SNOHOMISH — Losing revenue and limited in their services because of public health precautions, Compass Health laid off several employees and will shutter locations in three cities.
The behavioral and mental health care provider operates more than a dozen locations in Snohomish County. Since COVID-19 struck the area, outpatient service dropped about 20%, and revenues followed suit, Compass Health CEO Tom Sebastian said. Layoffs are set to begin in mid-June.
“Like everyone, we were affected by the important implementation of social distancing,” he said. “That had a particular impact on our outpatient service.”
The nonprofit mental health care organization will close outpatient sites in Marysville, Monroe and Snohomish. Most of those locations’ clinical employees are transferring to Compass Health’s Everett branches, but four were set to go on furlough, Service Employees International Union Healthcare 1199NW spokeswoman Amy Clark said in an email.
About 700 people work for Compass Health.
Seven non-union employees, either in administration, management or support positions at those offices, are set to be laid off as well, Sebastian said. They were given the same amount of notice — about a month — as the union members.
“It will allow us to accomplish what our major goal is,” he said. “These are really hard decisions to make.”
Compass Health also eliminated travel, training and other non-essential program or service expenses.
Money from the federal Paycheck Protection Program curtailed further cuts to staff, Sebastian said.
“Those are helping us greatly, and helping us from taking more drastic measures,” he said.
According to tax forms from 2017, the most recent available on Compass Health’s website, the nonprofit brought in more than $65 million in revenue. Half of that money came from the outpatient mental health program. It spent about $64.9 million, mostly on compensation, employee benefits and salaries for workers who deliver those services.
Despite the closures and cuts, patients at the shuttering locations can stay on with Compass Health. But it would either mean traveling to Everett for essential services that can only be provided in person, or using recently expanded telehealth services.
Compass Health launched its revamped telehealth offerings in fall last year. A major new component is a video device, called the Compass Health Bridge, with almost 360 degree views. It’s a mechanized stand that holds smartphones or tablets. Health care workers use it to evaluate patients and their environment, and can bring in other providers on the video chat.
“It’s not just FaceTime,” Sebastian said.
More than 500 of the nonprofit’s employees are trained on using the device, director of outpatient services for Snohomish County Frances Wilder said.
Usually at any time, Compass Health has about 6,000 to 7,000 patients who use their crisis, inpatient and outpatient services. About 70% of them are using the telehealth program, which means they don’t have to travel to a clinic.
“For mental health, telehealth visits are superior to what we would be doing,” he said. “I think it will fundamentally change the way that mental health is delivered.”
It’s more convenient for both parties, as it eliminates the need for travel. No more scheduling a couple hours of travel for clients who live in Marysville and see their therapist in Mill Creek. Or it can fit into a patient’s day as well, and they can have a session during someone’s lunch break, he said. For someone in need of an urgent meeting, it connects them with a mental health professional faster.
There also are public health benefits in the age of coronavirus. Instead of sitting together in a room and risking exposure, they’re able to link up remotely.
Masks, while good for preventing the spread of airborne respiratory diseases, hinder therapy sessions when the patient and provider aren’t able to see each other’s facial expressions.
Video allows them to see each other faces, but not their bodies, which communicate other cues.
“For the provider, it takes more work because you have to really pay attention more deeply than you would in a regular office visit where you can observe the nonverbal cues from the person’s entire body,” Schoenfeld said.
But for people with limited or no internet access, it can be more challenging. Wilder said they connect clients with other services that provide WiFi, and that they can use a telehealth station at one of their sites.
“We care about our clients and they need services and that doesn’t change with a pandemic,” Wilder said. “We want to encourage people for their own health, as well as the staff, to use the telehealth solutions.”
Similar to other doctors and health care services, Compass Health saw a dip in new referrals, likely from people wary of exposure to the new coronavirus. The nonprofit is still taking new clients.
Sebastian said he and other mental health professionals expect a spike in requests and need. People are stressed and fatigued from the pandemic’s toll, stay-home orders and job loss. Once the unemployment benefits expire for thousands of Snohomish County residents, he said the Medicaid enrollment likely will spike. A large part of their patient base is people on Medicaid, including people who are homeless.
“What we’re all thinking about is what the next wave around behavioral health is going to look like,” he said.