An Update or Two!

July 28, 2021

First – thank you all for your responses and support on Monday morning to help solve the very uncomfortable problem of “where are ten individuals going to sleep tonight.”   We do not have final details, but we know that your quick responses were helpful and supportive!  Sadly, this was not the first and it most certainly will not be the last!

Second – for those who were a bit put off by the communique from the Office of Licensing yesterday, here is my response!

I have several significant concerns, but the overall one is what appears to be a disconnect between DBHDS & DMAS and,  more significantly, a disconnect between DBHDS and the provider community:

#1          We supported the inclusion of the following (paraphrased here) in the most recent budget –

DMAS shall amend the  Home & Community-Based Services (HCBS) waivers to allow telehealth and virtual and/or distance learning as a permanent service option and accommodation for individuals on the CL, FIS & BI Waivers. The amendment, at a minimum, shall include all services currently authorized for telehealth and virtual options during the COVID-19 pandemic.

 Your letter strongly discourages virtual supports which seems contrary to the intent of the approved language in the Budget.

#2          You state that “providers should have a sufficient number of vaccinated staff at this time to provide supports to individuals at day support sites.”  This causes concern for several reasons –


  • As there is no state mandate for vaccination in our employment category (or any employment category as far as I know) your ”assumption” creates a false standard that many will take as a mandate
  • In a quick snap shot over the weekend ,  the majority of the response to “We are still unable to open day service sites because . . . “ was a combination of inability to hire staff and reluctance of families or individuals to return.”    
  • Estimates in the same “snapshot” of vaccination rates for staff revealed that providers estimate that only 50% are vaccinated.  Almost all indicated that while they would like to mandate vaccines, the decision to do so would result in mass resignations.


#3          We do not know the distribution of individuals receiving  Day Services in a group home, but unless the Day Services provider is able to reopen at 75% of capacity or more their services will not be sustainable and they will close again, forcing individuals home and, again, with no additional support.


Perhaps you could identify the providers who are providing Group Day within a residential setting and, on a case by case basis, discuss what their transition plan is and what barriers there might be.  And please, make no assumptions about vaccination rates or sufficiency of resources! 

Third – re the staffing crisis,  you know it is a “thing” when it is given a name and national organizations are rolling out webinars on how to manage for Executive Directors who are “wearing almost every hat!” 

                 Welcome to the “Great Resignation!”

And for those of you who are “wearing every hat” and pulling shifts to provide safe and secure care – thank you! You deserve a medal or two, but I know you would settle for a weekend off and a good night’s sleep!