August 5, 2023 • 29 mins
Dr. Robert Hilliard is the CEO of Legacy Community Health and Chinelo Nweke is their operations director for senior care. Senior care is one of the expanding areas of services Legacy Community Health has been deploying lately. Expansion is in fact the name of the game as they will also open 3 new clinics in schools. Dr. Hillard also explains how they are implementing value-based healthcare which includes keeping up with patients and helping them stay on their therapies. You can help them reach even more people by donating here: www.legacycommunityhealth.org
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(00:06):
Welcome to Houston, PA, Houston'spublic Affairs show, an iHeart Media broadcast.
Our disclaimer says that the opinions expressedon this show to not necessarily reflect
those held by this radio station,its management staff, or any of its
advertisers. My name is Laurent Iam the Texan from France, and I
(00:26):
welcome Legacy Community Health to the showtoday. They used to be called the
Montrose Clinic at the end of thenineties when I first encountered this organization.
It's an amazing place. It wascreated to serve poor people in neighborhoods that
were disregarded by I guess a societyof the time. I came into contact
(00:48):
with it in the mid nineties,back when the Age's scare was still on
high volume. We were still veryafraid of shaking hands with people wait to
HIV. It's hard to remember thatstuff right, especially since today HIV is
no longer a death sentence, butback then it was. And I remember
even going to the Montrose Clinic.I had a steady girlfriend. We wanted
(01:11):
to be in a serious relationship,and it was one of the places where
you could get to self texted fordiseases and we did that because it was
anonymous. It was so important backthen, of course, the people could
be treated and tested for all kindsof diseases anonymously. And they have since
rebranded themselves to call themselves the LegacyCommunity Health, and they've they've expanded their
(01:36):
services in ways that are practically incomprehensibleto this French kid. I grew up
in France where organizations like this couldn'tpossibly exist because the government has an ironclad
control over medical issues of all kinds, whether they are administered or cured.
They even control how you die overthere. And it's just extraordinary to me
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to see these private organizations, thenonprofit organizations anchor themselves into the community and
blossom because people recognize that they aredoing great work, and so much of
their support actually comes from the community. And they can work independently from the
government, which means that they canwork a whole lot better than the government.
(02:19):
And because they have to pinch theirpennies unlike the government, their services
are actually efficient and when you givethem some money, you can bet that
it goes to services that serve thepeople you mean to help. And you
can do that by going to LegacyCommunity Health dot org. Legacy Community Health
dot org. You can see theirprograms, you can part you can take
(02:40):
advantages of their programs they have.They even have dental services now. But
most importantly you can become aware ofit. You can spread the word.
They have clinics and schools. Nowwe're going to talk about that with my
guests. Doctor Robert Hillard aka BobbyHillard is the CEO of leg i See
Community Health and with him is Chanelloand Wike. She is the operations director
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for Senior Care, which is anotherarea in which they are expanding, looking
out for our seniors. The boomershave ushered in a new era of getting
older. They're doing in a hickof a lot better than everybody else,
and thankfully us gen xers who aretheir children are doing it even better.
And that is worth talking about.But Bobby, first of all, thank
(03:28):
you for coming. Man. Wehad to cancel the show because of a
problem I had. These people's kindnessand patience with me has been extraordinary and
I think it's probably representative of thecare you give your patience, So thank
you. Do you remember the Manto'sClinic back when it was called that,
of course, I do. Imoved to Houston in nineteen ninety seven for
(03:50):
residency and it was absolutely the Manto'sclinic. I recall those days. Did
you volunteer there by any chance?I tried to volunteer there. My schedule
would not allow it us a residive, but I definitely tried. And you
were on the board when y'all rebrandedto Legacy Health right before. Yes,
yeah, yeah, so you're aphysician, I am that it's correct.
Did you specialize in anything or sucha gynecology? So you take care of
(04:12):
women and that has been an areaof great expansion too. And do your
spearheading. What you're calling value basedhealthcare, which is a new way of
thinking about healthcare which essentially looks tothe needs of the people in accordance to
how much they can pay. Isand that I'm over simplifying the heck out
of it. So you want toexpand on that, I will expand again.
(04:35):
Thanks for having a solution. Soum, you know, healthcare is
one of the last industries that sortof has a payment for a service and
not a result. So here's anexample. If your kitchen seek was clogged
and you called a plumber and theplumber came out, and the plumber you
know, snake your kitchen, seekand when the plumber was finished, there
(04:59):
was still water in your seak.You would probably not pay the pumber for
that service, or maybe pay somesmall service fee, but you wanted to
seek water emptied and it's still fullof water. So healthcare is going in
that direction. Payers of federal governorssaying, look, we want people to
(05:21):
get better in their disease state,not just have a service of seeing someone.
So value based care is driving sortof results oriented medicine versus sort of
a service oriented medicine. So insteadof having people come in on a chain
link and charging them and giving thema prescription and sort of just hoping they
(05:44):
get better and counting on them tocome back if they don't, you're trying
to actually keep a look on thehealth outcome of the people you're serving,
so you're keeping up with them.Very well said that is the goal.
The goal is to make sure whenthey leave the four walls in the exam
room and they go home and theylive their lives, that they are still
taking care of their help, takingmedications, eating correctly, exercising. And
(06:10):
there are different mechanisms and tools,and those are tools are still developing to
help do that. So you're tryingto identify not only would is ailing your
patients, but what may be contributingto them getting sick. For instance,
that is you sound like a doctor. You sound like a French doctor.
Actually, you know, he getshome. I lived in a small town
(06:32):
outside of the big time. Butthe doctor came to our house and in
the evening if they were if thefever and the child was high, you'd
get a call. How's Laurent doing. Oh he's great? Thanks do clicking.
I mean it looks it's impossible ina city of five million people.
But but man, that that wholeidea that the doctor really cared for the
(06:54):
patients and had maybe somebody on thestaff make that call. We've lost that.
These are big machines. They chargeyou thirty dollars to parking for twenty
minutes. That's what it's about,isn't it. I mean, well,
I hope it's not like that alegacy. It's it is, absolutely there's
(07:20):
a part of it. This soundsalmost ridiculous that we're talking about these ideas
that sound revolutionary in twenty twenty four. Twenty three. Yeah, it's twenty
three. I don't even know whatday it is. But if you're spearheading
this idea, and I'm guessing youcan get people behind it, right,
(07:40):
isn't that something that would eventually spreadto the commercial medical field if we can
call it that, absolutely, Sovalue based care actually start its roots are
like in the nineteen sixties, It'sbeen talked about for a while. It
really is sort of excited accelerating duringthe Accountable Care Act, or better than
it's a bomb acare, there arelots of provisions for the payers that said
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or health insurance companies that said,look, we're going to give you extra
money when we see that your patientpopulation has improved their health, they've gotten
the tests they need, those kindof things, And that's what sort of
kind of jump started the bomb jumpstarted value based care in the most recent
sort of iteration of it. So, how do you implement this at legacy
(08:26):
community Health. You've got case workersthat are on the case, and do
your doctors actually your physicians actually followup? How does it work? So
great questions. That's that, firstof all, it begins with the intake
of the patients. So when apatient sees their clinician. The clinician tries
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to identify yet both what their physicalelements are, their behavior health elements are,
and then the barriers they may haveto achieve their best health possible.
And so we have social workers onstaff, We have case workers who can
then help the patient address their needs. So if there's a need with you
(09:07):
know, electric bill, light bill, housing, whatever it may be,
we try to address those needs ofpharmacies. So right, you could have
an amazing clinician, amazing medical assist, an amazing front desk person, but
if the patient can't get their medication, the patient won't get better. So
we have pharmacies in our clinics thatwere expanding that to make sure patients can
(09:31):
quickly and easily get their medication andtake their medication. How do you set
up a network of pharmacies up againstWalgreens and cvs, these massive conglomerates.
You can you make a profit atall in any way? I know you're
a nonprofit, that's not the points, but you got to keep the lights
on, and all these things arevery very expensive, including paying a pharmacist.
(09:54):
So for us, it's the utilizationwhere we think we do better than
the wall. Reason CBS is inthe big box. Pharmacies are our customer
service. Our customer intimacy is secondto nine. If you survey our clients,
our patients, they would tell youthat. So that's how we compete.
We don't compete all the other things. We say. Look, if
you come, if you come tous, you'll have better service. It's
(10:18):
been shown the US in our pharmacy, patients actually are more adherent to the
medications have better outcomes than those whodo not. Why, um, it's
it's the council that our pharmacists actuallysit around like council patients. Yeah,
so they actually take a few minutesto explain instead of getting one of those
grocery store rolls. It falls tothe ground. It's been printed out by
(10:39):
the computer. Nobody reads those things. First of all, there's there's five
pages of potential risks of death,a million ways to die, and but
but then and the instructions are systematicallyburied. To be honest with you,
the last the last ones I sawwere on the top of the first page,
but they were just sort of buriedin this hard to read print.
(11:01):
I practically had to pull out myphone to read them. And I'm familiar
with the medication I was taking it. But yeah, it's it's gotten a
little insane, and it's the drivethrough ting thing too super convenient. I'm
not, by the way, I'mnot criticizing these big box machines that are
doing a great job of getting abunch of medication into hands that people need
(11:24):
and a lot of times you justneed to get a refill. But what
you're pointing out it seems like aprimordial part of the service of a healthcare
organization and say, Okay, here'syour condition, here's what's causing it,
including maybe we need to fix yourair conditioning to reduce the mold in your
house. Then that's I'm a meanderinga little bit, but I'm impressed that
you're looking at these things because you'retrying to figure out why these people are
(11:46):
getting sick. And obviously I usedtheir conditioning because it's a big thing right
now. But if you have ifyou have a hot, human, moldy
house and you have respiratory conditions todeal with, it's a hundred and correct,
one hundred. Even even talking aboutthe family pet, the kid is
going to the mercy. Yeah,but all the time with rstry problems and
(12:07):
you find out their forecasts, right, and you sort of talk about what
that looks like. So you arelistening to Houston PA, Houston's Public Affairs
show. My name is Laurent andmy guests are here from Legacy Community Health.
They're online at Legacy Community Health dotorg. Legacy Community Health dot org.
(12:31):
You can partake of their services.All you need to do is go
to their website. They've got abunch of locations. We're gonna talk about
that now. They're even in schoolsand they're expanding their senior services. Uh.
And to talk about that, wehave Channello Nueke there O p there.
She is the operations director for SeniorCare and with her is doctor Robert
Hillard, the CEO of Legacy CommunityHealth. Channello, first of all,
(12:54):
I have to ask you where isyour awesome name coming from? So?
I am Nigerian, so it's aNigerian name. Were you born there?
No? I was born here inHouston, Texas. Have you been to
Nigeria? Yes, a few timesto visit family that still lives there.
So do you speak yes? Ido. I speak Ebo, So you're
bilingual. I would say a littlebit stronger on the English. Yeah,
(13:16):
but so when you go over there, can they tell your American Oh absolutely,
you speak you speak with an Americanaccent, well a bit. I
think it's a bit of the accent. And then also it's just um family
knows me, and so they arequick to kind of make that she's our
family from America. So it's alwaysexciting to visit though. Do they come
(13:39):
here too, Yes, Actually mygrandma is I'm visiting us an out is
the sum of America's the modern life. When I was a kid coming here
from France, it just it reallyblew my mind, the all the It's
just such an amazing place. Peopledon't if you haven't lived in other parts
of the older world, you justdon't realize how good we have it here.
(14:03):
It's just it's just absolutely amazing andhow much more advanced we are and
in some other words not so much. But uh so, So your grandmother
must be going around and there's anendless list of activities she probably wants to
do, mostly stay at home,just being with our grandkids. I think,
(14:24):
oh, yeah, well okay,so no, no, no,
you've explained that in a way thatmakes sense to me. Yeah, if
she came here, of course shewants to see her grandchildren. You're in
charge of the operations for senior care, yes, what does that mean?
This is the latest. It's arecent expansion of your services, right,
(14:46):
yes, And so you know,I think for many of those that know
legacies history, were committed to drivinghealthy change in the communities that we serve.
And so, as you mentioned,we have access to help care for
women and adults, pediat right,some of our vision dental, and so
we're serving all of those communities andwe realize that there was also a need
to sort of help our senior carepopulation as well, and so we kind
(15:11):
of expanded into that service and createddesignated clinics specifically to senior care. So
it's a designated location for Yes.So we have three clinics specific to providing
care for older adults, and sosome of our clinics you may see a
mix of some of our service lines. The unique thing about our senior care
clinics is that it's solely for olderadults. You know, of course,
(15:31):
if anyone comes for care, wenever want to turn anyone away, but
those three clinics are specific to providingcare for the older adults located around third
Ward Stafford as well as Missouri City. Yeah, we have an aging population
that we're still not talking very muchabout. And as a matter of fact,
I would say that the occident tothe west has a huge problem in
(15:52):
talking about dying. We're naturally afraidof it. Nobody wants to do it.
But it's difficult to to talk aboutthis subject without rising a bunch of
negative feelings, mostly of sadness,right because but we internalize these griefs and
these bereavements in such a way onthe West that is particularly unhealthy, I
(16:15):
think, and I think that that'sprobably one of the reasons why we don't
talk about senior care much, rightAnd I think that's one of the things
and perspectives that we want to educateour patients about, is that we don't
want you to feel like you're comingto our clinics just to receive some sort
of treatment, you know. Wewant our patients to consider their health from
a place of wellness. And Ithink when we kind of tie it into
(16:37):
some of Bobby's conversation about value basedcare, the goal for us really is
to help our patients live healthier,longer, and so for our patients who
do come to the senior clinics,you know, we really just want to
collaborate with you on their journey ofaging and really helping you navigate throughout that.
And so the clinic design, fromthe staffing to the layout a specific
(16:59):
solely to that population and really justmaking them comfortable as they navigate that journey.
Yeah, Bobby does jiu jitsu.I learned in the in the elevator.
Uh, I do not well.Yeah, obviously doesn't know what he's
doing. You shouldn't need you needa new trainer, but you're we're we're
(17:21):
starting to talk a little bit morefrequently about the importance of keeping muscle mass
as we grow older. Uh,it becomes more and more difficult to build
muscle mass as we go older.When you're twenty, it just lift weights,
eat protein, whoop, it justgrows. But even if you're if
you come into old age really buff, there's an atrophy of some kind,
right, we just naturally lose theability to maintain muscle mass. And yet
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uh, it's one of the mostimportant things that it holds up the whole
structure of the body. Were nothingbut bones and water. Really it's kind
of crazy. We're walking bags ofchemical reactions. If you think about it,
it really belittles our nature, whichis miraculous. But in a way,
we just we are a reaction andit takes its course. So how
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much do y'all talk about actually beingan active and going on walks? The
last time I heard a ten tofifteen minute walk a day, or just
walking around for ten fifteen minutes canstave off arthritis in a major way,
especially if you started earlier in life. So is that a big thing?
(18:30):
So for our senior care clinics,we kind of take an integrative care model
approach, and so our patients canreceive their primary care not only from our
board certified geriatricians who are trained specificallyto care for older adults, but they
also have access to additional resources likeour geriatric psychiatrist, nutrition, our social
(18:52):
worker, as well as our pharmacyprogram specialist, and so all of those
individuals are there to provide care forthe whole and so even conversations as far
as fitness and being active also takeplace. But where we see a lot
of that conversation is through more ofour preventative visits, like our Medicare wellness
visit and that kind of goes backto what you mentioned about being a little
(19:15):
bit more proactive to the patient's careversus reactive. Have you found that there's
a common problem among our aging populationthat is sort of being ignored. I'm
asking if there was something that hascaused you to re examine how you were
strategizing your services and maybe you'd realizedwe need to do more of this,
more counseling or because again, legacyhealth is about doing a lot more than
(19:40):
just distributing medicine. You're actually explaininghow the medicine goes down to put an
image that is I think very prescient. But yeah, is there have there
been any surprises as you're fielding allthis help? I think the biggest one
is realizing that our patients, wetry to empower them more into taking their
(20:02):
care into their own hands, andso we're available there of course and working
and collaborating with them together to sortof improve that health outcome or identify those
barriers that may be experiencing. Buta big portion of that is really just
empowering them and helping them understand what'shappening throughout that healthcare journey. A lot
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of times it's just a lack ofunderstanding or awareness that something exists or is
prevalent within either that community, patientsfamily history, and so we've kind of
expanded on our ability to really supportand educate them on what's happening throughout their
care. You are listening to Houston, PA, Houston's Public Affairs Show.
My name is Laurent and my guestsare here from Legacy Community Health. Their
(20:45):
online at Legacy Community Health dot org. Legacy Community Health dot org. Chanello
Nuiki is the operations director for SeniorCare and doctor Robert Hillard is their CEO.
You are expanding your care into schoolsand I wonder if that's not.
(21:08):
I mean, it's just so obvious, right if you're dealing with seniors that
need to learn a little bit moreabout how to take care of yourselves.
If you can catch them with theirkids, then they might develop those habits
when their kids. And again wementioned exercise and good eating habits. Uh
Man, people don't realize how actuallyit's fairly easy to to eat well.
If you have a croc pot that'ssomething that you can buy for very little
(21:32):
money, and even a secondhand store. But to cook and a crop.
But people don't realize how easy itis and how much less expensive it is
if you're buying all your produce andmeat. Anyway, that's it for another
show. Uh. You're you're expandingyour your healthcare services into schools though.
Uh, And it's kip academies.It's you know what, it's the usual
suspect of those schools that are actuallylooking to change how kids are taught.
(21:56):
And they're they're successful, Their schoolsare high performing, proving every day that
there's nothing wrong with the kids.It has everything to do with our political
will to educate them the right way. And I'm gonna get off my high
horse and let you answer this question. Yeah, what are you doing?
So the model we have in schoolsis something we are very proud of.
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So we have a behavioral person,so a therapist. We have a clinician,
so a nurse practitioner or a physicianand their supports. Now, and
the beautiful thing and the comparison Iwould say between the senior care and school
based care is really the behavioral healtha component. So that is a service
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underutilized by most seniors because it wassuch a stigma and their day of acknowledging
they have behavioral deeds today in theschools that we see kids say it with
pride. Hey that's my therapist.When they see her or him down the
hall. There's no shame, there'sno stigma. It's just part of the
(23:03):
help they talk about. It's abeautiful, beautiful change from generation to generation
and people talk about their problems.Maybe your friend can help too, and
if the friend doesn't know about it. So you're setting up these clinics and
you're essentially inviting young people to comein whenever they need. We see anyone
at the school, anyone at theschool, any kid of the school who
gets sick, we see them.How are you funding all these programs?
(23:26):
You're talking about specialists, people thatare professionals, that have a high education.
This is all very, very expensive. Where it feels miraculous that you
can set this up to this Frenchguy again, I mean, I'm so
impressed. We have grants, Weare constantly fundraising legacy Community helped dot org.
Five dollars makes a difference. Fivedollars makes the difference, And we
(23:49):
are constantly looking for different ways tobe efficient with our resources and also engage
the community when they have resources alsothat that we can to life. Yea,
So are you going to keep expandingin the schools? Do you have
plans on setting up more clinics?You have three locations now? No,
we have no we've we're thirty locations. We have three. What's opening this
(24:11):
school year? Okay, so there'sover thirty locations now and you're opening three
this year with plans on opening more. Y'all, y'all want to put y'all
want to put one in every school. Basically when there is a need of
where there is a need, weour mission is to provide access to care
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before we run out of time.I want to mention because it is so
pursuing to the current conversation, isthat you have a program which deals directly
with diabetes to help people deal withtheir diabetes. I think COVID did something
good and showing us that. Oneof the reasons we had more Americans die
(24:52):
from COVID on average then say aeurope saul among their population, especially the
elderly population, has been because ourelderly populations tends to be very overweight,
and there's just there's a constant streamof problems. You're going to run into.
Even if you don't contract it,you don't develop any kind of diabetes,
your joints are going to suffer andyou're going to lose mobility a lot
(25:15):
faster than somebody who does jiu jitsufor instance, Right, I mean back
to that muscular truth. So thisthis idea of managing diabetes, how do
you approach that? Because this isa very sensitive body issue. Right,
Your people are ashamed, afraid,and they I mean, we don't really
(25:36):
want to talk about it. Sowe manage it from a variety of different
angles. I think when we speakspecifically to our senior care clinics, one
of the biggest ways that we combatprevention is through that Medicare wellness visit I
mentioned, And so that visit isa free of charge visit for any Medicare
beneficiary that they complete once a calendarear and so that to visit focuses specifically
(26:02):
on creating a personalized health plan withyour geriatrition to help again improve the outcome
of that patient. And so youmay go through things like cancer screenings,
a health risk assessment, and eventighten some of that diabetes conversation and again
just helping those patients be more proactivewith their care and identifying things before they
(26:23):
get to a place where we startto fall into hospital admissions, which are
things we really want to avoid forsenior population. And then in some aspects,
we also have programs available, whetherit's through our nutrition team or our
care management team that Bobby mentioned thatties into value based care and really just
communicating with those patients, whether it'sproviding a specific kit or resource to help
(26:48):
them monitor that a ONC or thatsugar level and just going from there.
So we try to combat it justdepending on the patient and their specific needs
and where they're receiving their care,whether it's through our senior care clinics,
adults, pediatrics, and so forth. Yeah, well, you know,
we're just scratching the services. We'rejust scratching the surface of all the services
(27:11):
that are available at Legacy Community Health. You really have to go to our
website to check it out and seethe breadth of the development that they're undergoing.
And it get continues. They're openingthree new clinics and three new schools
just for this school year. They'vegot over thirty I think it's I think
I want to say that might beone of the most valuable strategic moves you're
(27:32):
making, because if we can teachyoung people to exercise and eat less processed
food, if we can just dothat, we would reduce a lot of
our mortality by a significant percentage.And then if we could teach those same
people to actually eat well and exercisewell regularly, our aging population would get
(27:53):
older and it would stay happier andthey get to play with their grandchildren more.
I want to say to close outthe only reason Legacy Community Health can
do this well. First of all, it's because it's operating in the United
States of America that allows these sortof organizations to set up shop like this.
It's just an extraordinary achievement as faras human evolution, as far as
(28:15):
I'm concerned, because you can't dostuff like this in Europe. A private
company, especially a nonprofit, wouldnot be able to expand the way it
is. They do it because ofour help and because we're a community.
If you go to Legacy Community Healthdot org and you only want to donate
a few dollars, it's all youcan afford, it makes a difference.
(28:36):
There's so many of us. Ilike to say that the average woman carries
over five dollars and loose change atthe bottom of her purse. And if
every woman in this town emptied theirpurse on the table and donated that money
to Legacy Health, we'd have overtwo million dollars easy, you know,
and imagine. I mean, it'sit's that simple to actually find five dollars.
(28:56):
And for those of y'all who usethe drive through Arbucks, consider maybe
one of those Starbucks goes to nonprofitorganizations. There are many ways that donate.
Don't think for one second that it'stoo small and that it's not worth
your time. It absolutely is.Legacy Communityhealth dot org. Legacy Communityhealth dot
(29:17):
org. If you have any questionsrelated to those shows that put on Houston,
PA, just send me an email. Texan from France at gmail dot
com. Texan from France at gmaildot com, and I want to thank
you for listening and caring about theissues that put on this show. My
name is Lawrence. I am theTexan from France and this has been Houston
(29:37):
PA, Houston's public affairs show,Houston Strong
Welcome to Houston, PA, Houston'spublic Affairs show, an iHeart Media broadcast.
Our disclaimer says that the opinions expressedon this show to not necessarily reflect
those held by this radio station,its management staff, or any of its
advertisers. My name is Laurent Iam the Texan from France, and I
(00:26):
welcome Legacy Community Health to the showtoday. They used to be called the
Montrose Clinic at the end of thenineties when I first encountered this organization.
It's an amazing place. It wascreated to serve poor people in neighborhoods that
were disregarded by I guess a societyof the time. I came into contact
(00:48):
with it in the mid nineties,back when the Age's scare was still on
high volume. We were still veryafraid of shaking hands with people wait to
HIV. It's hard to remember thatstuff right, especially since today HIV is
no longer a death sentence, butback then it was. And I remember
even going to the Montrose Clinic.I had a steady girlfriend. We wanted
(01:11):
to be in a serious relationship,and it was one of the places where
you could get to self texted fordiseases and we did that because it was
anonymous. It was so important backthen, of course, the people could
be treated and tested for all kindsof diseases anonymously. And they have since
rebranded themselves to call themselves the LegacyCommunity Health, and they've they've expanded their
(01:36):
services in ways that are practically incomprehensibleto this French kid. I grew up
in France where organizations like this couldn'tpossibly exist because the government has an ironclad
control over medical issues of all kinds, whether they are administered or cured.
They even control how you die overthere. And it's just extraordinary to me
(01:57):
to see these private organizations, thenonprofit organizations anchor themselves into the community and
blossom because people recognize that they aredoing great work, and so much of
their support actually comes from the community. And they can work independently from the
government, which means that they canwork a whole lot better than the government.
(02:19):
And because they have to pinch theirpennies unlike the government, their services
are actually efficient and when you givethem some money, you can bet that
it goes to services that serve thepeople you mean to help. And you
can do that by going to LegacyCommunity Health dot org. Legacy Community Health
dot org. You can see theirprograms, you can part you can take
(02:40):
advantages of their programs they have.They even have dental services now. But
most importantly you can become aware ofit. You can spread the word.
They have clinics and schools. Nowwe're going to talk about that with my
guests. Doctor Robert Hillard aka BobbyHillard is the CEO of leg i See
Community Health and with him is Chanelloand Wike. She is the operations director
(03:06):
for Senior Care, which is anotherarea in which they are expanding, looking
out for our seniors. The boomershave ushered in a new era of getting
older. They're doing in a hickof a lot better than everybody else,
and thankfully us gen xers who aretheir children are doing it even better.
And that is worth talking about.But Bobby, first of all, thank
(03:28):
you for coming. Man. Wehad to cancel the show because of a
problem I had. These people's kindnessand patience with me has been extraordinary and
I think it's probably representative of thecare you give your patience, So thank
you. Do you remember the Manto'sClinic back when it was called that,
of course, I do. Imoved to Houston in nineteen ninety seven for
(03:50):
residency and it was absolutely the Manto'sclinic. I recall those days. Did
you volunteer there by any chance?I tried to volunteer there. My schedule
would not allow it us a residive, but I definitely tried. And you
were on the board when y'all rebrandedto Legacy Health right before. Yes,
yeah, yeah, so you're aphysician, I am that it's correct.
Did you specialize in anything or sucha gynecology? So you take care of
(04:12):
women and that has been an areaof great expansion too. And do your
spearheading. What you're calling value basedhealthcare, which is a new way of
thinking about healthcare which essentially looks tothe needs of the people in accordance to
how much they can pay. Isand that I'm over simplifying the heck out
of it. So you want toexpand on that, I will expand again.
(04:35):
Thanks for having a solution. Soum, you know, healthcare is
one of the last industries that sortof has a payment for a service and
not a result. So here's anexample. If your kitchen seek was clogged
and you called a plumber and theplumber came out, and the plumber you
know, snake your kitchen, seekand when the plumber was finished, there
(04:59):
was still water in your seak.You would probably not pay the pumber for
that service, or maybe pay somesmall service fee, but you wanted to
seek water emptied and it's still fullof water. So healthcare is going in
that direction. Payers of federal governorssaying, look, we want people to
(05:21):
get better in their disease state,not just have a service of seeing someone.
So value based care is driving sortof results oriented medicine versus sort of
a service oriented medicine. So insteadof having people come in on a chain
link and charging them and giving thema prescription and sort of just hoping they
(05:44):
get better and counting on them tocome back if they don't, you're trying
to actually keep a look on thehealth outcome of the people you're serving,
so you're keeping up with them.Very well said that is the goal.
The goal is to make sure whenthey leave the four walls in the exam
room and they go home and theylive their lives, that they are still
taking care of their help, takingmedications, eating correctly, exercising. And
(06:10):
there are different mechanisms and tools,and those are tools are still developing to
help do that. So you're tryingto identify not only would is ailing your
patients, but what may be contributingto them getting sick. For instance,
that is you sound like a doctor. You sound like a French doctor.
Actually, you know, he getshome. I lived in a small town
(06:32):
outside of the big time. Butthe doctor came to our house and in
the evening if they were if thefever and the child was high, you'd
get a call. How's Laurent doing. Oh he's great? Thanks do clicking.
I mean it looks it's impossible ina city of five million people.
But but man, that that wholeidea that the doctor really cared for the
(06:54):
patients and had maybe somebody on thestaff make that call. We've lost that.
These are big machines. They chargeyou thirty dollars to parking for twenty
minutes. That's what it's about,isn't it. I mean, well,
I hope it's not like that alegacy. It's it is, absolutely there's
(07:20):
a part of it. This soundsalmost ridiculous that we're talking about these ideas
that sound revolutionary in twenty twenty four. Twenty three. Yeah, it's twenty
three. I don't even know whatday it is. But if you're spearheading
this idea, and I'm guessing youcan get people behind it, right,
(07:40):
isn't that something that would eventually spreadto the commercial medical field if we can
call it that, absolutely, Sovalue based care actually start its roots are
like in the nineteen sixties, It'sbeen talked about for a while. It
really is sort of excited accelerating duringthe Accountable Care Act, or better than
it's a bomb acare, there arelots of provisions for the payers that said
(08:05):
or health insurance companies that said,look, we're going to give you extra
money when we see that your patientpopulation has improved their health, they've gotten
the tests they need, those kindof things, And that's what sort of
kind of jump started the bomb jumpstarted value based care in the most recent
sort of iteration of it. So, how do you implement this at legacy
(08:26):
community Health. You've got case workersthat are on the case, and do
your doctors actually your physicians actually followup? How does it work? So
great questions. That's that, firstof all, it begins with the intake
of the patients. So when apatient sees their clinician. The clinician tries
(08:46):
to identify yet both what their physicalelements are, their behavior health elements are,
and then the barriers they may haveto achieve their best health possible.
And so we have social workers onstaff, We have case workers who can
then help the patient address their needs. So if there's a need with you
(09:07):
know, electric bill, light bill, housing, whatever it may be,
we try to address those needs ofpharmacies. So right, you could have
an amazing clinician, amazing medical assist, an amazing front desk person, but
if the patient can't get their medication, the patient won't get better. So
we have pharmacies in our clinics thatwere expanding that to make sure patients can
(09:31):
quickly and easily get their medication andtake their medication. How do you set
up a network of pharmacies up againstWalgreens and cvs, these massive conglomerates.
You can you make a profit atall in any way? I know you're
a nonprofit, that's not the points, but you got to keep the lights
on, and all these things arevery very expensive, including paying a pharmacist.
(09:54):
So for us, it's the utilizationwhere we think we do better than
the wall. Reason CBS is inthe big box. Pharmacies are our customer
service. Our customer intimacy is secondto nine. If you survey our clients,
our patients, they would tell youthat. So that's how we compete.
We don't compete all the other things. We say. Look, if
you come, if you come tous, you'll have better service. It's
(10:18):
been shown the US in our pharmacy, patients actually are more adherent to the
medications have better outcomes than those whodo not. Why, um, it's
it's the council that our pharmacists actuallysit around like council patients. Yeah,
so they actually take a few minutesto explain instead of getting one of those
grocery store rolls. It falls tothe ground. It's been printed out by
(10:39):
the computer. Nobody reads those things. First of all, there's there's five
pages of potential risks of death,a million ways to die, and but
but then and the instructions are systematicallyburied. To be honest with you,
the last the last ones I sawwere on the top of the first page,
but they were just sort of buriedin this hard to read print.
(11:01):
I practically had to pull out myphone to read them. And I'm familiar
with the medication I was taking it. But yeah, it's it's gotten a
little insane, and it's the drivethrough ting thing too super convenient. I'm
not, by the way, I'mnot criticizing these big box machines that are
doing a great job of getting abunch of medication into hands that people need
(11:24):
and a lot of times you justneed to get a refill. But what
you're pointing out it seems like aprimordial part of the service of a healthcare
organization and say, Okay, here'syour condition, here's what's causing it,
including maybe we need to fix yourair conditioning to reduce the mold in your
house. Then that's I'm a meanderinga little bit, but I'm impressed that
you're looking at these things because you'retrying to figure out why these people are
(11:46):
getting sick. And obviously I usedtheir conditioning because it's a big thing right
now. But if you have ifyou have a hot, human, moldy
house and you have respiratory conditions todeal with, it's a hundred and correct,
one hundred. Even even talking aboutthe family pet, the kid is
going to the mercy. Yeah,but all the time with rstry problems and
(12:07):
you find out their forecasts, right, and you sort of talk about what
that looks like. So you arelistening to Houston PA, Houston's Public Affairs
show. My name is Laurent andmy guests are here from Legacy Community Health.
They're online at Legacy Community Health dotorg. Legacy Community Health dot org.
(12:31):
You can partake of their services.All you need to do is go
to their website. They've got abunch of locations. We're gonna talk about
that now. They're even in schoolsand they're expanding their senior services. Uh.
And to talk about that, wehave Channello Nueke there O p there.
She is the operations director for SeniorCare and with her is doctor Robert
Hillard, the CEO of Legacy CommunityHealth. Channello, first of all,
(12:54):
I have to ask you where isyour awesome name coming from? So?
I am Nigerian, so it's aNigerian name. Were you born there?
No? I was born here inHouston, Texas. Have you been to
Nigeria? Yes, a few timesto visit family that still lives there.
So do you speak yes? Ido. I speak Ebo, So you're
bilingual. I would say a littlebit stronger on the English. Yeah,
(13:16):
but so when you go over there, can they tell your American Oh absolutely,
you speak you speak with an Americanaccent, well a bit. I
think it's a bit of the accent. And then also it's just um family
knows me, and so they arequick to kind of make that she's our
family from America. So it's alwaysexciting to visit though. Do they come
(13:39):
here too, Yes, Actually mygrandma is I'm visiting us an out is
the sum of America's the modern life. When I was a kid coming here
from France, it just it reallyblew my mind, the all the It's
just such an amazing place. Peopledon't if you haven't lived in other parts
of the older world, you justdon't realize how good we have it here.
(14:03):
It's just it's just absolutely amazing andhow much more advanced we are and
in some other words not so much. But uh so, So your grandmother
must be going around and there's anendless list of activities she probably wants to
do, mostly stay at home,just being with our grandkids. I think,
(14:24):
oh, yeah, well okay,so no, no, no,
you've explained that in a way thatmakes sense to me. Yeah, if
she came here, of course shewants to see her grandchildren. You're in
charge of the operations for senior care, yes, what does that mean?
This is the latest. It's arecent expansion of your services, right,
(14:46):
yes, And so you know,I think for many of those that know
legacies history, were committed to drivinghealthy change in the communities that we serve.
And so, as you mentioned,we have access to help care for
women and adults, pediat right,some of our vision dental, and so
we're serving all of those communities andwe realize that there was also a need
to sort of help our senior carepopulation as well, and so we kind
(15:11):
of expanded into that service and createddesignated clinics specifically to senior care. So
it's a designated location for Yes.So we have three clinics specific to providing
care for older adults, and sosome of our clinics you may see a
mix of some of our service lines. The unique thing about our senior care
clinics is that it's solely for olderadults. You know, of course,
(15:31):
if anyone comes for care, wenever want to turn anyone away, but
those three clinics are specific to providingcare for the older adults located around third
Ward Stafford as well as Missouri City. Yeah, we have an aging population
that we're still not talking very muchabout. And as a matter of fact,
I would say that the occident tothe west has a huge problem in
(15:52):
talking about dying. We're naturally afraidof it. Nobody wants to do it.
But it's difficult to to talk aboutthis subject without rising a bunch of
negative feelings, mostly of sadness,right because but we internalize these griefs and
these bereavements in such a way onthe West that is particularly unhealthy, I
(16:15):
think, and I think that that'sprobably one of the reasons why we don't
talk about senior care much, rightAnd I think that's one of the things
and perspectives that we want to educateour patients about, is that we don't
want you to feel like you're comingto our clinics just to receive some sort
of treatment, you know. Wewant our patients to consider their health from
a place of wellness. And Ithink when we kind of tie it into
(16:37):
some of Bobby's conversation about value basedcare, the goal for us really is
to help our patients live healthier,longer, and so for our patients who
do come to the senior clinics,you know, we really just want to
collaborate with you on their journey ofaging and really helping you navigate throughout that.
And so the clinic design, fromthe staffing to the layout a specific
(16:59):
solely to that population and really justmaking them comfortable as they navigate that journey.
Yeah, Bobby does jiu jitsu.I learned in the in the elevator.
Uh, I do not well.Yeah, obviously doesn't know what he's
doing. You shouldn't need you needa new trainer, but you're we're we're
(17:21):
starting to talk a little bit morefrequently about the importance of keeping muscle mass
as we grow older. Uh,it becomes more and more difficult to build
muscle mass as we go older.When you're twenty, it just lift weights,
eat protein, whoop, it justgrows. But even if you're if
you come into old age really buff, there's an atrophy of some kind,
right, we just naturally lose theability to maintain muscle mass. And yet
(17:47):
uh, it's one of the mostimportant things that it holds up the whole
structure of the body. Were nothingbut bones and water. Really it's kind
of crazy. We're walking bags ofchemical reactions. If you think about it,
it really belittles our nature, whichis miraculous. But in a way,
we just we are a reaction andit takes its course. So how
(18:10):
much do y'all talk about actually beingan active and going on walks? The
last time I heard a ten tofifteen minute walk a day, or just
walking around for ten fifteen minutes canstave off arthritis in a major way,
especially if you started earlier in life. So is that a big thing?
(18:30):
So for our senior care clinics,we kind of take an integrative care model
approach, and so our patients canreceive their primary care not only from our
board certified geriatricians who are trained specificallyto care for older adults, but they
also have access to additional resources likeour geriatric psychiatrist, nutrition, our social
(18:52):
worker, as well as our pharmacyprogram specialist, and so all of those
individuals are there to provide care forthe whole and so even conversations as far
as fitness and being active also takeplace. But where we see a lot
of that conversation is through more ofour preventative visits, like our Medicare wellness
visit and that kind of goes backto what you mentioned about being a little
(19:15):
bit more proactive to the patient's careversus reactive. Have you found that there's
a common problem among our aging populationthat is sort of being ignored. I'm
asking if there was something that hascaused you to re examine how you were
strategizing your services and maybe you'd realizedwe need to do more of this,
more counseling or because again, legacyhealth is about doing a lot more than
(19:40):
just distributing medicine. You're actually explaininghow the medicine goes down to put an
image that is I think very prescient. But yeah, is there have there
been any surprises as you're fielding allthis help? I think the biggest one
is realizing that our patients, wetry to empower them more into taking their
(20:02):
care into their own hands, andso we're available there of course and working
and collaborating with them together to sortof improve that health outcome or identify those
barriers that may be experiencing. Buta big portion of that is really just
empowering them and helping them understand what'shappening throughout that healthcare journey. A lot
(20:22):
of times it's just a lack ofunderstanding or awareness that something exists or is
prevalent within either that community, patientsfamily history, and so we've kind of
expanded on our ability to really supportand educate them on what's happening throughout their
care. You are listening to Houston, PA, Houston's Public Affairs Show.
My name is Laurent and my guestsare here from Legacy Community Health. Their
(20:45):
online at Legacy Community Health dot org. Legacy Community Health dot org. Chanello
Nuiki is the operations director for SeniorCare and doctor Robert Hillard is their CEO.
You are expanding your care into schoolsand I wonder if that's not.
(21:08):
I mean, it's just so obvious, right if you're dealing with seniors that
need to learn a little bit moreabout how to take care of yourselves.
If you can catch them with theirkids, then they might develop those habits
when their kids. And again wementioned exercise and good eating habits. Uh
Man, people don't realize how actuallyit's fairly easy to to eat well.
If you have a croc pot that'ssomething that you can buy for very little
(21:32):
money, and even a secondhand store. But to cook and a crop.
But people don't realize how easy itis and how much less expensive it is
if you're buying all your produce andmeat. Anyway, that's it for another
show. Uh. You're you're expandingyour your healthcare services into schools though.
Uh, And it's kip academies.It's you know what, it's the usual
suspect of those schools that are actuallylooking to change how kids are taught.
(21:56):
And they're they're successful, Their schoolsare high performing, proving every day that
there's nothing wrong with the kids.It has everything to do with our political
will to educate them the right way. And I'm gonna get off my high
horse and let you answer this question. Yeah, what are you doing?
So the model we have in schoolsis something we are very proud of.
(22:18):
So we have a behavioral person,so a therapist. We have a clinician,
so a nurse practitioner or a physicianand their supports. Now, and
the beautiful thing and the comparison Iwould say between the senior care and school
based care is really the behavioral healtha component. So that is a service
(22:41):
underutilized by most seniors because it wassuch a stigma and their day of acknowledging
they have behavioral deeds today in theschools that we see kids say it with
pride. Hey that's my therapist.When they see her or him down the
hall. There's no shame, there'sno stigma. It's just part of the
(23:03):
help they talk about. It's abeautiful, beautiful change from generation to generation
and people talk about their problems.Maybe your friend can help too, and
if the friend doesn't know about it. So you're setting up these clinics and
you're essentially inviting young people to comein whenever they need. We see anyone
at the school, anyone at theschool, any kid of the school who
gets sick, we see them.How are you funding all these programs?
(23:26):
You're talking about specialists, people thatare professionals, that have a high education.
This is all very, very expensive. Where it feels miraculous that you
can set this up to this Frenchguy again, I mean, I'm so
impressed. We have grants, Weare constantly fundraising legacy Community helped dot org.
Five dollars makes a difference. Fivedollars makes the difference, And we
(23:49):
are constantly looking for different ways tobe efficient with our resources and also engage
the community when they have resources alsothat that we can to life. Yea,
So are you going to keep expandingin the schools? Do you have
plans on setting up more clinics?You have three locations now? No,
we have no we've we're thirty locations. We have three. What's opening this
(24:11):
school year? Okay, so there'sover thirty locations now and you're opening three
this year with plans on opening more. Y'all, y'all want to put y'all
want to put one in every school. Basically when there is a need of
where there is a need, weour mission is to provide access to care
(24:32):
before we run out of time.I want to mention because it is so
pursuing to the current conversation, isthat you have a program which deals directly
with diabetes to help people deal withtheir diabetes. I think COVID did something
good and showing us that. Oneof the reasons we had more Americans die
(24:52):
from COVID on average then say aeurope saul among their population, especially the
elderly population, has been because ourelderly populations tends to be very overweight,
and there's just there's a constant streamof problems. You're going to run into.
Even if you don't contract it,you don't develop any kind of diabetes,
your joints are going to suffer andyou're going to lose mobility a lot
(25:15):
faster than somebody who does jiu jitsufor instance, Right, I mean back
to that muscular truth. So thisthis idea of managing diabetes, how do
you approach that? Because this isa very sensitive body issue. Right,
Your people are ashamed, afraid,and they I mean, we don't really
(25:36):
want to talk about it. Sowe manage it from a variety of different
angles. I think when we speakspecifically to our senior care clinics, one
of the biggest ways that we combatprevention is through that Medicare wellness visit I
mentioned, And so that visit isa free of charge visit for any Medicare
beneficiary that they complete once a calendarear and so that to visit focuses specifically
(26:02):
on creating a personalized health plan withyour geriatrition to help again improve the outcome
of that patient. And so youmay go through things like cancer screenings,
a health risk assessment, and eventighten some of that diabetes conversation and again
just helping those patients be more proactivewith their care and identifying things before they
(26:23):
get to a place where we startto fall into hospital admissions, which are
things we really want to avoid forsenior population. And then in some aspects,
we also have programs available, whetherit's through our nutrition team or our
care management team that Bobby mentioned thatties into value based care and really just
communicating with those patients, whether it'sproviding a specific kit or resource to help
(26:48):
them monitor that a ONC or thatsugar level and just going from there.
So we try to combat it justdepending on the patient and their specific needs
and where they're receiving their care,whether it's through our senior care clinics,
adults, pediatrics, and so forth. Yeah, well, you know,
we're just scratching the services. We'rejust scratching the surface of all the services
(27:11):
that are available at Legacy Community Health. You really have to go to our
website to check it out and seethe breadth of the development that they're undergoing.
And it get continues. They're openingthree new clinics and three new schools
just for this school year. They'vegot over thirty I think it's I think
I want to say that might beone of the most valuable strategic moves you're
(27:32):
making, because if we can teachyoung people to exercise and eat less processed
food, if we can just dothat, we would reduce a lot of
our mortality by a significant percentage.And then if we could teach those same
people to actually eat well and exercisewell regularly, our aging population would get
(27:53):
older and it would stay happier andthey get to play with their grandchildren more.
I want to say to close outthe only reason Legacy Community Health can
do this well. First of all, it's because it's operating in the United
States of America that allows these sortof organizations to set up shop like this.
It's just an extraordinary achievement as faras human evolution, as far as
(28:15):
I'm concerned, because you can't dostuff like this in Europe. A private
company, especially a nonprofit, wouldnot be able to expand the way it
is. They do it because ofour help and because we're a community.
If you go to Legacy Community Healthdot org and you only want to donate
a few dollars, it's all youcan afford, it makes a difference.
(28:36):
There's so many of us. Ilike to say that the average woman carries
over five dollars and loose change atthe bottom of her purse. And if
every woman in this town emptied theirpurse on the table and donated that money
to Legacy Health, we'd have overtwo million dollars easy, you know,
and imagine. I mean, it'sit's that simple to actually find five dollars.
(28:56):
And for those of y'all who usethe drive through Arbucks, consider maybe
one of those Starbucks goes to nonprofitorganizations. There are many ways that donate.
Don't think for one second that it'stoo small and that it's not worth
your time. It absolutely is.Legacy Communityhealth dot org. Legacy Communityhealth dot
(29:17):
org. If you have any questionsrelated to those shows that put on Houston,
PA, just send me an email. Texan from France at gmail dot
com. Texan from France at gmaildot com, and I want to thank
you for listening and caring about theissues that put on this show. My
name is Lawrence. I am theTexan from France and this has been Houston
(29:37):
PA, Houston's public affairs show,Houston Strong
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