S1E13 - Provider Relations
Service specifications, Ohio Revised Code, compliance, and rules, rules, rules - Provider Relations has many levels of monitoring and oversight.
Hear from Teresa Shane, Provider Relations Manager, and Erika Cowles-West, Provider Relations Specialist, about how the small-but-mighty COAAA Provider Relations team is growing and protecting the provider network in Central Ohio.
Let me know what you think of this podcast, as well as any ideas you have for an episode. Email me at kwhite@coaaa.org!
Copyright 2024 Central Ohio Area Agency On Aging
Transcript
Welcome to Pretend I Know Nothing About I'm Katie White, your host, and administrator of COAAA. On today's episode, we will hear from Teresa Shane and Erica Cowells West about all things provider relations. Let's get into it. Well, welcome to this show. Thank you so much for joining me today. We are going to talk about provider relations with Teresa Shane, provider relations manager, and Erica Cowells West, provider relations specialist. Welcome. Thank you, thank you. Let's start with a little bit about yourself. How long you've been here, what you do? Want to go first, Teresa?
Teresa [:Sure. So I am in provider relations. I've been with COAAA for 30 years and one month tomorrow. And I started here as a passport case manager and then a passport supervisor and then joined provider relations after ten years of being at the agency. And I've been here ever since.
Katie White [:Great, thank you. How about you, Erica?
Erica [:So I started the same day Teresa did 30 days in one month.
Teresa [:30 years.
Erica [:30 years. You laughed at that. Right. And I started as a passport case manager as well, and I did that for about five or six years and then moved into provider relations, and I've been there since.
Katie White [:So you started on the same day.
Teresa [:We did, August 9. There were nine of us.
Katie White [:And what was 30 years ago, what would that be? August 9.
Erica [:We were the biggest class they had had. They had just moved into the new building at 174 East Long.
Katie White [:Interesting. How many people were in the class?
Erica [:Nine.
Teresa [:Nine, we were the nine club, nine of us on the 9th.
Katie White [:Oh, it's like a Taylor Swift situation or something. Cool.
Teresa [:There are only two left. That would be us, right?
Katie White [:Okay, let's think through what all we want to cover here. So, provider relations. We'll start with Teresa. Tell us, just give us the overview of the department and sort of where the mandate comes from and give us the overview.
Teresa [:So our responsibility primarily, we do a lot of different things, but I think when people think of provider relations, they think of passport providers. So we are responsible for the oversight of those provider agencies and non agencies to ensure compliance with the Ohio administrative code, which comes from the Department of Aging and the Department of Medicaid.
Katie White [:And how many passport providers do we have?
Teresa [:Well, funny you should ask, because I wrote that down.
Katie White [:I figured you might have. Thank you.
Teresa [:So, right know, we have about 460 plus passport agencies, 44 assisted living waiver providers, and about 105 participant directed providers.
Katie White [:Wow. And so the provider relations department is a lot of passport providers, but not just passport providers. So who else are we monitoring?
Teresa [:So we monitor our Older Americans Act providers, those title three and Alzheimer's respite providers, of which there are about 24, 25 of those. And then we are responsible for monitoring three levy programs. We do their provider monitoring for Fairfield County, Delaware and Franklin County.
Katie White [:Okay, so Erica, how does it work? How do you break it down? Are you guys all specializing in different areas or explain who kind of does what and how?
Erica [:We figured that out, so we've transitioned a lot this year. We've had a lot of new staff join the team. And as our provider caseloads have gotten larger, I guess we have somewhat specialized, but all of us carry some passport providers. Jackie Rish does all title Three, that was new a couple of years ago, I think. And I share the passport providers with I also do participant directive providers and senior options. Easter does Delaware and senior options and passport. So we also have Angie who does assisted living, but she also has passport providers. So we kind of break it down that way. And then we all have an outer county. One person may not, but we all have an outer county where we do the providers in that area as well. So like mine is Pickaway County. So like Cheryl does Fairfield County. Therefore, she also does the Fairfield County levee.
Katie White [:Interesting.
Erica [:So we haven't gotten to where we are. Some of us, we call each other experts in the, like, home delivery meals. Maybe a few years ago, I was the expert only because I had all a lot of those providers where Cheryl would be the adult daycare expert because she has a lot of those, but nobody has just one provider type.
Katie White [:Okay.
Teresa [:Yeah.
Katie White [:And so how many providers is each provider relations specialist on average to the manager?
Teresa [:I think we're right around 65 ish. Okay, it's a lot. It is a lot and growing. We have just in the last month or two just gotten slammed with new provider applications from the Department of yeah.
Katie White [:It'S kind of a double edged sword, right? Like, we need new providers and more providers, really quality providers, but also anyone who wants to become a provider can become a provider in the state. And so a lot of times it is quantity and not necessarily quality, correct?
Teresa [:Yeah, 100%.
Katie White [:And how many people are on the provider relations team?
Teresa [:We have ten provider relations specialists, myself, our office assistant support person, Kim Johnson, and then Linda Gillespie is our director ADR and director, which is where provider relations falls in the agency.
Katie White [:Okay.
Erica [:I think one thing that's important too, when you're hearing like, we may carry 65 providers, one provider may have one service, but another provider may have four or five services. So you're not just monitoring one, like personal care only they may have personal care, transportation, adult daycare. So a provider may have one name, but have several different things they're doing, or multiple funders.
Katie White [:Okay, so then do you stratify your sort of I'm going to call it a caseload, I know that's not quite right, but do you stratify that based on how many services each provider has?
Erica [:Yeah.
Teresa [:So all providers have a point value assigned to them. So when I'm making a decision about when a new provider comes over who to assign that provider to, I'm counting how many providers they already have, that provider relation specialist, plus the points just to try to make sure I'm as fair in my assignments as I can be.
Katie White [:Okay, and how does the point system work?
Teresa [:So every provider gets a point based on how many funders they have and then how many services they have, and then some services are weighted slightly heavier because of the amount of time it takes to do a review.
Katie White [:Okay, would that be like a home health aid?
Teresa [:Is that a actually, no, it's oh, yeah. Okay. Shocking, they would get a point if they're a personal care provider, another point if they do homemaking services. So a standard home care agency is about three points.
Katie White [:Okay.
Teresa [:But our adult daycare providers get a little extra weight because of the new HCBS setting requirements and the time it takes to make sure they're compliant with those, plus interviews that we have to do of daycare staff. So it takes time. And then assisted living is actually weighted even heavier because it's a lengthy process to do those reviews.
Katie White [:Erica, do you do any assisted living?
Teresa [:I don't.
Katie White [:You don't? Okay, so remind me what you have. Some Passport?
Erica [:I do have some Passport and then Senior Options and then participant directed providers and I just started that in, so that's very reason. So when Stephanie left, I decided to do that for a change of pace. And it feels more social work y to me because I'm going out into the homes and meeting my providers who are the individual provider, the participant provider, and then the person they're caring for. So it's been a big change. I'm out doing home visits again and driving with all those crazy people out there, it's frightening, but still, then I do the Passport and the Senior Options agency reviews as well.
Katie White [:Okay, so because Passport is such a huge component of this, walk me through what it's like when you're preparing for a passport monitoring visit and then what it looks like when you're in that visit too.
Erica [:Okay, so the state mandates to us what a compliance review will encompass. And so there's a rule, the structural compliance review rule, and we have to follow that. So we all have our caseloads, we have to pull billing for the review, we have to do a billing audit, a sample of billing, and we pull the client lists and then based on their census, that's how we determine how many individuals are going to be reviewing. And so the rule requires a minimum of three, maximum of 30. So, again, depending on the census size of an agency. So, for instance, a home delivered meal provider, you can 90% of the time count on the fact you're going to be doing at least 30 clients you.
Katie White [:Were reviewing 30 clients charts.
Erica [:Correct. Wow. But we're reviewing a period of time, so typically it's the quarter prior to the one we're currently sitting in.
Katie White [:Okay.
Erica [:So right now we're doing April, May and June. I've always said this job is kind of schizophrenic because you're going backwards in time to choose your clients and do the review. Then you're writing your letter now, but you're also scheduling the next month out and you're getting evidence of compliance from the reviews you've already done. I mean, it's kind of crazy.
Katie White [:Yeah. So anyway, sure, I fully understand that. You will. Okay.
Erica [:That's what this is for.
Katie White [:Okay. Yeah, exactly.
Erica [:So we call and schedule the review. We try to give a 30 day notice as much as we can. We go out and we do the review. We do an intro with the owner or whomever might be available there that day, the nurses. And then we do clinical chart review, personal record review, and billing policy and procedure review. And then we end the day with an exit conference from there. Then, if anything, health and safety, I guess, issues would become like what's called a disciplinary action. So that requires a little extra step when you get back. That has to be done within a five to seven day period. Other than that, you send a summary letter, they send you evidence of compliance and you determine whether or not they've met the evidence of compliance. So that's the process. It sounds quick, but it can drag on depending on how the review went, actually.
Katie White [:Okay. And each provider has to be reviewed how many times per year?
Erica [:Annually.
Katie White [:Annually?
Erica [:Well, that just changed too, but annually up until July 1, that changed to every.
Teresa [:Some providers are eligible to have a deadline of three years as opposed to just every year. Kind of depending on their qualifications. If they're a Medicare agency or have other accreditations, they may qualify to have reviews done up to every three years.
Katie White [:Okay, so then will that change how you're assigning cases and the weights and all of that?
Teresa [:Oh, it might. Yeah. It's so new that we're really trying to figure out how to move forward with the process. So we're going to be brainstorming as a team trying to figure out because when this rule went into effect, there were some of our team members who had providers who many of them don't meet that qualification. They're still going to have to have a review every year.
Katie White [:Okay.
Teresa [:Others had more providers who met that qualification and so they have the ability to put off a review, maybe not do one this year, maybe not do one next.
Katie White [:So a lot can happen in three years. That's a long time.
Erica [:Yeah.
Teresa [:So we're, like I said, kind of brainstorming about not just looking at, okay, they're Medicare certified, so we can skip them for three years. We want to be sure that we're not letting providers fall through the cracks and taking into consideration other components of determining whether we're going to not do a review or do a review.
Katie White [:Okay, so Erica, you mentioned there might be a disciplinary action letter. And what happens? You come back, you file that letter, where does it go and what happens?
Erica [:So sometimes when we're doing a compliance review and a situation occurs that's considered a health and safety and so that's maybe a provider where they haven't done the criminal record checks or they've hired staff that don't meet the qualifications in those situations, we pull the staff while we're there that day.
Teresa [:Oh, wow.
Erica [:Right. They cannot work. So then we come back and we compose a letter. We all pretty much have a standard. There's certain things that have to be in the letter, but we all ask for different pieces of evidence of compliance or plans of correction. So we send that on to the provider and then Teresa notifies ODA that that provider has received this disciplinary action. The provider has seven days now to respond and they have to send us the evidence of compliance within that seven days. And hopefully they do, because if they don't, then that's just more work on our end. We have to either issue another disciplinary action or refer them onto ODA for further action. But that happens very immediately.
Katie White [:Okay.
Erica [:And then they get what's called a summary letter and we have 60 days to compose that and get that in the mail to them. And then they have 60 days in return to send in their evidence of compliance or plans of correction. So that might be something. They didn't have an incident reporting policy.
Katie White [:So as long as it's not health and safety, they get a little more time.
Erica [:Correct.
Katie White [:Okay. But there are times that you might take someone, quote unquote, off the floor that day.
Erica [:Absolutely.
Katie White [:And you're the one having to have that conversation.
Erica [:We just pull them. I mean, we've gone to places before where we've pulled every staff. So if you find someone that doesn't meet qualifications, we have to review so many staff. So we start with the standard that we're supposed to meet. So three home health aides, maybe two nurses, that's what we're going to review today. And aid number one doesn't meet the qualifications. So now, you know, you have to hope the next two do, because at least now you have one aide and a backup that meet qualifications, but if the second one doesn't, now you have to pull another aid. I mean, it can really snowball and we've walked in before where we have to pull staff that day. And people cannot get service if they don't have backup workers. They have to then rely on the plan they have with the case manager and the family for other people to support that service. It's not good when you have to do that, but you have to because we have to make sure people are qualified to be out there.
Katie White [:So has this ever happened, like at an adult day?
Teresa [:I can't say for sure that it happened.
Erica [:I think the most thing for adult day is probably more so the transportation drivers, maybe they haven't had the required first aid qualification or something like that. I think AIDS at the adult day is a little more cut and dry.
Katie White [:Okay.
Erica [:And because the client to staff ratio is higher there, we may have to pull someone, but it's not going to impact anyone attending the daycare because there's so many other people that have to be on the floor.
Katie White [:Okay, I see. So when they know you're coming, are they sort of nervous? Is it like, I think about, yeah.
Teresa [:The state's coming, kind of what they think. But we've tried really hard to use the approach of we're here to help, we share the same goal. We want to make sure that our waiver individuals are receiving the best service possible and that the providers are compliant with what the rules require. And so we try to make them understand we're really allies. We're not there to be punitive and we're not looking for trouble or bad things. And I mean, some providers still get nervous. Sure, I understand that. Yeah.
Erica [:I had a provider who you would sit in there, just a huge conference room, and as you're sitting there throughout the day, you just are getting more and more cold. And after the first couple of years, I finally said, what's going on with your air conditioning? He goes, I'm just sitting back there, I'm just sweating. So I just knew. Okay, sweater. Sweater agency. Because he was so nervous. Yeah.
Katie White [:And really, Teresa, you said it so well. We are allies in this, but we do need to make sure that on behalf of those we serve, that people are following the rules and doing the correct thing. So you mentioned a couple of different rule changes. How often do the rules change and how many rules are there?
Teresa [:There are a lot of rules. The Ohio administrative code, I mean, we've got requirements for every provider, so every provider type has to meet those rules. And then there are service specifications that are specific to whatever service they're providing. And then you have the criminal background check rules that they have to follow. So it's a lot and we try our best when we do our pre certification visits to even though when they're applying through the state's website, it very clearly says, read the rules before you even submit this application. And a lot of providers seem to miss that. So we ideally spend as much time at the front end providing technical assistance and making sure they understand kind of what they're signing up for. And I think Erica has said it best over the years, it generally takes a provider agency about three years to really have a good grasp on what's expected of them. And like you said, the rules change. And so I think the rules are reviewed every five years, but we do see changes that take place. And of course, through COVID and the public health emergency, we dealt with a lot of different things that we weren't used to, that providers weren't used to. And so now as we're kind of unwinding from the public health emergency, going back to the old way of doing things plus the new rules, it's a lot to wrap your head around. And as Erica mentioned, we do things in the quarter previous from where we're sitting and where we're doing that review. So we're still working with rules that were in effect before July 1 for our existing providers, but when we're doing pre certs, we're using the new rules.
Katie White [:Oh my gosh.
Teresa [:It'S a little bit.
Katie White [:Of so the preserts are new providers coming in, correct. It sounds like you do call it a caseload. So you have a caseload of those that you're monitoring and then are you also working on pre certs?
Teresa [:Yes.
Katie White [:So are those distributed in the same sort of way? They're weighted and okay, yeah.
Teresa [:So, like when she erica said you're kind of schizophrenic because you're doing things from the past. When you're doing current reviews, you're also collecting evidence of compliance of reviews you've already done while you're doing new reviews for new providers and existing providers and then working to collect that evidence of compliance that's due in two months. So it's a lot of calculating and figuring out and making sure we're scheduling reviews because those providers that have to have reviews done every year have to have them done every 365 days. That is the rule.
Katie White [:So it's not like they're all due in December. It's just it could be coming up any which way.
Teresa [:Right.
Erica [:And then the preserts area, that's a much smaller window than your compliance review too. So you may get one across your desk and you're like, oh my gosh, I got to fit that in because maybe you have three compliance reviews coming up. You can't change the dates on those, right. Because this is the day it has to be done so you meet that 365 day rule. And so, yeah, it's kind of crazy.
Teresa [:It's a little chaotic.
Katie White [:That's a tricky balance of just figuring that out. And so that's where I assume the teamwork comes in, right, like, okay, so and so is on vacation, but then these preserts are coming up, but these are due and is there some cross training there to make sure you can support?
Teresa [:And what I do ask for from everybody every six months is their anticipated schedule of reviews for the next six months, so that even if, by point value, someone would technically be due for an assigned presert if I see in the next two months. They are just weighted heavily with compliance reviews that are due. I might bypass them and not give them that pre cert because they're already feeling very overwhelmed. Okay. Or if I know somebody's going to be on vacation. One of the new rules, we used to have 90 days to complete an entire pre certification from start to when we make the recommendation to ODA. And the new rule now is 60 days. So that 30 days has made a huge difference. It really has gone beyond just looking at points for me when I'm making a decision about who to assign a pre cert to.
Erica [:And I think we have just because our caseloads have grown so much over the last few years. And quickly we are working together as a team to so, for instance, we have someone out right now on paternity leave and we have two folks who are on vacation and one person on their vacation is going to be for three weeks. But prior to leaving, I need someone to help cover these. So we're working better toward that. That's part of what Teresa mentioned earlier, where we're trying to figure out how do we really have to remap everything, right? And it's so funny because we had literally just remapped everything because we had a few folks who left. And so we're still trying to figure out how do we make this work in the past, and even just recently, if you're going on vacation, you better do it before it's due, because it's due on that 365 days, right. And so we're really trying to work better at I'm going to be gone for these two weeks. I have these two compliance reviews. Could someone help me? And then I'll help you. So we're working on that strategy as well at the very beginning stages of it, but we have to because our caseloads are such now that you just can't take that one or two week vacation and come back and still fit everything in. We used to be able to have like you should need to do it at least within that month.
Katie White [:Okay.
Erica [:But that changed, I don't know, in 18, maybe 17 or 18 and yeah, it's been crazy.
Katie White [:So are you doing all of this scheduling by hand or is there a software system or something that you're working with to do all of this? No software?
Erica [:No, we call folks and we track it. We each have our own way of tracking and then we give our tracking sheets to Teresa, as she mentioned, we give her in January through June and then we do July through December. But it's our responsibility to track and so we all have our own way of doing it. When new folks start, we share how we do it. Yeah, no, there's no software.
Katie White [:And then what about the actual monitoring? Is that done on paper?
Teresa [:Well, for Passport, we have the PIMS system. Okay.
Katie White [:The passport reviews go into PIMS.
Erica [:Correct.
Teresa [:But I speak for myself and probably Erica. A lot of us are still pretty old school. We take cheat sheets out, print the rules off so we can take our notes right on the rules and cheat sheets for ensuring the personnel qualifications are met, the consumer records have everything that they need to have in them and then come back and enter that into PIMS.
Erica [:Okay.
Teresa [:And we have just very recently started to we've joined the 21st century and have electronic records now. Good. Easter did that right.
Katie White [:Okay.
Teresa [:I think we retain probably the largest amount of storage in the basement of provider reviews because of course you can't destroy anything until six years after they're no longer a provider.
Katie White [:So anything you're pulling for a review are you making copies of and bringing back?
Teresa [:Well, we're getting better.
Erica [:We're scanning, we're scanning, scanning while there correct as much as we can. There are some folks across the state that I absolutely just want to do everything they're doing because they do a lot electronically. But it is difficult when you're at a larger review. We really would have to incorporate that all somehow through some software. But there are times when you can take your laptop out and enter information into PIMS while you're there because maybe it's the same three clients that you reviewed for the last three years and the same staff because there's been no growth. So those are nice. There are times when you go to a provider and they've given you their policy and procedure manual, but you wait an hour and a half for any record to be provided to you, personnel or clinical record. So I'll take my laptop out and just start putting those policy and procedures in the computer. But the whole handwriting thing I think is just because that's kind of the essence of the job. They're constantly bringing you things. So I say to you, Katie, I don't see a skills checklist here for Teresa. And you say, oh, I'll go get and so while you're doing that, I'm working on something else and 2 hours later you bring this form to me that I have asked you now for five times and I go, oh, let me get that and I write it down. Definitely that can be done electronically and that's also part of our conversations too. We have a lot of young folks on our team that I absolutely adore and they're very tech savvy and are really pushing for that and I think it will make our time management better, easier. So yeah, we're working toward those things.
Katie White [:So you mentioned some of the other AAAS have a software system for provider relations.
Erica [:They're using SharePoint I think is the one that the Paa Nine is using. But they've been electronic. I don't know how they do it, but they're a smaller group, again more rural than what we are, less providers. And they've had a pretty solid team, I'd say for the last five or six years too. So all of that goes into play I think, but I'm just glad we're having the conversations. I think it will make things much easier if you can put things in electronically there and then cut, paste and put them in PIMS when you get back or anything like that. ODA recently made changes to PIMS, which has been so wonderful for us because it could literally take you 2 hours to just enter policy and procedure information into the PIMS program, where now it may take you, I don't know, 30 to 45 minutes depending on how good or bad let's say the review is. So that has been absolutely wonderful. They listened and they've worked through some things for us. So that's been nice.
Katie White [:We just hosted some ODA. Ten new ODA staff members came to our building today to learn about Area Agencies on Aging, two of whom were new additions to their It team who will be working on Pim's updates. And so Linda was great and secured a spot. And you know, we have some ideas for you. We have a whole list, but I think it was a good conversation for us to talk about our work from our lens so that they can hear and really understand the day to day things. So it sounds like you don't really have a typical day or week.
Erica [:I can't ever say there is a typical there isn't. You come in with a to do list just probably like everybody else here at the agency and sometimes it doesn't get to done. That's what I said. Well that didn't get to done today, so there's tomorrow and it really just.
Teresa [:Depends on you just never know. On any given day ODA could reach out and say we have concerns about this provider agency and we want you to go like today.
Katie White [:So concerns can come up any day. Pre certs it sounds like can happen at any time and rule changes can happen at any time.
Erica [: ow so we've kind of missed in: Katie White [:So it's kind of a constantly moving target.
Teresa [:And when I do performance evaluations and there's that category about adaptability to changing conditions, that for us is a never ending battle.
Katie White [:It's a constant. Yeah, always changing. Would you say that's your biggest challenge?
Erica [:I think that's what I had thought about is just the rules and then on top of the rule is the interpretation of it. And then now one of the biggest challenges I think for us as a. Team is time to sit down and go through those rules where 24, 25 years ago a set of rules would come out and ODA would work with us. Through that. We'd get the rule, we'd get the interpretation, everything all within the same kind of time frame and that's definitely fallen off over the years. So now really that falls on us. And as a group, that's something else we've been doing differently. So we got this whole set of rules in July, so our next team meeting, because we're going to have to start using those in October. We all took a chunk and we work together in doubles or triples and we're going to report out to the team. These are the changes because we need to know that when we go out and do the job. And so that's a huge challenge, is just keeping up with the change. For me, that's huge, I think is the rule changes, probably, and I would.
Teresa [:Say mine is just dealing with the workforce shortage as it relates to all of these new providers coming on board. In July, 1 of the new rules was no longer is there a requirement for an agency to submit evidence of business history, which when we questioned that, we were told it's just because of the workforce shortage. But in my mind, and I know across the state it's different, but for us here, we are saturated with home care agencies and yet we still experience the fact that we have so many individuals who are waiting for services. And so it feels very I sat in a passport meeting earlier this week and let them know in the next couple of months you're going to see a lot of new provider agencies coming on board. And at the same time, I kind of have to deflate the balloon and say, but I can't promise any of them are going to have staff or be able to provide services to our individuals.
Katie White [:So you don't have to have any kind of certificate of need or anything like that. You can become a provider because you want to become a provider and you go through the steps.
Teresa [:Yeah. You just have to meet compliance with the rules. And of course, now the home care agencies have to be licensed by the Department of Health. So we have a little leeway there. Gives me a little hope, but yeah, there's no I just did a pre search last week with a new agency who's never serviced any clients and I'm not even confident he really understands what he's getting into. But we'll work with him. We provided a lot of technical assistance and keep our fingers crossed that he'll be successful.
Katie White [:That would be great.
Teresa [:Yes, it would.
Katie White [:So how about a success or a favorite story?
Teresa [:Well, my favorite story of all time is when Eric and I and the other seven people started at this agency and I was 30 years old so now you all know how old I am. And I remember saying we went through a month long training during that time before we ever got a caseload. We had to take a test, the whole nine yards to be able to do our job. And I remember at one point saying, I'm going to retire from this agency. And my friend sitting across the table, Erica said, how can you possibly say that? How do you know that? And I just know. I said, listen, we're city employees, we have great benefits. At the time we didn't even have telework or an alternative work schedule. But I said, this is where I'm going to retire from. And she's like, okay. And so, as I mentioned, she and I remain the only two left from that group of nine. So I will be retiring, obviously, and I think Erica will be too.
Erica [:You're abandoning me, but we are retiring from here. Which I thought. You're out of your mind, lady, I'm not staying here. Why would I hooked you? I was know and had my whole life ahead. But that's what we did then in those days.
Katie White [:That is a good story.
Erica [:Yeah.
Katie White [:How about you, Erica?
Erica [:I don't know. I think what I have loved about being in provider relations is because one of the biggest worries I had transitioning from doing case management here and at my previous jobs, I'm not going to have that client focus. And somebody that was on the team at that time had said, well, your providers kind of become your clients. And I was, so I've had several providers that I have had. Obviously I just transitioned my caseload over to Marissa when she started and so finally in July, she got pretty much my entire passport provider caseload. So I've been working with a lot of these people for 25 years, but the part of it that I liked the best is watching their growth. When Global Meals started, Olga owned a sandwich shop in the student union on Ohio state's campus. That's where she started. And today it's this huge I I've been a part of so because as we really the whole philosophy then was so know quality improvement versus quality assurance. And so we built relationships with the provider agency and the owners. I think that's what I would take away for me is just having been a part of their history. And then when I was calling people to say goodbye or I'm going to transfer your case and there were just a few that I thought, well, this is going to be really hard. And I was glad because on the other end of the phone they're like, oh my gosh, this is going to be so difficult. You've been with us forever and compliments of you've, really helped. You've been there for us. So you still get that when you become a social worker, it's, you know, not necessarily for the money or for the, it's those little nuggets that you get. And so I think overall that would be my, I think what I take away the most probably and it's a.
Katie White [:Huge contribution to be part of growing and protecting and enhancing the provider network in central Ohio. Because as we know, especially with the lack of service providers right now, it's exactly what we need. And if you don't have that advocacy and that protection and that quality improvement piece, the providers might not stick around. So as we close, I always like to ask some final thoughts. So what do you want staff to know about provider relations?
Teresa [:We always describe ourselves as small but mighty. And so I just want everybody to know that, yes, we do the provider monitoring, but there's so much more to our day to day activity, and we're out in the field. We're making sure that our individuals are getting the best care, we're doing the best we can with what we have. And I think we're respected by others in the agency, which always makes me feel good. There's one case manager in particular that every time I send out an email about a new provider or a provider has added a county or a service, this one particular case manager always sends me an email and thanks me for keeping her informed and just kind of says, what a great thanks for doing such a great job. And it just makes me feel really good about that. But I also want to say publicly now that I feel I have really the best team and they're not my team, we are a team. We went through a pretty difficult period where we lost a couple of staff to retirements and then we lost some staff to they just chose to go elsewhere in their career, which was fine, but we just weren't used to that. We had been so tight knit and so stable for so long and we went through a really rough patch. But I say confidently, we are in a great place right now. I couldn't be happier with the group that I work with.
Katie White [:That's wonderful, thank you.
Erica [:Yes, I would agree. I would say the last year has probably been probably the most upheaval in our group since I've been in provider relations. But I think we've come out on the other end with a really good, strong team. I think the one thing that I think I would tell people this in interviews too, but I believe that our small group is one of the areas in the agency that touches every other part. We area involved with clinical, we're involved with community education and outreach. I mean, we're in the outer counties. So I think that's what's also kept things interesting is because you're never stagnant there's always something new going on. So I think that's one of the things that it's tough, it's not an easy job, it's definitely not the job it was 25 years ago, that's for sure. But it's evolved. And I think the team that we have right now, I think we're doing a good job with everything we've had to go through. And I think we all like what we're doing and that's the key. That's what probably kept us all on the track the last year. We all do believe in what we're doing. I think that's important. We want providers to be the best they can be, but we also need to protect the consumers who are getting the care and that's a high priority for us. So when you asked earlier, is it difficult to have that conversation when you're pulling staff? Absolutely. But kind of no. You know what the rule is, you know what you're supposed to be doing. So sorry you made that mistake. They have to come off the folks. I feel bad for really area the aides because I think sometimes they're put in these positions without the owners doing what they're supposed to do. So that person now isn't going to get paid and they have a family to feed, but the owner is ultimately the responsible one. So I don't know, but keeping you.
Katie White [:Grounded is the fact that you need to protect the older adult people with disabilities that are getting these services. Well, I say confidently that it's not just the case manager who's very thankful for your team and your work, but definitely me and everybody across the agency. It's not easy, but it is a huge piece and crucial to making sure that people in central Ohio get what they need. So thank you so much for being here. Thank you.
Teresa [:It's fun talking about us.
Katie White [:I hope now you know something about provider relations. Thanks for listening.
