PandA Pod: Is There A Doctor In The Pod?

Hi everyone, and welcome to another edition of the Panda Pod, your favorite disability rights podcast. I am Michelle Bishop, NDRM’s Voter Access and Engagement Manager, and one third of your incredible hosting team.

I’m Stephanie Flint, one of NDRN’s Public Policy Analysts.

And we have another special guest host this month, Raquel Rosa. Shout yourself out to our listeners.

Hi everyone, this is Raquel. I am also at NDRN. I am part of the Rep Payee team, and I am solely transitioning over to the External Relations team. Thanks for having me.

Thanks, Raquel. We’re so excited for you to join. Before we get started with the business of this episode, I have some important business to conduct. I have to make good on a promise I made someone. This is our March 2023 episode, and officially the first episode of me calling out my mom every single episode until she starts listening to our podcast. I think y’all have heard me say before that my mom is our only listener, and I just recently found out despite the fact that I set up a podcast app on her phone, she is not listening to us. So mom, this is your official call-out. You better get in touch with me ASAP or I’m calling you out again next month.

Okay, so if she doesn’t listen to the podcast, she’s not going to hear you. You might want to text her.

I’m going to keep saying it until the word gets back to her. The four of you are just going to have to listen to this every month until the podcast inevitably crashes and burns.

You heard it here first. Y’all figure out a way to contact Michelle’s mom so that we don’t have to listen to this PSA every month.

If you’re stuck with Stephanie’s jokes every month, then I can do this, all right?

Fine.

Sorry. Sorry. Okay, Jack Rose and our trustee Producer, who we forget to introduce every single episode, please take it away. Tell us what’s in the news these days.

From Youth Today, a state is being sued for warehousing children with disabilities in foster care. Late last year, Disability Rights North Carolina and the North Carolina chapter of the NAACP filed a class action suit against North Carolina Department of Health and Human Services Secretary Kody Kinsley, seeking to end discrimination regarding children with disabilities who were placed in foster care as wards of the state, and who are then unnecessarily segregated from their home communities.

As a result, these children are often isolated and heavily restrictive, and politically inappropriate institutional placements called “psychiatric residential treatment facilities.” Through their attorneys, the North Carolina lawsuit alleges the children who stand as named plaintiffs, using pseudonyms of course, are receiving heavy cocktails of mind-altering, psychotropic medications while at these facilities.

I feel like I only have one word, and it’s a question, and that is, why? I know that the foster care system is a broken system, but this is just heartbreaking. I’m honestly at a loss for words.

I was just going to say, this is so gut-wrenching, the trauma upon trauma that these young people are faced with. There is a general perception I think that the child welfare system is benevolent and that these young people are in good hands. Unfortunately, that is incredibly the furthest thing from the truth. A lot of these young people are also receiving Social Security benefits, and those benefits are unfortunately not always used in their best interest, and they’re not always being conserved for when they transition into independent adult life. It’s bad every way you slice it.

Yeah, I’m not sure what else to say about this one. It’s truly terrifying, but it makes me thankful for organizations like the PNAs in our network that are doing incredible work to try to stop things like this from happening to people with disabilities. So, shout out to all of you who are out there protecting people with disabilities every day. I appreciate you so much.

What else do we have in the news, Jack?

From the State Journal in West Virginia, home care services shortages and issues placed West Virginians at risk. Advocates for the elderly and people with disabilities in West Virginia are calling for more investment and oversight in home care as workforce shortages and other issues within the industry bring consequences ranging from mere inconvenience to unnecessary institutionalization, and even death. These services can help individuals live independently in their own homes, be involved in their communities, and avoid institutionalization in psychiatric facilities or nursing homes. They also provide a cost savings.

It costs about $250-$300 per day to keep an individual in their home, compared to about $900 a day for that individual to live in an institution. Susan Given, the Executive Director of Disability Rights West Virginia, had this to say, “We’re trying to get people to understand that this is serious. People think this doesn’t affect them, but their parents may be one day away from having a stroke or heart attack that would be debilitating, or a car accident with a child. It’s just something that everyone should be concerned about because you never know when you’re going to be in that situation. No one is insulated from something like this happening to them or a family member.”

Disability Rights of West Virginia, first of all, are fearless, so shout out to them for the advocacy they’re doing here. Do we know y’all, and I’m kind of looking at you Raquel because I feel like you would know about things like this, is this a COVID-related thing? Are there worker shortages in this industry following the pandemic?

Well first, I also want to piggyback on the big shout-out to Disability Rights West Virginia because they are phenomenal. I am just so pleased with them being so bold in pushing for people to be at home, and thrive in their own personal space. Yeah, so to answer your question, Michelle, this has been a pre-existing issue. COVID has made it worse. When it comes to direct supports, and by the way everyone, I spent the first decade plus of my career providing direct supports so it’s something very near and dear to me, there’s more than one issue.

One of them is that it’s not a well-valued career. People unfortunately associate this work with intimate care that is just not considered appealing. It’s not paid well. People are not trained well. Oftentimes, service providers do not offer any kind of professional development or incentives to grow. For some of the people, myself included, who moved beyond that, it’s really up to us to make those steps into another direction, to deepen our advocacy, to deepen our expertise. Otherwise, it’s just unfortunately a cycle of not great recruitment strategies, no good retention strategies, and unfortunately just the de-valuing of people with disabilities.

COVID has obviously made it worse, and part of it is people’s fear of just being in spaces with people who are that much more vulnerable to COVID. Some people are saying, “Hey look, this has made me reassess what’s important to me, and I want to do something more.” People are taking the proverbial bull by the horns and getting that education on their own. They are attempting other career moves that can help people. I think it’s a really big issue. I think we need to get a lot of policy makers on board with enhancing budgets, and really trying to incentivize this workforce because everybody deserves the right to be at home, live at home, thrive at home, and to also go to the policymaking angel.

Having a cost benefit analysis is just chef’s kiss because people ultimately want to see how is this beneficial when it comes to dollars and cents. When you’re talking about at $700 difference between at home support and institutional support, it’s astounding. So not only is the quality of life for someone that much better when they’re at home, the cost benefit is undeniable. So yeah, I think it’s a really big issue for us to tackle, and it’s something near to me. I am happy to be part of the charge.

Well y’all see why we had Raquel on today.

Beats me.

I hear you snapping those fingers.

Yes.

Jack, any other news stories for us this month?

From a local NBC affiliate in Texas, KXAN, a Texas bill would ban schools from restraining students on the ground. Texas Representative Mary Gonzalez of El Paso, “This session introduced a bill that would ban teachers and other school employees from restraining students on the ground at school, specifically those with disabilities.” “Tragically, those restraints are happening more and more violently to students with disabilities,” disability rights Texas Senior Policy Specialist, Steve Aleman said.

Rep Gonzalez added, “I just think about how our schools exist or do exist for our most vulnerable kids to get the support they need. And when I see this video, it just gives me some red flags and that is why we’re doing this piece of legislation with Disability Rights Texas,” Rep Gonzalez added. The video in question was a school administrator throwing a 14-year-old boy into the wall of a “pull down room” and then restraining him on the ground. So, glad to see that Disability Rights Texas is working with the legislature to make some progress on banning this practice.

The fact that this is still happening in 2023 is just plain wrong. The fact that this is considered some sort of discipline is quite frankly disgusting. Like Steve was saying, this is something that is happening everywhere. This is something that is happening all over the country, and this is something that doesn’t really get talked about.

Yeah, I don’t understand why anyone’s getting restrained against the ground specifically, especially when we’re talking about a 14-year-old. That’s a child. I do love all the shout-outs to our amazing network today. Disability Rights Texas as well, just do incredible work. Thank you Disability Rights Texas for leading the charge on this one.

Yeah, I could not agree with you all more. Just the egregious nature of presuming that’s okay, that’s child abuse. It is absolutely child abuse. As adults, we collectively need to check ourselves. We are talking about young people who are developmentally different than us, they are generationally different than us. The world is different for them than it is for us in a lot of ways. Then you add disability into the mix, and we’re just going to wrangle kid and put them on the ground? It is nothing short of violence and abuse, and people should be ashamed of themselves.

Raquel, can you say that louder for the people in the back?

The whole thing?

The whole thing for the people in the back.

We need to do better. We need to do better. We need to hold one another more accountable. If people really have that much aggression, they can take boxing lessons. Do that with people who consent to physical encounters. Don’t be bringing kids down. It’s not cool.

I sense Raquel becoming a co-host.

Actually, on that note, let’s get into the main issue for today’s episode. We found out about this really cool program happening in Massachusetts called Operation House Call. We got some folks involved with that project on today to talk about it. Raquel, can you introduce our speakers for us?

Absolutely. First, we’ve got Maura Sullivan. She is a dedicated and passionate leader in advocacy for people with Autism, and intellectual and developmental disabilities. Her expertise is in disability health policy and education. Currently, she’s the Director of Government Affairs for the Arc of Massachusetts, and she’s the Director and Lead Instructor for Operation House Call, the program that teaches medical students best practices in caring for individuals with Autism, and intellectual and developmental disabilities. She teaches at all the major medical schools in Massachusetts, which reaches over 1,000 medical and nursing students every year. Her life’s focus for this work comes from being a mom of two young men with Autism and intellectual disabilities.

Then we’ve got Jonathan Gardner. He is a 20-year-old self advocate, cancer survivor, and decision maker who also happens to have Autism. He has a vision of helping others any way he can. Jonathan is currently employed by the Arc of Massachusetts as an Ambassador for Operation House Call. He is a council member of the Massachusetts DD Council, and he is a Flutie Fellow for the Doug Flutie, Jr. Foundation, where he gets to share his vision of helping other people. Most recently, he was named Co-Chair to the Massachusetts Supportive Decision Making Coalition. In his spare time, he enjoys video games, anime, wrestling, and advocating for himself and other people.

Thank you all so much for joining us today. I was wondering if we could just get started with Maura. Maybe you can tell us a little bit more about Operation House Call, and how this program got started.

Absolutely. Thank you so much for having me. Operation House Call is a really unique program. It teaches medical students and other healthcare professionals really how to provide the best care to patients with Autism or intellectual and developmental disabilities. But we do this from the patient and parent’s perspective. It’s true experiential learning combined with lecture that provides foundational learning, and education, but they really learn through our stories. Our stories highlight important learning objectives. They highlight those pivotal moments we’ve experienced with medical providers throughout our journeys.

The real goal of the program is to really begin to address the health disparities and the access issues that face our community. This is why the Arc of Massachusetts has prioritized this program. We have so much we want to teach and share with future doctors and future healthcare professionals. It has been a slow-growing program, but it’s now been about 10 years here in Massachusetts with the Arc of Massachusetts. We are currently in every medical school, and in a few graduate nursing schools as well. We’re so excited to have this presence. It’s not easy to get time in medical school curriculum, so it’s taken a lot to prove the importance of the program and to really build out our program, which is based on families participating.

In Massachusetts, we have 250 families across the state who participate by opening their doors and their hoes to medical students, and really just giving those students an opportunity to learn what life is like living with a disability. They learn directly from individuals and family members about the challenges that they’ve had in the medical community, some of the extraordinary things they’ve been through. They also learn just day to day life and the usual challenges they have for education, and out in the community. We feel like families do such a wonderful job showing medical students their resilience and their strength in the face of some very complex medical conditions, and those combined with intellectual or developmental disabilities can really be really challenging and complex for families.

We’re really excited. We see students coming away from this program just enlightened. They have incredible amounts of respect for the families and for the individuals, and they really have a willingness to learn more. I think that’s what’s great. It kind of breaks any of the fear they may have had about treating patients with Autism or I/DD, and they just grow confidence. That’s one of the main goals, is we want more providers willing to treat patients. Especially when we get to adulthood, we see that it’s really difficult to find primary care, to find specialty care. To have doctors who you may encounter in the emergency room, or as covering doctors really understand the needs of patients with Autism and I/DD, and their families.

Some of the things that I think are so important about our program are the learning objectives that we cover. We do that again through our personal stories, but we talk so much about communication and the importance of communication, whether it’s learning to communicate with someone whose non-speaking and uses gestures, and sounds, and play as part of their communication, or really partnering with family members, all the way to learning how to give patients enough processing time when they ask questions so they can really be engaged and participate in their own healthcare.

One of the great parts of the program is during our lectures in the medical schools, we bring in an individual who has Autism or an I/DD, intellectual developmental disability, and they serve as a co-teacher. You’ll hear from Jonathan later about this, but they share their experiences directly with the medical students, and then open up class to a question and answer session that is always incredibly moving and impactful as they learn more about this individual and their journey, and their needs. Then lastly, I would say they come away from class with a lot of resources. They have tips that we’ve put together about accommodations, and these tips come in from our 250 families.

And, the students write about their experience, which is also a whole other aspect of learning, is just reflecting and beginning to think about their biases that may affect treatment and assessment of patients, and through that essay they process with a parent instructor. A parent instructor will then provide feedback and answer any questions, and allow those students to explore additional resources. I feel like it’s a great model. It’s really remarkable how the students are transformed from meeting families and individuals, and we’re very luck to have the support of so many families and the support of the Arc of Massachusetts.

Jonathan, I have a couple of questions for you. The first part is, what has it meant to you to participate in this program?

I feel very honored and validated to be an Ambassador for Operation House Call. My vision has always been to help others in any way I can, and this is fulfilling my vision in so many ways. I get to share my story and help others share theirs. All together, we can make such an impactful positive change in the way everyone should receive their healthcare. Operation House Call gives me a chance to teach up and coming doctors and nurses from my own experiences, which were some good and some bad, so that the bad experiences that I went through won’t happen to others.

Sharing my story gives me a chance to help the students understand how to communicate with someone who happens to have a disability, and to look past that disability so that everyone is able to get the best possible care. I believe that all behavior is a form of someone trying to communicate. The students get the chance to ask questions when I teach, and this is a way for us to work together to make sure everyone is able to get the possible care possible. The students want to learn how to treat everyone equally, and this gives us all a chance to work together to make sure everyone is able to get the possible care.

Operation House Call has helped me with my own advocacy because I have always been shy. I was traumatized at a very young age. It has helped me become the version of myself that I knew I could always be. I have always wanted to help others to the best of my abilities, and now I get to do just that. I am now a strong advocate not just for myself, but for others. My voice is validated and respected when it used to not be. This is so empowering to me. I can make others feel more comfortable doing their own co-teaching and taking care of their patients. This all fits with my vision of helping others any way I can.

As an ambassador, I get to help mentor the co-teachers and provide strategies to cope through the classes, and there is no better way to learn than from someone with a personal story. Operation House Call is all about families and individuals with disabilities teaching our doctors. They are gaining a very personal education from the heart when the come to our classes. To me, nothing more is meaningful.

Thank you. You actually answered what I was going to ask earlier, but I came up with something kind of bridging the two together, which is how has Operation House Call given you techniques to advocate for yourself? What advice would you have for other people with disabilities, and how they can advocate for themselves?

That’s a very interesting question. I would say for how it helped me become more of an advocate, I guess the supports and the knowledge of the people that are around me. For example, my mom, whom is one my main teachers and one of my main mentors, she is wonderful and she’s taught me so much about this advocacy world. I’ve never been so grateful in my entire life. Then there’s Maura, who you just heard from a little bit ago, who is one of my mom’s mentors, and I’m glad to say she’s one of mine as well, because honestly she’s done a great job in supporting me and others through this wonderful program.

For others, I guess my suggestions would be to don’t feel like you can’t rely on supports to help you with advocating. I guess my suggestion is, don’t feel afraid to ask for supports and do what makes you feel comfortable in the moment.

I was wondering, in light of the success of Operation House Call, how can PNAs and disability organizations get something like this going in other states?

Like I mentioned, it’s really been a slow growth for Operation House Call here in Massachusetts, but I think the good news is there’s really national recognition of the health equity issues for people with I/DD and Autism right now. I believe more and more states are going to want their medical students and their doctors, and other healthcare professionals, better trained and better equipped. I think there’s definitely a movement to have more trainings available, more continuing emergency department, more trainings for emergency rooms.

But for us, the best way we built out our program was to connect with a champion at that medical school or at our local hospital, or even the local clinics that have more expertise in Autism or I/DD, like our Down’s Syndrome clinics here at Mass General Hospital. We found those doctors who are established champions in the field and in the community, and they were able to help us get a foot in the door at the medical schools. Offering a pilot program was really helpful. We were able to do the program with a small number of students and then get their feedback.

We have a great story of recently one of our medical students at UMASS Medical School, she really wanted this program. She advocated for it herself, actually bringing it to her administration saying she had Googled and found out that medical schools don’t have training programs in Autism or I/DD, and that she actually had found Operation House Call and was shocked to see that her medical school is the only one in Massachusetts that hadn’t implemented it yet. They really listened to her and they allowed us to do a pilot, and they brought us right onboard. So, it was wonderful.

Other programs have been longstanding, and each year we make sure that we’re constantly getting student feedback because the reality is they don’t have a lot of time in their curriculum. We really do need to prove how important this is for medical students, so we rely on the students’ feedback and they tell us what an incredible experience and what an important and impactful one it’s been during their medical school rotation or clerkships. What’s nice is we can always also use their reflection essays internally here to show really the power that these families are having to educate and to inspire these doctors.

I would also say that there’s been some studies and some research done on sort of the attitudes of doctors when it comes to treating patients with disabilities. I think the more research and studies that are done to show that not all doctors are willing to treat patients with disabilities, and some will go to a pretty extreme length to not treat patients with disabilities. We really need to break through where we can with that. Our program is really focused on those attitudinal barriers, but there’s much more to do.

We need to focus nationally on better reimbursement for these providers because they really do need to have longer appointments sometimes, not all the time. But it’s helpful. We talk about communication and processing, and building bonds with their patients, and establishing that level of trust and comfort. Sometimes, those things take a little bit longer. We’d love to see some… There is some federal legislation that would help in this way, but we would love to see more efforts put into reimbursement as well as mandating training across all medical schools.

Maura and everyone, thank you so much for joining us today. This has been such a fascinating conversation, and I know that a lot of our listeners understand exactly what you’re talking about in terms of medical professionals who aren’t willing to serve people with disabilities, or if they do, they don’t know how to respectfully interact with people with disabilities, or they don’t listen to us when we tell them what our symptoms are and what our concerns are. I know that this is a widespread problem, and a program like this would probably benefit people with disabilities everywhere. So, we appreciate you so much coming on and just telling us more about this. Any resources you have for us, we’d love to put in the show notes so that our organizations in other states can maybe pick up the torch and try to get something like this going in their states as well.

Thank you so much for joining us today.

We can absolutely share our resources. I would only add to that, one of the great things that families are able to share is their positive and wonderful experiences they have with their doctors. This goes a long way too. We talk about the doctors who have really worked at bonding, who have made all the accommodations possible for our loved ones, and the ones that think outside the box and go that extra mile, and how important modeling that kind of person-first behavior, and how far that can go because if one doctor is a champion and they can reach other doctors and healthcare professionals, we’ll see a great effect.

It’s about making doctors aware of the problems that are out there, and the disparities, and honestly really also staying current with the issues and making sure that we hit on things like intersectionality and the intersection of race and disability, and the disparities that come from that as well. Even COVID taught us so much. So, we’re doing our best to stay on top of all the issues and reach as many doctors and nurses as we can.

Thank you all so much for your hard work and your advocacy, and thanks for joining today.

Thank you so much.

Thank you so much for having us.

Okay, awesome. So that was a super exciting interview with hearing about the instructional aspect of Operation House Call, as well as the self advocate aspect. One of the things that we really want to give you is just a very well-rounded perspective on Operation House Call. We do have a medical student who actually was sharing with me earlier that she participated in a pilot program prior to Operation House Call, becoming I guess you could say more of a normal elective. I can’t think of the right words this morning because coffee is a thing and it hasn’t totally kicked in yet. But all that to say, super excited to hear her story.

My name is Nas. I am currently a third year student at UMASS Gen Medical School. As you said, I participated in a pilot program of Operation House Call in a more optional opt-in format, and then helped bring Operation House Call into the core curriculum at UMASS so that all students are able to participate in it. I grew up with an older cousin with an intellectual and developmental disability, and he was definitely a guiding force in my reasons for going into medicine. Though I changed my mind a million times about what I might want to go into, I’ve stayed true to that driving reason for pursing medicine in the first place.

So, I knew my first year that I wanted to find some way to still be an advocate in medical school. As you said, a lot of providers and people in the medical field don’t necessarily mean to overlook that patient population, but medical curriculums are often incredibly standardized and it’s hard to incorporate new educational material into them. I thought I would start on a small basis, and UMASS gives us the opportunity to lead student-driven electives. I have a particular interest in pediatrics, so I initially led an elective on caring for pediatric patients with disabilities and complex medical needs.

I did a little bit of research and discovered Operation House Call, which as you heard previously in this episode, it’s basically part core curriculum/part interactions with an individual and their family members with some sort of disability. I think that I can speak for most medical students when I say that the best way to learn how to care for patients with complex needs, is just to hear their stories, hear what day-to-day life is like for them, hear what obstacles they face, and hear about both difficulties and successes in the medical field.

That’s exactly what Operation House Call does. I participated in the pilot program through that elective, but now every first year has this Operation House Call program integrated into their first year curriculum. It starts with Maura coming in and giving some tips and tricks on how to interact with patients that might have sensory issues, or any sort of challenges or obstacles that some of these patients may face in medical settings. She shares her story, and shares some perspectives she has from being a part of the Arc of Massachusetts for so many years.

Then students get the chance to break up into smaller groups and meet with individuals with disabilities and their families, and just again, hear their stories, ask questions in a small group setting. A lot of times it can be difficult when you’re given a sort of standard curriculum in a 300 person class. You don’t want to embarrass yourself or kind of expose yourself for not knowing much about this patient population in such a large setting, so I really do think that breaking these conversations down into groups of five or six gives medical students the chance to ask any questions that are on their mind.

I’ve found that through talking with more and through participating in the program families can be more honest. Some medical students have never had the chance to really interact with anyone with any sort of disability. So, it kind of just breaks the ice and I think allows medical students to feel more comfortable going forward. There are so many individuals in the United States that have disabilities that are obvious or not so obvious. Just breaking the ice and giving medical students that initial interaction so that when these patients circle through their practices they feel at least a little more comfortable accepting these patients and billing willing to see them, I think is the ultimate goal of Operation House Call.

I’m glad that more and more physicians that are trained at UMASS will feel comfortable with these interactions, and feel comfortable accepting new patients regardless of the disabilities they face. I think the home visit is the most valuable part, and I think a major part of that stems from the fact that you’re not only discussing a patient’s medical conditions, you’re really discussing what day-to-day life looks like for them, the social challenges they face. I think that’s the most important part to keep in mind when interacting with these patients, understanding that it goes beyond just a medical condition or diagnosis. It really does impact day-to-day life, and getting to learn a bit more about what day-to-day life looks like for them does ultimately impact the care that medical providers should be providing.

I think that’s both the best and honestly the most tricky part, because yeah as a physician or a healthcare provider, your responsibility is to aid patients with their medical conditions or medical problems they’re facing. But a lot of times with these patients, there’s a lot of social issues that come up too, whether that be navigating resources that should be provided to them via the government, advocating for them in job settings or school settings depending on the patient’s age, securing transportation to and from doctors’ appointments. There’s a million social things that go into caring for this population.

And so, a healthcare provider’s job goes beyond just that basic medical care. It broadens into just caring for this individual as a whole, and helping to alleviate the day-to-day stressors they face as best we can. I think that’s a major challenge, and it’s not quite clear what the best solution for that is. I definitely think that some specialties have a little bit more time to navigate those kinds of social complexities and to make more change in just the day-to-day life of their patients. I think it’s at least a good thing to get physicians to start thinking about and brainstorming ways that they can really impact the day-to-day life of these patients and make them easier.

Yes. No, speak that truth. I think I can speak for all of our co-hosts when I say we love an OG. We love a trendsetter. So, thank you for being an early adopter of the curriculum through Operation House Call. I think it’s such a cool program. It’s going to make such an impact on the medical profession and for people with disabilities. I’m just going to say it, more doctors like Nas, that’s what we want to see. Also, more self advocates like Jonathan, while we’re on the topic. So, thank you Nas for sharing your story, and thank you to all of our amazing guests today. I hope all of our listeners are going to go forth and create something like this in their state.

Absolutely. Thank you guys so much, and thank you guys for sharing our story. I really do hope that more and more medical schools start to incorporate this into their curriculum.

Oh my gosh, quite the episode today. People were shouted out. People were called out. Our guests today were spitting that truth. Raquel was on fire. [email protected], if you want Raquel host with us again. Now comes the time in every episode that we all fear. Stephanie, do you have a joke?

Of course I do, although you did have a really nice pun there, Michelle. I’ll let people figure that one out for themselves. Here’s the joke for this episode. What do you call a dog that knows everything? Any guesses?

I got nothing.

A Labra-Google.

Oh.

By the way, my partner says that I should have given her credit for the last joke, so I’m giving her credit for this joke.

That one, last month’s joke, was better. Oh. It all makes sense now.

Wow, Michelle just said that she liked my jokes. You’ve heard it here, y’all. You heard it here.

I think I said I liked your partner’s joke, but…

Rewind. Rewind.

And that concludes the Joke of the Month. You could always hit the podcast at NDRN.org if you have topics you’d like us to create an episode around. Do you have a spotlight story you want to share? If you have a joke for Stephanie, or you want to vote to get rid of the Joke of the Month, all of those are acceptable, you can always email us if you don’t like the jokes.

Fake news.

Jack, how can they follow us on social media?

You can follow us on Twitter, LinkedIn, Facebook, Instagram. We’re @NDRNAdvocates on most of them. Yeah, follow us.

I think that’s a wrap y’all. Who’s got final words of wisdom before Jack puts the outro music on us?