Building Commitments
by
Charles Lamson
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It was at this time that I met my new business partner, Tonya. We thought maybe it would be a good idea to lay off the home care business for a bit and focus more on starting a non-emergency medical transportation service for seniors and adults with disabilities. We thought it might actually be easier and take less time to get the transportation business up and running, because with the home care business we have to create this rather lengthy proposal which is basically the business plan showing how we will structure, run, and grow our new business. And then, even before we submit our finished proposal, due to the large influx of providers submitting proposals, and many instances of payroll taxes and unemployment contributions not being paid for Medicaid consumers; MMAC (Missouri Medicaid Audit & Compliance) is requiring that all potential CDS (consumer directed services) providers (which is what Tonya and I are) attend CDS orientation training prior to submitting a proposal. Documentation of attendance will be required for all proposals received by MMAC after March 1, 2019. And then after we submit the proposal, again due to the large influx of CDS providers submitting proposals, it will take about six months to get our proposal approved by the state, barring no corrections or clarifications need to be made on our part. So bearing all this in mind, Tonya and I thought it might be faster and easier to start a business as Medicaid providers of non-emergency medical transportation services to seniors and adults with disabilities to help them get to doctors' appointments and medical procedures. Well, after a lot of in-depth research and investigating, we came to the conclusion that we were mistaken. There is no softer, easier way to get started in either business and to get any kind of loan for start up money, we were going to have to buckle down and write out a good clear, concise business plan, and we figured it would probably be easier for us to go back and focus on getting the home care business up and running first, especially considering that we would need to worry about getting enough start up money for a small fleet of handicapped accessible transport vehicles, and getting them all insured, and all that. In starting any kind of legitimate business, you have to jump through a lot of hoops and go through a lot of legal mumbo jumbo, before you are up and running, but when you are trying to start a business that takes money from state Medicaid, it is even more bureaucracy to deal with. You can go to all the Missouri Department of Social Services Medicaid Provider web sites and get some education from there, but it is total information overload. It is like trying to take a drink of water from a fire-hose. So I contacted this lady from the state and she put things in a simple step-by-step way. First thing I have to do to enroll as a Medicaid provider with the Missouri Department of Health and Senior Services was to write my proposal, which is basically a business plan for the home care business I want to create. ![]()
So, I got an okay start on the business plan by going to the Small Business Administration's website, sba.gov, and following a template they have for a business plan. I just really got to a point where I had no idea how to proceed. I needed help so I went back to some earlier parts of this proposal that were posted on this blog to figure out what I'm supposed to put into this proposal. I remembered the Missouri Department of Health and Senior Services had links for Medicaid provider instructional training and orientation classes.
So I went to my blog to check out some of the earlier parts of this series of articles on how to start a home care business. I found this link IHS (In Home Services) and CDS (Consumer Directed Services) Proposal Information, and at this site I found this link, Provider Certification Training. Clicking on that brought me to a site entitled IHS Designated Manager Training & CDS Orientation.
So, at this point, we had to decide whether we wanted IHS Designated Manager Training or CDS Orientation. For brevity's sake, I won't go into all the reasons why, but we figured things might be a bit simpler if we made our business a consumer directed services company.
So at this site here is what I learned about CDS Orientation Training.
CDS Orientation Training Due to the large influx of CDS providers submitting proposals and many instances of payroll taxes and unemployment contributions not being paid for Medicaid consumers; MMAC is requiring that all potential CDS providers attend CDS Orientation training prior to submitting a proposal. Documentation of attendance will be required for all proposals received by MMAC after March 1, 2019. Current CDS providers are also encouraged to attend the CDS presentations, pending availability of seats. Priority will be given to providers that have not yet submitted a proposal. ![]() TrainingThe training sessions will be available every other month throughout 2019. Pre-registration is required but there is no cost to attend. The training will consist of a three hour presentation of the CDS program, proposal submission, applicable rules and regulations, responsibility of the vendor agency (payroll, taxes, employment contributions and security background screenings), and general guidance regarding the CDS program. The training will start at 9:00 and end at noon. A MMAC representative will be available after the training to answer questions. RegistrationPre-registration is required because space is limited. The online registration form must be filled out completely. Once the training date has reached capacity, the date will no longer be available for selection. The next session will not be made available until after the current training has taken place. Registration link: CDS Orientation Trainin
So I clicked on that registration link and registered for the September 24, 2019 training session. That is a little over two months away. Hopefully I can get some good useful information there and make some contacts with people who are more knowledgeable in this area, than Tonya and I. In the meantime, I'm going to keep doing research at the Missouri Department of Social Services website for more information for Medicaid providers of consumer directed home care services for seniors and disabled adults who wish to stay in a community setting, and doing what work I can on my own in creating this business plan, until I can hopefully get some assistance at this upcoming orientation.
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When we speak, the symbolism we employ is caused partly by the reference we are making and partly by social and psychological factors---the purpose for which we are making the reference, the proposed effect of our symbols on other persons, and our own attitude.
When we hear what is said, the symbols both cause us to perform an act of reference and to assume an attitude which will, according to the circumstances, be more or less similar to the act and the attitude of the speaker.
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Internal noise can be created in at least four different ways. First, internal noise occurs because we each have a brain. If a person is talking at 125 words per minute and you have the ability to listen effectively at 200 words per minute and the ability to think at a much higher word per minute rate, your brain decides to use the "free" word per minute spaces to do other things. Paul Cameron, a professor at Wayne State University in Detroit, conducted a study with 85 college sophomores. An associate made a loud noise 21 times during professor Cameron's lectures over the length of the course. The students had been told that they needed to encode their thoughts at that time. The results reported to the American Psychological Association showed that 20 percent of the students were reminiscing about something, 20 percent were thinking about romance, 20 percent were actually paying attention, 12 percent were actively listening, and the rest were worrying, daydreaming, thinking about lunch, or thinking about religion. In other words, 88 percent of this population were not actively involved in the lecture due to internal noise. Imagine what occurs during a committee meeting. Second, external noises can also cause internal noise. Your stomach or another person's stomach growling may produce thoughts in the brain that cry out for lunch instead of paying attention to the discussion. The overwhelming smell of perfume or cologne may cause multiple reactions in your brain, from romance to revulsion. If you are focused on a breaking news story, you may not remember a phone conversation. And, there may be so much noise on, for example, the factory floor that the follower would not even bother to listen. ![]() The third way internal noise can be created is through the perception process of individuals involved in the communication. Every person has a distinct method for selecting, organizing, and interpreting verbal or nonverbal cues (Coon, 1992). For example, a person hears the term "leader" during a presentation. This term may evoke different thoughts in different people. A person who disliked a previous leader would interpret the term in a negative way; a person who admired a previous leader would think of the term positively. Internal noise can then be created as the former person would begin to think of the disliked leader; the other person would begin to think of the admired leader with neither paying any attention to the communicative acts occurring around them. The fourth way internal noise can be created is through the perceptual process. People do not behave on the basis of truth and reality. Their behavior is evoked from their perception and interpretation of truth and reality. These perceptions and interpretations are the product of information taken in through the senses: sight, hearing, smell, taste, and touch. So much information comes in that people cannot attend to it all. Through selective awareness, psychological maps are formed from only part of the information. Behavior is based on these maps. And the maps affect what people perceive. Communication effectiveness is enhanced if you understand the way people map their psychological worlds. People use their psychological maps to make decisions, to get around in life. However, the map is not the territory. It is based upon perceptions of that territory. And these perceptions differ from person to person. ![]() Here is an example of how perception affects behavior. Some friends made a reservation at a seaside restaurant that has a world famous view of the ocean and the crashing surf. Their reservations were for 7:00 P.M., but they arrived a little early. To their dismay, they watched as other groups entered the restaurant and were seated. Time passed, and it was now 7:10 P.M. Convinced that they had been snubbed or ignored by the management of the restaurant, they were about to make an angry complaint to the maitre d' when he approached. "May I seat you now?" he said, as he led them to one of the best tables, where they had a spectacular view. "I am sorry for the delay, but the previous party just wouldn't leave!" The friends' perception was opposite of what was really happening. Instead of snubbing them, the restaurant management was doing its best to seat them at a table with an excellent view. Had the situation been explained earlier, they would not have been so impatient, and they would have perceived the situation entirely differently. *SOURCE: MANAGEMENT OF ORGANIZATIONAL BEHAVIOR: LEADING HUMAN RESOURCES, 8TH ED., 2001, PAUL HERSEY, KENNETH H. BLANCHARD, DEWEY E. JOHNSON, PGS. 300-302*
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