HCBS Session Highlight: How State Directors Can Build and Sustain Provider Relationships

Sellers Dorsey was pleased to attend the ADvancing States HCBS Conference and is excited to share insights from an engaging session, “Master Plan to Building and Sustaining Provider Relationships: A State Director’s Guide.”  Featured speakers for the session included Abby Cox, VP of Business Solutions for Wellsky, Jessica Bax, Division Director for Missouri Department of Mental Health, and Chris Hempfling, VP of Service Excellence and Stakeholder Engagement for Brightspring Health Services.

The session highlighted existing tensions between states and providers, and solutions for overcoming them.

Challenges affecting state-provider relationships:

    • Organizational changes
      • Policy changes
      • Process changes
    • Past mistakes creating historical tension
    • Crisis Management

Organizational Change

Bax indicated that state governments are slow to change in general but quick to change in terms of leadership and organizational structure. She advised that state staff must get to know providers in person to combat isolation. For example, leaving the office and meeting providers in their community to understand their needs and what matters to them most, thus building trust. She also suggests that states acknowledge existing difficulties and establish open communication with the provider community, giving them updates on progress and actions from the State.

Regarding organizational structure, Hempfling noted another challenge. While younger incoming state staff have a high turnover rate, the provider base largely remains the same, making it hard to build consistent, strong relationships. Hempfling suggests that states remember everyone has a shared goal of enhancing overall quality, equity, and access. Additionally, process changes like system implementations and other IT rollouts require open and ongoing communication before and after implementation to ensure success. Cox suggested that when a new system is implemented, states create user groups for direct feedback and discuss the effects on providers.

Historical Mistakes and Tension

States and providers have historically tense relationships often due to past mistakes that have broken trust. How can states fix this? Bax advises states to get ahead of these mistakes by identifying association leads, and influential providers, specifically those with political connections, to enlist their help and drive resolutions when problems arise. State employees should foster such relationships and communicate with these groups regularly.

Hempfling also notes that historically poor relationships cannot be rebuilt overnight. Recognizing improvements can take time and states should be persistent and careful in approaching them. Recognize that everyone has risk associated with this type of work and problems within the system impact everyone.

Crisis Management

Like emergency service staff, states must prepare for the worst by developing a plan of action before a crisis occurs, strategizing how to reduce the severity of the crisis and documenting this in writing. Hempfling suggests that states identify resources and parties who will be accountable to help and gain their buy-in beforehand.

Additionally, Bax advises that states consider having year-round discussions with providers regarding legislative initiatives and budget requests. Understand these and plan for them, particularly where the State and providers might be at odds. Success is more likely to happen when states and providers can demonstrate that they are aligned.

Cox adds that it’s important to understand states cannot be complacent. They must continue to communicate and build relationships with providers by sharing data via dashboards and other means to communicate about problems honestly and objectively. Not placing blame is especially important and can help states share and relate to providers without being perceived as negative.

Overall, Sellers Dorsey was pleased to attend this session and share insights with our audience to provide innovative solutions to persisting challenges. If you’d like to learn more about Home and Community-Based Services, click here for more insights from Sellers Dorsey.

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