As the pandemic crisis continues without a clear end in sight, one of the big issues for managers is how to address the negative effects of the crisis on the workforce. It’s one thing to manage through this for a few months—it’s another situation to contemplate dealing with it all for six more months!
The situation is forcing managers of provider organizations to think more about how to address some of the pandemic-specific morale issues. There are two types of worker situations. There are “essential” workers that are delivering in-person services to consumers. And there are virtual workers who are providing therapy and support to consumers by telephone and computer. Each has distinct issues.
Essential workers delivering in-person services have physical health concerns, stress, and burnout. They are dealing with the fear of contracting the virus and bringing it home. The fear of serving consumers living in congregate care facilities and in emergency rooms. The fear of going into consumers’ homes. In a post-pandemic survey of direct support professionals (DSPs) who assist people with intellectual and developmental disabilities (I/DD), about 42% reported having a colleague who quit due to the pandemic. Thirty-four percent feared becoming infected with COVID-19, 9% left because they tested positive for COVID-19, and 25% had child care problems due to the public health emergency (see COVID-19 Pandemic Intensifies Workforce Shortage Of I/DD Direct Support Professionals). Fifty-five percent reported working more hours, but 76% reported not getting paid more during the COVID-19 crisis. And, the DSP workers reported continuing challenges with personal protective equipment.
These conditions—on top of the overall social conditions of all Americans—is accelerating burnout of health care team members working in contact with consumers. To address this, it’s important to realize the framework of burnout mitigation hasn’t changed. Start by understanding where employee stress is coming from—and be aware that it is more than just work-related stress, it’s also the stress of physical safety concerns, home and child care, and financial stress. Managers must support workers in finding new ways to “refill their tank” and adapt to the situation, and realize productivity may look different in this new environment. This was the advice of Gaurava Agarwal, M.D., assistant professor for the Departments of Psychiatry and Behavioral Sciences and the Department of Medical Education at Northwestern Memorial Hospital, who described the unique nature behavioral health care worker stress in the webinar, Balancing Act: Preventing Burnout For Health Care Professionals During The Coronavirus Pandemic & Times Of Crisis.
Virtual health care workers have a different set of problems. First, there is the issue of working from homes that were not set up for full-time work—homes that in some cases have children who need care, spouses also working, a lack of space, and/or limited internet access. In the webinar this week, So, How’s That 2020 Strategic Plan Going? A Roundtable Discussion About the Current Behavioral Health Environment, Jeff Silverman, chief marketing and sales officer of Qualifacts, said that one of the key findings in a recent national survey conducted with the National Council for Behavioral Health was that staff providing telehealth services were concerned about lack of connection with other team members and engagement with their organizations. As the crisis continues, the “connection issue” will grow. And, in that same webinar, Paul Curtis, executive director of the California Council of Community Behavioral Health Agencies, pointed out the negative effects of constant video interaction with consumers. This “Zoom fatigue” is not to be scoffed at. He explained that humans are not built for extended virtual interactions and if organizations are going to convert their models to full-time virtual therapy, it’s one of the issues that need to be addressed. (To read more on the physical challenges of online work, check out How To Combat Zoom Fatigue and Zoom Fatigue Taxes The Brain, Here’s Why That Happens.)
For managers of health care teams, the pandemic presents another set of talent management challenges—and we’ll be sure to cover those in the weeks ahead. In the meantime, don’t miss these resources for managing through the crisis from The OPEN MINDS Industry Library:
State & Federal Updates
On June 26, 2020, the federal Department of Health and Human Services Office for Civil Rights announced that the state of Tennessee updated its crisis standards of care plan to ensure the criteria does not discriminate against persons based on disability or age. Disability Rights Tennessee and other advocacy organizations filed a complaint about the state’s CSC plan.
On June 26, 2020, the federal Department of Health and Human Services Office for Civil Rights announced that the state of Tennessee updated its crisis standards of care plan to ensure the criteria does not discriminate against persons based on disability or age. Disability Rights Tennessee and other advocacy organizations filed a complaint about the state’s CSC plan. This is OCR’s fourth resolution with a state regarding disability discrimination concerns during COVID-19.
Oregon’s licensed long-term care provider organizations may begin providing limited outdoor visitation for residents if the facility develops a plan to adhere to required safeguards to prevent the spread of COVID-19. Following the safety prerequisites, including health screenings, face coverings, physical distancing, and limits on the number of visitors, is mandatory as Oregon continues to experience an increase in outbreaks at long-term care facilities.
On July 31, 2020, Michigan Governor Gretchen Whitmer vetoed Senate Bill 956, which would have created a new facility type to house people recovering from COVID-19 and prohibit housing them in nursing homes. In her veto notice, she said that the premise behind the legislation was unsupported and that the legislation also failed to address how such facilities would operate.
New Health Plan Initiatives
On July 15, 2020, Blue Cross Blue Shield of Massachusetts announced plans to pilot a new value-based payment model for small practices that provides financial support through a global payment, upside risk incentives, and an immediate support payment. A key goal is to provide independent physicians with a reliable revenue stream to continue providing care even in the event of disruptions, such as the drop in office visits during the COVID-19 pandemic.
On July 23, 2020, Humana, Inc. announced plans to mail its Medicare Advantage members in-home preventive screening kits for colon cancer and for diabetes management. Humana anticipates mailing more than one million screening kits during 2020. The goal is to increase access to routine screenings that many members have put off during the COVID-19 pandemic.
On May 18, 2020, Blue Cross and Blue Shield of Minnesota announced it was sending its Medicare Advantage members preventive screening kits designed for use at home. These kits are for diabetes A1C and microablumin tests for in-home chronic disease management, as well as colorectal cancer screening kits.
Clinical Updates In The Field
Despite stay-at-home orders and school closures, this webinar from Integrated Care Online provides tips on how to get reimbursed for school-based health care services through telehealth and virtual visits.
In this Integrated Care Online webinar, NextGen Healthcare’s Director of Special Solutions, Ronke Komolafe, DBH, MBA, discusses the impact of social determinants of health on health care, as well as interventions and solutions for addressing social determinants of health during the COVID-19 pandemic.
People diagnosed with active cancer who contract COVID-19 have a 16-fold higher risk of death compared to people with cancer or a history of cancer but who are not diagnosed with COVID-19. These findings were based on an analysis of more than 212,000 health records of people living with cancer across two major health systems in the Midwestern United States.
In July 2020, researchers at U.S. Food and Drug Administration and Syapse published findings based on an analysis of more than 212,000 health records of people living with cancer across two major health systems in the Midwestern United States. The analysis showed people diagnosed with cancer who contract COVID-19 have a higher risk of hospitalization and death compared to people without cancer.
Executive Resources For Leadership & Crisis Recovery
It may seem like an oxymoron—spending on marketing at a time when referrals, service volume, profitability, and cash flow are all low. But marketing spend may be the key to navigating the crisis and preparing for recovery. But note, I said “may.”
The pandemic has increased the demand for all things delivered at home. Meals, liquor, mattresses, and more—are all now at people’s literal doorsteps. This is true in the health and human service field too. Telehealth has brought “visits” home.
In this executive web forum, OPEN MINDS Senior Associate Paul M. Duck takes a deeper dive into different tactics and strategies provider organizations can leverage with payers to negotiate optimal fees and reimbursement rates.
Supporting Vulnerable Populations
SuperCare Health and Optum collaborated to create a COVID-19 Telemonitoring Program that allows symptomatic individuals to be monitored and to recover in their homes, avoiding unnecessary hospitalizations. According to Curtis Sather, M.D., medical director and pulmonologist at Optum, SuperCare Health was contacted in the early stages of developing the COVID-19 monitoring program, knowing close respiratory monitoring would be vital in setting up alternative care.
Chestnut Health Systems announced it is partnering with the McLean County Health Department to expand COVID-19 testing into rural McLean County, Illinois by offering 10 mobile testing sites in Colfax, LeRoy, and Heyworth during the next two months. Funding comes from a $2.8 million state grant, which also is covering increased contact tracing.
Chestnut Health Systems, which offers gambling addiction treatment from its Granite City, Illinois location, announced that amid the COVID-19, virtual treatment is available. An estimated 125,000 Illinoisans struggle with a gambling problem.
On August 2, 2020, Veyo, the non-emergency medical transportation broker for the state of Connecticut Medicaid program launched a new specialized vehicle fleet to transport individuals who may have COVID-19. The new, sterilized fleet will be used to transport individuals who are COVID-19 positive, symptomatic, or persons under investigation, to their required medical appointments.
On August 3, 2020, WellCare, a Centene Corporation subsidiary, announced that it partnered with Shipt to provide free home grocery delivery for about 200,000 Medicare Advantage members in 23 states for the remainder of 2020. The goal is to help address food insecurity and enhance member safety during the COVID-19 pandemic. Shipt is a same-day delivery service.
And for even more on post-crisis recovery strategy, join us for our upcoming web forum and technical assistance sessions:
- Planning For Revenue Expansion By Expanding Your Service Area – From Market Analysis To Launch: August 13 at 1:00 pm EDT led by OPEN MINDS Senior Associate Paul M. Duck
- From Ideas To Action – How To Assess Feasibility & Implement Your Strategic Plan: August 20 at 1:00 pm EDT led by OPEN MINDS Senior Associate Joe Naughton-Travers