Future of Community Mental Health in Virginia

My dream of opening a private practice zooms in and out of focus, as it has done over the last 20 years. When my day job as a community counselor is going well, opening my practice and jumping through the required hoops seems absurd. I am helping people and getting reimbursed through pay, retirement, and health insurance.

I attended a business meeting / Christmas Lunch at my day job, The CEO spoke on the economic changes in mental health. The insurance companies are hiring case managers to provide their clients support and direction. (These case management services are paid by Medicaid and keeps our Community Service Board in the black. Without this Medicaid reimbursement, the company will collapse.)

The CEO was positive about our company surviving. However, the one layoff we experienced took a toll on the employees. I don’t want to experience another one.

From everything I’ve read, one layoff leads to another layoff. And eventually to the death of the company. I will press forward. I will continue to work towards my goal of private practice.


Getting credentialed through private insurance

This was by far the most challenging task for me. I am an experienced licensed counselor with over 16 years experience. I resent numerous faxes and played many games of phone tag.

Step 1. Purchase Malpractice Insurance.

Step 2. Get two large 3 ring notebooks, and label the Insurance 1 and Insurance 2. Get dividers and plenty of paper.

Step 3. There is a credentialing Department at each insurers site. Write all numbers down. Some insurers want you to reapply and others want you to add a Tax ID.

Step 4. I started with Magellan and Anthem Blue Cross Blue Shield. These were the easiest to obtain. I reapplied with my new tax ID and address . . .30 days later, done. I later became an EAP provider for both those insurers. My first 6 clients were through these insurers.

Step 5. Start applying to other insurers. Keep track of all contacts, reference numbers and phone numbers in your binder.

Good Luck!

Costs of Starting a Therapy Private Practice

Starting a private practice can be costly. I spent $ 400.00 on malpractice insurance and a little over $ 1000 on furniture. I did not rent an office as I decided to use the sunroom in my house. I bought 3 ring notebooks to keep records, pens, Manila folders, plastic file cabinets, and a new printer. I estimate the cost of these supplies at $300.00.

I also purchased a web site /domain name. Caring confidential counseling.com My internet service is a dsl through my phone provider. I have a cell phone that I use for all business calls. My monthly costs for the above are approximately $220.00 per month.

I am still part-time and am not advertising. These factors will be covered in Growing my Business.

Establishing my Private Therapy Practice

My path to private practice was not direct nor simple. Initially, I was going to work for a friend who had a private practice 20 minutes from my home. She guided me through the basics:

1. Obtain malpractice insurance through HPSO or another insurer. This cost less than $400 a month in 2017. HPSO Malpractice Insurance

**This must be done prior to being approved or crendentialed by any insurance company.

2. Contact your state licensing board to be approved as a supervisor for future counselors. This is a very good income source. I previously completed the experience and coursework required for this certification.

I completed these 2 steps at my friends request. However, my friend became overwhelmed at the thought of starting a larger practice and backed out. So, I pushed forward.

3. Determining your physical address. You must have a physical address for your practice. Due to financial constraints, I determined the sunroom in my house was a good place to start. It has a separate entrance and I separated it from my kitchen with a large screen. I purchased classy and comfortable furniture as I wanted to exude professionalism.

**The insurance companies require your physical address but it takes months to be credentialed / paneled and later paid.

4. Start contacting insurance companies to be paneled. Each insurance company will have a slightly different process. Keep good notes and keep calling. And, keep good notes!

This step took me from one month to nine months, depending on the insurance company.

5. Obtain business cards. I used Vista Print.

6. Set up a website. A must for 2017 to give your business credibility. My web site link http://www.caringconfidentialcounseling.com

7. Use word of mouth to get the word out you are in business.

Five months into the process, I received referrals from insurance companies and from word of mouth. I work full–time in the community and fill up evenings with my own clients. It took about five months to build my base. I now have an active part-time Private Practice.

Next Question: How to morph my part-time Private Practice into a full-time business?

6 months in

Worked at my part-time therapy gig in Richmond yesterday. Yesterday marked my 90 day countdown to semi-retirement and of launching my private practice. I did not have time to write a blog entry on this momentous occasion.

So. . . Here we go. March 1 remains my launch date into private practice. At that time, I will work two days a week in Richmond in addition to my private practice in my home.

Financial: My Savings $16,000 to $18,000. Pay mortgage, and car payment with savings up to 12 months. Monthly – Add $1000 variable and $250 health insurance costs. My business must generate $1250 per month after taxes for the first year. Second year $2700 per month after taxes.

Lifestyle: Continue to keep expenses low. Plant garden this spring.

Health: Get gel injections in knee. Continue knee exercises.

Emotional: Visit family once per year.

Creativity: blog, write songs, collaborate on e-book with my sister. Make this income producing.

Time for Harvesting

Launch of Private Practice planned for March 1.

Over the last week, I decided to semi-retire on February 28. I shared my decision my husband, my work friends , my mother and my supervisor.

My husband initially freaked out but calmed down when I told him my plan. I held my ground. My work friends congratulated me. When I called my mother, I asked her to listen and not criticize. After telling her my plan, she responded by telling me my plan was “logical”. My supervisor verbalized his appreciation that I let him know three months in advance.

As I will be semi-retiring 3 months early, I have a few financial challenges. Plan for Challenges:

1. Car 1 needs to be paid off. As of today’s date I have $3000 left. Plan to pay down to $1000 by March 1. Then pay $100 monthly till paid.

2. Practice self-control at stores. Use Self-talk!

3. Face knee issues. Knees are feeling good. 3 months since my last cortisone shot. I will see my orthopedic doc on November 28.

Semi-Retirement Income;

Planned income: 8 Farmville clients (16 visits per month) & 20 Richmond clients (40 visits per month).

16 x 80 = 1280

40 x 50 = 2000

Total 3280 x .61 = 2000 per month

Savings = 1000 (12,000 per year). Goal Total = 3000

Feeling Thankful at Thanksgiving.

Tomorrow is Thanksgiving. It’s been awhile since I checked in with my blog. Busting ass on three jobs gives me little time for blogging. I’m am fortunately very busy in my day job and in my private practice.

Today I want to share my gratitude to God and his universe in the growth of my private practice. I have found my niche in my Richmond side job and the type of clients who benefit from my services. I told the owner of the Richmond location I would like to work two days in Richmond when I leave my day job. He asked when I can start.

Your pink slip is showing

We are having an agency wide meeting on December 11.  The Executive Director is closing down all locations of our agency at 11 am on that day. We will be meeting at the Fireman’s Sports Arena to discuss “Business”.  My husband, David, jokes about me getting fired at the Fireman’s Sports Arena.

Ah!  What will be, will be. I have been planning to leave but . . . . it is anxiety provoking hearing about this meeting.

I need to face reality concerning my bills. My business minded mother tells me to add the costs for health insurance (estimated at $250) to my $1100 mortgage and that is what I need to have tucked away in a savings account.

Savings Account Goal: $16,000-$18,000.

Getting ready for the spring

It is mid October, 145 days into my transformation. 220 days left. By next  Spring, I will have my foundation in place.  Decided  (with my present knowledge) to transition into private practice on March 1, 2017.  Then, I change my mind.  Shit.

I can’t plan my garden if I don’t know what vegetables I want to plant.

My insurance payments begin to trickle in.  Earning $500 a month in Richmond is realistic working two days a month.

My home business is now earning  $1000 a month. I see 4-5 clients a week.

$1500 is not going to cut it. I need at least $2600 a month for the first year. I have $12000 in a CD to use in my first year. I can use 1k in savings and 2k of earnings. I am assuming $2,600 in income and after taxes, $2000.