build for the most vulnerable will be there for all of us.
25:12
SPEAKER_01: And usually that creates a pretty rich community.
25:15
SPEAKER_01: To go back to your point earlier and say,
25:19
SPEAKER_01: You know, from there, whatever we build is this kind of cherry on top.
25:23
SPEAKER_02: So you mentioned we've talked about partnerships,
25:26
SPEAKER_02: primary population of interest,
25:28
SPEAKER_02: but you did say it is a place where anybody can go for health care.
25:33
SPEAKER_02: Is that a way that people with maybe more means can support the institution,
25:38
SPEAKER_02: go there for your basic health care or like what?
25:41
SPEAKER_02: Yeah.
25:41
SPEAKER_01: How does that kind of work?
25:43
SPEAKER_01: I mean, yeah, that would help a partnership thrive.
25:47
SPEAKER_01: I think we go out of our way to,
25:48
SPEAKER_01: at the very least,
25:50
SPEAKER_01: if there's no crass monetary incentive,
25:53
SPEAKER_01: we at the very least want people to know this option is here for you.
25:58
SPEAKER_01: And that can be maybe nothing having to do with your insurance accessibility.
26:05
SPEAKER_01: We just like the providers that partnership too.
26:07
SPEAKER_01: And it's kind of for people to figure out, but we do want people to know it's for everyone.
26:12
SPEAKER_01: Because sometimes I think when they hear about the sliding scale,
26:15
SPEAKER_01: they think, oh, that's for people without this insurance I have.
26:18
SPEAKER_01: But anyone can come in.
26:20
SPEAKER_02: David, it's been great learning about you, your philosophy, and how you bring it to your work.
26:26
SPEAKER_02: Our closing question, as always, tell us about the last time you changed your mind.
26:30
SPEAKER_02: Okay, I thought of one.
26:31
SPEAKER_01: Oh, great.
26:32
SPEAKER_01: And it's kind of a mind changer, but more just a...
26:35
SPEAKER_01: Just a little tweak, especially as the weather changes.
26:40
SPEAKER_01: When at first,
26:42
SPEAKER_01: when we had some of the colder nights and the snow had stopped,
26:47
SPEAKER_01: I said, ah, it's really nice.
26:49
SPEAKER_01: I love this cold air.
26:51
SPEAKER_01: And one of my buddy,
26:52
SPEAKER_01: Mike, who's on the streets right now, he's like, well, yeah, it was good for you.
26:57
SPEAKER_01: You got to go home and get in the bed.
26:59
SPEAKER_01: And of course I know this.
27:01
SPEAKER_01: I do outreach and like...
27:04
SPEAKER_01: I'll hear about the gas station attendant who wasn't nice.
27:07
SPEAKER_01: You know,
27:07
SPEAKER_01: so I know exactly when I talk to people,
27:10
SPEAKER_01: all of the things that are kind of like harmful or getting on their nerves.
27:17
SPEAKER_01: I think there's just a way that I will talk about those types of things.
27:24
SPEAKER_01: I felt, there's got to be a better term for this, but I felt a bit tone deaf.
27:29
SPEAKER_01: And I'm constantly doing that.
27:31
SPEAKER_01: And that's okay.
27:33
SPEAKER_01: No need to cancel me, hopefully, because we learn.
27:37
SPEAKER_01: And Mike helped me learn.
27:38
SPEAKER_01: He's like, yeah, man, it was freezing last night.
27:40
SPEAKER_01: And I'm like, I totally hear you.
27:43
SPEAKER_01: And it was freezing.
27:45
SPEAKER_01: And...
27:46
SPEAKER_01: You know,
27:46
SPEAKER_01: I'm going to do better not to talk to you about it,
27:50
SPEAKER_01: and I'm not going to pretend like I don't enjoy it now.
27:53
SPEAKER_01: But there's just a way,
27:54
SPEAKER_01: you know,
27:54
SPEAKER_01: you don't walk into what would maybe a movie theater and just start blabbing away,
28:00
SPEAKER_01: right?
28:01
SPEAKER_01: You kind of read the room,
28:02
SPEAKER_01: and this isn't the place for that, and I think it's a good example too, hopefully.
28:08
SPEAKER_01: The stuff we learn when we just talk to people who are not necessarily in
28:12
SPEAKER_01: the same social networks or groups that we're used to being around or have friends
28:19
SPEAKER_01: in or family.
28:21
SPEAKER_01: Beautiful place to land it.
28:22
SPEAKER_01: David, thanks for joining us.
28:23
SPEAKER_02: Thanks, Justin.
28:26
SPEAKER_02: Thanks for listening to A New Angle.
28:28
SPEAKER_02: If you like what we do and want to support us directly,
28:31
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28:37
SPEAKER_02: A New Angle is recorded at Studio 49, a generous gift from UM alums Michelle and Lauren Hanson.
28:43
SPEAKER_02: Our presenting sponsor is the Headwaters Foundation,
28:46
SPEAKER_02: working side-by-side with Western Montanans to improve the health
28:49
SPEAKER_02: of our communities.
28:52
SPEAKER_02: We are also supported by First Security Bank and the University of Montana College
28:56
SPEAKER_02: of Business, with additional help from CED, Drum Coffee, and Montana Public Radio.
29:03
SPEAKER_02: Keely Larson is our producer.
29:05
SPEAKER_02: John Brownell, Jeff Ament, and John Wicks made our music.
29:10
SPEAKER_02: Thanks a lot, and we'll see you next time.