Substance Use Disorder: How Granite Wellness is Transforming Recovery.

This episode unlocks the secrets of Granite Wellness Centers' innovative approach to treating substance use disorder as CEO, Victoria Blacksmith takes us behind the scenes of their life-changing programs. Be inspired by the diverse range of services tailored to preempt substance-related challenges, including the organization's deep-rooted commitment to early adolescent intervention and special care for mothers in recovery. Victoria's expertise shines a light on the necessity of evolving language within the field, as we transition from the term "substance abuse" to "substance use disorder" — a change that's not merely semantic but pivotal in reducing stigma and enhancing the support provided.

We vneture into the heart of Granite Wellness Centers with stories from clients who have come full circle to become pillars of support within the community, to the compassionate staff who pave the way for effective recovery. I examine the importance of the right entry points for those seeking help, the organization's strategic expansion to reach more in need, and the powerful impact of transitional housing in securing a stable path for individuals striving for sobriety. Victoria's contribution to our discussion underscores the organization's commitment to accessible care and the remarkable journeys of those who've walked through their doors.

As we wrap the conversation with Victoria, we can't help but express our profound appreciation for the tireless efforts of everyone at Granite Wellness Centers. The stories of transformation and the team's dedication serve as hope, illustrating the incredible work being done to guide individuals and families to wellness. Whether you're personally touched by substance use disorders or have a keen interest in the field, this episode promises to leave you with a renewed sense of possibility and the knowledge that recovery is not just a dream, but a reality being crafted every day at Granite Wellness.

For more information, visit https://www.granitewellness.org/

Thank you so much for listening to this nonprofit story! We appreciate you. Please visit the website to sign up for our email updates and newsletter. https://www.nonprofpod.com/ And if you like, leave me a voicemail to comment on the program, leave a question for us to ask in the future or a message for me, Jeff Holden. I may even use your voice mail message in a future episode of one of our incredible local nonprofit organizations. https://www.nonprofpod.com/voicemail. Thanks again for your support in listening, commenting and sharing the great work our local nonprofits are accomplishing.

Transcript

00:00 - Jeff (Host)
Victoria, welcome to the Nonprofit Podcast Network. 

00:04 - Victoria (Host)
Thank you for having me, granite. 

00:06 - Jeff (Host)
Wellness, I mean the name alone conjures up images of stoic health. It's solid and you're one of the largest substance abuse and related behavioral issue organizations in the region, correct? Yes that's correct. Yeah, tell us what the primary service of the organization is and what your regional territory is, what counties you serve. 

00:29 - Victoria (Host)
Okay, well, thanks for having us. Jeff, happy to be here. So Granite Wellness Centers is primarily located in Placer Nevada County. So we have our largest location is in Grass Valley, it's what we call the campus, and that is kind of your one-stop shop. Essentially every single service we offer is available in that campus in Grass Valley. We also have locations in Nevada City. We have locations in Truckee, lincoln, auburn and Roseville, so we span both Placer Nevada. 

01:00
However, we do provide services outside of just Placer Nevada, essentially all surrounding counties. 

01:06
We have some contracts with Soyolo County, amador, el Dorado, sutter, you know all of the kind of surrounding counties, and I think it's because we have such a vast array of services available kind of under one roof, it makes it really, you know, easy to follow that individual through their treatment process and then it just makes it so much easier on the client themselves to not have to go, you know, from one place to another. So the main focus of what we do is substance use disorder treatment and we treat adolescents, you know, all the way through adulthood at varying locations and levels of care. So we also treat individuals with co-occurring disorders, so that's individuals that have a mental health disorder that is either originated as a result of substance use disorder or the substance use disorder is making. It is exacerbating it, it's making it more difficult for them to function. So it's an array of services of preventative, we have outpatient services, intensive, outpatient, residential treatments. That varies a couple of different levels. So essentially anything you need when it comes to substance use disorder, granite Wellness can provide. 

02:16 - Jeff (Host)
And I'm going to ask you a question. This isn't one we talked about, but I noticed it in your language right now and also on the website substance use disorder versus what we would have normally said substance abuse one and the same, rephrased for a reason. 

02:32 - Victoria (Host)
Yeah, absolutely so. I think you know the DSM has made some changes over time on different disorders, what we call them, and reducing the stigma around it. Right, Because I think when you look at the term substance abuse, you immediately have a negative connotation with the word abuse. Right, and so we know that substance use disorder is a spectrum. Right, because we have individuals that absolutely have no problem engaging in a couple of alcoholic drinks or recreational marijuana use or whatever that looks like, and then it goes all the way to the other end of the spectrum where now their life has become unmanageable. So it's a spectrum, and I think changing the language to substance use disorder removes a lot of that negative connotation, that negative stigma that I think people experience even when trying to get help. 

03:20 - Jeff (Host)
And I agree, I think that's a great choice of words for a diagnostic of some sort, because it is not always a disorder, but it is a spectrum. Some people it's two or three drinks, some people it's a six pack in an evening, and it really is something that can be managed better, I think, if you understand where you are in the spectrum as well. It's polarized, you know, from zero to a hundred, and if you're a hundred, you've got a real big issue. 

03:49 - Victoria (Host)
Absolutely, and I think you know we've evolved in how we look at and how we treat substance use disorder. You know, in the past, the majority of treatment facilities were an abstinence based model. Right, 12 steps. You got to go to this many meetings, you can't drink, you can't and what we've learned and what the research tells us is that that doesn't work for everybody. It's not a one size fits all, and so a harm reduction model which is the language that you hear a lot as well, you know, is what we focus in on as a social model, not necessarily a medical model. So we're taking a look at not just the individual and the circumstance that they find themselves in, but let's go another step broader than that. What does the environment look like, what does their social supports look like, what does their family look like, and how do we support all of those different components to create an environment where they can better function right, where they can have better quality of life, and for some individuals that means abstinence, but for other individuals it might mean something else. 

04:52 - Jeff (Host)
You know, just for the benefit of the listener. You know on your website. I mean, your services are overwhelming, you know, in some cases, and I can only imagine the requirement that you've got to have them all practiced. But you've got inpatient programs, outpatient programs, medical services I'm reading this detoxification, dui classes, recovery residences, adolescent treatment, parents and family services, life skills and wellness, even testing services. I mean, that is a comprehensive list of services for care. Give us a little bit better understanding about the depth of those services and maybe what you see as most frequently used. 

05:31 - Victoria (Host)
Yeah, definitely. So. One thing is our website. It is a lot and it is under construction, so you're going to be seeing a completely new website in the weeks to come to make it a little more user-friendly, easier to navigate, because there is a lot right. 

05:42
So I think the number one need that we're seeing are our county providers and the individuals that we work with seek is detox services. So that is an individual who is currently utilizing substances and requires a medically monitored detoxification from that drug. At times, it will require the induction of certain medically assisted treatment, right. So different drugs that'll help them get through that process, and that's the number one need, followed by just standard residential treatment. So individuals that need you know they need to come and live with us for a little bit and have a change of environment and really focus 100% in on their recovery and themselves. That's what we're seeing as. The second most frequent need is residential treatment, followed by our outpatient, intensive outpatient kind of all of our other programs. 

06:33
I think the most important thing, though, for individuals to just be aware of is if you need help, you don't need to worry about what kind of help, if you just know you need that and you reach out to us. 

06:44
We will help you navigate where would be the most appropriate space to enter treatment. Right, because we'll conduct some assessments and determine, based on the current situation that these individuals find themselves in, what is it that they would benefit most from. So it is a lot, but it's also because we want to make sure that there's access to essentially every point of entry potentially necessary. Right, because we hear a lot about individuals, when they are seeking certain treatment, supports or whatnot from primary health, that, oh, you don't meet criteria for this but you meet criteria for this other thing, and that just might not feel right to that particular client. And so in this space, we do definitely take into account what is it that they're saying they need assessing and then inserting them in all of these components. And for one of our clients, if we, let's say, put them in an outpatient setting and they're like, oh, my cravings are really high, I'm not feeling safe in this setting, I think I need a little bit more we will absolutely elevate their level of care to keep them on that journey. 

07:43 - Jeff (Host)
And if I'm not mistaken, two of those are inpatient, so detox and resident services obviously are inpatient and the third is outpatient. What volume can you handle on detox and resident? 

08:02 - Victoria (Host)
Yes, so currently we have two residential locations. One is located in Grass Valley. It is a 40 bed facility, 20 men, 20 women. They're separated, it's not a co-ed facility. On our women's side we can actually also accept up to 12 children. So that's what we're looking at. In Grass Valley, from a residential treatment standpoint, we have a capacity of, you know, 40 adults, 12 children. At any given time we can have up to eight detoxes out of that. Out of that, 40 count. But you know it varies. It's a lot, it's a lot for our medical staff. So it varies. But we can. We can take. We can take four in that location. In our Nevada City location we can also take an additional four. So we have eight total detox beds. Our Nevada City location is a co-ed residential treatment and that location can hold up to 27 individuals. 

08:51
So in a residential setting we have capacity for a total of 47 adults, 12 children. 

08:57 - Jeff (Host)
In an outpatient setting. 

08:59 - Victoria (Host)
We can handle, essentially at the moment, as many clients as necessary. At times we'll have a short wait list, but we're talking about a week or so before individuals are able to get an intake. But they will be contacted almost immediately following their application. 

09:14 - Jeff (Host)
That's really encouraging to say that you can accept somebody almost immediately, even if it's just within a week. What is the? Not the capacity, but the usage of the facilities. In terms of the inpatient facilities, Are they pretty much full all the time. 

09:30 - Victoria (Host)
Yeah. So I mean, and I think it's because we offer kind of that continuum of care that we call it right so if an individual enters detox, most of the time they will transition into residential when they're done with that detox. So they go from that level of care to residential and then the warm handoff to an outpatient setting. So it does at times create a little bit of a bottleneck. Right, there's definitely more need than there are beds available and that's a statewide problem. But as an organization it is something that we deal with as well. 

10:01
So we do prioritize certain populations right. So our perinatal women, so IV users that are pregnant or they have children, those are definitely a priority. You know there's different criteria that can help individuals get in a little bit quicker. But the wait time is, you know, it is what it is and it fluctuates because also as individuals enter care, some people are like, oh, you know, I want to go treatment for 30 days and it's like, well, that's all great, but well, let's figure out what you actually need. And some people end up identifying that they need a little more. They need 60, they need 90. And so that does impact the flow of individuals that can come in. 

10:37 - Jeff (Host)
Oh, so somebody could be in residential treatment for up to 90 days, or is there a threshold of time that they stay? 

10:43 - Victoria (Host)
There isn't really a cap, you know. So I mean, I think, residential treatment, it depends on the individual In enter treatment, utilizing their Medi-Cal benefits as often as they need to, and then for us, we just we determine what it is that that client needs. But yeah, people can stay up to, I mean, a year. It really depends on them, right. 

11:23 - Jeff (Host)
You hate to see a frequent guest. You don't want them recurring 30 days out. We'll see you next year to see a frequent guest. You don't want them recurring 30 days out. We'll see you next year. Let's get them healthy and get them back into productive citizens, as opposed to recurring. Absolutely. We're talking about the active care part of it. 

11:46 - Victoria (Host)
Is there anything that is relegated to preventative support? Yeah, so I think we have a pretty robust adolescent program and so I think our adolescent program is really looked at as early intervention and preventative services. So we have some relationships with the local schools, we have a therapist that goes into the juvenile hall once a week to provide some of those services, and then we also have services here in our outpatient setting for our adolescents, and so probably one of our biggest, you know, preventative and intervention services. We don't want to see these adolescents as adults come through our program, and so I want to say that we've been pretty successful in that space. You know, I've heard only a couple of one-offs where it's like, yeah, we, you know, we used to take care of him when he was an adolescent, him or her, and now you know they're, they're entering residential. However, that's also a pivotal time, you know. If we get at what we call a TAY, a transitional age youth a youth, you know, 18 to 24, extra supports are given to them, even if they enter a residential treatment center setting, because we know how important it is to support them when they're in those early stages and that could prevent them from coming back later. So adolescent is one. 

12:53
We have an amazing mothers and recovery program, and I would consider that a preventative program as well, because it involves the child right. 

13:00
So while mom is receiving treatment and learning to become, you know, a better and more responsive parent, that child is also, you know, getting some assessments done and ensuring that they have all of the supports that they need. So that would be a preventative component for that child and maybe future children. And then, I think, you know, taking a look at our DUI program, because our DUI program, you know, we have first offenders. We have individuals that get. They've never had a problem with alcohol before, this is their first run in with law enforcement and they're now required to complete some DUI classes, and so providing that service in itself is absolutely a preventative and early intervention. Like, hey, this is your first time, here's what it looks like, but also here's what it has the potential to look like if we don't get this under control. What it has the potential to look like if we don't get this under control. It also allows us to screen individuals at that point in time to identify if maybe they do have something a little more serious that they might need some additional support in. 

13:56 - Jeff (Host)
That's wonderful. I love the fact that you can catch them in a situation, especially with the DUI program, because so many people make that one mistake and it's not recurring. It wasn't intentional, it was just foolish, you know, not not the consequence, it was two drinks versus one and it puts them into that situation. And those seem to be very remedial. You know, once you enter that DUI program, you're done, it's not going to happen again. So I really liked that. And same with the mothers and children. You know, just the education and just the understanding. So those are great preventative services. How about your staff? What does the staff look like? You know, how many people do you have? What sort of licensing do you require? I mean again, because your organization is so big, I can only imagine the size of the team of people that you're working with. 

14:41 - Victoria (Host)
Yeah, so we have about 104 staff at the moment. We do have some open positions and, you know, always looking to grow. And so we, because we do so many things right, we do have pretty much a pretty big spectrum of individuals. So we have, you know, some individuals that are what we call residential support staff, so they are there to support the counselors and support the clients. It's an entry-level position and that transitions into like a certified peer right, so getting some additional education and some support in that space. And then we also have our certified counselors, and so these are, you know, alcohol and other drug counselors that are focused specifically on substance use disorder. 

15:26
We take interns who are currently going through that program and then, as they finish school and become certified, you know, we also have placement for our certified counselors. We also work with practicum individuals both obtaining their bachelor's and their master's degrees. We take interns. We have great relationships with local colleges. We have, you know, a couple of licensed individuals that are some of the most amazing clinical supervisors I've seen who take in these interns and they get this great opportunity to work in so many different modalities. So when you have, like, a master's level intern, that has to have a little bit of a family component, crisis intervention component, and then you know this other component. We can offer that all under one roof. 

16:10
And then, you know, we have other individuals who provide maybe more of a specialized approach to some of these populations. So we have therapists that are solely focused on our adolescent team, we have therapists that are solely focused on our mothers in recovery, and then therapists that just do a little bit of everything. So it's a lot of moving parts all at once. 

16:31 - Jeff (Host)
Well, 104 is a lot to begin with and no shameless plug. What do you need? Let's put it into the episode and say what do you find are some of the services that are short-staffed at this point? 

16:42 - Victoria (Host)
Yeah, so our biggest need is substance use disorder counselors, and I think that the gap exists because some people might not know what that profession really is. 

16:52
I think a lot of people go directly licensure route, which is absolutely understandable, but there's also an opportunity to give back to your community, provide that direct kind of clinical support, without all of those additions, and that is where we're finding ourselves having the biggest gap, and so what we also offer is, if people are interested in that they have some interest in mental health but they don't know how to obtain certification or they might have some financial barriers in order to do that, we offer all of those components with individuals. So I think it's a beautiful thing to take somebody that's really green but has the great heart and to be able to mold and mentor and teach them all of the amazing things that come with, you know, taking care of our community and engaging in somebody's treatment process and so. But we also welcome, you know, our very experienced individuals that bring a wealth of knowledge to the field as well. But substance abuse disorder counselors if you're interested, if you don't know what it's about, check out our website, send us a little message, we will walk you through. 

17:58 - Jeff (Host)
How does one begin the journey with Granted Wellness? How do I get to you? Am I self-administered and saying, here I am walking through the door? Am I brought to you through a program? Does the school recognize the student with a challenge? Is it law enforcement? How do we get to you as somebody in need? 

18:18 - Victoria (Host)
It's a great question and actually all of those are entry points. So we do have direct relationships and contracts with our county partners. So Placer County, Nevada County, Yolo County, right? So if these individuals are Medi-Cal recipients in those particular counties, they can go directly to their county and seek that support. If they're having difficulty doing that, they can approach us and we can initiate the conversation with that county. We also accept all private insurances except for Kaiser and Medicare, and so if individuals have private insurance and they're interested, they can jump on our website and hit the contact us page. Somebody will get back to you within 24 hours to navigate that piece. But we do also work with a lot of law enforcement agencies that call us directly. But we have a lot of individuals that just reach out. They reach out and we're their first point of contact and we just help them navigate those pieces. 

19:11 - Jeff (Host)
How about collaboration with other nonprofit organizations in the counties Do? They also bring people to your services where they're over capacity. They can't they can't handle that many. 

19:23 - Victoria (Host)
Yeah, I think we have a lot of great relationships with local entities and then in some areas where we know that we don't have the capacity to serve, you know we will refer out and they will refer in. So I really, you know, I like to look at what we do in the nonprofit world, especially when it comes to behavioral health. There's no competition here. We're all trying to heal our communities, trying to heal our communities, and so, however, we can work best to support them. Whether that's a referral out or what have you, then that's what we do. You know we meet the client where they're at, and so here we work a lot with some of our like housing county partners so that we can support clients getting into long-term housing. We work with some of the partners that do medication assisted treatment here in Placer County so that clients can receive some take-home medications or whatever it is that they may need. But we absolutely partner and if anybody's interested in partnering, let's have a conversation. 

20:17 - Jeff (Host)
I love that comment right there because I know through the program of many of the organizations they're a capacity and their biggest frustration is they just can't serve anymore. We know the need is there and because you've got such, you have such capacity, it just makes sense for their overflow to possibly be handed off into another treatment program or care facility where they can get the appropriate need. And that's amazing to know. Do you have any stories or any situations where you could exemplify something? Here's somebody that came in through the program, successfully re-assimilated back into the community, that you could share. 

20:59 - Victoria (Host)
Yeah, I think you know, the biggest ones that stick out to me are who we have currently on staff, and so I think we have a lot of clients who have, you know, a great experience when they're in treatment and they're able to get their families back together. Right, women who get reunited with their children. There's a big family component of what we do. We provide some family therapy as well. It's a component of additional kind of support and services. Right, like individuals want to go on a weekend pass, let's make sure we've got your family involved in our treatment process. 

21:33
And so in those spaces what we've seen is we've seen individuals who start in residential. 

21:38
They have their family engage with them in treatment and we see them go to outpatient. We see their family continue to get also that additional support through the community and then we will hear I'll be back, you know, because our policy is one year. You've got to give us one year being out of the program and we will consider you for an entry-level position with the organization. We will put you through training to become a peer, and so we have had individuals who this is our 50th year in business, by the way, so we've had individuals that have come through our program, have successfully graduated, have come in through an entry-level position, have gone back to school and received, you know, higher education and are now in administrative positions in the organization. And so those are some of the most beautiful stories, because you get to continue to watch the story play out. But then you also get to watch these individuals kind of pour their own story and their own experience and energy back into the organization and into our community. 

22:38 - Jeff (Host)
That's the familiarity part where, hey, I've been through this. Don't tell me you can't do it. I've been through it, I'm here, I'm with you. I understand you can't do it. I've been through it, I'm here, I'm with you, I understand. That's amazing that you have the semblance of people who go through the program and then come back in to look for employment? 

22:57
Wow, yeah, I would imagine. In many cases it's probably not the situation. Who wants to go back? I don't want to revisit that situation ever again. You know we've only skimmed the surface of the significance of what the organization provides. I know we've only skimmed the surface of the significance of what the organization provides. I mean the complexity of support that you've got. I can only imagine the complexity of compliance that you've got that you have to fulfill for the state and for all the other services. But it's just a. It's a huge, huge benefit. Some things are changing. We talked a little bit about this in the pre-call and you had some exciting news that you are now engaged with on some additional programs, which is why I didn't ask are you multilingual? But I think you're going to answer that in this question. So what is it that's going on? 

23:44 - Victoria (Host)
Yeah, so one of the things outside of Granite Wellness, one of my passions is, you know, cultural appropriateness of services. So, as I'm a practicing clinician myself, I'm first generation in this country and so you know understanding some of the cultural differences that individuals experience as they navigate just the healthcare system in general. But also you know what we look at from a mental health perspective as being protective factors, as being, you know, components of health might look a little bit different to the non-dominant culture in this space, and so I'm really really happy to have entered into a partnership with Sutter Health to focus a pilot program in Lincoln on our monolingual Spanish speaking community. So one of the things that we've identified is that. So, yes, we provide services in Spanish both in Lincoln and in Truckee. So, you know, and we're able to provide some additional supports in that space, but that's one of my biggest things. So if we have a client who has a cultural need that somebody else hasn't been able to fill or meet, we will work our butts off to try and make that work. It might not look the best, but we have tried and partnered so much with our counties to try and ensure that we create an environment. 

25:05
Is this program that's going to focus on providing these wraparound services for the individual that's engaged in treatment and their entire family. We anticipate being able to serve about 10 families during this pilot period, where the entry point is going to be those that are enrolled in an outpatient or a DUI services. However, we will assess the whole family unit and identify what are the needs that that family has. How do we engage in preventative and early intervention methods to ensure that other individuals in this family don't end up needing our services? But one of the biggest components of that program is that it's going to be culturally specific. So we are going to ensure that all of our staff are bilingual, we are going to ensure that they are bicultural, because that component of culture isn't learned, it's experienced, and so we're also looking at bringing out traditional practitioners to be able to provide, you know, limpias for our community, things that we engage in in our home countries, our different home countries, that, to us, are a component of our health and well-being, and without those things we are not well In the Western kind of lens of looking at those things. That's not even a factor, right, it's not even a thing, and so it's really important to be able to provide that space to our community. 

26:22
And so, you know, we are in the capacity building stages of that program at the moment and we anticipate being able to open our doors in September of this year, which will be perfect because it's Hispanic Heritage Month in the month of September. So it aligns really well. And if that pilot goes well, you know, my hope is that the next step would be Granite Wellness opening a small residential treatment center that provides all of the programming in Spanish. That's something that doesn't exist, you know. It's definitely a need and so hoping that that is something on the horizon for the next year. Additionally, we are looking at expanding our detox beds in our Grass Valley location. So we're looking at doubling the detox capacity that we have, from 8 to 16, to better meet the need of the state and the community. You know. 

27:10 - Jeff (Host)
it's such a blessing that they have somebody of your capacity at the leadership helm, because you are monolingual, you are culturally appropriate, you do understand and you can see both sides of it. Both sides of it, and one can only imagine the frustration of somebody who is monolingual, gets into a situation that's less than desirable or possibly substance use disorder. Where do they go in a place where nobody understands? 

27:40 - Victoria (Host)
them, I mean it just fuels. 

27:42 - Jeff (Host)
Whatever the cause, root cause of the problem is in the first place. So I think it's a wonderful thing to be able to get to that monolingual community and they will grow into as you have another program that is teaching. 

27:55
English so they can just flow through the entire process and get themselves back into an assimilated position, to where they're productive and the families are healthy again. So that's what a blessing that you're in this position. One thing that we ask before we close every one of our guests is what's the greatest need? What do you see as the greatest need? And I put a little caveat because most of your stuff is funded either through Medi-Cal or through the insurance process, but you still have needs that are different than some other organizations. What is it? 

28:30 - Victoria (Host)
Well, I will say that even though treatment is paid for by, you know, by Medi-Cal or by private insurance, it's still very limiting to that particular client. 

28:40
So in this program specifically that we're going to open in Lincoln, for example, if we were to solely leverage Medi-Cal benefits, that individual would be the only individual that would be permitted to receive treatment and they wouldn't be permitted to receive other types of supports that we're going to be introducing. So that funding is where kind of Sutter private donors and things of that nature come in right. Being able to provide the full spectrum of services and not just the limits of what our health insurance world allows us to do is really where the biggest need is. And so, you know, private donations that come through could help fund an individual who, for whatever reason, doesn't meet medical necessity with their insurance company for treatment but so desperately is dying to get into treatment right, and they make too much income for maybe Medi-Cal, and so they're stuck in this space where now they have to pay for treatment on their own if they want it, because everybody else has determined that they don't really need it. 

29:40
Things of that nature right At times we also have when we have a mom that comes into treatment and you know, and she has her baby with us and we throw her a baby shower and we make sure she has all of the things that she needs and we send these kids off space. And we also provide those recovery residents that short-term housing when they're done with their treatment or when they're in kind of a more stable place. We provide homes for mothers with their children as well as fathers who have sole custody of their children. That is also very hard to find, so dads with their kids can get that additional support. Also, those things are not covered by insurance. 

30:36 - Jeff (Host)
And are those? Would those be considered transitional? So they've gone through the program. Now they're somewhere in that space in between of getting back into daily routine. 

30:46 - Victoria (Host)
So they, when an individual is in our transitional housing, they've completed at least 30 days of residential treatment or they have been, you know, clean and sober for a 30 day period. So they're they're a little more stable, they're enrolled in in our outpatient program or in another location's outpatient program, it doesn't matter, as long as they're programming and they are slowly working towards, you know, being 100% independent. This is a short term, six month. Stay with us, where you us, where they get all of the supports that they need to get them to that next level. And so we have currently in that space we have 59 homes available or beds available for that transitional housing space. So in that space, donors are really, really helpful in helping those families better prepare for what that next stage looks like. 

31:37 - Jeff (Host)
I'm so glad you clarified that, because it's easy to assume that everything's taken care of, you know, and then you just get your reimbursements and everything keeps functioning. But to your point, I can see that we know that in our own medical care system, to begin with, with the best insurance, no, that condition's not covered, or no, you're going to pay for that out of pocket. And you know our underserved and most vulnerable that's the last thing they have is, you know, money for care. They're worried about rent and car and getting back and forth to work or their children or whatever it may be. So, and you know, god forbid. The last thing we want is for them to end up falling into homelessness, where they don't have a place to go and they don't have shelter, because that's just a cascading cycle of not good. I'm just amazed that you have all these facilities and there's just one of you, and I'm sure you have the team broken out to regions and everything else, but that is a lot of responsibility. 

32:37 - Victoria (Host)
Yeah, so I handpicked everybody that we have and I spend a lot of time with them. I do clinical supervision once a week, one-on-one, one hour. What do we got? Here are the areas that I'm seeing for improvement. Here's some feedback on these things. We use KPIs. I mean, we use data for everything, and it's super important to make data-driven decisions, but that data comes from our stakeholders, it comes from our clients, it comes from our external parties, and so we're a work in progress. 

33:05
I think the biggest thing for me is I need to have the control in that space and I need to limit what they tell me we can do with the funds, because that's how we end up. Limit what they tell me we can do with the funds because that's how we end up in the position that we were in before, right. And so I think the relationship that I've developed with Sutter is great, because it's very flexible in that space where they have fully acknowledged like, okay, you're the expert in this space and you have the accolades behind it, we're going to let you do your thing. They do want me to collect some data, which that's my thing too, right, so I'll be able to show them the data that shows that it works. And so I think it has the potential to grow into a much larger partnership and to also start including other healthcare systems like that, because it's only going to benefit them. 

33:51 - Jeff (Host)
Well, I have to thank you. Thank you for what you're doing. You have a massive role to play in the organization and managing everything but your team as well. You know all 104 plus, because you'll probably get a volume from the episode of people applying, but you know nonetheless, it's so significant and so necessary to have an opportunity to have the ability to walk in when you know you need care, when you know that something's wrong, especially if you have a family, and for what you're doing, for what Granite Wellness represents. It's just such a comprehensive program from start diagnosis, treatment. 

34:33
Transition back back is just incredible. So thank you, thank you for sharing the story and we just appreciate what you do and what your team is accomplishing. 

34:45 - Victoria (Host)
Thank you, Jeff.