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Association of Programs for Rural Independent Living (APRIL)
Diversifying Funding and Your Organization: A Discussion
May 31, 2017
3:00 p.m. ET

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>>> Welcome folks. For those of you just joining us, we're going to get started in about six minutes here. If you need help accessing the captioning room, if you'd like to use that, you can go to our website at www.april‑rural.org to access that link. Or you can e‑mail me as well at Mary.Olson@mso.umt.edu. I can send that link right to you. We'll go ahead and get started in just about five minutes here. Thanks for joining us. 

>>> Thanks for joining us, Phil. I went ahead and made your mic live and you can mute and unmute from home. 
>> PHIL PANGRAZIO: Very good. Thank you, Mary. 
>> Thank you again. We appreciate you leading this call. 
>> PHIL PANGRAZIO: My pleasure. 
>> MARY OLSON: We've got a few more folks joining us here. If you have any questions, you can press star 2 and raise your hand and I can open up your mic and hopefully we can get whatever you've got on your mind fixed. Not, we'll get started here in just about three or four minutes. I'm excited to see the amount of folks joining us early today. That's great. We're all here and we'll be getting started in just about three minutes. Please let us know if you have any questions. You can raise your hand by pressing star 2. 
[ Writer standing by ]. 
>> MARY OLSON: Welcome folks. I see some more folks joining us. We're just about at the top of the hour. We'll get started in just about two minutes here. We'll let ‑‑ let folks keep joining us. And then we will rock 'n' roll. So thanks for those of you who are on the call. And again we'll get started in just a couple minutes. We've got a bunch of folks joining us on the line right now. Really excited for the group that I hope that this is going to be a really great conversation. It is one after, so I will go ahead and start my introductions. And, again, really looking forward to this call. So, thank you. 
Good afternoon and thanks everyone for joining on today's call. Diversifying funding, a discussion. It's going to be facilitated by Phil Pangrazio and Dennis Fitzgibbons We're really lucky to have them with us today, and I'm really excited about it. If you need access to CART for today's call, please go to the APRIL website at www.april‑rural.org. You can follow that link right on our home page. If you're having any trouble accessing it, please e‑mail me at Mary.Olson @mso.umt.edu, and I can send you that link. Today's call will be recorded. That audio recording and the transcript are going to be available online on our website under that IL conversations tab following the call. 
During today's conversation, if you would like to add to the topic from your experience or ask questions and we really encourage you to do that. We're hoping that today is a really big, great conversation. And in order to join it, you can press star 2 on your phone to raise your hand. And then I can make your line live. When I unmute your line, the moderator will state your line has been unmuted. Once your question's been answered or you've made your comments, if you press ‑‑ excuse me. If you press star 2 again, it will lower your hand and that way I won't keep calling on you. When I unmute your line, the moderator is going to say, your line has been unmuted. You may also type your questions into the CART chat box and I can voice those for you. 
Please remember to evaluate our conversations on our website following the call under the IL conversations tab. Your feedback's really important to us and it can only make us stronger. This IL conversation is presented by the IL net which is operated by the independent living research utilization program or ILRU in partnership with nickel, April, and Utah state. The report for this IL conversation is provided by the U.S. department of health and human services administration for community living. No official endorsement of the department of health and human services should be inferred. I'm going to introduce you to our facilitators for today. Phil Pangrazio has been the president and CEO of the ability 360 since 2000. It's one of the largest centers for independent living serving people with disabilities in the U.S. with a budget of $43.5 million. Wow. He oversaw the planning and construction of the disability empowerment center now called the ability 360 center that opened in 2008. And built the sports and fitness center that opened in October of 2011. Phil served for ten years as a board member of the national council on independent living. A person with quadriplegic and a wheelchair user for over 38 years. Phil has lived in Arizona. 
We also have Dennis Fitzgibbons, he's worked in independent living for over 27 years. First in Massachusetts and then in Maine as the executive director of AlphaOne. He's now happily retired, but we were able to hook him in for today's call. We're really lucky for that. Thanks for joining us and for leading this call. I'm going to turn it over to you, Phil. 
>> PHIL PANGRAZIO: Great. Well, thanks, Mary. And welcome, everybody, and good afternoon. I'm just going to kick it off kind of quickly and then I'm going to turn it over to Dennis. But just wanted to start by saying when Mary asked the two of us to, you know ‑‑ to do this teleconference, you know, we ‑‑ both of us, neither one of us kind of felt like we're certainly not complete experts on this subject. And we don't claim to be We thought it would be great to kind of have a conversation, throw out some of our experiences with, you know, fee‑for‑service contracting, trying to diversifying our funds. Dennis will tell you as long as you're involved at a center for independent living, your board of directors is always pushing you diversify your funds, we have to diversify our funds. It's a constant mantra in IL that we hear all the time. 
It's a lot easier to say than to do. And ‑‑ and there's a lot of different ways that CILs can diversify their funds. There's other funding sources you can consider pursuing and we'll talk about some of them later this afternoon. But we want to have this as interactive as possible. So, you know, please ask us questions. You can interrupt us and do that at any time during the ‑‑ during the session. And we want to hear some of your ideas, too. So if you've done some things that are really innovative that we haven't even brought up or discussed, we'd like to hear that, because I think ‑‑ you know, we want everybody on the line to learn from ‑‑ from what we're talking about today. So with that, I'm going to turn it over to Dennis to kind of go over some of what he's planned to talk about and then I'll come back and share more of some of the things that we've done at ability 360. With that, Dennis, take it away. 
>> DENNIS FITZGIBBONS: All right. Thank you, Phil. Hi, everybody. Always a pleasure to talk to colleagues from other CILs around the country. As Phil said, we're looking forward to hearing from you and your ideas. And as Phil and I were discussing about what we would talk about and how we wanted to approach this, one of the things that did come up is that there's a real difference out there in terms of what each of us deals with from our ‑‑ our perspective of where we're located, how big our SIL is and many, many other factors. In fact, I was at a conference a few years ago and I heard a colleague say if you've seen one SIL, and I expected that would be finished with, you've seen them all. The person said, if you've seen one SIL, you've seen one SIL. Took me a little bit by surprise because I expected to hear the other thing. 
After considering it and really thinking about all the people I've met from the various CILs around the country, I'd have to be in complete agreement on that. We have core services in common, we have a common philosophy, but as organizations we differ in so many other ways. I've always been in awe of Phil and Ability360 since I heard of him and his efforts there in Arizona and had the pleasure of visiting there several years ago. Phil was gracious and turned away my praise and said, well, you know, we've always admired what AlphaOne has accomplished as well. And he pointed out some of the differences that we ‑‑ we encounter in our different states. And it really was a strong learning I took from that encounter. It made me reflect on just what we all deal with individually. A good example would be that Maine as a state, our entire population is 1.2 million. And we're the only center for independent living here in Maine. In Arizona, I believe the population of the state is approximately 7 million. And I don't know how many CILs there are, but I know there's more than one. Just some other factors that are different for Maine, we are now the oldest state in the nation in that our median age is higher than any other state. We are 96% white, so we don't have a lot of diversity of population. And we're ‑‑ we have a high level of poverty. We have a high level of disability. And we're mostly a rural state. So we have some interesting things that impact the way we provide services, how we offer services, how we interact with the community that present us with challenges that way. But I'm sure each and every one of you has your own challenges that are different in many other ways. 
So we can talk about why you may want to diversify, but I think if you're on this call, you probably already do want to diversify. As Phil said, there are a variety of ways that CILs have diversified their funding and organization. I was thinking what are the ways we diversified over and above that pressure from the board of directors saying diversify, diversify, diversify. One of the things we struggled with in a state that is so white is reaching out to equal of minority groups and youth and others. And so an effort of diversify occasion that came about incidentally through a program helped us broaden our reach to younger people, young people of color, and to really start of think more of serving minority groups here in the state even though they're small. There are lots of ways to look at diversify occasion. Some of things worked for us here in Maine and some things haven't worked so well. 
We're known for developing fee‑based programming. But we've taken stabs at some other things, not to the degree that some of you have. There's that constant need and pressure, if there's a cut of any kind, it's not going to be a deathly blow and you'll survive because you have a broad base of funding. So with that, I'm going to throw it back to Phil, because I'd like him to fill in some of the blanks on demographics and things that they deal with from their perspective at Ability360. 
>> PHIL PANGRAZIO: Okay. Thanks, Dennis. You make a really good point about the fact that, you know, depending on where your center is located, you know, that's going to impact, you know, what really is possible. The things that we've done here at Ability360, being the center that is serving the greater Phoenix metropolitan area, you know, we're the fifth ‑‑ we just passed Detroit. We're now the fifth largest city in the United States. We were number six for a long time. And ‑‑ but if you ‑‑ if you include the greater metropolitan area, we're even much, much larger than that. Because you mention the population of the state. Maricopa county which is the greater Phoenix area is about, you know, it's pushing close to 5.5 million or so. So there's a lot of, you know, population base which means there's a lot of resources to some extent in the valley. And it gives us a lot to draw from both from the governmental side, the various city governments, the state and then even private corporations. 
Although, one thing about Arizona is that we really are not a corporate hub. There is ‑‑ you know, the big multi‑national corporations, a lot of them are in ‑‑ in other cities across the country and not really here in Phoenix. There are some, a few, but that ‑‑ that's a challenge for us wherein some of you who are in other cities ‑‑ you know, Chicago's a good example. I know access living probably has a lot more corporate kinds of support because of all of the various corporations that are in ‑‑ that are in Chicago and other cities that are like that, too. But, again, you know, what is possible really does depend upon where your center is. And a lot of you, you know, are from rural communities. And we know here in Arizona because we have ‑‑ we have a lot of the state that is rural, too. Dennis mentioned ‑‑ asked how many centers there are in Arizona. There are five centers here There's one in Tucson, one up in Prescott valley. One in Yuma, Arizona. Tucson's pretty urban, but Yuma is not. And although it's a growing city, the Prescott valley, northern Arizona area is very rural as is assist up on a Navajo reservation. You know, we have the challenges that those centers have in the rural communities accessing various funders and resources. Vastly different than what we ‑‑ you know, we experience here in greater Phoenix. 
So, you know, it's always kind of tough to talk about, you know, the various things we do and then try to suggest, well, you ‑‑ you know, you can do that, too. If you're ‑‑ if you're a center in a big city, maybe you can. If you're a center in a smaller community in a rural community, you have to ‑‑ you're going to have to be thinking about other creative ways to ‑‑ to diversify your funding. I know that the center up in Prescott valley has a large transportation program and they've collaborated with the state department of transportation to be like the transportation provider in northern Arizona. And they've got, like, ten vans and they've gotten drivers and they get paid fee for service for that whole ‑‑ they're taking people to the doctor and taking folks to and from various, you know, whether it's some of the group home operators or adult day center operators. Any type of transportation need that might arise in northern Arizona. 
They're doing that, so that was a pretty creative avenue for them to diversify some of their funding. And they've also ‑‑ they've also developed a really nice partnership with their veterans community up at New Horizons because they have a lot of veterans that live in the Prescott area. They get a lot of volunteer work out of them. I thought that was really creative for them to do that. You know, everybody ‑‑ at Ability360, kind of no secret if you've followed what we've been doing over the years, the biggest program that we have is our personal assistant services program. And that ‑‑ that has been our, you know, for lack of a better term, the bread and butter of the organization in terms of revenue. Mary mentioned, you know, in my introduction about our budget being $43 million or something. The vast majority of that is the personal assistant services. And I've given presentations on ‑‑ on that program in the past. And if any of you have an interest in it, I'm happy to share those PowerPoints with you. I'm not going to delve into that today because it would be ‑‑ you know, it's really not the focus. Though that is an excellent fee‑for‑service kind of program that I think any center might want to consider. 
I know philosophically sometimes centers struggle with becoming a quote, unquote provider of services because, you know, how it kind of ‑‑ there's a feeling of it potentially conflicts with the advocacy role that we all want to make sure that we have as our number one objective as a center. But we've balanced it, we feel pretty good about it. We've done it well. We feel like we've been able to maintain kind of two sides of the house. Our advocacy and our personal assistant services program side. And actually we kind of look at it in a way that that program is generated surplus dollars that has allowed us to go out and hire more independent living advocates to do the advocacy work that we do in the community. So we kind of see it as complementary, but, again, you know, we certainly understand that not all centers want to do personal assistance. But, again, I have that ‑‑ that information is available. 
The other thing ‑‑ the other thing that, you know, was mentioned in the bio that we started the sports and fitness center program. That's another program that, again, it's not going to be something that every community is going to be able to develop and implement and fund. It's a mammoth financial commitment. It's something that we ‑‑ after we built the disability empowerment center, we had an additional parcel of land and had an opportunity to ‑‑ to go after funding to build the sports and fitness center and co‑locate it here on site at the Ability360 center. We did a partnership with the city of Phoenix. We actually got included in the city bond program, and ultimately received $5.3 million from the city of Phoenix through city bonds to build the sports and fitness center.
And then that kind of kicked off our capital campaign, and then we pursued all the local foundations and some private individuals that made up our $12.5 million capital campaign to build a sports center. Depending on what city you're in, I think some of the larger cities in the United States, I think can pull that off. And some ‑‑ we hear it all the time. Some are pursuing it in various cities across the country because some folks really like the idea and they want to do it in their own communities. And we think that's kind of cool But with that has come an opportunity to diversify some funding and pursue funding sources that, you know, we had never been able to pursue previously. And that kind of goes to the corporate side of funding, you know, where we've ‑‑ we've gone after, you know, Arizona coyote hockey program and Arizona Cardinals football team. The whole range of private foundations that have, you know, done ‑‑ wanted to get on board and help support the sports and fitness center because the one thing about it is that there are no ‑‑ there's no government funding for a sports and fitness center program. 
So we've had to be really creative. Actually, one of our donors ‑‑ our main ‑‑ our main individual donor that's been with us from the beginning, he funded the development director for us. We actually paid ‑‑ he's given us an amount of money to go out and hire a development person. So that ‑‑ that individual has been, you know, work in the development community and, you know, we've ‑‑ we've had some pretty good success with it We've had, you know, donations anywhere from $5,000, $10,000 to $10,000 to $20,000, in the $20,000 to $50,000 range and some have been between $50,000 and $150,000. More recently, last spring we had an anonymous donor that contacted us actually out of New York City that heard about our program and made it ‑‑ then they sent their advisor, the person that kind of does the research for them to Phoenix and met with me and they ‑‑ they made an anonymous donation to the sports and fitness center program for $250,000. 
You know, this just came out of the blue, but, you know, the sports center was in its fifth year. It was gaining notoriety throughout the country. People were talking about it. You know, we're like, all right, that's great. We were excited that ‑‑ that that was kind of ‑‑ that our name was kind of out there and able to attract those kind of dollars. Some of the other things that we've done that I think fee for service wise ‑‑ you know, our ‑‑ certainly our home modification program. We started off like many centers for independent living doing home modifications through CDBG funded, the community development block grant funds, through local city governments. We have been doing that for probably 15 years. And when we had ‑‑ because we had developed a relationship with the manage care organizations in our community, you know, we went to them and talked to them about, you know, doing home modifications for their members. Because as many of you know, if you're on Medicaid, the CDBG funds don't cover folks who are on Medicaid because Medicaid should cover it. And ‑‑ but, of course, that was rarely happening that folks on Medicaid were actually getting home mods funded through that program. But we were successful getting some contracts with the MCOs. 
And now we've done ‑‑ at our peak, we did about 300 home mods a year. We were at ‑‑ kind of slowed a little bit over the last couple years. Last year, we did about 160 home mods and it generated around $750,000 of ‑‑ and again, that's not ‑‑ that was the gross dollars of including the construction costs and everything. So it's not like we generated surplus dollars of $700,000. It didn't. In fact, the one thing about home mods, I don't see it as being a program that is ‑‑ you're not doing it because it's going to add to your bottom line. You're doing it because you're going to create goodwill in the community amongst the disability community that ‑‑ that you're fulfilling an important need in the community and it gives you that, you know, credibility with the disability community and they ‑‑ they're going to appreciate your doing that work. But, again, it's not something that's going to add a lot of surplus dollars to your bottom line. 
And we've always kind of viewed some of our services that way, that we don't do it just because we want to generate extra ‑‑ you know, we want to generate surplus from it. We've never kind of, you know, viewed it that way. We've really viewed it more that, you know, if ‑‑ if we're providing what people with disabilities need and want, you know, then we feel good about it. And we think that's kind of ‑‑ again, that gets into that whole issue of being, you know, are you going to be a service provider. I know some centers struggle with this, whether it's personal assistant services or doing home mods. You know, home mods is service provision. And it's ‑‑ you know, you have to ‑‑ you have to balance it. And, you know, you've got to be okay with it, but also recognizing you need to fulfill your advocacy role and your mandate to do the advocacy that's required of us. Maybe I should stop there for a second. You know, Dennis maybe you have ‑‑ I have some other things I'll definitely come back and additional kinds of things we've done. But maybe Dennis, you have some thoughts based on what I just have talked about or even we can take some questions, too. 
>> DENNIS FITZGIBBONS: So I do have a few thoughts on what you've said, Phil. I think there's some questions as well. I just want to reiterate that even though there's some significant differences between us for some reasons, in fact personal assistant services has been the same kind of a boost for revenues at AlphaOne and has ‑‑ you know, excess revenues there have supported independent living services far and above what we could have done without it over many years. As you talked about meeting community needs and building goodwill, I think sometimes diversification is not about getting more revenue, although you don't want to give it away, but it's not going to generate the kind of revenue that's going to pay for additional services or supplement what you're already doing. Some of our oldest services that are in place ‑‑ in fact, the oldest one is driver evaluation program that can determine whether someone's able to drive a vehicle with or without adaptive equipment. It's never been a big revenue generator, but there's nobody else in the state of Maine who can provide that service or who does provide that service. It's made the difference for so many people over the years who have been able to buy a vehicle and acquire a vehicle to have greater independence in their lives. We made the investment in that program years ago. 
It's been difficult at times when the adapted van that we have has either died or broken and you've got that expense again. But we've seen that as a worthwhile investment of resources to continue to offer that service because used to be the closest competitor was in New Hampshire and now the closest competitor is in Massachusetts. And really an inconvenience for people to have to often go overnight to get a driver evaluation in another state. So it was something we were glad we were able to hang onto because it met consumer need. I'd have to say also, many of the services we've had that have lasted the longest were the ones that were developed as a direct response to consumer needs saying we want you guys to do this, which includes personal assistant services that we developed for the first time back in 1980. It's grown significantly over the years. But that, again, was kicked off by consumers who had no resources to stay in the community unless someone developed something. We took that on as a systems change effort that then resulted in programming, but that was not our original intent. It was simply advocating for consumers who needed services at home in order to remain in their homes. There's a lot of common ground here we have with our two centers despite the differences. 
And, again, I want dive into the personal assistants how‑to either, but I'm happy to share information in the future. I have one that we did back in the mid‑'80s to create a for‑profit subsidiary. That was some awkward looks and funny comments from some consumers because when you put for‑profit in front of a business, people see that as taking advantage of people with disabilities. I don't really think that was the case. That's just how those businesses tend to operate and that's how we wanted to compete in the community. And we also saw it as a way to generate those extra revenues to support independent living services. So getting into DME sales in the mid‑'80s paid many dividends for us that were not financial as well because it really fit like a glove to our advocacy agenda, making sure people had the adaptive equipment or equipment they needed to be independent and helping them find the money to pay for those things either through Medicaid or other resources. 
Now, as the years progressed, that business became instead of a profit center, it became more of a liability and we did have to eventually close it down because we're not in business to lose money on those things. For many years, it was worth having for not only revenue, but also because of the goodwill in the communities and the goodwill and attention that it attracted from private businesses who seeing us operate a business like that, I think it improved our credibility as an organization. And I can say for sure that we landed some significant demonstration grants as a result of having that business as well. So there are pluses and minus all the time. I think whether you get into fee for service or for‑profit operations or even the current things that you're doing, we all have to recognize that bad times can come to any aspect of the business and sometimes you have to cut something loose and know when to stop and move on so that you're not losing too much money. I don't think anything lasts forever. And that's that struggle around diversification is making sure you do last with that balance of funding. The for‑profit stuff we've tried on more than one occasion with mixed results. And one of the things I throw out first on something like that, and it's true for any kind of fee‑based program, for a for‑profit thing, the biggest mistake we made ‑‑ [ no audio ]. 
>> MARY OLSON: Dennis? 
>> PHIL PANGRAZIO: We may have lost Dennis. 
>> MARY OLSON: That's okay. Bummer. While he gets reconnected in, I do have a question from the chat room. We can go to that. And I wanted to remind folks again, if you've got specific questions for our speakers or if you have an example you'd like to share of fee for service you're doing, please press star 2. That will raise your hand and I can get you in the queue and make you live. The question is, do you all have any ideas about funding or fee for services in smaller CILs in primarily rural areas. So if you're somebody who's just getting started with a smaller CIL, do you have any thoughts or have you heard of anything that other CILs are doing? 
>> PHIL PANGRAZIO: Well, the transportation thing I mentioned earlier I think is ‑‑ is one that I think has a lot of potential, again, working with your state department of transportation as a funding source. I think that's a good one. I also think that ‑‑ you know, there's a lot of buzz going around now today with this whole contracting with community‑based organizations. How health care organizations or accountable health care organizations are now being required, you know, by ‑‑ and it's ‑‑ I think this is an outgrowth of what originally was the Affordable Care Act. But to contract with community‑based organizations. If you've been following what the administration on community living offered these grants to Nashwid and Inforay to work with area agency on aging or other organizations that centers for dependent living in developing fee‑for‑service contracts that could work with these medical entities, I think that's an area where CILs really should explore. 
And we haven't figured it out exactly yet. You know, we've been doing on outreach to the rehabilitation hospitals in Phoenix for a long, long time where we have a staff person that goes in and, you know, visits with patients at the bedside or in the rehab center on a requested basis. And, you know, does basically do an INR and peer support and, you know, kind of the peer counseling, family peer counseling, you know, right at the bedside. You know, distributes information about our centers. And that ‑‑ that program and I think there could be a way to bundle more services into that. Could be a viable fee‑for‑service avenue certainly for urban centers, but also for rural communities that have, you know, you have local community hospitals that have ‑‑ you know, have people with disabilities and ‑‑ that are experiencing disability and illness for the first time and are going to be challenged as they transition back out into the community and managing their health care needs. I think that's ‑‑ that's an avenue that we ‑‑ we need to figure out how to do it where we're maybe bundling some service coordination in there. You know, maybe there's some transportation piece to it. There may be some technology ‑‑ assisted technology piece to it. There could be some housing piece to it. And, you know, we just ‑‑ we kind of need to figure out how ‑‑ how we would bundle it and price it and then ‑‑ and convince hospitals or health care entities that we're going ‑‑ we can, you know, lower their cost, reduce readmissions and things like that. So I think that's an area that has potential, and maybe some of you are working on that. I'd love to hear if there's any of you that are working on it. 
I know some of you are trying to work to develop contracts with the manage care organizations in your communities. I think, you know, that would be good if any of you have anything to share about that because I think that's an area for the future for centers to pursue some additional funding sources. So that's kind of where I ‑‑ I was thinking. I don't know if we have Dennis back yet. 
>> DENNIS FITZGIBBONS: I am back. I fell off somewhere. I realized I was talking to myself, which I do often anyway. Yeah, I have one I could offer, too, that we've had some success with off and on over the years. We're closer to being that rural state where those questions what do you do if you're a rural center. I think it comes down to really what does well. We know our communities. Whether it's a local town or county or section of a state or anything like that. We really know what ‑‑ what's out there. Not just what the consumer need is, but what businesses exist. And often because that rural nature, rural small nature, we tend to have easier access to the people operating those businesses. Rural states tend to be more, everybody seems to know everybody. One of the things we had success with in that way, the city of Portland for some reason here in Maine is a mecca for disability insurance businesses. 
It seems like there's a new one every year cropping up and there's almost one on every block in Portland. And understand that Portland is not a large city. It's our largest city in the state and the population, I think, is still not 70,000. So it's small and you can get to know people and businesses and the people in those businesses. Over the years, we built a great relationship with one company in particular which was Union Mutual, later became UNUM, later merged with Providence. After the merger that spawned several other disability insurance companies that people created when they were laid off from the merger of the two. Anyway, to make a long story short, over the course of about 15 years, we actually had contractual relationships with three of these companies at one time or another. And it fit us like a glove because what we were able to offer to them essentially were the core services of peer support and skills instruction and information referral with a little advocacy mixed in. They didn't even realize we were doing that with them. 
We first had relations with these people, they knew the successes we had working with people with disabilities in Maine and helping people either reestablish life after a disability or just deal with ongoing disability issues. And they valued what we did. Then we started talking about how we could work with them in their job of managing disability claims both short‑term and long‑term disability. Honestly speaking, you have to know who you're working with. And we knew most of these companies, their primary interest is getting someone off of a claim so they can move on and reap the rewards and benefits of keeping the money they've reserved. But at the same time, they were starting to listen to us about the value of people having a life and returning to a life of productivity through work, et cetera. We were able to convince them that we take a look at someone's life along with that individual and sort of develop a blue print of how they might get back towards the goals that they have in their life. 
We explained how we did that which is simply through a conversation across the kitchen table in that person's home. Getting to know them, asking them to tell us, what's going on in their life, what's preventing them from meeting their goals or reaching their goals, what would help them get to those goals, what are their aspirations and dreams. A whole range of things to really explore what's going on not only with home access, but community access and many, many other things. Health, recreation, et cetera. So, you know, one of the first things that was interesting was way back when ‑‑ I think it was in the '90s working with UNUM they actually came to us and wanted to buy AlphaOne They valued us so much. I remember I was not the director then, and the founder thought it was a wonderful offer. Right from the very first minute, he said absolutely not. This ‑‑ we can't do that. We're not interested in doing that. However, it was fantastic for the private company that served how many clients and people around the country and outside the country to be interested in a little old CIL from the Portland, Maine area. What they saw in us was something of value. They liked our belief that people could work no matter what their disability was and our belief and steadfastness in helping people reach those goals. And they started to understand those core services, especially the peer supports value. 
So once we declined that we didn't want to sell out to them or become part of them, they asked us to help them build their own component internally to do that, which they eventually did. They had what they called services for independent living as one of their benefits to people who received the short‑term and long‑term disability services. We were actually part of the team of helping them hire people with disabilities to provide those jobs ‑‑ or fill those jobs and to manage that department. So we had a great impact on that organization. Later, we worked with another long‑term disability organization that wanted to get involved after the ticket to work act was passed back around 2000. And they were looking to become an employment network and they, again, wanted to use us as a connection to people with disabilities. Which we did. We actually engaged and hired some consumers who work for us who wanted to go back to work and used them as peers to work with people through that other organization. 
And then lastly, a third organization when they also through the relationship building learned about how we worked with consumers to look at their goals and objectives and how they wanted to proceed with their independent living, they said, well, could you do that in other states. Could you do that by telephone. And I thought about it a minute. I said, well, sure, why not. Because I didn't see why we couldn't do it. And then of course once we agreed to do it, I had to go back and convince staff we could do it. Many of them were saying I need to be across, on the kitchen table, I need to see that person's home, the environment. They went on about various things like that that were barriers to that. We had two employees who actually were the best at doing these visits and generating these reports that came out of them who were both blind and couldn't see the home environment yet they knew the right questions to ask and how to communicate with those individuals. Once I shared that with everybody, I said, well, if these two people can do it, everybody can do it. Just have to look at doing it a little bit differently. 
Then, you know, we generated a contract. We were paid an hourly rate for the support and the contacts that people had. And we were very successful in helping this particular disability insurer move people off of claim, but more importantly back to work and back to living the community. To the point we were able to persuade them to pay for things in order to make that happen. While they might be able to take money out of reserves and put it back under the profit line, they were making investments that allow people to do that. Some examples of some of those investments were buying out a lease on a vehicle that an individual couldn't drive anymore because of their disability and then purchasing a vehicle and the adaptive equipment that would allow them to drive and commute to work. Another was to help people ‑‑ to help an individual get the adaptive equipment for computer work so that they could work from home and eventually get back to the office once the office was made accessible. We had a lot of success with those things, too. There are also three examples of fee‑for‑service programs that had a ‑‑ I wouldn't say short life, but not a long, long life. Because when management changed at these businesses, then if something wasn't the new manager's idea, it wasn't always a priority. But I think that it was still worth doing and it still made a difference in people's lives. 
That, again, came from our ability to know the larger businesses in the area and the people who actually operated those businesses and led those businesses. I think lots of things are possible, whether it's a rural area or an urban area. It all comes back to building the relationships that are so key to moving those things forward. I'm going to take a deep breath. 
>> PHIL PANGRAZIO: Yep. And that was really good, Dennis. And I ‑‑ you know, I think couple of things that come to my mind about that is that, you know, as on executive director, you don't have all the answers on how to, you know, bring in new sources of revenue and funding and ‑‑ and sometimes we as executive directors really need to, you know, rely upon our people, our staff, our program managers, our ‑‑ some of us might say, I don't even have a program manager, I'm like managing it all Which is true, I get it. I understand that. Some of you, though, may have a little bit more horsepower than that. But I think we have to empower our people, our staff. And oftentimes we have staff that have real creative ideas and have aptitudes and their brains think in ways that are revenue generating. And I just say that to encourage you as executive directors, those of you who are on the phone as executive directors, to, you know, empower those people because they ‑‑ eventually they'll lead to better and greater things and more diversification of funding for your organization. 
I'm give you an example. When I first started in April of 2000, I had an operational person that was always mad about this one program manager that was developing these little piddly contracts. It was a thousand dollars here and a thousand dollars there. And she hated the fact that it was too hard for accounting to deal with and we just ‑‑ it didn't do enough. It wasn't, you know ‑‑ it just wasn't adding enough to the bottom line, at least in this person's mind, about how it was generating revenue. But I ‑‑ you know, the person that was ‑‑ that was generating these little so‑called piddly contracts has now been with the organization for 28 years and has actually, you know, generated, you know, some grant funded relationships that are, you know, worth hundreds of thousands of dollars today. That operational person who ‑‑ who was always kind of bashing it isn't here any longer and hasn't been here for a long time. So I just give you that little example that ‑‑ because I ‑‑ and I've seen other center directors that get so ‑‑ they get a little too control freakish. They just can't let go. They can't empower their staff. They want to make all the decisions. They want to control every little aspect. And that's impossible. And it's not healthy and it's not ‑‑ you're not going to have a culture within the organization that ‑‑ that is going to be designed to grow and build programs. So I throw that out. 
You know, there's a lot of things to think about when you're developing fee‑for‑service programs or grant‑funded programs or any other sources of revenue. You've got to ‑‑ you know, you got to develop budgets and you may have to get a bank line of credit. You got to manage the cash flow. You have things like liability insurance. You might need access to legal counsel. And you got to have competent finance, accounting, payroll, billing people. Oftentimes when you first start out, that might be barely one person that you're relying upon to do those things, but they have to be competent. As you grow, you probably will need to add even more competent people because typically you're not going to be able to afford, you know, the most highly skilled people in accounting and finance in the beginning stages of program development. But as you grow, you kind of ‑‑ you're going to have to bring on more sophisticated people. Not to mention, you know, computer software applications and your accounting and general ledger kinds of things. So more things to think about. 
>> MARY OLSON: Actually, if you don't mind me interrupting just a moment, I think that goes along really well with another question we've got in the chat room. I just wanted to throw out there one more time, folks, if you've got questions on the line, if you press star 2, it will raise your hand. If you're having trouble doing that or if you are pressing star 2, I'm not seeing it. If somebody could e‑mail me if you are doing it and it's not working, that would be great. While I'm getting that fixed, I'm going to go to the chat room. And along those lines, you guys were talking about getting competent people on board. And Kiki is asking does anybody have a line or do you guys have any suggestions on how do you really get your board engaged in this process? 
>> PHIL PANGRAZIO: I'll start with this and then Dennis can jump in. That's a good ‑‑ that's a really good question. When you're small, I think you ‑‑ you may have a greater opportunity to get your board involved because you have so few paid staff resources that you may need to lean on board members to maybe to volunteer some of their expertise and skill. The hope is that you have board members that have expertise and skill. If you don't, you better go out and find them. Whether they've got management experience or finance experience or accounting experience. I think what you'll find, though, in those early stages of, you know, when you're trying to grow a little bit, those board members, they really ‑‑ they're begging for something to sink their teeth into and help. I think you just need to ask them. Hopefully they are asking the kinds of questions that will lead them to want to jump in and get their fingers dirty in a project or a ‑‑ developing a program. 
You know, when you get as big as what we've got at Ability360, then it becomes a little lesser of a ‑‑ sometimes it's a lesser of a desire for board members to get in there too much because then it's ‑‑ you know, then it ‑‑ you got other issues and concerns. But I do think for a smaller center, it really can be valuable. 
>> DENNIS FITZGIBBONS: This is Dennis. I would just add that it's incredibly important to work on board development constantly to make sure that you've got a balance there. When I first joined AlphaOne, I think it was primarily a consumer board. And they're all great people and they used various programs of the center and they understood the programs, they valued them, they valued AlphaOne. But most of them didn't have any real business experience in operating a business. They would do anything they could to help out, and most of them were peers in our peer program. But when it came to needing business acumen and things like that, you know, it really sent the signal that we needed to do some more board development and really diversify the board. That's another way of diversifying the organization, having that balance between consumers and other people with disabilities who may actually have business experience, own their own business, et cetera, that they can offer some of those nuts and bolts things when you're a small organization that otherwise you're going to have to pay for when you go out and it's another use of resources that you don't necessarily have to expend if you've got that board expertise. 
So a lot of ways to do that. It's a lot of work. I think that's one of the major pieces of work for an executive director is that board development piece. But jumping into developing other programs, you really need to have those resources to do it. Maybe even recruiting a good grant writer to the board would be useful. Have a disability, all the better. Pretty challenging in remote and rural areas, though, I know. 
>> MARY OLSON: If I can add. This is Mary. I'm stealing this from one of our mentors from the APRIL mentoring program. She actually had each of her board members fill out a form that's called "who do you know."
Because, you know, one thing when you're doing even fundraising or diversifying funding is that she said a lot of times, your board members might have connections to people who maybe sit on the board of a foundation or, you know, they ‑‑ but you just don't know that. So she asks them, you know, who do you know who could maybe help with funding. Who do you know who might be a good person to donate services or time, because funding also doesn't always look like money. It might also look like goods and services that you don't have to pay for. So that's one way that she engages her board. I just thought I'd throw that in there. 
>> DENNIS FITZGIBBONS: That's really great. That's a great idea. That is a way to continue to make those connections with your community. 
>> MARY OLSON: I do have a couple more questions from the lines if this is a good time? 
>> PHIL PANGRAZIO: Yep. 
>> MARY OLSON: Great. All right. Go ahead, your mic is live. Are you ‑‑ 303 ZIP code. 
>> Yes. Can you hear me? 
>> MARY OLSON: I can. 
>> Oh, great. Am I on the line? 
>> MARY OLSON: You are. Go ahead with your question or your thought. 
>> Thank you very much. It's a great discussion. Thank you to the presenters and to APRIL for organizing. I have a question around this federal regulation called program income. And I'm wondering if ‑‑ are your generating programs all self‑sufficient or do you have any fee for service that is supported by federal funds? And if you do have any that are supported by federal funds or perhaps you had it in the beginning of the program developing, how do you deal with this federal regulation on program income? Thank you. 
>> DENNIS FITZGIBBONS: That's a good question. 
>> PHIL PANGRAZIO: Well, if you got the answer, Dennis, you go ahead. 
>> DENNIS FITZGIBBONS: I don't have a great answer. I could just say that over the years we've been able to develop fee‑based programs without using those federal resources we get from part C funding. And I understand the complication there is how do you get that funding if you only have the part C resources. But I think that's where it goes to the grant writing aspect. We've use grants and demonstration grants to try things out first, and then we've looked for other resources to initiate new programming. And so we haven't had to use those federal resources in order to do so. And it also goes back ‑‑ you know, we started with our federal resources back in 1979. So that goes back a long way before some of these rules were very clear or even in place and they've changed over time. So ‑‑ but I know that is a concern and even one we've had discussions about in the last couple of years with our controller because he doesn't leave any stone unturned with what needs to be complied with. Which is good. That's the kind of sharp person you need. So it hasn't been a problem for us, but I can see where it would be difficult for a smaller or newer center trying to get off the ground. 
I guess it's donations, looking for other ways to start things, using grant funding. We were actually able to persuade a business many years ago that provided the startup funds for the DME for‑profit company. So there are ways to do it, but it's a lot of work. 
>> PHIL PANGRAZIO: Yeah. Yeah, I think that that's a good answer. You know, and for us, we've been at it for so long that, you know, we've ‑‑ you know, we used ‑‑ we used our surplus dollars from our PAS program for the most part to help us launch some of our other kinds of fee‑for‑service programs. Like as an example, we're been an employment network under the ticket to work and work incentives improvement act since about it started, you know, in 2000. So we've been operating an employment network. So it's basically a fee for service kind of program through the milestone outcome payment system. And, you know, we generate, you know, it's close to half a million dollars a year with that program. I know the ticket to work is not one of those programs that a lot of centers have been in love with over the years. It's certainly not a cash cow or anything like that. But it is one of those programs that puts you in the game of offering employment services to people with disabilities. 
And that's really mission base for us. That's why we've committed to it. But we've also developed some fee‑for‑service contracts with our other employment providers in the community to service TANF participants with employment services. That's also been another, you know, part of mixing in our diversifying some of our funds, but also adding to our employment offerings. But, yeah, I ‑‑ the whole idea of how you can use your part C funds and ‑‑ for program development, you know, it's probably a bigger issue for smaller centers than it is for us at this point. We haven't ‑‑ we haven't had an issue with it from an accounting perspective. 
>> MARY OLSON: Great. I've got ‑‑ I've got some more for you. We're just kicking it up. 
>> DENNIS FITZGIBBONS: Bring them on. 
>> MARY OLSON: Let's go to the lines and then I have one more in the chat room, if that's all right. All right. Go ahead please. 
>> So this is me. Yeah, if I can just sort of add something to the last response in terms of the ‑‑ the grant requirements for how do you do this and not get sort of dinged for your fee for service on your grant. Here in Bluewater and then I was in North Carolina before. So the key is most of the things that you're going to provide for services are things you could provide under ‑‑ under your Part C grant, structured in a center way that ‑‑ the key is to tell the people you're providing them to that this is a one‑year, you know, introductory offer, right? And that if this works, here's going to be the fee structure next year and here's what you get. Here's how we're going to measure it. So be ‑‑ be ‑‑ have that in the packet. Have that in the ‑‑ in the works when you start it, so it's not a shock. So they don't have to choose to cut you off, so to speak. And they can also be then your partner in terms of how to do we raise local funds to pay for this. And that's been a fairly successful tactic for our center. 
Then secondly, one of the key diversification things that has helped us with that and fee for service as well is to not get stuck in the other only going to serve people with disabilities with this program right from the very start. So we have, for instance, a GED prep program. And, you know, we use the acronym WOW, with or without disability. We can get money our workforce development folks under the WIOA to run that program because they run that program for everyone. Then we can do that for people with disabilities and not ‑‑ and so if we don't have enough money under ‑‑ under the WIOA workforce development program, we can do those same things with our Part C funds with ‑‑ and the only difference needs to be to designate the disability. And quite frankly, the people participating in the program, they could care less. They get the same service and then, you know, if you do a pretty good job of that, actually quote, unquote, non‑disability programs, non‑Part C money will usually, you know, pay for a lot of that. And that's ‑‑ as long as you have ‑‑ you have to have a good accountant. And you have to keep good, you know, payroll time records. But it's not that hard. 
And in fact, I've found that communities are ‑‑ are very accepting to programs like that, far more than I think some of the CILs believe. And we don't lose our core idea that is the people with disabilities end up as participants in the community that way. So we don't have to segregate to integrate, so to speak. That's been something very successful to us. The other thing that I would suggest in terms of diversification that either I didn't hear or haven't heard yet, I heard good suggestions in terms of board participation. But I've been really successful ‑‑ I should say and in this case ‑‑ I've been very successful in terms of just not getting stuck in the traditional sort of frames of what's resource development, right? Because diversification means doing something differently than you normally do. So I use it with not only our board, but with our staff and say, here's the situation, you know, let's start with ideas. And what happens is we sometimes don't solve that situation. However, we come up with six ideas on how to provide something else. And how to do so with maybe four different funding streams. 
And we run it as an experiment. Run a lot of pilot projects, right? I think one of the keys to being able to diversify funding is to understand you have to ‑‑ you have to be ‑‑ you have to be willing to run experiments. I guess maybe that's what I'll add to that. But I've heard a lot of good things so far, so thank you. I'll hop off. 
>> PHIL PANGRAZIO: I appreciate that comment. It was really good. I like the idea of thinking outside the box that, you know, you can serve other ‑‑ you can serve people with and without disabilities. A good example of that here that we do is our sports and fitness center. Our sports and fitness center is fully integrated people with and without disabilities can join. There's a membership fee. We tell anybody that comes to us that says, hey, I don't have a disability, can I join ‑‑ can I become a member here. And we're like, well, it's our mission to serve folks with disabilities, but anybody can join, absolutely. So I think that's a great ‑‑ and, you know, we're generating probably couple hundred thousand dollars a year in membership revenue and we don't turn anybody away of course. 
>> Right, right. 
>> PHIL PANGRAZIO: If people can afford to pay. But, yeah, I think that's a great idea. Great suggestion. 
>> MARY OLSON: Great. I just have one more question for y'all. We're going to move back in time a little bit. Amy is wondering, Dennis, what did you mean by disability insurance? Were you referring to workman's comp carriers? Insurers in her area don't want to pay us for IL services because they say we have to provide them for free. Have you combatted with that or haven't you combatted that? I think we stumped Dennis. 
>> PHIL PANGRAZIO: Dennis, are you there or are you on mute? I'm not sure what happened to Dennis. He ‑‑ I don't know exactly how he'd respond to that question. 
>> MARY OLSON: Well, Amy, you know, we will get that question to Dennis if he doesn't pop back in and we'll get it answered for you. I also just wanted to throw out there, this is Mary talking, not the chat room. But, you know, I know that some of the folks in the rural areas we're talking about what are some ideas that you have. I know a lot of rural centers who have had some real success in doing fee for service around the youth services. Especially in rural areas, I think with the limited options to CRPs or to other, you know, agencies who can provide like the soft skills training or the soft advocacy training. I know that centers have really been able to step up in rural areas and do that. And then receive fees for their services since, you know, they're mandated to spend about 15% of their funding on that, and so there is money to spend. That was a call balk to a question from earlier. But I wanted to throw that out there. With that ‑‑ I'll let you go ahead and ‑‑ 
>> PHIL PANGRAZIO: Well, I was just going to say, I'm glad you mentioned that because I do think that's an area that centers really have an opportunity to step up and do more. We currently ‑‑ we just established a contract with our vocational rehabilitation program, the rehab instructional services, to offer the work incentives to youth in transition, DB101 and that kind of in transition services. Yeah, we know because we know how VR has to spend 15% of their funding on those kind of services. So I think, you know, developing those ‑‑ if you're not developing those relationships with your VR agency, you need to do that. I know we've got a big ‑‑ we've been a WIPA grantee for a long time. I know my staff have been very assertive in working that relationship over the past year and a half or so. I'm glad you brought that up. I know we hadn't talked about that yet today. 
>> MARY OLSON: I know that ‑‑ I think we have Dennis back now, too. 
>> DENNIS FITZGIBBONS: Yeah, I couldn't hear you for a while. Can you hear me now? 
>> MARY OLSON: I can hear you now. 
>> DENNIS FITZGIBBONS: Excellent. I think the question was about what is a disability insurer. It's not a worker's comp insurance. It's someone ‑‑ and they're not injured on the job and they have disability insurance then it's going to be income replacement and, you know, disability insurer will insure you often for a short term. Then after a period of time, then you become a long‑term claimant. At that point, they are required to set aside that income replacement money for you over a period of time. And many of us have that through our employment. Maybe not everybody, but it's a typical benefit that's offered in many companies that people have either short‑term or long‑term disability insurance. It's far different than the worker's comp insurance. I don't know if that helps or not. 
>> MARY OLSON: Great. Thank you. At this time, we don't have any more questions in the queue. If you guys had other information you wanted to share. And again, if folks do want to share, we'd love to hear what you're doing in your centers. So please press star 2 and we can make you live. And Dennis, sorry, one thing quick, the second part of that question was that insurers in their area say that IL services have to be provided for free so that they won't pay for it. Is that something you've ever had to deal with? 
>> DENNIS FITZGIBBONS: It is something we've dealt with quite a bit. I remember when I first joined AlphaOne back in the mid‑'90s, and I wasn't director then, there were about three of us there as staff people who did a lot of interaction with organizations that were looking for things. And often that was their response, well, we thought you guys were a nonprofit and did everything for nothing. And, you know, there were some things we would do for so‑called nothing, which were the core services. We would explain there's nothing that's free. Everything costs money. Happened to be covered by other resources. But if they were looking for something above and beyond those core services, then if they wanted it for nothing, we would simply say, no, there actually is a fee for that. We had an internal competition to see who could get the most for our services because we had firm belief that the knowledge we have as an organization is valuable. And the people out there who don't have that information should pay a fair price for it. I'm not saying consumers should pay for it, but I'm saying that other businesses who are looking for something just like they charge something for what they offer, they ought to understand that even a nonprofit has to pay the light bill and other bills in order to stay open. 
So we actually had a fun competition in terms of who could actually get people to agree to pay after a good discussion around those things and it kind of raised morale as we were able to have greater success with it. I think you look at different ways to make things work, and ‑‑ but we were always willing, if someone wanted something for nothing to say sorry we can't do that and not give in and do it for nothing. 
>> MARY OLSON: Great. Thank you, Dennis. All right. So, again, you know, we have time for a couple of other comments if folks want. You can press star 2. If not, I'll turn it back over to our speakers. 
>> PHIL PANGRAZIO: And if there's a question, we can take it. I was going to throw out one other kind of thing that my staff have done over the years that has brought in some additional revenue, but has also kind of connected us to our community that I think has been, you know, really positive. And we've ‑‑ again, I don't think every community can maybe ‑‑ I don't know how you do these in smaller communities or versus the larger communities. Again, it's resource based. But we've hosted a health and wellness fair. We've hosted a technology fair. We've done an African‑American disability summit. We do an American Indian disability summit and we're now in a second year of doing a Latino disability summit. And, you know, the ‑‑ kind of the cool thing about it, though, again, I've got certain staff that just really like doing those ‑‑ coordinating those kind of events. 
And the corporate sponsors really step up and help fund it. And usually, you know, it's been so successful that we've actually ‑‑ you know, they turn a little bit of a profit. I know the P word, we're not supposed to use the P word. But they do. And so they generate a little surplus. You're not ‑‑ they're not cash cows or anything like that. But they do create some really goodwill in the community and connects you to the disability community. So those are some other kinds of programming things you can think about that, you know, can connect you to corporate world, but also generate a little ‑‑ a little bit of revenue and the disability ‑‑ connect you to the disability community. 
>> MARY OLSON: Great. Thank you. I do have one more comment. 
>> Hi, this is Tony, a director for center for independent living Florida. I just wanted to find out if you‑all have experience in collaborating with post‑secondary institutions on grant writing efforts to obtain funding for CIL services and efforts and/or with the VA. Currently in the university community, there seems to be a lot of interest from faculty there to want to collaborate on grant efforts ranging from needs assessments to researching the efficacy of programs. These are also in line with some of the interests the VA has. I know the VA is undergoing some changes and looking to develop more institutional partnerships outside of the VA in order to provide services for veterans.
I guess I'm basically asking what are your thoughts and/or experiences in partnering with post‑secondary institutions on grant writing and with the VA. 
>> PHIL PANGRAZIO: I think it's a really good idea. Go ahead, Dennis. 
>> DENNIS FITZGIBBONS: I was just going to say the same thing. Any time you get a chance to partner with somebody and find some energy, I would think you ‑‑ why would you not do that. Good for you for doing that. In terms of the VA, we've had no success here in Maine really working with the VA. Not for lack of trying, but they're a difficult system to work with here and I've heard elsewhere as well. I love the idea working with academia and finding way to expand resources that way. 
>> PHIL PANGRAZIO: Yeah, and we've ‑‑ I echo the VA comment. Although we've had a lot of success at bringing veterans into our sports and fitness center, we have nearly 800 veterans that are now members of our sports and fitness center which is really cool. And we do have a small VA contract, but they are a tough nut to crack. Just because of the way that system works. But I do ‑‑ I think that developing the relationships with the post‑secondary education programs I think makes a lot of sense. We're doing it not so much to partner on grant writing or needs assessment or that sort of thing which is think is really smart. We've done it with Arizona state university's school of journalism to bring in journalism students to work with our marketing department to work ‑‑ to develop some of our marketing materials and write articles that we've gotten ‑‑ that we publish in our magazine, that we publish on our website, that we push out to the local media, newspapers and such. 
So we've had a great relationship with the school of journalism. Again, it's not generating funds necessarily, but it's giving us free, you know, marketing talent, journalism talent. 
>> DENNIS FITZGIBBONS: And we've worked with three universities or colleges up here that have occupational therapy programs. And we've been able to get each of them to jump on board with access surveys of local communities after teaching the students all the things they need to look for and they get to coaching around how to go out and interact with businesses so that they're not a threat. Get out the measuring tapes or various things like that to really do a local access report that can then be shared with businesses and others to try to move along that agenda. It's also a good way to educate those future health care providers more about living with a disability when they start to see some of those barriers that exist in the community. 
>> MARY OLSON: We're getting close to the top of time here. I do have one more comment. Hopefully ‑‑ for some reason, it's not letting me unmute. Mary, are you there? I apologize. Kimberly, if you've got a question, you're welcome to e‑mail it to me. If not, I know that we are getting to the top of the time. I appreciate everybody. Again, please remember to evaluate our conversation. I just want to give a big warm thank you to Dennis and Phil. I appreciate you guys leading this really important topic. Yeah, I'm trying to unmute the line. Man, for some reason, Kimberly, your line does not want to unmute 
>> PHIL PANGRAZIO: Have her send the question and we can respond offline. 
>> MARY OLSON: That's a great thought. So Kimberly, please let me know if you've got a question, we can get it answered. If not, you know, if you've got something to add to the conversation, we would love to add it up on the website for the page. And, again, I know that Dennis and Phil have said that they had some materials. If folks wanted to get in touch with them, we will make their information live up on the website. If that's all right with you guys. 
>> DENNIS FITZGIBBONS: Sure. 
>> PHIL PANGRAZIO: Absolutely. 
>> MARY OLSON: Great. All right. Well, again, thank you, everybody, and I hope that you guys have a great ‑‑ well, beginning of summer. It's June tomorrow. So with that, please join us next month. We actually have our youth topical call part of the series. And it's going to be on fee for service in youth programs. They're going to be talking a lot about voc rehab in that area, so it will go nicely with this one. So please join us for that. Oh. And actually ‑‑ so Kimberly's question, I know that we're out of time, is wondering how the gentlemen suggest we help to influence our local VRs in working with CILs. Can you answer that in a couple minutes or is that a whole new topic? 
>> DENNIS FITZGIBBONS: Well, say something briefly for sure. We've historically have had a good relationship with vocational rehab. We've had ups and downs in the 2000s, but prior to that they might have been the most instrumental state office in helping us advance the independent living agenda here in the state including the creation of personal assistant services and a couple other programs. So I think that really for us, I think there's a benefit to being in a small rural state because everyone has to really work together or things really fall apart easily. And there's a lot more communication and interconnection with people. So to me, it was a breath of fresh air when I moved to Maine and found that you could pretty much talk to anybody, including the governor of the state, which never would have happened when I was in Massachusetts prior to that. So I think we've been fortunate here with the ‑‑ a good relationship with vocational rehab. 
>> PHIL PANGRAZIO: Yeah, and I would say that similarly we've had our ups and downs with them over the years, too. I think because we're ‑‑ we have the WIPA grant, the work incentive grant, that they really value us because of that because we're serving their ‑‑ their consumers as much as, you know, we're serving the entire disability community that's looking for that kind of information. But I think that is a big help, but I think now because of the changes with WEOWA, I think they know that we can benefit from relationships with CILs more than maybe they valued in the past. So I'd set up those meetings and go ‑‑ go talk to their leadership and try to, again, you know, reinvigorate that relationship. 
>> MARY OLSON: Thank you. You know, and I ‑‑ I just wanted to add with that that I think that it takes a whole team, you know. Everyone from the CIL needs to be working with your VR leadership at the state level to, you know, individual agencies, you know, working with them. And it can be really frustrating, you know, if VR's not working with you. One thing I have always recommended to folks is that maybe if the VR in your local area that isn't playing nice because those individual offices do tend to act a little bit differently. And so if you've got somebody else, you know, at a different office of the state that's doing a really good job, you know, maybe see if you can get them to help spread the message. Because, you know, that peer support is so valuable from VR to VR. That's my throw‑in. But I know it's frustrating and we are over time now. So we will let you all go. I really appreciate again, thank you so much Phil and Dennis for taking your time out to work with us today. I think it was a success. 
>> PHIL PANGRAZIO: We were glad to be with everybody. 
>> DENNIS FITZGIBBONS: Absolutely. 
>> MARY OLSON: We will talk again soon. Thanks, everyone. 
[ Discussion concluded at 4:35 p.m. ET ]