COVID-19 IMPACT SURVEY RESULTS - i2i Center for Integrative Health

In mid-April, the i2i Center for Integrative Health developed several surveys to collect data on the impact of the COVID-19 pandemic on behavioral health/I-DD Consumers, Providers, and Payers in the public system. It is our hope this information will be used by legislators, state leaders, and other partners moving forward as decisions related to COVID-19 support, funding and service changes are implemented.

In reviewing the survey results, it is clear that the COVID-19 pandemic has had a significant impact on our system at all levels. The crisis has caused a shift in how consumers can receive services and has changed how services are delivered. As expected, it has had a negative impact on Provider financial stability due to unanticipated expenses as well as a loss of revenue. It has also been a challenge for payors who have made significant investments in new technologies in an effort to combat the effects of social distancing. On the flip side, the crisis has served as a good test case for telehealth and virtual care, showing that if done correctly, future use of telehealth could result in a much-needed expansion of behavioral health/SUD services.

258 Providers of Behavioral Health/I-DD services completed this survey.

Services

60% of Providers report they are able to maintain contact with their existing clients
76% of Providers are using some form of telehealth to provide services
40% of Providers have invested in new equipment in order to offer telehealth services to consumers
- Investments range from several hundred dollars to $10,000 and upwards of $150,000 -$250,000

Financial Impact

90% of Providers anticipate that COVID-19 will negatively impact revenue over the next 6 months
- Losses are expected to range from $150,000 – $3 million, with a percentage loss estimated at between 10% – 60% of revenue
56% of Providers are spending money on PPE (masks, cleaning supplies, etc.).
Spending reports range from tens of thousands to hundreds of thousands of dollars.

Employment

23.83% state they will furlough staff, but expect to return staff to these jobs
11.33% will lay off staff and are not sure that positions will be reinstated
3.91% will terminate positions
59.77% will not terminate or furlough staff
8.20% are not furloughing staff today, but are planning to do so in the next 4-6 weeks

3 of the 7 LME/MCOs completed the survey.

Funding & Community Investments

All report using their Risk Reserves to address COVID-19 community needs
2 out of 3 have already used their Single Stream funding for COVID-19 needs
All report increasing Provider rates. Rate increases were noted for the following services: all MH & IDD Residential Rates, Child Residential, ICF and All residential, Community Living and Supports, Supported Employment, outpatient, crisis services
LME/MCOs are investing in equipment and related supports (technology, hardware, training) as a result of the COVID-19 crisis, including: Smartphones, Wi-Fi hot spots, laptops, cell phone reimbursement, telehealth equipment in certain locations as well as TEMI personal robots and HP personnel check-in devices
Two out of three LME/MCOs report they are accepting new providers into their networks
All are addressing more SDOH needs and expanding the use of technology for webinars, meetings and communication
Two LME/MCOs report an increase in Care Coordination efforts as a result of COVID-19

48 Behavioral Health and SUD Consumers took the survey.

83% of consumers report that they are currently in contact with their Provider(s)
88.83% report they are currently receiving services from their behavioral healthcare provider(s)?
74% have been offered the use of telehealth (phone, video, computer) as a way to receive care
62.50% are utilizing telehealth or other non-face to face methods (phone, video, computer) to receive behavioral health or SUD services

Consumer Satisfaction with Telehealth Care

31.43% Very

28.57% Mostly

17.14% Somewhat

11.43% A little

11.43% not at all

46 I-DD Consumers or Family Members took the Survey.

Over 95% of consumers taking the survey report that services to them or their family members were interrupted due to the Coronavirus
Some reasons for the interruption include:
34.38% lack of available Direct Support Professionals
53.13% concerned about having Direct Support Professionals in their homes for fear of Coronavirus contamination
59.52% of I-DD consumers are using some form of telecommunications to communicate with their providers
90% of individuals with family members who serve as the Direct Support Professional have seen no disruption in payments for care

What the Data Tells Us about the Impact on Behavioral Health/I-DD Care

It is clear from the data that MH/IDD/SUD Providers are working hard to adapt and change how they provide services during the COVID-19 pandemic, making significant financial and technological adjustments to the extent possible to offer consumers care while they remain in their homes. While Payers are working to support Providers, many Providers are still expecting to see significant reductions to their billings and revenue. This suggests that financial and other supports will be needed for behavioral health/IDD providers going forward in order to ensure their viability and systemic stability overall.

Another key take-away from the data is the new and valuable role that telehealth and virtual communications play in creating accessible care. A number of temporary state and federal regulatory changes to telehealth billing, staffing, and technology have been critical to providers’ ability to continue services for their clients. With thoughtful consideration adapting some of these rules for permanent change going forward will support telehealth to become an important factor in the availability of services in the future.

System stability will be critical throughout the crisis and as it subsides. Many are predicting an increased demand for behavioral health and substance use services due to the negative impact of social isolation, unemployment, and social unrest. Financial impact across the system is a key factor.