Improving Healthcare Access for Vulnerable Populations in 2021

 

 

This past year—much like the year before—has put increasing pressure on professionals working in life sciences and healthcare. We hear the inspiring and sobering stories from those on the front lines of life sciences who are making a real difference to save lives. 

To celebrate the strong tailwinds behind us and the people who helped pave this road to success – notably amid an ongoing pandemic – Qualio is donating for the 2nd year in a row 1% of annual revenue. We call this initiative 1% For All Life. Every year we will continue to support organizations that ensure underserved communities receive the healthcare they need.

At Qualio, we share a core belief that everyone deserves to live a long, happy and healthy life. We are continuing our work to extend this mission by supporting organizations that align with our shared values. 

After nearly two years in a global pandemic, we feel strongly that we must continue to support better healthcare access to underserved communities. Here is where our donations will go as 2021 comes to an end:

• Saint Francis Foundation: Community Crisis Response Fund (COVID-19)
• Gates Philanthropy Partners: the Must-Solve Problems fund with the hope of supporting their efforts to drive healthcare innovation, eradicate disease, and reduce inequity in the world.

Learn more about why we’ve made this pledge and hear from Saint Francis Foundation’s President, Mark Ryle on their inspiring work in this episode of the From Lab to Launch podcast.

Links:

• https://www.saintfrancisfoundation.org/
• https://sfcommunityhealth.org/program/hhome/
• Find service opportunities near you: https://www.volunteermatch.org
• 1% for All Life 2020 article

Apply to be on the show: https://forms.gle/uUH2YtCFxJHrVGeL8

Music by keldez

Grant: 0:17

Hi everyone. Thank you for joining today's special episode. It's a fun one that we do every year. And we'll continue to do every year. It's quality owes 1% for all life episode. In this podcast, our goal is to share inspiring stories from the front lines of life sciences, including healthcare. And that phrase front lines is meaningful, especially in healthcare, since it means providing services directly, where they are most needed especially in remote and rural areas. And over the past year, we've heard stories from entrepreneurs, nurses, investors, and many others who are creating solutions to provide healthcare and improve healthcare access and unique ways. And we love hearing these stories and talking to these pioneers. On today's show, we're talking to Robert Fenton, CEO of Qualio and Mark Ryle, President of St. Francis Foundation in San Francisco. Who we're delighted to have back on the podcast. Both Robert and Mark can speak from firsthand experience about what it's like to bring health care access to vulnerable populations. Robert shares about why giving back is a crucial part of Qualio's definition of success and why it personally matters to him. And Mark shares an update on the St. Francis Foundation from last year's episode. He talks about the fatigue challenges workers are facing and also a beautiful and compassionate solution to bring healthcare access, where it is needed most- even tent to tent. Ask anyone who's familiar with the bay area about the Tenderloin and you'll get some interesting reactions like yuck or tragic and heart-wrenching. If you want to get serious about frontline work and healthcare, there's no better place to look than St. Francis. Known for never turning away a person in need of healthcare St. Francis Memorial has shown brightly as an example of strength and compassion through two world wars, two earthquakes, global pandemics, and the continued economic forces affecting healthcare delivery and costs. Their stories are inspiring and we hope motivating to you in some way to join us at Qualio and give back to our communities. Check out the show notes for links to specific places where you can go to donate and give back even in small ways. Everything helps and you can make a difference. All right. Let's get started. Rob, here we are a year later and talking about the 1% for all life initiative.

Robert Fenton: 2:32

Hey grant. Yeah. It's amazing how fast this comes around. It's it's been one year. It feels like one moment.

Grant: 2:37

Yeah, it's true. We'll put the link to the show notes of when we first started 1% for all life last year, they'll be in the show notes if anyone wants to go back and relisten to that episode. But for those who haven't heard that episode, or maybe don't know, tell us a little bit about your background, Rob. Kind of leading up to Qualio and then we'll get into this initiative and why it's part of the company culture.

Robert Fenton: 2:56

Sure grant a good question. So the brief version of my background is that you can probably tell I'm from Ireland grew up there, always fascinated by science and technology and the intersection between both these fields was always something that I found fascinating followed that you studying pharmacy, which ended up with me working at some of the world's biggest pharmaceutical companies, where I saw that this idea of quality or this promise of quality was. Co-equal promise to the Hippocratic goal with the doctor takes before practicing medicine. So where a doctor might say at first, you know, Herm, these pharmaceutical companies, medical devices, companies make a co-equal promise around the products and services they build are safe, they're effective. And they were consistently. And what was really surprised. Well, I was watching these huge companies with enormous budgets and they're really struggled with that. And it wasn't that they didn't get there was that it was pretty apparent that the industry viewed this idea of product quality as an opposing force business philosophy. And every decision was always a trade off between one and the other. And this whole idea of these being opposing forces never really sat well with. And that insight was coupled with, the start of this transformation we're seeing in life sciences right now, this just once in a generation shift where we're seeing an entirely new type of company being born with the new type of needs, right. We have. We still have all of the companies building traditional drugs, pharmaceutical products, you know, physical devices, but we're also seeing these companies doing things like computational biology you know, machine learning algorithms and medical image, data and everything in between. That seemed like an incredible opportunity for us. So that was really the starting founding insight for quality. Oh, pat built a first product and you know, a few later, a few years later, we're now in a position where we are the trusted quality platform for this industry. And we're proud to be able to support this company. Launching and scaling life's different products and no longer having to make that sacrifice between product quality and business velocity. So that's a bit of where we've come from and where we are today. It's been a fun. Yeah.

Grant: 5:12

Yeah, absolutely. And it's fun to be a part of the growth and see what's happening. You've mentioned this in company meetings before that there's a difference and you kind of alluded to a little bit here that there's a difference between a company's financial success and their financial growth. And perhaps alternative definitions of success and how, if you're only basing your company's success on financial outcomes, that can seem the hollow, I think, is the word that you use you've used in the past. So how do you define success as a company? You know, for other entrepreneurs listening and even as, you know, as you're leading quality, oh, what is success?

Robert Fenton: 5:43

I think success has several different measures that are important and yes, of course the financial one is important. It costs a lot to build a business. There needs to be financial outcomes as well, but I think the problem some people run into is they think that's the only dimension that matters. I think success is really relates to the impact. That you create an a, is it either with your teammates and their careers with their customers and their success in helping an industry transform and become more effective and breakthrough to new levels of productivity. And for some companies, it also means impacting the world at large. And I think that is where I think the most interesting companies live, because that is making impact that at a size and scale. We can really shape the world and how all of our lives are really positive and impactful ways. And I know that a quality of we're fortunate to have found ourselves in a position where we can also make an impact here. So when we think about impact it's yes, it's Seneca with the customers. Yes. It's with our shareholders, stakeholders and employees, and it's also the world at large. And I think that puts us in a position where we have the opportunity. And with that, I believe comes the response to.

Grant: 6:59

I like that. Yeah. It's a responsibility, a corporate responsibility. When you have that kind of opportunity in front of you as a organization, and this is also

Robert Fenton: 7:07

Just say, I think, an emerging trend as well for companies who want to become leaders, I believe it's becoming the table stakes to be credible as a leader right now is you need to look at duel. What are we really doing? And what is the, how are we giving back? Or what are we doing to do something better? Yeah. And

Grant: 7:25

that leads us to the topic of today's podcast, which is the 1% give back initiative. Eh, for those who haven't heard of this before tell us a little bit about what that means. I know there's a lot of other companies that are being involved in the same type of initiative. So tell us why why is that important to you in quality and overall what's the program for the 1% give back.

Robert Fenton: 7:45

So at the highest level it's a way for us to widen the scope of, for impact. And it's really part of I alluded to our corporate responsibility to do good, where you can, when it's aligned with your mission and how the business operates, that the inspiration from this came from some conversations we had last year, mid last year, when we were talking about the, what is the impact we're having. And we had a conversation where we w we came to the conclusion that increasing the quantity increases. Of treatment offerings out there does the Ulta positively impact the people who can actually get access to with healthcare. The people who are not able to participate in healthcare, the way it's defined and in most of the world and the United States and Europe everywhere. And we believe that's well, is that, does that really ring true to our mission? Right. And our values. And we said, no, it doesn't. So how can we impact that? And we felt that one, a really tangible way to do that is to take a proportion of a revenue. And funnel that directly to causes that help what we call vulnerable populations, better access, health care and treatments. And we felt that is an important way to set a stance or make a statement and live by that in a measurable way. So every single time we invoice a customer every single time somebody joins quality. That directly impacts our ability to be able to help provide better treatments for people who otherwise might not get there. So that felt like a very tightly mission aligned to values aligned way to do it. And I know a lot of companies, well, not a lot, many companies have found ways to incorporate similar ideas and we felt that the straight 1% of revenue was the purest way to do that. Easy to measure a very transparent and totally. Yeah.

Grant: 9:32

Yeah. Yeah. I love that. So with that initiative in mind, let's talk about the organizations that you chose to donate to. Right? So 1% is going to grow every single year. And so we'll do this episode again next year, same time, you know, and yeah. And it'll be fun as the, as our opportunity to give an impact increases, right. As quality continues to be. Across all spectrums of successful. So let's talk about the organizations that you chose for this year's initiative. Tell us a little bit about them and why you chose those.

Robert Fenton: 10:01

Yeah. So this year we've chosen two organizations to partner with and the way that. We've looked at this grind and we've spoken about this is it's better to start small and build from there. And we looked at this on both like a hyper-local and international view and hitting it from both ends is the perfect way to start learning how to do this well. And we're very fortunate to find an incredible partner in the. The St. Francis Foundation and mark Royal, who we'll chat to very soon her doing really incredible work well, where I live here in San Francisco. I won't talk much more about that because we will get there very soon, but it's an incredible foundation doing lots of really incredible work and. It means a lot to be able to support that level here and then internationally, we're working with the part of the gates foundation as well. And we can talk a little bit more about that soon as well, but the idea there is to expand our reach, knowing that as every year, the amount that we donate becomes much, much larger, where it helps us, I think find a perfect launch pad to start really building out a program that makes an impact and makes sense. And while we're early with this, it also, I think, creates the foundation to start getting our global teammates more involved and restart building ways to measure the impact and the ROI and the benefits that we're directly creating. Cause it, all these things it's really important that we, you know, we understand the impact we're making it. We can use that as we grow with this program over time.

Grant: 11:31

Yeah. And speaking of that, just for a second, what are some of the maybe. Measurable things this soon in the game, but are there other benefits or initial results that you might've seen from rolling this out either across, you know, internally in the company or outside any other kind of benefits you've seen that might encourage other entrepreneurs or leaders of other companies to get involved in the same type of

Robert Fenton: 11:51

initiative? Sure. The external benefits right now are. How would you describe discretely measure? Because it's the size of the impact we're creating is part of the mix that the foundations we support have. So we're not yet at the point where we're able to discretely measure the return over the next year. That's something we're going to be looking at more closely, and I'm excited to start pulling a form of impact report on that. I can say that internally it's been. Incredibly powerful. And it's something that, funnily enough, when we were working on this, I was nervous to say, to learn, well, how will people respond to this? Is this something that people believe in internally? I hope it is. And I'm just blown away by, by the response from everybody internally. It's because it's something we learned is that your broader team and the company always look to you and look to the company to see what. This is what they state their mission is. Do they really care? And I think your values are what you do, not what you say they are and your principles are similar. So I think it was incredibly powerfully internally as an alignment tool and focus tool and has really helped in our company rally around why we're here and why our success matters. So that part has to be really easy to measure internally. And over the next year, we hope to connect it both with external ROI and internally.

Grant: 13:09

Yeah, that's great. So anybody who's listening, that's thinking about getting this or starting some kind of initiative in their company. It's it's definitely something you should consider because like you said, values are seen more than they're just heard. Appreciate that. I just would

Robert Fenton: 13:22

add to that. Yeah. To the truth through, there were two kinds of pitfall. That we came across as we were designing this and we see no other people stumble on is that it's where you can find something that resonates with your core. Why is a business? Because that way it's a straight line and it's congruent with everything you do. And also always trying to find ways to be transparently accountable about how you're measuring your impact and how you help. Because if. Fungible that can also be a trust issue. So it's really important to find something that you can anchor on that people can inspect it scales better that way.

Grant: 13:59

Yeah. Good advice. Awesome. Anything else you want to add to this as overall context before we bring a mark from St. Francis Foundation inside?

Robert Fenton: 14:07

I'll I will only say that I can't wait for next year is to see where.

Grant: 14:12

Yeah, it'd be fun to look back on these several years in the future. We'll look back on the very first episode and think, wow, it started with just this does, you know, this micro donation in comparison with what we're able to do as the years go on that. That'll be fun to look back in the rear view mirror.

Robert Fenton: 14:26

Yeah I can't wait.

Grant: 14:28

Awesome. Well thank you, Rob for everything you do. And, with that, let's switch it over

Robert Fenton: 14:32

Thank you, Grant. Mark. Good morning. Awesome to see you looks like you're not working from home today, so that's a nice change. How are you doing?

Mark Ryle: 14:41

I'm doing great. I'm trying to let the season kind of roll over me and remember what's important right now. And sometimes when we get mired in the day-to-day, that's difficult, but it's working out.

Robert Fenton: 14:51

All right. I know that feeling now. You know, we've had a chance to get to know each other a little over time, but for people who don't know you, and this is the first time we're hearing about you and the foundation, maybe tell us a bit about you know, the foundation's history and then I'll ask how you got involved.

Mark Ryle: 15:07

Sure. Let me start though, by, by thanking you a little bit over a year ago, we first met and you unflinchingly gave not only from your wallet or from your heart to the work we do with. That doesn't happen all the time. I'll say thank you a few more times before we're done, but I'm going to start off with that. It means a lot the St Francis foundation has been around since the late forties. We started as a independent foundation, trying to make a difference in the community and back then. So the, those really honest and important tensions were driven more. Output and some societal aspect of giving a, an hill foundation looking to make a difference in the neighborhood. That has changed significantly in the last 75 years. And now we are we remain an independent health care foundation investing in the Tenderloin and we invest in things that work for a lot. And this is probably my second decade working in the Tenderloin. And I'm not seeing it improve. And our commitment to the Tenderloin is to fund what works in the fund, where we can measure impact and where we can measure the improvement that doesn't always happen with nonprofits. Sometimes you have to go out on a limb and hope they've got it right. But oftentimes there's evidence that you can show that demonstrates the the value of that investment. You know, you, I know you think about that not only for your own company, but for the work you've been doing, one of your success measures was how do you measure impact? And that's what we look to do here, so that we go back to our donors as investors and we show the value of what you've given us. And I think, I believe that the St Price's foundation is uniquely positioned as one of the larger healthcare foundations in the city. To make a difference in a very small geographic community with very significant problems. And I can talk a little bit about that as more as we get into our conversation today.

Robert Fenton: 16:54

Thanks, mark. Yeah. Lots of questions about that. Maybe I think your story is fascinating. Maybe share the cliff notes version of your history and how you found the foundation and decided this is why you wanted.

Mark Ryle: 17:06

All right. Well, you already know that I'm not great at cliff notes, but I'm going to try and grant can edit me out. So I, I was born in a very small town in west Texas, youngest of six. And I spent most of my life until adulthood afraid of the lights going off or the gas student turned off or not having enough food at the end of the week. My parents worked their butts off and still there just wasn't enough. So scarcity and need is something I'm very familiar with. I had to get out of that. So I went to grad school and worked for the darkest of the dark investment banks for a very long time. And has spent the last 15 years trying to earn my way back into heaven. My mom would say, And I'm doing that by doing work in the nonprofit field. I started that workout after an MSW from Chicago, doing clinical work with kids in the Tenderloin and kids who couldn't be home because it wasn't safe to be home. I went from their project open hand, which is a very large food agency in town and doing work for people who are very sick three years ago. There are workout. Sorry, don't worry. I think every year I have an ambulance go by just freed her up. And and then moving into the St. Francis Foundation three years ago to lead this organization mostly to bring the focus back to discrete grantmaking, that shows an impact. And and that's what our mission sits today.

Robert Fenton: 18:26

So you alluded to something earlier about the St. Francis Foundation being. A relatively large foundation compared to lots of the groups trained to do work. And you're also hyper targeting that in an area of great need. I think that model is every good one based on all the reading I've done, but maybe talk a little bit about the what's the kind of impact you're making today. And how do you think about the programs you're running?

Mark Ryle: 18:55

Yeah. I, the way I best know best how to do this is to be very specific because it's hard to talk in vague reason, generalities and have people care. We're now two years into the pandemic almost one year into the vaccinated structure. Well, we have seen most in our Petri dish, our lab, if you will, is the St. Francis Memorial hospital. It's a small nonprofit hospital in the middle of the Tenderloin. It's the only hospital in the Tenderloin. It has the busiest emergency department in the city. It sees. All the folks that you drive by or walk by on Hyde street or Ellis or Eddie or any of the streets where we see a society in disrepair, those patients are being taken care of St. Francis. So we use that hospital as our measure of what's going on and where the need is. What we've seen surprisingly in the last year is a better than 50% uptick in emergency department admissions for what are understood is transition aged youth. Youth 17 to 24 years old. Most of the times. And I know those kids, I've worked with those kids for a long time. Most of the times when you pass by those kids, you have a lot of thoughts. Some people think why aren't you working? Why aren't you house? What are you doing? Some folks have more compassion than that. But mostly we think about resilience because youth can get through most things and come out the other end. But what we're seeing actually is that 50% uptick in the ed is driven mostly by a suicidal ideation among that population that's dramatically different than we've seen the last 10 years and directly a result of the isolation of the. What do we do about that? We, there, there are some forces working against that population. The substance use population is strong in San Francisco and the money behind it is stronger. So how do we make a difference in such an enormous situation and the way we've done it is twofold. We have. Taken to extending the stay and our closed mental health unit at the hospital so that those kids can have more time to come down from where they were from whatever, whether it's a new version of meth or other substance to settle into an appreciation of what they want to do next, because the way the county reimburses that you have to be out in the. A week's not enough time. Just isn't that just pushes your right back onto the street. So now we extend that until they're ready to go, and that's not a cheap endeavor, but we find it a very stabilizing factor for that population. And then the second thing we do is we have a peer counselor that we brought in from the community based organization. That is, that looks then that sounds like then the blacks like them that has walked there in their shoes. That physically escorts them out of the hospital on their day of discharge and engages them in community service, support stabilization. The result of those two efforts has been a 50% increase in stabilized housing among that population and a 30% reduction in the emergency department usage among that population. Those are real numbers. That's how you that's, how your money, my donation. We all see a return on a very important population.

Robert Fenton: 21:57

That's really awesome, mark. Thanks for sharing those impacts. It means a lot to hear that I'm curious, you know, this is being well, the second year of exceptional circumstance we've had. The last time we spoke, we were maybe six months into this and thinking it's maybe about to change, but it looks like it hasn't changed a whole lot, or at least as much as everybody in the world, what was hoping, maybe can you share some of any unexpected, roadblocks and lessons learned over the past year? And I'm curious to see how we can apply those learnings from. Yeah,

Mark Ryle: 22:31

I, because we see it every day, so close and because we're part of a medical community, I sometimes I, for the early part of the pandemic, I was everyone's go-to because I had information to others don't and I thought that was pretty cool for a little while. And now I wish they'd stopped talking to me because sometimes I just don't want to know everything that's going on. But the roadblocks we have seen is just that sort of. Fatigue, not a fatigue around something that we all thought would be gone in two weeks, and then we thought we'll be gone in June. And what we're seeing is folks are just starting to exhaust that is that's the only are healthcare professionals, but that's the clients. That's the individuals who are having to get up every day and face the reality that we're going to be in this for a little while and that there is no magic cure. So motivating that out of that fatigue is tricky. We haven't figured it out yet. Rob. We are, what we're doing is every day we're bringing realistic hope, cautious optimism to the situation. We still never say no, we still refuse no one at that emergency department, still the only hospital in the city to never turn anyone away. And we are trying our very best to keep the health care professionals as healthy as they can be because they are the, they have been at it 24, 7 for two years now, but I think fatigue is our biggest obstacle. Right. We battled that with hope optimism and data. We show folks how, what we're doing is working and that gives you a little competence.

Robert Fenton: 24:01

Yeah. Yeah. I'm sure it does. I think that's fatigue. Problem seems like it's the same problem everybody has, right? Yeah. Yeah. Well, if you solve that please let me know. It's like universal.

Mark Ryle: 24:17

And part of the challenge there is not only in the the patients or the clients or the health care workers, but also in the donation community and the fundraising community. I, for a very long time, and I worked in this spoil this area for awhile, you gave money in because you saw output because you saw that. If I give you a hundred dollars, you're going. You're going to see five patients or you're going to encounter 10 substance use programs. But it's really what really matters to me as an investor. And also as the manager of this foundation is the so waterfall that, the number of times you see a client doesn't matter, unless that client is changing their behavior or improving their situation. Part of our R fatigue comes in donors, understanding that we can produce measured outcomes. We can produce out impact in a really quantifiable way, just like you do when you're looking at your 401k or your stock options. And you're seeing those numbers change. We want to show you those numbers in the individuals that we work with so that you're excited about the future. We are.

Robert Fenton: 25:21

That's a nice gesture and I believe you share these reports. Is it once a year you share these out that's right. Yeah. When is the next one? Do you

Mark Ryle: 25:30

the next week? Oh, well it's good reading. I promise ya. Yeah,

Robert Fenton: 25:34

I'm excited to receive it. I'll be reading it over the holidays then. You mentioned the donor fatigue being one of the areas and you help share some of the stats. I'm more curious about the. The broader mission. And are you seeing a change in the price, the patterns of getting donations? Are you seeing like an increase or decrease? How has that fatigue impacted? Yeah,

Mark Ryle: 25:59

we we are very lucky because we've been at this for awhile, so we are very stable pretty well-funded foundation and what we're, and because of that, What we're trying to do is to show the leverage of donation. So for when Kaleo generously donates to the St Francis foundation, we use our endowment to match that donation to double or even triple the investment that's made by donors. And we're finding that as a really valuable way to incentivize others, to engage making that a multiplier effect of an individuals or corporations donation. And. To push it a little bit further. We've started to challenge other corporations to match that match. So those numbers start to make a difference. And where someone who gives us $5 can turn it into 15 in a heartbeat is an important distinction in what we're doing. Where we're leveraging and we're multiplying, and we believe that starting to improve a donor's perspective on what they can do individually.

Robert Fenton: 27:02

And on that individual contribution piece, I'm curious. You're pretty, well-funded, you're pretty large organization. If people are looking to get involved and help. Our folks are people like you, what's the, how do people do that besides just going to your website?

Mark Ryle: 27:18

I'm going to, I've got this down. Cause I've been at this for a while. I volunteer every week I have for forever. It feels and the way I stay motivated is I find, I found something that means something to me, it's with the food organization. Cause I remember very well being hungry and it makes it personal difference in my heart when I finish every day. And that's better than the five miles that I run on good days or the couple of areas I have, or maybe three on a good days. The feeling that I leave after volunteering is important because it matters to my heart. So my first recommendation is to find something that matters to you. Don't do it because it's an hour a week do it because it means something to you. And then it'll be more than an hour a week before you. And then the second piece of advice to folks wanting to get involved is to raise your expectations. Don't assume a non-profit can't meet those expectations or do even better and find the ones that do and reward them with your time. And if you feel like they deserve your money, start out small and give them five bucks a week, drop the latte and give them a five. But. And make that small donation because over time you'll start to feel like you're ready to go larger, but don't want to start big every little bit matters to folks. So find where your heart sings and start out small. And until you grow into it,

Robert Fenton: 28:36

Well, that's really helpful. The market reminds me of the earlier part of this. When I was speaking with grant about the corporate focus. I think if you do something that actually resonates with you you'll stick with it longer. And I think you'll do a far better job. Yeah, I think that's, I think people forget that.

Mark Ryle: 28:53

Yeah, I agree with you. I think Rob, that there is a, there are two organizations in the Tenderloin that I am. I'm. I can't say that I can't be favorites, but I've had two favorites. One is project open hand because I worked there forever. You can go as a volunteer and you can deliver meals to an individual and you can see their face light up. You can chop vegetables if you don't want to be engaged with the public. And you can know that the work you're doing makes a meal for someone who otherwise would be hungry and sick, that's tangible work. And and you're tired when you're done and you're tired in a really good way. And then there's the community health center, which does street medicine. And edit out what you don't want. But the department of healthcare services in California has just as a Friday begun to support street medicine in a reimbursable way. So that means if you're living in a tent and your wits are about, you are not a person. We have people who are. Nurse practitioners who carried backpacks through the Tenderloin who go into those tents. And so in the privacy of your home, you don't have to go into a van. You don't have to leave all your belongings behind a person will come into your home, meet you where you are in that traditional social work model, and provide you with lab tests. With all the things you could need, vaccinations, everything you could get from a doctor's visit. The agency gets reimbursed because the California's progressive that way. And the individual gets help on a presentive model that assumes they need the care, rather than making them jump through a bunch of hoops. The community health center is a miracle that way they have folks on the street every day is that doctors in tents.

Robert Fenton: 30:28

Is that a new program or a new way of

Mark Ryle: 30:30

that? It's about six months old. I started out with a pandemic for that for obvious reasons, but it's working for everyone and it's you should just see them. They, there, they carry these heavy backpacks full of a lot of stuff, and they are at it all day long knocking on the doors, you know, hoping they can come in, but respecting the privacy. And it's beautiful. It's beautiful tangible work.

Robert Fenton: 30:53

Yeah. I think it's important for people who really need it tend to be the people who don't seek it up because they tend not to believe it's. They can often, it's a weird circular thinking. Yes.

Mark Ryle: 31:04

I agree with you. And if you have to think about it, if I, if to go and see a doctor, I had to leave my front door unlocked at my apartment. I wouldn't have. Well, we're asking the homeless to do.

Robert Fenton: 31:16

We can just open up an app on our phone that we can talk to it about her. Right. So we're already doing that. Right. And we forget how much that helps us even do and just be more comfortable. Well, mark, anything else you want to share? Finish up.

Mark Ryle: 31:29

What I promised earlier is I'm going to thank you again. I thank you for this format. I thank you for your. That you were raised, right? My mom and dad would say, because you are leading this work and on the behalf of the Tenderloin in San Francisco, I'm grateful.

Robert Fenton: 31:43

Well, mark, it's been a real pleasure supporting you folks and happy to continue to do so. I appreciate all the great work you're doing. Please keep it up. Thank you.