How to Maintain a Professional Presence on the Phone


If you are job hunting, start thinking about how you will handle employers' responses to your resume. While some recruiters will e-mail you, others may call. All too often, this happens when you're sitting down to dinner, the dogs are yapping, the kids are yelling or you're settling into a favorite Netflix binge. Don't get caught off guard. There's an easy way to know that a call is of a professional nature before you pick up the phone.

Protect Your Image

You can manage calls that come at awkward times by adding a phone number to your smartphone or landline. Many cell and landline companies offer multiple lines on a phone, each with a distinctive ringtone. With a second line, you can have a dedicated and confidential number with a voice mail message tailored to the professional image you wish to present to the world, and you can use this number exclusively for your job search and career management activities. If this line rings at an inconvenient time, you'll know to get yourself into a space where you can switch to your "professional voice" and talk without distraction, or to return the call in a few minutes when the mayhem at home is under control. Use this number on your resume, in your LinkedIn profile and for all other business communications: This can enhance your professional image, and it also acts as a buffer between your professional and personal life.

 Put Your Extra Line to Work

Unemployment due to the pandemic has hit 30 million workers, or about one-quarter of the U.S. labor force. Record unemployment means that getting back into the workforce will require upgrading your job search and sharpening your interview skills.

In such a disrupted world, it would also be a good idea to think about a side gig that might leverage some of your professional skills. An additional revenue stream never hurts, particularly in times like these, and a side gig could even lead to full-time employment. Plus, every nickel you bring in can help ease the financial strain.

Just as it can help with your job search, your extra phone line can help you field and make calls related to your side gig. When that distinctive ringtone sounds, you'll know the call is about money, whether it's for a new job or a potential customer. Either way, you're alerted that the call requires you to answer in your professional voice.

It can take time for that side gig to start making you real money. Not all ideas take off like a rocket, but you'll learn more from your mistakes than your successes. Meanwhile, your efforts may bring in a little extra cash and keep your spirirts up.

If you've always had a dream for a side gig and you've been laid off, now is a great time to put your dream into action. If you need some inspiration, check out these ideas:

Make sure to set up a differentiated LinkedIn profile for your new business to act as a website for your side gig. Think of it as a resume written around your business's goals. With a phone number and a starter website, you have the two foundational basics for a 21st century global business.

SOURCE: Yate, M. (10 August 2020) "How to Maintain a Professional Presence on the Phone" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/organizational-and-employee-development/career-advice/pages/how-to-maintain-a-professional-presence-on-the-phone.aspx


Benefits Consideration for Onboarding Furloughed and Laid Off Employees

As the COVID-19 pandemic continues to create obstacles for the workplace, many professionals are still having to continue with their day-to-day work lives which include having hard discussions with furloughed and laid-off employees. Read this blog post to learn helpful tips on re-enrolling employees into their benefits.


COVID-19 continues to throw us curveballs. While some states that were continuing on their path to recovery are having to backtrack, others have managed to temporarily halt the progression of COVID-19 and are proceeding as planned.

Amidst all this uncertainty, one thing is certain: human resource professionals continue to face overwhelming obstacles. Below, we outline issues that human resource professionals are likely to face as they onboard furloughed and laid-off employees.

Onboarding Furloughed Employees

HEALTH AND WELFARE PLANS

For employees enrolled in one or more employer sponsored health and welfare plans and receiving coverage during the furlough period:

  • Payroll deductions for required employee contributions for the plan generally resume upon return from furlough, subject to any changes in employment status that may affect eligibility.
  • To the extent repayment of employee contributions advanced during the furlough period is required, consider how to collect the employee contributions (e.g., through payroll deduction or otherwise), keeping in mind state law requirements related to payroll deductions.
  • Consider the extent to which election changes may be made upon return from furlough.

For employees not enrolled in an employer-sponsored health and welfare plan during the furlough period (or enrolled in COBRA continuation coverage):

  • Determine when eligibility for the plan resumes in accordance with plan terms (e.g., immediately or after a waiting period), subject to any impact on eligibility due to changes in employment status.
  • Consider the process for enrolling employees and the extent to which election changes may be made upon return from furlough, including any HIPAA special enrollment rights.

In addition:

  • Evaluate the impact of the furlough on employees' full-time status under the Affordable Care Act's (ACA's) lookback measurement period and stability period requirements.
  • Evaluate the impact of return from furlough on participation in wellness program activities and eligibility for wellness program incentives.
  • To the extent employees will have staggered work schedules, consider entitlement to benefits based on reduced hours (full time/part time) or new job requirements and whether any plan amendments are needed.

401(K) PLANS

Generally, employee and company contributions resume upon return from furlough; however, changes in job titles or positions may affect eligibility:

  • Determine whether employee and company contributions will resume immediately upon return from furlough based on elections in place immediately before the furlough period or whether new elections will be required.
  • Determine the extent to which legally required notices relating to plan participation must be provided.
  • Address the treatment of loan repayments upon return from furlough.
  • Determine the extent to which the period of furlough must be counted for purposes of plan eligibility, vesting and the right to allocation of contributions.

PENSION PLANS

  • Consider whether changes in job titles or positions may affect eligibility for continued participation upon return from furlough.
  • Review plan terms to determine the extent to which the period of furlough must be counted for purposes of plan eligibility, vesting and benefit accrual.

OTHER BENEFITS

  • Consider the impact of return from furlough on any commuter benefits (parking and transit).
  • Consider the impact of return from furlough on vacation and holiday accrual.

Onboarding Laid-Off Employees

HEALTH AND WELFARE PLANS

  • Treat rehired employees who have been laid off as new hires who must complete new hire paperwork for health and welfare plan eligibility.
  • Consider the impact of the termination of employment and rehire on the employee's status as a full-time employee under the ACA's lookback measurement period and stability period requirements.

QUALIFIED RETIREMENT PLANS

  • Defer to plan terms and break-in-service rules for purposes of determining the impact of the layoff on plan eligibility, vesting and benefit accrual.
  • Review plan terms and procedures for enrolling rehired employees in a 401(k) plan, including application of the plan's auto-enrollment feature, if any.

SOURCE: Pepper, T. (29 July 2020) "Benefits Consideration for Onboarding Furloughed and Laid Off Employees" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/benefits-consideration-for-onboarding-furloughed-and-laid-off-employees.aspx


COVID-19 at-home testing kits can make returning to work safer

As many begin to return to the workplace, both employers and employees are fearful of bringing the COVID-19 virus into the workplace. A company has produced an at-home testing kit for those returning to work. Read this blog post to learn more.


While access to wide-spread coronavirus testing is still a barrier for millions of Americans, computer software company Appian is partnering with Everlywell, a digital health company, to offer COVID-19 at-home testing kits for employees returning to the workplace.

“Everlywell was founded to give people access to high-quality lab tests that can be taken at home,” said Julia Cheek, founder and CEO of Everlywell. “We are proud to support Appian’s customers in providing FDA-authorized COVID-19 testing to help keep them safe.”

Since March, more than 50 million coronavirus tests have been reported to the CDC, of which 5 million were positive. But as states reopen their economies and infection rates increase, there are growing concerns about supply chain problems, according to Politico. Reopening has increased demand for testing, causing samples to pile up faster than labs can analyze them, which is lengthening turnaround times for results — complicating efforts to contain the virus.

Everlywell’s at-home lab tests seek to streamline the process of testing for their employer clients. The COVID-19 test will be integrated within the Appian Workforce Safety solution. Through the partnership, people using Appian’s return-to-site solutions will be able to request home delivery of Everlywell’s COVID-19 testing kit by taking a screening questionnaire based on CDC guidelines. Each test request will be reviewed by an independent physician from Everlywell’s third-party telehealth partner. Test results can be delivered to the test-taker’s mobile device in 24-48 hours after the sample arrives at an authorized lab.

The lab tests have received emergency use authorization from the Food and Drug Administration. The testing used by the company and its lab partners meet the FDA’s performance criteria for COVID-19 test accuracy, and telehealth consultations are included for those who test positive.

“How much you know as an organization is how much you can protect the members of your organization,” says Matt Calkins, CEO of Appian. “This is the fastest way to get information on infection. We've seen that high amounts of testing can help minimize COVID-19. Knowledge is power, so we're trying to get [employers] as much knowledge as possible, as quickly as possible, and provide them with another tool to keep their employees safe.”

As employers make their strategies for returning to work, workplace safety is of top concern. Antibody screening, thermal cameras and on-site nurses are all methods being considered to help employees stay safe. Digital health is playing a major role in helping employees self-report their risks, whether that be the employee taking the subway, or living with someone who’s immunosuppressed. It can also help employers scalably monitor and assess people's symptoms on a daily basis, ensuring that sick employees stay at home and quarantine. Workplace changes may also include desks and workstations being spread further apart, and stricter limitations on large meetings and gatherings in the office.

Appian’s platform helps employers centralize and automate all the key components needed for safe returns to work. Through the platform, employers can process health screenings, return-to-site authorizations, contact tracing, isolation processing, and now, COVID-19 testing.

“A lot of people would rather work with an employer who goes the extra mile, who’s willing to offer and pay for tests if necessary for their own employees, and to quickly deploy it, where there’s even a suspicion of transmission,” Calkins says. “It’s a responsible gesture and a serious signal that the employer cares about the health of their workforce, and employees are reassured that their colleagues are more likely to be healthy.”

SOURCE: Nedlund, E. (30 July 2020) "COVID-19 at-home testing kits can make returning to work safer" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/covid-19-at-home-testing-kits-can-make-returning-to-work-safer


Why continuous listening is the key to a smooth transition back to work

Returning to the workplace during this time can be difficult for many, especially with employers who are being faced with the question of how to create and keep a safe and comfortable workplace scene. Read this blog post to learn more.


As states and businesses reopen in the U.S., many employers are faced with a difficult decision: Should their employees go back to the workplace? And if so, when? Amazon told their workers they likely wouldn’t return until October, while Google announced that their employees wouldn’t go back to the office until 2021. Twitter and Facebook decided most employees could work from home forever.

But once employers do make that decision, they’re then confronted with a more formidable one: How do they get their employees back in a way that is both safe and comfortable for everyone? In short, how do they successfully manage employee experience?

Most companies have coordinated COVID-19 task forces charged with making those decisions and helping their employees navigate the global pandemic. And whether they realize it or not, those task forces are broken down into two different functions: operational and experiential.

When COVID-19 first hit, the task forces had to deal with the operational challenge of moving massive workforces home overnight, and they worked to ensure employees had the equipment and software needed to function remotely. And soon after, many realized they also had another responsibility on their plate: employee mental wellbeing.

Leaders recognized they’d have to find new ways to keep their people sharp, productive, and happy. In fact, their employees’ experience with remote work was a central component in making that big operational move successful.

The same will happen as task forces bring people back to the workplace. In fact, managing employee experience will become a task force’s most critical responsibility. To ensure employees feel comfortable returning to the workplace, company leadership needs to know how they feel about coming back and what safety concerns they may have. Then leadership must act on that information.

But the current situation (and their employees’ feelings) can change rapidly. That’s why a method called “continuous listening” is essential to managing employee experience. At least once a day (if not more), employees should be able to respond to a few questions about how they’re feeling, and leaders can use that real-time information to successfully take care of their teams.

A large retail bank in North America has set up an always-on feedback channel for retail branch employees to identify safety concerns in different branches. The bank recognized that, when it came to health and safety concerns, employees might need to offer feedback immediately rather than waiting for a survey that came around once a day. Other organizations have used pre-screening tools that allow employees to self-report each day so company leadership can decide whether they should come into the workplace.

Continuous listening helps leadership communicate with employees, and vice versa. If there’s ever been a time to listen to your people and manage their employee experience, it’s now.

A Qualtrics study conducted at the beginning of May found that two out of three workers in the United States didn’t feel comfortable returning to the workplace. In fact, nearly half of all workers said they didn’t expect to go back to work until August or later.

Most respondents said they want assurance from public officials like the Centers for Disease Control or state and local governments before returning, while about half said they’d feel more comfortable once a treatment or vaccine is available. Nearly 70%, though, said they trust their company leadership to make the right decision on when to come back.

Once leadership makes that decision, however, employees expect them to enact policies and procedures that will protect workers’ safety. Almost 75% said they want their work facility to be thoroughly and regularly cleaned and disinfected, while 62% said they want strict policies about who cannot come to the office, including those who are sick and have recently traveled. Nearly 60% said they want masks available to everyone who wants one, while the same amount said they want all employees to be required to wear a mask at all times.

A majority expect their company to require those who travel to self-quarantine for 14 days, prohibit handshakes and hugs, and set safety measures around communal food. Almost 40% said they want employees to be brought back in phases instead of all at once.

Employees also want the freedom to take action themselves. Over 60% said they want to be able to wear a mask and maintain social distancing at work, and half said they want more flexible sick-leave policies that employees are encouraged to use, even with minor symptoms. Nearly the same amount said they want to be able to limit the number of people they’re exposed to in workplace meetings, and almost 40% said they want to be able to skip work without penalty or continue working from home if they feel unsafe.

These findings provide companies with a general idea of what their employees want to see before coming back to work, but gathering data specific to each organization is even more helpful. Before and after companies begin their initial return, they’ll need to listen closely and continuously to their employees and should increase emphasis on employee feedback.

After all, employees are an organization’s best ambassadors. Invest in them, and they’ll invest in you.

SOURCE: Choi, J. (27 July 2020) "Why continuous listening is the key to a smooth transition back to work" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/why-continuous-listening-is-the-key-to-a-smooth-transition-back-to-work


Benefits fair cancelled? 6 strategies for remote benefits communication

Even as states begin to reopen from COVID-19-related closures and many employees return to their places of work, employers can’t rely on past approaches to communicate benefits information during open enrollment and to educate employees about their benefits. It’s unlikely that employers will be hosting large events like benefits fairs, a staple of open enrollment in past years, soon. In addition, some employees may continue to work remotely for an extended period, which means in-person benefits communication can’t be the only strategy.

Employers can consider several alternatives to craft an open enrollment and benefits education and engagement strategy that addresses these issues. For many employers, the solution will be to combine several of these approaches to ensure they are effectively communicating important benefits information and providing employees with more than one way to learn about their benefits and get answers to any questions that may arise.

Before developing a strategy, consider surveying employees to find out how they would prefer to receive information about benefits. Some people find email or printed materials effective, others prefer videos or interactive webinars, while others may be more responsive to receiving information via text message. Once you know your employees’ preferences, you can tailor your approach to increase the likelihood that your employees will use the tools you provide and have a positive experience.

  • Recast your benefits fair as a virtual event. If you want to gather employees together and explain benefit options, how the open enrollment process will work this year and provide them with the opportunity to interact with benefit vendors, you could create a virtual event modelled on the in-person benefits fair. Depending on your organization’s size, the number of employees you need to reach, and where they are located (for example office employees, warehouse or field employees, and remote employees), your approach to hosting a virtual benefits fair will vary. A growing number of IT service vendors offer virtual event planning and execution services that include setting up the technology needed to conduct the event, handling invitations and registrations of participants, working with benefits vendors to set up virtual booths and arranging educational webinars as part of the event.
  • Use your employee intranet, portal, or app. Regardless of whether you host a virtual event, you can use your employee website, portal or app and upload all the informational and educational material employees will need to make benefit choices. This approach can also include a secure portal that employees use to complete benefits forms. Another good feature to include is a chat, which can be either live chat or a chatbot, where employees can get answers to frequently asked questions and assistance with completing open enrollment forms.
  • Host webinars. Webinars not only give you the ability to communicate information about benefits, they also give employees the chance to directly ask the HR and Benefits team questions. In addition to the live webinar, you can record the event and post it on your organization’s employee site or send a link via email so that employees who were not able to attend can still hear your message firsthand.
  • Mail printed materials home. Some employees still prefer to receive benefits and enrollment information and forms in a printed format. It can provide a resource that they can easily refer back to when making their benefits sign up decision. Mailing these materials to employees’ home addresses rather than using your business address ensures that all employees, those who have returned onsite and those who are working remotely, have access to the information they need.
  • Use texts and calendar reminders. To help employees stay on top of enrollment deadlines, send text messages and add reminders to their work calendars. Text messages can also be used to send links to more in depth information resources so employees can access information when required.
  • One-on-one support is key. Employees are bound to have more complicated or confidential questions about their benefits choices, e.g. the need for information about coverage for cancer treatment or labor and delivery. Providing one-on-one phone and chat support from the HR and Benefits team gives employees a way to get answers to questions they don’t want to ask in a more public forum such as a webinar.

A benefits plan is only valuable if employees are knowledgeable about what benefits they have and how to access them. Many of these approaches can also be used on an ongoing basis to provide education on and drive engagement with benefits so employees and employers both get the most out of their plans.

SOURCE: Varn, M. (27 July 2020) "Benefits fair cancelled? 6 strategies for remote benefits communication" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/benefits-fair-cancelled-6-strategies-for-remote-benefits-communication


Jobs are being wiped out at airlines, and there’s worse to come

About 400,000 airline workers have been fired, furloughed or told they may lose their jobs due to the coronavirus, according to Bloomberg calculations.

The aviation industry has suffered more than most as the pandemic destroys ticket sales and strips companies of cash. Airlines the world over have drastically cut back on flights due to border restrictions and a lack of appetite for travel, particularly internationally, because people are worried about contracting the virus and spending lengthy periods in quarantine.

British Airways, Deutsche Lufthansa AG, Emirates Airline and Qantas Airways are among the carriers announcing thousands of dismissals and unpaid leave programs. Many more are expected in the U.S. after a ban on job cuts 一 a condition of a $50 billion government bailout 一 is lifted at the end of September. Delta Air Lines, United Airlines and American Airlines have already warned about 35,000 employees that their jobs are at risk. The trio’s combined personnel losses could top 100,000 by year-end.

Even the pilots and cabin crew who manage to keep their jobs are, in general, facing salary cuts.

The 400,000 job-loss figure is for airlines worldwide and covers pilots and cabin crew, who have found themselves on the front lines of the virus fight when they are at work. It includes planned cuts by U.S. carriers and was compiled from company statements, Bloomberg News stories and other media reports.

Job losses in related industries including aircraft manufacturers, engine makers, airports and travel agencies could reach 25 million, according to the International Air Transport Association. The hotels and lodging sector in the U.S. sees 7.5 jobs lost for every one in aviation. Airbus and Boeing are cutting more than 30,000 positions.

SOURCE: Kotoky, A.; Modi, M.; Turner, M. (24 July 2020) "Jobs are being wiped out at airlines, and there’s worse to come" (Web Blog Post). Retrieved from https://www.benefitnews.com/articles/jobs-are-being-wiped-out-at-airlines-and-theres-worse-to-come


The Saxon Advisor - July 2020

Compliance Check

what you need to know


SF HSCO Expenditures. The last day to submit SF HSCO expenditures, if applicable*, for Q2 is July 30, 2020. *Applicable for employers with 20+ employees doing business in SF and Non-Profits with 50+ employees.

Form 5500 and Form 5558. The deadline for the 2019 plan year’s Form 5500 and Form 5558 is July 31, 2020 (unless otherwise extended by Form 5558 or automatically with an extended corporate income tax return).

Form 8955-SSA. Unless extended by Form 5558, Form 8955-SSA and the terminated vested participant statements for the plan year of 2019 are due July 31, 2020.

Form 5558. Unless there is an automatic extension due to corporate income tax returns, a single Form 5558 and 8955-SSA is due by 2½ months for the 2019 plan year.

Form 5330. For failed ADP/ACP tests regarding excise tax, Form 5330 must be filed by July 31, 2020.

401(k) Plans. For ADP/ACP testing, the recommended Interim is due August 1, 2020.

In this Issue

  • Upcoming Compliance Deadlines:
    • Eligible Automatic Contribution Arrangement (EACA)
    • The deadline for the 2019 plan year’s Form 5500 and Form 5558 is July 31, 2020.
  • Medicare 101: A Quick Guide For Employers
  • Fresh Brew Featuring Saxon’s Holiday Favorites
  • This month’s Saxon U: The Steps Of An Internal Investigation
  • #CommunityStrong: Pick your Own Charity! One of our Own, Deborah Raines, made a meal for a family in need at her temple!

COVID and the ADA and EEOC

Join us for this interactive and educational Saxon U seminar with Pandy Pridemore, The Human Resources USA, LLC, as we discuss COVID and the Americans with Disabilities Act (ADA) and Equal Employment Opportunity Commission (EEOC).

Medicare 101: A Quick Guide For Employers

Bringing the knowledge of our in-house advisors right to you...


Medicare is a government-funded health insurance program for those aged 65 and above, those under 65 with certain disabilities, and those with End State Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). Employers that offer group health insurance plans to their employees have an interest in learning how employees’ entitlement to Medicare benefits can affect the administration of those plans.

“Ask a licensed agent for assistance. Advertisements can be confusing, and everyone wants to make the right choice. Using my expertise, I take the fear out of the decision making, so my clients can make an informed decision concerning their healthcare.”

Advice from Olivia

Fresh Brew Featuring Saxon's Holiday Favorites


In celebration of Independence Day this past month, the Saxon crew has decided to share one of our favorite summer recipes for this month’s Fresh Brew! We hope you all have a safe and happy holiday! 

Marinate your Chicken

This Month's #CommunityStrong:

Each member of Saxon will be choosing their own charity that they want to make a positive impact on!

This May, June & July, the Saxon team and their families will be choosing their own charity that they would like to make a positive impact towards!

Are you prepared for retirement?

Saxon creates strategies that are built around you and your vision for the future. The key is to take the first step of reaching out to a professional and then let us guide you along the path to a confident future.

Monthly compliance alerts, educational articles and events
- courtesy of Saxon Financial Advisors.


Health Care Nondiscrimination Notice Requirement Is Going Away

The Department of Health and Human Services' has removed requirements that employers issue non-discrimination statements to employees that will go into effect on August 18, 2020. Read this blog post to learn more.


On Aug. 18, 2020, the Department of Health and Human Services' (HHS's) finalized changes to the Affordable Care Act's Section 1557 nondiscrimination rules will take effect, removing requirements that employers issue health care nondiscrimination statements to employees and add health care nondiscrimination taglines to employee communications.

Prior to the changes under a final rule HHS published on June 19, employers had to ensure that they, along with their insurers (for fully insured plans) or third-party administrators (for self-insured plans), abided by a 2016 HHS rule requiring employer-sponsored plans to:

  • Create and maintain a notice of health care nondiscrimination.
  • Include it in "significant communications" along with taglines in 15 different languages advising individuals of the availability of language assistance.
  • Include similar taglines for other communications but only in three different languages.

These notices are still required until Aug. 18.

"Now more than ever, Americans do not want billions of dollars in ineffective regulatory burdens raising the costs of their health care," said Roger Severino, director of the Office for Civil Rights at HHS.

Less Paperwork and Lower Costs

"The final rule eliminated the requirement to post the discrimination notice and add taglines," said John Kirk, an attorney at law firm Graydon in Cincinnati. "The final rule also eliminated the requirement that the discrimination notice and taglines be included with all significant publications sent by the organization. This change will be a significant cost and administrative timesaver for most entities."

Employers offering employee benefit plans that were subject to the prior 2016 rule "should review any notice and disclosure obligations and may begin revising their disclosures to remove the nondiscrimination statement and required taglines," Kirk advised.

"This is welcome news for employers that were required to create and maintain these complicated notices," according to compliance firm HUB International. "In the preamble to the new final rules, HHS stated that the notices were costing employers and other entities hundreds of millions to billions of dollars, but were not, in HHS's view, providing meaningful additional help to individuals."

HUB noted that "the onerous notice requirement is gone, but nondiscrimination rules still generally apply," prohibiting discrimination in health care on the basis of race, color, national origin, sex, age or disability.

Overshadowed by Transgender Controversy

Most coverage of the HHS final rule focused on its controversial rollback of anti-discrimination protections based on gender identity, which overshadowed the rule's repeal of the notice and tagline provisions under the 2016 regulation.

A coalition of LGBTQ groups and health care providers are suing the Trump administration, alleging the new HHS rule conflicts with the Supreme Court's June 15 decision in Bostock v. Clayton County, Ga., which found that the prohibition against sex discrimination in the workplace under Title VII of the Civil Rights Act covers sexual orientation and gender identity.

SOURCE: Miller, S. (16 July 2020) "Health Care Nondiscrimination Notice Requirement Is Going Away" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/health-care-nondiscrimination-notice-requirement-is-going-away.aspx


doctor and patient

How Hospitals Can Meet the Needs of Non-Covid Patients During the Pandemic

As there has been many waves of coronavirus cases for many months, health care has seemed to only point to helping those who have been impacted by the virus. Although there are still many cases that test positive for the virus, there has been a dramatic decline in other non-COVID related health issues. Read this blog post to learn more.


During the initial wave of the Covid-19 pandemic, hospitals worldwide diverted resources from routine inpatient critical care and outpatient clinics to meet the surge in demand. Because of the resulting resource constraints and fear of infection, clinicians and non-Covid patients deferred “non-urgent” visits, evaluations, diagnostics, surgeries and therapeutics. Indeed, early in the pandemic physicians and leading public health officials noted a dramatic decline in non-Covid-related health emergencies, including upwards of a 60% decrease in patients with acute myocardial infarctions and strokes.

While these postponements may have reduced the amount of unnecessary services used, they likely also caused a perilous deferral of needed services, which many believe will lead to later hospitalizations requiring higher levels of care, longer lengths of stay, and increased hospital readmissions, thereby further straining hospitals’ inpatient capacity. It is critical that we not only focus on the acute care of Covid-19 patients, but that we also proactively manage patients without Covid-19, particularly those with time-sensitive and medically complex conditions who are postponing their care. This is important not only to sustain health and life, but to preserve future hospital capacity.

Drawing on key principles from operations management and applying a health-systems perspective, we propose four strategies to facilitate care of non-Covid patients even as hospitals are stretched to absorb waves of patients with Covid-19.

1. Innovate outpatient management to reduce demand at downstream bottlenecks. 

To reduce future bottlenecks in emergency departments (EDs) and hospitals, outpatient clinicians should expand their proactive management of patients at high risk of needing acute or inpatient services, such as those with poorly managed hypertension or diabetes, and triage patients with acute needs to EDs now in order to reduce more serious complications later. This will help reduce potential future spikes in demand on EDs and inpatient beds from non-Covid patients.

While most clinicians have rapidly adopted some form of telemedicine, they will need to increase their digital engagement with high-risk patients in a more targeted fashion. Clinicians should evaluate their patient panels to identify high-risk individuals and initiate telemedicine visits, rather than relying on patients to initiate contact, similar to the process for proactive disease management used by several community health care organizations.

Although high-risk patients will vary by specialty, targeted populations may include patients recently discharged from the hospital and those at high risk for hospitalization, including those with uncontrolled heart failure or active malignancy. To facilitate remote patient monitoring of high-risk patients, clinicians may opt to send telehealth kits tailored to patients’ medical and technological needs. These kits may include connected health devices such as blood pressure monitors, pulse oximeters, and heart rate monitors, and even mobile technology devices such as tablets or smart phones. To most effectively leverage telemedicine during the pandemic, clinicians must also promote multidisciplinary virtual collaboration across primary care clinicians, specialists, social workers, home health clinicians, administrative support, and patients and their caregivers.

2.  Combine essential non-Covid inpatient services across hospitals.

To balance demand across hospitals, public health officials should apply a version of the logistics strategy known as “location pooling,” combining demands from multiple locations. Rather than each hospital in a region redundantly providing the full suite of essential inpatient non-Covid clinical services, each of these services should be concentrated at one location. For example, each region should have a single designated cancer center, transplant center, stroke center, and trauma center. Implementing this strategy is fraught with challenges as hospitals are currently organized independently and compete with one another for patients and revenue. Nevertheless, during the initial Covid-19 wave, several hospitals in Boston collaborated to share data on the availability of hospital beds to efficiently route patients based on their clinical need and the available capacity. And centralization of acute stroke care, in which patients are taken to central specialty hospitals rather than the nearest hospital, demonstrates both the feasibility and potential improved outcomes of utilizing this approach in several countries including the United States, Canada, the Netherlands, Denmark, and Australia.

Crises require all possible realizations of economies of scale. Location pooling mitigates variability in service-specific demand faced by each hospital. As demand falls for specific non-Covid services at an individual hospital (e.g., for acute stroke care), hospital administrators can close those services and repurpose the specialty capacity to care of Covid-19 patients with underlying conditions, as discussed below.  If all hospitals implement this strategy, not all non-Covid services will be available at every hospital. However, location pooling draws demand from across hospitals, ensuring that as a given hospital loses some patients it gains others, allowing it to maintain sufficient census to remain fiscally viable.

Centrally coordinated regional organization, similar to mass casualty planning, is critical to ensure that each essential service remains fully operational for routine emergencies, while adapting to dynamic changes in the region’s hospital capacity. The number of hospitals to include in location pooling should be determined by weighing the tradeoff of efficiency gains from pooling across more locations versus inefficiencies from increased travel time incurred by patients and emergency medical services.

3.  Group hospitalized Covid-19 patients by their underlying clinical conditions.

At the same time that hospitals should be location-pooling specialty services for non-Covid patients, to the extent possible they should place their Covid-19 patients who have serious underlying health issues (e.g., cardiac conditions) with other Covid-19 patients with the same condition. In each of these “cohorted wards,” redeployed clinical staff from the relevant specialty service, such as cardiology, can provide essential specialty care alongside clinicians addressing patients’ Covid-specific care needs.

While such cohorting limits efficiency gains from pooling all Covid-19 patients in one ward, it maintains specialty care for patients who still need it while reducing the additional inpatient capacity strain resulting from patients being dispersed across the hospital. Indeed, prior research demonstrates that displacing patients from cohorted specialty units is associated with prolonged hospital length of stay and more frequent readmissions.

4. Discharge patients into post-acute care based on Covid-19 status.

Nursing home, rehabilitation hospital, and long-term acute care facility leadership should collaborate to establish separate regional, specialized, post-acute care facilities for Covid-19 and non-Covid patients. Sending patients to specialized post-acute care facilities based on their Covid-19 status will facilitate discharge planning, improving patient flow out of the hospital for Covid-19 and non-Covid patients alike. This will relieve strain at ED and hospital bottlenecks while maintaining care quality. Furthermore, having dedicated post-acute care facilities for Covid-19 patients will preserve post-acute care capacity for those recovering from non-Covid illnesses, while lowering their risk of becoming infected.

Challenges to this model include ensuring timely access to Covid-19 testing and rapid test results to guide appropriate patient routing. To prevent discharge delays due to testing constraints, hospitals need to implement rapid tests more widely, and post-acute care facilities should designate quarantine areas for patients to receive care while awaiting results.

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These strategies will undoubtedly be challenging to implement. But now is the time to rethink health care delivery and adopt operations management strategies with demonstrated success that are most promising. This will allow us to be better prepared for future waves of the Covid-19 pandemic.

SOURCE; Song, H.; Ezaz, G.; Greysen, S. Ryan.; Halpern, S.; Kohn, R. (14 July 2020) "How Hospitals Can Meet the Needs of Non-Covid Patients During the Pandemic" (Web Blog Post). Retrieved from https://hbr.org/2020/07/how-hospitals-can-meet-the-needs-of-non-covid-patients-during-the-pandemic


Navigating the New Normal in International Business Travel

The coronavirus pandemic has placed many restrictions on travel for both leisure and business. As parts begin to open up and lift certain regulations, organizations are now looking at travel for the business, and if those are possibilities once again. Read this blog post to learn more.


What can your company expect in terms of your employees' ability to travel internationally as parts of the world begin to come out of months of lockdown?

And what will the ongoing restrictions and changes in everyday life mean for your company's ability to transfer or hire new foreign national talent in key areas? Only time will tell exactly what will happen, but we are beginning to see patterns and hints of what is to come.

Some countries that have managed to flatten the curve of COVID-19 infections are gradually easing restrictions on freedom of movement and commerce. This is typically being undertaken cautiously and in a multistep fashion. Other countries have been slower to ease travel restrictions. A broad travel ban remains in place in China, and countries in Latin America continue to extend travel limitations with a wary eye on the outbreak in Brazil.

International travel restrictions on freedom of movement are being eased, albeit more slowly than domestic restrictions. We expect that the easing of international travel restrictions will be incremental in nature as the easing of domestic restrictions has been. We also expect that quarantine requirements for arriving travelers are likely to be put into place in many locations, significantly hampering international business travel.

Arriving travelers are also likely to be questioned more closely than in the past regarding their recent travels, health, reasons for visiting and plans for satisfying quarantine requirements. Although the primary purpose of the vetting may be to limit the spread of COVID-19, an unintended consequence may be that the purpose of the visit and whether the traveler has the correct documentation is scrutinized more closely than in the past. If the traveler is attempting to enter to engage in productive or remunerated work—which often includes consulting, commissioning, installing, troubleshooting and, in some countries, even training or audit activities—without the proper work visa, they are likely to be identified and denied entry.

Governmental migration authorities around the world are beginning to either ramp back up where they were operating at limited capacity or to reopen where they were shut down completely. But although many facilities are ramping up and/or reopening, significant backlogs of applications exist. Many government offices and consulates are encouraging or requiring contactless submissions via post or even e-mail.

The New Normal: A Long-Term Perspective

Looking ahead, it is somewhat challenging to predict what will happen in the global immigration space given that we do not yet know how long the pandemic will drag on. The longer it continues, the more different our new global immigration normal is likely to be. What is already clear is that even if a vaccine or effective remedy for COVID-19 is developed, things are unlikely to go back to "normal" as we knew it before the pandemic. So, what will the new normal look like for your company?

Rise in Remote Work—Decrease in Global Mobility

Many companies have discovered the ability to conduct business remotely, including across borders. What used to require an international business trip (with the corresponding time, costs and visas) now takes place via conference call. Where you used to relocate key staff across borders to facilitate teams working together in person, you likely have now discovered that with everyone working remotely, it may not matter whether your newest team member is physically sitting in Canada, China or France.

New Challenges for Essential Travel

Despite the rise in remote work, technology can't replace all short- or long-term global movement of employees. Some work—installing or commissioning equipment, quality control on a production line, testing of systems and more—simply cannot be done via conference call. If your company has employees who must travel for business purposes, those employees will likely continue to encounter quarantine requirements until the pandemic has been resolved. This means your employees traveling for work will need to provide evidence that they will quarantine for 14 days following arrival, before attending their meetings and/or work duties.

In the past, citizens of privileged countries, such as the U.S., have often enjoyed a low level of scrutiny at ports of entry and have been able to avoid issues when traveling for work purposes without a visa. In fact, before the pandemic, your company's employees may have been previously accustomed to traveling to certain countries with just their passport and no visa. Under the new normal, we anticipate that all international travelers will be subjected to increased scrutiny on entry through the destination country's customs and immigration process. This means your employees are more likely to need to secure a visa in advance of any foreign travel. For this reason, it will be important for you to verify immigration requirements with the most recent information well in advance of your employee's planned travel date. After all, the last thing you want is for your employee to experience the unpleasant surprise of being denied entry or prevented from boarding a flight.

New Challenges for Long-Term Relocation and Local Hires

While it is true for some industries that it does not matter whether a new hire is sitting in Canada, China or France, for others, it absolutely matters. It is probably impossible for a manager to supervise a manufacturing facility via Zoom. Unfortunately, it is likely that companies seeking to transfer or hire foreign nationals will face increased hurdles, even beyond the immediate travel-related hurdles posed by COVID-19 travel restrictions. As unemployment numbers have soared, we have already seen a significant political backlash against immigrants in the U.S. Even putting aside any politically or economically motivated reduction of work visa numbers, the labor market reality of having millions of citizens out of work will make it extremely difficult to pursue work visas that require labor market testing. This would include Labour Market Impact Assessment work permits in Canada, Tier 2 General work visas in the U.K., and Subclass 482 work visas in Australia, among others.

Mitigating Negative Impacts: Preparation and Strategy

It is hard to imagine how any company, let alone a company with global operations and travel needs, could avoid the negative impact of the pandemic. Here are a few ways your company can mitigate (rather than eliminate) the negative impacts:

  • Raise awareness. Your company and your employees are likely to face many obstacles that you are not accustomed to, whether it is a requirement that employees add 14 days to a business trip to accommodate a mandatory quarantine period, the need to obtain visas in advance of travel where they previously could travel without one, or delaying many months before starting a new position while waiting for a work visa approval. It is crucial that all key stakeholders within your company are made aware that immigration is not business as usual. Stakeholders include not only HR and legal personnel but also company managers and recruiters. To the extent that employees can book international travel without managerial approval, it may be prudent to disseminate policies and information to all employees regardless of level. Requirements for travel, transfer and new hires alike must be checked before business commitments and plans are made or contracts with clients are signed. We recommend providing both written and video training to ensure that managers and other employees outside of legal and HR who may not be familiar with immigration concepts have both an opportunity to ask questions and reference materials to refer to in the future.
  • Conduct quarterly planning. In countries where international transfers or hiring of foreign nationals is not prevented by political and labor market challenges, it will be important for your company to plan well in advance for any transfer or new hire. It is likely that the process of obtaining the necessary work visa and/or permit will be slower for some time given the COVID-19-related backlogs. Even where the immigration process itself is not slower than usual, it may take significantly more time to procure the corporate and personal documents (such as birth certificates, marriage certificates and university diplomas) that often must be included in visa applications. It is also possible that there will be more requirements that must be satisfied to obtain the visa, such as medical exams and negative COVID-19 tests. Given this, we strongly recommend that your company plan as far in advance as possible. Although it is not always possible to anticipate all business needs, it is a best practice to work to identify upcoming assignments or new hires on a quarterly basis. We have seen that having a policy and schedule in place with the relevant managers and recruiters can go a long way to reducing last-minute immigration surprises. As part of this plan, before committing to a client contract or signing an employment contract, companies should confirm with their immigration counsel or another trusted source that the employee is able to qualify for the necessary visa and the timeline involved.
  • Implement a global mobility management system. While we have always recommended that companies with global mobility needs have an organized way to track and manage the global movement of their employees, the pandemic has greatly increased the need for such a system. Many companies were caught off guard by the fast-moving pandemic and did not know where their employees were in the world, when their visas were expiring or how they were going to get them home again. Having a centralized system will certainly not solve all your problems, but it will at least equip your company with the information and tools needed to make informed decisions. A "system" does not necessarily mean the very latest and most expensive software for managing global mobility, but rather, some sort of functional, organized method by which to vet and track travel, international transfers and new foreign national hires, along with a clear company global mobility policy.

SOURCE: Lustgarten, A. (08 July 2020) "Navigating the New Normal in International Business Travel" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/talent-acquisition/pages/navigating-new-normal-international-business-travel.aspx