Economic Recovery for Ohio’s Behavioral Health Businesses Neil Tilow Talbert House President/CEO
A Quick Look at the Numbers • Talbert House – Mission is empowering children, adults and families to live healthy, safe and productive lives – Operates within five service lines: Addictions, Community Care, Community Corrections, Housing and Mental Health – Served over 24,200 clients face to face with an additional 80,200 receiving prevention and hotline services with almost 800 case managers, counselors, nurses and doctors providing care to our clients • Talbert House’s behavioral health revenue loss equals $700,000 in Q4. – $150,000 in additional PPE costs – 7 weeks cash on hand – Over 500 employees and therefore not eligible for federal stimulus funding • This equals a 20% revenue loss for Talbert House. – Other providers across Ohio are not this “lucky.”
BH Association Member Surveys • The Ohio Council conducted • The Ohio Association of a survey of members from Recovery Providers 03/30-04/2/2020. conducted a survey of members from 4/9- 4/13/2020. • 125 member organizations responded, which represents almost 80% of membership. • 35 member organizations responded to this survey, which represents 83% of • 85% of members have less membership. than 500 employees
Operations Overall service delivery and revenue remains 21% – 50% below budgeted amounts even with the transition to telehealth. • 100% of survey participants are accepting new outpatient admissions and 70% are accepting admissions for all services. • 78% are providing most services by telehealth, 50% have maintained usual office hours, and 40% are continuing community and home- based care as needed. • 57% have suspended all in-person group counseling services, 36% have suspended IOP/PHP and/or Day Treatment, and 7% have suspended residential treatment admissions. Note: All while the opioid epidemic continues to impact Ohio
Staffing The total number of anticipated layoffs based on current operating status is expected to almost double to 1664 FTEs in the coming weeks. • 57 organizations reported already laying off or furloughing staff. • A total of 869.18 FTEs have already been laid off or furloughed. This is an increase of over 400 additional staff laid off or furloughed since an initial report on 3/20/2020. • Administrative staff, school-based clinicians, and office-based clinicians were to most likely to be laid off.
Financial Impact Using all available cash management strategies, including loans and lines of credit, over 52% of survey respondents indicated they will run out of funding options within the next 4 payroll cycles. • 9 organizations reported they can only cover their current payroll expenses and another 16 organizations have 1-2 payrolls. • Over 53% of organizations report they have less than 45 days cash on hand. Over 68% report having less than 60 days cash on hand. Layoffs and furloughs reduce expenses and are extending available cash flow.
A Look At Solutions Five Common Sense Solutions for Short and Long Term Recovery for Behavioral Health Businesses
Recommendation #1 • Require Ohio Medicaid to invoke the authority granted to it in HB 197, by authorizing increased reimbursement rates to behavioral health providers as recognized “COVID -19 providers” – Cost neutral for the State using the recent 6.5% increase in Ohio’s FMAP – Accomplished very quickly with an emergency rule filing by Ohio Medicaid – Provides a rapid influx of funding to allow for continued service delivery and access to care during the pandemic
Recommendation #2 • Continue expanded access, modalities and Medicaid reimbursement for telehealth after the emergency passes – 78% of providers and their clients have transitioned to telehealth successfully over the last three weeks – Organizations have made significant investments in technology and training, which should not go to waste – Telehealth will be an even more viable option when Ohio is open for business and patients can access wifi hot spots more readily
Recommendation #3 • Pass HB 580 (Patton, Liston) to require commercial insurance coverage of telehealth services – This would impact about 14% of Ohio’s population, which is not covered by an ERISA plan, Medicaid or Medicare – Talbert House’s payor mix is less than 5% commercial insurance
Recommendation #4 • Require Medicaid Managed Care Plans to reimburse behavioral healthcare providers immediately on receipt of claims, with a reconciliation process on the back end – Ohio Medicaid data shows that 90.6% of all “clean claims” are paid by the Managed Care – Plans currently have 30 days to pay claims, resulting in a significant delay in cash flow for providers – On average, Talbert House receives payment from the MCO Plans 55 days after claim submission
Recommendation #5 • Pass HB 365 (G. Manning) to allow for a more rapid workforce expansion once the pandemic is over – Revises the requirements to qualify for a chemical dependency counselor II license by recognizing experience in the field or academic preparation – Ohio’s behavioral health businesses have had a consistent workforce shortage problem during the ongoing opioid epidemic; HB 365 will help – Passed unanimously out of the House Health Committee on January 15, 2020
Final Thoughts Behavioral Healthcare is Healthcare. We are essential to Ohio’s healthcare system. • Our employees are an often invisible first responders and front line that get people into treatment and keep them in recovery. • When we succeed, we are doing our part to reduce emergency room, other hospital and physician utilization. • When we succeed, your communities are safer. • Behavioral health businesses need your help today and into the future to continue as valuable healthcare partners in your communities.
Thank you for your Neil F. Tilow service and for the President/CEO opportunity to present 2600 Victory Parkway today. Cincinnati, OH 45206 513-751-7747 x 1001 Please contact me with any follow up questions: Neil.Tilow@TalbertHouse.org
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