S2 E5 - Screening
Thousands of calls, emails, website inquiries, and faxes come into COAAA each month. For individuals seeking information and assistance, there is a team at the agency ready to offer support. Learn how the screening team provides and educational and supportive environment from Marikate Leavens, Screening and Pre-Admission Review Manager, and Chelsee Russell, Screener.
Key Takeaways
1. The screening department of COAAA faces challenges in handling a large volume of waiver referrals and programs, both internally and externally.
2. They request patience from clients and encourage them to ask questions while assuring them of their commitment to helping as much as they can.
3. The department shows care and compassion when dealing with individuals in crisis and provides support and guidance for navigating complicated systems.
4. Staff members in the organization are responsible for different aspects of scheduling and coordination, handling referrals from various sources with strict timelines for response.
"There's a lot of emotion that goes into the phone calls and a lot of emotional support that the screeners provide all the callers."
— Mary Kate
5. Referrals come in through multiple channels such as phone calls, voicemails, online systems, faxes, and emails, and are handled by different staff members who prioritize and manage them on a day-to-day basis.
6. The assessment covers tasks needing help with, health conditions, social determinants of health, level of care, financial eligibility, income, and asset details.
7. The income eligibility level for Medicaid is $2,829
8. The asset level for Medicaid is $2,000 with a five-year look-back period
9. The screening team is tasked with handling referrals for multiple waivers and programs, except for MyCare, and completing LTSQ for scheduling assessments.
10. Despite the challenges of handling a high volume of calls and the stress and anxiety it causes, the screening team remains committed to providing comprehensive support to callers.
"You did everything you could have, should have, would have done, and there's nothing more you could have done."
— Chelsea
Memorable Moments
06:11 The Screening department directs calls for various assistance.
08:00 Assessing needs of individuals for care services.
13:42 Screeners ask questions, finalize LTSQ, and coordinate assessments.
19:06 Limited staff for strict referral schedule challenges.
21:03 OGM sends various referrals through different channels.
25:22 Grateful for those who answer the phone.
32:13 Desire for authentic job satisfaction and challenges.
36:35 Excited for your new role and improvements.
38:50 Managing numerous waiver programs requires a complex referral process.
42:02 Handling emotional and dire situations with callers.
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, Administrator of COAAA. Thousands of contacts come into our screening department each and every month. Today we'll learn from Mary Kate and Chelsea about the supportive and educational experience provided by our screening team to those who need us. Well, welcome. Today we are learning from Mary Kate Levins, screening and pre admissions review manager, and Chelsea Russell, screener extraordinaire. Welcome to you both. Thank you.
Katie White [:So I like to start off just by having you introduce yourself, tell me a little bit about your role and also maybe a little history about how you got here. So, Mary Kate, let's start with you.
Mary Kate [:Thanks. I am the manager for screening and pre admission review, and in that role, I do a lot of different things because there are two very different departments. So with screening, it's a lot of managing referrals, handing them out, talking about them, consulting regarding those, interfacing with ODA and ODM, Franklin county senior options in particular, a little bit with Mycare and then with pre admission review, that's completely separate people, different department, and we interface primarily with nursing facilities and the community. And assessment. We work a lot with assessment in pre admission review. I've been here about four and a half years. I came from the office on Aging, where I worked for senior options, and then in the QI department, provider relations, and I was there from 2013 to 2019. Prior to that, I was at Heritage Day health centers for ten years in the joyous world of adult day health, which is lovely to work in.
Mary Kate [:And prior to that, I was in nursing facilities and hospice care.
Katie White [:Okay, and you're a licensed social worker?
Mary Kate [:I am a licensed social worker.
Katie White [:Great. Thank you. Thank you for coming on today.
Mary Kate [:Thank you for having us.
Katie White [:Kelsey, how about you?
Chelsea [:So I have been here almost seven years, been with screening about a year and a half. Prior to that, I was in a nursing facility doing a lot of the long term residents. We kind of split it that way. So I did a lot of the long term people, and my role is I answer a lot of the live phone calls that come in. That's primarily my day to day. So I'm getting a lot of referrals, but also people calling aren't sure even where to start. We get a few that say, I'm calling for my passport. I want to travel.
Chelsea [:When they google passport, we get them. So I'm getting a lot of different calls every day.
Katie White [:Okay, and what did you do before screening at COAAA?
Chelsea [:I was with the Aetna, my care program.
Katie White [:Okay. See, I love this part to see where kind of everybody started and came from to get here.
Chelsea [:So I was up there about five and a half.
Katie White [:Great. So probably at the beginning of my care then.
Chelsea [:Yeah, I came in at 2016. So they were a few years old.
Katie White [:Okay, got it. So we release two episodes at a time. So during this release it's going to be the screening episode and the assessment episode. So what I'd like us to do is kind of talk about when somebody calls COaAA, whether they speak to someone at the front desk or know to directly get into the screening department. What does that look like? So I know we get roughly 4000 phone calls through the front desk every month. But Mary Kate, talk to me a little bit about how the calls come in and some of that call volume into the screening department.
Mary Kate [:Sometimes calls do start at the front desk and they will transfer many different calls to screening. But now that we have the phone tree, we're getting direct calls as well. I looked at December and we had 3095 calls for the month of December for screening.
Katie White [:3095 calls for the month of December and screening.
Mary Kate [:Right. We have ten people that manage the calls.
Katie White [:And when we say calls, that can actually mean emails and requests from our website or that's just, that was phone calls. Oh my goodness. Okay, so then how about total contacts that came in for the month of December?
Mary Kate [:That was for December was 929, which was actually low for the year. We in April had 812 and in May jumped to one on hundred and 72.
Katie White [:Oh my goodness.
Mary Kate [:That was a 44% increase in contacts.
Katie White [:Okay.
Mary Kate [:And our phone messages increased 70% in that time as well.
Katie White [:So an individual can call our front desk and press one to get to the screening department, which is a new change. But we're trying to kind of work on some efficiency, maybe because our volume is so high. Or they can directly call the screening department through the obltss phone line.
Mary Kate [:Yes, we manage two phone lines. So we have the ACD call line which the screeners answer through COA. And then the state has a statewide Ohio benefits long term services and supports phone line that anyone in the state can call. And then based on the zip code you enter, it is directed to your PAA and those come in daily as well. So we're managing two separate phone lines throughout the day.
Katie White [:So we have a huge amount of call volume that comes in. What is the screening department providing?
Mary Kate [:Just in general, the screening department is literally as designated by OdA, the front door. So a lot of calls come in regarding a lot of different requests. Some of it is INR. So information and referral or information and access to other agencies. But we are primarily, most of our time is spent on the true referrals. So helping people decide what program through Medicaid waiver, they might be eligible for, filling out the initial screen for that. If they're not going to be eligible due to level of care, finances, then we are trying to search for other programs that they may be eligible for that will help them with whatever their presenting request is. So it's just a lot of conversation about what is it you're calling about, what is your need and how can we direct you to any available, appropriate resource that might be in this area for them.
Katie White [:Okay, so, Chelsea, one of your primary roles is answering the live calls, you said. So there's a number of different voicemails and things like that that we get, but there's always a couple of people on the live calls, is that right?
Mary Kate [:Yes.
Katie White [:Okay, roughly how many people are on live calls at once?
Chelsea [:You mean as far as like screeners or people calling in screeners? I would say four.
Katie White [:Okay, so you get a call and someone wants to understand whether or not they are eligible to join passport or Mycare. So we know they're going to need an assessment. Walk me through what the questionnaire is that you complete with an individual before they are scheduled for an assessment.
Chelsea [:So we really get just a basic high level overview of what tasks each person's needing help with, like the bathing, dressing, grooming, things like that. If they're needing help with meds, what their health conditions are, we get a little bit into other social determinants of health to see. Can we link you with any mental health resources? Do you need a referral to a department of developmental disabilities? Do you need substance abuse, Aodu services, things like that? So we get a little into that to try to link with some more resources. But the general, most of the time we get into that adls, the bathing, dressing, grooming, health conditions. Do you need a nurse? Do you have a skilled need? Things like that?
Katie White [:Okay, so that's more of like the level of care. And in the assessment episode, we'll talk a little bit about level of care, but what about the financial requirement? Are you asking that type of thing too?
Chelsea [:Yes, we ask how much your monthly income is, what your assets are, and we have all those numbers from Medicaid and JFs. So we can tell someone if they're likely eligible. We don't make the determination. That's up to job and family services, but we can kind of give them an idea. Are you going to be eligible? Are you absolutely no way eligible? Could you spend down a little things like that? So we can give them a ballpark of should they or should they not be eligible.
Katie White [:And what is that monthly income eligibility level at these days? I know it kind of changes, right.
Mary Kate [:As cost of living changes just changed.
Chelsea [:In January 1 $2,829 I think.
Katie White [:Okay. And so if they are making more than that, then they would not be eligible for med.
Chelsea [:Not necessarily. They could set up a qualified income trust and that's for anything over that. 28, 29 so how does that work?
Katie White [:Well.
Chelsea [:We can give you some basic information on that, but that typically goes through like a bank. You're going to set that up like another bank account. They can use it to pay share of cost for medical bills, expenses that are necessities for them, things like that. So it doesn't necessarily make them ineligible, but a lot of people either aren't interested in losing a certain percentage of their income or dollar amount or they can't afford it or whatever. So sometimes it does make people ineligible just for their own personal reasons.
Katie White [:Okay. And how would someone know to call us to see what they're eligible for? Area they learning about that from their insurance, from Oda, from ODM? Or is it just that they've gotten to a certain point in their life and they know they need something?
Mary Kate [:I think we're a starting point for a lot of people. Oda and ODM definitely advertise to contact us on their websites. The office on Aging and the senior options program here will also direct people to us. A couple things I did want to clarify is that we process the screens, the initial contact intake for a number of waivers, but not my care.
Katie White [:Oh, thank you for clarifying.
Mary Kate [:So we will process passport, assisted living waiver, Ohio home care waiver, the Department of Developmental Disabilities, residential services, supplemental services, srs and Ohio rise, but not my care. We will direct people to the mycare program, but we are not accepting a referral for it because they have to through their insurance, through their own insurance.
Katie White [:Good clarification. Thank you.
Mary Kate [:And then the asset level for Medicaid is always $2,000. So the income, you can have a little higher income and set up the qIt, but the asset level is $2,000. There is no getting around that.
Katie White [:And so if you have more than $2,000, you have to figure something out. And there's a look back period too, right? Does anyone want to explain kind of what that means and looks like?
Chelsea [:Yeah. So that look back period is five years, the JFS worker will look back to see if there were any improper transfers. So if you had $50,000 in a bank account and you transferred 48,000 of it to a son, daughter, family member, someone as a gift, they look at that as improper. So then there's some other things that happen. Restricted Medicaid coverage and things like that. So they look back five years. Five years in one day, they don't look at it. Okay.
Chelsea [:Or if with estate recovery, you could put your home in a trust as long as that's been five years, they won't look at your home for a state recovery, things like that.
Katie White [:Okay. So any of those assets are five years. Okay. So when somebody calls in and they essentially know that they need some services, right now, we are going to work with them and ask them all the questions to see what they might be qualified for. And then if there are steps that we can take to get them connected to what they might be qualified for, we do that as well. And then the name of the actual questionnaire.
Mary Kate [:The LTSQ.
Katie White [:Yes.
Mary Kate [:It's the long term services and supports questionnaire.
Katie White [:Okay. And so that is what then leads into a referral to get an assessment from our team to go out and actually see someone.
Mary Kate [:That's right. So the screeners ask many, many questions, fill out the LTSQ, and they finalize the LTSQ. In the management system we use, which is obltss, once it's finalized, if it's an ODA referral for passport or assisted living waiver, then it pops over into pims. And our scheduler. We have a person designated to coordinate all the scheduling that has to happen for the assessments. She links those cases from obltss to pims, and from there develops the schedule for the day that is sent to the assessors. And from there, they make their contacts.
Katie White [:And so in order for that schedule to go over, the LTSQ is completed.
Mary Kate [:Right.
Katie White [:And then that's what prompts it being sent over for the assessment. And then is your team scheduling the assessments or they're sending over the official referrals?
Mary Kate [:Our scheduling coordinator is creating a list daily that assigns the people who have been linked for passport or assisted living. The other assessments that we coordinate are level of care for nursing home placement. And RSS comes to scheduling to coordinate being assigned to an assessor. So she puts that list together on a daily basis, assigns all of the referrals to an assessor, and then that list, which is just an excel list that we've created, is sent to the assessors every day by Michelle.
Katie White [:Okay.
Mary Kate [:And then they are responsible for looking through the list, which can range from ten to sometimes 35 assessments a day. And they're responsible for looking for their name and then contacting those people to set up the assessment directly and scheduling it out.
Katie White [:So how many people total are there on the screening team?
Mary Kate [:There are currently twelve.
Katie White [:Okay.
Mary Kate [:One person, Michelle is devoted to our scheduling coordination. Chelsea and now Sarah are backups for when she is off, which pulls a screener off of screening. And then Vicki is our triage coordinator. So she is the person that is listening to the many, many voicemail messages that are left daily, sometimes up to 55 or 60.
Katie White [:Wow.
Mary Kate [:And then trying to assign those out to folks to follow up with. She also collects the faxes, emails, online referrals, and coordinates those. And then I am responsible for pulling off and assigning all the ODM and ODA referrals along with senior options and sourcepoint. So we have a few people coordinating all of the information that comes in and then trying to make sure it gets assigned to folks so that they are contacting everyone to get that screen.
Katie White [:So the first time I sat down with you and sat in and listened to a screener, the referrals never stop. They never stop. The fax machine can't turn off. We can't turn off the phone if it's coming in from certain lines. We absolutely have to pick up that line. And so it feels, and maybe you guys are used to it, but it felt really overwhelming to me when I was there to think it never stops. Right, right. And so it sounds to me like there's individuals that are dedicated to coordinating all of the contacts that are not live phone calls.
Katie White [:And that's Vicki. But then there are some people that are taking live phone calls. So Chelsea, do you only take live phone calls or kind of tell me how that scheduling.
Chelsea [:I don't. I, majority of the time take the live calls. I am still getting senior options referrals, Ohio Department of Medicaid referrals, source points, things like that. But the majority of my day is spent picking up live.
Katie White [:So you, so individuals know when they're scheduled to do the live calls and then are you scheduled to not do live calls? But you get like a stack of things to work through.
Mary Kate [:We primarily have four people that are concentrated on the phones. So Stace, Chelsea, Cameron and Ayesha are primarily answering live calls. Stace, almost 100% of the time, all day, every day. Right. Okay. And then everyone else is managing the phone messages and then the other types of referrals that we get from Oda, ODM senior options, sourcepoint, they will on occasion answer live calls as well. And then the people who primarily answer live calls also get some of the other referrals simply because there are so many referrals coming in. Sure that they have to be divvied up.
Mary Kate [:I mean, sometimes I'll pull off twelve senior options referrals. They just have to be given out to everybody available.
Katie White [:Okay.
Mary Kate [:And if we have people off for scheduled vacations or illness, it just further limits the number of people available to give those out to. And Oda and ODM have a very strict timeline schedule for us, which is a one business day turnaround on contacts. So we're required to try to reach out to individuals within one business day for any referral received by Oda and ODM. And they have increased since I've been here. They've added four new ways for them to provide referrals to us. So we get contact us from Oda and ODM, we get the share file referrals from ODM. We have Ltssis now from Oda. There are so many that it's just hard to keep up with all of them and we have to pass them out and contact folks within one business day.
Katie White [:So how many different places are referrals coming from? Calls, contacts, emails, faxes.
Mary Kate [:Right. Phone calls, live and voicemail online through our online contact system. ODM sends multiple types. We also get veterans referrals through ODM. They have set up an arrangement where if a veteran is seeking a referral, it goes through the ODM comes to us through share files. OdA sends us referrals directly through at least two methods. We do get emails, faxes and walk ins.
Katie White [:So like twelve different ways. And are these all centralized? You can go into one place and get all these referrals at once? Or do you have to go hunt and peck and check all of the different sources?
Mary Kate [:Correct.
Katie White [:Every day?
Mary Kate [:Yes. Every day.
Katie White [:All day long? Yes.
Mary Kate [:All day long? Yes. So the OGM sends referrals, veterans referrals, text referrals, which is just a name and a phone number, contact us referrals and then just the normal ODM referrals. They go through one point called share file. Oda sends things to me and Vicki in the screening directly through email. That's a contact us form. And then they also send us the LTsis which are actually managed through their website. And then senior options, we have to go into the queue system and pull those out individually. Okay, source point faxes to us and then the rest are again like our online contact form and emails.
Mary Kate [:Different professionals will email screening directly and those go to Vicky. It's just a huge conglomeration of various points of entry that all have to be managed.
Katie White [:It's wild. Linda once described it as a bowl of boiled spaghetti thrown against the wall.
Mary Kate [:Yes.
Katie White [:So it's like all these noodles all just intertwined and then you guys go in and pull one out and straighten it out and get people where they need to go.
Chelsea [:Yep.
Katie White [:So, Chelsea, you're answering these live calls, you're getting additional referrals on your you. How do you prepare for your day? How do you prioritize? Tell me a little bit about your day and you can be honest.
Chelsea [:To be truthful, there's no way to prepare because each day is a little different. Okay. If I have something left over from the day before, like if I get a call at 430 and I didn't finish it, I finish it first thing and then I pick up the phone and I kind of work through the things I need to follow up on from the day before based off of the time that I called the day before. So I don't want to call every day at 09:00 so if I called at 09:00 yesterday, I'll call it noon today.
Katie White [:Okay.
Chelsea [:So it kind of works itself out for me.
Katie White [:Okay.
Chelsea [:But I kind of just try to pull it out at one noodle at a time as best I can.
Katie White [:Sure. And so sometimes you are getting a live call and start to finish. You do what you need to do, but other times there's probably calls from the call and follow ups from the call or voicemails and callbacks. Do you have a system on paper or on a spreadsheet? How are you keeping track of all that?
Chelsea [:I do one thing at a time, okay. If I get a referral, I start to finish, however long that takes.
Katie White [:Okay.
Chelsea [:If I can, if I'm waiting for callbacks or if it requires research or whatever the case may be, or if it's at the end of the day, I need Linda, who has already gone for the day, something like that. Those have to wait. But I do it start to finish because there's just so much variable. One call could be five minutes, one call could be 55 minutes. So I just try to do it start to finish or I don't know that any excel spreadsheet could save me if I didn't do that.
Katie White [:Okay. This is kind of a weird question, but your phone rings. What kind of call is like the call you hope for when you pick it up.
Chelsea [:I kind of like the variety, so I don't really hope for anything.
Katie White [:Okay, that's a good answer.
Chelsea [:Truthfully.
Katie White [:Screener.
Chelsea [:That's why I like to answer the call live.
Katie White [:You do? Okay.
Chelsea [:Because sometimes it's I'm calling about my mom. We're just getting to this point. What do I do? Sometimes it's, oh, I have my family member who left the country to visit family. They're back now. We need to get started. They already know. They've been through this once before. They know what the process is.
Chelsea [:So those are pretty quick.
Katie White [:Okay.
Chelsea [:Then we have others who you kind of have to explain from start to finish because they said, my doctor gave me this number. I don't know what you do. Tell me what you do.
Katie White [:Okay.
Chelsea [:So we kind of do that. So I like the variety. It's fun.
Katie White [:Thank you. For you. I am half joking when I say this, but mostly true that I've been here about a year and a half and my phone's been on do not disturb since I started because I like to hear a voicemail and understand what someone might ask of me before I call them back because I'm so anxious about not being able to have an answer in the moment. So thank goodness for folks like you that feel comfortable and confident and are picking up that phone and helping people kind of no matter what they throw at you.
Chelsea [:It is anxiety producing at times because there are situations that I could answer the phone 5000 times. That 5001 is something I've never heard before. Interesting. So I have to be okay with saying, I don't know, I will call you back.
Katie White [:Okay.
Chelsea [:And at first I was like, oh no, I don't like that. I want to have the answer right now. Yeah, but they would just want you to be honest with them. They have talked to 4000 other people. With you being honest with them. They'll say thank you for at least giving me what you could call me when you can.
Katie White [:Yeah, and we do get good feedback too. Mary Kate, you've shared some emails or voicemails where people are like, thank you so much for actually calling me back with the information that I needed and it was so helpful. And in a couple of episodes we've talked about how fragmented this system is for individuals. And so maybe you have to wait a little bit to get your screening call back or whatever. But once you do get that, we really are that fabric of the community connecting people where they need to go.
Mary Kate [:And we do have to reach out. ODM and Oda require us on their referrals in particular to reach out three times over the course of five business days. After that, they do let us wrap it up because it seems as though we've left messages or if their voicemails set up.
Katie White [:Okay.
Mary Kate [:If it's not, our phone number has appeared on their phone a number of times. If they're not calling back, then that is as much effort as we need to put into it. Okay, so there are some parameters about how often we follow up simply because we could follow up with some people for weeks and never hear back. And that's not a good use of our time. Sure.
Katie White [:Not with the volume that you have coming in nonstop. Okay, so then the opposite end of what kind of call do you hope for? Do either of you have a kind of phone call that you dread or that's really difficult or it's kind of related to. The question I ask a lot of people is like, what's your biggest challenge?
Chelsea [:I think having someone call and tell me, like, I know you can't help me and think that I don't want to help them. Either the Medicaid eligibility or they may not meet the level of care, or when I give them these parameters, they get upset and say, well, you just don't want to. Or if a resource doesn't exist or a service they need doesn't exist, you just don't want to help me. And those are difficult because I do want to help you. But either you're not there yet with either level of care or financially, or it just doesn't exist. It's just not there.
Katie White [:Yeah, I don't get many referrals, thankfully. Those that I do, I'm like, oh, send me right over to screening. Thanks so much for your help. But the ones that break my heart are, hi, I'm calling and, like, looking for the list of low income older adult housing, or I'm looking for the assisted living that my Medicare is going to pay for.
Mary Kate [:And it's like, oh, right, that doesn't exist.
Katie White [:Yeah. So having those tough conversations with people, particularly when they're already feeling like you're not doing enough for them. One of the first times we ever interacted, I feel like you had just gotten off a bad call. Remember we were in the lunchroom and you were like, I just need a second. And I don't know if you were getting a snack or something and you're like, it's fine. It's just like sometimes you just need to walk away and then, yeah, and I definitely walked away like, you're strong. Good for you to just take a second and then turn around and go back at it.
Chelsea [:Yep.
Katie White [:So, Mary Kate, how about you? What's one of your biggest challenges?
Mary Kate [:For me, the challenge is just our volume and the inability to meet the volume. It has nothing to do with the great people who are doing the job. It's not anything they're not doing. It's simply the sheer number of contacts. Referrals that we receive isn't manageable for the number of people in the department. So I know that that causes people some stress and anxiety. And my goal is for them to understand the great job they're doing and how hard they try and how much their work is appreciated. And having folks understand that, unfortunately, at this point we will be behind in our callbacks, particularly on the voicemail messages and so forth, and not feeling terrible about that.
Mary Kate [:So that's probably the biggest challenge I face with screening right now.
Katie White [:Yeah, and we've talked about that before and holding some of the pressure and overwhelmed feelings that your team feels because there isn't really a way to decrease that. Right. You just kind of have to grin and bear it. Grin and bear it. Put your head down. Keep going. And if we know the 60 plus population is going to double, right. We know more is coming.
Katie White [:And then part of the challenge is, I know we don't necessarily get paid by the widget in screening, so it's not like by answering more calls and doing more things, we get paid more and then we can grow our staff.
Mary Kate [:Right.
Katie White [:It's like we have a pretty well fixed budget through our OdA administrative budget.
Mary Kate [:Correct.
Katie White [:And we have to be pretty lean and thoughtful about that. But I do feel like there's going to need to be kind of a breaking point here soon where we need to either advocate and make sure we can get more money because it's going to be hard to keep staff in. One of the number one reasons we lose people across the aging sector is burnout. So if you can't prevent the burnout, then it's going to be hard to keep the people there, which makes it hard to get the phone calls, which makes it harder for everybody else.
Mary Kate [:Right. And we have good people. I want to keep them there. And we have some people that have worked for this agency for 25, 30 plus years and we have some newer folks, but I don't want them to become frustrated and burnt out and not want to be a part of what's a great team.
Katie White [:I agree. I've said a couple of times this week. I don't know if this is naive or what, but I just really want people to like their job here authentically. I feel like most folks that I talk to, especially if they're in any kind of supervision role, feel the same way. But then there are some pretty strict boundaries and things that are out of our control in terms of sheer volume and not only volume, but severity. Right. I mean, I would imagine probably the level of need in some of those calls. Chelsea, are they changing? Are they different?
Chelsea [:Sometimes they call in and they needed it yesterday. And as anybody who works in this field knows, anything with ODM is slow, Medicaid is slow. It's a slow process. There's a lot of things to do with it. So it's just the way it is. It takes time. And when it's an emergency, it's an emergency. Like, I can't wait even five minutes.
Chelsea [:And then you have people who are like, oh, I need this in six months. Like, oh, okay, great, you're too early.
Katie White [:Six months. I can do that.
Chelsea [:We have people that needed it six months ago. We need it in six months. So you never really know what's coming. And I think that's also part of the challenge is that we have to know a lot about a lot.
Katie White [:Yeah.
Chelsea [:I can't just know, like, I knew a lot about my care. I came down and I knew everything there was to know about my care. I didn't know anything about anything else. So it's a lot to know because you have to know. Are you too early? Are you calling six months too early? Are you calling a year too late? Things like that. So you have to know a lot about a lot.
Katie White [:It's breadth and depth in skating, right? Yes, I need to know a lot about a lot. What other kinds of numbers or data do you want to share? So for somebody listening to get an idea about screening, what else do you want to make sure we talk about?
Mary Kate [:Out loudly. I just did the statistics for screening for 2023. I had shared them with Linda and Brenda. So last year we had 12,386 contacts. Many of them were referrals, some of them were not just contacts. Phone calls, messages. I need a phone number, those sorts of things.
Katie White [:Okay.
Mary Kate [:And we had 6743 voicemail messages for the year, managed primarily by one person at a time, which is a lot of information to manage. We completed almost 5000 of our ltsqs, so it was 4927.
Katie White [:Amazing.
Mary Kate [:Which is the actual referral for someone to move on to an assessment for a waiver service.
Katie White [:Okay.
Mary Kate [:We had that huge increase from April to May of last year, and I cannot verify why, but my feeling on it is probably related to the end of the emergency for Covid. That was the May 11, I believe, was the end of all emergency processes for Covid, for Medicaid, Oda, ODM, some of the things we were following. So it seems as though people perhaps lost some services that they had been getting and now are seeking to have them again, or people who were doing okay during the pandemic now are not. And they need help at home or resources that they didn't need during that time because people were home.
Katie White [:And the team grew during 2023. Right. How many staff members did you start with and how many are you at now?
Mary Kate [:Again, we added two full time screeners. Screeners. So we had ten again with Vicky and Michelle's duties being outside of the typical screening position. But then we were able to add Cameron and Ayesha, which took us up to ten people doing the screening function, and then still Vicky and Michelle doing the scheduling coordination and the triage functions.
Katie White [:And then you were recently promoted into a new position, and so we'll be adding a supervisor as well. And so really what I'm excited for in your new role is to kind of be able to take a second to step back, not too far back probably, but a little bit back and kind of see, are there places that we can improve efficiency? Are there, I don't know, resources or software, anything that we can do to kind of help alleviate some of that burden? Because, again, the volume not likely to stop. We can't do anything about the funnel up here, but what can we do once it gets in our door?
Mary Kate [:Right. Yeah, I'm excited for that, too. It's hard to be as proactive and planful as you would like when you're in the middle of whatever it is, the fire that's burning.
Katie White [:Well, and you're a very hands on manager as well. I know you're doing referrals and taking calls and making sure that things are staffed or if people are off or it's a holiday.
Chelsea [:We definitely grieved as a department. We're very excited for a new opportunity for somebody, but we grieved a little bit.
Katie White [:Yeah, well, she's not going to be going.
Chelsea [:No, it'll be different.
Katie White [:It will be a little bit different. Yeah. Hopefully, though, in six months from now, it'll feel different in a good way, and we'll be like, oh, my gosh, how did we ever do this without this change?
Chelsea [:Right?
Katie White [:That's me. We're still thinking. Okay, so as we wrap up, what.
Chelsea [:Are some of your final thoughts or.
Katie White [:Anything that you want to make sure that people know about the screening department, the screening role? Just some wrap up thoughts.
Mary Kate [:We touched on some of them. I really just like to emphasize how much the screeners have to know about so many different programs. There's a lot of information that they have to learn so that they can pretty much recite it on queue for people who are calling. So I just respect them for all that information that they store in their heads.
Katie White [:Oh, gosh.
Mary Kate [:Yeah, it's a ton. I mean, so many waiver referrals, so many waiver programs, all the processes surrounding that, because each one has a different process for getting the referral to the assessment area. We only assess for a few programs here. The rest go outside the building to other entities that are going to process that assessment. And everyone requires the referral to be sent to them in a different way. So that's just a lot of extra work and a lot of things to keep in your mind when you're trying to complete the work. Where does this go? How do I get it there? And then again, just that we area constantly receiving referrals in new ways. So we are trying to help as many people as possible, as quickly as possible, internally and externally.
Mary Kate [:So if we're a little slow to get back to anyone in the building, we apologize.
Chelsea [:Please be patient with us.
Mary Kate [:But, yeah, please be patient. We are trying to process just a lot of information and a lot of contacts from all over.
Katie White [:Thank you.
Chelsea [:Yeah, to kind of piggyback off of that, we're trying our best. Please be patient. If you have questions, ask. We want to help you as much as we can, but it also helps us to help you faster. So if you have questions, just ask. But please just be patient. We're doing the best we can.
Katie White [:Yes. Well, and I would say, I feel like I hear this and people know this, but just to make sure we say it, that the care and compassion that exists across the agency. Absolutely. But also thinking about this department is likely talking to someone in the middle of the crisis for the first time and hearing whatever's going on for the first time. And we're maybe the first real person they've talked to and the first sort of outlining of the, you know, just my appreciation for not only all the knowledge, but also the delicate care in which you provide those callers, too.
Chelsea [:Yeah. To kind of give a funny perspective on that, we have had a caller tell one of our coworkers, Terry, that she was, quote, an oasis in a cesspool of Medicaid because she was actually the one who gave him some good information, like the first real person that he talked to. And he said, you are the first person who was able to give me what I needed without giving me 4000 other phone numbers. Like, oh, I can't do that. She may not have been, but she was able to explain from a to z what he needed to do. And that's like my favorite thing someone has said because it really shows how helpful she was to him. Like you said earlier, a broken process.
Katie White [:And even if individuals, if we can't give someone a solution, if we can give them information and a roadmap, that in and of itself is extremely helpful and powerful in a world of trying to navigate so many complicated systems.
Mary Kate [:I just want to piggyback on something you said that we get that initial phone call in screening, or the screeners get that initial phone call. And that phone call can be very emotional. The person may be crying, they can be very upset, they might be angry. And yet we're still responsible for helping them through that phone call and trying to address whatever their need is. And some of the phone calls are just terrible people in very dire situations. People who, young people who area in the hospital have been shot and are now completely paralyzed. It's their mom on the phone. So there's a lot of emotion that goes into the phone calls and a lot of emotional support that the screeners provide all the callers.
Katie White [:Yeah. And so how do you all support each other or yourselves through a really difficult phone call like that? Do you have a little process or ritual?
Chelsea [:So the way our office is set up, we're pretty close to each other.
Katie White [:It's putting it nicely. Thank you.
Chelsea [:So I will go in and kind of, I don't know that unload is the best word, but kind of debrief and unload everything that just happened.
Mary Kate [:Process.
Chelsea [:Yes, process. And a lot of times it's just getting it out and saying, like, here's what I just dealt with, and someone will say, you did everything you could have, should have, would have done, and there's nothing more you could have done. So just hearing that, sometimes I just walk away and go have a snack. Sometimes I need to go sit in my car. There are certain calls that I get that send me to my car crying, and they know it's coming. So they know, like, just let her go if she just needs a minute. Yeah, but, yeah, we're very close. I say all the time.
Chelsea [:I found my people. So it's easy to say. Do you have a second? I need to get this out. And they'll listen and just give you that peace of mind that you did everything you could.
Katie White [:Yeah. And that's COAAA. I mean, that's who we are to our core, is we are these excellent, aging, compassionate, dedicated clinicians. Sometimes, sometimes not clinicians, but individuals that are here for our region to be the place that people can go to to help with whatever they need. Thank you both so much for being here, for sharing about screening, for doing your wonderful job, and just appreciate it.
Mary Kate [:Well, thank you. Thanks for having us. We appreciate it.
Katie White [:I hope now you know something about the screening department.
