The Alliance is pleased to welcome its newest member, A Caring Touch Corp., a private care agency in Newton, Massachusetts.
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Month: March 2011
Guest Post: Nicole K.
Hello everyone,
Today the Home Care Alliance of Massachusetts has graciously allowed me to guest blog on some very important regulatory issues facing home care. I am a home care nurse working in quality and compliance for one the largest home care agencies in the state. Currently, I’m a student at the Yale School of Nursing in their Nursing, Management, Policy, and Leadership program. I am completing an internship here at the Alliance and I plan to end it with a trip to the NAHC “March on Washington” conference this week.
This is a very exciting and challenging time for the industry. Home care is viewed by many as a way to safely and effectively care for people, in a financially sound way. I want to make it THE way for patient-centered care.
As the state and nation look towards care redesign in health care, home care should be at the head of the table for this conversation. Yet at the same time, proposed and enacted federal regulation will do extreme and permanent damage to home care. Currently, the certified home care industry is frantically preparing for the implementation of the Face-to-Face rule that takes effect April 1st. As Bill Dombi from NAHC stated, ” this is the most important Medicare change affecting home care in the last 20 years.”
On a positive note, one of our New England legislators, Senator Susan Collins, is actively working to propel forward a bill that would create greater access to home care for our sickest patients. These are the patients that can’t easily visit a physician’s office due to serious and chronic medical conditions. Senator Collins’ Home Health Care Planning Improvement Act of 2011 (S.227) would allow nurse practitioners and physicians assistants, among others, to order home care. While in Washington, I plan on speaking to any legislator who will listen to me about the damaging impact of the Face-to-Face regulation as well as the importance of passing Senator Collins’ bill. I have also lobbied remotely via telephone and using HCA-prepared emails and you can too. It’s quick and easy and makes you feel good after it’s completed.
Now is the time for all of us who work in home care or have loved ones who use home care to lobby our elected representatives to advocate for the preservation of home care.
Thank You!
Nicole K.
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Lobbying Congress and/or Lobbying CMS?
Next week, Home Care Alliance members will be in Washington DC to make sure that our elected federal officials understand the role of home care in the health care delivery system and the strain on services being imposed by new federal rules, such as the face to face requirement. We will also be seeking their help in carrying our message to those unelected federal officials who run the Medicare program for the Congress and the American people: the Centers for Medicare and Medicaid. With both enormous responsibility and authority, this federal agency can hugely influence who gets and who provides health care.
In advance of our meetings, the Home Care Alliance sent a letter to United States Secretary of Health and Human Services Kathleen Sibelius asking that she use her recently granted authority to at least temporary impose a “cooling off” period for new home health agencies in our states. Included in the letter was the following:
- ” CMS has sufficient data to indicate that rapid increases in the number of home health
agencies has led to increases in utilization and spending beyond that which would be
indicated by payment changes, growth in enrollees, or policy actions. The National
Association for Home Care and Hospice collected data indicating that from 2001-2006,
Medicare spending grew 2.5 times more in states where the number of home health
agencies (HHA’s) increased as compared to states where the number of providers
remained the same or decreased. - The proposed rules suggest that determining factors for moratoria include a trend of
growth that is disproportionate relative to the number of beneficiaries or a rapid uptick
in enrollment applications. The recent situation in Massachusetts satisfies both of those
requirements. After virtually no growth between 2001 and 2006, our state has seen an
increase of 27 certified agencies in the past four years – an increase of more than 20
percent. This has occurred despite the fact that no area of the state is un-served or
underserved. - This recent growth is driven by that fact that Massachusetts is one of only a few states
that has neither state licensure nor certificate of need rules for new home health care.
This ability to “take all comers” was further exacerbated by a CMS decision a few years
ago to allow state Survey agencies to transfer their responsibilities for new Medicare
home health certification to private accreditation agencies. Our experience is that these
private surveys are less rigorous and that it has become much too easy for new agencies
to become established without a full understanding of the complexity of Medicare
compliance. In fact, we believe that several agencies received Medicare deemed status
in the past five years have either been decertified or in danger of being decertified once
the state makes an initial survey. All of this adds costs and no value to our system.”
Our agenda also includes – thanks to one of our most responsive elected officials Congressman Jim McGovern – a meeting to try to bring some reasonableness to the federal/state “TPL” fight over paying for home care.
Please continue to share your thoughts on both our current industry challenges and what you see as needed fixes. When we are in DC, we are speaking for you.
Physician Face-to-Face Encounter Update: New Q&As
The Centers for Medicare and Medicaid Services (CMS) have posted new guidance regarding the physician face-to-face requirement in order for patients to receive Medicare home health services.
Questions & Answers have been updated periodically by CMS and a new round has just been made available.
The new Q&A’s include:
Also, if you are from a home health agency and have not already done so, please comment on a national Face-to-Face Encounter Requirement Survey. Your feedback on whether the report reflects the issues your agency is facing will be instrumental in the Home Care Alliance’s advocacy and meetings with federal elected officials taking place at the end of March. You can comment on this newsfeed post or email James Fuccione at HCA.
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Patrick Administration Postpones ADH Rate Cuts, Services Still in Jeopardy
Officials in Governor Deval Patrick’s Administration announced that rate cuts that would have taken effect today (Tuesday, March 15) to Adult Day Health, Adult Foster Care, and Day Habilitation Programs would be “postponed indefinitely.”
Those rate cuts amounted to a total of $10 million for the three programs, but there is still the danger of the much larger $55 million cut to Adult Day Health Services that would eliminate the “Basic” service category. A special advocacy day is planned for March 22 at the State House and any interested agencies offering Adult Day Health services are invited to attend. More information on the event is available here.
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HCA Welcomes New Member: Ayah Caregivers for Homecare, LLC
The Alliance is pleased to welcome its newest member, Ayah Caregivers for Homecare, LCC, a private care agency in Hingham, Massachusetts.
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Physician Face-to-Face Encounter National Survey: Please Comment
The Home Care Alliance will be traveling to Washington DC later this month to advocate on many issues of concern, including the physician face-to-face encounter requirement set to be enforced starting April 1.
Please see this summary of results from a nationwide survey and let the Alliance know if your agency is in line with how other home health providers from across the country answered.
The survey was conducted by the National Association for Home Care & Hospice (NAHC) and is important in helping HCA shape the message that will be delivered to our Congressional delegation and other key government officials.
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HCA Advocacy Notebook: Federal Advocacy, Adult Day Health, State Priorities
Join Us for Lobby Day in DC March 29
With all the major federal policy issues facing the home health industry right now, effective advocacy on the national level is more critical than ever. The Home Care Alliance will be front and center with the National Association for Home Care & Hospice’s (NAHC) annual “March on Washington” at the end of the month, where federal advocacy on major issues will be the focus.
Some of those issues include:
- The physician face-to-face encounter requirement,
- Home health co-pays proposed by MedPAC,
- Third Party Liability/Dual Eligible issues
- Halting case mix “creep” adjustments and establishing better rebasing standards
- Allowing NP’s and PA’s to sign home health plans of care
The Alliance will host a briefing for legislative staff from the Massachusetts Congressional Delegation and for Alliance members on Tuesday, March 29, at 12:00. This briefing will feature Congressman Jim McGovern, among other speakers, and is free for any Alliance members who wish to join us. Registration for the NAHC activities is not required as this is an independent event! This is a great opportunity to discuss our priority concerns with legislators and their staff members.
Please contact James Fuccione at HCA if you are interested in attending or have any questions.
Adult Day Health Advocacy Day
HCA is cosponsoring an event to oppose a devastating cut to Adult Day Health Services.
This special advocacy day will take place on March 22 from 11:00am to 12:00pm in the Gardner Auditorium of the State House. The proposed $55 million cut in MassHealth Adult Day Health spending from its fiscal year 2012 budget would eliminate the “Basic” level of service on July 1, 2011.
According to the Massachusetts Adult Day Health Services Association (MADSA), this would eliminate services for most program members in the state. The organization estimates that out of 11,500 ADH participants, only about 500 are in the “complex” category.
No registration is required for the event, but please let the Alliance know if you plan on attending.
Legislation Update
The Home Care Alliance’s legislative priorities have received bill numbers and assignments to the committees who will hold public hearings on the issues. Most bills are headed to the Joint Committee on Public Health with one exception: HCA’s home care omnibus bill, An Act Establishing Cost Avoidance Through Care at Home (CATCH), has been referred to the Joint Committee on Health Care Financing.
Stay tuned for when public hearings are announced by these committees so you can offer testimony and comments on these important issues.
More News Coverage of Accredited Members, Ctd.
More announcements in local press about members who have received the Alliance’s Agency Accreditation:
…[A] private-pay home care agency, based in Fairhaven and Dartmouth, is among the first in the state to earn accreditation from the Home Care Alliance of Massachusetts…
“We are proud to be in the initial group of home care agencies to promote these accreditation standards that convey Community Nurse & Hospice Care’s commitment to quality,” CEO and President Jane Stankiewicz said. “The peace of mind for our clients is paramount and we are hopeful people will continue to see the advantages of keeping people independent in their homes and communities.”
…Beverly and Addison Gilbert hospitals’ private-duty home care agency was one of the first organizations in the state to earn accreditation from the Home Care Alliance of Massachusetts. The alliance represents 170 home health and elder care agencies across Massachusetts and has created an accreditation protocol to promote quality services, ethical business standards and superior employment practices.
Since Massachusetts does not offer a specific license for private pay home care agencies, the Alliance created a Home Care Agency Accreditation Program in July 2010 to establish operational and quality standards equivalent to licensure in most other states.
Accreditation is only awarded to agencies that meet or exceed all fourteen standards relating to: client rights,
privacy, and complaint procedures; protections against abuse; fair employment practices; caregiver criminal background screening; competency, training and supervision; insurance coverage; and compliance with all applicable federal, state & local laws.
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HCA Advocacy Day A Success
The Home Care Alliance and State Senator Michael O. Moore hosted a very successful 2011 Home Health Care Advocacy Day at the State House yesterday that brought a great turnout of agencies and legislative staff to hear issues of importance, including HCA’s legislative priorities.
More than 60 attendees consisting of legislators, legislative staff, HCA members, government officials and partnering organizations heard a dynamic lineup of speakers. Senator Michael Moore offered welcoming remarks and touched on his experience on a home care visit seeing a telehealth patient with VNA Care Network in Worcester.
Dr. Matthew Shuster, Chief, Department of Ambulatory Geriatrics for Harvard Vanguard Medical Associates gave a great speech on the importance of home care from the physician perspective.
Judy Flynn from Partners Healthcare at Home presented how home care not only fits well into payment reform, but how the industry could represent a huge cost-savings to accountable care organizations based on the broad range of services that agencies provide.
Kathy Duckett, also from Partners, presented on the cost-efficiency and clinical effectiveness of telehealth. One patient she mentioned went from struggling to perform activities of daily living to planning trips to Alaska and Atlantic City (with a warm up stop at Foxwoods) thanks to the care she received through telehealth.
The Alliance’s Executive Director Patricia Kelleher rounded out the first part of the speaking program talking about An Act Relative to Home Health Aides, otherwise known as “nurse delegation,” and also kicked off the second part, which was a briefing for HCA Members only.
Dr. Jean M. McGuire, Assistant Secretary for Disability Policy and Programs for the state’s office of Health and Human Services spoke about the state’s activity on federal grants, pilot programs and other endeavors. Dr. McGuire mentioned how home health care fits in to those initiatives now and could possibly fit in for the future before taking questions from attendees.
After a short break, HCA members fanned out across the State House to meet with legislators and legislative staff to seek support for home health issues and legislation.
To see and hear some of the activity from Home Health Advocacy Day, visit our Facebook and YouTube pages. If you’re interested in becoming involved with the Alliance’s advocacy efforts, contact James Fuccione.
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