The leader’s role in a crisis is a lonely one. It feels a bit like being trapped in a video game. The ground is shifting around you, with the “rules” and the “plans” changing daily. Larger organizations are falling in your path (well-known names like J. Crew, Gold’s Gym, Frontier Airlines, and Hertz as well as health care organizations like Choice Healthcare, Envision Healthcare, Quorum Health, Verity Health). Your job is two-fold. First, to survive the crisis—navigating a path that takes your organization and your team through the “burning cauldron” to safety on the other side. And then, to position them for economic sustainability in the new normal, so they are ready to “run that race” when it’s time.
We have put together a staged plan for executive teams to tackle this formidable challenge (see my web briefing, The OPEN MINDS Executive Blueprint For Crisis Management: Building Resiliency In The Face Of Adversity). And, I had an interesting web discussion with three other chief executive officers (CEOs) on the actions leaders need to take to make that plan a reality (see Can We Learn From This? 12 Steps For Leaders To Manage Beyond The Crisis).
So what is happening on the ground? Recent surveys by the California Council of Community Behavioral Health Agencies showed that 52% of California behavioral health provider organizations are serving fewer consumers, while 32% of organizations have furloughed staff as they deal with cash flow challenges (see The Big Questions For Leading Through This Crisis Period). A snapshot survey conducted by five Illinois provider organizations (see Illinois ID/DD/MH/SUD Community Provider Survey) revealed that 32% of provider organizations have less than 30 days of cash on hand, and 34% do not have access to a line of credit. An April survey of 70 addiction treatment organizations (see Addiction Professionals Of North Carolina Reports Current Impact On NC Addiction Services & Requests Immediate Emergency Relief Due To COVID-19 Impact) showed that 57% of organizations have closed at least one program, 27% have laid off staff or cut positions, and 43% believe they can only survive financially for another month or less. A survey by the Medical Group Management Association indicates that medical practices reported an average 55% decrease in revenue and 60% decrease in consumer volume since the beginning of the crisis (see COVID-19 Financial Impact On Medical Practices). Navigating that path to safety is a difficult proposition.
But despite this tumult, I am amazed at the creative tenacity that I see among executives of health and human service organizations serving the most vulnerable populations. As I think about the discussions our team has had with those executives over the past few weeks, there are three big takeaways. First, the leaders of organizations that have invested in solid infrastructure prior to the crisis have an advantage, and the ability to leverage that infrastructure in important ways. Second, rapid response and rapid problem solving is key—crisis management demands decisions at “warp speed.” And, positioning for the “next wave” is happening right now—go forward strategy should be the framework for every decision. Three CEOs—Bruce Bird, Ph.D., of Vinfen, Carl Coyle of Liberty Resources, and Shar Najafi-Piper, Ph.D., of Copa Health—shared how they have been doing this.
Leveraging Infrastructure For Survival & Future Success
What strong organizations do to get strong is not rocket science. They invest in the foundational infrastructure for success—strong teams, solid financial management, performance reporting, customer relationship management, consumer experience optimization, contemporary clinical practices, optimized operating processes, and much more.
These “fundamentals” become important assets in a crisis—the framework for crisis management. At Vinfen, the long-standing partnerships with other health and human service agencies and the relationships with government helped them make the case for the support they needed during the crisis, says Dr. Bird. Mr. Coyle explained that an important part of their strategic growth at Liberty Resources is to build replicable practices—whether it’s multisystemic therapy (MST) for youth at risk of out-of-home placement or telehealth. Replicability of process allows for quick growth—and for adaptation in times of crisis. Liberty also emphasized “a culture of technology,” which served them well when they had to pivot to virtual services and operations with COVID-19.
Success In A Crisis Requires Prompt Action
Crises, by their very nature, favor the leaders that are able to act decisively. The ability to synthesize available information and analyze the short-term and long-term consequences of various options are the hallmarks of a leader who can manage in a crisis. One great example is Copa Health. Their management team, led by Dr. Najafi-Piper, took a telehealth plan that was to be rolled out over six months and launched it in four days. The immediate problem solved was the means for continuing consumer care while allowing their staff to work from home. But the organization was quick to capitalize on the expanded access offered by the new platform, providing free virtual counseling to people in the community and strengthening future relationships and referral generation for future growth.
Liberty Resources had a telehealth platform before COVID-19 and they were able to “flip the switch” to virtual for all mental health and addiction treatment in just 12 hours—today they are at 103% of service capacity and have even brought in new consumers. They were then able to leverage this experience to “go virtual” with school-based early intervention, therapy, and early childhood education services when the state lifted restrictions shortly after school closures. Seeing that Zoom was offering free use of its platform for schools, the Liberty team contacted them and immediately procured 200 additional licenses for their HIPAA-compliant “Zoom for telehealth” at no extra cost. Use of children’s services has gone up from 10% initially to 65% of full service volume now.
Vinfen runs more than 180 residential facilities for people with serious mental illnesses and intellectual and developmental disabilities in COVID-19 hotspots like Boston, Lowell, and Lawrence in Massachusetts—and has seen more than 100 “medically fragile” consumers and 80 staff contract the coronavirus (most are recovering now). To maximize the safety of consumers and staff, they rapidly developed new protocols for staff to stay in their residences during the crisis, reducing the possibility of additional infections in their facilities or staff members’ homes. They are also, in conjunction with the State, increasing the availability of coronavirus testing.
Anticipating The New Landscape & New Opportunities
While crises can be all consuming, good leaders need to have their long-term plan in mind at all times. They need to make sure that actions taken during a crisis won’t compromise future sustainability—or preclude them from pursuing the opportunities for growth that inevitably arise out of any crisis. Rather than allowing a crisis to thwart their long-term growth plans, good leaders look for the new opportunities in adversity. Every lesson learned during the crisis, every problem solved, and every shift in the market are data points for long-term growth.
Dr. Najafi-Piper reflects on how the swift and successful shift to virtual care has opened up new possibilities for expansion beyond state boundaries. “We don’t need to invest in brick and mortar establishments for growth,” she says. The success of virtual operations has also opened up new possibilities to recruit and retain talent. Working from home is a significant benefit to offer, especially when competing for talent with other organizations that can afford to pay more.
Mr. Coyle explains that they are “finding new ways to unlock value,” and forging ahead with earlier plans for “de novo growth.” “We have immense possibilities to integrate primary care and behavioral health using a combined approach with telehealth, remote patient monitoring technologies, and care management home visits,” says Mr. Coyle. “Consumers can come in through any door, seeking care for mental health, addiction, or physical disorders and get the benefit of ‘real-time integration’ in care.” For example, given the broad range of children’s specialty services that Liberty provides, they are planning to hire a renowned pediatrician with expertise in trauma-informed care to be accessible to consumers anywhere through virtual visits. To do all of this, they are exploring new partnerships with private equity and other non-traditional entities.
As your team navigates these waters and plans future strategy, our role is to keep you posted on what you need to know, when you need to know it. You can check out the resources in our OPEN MINDS Executive Blueprint For Crisis Management. And for our Elite-level OPEN MINDS Circle members, participate in the live discussion on post-crisis recovery strategies with four of our senior team members:
- Joe Naughton-Travers, former Vice President, Hill Associates
- Ken Carr, former Chief Financial Officer, Guild Incorporated
- Sharon Hicks, former Chief Operating Officer, Community Care Behavioral Health
- Leon Hoover, former Chief Executive Officer, Kings View Behavioral Health
The discussion, Planning Your Post-Crisis Recovery: What Are The Big Issues? An OPEN MINDS Executive Roundtable, will be held on Tuesday, May 12 at 4:00 pm EDT—RSVP to get the Zoom link.