Advocacy Alert: Send a Message to Support Home Health Care in Senate Budget

A new advocacy message has been posted on the Home Care Alliance’s Legislative Action Center webpage and is ready to be sent off to state senators to support home health care in the senate’s FY14 budget.

HCA has three priority amendments in the Senate Budget that would create a home health care “certificate of need” process (amendment #517), establish MassHealth reimbursement for home telehealth services (amendment #718), and improve payment for pediatric home health agencies (amendment #593). The Alliance needs emails to senators to gain support for these important amendments so see the new advocacy message, fill out your contact info, and the message will automatically be sent to the senator representing you! It only takes a minute of your time and every email counts.

The Alliance is also supporting three other amendments. One would create an FMAP Trust Fund (#634) that will set up a special fund for payments from the federal government relative to health care reform, rather than having the money go into the state’s General Fund, which is less transparent. The other two amendments HCA supports would provide a rate add-on for personnel providing homemaker and personal care homemaker services to elderly clients (#544) and an amendment to boost funding for pediatric palliative care by $674,000 (#629).

Help advance home care in the state budget and send a message TODAY!

Return to www.thinkhomecare.org.

State Senate Releases FY14 Budget Proposal

The Senate Committee on Ways & Means continued the state budget-making process today by releasing their version of the FY14 budget, which will be debated before the full Senate next week.

The $33.92 billion proposal is a $1.4 billion increase over estimated FY13 spending, but $904.3 million less than what the Governor proposed. The Senate Ways & Means version is also $67.5 million less than what the full House of Representatives approved in their budget last month.

Here are some items of note:

  • $4.5 billion for the MassHealth Managed Care line item – $39.5 million over the final House budget.
  • $2.9 billion for the MassHealth Senior Care line item – $42.5 million over the final House budget.
  • $187.2 million to fully fund the elder home care programs, an additional investment of $6.2M over FY 2013, to eliminate the current waitlist of 1,500 seniors. This includes $98.7 million for Home Care Purchased Services.
  • $10.5 million for Grants to Councils on Aging, increasing support to $8 per elder, marking the highest ever level of state support for councils on aging.
  • $2.1 billion for the MassHealth Fee-for-Service line item – $7.2 million LESS than the final House budget.
  • Level-funding the Pediatric Palliative Care Program.

The Home Care Alliance will again be working with Senators to file three budget amendments to create a home health certificate of need program, establish MassHealth reimbursement of home telehealth, and strengthening pediatric home health.

As the Alliance works over the next few days to submit these amendments, association members and advocates should be on the lookout for “advocacy alerts” with message templates that can be sent to Senate offices. Of course, more information on budget development will be released as it becomes available.

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US HHS Releases Data on What Hospitals Charge

The federal office of Health and Human Services and Centers for Medicare and Medicaid Services (CMS) have released data on what hospitals across the nation charge for the 100 most common Medicare inpatient stays.  Hospitals determine what they will charge for items and services provided to patients and these “charges” are the amount the hospital generally bills for an item or service.

The variance in what hospitals charge both regionally and by procedure is apparent and is already the subject of a story in the New York Times.A press release by HHS highlights the fact that, even within the same geographic area, prices can vary dramatically. For example, the average inpatient hospital charges for services that may be provided to treat heart failure range from a low of $21,000 to a high of $46,000 in Denver, Colo., and from a low of $9,000 to a high of $51,000 in Jackson, Miss.

The Home Care Alliance isolated the state-specific data for Massachusetts here.

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HCA Celebrates National Nurses Week

The Home Care Alliance is proud to join associations and medical providers from across the state and country in celebrating National Nurses Week.

Every year on May 6-12, National Nurses Week raises awareness of the value of nursing and the hard work performed everyday by nurses in all health care settings. In particular, the Home Care Alliance thanks the nurses working in home health care – along with the therapists, social workers, aides and other staff that are part of the care team with nurses – to ensure that people can remain at home for as long as possible.

Recently, the Home Care Alliance held the annual Home Care Innovations Showcase and Star Awards where the association recognized Patricia Darling from the Visiting Nurse Association of Boston and Shirley Lucier of VNA Care Network  with HCA’s “Clinician of the Year” awards. Many of the Innovation Awards to home health agencies recognized forward-thinking practices or policies that involved nurses as a vital component.

For those looking to join in recognizing nurses, the American Nurses Association hosts a special National Nurses Week website with resources and reports on the nursing profession and how to celebrate.

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Home Care Agencies Donate Services to Boston Marathon Bombing Victims

BostonStrongRibbon.jpgHome care agencies are pitching in to help those injured in the Boston Marathon bombing by donating personal care services to victims whenever they are discharged from the city’s hospitals.

The Home Care Alliance is coordinating the volunteer effort that currently includes 55 agencies collectively providing coverage to the entire state. So, no matter where in

Massachusetts one of the affected people may live, an agency stands ready to help their transition back home.

The Home Care Alliance has notified all Boston hospitals and has provided the list of agencies donating services to staff at those facilities. Many have already been discharged from hospitals and the Alliance hopes that those people can also be aware that they have access to these donated services as well.

A special webpage listing the volunteer agencies has been set up and anyone hurt by the Marathon bombing that can benefit from free personal care can contact these agencies, but HCA also encourages hospitals to make the list available to patients as well.

The Home Care Alliance and its member agencies are proud to help those affected through a difficult time and hope they can take advantage of the compassionate care provided by agencies across the state.

Any hospitals or families impacted by the events of this past week can contact the Home Care Alliance for further details.

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HCA Promotes National Health Care Decisions Day

The Home Care Alliance supports National Healthcare Decisions Day (NHDD), which is April 16th, and was created to educate and empower the public about advance care planning – the ongoing process of discussing and clarifying the current state of a person’s goals, values and preferences for future medical care.  It has amassed a national following, with over 1,000 organizations participating each year, including the American Association of Retired Persons, the American Medical Association, and other state and local organizations.

The NHDD website has great information, including how to obtain an advance directive, legal resources that are available, and how to engage your family in these important conversations about one’s care.

In Massachusetts, it can’t be assumed that a spouse or other family member will be authorized to make medical decisions on their loved one’s behalf in all situations or settingsIn Massachusetts, if a person has lost the ability to make medical decisions (e.g. because of unconsciousness, coma, dementia or other mental limitations), it is their “health care agent” who is legally authorized to make medical decisions on their behalf.

To plan for future medical care, all adults ages 18 and older, whether they are healthy or sick, should name their health care agent by filling out and signing a legal form called a health care proxy form.

A health care proxy is the only legally authorized advance directive in Massachusetts. “Advance Directive” is a general term referring to a written document for future medical care in the event that a person loses capacity to make health care decisions.

For more information on Healthcare Decisions Day, visit www.nhdd.org.

Information on other state-specific resources are available on this mass.gov webpage.

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Help Get Vital Support for Home Care Amendments in FY14 House Budget

boston-statehouseA new advocacy message that home care agencies and advocates can send to their state representatives has been posted on the Home Care Alliance’s “Legislative Action Center.”

The pre-written message urging the House to support the Alliance’s budget priorities will automatically be sent to your state representative based on the contact form that you fill out after clicking the link. You will be able to review the message before sending, if you choose, and it only takes a minute of your time!

Here are HCA’s priority budget amendments:

  • Telehealth Monitoring (Amendment #341), sponsored by Rep. John Mahoney:  – establishes MassHealth reimbursement for home telehealth services provided by a home health agency.
  • Home Health Agencies Certificate of Need (Amendment #552), sponsored by Rep. Kate Hogan – establishes a “certificate of need” process for new home health agencies.
  • Pediatric Home Health Care (Amendment #609), sponsored by Rep. Michael Brady – balances the payment formula for independent practitioners and agencies providing continuous nursing to account for an agency’s overhead, including scheduling and documentation requirements.

You may also call your state representative to urge their support of any of the amendments listed above. Those unsure about who represents them can lookup their legislator and contact info at www.wheredoivotema.com. The above links to each amend includes a fact sheet with talking points you can use on the phone call.

return to www.thinkhomecare.org.

 

House Begins Budget Process with Reductions from Governor, Improvements Over FY13

The House Committee on Ways & Means released their proposed version of the FY 2014 state budget today and although many items are reduced from what Governor Deval Patrick proposed, most items are still an improvement over fiscal year 2013.

House Ways & Means’ $33.8 billion budget reduces the MassHealth Senior Care, MassHealth Managed Care and MassHealth Fee-for-Service line items by a total of $205.8 million from what the Governor proposed, but those items still represent a collective increase of $625.1 million above the FY13 budget.

Meanwhile, most Elder Affairs line items that fund the State Home Care Program, administered by the Aging Service Access Point network, received slight reductions. One item, Home Care Case Management and Administration, saw a $478,097 increase over what the Governor proposed, but $593,317 less than the FY2013 number.

Below are the line items, the House Ways & Means funding level, and their difference (+ or -) from the Governor’s proposal and the FY2013 budget. Also included is a brief explanation of what the line item covers.

  • MassHealth Senior Care: $2,861,335,505 (-$50 million from Governor’s budget, +$105.2 million from FY2013)

The MassHealth Senior Care item funds services for seniors on MassHealth as well as the Senior Care Options, or SCO, Program.

  • MassHealth Managed Care: $4,499,411,804 (-$53.5 from Governor’s budget, +$331.9 million from FY2013)

MassHealth Managed Care is for services provided to medical assistance recipients under the Executive Office of Health and Human Services’ primary care clinician, mental health and substance abuse plan or through a health maintenance organization under contract with the executive office and for MassHealth benefits provided to children, adolescents and adults

  • MassHealth Fee-for-Service: $2,145,499,061 (-$102.3 million from Governor’s budget, +$188 million from FY2013)

MassHealth Fee-for-Service covers other MassHealth recipients not under Senior Care or Managed Care.

  • Home Care Purchased Services: $97,780,898 (-$8,891 from Governor’s budget, NO change from FY2013)
  • Home Care Case Management: $53,145,060 (+$478,097 from Governor’s budget, -$593,317 from FY2013)

Home Care Purchased Services and Home Care Case Management fund the operation of the state’s Home Care Program and its related contracts.

The Home Care Alliance will be working with state representatives to file amendments seeking MassHealth reimbursement of home telehealth services, a certificate of need process for home health agencies in the state, and an adjustment to pediatric home health care rates.

Budget amendments will be submitted by April 12th and the Home Care Alliance will send advocacy alerts looking for emails and phone calls asking state representatives for support on our amendments the week of April 15th. The full House of Representatives will debate the budget the following week.

Stay tuned for more information and for advocacy alerts on how you can help gain support.

Return to www.thinkhomecare.org.

Neighborhood Health Plan Drops Out of Dual Eligible Demonstration

Neighborhood Health Plan announced to partnering providers and organizations that they are withdrawing from the Dual Eligible Demonstration Project as an ICO, or Integrated Care Organization.

NHP was one of six groups that were working to become an ICO, but dropped out due to concern about payment rates conveyed from the state’s Executive Office of Health and Human Services (EOHHS) and the federal Centers for Medicare and Medicaid Services (CMS).

“EOHHS and CMS have acted in good faith to mitigate many of the factors involved in the rate discussions and unfortunately, for NHP, the final proposed rate structure, as projected, would result in substantial losses for NHP,” stated the emailed announcement.  “We feel that it is in our best interest at this time not to pursue the Duals demonstration further.”

The Home Care Alliance  spoke with NHP and met with other potential ICO’s with most expressing concern about the rates of payment. For months, stakeholders have been told that providers will receive no less than Medicare payments for Medicare services and no less than Medicaid payments for Medicaid services, but it is unclear if that is the case.

The Home Care Alliance will be attending the next “open stakeholder” meeting on April 19th in Shrewsbury to obtain more information.

“We strongly believe in the potential of truly integrated care models to improve care for the dually eligible and all Medicaid populations,” the NHP statement continued. “We wish your organization and the remaining ICOs much success.”

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HCA Executive Director Named to Key Health Policy Advisory Group

Home Care Alliance Executive Director Patricia Kelleher has been named to the Health Policy Commission Advisory Council joining a list of other health care leaders  who will help guide the implementation of the state’s Health Care Cost Containment Law.

Better known as Chapter 224, (“An Act Improving the Quality of Health Care and Reducing Costs through Increased Transparency, Efficiency and Innovation”) the law requires the Health Policy Commission’s (HPC) Executive Director to establish the Advisory Council and designate members with diverse perspectives on the health care system to two-year terms. The Council will advance Chapter 224 implementation by advising on the HPC’s overall operations and policies, providing feedback on a grant program to support new system delivery and payment reform methods, and encouraging public and stakeholder engagement in the HPC’s work.

“This is an impressive group that promises to enrich the HPC’s work,” said Executive Director Seltz. “They are part of the coalition that made the first chapter of Massachusetts health care reform such a resounding success and the passage of our nation-leading cost containment law possible. Each member will bring a different and important perspective to our work to implement Chapter 224. I am grateful for their willingness to serve.”

The Advisory Council includes the following members from across the state:

  • Christine Alessandro, Executive Director, BayPath Elder Services, Inc.
  • Dianne Anderson, RN, President & CEO, Lawrence General Hospital
  • Michael Caljouw, Vice President, Government & Regulatory Affairs, Blue Cross Blue Shield of Massachusetts
  • JD Chesloff, Executive Director, Massachusetts Business Roundtable
  • Cheryl Clark, MD, Director of Health Equity Research & Intervention, Brigham & Women’s Hospital
  • John Cox, President, Cape Cod Community College
  • Karen Day, Executive Director, US Policy, AstraZeneca
  • Ralph de la Torre, President & CEO, Steward Health Care System
  • Vicker “Vic” Digravio, President & CEO, Association of Behavioral Health
  • Ronald Dunlap, MD, South Shore Hospital, President-Elect, Massachusetts Medical Society
  • John Erwin, Executive Director, Conference of Boston Teaching Hospitals
  • Julian Harris, MD, Director, Office of Medicaid
  • Jim Hunt, President & CEO, Massachusetts League of Community Health Centers
  • Jon Hurst, President, Retailers Association of Massachusetts
  • Dan Keenan, Senior Vice President, Government Relations, Sisters of Providence Health System
  • Patricia Kelleher, Executive Director, Home Care Alliance of Massachusetts
  • Gene Lindsey, MD, President & CEO, Atrius Health
  • Geoff MacKay, President & CEO, Organogenesis
  • David Martin, Senior Director, Health Policy, Covidien
  • David Matteodo, Executive Director, Massachusetts Association of Behavioral Health Systems, Inc.
  • Dolores Mitchell, Executive Director, Group Insurance Commission
  • Abraham “Ned” Morse, President, Massachusetts Senior Care Association
  • Joyce Murphy, Executive Vice Chancellor, Commonwealth Medicine, University of Massachusetts Medical School
  • Lynn Nicholas, President & CEO, Massachusetts Hospital Association
  • Cheryl Pascucci, APRN, FNP-C, Commonwealth Care Alliance
  • Lora Pellegrini, President & CEO, Massachusetts Association of Health Plans
  • Julie Pinkham, Executive Director, Massachusetts Nurses Association
  • Donald Thieme, Executive Director, Massachusetts Council of Community Hospitals
  • David Torchiana, MD, President & CEO, Massachusetts General Physicians Organization
  • Celia Wcislo, Vice President, 1199 SEIU of Massachusetts
  • Brian Wheelan, Executive Vice President for Corporate Strategy & Development, Beacon Health Strategies
  • Amy Whitcomb Slemmer, Executive Director, Health Care for All

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