Deploying telehealth for safer assessments
With in-person assessments no longer an option during COVID-19, we leveraged technology and a total team effort to create a new set of fully compliant solutions.
Assessments by the numbers
clinical assessors delivering telehealth services
virtual assessments delivered as of May 2020
state programs supporting virtual assessments
COVID-19 demands a new approach to clinical assessments
How can you conduct medical disability and behavioral health assessments in the midst of a pandemic? At the onset of COVID-19, it became clear that established, in-person methods wouldn’t work with social distancing. After all, the individuals being assessed often have complex health conditions that require added precautions against the virus. To ensure these vulnerable individuals could still get access to government-sponsored care, we developed an assessment solution that would maintain safe distancing while fully complying with stringent HIPAA and program requirements.
A wholesale shift to telehealth
Given today’s new realities, we quickly transitioned to video evaluations. Drawing on decades of program experience, Maximus expedited the necessary approvals and procurements to distribute a secure, fully encrypted telehealth platform. Working around the clock, project leads revamped training for new processes and software. By mid-March, our U.S. Health and Human Services team began offering virtual assessment services to all 50 states, enabling hundreds of clinical assessors to start work for early adopter jurisdictions.
Mutual trust enables change
Lateral-thinking and pragmatic-minded project managers played a crucial role in ensuring services could continue during state lockdowns. MAXIMUS project leaders drew on close relationships with their counterparts in state governments to identify and anticipate the full range of regulatory and compliance hurdles that would need to be addressed. Those long-standing relationships and established trust led to tremendous cooperation and buy-in for practical solutions that would best serve impacted citizens. Federal regulations and state laws have always, up until the pandemic made them impossible, required in-person assessments. States came around to the unprecedented ask that processes and legal requirements be modified. Their early buy-in was absolutely essential in avoiding severe disruptions to critical citizen services.
With a change of this magnitude, certain obstacles were inevitable. Many of the people we assess — and many health and assisted living facilities — lack access to computer equipment, cameras, and internet service robust enough to maintain a secure video connection. In addition, there are the complexities of coordinating and collaborating with facility leads and IT infrastructure support. Despite all this, we’ve been highly successful in finding workarounds and carrying out assessments effectively across programs.
Success Stories: Early adopters of virtual assessments
- California PASRR
Maximus kicked off virtual assessment operations for California on March 27 — after an impressive push to build out necessary infrastructure, secure approvals and regulatory exceptions, and fast-track training for assessors and outbound call operators. Currently, we’re collaborating with hundreds of nursing facilities across the state and have reached out to hundreds more.
- 40 assessors serving citizens via our telehealth platform
- 575 nursing facilities working with Maximus
Due to an astonishing COVID-related increase in demand for telemedicine tools across the global health sector, the Maximus team and its counterparts in the state government faced significant hurdles in procuring equipment and IT services. Their dedication and resourcefulness has helped avoid further delays and service interruptions.
- New York Children and Youth Evaluation Service (C-YES)
100% of families completing our surveys responded positively to the virtual assessment experience. Some with medically fragile children even said it provided a better, more comfortable experience for their families.
- 452 virtual assessments completed by a team of 25 assessors
- 100% customer satisfaction
To successfully complete these assessments and connect youth to services, we’ve had to adapt. For one thing, school and office closings have impeded the timely collection of consent forms from families and supporting documentation from health facilities, schools, and social services organizations. So we developed practical approaches such as HIPAA-compliant fillable forms to help families access and sign forms, documents, and records electronically. When families lack internet, we use mail. We’ve even had assessors scan documents at the front door. To better address this process gap, we’re developing a proprietary mobile app for families to send their documents to assessors.
- New York Conflict-Free Evaluation and Enrollment Center (CFEEC)
Maximus administers New York’s single point of entry for long-term care. To ensure elderly and vulnerable citizens could access services, we expedited virtual assessment readiness activities – including purchasing HIPAA-compliant Zoom accounts, modifying scheduling, and fast-tracking training for assessors and customer reps. Thousands of assessments later, we’re achieving near-universal customer satisfaction.
- 10,111 virtual assessments completed
- 225 assessors and 42 customer service reps trained
- 98% customer satisfaction
- 26% drop in appointment cancellations since transition to virtual
Because COVID-19 has made it much harder for family members and friends to be present during an assessment – depriving assessors of an invaluable source of medical information – our assessors now conference them in during our virtual assessment. This helps ensure we can collect and document all the information needed for an accurate evaluation.
- New York Office For People With Developmental Disabilities (OPWDD)
OPWDD has developed specific techniques for its specialized assessments of individuals with intellectual and developmental disabilities. In moving assessments to an online platform, it was critical that our team didn’t compromise best practices or methodological requirements. To date, our assessors have received truly remarkable customer satisfaction scores and feedback, even as they continue fine-tuning their new skills.
- 99% approval score from individuals, families, and caregivers who participated
- 234 virtual assessments completed
- 110 assessors deployed across the state
Working closely with OPWDD, our assessors learned and implemented new assessment protocols and techniques for a virtual assessment, conducting extensive peer-to-peer training and mock assessment interviews until they had it right. These efforts have ensured that changes to processes and use of technology have not impacted accuracy.
- Tennessee PASRR, SIS, Audits & Appeals, and ICAP
Our goal is to ensure that the “digital divide” and limited broadband connectivity don’t keep citizens from getting the quality of service they need. Since March, Maximus assessors have conducted hybrid virtual assessments — using Zoom over voice or video connections, or a combination — based on the equipment available to individuals. Our team consistently finds a way to get the job done, even if it means making landline calls.
- 1,100 virtual assessments completed
- Assessment team expected to double in size
- 700+ health facilities working with Maximus
In addition to conducting assessments for homebound applicants, Maximus has begun working with hundreds of health facilities to deliver assessment services to vulnerable populations. This extended collaboration emphasizes creative problem-solving to find new ways to ensure positive outcomes.
- Virginia SIS
On March 16, the AAIDD (American Association on Intellectual and Developmental Disabilities) released SIS guidelines approving of virtual assessments. We started performing them the same day.
- 750 virtual assessments completed
- Fewer cancellations than before the pandemic
Using Zoom (as well as voice calls when connectivity falls short), we’ve transitioned exclusively to virtual assessments. While still early, lower cancellation rates indicate citizens may prefer virtual as it allows them to avoid logistical hurdles and travel. AAIDD has approved the virtual assessments through September 30, 2020.