Author: James Fuccione

Boston Globe’s ‘Salute to Nurses’ Recognizes Home Care

Home care had a prominent place in this year’s “Salute to Nurses,” a special section published every year in the Boston Globe recognizing the work of nurses in every health care setting.

The compassionate and high-quality care of nurses from several home care agencies were recognized, including CareGroup Parmenter Home Care & Hospice, Comfort Home Care, Emerson Hospital Home Care, Hallmark Health VNA & Hospice, and Home Health VNA. Many more stories from patients, their families and nurse colleagues highlighted cases where a nurse from a setting other than home care arranged for post-acute services or follow-up in some way.

Although it wasn’t from a traditional home care agency, another article was dedicated to Allison Neff, a  nurse in Boston Medical Center’s “Elders Living at Home” Program. The article explains:

Neff joined the Elders Living at Home Program, which prevents homelessness among seniors, in 2008. Her job is to conduct home visits to ELAHP patients who don’t qualify for visiting nurse services provided by the state, but who need assistance with some aspect of their health. Many of her patients are at imminent risk of losing their housing, or were homeless and are now transitioning into housing.

The Home Care Alliance will be recognizing all levels of home care staff at the annual Innovation Showcase & Star Awards on June 14th. Clinicians, aides, managers, physicians and other home care champions can be nominated for recognition at the event’s website.

Return to www.thinkhomecare.org.

 

House Budget Denies Several Home Care Programs

Although the House budget process has yet to officially conclude, state representatives voted on items related to Health and Human Services, Public Health and Elder Affairs with barely any home care-related initiatives approved.

The traditionally conservative House budget process saw just over $12 million in additional money for all health care-related initiatives in general. The Home Care Alliance was itself asking for $8.9 million for home health aides, $10 million for homemaker wages and benefits – in conjunction with the Home Care Aide Council – and supported a number of amendments that were either low-cost or had no cost associated.

Beginning with the positive, an amendment creating a publicly-available home care workforce registry was denied. The Home Care Alliance was opposed to allowing the public access to the personal information of home care workers proposed in this amendment, including full legal name, date of birth, home address and gender of these workers.

Also, $200,000 was reinstated for Nursing and Allied Health Workforce Development that has funded improved access to education and training for direct care workers as well as nurses. One such example of a program funded through this item was the Home Health Nurse Residency Program that is run by VNA of Boston/VNA Care Network.

In the elder services category, $750,000 was provided to “meals on wheels” and the House approved a study of expanding income eligibility standards for home care services contracted through Aging Service Access Points.

Meanwhile, the House denied a commission to study oversight options for home health and private-pay home care, a raise for both home health aides and homemakers, a study of home health rates from MassHealth, and a boost in funding for pediatric palliative care.

The budget discussion and focus will turn to the Senate and the Alliance will be sending advocacy alerts to inform members and advocates about how they can help advance important policy priorities.

Return to www.thinkhomecare.org.

Contact Your State Rep to Support Home Care in the FY17 State Budget

The Massachusetts House is preparing for debate next week on their $39.4 billion state budget proposal and the 1,307 amendments that were filed on a range of different issues from home care to homelessness.

Please visit the Home Care Alliance’s Advocacy Center and send a message to your state rep to urge their support of the HCA’s priority issues. Simply click on any of the top four issues on the Advocacy Center, fill out your contact information, hit SEND, and an email will automatically be sent to the legislator representing you!

The top message (“Please Support Home Care in the FY17 Budget”) includes all the HCA’s priorities, or you can choose from other single-issue messages. There are explanations of each message and you can read the actual message before sending.

The Alliance posted a summary of the House budget proposal that will be debated next week and other updates will be posted as they become available.

Return to www.thinkhomecare.org.

House Releases FY17 Budget Plan and Rearranges Elder Services Funding

With a $39.4 billion FY17 state budget plan, the House Committee on Ways & Means kick-started the legislature’s budget deliberations.

As always, a significant portion of that total – $15.4 billion in proposed spending – is allocated for MassHealth programs. In their executive summary, House budget writers noted that MassHealth spending growth has been limited to 5%. They also mention that their budget plan “supports enhancements to the eligibility systems, caseload management and program integrity efforts, especially in the area of long term care, which ensures that our significant investments are being well spent, which is crucial to providing healthcare to some of the Commonwealth’s most vulnerable residents.”ma budget pie chart pic

That “support” could be part of the $8 million increase in the EOHHS administration line item (400-0300) as it does not show up in the line item specifically set aside for audits of MassHealth providers and utilization review (4000-0301). That item was actually set by the House at $413,000 less than FY16 spending.

Meanwhile, the House restored the Enhanced Home Care Services Program (ECOP) that Governor Charlie Baker consolidated into other items. With ECOP funded at $74.3 million, it comes in at $3.7 million above the FY16 spending level. That leaves some items noticeably lower than Governor Baker’s budget plan, but it also falls below what the state spent in FY16.

For example:

  • Elder Home Care Purchased Services is $3.1 million below FY16 spending
  • Elder Home Care Case Management and Administration is $2.6 million below FY16 spending
  • Elder Nutrition (Meals on Wheels) is more than $746,000 below what was even set in the FY16 budget

Other newsworthy items from the House Ways & Means budget proposal include the following:

  • $250 million assessment on hospitals that will support new MassHealth accountable care organization (ACO) incentive payments, which the Hospital Association supports with certain conditions.
  • $5.7M for the Supportive Senior Housing Program, an item not included in budgets of previous years.
  • $15 million above the Governor’s proposed spending for Nursing Home Supplemental Rates.
  • $4.5 million above FY16 spending for Elder Protective Services.

The entire House Ways & Means budget can be found here. The Home Care Alliance will be working with State Reps to sponsor amendments creating a home care licensure commission, increasing MassHealth reimbursement for home health aides, and for EOHHS to conduct a full review of home health reimbursement. The Alliance will be fully partnering with other organizations to push a homemaker wage increase, expanding income eligibility for elder home care services, and other items.

More information on advocacy efforts will be released soon and the budget items will be a focus of HCA’s lobby day at the state house on April 28th. Contact James Fuccione at the Alliance for details.

 

Return to www.thinkhomecare.org

 

Unique, Grant-Funded Training Opportunity for Central Mass. Home Care Workers

Registration is OPEN NOW for the first Community Health Worker (CHW) Registered Apprenticeship Program established in Massachusetts and one of only a few in the nation.

The Center for Health Impact TM (formerly known as Central MA AHEC) in Worcester, Massachusetts is delighted to report that the Fairlawn Foundation Fund of the Greater Worcester Community Foundation has awarded funds to establish the creation of a Community Health Worker (CHW) Registered Apprenticeship Program in Central Massachusetts.

Apprenticeship is a flexible training system that benefits both employers and workers through its structured on-the-job learning and job-related classroom instruction. (Learn more about Apprenticeship USA at: https://www.doleta.gov/OA/apprenticeship.cfm.)

The 150-hour course, anticipated to start on April 5th, 2016 (pending enrollment/subject to change) will be offered free of charge to qualified applicants in Central Massachusetts by the Center for Health Impact TM Outreach Worker Training Institute (OWTI) in Worcester. Participants will earn a certificate of course completion aligned with the requirements established by the Massachusetts Board of Certification of CHWs.

To qualify, an individual must be employed or about to be employed with an employer who will:

  • Provide them 2200 hours of on-the-job paid apprenticeship learning and supervision in one calendar year
  • Reward the apprentice for skills gained by an increase in pay within one calendar year
  • Authorize the apprentice to attend the 150-Hour course (120 hours of class time; 30 hours of homework).

Benefits for employers:

  • Access to free CHW core competency training for employees
  • Access to incentives as an employer working with the CHW Registered Apprenticeship Program
  • Well trained and job proficient employees who meet employers’ specific needs
  • Enhanced employee retention
  • Improved service delivery

For questions, or to request the registration package for the Community Health Worker (CHW) Registered Apprenticeship 150-Hour Certificate Course, please contact: Tatyana Gorodetsky,  at tatyana@centerforhealthimpact.org or by phone at: 508-556-1332.

MassHealth Hosting One Care Outreach Events

This Spring, MassHealth is hosting several One Care outreach events to let individuals who may be eligible for One Care know about the benefits of the program.

One Care Presentations as well as Drop-In Events will be held throughout Suffolk and Worcester County between the dates of March 25th and April 13th. This is a great opportunity to learn more about One Care, particularly for clients who may have received notices indicating that they are being automatically assigned to a One Care plan. More information about One Care can also be found at: www.mass.gov/masshealth/onecare.

Please share this with individuals you serve who may be eligible for One Care and feel free to forward to colleagues and other providers.

Return to www.thinkhomecare.org.

MassHealth Releases Prior Authorization Presentation

The first in a series of education sessions administered by MassHealth on their newly implemented prior authorization process occurred on March 16th and the slides have been made available.

After a basic overview of home health regulations, the prior authorization portion begins on slide 20 with helpful information and links as well as the contact information for the MassHealth Prior Authorization Unit (PAU). With a limited number of spots for this webinar, the Home Care Alliance is continuing to work with MassHealth on offering additional sessions.

The Alliance continues to take questions from agencies and is actively and constantly in contact with MassHealth to address ongoing issues.

Next week, MassHealth will be offering separate one-hour sessions on utilizing the Provider Online Service Center, or POSC.

During this training, MassHealth will provide step-by-step instruction on how to submit a prior authorization via the POSC, including how to inquire on and view prior authorization decisions, as well as other POSC techniques.

As space is limited, agencies are encouraged to register soon, if they have not already.

The sessions will be held at UMass Medical School (333 South St, Shrewsbury, MA 01545) on the following dates.

  • Wednesday, March 23, 2016  1:00 PM – 2:00 PM
  • Friday, March 25, 2016 10:00 AM – 11:00 AM
  • Friday, March 25, 2016 1:00 PM – 2:00 PM

Register here for POSC Training

The official Public Notice of the regulatory change requiring prior authorization was published last Friday. The notice include an invitation for public comment, with all comments due by April 1, 2016. Agencies are encouraged to submit constructive comments.

Return to www.thinkhomecare.org

Health Care Innovation Grant Opportunity Released by HPC

After months of planning, the state’s Health Policy Commission has released the RFP for their Health Care Innovation Investment Program (HCII).

An initial round of $5 million will be distributed to applicants that partner with other organizations to propose innovative, multi-stakeholder payment and care delivery models with an emerging evidence base of cost savings. Among the focus areas are post-acute care, end-of-life care, behavioral health integration and social determinants of health.

Since this is being administered by the HPC, aside from the benefit of getting a grant any successful applicants will have the added benefit of having their project be high-profile and also a higher likelihood of influencing policy for others.

The HPC has posted the following schedule for due dates and information sessions:

  • Information Sessions:  

    March 16, 2016 – 10:45 AM, HPC Offices

    March 25, 2016 – 10:45 AM – Webinar (Register Here)

  • Letter Of Intent Due Date: April 8, 2016 by 3:00 PM EDT
  • Proposal Due Date: May 13, 2016 by 3:00 PM EDT
  • Anticipated Awardee Announcements: July 2016
  • Anticipated Period of Performance: October 2016 to September 2018

The Home Care Alliance strongly encourages both home health care and private pay home care agencies to apply. More information is available on the HPC’s HCII webpage and any questions or guidance on the program can be directed to James Fuccione at the Alliance.

Return to www.thinkhomecare.org.

MHA, ONL & HCA Publish Latest Quality Measures for Hospitals, Home Health Agencies

The Massachusetts Hospital Association (MHA), Organization of Nurse Leaders of MA, RI, NH & CT (ONL) and Home Care Alliance of Massachusetts have publicly posted the latest available key national care quality performance measures for both hospitals and home healthcare agencies in Massachusetts. Data from Medicare’s Hospital Compare and Home Health Compare are now available on the PatientCareLink website for 77 Bay State hospitals and 89 Bay State home health agencies.Patientcarelink logo

Reported measures for hospitals include best practices for heart attack or chest pain, heart failure, pneumonia care, influenza prevention, surgical care improvement, stroke care and blood clot prevention and treatment. For home care agencies, the reported measures include timely initiation of care, patient/family medication education, depression assessment, and more.

To view the updated reports, visit www.patientcarelink.org and click on the “Healthcare Provider Data” tab and then either the “Hospital Data” or “Home Health Agency Data” link, then “Individual Hospital Performance Measures” or “Select an Agency.”

The home health agency reports now incorporate data for the period June 2014 – July 2015 for all measures, and the hospital reports cover April 2014 – March 2015. In addition to each facility’s individual performance, the PCL pages also provide a comparison to state and U.S. “peer” facility averages.

“Providing high quality, safe patient care is a top priority for Massachusetts hospitals,” said Pat Noga, PhD, RN, Vice President of Clinical Affairs for MHA. “Our hospitals are also committed to publicly posting important quality and staffing information to provide patients and caregivers alike additional confidence in their care.”

Patricia Kelleher, Executive Director of the Home Care Alliance of MA, added that the partnership between hospitals and home health agencies on PCL furthers positive working relationships along the entire continuum of care, which can only improve patient safety and quality overall.

“Choosing in-home services can be a daunting task and that’s why we’re proud that PatientCare Link (PCL) website allows patients and their families to find high-quality care in the home setting that fits their needs,” Kelleher said. “PCL includes Medicare-approved agencies that meet certain federal health and safety requirements, and provides patients, caregivers, and families the tool to easily access home health agency quality data to take control of their care and their health.”

Massachusetts was the first state to voluntarily make hospital staffing and nursing-sensitive quality information public starting in 2006. Home Care Alliance of Massachusetts joined the PCL quality and patient safety transparency effort in 2013. The PatientCareLink website is a great resource and gives patients an open and transparent view of the hospitals providing them care.

Hospitals and home care agencies welcome transparency about their performance when performance measures are grounded in good science and are designed to make fair comparisons across institutions. Publicly reported performance data can offer several benefits, including:

  • Offering useful information for making decisions about where to obtain healthcare
  • Helping healthcare professionals and institutions improve the care they deliver; and
  • Providing extra motivation to improve performance.

Return to www.thinkhomecare.org.

Prior Authorization Demo Proposed by CMS

Piling on top of existing pilots and demonstrations, the Centers for Medicare and Medicaid Services have released another proposed program that would establish Medicare prior authorizations and a fraud measurement pilot.

Massachusetts is one of five states – along with Florida, Texas, Illinois and Michigan – selected for the prior authorization demonstration. There are no details on what the authorizations would entail in the proposed demonstration aside from CMS stating that it would be similar to “Prior Authorization of Power Mobility Device (PMD) Demonstration, which was implemented by CMS in 2012.” The rule continues that “this demonstration would also follow and adopt prior authorization processes that currently exist in other health care programs such as TRICARE, certain state Medicaid programs, and in private insurance.”

CMS’ reasoning for implementing such a program a belief that it will help assist in “developing improved procedures for the identification, investigation, and prosecution of Medicare fraud occurring among HHAs providing services to Medicare beneficiaries.”

According to CMS, Medicare contractors will request the information from home health agency providers submitting claims for payment from the Medicare program in advance to determine appropriate payment.

The second piece of the CMS’ proposal is titled the “Medicare Probable Fraud Measurement Pilot.” The pilot would establish a baseline estimate of probable fraud in Medicare fee-for-service payments for home health care.

CMS purports that this would be accomplished using, at least in part, a summary of the service history of the HHA, the referring provider, and the beneficiary to estimate the percentage of total payments that are associated with probable fraud and the percentage of all claims that are associated with probable fraud for Medicare fee-for-service home health.

HCA is currently working to get more details on this demonstration so as to devise an advocacy strategy.

Comments on the proposed demonstration are due by April 5th and details are available here on the Federal Register.

Return to www.thinkhomecare.org.