Angie Fiedler Sutton
Welcome to Destination Change, a podcast where we talk recovery, treatment, and more. I'm your host, Angie Fiedler Sutton with the National Behavioral Health Association of Providers.

Angie Fiedler Sutton
Our guest today is Harry Nelson. Harry is the founder and managing partner of Nelson Hartman LLP, as well as the founder of the National Behavioral Health Association of Providers. Beyond his legal expertise, Harry is known nationally as a consummate leader in the intersection of healthcare, law and business, as evidenced by his role in co-founding five healthcare related startups in the last decade. Deeply immersed in healthcare transformation and innovation, he frequently speaks on cutting edge issues, and the future of the industry itself. Harry, welcome to the podcast.

Harry Nelson
Thank you for having me on. All right to be here.

Angie Fiedler Sutton
First question, I guess is why healthcare law as opposed to all the other different types of law that there is available for you to go into?

Harry Nelson
You know, I, I grew up in the Midwest in Michigan, and I spent a summer of college working as an intern on Capitol Hill for a congressman, and mostly answering constituent mail. And I gotta be honest, I had not really thought much about our healthcare system until that summer. It was summer of 1988. First, George Bush was running for president against Governor Dukakis and the, I spent my whole summer writing letters about Medicare, and discovering this massive, this fascinating government agency and a whole broad array of government programs. And I came back from that summer to my junior year of college really animated and fascinated by regulatory work in general as this intersection of government meets the economy, and like the way that this whole part of our society works without direct visibility to most people. And particularly fascinated by the way that healthcare was dominated by that by that.

From that point forward in college, I knew I was gonna go to law school. From that summer, I knew I wanted to get involved in regulatory work, and I was thinking about healthcare. I didn't lock in on healthcare. until years later, I went to law school, I knew I wanted to do regulatory work just from that time in DC, sort of like I when I moved out to California, years later, I discovered there all these jobs in entertainment. And it was like a wake up call of growing up in, in suburban Detroit where we didn't have that's not something people did. And so I knew I want to do regulatory work but the longer I kept going, doing some university, regulatory work, financial regulatory work, I got a chance in the university context to do academic medical center, teaching hospital, medical school faculty, dental school work, and I got fascinated with all the interplay, just how complex it was, and decided that that was where I wanted to spend my time. So yeah, it's been a good decision. It's 30 years later, I really grateful that I whether I stumbled into it, whether it was by design, somebody else's design, I don't know. But that's how I got here.

Angie Fiedler Sutton
Okay. Now, addiction treatment is kind of just a subset of healthcare law. But you helped found the National Behavioral Health Association of Providers back when it was still called American Addiction Treatment Association. Why addiction treatment? Tell me your kind of your entry into the recovery space.

Harry Nelson
Sure. So when I started practicing healthcare law, which was really 94, 1994 in Chicago, and my first law firm, it was for big university medical centers as for Loyola University, Medical Center, Northwestern University Medical Center, and it was mostly academic clinical research, Medicare, all of these, these kinds of in what we call institutional healthcare issues. And what happened was my law firm splintered, and it was coincided with the birth of my oldest son, who's now 22. And I decided to move to California. And I started working while I was thinking I would go, I'd find a similar position doing similar work in Los Angeles, I started working with a lawyer who represented doctors and health professionals in trouble. And it was like going to the complete opposite end of the spectrum from representing gigantic healthcare providers.

And so I represented a lot of different kinds of doctors and health professionals in trouble. But the people who I what I realized I felt a very different relationship to the doctors and mental health professionals who were dealing with addiction issues, and particularly those in recovery. And I appreciate the opportunity to serve. But I started feeling I could see myself in many ways in the people I was working with, even if I didn't, hadn't had an experience of, for me, it wasn't alcohol, or drugs, it was probably if anything, you know, disordered eating, among other things, but I came to see and understand my own brokenness and sort of why that was a source of strength to just sort of be able to talk about it through really developing not only working relationships, but close friendships with mental health professionals and doctors who had done the same thing around addiction.

And so what happened was a lot of these people, you know, started referring me in and asking me, after I help deal with whatever they were dealing with; sometimes it was medical board, sometimes it was reimbursement problems with Medicare or issues with the DEA. Whatever it was, they started asking me, Hey, can you help us with this addiction treatment program we're working with or trying to start, this outpatient program, this residential program. And at first, I didn't know anything about that world, I was really a hospital and doctor lawyer. And what I found was, they said, there's nobody, we don't really have anybody to do this, like, we think you can figure this stuff out. And I did a couple times. And all of a sudden, I found you know, the secret of the world I occupy is you do something a few times in regulatory work. And you you very quickly know more about it than almost every other lawyer out there, because so few people were doing it.

So what happened was I got to be a lawyer for many addiction doctor, addiction medicine doctors and psychologists, other mental health professionals for addiction treatment programs. And that was kind of in the middle 2000s. And then the Affordable Care Act happened. And all of a sudden, there was this whole new wave of insurance reimbursement being mandated by the federal government, and the industry was growing by leaps and bounds. And I turned out to be one of the few people who actually knew quite a bit about it before then at least as it related to some of the licensing work, particularly in California and some of the western states. And so my phone started ringing off the hook on one addiction treatment and mental health program after another. And I very quickly realized that besides just being a source of work, there was a lot of work to be done to establish standards, and really to help educate the leadership, the management, and the staff, the operational staff of these programs, because people weren't familiar with very traditional health care concepts.

So I started speaking and writing about all kinds of issues, things on relating to patient safety, things like how to deal with issues where the licensing schemes that the state created didn't match up exactly with what the insurance companies were demanding, how to deal with not getting paid by insurance companies, how to deal with clinical safety issues, risks of overdose and other kind of patient harm.

I was just in the right place at the right time. And I really did feel a sense of mission that I had could take a lot of the experience of coming out of the more traditional, you know, well established parts of healthcare, that we hadn't had to fight so hard to get recognized as healthcare. And I was able to direct that and leverage that for the addiction treatment community and the broader behavioral health community. And I really felt like I had something I could do in the world that would help people. And it was kind of an exciting to be honest with you. It was It was exhilarating for me, to be able to get up in front of a group of people and talk from experience about issues that a lot of people were seeing for the first time and thinking about for the first time. And yeah, I was really grateful for that opportunity. And it's, you know, it's basically, I don't know, 12 years later, since the Affordable Care Act stuff started, but it really that was the thing that propelled me into the role I've been able to play in the behavioral health community.

Angie Fiedler Sutton
Well, let's talk a little bit about the founding of Nelson Hardiman and also the founding of National Behavioral Health Asociation of Providers, which was originally American Addiction Treatment Association. What kind of caused that to happen. So okay,

Harry Nelson
so the first step, I'm not just talking about Nelson Hardiman. In the old days, it was called Fenton Nelson, my first partner. So basically, I made this move, I was doing institutional healthcare in Chicago, I come to California, and I'm working with all the -- and I thought I was going to just spend a few months working with a lawyer who did all these doctors and mental health professionals in trouble. And it turned out that once I started getting into that work, I found that the work of working with like small providers was like much more intimate. And it just was emotionally much more satisfying for me than working for large, you know, nonprofit, huge universities and other big institutions. And so I started, I was like, so while I thought I would only spend maybe a couple months or a year doing that work, I realized when I started doing it, that there was work that really mattered to me, in terms of helping these people that wasn't being done by anybody else. And what I discovered was, there was a whole group of lawyers who were really good, really expert at helping people get out of trouble. But like, once you dealt with that problem, whether it was a licensing board or hospital, staff privileges issue or a fight with arena over reimbursement or with a different government agency, there was no there was nobody there who was saying, Okay, here's what you should do next, you know, as you build your next you rebuild your business or build your new business, here's what you should do on compliance, here's what you should do on business strategy.

And I realized there was this gaping hole. And that's really what led me to start my own law firm in the first place. And I what I found was, and you only see this in the rearview mirror, it's not like this was by design. But in retrospect, all the work that came to me was the work that wasn't being done by other healthcare lawyers. And it was in all these areas that were just unloved or newly developing, emerging, innovative, you know, it's all of the above. And I just love that stuff. It was really like a treat for me as a lawyer to think through these issues. figure them out. And so I started building expertise and things that back in 2005, you know, nobody was doing addiction treat well am I healthcare lawyers, addiction, behavioral health, telehealth all these things that like now today are huge. They were nothing back then in health care law. And so anyway, so that was the beginning of a law firm.

What happened was I very quickly, the deeper I got into behavioral health, and this is really more like fast forwarding about seven, eight years to like 2012, 13, 14 was behavioral health was exploding, I was speaking, but I really wanted to figure out how I could put more resources in front of more people. And I realized, like working as a lawyer, there's a very limited number of people I can reach. We end up getting expensive, unfortunately, the economics of law, practice hourly rates make us kind of prohibitive for a lot of people. And it also means that most of the time people, if they want to work with you, they'll a lot of people will work with you when they have a big problem. But as soon as they get past the kind of over the hump, you know, it's like, Thanks, we'll take it from here on our own.

And I was trying to figure out a way to really put more resources for behavioral health compliance and regulatory knowledge out there for a lot more people, for the whole industry, for other lawyers, and also to start developing standards and certifications to address problems that were coming up with insurance companies with government agencies. And so I that all came into being in what is now today, you know, the National Behavioral Health Association of Providers, it had a different name, when we first started -- AATA and then BHAP, it was all really an effort on my part, to take the expertise that we had built and figure out a platform that would, whether it was e-learning certification, that would really disseminate knowledge, because I thought there was a huge gap out there on getting really reliable, you know, knowledge, reliable information on complex regulatory issues. And so that was the sort of impetus to start and what drove me to do it.

Angie Fiedler Sutton
So you are a regular speaker at conferences, especially in the health care and behavioral health industry, do you have a favorite topic that you'd like to talk to you? Or is that like, choosing your favorite child?

Harry Nelson
I'm definitely ADHD, I get distracted easily. So I find that I get very passionate about particular topics, and I start speaking about them. But generally, by the third time I've talked about a topic, I'm a little bit bored with it, I do appreciate, look, the thing that drives me to do this work is my own, I have a, you know, there's some insecurity in me, that makes me really want to help other people, in part to help other people. But in part, if I'm being honest, just to, you know, be valued and appreciated, right.

And so, so so there's this aspect, where there's always a new issue, a bright, shiny object that's kind of calling to me. And I feel like I should speak to that, and I want to address it. And I guess I'm interested in kind of trying to unpack what's happening and translate that to people.

At the same time, the response from of what people want and need is constantly evolving. So I feel like the issues have shifted over time. I mean, there's some things that have run through and that are, you know, like marketing, if I don't give another talk on EKRA, and marketing and challenges with marketers like I that topic is not necessarily one that's still so interesting to me, I feel like we've I've, you know, lived and breathed every nook and cranny of it. On the other hand, it's of continuing burning interest, because the government is pressing hard on that, right.

So there's a lot of topics. Today, the topics that I'm most personally interested in are privacy, and the way that privacy has been completely up ended, and what health privacy means and what providers need to be doing to really be ahead of the curve on health privacy. And the other issue that's really, that I'm really trying to figure out how to communicate is a topic that a lot of people scratch their heads on or don't even know what I'm talking about, which is corporate practice of medicine, and the way that the industry has been transformed. And some people, including me, say, for the good through the investment coming from private equity and from venture capital and other sources and moving, creating opportunities to scale companies. And we also have an attack going on, a critique going on if people think that private equity has spoiled healthcare, and it's killing behavioral health. So I'm very, that's a topic that is really interesting to me, and one that I'm trying to figure out how to explore. But I feel like I sort of let the universe decide what is gonna be interesting to people. And you know, and I'm just constantly trying to think get put my own thoughts out there and sort of, hopefully, give people some clarity in the process.

Angie Fiedler Sutton
Now you've written a couple of books. Let me get the titles right: "From Obamacare to Trumpcare: Why You Should Care" and then "The United States of Opioids: A Prescription for Liberating a Nation in Pain". Let's talk a little bit about those. Kind of give me your elevator pitch for both books.

Harry Nelson
Sure. So "From Obamacare to Trumpcare" was the first time I thought about writing a book. And the context was I was traveling, I was actually in Israel, and a friend who works in digital health sent to me, you know, if you have time, I'd love for you to a lot of people are in, you know, here, like medical device manufacturers are worried about what's going to happen to, you know, the Affordable Care Act. This was right after President Trump was first elected. Is it all going to be kicked aside? Now? Do we have to remake our strategies, because we've been building based on everything we've been seeing happen in US healthcare for the last, you know, five, six years. And so I said, Sure, I'm happy to talk about it. And I showed up, I thought I was gonna speak to a group of, you know, four or five people, I found myself in a room of like, 50, 60 people crammed in to hear what I had to say. And I put together some slides, and a sort of where of where US healthcare was going.

And what I really wanted to say to people is, don't panic, you know, the Affordable Care Act did do some significant things, some of the things that it did are not going to be reversible. It also failed in some key ways and or it hasn't succeeded yet in some key ways. And the Republican vision of healthcare, which was then more Paul Ryan than Donald Trump was not a, it wasn't terrifying, it was just there are things that it really did address that that were interesting and promising and things that were just left out and missing. And then I tried to say, you know, focus more on systemically what's broken and what needs to be fixed. That's where you should be if you're in healthcare is like, how do you fix? How do you address the brokenness and don't pay so much attention to which party is in control, and whether they're going to favor this program or that program? That's a losing strategy, in my opinion.

So anyway, I was leaving on the plane, a long plane ride home 15 hours. And I thought to myself, this is a moment where a lot of people are asking the same question I was being asked in that room. And there's really an opportunity to communicate something different, and to say something that people need to hear. And so I put that book out there it was, we did it quickly. It's funny, I thought, when I was thinking, oh, a lot of people are going to be thinking about this topic and wanting to say something about it, I should really get something out early in the Trump administration and not try to be political. I'm always trying to get people to avoid being ideological and political, and just try to figure out a practical, you know, approach where you call balls and strikes on both sides. And so the book was, it was huge. It was a good success. It wasn't like, whatever, it didn't hit the New York Times bestseller, but it got a lot of attention. And it was a lesson for me, because it's worried as I was that a lot of people were going to have, you know, things to say. And I should hurry. Nobody else ever published a book on this topic. So it still stands up, I actually teach a couple of college courses, and I mean, graduate medical education courses. And I still I use some chapters in that book, I've been asked to have them republished, so that books still continues to be and has a lot of value in some of the discussion of what's broken and what needs fixing in US healthcare.

The second book was much more, "The United States of Opioids" was a passion project in a different way. I was I described I was doing all this work with addiction treatment programs, and mental health programs. And normally, you know, the early work was licensing, contracting, reimbursement, fairly dry topics, marketing, but all of a sudden, around 2000. And I don't know 16, 15, 16, I started getting more and more phone calls about patient overdoses. And I started and it was literally became like a drumbeat of facilities, residential treatment programs calling me patient had died, a patient who committed suicide, patient, a lot of overdose deaths. And it was really a different kind of work.

And there was a bizarre feeling, because on the one hand, I was sort of, again, honored to be the one that was getting these calls and helping work this through and several times programs that had multiple, it had happened multiple times, in the same programs, and they were worried about, were they going to be able to survive, how did they communicate to the licensing agencies, and I was there as the healthcare lawyer, but it really felt like, if, on the one hand, I felt like wow, this is such an opportunity to, again to not only do this work, but to communicate and hopefully save lives and prevent this from happening. But I realized, like, there was also something that was problematic for me about just making money on the way that this that behavioral health was dealing with this, this wave of tragedies. And it was just it didn't feel right for me to stand on the sideline. I thought I needed to do something to put together a new perspective.

And my thinking was that not many people, certainly not many non lawyers, and also very few lawyers, were seeing this industry from all the sides that I was seeing it dealing with the doctors and issues around prescribing and pain, dealing with these overdose deaths, dealing with pharmacies and the way that they were reacting to this, and I wanted to say something different. And I also wanted to say not to say not not just how do you deal with these immediate problems - How do you prescribe for someone? How do you avoid an overdose death? - but how do we solve this problem? Because I think when you if you take a hard look at the opioid crisis, you see this like merger of all of the I mean, it's so endemic is you know the term that Um, that I think we have to use for which is overlapping, parallel epidemics, right an epidemic of pain, an epidemic of despair and an epidemic, a mental health epidemic and an addiction, you know, this, this, this terrible specific addictiveness of opioids.

And we also see a really broken, it shows you the most broken part of our government where, in my opinion, the federal government, you know, was so worried about getting patients, doctors to prescribe fewer prescription opioid medications that they successfully, you know, crack down on the doctors and drove the market for this onto the street into a toxic drug supply, killing more people, harming more people. And I felt like I needed to say something about it. So. So that book was really like, I just felt like I couldn't, I couldn't work on anything else until I got that off my chest and tried to put something out there. I feel good about it. I feel like it's still the most harrowing problem that we're dealing with. And one that's really hard for people to even wrap their heads around. But I do feel like the conversation is moving in the right ways. I feel like I hope I played some small part in driving that. I think we're just like, at the very beginning of the beginning of trying to really get an understanding of what's going on so that we can address it. That was my reason I did it.

Angie Fiedler Sutton
That is great. In the recovery industry, one of the things we've talked about in prior podcasts is just kind of some of the resources that people in the industry use on a regular basis, while you're more healthcare generally and focused on behavioral health. If someone was interested in kind of keeping updated with the latest outside of NBHAP, what would you recommend in terms of resources to keep ahead and keep abreast of things?

Harry Nelson
Beyond behavioral health? There's a lot of places to look, I tend to keep I first of all, I thank God for the search engines and the ability to just put particular topics in and find out what's happening because there's so much changing on so many fronts. I personally have like prompts set to get news on probably about 40 healthcare topics because I even though behavioral health is one of my deep passions, there's a lot of areas that I'm very interested in: telemedicine, telehealth broadly, genomics is kind of what's happening, what's the future of medicine, and how we're dealing with problems like the upcoming the doctor and general health professional shortage, you know, with the ageing of America.

Anyway. So where do I look, I read a lot. I know these are some polarizing choices. But I happen to like STAT, which is a more kind of digital health life science focused publication. But that's one that I read a lot. I read Modern Healthcare pretty regularly. And there's a few other some of the Becker's, Becker's Hospital Review. And to be honest with you, there's a lot as a lawyer, I there's other law firms are constantly publishing - Lexology is a is a great resource that I encourage people to check out if you're interested in the kind of regulatory dimensions and legally what's happening. But it's it's hard to keep track of everything, things are moving on so many issues so quickly. But those are the main places that I go.

Angie Fiedler Sutton
Great. Now, one of the things we also have talked about in prior podcasts that you may or may not have some input in is the concept of recovery capital, basically, the idea of things that help people go through recovery, is that something that you have some knowledge about?

Harry Nelson
For me, this work of this this last 20 years or so, has been a massive education and transformative in my own life. And recovery? Capital is Yeah, is a huge topic. I would not claim to be an expert on recovery capital in the same way I would on healthcare regulatory issues, the person who is most moved by on this topic is David Best. And yeah, I think, to me, recovery capital fits in a broader topic of kind of social determinants of healthcare, which is to say that, like you can only really address the healthcare needs. And that applies to dealing with behavioral health issues and addiction and sustaining recovery. Or to a very limited extent, maybe 20% of the work is actually in the healthcare system, and through direct healthcare interventions.

And most of the work is really around the social determinants, like are you connected to a community? Do you really feel like you have a sense of purpose? Do you feel like there's things for you to do in the world where you can be of service to others? Are you needed, right? Like so to me, like that stuff is the stuff that keeps me alive and healthy in my own life. And I really think that it's a place where we need to be focused. So I do believe that, you know, when you talk about recovery capital, that's where my head goes, is to all of these things that, you know, I look, I think we were living in an age of profound pain and despair and dislocation and trauma. But the problem is that if you get stuck in your pain and in your dislocation and in your trauma, not only are you stuck but you're also alone and isolated in it. And it's not a place where it's, it's easy to tap into the energy to move forward. And so I just think that in our own lives, really stay deeply connected and contributing and being and really being of service in and we're building up capital, right. That's what the thing that I think getting out of the place of fear to talk about what's going on with you getting out of the place of reluctance to ask other people how they're doing, being in a place of empathy and not have judgment, so that people you can actually have, communicate with people and support each other and, and get the support you need.

But to me, that's really the essential stuff, right? Like I when I look at the crisis of despair, and I don't mean to like, I think there's the stuff is this stuff is complicated, right? It's there's so many pieces of the puzzle. And people are dealing with different trauma issues, there's massive socio economic pieces that we and it's not to take anything away from that. But I do think if we can get to a place where people feel genuinely connected to a community that needs them, and that they need, and get to a place of really feeling like they have a sense of purpose, and that they can really contribute something, and those things do not lead you to a sense of autonomy and ability. And those are the things that sustain us, right? Like, to me, that's how I think about it. I'm always reluctant, being around incredible mental health professionals and doctors and recovery, and recovery, you know, counselors, everybody, people who dedicate their lives on these issues, I feel, I'm sometimes a little embarrassed to, like, get out there and speak on those topics. But I will say those are animating forces in my own life. And I think that we have to figure out how to get those messages across, I sometimes retreat to the space I feel safer in talking about which is like, you know, the technical regulatory stuff, but that's the stuff that matters most.

Angie Fiedler Sutton
Well, let's then pivot a little bit. Just when I introduced you, I mentioned that you had co-founded five healthcare related startups in the last decade, talk a little bit about the, you know, process of creating a founding a startup and, you know, what are some of the things that you found were the most difficult and as well as the easiest parts of doing that?

Harry Nelson
Yeah, I've had some successes, and some, you know, some learning experiences. I definitely think even though I'm, in some ways, being a lawyer is kind of a conservative choice, I have an entrepreneur's heart. And so every time I walk around and see a problem or an unmet need, I'm always thinking to myself, like, could I solve that? Is that something I could be part of solving.

So the first time that I did, it was around healthcare compliance, I was talking earlier about the issue of, you know, one of the challenges as a lawyer is like, I don't even want to tell you what my hourly rate is, because it's so it's so absurd. And it discourages people from really like using lawyers on a long term systemic basis. And so I was thinking to myself, and I was like, well, you need to find a long different cost model to do things that that are needed systemically. And by that, I mean, things like, really assessing risk, you know, putting in place policies and procedures, training, auditing, and sort of figuring out how you're doing, we have such a complex system. So I came up with I had this idea. And by the way, it started also, with the Affordable Care Act, the affordable, it's funny, this is like just an aside, I had an idea, the Affordable Care Act said that every provider in the country was going to need compliance programs. And I thought to myself, I can't do this through the law firm, it's going to be too expensive and too clunky. Let me create an organization that's going to create compliance programs. And we created I actually tried to create a software company in the process. And the software company taught me mainly that I should not be in the business of starting software companies.

So what I'll say, I guess, let me so to answer your question, what I learned is, it's I think it's a good thing to walk around and sort of ask the question, like, is there an unmet need here? Is there something that's not being done or isn't being done? That could be done much differently or better? And then the next question is, Can I do this? And I think the question that I've learned, and I didn't sort of appreciate fully on day one is, what's the team of people that builds this need to what does it that need to look like? Right? Like there's, I tried to build a software company without having a coder or programmer in house. Lesson. Not, you know, that's just a fundamental mistake to try to put to put to move forward on a venture without the right team. So you have to ask, Do I have the right team? And then I think you really need to push Do I really have the right idea? Right? I think there's there's a missing piece here. There's an unmet need. But is it really that way? And you have to really dig right?

Sometimes I've made the mistake of investing in companies because the person who the founder persuaded me that there was nothing there was it was like a gaping hole. And had I looked a little harder and really put kick the tires on that. I would have discovered that. No, in fact, there were other people really doing that. It just wasn't, it might not have been obvious, but there was actually a need that was being addressed. So I think that I think it's really important to be constantly. I think there are massive opportunities out there to build businesses. But you have to start off Do I have the right team? Is it really is this opportunity real? And I think you have to be just constantly - the lesson for me is you have to constantly be paying attention to the feedback and being prepared to pivot. The successful businesses that I've started, you know, I mentioned that one, I thought the Affordable Care Act was going to prompt this wave of a need for compliance programs, it turns out that that was a part of the Affordable Care Act, it's still there, but it's never been enforced, doesn't really mean anything, no, whatever, it didn't push people to launch compliance programs, the way that I assumed it would. And that wasn't the need that was met. But we, you know, just by pivoting, we stumbled on to a much a different need, right, this need for a lower cost model of compliance of fractional compliance officers.

And that's been my most successful, personal spin off, I've been involved in a lot of other people's businesses, you know, venture is trying to just add strategic support. But I think I think it's difficult, right? The hardest part, when I look at a venture, I obviously want to ask, is this is this really a good idea? That's meeting an unmet need? But then the question is, are, is this the right person to lead it? Do they have the ability to build and get the alignment of the right team around them? And then and then the hardest question is, can they raise the capital? You know, can they raise the money that this is going to need because ultimately, money is oxygen, you know, and if you if you have been involved in amazing startups with amazing teams, but they just like, had to stop and start because they ran out of money, and they needed to wait, and you don't ever build a business in a stop start mode. So that's the hardest question.

But if you have people who, where you can answer all four of those questions, you know, and and get comfortable that you have the right idea, the right team, and they can, they actually can execute, and they can raise the money they need to make it happen. You know, it's magic, right? It's you see companies out of out of nothing, I've had the privilege as a lawyer, to watch people build in the space of two to three years build literally billion dollar companies where there was nothing. And it's not easy. To me, when you see that happen. It's really, it's amazing, right? It's it's only one of many things, maybe we celebrate it too much the sort of heroic, whatever venture, but I personally find it really exhilarating to be around people who are trying to transform things in general. And that's certainly one space that I am always drawn to. And it's a little bit of a roller coaster, I'm involved now in a genomics venture. And this might be, you know, truly transformative, or it's got a difficult course, who knows, it could finally come up against whatever, you know, get into a problem. I mean, there's no you can be early, sometimes being early as the same. And in building a company as being wrong. It's like for every, whatever, pick your pick whatever massive brand you want to pick, there were dozens of companies trying to do the same thing that didn't quite get there. I love the venture space. I think it's it kind of really tests everybody involved in it, but it's it's definitely an area that I keep coming back to and, and yet exhilarated working.

Angie Fiedler Sutton
Great. Now we're running close to the end of time. Was there something that you wanted to talk about that we haven't, or something that you thought I was gonna ask that I didn't?

Harry Nelson
I don't know. You know, it's funny, I there's, I feel like things behavioral health is constantly changing. I'm trying to think if there's anything, you know, I think I would just say, I thought you might ask about the current moment in where we are. I think I think it's a really interesting time, I think a lot of people, you know, lose sight of like cycle. To me, I think it's very important to kind of pay attention to the, the where we are in the regulatory cycle and development and to be paying attention to the kind of what we can learn from, you know, the behavior of payers, and government regulatory agencies. And it's tricky, really, to figure out, like, what's going to happen next.

I think we're living in a kind of scary moment for a lot of providers, in the sense that the payers are getting more and more adapted to cutting back on payment and figuring out how to reduce payment, and just making it tougher. On the other hand, I think I'm personally extremely excited about the therapeutic advances that we're seeing. And I think we are living through a time when, you know, for me, in many ways, like addiction treatment, behavioral health, was kind of a neglected space, because the reality in American healthcare is that if there isn't money in it, if there is an insurance reimbursement, if it's not covered it, people aren't going to not only are they not going to be delivered, they're not going to study it. And we're getting we're in a period of real catch up. And I think that I think it's going to continue to be challenging, but but a space with massive opportunities for people who can who can navigate current challenges, and so I'm still bullish on the future of it, but I do think you got to be paying close attention to sort of where our system is moving directionally. And yeah, I'm happy to get into more specific issues, but that's kind of at a high level how I think about it.

Angie Fiedler Sutton
Okay. How can people get a hold of you and learn more about you and / or Nelson Hardiman?

Harry Nelson
The best place way to reach me is through Nelson Hardiman. My email's, HNelson at Nelson Hartman, you can find us online and my information is out there. If you look around, I'm not I don't think I'm that hard to find. But emails, email is a great way to communicate with me and with our law firm and yeah, I'm always interested in issue that I can help people with directly or whether it's just pointing people in the right direction. always interested in finding and sort of hearing what's going on. And, and thinking about challenges that that people are facing, you know, in behavioral health. Love to hear from people and really grateful for the opportunity to contribute to trying to improve our behavioral health system.

Angie Fiedler Sutton
Great. Well, you've been listening to Destination Change. Our guest today was Harry Nelson. Thank you again for being here. Our theme song was "Kita" by Sun Nation and used via a Creative Commons license by the Free Music Archive. Please consider rating and reviewing the podcast on Apple podcasts so we can get more listeners. In the meantime, you can only see more about the podcast including show notes and where else to listen to on our website, www dot NBHAP.org. If you have questions for the podcast, please email us at info@nbhap.org Thanks for listening.