With so many changes and uncertainties surrounding the EVV mandate, providers have been left with several questions. We have compiled the most frequently asked questions for your agency to access at your convenience.
Download this fact sheet to get answers to the most frequently asked questions surrounding the EVV mandate.
Fill out the form below to be emailed the download link.
A recent snapshot survey conducted by five Illinois provider associations -The Arc, Community Behavioral Healthcare Association, Illinois Association For Behavioral Health, Illinois Association of Rehabilitation Facilities, and The Institute on Public Policy For People With Disabilities – of clinic-based and residential provider organizations includes information on how providers are adjusting pay, payrolls, and operations during the emergency.
The rate increases for hourly staff were implemented using a wide range of criteria. Responding executives reported hourly increases between $1.00 – $5.00 per hour, and $20 per day incentive payments. Some organizations were providing overtime pay for all hours worked, or double pay for staff in residential settings and/or those working residents who tested positive for COVID-19. Some were using lump sum bonuses.
The pay increases reflect the stress and fear of the risks of providing residential services for consumers with disabilities.
Executives across the country, running these critical residences, are using a variety of approaches to keep their services going. One example is using empty hotels to house consumers who test positive for COVID-19. Remedies Renewing Lives, which offers substance use disorder treatment, and runs a 62-bed domestic violence shelter in Rockford, Illinois, is one of several health care and shelter organizations partnering with the local housing authority to put people suspected of having the virus or diagnosed with it in hotel rooms to contain the virus.
This “hoteling option” can also be used for overflow at local shelters, and treatment facilities, said Gary Halbach, chief executive officer of Remedies Renewing Lives. And while it hasn’t yet been needed, it’s a relief to know it’s there, “because it’s a question of when it’s going to be needed, not if,” he added. “It’s like the Wild West and it changes every day.”
This has also been a successful tactic for the Hazelden-Betty Ford Foundation, which instituted a requirement that all consumers have a “fever discharge plan” identifying a person (not public transportation) who will pick them up if they spike a fever and must be discharged. Everyone who comes onto a Hazelden-Betty Ford campus gets a temperature reading.
“That fever discharge plan is key to us staying open,” said Mark G. Mishek, the nonprofit’s president and chief executive officer. In January, when news of an outbreak was first heard, the organization started asking people during intake about whether they had traveled to China. Hazelden-Betty Ford team members started taking everyone’s temperature on each campus a month ago, and moved all of its outpatient treatment to virtual two weeks ago. To learn more about how agencies manage hazard pay and other differentials, download the Guide to Payroll Rules Used by Agencies ebook or the myAttendance fact sheet.
Engagement is an employee’s emotional commitment to your organization and its goals. When engagement is unlocked, it leads to higher productivity, cost reductions, and retention.
True commitment is a two-way street. What are you doing to earn it and how can you reciprocate? MITC offers a variety of tools to help your organization drive engagement:
In 2019, several CEO’s at different agencies in Arizona, Georgia and Pennsylvania asked me essentially the same question:
“Why don’t you have an EHR?”
I gave the same answer I have given for many years.
“Agency Workforce Management is about Time & Attendance, Documentation, Scheduling, Payroll Integration, Billing, HR, Training – everything about managing staff. Anyway, there are lots of good EHR products out there. What’s wrong with what you have?”
The answer I got surprised me:
“Our EHR is fine but it does too much; It’s too expensive and complicated. We need something straightforward and inexpensive – why don’t you make us something?”
So that’s what we have done!
At ANCOR in late April, MITC will unveil Client Profiles – the latest addition to Agency Workforce Management!
When MITC contacted providers late last year to float the idea, we got a positive response. Many providers applied to join an Early Adopter Program, ten of which have been selected. These providers will collaborate with MITC and work directly with our agency software developers once a MVP (Minimum Viable Product) is created. This will help MITC ensure v.1, due for general release in June 2020 and v.2, due for release in October 2020, are closely aligned with agency needs and priced right. During 2020, MITC will commit agile software development resources to respond rapidly to provider needs with the goal of wrapping up the bulk of the development by the end of quarter 3 2020.
Three developers in the USA will be working on this project. They have a lot of experience in creating great software for agencies, and we know they will do as good a job as they did with mySchedules in 2018-2019.
Because of all the activity associated with EVV, MITC was reluctant to make this investment at this point in time. However, MITC’s market research found that many of the providers most effected by EVV were exactly the sort of providers who could benefit from “EHR light”. MITC has hired additional staff to provide extra support services for EVV.
We don’t intend to go head-to-head with full service EHR products. Client Profiles will be designed for providers managing HCBS and Day and Vocational programs whose EHR needs are more limited than providers managing ICF’s, large group homes, or intensive supported living programs.
We will also price position Client Profiles in the “cheap and cheerful” range: straightforward to use, functional, and relatively inexpensive compared to other, more complex EHR systems.
Hopefully, along with existing applications like myCommunications and Documentation, Client Profiles will prove to be of value to many agencies. All of here at MITC are excited to find out.
John Graham
MITC CEO and Software Architect
In order to attract caregivers, Maine’s labor commission is calling for something radical: a requirement to ensure they’re paid at least 125% of the state’s existing minimum wage.
Overall, state-mandated minimum wage hikes have become somewhat commonplace in recent years. At least 21 states, for example, started 2020 with higher minimum wages than the previous year.
A legally mandated home care-specific boost to a given minimum wage, however, is a relatively new concept. However it is a long standing tradition Australia where the minimum wage is set by profession. Direct care workers earn $18.82 an hour to $22.84 depending upon skills plus overtime after 38 hours.
Maine’s Commission to Study Long-term Care Workforce Issues, a group established in 2019 to study direct care labor shortages, shared its recommendation in a new report.
The Maine legislature’s Health and Human Services Committee voted unanimously to push forward accompanying legislation that would back the proposal on the same day.
Raising caregiver wages is just one of a number of recommendations made by the commission.
The group also called for a public service campaign that promotes direct care worker jobs as a viable career option, industry-specific state-sponsored job fairs, direct care worker training and education programs, and student loan repayment eligibility. The commission also recommended the creation of a long-term care workforce oversight committee.
In addition to the previously mentioned plans, the long-term care commission also called for an increase in Medicaid reimbursement rates to better reflect providers’ costs. Nationwide, the delivery of home care is becoming more expensive, propelled upward by minimum wage hikes, more paid-time-off rules, electronic visit verification (EVV) requirements and background checks.
While the Home Care & Hospice Alliance of Maine was supportive of the proposal, it did so partially under the notion that home care wages would rise in tandem with reimbursement rates. If that didn’t happen, a caregiver floor wage of 125% of Maine’s minimum wage would likely prove catastrophic for home care providers.
Just last week, the Maine-based nonprofit Home Care for Maine announced it would be closing its doors in April due to financial troubles brought on by a recent minimum wage raise. The shutdown will leave almost 600 patients without home care.
In 2017, Maine’s minimum wage increased from $7.50 to $9.00; it then spiked to $10.00 in 2018 and to $11.00 the following year. Currently, the state’s minimum wage is $12.00, a result of another hike in 2020.
For context, 125% of Maine’s 2020 minimum wage would mean a caregiver baseline of at least $15 an hour.
A growing number of companies are helping workers gain access to payroll advances and loans, reflecting concern over the impact money problems are having on productivity levels and worker retention.
Employers, including Walmart Inc., have recently added these services. The aim is to help cash-strapped employees, many with damaged credit, cover unexpected expenses without resorting to high-cost debt.
“Employers have woken up to the fact that a majority of workers are having a lot of trouble simply getting by, never mind getting ahead,” said Sophie Raseman, head of financial solutions at Brightside, a company Comcast Corp. co-founded that provides financial guidance to workers and is testing payroll loans with some corporate clients.
Workers typically access the services online. The payroll-advance programs generally give employees the option to accelerate a portion of their next paycheck for a fee that often amounts to a few dollars. The loans are typically a couple thousand dollars, and are repaid through automatic payroll deductions over a few months to a year or longer. Approval and interest rates, generally 6% to 36%, often depend on factors including a borrower’s credit score.
Because the services deduct repayments from workers’ paychecks before the money goes to their bank accounts, default rates tend to be low.
According to an Employee Benefit Research Institute survey of 250 employers last year, 12% offer accelerated pay. The same percentage offer short-term loans repaid through payroll deductions. Another 4% and 6% plan to add the services, respectively.
Companies, meanwhile, are responding to data that indicate American workers are financially stressed. While incomes have been stagnant for many, expenses for items including health care and education have risen.
Employers are concerned about the impact on productivity and turnover. Research by Todd Baker, a senior fellow at Columbia University’s Richman Center for Business, Law and Public Policy, looked at 16 companies in the U.K. that offered payroll loans and found that borrowers had, on average, an annualized attrition rate 28% lower than the rate for all employees.
Mary Haynes, chief executive of Nazareth Home, which runs long-term-care facilities in Louisville, KY, said the company began offering accelerated paychecks through PayActiv Inc. two years ago after realizing many of its staff were incurring late fees and using payday loans. PayActiv works with 500 employers, including Walmart.
Of Nazareth’s 400 employees, 338 are enrolled in PayActiv and 280 use it regularly, Ms. Haynes said.
The benefit attracts workers and saves Nazareth money, Ms. Haynes said, by “practically eliminating” its use of a staffing agency some workers preferred because the agency provided access to paycheck advances.
Typically, payday loans charge $15 for every $100 borrowed. Bank overdraft fees often cost about $35. In contrast, PayActiv charges $5 per pay period when an employee uses the service, which also includes financial counseling and online bill payments.
Some point out that a $5 fee can equate to a high annualized percentage rate on a small short-term loan.
Robyn McGuffin, a medication technician at Nazareth Home, says PayActiv has helped her avoid late and overdraft fees of as much as $80 a month.
Ms. McGuffin, 36 years old, says she typically uses PayActiv once or twice per pay period, generally for bills due before her next paycheck arrives. The Louisville resident also used it to buy a new car battery and cover her fiancé’s share of the household expenses when he was temporarily out of work due to a medical emergency.
Some employers pair loans or accelerated paychecks with online tools to help workers budget, reduce debt and amass emergency savings.
Walmart introduced salary advances in late 2017. It has seen employees rely less on payday loans and bank overdrafts, said David Hoke, who oversees health and well-being.
Employees pay $6 a month to use PayActiv. It is embedded in an app called Even, which also includes a budgeting service that nudges users to save surpluses. Walmart covers the cost for one month per quarter and caps the amount workers can accelerate at 50% of pay. Of the company’s 1.4 million workers, 380,000 are frequent app users, Mr. Hoke said.
For those in need of larger sums, some employers offer loan services that typically advance as much as $5,000, with repayments deducted from workers’ paychecks over four months to a couple years.
Lender Kashable approves “more than 60%” of applicants, said co-CEO Einat Steklov. It considers factors including job tenure and credit scores.
The average user has a subprime credit score and pays an annual interest rate of about 20%, Ms. Steklov said. Kashable’s default rate is 5%. Borrowers who leave their jobs before repaying in full generally switch to automated bank transfers.
Learn more about how Agency Workforce Management can integrate with advanced pay software by reading our ebook.
Incentive plans can help an agency boost its performance and improve quality of care by motivating employees and managers to increase their efforts toward achieving agency goals. For example, if any agency wants to maximize client care authorizations, it may offer employees a bonus if they are able to reduce their non-billable hours.
In order for an incentive plan to work, the provider must have measurable, self-financing plans that deliver major, identifiable benefits to the agency. The defined goals should be achievable for at least half of your workforce. Such goals might include:
Providers across the country have achieved these objectives (and many more) from their incentive plans. The following examples of incentive plan models are based on real experiences.
Overtime costs in group homes and HCBS programs have been rising in recent years due to the labor shortage. While you may never eliminate overtime completely, an incentive plan can help you reduce it. Overtime control plans provide a continual reminder that minimizing overtime is always important and shares the savings with those who did the most to make a difference.
To measure your progress, it is important to have a time & attendance system that provides detailed overtime reports. Also, managers should use a scheduling solution that can highlight available employees already in or approaching overtime.
To control overtime through an incentive plan, follow these steps:
Many HCBS programs involve authorizations and budget caps. But some providers may fail to maximize the authorization or, even worse, exceed the authorization. An incentive plan focused on increasing revenue, with the help of integrated time & attendance and scheduling solutions, will encourage managers and staff to maximize authorizations without exceeding them.
To increase revenue through an incentive plan, follow these steps:
Staff who work in HCBS programs often need to travel between clients. Since travel time is non-billable, providers need to keep it to a minimum. To do this, providers use smart scheduling solutions to map out shifts for minimum travel time and an automated time & attendance solution to track billable vs. non-billable hours. But sometimes, a little incentive can help managers use these tools more effectively.
For example, a provider in New York noticed that staff were spending a lot of time on non-billable travel around Long Island. So the agency promised a bonus to managers who could reduce travel time by adjusting schedules and routes. The plan worked. Through simple schedule changes and route-mapping, the agency significantly reduced non-billable travel time.
To increase productivity through an incentive plan, follow these steps:
Reliable attendance is crucial for agencies, especially when one employee’s tardiness turns into another’s overtime. While employees may occasionally forget to clock in or out, 95% of an organization’s attendance records should be correct. An incentive plan encourages prompt attendance and reduces the risk of fraud.
To strengthen time & attendance compliance through an inventive plan, offer bonuses, gift cards, staff lunches, or other special recognition to employees with perfect attendance in a given period (no missed punches, no edits, no late arrivals or early departures). Even better, if you reward employees in groups (i.e. the entire group home staff must have perfect attendance to receive a bonus) they will encourage each other to be on time.
One of the best sources for recruiting is an agency’s own staff. Employees often know of others in the same field who might be interested in a new opportunity, and they can speak to their character. Incentive plans can motivate them to reach out to their network and guide them toward agency job openings.
To hire and retain qualified staff through an incentive plan, offer referral bonuses, track retention by manager, and reward managers who have the highest retention rates over a quarter.
Performance incentives are designed to influence behavior and result in positive gains for the agency. When implemented correctly, incentive plans can bring measurable improvements to consumer care, like reliable attendance, long-term relationships with faithful employees, and fully-utilized authorizations.
However, an organization needs effective tracking methods to implement an incentive program. If you would like to learn how your organization can reliably track time & attendance compliance, overtime by individual/group, client authorization utilization, billable vs. non-billable hours, and more, reach out to info@mitcsoftware.com.
This short quiz helps determine which workforce management solution best fits the needs of your agency, from an HR perspective.
Human Resources professionals have a surprising amount of insight into the health of an agency. You regularly work to increase hiring and retention success. You may manage employee training and payroll. And you often get a glimpse into time & attendance, billing, and even scheduling. If anything is amiss, you are usually among the first to notice.
Take the quiz to test your knowledge of the agency and learn where you may have a weak spot.
As the warm weather clears up and gives way to the cold, providers start to plan for inclement weather. Will the snow and ice cause road closures, power outages, or slippery conditions this winter? How can we prepare ahead of time?
Weather is a bigger concern for some areas than others. For example, last winter sent four nor’easters whirling through New England, causing mass power outages, cancelling flights, and creating dangerous or impossible driving conditions. Providers in the affected areas had to scramble to alert their staff of closures, delays, schedule changes, and special accommodations.
For those in warmer areas, conditions like hurricanes, tornadoes, or high wind can also disrupt regular services. Regardless of the climate, all providers should have a system in place to send immediate communications to the staff.
Many providers have already adopted systems to deal with inclement weather (and similar emergencies). However, these solutions require a lot of time and resources, and they are usually ineffective.
Providers will often reach out to staff by phone in the event of emergency weather conditions. Some providers keep a big list of staff cell phone numbers; when the weather strikes, managers pull out the list and start a phone campaign to reach everyone. Other providers set up an old-fashioned phone tree, where managers call a small pool of employees, who are then responsible for calling several more, who are then responsible for calling several more, until the entire agency has been contacted.
Both of these phone methods have several problems. First, they are inordinately time-consuming. If an agency has 100 employees, and each phone call takes about 2 minutes, it will take four managers almost an hour to contact everyone. That can increase to multiple hours if the agency is larger, if fewer managers are available to sit at their phones, or if employees lengthen the phone calls by asking questions. Providers rarely have that much time to spare in emergency conditions.
Another problem with these phone methods is that they are hard to maintain. In a high turnover industry, managers have to remember to update the phone lists constantly. One error could make the whole system fall apart. Also, in the case of the phone tree, managers cannot confirm that all employees receive a call. One person in the tree may get distracted and forget to call the others, creating a big hole.
The last thing providers need is extra stress during a weather emergency. Instead of phone campaigns, they need a faster, more reliable way to contact employees.
An automated alert system, such as Agency Workforce Management’s eNotify, eliminates the problems of a phone campaign. Instead of a mass network of phone calls, a manager can send just one alert to everyone within seconds. Alternatively, the manager can send alerts to specific groups of people; for example, if a notification only affects group home staff, the rest of the agency will not receive it. The benefit of eNotify is that it saves time – allowing employees to take action more quickly – and it eliminates the burden of maintaining contact lists.
Since eNotify is so easy and convenient, agency staff can receive quick “heads-up” alerts, even in non-emergency situations. For instance, if the weather report threatens snow but the forecast is uncertain, managers can send weather updates and coordinate next steps ahead of the storm. A phone call system is too cumbersome to handle this much communication.
With eNotify, providers can also ensure that employees receive up-to-date information straight to their smart phones. They do not have to worry that an employee will miss a call and forget to check voicemail, or that someone will forget to call someone else.
eNotify’s limitation is that it only supports one-way communication. While that is fine for many providers, some prefer real conversations. Maybe a few employees are better prepared to brave the elements than others, and they can offer to cover extra shifts. Or perhaps managers want staff to send updates about certain areas. Whatever the case for two-way communication, Agency Workforce Management has a solution.
myCommunications is a multi-way communication platform that is secure and accessible remotely. By facilitating the exchange of information among all employees in a secure, HIPAA-compliant way, myCommunications keeps staff connected on administrative, personal, or individual care-related issues.
No one can control the weather, but providers can control their emergency weather procedures. When the weather is bad, staff need to receive updates and instructions right away; managers can provide information immediately and can send as many updates as necessary with an automated alert system. This ensures that services continue despite the elements.
People have been resisting technological advances for hundreds of years. Nowadays, we wonder why people ever avoided mechanical farming equipment or doubted the usefulness of personal computers. But as far as we venture back into the history of technology, someone is always hesitant to adopt something new, even if it simplifies their work. The human services industry is no exception to this.
Here are a few common reasons agency staff resist technology and some considerations to ease any doubts you may have:
Many are wary to introduce technology into their workflow because it means change. Change is hard. Especially when it means moving away from familiar tools like pen and paper and Excel spreadsheets toward the unknown complexities of technology. But if an organization cannot adapt to anything new, it will not thrive.
Workforce management technology is designed to make things easier for an organization. After the initial shock of unfamiliarity passes, you will find that the new way of doing things is simpler and more streamlined. Instead of typing all your time and attendance data into the payroll system, you can import it in seconds.
Technology implementation can be a pain, especially in large agencies set in their ways. But the truth is, implementation does not have to take forever.
The biggest barrier to a successful implementation is poor staff compliance. This can occur when managers and executives do not clearly describe the benefits of the new technology or provide adequate training. Most implementation snafus are easily avoidable with a strong compliance plan. As an example, read the story of an agency in Pennsylvania that fully implemented a new time and attendance system in a few weeks.
If you look at the dollar expense of new technology, you may be tempted to write it off. Who needs another cost when resources are already strained? But the truth is that technology has high potential for return-on-investment.
If you have trouble visualizing the long-term savings of effective technology, consider the ways technology saves money:
When implemented correctly, technology can save your organization far more than it costs up front. For more tips, read this eBook and learn six best practices for introducing new technology in your organization.
2018 MITC
2018 MITC
2018 MITC