Case Management During COVID-19
The COVID-19 pandemic has caused many businesses to completely change the way they operate. Human service agencies are also heavily impacted by stay at home recommendations and orders to close until further notice. COVID-19 closures have seriously hit day support programs and programs that provide supported employment. These programs have been shut down and have already caused some end their programs permanently after only a few weeks of mandatory closures.
Group homes have not been hit as hard as other programs. However, the situation has forced many programs to increase staffing during the day when the residents would normally be at work or at their day program. Depending on the state, the group home is paid a daily rate or an hourly rate. Group homes that are compensated on a daily rate take the hardest hit. They have to increase staffing while receiving no increase in reimbursement.
The pandemic has also made the jobs of case managers even more difficult. Many group homes have limited outside contact to reduce the chance of infection. This includes family, case managers, and other human service professionals that may visit the home to monitor services. In addition, clients can’t come to the office at this time. Public case managers are considered essential personnel and are still expected to provide services despite the pandemic. So how can case managers continue to monitor services without observing the clients in the home or in the community? How do case managers conduct meetings and coordinate services during a pandemic? Restrictions on face to face contact present a significant challenge to case management. Fortunately, there are some alternatives to traditional case management methods. Telehealth and teleworking have been implemented for many clinicians in order to continue to provide support and bring in revenue to avoid layoffs and furloughs.
Telehealth is a method of providing healthcare services via electronic methods such as by phone, teleconference, and or video conference. Meetings that would normally be conducted in person are conducted by video and by phone. Fortunately, case managers provide the majority of their client contact over the phone so the quarantine has very little impact in this regard.
However, many agencies have been slow to embrace the video aspect of telehealth. This is primarily due to privacy concerns but also a reluctance to let go of traditional methods of providing services. Face to face contact were always expected to be in the office, home, or community. This pandemic has forced agencies to use video conference applications such as Zoom, Cisco Web X , Skype for Business and many others.
Advantages of Telehealth
Telehealth allows case managers and other health professionals to continue to provide services despite social distancing guidelines. The loosening of some guidelines has also allowed for the billing of “face to face” contact via telephone or video contact.
Telehealth can be cost effective for both the employee and the employer. Clinicians using telehealth can work from the home or office. More employees working from home can reduce operation costs for the employer and reduce the cost of transportation for employees.
Drawbacks of Telehealth
One of the few challenging aspects of meeting via telehealth is getting paperwork signed. In many cases, signing documents consumes the majority of the meeting time. These forms will have to be mailed or emailed and scanned if there are no other way to sign electronically. Clinicians who prefer the personal contact of a face to face visit may have difficulty with telehealth services. Those who are limited with technology may also struggle with learning how to use some of the teleconference and video conference programs.
Teleworking or telecommuting as it is sometimes called, is basically working from another location other than the normal office. In most cases teleworking occurs at the employees home. I have been a big proponent of teleworking because of the economic and practical advantages. Most of my colleagues agree that teleworking makes the job of a case manager so much easier. One of the advantages I have enjoyed by working from home is that there are less interruptions from co-workers or the unscheduled, walk-in appointment. I have often found myself having 20 minute conversations with colleagues and then a walk-in client will come to the office and before you know it you’re an hour behind schedule. Working from home has helped me set up a daily agenda and complete tasks in a more organized efficient manner.
Teleworking saves time on travel and money on gas. The employer also saves on travel reimbursement. Fewer people in the office can also reduce energy costs for the employer. However, working from home can cause the employer to have higher energy costs due to using more electricity at home as opposed to the office. But I think these costs cancel each other out. In addition, working from home also reduces wear and tear on your vehicle.
What Happens after COVID-19?
I think the COVID-19 situation will change the way we live and work for many years to come. On the positive side I think this experience has made us realize that many of the functions we were doing in person can be done be done virtually. The pandemic forced us to get out of our comfort zone and try new technology to get our work done. Conducting meetings via video conference was the thing I needed to adjust to more than anything else. My hope is that employers that were reluctant to telecommuting and telehealth will see that it works and the majority of employees enjoy working remotely at least a few days a week. Also, happy employees tend to work harder.
Unfortunately, not every business will come back when the pandemic restrictions are lifted. Several day support programs moved from center-based to predominantly community- based programs in order to satisfy state requirements meant to encourage community engagement. The pandemic caused this approach to completely backfire when everything closes and there are little to no community activities available. After COVID-19 businesses in the human services field will have to be more strategic and develop a plan b, c, and d in order to maintain consistent revenue during unusual circumstances.
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