Senior Care Academy
Senior Care Academy is a podcast dedicated to providing valuable information and expert advice on navigating the world of senior care for both senior care providers, and families with aging parents. Hosted by industry professionals, each episode covers a wide range of topics including healthcare options, legal considerations, financial planning, and emotional support for caregivers. If you are a healthcare provider, have aging parents, or are a senior adult, this podcast is for you! Tune in to gain valuable insights and resources to help you make informed decisions and provide the best care for your loved ones.
Senior Care Academy
The Intersection of Legislation and Senior Care with Doug Robertson
What if your career path led you from aspiring research historian to a leader in home care regulation and advocacy? That's the fascinating journey of Doug Robertson, our guest on this episode of the Senior Care Academy podcast. As the Senior Director of Government Affairs at Right at Home, Doug delves into his extensive background in public policy, including his work with the Grocery Manufacturers Association, and shares the intricate details of transitioning into the home care industry in Omaha, Nebraska. Get ready to explore the dynamic interplay between legislation and regulation, and understand why senior care may not see as many targeted bills compared to other sectors.
Doug sheds light on the vital projects and responsibilities at Right at Home, especially their endeavors to comply with new regulations like New Jersey's Domestic Worker Bill of Rights. Learn about the meticulous processes involved in analyzing legislation, crafting essential documents, and communicating these vital changes to franchisees. Through this lens, Doug discusses the critical role of government affairs consultants and lobbyists in ensuring business compliance with state laws. From state licensure and government reimbursement contracting to grassroots advocacy, understand the day-to-day operations and the complexities posed by varying home care regulations across states.
Finally, Doug shares his memorable "eureka moments" in the realm of policymaking and problem-solving, underscoring the significance of data and perspective sharing among stakeholders. Discover the inspiration behind the Home Care Leadership Series podcast and its mission to educate and advocate for home care issues. With insights into the potential impact of AI and technology on home care, along with actionable advice to enhance the quality of life for seniors and their caregivers, this episode is packed with invaluable information. Don't miss out on the expert insights that Doug brings to the table, making this one of the most informative episodes for anyone in the senior care industry.
Hey everybody, welcome to the Senior Care Academy podcast, a podcast focused on innovations, leadership and industry insights from great people in the senior care space and the aging space. Today, we're joined by Doug Robertson. Doug is a seasoned home care regulation and advocacy professional. Doug serves as the Senior Director of Government Affairs at Right at Home, where he leads efforts to navigate and influence legislative and regulatory changes in the senior care market. He has over nine years with Right at Home and Doug has played a pivotal role in ensuring compliance and advocating for the home care industry. His extensive background in government affairs, coupled with his commitment to improving home care services, makes him a vital voice in the senior care advocacy space. Doug, thanks so much for being with us today.
Speaker 2:Great. Thank you for having me. Alex. It's good to be here and talk about home care and what the industry is doing to meet the needs of our seniors, disabled and veterans.
Speaker 1:Yeah, definitely. I was, I guess, pleasantly surprised by your resume or impressed I guess impressed is a way better word with your work in the government. I'd love to learn a little bit more about that. But first could you maybe introduce where you grew up, how you got your start in senior care, maybe a few career paths that you'd been on. Love to get to know you a little bit better.
Speaker 2:Yeah, sure, alex. So I think most people don't choose to become a lobbyist or an advocate. It's oftentimes something you channel into as you pursue some various interests, and that certainly was the case for me, as I desired to be a research historian at one point and somebody suggested to me well, what about public policy and pursuing, maybe, an internship in Washington DC? And so I took up that advice and really loved Washington and stayed there for a number of years and represented food, beverage and consumer product manufacturers at the state, federal and international level through the then Grocery Manufacturers Association, now Consumer Brands Association, and worked with some wonderful people, wonderful member company representatives, who I still interact with today, and then eventually, through a lot of life changes, transitioned out to the Midwest, to Omaha, nebraska and my wife is from Des Moines kind of the Midwest connection.
Speaker 2:We have two kids and two dogs here in Omaha and I spent the last nine years at Right at Home, which is a in-home care franchise or headquartered here in Omaha, and we have a corporate staff I think around 150 employees or so, and not including a lot of corporate-owned locations that we have. We also have about 400 franchise home care locations nationwide and my role is to help our franchise system, our executive team and corporate staff understand legislative and regulatory developments in home care to allow our system to stay abreast of changes and opportunities, and I also enjoy playing a role in the Home Care Association of America in helping the association staff, as well as members, committees and councils, both at the federal level as well as state level, understand some of the challenges and opportunities that our industry faces today.
Speaker 1:Wow, that is amazing. Each of our guests bring to the show something unique about their career, something unique about their current role and whatever company they may be working for. And I've always been interested in kind of the backbone behind what allows these companies to function. And I think of regulation, I think of policy, and I'm glad to have a guest like you on today so we can talk about, like I guess I'd love to learn about the generals of senior care law. I guess, just to put it generally, senior care law, I guess, just to put it generally. And then I'd love to see what right at home does what your role looks like, because that's pretty amazing that you're an expert in regulation. You're an expert in compliance, I'm assuming. Can you talk to me, I guess, just so I'm aware? What is the difference between regulation and legislation? Does that differ at, like, the state or federal level? I'm kind of interested by that.
Speaker 2:Well, legislation is passed by the legislative branch of government, okay, and regulation is implementing language from the executive branch and oftentimes what happens is a bill is passed by the legislative branch, signed by either the president or the governor, whatever the chief executive officer of the organization. Would be language and instructions for the department or the agency, the government agency that is going to implement and carry out the directive in the legislation.
Speaker 2:So you have legislation would pass first, regulation would be introduced and put into place second, and so that's the difference and that's how they work together. Legislation goes through just that the legislative process where there's a bill introduced, there can be committee hearings, floor debate and is going to be introduced in one house either the House or the Senate, or Assembly and Senate and then it'll go through the other house. There might be some type of final negotiations between the governor or the president, and then Congress or the state legislative leaders, and then it becomes a law and then the agency, the department that is going to implement it, will introduce some regulations to implement that bill. That's kind of the relationship.
Speaker 1:Okay, that's pretty cool. How often, I guess, does legislation pass concerning, like, seniors or the aging space, like, is that something that happens frequently? Or you always do? You have like a notification on your phone that's like hey, this just passed. What's the rate of change? Sure.
Speaker 2:So when I was advocating for the food, beverage and consumer product industry, I think there was 10,000 pieces of state legislation introduced that would impact that industry, 700 of which directly impacted and targeted the industry, and I tracked all that. At the state level, home care receives far less attention. I would say there might be 15, 20 bills nationwide that are directly targeted at the non-Medicaid personal care space in the form of some type of legislation about licensing, supervision of care, care plans, quality assurance, something along those lines. Then there's probably oh I don't know, I care to guess maybe about 20 to 30 bills a year focused on Medicaid reimbursement rates in one way shape or form or Medicaid eligibility. But that is really directed at a particular payer source and isn't necessarily targeted at home care because of the services. It's more to do with the money coming from the payer. So that's how I would summarize that Okay.
Speaker 1:You mentioned lobbying earlier that people had suggested, or you said people wouldn't assume that lobbying would lead into home care in any way. Can you talk a little bit about your lobbying experience or your experience with, I guess, seeing legislation pass, maybe the first time it happened? What was that kind of like?
Speaker 2:Well, I think it's an interesting experience and I think my comment was that, you know, lobbying isn't necessarily something a lot of people kind of choose. You become interested in a particular field or industry and you want to see improvements, which then leads to folks trying to figure out how do I influence policy, which then leads to advocacy, or lobbying as it might be called. And it's very interesting to engage with state legislators who are managing hundreds of bills in some cases in a legislative session, perhaps even thousands and trying to manage a lot of different constituency interests and needs. I mean, there's a lot of real needs in the community that could be addressed or improved by legislation, and so it is a game of competing priorities by state legislators to determine which issue is going to get the priority this session and to engage with them to make an argument. Well, it should be our legislative issue that should get the priority and the attention because the need is so great, because of the immediate concern. Whatever the rationale might be, here's some data to support that. So that's a fascinating discussion.
Speaker 2:Case in point Connecticut just had a legislative session this spring where home care received the priority bill number HB 5001, the House bills have a five at the beginning, and number one is the number one House bill, and it was a bill focused on elder care and it encompassed both nursing home as well as home care issues.
Speaker 2:In the nine years I've been doing this, I don't think I've seen a state legislative session prioritize home care as the number one issue.
Speaker 2:There were some circumstances, some recent events, some difficult events that happened in Connecticut that I think led to that elevation, but that made for a very busy session for the state home care association chapter, because they needed to engage with a number of different legislators as well as leadership throughout the entire legislative process, from introduction of bills through various committee hearings and then through floor debate, and then even on up to the governor's office before he signed the legislation into law. And it was signed into law, and now the association will work with the departments that are going to implement various pieces of this legislation. So we had grassroots efforts by a lot of very diligent and dedicated home care agency owners testifying about the bill, meeting with legislators, sometimes waiting in hallways for hours for a key three to five minute conversation with a legislator before they go back in to vote on that bill. So that is a very dynamic experience. What Congress, though, does in years, a state legislature can do in months what?
Speaker 1:takes months in.
Speaker 2:Congress can take weeks or even just days in a state legislature and I bring up the states because the part of the home care industry that I'm engaged in which for the most part, we are not Medicare certified providers because Medicare does not provide ongoing assistance with activities of daily living.
Speaker 2:That's not a benefit Medicare pays for. Medicare would go broke in a week if it did so. Our franchisees and our home care agencies that are members of HCOA. Most of their business, then, is private pay. Families are saving up resources, cobbling together whatever resources they can to pay for home care. There's some Medicaid, there's some VA benefits, but a lot of it's private pay. And because we're not engaged with Medicare, medicare doesn't have oversight over us, nor does it need to. But the states regulate us through licensure and Medicaid is a payer source directed by state governments. So there's a lot of state oversight and state interaction for our home care agencies, who spend a lot of time in state legislature legislators to have conversations and debate much less time before Congress, where maybe it is a federal change, a Medicaid rule, or it is to advocate for some type of policy that kind of nibbles around the edges of our work to provide some new opportunity. Most of our interest is at the state level.
Speaker 1:When a change is presented, it doesn't take years like it would in Congress. That, to me, communicates some type of efficiency, some type of I guess understanding or quickness. What do evolving policies present for home care agencies? What type of opportunities do you guys see as a result of changes happening? Do they impact you negatively, positively? Is it 50-50? What is that like?
Speaker 2:I suppose the outcomes vary.
Speaker 2:Things that can trigger an outcome, as to whether or not it's going to be positive or negative, could be certain events. There could be an event that takes place that leads legislators to think well, we need to act to stop this from happening again, and they may come in with a rather heavy-handed approach. And a one-size-fits-all approach is a common response by policymakers in hopes of eliminating whatever negative event that they don't want to repeat. But it can oftentimes make things quite difficult for those that are trying to follow the rules and the laws and are kind of caught up in this one-size-fits-all approach and even though they weren't the offending actor. So that's one way that there might be a negative outcome. There could be a positive outcome because there is a widespread grassroots effort to affect change, presented with some data, some good data, some good testimony before committees, with examples, and it gets some type of public groundswell of approval behind it and policymakers realize you know, here's something that appeals to my constituents, so I'm going to adopt this or I'm going to vote in favor of it.
Speaker 2:You know I'm thinking right now of some of our home care agencies in Rhode Island. We had a right-of-home franchisee that was engaged in debate there in Rhode Island for a number of years to try to see an increase in Medicaid reimbursement rates and that led the state to study Medicaid reimbursement rates in the five surrounding states. They found that Rhode Island lagged way behind their neighbors in Medicaid reimbursement for home care and they just passed and implemented a 60% reimbursement increase in Medicaid reimbursement for home care in Rhode Island, which is absolutely staggering. I don't think I've ever heard of a state government increasing that amount that much and so suddenly. So that was a great outcome from some positive advocacy.
Speaker 1:What do you guys do to maintain relationships with policymakers and stakeholders in the home care industry?
Speaker 2:I think there's a couple of things to do.
Speaker 2:I mean, it's important to be proactive when there is not a request.
Speaker 2:So, before the industry has requests of policymakers, I think it's imperative for the industry to realize you Congress senators, they have informal public gathering times.
Speaker 2:They might have a newsletter where they put out times they're going to have an informal coffee with or some type of public engagement where maybe it's office hours hours and you can come in. And even if you can't meet with the policymaker, if you can meet with their staff and provide them an introduction of who you are, what interests you, particularly if you're an employer and you create jobs, which is a taxable event and activity, that's something that policymakers and their staff are interested in. Explain to them, from the home care perspective, how you help people stay healthy and happy at home, where they want to be, which reduces burden on facilities. It can stretch out the time before anyone would need to go on Medicaid because they have the opportunity to pay for home care themselves. So I think that's something that needs to be done is talking to policymakers before there's a need and engaging with them at public events and introducing yourself, and that fosters the relationship.
Speaker 1:What would you say are some, I guess, current projects that you have ongoing with Right at Home, and I know you work closely with the franchisees and now you work closely with the franchisees. Can you describe what your? You receive legislation or you receive some type of update to regulation. How do you implement it and what are you currently?
Speaker 2:working on a domestic worker bill of rights, and home care agency employees are covered in the description of domestic worker in that bill, and so that bill passed and now it's going to go into effect in 10 days, july 1. And so there are certain things that home care agencies need to do in New Jersey to be in compliance, and so what I did was I reviewed the bill, looked at the language, looked at resources that we currently have for our franchisees to be in compliance, identified areas where we needed additional documents or improvements in current documents, and then myself, my colleagues here at the corporate office, we worked with a law firm to develop some documents to help our so there's an analysis of legislation.
Speaker 2:There's an analysis of regulation, then there are some documents that are created and then there needs to be communication, and so then we held a webinar and we sent out some emails with the documents, a recording of the webinar, so that the home care agency owner, who's an employer, has the materials needed to implement with their staff to be in compliance with this new law.
Speaker 2:So that's kind of the life cycle of communicating and interpreting and supporting busy employers who, honestly, don't really have time to keep up with everything the state legislature is throwing at them, and so the corporate office of a franchisor is a valuable asset to help franchisees stay abreast of fast moving changes in the policy environment.
Speaker 1:That's fascinating. I find that interesting because at the company that sponsors the podcast Helperly, we primarily build through Medicaid and New Choice Waiver in Utah and it has me thinking about what resources we have access to to know about these updates and these changes. I'm sure it's changes from state to state. Would it be more of like a legal service that would come in and kind of teach you, educate you, on legislation, or are there companies that do that? How common is it to have kind of a third party teach a company about legislation?
Speaker 2:Yeah, it is somewhat common. There are government affairs consultants, lobbyists, in each state capital that a business could contract with to do a number of things. It could be project work, where, on a one-time fee basis, there's a certain number of hours devoted to creating documents or a plan to be in compliance with a particular law. There could be lobbyists that are on a monthly retainer to advocate on behalf of the business before the state legislature and to help repair their client, to testify and engage with policymakers. It really kind of depends on how much time a business wants to devote to advocacy, how much they are impacted by legislation as to who they contract with and for the duration and the scope of work. There really isn't any limit to the amount of the scope of work that you could contract for to be in compliance and to advocate. You just have to make that business decision feel like a sponge, like I'm.
Speaker 1:This is all new information to me. I'm really enjoying it. I kind of want to learn more about the details of your day-to-day. What does your like team look like? What does it constitute? Do you have a specific focus or niche? Do you have, like another person, focus on another factor in the senior care space, like maybe someone's focused on the things about finance or someone's focused on things about concerning housing or, you know, caregiving? Talk to us about like your team's functions.
Speaker 2:Yeah Well, I'm a one of a team of two here right home corporate and Ginger Gill foil is my associate and helps to keep track of a lot of different moving pieces of paper, because our work kind of falls into three buckets. There is state licensure getting, keeping and maintaining compliance with state home care licensing in currently 33 states and that number is growing, and so that could include helping with an application to get a license, helping with a response to a survey that comes because it's an annual survey or it came as a result of a complaint of some sort, whether that's valid or not, and then there needs to be a response. So there are state licensure needs in 33 states. There's also the second bucket would be contracting government reimbursement. Contracting Right at Home does a lot of work with the VA and we provide services home care services to veterans, so there's a contract needed in order for a home care agency to get into that network.
Speaker 2:And then there's a recredentialing, which is basically a three-year validation that you're still doing that work, want to keep doing that work, and there needs to be a response. And then we have a relationship with national VA leaders. In Washington DC I chair the VA advisory council for the Home Care Association of America. We engage with VA leadership about how things are going providing care to veterans nationwide and also engage with the contractors that VA contracts with to create those provider networks. And then there's any number of questions from HCOA members as well as our franchisees on billing practices and policies. A lot of questions there. So that's the second bucket and oftentimes we would get some Medicaid contract related questions as well. Third bucket of our work is grassroots and advocacy studying legislation, regulations and communicating the effects of those things out to our home care system here right at home. So those are the three buckets that pretty much our day-to-day falls into each and every day.
Speaker 1:I'm sure there are, but are there a lot of inconsistent home care regulations across different states?
Speaker 2:They do differ. When you've been in one state, you've been in one state. There could be differences in how the law is written, but then there are oftentimes differences in how the state agency or the state department views that law, implements that law and their view of the home care industry. There are some states that have a very dim view of home care and there are other states that have a very positive view and home care and there are other states that have a very positive view and a collaborative relationship with home care and I can tell you that home care and the quality of care is so much better in those states where there's an open collaboration between state government and the provider groups that are providing care to seniors and veterans. Government and the provider groups that are providing care to seniors and veterans.
Speaker 1:What does that relationship look like? Is it like emails to and from policymakers, lunches, dinners? What type of environment does collaborative entail?
Speaker 2:It certainly can be on a one-to-one basis between the home care agency owner and the policymaker, via email or maybe one of those informal events with a meeting and a conversation.
Speaker 2:I think the education sessions that the Home Care Association of America sponsors for home care agency owners to meet with state legislators as well as state agency representatives that implement the bills and the laws. I think those education sessions are invaluable because it allows a group of home care agency owners to talk to regulators and policymakers and then to be able to listen to each other and hear the feedback and responses. I don't want to name the state, but I was just recently in a particular state home care agency owner meeting and we had one set of policymakers on the stage answering questions while another group of policymakers were listening, and there was an exchange later that revealed, you know, the one policymaker group didn't really understand what the other policymaker group was doing until that meeting. It provided a lot of clarification and helpful education, even amongst policymakers, because oftentimes government acts in a very disjointed way, and so those group settings are a great opportunity for there to be very helpful listening that takes place.
Speaker 1:That's fascinating to me. Would you say it's one-to-one in terms of communication and how quick positive changes happen for home care agencies? Would you say that that's kind of like a one-to-one relationship?
Speaker 2:I guess what you're asking is if there's some type of personal connection, perhaps between the policymaker and home care. Is that what you're getting at?
Speaker 1:Yeah, what you just described really like blows me away, because I haven't heard that happen, where you know, groups of people come together and they communicate and one understands the other and I'm sure positive change and efficiency were upped. When you see those type of events occurring, where an understanding is made, do you see a lot of changes occurring, or are they not related?
Speaker 2:Well, I don't know that it always directly leads to the change, but it definitely helps and it can certainly unlock a lot of clarity and eliminate a lot of preconceived notions and perspectives that people had that they perhaps were missing vital information, and so every one of those types of meetings I think those eureka moments really helped to move things along in the public discussion in a favorable way.
Speaker 1:Have you ever been a part of one of those like eureka moments, whether with like a franchisee or with a policymaker, with your team? Have you experienced that?
Speaker 2:Yes, yes, I have a number of times and it's really refreshing when that happens.
Speaker 1:Does it tend to be like a simple thing you misunderstood? Are they more complex and problems? What would you describe the Eureka as?
Speaker 2:Yeah, I think it's usually a complex problem where there are a lot of moving pieces and different parties involved only see the piece that they're currently responsible for. But then if you can lay out sometimes literally on table, data and a collection of information that perhaps they haven't seen and put into perspective, that can be a very eye-opening moment and help the different stakeholders see the perspective of others and the consequence of their own decisions and policymaking, and then that can lead to some clarity in those eureka moments policymaking and then that can lead to some clarity in those eureka moments.
Speaker 1:I feel like I'm having a really elongated eureka moment with you today. I never knew the function of legislation and regulation. I think that's fascinating. Kind of pivoting a little bit, I kind of want to talk about the podcast you co-host, the Home Care Leadership Series. What inspired you to start that?
Speaker 2:Well, myself and a former colleague here right at home, karen Zuger, and I we would have on some guests to talk about some innovating policies and collaboration taking place in the home care space. We know there's a lot of innovation in the home care space and oftentimes around policy, and that intersection between health care and business and policy is a unique area. We continue to see new developments Right at Home tries to stay abreast of all those developments, to look for opportunities to increase hours of care for our clients, to, as my LinkedIn post that brought about this podcast stated, to try to reduce the cost of care, either to make it more affordable or provide greater reimbursement so that people can get more care and also understand some of the policy changes in state legislatures that would impact home care agencies and have folks on to talk about all those things.
Speaker 1:That's cool. I'm sure there's an impact made. I personally love to listen to the podcast, but how do you guys leverage your shows to educate and advocate for home care issues?
Speaker 2:Well, I think just by having someone on to have that additional perspective and then to communicate that out to the podcast audience, have questions prepared, as you've done today, that address the interests of the speaker and poise the speaker's knowledge with current events, I think all that is a credible source of influence.
Speaker 1:With the rise of AI and with the rise of technology, do you see your role or your position shifting, or even legislation shifting, regulation shifting? Are there any trends related to the use of technology?
Speaker 2:Well, the president has issued a directive about AI, but it is only an executive action, executive order that really doesn't have the force of law behind it. I think the president wanted to at least stake out a position, but it remains to be seen how AI is actually used extensively in the home care environment. I mean, it is used for general business purposes, to improve efficiencies, note-taking or report-making, that sort of thing, right, that sort of thing. But whether or not it can create a product in and of itself or be involved in changing how care is administered, I think we're still some time away from that, and technology usually provides a change or improvement first, and then policymakers are playing catch up to figure out well, is this how we want this to be used, or do we want to steer it in a different direction by introducing some laws governing this?
Speaker 2:I think we're still quite a ways away from legislation with teeth and any type of stick approach on AI, and that'll probably come at the congressional level first, and, as I mentioned earlier, that's very, very slow. Now, if there's some type of public threat in any way by AI and Congress is not acting, or not acting fast enough, you will see state legislatures act quickly, and then it'll be very different responses by different states depending upon the interests and desires of that state. So you might end up with six or seven different AI laws in different states, even though health care is the same for the most part nationwide. But I think most states will just defer to the federal government to manage that. That's something most states are not going to want to touch themselves.
Speaker 1:That's something most states are not going to want to touch themselves. What would you say is currently trending in the legislative sense for, I guess, anybody in any state to keep an eye on or to watch out for?
Speaker 2:I think there are probably two things you know. As I mentioned, there's 33 states that require a state home care license. We're going to see that number grow. I think the respect for the non-medical home care community has grown tremendously and that was augmented by the pandemic when folks had to be at home and we were an essential service.
Speaker 2:There's no question, we were an essential service before the pandemic, certainly during and after the pandemic, certainly during and after the pandemic. So there was a lot of attention and respect given to the home care community providers and our caregivers and the great work that they do every day. So as a result, you'll see more regulation of a community that's more on state legislators' radar. So right now, in May they passed a bill to create a state license law. There are regulations that are currently in open comment period right now, and then there'll be a state license required in Maine to have a home care agency that provides non-medical care, probably within the next year or so. Kansas is also working through a process to create a license law for non-medical home care agencies and we'll see some other states, I think, embark on that course that have not already.
Speaker 2:I think another trend to watch is states that are contemplating a public long-term care insurance benefit. Washington State has already created one where taxpayers pay a certain amount of payroll tax into a fund that will eventually be used for a long-term care benefit accessible by those that paid into the fund, and currently in Washington that's a two-year benefit of $36,000 that can be used for long-term care expenses, because long-term care expenses have risen dramatically in just the last 10 years. Long-term care expenses have risen dramatically in just the last 10 years, driven mostly because of the cost of labor to provide that care. The rising cost of care should be a great concern for policymakers. They should be doing all that they possibly can to make it as efficient and affordable as possible to provide care in the home, rather than making it more expensive, more challenging. So that's something policymakers need to think about. State long-term care insurance funds are one of the things that they're implementing. I said Washington created one. California is studying the same course of action anywhere from a $36,000 two-year benefit to $144,000 benefit.
Speaker 2:Think about that for every person in California, that would be a huge undertaking. Minnesota is contemplating this. New York has legislation in both the Assembly as well as the Senate to create public long-term care trust fund paid for by payroll taxes. States are trying to do something because, as I mentioned at the outset of this podcast, medicare does not provide a benefit that provides ongoing assistance with activities of daily living, which is what really allows people to stay at home and out of facilities if they need assistance from someone and a family member is not available, if that's the case, and they need to pay for that. A lot of folks have not thought or planned for that, which is unfortunate, and there's a lot of opinions about that decision. But be that as it may, that's where we're at, and so what are we going to do about that?
Speaker 1:to, kind of to end it, I think, our listeners. If you're in the senior care space and you see the effects of rising costs, you can approach your local state leaders and advocate for that. Anybody can do that right, like anybody can just reach out to them, communicate with them. We would encourage you to do so. I kind of want to now. After this, I kind of have a better understanding of how things work. I think that's wonderful. Everybody. This has been the Senior Care Academy with Doug Robertson. Doug, thank you so much. This has been one of the most specific episodes I've ever had. I feel like we hit the nail on the head. We didn't just like see a box of nails. You know, it was really wonderful to be with you today, thank you.
Speaker 2:Good to be here, Alex. Thanks so much for the time. Glad it was a help.