When a local agency caring for the elderly wanted to explore all possible options for improving their services, they turned to a student-run organization at Washington and Lee University for help.
"We wanted to know the feasibility of changing from contracting out our personal care services for home-bound clients to possibly providing these services in-house by employing our own personal care aides. The project relates to Buena Vista, Lexington and Rockbridge County," said Jeri Schaff, director of senior services at Waynesboro, Va.-based Valley Program for Aging Services (VPAS).
Schaff recently received the final report from Washington and Lee Student Consulting (WLSC), a student-managed organization created to provide pro bono consulting services to for-profit and not-for-profit business and community organizations. "I can't begin to express how impressed I am with the quality of the report," said Schaff. "The students showed remarkable resourcefulness, professionalism, thoughtfulness and — especially — patience as we all wandered in relatively uncharted territory. The final report is professional, realistic and exactly what we need to help us make an informed decision."
"The students deserve the accolades," said Rob Straughan, associate dean of W&L's Williams School of Commerce, Economics and Politics and professor of business administration/marketing. "It was a challenging project involving a good bit of research and forecasting."
The three students who worked on the project were project manager Doug Poetzsch, a junior double major in economics and accounting from West Islip, N.Y., senior Mac Davis, a double major in European history and politics from Prospect, Ky., and sophomore Dillon Myers, a double major in business administration and East Asian languages and literature from Foxborough, Mass.
"We spent almost the entire winter semester working on this, and I learned a lot about how the health care industry works," said Poetzsch. "I also learned a lot about regulation, Medicaid reimbursement rates and the general role of the personal care industry and the struggles of providing personal care to people who really need this service."
VPAS receives funding from state and federal governments and currently provides personal care services to 20 clients through outside agencies who employ personal care aides. The aides look after clients' personal hygiene such as bathing, skin care and shampooing. According to service standards enforced by the state, all aides must be trained and certified, and the agency employing them must also be certified.
During the research phase the students conducted interviews with a home care consultant, collected information from industry publications and business journals and conducted a survey of randomly selected personal care providers.
During the analysis stage, the students explored different options, including having VPAS apply for Medicaid funding.
"If VPAS wants to expand the number of clients it serves, it will have to find an alternative source of funding such as Medicaid, which means restructuring the agency," explained Davis.
"That's feasible under some very strict assumptions," added Poetzsch, "but VPAS would need to invest a lot into significantly expanding its client base and hiring a decent number of personal care aides while managing costs really well."
However, Medicaid reimbursement rates are modeled on personal care service to clients in urban settings, where clients are grouped closely together. "In rural areas like Rockbridge County you might have clients that are 20 miles apart, and that increases you're overhead," explained Davis.
Another downside to applying for Medicaid funding would be the difficulty of paying personal care aides more than the minimum wage, which VPAS considers a priority. "The hard reality is that our society entrusts the care of our most vulnerable to people that are paid very little," noted Schaff. "That means that the jobs are unattractive and have a lot of turnover. This leads to disjointed service from people who are only 'marking time' until they can find something better. Our hope is that by actually employing personal care aides ourselves, we can help them see that this is a very important service as a career, not a stopgap on the way to something better."
In the end, the option the students found potentially feasible would be for VPAS to keep the same state funding and the same number of clients, while employing their own personal care aides. One advantage to keeping the number of clients to 20 (rather than increasing to 30 clients) would be that the savings they would realize would provide a safety net to provide for unforeseen expenses.
All three students credited the WLSC faculty advisors, Straughan and Elizabeth Oliver, the Lewis Whitaker Adams Professor of Accounting, for volunteering their time to advise the project team. "We have our Student Consulting meetings every Monday'" said Poetzsch. "We would give them an update, and they would provide feedback to keep us going in the right direction, or give us ideas on how to attack a problem."
"This project would not have been possible without them," added Davis. "I know that everyone in Student Counseling is grateful to them for giving us this opportunity."
"I think Elizabeth would agree with me that when the pieces fall into place, this is some of the most rewarding work that we do," said Straughan.
According to Schaff, the WLSC report has been sent to the Valley Program for Aging Services board of directors for consideration. "I expect that they will act on the recommendations at their meeting at the end of May," she said.
Over the years, WLSC has worked with a diverse group of clients in the Lexington and Rockbridge County area and beyond. Some of the recent clients include:
- TeraDact, a Missoula, Montana-based redaction software firm
- PIATAM, a NGO in Manaus, Brazil assisting indigenous communities along the Amazon with sustainable development
- Horrible Hire, an Atlanta-based human resources software startup
- W&L Sustainability Committee, a campus faculty, staff, and student committee involved with, among other things, development of the campus solar energy initiative
- Rockbridge Choral Society, a local not-for-profit supporting choral music
For additional information, see the WLSC website: http://www.wlu.edu/x38891.xml.