Author: WJHamel
Posted: Thu Oct 06, 2011 3:57 pm
As the former owner and founder of the SCG program, i feel compelled to address some of the issues touched upon here as well as a myriad other places "out in the wild".
While this thread started out with a different direction than it ended with, i’m confident that which follows will not fall upon deaf ears.
First and foremost, the dynamics which led to the ultimate demise of Synergy Counseling Group were due largely to forces outside of my control and multiple efforts to counter those dynamics took place between the months of January 2011 and April 2011. Ultimately, the weight brought to bear by the powers that be were more than we could contend with and left me with no choice but to close down as abruptly as we were forced to do. Understand that, within that, there was no appropriate context which would have opened the door to any ethical conversation between ourselves and our patients regarding the external dynamics which we were fighting that brought us to our knees. I will own the percentage of responsibility which is mine that had to do with other choices which i could have made in the years prior which "could have" buffered us from the changes which were threatened. Finally as part of this preface, my heart still aches for the persons who were negatively affected by the our hand which was ultimately forced by those dynamics and the resulting decision.
Now, as no attention whatsoever has been paid to the first point i am about to make, i will begin at that juncture. In the late summer of 2010, the State medicaid system, upon which we relied for 90-95% of the revenue which kept us in business, made threats of significant reimbursement cuts to certain categories of medical providers. All of the services we were providing were affected by those cuts. ALL of them. They "threatened" to make those cuts in the pending months, but gave no clear timeline for such. Nonetheless, because the writing was on the wall at that point, administrative decisions had to be made. One of those decisions, which clearly falls under the label of "business is business" was the laying off of numerous staff positions in the Fall and Winter of 2010 as well as contract adjustments for the remaining staff. This, obviously, created some discontentment amongst the staff which remained. There were also efforts to diversify the services we were offering in order to compensate for the services currently being provided which were doomed to the pending draconian cuts. So we increased our efforts to provide primary care style medical services beyond just the addiction medicine components we were providing. This was a calculated gamble.
Fast forward to January of 2011. With the first Medicaid reimbursement which arrived for the new year, we were shocked to see that reimbursement arrive 50% lighter than was expected or budgeted for. We scrambled to find answers to why our reimbursement was so abysmally low. For more than a week, we received a vast and convoluted run-around from the State representatives as to the justifying those numbers. Ultimately, they conceded that, in the middle of the night, behind closed doors, had implemented their cost reduction scheme presented in the previous year. This plan ultimately reduced our typical weekly payments between 40 and 50%. This was immediately unsustainable, but the choice was between bailing out at that point or finding a way to pull it together for the benefit of the patients and the staff. The choice was obvious. In the following week, we presented to both the staff and the patients, the plan to downsize, closing the Berlin clinic and moving a percentage of that staff to the South Burlington clinic. The exact reasons for that downsizing were spelled out in black and white for EVERYONE to see. The writing was now on the wall for all to see and in large bold letters. In January of 2011, we conceded that we were in trouble, but were dedicated to moving forward.
After the reconsolidation was complete and things were more or less "settled" in S. Burlington, i was hit with demand after demand from our MD’s and Nurses for "more money". Of course, these members of our "team" knew as well as anyone else what our financial situation was and the reasons we were in that situation. Yet, they threatened to walk if their "requests" were not honored. One of those Nurses actually sued us for having not increased her salary according to the terms of her old, and now defunct contract. She won that suit and was immediately provided with an order that intercepted our next week’s reimbursement from medicaid and pocketed that money. This was damaging for us, but, again, there was no context by which any of this could reasonably be disclosed to anyone. Remember, at this point, the news of our financial health was public.
As the months between January and April progressed, we became further and further in default of a number of bills which were owed by the company, not the least of which was the rent which we were now months behind on. All of this despite the layoffs, clinic closure and the now months old decision to no longer draw a salary for myself (which ultimately led to the foreclosure of my own home and eviction of my family). In the last week of March, 2011, we were dealt with a double blow. First, our landlord informed us, that due to the default of our lease agreement, we would be locked out of the facility the following wednesday. Finally, the external billing company which we were using for our A/R, shut us off from utilizing their services as of noon that Friday.
With no backing in the bank, no ability to continue to bill for services, no place to do business in the next week, and no willingness from the staff to work without pay (an understandable point), our hand was forced. After a weekend of much consternation, a decision was announced the following monday morning, that we would be closed by that wednesday.
Now, there is much, much more that i could add with regard to how LITTLE attention was paid to us and the good work we were doing all that time as well as the void of attention which was paid to the countless pleas i made to the medical community and the public at large as to what would keep us sustainable and moving forward in a volatile economic environment, but that discussion is for another post or another forum.
I also will not take this opportunity to tout our successes during the years of our existence. The healthier lives of our patients are a testamant to that.
The correct context simply needs to be applied to the dynamics around the events of 2011 for synergy, as any other representation, lacking those facts, is inaccurate.
Thank you for your time
James Hamel
