Prior to the rousing grand opening and ribbon cutting ceremony of our Avenues Recovery facility at the Eastern Shore, Shane Walker at WBOC talked with our National Director of Clinical Engagement, Russ Francome. Russ shared our approach to fighting the opioid epidemic and how we can all offer assistance to those heroic individuals journeying to sobriety,
Listen to our dreams for a drug and alcohol addiction free Maryland here:
Or, dive into the full transcript:
[0:00] Shane Walker: Hello, and welcome to another edition of Mid-Shore Focus. I’m your host, Shane Walker. In Focus this morning is Russ Francome. He’s the National Director of Clinical Engagement for Avenues Recovery Center. We have the grand opening of Avenues Recovery Center at Eastern Shore coming up. On Monday, we’re going to talk about that and the entire program, all of the staff that are there, all of the help that you can get. It’s a very comprehensive program. I can’t wait to dive into it. Russ, good morning. Thank you for being in Focus today.
[0:33] Russ Francome: Good morning. Thank you so much for having me. It’s an absolute pleasure.
[0:36] Shane Walker: Let’s begin by finding out what exactly National Director of Clinical Engagement means through Avenues Recovery Center, Russ.
[0:44] Russ Francome: Oh, man. I’m glad you brought that up. I would say if you can define it accurately, I’ll buy you lunch.
[0:51] Shane Walker: I love it.
[0:51] Russ Francome: Essentially, my role is that I am in charge. We are a national conglomerate, so we have eight facilities across the country, two of which now will be in Maryland. My job is essentially to oversee all kinds of community relations, outreach, and also just ensure best clinical practices nationally at each of our centers.
It touches on a couple of different hacks. It’s great with my background. I’m a social worker for 13 years and have been in outreach for quite some time as well. So, a place to all my strengths. It’s a blessing, and I’m blessed to work with Avenues.
[1:25] Shane Walker: I’m so excited to have you guys here in the community, opening up on the Mid-Shore. It’s kind of twofold. I’m a recovering addict myself. I’m an alcoholic; four-plus years of sobriety, and seeing the mission behind what Avenues Recovery Center at the Eastern Shore is going to provide is so exciting. Wow!
We talked a little bit about this off the air. They need it so great here on the Mid-Shore and the surrounding area. We’re going to be talking about the ways you can take part in the program. But let’s begin, Russ, with exactly what Avenues Recovery community and Avenues Recovery Center Programs are. How did all this come together?
[2:03] Russ Francome: First and foremost, I appreciate your disclosure.
[2:07] Shane Walker: Oh, yeah.
[2:08] Russ Francome: I think people like yourself being open and a public person like yourself. That’s how we’re going to really defeat the stigma here.
[2:16] Shane Walker: Yes.
[2:17] Russ Francome: We are a very visible company. We don’t dress ourselves up as some kind of spa. We’re a treatment center. We’re in your local community. We’re serving your local residents. That’s how we started. We started with a program in Pennsylvania. It was our initial facility in Bucks County, and it expanded from there to the point where now, we’re eight facilities across the country. We’re opening, like you said, right in Cambridge. There are 104 beds, once it’s at full capacity, which will take some time.
[2:43] Shane Walker: Wow.
[2:44] Russ Francome: And it’s large. It’s very large, but the building is extremely well situated that even at full capacity, it’s going to remain intimate. It’s a very, very large building. It’s in a beautiful area with a beautiful water feature there. It has a gym inside and outside, like basketball courts. So it will be very comfortable, yet at the same time, it’s treatment-focused.
We’re clinically-focused. We’re not the kind of place where you’re going to come in and where we’re going to discuss waterfalls in the foyer, and what kind of private chef we have, and things like that. We are a focused-clinical program. We’re here to help people get better, not to help people go on vacation.
So that’s what we’re about. We’re about our clinical treatment. We’re about individualized care. As you mentioned, you know better than anyone that when someone takes that first step toward getting help, self-worth and someone’s self-esteem had been just destroyed, our job is to love them until they can love themselves, and bring them in and treat people with dignity and worth and do so in a comfortable environment. That’s what we’re here to do.
We’re here to help the whole community of Cambridge. Our firm philosophy is that we believe treatment should be inclusive and not exclusive. How we go about that is by working with all commercial insurances as well as Medicaid. We want our clientele, [inaudible 4:11] to be representative of the Cambridge community. We’re not travel agents; we’re not trying to bring people in from outside to repopulate the Cambridge area. We’re here to serve local residents, and we’re here to be a part of the fabric of the Cambridge community.
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You’re listening to Mid-Shore Focus. Russ Francome is my guest. He’s the National Director of Clinical Engagement for Avenues Recovery Center. We have Avenues Recovery Center at Eastern Shore located at 821 Fieldcrest Road in Cambridge. If you want to get in touch with them, you can do so electronically at admissionsavenuesrecoverymaryland.com and also call 410-673-4600. A super, comprehensive, easy-to-navigate website at https://avenuesrecovery.com. I recommend that you go and read along with us.
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[5:02] Shane Walker: So, Russ, I want to begin at the beginning – the different programs and experiences at Avenues. When someone makes that decision that it’s time to – and I also want to ask this. Maybe let me ask this before we get into the programs. Is this an “I need to get myself help” program, or is this “My spouse, my son, my daughter, my brother needs help,” and you cannot admit someone on their behalf, but get help for them? How exactly does this begin?
[5:38] Russ Francome: Sure. I think it’s a combination of everything. I always like to say, it never really bothers me what gets people into our door, so long as they come. Whether it’s a self-mandate, someone’s really ready, and they are ready to engage that on a personal level or whether it’s sometimes – I like to use the word momdate, where it’s a family get-together, and they do some kind of intervention or just let people know.
Once someone knows that their addiction is affecting other people and family and loved ones, puts them into treatment. Or whether it’s legal, or whether it’s a job or an employment situation. It never matters to me what gets people in the door. The fact is that we just want them to get in through our process, obviously starting with a medical detox where necessary.
Based on the length of their stay, they’ll start to feel the benefits of recovery, and that’s what’s going to keep them in treatment. That’s what’s going to keep them engaging in our clinical services. So to answer your question, it is a combination of all of those things.
Ideally, you want someone to come in and be ready. You know how addiction works. The ramifications of someone’s addiction and the punitive measures that come along with that sometimes push people into treatment, and that’s absolutely fine as well. Sometimes, people need to feel that consequence.
Unfortunately, the absence of that consequence, a lot of times, precludes people from coming into treatment. So, sometimes, it is that punitive action that pushes them in. Then, that doesn’t minimize from their journey by any stretch of the imagination. I don’t care if they’re driven there in a cop car, not that that’s a normal scenario. It doesn’t preclude or doesn’t take away from the achievement of someone gaining long-term sobriety. As you know, it’s a very difficult journey.
[7:26] Shane Walker: Yeah.
[7:26] Russ Francome: What starts that, whatever the catalyst is, is minimal, in my opinion. It’s all about the journey once they come in – whatever brought them in. So a combination of all of those things, I would say.
[7:40] Shane Walker: And it’s important to point out that the Avenues Recovery Center at Eastern Shore is an Eastern Shore Maryland drug and alcohol recovery center. So, we’re going to cater to your addiction, no matter what it is. But it’s tailored. I talk with people about addiction and recovery, and I say, “Everybody’s different, so everybody’s experience is going to be different, and that includes making the decision and taking the steps to recover.” We’ve talked about that already. So when somebody walks in, take me through it, Russ. “I’m done. I’ve had enough. I can’t do this anymore. Please help me.”
[8:14] Russ Francome: Sure. The first thing that would happen is they would be dealing with our admission staff who are available 24/7 at the number you mentioned before. That can also be done virtually through the website, where they can chat with a live, real employee. I assure you it is not a robot. And then start to engage the process.
What happens is, initially, there has to be a verification of insurance. We get the insurance information, whether it’s commercial or Medicaid. We verify that information extremely quickly. We understand that there’s a very small window of willingness for someone to enter treatment. My job, my team’s job, our job as a company is to remove as many boundaries as possible. So, wait time is one of them.
The big thing, for me, is it goes to the core of who we are as a company and what we represent. We’ve widened the eligibility for treatment. We’re one of the very few private treatment centers in this country that accept Medicaid as well as commercial insurance. What that allows us to do is to really come in here and say like, “We want to be a part of this local community. We’re here to help the entire community, not just a small subset of it.” So when I say treatment should be inclusive rather than exclusive, we’re not just looking for specific premium insurance in order to help someone. We’re here to help the whole person, the whole community.
Someone comes in. They contact our admission staff; however, they get in touch via phone or email or through the website, like you said. There’s a phone screen done, a very short, quick phone screen that determines and allows us to set up for the person coming in the door. It will be determined what level of medical intervention is going to be needed.
As you mentioned, specifically with alcohol, benzo dyads, [inaudible 10:00]. It’s a very dangerous detox, and people are very scared to go through it. We’re prepared for them. When they walk in the door, we have a baseline of information that goes right to our medical staff, and we start the process right away as far as comfort, medications, and detox medications. And we start to integrate them into our clinical care right there and then.
Obviously, detox is a medical procedure. We have a very high level of medical care, but we also bring in clinical experience right from the beginning. It’s not that someone’s going to be sitting in their room like vision a hospital bed, essentially. This is a community experience. As soon as someone’s able to and willing to and feels good enough to engage in our clinical process, we push that as soon as we possibly can. We want rapid engagement at the clinical care.
The other part is that communication with the individual support system happens right from the beginning. So whether it’s a safety call to a family member or whoever the individual is that’s in support of our client, that starts right in the beginning. We’re also going to get collateral information from these individuals, collateral information from employees if the employees made the referral, from the legal teams that may be involved, from the loved ones, the parents, the kids, the grandparents. We’re doing a holistic assessment on what’s going on. What is the situation with this individual, and how best can we individualize our care to their needs? That’s completely key.
As you mentioned before, no one’s addition is the same. Addiction doesn’t discriminate. It touches all levels of our society, and we need to individualize someone’s care to their individual needs. That’s what we do, and we’re very proud of our clinical care.
[11:59] Shane Walker: Residential treatment program – how does that work, Russ?
[12:01] Russ Francome: We have to detox clients going to residential. What it is, it’s seven days a week. It’s onsite. It’s treatment all day, every day. It’s learning and unraveling the individual. As you know from experience and everyone who’s gone through addiction and is in recovery, as you take away the substance, feelings come. The weight of the past comes.
All of the things that have led to that active addiction going on for so long start to come to the forefront. It’s a very raw emotional time for someone, so what we do is we surround them with genuine care with dignity and respect. They get to start unravel those feelings in a supported environment. I think, specifically, with COVID, people feel alone right now. There’s a real lack of connection. Everyone knows about an opioid epidemic. It’s talked about on every radio station, TV station, but people don’t talk about it in intimate terms. Everyone knows it’s there, but let’s not–
[13:07] Shane Walker: Let’s not talk about it.
[13:09] Russ Francome: Yeah. Not in my school, not in my family, not in my college.
[13:10] Shane Walker: Not in my town.
[13:12] Russ Francome: Exactly. I assure you that it is. I assure you it is because we treat your nurses, we treat your lawyers, we treat your judges, we treat your emergency workers. It touches every single level of our society. And it takes people like you being brave and being very transparent with their own situation to really start to normalize it.
So when people come into treatment, this aspect of community is almost overwhelming to realize. Imagine a full capacity with 104 clients. You’re there with 103 other people that are going through exactly the same thing you have. So it’s a really beautiful, invigorating supported kind of experience. People really thrive on that. You’re not alone. You always think, “Oh, the things I’ve done. I’m the worst. No one could have done the things that I’ve done to support my addiction.
[14:09] Shane Walker: I don’t know what you’re talking about.
[14:11] Russ Francome: Yeah. And then you sit in a process group, and you’re like, “Man. I’m genuinely not alone.” The negative, intrusive thoughts that I’ve had that I’ve never told anyone about before that have driven me to self-medicate and quiet those urges, and that negative self-talk. Everyone else is experiencing the same thing. They start to share it, and it’s this extremely powerful process. It’s a beautiful thing to watch from the outside.
As I mentioned, I’ve been a social worker for 13 years. I’ve started my career working with gang-affiliated youth. Obviously, my own family has a significant history of addiction or mental health. It’s the most beautiful thing to do this for a living and really, genuinely get to witness change.
We witness a lot of pain along the way, too. The stakes are high. We know what we’re doing. Again, we treat every single person that’s going to walk in our door with dignity, respect, and love until they can love themselves. Then they start to love their neighbor while in treatment too. What happens, especially with our length of stay, it creates this really pure positive peer-to-peer interaction within our services that it’s not just the interactions with the clinicians that are very powerful in someone’s recovery.
They access with their peers, and the interaction is with their peers. If you and I are in there, and I’m on day 3, and you’re on day 45, and we’re outside, and we’re chit-chatting, and I’m talking about, “I just don’t know if I’m going to make it. I think I’m going to leave.” That positive interaction you can have with me as a peer is sometimes more powerful than any clinician could ever have with a client.
[16:07] Shane Walker: Yeah.
[16:09] Russ Francome: It’s so pure of motive. Don’t get me wrong. As clinicians, we don’t do this to become millionaires. We do this to help people. But still, it’s that kind of peer-to-peer interaction with someone that looks like you, that’s been going through the same thing. That is sometimes the thing that just sticks with someone. That’s what it’s about. Something will stick, and it’s about holding onto that thing.
Throughout someone’s treatment, times get hard, and you can always go back to that moment where you heard that one thing that really clicked, and it will keep you in there for another day. It’s one day at a time until you get to the point where you feel confident enough in your own recovery that you can start helping others, and then that leads you in your recovery as well. It’s honestly a beautiful thing to witness on a day-to-day basis, and I’m really happy and proud that we’re coming to Cambridge and bringing it to the Eastern Shore.
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You’re listening to Mid-Shore Focus. My guest today is Russ Francome. He’s the National Director of Clinical Engagement for Avenues Recovery Center. Avenues Recovery Center at Eastern Shore is on Fieldcrest Road in Cambridge. We’re going through the programs and the process that comes with involving yourself on your road to recovery.
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[17:24] Shane Walker: We’ve covered detox. We’ve covered residential treatment a little bit. Partial hospitalization, Russ. How is that working with Avenues?
[17:31] Russ Francome: Partial hospitalization is essentially a step-down service to keep people in our level of care. What it does is it allows us to go past the traditional kind of 14 to 28-day treatment stay. Unfortunately, in the treatment industry – you know, it’s funny because we’re dealing with an epidemic, and there’s more treatment available today than there ever has been in our history as a country.
People say to me, “Why isn’t it getting better?” First, the big thing is, like we talked about initially, the stigma. That’s a huge part of it. But, secondarily, services are disjointed. There are levels of care for a reason. It takes a community; it takes partnership with other programs. But what happens is, clients will come in for just detox only at some places. Maybe they only offer detox, and then they refer them out to another facility.
Or, alternatively, a lot of commercial insurance, what they do is, they drive the length of stay of someone in treatment, so an insurance company can say, “After 14 days of residential treatment, we have to do a doc-to-doc review, and we feel like this person can step down,” is what they’re saying, and we’re like, “Absolutely not.”
[18:45] Shane Walker: Yeah. They’re not in the picture.
[18:47] Russ Francome: 100%. With Avenues, the other part that’s beautiful about what we do is, we’re so extremely focused on utilization review, which is that fight. It’s the fight that happens behind the scenes that allow people to extend their length of stay with us. When an insurance company tells us, “No,” we don’t say, “Okay. Thank you very much.” We fight them, and that’s what we do, and we do it very, very well.
They are the unsung heroes, externally anyway, because I think they’re rockstars. They’re the unsung heroes of our facility and our company. The PHP, what allows that to happen is, for a lot of other programs, when a client hits the 14-21 days between detox and residential, and an insurance company says, “That’s it. That’s enough.” They’re being referred out to outpatient.
They’re going back to a toxic environment. They’re potentially going back to work if that’s the scenario, too soon. Then, all those triggers, the anxiety, the depression – the home situation hasn’t had a chance to get healthy too. Because, remember, addiction is not an individual disease. It’s a family disease.
[19:58] Shane Walker: Absolutely.
[19:58] Russ Francome: So what we need to do, and a big part of what I love about my job, is not only helping the individual – that’s the person in treatment. They’re going to be fine when they’re with us. It’s helping that home situation, too, that they’re coming from, be that educating the parent or loved ones, husbands, wives, grandparents.
What addiction is, is not like a failure of personality. This is not like a decision like a choice that’s someone making willy-nilly to use drugs and alcohol and negatively affect their family life. It’s so much deeper than that. So, a big part of what we like to do and what we need to do as a company and as a community in this field is to continue to provide education and services to the family and the extended support system. So that’s what we do.
The PHP program allows us to take people back or keep people in treatment, should I say, past that 21 days, past that 28 days. Now, we’re talking about keeping people for an extended stay, and we’re talking about a foundational stay in recovery – people hitting milestones while in our supported environment.
The biggest milestone anyone can ever hit is the 24-hour milestones. The tough ones are, by far, the hardest. Then you do have other markers – 30 days is a huge marker. It takes substances a while, not just medically, to leave the system, but psychologically. It takes a while for the brain and body to unwind and process all that kind of built-up trauma that I discussed before.
When those feelings start to come back, that all needs to be processed. That’s an extremely raw time in someone’s recovery. It may take two to three weeks for them to even start to feel that process. Now, if I was to say I’m going to release them back to their house and go to outpatient at that point, my personal opinion, and I think anyone in this industry’s opinion, would be that is setting someone up for failure.
Sometimes, it’s not the treatment center’s fault. A lot of times, there’s nothing anyone can do about it. All you can do is put supports around them and really hope for the best, and remain engaged with them. But what we like to do is we like to keep them in our services throughout that process.
So, post-acute withdrawal, emotional regulation, and potentially, you’ve got to add in the fact that 90% of clients that come into any treatment center across the country are going to be dealing with some kind of co-occurring issue. Now, that could be substance-induced. It could be anxiety and depression based on one’s addiction. It also could have come before the addiction, and they’re self-medicating.
It’s that age-old question: what came first – the chicken or the egg? I firmly believe you cannot answer that question in 21 days. You cannot answer that question in 30 days. You have a much better chance of answering it in 60. What that allows for if there is the need for some short-term medication to deal with whatever that underlying diagnostic issue is, it will allow that medication to adjust and take hold because it’s not like someone takes medication for depression and 24 hours later, they’re feeling great, and the medication is working to optimum efficiency. It takes time.
We allow for that time to happen, and that process to happen organically and clinically in our supported structure. What that allows for is by staying in treatment, they don’t get to go home and potentially backslide and go back to old faithful and crack open a bottle or use some drugs in order to deal with the symptoms of that underlying issue. They stay in treatment, and that medication gestates, and adjustments can be made.
People find their true baseline. If we can improve people’s baseline and we can improve people’s ability to function and deal with and identify what their own personal struggles are and what their underlying issues are, then look, we’re not curing addiction, but we sure are giving them a much better shot at obtaining long-term abstinence and, hopefully, long-term recovery. That’s our goal.
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Avenues Recovery Center at Eastern Shore also offers intensive outpatient and silver-living programs. You can see more about them at avenuesrecovery.com.
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[24:26] Shane Walker: In the interest of running short on time, Russ, I want to go back to something that you said earlier. I say to people who ask me about addiction and recovery, be it just a layperson who wants to know about my story, but also to people who are going through the process.
And I’ve not heard anyone say this in my four-plus years of recovery until you said it today, and that was, the process is scary. The thought of the process is scary. Russ, I will tell you, I did not know – I did this myself. I did it cold turkey with the help of a couple of people when I got into my journey, but I did not expect the thought of going through 24 hours without several drinks was going to be so terrifying. I thank you so much for saying that this is scary, and that it’s okay to be scared.
[25:21] Russ Francome: I appreciate that, and I think if we don’t acknowledge that, then we’re contributing to what’s allowing this epidemic to continue. People have to know that this is not a failure of some kind of an individual or willpower. This is a legitimate medical issue, and it’s uncomfortable, and it’s scary, and it is one of the bravest things anyone can ever do to put themself first, to a degree, and come into treatment. It is by far the bravest thing someone can do.
So I think when people do it, we really need to applaud that they were able to say despite all of these kinds of fears, concerns, and genuine concerns. People are worried about their jobs, their families, their pets, their kids. There are a million reasons for people not to come into treatment, so when someone says, “I’m willing to do it,” they need to be celebrated because, in that moment, they are a rockstar.
In that moment, they were the bravest person on the planet, and if we don’t acknowledge that and acknowledge how difficult it is, we’re doing them a major, major disservice. I don’t care if someone goes to treatment, comes out, and use again, and have to come back in. That is not a failure. That is an acknowledgment that “I tried this once, and something went wrong along the way.”
We have to be introspective; we have to look at what went wrong. What can we change this time around? It’s almost braver to come back in the second time. It really is. Some of the people I love the most and respect the most in this world are in recovery. If a facility said to them – a lot of my people I know took 10, 15 times to get treatment, to get help, and to get better.
If a treatment center turned around and said to them on like a third admit, “You tried this two times before,” and didn’t acknowledge what this individual’s going through, the world would be a much less bright place without those individuals in it. So we do not make decisions like that. We accept everyone into treatment. We are here to help acknowledge the fear, acknowledge the struggle, and love them until they can love themselves. I think that’s got to be the underlying theme here.
[27:45] Shane Walker: Can we come and check out the facility, Russ?
[27:48] Russ Francome: Absolutely. We’re doing a grand opening on the 21st. We’d love to have people there. They can check the website for more information. I think it is important people see it. Again, we don’t dress ourselves up as a day spa. We’re a treatment center. Having said that, it’s a beautiful treatment center. It’s on a very large property. It’s private; it is comfortable; people have access to their own rooms. There’s an internal basketball court, yoga.
We believe in a holistic approach, so while someone’s going through that very scary, painful, emotional process, we like to keep them as comfortable as possible and introduce ways for them to deal with that internal, emotional process, to start to sublimate those feelings. Yoga, for instance, is a great way for someone to utilize for relax or prevention. Maybe that’s something they could take into our lives. We have to replace the addiction with something.
[28:49] Shane Walker: Yes.
[28:50] Russ Francome: Otherwise, there’s this concave in their soul. So we have to fill that up with something, whether that’s therapy, whether that’s going to the gym, whether that’s yoga, whether it’s reading. It could be writing. It could be a million different things. There are so many positive ways to replace addiction, but we have to find out what works for the individual.
So we like to try all of those things while they’re in our supported environment, not just keep them clean, they’re in treatment, and then 30 or 60 days later say, “Okay. Good luck out there.” We have to start to process that essential transition while they’re in treatment, and that’s also extremely important. We work on discharge from day one.
Why that’s important is it’s easy to stay sober in treatment. It’s not easy because you can always walk out, but you know what I mean, in a supported environment – it’s when you leave that everything you learned gets tested. If we’re not preparing people for that transition, we’re doing them a disservice, and it’s a huge focus of what we do clinically.
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Avenues Recovery Center at Eastern Shore is at 821 Fieldcrest Road in Cambridge. You can contact them via email at admissionsavenuesrecoverymaryland.com, 410-673-4600, avenuesrecovery.com. Russ Francome is the National Director of Clinical Engagement.
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[30:19] Shane Walker: Russ, four-plus years into sobriety, this conversation has gotten me excited, once again, about continued sobriety journey and recovery. For those who you’re going to serve here in our area, I can’t wait, man. I wish you much success, and thank you so much for talking with us today.
[30:36] Russ Francome: Oh, thank you so much for having me, and we’d love for you to remain involved with us. It takes people who are courageous like you and who are visible. Being visible is a very big deal, and it’s the only way to defeat the stigma. We’ve got to be visual, and we’ll be out in the community helping the community in every way we can.
We’re going to be vocal, and it takes people like yourself supporting us in that, and we’re going to be local, so you’re going to see us, and we’re going to be here. We’re here to help absolutely in any way we possibly can in local community organizations, local EMP, local radio stations like yourself, any way that we can help you and your listeners, we’re 100% going to do it. I can assure you of that.
[31:13] Shane Walker: I love it. Russ, thank you so much for being In Focus this morning.
[31:16] Russ Francome: Thank you so much for having me.
[End of Mid-Shore Focus episode 31:26]