Updates

To Our Valued Clients, Family Members, Employees and Stakeholders:

COVID-19 Status Update – Since our last update on Nov. 2 regarding individuals testing positive for COVID-19 in two Washtenaw County locations, Rainbow has been notified of additional employees and residents testing positive in those locations. Additionally, Rainbow has been notified of other employees in other locations testing positive. Our team has notified affected residents, employees, and family contacts and are working through ongoing contact tracing to communicate with other people who may have had an exposure. Additionally, enhanced precautions have been implemented including in-home quarantine and use of additional protective equipment. Clients and staff in affected areas are being tested.

Spike in Michigan Cases – Michigan and the entire nation are seeing a dramatic increase in the number of people testing positive for COVID-19. Michigan is seeing more than three to four times the average number of daily cases as compared to September. This spike is also affecting Rainbow.

To continue focusing on mitigation strategies, we have taking several steps. 

• In addition to wearing masks, employees are now also wearing face shields when possible. We expect there will be an adjustment period for employees and clients, but this is an additional step to help reduce the spread of the virus.
• Cleaning protocols continue to be followed in all locations.
• Telehealth is continuing to be utilized where possible. Teams continue to assess when this service can be used instead of in-person treatment.
• All employees who can work from home are working from home and limiting any time in the office to only required time to support the organization.

Visitation / Thanksgiving Update – The State’s Michigan Department of Health and Human Services (MDHHS) has classified Genesee, Oakland, Washtenaw, and Wayne Counties as “E” risk classification. As of this writing, all but 1 of 83 Michigan counties are now in the “E” risk level. This means we are prohibited from allowing visitors into our residences. 

Due to the overall level of rising COVID-19 in our counties, we are limiting all outdoor in-person visits unless absolutely necessary, and only if the visit meets the MDHHS criteria.

We understand 2020 has been a difficult year for many people. The virus has and continues to impact so many of our families and friends. Although we may want to gather for Thanksgiving, all Leaves of Absence are ill advised at this time.  Additionally, the State has implemented strict testing protocols for any required Leave of Absence. We continue to encourage visits electronically through Skype, Facetime, and other means.

New Testing Requirements – On October 28, the MDHHS issued a new order regarding testing requirements in Skilled Nursing Facilities, Homes for the Aged, and Adult Foster Care homes with 13 or more residents. This new order requires these facilities to routinely test both residents and staff in certain situations (assuming availability of adequate testing supplies). Effective dates for Rainbow’s locations that have capacity for 13 or more residents (Neuro Rehab Campus and Southfield) will begin no later than November 24, 2020. We are working with the State to obtain the necessary testing supplies, certifications, and protocols. We will continue to update you on our plans for compliance with this new order in the coming weeks.

We will continue to keep you updated. Please do not hesitate to contact your Rainbow Case Manager or Rainbow Administration with your comments or questions. We will get through this together. 

One Team – Together, 

Bill Buccalo 

President and CEO 

To Our Valued Clients, Family Members, Employees and Stakeholders:

We are pleased to report that it has now been over four months since any client has had a new onset of COVID-19. We remain vigilant in our efforts to follow sound recommendations, screen employees, clients, and visitors, and routinely review and educate stakeholders on the virus. While we have not had any client cases of COVID, we have had some employee cases, however no outbreaks.  This is an indication that the precautions we are following are working to minimize or stop the spread of the virus. We remain highly focused on the health and safety of our clients, employees, and our broader community.

As we approach fall, there are several updates that we would like to share including a new Order on Outdoor Visitation to our homes.

Visitors

The Department of Health and Human Services recently revised rules, allowing “Outdoor Visitation” to residential care settings. With the remaining warmer weather this fall, we are encouraging safe visits between families and clients. While indoor visits remain prohibited under the Governor’s Orders, we are able to accommodate outdoor visit at locations meeting the requirements. These requirements include limiting visitors to two at a time, screening in, wearing of masks, maintaining social distancing at all times, among other requirements. Visits must be pre-scheduled. Please talk with the Residential Manager to schedule an outdoor visit or to continue with the existing window visits. 

Remember, Rainbow has also added technology devices at all locations to ensure you can connect via telephone, or video chat through Skype, FaceTime, Zoom, or Facebook. Assistance is available if you are having difficulty connecting; please let our team members know and we can help get you connected.

Systematic Testing

Systematic testing of residential clients has continued over the summer and will continue this fall. Rainbow has expanded the number of individuals tested, including a weekly selection of homes in different geographic areas to systematically test clients.  In the event we identify any asymptomatic clients or employees, this process will allow us to implement isolation measures quickly, reducing the risk of further exposure to others.

We will continue efforts to test on a systematic basis, and we will trace and isolate any individual testing positive to help keep everyone safe. Should there be a positive case, appropriate people will be notified.

Therapy Services

Following the guidance of the CDC, OSHA, and the Michigan Department of Health and Human Services, Rainbow has developed and implemented a thorough COVID-19 Preparedness and Response Plan to ensure we have the mechanisms in place to help protect employees and clients. 

Under these standards, our outpatient therapy centers are up and running, offering clients most of the therapy services available prior to March, including vocational services and training opportunities. Hours of operations have been modified to allow for social distancing and lower numbers of people on site at the same time.

Telehealth services continue to be available and have proved very successful as many clients prefer the convenience and reduce the need for transportation. Telehealth also offers the benefit of strict social distancing yet allows people to receive that care they need to thrive towards rehabilitation goals.

Our enhanced safety procedures at our Outpatient Centers include:

• Health screenings are completed before entry via telephone and then again upon entry, including use of touch-less thermometers for further assessment
• Nursing staff are available to triage anyone who presents with symptoms to educate and provide referrals for further care
• Masks are provided and worn by all clients and staff
• Additional personal protective equipment (PPE) is readily available and utilized whenever deemed necessary
• Clients are asked to wash and sanitize their hands frequently along with our employees
• Social distancing measures have been implemented wherever possible
• Sanitation procedures for all facilities and between treatments have been enhanced
• Our Infection Control team continues surveillance and monitoring of all Rainbow environments and tracking of any individuals who present with symptoms

Updates on recent Governor issued Executive Orders relating to long-term care facilities

• Order 2020-177, issued September 3, 2020, extends the State of Emergency through October 1, 2020. 
  • Rainbow will continue to provide telehealth services and in-person therapy services at the Residential Sites for those most vulnerable. Additionally, we will continue in-person therapy for residential clients and outpatient clients at the Outpatient Centers where appropriate.
• Order 2020-179, issued September 3, 2020, extends Protections for Residents and Employees of Long-term Care Facilities through until September 30, 2020. 
  • Rainbow continues to comply with the requirements of this order, focusing on the safety of residents and employees, and the overall preparedness of the company.
• Order 2020-174, issued August 28, 2020, extends the previous order which temporarily Restricts Visitors to Residential Care Facilities through September 30, 2020. However, MDHHS Order loosens the order allowing for “Outdoor Visits” under certain conditions or exceptions. 
  • Rainbow can make “Outdoor Visitation” available for clients and family in certain circumstances. Please speak to the Residential Program Manager or Division Director for any questions or to make arrangements for an outdoor visit.
  • Rainbow continues to make client / family communication available and encouraged through FaceTime and other video and phone means so we can all stay connected. Additionally, ‘window visits’ are available where safe.

I would like to recognize our wonderful employees for all they are doing to continue to perform their work admirably every day, while also doing their very best to keep everyone safe. You are greatly appreciated!

To our stakeholders, thank you all for your continued support. We will continue to keep you updated. Please do not hesitate to contact your Rainbow Case Manager or Rainbow Administration with your comments or questions. We will get through this.

One Team – Together,

Bill Buccalo

President and CEO

To Our Valued Clients, Family Members, and Stakeholders:

As we continue to work towards a new normal, this Stakeholder Update provides some information on the current status of the COVID-19 impact on our environments. We remain focused every day on the health and safety of our clients, employees, and our broader community.

I am happy to report that for more than a month, there have not been any positive cases of COVID-19 amongst any of our clients or employees. The team remains vigilant in following needed precautions, ongoing staff education, information sharing, and securing needed personal protective equipment.

Systematic Testing

As noted in the last Stakeholder Update, testing has become more readily available. Rainbow has expanded the number of individuals tested, including a weekly selection of homes in different geographic areas to systematically test clients.  In the event we identify any asymptomatic clients or employees, this process will allow us to implement isolation measures quickly, reducing the risk of further exposure to others.

We will continue efforts to test on a systematic basis, and we will trace and isolate any individual testing positive to help keep everyone safe. Should there be a positive case, appropriate people will be notified.

Resuming Therapy

Rainbow has developed and implemented a thorough COVID-19 Preparedness and Response Plan to ensure we have the mechanisms in place to help protect employees and clients. Teams have customized procedures site-by-site following guidance provided by the CDC, OSHA, local health departments, and the Michigan Department of Health and Human Services.

Under these new standards, our outpatient therapy centers are up and running, offering clients most of the therapy services available prior to March, including vocational services and training opportunities. Some hours of operations have been modified to allow for social distancing and lower numbers of people on site at the same time. Telehealth services continue to be available and have proved very successful as many clients prefer the convenience and reduce the need for transportation. Our focus remains protecting those who are most vulnerable, while ensuring individuals receive the care necessary to preserve their health and safety and thrive in rehabilitation goals.

Accessibility

During this time of operating through a pandemic provides additional challenges. Individuals in need of rehabilitation or long-term care do not always have the luxury of putting care on hold. Considering this, Rainbow has taken several steps to address concerns, prepare, and ensure program accessibility for clients, employees, and guests alike. Below are a few of those additional steps.

• Telehealth has been added to provide treatment to reduce in-person contact
• Virtual Tours are now available for individuals and families to see the programs
• Education on infection control for employees, clients, and the broader community have been implemented and are taking place to allay fears, focus on fact, and increase personal control over the situation
• Rehab Transportation remained open during the shut down to provide essential transportation services, and is now in full operations with screening, cleaning, and masking protocols
• Our Outpatient Centers have continued to expand the types of commercial insurances accepted to ensure our therapy services are available based on your coverage, as well as making available post-COVID rehabilitation for those in need
• Technology investments have been made in several areas to ensure virtual physician appointments, ongoing care meetings, and visitation all take place uninterrupted
• In-person treatment is being scheduled to provide separate space or times for residential and outpatient clients
• Personal protective equipment has been purchased in quantities to ensure we are prepared

Visitors

With the beautiful summer weather, we are encouraging safe visits between families and clients. Under the Governor’s Executive Orders, residential homes are currently prohibited from allowing visitors into the home. Additionally, CDC guidance continues to discourage in-person visitors. Although we cannot invite visitors into the home, ‘window visits’ give families the option to come by the house, but not come into the house, for a safe visit near a designated window. ‘Window visits’ must be pre-scheduled, shorter in length, socially distanced, and will require masks and screening by all participants. Please talk with the Residential Manager to schedule a window visit or if you have questions. Rainbow has also added technology devices at all locations to ensure you can connect via telephone, or video chat through Skype, FaceTime, Zoom, or Facebook. Assistance is available if you are having difficulty connecting; please let our team members know and we can help get you connected.

Enhanced safety procedures at our Outpatient Centers include:

• Health screenings are completed before entry via telephone and then again upon entry, including use of touch-less thermometers for further assessment
• Nursing staff are available to triage anyone who presents with symptoms to educate and provide referrals for further care
• Masks are provided and worn by all clients and staff
• Additional personal protective equipment (PPE) is readily available and utilized whenever deemed necessary
• Clients are asked to wash and sanitize their hands frequently along with our employees
• Social distancing measures have been implemented wherever possible
• Sanitation procedures for all facilities and between treatments have been enhanced
• Our Infection Control team continues surveillance and monitoring of all Rainbow environments and tracking of any individuals who present with symptoms

Updates on recent Governor issued Executive Orders relating to long-term care facilities

• Order 2020-151, issued July 14, 2020, extends the State of Emergency and the Stay at Home order until August 11, 2020. 
  • Rainbow will continue to provide telehealth services and essential in-person therapy services at the Residential Sites for those most vulnerable. Additionally, we will continue in-person therapy for residential clients and outpatient clients at the Outpatient Centers where appropriate.
• Order 2020-148, issued July 13, 2020, extends protections for residents and employees of long-term care facilities through until August 10, 2020. 
  • Rainbow continues to comply with the requirements of this order, focusing on the safety of residents and employees, and the overall preparedness of the company.
• Order 2020-136, issued June 26, 2020, extends the previous order which temporarily restricts visitors to residential care facilities through July 24, 2020. 
  • Rainbow continues to make client / family communication available and encouraged through FaceTime and other video and phone means so we can all stay connected. Additionally, ‘window visits’ are available where safe.

Thank you for your continued support. We will continue to keep you updated. Please do not hesitate to contact your Rainbow Case Manager or Rainbow Administration with your comments or questions. We will get through this.

One Team – Together,

Bill Buccalo

President and CEO

To Our Valued Clients, Family Members, and Stakeholders:

On behalf of the Executive Team and all employees of Rainbow, we want to thank you for your ongoing support and encouragement over these last several weeks. We are carefully working towards a new normal, however several restrictions remain in place. We understand this has an impact on everyone and we thank you for your understanding.

We continue to focus on the overall health and safety of our clients and employees. There are many inspiring stories of employees going above and beyond to serve clients well and do the special little things to make a difference. We thank you all! 

Visitors – With the beautiful spring weather, we are working on ways to enable safe visits between families and clients. Under the Governor’s Executive Orders, residential homes are currently prohibited from allowing visitors into the home. Additionally, CDC guidance continues to discourage in-person visitors. Although we cannot invite visitors into the home, ‘window visits’ give families the option to come by the house, but not come into the house, for a safe visit near a designated window. ‘Window visits’ will be pre-scheduled, shorter in length, socially distanced, and will require masks and screening by all participants. Please talk with the Residential Manager to schedule a window visit or if you have questions. Rainbow has also added technology devices at all locations to ensure you can connect via telephone, or video chat through Skype, FaceTime, Zoom, or Facebook. Assistance is available if you are having difficulty connecting; please let our team members know and we can help get you connected.

Testing

Rainbow has pursued testing of symptomatic individuals since the onset of this pandemic. As testing has become more readily available, Rainbow has expanded the number of individuals tested, including obtaining test kits for administering by our capable nursing team. Through this expanded testing process, asymptomatic employees and clients have been identified which has allowed us to implement isolation measures quickly, reducing the risk of exposure to others. The State and best practices require we designate a grouping of rooms where individuals with COVID-19 can recover. As we have individuals recovering at the NeuroRehab Campus, we have designated rooms there for this purpose. We will continue efforts to test on a systematic basis, and we will trace and isolate any individual testing positive to help keep everyone safe.

Preparedness to phase into more Therapy

Rainbow has developed and implemented a thorough COVID-19 Preparedness and Response Plan. This Plan ensures we have the mechanisms in place to help protect employees and clients as we begin to phase back into increased rehabilitation activities. Teams have customized procedures site-by-site to consider differences in physical layout, needs of clients and employees and other nuances, all following guidance provided by the CDC, OSHA, local health departments, and the Michigan Department of Health and Human Services.

Over the past two weeks, we have begun to provide therapy services at our outpatient centers. Outpatient centers are currently open for limited hours each week. We anticipate increasing the frequency of in-person treatment at the centers each week, and also finalizing plans for restarting the vocational services and training opportunities. Our focus remains protecting those who are most vulnerable, while ensuring individuals receive the care necessary to preserve their health and safety.

Enhanced safety procedures at our Outpatient Centers include:

• Health screenings are completed before entry via telephone and then again upon entry, including use of touch-less thermometers for further assessment
• Nursing staff are available to triage anyone who presents with symptoms to educate and provide referrals for further care
• Masks are provided and worn by all clients and staff
• Additional personal protective equipment (PPE) is readily available and utilized whenever deemed necessary
• Clients are asked to wash and sanitize their hands frequently along with our employees
• Social distancing measures have been implemented wherever possible
• Sanitation procedures for all facilities and between treatments have been enhanced
• Our Infection Control team continues surveillance and monitoring of all Rainbow environments and tracking of any individuals who present with symptoms

Updates on recent Governor issued Executive Orders relating to long-term care facilities

• Order 2020-100, issued May 22, 2020, extends the State of Emergency until June 19, 2020. 
  • Rainbow will continue to provide telehealth services and essential in-person therapy services at the Residential Sites for those most vulnerable. Additionally, we are beginning more in-person therapy for residential clients and shifting care to the Outpatient Centers where appropriate.
• Order 2020-108, issued May 29, 2020, extends the previous order which temporarily restricts visitors to residential care facilities through June 26, 2020. 
  • Rainbow continues to make client / family communication available and encouraged through FaceTime and other video and phone means so we can all stay connected. Additionally, ‘window visits’ are available where safe.
• Order 2020-110, issued June 1, 2020, rescinds the Stay at Home order, and significantly increases the types of activities which can be resumed. Resumed activities include restaurants, outdoor camps, libraries, museums as of June 8; indoor gatherings of 10 people and outdoor gatherings of up to 100 people with appropriate safeguards.
  • This order does not relax the Visitation Restrictions at Long-term Care Facilities or other limitations on activities allowed in Long-term Care settings. Rainbow continues to advance rehabilitation and related activities, while also mitigating the chance of spread of the virus.

We will continue to keep you updated. Please do not hesitate to contact your Rainbow Case Manager or Rainbow Administration with your comments or questions. We will get through this.

One Team – Together,

Bill Buccalo

President and CEO

To Our Valued Clients, Family Members, and Stakeholders:

On behalf of the Executive Team and all employees of Rainbow, we want to thank you for your ongoing support and encouragement over these last several weeks.

The efforts of our Infection Control, Emergency Management, and Leadership Teams have been outstanding, as have the efforts of All Employees throughout the organization. In the face of the novel coronavirus, we have focused on the overall health and safety of our clients and employees. Employees have stepped up to meet the challenge and we have celebrated them throughout this fight as ‘Health Care Heroes’ because they truly are heroes!

Preparedness to phase into more Therapy

The organization has developed and implemented a thorough COVID-19 Preparedness and Response Plan. This Plan, along with related policies and procedures, ensures we have the mechanisms in place to help protect employees and clients now and as we begin to phase back into increased rehabilitation activities.

In mid-March, as the coronavirus began to flare up in Michigan, Rainbow took several aggressive steps to help mitigate the spread of the virus and flatten the curve. In the past several weeks, we have seen a decrease in the number of cases of COVID-19 in southeast Michigan, and at Rainbow. We are pleased to report we have not seen onset of a new client case in over a month and we have had one employee case over the past 3 weeks. This is a positive and encouraging trend.

We are now planning to resume certain limited therapy activities within the confines of the State Executive Orders. Our focus remains protecting those who are most vulnerable, while ensuring individuals receive the care necessary to preserve their health and safety. Over the ensuing days and weeks, residential clients will see an increase in the frequency of essential therapies taking place, both at our homes, and on a limited basis at the Treatment Centers. Additionally, outpatients will be welcomed back into the Treatment Centers for essential therapies. The Rainbow Team has put extensive plans in place focused on the safety of clients and employees, and following guidance provided by the CDC, OSHA, local health departments, and the Michigan Department of Health and Human Services.

Enhanced safety procedures at our Outpatient Centers will include:

• Screenings upon entry including touch-less thermometers and completion of a brief health questionnaire
• Masks will be provided and worn by all clients and staff
• Other PPE will be available and utilized as appropriate
• Clients will be asked to wash and sanitize their hands frequently along with our employees
• Social distancing measures are being implemented where possible
• Enhanced sanitation procedures between treatments will occur
• Our Infection Control team will continue surveillance and monitoring of all Rainbow environments and track any individuals who present with symptoms

Telehealth has been an effective treatment method in certain situations

To best observe social distancing practices, telehealth will continue to be used where appropriate. Additionally, some individuals now prefer telehealth as this treatment method can have the added benefits of reducing the time and costs associated with travel.

Updates on recent Governor issued Executive Orders relating to long-term care facilities

• Order 2020-72 extends the previous order which temporarily restricts visitors to residential care facilities until May 31, 2020. Rainbow continues to make client / family communication available and encouraged through FaceTime and other video and phone means so we can all stay connected.
• Order 2020-77 extends the Stay at Home order until May 28, 2020 and sets conditions on the amount and types of in-person services that we can provide for our clients. Rainbow will continue to provide essential in-person therapy services at the Residential Sites and soon at the Centers. Telehealth Services will also continue to be utilized where appropriate to encourage social distancing practices.

Happy Mother’s Day! – We understand that connecting with your loved ones is incredibly important. While we still must follow state orders to restrict visitors, Rainbow has added technology devices at all locations to ensure you can connect in a variety of ways. These include telephone, or video chat through Skype, FaceTime, Zoom, or Facebook. If you are having difficulty connecting this Mother’s Day weekend or otherwise, please let our team members know so we can help get you connected.

We will continue to keep you updated. Please do not hesitate to contact your Rainbow Case Manager or Rainbow Administration with your comments or questions. We will get through this.

One Team – Together,

Bill Buccalo

President and CEO

To Our Valued Clients, Family Members, and Stakeholders:

Over the course of the last two months, we have worked diligently to keep you informed regarding COVID-19, company response to the pandemic, and how it has impacted us at Rainbow. Our top priority continues to be the health and safety of our residents and our employees. For the general public, the challenges associated with fighting this virus are great, but when providing care for vulnerable individuals in group settings, it can pose even greater challenges.

The Rainbow Team has responded very well to this pandemic and we couldn’t be prouder or more impressed with the effort and dedication of our employees and the caring and compassionate way the team is working together for the benefit of our clients.

Since February, our Infection Control and Emergency Management Committees have been actively engaged in planning, monitoring, training and educating regarding COVID-19. We meet daily to ensure we are addressing the needs of clients, employees, and responding to the ever-changing environment.

In addition to our longstanding infection control precautions and protocols, increased use of Personal Protective Equipment (PPE) is particularly important to help control the spread of the virus. Rainbow has worked diligently to secure ample supplies of masks, gowns, face shields and other PPE. A combination of purchases, generous donations, and self-manufacturing of certain items by our Vocational Team has put us in a good position. More data is showing that many people with COVID are not showing symptoms. Currently, all employees and clients are wearing masks daily. With everyone wearing a mask, the chance that someone who has COVID, but does not know it, infecting someone else is minimized. Heightened precautions and isolation procedures are also in place at locations where COVID is suspected or individuals are recovering from COVID.

Rainbow has been aggressive in pursuing testing for individuals who present with symptoms. Over the past two weeks, we have seen a relaxing of the requirements to obtain a test. This has allowed for more clients to receive tests; and we are also encouraging employees to get tested. To date, we have had several residents and employees test positive for COVID-19. Some with very mild symptoms that have resolved and some with more severe cases. We continue to support and hope for everyone’s recovery. With our client cases, our Case Managers and Department Managers are in frequent communication with affected clients, families and stakeholders. We will continue to aggressively pursue testing of clients and employees.

Researchers continue to investigate the potential of aerosolization of the virus. This past week, Rainbow purchased new air purifying devices for each of our residences and centers out of an abundance of caution. These units were delivered Friday and will be installed this week. While social distancing, covering a cough, wearing masks, and ensuring employees who are ill stay home is the best defense, these purifiers have a very high kill claim for many airborne pathogens and will only enhance air quality.

Recently, the Governor issued new Executive Orders relating to long-term care facilities. 

• Order 2020-37 extends the previous order which temporarily restricts visitors to residential care facilities until May 4, 2020. Rainbow continues to make client / family communication available and encouraged through FaceTime and other video and phone means so we can all stay connected.
• Order 2020-42 extends the Stay at Home order until May 1, 2020 and limits the amount and types of in-person services that we can provide for our clients. Rainbow has established Telehealth Services to ensure clients are able to participate in needed therapy, while also respecting the need for social distancing and following this order. If a service cannot be performed via Telehealth or reasonably deferred at this time, therapists and caregivers are continuing to perform these necessary services.
• Order 2020-50 provides enhanced protections for residents and staff of long-term care facilities during the COVID-19 pandemic. Rainbow has reviewed this Order and has determined we are already in compliance with the requirements.

On a daily basis, we are monitoring for updates and changes of the guidelines and requirements from the CDC, Michigan Department of Health and Human Services, and local Health Departments. We are in frequent communication with these entities, local hospitals and consulting physicians to ensure our practices are appropriately updated as new information becomes available.

Going forward, the Governor has indicated there will be a loosening of the Stay at Home order and related mitigation measures. Rainbow is planning for these changes now and looking at how our new normal will unfold in ways that continue to focus on the safety and welfare of our clients and employees, assuming the ongoing threat of the coronavirus. We anticipate some things will look different and be different, yet at the same time will spawn innovation under these conditions. We have already seen inspiring innovation and new ways of doing things.

We will continue to keep you updated. Thank you for your support during this unprecedented situation. Please do not hesitate to contact your Rainbow Case Manager or Rainbow Administration with your comments or questions. We will get through this together.