Author: James Fuccione

Home Health Plays Critical Role in Patient Medication Adherence

The New England Healthcare Institute (NEHI) recently completed a study finding that patients who do not take their medications as prescribed by their doctors cost the country’s health care system $290 billion per year.

NEHI conducted the study “Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease,” which found that the billions of lost dollars come in the form of unnecessary hospitalizations and increased medical risks for the one-third to one-half of all patients who do not take their medications properly. The NEHI study also noted that creating “health care teams,” which would include home health workers among other health care professionals, is one of a few solutions to  improving medication adherence.

Click here to read the Alliance’s Press Release on the NEHI study.

Other solutions addressed in the NEHI study included patient engagement and education, payment reform where positive outcomes would be rewarded, and leveraging health information technologies like electronic health records.

To find out more about the study, visit http://www.nehi.net/.

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Health Care Reform Update: End-of-Life Provision Cut from Senate Proposal

Although a provision allowing Medicare to reimburse doctors who voluntarily counsel patients and their families on end-of-life issues and care was dropped from a Senate version of a health care reform proposal, a separate House version has kept it intact.

The Senate Finance Committee’s ranking Republican member, Senator Charles Grassley of Iowa, said the provision could be “misinterpreted” and would not be included in the committee’s proposal.

According to the Boston Globe, the end-of life provision, written by Oregon Democratic Congressman Earl Blumenauer, would cover counseling sessions for end-of-life issues like “living wills, making a close relative or friend a health care proxy, hospice care, and information about medications for chronic pain.” The counseling sessions, the Globe reports, “would be covered by insurance every five years, and more frequently for the seriously ill.”

Thanks in part to former Alaska Governor Sarah Palin, the provision was “misinterpreted” by many as Senator Grassley feared and subsequently spun into what has become known as the “death panels” proposal, where, Palin and others allege, the government would decide who is treated.

In the Globe article, Congressman Blumenauer dubbed references to the so-called death panels or euthanasia as “mind numbing” since “the bill would block funds for counseling that presents suicide or assisted suicide as an option.”

Click here to read the Boston Globe article on the end-of-life provision.

A Los Angeles television news station highlighted hospice care as a cost-saving alternative to expensive and extraneous treatment in their report on the end-of-life provision, which can be viewed by clicking here.

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State Steps Up Defense Against Flu

State public health officials have adopted emergency regulations to allow dentists, pharmacists and paramedics to provide the H1N1 flu vaccine for the upcoming fall flu season.

As reported on State House News and in the Boston Globe, the Public Health Council made the decision in light of budget resrictions and the need to protect millions of state residents against the H1N1 virus. According to State House News, the Springtime wave resulted in 1,383 confirmed cases and 10 deaths in Massachusetts.

The emergency regulations go into effect on September 14 and accompany an additional 75,000 doses of  the vaccine purchased by the Department of Public Health. The 885,000 doses this year are up from 810,000 doses a year ago. State House News reports that “Another 2.2 million doses are expected to come from the private sector, including commercial vaccinators, health care providers and health care facilities.”

For more information, click here to read the story from Boston.com on the new precautions.

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CNN Story Highlights Impact of Possible Home Health Cuts

A proposal in the US House of Representatives, known as the “Tri-Committee” Health Reform Bill, would take $56.8 billion over ten years from the Medicare home health payment, according to the Congressional Budget Office (CBO) and the National Association for Home Care & Hospice (NAHC).

CNN reported on a 12 year old California girl getting care from a team of home health professionals. The story highlights how that care is threatened by potential cuts in the Tri-Committee bill.

Click here to read the CNN story and please visit our “contact your legislator” page to send a message to your federal representatives in an effort to oppose cuts to home health. Just fill in your contact information and click “send” to deliver the message.

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Send a Message to Legislators on CORI Delays

A new message is available on the Legislative Action Center of our advocacy page relating to the delay in CORI processing for potential employees that agencies are experiencing.

Please take the time to read the brief email message and send it to your local legislators, as well as the House and Senate Chairs of the Joint Committee on the Judiciary, by clicking here. All you have to do is fill in your contact information, click send, and our website will take care of the rest.

Learn more about the Alliance’s efforts surrounding the CORI processing issue by clicking here.

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New Medicare Website Launched to Help Caregivers

A new website called “Ask Medicare” was recently launched as a resource and navigation tool for the millions of caregivers so that answers and information can be readily obtained for those who give much of their time caring for others.

Many features are available on the site, including help with billing, comparing drug plans, locating care, and even a chat room for caregivers to exchange their stories and experiences.

CNN did a report on the new website, which you can see by clicking here. The article focuses on Kim Mickens, a Baltimore woman who spends 40 hours per week caring for her mother Delphine who lives with Alzheimer’s disease.  Below a a brief clip from the CNN story:

Today, Mickens and her mother are a loving twosome. When Mickens is at work, she leaves Delphine with an in-home nurse and relies on her son to help out when he gets home from school. Mickens finally feels content about the quality of care her mother is getting, and she says it would have never happened so quickly had she not found the Ask Medicare Web site.

“I have no problems with it: Once I punch it in, it comes up and takes me out to all the different Web sites,” say Mickens. “It’s very helpful. I am glad they came up with it.”

Click here to visit the newly-launched “Ask Medicare” web tool for caregivers.

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Organizations Send Joint Letter to Legislators on CORI issue

A group of six long-term and community care organizations sent a joint letter to key state legislators regarding cutbacks that have resulted in a burdensome delay in CORI processing.

The organizations – Home Care Alliance of Massachusetts, Massachusetts Senior Care Association, Massachusetts Council for Home Care Aide Services, the Paraprofessional Healthcare Institute, Massachusetts Assisted Living Facilities Association, and MassAging  – voiced concern over a substantial reduction in staff to the Criminal History Systems Board (CHSB) who, among other things, process Criminal Offender Record Information for employers.

Click here to read the joint letter sent to legislators.

The group of organizations, and the members they serve, were informed that processing delays could take up to six weeks from the former turnaround time of two days. Until the state realizes the goal of an automated system where access to information for employers and landlords is near instantaneous, the joint letter asks that an alternative be reached so that agencies can hire staff to, in turn, deliver the necessary care that patients require.

For the latest updates on CORI processing delays and other pertinent news, check the CHSB website by clicking here.

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Congressman Barney Frank Responds to Alliance Letter

The Alliance recently received a response from the office of Massachusetts Congressman Barney Frank after Home Care Alliance Executive Director Patricia Kelleher urged him to sign onto two home health initiatives:  One was a letter opposing damaging cuts to home health and the other asked that he sign on to the Home Health Working Group.

Both of those initiatives were led by Frank’s colleague, Congressman Jim McGovern. The Alliance appreciates the response and the support that Congressman Frank offered.  Click here to see the sign-on letter opposing cuts to home health, along with the supporting signatures from members of Congress.

See the Alliance’s letter sent to Congressman Frank below, which was sent to the entire state’s Congressional Delegation in late April, and click here to see Frank’s response.

Dear Congressman Frank:

On behalf of Home Care Alliance of Massachusetts, I urge you to sign on to a pair of initiatives championed by your colleagues James McGovern and Walter Jones that opposes home health care cuts in the President’s budget and establishes a House Home Health Working Group.

Home-based services promote independent living for seniors and other individuals in need of care, which help them to remain in their communities where they are most comfortable and familiar. These services are cost-effective in keeping patients out of the hospital and nursing homes. At an economically challenging juncture when home health rates are being frozen and reduced in Massachusetts on the state level, we need to encourage and expand the utilization of home-based care rather than make damaging cuts.

The Working Group will look to further the role of home health in our nation’s health care delivery system while the McGovern-Jones “dear colleague” letter – addressed to the Committee on Ways & Means – resists the President’s proposal to cut Medicare home health payments by $13.16 billion over the next five years. If the President’s proposal is allowed to pass, Massachusetts would lose $16.7 million in Medicare reimbursement for fiscal year 2010 alone. The Government Accountability Office (GAO) report may have uncovered sporadic fraud in home health, but a better approach to controlling Medicare home health spending is to prosecute and punish the few agencies responsible for that fraud instead of reducing rates.

Again, please contact the offices of Congressman McGovern and/or Congressman Jones to support your constituents who deliver and receive home health care services.

Sincerely,

Patricia Kelleher
Executive Director

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Alliance Testifies on Nurse Delegation

One of the Alliance’s highest legislative priorities, Senate Bill 860, An Act Relative to Home Health Aides, came before the Joint Committee on Public Health for a hearing on July 28. A coalition of home health agencies and supporting organizations attended to comment favorably on the bill, which is aimed at refining the state’s Nurse Practice Act (NPA) to allow the administration of certain medications to a home health patient by a trained and certified home health aide.

Home Care Alliance Board President and Executive Director of Hebrew Senior-Life Home Health Care  Patricia O’Brien submitted testimony, which you can view by clicking here.

O’Brien was joined by Norwell VNA Executive Director Meg Doherty, Stoughton VNA Executive Director Lisa Parent, and VNA of Boston Home Health Aide Manager Margo Bourne. The bill’s sponsor, Senator Richard T. Moore, came to speak in support of the bill as did Mass Home Care, the Massachusetts Council of Home Care Aides, and the Hospice and Palliative Care Federation of Massachusetts.

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Eagle-Tribune Announces Home Care Manager of the Year

The Eagle-Tribune Online (North Andover, MA and area) announced Kathryn Baker of the VNA of Greater Lowell as the Home Care Alliance’s “Manager of the Year” in their business section.

Click here to the announcement.

Kathryn, known as “Katie” to her co-workers and friends, began her work at VNA of Greater Lowell 20 years ago as a physical therapist, was promoted to Rehabilitation Manager and again promoted to her current position as Director of Rehabilitation. She is now chair of the agency’s Policy and Procedure Committee and a member of the Performance Improvement Committee, Customer Service Committee, and Job Satisfaction Committee. Having earned the respect of her peers and employees, Kathryn’s rehabilitation staff has an excellent retention rate, according to VNA of Greater Lowell Executive Director Nancy Pettenelli, who said most of have been with the agency for more than 10 years.

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