Ten Weeks and Counting!

May 09, 2020

If you count from our first post on where to find guidance about protecting yourself and others from infection – we have moved into the tenth week of coping with COVID19.  On Friday the Governor announced the next steps of easing the restrictions and moving back to a “new” normal for business which will, perhaps for many months to come, involve smaller meetings, and trainings, no lunchtime gathering in the breakroom, staggered work hours and/or staff still working from home.   And while the optics are very different, the work will get done and discussions will take place and slowly we will reconnect and be able to gather for a team meeting (perhaps in a larger room and with face coverings, but in the same room nonetheless).
  • Specifically, in Phase One (beginning 15 May) in-person work-related “gatherings” such as conferences, trade shows and trainings are to be limited.  When in-person meetings need to occur they should be as short as possible, the number in attendance should be limited and physical distancing should be used.
  • The problem now is what are the next steps going to look like – it is clear from all the recent data that prudence in continuing to be conservative in moving out of the public heath restrictions along with the 14%+ unemployment will not produce a rebound in consumer spending to push the economy back onto it’s feet by summer.  A slow economy means lower state and local revenues; lower state and local revenues mean that service rates are less likely to increase and “extras” to stabilize provider’s lost revenue are less likely to be available long term.
  • Add to that – Medicaid expenditures are counter-cyclical; in other words – in a booming economy Medicaid costs overall tend to fall as fewer individuals are eligible.  When the economy slides, and unemployment grows, more individuals qualify for Medicaid and costs rise.   While we are a specialized slice of the pie; it is difficult to make our slice bigger when the pie itself is growing and has to be paid for.
  • Retainer payments will be available soon for Group Day, Community Engagement and Community Coaching.  They will be retroactive to March 12th and can be billed through June 30th.   The most recent edition of  Open Minds defined “business as usual” as getting revenue back on track and stabilizing financially.  Retainer payments will do neither of those, but will potentially slow the bleeding.
  • Benefits from being able to work in a different location for Group Day are not likely to benefit the independent Group Day providers in large measure because of the restrictions most residential programs (and many/most families) have placed on others coming into their residences.  It may give some opportunity to cover losses on the residential side for providers who play both roles.
  • The requirements to be imposed for Community Engagement and Community Coaching services provided for an individual who does not leave their residence will, we believe, make that option available to relatively few individuals – a lot of preparation and development for a relatively short window for service.  And still a challenge, for the reasons stated above,  for an independent provider.
  • In-Home providers, especially those who support individuals living independently,  should be able to be reimbursed for the work most have already been doing if they thought to modify their POC when they began virtual support!
The Memo – with details – should be out next week!  And thanks to all the DMAS/DBH staff who have been working hard to get it done!