Community First-Partnering for Upstream Affordability
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About the Show
Affordability isn't just about medical bills—it's about addressing what drives health in the first place. When people have stable housing, access to healthy food and support for mental health, they use the health care system less and live healthier lives.
In this episode we explore how health care affordability starts far upstream—from food security and housing stability to behavioral health and chronic disease prevention. This episode will spotlight community-based partnerships that Blue Cross Blue Shield of Michigan has invested in to address these social determinants of health and ultimately reduce unnecessary costs across the system.
Transcript
Chuck Gaidica:
Welcome to this special series of a A Healthier Michigan Podcast, coming to you from the Mackinac Policy Conference where we're taking a closer look at one of the most urgent challenges in healthcare today, affordability. Welcome to this special series of A Healthier Michigan Podcast, coming to you from the Mackinac Policy Conference where we're taking a closer look at one of the most urgent challenges in healthcare today, affordability.
In this episode, we're looking beyond the exam room to the root causes of health and the powerful role that community partnerships play in health insurance affordability. Stable housing, food security, access to behavioral health, these aren't just social issues, they're healthcare issues. And when we invest in these upstream solutions, the downstream impact is clear, fewer ER visits, lower costs, and better outcomes for everyone. Today's guests bring local and statewide insight into how these partnerships are working.
Tiffany Albert from Blue Cross Blue Shield of Michigan will share how Blue Cross is investing in health equity through grants and partnerships. Jim Ananich of the Greater Flint Health Coalition will talk about how their coordinated community health model is making a measurable difference. Neel Hajra from the Michigan Health Endowment Fund will highlight the data behind social determinant investments.
And Oakland County Executive Dave Coulter will spotlight local programs including behavioral health supports and food security initiatives that are helping residents live healthier lives and easing the burden on the healthcare system. Well, Tiffany Albert is dropping by now. She's Senior Vice President for Community Relations Blue Cross Blue Shield of Michigan. It's good to see you.
Tiffany Albert:
Good to see you, Chuck. Good morning.
Chuck Gaidica:
Good morning. Well, this is a great event where everybody gets together. We're hearing an awful lot this year, and we will in this podcast as well, about things like food access, safety, net clinics, community health agencies, filling in the gap where maybe sometimes there's unpaid care, but Blue Cross is investing in these things, right?
Tiffany Albert:
Absolutely we are. At Blue Cross, we really have a unique social mission. We're committed to increasing access for affordable healthcare, enhancing the quality of care that patients receive, and also improving the health of Michigan citizens and communities. We honestly believe that health insurance affordability starts long before someone walks into a doctor's office or an emergency room.
Factors beyond healthcare access, like housing, food security, transportation, those things can affect everyday well-being and really impact health outcomes. If someone can't access healthy food or they're living in unstable housing, they're more likely to experience chronic illness, mental health challenges, or even end up in the ER. Our investment in Upstream solutions is really part of our long-standing nonprofit commitment to improving the health of all Michigan residents, not just those that carry the BlueCard, and really reducing long-term healthcare costs.
Chuck Gaidica:
So if we dig down to specifics, let's talk about that. Are there certain programs that Blue Cross has supported and then what kind of impact are they actually having?
Tiffany Albert:
Yeah, absolutely. We have lots of programs. So our social mission in Blue Cross Blue Shield of Michigan Foundation, we've literally invested in hundreds of organizations over time and a lot of community-based initiatives across the state that tackle upstream health issues. Some examples might be our support for the Greater Flint Health Coalition, which works to improve the overall health of residents, as well as the quality of the healthcare system in Genesee County and Oakland County.
We're partnering with the Disability Network of Eastern Michigan to promote independent living for individuals that have disabilities. And then we're also investing in collaborating with the Michigan Health Endowment Fund to tackle really critical health issues like access to healthy food, caregiving for older adults, as well as behavioral health.
Chuck Gaidica:
This event is always so interesting to me, Tiffany, because you've got captains of industry, people that use an acronym ROI, return on investment. But when you look at these kinds of programs, how can you measure success, you call them upstream programs, of those upstream programs when the return on investment isn't right now? I'm not getting any money out of it necessarily, but you're getting a whole lot more.
Tiffany Albert:
Yeah, you're absolutely right, Chuck. It really does take time to deliver impact, and we continue to measure not just for a day, a week, a month, or even a year, we're looking at these programs over a period of time. We're looking at health outcomes, as well as system level metrics. We have something called Safety Net clinics. They're a great example of our long-term investment that have led to really impactful results.
Over the past 20 years, we've invested more than $17 million in our strengthening the Safety Net Grant. Those increase access to affordable healthcare, as well as improving health outcomes for both uninsured and underinsured individuals here in the state, again, not just those that carry a BlueCard. Our Safety Net program grantees have actually reduced unnecessary emergency room visits by more than 400,000 over that period of time, which resulted in $200 million in savings for the healthcare system in general.
We also provide high quality, affordable health coverage for people in need, and the Safety Net clinics improve those outcomes for vulnerable populations, like I mentioned, but they also reduce those emergency room visits, uncompensated care costs. And all those things really influence consumer insurance premiums and affordability. We've got a lot of healthy resources as well, like our mental health awareness toolkit that raise awareness about mental health and connect people with community programs and services.
We have dedicated agencies that we collaborate with that train professionals across the state, as well as our support of the qualified health centers and free charitable clinics. So lots of real solutions with measurable impact, and we're here for it all.
Chuck Gaidica:
Well, and those real solutions means that you've got to help create partnerships that are truly somebody Blue Cross wants to work with and vice versa. So talk about this idea of building sustainability into partnerships so that this isn't just a flash in the pan, it goes on for a while with the intention, I guess, of truly improving healthcare and affordability. How is Blue Cross exceeding at that idea of partnerships?
Tiffany Albert:
Well, partnerships are really incredibly important for us. We partner to establish those shared goals, like I mentioned. And then we know that it starts with trust and shared purpose. We really approach every partnership as a two-way street. It's not just a one-way for Blue Cross. We're listening to the needs of the community. We're respecting the expertise of local organizations because we have our own expertise, but they have theirs as well.
The long-term impact really requires that long-term commitment, and that's why we don't just offer one-time grants. We often engage over multiple years in support capacity building. So it's not a one-and-done. There are some people I've met recently that we've supported with grants for decades. We also convene partners to share best practices and break down silos between healthcare, social services, and public agencies. Again, that spirit of partnership.
And our success comes from really being a convener, a collaborator, and a co-investor, not just a funder. We don't just write a check and disappear. We're there to do the work. And we know that affordability is a system-wide challenge, and it does take that collaboration and innovation to build healthier Michigan where really everyone has access to affordable healthcare.
Chuck Gaidica:
Well, that's great. I mean, it's great to know that these partnerships are not only flourishing. I mean, when you've got a partner that's Blue, you kind of know that things are going to happen. So that's wonderful to hear. It's good to see you.
Tiffany Albert:
Good to see you as well.
Chuck Gaidica:
Yeah. Thanks for dropping by, Tiffany Albert, who is Senior Vice President Community Relations for Blue Cross Blue Shield of Michigan. Neel Hajra joins us. He's the CEO of Michigan Health Endowment Fund. It is good to see you.
Neel Hajra:
Thanks for having me, Chuck.
Chuck Gaidica:
Yeah, are you having a good time?
Neel Hajra:
Having a great time. It's always fun on the island. You get to see a thousand people that you don't run into every day the rest of the year.
Chuck Gaidica:
Yeah. The Michigan Health Endowment Fund, it enables programs all over the state to focus on improving health. And that's always been a thing. And you do this in different ways, but what are some of the most effective efforts that you would say you've seen in recent time?
Neel Hajra:
Yeah, that's a great question. So just for the listeners out there, we're the largest health foundation in Michigan. So your question is really a statewide question and we work statewide. So before I give you an example, I want to give you some ingredients into what really works. The first is really focusing on collaboration. So the reality is is none of us alone can improve the well-being of Michigan population. So we have to act in concert public, private, local, regional, statewide.
And so when we make grants, we're not looking to make a singular grant to a singular institution. We're looking for collaboration where that grantee is already working with a network of other actors who are all aligned around the same goal. So that's ingredient one. Ingredient two is making sure the community has a say in the solutions that we're trying to fund. We know from experience that top-down doesn't work.
But when you listen to a community, they're closest to the issues, they know what some of their barriers are better than we do. So when we combine their knowledge and expertise with ours, that 50,000 foot expertise, we're looking for grantees who already embed that community voice and thinking into the work that they're bringing to us. So you've got collaboration.
You've got community voice. And then the last piece I'll mention, there is no single grant I'd point to as the silver bullet that solved anything. We think in terms of a systems approach. So in any grant we make, let's say it's at the community level, is there a state policy that makes that work harder or easier? Is there an infrastructure in that county where we've made that local grant that facilitates the goals that we're trying to achieve?
And so if you don't mind, I'll give you one example. Community health workers are a really cost-efficient way to improve health outcomes for communities that traditionally don't have a lot of access to health systems or resources. Think of them as a bridge between a community member, a health system, but also other supports, transportation, housing, financial assistance.
All of those things come together so that the community health worker can take a whole person approach. Great. The data shows the more community health workers are there, the better the health outcomes are at a very cost-effective way. So I got good news. The good news is state Medicaid office recently started reimbursing for community organization's use of community health workers.
That means we'll see more community health workers across the state lowering the cost of healthcare and improving health outcomes. However, okay, that's one piece of it. And many, many institutions partnered with the state to make that happen. Turns out community organizations weren't aware necessarily of this change. So we had to make another round of grants to build awareness of those closest to the community that you can now bill for reimbursement for community health workers that you hire to do your work.
Well, now we've run into another barrier, which is a lot of these community organizations don't have the capabilities to bill Medicaid for these things. So now we're investing in umbrella groups that can do collective billing for many community organizations. We're talking about many, many grants all towards the same goal, but you've got to take the systems approach. So just to recap, it's collaboration, it's community voice, and it's a systems approach that we always combine into all the grant-making that we do.
Chuck Gaidica:
But how much you must be learning then about getting down to this boots-on-the-ground level, so that when you do start to attack issues like senior care, food disparities, you've learned from other systems, other ways, these other umbrellas, you're probably able to duplicate some of the best in practice across the board?
Neel Hajra:
That's exactly what we're trying to do. Another interesting story is we did a pilot with four different communities on certain behavioral health access outcomes we wanted to achieve. It turns out all four communities really disparate in where they were in Michigan were running into the same policy barriers.
So there was a case where we weren't looking at it as a policy issue until we did the on the ground work, and it was communities that really helped us realize there was a policy issue we needed to address as well. And once we did, that would create the environment where we could then scale that solution to other parts of Michigan.
Chuck Gaidica:
So affordability is a big thing that Blue Cross is talking about. Everybody's talking about it even if they don't use that word. When you look at moving towards some of these issues that are problems, if you will, senior care, food insecurity, children's health, where are you seeing the cost savings in the long run? Because obviously you're making grants, but what are you hearing back reflected to you about where money is being saved?
Neel Hajra:
Yeah, that's a great question. And so I want to put it into context. So we grant out about $35 million a year right now. Just to put it into context, that's one less than 1/1000th of the total amount the state spends only on Medicaid. I say that to say, we will not subsidize our way to more affordable healthcare. And really, it's such a massive system, none of us can, right? And so our solution, because part of our mission is to reduce the cost of healthcare, is to move upstream.
The lowest cost form of healthcare is the kind that you don't need because you eat healthy food. You live in neighborhoods that encourage walking and playing by children. You are in circumstances that promote healthy living. And so we have been doubling down on a lot of upstream social determinants of health because we know that's actually the most cost-effective way for folks to live healthy lives.
And the problem, Chuck, is everyone understands medical intervention. So we do invest in health clinics and health systems and health workforce. That's really important. That's tangible and it's immediate. What's less tangible and immediate is if school systems are serving healthier food, those kids 20 years later will still show greater health outcomes.
And another example is if we can help moms be healthy when they're pregnant and babies be born healthier and at better birth weights, that actually predicts a lifetime of less intersection with health systems and therefore less cost of care over a lifetime. However, it is hard to think long-term like that when the problems are in our face all the time. And so one example of how we move upstream is something that's becoming really popular across the state.
It's called Rx Kids. Rx Kids is a new program C.S. Mott Foundation started in Flint. We quickly co-invested with them and we are now investing in the UP. And the model is expecting mothers get a one-time payment that's prescribed by their OB and they can spend that money however they want to.
Then once the baby is born, they get $500 a month for 12 months, and we don't tell them how to use that money. But we started asking them, how do you use that money? And it's not for health visits and it's not for clinical care. It's for groceries. It's for diapers. It's for all the things we take for granted.
Chuck Gaidica:
How about a car seat to be safe if you get transportation, right?
Neel Hajra:
Exactly. And so the reality is is these moms know what it takes to be healthy and keep their babies healthy. They just may not have the resources for it. What we know is already learning from the great work in Flint is we're already seeing better health outcomes very early in this process. And so that's a great example of it's not a medical intervention we funded, we just funded a different way of supporting a mother and a baby to live a healthier life.
Chuck Gaidica:
So how is Blue Cross supporting the work with the Endowment Fund?
Neel Hajra:
Oh, man, in so many ways. First and foremost, the foundation's assets have been transferring from Blue Cross since 2014. That'll continue through 2032. So we exist because of those transfers. And it's sort of this quiet, untold story that I don't think a lot of people are aware of is right now, Chuck, that's $100 million a year Blue Cross is investing in the health of Michiganders through those transfers to the Michigan Health Endowment Fund.
We also collaborate deeply with a couple of teams at Blue Cross. Their social mission team actually has been working with us a lot on older adult health issues. And then their foundation has been teaming up with us on UP Health for years. And so Blue Cross puts its own money where its mouth is as well in terms of being really good partners in our work. And then finally, I'll just give a shout-out to Blue Cross.
Every year, Blue Cross hosts a health symposium. Hundreds, hundreds of community health providers from across the state convene. We join it as well because it's just such a great place to see everybody and to learn what's going on. But it is one of the premier convenings across the state, and we hear nothing but positive feedback from our grantees on how valuable that symposium is.
So Blue Cross tends to take kind of a policy-pronged approach to lowering the cost of healthcare and improving health outcomes. And in a lot of ways, they always start with a partnership mentality, and we've really benefited from that.
Chuck Gaidica:
It's all great stuff. It's so good to see you. What an update just from last year. I mean, it's just exciting.
Neel Hajra:
Yeah, it's great to see you, Chuck, and I appreciate the time.
Chuck Gaidica:
Sure thing.
So Dave Coulter joins us now. He's the Oakland County Executive. It is good to see you.
Dave Coulter:
Great to see you, Chuck.
Chuck Gaidica:
Yeah, thanks so much. What a great conference, huh?
Dave Coulter:
It's been amazing, and it's sometimes hard to quantify for people that aren't up here. What did you accomplish? What did you do? But the seeds that get planted up here, the conversations that happen I really do think bear fruit. Sometimes not immediately, but it's a great group of people and a special place.
Chuck Gaidica:
There's so much going on in Oakland County. You've supported over time local programs that are focused on mental health, food access, all of this aimed at improving the lives of residents and their health. Why are those becoming or have become priorities for you?
Dave Coulter:
Because when I think about health, a lot of people think about health, they think of their doctor. They think about the doctor's office, the hospital and the prescriptions and all of those sort of things. But if you really look at it more holistically, health starts when you're healthy and staying healthy, right?
And there's a lot of things that influence whether somebody stays healthy or not that are not medically related. And so I just believe that the county has a responsibility to its residents, and we have a responsibility to each other to promote lives that create long-term health.
Chuck Gaidica:
Well, and that's so interesting because in today's world, as we all age, we always used to think about our lifespan. How old are we going to get? Now it's health span. How long can we go and be healthy?
Dave Coulter:
It really is. It really is. And that's the goal, right? To be healthy, not to need the doctor. And I have Blue Cross Blue Shield insurance, so I'll just say I appreciate it, but I hope to not have to use it. And so I try to do things like exercise and diet and other things that we all know about. And we try to do the same thing for our residents. And we know that it can take many forms. You talk about this notion of social determinants of health.
We know that lower income people have higher incidence of poor health. Education, and literacy and poverty and transportation even can all lead to a reduced access to healthcare and poor health outcomes. So we look at it in Oakland County, we call it Health360. We look at it from the entire way around upstream, some people call it. But how do we keep people out of the healthcare system as much as helping them once they get in?
Chuck Gaidica:
So it's got to be appreciated that a county is doing this because oftentimes we think of this as something that's pretty neutral. It's like, well, they're the guys that help with government and garbage pick up. This is a different thing, and there are some unique partnerships going on in Oakland County too, right?
Dave Coulter:
There really are. And I will say, I occasionally get pushback that why would county government be involved in this? But I do, again, taking the broad view, I think it's my responsibility to help promote the health and welfare of people in Oakland County. Health directly in this. So even though it may not be our direct lane, I believe it's our responsibility to partner with organizations, our FQHCs with Blue Cross, with the health systems, with the nonprofit to support them in their work. Because when they succeed, we all succeed and all do better.
Chuck Gaidica:
So it's public and private. I mean, it's reaching across all kinds of places.
Dave Coulter:
And Oakland County has not done in the past a lot of public-private partnerships. We just stayed to our lane. But we've really reached out to work with Honor Community Health, for instance. I'll throw them out. That's our largest FQHC in Oakland County. They've been a tremendous partner. We could not have brought the resources to our public health offices and clinics that we run if it had not been for them.
We run two clinics. And in the past, you would go there if you needed a vaccination or traditional public health stuff. Now we have mental health services there. We have dental health for children's services there. I'm trying to do all the wraparound services so that it's a one-stop shop for anything that you might need, even human services.
So for instance, if a mom comes in to get her kid vaccinated, but she also just got a shutoff notice from DTE, and that's what's really weighing on her mind and keeping her up at night, we have somebody there that can help figure out how she can get her electricity back on. So again, we look at it 360 holistic view of health.
Chuck Gaidica:
I had someone tell me years ago that you wouldn't believe the impact of kids that don't have a mattress to sleep on, or what if there's a food disparity? You're talking about the pressure and anxiety that comes from something that maybe we didn't think about.
Dave Coulter:
That's right. I used to do some work with the Children's Hospital of Michigan Foundation, and one of the things I discovered when I was working with Children's Hospital is 60% of the parents don't keep their appointments. And you say, "Wow, are they irresponsible? Do they not care about their kids?"
No. Transportation was the number one access. They don't have a car. They have to try to get the kids on a bus or something, and then the bus doesn't show up. 60% weren't making their appointments. So transportation is a huge health issue for people. So you got to look at it holistically.
Chuck Gaidica:
So you're speaking to leaders who may catch this podcast, but what would you say to other local leaders about connecting the dots here and bringing affordable healthcare to the community? Because a lot of what you just said, we've heard from other people that run hospital groups from Blue Cross, making it affordable to make sure that people aren't just showing up in an emergency room, let's say, as a last ditch effort when indeed they could be healthy before they ever get to the point of a problem.
Dave Coulter:
What I would say to them is this, you may not think this is traditional government role. The good news is you don't have to create the programs and the services because they're already out there. There's already great providers and nonprofits doing this work. They need your help.
So you don't have to hire extra staff to do this. You just have to be open to meeting the partners that are doing this work and helping figure out how you can better support their efforts. And I will tell you, if you do that, it'll make a measurable, impactful difference in your communities. And that's what we're here for.
Chuck Gaidica:
Well, it's good to see you.
Dave Coulter:
Great to see you, Chuck.
Chuck Gaidica:
Thanks for all you're doing. Be well.
Jim Ananich is with us. He's the president and CEO of the Greater Flint Health Coalition. Good to see you.
Jim Ananich:
Good to be seen. Good to be here.
Chuck Gaidica:
Yeah. How's the conference going for you?
Jim Ananich:
It's great. The weather's wonderful, and it's been a lot of good meetings and a lot of good panels, so it's been fun.
Chuck Gaidica:
I just heard someone say to us that thousands of people to network with, and it really is that.
Jim Ananich:
You run into people just randomly on the porch or at a different restaurant and it's great.
Chuck Gaidica:
So in your role, you must do a lot of juggling, right? Community organizations, hospitals, health plans. You're working with all of the above and then some. So what kind of partnerships are you seeing right now that are helping people the most?
Jim Ananich:
Yeah, I think partnerships are really critical. And obviously our health plans, especially Blue Cross and the hospitals are anchor organizations. We have 36 people on our board and partnerships way beyond that. For instance, we'll work with the health plans or a health plan and the National Kidney Foundation on issues of activity and eating healthy so that folks don't have diabetes and work with the Heart Association and making sure that folks are doing the early detection and things like that.
Because from a cost standpoint, if you wait until the end, if you're in the emergency room, we've already failed the person. The health issues are much more important than the cost, but both those are relevant. And if we can upstream get those issues and help people so they don't have those problems, it's a win for everybody.
Chuck Gaidica:
So affordability is a big word being used this year, especially by Blue Cross. But the idea of upstream, I'm hearing that from a lot of our guests on this podcast, by starting at let's say food insecurity or housing. If you start to deal with some of these issues upfront, you're reducing anxiety. You're encouraging people to be healthy first, right?
Jim Ananich:
100%.
Chuck Gaidica:
What are you seeing there?
Jim Ananich:
Yeah, that's the focus of our work.
Chuck Gaidica:
Is it?
Jim Ananich:
Yeah. That's the work we do with Blue Cross, with the other plans, the hospitals, is we find out what's causing you not to get the care you need. Is it you don't have a primary care doctor? Okay, we'll find you one. You don't have transportation to get to the doctor, so you keep missing appointments and that's causing you to go to the emergency room? Okay, we'll help fix that. So those kind of what they call social determinants of health, addressing those early on, as you said, upstream is going to, one, save a lot of money and it makes people have a much healthier output.
Chuck Gaidica:
Do you actually see the metrics of the money being saved?
Jim Ananich:
Yeah, and we're doing a study right now. We did one through the Department of Health and Human Services. I think it was 20... It's the end of Governor Snyder's term, beginning of Whitmer's term. We saw significant savings. The problem was in that study part of the time was during COVID. We controlled for it, but nobody was going to the hospital during COVID. So the numbers got skewed a little bit, so we're studying it again.
Because we saw multimillion dollars in savings for health plans because they're just not missing the appointments. They're not going on dialysis for the rest of their life. All those kinds of issues. Once we've reached that point, it's just a massive amount of money and a much less quality of life.
Chuck Gaidica:
And I'm sure you see personal stories and then even the broader case where some of these efforts are producing tangible results that maybe you can't see for a few years. If you're encouraging me to be healthy and I'm not becoming a diabetic, but that may not show up for a while, but all of a sudden I'm walking more, I'm less stressed. You know?
Jim Ananich:
Yeah. The problem too is it's like if you were going to be a diabetic and we helped you not become one, it's hard to prove that that was going to happen other than just you can look at the person and see that they're healthier, they have better test results. So some things have to be quantified, I think. I mean, I think if you can, it's great, but there's no question it's a saver, and it's just a better way to look at public health.
Chuck Gaidica:
I would have to say of almost all the guests that we've talked to in the past couple of days here on Mackinac, the word partnership comes up. And I don't know when this, in my mind anyway, it used to be, especially when we've interviewed heads of government now, folks like you, where these are public and private partnerships. It seems like the old days, whatever, the old days were, cats and dogs didn't live together. But now these things, partnerships, are real and everybody is seeing the fruit from them, right?
Jim Ananich:
100%. I mean, it was a mistake, I mean, I was in legislature for 12 years, us not doing it before as much as we should. It was a mistake. There's just no question about it. Now it's imperative that we do it. I mean, there's only so much resources and we have to do it. But it's also just more brains looking at an issue is always going to be better than less. So to me, it's an obvious thing we should be doing.
And you also get more grassroots. You find out what the people actually need versus saying, "We think you need this." If you have partnerships, you're going to find out, oh, this is what they really want, and you're going to get a better outcomes from that too.
Chuck Gaidica:
So outside of an event like this, which gives everybody hope and we have a good time and you get to network with people, as you're looking in a couple years, two to five year forward, what's encouraging you about affordability and healthcare and outcomes too?
Jim Ananich:
For sure. One of the things I was looking at when I come to this conference is the work starts the day we leave. We make all the relationships when we're here and the connections. And then now we have to take those connections and form into partnerships. So I'm seeing a lot of that happening. And I think some of the work we're doing in Genesee County and other counties that we represent in and other groups are doing similar things.
We're even doing even partnerships in areas where we're not necessarily providing the work, but we're saying this is what worked for our community and offering ideas. And that's been helpful as well. So I see down the road the siloing effect that happened for a long time, those silos are going to be gone. And we're going to just say, okay, food insecurity is a healthcare issue.
So food is medicine. Let's do these things together. It's going to take a little while to figure out how to do them, but that's a good problem to have versus just knowing a bunch of your people you care for or the clients or patients or members or whatever you want to call it, are food insecure and well, that's somebody else's problem. It's all of our problem. It all relates.
Chuck Gaidica:
And it's really great to hear that. If you've got the keys to the safe and you figured out the plan, why wouldn't you make this open architecture? Why wouldn't Wayne County or Oakland County want to learn from Genesee? Exactly.
Jim Ananich:
Yeah. I say to them, "Hey, everything I'm offering you. If you've got something that is working for you, hey, I'll copy it. I'll cite you. I'm not going to plagiarize, but I'll take your idea and run with it." It's been great.
Chuck Gaidica:
Jim, it's good to see you.
Jim Ananich:
Yes, thank you. You too.
Chuck Gaidica:
Thanks for your time.
Jim Ananich:
I appreciate it.
