PoliticsAside: Behind the GENESIS Program

Congressman Porter was joined by Roseman University's Dr. Renee Coffman and Dr. Tom Metzger to discuss the GENESIS Program. GENESIS is an answer to the challenge of how to effectively merge health services and social services in a way that will truly improve the health of high-risk populations. GENESIS provides high-risk patients with tailored high-tech and high-touch medical and social services aimed at helping them conveniently address barriers to optimal patient and household health outcomes. 

Transcript

Greetings from Washington DC.

0:09

This is another very special edition of Politics aside where I take the opportunity to introduce friends of mine that I think are changing the world one day, one step, one motion at a time.

0:21

And today we wanna talk about something that's near and dear to all of us and that is health care and the challenges for educating to, of course, the delivery of professional services.

0:32

And I have two guests today from Roseman University that are in Utah and in Nevada Roseman University.

0:39

We do have president and co-founder, Doctor Renee Coffman, who is with us today and also Tom Metz Metzger, who is also Vice president of Roseman University before we get into the, the full details of the conversation today.

0:57

Again, I wanted to just recognize the fact that Roseman is on cutting edge of finding unique and important ways to deliver health care into the community and in many cases that may be mobile.

1:09

So today, I want to turn over to Stephanie Walker who is our senior vice president of the Porter group to really start the conversation if you would please.

1:18

Stephanie.

1:20

Thanks, Congressman.

1:21

Y yes, I'm really excited to be joined today by Roseman University who we work with pretty closely who has a presence of footprint on over in the West, like you said, Utah and Nevada.

1:31

Before we dive into a really cool program called Genesis that we, we wanna learn a little bit more about Doctor Kaufman, Doctor Metzger.

1:40

Can you tell us a little bit more about who Roseman is?

1:44

And, and what you guys do over there on the West?

1:48

Sure.

1:48

Stephanie, thanks.

1:50

Rosa University is a private not for profit university was founded by myself and two other co-founders.

1:59

In 1999 we started in Henderson, Nevada and still are in Henderson Nevada.

2:05

And we started with a College of Pharmacy and the reason that we started the program was because there was not a College of Pharmacy in the State of Nevada and there was a huge shortage.

2:18

So as we matured with our College of Pharmacy, many of our partners came to us and said they needed nurses.

2:26

So we started a nursing program, we expanded into Utah with our pharmacy and nursing programs there.

2:33

And then we added the first dental medicine program in the state of Utah.

2:38

And we now have also a college of graduate studies that produces master's degree programs in biological sciences and pharmaceutical sciences.

2:48

And then we are on path to start a, a, an MD granting medical school at our campus in Summerland, Nevada.

3:01

And you know, right now what, I don't think there's anyone who would deny the existence of a health care shortage is both from an access point of view, but also from a health care worker point of view.

3:15

How and, and maybe Doctor Metzger can weigh on this, weighing on this too.

3:19

How is that shortage impacting Roseman if it is at all in terms of program changes or enrollment changes, things like that?

3:30

Well, I I think you know, Roseman has always been responsive to the needs of the community, that's been one of its driving forces in in addition of new programs.

3:37

And that's obviously what's led us to, as Renee mentioned starting out with nursing in 2006 and the, and the looking at a medical school, the need for professionals, especially doctors and nurses, but there are also other professions where the the lack of health care professionals, especially in southern Nevada, you know, drives what we do.

3:58

the medical school.

4:01

iii I think the key there is you need physicians focused on primary care.

4:05

I think this medical school has a very unique mission and a very unique approach to the way it it helps to train doctors and especially keep doctors in Nevada.

4:14

That's one of the major themes for the medical school is keeping those doctors in Southern Nevada.

4:19

And there's, there's an understanding, I think perhaps even conventional wisdom amongst the community, political and leadership that graduate medical education or GME is the solution there.

4:31

But that focus, I I think what I like about our medical school is it adds a new dimension to that, which is when we're looking at recruiting students and building pipelines from students, especially within Southern Nevada and Nevada.

4:43

A lot more largely is taking students that are first gen students that are looking to come into the medical school program.

4:51

And perhaps they come at Roseman, they graduate and they do their residency in, at Harvard or at UCL A or at Johns Hopkins, those students and they have evidence from this, from a prior institution.

5:03

The College of Medicines leadership team has is a cohesive team that had experience together at a prior prior medical school in a different region.

5:10

But what they were able to establish was that those first gen students, if they come from the community, if they train their residency elsewhere, it doesn't matter.

5:20

It doesn't mean they won't come back and won't serve those communities because their ties are usually very strong.

5:25

So I think that adds an additional and complimentary dimension to, it's not just GME, there are other ways that we can do this.

5:32

And there's, there's great support for that program.

5:35

So it really opens a lot of doors for us.

5:38

doctor, doctor, if I could ask a little bit about your facilities, I've had the, the honor to have been to your facilities and have seen firsthand the infrastructure and what you've created there on the campus.

5:53

So, doctor Cropping, tell us a little bit about your facility and how it works as you're, as you're recreating the training for health care professionals.

6:02

Yeah, we should have a very innovative way to train and educate health care professionals.

6:07

And we've actually trademarked the name, we call it the six point mastery learning model.

6:12

And the idea behind this is that we want every health professional that graduates from Roseman University to be highly competent.

6:21

And so, in terms of our facilities, we've actually designed our facilities to really support the learning model that we have.

6:31

our classes are not the typical stadium classroom seating where people can hide in the back row.

6:38

The classrooms are hexagonal shaped so that there can be a lot of interaction between the faculty and the student and, and students with each other.

6:47

We emphasize a lot of collaborative and cooperative learning between the students.

6:52

And, and this is important because it mimics what they're going to see when they get out in health care.

6:58

There's no one that's an island in health care and you have to learn how to communicate with people from different backgrounds, people from different different professions and, and if you don't get practice with that when you're in school, like you do at Rose because we put our students in teams from day one.

7:14

and we, we really have developed a very nice curriculum centered around inter professional education where our pharmacy students, nursing students, dental students and eventually our medical students will all be training together.

7:27

If you don't do that while you're in school, it's much more difficult to do that once you get out.

7:32

So the facilities that we have are you know, really designed to help facilitate the learning.

7:39

But at the same time, they're very very amenable to students.

7:43

Students love learning in our classrooms and it's a pretty exciting place to be really and a place to be place to learn from the Yeah, go ahead stuff.

7:57

I'm sorry.

7:58

No.

7:58

Yeah, I was just gonna say, I, I mean, I think that gives us a really good background about, about who you guys are.

8:03

I do want to briefly ask though you have a, a couple of campuses, you have both Nevada and Utah.

8:10

What, what differentiates the two, what are you offering the same programs or both or, or what makes each unique?

8:18

So our, the, so the way that we've grown has really been very unique with those two campuses.

8:24

We sort of have started with a program in one location and then expanded to the other.

8:29

So the the two campuses, both have pharmacy and nursing.

8:35

The Utah campus has the only has, is the only campus where we offer the doctor of dental medicine degree.

8:43

But complementary to that, we have two resid dental residency programs that are also offered on the Henderson campus.

8:50

So we have an advanced education in general dentistry degree program as well as an orthodontics program here.

8:58

The nice thing about that is, again, it's an, it's a residency program just like you would see with a traditional medical doctor.

9:05

But the training is such that we also offer care to patients in the community.

9:12

And that care is, is typically at a much reduced price.

9:14

So, for members of our community here in Southern Nevada or in Utah that want to come and get dental care from our dental students and our residents of course, supervised by faculty.

9:26

It's sometimes as much as half to two thirds.

9:29

The cost of what would be a as it would be going to a more traditional dentist's office and it's cutting edge because we're trying, we have to show that our students are cutting edge that the next 50 years of practice, not just the last 30 years of practice.

9:43

So, those facilities are, are very much cutting edge and any patient that walks in is gonna get absolute best care well, while we're on that subject.

9:54

of course, facilities state of the art quality of education, state of the art, why, why would a student choose Roseman over another institution?

10:07

And I know there is none like Roseman and we could get into the specific differences.

10:11

But when, when a individual of whatever age category is choosing, what, what would they pick about Roseman that you'd like to share, you know, with those that are listening today.

10:26

Well, that six point mastery learning model that I talked to is talked about is very student centric.

10:31

It is really designed to help students succeed.

10:34

And in fact, I just welcomed a new class of pharmacy students this morning.

10:38

And one of the things that I always like to talk to, say to new students when they come in is when I went to pharmacy school because I, that was my first degree that I got, I walked into pharmacy orientation.

10:48

And one of the deans said to the entire class, look to the left of you, look to the right of you.

10:55

One of those people will not be here when you graduate.

11:00

And we have really turned that on there on its head.

11:02

So I always say when I welcome a new class of students with this six point mastery learning model, look to the left of you, look to the right of you.

11:10

One of those people is going to one or more of those people is going to help you achieve what your goal of graduating and passing the board exam.

11:18

So that's one thing, it's very student centric, but maybe even more importantly is the actual outcomes.

11:24

So the outcomes of that six point math relearning model have been really phenomenal.

11:28

I mean, our last nursing class, our last dental class both had 100% pass rates on the boards exams.

11:34

Obviously, you need to pass the board before you can practice and, and actually earn a living as a pharmacist, doctor, a dentist or a nurse.

11:45

And so this, this, this model really works.

11:49

And you know, with our dental program, it is now, the other two programs have always been shorten timeline from traditional programs.

11:57

Our dental program now just began offering a three year doctor of dental medicine degree.

12:02

And we do that in a way again, that's very student centric.

12:05

The the cost of education has gone down because it's three years instead of four.

12:11

So it is significant in terms of the cost savings to the student.

12:15

But secondly, when a student graduates a year earlier, they get out a year earlier, they have an extra year of earning potential.

12:21

So when you really compare apples to apples, our private educational model, with our students finishing in less time than they would in more traditional settings, makes us very cost competitive with even state school in state tuition.

12:40

So when I was a member of Congress and, and had a, a strong focus as today and into health care.

12:48

And in fact, seniors, young adults and Children, one of the things that we discovered and had num numerous town hall meetings across the country to talk about health care was the challenge of finding trainers to train of the students.

13:04

So what are you finding in, in your world?

13:07

As far as finding the professionals that will want to train and train the trainers, what's happening?

13:16

Well, I think again, we've been very fortunate.

13:20

you know, we don't really have high turnover rates amongst our faculty.

13:24

Number one, but number two, we tend to attract faculty who are very al very much also in tune with this six point mastery learning model.

13:35

So you do have Padres of professionals in out out there that are really, they really do want to make a difference in students and students lives and their education and they really gravitate gravitate toward this this model.

13:50

So we've been able to attract very high quality faculty and more importantly, retain those faculty and some of the faculty that I were those that were in today, today's orientation session with the pharmacy students were saying, yeah, this is my 10th year at Roseman, this is my 15th year at Roseman.

14:07

So we've been very fortunate now having said that they overall that that's Roseman specific, but overall it is true that the shortage in health care professionals becomes even more concentrated when you're looking at those health care professionals who are willing to or want to train the next generation of health care professionals.

14:31

And, and you Stephanie, I know you've been working very closely with Roseman and the team.

14:36

And one of those areas that you've been talking extensively about is, is the Genesis program.

14:41

Stephanie, can you kind of give a perspective of of what you're seeing and, and what we're doing to assist with the Genesis program?

14:49

Yeah, so we'll, we'll let, we'll get into the Genesis program here, which is this pretty, you know, the technical term I think is really neat program that brings health care out into the community to address the holistic health needs of individuals before they or after they're within the health care system.

15:10

I'll let the team talk about some of the goals, but I know some of the goals are to address address issues which can cause chronic health care concerns before they become chronic.

15:21

This is gonna be targeted at neighborhoods who historically do not have equitable access to health care or equitable access to groceries or clean air or, you know, the things that cause other health care concerns.

15:35

So, you know, Renee Tom, please jump in, tell us a little bit about Genesis what it is and why Roseman has decided to adopt it and, and bring it to their campus areas.

15:49

I've been doing all the talking.

15:51

So I'm gonna let you jump in here with Genesis.

15:55

Well, I I think this is really consistent with the vision of the Dean, Doctor Joe Greer.

16:00

because there's a huge emphasis on social accountability in the College of Medicine.

16:04

And so the focus of care in the Genesis program is the most underserved areas in the community.

16:11

and the, the, the center of that is the household.

16:14

So the the term household centered care has kind of become a thing you know, with enrollment and within Genesis because the the the care actually takes place in the household.

16:24

It's not an individual patient necessarily, that's the center of that of that health care provision.

16:31

It is the household because there's so many things that are connected and they are that are interconnected, whether it be the the members of the family or whether it be, you know, different aspects of what that family is experiencing or do they have food insecurity?

16:43

Do they have housing issues?

16:44

Do they have other ancillary issues where the wraparound services can be provided?

16:48

Genesis, it provides a central role, not just in the health care, but in provision of services that are basically improving outcomes of the folks within those communities.

16:59

You know, as an example, it's been demonstrated and it's been documented that you can go into those households and you can save the overall system money because you're keeping those individuals who will be heavy users of emergency rooms by the services that are provided by Genesis, they're staying out of those emergency rooms.

17:14

And it's a, it's a, it's very easy to quantify the value of that.

17:18

An emergency visit costs X $1000.

17:21

We can demonstrate that we saved 100 and 50 of those last month.

17:25

It's multiplication from there.

17:26

So the, the value to the community, the value to the health system, all of which is evident and, and, and runs across the system.

17:35

But I think the vision of social accountability, I, I think Doctor Greer is really passionate about, you know, we go in these communities, we, we take their blood, we take their data and we go away and you wonder why they don't trust us.

17:46

And I think that that's really important point is to go into those communities to have the expertise that the leadership team in medicine has to build trust to enable that possibility of them really improving their outcomes.

17:59

I think that's kind of the, the way I would describe Genesis overall.

18:04

Thank you.

18:04

And I know, you know, I think the both of you have gotten a chance to see a Genesis pretty up close and personal in terms of what you're able to provide.

18:12

Can you give some examples of some of the unique things that the, the Genesis team helps with that is related to health care that, that people might not even think of when it comes to making sure people have access.

18:27

Yeah.

18:27

I, I actually did a ride along with the Genesis team a few months back and, went to a household where, the gentleman who needed care had been in the hospital had, had some, had some long term health issues.

18:43

and one of the first things that they did when they walked in there and I should also mention that he's married, his wife did not speak English very well.

18:52

, she was the one that was sort of triaging things that were coming in and out of the household.

18:59

and it turns out that his biggest problem that day was not necessarily how he was feeling or his current, medical status.

19:08

His biggest problem that day is that he had been receiving bills from the hospital that his wife was tucking away because she couldn't read them and she didn't understand them and she felt like they couldn't pay it anyway.

19:20

So she had this stack of bills that had gone unpaid.

19:24

and so what the Genesis team did was they immediately got on the phone with the folks in, at the hospitals who typically will have some sort of a plan to get people current on their bills and doesn't mean they have to pay the full amount, but they can pay it over time.

19:38

, and it was amazing just to see the relief on the face of both the husband and the wife in that setting that it had been taken care of.

19:47

The Genesis team is bilingual.

19:49

So they were able to explain a little bit more detail about the, the billing and the process and why it was important for her not to stuff those bills away for months at a time.

20:00

but just that the relief on their faces to say, ok, well, somebody was in here to help and understand my most important problem that day.

20:08

That's another thing that Dean Greer has sort of drilled into this program.

20:12

Is it most medical professionals are trained to think sort of in a tunnel vision and they'll walk into a patient and say, ok, you know, how are you doing?

20:22

What's wrong?

20:23

You know, what's your major medical complaint?

20:26

But that may not be the most important thing on that person's mind at that time or even the thing that's going to move that person forward toward health and resilience.

20:36

So, so I thought that was a pretty, that was a great visit for me to go on to really see the benefits of Genesis.

20:44

And then to have our students integrated into that Genesis program when we have medical students and we get our pharmacy and nursing students involved is really important.

20:52

It, it, you can, you can maybe say that in a textbook, but it's not as just upfront and in your face as when you're actually in that patient's home, sort of seeing how they live, seeing what issues they confront and then helping them to deal with that and understanding what wraparound services are.

21:14

So, you know, maybe the docs that graduate from Rosemond will be much more inclined to say, hey, you know what, I need to hook you up with social services here or I need you to hook you up with this.

21:24

Yeah, maybe it's a church oriented, place that's providing food, you know, meals on wheels or something like that.

21:33

So just sort of thinking outside the box and recognizing that that patient and their household or a whole environment or a whole system and you have to think about it from a systems perspective instead of this narrow focus of, well, you know, today I've got a cut on my wrist that doesn't seem to be healing whatever.

21:52

You know, I, I guess to admit the fact that I've of that vintage when I remember our doctor, family doctor would come to our home and be carrying this leather bag with all, all of the, the tools of the trade, I guess at the time, you know, a stethoscope and maybe something to tap on my knee.

22:13

But I, I still remember how much better I felt the fact that the, the doctor and, or his staff cared enough to come to our home and of course, my parents would never abuse that privilege and it had to be pretty serious, but I still remember that.

22:36

it, it's, it changed my life when it comes to a public servant and delivering and trying to change the world one person at a time.

22:44

So I applaud you, I commend you for, for there's more to medicine than prescribing a, you know, some medication and, and there's more to health care than visiting an emergency room.

22:57

It's about that one on one.

22:58

So what you're explaining and, and what I think is, is so cutting edge and bringing health care back to where it used to be, I think is really tremendous.

23:08

Are, are you running into many obstacles with the Genesis program?

23:12

that it, it is, it, it isn't new, but yes, it is in this environment.

23:22

I, I don't know if you want to talk about it, but I mean, we do have, obviously we have partners in our community that are very helpful at directing us to some of these households that need help or helping us to identify some of these wrap around services that we talked about.

23:38

But just like any other startup, probably they, they most difficult issue that we face.

23:46

you know, we are a private institution so we don't receive state funding or anything like that, but some support to help us offset getting this started.

23:55

And, you know, there's a lot of care that we're providing to the community.

23:59

As Tom mentioned, there is a real economic impact to the community when we're able to find these things earlier, keep people out of emergency rooms, keep people healthy, ensure that they are become resilient.

24:13

So they aren't continually using government supported programs necessarily.

24:19

you know, all of those things are important, but it takes some startup funding to help us get over that initial hurdle.

24:27

So from an insurance perspective, how does it work?

24:30

Are, are there challenges with insurance?

24:32

Is there a line item that the the Blue Cross Shield can look at and go?

24:36

Yes, this is covered or not or what are those issues regarding insurance?

24:41

So there are so many issues.

24:44

you know, many of these pay, these households may be on government subsidized programs.

24:51

There are some issues that in fact, the household that I visited because the wife worked, it put them just above the poverty level.

25:01

So they didn't qualify, but at the same time, they were, it was clearly difficult for them to get the full realm of services and, and clearly they still had difficulties paying those hospital bills, which is why the wife was stashing them away.

25:15

So there are those that do kind of fall through the cracks.

25:19

And you know, again, in some cases, it's just helping those folks be able to identify resources that might be available to them and get them on those programs.

25:28

So, so yeah, it is challenging.

25:30

but in the long run, you know, kind of circling back to a, you know, a an element of the question that you asked was in the long run, these will help save health care costs overall.

25:43

And when we can reduce those health care costs, keeping people out of the emergency room, keeping people healthy, getting them to resiliency that lowers the cost overall for everybody.

25:53

So it really is a, a very positive economic impact as well as a positive health outcomes impact that this program can have one of the Yeah, sorry, step.

26:09

No, please.

26:09

Sorry, I was gonna say one of the unique feature of the program is of course, that it's mobile and I like that congress reporter sort of reminded us it's actually a bit of a return to the way we used to do medicine.

26:21

So they're sort of, it's both new and, and old.

26:23

But you know, at a time when everyone is concerned about air quality and climate and what's the role of elec electric?

26:31

I know you guys at Genesis are doing some pretty unique things with your mobile fleet.

26:37

So I don't know if you can talk about that a little bit.

26:39

your electric cars and the art program you guys have that made that possible.

26:48

I don't want to do all the talking, so I'm gonna have this one to you too.

26:51

Yeah, this one.

26:54

As I understand again, this is mostly through the College of Medicine.

26:56

So there are two electric vehicles that are used regularly by Genesis for the household visits.

27:02

And for that outreach, each one has a unique theme and we have reached out to local artists to develop the design for those cars.

27:10

The first theme I believe was mental health through through an, a local artist.

27:17

And so that's one of the electric cars.

27:20

The second one, the theme escapes me at the moment, but we do have those two and we had a different artist design the second car.

27:27

Again, I, I maybe with food insecurity was the, was possibly the, the theme associated with that car.

27:33

But it's you know, it, it's all about that outreach, community building.

27:37

And, you know, I, I think to add to, to what Renee had said before, you know, in terms of the value add in, in Genesis, one of the, the struggles we've had congressman I is, I think it, it's just getting that message out there of what this is and what it does even internally, we've had discussions, what is Genesis.

27:55

And so, you know, we, we've asked this question a lot, but I, I think, you know, there are a couple things to latch on to household centered care.

28:04

You know, the interconnectedness of the household and the household as the unit that is receiving that care.

28:09

And then, as Renee mentioned, both the community and the economic benefit.

28:13

It's clearly there, but sometimes difficult to demonstrate.

28:16

I think that is at least in a time sense can be an obstacle to, to getting it where it needs to be.

28:25

We're, while we're on the subject of, of innovative health care, I guess a test question is what is A I doing?

28:38

And, and how do you see A I involved with genesis and other programs that you're working on artificial intelligence, chat, GP T, etcetera.

28:48

So I'll, I'll, I'll, I'll step into this boldly or pretending to be bold.

28:53

But I think it's gonna change the role of the position.

28:57

I think there will be some reliance on A I for features that they're traditionally given to the physician.

29:03

And, you know, whether it's their their horse sense versus what the, what you're getting from A I in, in, in a purely data driven process.

29:13

There are obviously demonstrated superiority if I, if I can use that term for A I and say, you know, reading a, a radio graph or an x-ray or some other type of image.

29:25

I, I think there are studies that clearly demonstrate that A I will do that statistically in a superior fashion.

29:31

So the role of the physician is gonna change how that's going to change and, and how that's gonna manifest itself in the system.

29:37

Like a lot of things with A I is, is, is to be determined.

29:40

But that's just a few examples.

29:43

Well, you know, a lot of us, will turn to doctor Google first and, you know, I, my finger may hurt and all of a sudden I'm diagnosing myself with, you know, with something, some major disease.

29:54

I expect that more and more people will be turning to Google Chat GP T and trying to get self diagnosed, that's got to be a concern as well, right?

30:06

For health care is overthinking things possibly by a, a patient that, or is that a good thing that they first should advice from Chat GP?

30:17

T that's a tough one because it really depends.

30:21

I, I because you, you laid out both sides, it is a concern and it is an opportunity.

30:26

I, I guess, I think we all do this, we all Google stuff and look at it and depending on how you filter that information and depending on how that you use that information, it isn't necessarily a bad thing.

30:36

However, if you're, if you're going in there and you're looking at the isolated facts and you're not connecting it to anything and you're not talking to anyone.

30:42

If you're not reaching out, you know, that input then becomes very questionable and there's risk there.

30:48

But on the other hand, you know, if you are, if you, if you're, if you just want access to information, it, it is there and sometimes that can help inform you to ask the right questions when you do get access to the physician, assuming that you do.

31:00

So I, I think, I think there's opportunity as well as risk associated with that information access component.

31:07

Well, I failed spelling in fifth grade and I turned to any technique that I can to help with proper spelling.

31:15

So I can imagine what this means for the professional and if used properly, what a great tool it will be and in making life better for so many people.

31:24

I, I know we're running in a short on time, but Steph is there some of the things that you'd like to address before we conclude today?

31:32

I, I just think in a concluding question how Genesis is one program that Roseman offers.

31:39

And if you can articulate it, how does Genes is Genesis reflective of who Roseman is in the community?

31:47

Well, I think the easiest way to answer that is that Roseman does respond to the needs of the communities that it serves.

31:55

That's actually even in our mission statement.

31:58

And so when we identify issues in our communities, whether that is with respect to educating health care professionals, identifying particular geographic regions within our sort of scope of influence where we can have an impact or whether that has to do with the need for care with patients within the realm of health care.

32:20

We look to it's in our DNA to help try to find a solution to that.

32:26

And so I think Genesis along with, you know, where we started our core of offering health professions, degree programs to offset the this the shortage of health care professionals that we saw here in the west, in the mountain West, in particular.

32:43

you know, it just is, is sort of who we are in the DNA.

32:45

And I will mention one other program.

32:48

and one that we're really proud of and it sort of intercalate with, with genesis pretty easily.

32:54

but it was started by an actual, one of our actual pharmacy graduates who was a neonatal intensive intensive care pharmacist.

33:02

And one of the things that she noticed in that unit was how many babies were born with neonatal abstinence syndrome and neonatal Natal abstinence syndrome is when a baby gets born.

33:13

And they've been during the mom's pregnancy, she was addicted to substances, bad substances.

33:21

So this baby has to go through withdrawal, just like a an addicted individual has to go through withdrawal and its most innocent of wives who it's not their fault.

33:29

They didn't take the drugs.

33:31

This baby is born with, with that type of an issue and a problem from the very get go and then that leads to things like you know, maybe child protective services coming in and taking that child away.

33:44

Well, this pharmacy grad solve that problem and devised a program called that we call now empowered to deal with that problem.

33:52

So this provides support to pregnant moms or moms who have recently delivered to help get them off of the substances that have caused them issues and problems in the past to give them support.

34:03

Give them training, give them parenting classes so that they can get off the substances and become a healthy mom that can raise a healthy baby and keep that family intact.

34:14

So, again, empowered is another really good example of a program underneath Roseman Scope that was started by a Roseman pharmacy grad.

34:22

That kind of shows how Roseman has an impact on the communities that it serves Renee and Tom, thank you so much for sharing your vision.

34:34

And what I see is the prevailing model for health care delivery country, if not in the world.

34:40

And we thank you for being true leaders and making the world a better place.

34:45

So thank you for your time, excited for your future and the organization and all those folks out there that really need your help.

34:52

So thank you all.

34:53

We hope to see you very soon and we'll see you in a couple of weeks here in DC, right?

34:58

Yes.

34:58

Thank you.

34:59

Thanks all the best Thank you.

35:01

Take care.

35:02

Bye, thanks.