Oct 18, 2024

90 – How Lobbyists Quietly Shape the Future of Your Healthcare! w/ Jenna Paladino

Featuring: Vic Gatto, Marcus Whitney & Janna Paladino

Episode Notes

In this episode, Marcus and Vic are joined by Jenna Paladino, a healthcare lobbyist and founder of Paladino Advocates. They discuss Jenna’s work in lobbying for healthcare, including the influence of public policy, the impact of lobbying at both state and federal levels, and the importance of building relationships with legislators. Jenna provides insights on how startups can engage with lawmakers, the role of advocacy in shaping healthcare policy, and the complexities of navigating government regulations. The conversation also covers the differences between private equity and venture capital in healthcare lobbying.

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Episode Transcript

Marcus: 0:00

If you enjoy this content, please take a moment to rate and review it. Your feedback will greatly impact our ability to reach more people. Thank you. All right. Uh, welcome back to tell further our guest series, uh, bringing in a friend who I met last year while I was on the road and, uh, doing a keynote at the national hospice and palliative care organization meeting in Little Rock, Arkansas. Uh, after I got done, I was getting ready to. And was it at the coffee shop in the in the hotel? And, uh, this, uh, very outgoing, uh, sort of very happy, uh, woman. Jenna just sort of reached out and was like, Hey, you know, can we talk? So you're on stage? Uh, can I buy you this coffee? And we got into like, we were like, What felt like about a 45 minute conversation where she really, uh, piqued my interest into all things in the world of lobbying, something that you and I sort of never spent any time talking about. Right? And so over the course of the last year, we've just kind of kept the conversation ongoing via email. And, uh, as the podcast kind of got to a point where we were really focused on getting guests on regularly, I was like, Jenna, you know, would you like to come on the show and, and, uh, you know, educate us live in front of the whole world about how stupid we are about lobbying. Uh, and she was gracious enough to accept. So Jenna Palladino, welcome to the show.

Jenna Paldino: 1:22

Thanks guys. Thanks for the invite. I'm coming to you live from Tampa and yes, that coffee was worth my effort of 5 or however much it costs. So, so thank you for the introduction.

Marcus: 1:34

Hey, really quickly. Um, how's everything in Tampa? My, my friend Edmondo Robinson, uh, who's an Aspen fellow with me, he lives in Tampa and he was actually here in Nashville the week of, of Helene and, uh, he, he was delayed going home because the airport was shut down and I know stuff, you know, I know there was. Some flooding there. Everything okay there at the moment.

Jenna Paldino: 1:53

Yes, we're um, north of the city and we're fine, but I do have some dear friends over the last few days that I've been helping schlep stuff out of their house. I never thought I'd have that role, but um, we're going to be okay. Tampa, Tampa will be fine.

Marcus: 2:08

Okay, we'll get back. Thanks. Yeah, thanks. Thanks for sharing. Um, all right. Well, I guess we can just start. Vic. Do you want to start? Do you have the first question? I'm happy to start. No, go ahead. All right. All right. So, so Jenna, like, do me a favor and just frame up for us. What it is you do, um, on a, on a day to day, week to week, month to month basis. Like, what it is you do and where we might find you physically in the world doing what you do. Like, I want to get a full visual of the work that you do as a lobbyist in health care. Okay.

Jenna Paldino: 2:42

I am the original influencer before social media hijacked that word. I like to think that public policy can be influenced, even in my home office here, which I've been doing for 10 years as the founder of Palladino Advocates. I problem solve for my clients at the state and federal level. To understand how just changing a little bit of a policy, um, or introducing a new bill could directly impact their growth segment, their ability to expand maybe even a market that they hadn't even thought about that I already know Congress is talking about. So I am that influencer. I'm able to see the big picture, package it easy for, uh, your startup investors or your Um, CEOs that are starting out and then make sure that I hold their hand the whole time and say, have you thought of and did you think of this? And did you know that when they pass this bill 5 years ago? It's coming back around for renewal because I've been around long enough to know that. After that five year, uh, carve in, it's now going to be a carve out or, uh, pieces like that, that institutional knowledge comes with being a lobbyist.

Marcus: 4:04

Got it. And, and are you, like you said, you're doing it from your home office. Um, how much time are you spending, uh, in the legislative halls actually, you know, shaking hands, meeting with people, getting time on their calendar versus just sending emails or doing research? Like what, what is, what does that sort of division of time look like?

Jenna Paldino: 4:25

Much like buying you that coffee, I buy a lot of coffee. Um, I think it's better than beer and wine. Uh, you can get people when they're alert and awake. So I hit the halls of the Capitol all the time. Um, even when they're not in a session. So in the state legislatures, they're usually in session in the springtime. Sometimes they're every other year. Sometimes they're full year. Most of them are part-time. And then in Congress, you know, they say they're not year round, but they are, they still have a full office staff there. And as a former legislative aide, I can tell you that those are the ones that get the job done. So if I can go into a legislator's office or a member of Congress, uh, in the off season with, um, that cup of coffee and a conversation with maybe a. bring along one of your startup find, you know, founders, then we can get a lot done. So year round, I travel DC state legislators offices. And then in the election season, um, I average about a hundred candidate interviews across several states to get to know them before they get elected. That's important because my clients, um, want to see the landscape for the next two years or four years. We can't look past those four years because we really don't know who's going to be in power, but we can at least see two years, you know, before term limits. And it's nice to do some relationship mapping for them, figure out, um, if Representative so and so, you know, donates to the local synagogue or church, or maybe they go to the same place. And I do all of that for my clients, making sure that they know before that session starts, um, why we're going to work with Senator so and so instead of the other one. And I make sure that I work with D's and R's, which is pretty rare. But I, I usually lead any interview by saying that I believe that health care is universal, but it doesn't have to be universal health care. That's my tagline.

Marcus: 6:36

So tell us a little bit about like, what the. The field of play looks like when it comes to lobbying in healthcare, right? So you're out there, you're doing work. There are other folks out there also doing work. Is it like, basically you go in with your agenda of things you are trying to influence and you're trying to find people who can be influenced. Do you run into people with a counter agenda and, you know, you have to sort of maybe even triangulate where. You don't want to be shouting in both sides of the ears of, you know, whoever your target is. And you have to find a way to sort of meld that message. Like, because I know it's not just you when you're out there sort of interfacing with legislators.

Jenna Paldino: 7:26

So I like to say that I'm an advocate as well as a lobbyist. So the lobbyist is the profession. Advocacy is, um, you standing up against your HOA and saying, no, you're not going to put that, uh, insurance right here where you want it over here. And you work, you know, as a volunteer. So I have a lot of experience taking volunteer groups, as well as for profit entities, putting them together, building some alliances together. And then when we go to do our meetings, we're well prepared on what both sides could be. Because volunteers will, will tell you that they can be pretty strong on one side, but then I can also get the other side to come to the table for that same meeting. So I'm, I'm never going to pound my fist and, you know, go to the media and, and holler that, you know, there's injustice. I can fix injustice. That's easy. I, I can, I can work as an advocate and get all of those folks together and take my passion in a different direction.

Vic: 8:32

So I'm curious, um, how much is you meeting the candidates before they're elected and then kind of getting to know them so that you understand their, their favorite, um, initiatives or their, their real passions. And then for a client, you know, Okay, these state, uh, legislatures and these national legislatures, they'll be very receptive because I already know they're passionate about your topic. Or alternatively, are you trying to change minds and like introduce something that the legislator hasn't thought of yet? What, what's the balance? Is it, is it more one than the other or is it just depend?

Jenna Paldino: 9:11

During COVID, it was really easy to get to know candidates because they were all in their bedroom or maybe in their living room. And they had the kid running by with the soccer ball and they were trying to do life while they were trying to be a candidate. And I can say there's some pretty, uh, high powered, high influence folks that I've seen, um, you know, quickly turn and swat at the kid who's running by. because they were in real life. And so those folks, I got their cell phone numbers, you know, we chit chat about the soccer game or, or whatever, you know, it might be, they got a new dog and they send me a photo. So I bring my clients along for that. It doesn't have to be a big spend. I'm not looking for the next client that has a huge PAC, a political action committee, I'm looking for the next client that says, you know what, we really could have done a better job of letting our legislators know that in their backyard, there's a great new startup. And we're different than a private equity that's trying to come into healthcare and dominate. You have to delineate yourself right away. So that conversation at the beginning when they're just a candidate and they really want to help the world, because I do believe that people run for office because they want to help, You have to keep them engaged with, Hey, don't forget this startup. You know, it's more than just a ribbon cutting or you coming, uh, you know, to see our office one day. It's you inviting that founder to come to the Capitol for a founder's day in the Capitol. And then we both get the benefit of that relationship. So I think that starting when they're a candidate is the first step. But it can't just drop off. I can't just send them dog pictures and baby pictures after that. You know, I then have to have that founder, that startup person, come with me and bring them to the district office or the, wherever we're headed. Um, and then the ribbon cutting. And then there's, there's different steps along the way. Well, before we need a bill passed,

Marcus: 11:20

you, you, uh, you brought up differentiating startups from private equity. We, we are constantly sort of covering, uh, the, the discussions around private equity in healthcare, uh, kind of across the country. Um, probably the two biggest states that we are mostly covering are Massachusetts because of everything going on with Stewart health. And then also California, just because of some of the, the laws that are on the, that are We can being considered to be on the books there. Um, you know, you brought that up as as something that was important for startups to, uh, differentiate from. And I get that. I can see why on a myriad of different levels, it makes sense. It's more sort of, you know, Main Street versus Wall Street, et cetera, et cetera. But like, what can you tell us about how private equity is doing? In healthcare in government right now, you know, with, with legislators, like, you know, do they have lobbyists in there sort of working to try to clean up their image? Cause it, it seems like the image is, is really, um, getting a hatchet job from a PR perspective. You know, we see so many stories in the wall street journal and the New York times targeting private equity and healthcare. You know, inside of the actual legislative halls. Are you seeing more discerning conversations about that or and we're not private equity. So, you know, I think we're just we're just sort of curious about where this is all going because it does affect M and a later on. Right? Um, what are what's kind of your your sense there?

Jenna Paldino: 12:50

So I have represented, represented PE in the past. Um, we did some really great things for PTSD, for first responders, getting them better work comp coverage. So there are altruistic, um, thoughts on PE. And I think that, Your question about the halls of government. Um, you really have to pay attention to Senate Bill 4804 and that's the, um, the new Health over Wealth Act. And that's, that's a senator from Massachusetts. So that's, that's the correlation you just brought up. Um, that's looking at disclosure for those that were employed before they were acquired. and making sure that, you know, they still have a job, they still have the same rights, all of those things. But I think that's also a really great opportunity for VC to come in and say, okay, while you think that big bad PE is, uh, you know, taking everyone over, let me show you where we're starting. Let me show you how we're innovating and our strategy to grow these mom and pops. In the technology, in the integration of what the strategy is already, you know, we're not, we're not creating, um, uh, we're not all creating new lines of business. We're improving what's there. And if there is a new line of business, then jump and scream and shout and show it off.

Marcus: 14:19

Do you see VC like in the lobbying world, generally speaking? I mean, um, It feels like over the last year, VC has gotten very political. Um, you know, we're, we're, I mean, I think we can, we can. Reference injuries and Horowitz as a, as a firm that just was always very much about innovation and capital. Um, but this year is actually, you know, focusing on politics. It's, it's right on their homepage right now. They've got sort of a whole manifesto around little tech and their sort of positioning around the differentiation between big tech and little tech and really being, um, very outspoken about the way in which they perceive government to be trending as it pertains to embracing the innovation from little tech, AKA VC, you know, um, the only thing I've ever sort of encountered from a lobbying perspective with VC as an organization called engine, uh, that, that like basically does advocacy on behalf of the entire venture capital and no knock to them, but I've never felt that compelled by the, you know, the different things they email me about. It just doesn't feel like it's that consequential. Um, it feels like I'm glad somebody is out there doing it, but not enough to be like, okay, I'm going to show up to their events or things like that. So are you seeing a shift recently where you're seeing more VCs recognize, um, the impact and maybe, maybe even more so in healthcare VC, but. Uh, we're seeing more VCs saying, actually, we have to find ways to, to get involved. And it's important for us to not sit on the sidelines because there's real implications of what happens in, in DC, at least in particular, uh, to our industry writ large.

Jenna Paldino: 16:07

So government is set out to be reactionary, not proactive. And if you think of that all the time and you're able to follow the money, yes, there's always a campaign component. But that's because it costs money to run a campaign to get people elected, so it shouldn't make you shy away or say, you know that we're a lost cause or we don't have money to play. There's always money to play. You always have the opportunity to even write the 500 check and help the local person who then can help guide your board and maybe they have a consulting job on the side because they all have second jobs. Um, they're all involved in something and they're able to help guide and say, Hey, this is where we're headed. So bring that legislator on board. As an advocate of their own, you know, they probably have some great business venture that they're looking to launch to, but we wouldn't know if we didn't ask them. So I think that yes, there is VC advocacy and lobbying. Um, I'll stick to the lobbying side because I only know of that one organization that you mentioned. There's not a lot of them. Yeah, but if we go into the policy side, you and I talked briefly after that hospice, um, uh, conference, but then there's also hospital at home. There's, we're going to bring everything that you need into your home. We're going to assume all the risks and you're going to be great. You're not going to be readmitted and we're not going to get dinged for that. Okay. That sounds really nice. But what just happened here in Tampa? We had an onslaught of bad weather. We had folks who were in the hospital at home program from our local hospital, which I don't want to throw out the name. They were in a shelter and unable to even talk to the hospital. So we have, we have little incremental steps of where we're able to age in place where we're able to get people into their homes, but we really don't have great research yet. Yeah. It's only the top tier hospitals that are providing those services. Hospice keeps getting their rates cut and they'll get cut again after sequestration and everything else that keeps falling into into place. And that's where you fall into place saying, Hold on. We have some technologies that would allow that person to keep in contact with that hospital. We have some technologies that are available in in whatever setting doesn't matter where they are. I went through your portfolio quickly and said, Oh, this would have worked in that hurricane. This would have allowed people to communicate with their practitioners.

Marcus: 18:51

And are those are stories that you, that you feel like immediately after the fact, like while it's fresh on people's brains, you should be saying, Hey, you know, this is something to kind of put on people's radar. Like, okay, this happened. There was a gap in communication. This kind of technology may have been able to create a solution and maybe, you know, not necessarily immediately, but over the course of two years, you can have a conversation that can lead to potentially a pilot, you know, with, with the state Medicare and Medicaid, you know, is that kind of where you're going with that? I'm trying to understand like the practical, like how, how would we, the next

Jenna Paldino: 19:26

part is. You know, pilot programs are great because you can get a chunk of money to start the research, basically. And then you become that subject matter expert. And you mentioned Massachusetts and California. Florida loves them, too. Um, you know, Rick, come on down. I'll show you around. But it's a really great caveat to say We've already been, um, orchestrating this in these states, or we have this kind of, uh, data already, and we're ready for that next storm, because it's not an, uh, an if, it's a when. It's coming. And with 11, 000 new, um, Medicare beneficiaries every day. The the market's there and as far as medicaid, there's some other states I'd probably prefer over florida, but uh, we could talk about that another time.

Vic: 20:18

Yeah, so jenna i'm interested in Um, we we hear stories of big money Lobbying like, uh, peter teal supporting particular candidates or or funneling money in who's a, you know, famous vc other other folks where Um, for me and for a lot of the startups and even the audience members that are investors or healthcare executives that are listening, I don't have that kind of money. And it seems like you're implying that for smaller amounts of money, you could group together and talk about a topic that you have a creative, innovative technology solution, you know, better, faster, more effective for the nurses and doctors and patients. What is the budget, or how do people approach this if they don't have that, that huge war chest and they want to come to you and just get some advice, some help? How do they start?

Jenna Paldino: 21:14

So I'll give one example and then answer your question if you don't mind. Um, when I first started lobbying, I had the national multiple sclerosis as my first client. And there's roughly a hundred thousand folks living with MS that affects your central nervous system. And you may not know that someone has it. So I would take folks to the Capitol and they'd go, well, they look fine, every, everybody looks fine. What's the big deal here? What do you really need? But then we did a really great demonstration and we had them put on slip, um, mask and snorkel feet and some crazy gloves. This was to show what optic neuritis and your central nervous system shutting down and you with drop feet trying to walk. Immediately, those 100, 000 people that I was speaking on behalf of with the three or four in that room, we got their attention. If we can show, back to your question, Vic, if we can show that we are a solution to a problem, then the big checks are a nice to have, but everyone likes to hang their hat on what's going on in their district. They like to be proud of what you guys are accomplishing, and if we can do some relationship mapping and figure out that, you know, Mary, who works on an app that you just helped fund, lives in so and so's district, I, I can run the course with that conversation and, and get them in front of the right people. So checks come into play, um, more for Congress than state. Because those campaigns are incredibly expensive in Florida. You can run a campaign for a house district. That's about 150, 000 people. You can run off of about 200 300, 000. So just magnify that for Congress and see how much more they need for for a major city. Um, and the Senate's totally different. So signing up to be a part of their dialogue before they're elected, and then taking the steps to make sure that they understand the value before they get elected, then they bring you along. A lot of them form different, um, uh, uh, like community leader groups after they've gotten elected to help them navigate policy because they really They can't possibly know it all. So I've sat on a couple of those, um, coordinated groups, you know, Hey, we'll get the best brightest in the room to talk about healthcare policy in the district. Those types of things happen as soon as they get elected. Um, and that's kind of how you bootstrap your way through.

Marcus: 23:54

So that's, that's pretty interesting. Um, there are definitely a fair number of, um, healthcare startups around the country. This is not just in our portfolio, but we certainly have. Uh, a critical mass of them. So I can say this is representative of the broader, you know, startup universe that are trying to sell into state managed care organizations. Um, state Medicaid agencies, um, or, you know, state Medicare trying to get state Medicare contracts. Right. And I think generally speaking, they are focused on, uh, selling into the state agency. and or the managed care organization in that particular state, right? Um, what can you tell us about situations where you have seen organizations who are doing that, where they've leveraged lobbying to also have, um, influence with. lawmakers, and that has been beneficial in, in what they're trying to achieve as a company.

Jenna Paldino: 25:13

I can go back to that PTSD example. So there were also some value adds at the Department of Labor, at the US level, as well as the state level. And over time, agencies, they run out of ideas. You know that they are, uh, for example, when I worked with the Department of Education years ago, we had, um, you know, plenty of innovation. And then when it stopped, it stopped fast, um, people stopped coming to meet with us. So I would say that people are afraid to approach the agencies because, oh, they're just a bureaucrat. They don't understand. But just like meeting with a legislator, if you are kind and informed and passionate and come with that example of how it will help and solve, they'll open some doors for you before we even make the ask, because they want to see things improve for the patients that they serve. Now, of course, you run into those that, you know, probably should have retired a long time ago that. That wouldn't be so receptive, but there's other doors. There's other ways to get in. And then when you pair that with the legislator who serves on the committee overseeing that state agency or that budget item, that's the marriage that you want, um, for many years.

Vic: 26:38

Maybe, Jenna, talk about the process, um, where you start to find, uh, legislatures that are, that are, people that are interested in a, in a topic. Maybe you're doing some education with them. They draft the initial bill, but there's a lot of steps in the process. What, what's a reasonable timeline, like how do you advise clients on, you should plan on doing this for six months or maybe it's six years, like what is the timeline that, that makes sense? Um, not like if everything lines up perfectly, but on average, how long you have to work on it.

Jenna Paldino: 27:16

It gives me a lot of gray hair to say that on average in Florida, for example, this is similar across the country in the state legislatures, about three years to pass a bill. However, There are other ways to do it. I can't give away all the secrets, Vic.

Vic: 27:37

Yeah, sure, yeah, yeah, yeah. We don't need the free secrets, Vic. What I want to ask is, uh, so it's three years, and if you're not in at the beginning, you still can jump in, even, maybe something's been going on for the last 18 months, it's halfway through. Some of the bill has been written, but it's not final passed yet, and you can, you can learn about it, begin preparing your business for what you advise them is the likely outcome, but also try to shape it maybe in a minor way that would be beneficial for the, uh, population and for your business. Is that, is that sort of part of the process too?

Jenna Paldino: 28:18

It is. The education piece and that institutional knowledge is what I'm able to bring to the table. So when the bill is already drafted, it's not too late because as I just stated, it's three plus years to get it passed. When you open a chapter in the statute, so let's say it's chapter 400 in Florida and that has to do with hospice licenses. Once you open that chapter, anyone and that wants to add something. It's a cattle call really. Has the opportunity to do so. So my fortitude would say, I think that these organizations are probably the ones that are going to come and try and change something. And sometimes you're on the offensive. Sometimes you're on the defensive. It just depends. But it's a really nice opportunity for your founders and your startups to say. Uh, while you're doing that, if you offered this, um, training for new nurses or you were to look at a, a, a study or a pilot program and we've already done the research, we know how much it costs and we know the benefits to it. Um, to serve it up on a platter like that as a real win.

Marcus: 29:31

So three years, that's, that's helpful. Um, Vic, I was. It just hit me. I can't believe like I hadn't thought about it in the lead up to this show. But, uh, you remember our conversation with, um, with Aaron Ghani and he was talking about like the work he's trying to do in digital therapeutics. So, so Jenna, here's, here's a, here's a situation. Um, A friend of ours runs a company called Behave VR. So they are in the VR space with a digital therapeutic. And if you know anything about digital therapeutics, basically, um, they're, they have tremendous promise because they are digital. The supply chain is not physical. Um, and the, the marginal cost is basically zero to, you know, do dosing. Um, and so it is, it's a really great, um, it holds great economic, um, Promise for health care, right? Uh, but the regulatory environment for it is not yet clear on how to reimburse for it. And so there's been a lot of work being, being done, uh, by a group of companies that have now full organization for this, where they're trying to sort of push this. Um, I'm just curious, but, but in the meantime, They are selling the product. They are like working directly with specific payers, kind of creating these, these pilot, you know, payment models and things like that. Um, is, is, is that kind of situation something you would say is, is ideal for lobbying meaning, right? You have, you have an entire category where a group of companies all can benefit from the upside, they can come together because it just makes me think about like the, the, the American hospital association, right? It's like, there's no question that lobbying works. When you look at the results that the American hospital association has delivered for nonprofit hospitals over the last 24 months, right. You know, three 40 B and all the, all the wins they've been able to rack up. So, so we know it's valuable, but trying to think about it in the context of a startup, um, And and with that average three year window, right, it seems to me digital therapeutics might be a perfect example or one of these areas where it holds tremendous potential, but you're going to have to get some new rulemaking in place to really open up the the financial opportunity for for the industry. I'm trying to look for characteristics, uh, of. Um, of a challenge that really make the lobbying effort worth it. Given the three year sort of on average window, like how, how would you respond to that? Right. Because, you know, we, we don't want to say every company should have a lobbyist. Like that doesn't make sense, but, but help us maybe shape up when it makes a lot of sense. right to bring lobbying in. And I think digital therapeutics makes sense, but maybe what other characteristics would you give to, um, a business opportunity that also is in the best interest of the general public?

Jenna Paldino: 32:32

I think I'm familiar with the VR story that you're telling me. I've heard it for addiction. I've also heard it for cognitive behavioral therapy. Are we on the same conversation here? Okay. So I am familiar with that. That's an easy show. Don't tell. Right. So you get some really great stories, um, some anecdotal and some data from patients, um, who have had great success from it. You pull some strategy from, uh, those who are varying age, uh, varying demographic, and you, you tell the story as, if they did not have this, you tell the story as, if they did not have this. Then they would be in your behavioral treatment centers that are $20,000 a week, they would be out on your streets, homeless because of their addiction. They would be, and tho those are things that happen every single day. You don't have to elaborate. Everyone understands. Those are real situations in healthcare. So if we can get it to where the VR system comes in your in your mail and it's a box and all you have to do is hook it up USB to your computer and it's really user friendly. Then that's a really great demo to take to a capital. Really easy. Um, then I would say I would find a few more of your friends who have some abilities to show with apps with technology and we do a technology day at the capital. And we put several of those out there and let the aides and the members, legislators, come and try them. Walk by them, tell them we're there, um, and have some of those personal stories ready to share. But then we have to be clear on the ask. Is the ask just the reimbursement? Or are there other options out there? And that's where I come in with the strategy of Yes, it's always nice to get reimbursed, but they're also looking at cutting telehealth right now. So if they're looking that way at Congress, then what can the state do to support technology that's in their backyard? Without just going out with the

Marcus: 34:47

bathwater.

Jenna Paldino: 34:47

So I think I, I think I answered it for you.

Marcus: 34:49

No, I, I, I, I think you did. I, I mean, that's really interesting. You know, you, you talked about the tech, the technology day or the, or the innovation day. Um, here, here in, uh, in Tennessee, our local entrepreneurship organization, um, launched TN. They have, they have a day on the hill that they run and they're not really a lobbying organization, but they are partnered with, with the state. Um, How how effective are those organized days? Because that that does feel like something where, you know, I could see partnering with a set of different organizations and crafting some stories and in sort of seeing the benefit of doing that. Over the course of five years, and it also not feeling so overwhelming, you know, but it's like a regular appointment thing. You do you build your stories around it? Um, and you have sort of a long view on what it is you're trying to achieve there. You know, how often do you pull that tool out of your toolbox and say, This is something, you know, this is something that that warrants a day on the hill.

Jenna Paldino: 35:58

So a day on the hill is similar to an in district visit. it and that's going to their home turf, you know, back home, uh, where you're a little more casual. But when you're on the hill, think of the vision of what that allows you. You bring, um, all these bright minds to allow for photos, allow for videos, allow for social. They can use it on their channels as well that you didn't have when you were singular going to the district office. One is not over the other. It needs to both happen. So you asked if a hill day is beneficial. A hill day to me is like Christmas. I am elated to show my client's story in the flesh, in the technology, in a committee meeting, because it's not only just come see us. So we're going to go to your office. I'm going to schedule you to speak at that technology committee hearing. Um, we're going to take that reporter that's standing over there looking for a story, and we're going to walk along all these tables. Um, it has to be multi pronged. And then the follow up. The follow up is crucial. I still write handwritten notes. Um, I, I still get those, um, those folks we were just talking about who established this technology to go make that in district visit with or without me. So that they can say, Hey, we enjoyed our time on the hill, but here's where we could grow. These are the asks. These are the things that would help us as a startup.

Vic: 37:40

And I guess it strikes me that there might be benefit in having a group of related companies. work with you together, where you could show several different approaches to VR or another technology where they're saying simultaneously, there's a myriad of applications we can help here and here and here. And then also, I think it's valuable to point out, often these startups will say, yes, there are important. Right lines where, um, you have to qualify by delivering this kind of, uh, maybe it's a physician, uh, advisor, or it's clinically validated so that, um, both that makes it safer for the patients, and it also creates kind of a barrier to entry that benefits the businesses. Does that grouping, uh, happen in your industry, or is there a benefit to that?

Jenna Paldino: 38:34

You teed it up very nicely, Vic. Thank you. So we have, um, yes. So I love to form an alliance. So it could be an internal alliance, taking the stakeholders that you guys have on your books, or it could be an external. So there's grassroots and grass tops. So obviously the tops are, are, are you gentlemen there, you know, and the ones who are funding it. The grassroots are those who are startups who say, without a doubt, I'm going to continue until this is in everyone's hands. And they have that passion. They have that drive. And that's why we on this call got into this business to help elevate them, to get them the opportunity to sell it that way. So as American consumers, we're very excited to hear about the latest greatest, but numbers, like you just mentioned, a coordinated effort with similar tactics, similar types of business lines, and a similar target market. If you can tell me that three of them will benefit seniors mostly, then let's go. Uh, or if it's, you know, a certain population on this side, let's group them together.

Vic: 39:43

Yeah. So you could have behavioral health and then there might be. eight different disease states within behavioral health, where each company is kind of different, but they share your expense, but they also give much more. breadth to the story. It's a more interesting story for that reporter for that congressperson.

Jenna Paldino: 40:03

And there's a reason that they got involved in that startup. They didn't just wake up one day and say, I'm going to start this app. They had a problem. They're looking for a solution, right? Um, their story of the why is what gets me excited. I'm able to then Parlay that to why Senator so and so should care, you know, if we don't care then we're not getting anywhere your startup founders care enough to To blood sweat and tear this through.

Vic: 40:39

Yeah, and it strikes me that um, I typically am You know, probably bordering on the cynical side, but if I put that away for a minute, the representatives, whether it's state or federal, at some level, they want to find the solutions that the new bill, the new law that will help their constituents. And one way to look at lobbying is educating them and teaching them how this is important to their constituents that they're. has to go represent and it, and it, it can be very authentic and really sort of helping them understand why this matters.

Jenna Paldino: 41:21

And when they're elected, they're elected as, you know, attorneys, business owners, uh, chaplains, whatever their title is back home. They do not have a clue how to build a road or to staff a hospital, but that's where we come in. I don't really care about roads unless I need them, but I do care about the staffing issue. And I know how to improve it. And every time I'm asked, I'll give them 10 ideas. Let's, let's narrow it down for them. Take your technology and make it the top two ideas.

Marcus: 41:58

Okay. I'm, I'm, I'm really coming around to this, to this idea. Um, you know, but, but like, but, but in a, I mean, I feel like I need to think more about it, but I think from a long view, I'm starting to kind of understand better, um, One of the things that just sort of popped in my mind is that, you know, in our industry, um, everyone likes to act like it's not true, but a warm intro matters a lot, right? Like your ability to convert whatever your objective is, your ability to convert that thing based on the strength of an introduction into the decision maker is massive, right? And so I'm wondering, to the degree that you are trying to, Um, engage in partnership with the government is one way to think about this, that this simply creates, you know, as opposed to having like a hard objective, that just generally speaking, it also creates more warm intros, if you will, um, inside of your sort of large surface area of partnerships you could be going after over the course of, you know, 2345 10 years, right? Like, is that is that one way to sort of think about this?

Jenna Paldino: 43:19

I think that, yes, I think that the three of us probably have relationships that we could call upon that are 1520 years old. And I also have those. Those lead to other relationships. Which are nice to say that at the end of that call, at the end of that meeting, I always say, how can I help you? Because I came with an ask, yeah, I want you to institute this new technology Marcus has, and I really want this money, and no, nope. This is about how can I help them build their brand as a legislator, they have to build a brand in order to stay in office. And if they're a decent person and we like them, then we want them to stay around. And so we need to help cultivate their opportunities as well. So yes, it's fine to bring them to a ribbon cutting, but it's also really important to have them come speak to your board or a retreat, a staff retreat, or when your startups are in a strategy session, have them come in. I used to, I was a legislative aid as well. And I used to bring my member all the time to anyone that would have us. Anyone

Vic: 44:33

yeah, and I'm thinking about this as well. There's topics like we talked about hospital at home earlier. So I'll use that where. There's a lot of momentum moving towards more hospital like services at home, and I see a lot of benefits to that for, for startups, for the patients, for hospital, health systems, for providers, for the caregivers. And I also see, as you mentioned with the weather concern, things that, uh, need to be thought through so we don't have unintended consequences. And we clearly delineate between. what care really needs to be delivered in the inpatient setting, and what care can be better delivered at home, and what care is really home health, and we shouldn't call it hospital or home to be able to bill more. And um, is it something you do to begin shaping even the topic before there's really laws being proposed or bills being proposed, or is that too early? When do you start getting involved in these topics?

Jenna Paldino: 45:45

It's never too early to have a conversation with, um, some targeted individuals, and you bring them to your, to your office in Nashville and say, these are the concerns that we have in the industry for, let's use your example of hospital at home. These are the ways that we think our research can, can help, you know, mold this a little bit better. How can we help you on the policy side to navigate this before it becomes? A problem. They know what they're getting into. They appreciate the soundbite conversation and the talking points as well as sound data that, you know, you've had this program in existence for a year or two already, and you're working on it. So it's never too early. Now, would that same legislator expect to check on the way out? I do have to address that. I have to say probably, you know, they're spending some time coming to listen to your ideas. You have to listen to theirs. And you also have to be willing to possibly pony up a little money. Um, every dollar amount is different for each person. But, um, yes, I mean, that's their time. You owe them for their time.

Vic: 47:02

Yeah. So that's interesting. So it is, um, accepted practice by elected officials that in order to come learn, they would Expect to be compensated for that

Marcus: 47:17

through a donation,

Vic: 47:18

right? Yeah,

Marcus: 47:20

yeah, yeah, yeah, yeah, so I don't

Vic: 47:24

I don't mean I don't mean to imply a paid pay Anything

Marcus: 47:29

like that just but

Vic: 47:30

part of the expectation just so we're clear I mean, it's us learning is there is a an element of donation in order to Uh, justify their time to come and learn about an issue that I'm passionate about.

Jenna Paldino: 47:44

So, so there's less of an expectation when they're just starting out, right? Because they're fact finding. They're trying to figure out their district. They probably only know a certain population and they don't know that you're sitting in the corner making great products. Now, they've been in office a few years, things have changed, things cost more to get their message out. So you weigh that option of, you know, how you want to influence them.

Vic: 48:13

That's interesting. So, well, things cost more. They also have much more seniority and more power to get things accomplished the more years they're in office.

Jenna Paldino: 48:25

Their staff is bigger. Their, um, outreach is bigger. Yes, things change over time.

Vic: 48:32

Okay, yeah, I've been resisting that kind of donation process just because I'm a cheap Cheap afternoon, but I think it makes it makes sense. I understand it. I'm just not sure. I'm totally ready to do it.

Marcus: 48:51

Yeah. No, but I mean, we're just trying to under this was learning for us. Yeah. Right. I mean, uh, okay. So, so we're, we're, we're coming up at the end of time, Jen. And for me, this has been very, very educational. So thank you for taking the time to walk us through this. Um, you know, what, what, what didn't we sort of ask? What, what have we missed on, you know, before we, before we close out? But

Jenna Paldino: 49:13

I would say that win, lose, or draw when a candidate has anything happen, you know, from their election night, don't lose their number. They're coming back around. They often run again or they change seats. And those are the folks that you're already on the ground floor with. So Vic, if you write a check tomorrow and, you know, your family drags you to an event, By all means, get to know them. They may not win in November, but when you see them out at the grocery store, hey Vic, I'm coming back around. Oh great, great, you already know me. So don't lose sight of the long range goals of someone's trajectory.

Vic: 49:57

Okay, well Jenna, this has been great. Uh, maybe give people a hand off. How can they learn more about your firm? Uh, where should they go to, to hire you? How do they find you?

Jenna Paldino: 50:07

Sure, I, um, I curtail my, my contracts to the client needs. I, I don't have some blanket statement of this is all I do. I do the advocacy, the lobbying, the communications, you name it. I sub out to awesome, uh, fellow lobbyists. We all work together on this, but we're all healthcare experts. I'm on LinkedIn, Jenna Palladino. Um, my website's needing some updating, but it's paladinoadvocates. com and uh, hopefully I'll hear from somebody.

Vic: 50:36

Yeah. And we'll just reveal, we'll put these details in the show notes so they can easily click on it, but this has been really helpful. Thank you.

Marcus: 50:42

Yep. Uh, for sure. Thank you so much. Definitely give, given a Vic and I some stuff to offline talk about. I got to figure out

Vic: 50:48

a budget plan now.

Marcus: 50:53

Thank

Jenna Paldino: 50:53

you guys for the opportunity.

Marcus: 50:54

Yeah. Thanks Jenna. Thanks Jenna.

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