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Opioids Are Not The Problem

-Badly broken systems at every turn impede recovery and behavioral health-

By the time I finish writing my blog, How About We Think Out Loud?, many families in America will be shocked, horrified, and devastated at the loss of a loved one to some form of opioid concoction – probably heroin and Fentanyl. It’s tragic, indeed, but predictable. Insensitive? Perhaps, but tell me after you read this by leaving a comment.

 All the politicians and their crisis task forces and the media with their expert interviews are searching for answers. The State of Vermont made it their number one priority almost two years ago. Other governors and federal agencies are pouring millions of dollars into existing treatment agencies and their Help Lines. Very good and dedicated people are participating in large coalitions of frightened citizens down to a handful of folks at church information nights. They include professionals from law enforcement, behavioral health, education, media and medicine.

The deaths continue every day in all zip codes, but opioids are not the true reason.


-What was built to help is badly broken-

What we thought were responsive behavioral health systems are overwhelmed, ill prepared and struggling for answers when the TV microphone is pointed their way. The behavioral health infrastructure has been broken for years and is a serious part of the current inability to respond. Opioids are not the problem. The preparedness to respond to a neighborhood, county, state or national behavioral health rampage is not in place. It’s the toughest pill to swallow but it is painfully apparent to me. Mental health remains the bastard child of healthcare – hospital administrators say it takes up expensive floor and bed space. Insurers still do what they can to avoid a fair reimbursement while they deflect subscriber calls for help. One family was referred to a hospital in Buffalo, New York that was closed for about five years. Even now, they limit the number of mental health providers approved to be on their panel – parity laws have been window dressing, let’s face it. Ask any parent or spouse who called to get help if they felt compassion on the other end of the phone. Yes, there are some wonderful people on those lines, but they are not the majority. A depressed and suicidal teen might wait 8-12 weeks to see a child psychiatrist and 6-8 weeks to see a psychiatrist treating adults. Psychiatrists are opting out of the intentionally cumbersome approval and paperwork processes, imposed by insurance companies, to see their patients hassle-free. If you are a trained clinician from another state with a Master’s degree in clinical psychology or marriage and family therapy you cannot get a license in New York State or get on any insurance plans. Sadly, these issues date back 30+ years, but it has created a shortage of approved providers.

Our prison facilities now treat more of the mentally ill than our psychiatric hospitals by a very large margin. Many jails refuse to administer certain medications claiming safety concerns while watching inmates go through the horrors of withdrawal even when the individual has a legitimate physician prescription. I’ve mentioned broken systems and I’ll add inhumane, too.


Prevention funding goes very heavily toward addiction prevention with very little mental health messaging. It should have always been behavioral health education, instead of splitting the two, but then again most schools do not have nearly enough behavioral health education in the curriculum – it needs to be in K-12, especially with the amount of trauma children experience or witness. Consider this, two years ago more than 1,400 high school students in the Buffalo Public Schools attempted suicide. I co-chair the Mental, Emotional and Behavioral Committee at the Buffalo Public Schools. We received a solid three-year grant from a large, local foundation to address the high rate of suicide attempts and our committee’s efforts proved successful. District administration, I’m told took responsibility for filing the required report to the foundation, but failed to meet the deadline and the grant was rescinded. Accountability, you ask? None. Broken? Painfully obvious. A senior member of all our efforts was given two minutes to make an annual report and the minute she got to the podium every School Board member went to their cell phone. Another seriously broken, yet critical system for children’s mental health looking the other way.

Fresh out of graduate school, I was employed as a Supervisor of a 30-slot adolescent day treatment center (8:00 a.m. to 6:00 pm – M-F). I carried a caseload of 10-12 teens. We were required to provide individual, daily group and family therapy to our clients. It was during those years, in the late ’70s and early ’80s, I learned not one of the teens woke up one day and said, “I think I’ll become a drug addict.” UBMD Addiction Medicine’s Dr. Rick Blondell says the same thing about opioid addicts today in 2017. No one wants this life. No one wants any illness, right? The tragic reality is other diseases have far better systems, professionals, and community support in place to respond and I salute those who do.



Fragmented healthcare systems caught up in creating the next best program, company name or theme have been missing the core humanity of behavioral illnesses, namely, people and their families are in pain and full of fear. The simple things like a human being on the other end of the phone, getting compassionate, but more importantly, helpful information they can use, a warm touch of comfort, a follow up call and a payor working with you instead of posing confusing alternatives and long waits. How is someone dying from opioid abuse any less critical than the guy who walks in to the local emergency room with chest pain? I’ll tell you. People look at the chest pain patient as potentially close to death. Even healthcare providers, who are supposed to be beyond any prejudice, treat addicted patients with a different watch. They are not trained, need active listening skills and are not usually held accountable for poor hospitality. Patients with a behavioral need or disorder wait double the hours even in our million-dollar renovated emergency rooms.

My degrees, continued studies, executive positions, committee posts, mentoring and 35+ years experience working in this field brought these broken systems to the surface. What I’ve heard very loud and clear is too many services are not working toward a positive outcome and patients feel they would be better off with cancer. They hurt. As a therapist in Florida, my teens were victims of sexual abuse, incest, school failure, home failures, bullies, parental abandonment and used by dealers interested in creating new customers. They needed to be heard with “unconditional positive regard.” In those days, alcohol, marijuana, and Quaaludes were given away to troubled kids – like opioids and heroin today. Many dentists are still prescribing Lortabs for extractions despite what we know. Middle school and high school athletes with injuries are also given powerful painkillers. But we don’t dare confront the physician’s practice regime or tell a dentist how to treat a patient. I went to a local managed care company and was told, “we can’t tell them (dentists) how to practice.” No accountability.



-Every Visit is an Opportunity to “Check-in” with Your Patient-

Although there is a great deal more broken, the concept of primary care and behavioral health gets talked about today as if it’s some new brilliant idea or medical break through. The truth is it has been window dressing, not practiced, and fundamental screenings are not conducted at opportune times. I attended all of the Health Home meetings at WNED when the concept was taking a small step forward; however, I was deeply concerned because the thrust of much of the activity was jockeying for turf and forging power bases to keep others out. As an independent, I had fresh eyes on a tough subject. I’ve been advocating major changes for years as I felt it was a calling and a professional duty. I was lucky to have a platform on radio with Mind Matters on Oldies 104 FM, Frankly Speaking on WBEN 930 AM and for 16 years with Spotlight on Health. In Buffalo Business First, I wrote about workplace behavioral health (and primary care integration in 1991) as a regular guest columnist in the ’90s. Recently, my volunteer time has opened my eyes to the inexcusably broken way we care for our veterans with mental illness and addiction and I was actually criticized a few years back for “doing what the VA was paid to do.” I was criticized for supporting the emerging WNY Heroes, Inc. and bringing in Barbara Van Dahlen, Ph.D., named to TIME Magazine’s 2012 list of the 100 Most Influential People in the World, president of Give an Hour http://www.giveanhour.org. A colleague of mine told me about Give An Hour and suggested we become a chapter – turns out we were the first in the country. For veterans with a mental health or addiction legal challenge, I created Take a Case with the Erie County Bar Association. In August 2016, a musician buddy of mine and I were sipping a ‘Cup ‘O Joe’ at Spot Coffee in Orchard and we talked about the mental health tragedy of veteran homelessness. In about an hour, Buffalo Blues for Homeless Veterans was born and we agreed to a big bash benefit at Sportsmen’s Tavern in Buffalo, N.Y. with a CD featuring all local musicians called HOME was produced by this same buddy, Bob James. Bob took the project and concept to 10 more bars and found creative ways to support veterans, including getting Mayor Byron Brown and County Executive, Mark Polancarz involved – all benefitting the WNY Veterans Housing Coalition run by Celia O’Brien. Bob raised a nice chunk of money and the veteran condition was given the attention it needed. A badly broken government service agency further crippled mentally wounded veterans, yet a community of western New York musicians led by a former mental health agency executive and a Buffalo Music Hall of Fame musician, all in one, created a response. One of the major reasons so many systems are broken is the lack of creative solution development – and I don’t mean form a committee.

I’ve become a Reserve Deputy Sheriff on the Scientific Committee in Erie County that has given me more and more perspectives to see opioids are not the problem.



Extremely dedicated professionals, many my long-term friends, in the behavioral and neuroscience fields are doing herculean work. They serve on committees, take the 3:00 a.m. crisis call, go to the jails, sit in the ERs with frightened parents, march to Albany, battle prejudice and stigma, buy food out of their own pocket for others, sit with the addicted 3.0 lbs. newborns, talk the veteran out of suicide and much more.

Tragically, that precious time to save a life is within a badly broken behavioral health system that wastes that life-saving time, government and grant money, and defends the broken systems. All the combined systems created to ease anxiety, support treatment, and achieve a happy path in life are doing the polar opposite in too many ways. Therefore, accept that opioids are not the problem. See that the recommended roadmaps to recovery are filled with broken pathways poorly structured to address this opioid crisis, and so people will continue to die in the hopeless hallways jammed with addicts, mentally ill, spouses, parents, boyfriend/girlfriends and family members suffering in broken systems. How many died today?

What do you think?

Tom McNulty

Tom is a consultant who facilitates change, develops marketing plans, conducts program evaluations, builds creative programs and conducts presentations along with speaking engagements. He’s hosted 800+ radio shows, produced five short films and three long form television specials. He is an adjunct professor at Hilbert College for six years teaching two MPA courses on Financial Resource Development and Marketing and Public Relations. He is founder of a not for profit, Spotlight on Hope, Inc. in 2005 and president of his firm, Success Stories, Inc. since 1990. He is a screenwriter and currently in production of a full length film in the field of behavioral health. He resides in Orchard Park, New York with his wife, Nancy. They have three adult children, Ryan, Colin and Bridget. (716) 481-4578 or tomsuccess@verizon.net




Still Red, White & Blue

Still Red, White & Blue

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My absentee ballot was cast days before the election as I would be flying back to Buffalo on Election Day. No lines to worry about or figuring out what time of day would be best. My schedule, like all of yours, is very busy. I got home by 1:30 p.m. and Nancy walked in after 5:00 p.m. I was tired from changing planes and she had more than a full day with elementary-age students.

We agreed not to put the TV on until around 9:00 p.m. We were hoping to avoid any more hype, stories, profiles and mostly those ever-reliable polls. In a strange, yet similar sort of way, it was like Super Bowl Sunday. We didn’t need a review of every Super Bowl going back to the Green Bay Packers – Joe Buck wasn’t even born yet so we got to avoid his superfluous yapping about nothing. We figured the reporters would be all warmed up on the competing stations and the fringe ones, too.

As if it was kick-off time, we turned the 60″ Vizio so we could see everything including the replay of a reporter calling a state before a competitor. You understand, don’t you? Their lives, then their jobs depend on who calls Ohio first and prays it holds up with no bent corners on the ballots found the next day. It’s 9:02 and the screen with all its red and blue TV station stages, whiteboards, touch screen technology and a very puzzled analyst tries to relay the numbers, after they have been double-checked and triple-checked, to a high rise table where totally baffled reporters look at each other hoping someone will  s t r e t c h the conversation or go to commercial break. My wife and I look at each other as if to say, “are you seeing what I’m seeing?” Trump has a considerable lead. We sigh and say, “we’ve seen this before plus there’s always California and it’s only about 6 o’clock there, right?”

Suddenly, like unpredictable weather coming upon you without warning, it happens. Hurricane brewing in Florida, flash flooding in Ohio, black ice in Georgia, mudslides in Michigan and forest fires in Pennsylvania. Armageddon? You’d think so if you watch any of the TV stations. Trump’s numbers are becoming too hard to catch. No longer are reporters looking to call any state in fear of getting dirty looks right through the TV set from the Hillary Team or Donald Trump’s camp claiming the “rigging” is starting. Oh, what a night!

At 11:00 p.m., Nancy said, “nothing’s happening until morning on Good Morning America” – now without Billy Bush (no, not related to them). Then 2:00 p.m. comes and goes and Nancy’s still right, so I call the great state of exhaustion the winner and go to bed.

The next morning at 7:00 a.m., I find out the reporters, probably in unison, declared Donald J. Trump the next President of the United States. Deal with it America. You won’t lose your right to speak, propose new ideas, volunteer to help veterans, plant trees, support advancing women’s causes, help turn around the obesity epidemic, read the sports page to an old fella in a nursing home, run for political office, volunteer at your school, break the stigma of mental illness or start a company. The point is to move on and do something productive to improve the human experience. Isn’t that how we became a great country? God bless America, land that I love.

OK folks, who’s with me?

Looking for a speaker at your event? Contact me at tomsuccess@verizon.net Thank you!

At a Crossroad?

At a Crossroad?

Yes, I’m older than you, well maybe. I watched The Ed Sullivan Show, Rawhide, comedian Rich Little, Bonanza, The Monkees, I Dream of Jeannie and there were never any bleeps.

My wife will occasionally (she’s much too smart to be a regular) watch The Bachelor. This is a reality show designed to bring two people together who will love each other for eternity. Therefore, one might think the participants would work hard to impress the other – certainly the “prize” bachelor. I’m in my recliner on my computer catching up on emails and such. I start to hear a series of bleeps and fragmented sentences. I glance over and see several post-pubescent women apparently swearing and clearly dropping the “F-bomb” often. It must be the number one favorite swear word to use to:

A.) Impress people with your vocabulary

B.) Demonstrate that you have a strong opinion on a matter of importance

C.) Show people what anger management is NOT

D.) Make your parents proud of you on national television

E.) Imitate (pick any) a brainless Kardashian

F) Impress your future husband and his family

Aren’t you tired of all the swearing beeps on TV and the blatant swearing in music – mostly rap and ‘gangsta’ musical expressions? The Wolf of Wall Street was ruined by the overwhelming number of swear words and disgusting references to lewd acts. My father – not a prude-  always told me, “people who swear often usually do so because they are deficient in vocabulary skills.” To this day, he’s still right. Enough.

I swear, but not where anyone can hear me. I swear in my car when a woman in a Cadillac Escalade is on her cell phone and just cut me off. I do not “flip the finger” at her as I drive on. I swear at myself when I misplace my keys and I’m already running late. I swear when I stub my toe in the dark and it’s hard to understand because my teeth are clinched tight and saliva went flying a short distance. OK?

But I am so very, very tired of all the swearing all around me. I was in a City of Buffalo High School – SouthPark High School in South Buffalo a few weeks ago for a meeting. The bell rang as I was in the middle of the hallway and a flood of students came out. The first thing I heard was from a young girl who just had her rear end grabbed by a guy…”get the “F” off me, “B” she said rather loudly. I asked her if she was OK and the two male students said, “what you gonna do about it punk ass?” I did not respond and continued. Along my way, of only about 100 feet, I heard lots more pretty harsh language. It was also heard by two school personnel waiting at an elevator. It was painfully apparent, they were numb to it all as they couldn’t have missed it.

There were no bleeps at the school. It was common practice. It was accepted. No effort was made to curb the abuse of the young lady or the bullhorn sounds of raw swearing. No bleeps. I would have liked a few.

Is it surprising that swearing on TV, in music and schools is commonplace and accepted? Even TV sponsors seem to go along with it when they could stop it in a heartbeat. Freedom of speech? Really? Is that your position?

Let me hear you think out loud.





As I just got another year older, I find I have far less time for people and things that make no real contribution to the quality of my life and maybe your life, too. Many of these people and things keep reappearing despite all common sense and an honest value of how short a 24-hour day is becoming.

So, here I go again, in no particular order, with people and things I hope will vanish and never be heard from again:

  1. Any member of the Kardashian family, including a guy I liked when he was an Olympian instead of the after picture for bad plastic surgery, Bruce Jenner. Please take Kanye West with you, too. I don’t care if you include North, South, East or West, too. Take them all.
  2. Another corner Coffee Shop of any kind. I love my coffee, but I feel I’m getting environmentally polluted by coffee shops. I’m getting flat out squeezed out by coffee, Mr. Valdez.
  3. The word “like” – not only on the Internet, but every third word of far too many people who open their mouth and like talk to me like I’m like interested in like what they did like last night, know what I’m saying. For real. Like I’m just saying.
  4. Biggest Loser. When did becoming a “Loser” become a good thing to be? I fully understand the obesity epidemic in our country and the need for healthy change, but being a “loser”, despite the play on the word, probably does nothing for the self esteem of the winner of the crown Biggest Loser.
  5. Rocky fights the Raging Bull? Obamacare is not going to pay for any of their injuries. Read the 6-point font in the law.
  6. Are only golfers impotent? Please! Enough! Try playing a Cialis commercial with two people in separate tubs in the middle of nowhere with no bathrobes or transportation anywhere to be seen during  one of those cage, fight to the near death boxing matches. Yeah, that’ll go over well, but please stay away from golf. There’s a stick, a ball and a cup – really, it all works out and people even clap.
  7. Bring back real people to TV. Cable TV has created every unnatural human type of misfit and made them millionaires while the USA is ranked 26th in the world in math. Give these people their own planet and a TV network where they can watch each other.
  8. Late night talk shows…or…any talk shows. Trust me, no one or no thing is that interesting. I would be willing to watch Johnny Carson re-runs.
  9. All WalMarts
  10. Miley Cyrus, Chris Brown, Justin Beiber, Kanye Kardashian, and Lindsay Lohan. Listen to me. This can work. You don’t hear from Paris Hilton anymore, do you?
  11. All Vegans. Sorry, you must find a plot of land where nothing lives except water and dust. Then, knock yourselves out and have a party!!
  12. Finally, sports broadcasters who feel they must comment after every play or research back to the athletes’ experience in the birth canal. “Is that when you knew you had a talent to get to the finish line?” Enough! Don’t you guys ever have to use the restroom?

So, there you have iit. Could there be more? Sure. I’d like you to comment on what you wish would vanish and never be seen or heard from again.

Damn, almost met my maker today! Hey, I’m not ready people. Put the damn phone down!!

When the Eagles returned after a 17 year vacation, they added a Don Henley-inspired song to their standards playlist – a song called, Get Over It. I’ve been thinking more often how relevant this song becomes every day a kid starts school.

Call me old fashioned, a grump, uncool, out of touch with modern day parenting or a brutally insensitive human being. One thing I’m extremely proud of is I was never one of these, “let me always be there for my kid, catch him/her when they fall, battle with the teacher about how my kid was unfairly treated, he has to have an iPhone so I can be in touch, why can’t my kid play shortstop”- kind of Dad. Damn, are our kids that fragile? Will they really break if they fall or get a bloody nose for being a jerk? Maybe I should have given my children a trophy for going to school.

I have been in the behavioral health field for more than 35 years and I have seen fragile kids. I was a therapist who worked with teen drug abusers and inpatient psychiatric patients under the age of 18 for years. I’m not a cold person. I am a parent of three children…now 26-24-22 years of age. I have volunteered on my children’s school board when they were in elementary school and now again in 2013. The parent generation change has been stunning and rather frightening. Here’s why…

Children are being taught by their parents that no matter what they do, they will be defended. They are taught they will be caught before they fail. They become totally befuddled when told “everyone won the game because it was a tie” A baseball game with a bunch of 6 year-old players is supposed to be 22-8 because one team can dominate another team for lots of reasons, such as some kids stink at baseball. But Mommy and Daddy want them to have their opportunity to do everything. This is flat out stupid and very developmentally unhealthy. Making matters much worse is these same kids are given whatever they want and they do not have to demonstrate manners and say, Thank you! They get iPhones in third grade, TVs in their bedrooms, laptops, their own seat to Buffalo Bills and Buffalo Sabres games, $150 jerseys, and no bedtimes.

Tragically…yes, tragically, all this leads to a few common themes:

  • Kids without strong coping skills – an ability to adjust to disappointment, conflict, losing, setbacks and failure
  • Kids who are disrespectful of all authority figures
  • Kids who struggle to make up their own minds – they avoid things that require them to take a position, so they get stuck in perpetual neutral
  • Kids who have a new car, but don’t know how to change a flat tire or put wiper fluid in the tube
  • Their heroes are Chris Brown, Kanye West, Lindsay Lohan, Kim Kardashian, Tiger Woods and the revolving cast of Pregnant and 16 on MTV (didn’t MTV used to show music videos? What does MTV stand for today..oh, yeah, swearing and bleeps)
  • These are the kids who go to college for 6 undergraduate years and still come out with a meaningless major
  • These graduates want Mom or Dad to get them their interviews…”Don’t you know someone who will give me a job?”
  • Parents who can’t cut the chord because “my kids need me”
  • Kids who spend more money than they make and need their own credit card
  • Kids who don’t go to church
  • Kids who won’t (not can’t) write a thank you note to Grandma for the $100 check at Christmas
  • Kids who don’t answer parent’s cell phone calls, but expect to stay on Mommy and Daddy’s wireless plan
  • Kids who don’t get summer jobs because they are too busy

At this point, you are guilty and/or you know my list of common outcomes could go on and on.Maybe you are not guilty, but you know what I’m talking about. The true common theme is parents are enabling, protecting, spoiling, pampering and excusing their children to the point of stalling their maturation process, community responsibility and true sense of their strengths and weaknesses. Parents are creating soft children and I don’t mean the caring type of “soft” child. They become soft by being helpless, emotionally fragile and ill-equipped for the world outside of the family room.

Where do I see this, you ask? Besides the parents who proudly boast how they they “love” their children, I’m a professor and I see it in the freshmen classs. I coached Little League baseball and can’t tell you how many kids are “going to the pros” because they are getting private lessons and had a DVD made of them pitching in the 12 Year-Old All Star Game in Cooperstown, NY. YIKES!

It’s long overdue for today’s kids to fall, get scratched, lose a game, come in last in a race, get an F on a homework paper, actually serve detention, not play shortstop, and get punished for swearing. They should go to church, eat dinner with their family, write thank you notes, say hello Mr. or Mrs. to your friends, call Grandma on her birthday, cut the lawn, buy their own used car and get their first cell phone in high school (Oh my God, have I gone mad?).

Children expect guidance, rules, consequences, truth, consistency, and a chance to stumble through to become who they are.

Hey…I know parents make mistakes and I’ve made my share, too. Yes, I know many parents do work very hard to get it right and no child comes with a guarantee. My thoughts here are based on repetitive comments, themes, scenarios and discussions with teachers, mental health professionals, coaches, law enforcement and other parents.

It is an important matter because our children are very precious to us and we have an obligation to help them be kind, independent, respectful and fail – in failing they become better equipped to be happy, productive adults and maybe parents themselves some day.

Final thought: Laugh with your kids more often! It will keep you grounded!


What a year! Good things and too many bad things. I was thinking the other day, “what could we use less of and what would be great if we had more of!” Yes, I had an exclamation point in my thoughts. It happens…like other things happen.

Here we go…


  1. Tattoos on anyone
  2. Reality Shows
  3. Anything to Do With the Kardashians
  4. Political Bashing Ads
  5. Use of the Word “Like” in Every Sentence
  6. Kanye West
  7. Chris Brown
  8. MiIley Cyrus, Lindsay Lohan, and Tom Cruise
  9. Guns
  10. Mindless Advertising…Yes, you!
  11. Anything Made in China
  12. Fast Talking, Constantly Interrupting “News” People-You Know Who You Are
  13. The View, Kelly & Michael and Kathy Lee and Koko’s Booze Fest
  14. Weather Reports (I Really  Can Look Out My Window)
  15. Military Deaths, Military Suicides, Lack of Support for Military
  16. Another Penny Going To Weather Victims in Haiti, Japan, India, Indonesia until money goes to returning veterans, victims of Katrina, Sandy and all U.S. of A. disasters. It’s long overdue that other countries kick in!
  17. Underage Drinking and Driving
  18. Kanye West and Chris Brown – Yeah, I know. I’m making a point.
  19. Wall Street Bastards Not Going To Jail
  20. Homeless and Hunger in the USA

Things I’d Like To See More Of in 2013

  1. Love of Children and Older Adults
  2. Buy Products Made in the U.S.A.
  3. Healthy Eating and Nutrition Counseling

    Let’s All Have a Peaceful and Successful 2013

  4. Better Math and Science Scores Through Exposure to Music
  5. Dinner at the Dinner Table With The Whole Family
  6. Reading to Children
  7. Support for Our Returning Military and Their Loved Ones
  8. Not For Profit Board of Directors Who Truly Contribute
  9. Inner City Little League Baseball
  10. Acceptance and Treatment of Mental Illness
  11. Fidelity
  12. Teaching People How To Save/Invest Money
  13. Laughter
  14. Good News on TV
  15. Cars That Do Not Require Gasoline
  16. Trees in the City
  17. Photography Capturing a Moment
  18. More Medicine That Really Works
  19. Children With Manners
  20. People Going to Museums, Theaters, Concerts and Libraries 

How about you?

Tom McNulty

President, Success Stories, Inc.

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