The Crisis with TDT – the Data Is In!

August 29, 2019

Sixty providers responded to the recent survey (with our thanks to VACBP and Caliber for their willingness to distribute to their members!) and the results are both dramatic and terrifying.  The Survey Summary shows the critical state of services for not only TDT, but for the other services which by staffing or business necessity are linked together: Between August 21 and August 28, 2019 private providers of CMHRS were surveyed; the survey was distributed through VACBP, Caliber and VNPP.  Similar information was requested from the Community Services Boards and collected by VACSB; those results are not reflected here, but would be available through VACSB.  This summary was prepared by VNPP, Inc. Respondents provide a variety of CMHRS and the majority provide services in multiple regions; a significant majority currently have contracts with all six of the CCCPlus/Medallion 4 Health Plans. Recent contract terminations (to date, by Aetna, Anthem and Magellan) have impacted approximately 17% of the respondents; we asked what impact these terminations have had, specifically on the provider’s ability to provide TDT services and honor their commitments to both the schools and the children/youth that they serve.  The answers appear on page 2 of the full summary. The more significant issue, which is happening concurrently, is the sharp increase in either denial of authorization requests or the reduction in units of service approved.  The impact is described on page 4 of the full summary. We also asked for specific information on the impact to the workforce:
  • 40% of the providers are reducing non-licensed staff,
  • 22% of the providers are reducing licensed staff,
  • 36% report delays in starting services because of the slowness of service authorizations
  • 18% of the providers have eliminated one or more service location(s), and
  • 6% have already closed the service
 We asked for other impacts and/or more detailed explanation of the impact.  Those answers appear on page 8 of the full summary .  It should be noted the approximately 30% of the respondents said they are the sole TDT provider in the school or district. The impact of the severe cuts in TDT extends beyond that line of service, approximately 30% of the providers also report that have had to reduce or eliminate other services.  The impact is described on page 9. We will not argue that the service as currently described and utilized in Virginia is perfect, we will, however, argue that in the absence of an alternative this dramatic shift will put children at risk and service providers in an untenable position.   An unsustainable business can not be a quality provider.