In-home care employer shift now underway

A Montana-based company soon will manage individual providers who offer in-home care to clients through the state’s Department of Social and Health Services.

It’s a switch from the current system that has DSHS handling all administrative functions. Now, Consumer Direct Care Network out of Missoula will become responsible for 20,000 individual care providers across 22 counties in much of the southern part of Washington state, including Benton and Franklin counties.

Consumers will continue to be able to select, schedule, supervise and dismiss their individual providers.

CDCN recently was selected as one of two employers contracted with DSHS to oversee individual providers, with the other company handling the remaining 17 counties in the central and northern part of the state.

“This is a big deal for us,” said Ben Bledsoe, the company’s president and chief executive officer. “It’s the biggest thing we’ll probably do as a company, so it’s very important for us to succeed.”

The conversion is underway following a change in law that required a consumer-directed employer to manage these workers, removing the burden from DSHS. In promotional materials, the state said this “will make the system work more smoothly for everyone,” suggesting it will free up case managers to have more time with the clients actually receiving services. Prior to this, case managers and staff at offices across the state had taken on additional duties to manage individual providers, including timecard approval, background checks and training.

CDCN will now be the legal employer for all individual providers in the region.

These individual providers offer care to clients for everything from bathing, dressing and grooming, and also may cover social supervision and respite care. Typically, the workers have skills similar to a certified nursing assistant, offering in-home care for daily life tasks. Due to the often sensitive, private nature of the role, clients always have had the ability to choose who works with them, and this won’t change.

“The client still gets the choice to hire, fire and train,” Bledsoe said. “Typically they have a better satisfaction with the services they receive, a better way to control what’s happening in their home. It doesn’t necessarily eliminate those folks that want to do a traditional model of service where we send people into their homes. We’re not absolved of that by making sure quality care happens.”

The process to find a contracted employer began last year and is expected to be fully in place by summer 2021. By that time, CDCN will take on all responsibilities currently administered by Aging and Long-Term Support Administration, Developmental Disabilities Administration and the Area Agencies on Aging. 

Bledsoe said he’s targeting March or April 2021 for the switchover to begin so that everything is in place by the official July 1, 2021, start date.

“When you have 20,000 people who are basically grandfathered in, they’ll have to fill out some paperwork, because that’s how the world works,” Bledsoe said. “If you’re a new carrier, you’ll do some sort of application online, and we’ll make sure you’re matched up with a client, someone who’s receiving services, or that person receiving services may submit that application directly to us.”

Bledsoe said his company has been preparing to increase the capacity of those it employs, already providing care in 17 states with the intention of using a model that was first tested in Virginia.

“Washington’s got a very unique model of service,” Bledsoe said. “We’ll have some local staff. We plan on having five offices and then a handful of home offices across the southern part of Washington state. Our goal is to make sure that you can reach a representative of ours face to face within 90 minutes if you really need to, no matter where you are in the state. So we’re not just going to be sitting here in Missoula pretending like we know what goes on in Washington.”

The roll out will coordinate with a change in federal law known as an “electronic visit verification” and will require electronic timecard reporting from individual providers who visit a person’s home. It’s an additional change in processes for the providers during a similar timeframe, but the impact to clients receiving services is expected to be minimal.

“Our goal is to always have that continuity of care and for it to be as painless as possible but we acknowledge there will be some painful points,” Bledsoe said. “We want to make sure we get out and communicate with everyone, introduce who we are, not just a big out-of-state entity.”

For the caregivers, Bledsoe also hopes the switchover is well received. “You’re changing your employment relationship, you’re changing who your paycheck comes from, managing Medicaid dollars coming through and you’re also doing a new time sheet system. With all that, there are some hurdles to clear, and we have roughly a year and a half to do it,” he said.

Both the state and CDCN aim to improve service with the new system, allowing more time for clients and their case managers, and for individual providers to work with a single entity for all employment needs.

“We’ve been preparing our own company for a large leap in our capabilities, trying to scale up to take on large volumes of clients, caregivers and support them the way we like to support them. We want to have people feel like they’re the only ones an organization cares about,” he said.

The state is offering monthly webinars for interested parties to receive updates on the changeover, the next scheduled for Oct. 22. Go to dshs.wa.gov/altsa/stakeholders/consumer-directed-employer.

 

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