dumped out of county and because as he says, there are no skilled nursing facilities, between eureka bakersfield because there is a lot of elderly people that cannot live in the community and should not be dumped out of county i am the director of the services and we are the contract mode, of the ihs program here in san francisco, and we basically served the most challenging consumers and we all want the programs, and that was talked about that, and we will be rolled under the managed care essentially. and this is a very exciting time, and in terms of the healthcare field and it is a challenging time and you know, all of us, i think on the and not to change the program and not to be proactive and to do that, it is going back into the 200,000 that we need in terms of managed service organizations and what the hope is that it will help the non-profit community to be able to be competitive in the market place. they will be purchased by the managed care organizations and the hospital and the group and now everyone is pdsing that the only way that they can have an effective cost healthcare system, is