S1E6: You Have the Power

Cal and Cathy welcome Chanda Hinton, love-driven interdisciplinary powerhouse. Chanda talks about how integrative care saved her life, and what she is doing to ensure everyone has access to services. If you've ever wondered what one person can do, this episode is for you.

Support us on Patreon and get early access to all episodes, and special exclusive content: patreon.com/interdisciplinary

Chanda Center for Health: Deliver and advocate for integrative therapy, primary care, and other complementary services to improve health outcomes and reduce healthcare costs for persons with physical disabilities. https://iamtheplan.org/center-for-health

Chanda Plan Foundation: To promote the mission of the Chanda Center for Health by providing sustainable financial support. https://iamtheplan.org/

About Our Guest

When you look into the face of Chanda Hinton, you see vitality and radiant health; you see a young woman with passion and determination; you see a person of strength and purpose. If you glance down from her face, you will see her wheelchair, and you realize that the goals of the nonprofit organization she founded 15 year ago. You will see that her role is rooted in her own personal story.

Chanda is the Executive Director of the Chanda Center for Health and Chanda Plan Foundation, which provides access to holistic, collaborative, access and disability competent healthcare programs to individuals with physical disabilities. In 2009, she led the movement to pass Colorado House Bill 1047, which created the Spinal Cord Injury (SCI) Waiver, offering acupuncture, massage, and chiropractic care through Medicaid to evaluate cost-effectiveness and improve quality of life for persons with spinal cord injuries in the Denver metro area. She will be expanding these services legislatively in 2021 to other diagnosis.

In addition to her work (passion), Chanda presents extensively to diverse audiences about wellness and disability. Chanda has a bachelor’s degree in Communications from the University of Denver and recently earned a Masters in Non-Profit Management from Regis University. In her spare time (wait, what spare time?), she enjoys cheesy ‘80s chick flicks, intense conversations with people in community and spending time with loved ones.

About Interdisciplinary:

In this podcast, massage therapy educators, practitioners and positive deviants Cathy Ryan, RMT and Cal Cates, LMT will use research, science, experience and humor to explore the broad landscape of health care through a truly interdisciplinary lens. We will be joined by compassionate, self-aware humans who are actively participating or are interested in participating in interdisciplinary care to have honest, uncomfortable conversations about topics like access, racism, death, ageism, ableism, and equity that address the intersection of being a human being and providing quality care, so that we can expand our impact, confidently navigate new challenges, and together create lasting, sustainable changes in health care. You’ll always learn something. You’ll always laugh and you’ll come away better informed and with real things you can do in your own community and practice to create a more compassionate and collaborative system of care for all humans.

Transcript

Cal Cates: Hello, I am Cal Cates.

Cathy Ryan: And I am Cathy Ryan, major Healwell fan person.

Cal Cates: And this is another episode of Interdisciplinary. In this podcast, massage therapy educators, practitioners, and positive deviants Cathy Ryan and me, Cal Cates, we use research, science, experience, and always humor to explore the broad landscape of healthcare through a truly interdisciplinary lens. We'll have honest, uncomfortable conversations about topics like access, ableism, racism, deathism, equity, all those things. And you'll always learn something. You'll always laugh. And, you'll come away better informed and with some real things you can do in your own community and practice to create more compassionate and collaborative system of care for all of the humans. Please be sure to Like us and Share us and use all of your social media might to get the word out about the podcast. Remember to leave us a rating or, better yet, a review at Apple Podcasts or wherever you get your podcasts. Thanks for listening. And now the moment you've all been waiting for, this week's pun. Man, it was a tough one, because when you recover from surgery, people send you all kinds of things to keep you busy. And somebody sent me a book of three hundred five dad jokes. And a lot of them are ones I've never heard before. I feel like I've really fallen down on the dad score. So, we'll go a little anatomical today. You know what makes me smile? My facial muscles. (Ba-dum tss.) (Hollering and cheering.) So Cathy, what's happening in British Columbia?

Cathy Ryan: Oh, there's lots of snow. It's really cold, and COVID is the thing, and it's still happening. And yeah. Just still being careful, not going anywhere, not doing anything, wearing a mask, wiping down, washing everything, disinfecting everything. That's pretty much where we're at.

Cal Cates: Yeah, I think we're about in the same place. I mean, I think and I wonder if you guys are experiencing the same situation we are here where there's sort of a lack of understanding about what it means that people are getting vaccinated. And sort of, what, how, and how not that opens anything up in terms of our being in public spaces and things like that. So, I think we never really got off the education curve. And I think we have a new education curve now as we help people understand that it's important to get vaccinated, and it's also important to keep wearing your mask. And, this is how the vaccine works, and it doesn't necessarily make it so that you can't spread it. Although, the latest data about--I think it's AstraZeneca has a new one that's coming down the pipeline that actually they are showing that it also helps to prevent the person who has been vaccinated from spreading. But, I think that's just going to serve to confuse things. So, we will have to just continue to be diligent in our understanding of how it works and helping others to understand that.

Cathy Ryan: Yes, I am just of the mindset that I will be wearing a mask for the foreseeable future. And anyone coming into my practice will be wearing a mask for the foreseeable future. (Cal Cates: Absolutely.) You know, it's the kind thing to do.

Cal Cates: It is the kind thing to do. And I sort of, I love that the shift in administration here in the States has sort of... I want a small action figure of Dr. Anthony Fauci. But particularly since Joe Biden has become the president, he has been saying some of the things that I think he had been wanting to say in the prior administration. And I think my most favorite, I'm not going to quote him exactly, but basically he said, "Why is it so hard for me to help you understand that it's important to take care of other humans?" That this is really what this is about is just being kind to each other. You wearing a mask is a little thing that you can do for me and everyone else in your community, so...

Cathy Ryan: Yeah, and it's interesting, the public health officials here in BC. There recently was an article that came out about how the cold and flu season has magically disappeared here, because so many people are wearing masks. So, it's been interesting to see that. I think that was kind of an "Aha!" moment for a number of people. It's like, "Oh, I haven't had a cold this year. Oh, normally we see a lot more cold and flu kind of stuff going around, and it's not happening this year. Why is that? Hmm."

Cal Cates: Masks or conspiracy? Hard to know. Oh science, you trickster.

Cathy Ryan: But enough of that. We have got a really fancy guest today.

Cal Cates: We do. Go ahead, Cathy. I'll let you.

Cathy Ryan: I'm just excited to let our fancy guest introduce themselves to our listeners out there. Fancy guest, take it away.

Chanda Hinton: I love that. I love the fancy guest. My name is Chanda Hinton, and I am the Executive Director. I'm calling in from Denver, Colorado, and I'm the Executive Director of two organizations. One's the Chanda Plan Foundation, one's the Chanda Center for Health. We've been around for 16 years. And as the founder and the executive director, it was really coming forward to say, hey, folks with long term physical disabilities really needed an additional way to be proactive and preventative with their bodies and their healthcare. And, by doing so with acupuncture, massage, chiropractic, a lot of other services where, one, it's sustaining their wellness, reducing additional cost for unnecessary things that just happen by being a human and getting sick. But then, there's extra when you have a long term disability and also saving some money for the State and for healthcare. And then, just producing a quality of life where people get to live in the light and in the vibration that they are meant to live in. And be social, be employed. Do all the things that as humans we strive and love to do. And so, our organization, that's kind of a little nutshell of what it is that we do. And, I'm so excited to be talking with you guys today, and just talking about our work but all kinds of things where our work can blend into other areas.

Cathy Ryan: Well, I think I just heard a mic drop.

Cal Cates: I feel like your name should be Chanda "Interdisciplinary" Hinton. One of the reasons we're so excited to have you on is that in so many ways, the way that your organization approaches care is interdisciplinary and multilayered and multifaceted like the people that you serve. Would you tell us--so, you came to this quite personally? (Chanda Hinton: Yes.) And would you tell us more about that?

Chanda Hinton: Absolutely. So, I was injured when I was nine. So, I was accidentally shot between C5/C6 and in the cervical spine. And so, it severed my spinal cord there. And from nine until I was 21, I was obviously just a part of the medical model. I grew up in Nebraska. Not to say that, I think that obviously, different states have different progression based on also who's running the state and in terms of what healthcare looks like in that state. But then also just being in... '91 was the year that I was injured. So even in '91, regardless of the state being conservative or not or who's really running the state in terms of the governor at that time or even the country, there's a progression of when things occur. And I think that we're still living in a space where interdisciplinary services are still a fight. And so, when I was injured, the conversation was really, "Hey, here's your spinal cord injury. Here's all the secondary conditions that come with that. But here's all the medications you're going to take to address those secondary conditions." Well, from nine until 21, a body doesn't take on that level of model of healthcare. It's not giving the body what it deserves in order to be vibrant and live healthy and all the things that we kind of discussed at the very beginning. And so, when I turned 21, I started having kind of another "secondary condition," which was having a lot of severe chronic pain in my chest and lower back. So basically, I started having that chronic pain, and I go to my physician, and he's like, "Oh, that's another secondary condition. So here's a narcotic, here's the Percocet." And so in '03, that's the point in which the narcotic epidemic was really starting, where it was kind of being given as this long term level of care versus it's supposed to be very short and minimal. And so, with me, it really, really... I feel like that was like my body having a spinal cord injury, having all that medication, and then this one additional piece that just really knocked my system out, like slowed everything down. And we even talked about just like, pooping is one of them. It slowed down the level of toxins being able to be released from my body and in so many other ways, like lack of clarity. So I got to the point where I was like, wow, when I was first injured, I remember them saying to me, "Your life expectancy is going to be shorter with a spinal cord injury." So, I just started to live into that reality, thinking like, "Wow, so this is the time. This is where it's all happening, right?" And so, where it was like, I just assumed I was transitioning. And so with me, when the narcotics, being able to--it messed up my stomach severely. I stopped eating. I stopped having really that thrive for life. And so, got down to 59 pounds. And at that point, my family got really, really scared. So, medical intervention was essential. And so, I was put into the hospital to use medical intervention, which it's very weird to think about that dynamic, where it's like the medical model caused me to seek or need medical intervention. (More.) Right? Like, save my life. Oh here, this is supposed to be producing your quality of life. But guess what? It didn't. And so, now you're here. And we've got to use more to save your life. And as a 21 year old at this point, I was just like, this is very weird, right? And so, the medical intervention, they put a feeding tube in. I was being fed intravenously, all of that. And so, the medical intervention saved my life. So then at that point, the doctor is like, "Hey, with you, we're good to go. Go back and live life and do what you were doing before." And that's when it was like...

(screeching sounds) Wait a second. My sister, who had been practicing yoga for so long, stepped forward and said, "Hey, why are we going to go back and do what we did before?" Because here now, we're looking at a vicious cycle of just going back to the old thing that's going to cause us to be where we are today. And so, she said, "Let's try and think about what other ways can we redefine the way that we address Chanda's spinal cord injury for the sake of giving her body the things that it needs to address the secondary conditions but also to give it the blood circulation, the lymphatic drainage." Because, those medicines that you get for the secondary condition, they only address that secondary condition, but they don't give you other things in addition. So when when I do massage, it's addressing a secondary condition, but it's giving me the blood circulation, so it's addressing, even with chiropractic... So my doctor's like, "Okay, well, what do you want to do? Like, what should we try?" And she's like, "What about acupuncture? What about massage? What about chiropractic? What about all of these services that the body deserves?" And it's so funny, because when you think about it, you're like, "Oh, that makes a lot of sense." That makes a lot of sense, right? And we can go back into why I feel like a lot of physicians even don't recommend these kinds of things, because I think there's a lot of red tape and barriers and all that kind of stuff. But, the fact that she brought it up, and my family was so motivated to say, "Chanda's life and body deserves that." So, we just financially took it out of pocket and did it. And so, I am talking with you guys today because of integrative healthcare, the interdisciplinary, all of these services, giving my body, and they all give something different. So when I put them all together, I get to be this vibrant individual that has ideas and motivation and can inspire other people to get involved into something where we're actually giving the body and other people the access to these. So when it saved my life, I'm like, "Okay, this is great. But what about everybody else's life?" I started to look into was this just isolated incident here? Am I the only one in the world that experienced what I experienced? And it was like no, you weren't. And so with that, I got really motivated, especially because I had so much clarity in my mind and not being drugged up all the time, to the point where I could have the motivation to do the research and outreach and all these kinds of things. And so with that being said, I really noticed that what I was experiencing was not just my story. It was millions of people's stories. Not just people with spinal cord injuries. Like, everybody. But I had to focus on the population that I knew could really be at benefit, especially when I had Medicaid paying for all the sick care but not having Medicaid pay for proactive and preventative care. And so for me, that was the biggest thing. I called up Medicaid and I was like, "Hey, so like, I'm really doing well and I'm saving you lots of money."

(Yeah, right. You're welcome.) Exactly. You want to pay for my integrative healthcare and not my sick care? And they were like, "Oh, well, we don't do that." And I said--and I was 21, right--so then I'm all like, "Well let me talk to your supervisor." (Yeah!) They're all like, "That's a legislative decision." And I was like, "Oh, well tell me more." And they're like, "You've got to go to the legislative body within your state and really propose that Medicaid work to fund those services and why and la-la-la." So, that's what I did. So in '09, I went to Colorado legislation. In '09, we passed a bill that got Medicaid to pay for acupuncture, massage, and chiropractic for folks with spinal cord injuries. And I said to them, "We're doing this because I guarantee we're going to save you money, we're going to improve the quality of lives, and all the population that you say are unemployed and not contributing to society..." (Unemployable!) Exactly, right? So, it's all of these things. It was focused on the healthcare, but there's, as you know, there's all these other things that it affects. And so, we now have that waiver in Colorado as of today. And this year, we're actually expanding it to other disabilities. So, we wanted to show them that with a smaller population, we'd have cost savings, but that with that we could then show them that by doing it for other--MS, MDs, brain injury--all of these others, that we're going to have a huger cost effectiveness. And so this year, we're expanding it to other disabilities and statewide. And then eventually, I think that there's a deeper conversation about why isn't this conversation happening with CMS on a federal level rather than having each state fight state-by-state, which is, I think for me, that's ridiculous when there can be more of a conversation on a federal level, you know? So, that personal story led into being an advocate on a systemic level. While the systemic level is being narrowed, I had to then look at, well wait a second, how can we still serve those other disabilities that are not being funded by the waiver? And that's where the Chanda Plan Foundation raising money to make sure that the other folks could still access what this population is getting for Medicaid. Because, it's not fair to be living in the community, and your disability is not the same, but rather, your secondary conditions are, but you're like, "Oh, wow, you're in some sort of pilot program with the Medicaid, but I've got the same complications, but I don't deserve it?" And it's like, bull. Yes, just through another avenue, through the Chanda Plan Foundation. You're getting services at the Chanda Center for Health. Listen, I love this stuff, so I can talk too much.

No, well, I think it's really interesting, because... well it's just really interesting. We can just put a period on that.

Cathy Ryan: And commendable. Come on, man.

Cal Cates: Yeah, yeah. Amen. Exactly. But I think that this idea of... one of the things that I really love when we were first introduced to your organization is that you are providing the service while doing the advocacy work. And I think that this is part of the problem with our excitement about starting nonprofits in the United States, is that we solve health problems by putting a bandaid on it. If you are raising money from the community to provide a service that should be mainstream care, you're kind of part of the problem if you're not also going to the decision-makers and saying, "So why should I have to raise money in my community for this thing that would save the community a ton of money and even make the community money?" And, as you were talking, I was thinking, and it never occurred to me until just now, but I really wonder how much of the ongoing resistance to this is about the loud people are women. The people who live with chronic conditions are often people of color. And the people who are deciding about this are white men and that we have a very sort of white supremacist healthcare system. And that, without even thinking about it, like I think about the massage therapy profession, we're upwards of 90% female. We're not going to get a bunch of white men to say, "Well absolutely, we would want to entrust care to all these ladies." And so, they say, "Oh, well, we need more data. And we need this, and we need that." But, there's a thing that they're not even aware of, like their basic discomfort in entrusting healthcare to female people. And that it doesn't feel like an emergency to provide this kind of care and quality of life to people who aren't like them. So, I think, I mean, it's very much a social justice issue.

Chanda Hinton: Absolutely. And I loved everything that you just said. And I think that what's even more frustrating is when you say that, then those that--and I may be giving away my secret--but over here on the back side, I had to be creative and tricky about how then I presented it. Because, if I would have went in with all of what you are talking about, meaning like a ton of women in wheelchairs that were all white--or not white. That's what I meant was a ton of women in wheelchairs that were not white. The outcome would have been very different. What I did is I staggered it with white women in wheelchairs, white men in wheelchairs, and I had it all driven by the consumer, meaning there were no providers that were there to say, "Well my serv--" Because then I thought even they would be going into a place where it's like, "Oh, well, the consumer is just the massage therapist and the acupuncturist. They just want want more money." And it's like, we're not even going to let that go into their heads.

But for me I was like, I wanted to be able to say that--driven by consumers to say that--this is what we're saying that we need. And whatever I could eliminate from the bias that was existing, even though it's like, I also want to break that down, but at what capacity was I going to lose out on something by also trying to break that down? And so, it's been a hard struggle. And I love that you brought that out, because it's something that absolutely is a part of the bigger problem. And, I also love that you said that organizations, nonprofits. There are so many organizations that are starting up. And it's like, I always want to see them having some level of systemic change while they're doing the work on the ground, because it's kind of like, it is being a part of the problem. Because, when I say to my donor, "Guess what, your donations are going to go further, because we're trying to fix the primary problem, which would mean that if we go away, these people still get the services." That's the goal at the end of the day and to actually try to make ourselves go out of business.

Cal Cates: Exactly, right! We want a world where we don't need the Chanda Plan Foundation.

Chanda Hinton: Exactly. And so I do love, Cal, everything that you just said just resonates with me and our organization and our mission and what we really strive to do, especially within those other complex areas that are just also right in our face so much over the last four years. It's been really, really hard to watch. And, but yeah.

Cathy Ryan: Well, the bottom line is you appealed to the bottom line as well. So, you gave them that information on "this is going to save you money if you do it this way." It's not going to cost Medicaid more money. This is actually going to save money and not just in healthcare, but you outlined all those other ways, people being able to be viewed as more employable and all of those various tentacles attached to that. And, I have to say you're brilliant in the way that you went about this. And as well, just to have that vision of, as Cal had pointed out, rather than just funneling money to care for people, which is very important, but also the advocacy piece to change what is broken in the system to make the system better for everyone.

Chanda Hinton: Yeah, and thank you. And I'll also say that, I did this with a lot of counsel and other humans, like connected, which I think is really important that we always remember that when we're doing our work as grassroots organizations or individuals. I did it with so much love and support from other people, like a pro bono lobbyist, and one that keeps coming back and being like, "So what do you want to do this year?" Those kinds of things are just like, yeah, I have this thought and vision of how something but the fact that people rise to then be the supporters of that continued movement is just, it's beyond... I always say that I've been experiencing humanity in the most beautiful way possible, especially during what we are seeing around humanity. It's like, it feels good to know that I get to be connected with people that are doing good. And so, I feel very, very fortunate about that. And because, I guess for me, it's like, I never want to be an individual that takes credit for this work, because it takes so many people to put it together. And yeah, it's just, it's really amazing.

Cal Cates: Absolutely. I wonder... I'm not... Maybe a question will emerge from this, but so we had a wonderful guest on our show last season on Massage Therapy without Borders, Kelly Mack, who has lived with rheumatoid arthritis quite seriously since she was really young. And she lives in a wheelchair now, and she talked about how much she loves her wheelchair and how people don't understand. Like, "thank God for my wheelchair." But also as we talk about racism and just lack of equity and things, the fundamental challenge is this idea that we don't know we're deciding who's human. And that people that we bestow with the title of human get better care, get seen, get appreciated. And I think people of color, people with disabilities, trans people are other-than-human, and I wonder, I mean, I think like you said--and I think we do the same thing at Healwell--you can't go straight into people's faces and say, "You're not seeing me as a person." But I wonder if you could speak to: do you see a sense of, I mean, to be a human of course there's the whole model of you have to work and you have to "contribute" to society, and those stories are wrong too. But, what do you see happening as people who, like you said, like you thought, "Well, I'm dying. This is the end of my road because I have a spinal cord injury." And as people come out of that, through the services from your organization and through other advocacy, do you see any sort of shift in mainstream understanding, at least in your community, of what does it mean to be a person with a disability and how valuable as any other human people with disabilities are?

Chanda Hinton: Yeah, no, I love that question. You'll notice that I love a lot of stuff because I just love. (That's excellent.) Like, I love love. I love, love, love, love, love. Yes, I have a very close friend, which I think you guys and I have talked about. His name is Matthew Sanford. He's up in Minnetonka, Minnesota, and he does Mind Body Solutions. He does conversations, adaptive yoga with disability. And, he just opened up a conversation about the term disability and breaking that down to a level of truly understanding where I think what's happening is that yeah, we go into the world almost being identified not by this term but how people identify with the term. And so it's like, I feel like sometimes we can make things happen, because, oh, people are feeling sorry for those with disabilities that need these... So, that's wrong, too. So it's like, yeah, not feeling sorry, not having this pity, not having... I think that one of the things is that when people start--and I think it varies too--but when people start to identify and look at their own level of how they identify with disability, they start to represent themselves in a way that hopefully are allowing others to then understand what disability is meaning in community. Am I making sense by saying... Okay. Because I feel as though that unfortunately, the term should be identified by those that are living with it and the issues and problems that need to be called out with it. But that doesn't always mean that those that are experiencing disability from the outside, of not living with it, is going to fully... I mean it's going to take time. It's like, all of this is going to take time, and are we going to fully even experience it within our lifetimes? No, we're not, and I think that there's this whole term called inspirational porn, right? Where they talk about, "Oh, you make me feel so good about myself." It's not my job that with my disability that I'm inspiring you so much, that it's... I mean, I want there to be inspiration in the world. I don't want to sound so cold about it, if that makes sense. But I want people to take witness or notice about what is it that they're being inspired by. Is it in the right way? Is it for the good of themselves and the person that is inspiring them? Like really checking in with that. And so, I do think that... And then some people will never... I dive into the word, and I want to know all about it, and this is like... And then other people will want to avoid the conversation even with the disability, meaning they're angry at the fact that they have to be in a wheelchair. They're angry of... And so they're not going to go there. So then, them not going there will prevent those that are witnessing them to have whatever view they're going to have of it. I hope that my answer or my thoughts there really made some sense.

Cal Cates: Well, I think they do. I'm reminded of people that I've worked with, with cancer, who have said, "I hate it when people call me brave. I'm not brave. I have a shitty choice, and I made it. And like, my choice is to sort of lie down and die and let cancer kill me or to take these treatments that are really difficult. But, it doesn't feel brave. It feels like I got backed into a corner. And I did what I had to do." And, I feel like the same thing, people say, "Oh, you're so brave to have this surgery or go through chemotherapy." And it's like, well, it doesn't feel brave to me. And like, it's weird that you're taking inspiration from my will to live, basically.

Chanda Hinton: Yep. And that's a really great way of putting it. And then I think that at the same time, any chance that--the balance between the two--any chance that, yeah, you can not have what you just said. But then also, when I'm in the world, and I see a little kid observing me, and that little one is really inspired by whatever it may have triggered in them to then know that they may be able to also deal with challenges, discrimination, whatever it may be--that's the part that I love it the most. That's the true essence and honesty that lives in that. And then there's all these things that live inbetween, all the way to the extreme of "you inspire me because your will to live," which is, that's ucky. I'm trying to be, and I always live in the space of balance. I'm always trying to... Where does it fall, the pendulum from both extremes, and how can I live in this space in the middle of balance? Because, I want to meet people where they are, too. I don't want to be trying to prevent or judge where they're coming or have been... Like, where did they grow up? What was their family like? So, there's a lot of things I always want to take into consideration without... Just as much as I don't want them to judge this situation, I don't want to judge that. And find this level of common ground and discussion. Not compromise. I don't want that term. I don't think anybody should compromise. But finding things that are in common are very important.

Cathy Ryan: Yeah. Well, and like this whole conversation and right at the beginning, what you had to say, and I said, "Okay, I just heard the mic drop." Because you really encapsulated I think what Cal and I is the driver for us to do this podcast, is to have these conversations about can we just be kinder to one another? Can we regardless of what that person looks like or how they... Can we just as human beings step up and be kinder?

Chanda Hinton: Yeah. And, that seems so, like for me, I'm like... (Duh.) I know! (Why is it so hard, though? Why is it so hard?) I don't know. It's like, kindness and love just feels so easy. It's like...

Cal Cates: It does! Well, and I was thinking as you were talking, about the challenge of... People who really fit into the approved model is actually a very small group, but it's kind of amazing how powerful the sort of approved model of what a body is, what a person is, all of these things, but that we also... I feel like the struggle when we're doing any kind of advocacy work is to continue to come back to: each person is a person. And I was talking with my son, and he said, "I was really surprised to hear your friend Kelly say that she loves her wheelchair. And I didn't know that disabled people love their wheelchairs." And I said, "Well, hold on. Kelly loves her wheelchair. I think there are plenty of people who find themselves in a wheelchair who don't love their wheelchair in the same way. And, you don't now know what disabled people think of their wheelchairs. You know what Kelly thinks about her wheelchair." (Chanda Hinton: I love that.) I know that's hard, but that means that the next time maybe you're forging a friendship with a person who's in a wheelchair, your job is just to listen to what they say about it. This is what it is for this person. We just want so much to get it right. And we come back to this in the podcast almost every episode that we do so much harm by being afraid to get it wrong. It's like part of kindness is being like, "Oh, I'm going to stick my nose out here. And I know I'm going to say something dumb, but I just want to understand. And so, how do we, what's the best way to approach this with you?"

Chanda Hinton: Yes.

Cal Cates: I'm not going to ask you. People always want me to, "Well, what do trans people think about blah, blah?" I don't know. It's a pretty wide swath of people. (Chanda Hinton: You're like, I'll tell you what I think.) Exactly. If you want to know my opinion, I got lots of opinions. But, yeah.

Chanda Hinton: Exactly. No, no. Exactly. And, what you said brought up this notion that it's like when you think about disability, and how somebody thinks about it, it's like, I think too the fear is that when we ask the question that we're going to offend, and by--okay, here's the deal. You will offend somebody. People ask me, and I don't get offended, just because that's my personality. As a human, that's my personality, not because of anything else. And then there could be somebody that's right next to me that you will ask the same question, and you will offend them. And so it's like, I always encourage people: don't go in to not asking it. And if you do offend them, just be like, "Can I understand why? Can you support me?" And again, that might be a difficult thing too, because then it's like, "Well why is it my job to support you to understand?" It's so complex. I think that it's interesting, because I love just with your son being able to be like, that's what Kelly thinks but not what everyone thinks, right?

Cal Cates: Right. Yeah. I want to ask you a more granular question about--because I know a lot of our listeners are interested in all of these topics, because they want to increase access for their patients or for themselves. So in terms of how it really looks, when you say there's a waiver, what does that mean? Take me through it either as a patient or a provider. Like, if I've got a person who is living with a condition that sort of falls under this waiver, how does that work?

Chanda Hinton: Yeah, yeah. So, we basically, with the Medicaid program, what you can do is you can develop specific waivers in each state. And a waiver is basically saying, instead of the traditional just state model of Medicaid, we're going to parcel out this very specific kind of packaged services. So in the state of Colorado, we have what's called the brain injury waiver. We have the spinal cord injury waiver, which is the one that we helped create. We have what's called the elderly blind and disabled waiver. And so, I think Colorado might be the one with the most waivers. There's other states that have them. And so with that, it's just making sure that you're... You're not waiving. Because people look at waivers meaning like, "Oh, I'm signing off on something that's a waiver that I'm not going to sue you." So, it's very different. It's asking the government to kind of waive and say, "Hey, instead of the services looking like this, we're going to package it like this for this population and for this services for these reasons." And so right now, the only frustrating part about the waiver that we helped create is that it's Colorado only. And it's the Denver Metro only and spinal cord injury only as of right now. But this legislative session, we're going statewide. So it's not just Denver Metro. Still will be Colorado, but it'll be outside of Denver Metro, if we can get it passed, which I'm confident that we can. The other portion would be that we are expanding it with additional disabilities. And so, what that looks like is then providers of acupuncture, massage, and chiropractic in the state of Colorado would become a Medicaid provider. There's some areas in there where I think there's additional advocate work that we need to do as an organization that prevents really qualified providers from becoming a Medicaid provider because of the application process and some other things. And so, it's funny to think that we have government assistance for a lot of things, but the government makes it so difficult for providers to become a provider. And then once they're a provider, additional complications associated to that and red tape of how it's affected by Medicare or other private insurance companies. So, people will throw up their hands, and be like, well then, I'm not going to be a provider of that. So then there's this government--or, this state waiver--that does a really amazing work with providers that don't want to do it, because they're not going to the process of doing it. Then once they're on there, the sustainability of it just feels like a nightmare. So then, then there's people that have funding that are not going to access it, because it's like, oh, well, there are no providers in the state that are going to serve it or be a service to it. So, we're a provider of the waiver. We decided that there's only two of us in the state, which Metro-wise I think that that's okay. But another one of our advocate roles in expanding this waiver is that we're going to really have to support the department, Medicaid Health Care Policy and Finance here, is that educating providers how to really effectively become a provider of this waiver. And given we're a provider, we can have the pros and the cons and the things to look out for. And so, I think that's going to be... Because one of the issues is one of the legislators said, "Okay well, if we expand this statewide, then are we getting ourselves into a space where we're going to have a provider problem where somebody down in Pueblo with a spinal cord injury wants it, but then there's no providers?" Because, I'm like well, that's going to have to be something that has to be... That's an outreach. That's an education. That's a piece that has to be done. Believe me, our waiver and our services are not the only one that's going through that. There are providers in the other parts of the state and services that don't exist, because nobody's out there doing the outreach to educate them on this. So, we will make it a part of our effort to ensure that more providers are aware of it. We'll probably, even as an organization, partner with providers to where we're the umbrella provider, but we enroll in the Medicaid as they're the satellite location. So it's like, we'll have probably a ton of satellite locations where people will go in and do that, because that's an easy way to do it. But right now as a provider, that's where the Chanda Center for Health is a provider of Medicaid. So, folks come in to our clinic here, and they can get the acupuncture, massage, and chiropractic. But on top of that, they can get in collaboration behavioral health, care coordination, primary care. Once a month, we have the dental folks that come in. And so, it's really putting all of that collaborative care underneath one roof, because we know that those three services on Medicaid are not the only three services that our folks need. And so, we'll eventually want to expand even the services to say, these three were awesome, but what about physical therapy? What about all these other things that this population truly needs on an ongoing basis?

Cal Cates: Absolutely. So do you have two organizations, because you have a C3 and a C6, or...?

Chanda Hinton: We have two organizations. The Chanda Plan Foundation is a 501c3, so we raise the money to basically support the Chanda Center for Health. So, offsetting any loss when for example, when Medicaid reimburses us or the other services that we provide that are not currently being reimbursed for by Medicaid. We raise money to support the services over at the Center, which is basically at no cost to the individual, because they're on the waiver or $5, $10 per service, because we have money to offset it and tell their disability is eligible underneath the waiver. So, it's a very complex way of making sure that we're giving access to people while we're also systemically changing their access on the Medicaid level. And so, it's pretty interesting to be able to have all of our staff and our program manager, everyone, to kind of know when somebody comes through the door, they may be eligible for the SCI waiver. And so right away, we're going to be like, we're going to support you in getting on the SCI waiver, because then you'll get acupuncture, massage, and chiropractic under Medicaid, which is sustainable. And then two, if right now you want another service, we have dollars that can support you in getting access to counseling or access to other physical therapy that otherwise wouldn't be affordable to them or access because it's not covered yet.

Does that...?

Cal Cates: Yeah. I mean, I think people think that we're sort of giving them the Heisman when they ask us, "How do I do this?" And we sort of describe everything you just said, and we say there's not an easy way. And as a provider who wants to be a part of this increased access and equity, you're going to take some hits. It's going to be hard. There's going to be bureaucracy. That part of the situation has not been resolved, and I think we're years away from solving that. But if we can increase access, and as people who have the ability to take some of those hits, whether they be financial or bureaucratic or whatever, that's the commitment that you make in being an advocate. And not everybody is in a place where they're able to do that. But it can't be done simply at this point in time.

Chanda Hinton: Correct. And what I've said to our Board of Directors is that one of the reasons why we started is that because we want to make sure that we're giving access to humans getting these services. Because one of the conversations as being the Chanda Center for Health on that side, the actual delivery side of it, is that the question came up, "Well, do we just stop taking Medicaid for that service? Because, now that you're on Medicaid, you had to bill Medicare and the other private insurances to get denied by them first before you got reimbursed." And it's like, oh my goodness. But then I say to my board, then if we stop becoming a Medicaid provider because of that rather than changing this issue, then we are now not doing the mission that we were set out to do.

Cal Cates: We're not showing the system that it doesn't work.

Chanda Hinton: Exactly. I said it's more of an advocate issue that we've got to change this rather than back out. And that's a lot of work. But I think that when you have folks that are dedicated to making sure that they've set out to do a mission and that people are getting access to services that they otherwise would not have, and if you bail on that because of the red tape, then you're not doing your mission. And I'm not saying that organizations that have had to make that choice because of financials or, I mean, had to... I think that there's a time and place when organizations might have to make tough decisions, because they just had to.

Cal Cates: Yep, definitely.

Cathy Ryan: Well, and what you're doing to me seems like a perfect parallel to your life path in general. You got to an age where it's like, in the conversation that you had with your sister, well, we can go back to this same way of doing things, but X amount of years from now you're going to end up in the same place. Or, we can completely change how you are going to go about living your life and wellness. And, you're doing the same exact thing with your organizations in that instead of just doing it the same way it's always been done, let's change the system. Let's change the system in a way that's going forward is going to make life so much better for so many people. And as you're talking, I got this image of a Swiss Army knife, because you're kind of like the Swiss Army Knife of organizations. Not only are you providing care, but you're advocating with lobbyists to change systems that are non-functional. So it's like, you've got so many tools going on here. And it's really exciting.

Chanda Hinton: I think that's really interesting is when you have those two pieces where you're the advocate organization and the provider. Sometimes I get worried, because I want to make sure that those that see us advocating don't see us advocating for the sake of like... (To make more money.) Correct. It is actually to provide the access. Because when you look at our financials, when we get that reimbursement, we are making no money. We make sure that the most of the dollars that are reimbursed to us are being paid to the person who delivered the services. We're not having massage therapists do an hour worth of services and getting paid $30. No, they're going to get the most of that reimbursement, and a tiny percentage is going to go to us for the overhead cost associated to it. Whereas, a lot of providers don't do that. And I think that there's a whole other advocate thing where it's like, I think that there needs to be as a provider, you only get to take this percentage, and that this percentage needs to go to the actual person that did the work. Yes. It's so frustrating.

Cal Cates: No, I think you make a couple of really good points there. And I think that paying, this can't happen on the backs of providers, clinicians. And also, I find it so funny that people get all up in a twist that you'd be advocating to make money in our proudly capitalist society, which of course, that isn't what you're doing. But there are certain times when capitalism is uncool, and when you're taking care of people who need more access, that's one of those times. (Chanda Hinton: It's uncool.) Exactly. (Chanda Hinton: You're so uncool for helping people get access to service.) That's right. Now, I do want to ask you, when you made your approach to the legislators, I know that two of the biggest--Mike Coffman and Jared Polis are in Colorado, and they were part of starting the integrative health and wellness caucus. Were they there when you approached them? Have they been helpful? Were you initially well-received and it was a matter of logistics? Or did you really have to sell whoever it was you were approaching on the value of this?

Chanda Hinton: Yeah, this was when they were not in office. I don't even know... It would be nice to actually look back and see where they were in '09. Again, I'll be honest, when I went into it, I was very naive. I was very naive about what--and to some extent I'm going to say it worked in my favor, because I didn't go in there with fear. I went in there with "this is what we're going to do, and regardless of who is in office..." I quite frankly, I don't know. Can I say give a shit on this podcast? (You can!) (Oh, yeah, please do.) (She doesn't give a shit in case you didn't hear that!) Yes, thank you Cathy. So I didn't, because it was just like, there was such a vision of humans getting access to services and really presenting it in a way that it was like, I was so naive about the players. And thank goodness I had a lobbyist that understood that to some extent but didn't really come to me and say, "Oh, we're not going to do it this year, because such and such." For them it was like, first of all, we're going to make it bipartisan, which we're doing again this year. We have both parties that are supporting the bill. I love that, because I think it's critical, and I think that that always plays in our favor, having the individuals that are getting the services always representing the story. I think those are what make it successful. And, I'm going to go research and see where Jared Polis was in '09. And right now, he's been very heavy with education, and a lot of the disability folks have been... Well, our Lieutenant Governor, Dianne Primavera, she actually was a sponsor of our bill many years ago. And so, she is a huge advocate for the disability community, and she is always listening to us and our needs and our access and our services. And so, that's really beautiful. And she's then been able to represent that to Jared Polis and making him aware of it, because education has been really his platform. But yeah, so that's a great question. I just went in without giving a shit. In some area, giving a shit and a lot in another area.

Cal Cates: Definitely. Yeah, I think that's a huge thing actually, to the naivete of like, this is just true. So I'm just going to go and, I mean, speak truth to power, and be like, "Oh, this is just... You'll get it. It's common sense." (Chanda Hinton: Yeah, duh.) Exactly.

Chanda Hinton: And some people, Cathy, they'll even say, "How did you do that?" And I'm like, if I can do it, anybody can do this. Like, I am not a unicorn. I am not like... Well, I mean... Okay, maybe I am.

Cal Cates: I mean you are, but... Maybe a bit of a magical pickle. That's not what made it work.

Chanda Hinton: Exactly. Meaning that we're all unicorns, and we can all make it happen. And so it's like, for me I always really stress that as a citizen, as a member of your community, you have the power to really create change. And it's like, the fact that my family knows that I've changed legislation, to them will blow their mind. And I'm all like, I kind of just went into it being like, this is the right thing to do.

Cathy Ryan: That's right. Here's a problem. I'm going to come up with the solution. Exactly.

Chanda Hinton: Yeah, yeah. And it can be exhausting, as we all know. We all have different things that we're... I mean, every day I get motivated by a problem, I have to step back and be like, okay, what problems am I really going to focus on? Because if I focus on all of the problems, I'm not going to make any sort of impact. I really have to [compartmentalize] what it is that I can be the most influence in, because I get motivated by so much. And, I really encourage those that get motivated by problems to really let those that are already doing certain things do it. They kind of stay in your lane a little bit, because I just think that that's really important for yourself, your self care, and that of who's else out there doing the work.

Cathy Ryan: Well, so much of what you have said is everybody should be listening. And one of the really important things that you just mentioned too that I think warrants another mention is bipartisan. I think if we've learned anything during COVID--hopefully we've learned a lot of things--but I think if we've learned anything during COVID, is that people's wellness and health and wellness should not be a political issue.

Chanda Hinton: I agree. I agree. I think that the fact that so much of us have to fight for our health and wellness, still to this day, blows my mind. It's very interesting. And so, I just encourage that we all keep being the voices that need to be heard. Because when we stop voicing, we then stop the movement that could be possible. And again, not all of us have to speak up. There are those that are going to speak up, and then there's going to be those that support those that are speaking up. And that's another really critical thing to remember. I think we forget that too. And so Maggie, our Director of Operations, she's been with me forever and it's been so... The level of our dynamic around where I speak up and I have an idea, and she's the one that's been implementing, it's been like... And I've seen this dynamic, and a lot of successful... I've read about it. It's a very powerful way to be able to execute things. She was like, "I don't want to speak up. I don't need to be seen, la la la. But I want to be doing all of these things behind the scene." A lot of our success is for those that are sitting behind and doing these things that quite frankly, I don't want to do. It's really beautiful to make sure that we're being a witness to the different strengths that exist and that all of that happens when you put those together.

Cal Cates: Absolutely. Wow. Well, normally we ask for a closing piece of wisdom. But I think, I mean... I would love, love, love to keep talking to you.

Cathy Ryan: Exactly. Another mic drop.

Cal Cates: But yeah, that was a total mic drop. That was amazing. Chanda, thank you so much for being with us and for everything you're doing for humanity and the love that you're spreading.

Chanda Hinton: Likewise. I feel the same about you both. And, thank you so much for having me here and talking about really, really important things that need to be discussed. So, thank you so much. And know love!

Cal Cates: Love. And with that, this has been another episode of Interdisciplinary, the podcast where you have all the feels, and you leave inspired and ready to play whatever your part is in the transformation of our society to a place that is more caring and more loving and where we don't have to fight for our healthcare. It's just a fact. So, go Like us. Go Share. Go tell your mom. Tell your pets. Tell whoever that they should listen to Interdisciplinary. And leave us a review, leave us some stars, whatever works for you. But we'll look forward to seeing you soon. And remember to think about becoming a Patreon, because the cool stuff happens to the Patreons. So, thanks again. We'll see you next week.

Interdisciplinary is produced by Healwell. Our theme music is by Harry Pickens. You can send us feedback at info@healwell.org. That's info@healwell.org. New episodes will be posted weekly via Apple Podcasts, Spotify, and our Facebook page. Thank you.