Episode 7 with Kyle Lininger

Keith: Welcome to Disability Empowerment Now. Today I am talking with Kyle Linger who is the Vice President of Clinical Integration at Intermountain Behavioral Services. Keith: Kyle, welcome to the show. Kyle: Oh, well, thank you so much. It's a pleasure to be here. Keith: So we have a very long and storied history together. We were in the Masters of Public Administration Program together at the University of Arizona. And then our paths keep crossing over the years. Kyle: Yeah, and from time to time at the bar with the beer. Keith: Yes, yes. So how long have you worked at Intermountain? Kyle: Well, I have been here for almost 15 years. I started in 2008. Keith: And for those listeners who don't know what Intermountain is or what they do, because you guys do quite a lot, please give us some background on Intermountain. How it started, who founded it, the reasons and motivations behind it, and how you first became involved in it. Kyle: Well, I think I'll start out with our current kind of state and then I'll work backwards to answer some of your questions. Currently Intermountain Centers is an integrated health and human services organization that delivers services to folks all throughout Arizona. And we have five kinds of core lines of work that we do to serve our community. The first is outpatient, behavioral health care. We provide residential services. We have a rather large foster care continuum. We do primary care and then we also operate a school, a specialized school for children on the autism spectrum. So that's kind of the work that we do now and we have 800 plus staff throughout Arizona, and we serve folks from Flagstaff, which is in Northern Arizona. People that are listening to this and haven't really spent too much time in Arizona, all the way down to Nogales which is right at the border of Mexico. The organization started in the late sixties when one of my mentors, Dr. David Giles, who was also at that time kind of finishing up his doctorate degree. He got the opportunity to create a new model for serving, Native American youth who had been placed in correctional facilities with very serious offending adults. These kids were coming out of these correctional facilities, like worse off than when they went in. And so it certainly was not the tribe, which is the Tohono O'odham Tribal Nation, It wasn't their intent to have that be the outcome. So Dr. David Giles, just coming out of grad school, his mentors at the University of Kansas, a guy named Dr. Todd Risley and another professor named Dr. Mantras Wolf, supported him and other colleagues in starting what was kind of like a group home type of environment. So instead of sending these folks to correctional facilities they sent them to the top of Mount Lemmon, which was a converted old prison camp from World War II, and they had tremendous success with these youths. They basically modeled these group homes after family homes rather than like institutional settings. They had a lot of success, but they kind of realized that if they were really gonna help they really needed to be in communities that weren't isolated. So they brought this group home model concept down into the Tucson area and their cultural responsivity made them heroes amongst other tribal nations around the country. So it kind of spread that model throughout the Southwest. In the eighties they kind of felt like this group home model had been better off if they had instead just one parent and it really being like a family home. So they pioneered the first therapeutic foster home settings and then kind of went on to grow in-home models. So instead of having kids being removed from their homes, like let's serve them in their homes and support their parents and kind of being the best caregivers that they could be according to what's important to them. So that's kind of like how things got started at Intermountain. That history is all rooted in a very powerful clinical practice coupled with cultural responsivity and humility called applied behavior analysis. That’s what I do today is I practice in the field of applied behavior analysis. My introduction to the organization was in 2008 and I was out of undergrad. I wasn't really sure what I wanted to do, and I got an opportunity with this organization to work in a group home with people that were, you know, teenagers and that were in state custody. And the whole goal was to help them prepare for independent life post 18, and I had just a life-changing experience of being there. And I realized that this is what I want to do for the rest of my life. I want to help kind of the underdogs, you know, people that are having, you know, really not getting a fair shake in their life, kind of lifted their potential, you know, whatever, whatever that is. And over the years I've been in many different facets of the company I did in-home work care coordination. I helped start the school that's still here today. I developed a department to serve people with developmental and intellectual disabilities, and then, you know, now I'm kind of in, in my role, kind of helping all the different pieces of our continuum connect to really wrap around the people that need our help and serve our communities. Keith: I remember meeting with Rose who was at that time, the assistant or something and we all had lunch at the Arizona Inn several years ago. Feels like a lifetime actually. Is Dr. Giles still with the organization? Kyle: Well so we call him Dave, you know, and I'm sure he would be like, yeah, call me Dave. Dave is, you know, supports the organization in, in a lot of ways, but he's no longer employed. He was the CEO for 40 plus years. So I don't, and it's been such an important part of his life that I don't think he'd ever give up, but he's not, he doesn't work here anymore. And Rose is the active CEO and continues in that role. Keith: Nice. So you mentioned coming into this organization and having a life changing experience because of it, so much so that you decided right there on the spot that this is what you wanted to do for the rest of your life. Professionally speaking, go deeper into that, because that is something that I think a lot of people wish they had, but don't with their jobs for whatever reason. You're clearly extremely passionate about yours, so take us back to that first life altering experience with Intermountain and how it deeply rooted you in the organization. Kyle: To go into this specific event, I'm going to borrow from this, this guy named Pat Fryman. He's really famous in my field, but I'm the beneficiary of people that have spread what I think is one of the most powerful ideas ever in human history. I won't give it a name because I don't want people to associate with anything else. But the idea is this, that who we are today, is not necessarily because of our genes. It's not because of, you know, I don't know what your religion is, but you know, we can free ourselves from believing. So, you know, to some degree that there's somebody pulling the strings, you know, or that there's a destiny for us. And instead who we are today was largely shaped by the environments around us. You know, our relationships, our access to care, to other resources that put us into contact with opportunity. You know, that idea is really behaviorism. It's kind of the idea that environments shape people working at my first job and I come from a very privileged background. I really hadn't interacted before with, you know, many teenagers that had spent their entire life with a guardian that was not their caregiver or, you know, maybe a family member. So the people that I was working with, you know, they didn't have people that loved them, you know, in the same way that maybe you Keith or I experienced that, and that is never more powerful or evident than during the holiday. So in 2008, all of the other staff that I was working with had Thanksgiving plans and no judgment about that. I was 20. Uh, how old was I? Uh, 2008. I was around 24 and my family lives in Washington, DC. So I wasn't going to go home. But other people I work with, they have families and they have stuff going on. So I stayed at the group home that Thanksgiving and spent time with the people who had no families to go home to. I had a really special day, you know, we cooked together. Yeah, we laughed together. We played games together, you know, the kinds of traditions that I engage with my family, I got to engage in with these, you know, they were kids, but they weren't that far removed age wise for me. I just felt like a real sense of purpose that I was doing something special that maybe, or giving someone an experience maybe they never had or showing, you know, them that I was, I was there to care about them and their life and that they had somebody there for them at that time. So I think that experience for me was really powerful and it kind of opened up this whole window into parts of our society that many of us haven't gotten exposure to. That eye-opening experience, you know, made me feel like there's a lot of people out there that need somebody. So I've kind of, I was like, and I want to do that professionally. Um, that's not really a job, that's a calling. And so I get, I have the pleasure of living a calling everyday. Keith: That's beautifully put and I couldn't agree more. So you'd seem very, very content with your job, with your work environment and with serving others. What are some takeaways that can motivate others to feel at least similar if not the same, because the work you do at times can be I imagine very very challenging, and your mood, your outlook everytime i see you or talk to you over the phone or zoom, it doesn't change, too much. So following up that question, your job isn't always easy, but how do you anchor yourself in your moral and spiritual beliefs even when the job is at its toughest, and you may feel like you want to walk away from your calling, how do you for the lack of a better term, push back against that. Kyle: That's a great question. Well my mood is like the weather. So you see me on sunny days most of the time. Um, but Keith, you also have a way of pushing the clouds away, you know, you've got great energy and you know, every time I see you, which isn't enough, you know, I just am, so, you know, I'm, I'm excited to be around you. Um, But I, I think like getting to your question about, um, how to, you know, like, I think it was about maybe perseverance or like maybe resilience in the face of like, challenge. I know where I'm headed. I know what direction I'm headed in the direction is related to my values.You know, my values are, you know, aligned with, you know, helping reduce human suffering, you know, kind of having caring and meaningful relationships with other people being supportive to my staff. You know, the staff that I work with every day and my colleagues, you don't ever really achieve those things, they're not goals, they’re values and I'm always headed in that direction. Even if I take a step back, I'm still, you know, headed in that direction. It's almost like in the frontier days, like you're, if you're like a frontiersman and you're like, you're heading west, you know? And so, um, every day I experienced new things, some setbacks, sometimes progress, but I'm always heading west. I will say that I don't push back against hardship because hardship and pain teaches us lessons. If you can find a way to deal with it and the discomfort, there's usually a value or a need, that's, you know, a value that isn't being followed or an unmet need that isn't being met. Um, and so those there's lessons in that too. So I don't really, like, I wouldn't say there's, I try not to resist to be honest, like the pain or discomfort. I found that that is impossible to do and the pain and discomfort isn't just physical, it's the, you know, imposter syndrome. It's the, like, I kind of joke with my wife on Saturdays, for whatever reason, I have all these thoughts about how, how stupid I was that week, or like the mistake I made in an interaction. And I call it a self-loathing Saturday. And on a self-loving Saturday, I just notice, um, that I'm having that thought, or I notice that I'm having that feeling or experience. And I try to, I try to make sense of what it's truly telling me about my values or my needs. So that's how I, I mean, that's kinda how I moved through it. I don't know if that answers your question, but, that's been helpful for me. Keith: Fair enough. So you'd said you’d started or became aware of the organization in 2008. Correct? Kyle: Yes. Keith: So when you started working there. Did you have any previous knowledge of working with either Native Americans or people with disabilities and if not or even if you did, how steep was the learning curve to fully immerse yourself in learning and studying in such a way that you could understand the complexities of everyone of your clients. Kyle: Well, there was definitely a big learning curve. I have people in my family with disabilities, substance use disorders. I hadn't really interacted with too many native American youth or adults. And I hadn't really had lots of interaction outside of my family of people who experienced serious mental illness or like, you know, disabilities the way this school system that I grew up in was very segregated. So I think people that are experiencing disabilities or would call themselves disabled. Um, you know, I didn't have as much interaction as I thought would have been helpful for me, when I was younger. I think it's one thing to have personal relationships with people that are, you know, having hardship in their life or have, you know, exceptional needs, but it's another thing to work professionally. And there's certain ethical components of professional support that are very different from personal support. And that was a big learning curve for me, but once I learned the hard lessons, you know, I haven't repeated the mistakes too frequently. Keith: Could you, without breaching confidentiality, could you give some examples of those hard lessons and the difference that you had to learn between personal support and professional support? Kyle: Well, I mean, it's, it's kind of like a, it's a sensitive subject to be putting on a podcast, to be honest for me, but, you know, I think no, but it's okay. I don't mind. I'm trying to think of a good example. That's just the right one. Keith: If you're not in the direct service provider industry like I know you are, like I know Jared Perkins is, an extremely good friend of ours, and of Brie Seward who you are on the board, or you’re I think are the president of the Autism Society of Southern Arizona. Jared was the past president, I think your wife, who I want to talk about later, is an honorary board member. So you are all directly in the service provider sphere of professionalism, what I am trying to do with these probing questions is to be first of all sensitive to confidentiality but I am trying to pull whatever curtain back I can to illuminate how complex this professional environment can be on any given day, because I don't think that a lot of people who either are not involved directly or have studied this line of work know how complex the environment can be. So I wanted you to speak about that in that probing question that I just asked. Kyle: Yeah no I think it's a really good question and what I will say, or what I can talk about related to that is you know how I had some energy and some desire to support people personally yet I maybe have a professional relationship with them. And that is really why I sit on boards, and grow resources that maybe aren't associated with the professional provider side, and I think Jared would say something similar, but there are a lot of areas where the medical establishment, the medical model of helping people don't meet all the needs that people have. Health is more than just medical health, or even like, you know, behavioral health that one of the, you know, you brought up the Autism Society. So I just wanted to point out that, like one thing I, one reason I've been so dedicated to the Autism Society over the past eight years is that it creates a kind of that natural support and personal element that I don't believe the provider community can never really ever meet. I think having those kinds of avenues gives me ways of making sure people are getting a personal connection. Um, while I can also maintain the kind of professional boundaries that I'm obligated to follow. So some short, some things that can happen if you have what is called a dual relationship, right? It's like where you have maybe a professional and a personal relationship with somebody. It can negatively impact the care that somebody receives, um, and that where you can't make decisions fully as a professional or fully as a personal relationship. I really have tried to avoid that in my career. I really want to make sure that I can be, you know, the one thing to the person that I'm supposed to be at that moment. It's really impossible, I think, to do somebody's service being, you know, when you've got the professional job to do, but you've, but you've got the personal weight impacting the decisions. So I don't, I know that's not a specific example. I guess as I've tried to make sense of where I put my energy and why I put my energy and like unpaid work that just benefits the community. It's because I have a personal connection, but I can't be that personal connection for everybody that I may be supporting professionally. Keith: So as I opened the interview, we have a very storied history together, we were not only in the same graduate program but you were kind enough to nominate me to become involved with Arizona LEND, a further medical teaching program surrounding disability and other related disorders. How did your time at Arizona LEND, because you were the cohort right before I joined, impact and influence your work at Intermountain. Kyle: Well, most people that do the work, I do, you know, behavior analysts around the country. You know, generally focused on behavior analysis. And I think we recognize a profession that we're not very strong in collaborating with multidisciplinary teams. That is a generalization, but most of my training outside of Intermountain had been, inside of what is like a traditional behavior analytics setting. And there was not a lot of collaboration. So participating in the LEND program gave me an opportunity to learn a lot more about different theoretical orientations, clinical orientations. At that time, social determinants of health, which I'm not sure if your listeners are familiar with, but social determinants of health are conditions, socioeconomic conditions that result in barriers to accessing health care that could be like race, it could be ethnicity, it could be poverty, it could be access to housing or transportation. I learned a lot about that in the program, and that was really valuable to me. I also had presentations with people that identify as, you know, as being disabled or people that also identified as having a disability. The parent perspective, I think like really just a multifaceted perspective that the whole system that's trying to help people with healthcare difficulties. And I really, really valued that experience at Intermountain and how it impacted my work at that time we had, you know, an 18 month waiting list for an autism diagnosis and in Tucson. And it inspired me to be part of solving that particular challenge. And at one point in 2016 we had gotten our diagnosis timeline down to like 45 days. And that was pretty cool. Um, I also just saw, you know, I, I saw all this multidisciplinary team work being done under Dr. Rice's leadership and I tried to emulate various aspects of that in the context of behavioral health, which back then was a very different system. The other thing that I got from it was exposure to a sub-field inside of behavior analysis called acceptance and commitment therapy. And it's totally changed my life personally and also in the treatment that I deliver. Um, that was one of the most rewarding experiences that I've had as a professional, but it was really hard because I also had a daughter that was born during that time and it was pretty wild to be doing all that stuff at the same time. How has your experience been with LEND Keith? Did you take any meaningful cues from that? Keith: Yeah, the two greatest things, one was getting connected with ACUD the Association of University Centers on Disability, correct, it's been a while since I looked at their page. The overhead agency that looks at the various use ads that intern look after all the LEND programs across the country, and I met a lot of great people there, professionals, and self advocates galore. But the other localized personal thing that could not have happened at an ACUD conference or a disability policy seminar, is when my advisor at the time, Elieen, who runs the program with Dr. Sydney Rice offered me the chance to fully teach one of the programs that year on what it was like growing up and living with Cerebral Palsy, which I have. I mean that was an opportunity for me to talk for three hours straight in front of my cohort colleagues, and normally I would have jumped at the chance to speak for three hours straight on growing up and living with Cerebral Palsy, but I identify as male, and females have Cerebral Palsy too, and they didn’t to speak to what it is like living with the neurological disorder differently than males can in some regards and vice versa. Luckily there was one of my fellow cohorts, a young woman who had Cerebral Palsy, a lot different than mine actually and her sister had another disability completely unrelated to CP, and so it was that knowledge to allowed me to convince my mentor at the time in the program, one of the co-directors to split the time evenly between me and my fellow cohort and her sister. That was one of the most rewarding experiences of the entire program. Now I could very easily, without much effort at all, talk the entire three hours of that week's lesson, but I didn't want to hog the spotlight particularly when I knew there was another cohort taking the program that had similar but different experiences that I had with my own disorder. So it was convincing the co-directors to split it up between the three of us and also giving that talk about co teaching what it is like living with Cerebral Palsy that was without a doubt the most professionally and personal highlight of my entire LEND experience. Kyle: That’s cool. That sounds really powerful. Keith: Yes it is, and I am lucky to be a part of that, to have it be recorded and that I have access to it whenever I have internet. I can send it to you if you need a refresher, or any of the listeners I can put it up. What are some of your hopes for Intermountain in the next five years? You talked alot about the strengths of the multifaceted program that Internmoutian is, talk about some of your hopes and dreams for the future for Intermountain, and also some areas in which there is room for improvement because we both know that every organization has things that they excel at and things that they can do better. And that’s what I want to again, peel back another curtain into the organization that is Intermountain. Kyle: Well, that's an interesting question. Well, it's like three things I think, two are kind of like directionally, like where we're headed and some of my hopes and dreams. So the first one is around substance use disorder work that we're doing, and I'll tell you about that. Then number two, we're forming an accountable care organization along with some partners. And I'll talk about that as the second piece. But the third piece is stuff that we have to do better moving forward and it's kind of associated with you know, trends and healthcare. The trends in healthcare on the contracting side is what's called value based purchasing. So instead of focusing on outputs, like the number of people served, you know, the next focus in healthcare, you know, across the board and particularly in behavioral health, and this is kind of new for behavioral health is value-based care, which did you show improvements in outcomes? You know, somebody came for you to prep for depression. Is there a depression resolved or manageable so that they can live the kind of life that they want? That'll be applied on a population scale. And right now most providers get paid for delivering like an hour of service and it's called fee for service. But in the future, you might continue to get some payment on a fee for service basis, but in order to really realize all of your payment, you're going to have to demonstrate outcomes. I think that that's a challenge for our organization and every other organization that operates in the healthcare space today. How do you prove that the people that are coming to you are doing better and there are some national standards around that, but in order to do this really well, we have to have good data on the kind of population that we serve. Then we also need to change our practice to make sure that people are getting what is regarded as the best practice that works. And we happen to know it works in a lot of different areas. One of those is in substance use disorders. And I don't know if you know this key, but in 2021 in our country, over a hundred thousand people died from a substance use disorder. And I think that's crazy. You have those statistics. My friends and I have family members that are at risk for being, you know, one of those numbers. I want that to happen. Intermountain has gotten a couple large SAMHSA grants over the past six months that will last five years from now, roughly. And those grants, which are quite large, you know, around $7 million over that time period, will help us grow our substance use services. You may not know this about me, but I have been working in the substance use field for the past four years. And that I now have the opportunity to share some of the evidence-based practices across our organization. So right now I'm really working on building the clinical competency of our workforce to develop STD programming that's going to change our communities and what I like about the approach, and it's called the community reinforcement approach. And I mentioned ACT a minute ago except it’s commitment therapy. We're putting together some clinical frameworks that combine these two interventions. And it's really pretty simple distilled. It is number one, helping people connect to what's important to them, recognizing that if punishment works, we'd have zero drug addicts in the world and number three, helping people contact meaningful and enjoyable lives and we can help them do that. So substance use disorders are, you know, we need to develop programs that are going to save our communities and that's what we're doing at Intermountain. So I'm really excited about that. The second thing was an accountable care organization. So Intermountain in partnership with another national organization is forming an accountable care organization. And what kind of healthcare care organizations are, is they were written into the affordable care act. And what they do is they allow organizations to build networks that focus on value based outcomes and where we share risk. We share benefits when people improve in their health or deteriorate in their health so that there are benefits when people improve in their health and there are costs and risks when people are not getting healthier. And so becoming an accountable care organization and forming a network of, you know, premier providers in our communities throughout Arizona is a really exciting path that we're on here over the next five years, and not exactly sure what my role in all of that is going to be. I think what I'm going to bring to the table is a deep knowledge of things over experience and through my training that if I can help grow the next generation of helpers we'll make our communities healthier. So that's kind of my answer. Keith: Wasn’t there a third thing that you were going to mention? Kyle: Yeah, you know, I started out with the third thing, which is like what we can do better. And I think that we need to do a better job of understanding, you know, really understanding our populations that we're serving and kind of improving our data and practice connection. So basically using real time, health information to improve our members' care. So an example of this would be like, you know, if somebody's in the hospital for a psychiatric reason or a medical reason, we now have ways to get that information in real time. Good care and good practice would be that I made contact with that person immediately upon discharging. Um, and that I do whatever is possible to help them from needing to go to that level of care or to the emergency room. Like how can I keep them into the community? How can I prevent, you know, this medical condition from becoming so problematic for the person that they have to go to the hospital. So that's an example of where data, you know, like the hospital admission kind of data would be linked to the practice of therapeutic support to keep somebody out of the hospital. And I think that kind of work is what we need to be better at if we're really gonna drive health care improvements in the communities that we serve. Keith: So getting back to Arizona LEND for a second. I know you're in constant communication with Jared and Brie because you are all a part of the board of the Autism Society of Southern Arizona. Are there any other cohorts from your time at Arizona LEND who play either a direct or indirect role in your professional career. First, I've interacted with a lot of people, um, with LEND outside of LEND. Ryan Davidson was a psychology student who I met through LEND, and she connected me with one of her mentors, a psychologist named Dr. Ann Bowen and Dr. Bowen has become one of my mentors, I just call her Ann. Ann is currently involved in helping train and provide supervision to staff across the state of Arizona here at Intermountain on acceptance commitment therapy and substance use disorder and addiction treatment. So that wouldn't have happened without LEND. Dr. Andrew Gardner, you know, I hear that he's going to continue to play an instrumental role in the LEND program moving forward. I'm not sure if you know him. Keith, do you know Dr. Gardner? Keith: Oh, yes, absolutely. I don't keep up with the LEND program because it is out of my purview as a disability advocate who is not really involved with healthcare or direct service providers. One of the things that threw me about the program is all the terminology they used. Had I taken my research course, research methods course that I took a few years after I was in the Arizona LEND program, before the program itself, would have made a lot more sense for me in terms of retaining that knowledge, they do throw quote a lot of information at you every section and they expect you to read everything, and then the clinics outside of the in classroom setting was some of my favorites and that is how I got to really know and appreciate everything that the Children's Clinic does and I talked to Jared about that tomorrow when I do his interview. Yeah I mean, I imagine someone who is either invloived or studying health care or direct service would have a lot easier time retaining the knowledge that the LEND program for better or for worse, mostly for be better to be honest, throws at their cohorts and I really struggled with that aspect but I mean, people who are involved with these areas of study are that LEND seems to gravitate more towards, they will have a lot easier time with understanding the program materials. Kyle: Yeah, absolutely. I think it is made for like, somebody who's like a graduate or already has some kind of terminal degree or interest in clinical work. I definitely learned a lot of vocabulary too, and I'm, you know, I was already licensed in my field at that time, so it was a lot. Just like, you know, just to kinda end your question, you know, answering your question, Andy Gardener, he, you know, I've worked with him over the years a number of times, he’s been very influential in terms of some clinical models and approaches that he uses to provide brief intervention based on evidence-based practice. And the third person is Ruey Mateo, who is a speech language pathologist. I was for four years, the actorly ambassador to Arizona for the centers for disease control prevention. She became like a master trainer in one of these trainings that we were doing around the state. She also helped out with a grant as a speech language pathologist that we were operating here at Intermountain. So yeah, I mean, I networked and met so many great people through LEND. Keith: So going back to your professional origins for a second and how I first met you. We were in the Public Administration Masters Program at the University of Arizona and I applied and completed that program as an ode to my mother who was a public administrator in Arts Organizations especially, and she always wanted a masters degree but as she was about to get into a program to get a graduate level degree, she got pregnant with me. That program was my way of doing a small thing to pay her back for the tireless dedication she has shown me over the years. So out of all the degree programs and specialties, what made Kyle Linger choose to study a masters in public administration. Kyle: I was really interested in non-profits. I always have been, it's really just such a cool business model for goods that where there is not a profit motive can’t drive it and where there probably isn't revenue that will ever support it. And that's like too specialized for the federal government to fund in a meaningful way as like a core service to the people. So I just thought, I just want to learn more about non-for-profits and also wanted to learn more about public policy. You know, I grew up in Washington DC and you know, I'm not a political animal, but everybody around me is a political animal, including my wife who I'm surprised I've married a political animal. Um, but policy always appealed to my practical side because that's where that's really where the work gets done, that operationalizes, how we're going to do things or what's possible. So as interested in non-for-public policy, as interested in not-for-profit management and something just didn't feel right to me about getting more knowledge about that with an MBA, I thought the MPA was the way to go in the school of government public policy. I also liked that the program was small. It was kind of scrappy. It was highly regarded, but it was kind of like an underdog program at the U of A. I think that kind of sums up why I went that route. Also, it was so much less expensive than the classes were at night. So there all the stars were aligning for why I went that route. Keith: Indeed. So at Intermountain you must deal with a plethora of disabilities on an ongoing basis. We talked about the learning curve when you first started at Intermountain. Now you have been at Intermountain for nearly a decade, eight years if I remember correctly. But you couldn't possibly retain all of the different knowledge about the plethora of disabilities and I assume again the plethora of different races, cultures, and so the question I am trying to ask is, you mentioned that you take time to serve on boards and organizations that aren't directly related to your professional life. Do you find that you still need to study up with a certain disability or a certain culture or maybe more even eight years into the job or do you feel that you've got a really good knowledge base at the moment. Kyle: Um, no, I just you know, my approach to all of it is like, I am a sponge and I try to gather as much information that I can always, because I just enjoy learning. But, you know, humility is the virtue. You know, that you have to have, when you're working with people, even studying, you know, or learning about disability categories or diagnoses or cultures, it would be a major mistake to think that even, what a writer wants to describe, you know, the terms a writer uses to describe a specific disability or culture really captures the individual experience. So you might know some of that background, but I mean I'm very humble in the fact that I got, I approach every situation as a learning opportunity and I don't, I really try hard not to, take the limits of my knowledge for granted. I don't know if that answers your question, but like, yeah, I like constantly studying, learning more. I'm curious, a curious person by nature and I'm always wanting to learn and know more. Keith: To be honest, that is one of the reasons we get along so well, because we are both very curious persons by nature, another person who is both curious and dare I say ferocious in nature is your wife, Courtney. Kyle: She is ferocious, that is a good word. Keith: We've mentioned her several times, over the course of this interview, and I really really get personal about family members, unless there is a direct link to disability or empowerment or advocacy, but I have admired both you and your wife for years, but particularly your wife because she is a lawyer, and her work ethic is extremely envious. And so if you wouldn't mind talking about how you two complement each other professionally, and how you two differ from each other again, professionally, I don’t want to get to personal in your personal life, but you both are very curious people I have met, you both and your wonderful kids, several times, and I have always been impressed by the family dynamic and how intellectual you both are. Kyle: Oh, first of all, great question. First of all, thank you for all the kind words. And I am so proud and lucky to be married to such an incredible person like Courtney. Um, so I mean, on a professional and personal level, like I am peanut butter. Courtney is jelly. She is, uh, she's analytic, I'm intuitive. She's more extroverted. And even though I can mask like an extrovert, I'm more of an introvert. You know, I think when one thing that we always do, you know, co-organized, you know, we just talk about stuff that's of interest to us. And I think one reason she married me is 'cause, I don't really like football that much and I don't like to spend my weekends watching sports. So instead my hobbies are like, let's talk about public policy or let's talk about this need in the community that we're seeing and that's just like, what's fun for us to talk about over cards with a beer. You know, in our professional life, Courtney's that attorney, like you said, and I never knew how useful it turned having been married to attorneys is if you're someone that gets in trouble a lot. Courtney, like I just bring Courtney into pretty much anything where there's like some kind of, you know, conflict and Courtney is like the great resolver. She's just really good at seeing all different angles and also coming up, she's really strategic and how to structure conflict resolution. This comes in really handy for her in like dominating our household. And also in things like, you know, Courtney doesn't get a lot of credit for this, but, you know, there was a ASD advisory group that was put together by the governor's office and Jared and Dr. Rice really influential, in that group once it got up and going, but it was really Courtney that led to the creation of that governor's committee by teaming up with Anne Ronan who's at the Arizona center for public law, for law and the public interest and, and Courtney reaching out to access and you know, some of the state legislature to push an agenda of improving supports for people with disabilities and Arizona. I don't really know how to answer the question entirely, but you know, Court, how we compliment each other as I usually bring the causes, you know, the things that I'm seeing boots on the ground and Courtney doesn't really see like what's going on in our community on a daily basis, you know, with like people's experiencing disability or substance use disorders or poverty, but she has a heart for it. And I help her get involved by pointing her in the direction of causes. So I think that that's kind of, that's kind of like our, the yin and yang. Our professional relationships. Keith: So had she been a resource for Intermountain through you and the work that Intermountain does? Kyle: Um, in the past she did, she helped with matters in the past, but then around then we work with her law firm Snell & Wilmer and they do all of our employment work and help out with other stuff. But you know, she isn't super directly involved at this time in legal work at Intermountain. Keith: You both were selected as one of the Hispanic Chamber of Commerce who nominates and confides the 40 under 40 award for excellence in professionalism. Can you speak more about how that recognition, maybe not necessarily directly from your peers, or maybe it is I don't know I wasn't there. How receiving that award impacted you both personally and professionally and what kind of momentum it gave you going forward. Kyle: Um, I don't know. I'm not sure. I mean, I think some people noticed and congratulated me, but I don't know that it necessarily impacted my professional career very much, but I did get a really awesome gift certificate to stay at Starr Pass Marriott and I have a little award in my office. Um, it didn't really have much impact on my career, I don't think, but it was definitely like, it was a, you know, really special moment to be recognized like that. And also to be just recognized with a lot of other really awesome community leaders, you know, Jared was in that cohort of 40 under 40, when I was at 40 under 40 and, for Courtney, I couldn't say, but I think she appreciated getting recognized that that's just a really unique thing. You know, you do all this work and you don't know who's watching or what you know, what it means and so just for one morning, one breakfast, just to have people hear about all the things that you've been doing to help the community or support the community, you know it's just this really nice thing. Keith: So self advocacy particularly in the disability community is a huge part of the community, and as we close out this interview I would like to end on two questions, one if there are any listeners who are self advocates and but are just getting started in the field of self advocacy. As someone who provides direct service, you have gotten to know several disabilities, if not more up close and personal even in a professional sense. In your opinion, what are some action steps that self-advocates who are just getting started in advocating for themselves, for their needs, for the needs of their community. What are some recommendations you have for them? Kyle: I think the disabiled community continues to face extraordinary discrimination and injustice, so I think it's incumbent upon people that can speak for those that are maybe having a similar experience, using their privilege, if they have any to you know, speak for those that may be can’t and help shape the policy agenda helps shape the provider and healthcare agenda because people that are living with disabilities, are people and our society, you know, I hate to say it, but our society still others, people with disabilities. So I think people that are, it's hard to speak for self advocates, but I've gotten the opportunity to spend time with self advocates and make changes and the way I live my life and how I treat other people and perspectives I have. I think it's important for self advocates to do that, advocate, but don't just do it for yourself, you know, do it for other people that maybe aren't getting a fair shake or their, the opportunity to lift their potential, whatever that is. Keith: Yeah. Last question, for those listeners who may not have a disability yet, or a lot of knowledge or personal experience with disabilities, people with disabilities, who are listening to this interview as the Vice President of Clinical Integration at Intermountain, what knowledge do you hope that they take away from what you so accurately described as not just a job for you but a calling and one that you would be happy and content to do for the rest of your life. What do you hope that people who don't have the first hand or direct experiences with disability yet, take away from listening to this interview? Kyle: I don't know. I guess the fact that me and you were talking, I really value our relationship. If you don't have somebody in your life that, you know, experiencing disabilities or you know, maybe identifies as being disabled, like make a point to get to know somebody, you know, learn about, about their experience. If you can, I also want to point out that as much as I may have given to people with disabilities, I've gotten as much or more out of it. So not, not looking at it as a, like one sided, like people with disabilities or charity cases, that’s not, that's not helpful. People with disabilities can teach us a lot about who we are now and like you said, it's like they don't have a disability or maybe they don't know somebody with a disability yet. It's impossible to go your whole life without experiencing disability yourself too, at a certain point, you know, we're all my mom says, like none of us are getting out of here alive. And in the process of, you know, aging, it's very, very likely that we're all going to experience disability. So don't look away from it, it's part of humanity. Keith: Indeed it is. And for those listeners who want to know more about the incredible work that Intermountain does or maybe they want to donate if not financially then with supplies, or just to hear more about the fascinating history that motivated Dr. Giles to create Intermountain. Where can people go online to find out more about Intermountain? Kyle: Well, it's pretty easy. You should go to Intermountain centers dot. org and you can learn more about the organization there you can give and then people can always reach out to me, if they ever have questions, my phone number, I'll give it on the podcast. 5 2 0 6, 6 8 3 9 1 2. You know, if you ever want to connect I'm here, Keith: You heard it here, folks. He’s not afraid to give out his personal contact. Kyle, it's been far too long and an extreme pleasure to do this interview with you and to find out more about the multi-faceted approach that Intermountain takes to behavioral healthcare and helping youth excel and propel them in their lives. You have done it for eight years in several different job titles, that I can remember as the organization, and you don’t seem to be slowing down at all. And like i just said, you so accurately describe your quote on quote job, not as a job, but as a calling. If more of us felt like that about our jobs and our professional lives, we would probably be a lot happier, a lot less stressed and would treat each other with kindness and compassion, and once more we would treat ourselves with kindness and compassion and therefore most likely live a lot longer than we do. So thank you for not only agreeing to this interview, but for being a beacon, an example of how to fall professionally in-love with serving others, yet you get paid for it. But just like you studied non-profit management in your Masters of Public Administration Program, getting into the line of work you're in, you don't do it for the money. If you do, you are in the wrong profession, you do it because you care. I see that and I experience it when I read every facebook post and every Linkedin post where you are just fawning over your wife and her accomplishments and she is doing the same thing about you. Or you are promoting the latest event at Autism Society for Southern Arizona, you are a big motivation in professionalism and how I hope we can get to because it’s very encouraging for the future, if we all were involved in jobs that we didn't see as busy work, but really lived for and strived to emulate that in our children, in our families, in our professional and personal connections, and that is something I have always extremely admired, not only about you, but about your wife. Kyle I want to thank you again, for coming on and talking so openly about Intermountain and its critical mission of serving Arizonanians. Kyle: Thank you Keith, it’s been a great way to close the day out and lets get together soon for a beer. Keith: Thank you, and I hope you come back. Keith: You have been listening to Disability Empowerment Now. I would like to thank my guest today and you, the listener. More information about the podcast can be found on DisabilityEmpowermentNow.com. The podcast is available wherever you listen to podcasts or on the official website. This episode of Disability Empowerment Now is copyrighted 2022.