By the 1980's the natural overlap between the two organizations became more evident. There were more and more patients and families who had interactions with both organizations, they also worked together on events and in other ways. Some, like Lloyd Zeise (Olympic Athlete), was treated at Sister Kenny Institute as a child and used the services of the Courage Center as an adult due to contracting polio at age 3. An increasing number had exposure to both organizations due to brain injury or spinal cord injury; they would be initially treated at the Kenny Institute within Abbott-NW Hospital, and then continue their healing at Courage Center. Managed-care health plans and other systemic changes in the US had impacts on both organizations, as their network situations and their service provisions continued to be updated.