Open Letter to Molina

922 S. Cowley St Spokane, WA 99004; Ph. 509.822.6777, F. 509.676.6655

June 14th 2024

TO: 

Molina Healthcare

1330 N. Washington Street Suite 4000 

Spokane, WA 99201​​​

RE: Urgent Request for Reconsideration of Therapist Reimbursement Rates and Re-Credentialing Procedures

Dear Molina Healthcare Leadership,

I am writing to you today with deep concern regarding the current state of therapist reimbursement rates and the inefficiency of the re-credentialing process at Molina Healthcare. 

As a mental health practice working within your network, our team have faced significant distress related to these issues. In 2023, our team provided care for 670 of your more than 5 million members. While we are a small practice, we are dedicated to providing quality care to your members. In addition, a core value to our mission is to advocate for and provide real opportunity for our providers to balance work life, productivity, and a healthy personal life balance. 

For the first three months of this year,  through no fault of our own, our contracts failed to be updated and required a great deal of administrative work and much too much time to find a resolution. This not only impacted our ability to operate effectively but also caused immense stress and anxiety for our entire team. We are still working to recover financially from these unexplained delays. 

The re-credentialing process at Molina Healthcare is unnecessarily cumbersome and unreliable. The delays and lack of clear communication create frustration and uncertainty for therapists and other healthcare providers, adding yet another layer of anxiety to our already demanding work. 

The emotional and mental well-being of therapists directly affects the quality of care we can provide to your members and is making it increasingly difficult to retain highly skilled providers and a positive morale.

Mental health professionals are a vital part of Molina Healthcare's network, playing a critical role in the well-being and scientifically supported preventative care to your members. We are passionate about providing quality care, but the current system makes it increasingly difficult to do so effectively.

Therefore, I urge you to reconsider the following:

• Increase therapist reimbursement rates: A significant increase in reimbursement rates is essential to ensure the financial sustainability of therapists within your network and is core to the mission of burn-out prevention.

• Implement a streamlined re-credentialing system: A more efficient and reliable re-credentialing process will eliminate unnecessary stress and delays for therapists.

By taking these steps, Molina Healthcare can demonstrate its commitment to supporting the mental health professionals and those of us working in small, family-owned, private practices who are the backbone of our economy and a strong middle class. We can then work together to ensure that your members have access to the quality mental healthcare they deserve.

Thank you for your time and consideration. I look forward to your response and a collaborative effort in creating a more sustainable and supportive environment for mental health professionals as we continue to value our partnerships with the Molina Healthcare network.

Sincerely,

2022

Growing Pains and Healing

I am getting a late start to this annual update. This would be just one more indicator of how much has been happening in the world of Foundations. 

In 2022, we saw our values and philosophy tested to the limit. As with all sectors of healthcare, we also experienced the weight of inflation and the rapid shift of available funds. Many healthcare organizations experienced massive layoffs and financial crises as well as crucial staff turnover– all during a global pandemic and overall national healthcare shortage. While we also experienced financial strain and staff turnover, these experiences furthered our resolve, our dedication to our important work, and left us with an improved workplace culture of teamwork and collaboration.

Personally speaking, 2022 underlined the increasing distress and burnout experienced by many healthcare workers– myself included. While struggling with depression, I found that many of my best friends and fellow healthcare workers were simply not available to be there in the ways that would have been helpful. It can be such a lonely place to be a therapist, a boss, a business owner, and also need to reach out for help. I am proud to say that I did reach out for help and that I spoke up. While many people were not available or willing to help, I am very fortunate to have family and professionals who showed up and came alongside to my aid. To all of you who were there– thank you and you know who you are. 

As we in the healthcare field continue to face the challenges of burnout, underfunding, as well as supporting an increasingly ill population, we must show up for one another. Many of us struggle in silence and do not have the family and the support that I have. We simply must support one another. 

I am making the pledge to do more as well. 

With all the sacrifice brings reward as well. We have successfully balanced our budgets, fostered a collaborative working environment, and have added benefits of health, vision, dental, and retirement. We have welcomed an amazing virtual receptionist as well. We are super legit and here to stay. 

Florida

With special thanks going to Jennifer Anderson, one of our senior most partners with Foundations, we have been able to expand into the beautiful State of Florida. Located in South Bradenton, our spaces bring the same Foundations' flare but with a fun tropical twist. Not even a month after opening as well, we weathered our first hurricane successfully. We are so excited to have our Florida team along with us on this ride! Next steps: Continuing to sort out the never-ending insurance paneling process. We are so lucky to have Jarrod’s help with this!

Florida office

Pride Schools

Counselors and administrators with Pride Prep and Innovations High School invited us to be onsite to offer mental health resources to their student population. I have been aware of their incredible project-based approach to education for some time now and am so excited to be able to partner with them. This has been one of the most rewarding projects this past year. To date, with special thanks going to Alysa Johnson and Hope Gerdon, they have been able to serve 38 students. 

New Services 

It has been a goal since opening in 2018 to be able to offer our communities medication management in combination with psychotherapy. The research is clear that using these tools in tandem works amazingly well for many or our consumers. We have been so lucky to begin this new journey with Ursula Avilus who is now available to meet with folks and provide psychiatric and mediation services to our clients. I am so excited to have Ursula on board with us! This is also where I get to mention how incredible Jarrod has been in helping to navigate this new addition with regard to insurance paneling. 

More to come: Psychological testing perhaps? Let's wait and see. 

The Numbers

Foundations fell short of our predictions in the year 2022 by nearly $300,000. That said, we still saw a 15% increase in overall revenue over 2021 making this our best year ever yet again. More than one million dollars was paid to our contracts and staff in earned wages and commissions. I cannot express just how grateful I am to be in a place where I get to see our team members thrive, expand their families, buy homes, and continue to exercise their passion in the field. 

Forty-two therapists served 1,100 clients providing more than 15,000 services. With respect to diversity and honoring our commitment to giving voice to marginalized folks, our team is approximately 72% female, 21% BIPOC, and 24% LGBQT+. 

Into the FuturE

Thus far, 2023 has been off to a wonderful start despite the ongoing surprise snow storms. The growing pains have given way to stability, predictability, and excitement for more to come. I am excited about our continued efforts toward growth in a sustainable way that will take our philosophy for clinician and client empowerment forward. 

I am particularly excited for expansion into medication management and cohesive wrap around services. I am also excited to plan for EMDR intensive clinics using the latest research. Additionally, I am incredibly excited to welcome folks back into our offices for group therapy offerings including a fun outdoor youth summer group to support social anxiety and social skill-building in youth impacted by COVID-19 and isolation. We are going to have FUN!

In closing, I want to express my gratitude for this incredible team and for all they do. I am honored each and every day to have the opportunity to learn and grow from each. For this coming year as a way to try to say “Thank you,” I am planning to double down on efforts toward kindness and supporting fellow health workers as well as working to do better in taking care of myself as well. 

Have a wonder 2023! 

2021

Another Step Forward

2021 has been another wild ride of a year. Many of us has been hopeful that 2020 would be the end the misery and that 2021 would being a fresh sense of normalcy. This has not been the case for many of as we are seeking a new sense of what is “normal.” The pandemic did not end. People did not stop dying. We were not all able to return to our jobs in the way we wanted. Many of us rightfully chose not to return to our jobs. And, we are beginning to see the effects of the pandemic on our physical and mental well-being. Mental health providers are not immune to these effects. It is now more than ever I believe in the Foundations’ philosophy of promoting provider care and self empowerment first and foremost. While doctors and nurses have been on the front lines, we are now about to join them. Take care of yourselves. Honor your experiences of vicarious trauma. Seek support. We need each other now more than ever.

New Growth

Foundations’ Garland

We are so proud of having put together our largest project to date: The Foundations’ Garland Offices. It has been a goal since the beginning to find ways to de-centralize mental and behavioral healthcare in ways that smaller offices could be offered in more communities. This office opened Summer of 2021 and offers ten cozy offices and a sunny play room for folks located on the Norther/central areas of Spokane. Melissa Rockwell has been incredible in stepping up to support this team and to make this practice a supportive and affirming place to come as a client as well as to work. Thank you Melissa!

The Oh-So-Many Changes

If there is a constant in this field, it is that every changes constantly. In the Spring of 2021, we made the terrifying choice to bring insurance billing in-house. As with all financially-related choices, my biggest worry is in maintaining our providers’ livelihoods without delay or impact on compensating their heroic work. I was nervous that there would be delays as we changed over or that it would all completely collapse. This could not have been further from reality. The process was seamless and rewarding. This change has allowed us to save money to pass on to providers as well as saving us time and effort in the billing process. We are eternally grateful for Lilc City Billing Services LLC for all that they have done to help get us to where we are today. I am so grateful for the relationships we have been able to cultivate as well. And I am incredibly grateful to Jarrod for taking this project on with grace and hard work. THANK YOU!

The Numbers

Compared to last year, Foundations has seen more than a 100% increase in fiscal revenue. In total, we have processed more than $1.2 million with more than $800,000 being paid out to our providers. Twenty-five partners provided services to more than 1,100 different clients in our communities.

Coming in 2022

An unmet goal from 2021 still needs to be realized: The opening of offices in Sarasota Florida with the project led by Jennifer Anderson, LMHC. This is now a priority for myself to begin the opening this Spring. I am truly grateful for Jennifer's patience with me as I am working to balance rapid growth with provider and consumer safety and contentment.

As we continue our growth, it is becoming increasing important to hire an assistant to support with managing phone calls, faxes, billing, and client scheduling. I am excited to offer a part-time position that will be work-from-home and will offer a living wage.

Additionally, as we have come to the realization that an independent contractor model is not sustainable in operating a business in Washington State, we are excited to begin looking at transitioning our contractors over to W2 Employees to offer similar compensation as well as added benefits (PTO, Sick Leave, Holidays, etc). So far, those who have transitioned over are very happy with how this has rolled out. As nervous as I had been about this transition, I am confident that this is the better way to go as well. Eventually, we will be able to offer medical benefits and retirement benefits as well!

Happy New Year!

Thank you to all that you do in our communities and for your dedication to Foundations. I want to reiterate that this is a difficult time for those around us and that we directly and vicariously experience the impacts of the hurting as well. This is going to get harder before it gets better. Please. Reach out for support. I am always here to talk. Reach out to get counseling as well. Take care of you— you matter.

2020

This is the time of year when we often find ourselves reflecting on the previous twelve months and begin to look toward the next twelve. We are all aware of the trauma that has impacted our collective experiences during 2020—and that said, this trauma is not over. 2020 will mark the deadliest year in the United States’ history with more than 400,000 more people dead than in 2019. Not only have so many family members, friends, and neighbors died; millions of us have been without a steady source of income, food, housing, and healthcare. Millions of children have had to say goodbye to classmates, teachers, and so much that represented security, safety, and predictability. As one child told me, “I don’t like saying that word…” then proceeded to spell: “….C-O-V-I-D dash 1-9…”  

 “I don’t like saying that word… C-O-V-I-D dash 1-9…”

While in past years, we would be reflecting on the stress, the sacrifice, and the amazing reward of building Foundations. Words cannot describe the rollercoaster of emotion one rides while working to building something like this. The end result has been truly amazing—we get to work with the smartest and the kindest people in our communities. That’s you! This year however, all the successes and triumphs are muted with the weight of all that is 2020. This is trauma, both first-hand and vicarious, especially for those of us in these helping professions. This trauma helps to put the difficulties of growing a practice such as Foundations gravely in perspective: There is still so much more to get done.

Foundations has changed remarkably over the course of 2020. While being founded in one tiny office in 2018, we processed more than half a million dollars in business just two years later for all of 2020. Nearly $350,000 was paid to clinicians during this year. This is more than a 400% increase from 2019. Fifteen providers served nearly 800 clients in 2020. As we become more established, the name ‘Foundations’ is representing healing, growth, and empowerment in our communities thanks to our awesome providers as well as to amazing partnerships with CHAS and Lilac City Billing Services LLC. 

Over the course of 2020, we began offering telehealth. This subsequently launched Melissa Rockwell, LMHC into taking lead with these operations and our role supporting her to become a qualified supervisor. We also opened offices in Cheney, WA marking our first efforts to build multiple locations. We also welcomed amazing new providers: Shoba Nishek, MSW, James Taylor, MS, Christie Ray, MS, Karryn Satchell, MS, Paden Vance, MA, Kellie Anderson, MSW, and Jenny Robinson, MSW. Also, we were forced to implement a change in how providers are paid in June of 2020. This was a very difficult decision to make. This change was even harder on our providers and it is my hope that it was for the best. Thank you so much for your patience with Jarrod and I during this as well.

Looking at 2021:

While the impacts of the COVID-19 pandemic will take years and years to fully comprehend, I am cautiously optimistic for 2021. Our plans include opening new offices in the Northside of Spokane as well as beginning to support a location near Sarasota, Florida with efforts led by Jennifer Anderson, MA. We are hopeful and planning for the eventuality of operating within a Single Payer health insurance environment as well. We are continuing to expand telehealth operations in efforts to promote health/safety/freedom of our providers as well as to offer options to those in vastly underserved rural areas. In addition, we are planning to send our consumers a survey to seek areas we can improve or streamline our efforts. Ideas of starting virtual group work is also bringing us hope for the new year. We are so grateful to our providers who have been with us from the beginning as well and are so excited to continue to support you all in all the good work you do. Thank you.

According to the numbers, Foundations has had a wonderful year of growth and prosperity in 2020 for which we are truly grateful. The trauma of the past year has helped to place this into a healthy perspective as well. Our rapid growth and the outlook for even more to come drive home a bleak reality—There is just so much hurt and need for healing in our communities. Our dual realities are: 1) We hope for continued growth in empowering providers to take charge of building their independent practices in a supportive and caring network serving more and more people in need, and 2) We are working toward a future that will no longer need a Foundations Family Support in its current form. 

To each and every one of you who make us who we are— please keep taking good care of yourselves and reach out for any support we can offer. Thank you for all you do and Happy New Year to you and your families.

Trevor and Jarrod