Conquering Turnover Through Benefits Flexibility

In this episode of The Quest for the GoodLife, we’re redefining what’s possible in workforce benefits, disability services, and staffing solutions.

Join Dr. Mike Strouse, Ivo Ivanov, and special guests Lauren Vohland and Megan McKinney Todd as they dive deep into what it truly takes to build a thriving workforce in care services. From innovative benefit structures and staffing models to the power of flexibility, personal choice, and work-life balance, this conversation might just change your mind about benefits at your company.

How can organizations retain top talent while operating in an industry with limited funding? What if we reimagined benefits to better serve both caregivers and those they support? And how can thinking beyond traditional compensation—like housing, transportation, and scheduling—lead to a win-win-win for employees, organizations, and the people they serve?

Through personal stories, industry insights, and a few movie references (yes, Indiana Jones makes an appearance!), this episode is packed with actionable takeaways for HR professionals, disability service providers, and anyone passionate about creating sustainable, people-first workforce solutions.

Listen now to discover how GoodLife is rewriting the rules.

Transcript

Ivo Ivanov (00:00:07):

Hello? Hello, hello. Dr. Mike Strouse has his trusted Fedora on and that means only one thing. We are on a quest for a good life and we are ready to start yet another episode today. We have fantastic guests, you guys. You guys, you are the first guests on the Quest for the GoodLife. To the right of me, we have the one and only Megan Todd, our Chief operating and integration officer with many, many years of experience, she's multi talented and experienced, and encyclopedic. And we are going to talk today about many topics that involve her input on a day-to-day basis. And we have the great Lauren Vohland, who is our Executive Director of GoodLife Services and she's been with GoodLife for

Lauren Vohland (00:01:02):

15 years now.

Ivo Ivanov (00:01:04):

15 years. Unbelievable. She knows the organization inside and out. We are very, very honored and very happy to have you guys here. And I don't know if you are familiar with the traditions here at the Quest for the GoodLife, but we are not only on a Quest for a Good Life, we are on a quest for irrelevant tangents. And it's now a tradition that the episode starts with a tangent. And today's tangent is, a couple of days ago I dealt with a kidney stone. It came out of nowhere. And I know Dr. Mike Strouse has experience with this and it's…It's excruciating, excruciatingly

Lauren Vohland (00:01:45):

Painful. It's not living the GoodLife.

Ivo Ivanov (00:01:48):

Yeah, apparently you're supposed to hydrate. This is the first time I hear about this, but I don't drink water. I drink coffee. And that's apparently not good for your kidneys.

Dr. Mike Strouse (00:02:00):

All that's true, Ivo. I got to tell you, when I had that problem, I went to the doctor and the male doctor told me that. He said, I believe that the pain that you're experiencing from kidney stones is very much like childbirth. And my wife looked at me and then looked at him,

Lauren Vohland (00:02:18):

Started clapping.

Dr. Mike Strouse (00:02:20):

Not only would clap but said no idea. Obviously our threshold for pain is much lower than women.

Ivo Ivanov (00:02:33):

Oh my goodness. Oh, it is painful. Thankfully I didn't have triplets. I had just one stone. Yeah, I feel better. And I learned my lesson and I passed a stone and I hydrated two birds with one stone, pun intended. But yeah, that got me thinking though, the trips to the doctor, the pain, the painkillers, all that got me thinking about work-life balance. I was here at work when it hit me and I was able to get in my car and get home and get help.

Dr. Mike Strouse (00:03:13):

Well, back up, Ivo. What did I tell you when you were here at work? We were talking about all the things that you still had to do. And I said, no, get in your car right now and go directly home or you're going to be sorry.

Ivo Ivanov (00:03:25):

That is important because a lot of executives would say, finish your work. It's important and it seems like you can handle it, but it's a culture here. It's different. The person comes first and your health and wellbeing comes first. And I feel that it's important to foster this kind of culture and that actually helps maintain talent and keep talent around because it is a close knit family that we have here. And it's an attitude that comes from the top and goes to everybody else in the organization. So I wanted to talk to you a little bit about this because it got me thinking, work life balance. It's so important. People…

Dr. Mike Strouse (00:04:13):

And Ivo eventually before this darn show’s over, we're probably going to talk about benefits too, is possible at least. But my point is that's not a bad segue into this because that's really what benefits fundamentally are about. It's about each one of our own Good Life and are we adding to it or not? And benefits. There's a good discussion about that, but I think an interlude may be appropriate here that

Ivo Ivanov (00:04:40):

Exactly I planned that segue.

Dr. Mike Strouse (00:04:46):

But Ivo, if I could offer my own, because you just don't control everything as much as you try. I wanted to tell, everybody knew about me because we told 'em about me and I told everybody why I wear a Fedora and I was embarrassed to wear a fedoras for a long time. I would buy them and I'd go to a place with Jennifer, my wife, and I'd buy one and she'd just roll her eyes because I would buy it, fall in love with it, take it home and put it on my hat rack.

Dr. Mike Strouse (00:05:21):

I wouldn't wear it, but I always wanted to. And for those that don't know why I'm going to send you back to the first episode, you need to watch that because that'll explain the WHY on it. But you asked me why I did it, and part of the reason was that I was a fan of Indiana Jones and he was kind of my idol as a movie because he's a scientist. He kind of was everything I wanted to be. He was a scientist, he was good looking. I wanted to be that. I wanted that too. But he was on an unbelievable quest

Dr. Mike Strouse (00:06:09):

To something that no one else had ever done and actually things that everybody would almost think was ridiculous to even try. But he did it anyway. And you've heard the poems those things that were the fuel for that. But I just thought it'd be a really good idea that since I told everybody why I wear it and then I'm now kind of starting to wear it because I'm tired of, you get to an age where you stop worrying about whether you're being silly, and then you start living the life you want to live. So I thought, well, that would start with me wearing the fedora that are all on the hat rack. So that's my movie character. That's the one that I kind of aspire to be. So who's yours one, if you were a living your movie character as an idol, who would that be?

Lauren Vohland (00:07:04):

So I've got two, Steve Martin, I love his humor and growing up, I don't think there was a movie that he didn't just bring lightheartedness and humor to. So I love him. And then you would probably know this Wild Tarts can't be broken.

Megan McKinney Todd:

I know that very well. 

Lauren Vohland: 

Yeah. Wasn't that movie amazing? Yes, growing up. So I ride horses and horses have been a big part of my life and I just loved how brave she was to go in front of these crowds, do something that probably most women weren't even had doors open to do at that period of time. And even after she lost her vision, she continued to do it. So she had that bravery, she had that drive and adventure. So those would probably…

Dr. Mike Strouse (00:07:53):

I have to tell you, 15 years ago when I interviewed you for your first job at Good Life, I think you were just three at the time. You might've been five. I might've been five. But anyway, when I was interviewing you and it came out that you were into horses, I have lived my life with that too. But that's actually one of the most compelling reasons why I was so interested. Cause you have all these other skills and you know and I know what a life of horses is like. There's glamor to it, but before all the glamor, there's a lot of

Lauren Vohland (00:08:35):

Horse poop. There's a lot of horse poop and

Dr. Mike Strouse (00:08:37):

There's a lot of work and it is a daily drudgery. And I always remember growing up that my dad always had the horses have to eat before we eat. And he meant that every day it didn't matter whether there was five feet of snow out there or nothing. Every day I had to ride those horses before I went to school every night. Every night I had to feed them and care for them. And it could be eight or later before I got into even eat sometimes. 

Dr. Mike Strouse (00:09:09):

But that's the way it works. And that teaches you that it is not all about yourself.

Lauren Vohland (00:09:13):

Yeah, and I think the other thing, that I've always enjoyed working with horses, and so you're talking about the other day when you weren't feeling well and going home, that is definitely something. So horses obviously, they don't communicate the way that people do, so you have to really be perceptive and in tune with how they're responding. And so you can have a fantastic horse, but he might have an off day. And so it's really how you adapt to those conditions of like, do I really come down on this horse? Do I get to the point where I'm really driving it hard when most days we're having a really good day, or do I accept that today might be an off day and he can't tell me he's not feeling good, but there could be other conditions that are impacting how he's feeling. And I think that very much in our workforce too, of just trying to be intuitive or perceptive about where people are at in their life and maybe they're not sharing that. They don't have to share everything with us, but you don't have to be on your game every single day. And we all just have to understand that there's stuff that can impact that and be compassionate towards that. And so like with horses, that's something that hits home. You just have, and they're big animals, so you also have to understand that if they wanted to win, they will win. So how do you communicate with them to compromise and come to a good outcome for that day.

Dr. Mike Strouse (00:10:38):

I'm one to just emphasize that because everybody knows that I'm a behavioral analyst and I will always tell you that the best trainers I've ever met are horse trainers involved in trainers. Because you cannot control what they do, they don't speak our language that in a way that we would. But you learn that they are speaking language, you have to shape their behavior because you can't make them do what they don't want to do. My favorite training was what we call round pin training because you would just harness their natural, you learn about a horse and they're a flight animal.

Dr. Mike Strouse (00:11:21):

And so they have natural tendencies and flights also have superhuman hearing and they're aware of their surroundings and stuff. So this is where I have seen people like you, my daughter, who could ride a horse and it was imperceptible what her controls were because the cues were so small and so unique that when you're in sync with them, they were looking like they, you were in a mind-meld or not, or not. But it's fun. I just admire that even though people come from that world and maybe they're not behavioral analysts, they are really behavioral analysts, more so than most I've met and know how to do that. And if you can do that, then how do you work with people who have challenging behaviors or how do you work with people who have other needs or have communication issues? It changes your whole perception on stuff. It really does. Absolutely. What movie character Megan would you be and why?

Megan McKinney Todd (00:12:31):

So I don't know, hopefully this counts, but my movie character is Joe March, and so Joe March comes from Little Women, which is also a storybook, but it's also sort of a biography or memoir. And what I really like about this character is she is very in tune with family and the passing of time and independent and individual growth and just sort of social justice, social rightness. And I really, again, hearkening back to old times, the opportunities that she had were pretty limited just for the one reason of being a woman. And I really found that the heroism in that was, I can take my intelligence, I can take my grit, my willingness to sacrifice a lot, especially on behalf of my family and accomplish small, great things. And I thought that was really tremendous. So it doesn't really matter what sort of depiction, the story, the movies, they're all pretty great. So that's who I pick.

Dr. Mike Strouse (00:13:50):

Well, we're just going to have to dress up as our character more often.

Megan McKinney Todd: 

No, no, I don't think so.

Lauren Vohland (00:13:53):

I'll bring my horse to work. That's right. Show up on a horseback instead of a car.

Dr. Mike Strouse (00:14:03):

Well, but it also talks to us a lot about life balance and how you want to spend your time. And because we talked in an earlier session about everybody's passion and the art, I think, of managing people and working with people is understanding their passion and what makes them tick and then how can that be sort of pulled in and worked with as you try to get everybody oaring in the right direction and seeing a vision and stuff. So takes all kinds of people.

Ivo Ivanov (00:14:42):

Benefits are extremely important and I feel like for the work-life balance, sometimes benefits are more important for the employees than actual salary. So it would be interesting to hear your input about how we approach benefits because I feel like this organization has a little more unorthodox approach to resolving this issue and making employees happy, preventing turnover. For those of you who don't know turnover is to Dr. Mike Strouse, what snakes are for Indiana Jones. So he tries to avoid it. He has always tried to avoid turnover and he's successful with it.

Dr. Mike Strouse (00:15:31):

Not in this industry. You're not. Like I said, what I loved about Indiana Jones, it was a lifelong quest for something that was, to most people, it was completely, utterly a pipe dream and unattainable. And I think when you look at the care industry, you kind of feel that way. I mean literally 40 years, 40 years, we have been pursuing and delivering services in the context of a completely unstable workforce.

Dr. Mike Strouse (00:16:03):

And f you look at the data, it really hasn't changed up until the pandemic, I'll say it really hadn't changed in 40 years. Some things have changed, who we hire has changed, but the rate of turbulence is probably the same now as it was in the seventies having been there in some of those eras. And it's just really crazy to know, and that adage that if you behave, how does that go, Ivo, insanity, the definition of insanity is

Ivo Ivanov (00:16:40):

Doing the same thing and expecting a different outcome.

Dr. Mike Strouse (00:16:42):

And that's exactly how we got to where we are today. We keep behaving in the same way and, lo and behold, we get the same results and I'm committed to stop that madness and look at it differently. In turnover, the first thousand studies were correlational studies. I don't know if everybody knows what correlational means, but basically it isn't causal. It isn't like they do something and see if it actually improves things. Correlation is, well, I look at the people who turn over less and they tend to be like this or they tend to do these things, but you don't really know.

(00:17:27):

It really wasn't until a lot of people, there were relatively few studies ever done on I do this and then I see if that can actually impact turnover. They just keep wanting to measure, cause it’s the easy button. It's just the easy button. The correlation stays really always the easy button and that's why there are a thousand of them. But there aren't that many studies that say we can do these practices and then that leads to greater stability. And that's kind of what our group is always focused on. We want to do something. And the other thing I want to kind of talk about is the most important culture I think of is we have to do it and really understand the person and what their needs are before you can craft something that might work. So you can't start a journey unless you know who you are and how you got there. So when you look at benefits and life balance, and I look at the workforce, I mean we have what, almost 400 people in our workforce not counting our Shared Living people, which is another 150, probably five or 600 people helps us. Do you think that the people who are actually delivering care and maybe the top hats in GoodLife and the clinicians, do you think they all want the same thing?

Lauren Vohland (00:18:55):

I definitely don't think they do based on conversations. And I think different people are at different places in their life and at those times different things are important.

Dr. Mike Strouse (00:19:05):

Yeah, 50% of everybody, this is national, 50% of everybody that's delivering care out there are eligible for the same benefits as the people we're supporting. They're generally poor people. I mean as a group they're amazing, but they are not earning a lot of money. We all know that there's not a lot of pay in direct support. What do you think their priorities are compared to people who are making a lot more money? What do you think?

Lauren Vohland (00:19:37):

Or even double income, if you're a single mom and your income is X, what are the things that are going to be more important to you versus if you've got two earners in a household for you know a single mom of two kids versus a double income family with two kids? Looks a little different.

Megan McKinney Todd (00:19:57):

Really different. And I think not only are they maybe a single mom, but often, especially in multicultural communities, they have more than just their kids that they're taking care of. It's an aging parent for example, or an auntie. I think to answer your question, the gaps are really more like how am I going to pay my bills? What is going to come through that's going to make it easier for me to get through to the next pay period? And so those things look a little bit more, in my opinion, like, childcare, has gotten really, really expensive. Transportation, especially living in the Midwest, we don't really have public transportation to lean on. And so everyone needs their own vehicle to move about. And I think that can be a real challenge. Paying rent can be a challenge. And I think all of those things sort of compound to make the, especially the paycheck for a caregiver compared to the rising costs of living, become sort of at odds with each other.

Dr. Mike Strouse (00:21:11):

One of the things I hate is, I hate people putting limits or guardrails on our problem solving. If you're really going to solve problems, big ones, we tend to not even discuss things we don't think are possible. And that's limiting. And I wrote a prior episode, I shared that I've written five poems in my life all on the same night because I wanted to know if I could do it. And the poems were all about what describes me, and I'm not going to go through those again. But I did it one night and I haven't done it before 30 years, and I didn't do it after 30 years, so I just did it once. But they still were relevant. And the poem that probably describes me the most is one about rules, which basically says I don't like 'em very much and I don't like 'em because it stops conversations from solving problems. People don't understand that regulations are formed after in the service industry, for example, all the regulations around services are created given the existing practices that exist. So they're almost designed to perpetuate existing dogma, how you deliver services. Once that becomes standard practice and the rules come around, that are somewhat keeping everything in those guardrails. And I just don't like those constraints and I don't like them in a lot of benefits discussion. There's laws out there that say, we got to treat everybody the same.

(00:22:56):

Well, I don't really think that's a great idea if people don't want the same things. Now the truth is we don't have to follow those laws. They only apply to certain things. But just the idea that everybody wants same

Megan McKinney Todd (00:23:12):

Thing or that it's an umbrella, that it's an umbrella.

Dr. Mike Strouse (00:23:14):

If it's good for you, it's good. For me, it's like, well, guess what? If I have, what, $40,000 to live on this year and my housing costs are, what, three quarters of that? I mean not that, but food, housing, transportation, but that together and Lord help you with healthcare that exceeds all your resources before you even start. Then there's other people that it doesn't harm at all. So their idea of what they need is completely different. So I think the first thing that you always have to do, the first thing is you have to really know what somebody wants and what they need. And part of that, you mentioned housing and transportation and basic buying power or time with their kids or

Dr. Mike Strouse (00:24:20):

Childcare, things like that. You might look at me and say, well, what does that have to do with work? That's home.

Dr. Mike Strouse (00:24:30):

That's not how we approach care in our world. Do we just look at a person that we support and say, oh, that's home. We don't have to worry about your living at home. Well, that's what we do. So how can you just focus on, my question is, how is it possible to ever advance care for people that we support—I don't care what your population is—unless you're advancing the life of the person that's making that [care] possible. How do you do only a one win situation, not a win-win? How do you do that?

Megan McKinney Todd(00:25:06):

Well, and I think even beyond a win-win. So yes, improving the lives of the individuals that we serve, absolutely improving the lives of the individuals who make that possible, the core and the backbone of the mission, the ones who drive what we're able to accomplish. It's a win for the organization too. And we're watching, I think it kind of does come back to a family and that philosophical approach of we are making lives better by building up and strengthening communities. And the way that you do that is by listening and weighing the factors that go into making equity and access available to anybody who aligns with the mission behind what we're trying to accomplish. So

Dr. Mike Strouse (00:25:54):

You movie of fairness is important for your motivation.

Megan McKinney Todd (00:26:02):

For sure. I think fairness as a sliding scale, and it goes back to what you were saying before about what I prioritize in this space in my life and with the needs that my family has, look really different from an individual that we serve, for example, or somebody who has been hired as a direct care worker. But you asked, the very first question was: do we want the same thing? And at first I was like, oh wait, I think we all do want the same thing. We're working toward the mission, but do we need the same things? And that's really what is the core.

Dr. Mike Strouse (00:26:44):

I think we want a good life.

Megan McKinney Todd (00:26:47):

We all do. Yeah,

Dr. Mike Strouse (00:26:50):

Remember I love movies again, remember what was that Curly? What was it? City Slickers!

Ivo Ivanov (00:26:58):

That one thing.

Dr. Mike Strouse (00:26:59):

It is that one thing,

Dr. Mike Strouse (00:27:00):

Then they said, well, what is that? Well, that's what you got to find out for yourself, right?

Dr. Mike Strouse (00:27:05):

Everybody wants a good life, but what they need to get there

Megan McKinney Todd (00:27:10):

To accomplish that

Dr. Mike Strouse (00:27:11):

Is different.

Megan McKinney Todd (00:27:11):

It looks different.

Dr. Mike Strouse (00:27:12):

And where they are on the journey to it, it's a different starting place than some people. I mean, I've been around for a while and maybe what I need is a whole lot different than what somebody who's just starting out might need or something like that. Maybe their life circumstances are going to require a different kind of help to get to a Good Life. But remember, what was it about? I don't know, it was 2016, I think 15. We actually formally changed our mission. Do you remember that? I mean it was to make a meaningful, the first mission, was to make a meaningful difference in the lives of people who need help to live with independence. We changed that from I/DD (individuals with intellectual or developmental disabilities) to “people”. So that was the first change we made. The second change that we made because we wanted to make sure it was silo free. That's our vision and our goal. The second thing we did is we added the statement “and those people who make it possible.”

Dr. Mike Strouse (00:28:13):

Because that was the second part of that change. And I think at the time it felt real good and stuff, but I never really understood until we did that, the impact that it would make because it really has said that you cannot do one without the other.

Ivo Ivanov (00:28:32):

Yeah, because when you take care of the direct support professionals of the people who actually provide services…

Dr. Mike Strouse (00:28:40):

or the nurses! Or the service coordinators!

Ivo Ivanov (00:28:42):

Everyone, the entire system, it actually nourishes the services provided to our men and women. And it's obvious that the quality increases, the quality of service increases as you provide this personal choice and you have personal approach to each and every one of our employees.

Lauren Vohland (00:29:06):

So Mike, I've been here for a minute and seen the transition through some of these things such as our pay strategy, like premium pay, the ICHRA (Individual Coverage Health Reimbursement Arrangement) that we now offer, as you said, turnover has been very consistent over time over the 40 years. So at what point did you recognize that there is flexibility within those laws, within those regulations that can be adapted to our workforce? Where was the ‘aha’ moment or how did you come across those opportunities to know, okay, I know I've got a couple different workforces within the same company and I want to

Dr. Mike Strouse (00:29:47):

Treat them differently?

Lauren Vohland (00:29:48):

Well, and give them options so that they have that. Like, our 401k is offered to everyone. Health insurance is offered to everyone, but it makes it to where it's a choice for them and we try to make it as affordable as possible, but I think we've only been able to do that because of those unique strategies. So was it something, how did you come across those things and where was your ‘aha’ moment in those?

Dr. Mike Strouse (00:30:14):

It’s those pesky rules. I will say though, and one of these we have Jim Holland, he's my favorite attorney of all and Jim is amazing. He's a labor attorney and there is nobody that can spout off rules better than Jim Holland.

Dr. Mike Strouse (00:30:34):

But he and I have had a 25 year relationship where he knows every time that we're going to talk about a topic, I ask for the legal underpinning of that. He shares with me through the regulations and I'll come to that thing with a little yellow on it and all kinds of stuff and little things in the margin and ask him a thousand questions. He knows what's going to happen. He knows that I'm going to go back and look at, how can I work even within the rules to do something very different? And that's what we ended up doing with those healthcare and benefits and things. And we'll get into those discussions. But the truth is, the fundamental thing that I did is we ignore those things and you say, what do people want? Before you get into the reasons you can't do it, and this is like you do these, lots of times we do presentations and everybody starts these presentations, these training, and they said, well, you can't do that. You can't do you that. I said, can you just put it WAIT. Just wait and go through the process of just thinking without those roadblocks, without those guardrails, without those rules, let's just forget about it because those were all written around things after they've been done or it really is.

Dr. Mike Strouse (00:31:58):

And so the next cool thing is going to not be conformed to that. And then they're going to write new rules around that. But I just keep going back to that thing of what do people want? And when you talk about traditional benefits, you mentioned some: healthcare and 401k, knee-jerk reactions for what people want. And while I was interested in changing those, and we have, I was more interested to find out what do they really want?

Megan McKinney Todd (00:32:31):

And you have to listen. You have to listen to what they say?

Dr. Mike Strouse (00:32:33):

I have to tell you, our direct support professionals, they will participate in a 401k only because it's free money. You match money to their contribution. But the truth of the matter is, as a behavioral analyst, their needs are more immediate than when they're 62 and a half or 59 and a half. They have needs that are like, next week.

Megan McKinney Todd (00:33:01):

So what can we do then to take what we would contribute and maybe allow them the flexibility to spend that money differently or better for what is right individually for them. 

Dr. Mike Strouse (00:33:16):

Well, I think all of that is a goal. And do we have all the answers? No, but that is a quest we're on, right? And part of it is like I remember once, and we should do it more. We got a bunch of people together and say, okay, let's make a budget.

Dr. Mike Strouse (00:33:37):

We have $40,000 to spend this year. At that time, it was years ago, we've got 25,000. If you look at the DSP nationally, I think it's average age is 35 years old, 81% are female, 62% are the primary breadwinner for their family. 45% have a child, 40% have a second job for at least part of the year. What they don't tell you is we're the second job for most of those. They don't have a second job. It's us. That is the second job half the time because about 35% of our workforce is part-time. I mean, I'm spouting out statistics, but that's because I know them. And there's lots of deeper statistics because when we got people together and we had DSPs and us sit around and try to say, okay, if you are a female, then if you have a child and you're 35 years old and you got $40,000 to spend, and here's what you guys go hole up, you five go over there and hole up and come back with a budget,

Megan McKinney Todd (00:34:44):

A monthly budget that covers all of the necessary expenses. 

Dr. Mike Strouse (00:34:48):

You know what they couldn't pay for? They couldn't pay for all the things that do they really want to take 5% of their money and have it matched to a 401k

Megan McKinney Todd  (00:34:59):

That paycheck could be used differently, yeah. 

Dr. Mike Strouse (00:35:01):

No, they're not. And if you look at the data, even though some do it, high percentage of them, do they want to do healthcare? Yes, they want to do it, but they're children. And so the reality is there's so much out there that we should be looking at. I mean, if they are eligible, 50% are eligible for public subsidies. Why aren't we helping them with that? The whole idea of what they call navigators you were working in of what state was it that…

Megan McKinney Todd  (00:35:36):

Yeah, we're working in both Washington and Oregon who have made really tremendous inroads by bringing navigators in who can just be walking alongside the direct care workforce while they find work, find ways to pay their bills. And then essentially knowing that the benefit structures and systems are all relatively complex.

Dr. Mike Strouse (00:36:05):

How do you access food stamps? I mean, do I want people to have to need food stamps? No. But if they're there, do I want to help them get it? Yeah, I do. Or do I want them to help get food for their families or low cost items? It got me into the whole idea of tax-free strategies for paying for care. You can pay in certain care models, of course, like Shared Living, their whole compensation can be tax free, what we call Family Teaching, which is still employment based, where they live with somebody can be paid compensation, tax free. There are other conditions where they may live in a neighborhood supporting somebody. Housing can be tax free.

Dr. Mike Strouse (00:37:00):

And then you've got all the labor laws that go into that to say, well, if you live there 24/7, then you can provide support at night only when you need to, but we don't have to pay for what you use. So all of a sudden I found out there's ways that you can give something to a caregiver, you know, housing and also it would be less costly for the agency. It's like, wow, that's a third win. So it's like you've got to get rid of all that stuff in order to and be willing to say, benefits are not what we think they were. Benefits are like Costco membership, prime membership, it's a cell [phone] plan. The stuff that they're going to spend money on anyway,

Lauren Vohland (00:37:49):

They have to. So, I think it's important to note that you've had to be innovative and creative on this strategy because we are a primarily Medicaid funded program where it's fee for service. We have to provide the service, which means we have to carry the cost before we get paid. And we don't get to control our revenues. We don't get to control the fees that are charged. That is all determined by the state. And I know within the state, Medicaid is never something that is getting major increases, huge increases. And so I feel like we're always behind on what the market is really demanding for that labor and some of the other cost drivers. So labor insurance, whether that's general liability insurance for our vehicles, all of those things. And so all of those costs continue to rise every year. There's no consideration that Medicaid funding isn't increasing every year. So we're continuously behind on that. And I think talk about turnover being consistent across 40 years. So has the funding and the funding increases and how it's perceived from the people who get to decide the state budget.

Dr. Mike Strouse (00:39:06):

And we advocate, not just us, but advocates, stakeholders have advocated for 40 years. And you know how that works. You advocate, advocate, advocate you’re one foot underwater and you advocate to get your nose above water and then you go back under. So what people, but we still do it because we have to. The best that gets us is get our nose above water.

Lauren Vohland (00:39:31):

I think education is very important in how the I/DD and HCBS (Home and Community Based Services) community works within the state. I think making sure that our senators, our representatives, are all familiar with what we do and what we're giving back to the community, whether that's through the people we serve or the employees that are helping support those individuals. But I do think it can be kind of a hard reality of how do we keep going knowing that you have all these roadblocks. And I do feel from working with you, you said, okay, these are the conditions that are true and these things I don't have control over. So what do I have control over and how can I change that…

Dr. Mike Strouse (00:40:14):

And what movie did I get that from?

Lauren Vohland (00:40:17):

Probably Indiana Jones?

Dr. Mike Strouse (00:40:19):

No, it’s Apollo 13! That's where I got it. I mean, okay, 

Ivo Ivanov: 

You have to be resourceful to survive.

Dr. Mike Strouse (00:40:26):

And that's Indiana Jones is resourceful, but it's about the reality that you're up there in that spacecraft and you got to land this sucker and you got duct tape.

Ivo Ivanov (00:40:37):

Yes.

Dr. Mike Strouse (00:40:38):

I mean, this is the, 

Lauren Vohland: 

That’s how it feels some days: Cheetos, duct tape. 

Megan McKinney Todd: 

Duct tape and cheetos! How many days? I felt like that. 

Dr. Mike Strouse

But you know what? You're right. This team we have is all about that.

Megan McKinney Todd (00:40:53):

Well, and I think what's so fascinating about what you just said is you're right, we are never really breaking even. We're always lagging behind. And all the advocacy gets us up to the point where we almost caught up with the cost of living increases and whatnot. But it comes back down to what we have to pay for in order to deliver a Good Life. And what's so, I guess wonderfully ironic about it is that we all do want the same thing. So when it comes to the housing and the transportation, the things that aren't really covered under, at least in our state-specific HCBS reimbursements, then this is where the creativity and the innovation gets really exciting in that resourcefulness. Because we're like, oh, we all need to get around. We all need a roof over our heads. We all need to be able to purchase food and get into the community. And so leveraging those resources in a way that is mutually beneficial does give us that win-win-win.

Dr. Mike Strouse (00:41:57):

And before we get into the fact that we're the reason across 40 years that once again for 40 years we've been doing the same things and getting the same results,

Megan McKinney Todd (00:42:09):

Surprise, surprise,

Dr. Mike Strouse (00:42:10):

Surprise, surprise. And even on that we need to change. And for sure there is a way to do that, which we'll talk about in a little bit. But what you're talking about, Megan, and I know what you're really focusing on is the fact that when you're Apollo 13 and you're landing because you just got what you got, right? Well, you got to look at what you got and see how could you leverage more out of that. I mean, this is an old adage, but when Megan was talking about, okay, everybody needs a car. Everybody needs the phone. We need

Megan McKinney Todd(00:42:48):

Everybody to have a car and to have a phone,

Dr. Mike Strouse (00:42:50):

Phone. Everybody needs a house. Everybody needs that. And that's kind where that sharing mentality kind of came on. It's like, okay, well good life. And it still does, but this is again part of our goals of stuff. Good life has 71 vehicles, and I suspect that the employees, 450 employees that we have have some

Megan McKinney Todd (00:43:19):

Somewhere around,

Dr. Mike Strouse (00:43:19):

Somewhere around that number 50 plus or minus at any given day

Megan McKinney Todd (00:43:24):

For sure.

Dr. Mike Strouse (00:43:25):

But they have that. But we both need that. So I think the innovation that will help us as a country is if we stop looking at how we have traditionally done that and think of things outside of our sphere. I looked at the example and every time I see a problem like that always by myself, I always look at other industries. We're into rapid deployment and I look at other industries on how they've done that. Logistics we're the logistics and there's whole careers out of logistics now in the transportation industry. And then I think about Uber, and I think Uber has transformed personal Transportation. 

Lauren Vohland (00:44:18):

For sure.

Dr. Mike Strouse (00:44:19):

And what's really unique about it, which I will tell you is so different and refreshing, is there's lots of unique things about it that's so worth studying. Because Uber basically elevated the lives of the people who were driving for the benefit of the lives of the people that they were supporting. They made individualized transportation possible by doing those two things. So they didn't have people drive cars that were 40 years old. They have empowered them to have a better car. And some of these Uber drivers drive only because they wanted to part-time

Lauren Vohland (00:45:03):

Like gig work?

Dr. Mike Strouse (00:45:05):

Just to make it work. And some are full-time and just amazing, but they're delivering individualized transportation,

Megan McKinney Todd (00:45:12):

Talk about access.

Dr. Mike Strouse (00:45:14):

Right! And they've done it by improving both people's lives. And it totally almost overnight ended the taxi industry for the most part, the only reason it ever persists is because of rules and regulations that require it. That's through lobbyists because of how different jurisdictions work. They're just trying everything they can to keep the old thing together when if just the reality is it is dead.

Lauren Vohland (00:45:42):

Let the market drive it.

Dr. Mike Strouse (00:45:43):

The market was innovatively, changed the world on that. But if you study Uber, it's so fascinating. They have levels for those drivers that reinforce them for delivering exemplary service.

Megan McKinney Todd (00:46:00):

What's needed,

Dr. Mike Strouse (00:46:01):

What's needed.

Lauren Vohland (00:46:02):

Airbnb is also a similar strategy. Knowing people who have been able to buy a second home, but their costs are essentially covered because they've been able to do Airbnb most of the year, which a lot of them are like, I'm going to rent it out for these years and then hopefully one day I'll retire there or whatnot. So it is given them access and kind of the same strategy of we're no longer dependent on hotels and the pricing at hotels and the peak times and all that stuff.

Megan McKinney Todd(00:46:34):

It's almost a crowdsourcing approach,

Megan McKinney Todd (00:46:37):

Which I love that for Communities

Lauren Vohland (00:46:39):

All in an app. It's so easy. Yes, cell phones have really made life easier.

Dr. Mike Strouse (00:46:45):

This is for a different episode, but you guys should come back about this one because I have that also thing about my problem with technology is that, in I/DD specifically, they think everything is an app for that.

Dr. Mike Strouse (00:47:05):

You take your iPhone and you go like this, and there's a hundred apps, so many apps that you have to have folders for them. If you take all of your apps and all of your apps and all the Ivo’s and mine and you add 50 people to it, how could an agency in any way run technology like that? I mean, it would be like having an EMAR (Electronic Medication Administration Record) or HRIS (HR Information System) for every individual employee of the agency. Everybody gets picked their own HRIS or everybody gets picked their own payroll system or everybody. No, there is a platform of support that provides individualized transportation and it's the only way it could be scalable. We have to keep looking outside to see how in the heck it's done. If we keep looking at the way our industry has done stuff, we're going to go crazy!

Lauren Vohland (00:47:58):

So the user end is individualized and you have choice and control over the user end, but the platform allows there to be consistency.

Dr. Mike Strouse (00:48:06):

No scalability to it. I always leave this book out here, you guys see it is my implementation practice in science, is my old friends, Karen Blase and Dean Fixsen, were really the grandfathers of all of this. And those guys understood that you deliver individualized support by models, services, and sort of platforms of care, the

Megan McKinney Todd (00:48:32):

The Infrastructure,

Dr. Mike Strouse (00:48:33):

Right? And the truth is, I don't want to migrate from the discussion about individualized services, but the reason this is important is because you can get as much for people in their quality of life by focusing on the program design than you can the benefits. I mean the Neighborhood Network this for another day, but it is establishing Ivo, we talked about Blue Zones, right? That's my big deal. Inspiration behind a Neighborhood Network is the six blue zones that exist across the world. It's like look at that for inspiration. If you want to, you want a good life, go to a blue zone because you'll live 20 years longer and you got to look at why?

Ivo Ivanov (00:49:21):

And higher quality of life too.

Dr. Mike Strouse (00:49:22):

Why do they live 20 years longer? Why are they having such a great life? And you start looking dissecting that and they're happy. And number one, they're the other two. They have a little wine every day. You can't forget that

Dr. Mike Strouse (00:49:38):

I've been really working with that part.

Ivo Ivanov (00:49:41):

So is it safe to say that whereas other organizations like ours have kind of a bundle approach to benefits and offer an umbrella of benefits, we kind of recognize that in an era of stagnant funding streams based on a kind of budget that's unimpressed by inflation, we provide flexibility and we segment our benefits and give an opportunity to the employees to be flexible and choose what they want to do. What they want to purchase is a benefit based on their needs.

Dr. Mike Strouse (00:50:18):

And I think we should try to get into a few details and stuff, but I think getting the point across is more important than the details. The details will change. The point is that we look, I mean there's levels of this. We have 50 million to spend or something. There's an amount of money we spend, but within that, we spend it for things that are useful for not just the people we serve, but are also useful to people who make that possible. It's like we need transportation, we need phones, we need housing, we need all these things. Why aren't we sharing these costs resources with the employees and us?

Dr. Mike Strouse (00:51:01):

Not sharing it to push it on them, but sharing it would make it less costly for them as well as for us. I mean, if you have a phone and you have an agency phone, how crazy is that as an expenditure? You know what I mean? But you can hide behind you know…

Lauren Vohland (00:51:22):

T-Mobile and Sprint, probably enjoy that I have two phones with them. But yeah, there's duplications.

Dr. Mike Strouse (00:51:28):

But there's mad scientists out there that have created ways so you can have business parts on that phone and personal support on that phone and you can actually share your phone. So instead of me buying a phone for $25, $30 a month for GoodLife, I could give you that money.

Megan McKinney Todd (00:51:45):

To subsidize your phone bill that you have to have regardless.

Dr. Mike Strouse (00:51:50):

Did it save me any money? Maybe not. But it was Apollo 13. It was the stuff I had, that I could use to help somebody else's life and help my own. And here's the thing, I have never seen A DSP stay at GoodLife because of a 401k. The reason being is every agency has a 401k, number one, and number two, it’s just not a here and now priority for them. But can you imagine a different thing? Imagine they have a house. Imagine that we’re paying for Prime membership and a cell phone and subsidizing the transportation of their car. Imagine you're doing those things at what point in time, I don't like the word golden handcuffed. It sounds like you're trapping somebody. 

Lauren Vohland (00:52:47):

But it’s mutually beneficial.

Dr. Mike Strouse (00:52:49):

At what point in time is it really going to be like a moment of paused thought before somebody actually leaves this industry if they have those kinds of amenities and quality of life things, if we could start bolting those things together. So all I'm saying is the first element to thinking about benefits is stop thinking about traditional benefits. Start thinking about, I mean, that's the easy button. You meet twice a year with your broker and they come back with a plan with you and you do what everybody else does and you treat everybody the same even though they don't want that. But the better thing is looking at program design. How do you pay people? How do you design your program? How do you deliver services? Do you have neighborhood services? Are you offering everything you can? There's a slide in one of my presentations, Megan, I know you know it. Cause you make it look better than I do, but it talks about: what do people want? And DSPs, there's highlighted ones. There's so many more, but there are common things like they want housing, they want transportation, they want childcare. They want as many days off in a row as possible. They want to work extra, but only when they want to work extra.

Megan McKinney Todd (00:54:08):

They want higher wages.

Dr. Mike Strouse (00:54:09):

They want higher wages. They want to paid as often as you paid em. 

Lauren Vohland (00:54:14):

I think higher wages, take home money. 

Dr. Mike Strouse (00:54:17):

That tax free style.

Lauren Vohland (00:54:18):

Yeah, that hands down they have choice and control over what they can spend their money on. And so I think higher wages has definitely, like when we're hiring people that take home money is what's important. 

Megan McKinney Todd (00:54:34):

It MATTERS.

Lauren Vohland (00:54:35):

And I know, when we've done calculations, once you back out taxes, that's a very different take home than what your hourly wage actually is. Absolutely.

Ivo Ivanov (00:54:45):

There's something else guys, that is probably a topic for another episode or two or three episodes. But really I feel like this topic is kind of a connective tissue that goes throughout the entire podcast and every episode. I think we do pay, of course, our employees with traditional currency, but we also pay them with the most priceless currency in existence. And that's time. Time is priceless. And we have found a way for scheduling to give the benefit, the most important benefit, to our employees. Time, extra time. Mike has mentioned this in every episode, he just mentioned it as well, working, having as many days in a row off as possible. And that gives you an opportunity to be with your family, to raise your children to save from childcare or to even do a second job.

Dr. Mike Strouse (00:55:47):

So Ivo, but it is how it sounds like all these things are innovative things and they're different and I think they come across as innovative, but they all literally do the same thing.

(00:56:00):

They all approach things the same way. It's not like all these innovations were just different thought patterns. It was about looking at what you had and how you could arrange it differently and how you could give people as much of what you can afford as possible. I mean, in our labor stuff, we are pivoting from what, 32% as a nation of part-time to GoodLife’s doing 98 or 99% full time full-time, right? People are working three day work weeks now, why did we pick three day work weeks? Well, because having three days off in a row, sometimes four days off in a row, that's 17 days off a month and working 13 days a month.

Megan McKinney Todd (00:56:40):

There's no PTO policy in the world that can meet that.

Dr. Mike Strouse (00:56:43):

Nothing you can do with PTOs, never. But that's what I mean by program design. Nothing you can do with PTOs. I can take a five day work week. You are off two days a week times 52 a year. That's 104, right? Four day a week times 4, 52, that's 208 days off. I have never known somebody to give up 104 more days off in PTO a year. That's not going to happen. You're going to give what, 2030? Something like that. Most you can do

Megan McKinney Todd (00:57:12):

Not to mention because that's not a win-win on behalf of the organization. We have to backfill all of the time off that we give.

Dr. Mike Strouse (00:57:19):

It's hard.

Megan McKinney Todd (00:57:19):

It's hard. Yeah.

Dr. Mike Strouse (00:57:21):

And the crazy thing about that is that the traditional, and I'm going to go do this to make a point, the five day work week, and it has to have benefits. It is a benefit

Megan McKinney Todd  (00:57:32):

For sure.

Dr. Mike Strouse (00:57:32):

But if we keep thinking of benefits is classical benefits, which I know everybody wants to hear about because it is worth a whole show on ICHRA. I can't even spell an ICHRA, but it is a cool thing and offers a lot of stuff and you're going to have to wait to hear more about it. But it's a way to treat your hourly workforce different from your salary workforce and geographically treat people different and do some other things so that you can have different approaches for things. So anyway, another day to talk about that. But my point is just to say all these things that we do for benefits are mostly achieved by program design and looking at things more broadly. And I think that that's the first thing that you learn what they want and you say, well, that's silly. How can we give them that? And it's like, well, you know what? We can! We can do more. We can give them housing, we can give them transportation. We can give them relief on those things. Example: Here's a perfect example of how a rule can be worked with. It is a requirement that if anybody who picks up 401k, anybody who does it, we get a matching amount of money. You got to treat them the same. It's the safe harbor approach.

(00:58:57):

However, if you also tell an employee, yes, but if you don't pick a 401k, I'll give you the same matching money for you to use for you to pay back your student loan or for a housing benefit or for transportation benefit. I'll give you the same. I'm not going, if you don't pick a 401k, I'm not going to keep the money. I'm just going to, you have it no matter what.

Ivo Ivanov (00:59:22):

No matter what. Exactly. Yeah.

Dr. Mike Strouse (00:59:25):

Well, if I did that, how many people do you think would pick DSPs, would pick a 401k or a housing benefit?

Lauren Vohland (00:59:34):

I think a lot would. I can speak to my own personal self. I've got three young kids and daycare when all three of them were in childcare, my 401k was not my priority. Even though there is that match of contribution, it's like I have to make decisions

Dr. Mike Strouse (00:59:50):

That it's a priority only because you're given up 5% of somebody else's money.

Lauren Vohland (00:59:54):

Yeah. But even then, I didn't have the opportunity to do that because I've got three kids in childcare, which absolutely has to happen with both parents working. And so as my children went into elementary school, I was able to increase my contribution towards my 401K. So I was able to adapt my benefit structure based on where I was at. 

Megan McKinney Todd: 

What you needed. Yeah.

Dr. Mike Strouse (01:00:26):

Well, I know this episode's kind of coming to an end and some people are going to think we didn't get to the pudding, but I want to tell you we did. If people leave this episode, knowing that you can approach these benefits differently, it's a win.

(01:00:45):

And if they stop thinking about classical benefits and thinking about what do people want and how do you design the program to be a win-win? And I'm going to even say a win-win-win for the DSP, A win for the person served, and a win for the agency, and probably a win for the government. So if you approach it differently, you're going to have different results. And we do have workshops and training and stuff on the details. So we don't just keep 'em to ourselves. But you have to go in knowing that you can't really improve the lives of all these people unless you're willing to rethink how you approach it.

Ivo Ivanov (01:01:31):

Yeah. Curly, when he wanted to illuminate Billy Crystal's character, he said, do you know what life is all about? And I'm repeating this Mike for a reason because Billy Crystal said, what is it? And then to demonstrate that it's about one thing curly extended his index finger. And Billy Crystal said, what your finger, that's what life is all about. And Curly said, no, no, no. It's about that one thing. What is it where it's for you to find out. Well, that's what this podcast was to indicate that it's about that one thing. But you have to find out. It's your quest. We are just here to guide you a little bit and be your Curly on your quest. So we want to thank our guests, Lauren Vohland and Megan McKinney Todd. thank you guys for being here and being the first guests on this wonderful podcast. 

Lauren Vohland (01:02:28):

Hopefully, We didn't mess it up too bad, and we'll be asked to come back. Come back.

Ivo Ivanov (01:02:32):

Oh, you were spectacular. And you'll be repeating guests. This was the quest for the GoodLife with Dr. Mike Strouse. Today's episode was produced by Megan Olafson and recorded at the GoodLife University studio, sound editing, sound engineering, and fun. Editing and engineering were provided by me, your co-host with the co-host Ivo Ivanov. Reverse Engineering of every topic was provided by Dr. Mike Strouse. We want to emphasize to our listeners that our inability to remain concise is deliberate. Please feel free to contact us, ask questions, or simply vent your frustrations by sending us an email at GoodLifeUpod@mygoodlife.org. Together we thank you for listening and promise you that The Quest for the GoodLife will continue next week.

(Producer's Note: It will ACTUALLY continue April 10th, be sure to tune in then!)