by ALY DE ANGELUS
Staff Writer | May 30, 2020 1:00 AM
Bonner County Daily Bee
SANDPOINT — Panhandle Special Needs, Inc. Executive Director Trinity Nicholson was tending to the retail greenhouse on Boyer Avenue when I called for an interview. Normally the greenhouse would be groomed and cultivated by Nicholson’s clientele in the summer as an employee training program for the disabled in Sandpoint.
“This is when we make money off of our greenhouse and the whole world is shut down,” Nicholson said. “We have plants out there and no employees.”
COVID-19 social distancing protocol has completely thrown PNSI routine care for a loop. As a result staff has decreased from 27 to 11 workers, newly providing 24/7 telehealth care and house visits to continue service for Bonner and Boundary County’s disabled community.
At 10 weeks of service during the pandemic, PNSI reported staff taking over 500 temperature reads, delivering 240 meals from their facility and bagged lunches from the soup kitchen, as well as 300 home visits and 8,000 phone calls. Nicholson said the clients she talked to are mostly scared and confused, frequently asking if they should go to the emergency room because of COVID-19 concerns.
“I think had we not been there holding that wave back, and other agencies around the state, I think the emergency room and doctors offices would have been flooded with clients who were scared,” Nicholson said. “We are a unique first responder but we don’t really get the respect of that or the support, but we are in the trenches and have been the whole time.”
PNSI’s specialty program is the adult day care program that provides social opportunities for adults and elderly that could not otherwise participate in senior centers or community activities due to their special needs. Vulnerable residents such as the elderly will not be allowed to receive service from PNSI until the CDC updates their recommendations.
Nicholson and staff have continued to teach life skills such as shopping, house cleaning, paying bills, employment and cooking with minor adjustments. Home visits are limited to once or twice a week in order to increase safety of staff and clients. The workers conduct food inventory and cook meals for clients in person and shop and hand off the client’s bill payments alone.
For precaution staff travels with masks and sanitation kits to wipe down door handles. Nicholson said home visits have been critical to give clients a sense of normalcy, especially for individuals who are anxious and looking for ways to pass the time.
“One example is I had a client call me and say, ‘I don’t know where to take my dog to go to the bathroom because I can’t leave my house,’” Nicholson said. “That is the interpretation of the state home order. Hearing information on the news and getting really scared … we have had a few ambulance phone calls but we are on call 24/7 right now so clients can call us first.”
Over 800 training packets have been packaged and delivered as tools for staff to use during telehealth calls. Nicholson said disabilities cause communication barriers and have limited the effectiveness of care, but she is thankful for Idaho’s temporary solution in March to authorize telehealth visits for adult day health and developmental therapy.
“I call them and say, ‘Let’s get out your calendar, your day planner, your price round up sheet’ and using that physical packet has made us able to do telehealth,” Nicholson said.
There are six special needs facilities in Bonner and Boundary County that have come and gone in the last six years, “So that’s a lot of pressure for one agency to serve everyone,” She said.
PSNI predicts reaching maximum occupancy in the next five years, more than doubling their clientele in the last four years. They have had a waiting list since 2010.
Nicholson has worked closely with Sen. Jim Woodward, R-Sandpoint, and Rep. Sage Dixon, R-Ponderay, to push for financial support in the district.
“Given we were working on shoestring budgets and here we are with COVID-19 and all the clients can’t come and there is nothing keeping us going, there is no supplemental funding to keep our doors open,” Nicholson said. “We just suddenly had no income so that’s been a big deal.”
Medicaid funding for PSNI is based on attendance, by a fee for service charge, and there has been no fee increase since 2006. This reality has made it difficult for PSNI to stay open and offer out-of-facility care during COVID-19.
“We are not even billing 50 percent of our services (with telehealth) so that’s been very painful,” Nicholson said. “There are clients that we have to serve, they live alone, we take them shopping and pay their bills, so also working with the state to understand that they listed us as essential workers because we are, but they didn’t help us … We just had to fend for ourselves, hard core, which is exactly what we did.”
PSNI has been around since 1975 and generally services 200 individuals, 17 of which live alone.
She thinks telehealth could be a long term solution for some clients, which would cut transportation costs. Previously the agency would shuttle clients to the buildings with a medicare bus.
Nicholson is also looking for maintenance of effort payments to keep her doors open and funding to upgrade her buildings to accommodate wheelchairs, update lighting and guarantee space for all clients that participate in their day programs. Her goal is to continue to grow the program and support the disabled community in Sandpoint.
“I advocate like a maniac,” Nicholson said. “There is just that group that always slips through the cracks.
“We lean on donations and funding but that’s a scary business strategy, you’ll have a year where you are getting a lot of donations but that does not mean you are getting them next year.”
