HJAR Sep/Oct 2020

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2020 41 Strategic Implementation DHS organized the COVID-19 Response Team to conduct new outreach to clients and providers. Secretary Gillespie challenged the team to contact 15,000 predominately elderly and homebound Medicaid enrollees twice a week. About 170 DHS employees made di- rect calls to clients as part of Project Good Neighbor over a 14-week period. This cam- paign gave peace of mind to thousands, and even assisted some individuals found to be in life-threatening situations. At the beginning of this initiative, DHS identified about 150 in- dividuals each week who reported some type of unmet need for care, medicine, or food. Clients also were able to ask questions or report needs through a new COVID-19 call center. The team held weekly calls with more than a dozen different provider types. These calls helped identify potential policy changes to be elevated to the secretary, and resulted in new initiatives that were presented to the governor’s CARES Act Steering Committee for funding. More than 30 employees worked together with interlocking responsibilities related to emergency or revised policy, rules, and implementation. In the early days of the response, the team Dawn Stehle DHS Deputy Director for Health & Medicaid Director Arkansas Department of Human Services met three times a day to plan, prepare, and revise. Policies were presented to Secretary Gillespie and the senior executive team daily. This gave the entire management team and the governor’s office a comprehensive view into what was happening throughout the de- partment. The Division of Medical Services (DMS) staff was the single point of contact with the Centers for Medicare and Medicaid Services to ensure the appropriate vehicle (State Plan Amendment, 1135 waiver, or Ap- pendix K amendment) was employed for ac- curate exchange of information, to enable swift approval from the federal government. Once approved, a policy was then posted by the Rules Team to ensure compliance with state laws and regulations, including the gov- ernor’s executive orders. It also constructed a firm record of approved actions to enable the department to respond to future audits and oversight. Finally, the implementation team in turn generated the reporting forms, guidance, and a series of Frequently Asked Questions (FAQs) necessary to enable providers to sub- mit requests for funding correctly. The work of the team ultimately led to more than 70 individual actions tak- en, including the expansion of the use of telemedicine, and approval of the more than $340million in funding to critical health care providers, including those working directly with COVID-19 patients, and social services benefits through nutrition programs and childcare. Continued Crisis Management At the beginning of a crisis, there are al- ways more questions than answers. The state of emergency due to the sweeping and devas- tating path caused by COVID-19 was a unique event that the department had not previously experienced. However, Secretary Gillespie recognized the crisis required a new risk management approach that could rapidly identify the threats and opportunities, and formulate changes in policies and operations. DHS continues to manage the crisis through new lines of communication, reallocation of resources, imagination, flexibility, and new forms of engagement with our providers and clients. n Dawn Stehle serves as the DHS Deputy Director for Health &Medicaid Director at Arkansas Department of Human Services. The divisions included in her oversight are aging, adult & behavioral health ser- vices, county operations, developmental disabilities services, provider support & quality assurance, and medical services. In this role, Ms. Stehle also serves as the state Medicaid director. About 170 DHS employees made direct calls to 15,000 homebound clients as part of “PROJECT GOOD NEIGHBOR” over a 14-week period.