Author: James Fuccione

Pavasaris Testifies at Healthcare Cost Trends Hearing

The MA Health Policy Commission (HPC) held its 2014 Healthcare Cost Trends Hearing on October 6th and 7th. During the two-day event, representatives of major health systems, individual providers and insurers were called to present recommendations on the direction of cost and quality in the Massachusetts healthcare marketplace.

HCA Board Member Beverly Pavasaris of the Brockton VNA was on a panel looking at post-acute care, which the HPC has spotlighted in recent reports as more highly utilized in Massachusetts relative to the rest of the country. Pavasaris noted the heavy use of acute care services in the state in general and the fact that the high use of post-acute care is not necessarily a bad thing, as patients are receiving appropriate follow-up care when they leave the hospital setting.

Dr. Richard Lopez of Atrius Health, which is affiliated with VNA Care Network and the VNA of Boston, also spoke of the pressures on reforming post-acute care and the need to do so. The first thing Atrius looked at when their ACO was formed, he said, was post-acute care. A post on the Atrius blog goes deeper into the comments submitted by the organization and the responses of Dr. Lopez on the panel.

Each day of the annual hearing was led off by speakers like Governor Deval Patrick, Senate President Therese Murray, and legislative leaders of health care committees. A major topic throughout the hearings from presenters, speakers and panels was saving costs in behavioral healthcare, which was unanimously labeled as overly complex with no consistent way to report spending and a severe lack of financial and infrastructural support.

The Home Care Alliance will continue to work with the HPC on elevating home care and promoting our quality, cost-efficiency, and array of possible services that can be provided.

For more on the 2014 Cost Trends Hearing, see the HPC webpage.

Return to www.thinkhomecare.org.

MassHealth Recruiting HCBS Waiver Providers

The MassHealth Home and Community Based Services (HCBS) Provider Network Administration Unit is recruiting service providers to serve people with disabilities and/or elders who live in the community.

The Provider Network Administration Unit will host several HCBS Waiver Service Provider Technical Assistance Sessions in the coming months to provide an overview of the HCBS Waivers and services offered, as well as an in-depth review of the application forms and submission requirements/process.

Sessions are scheduled for:

  • Oct. 7, 1:00-3:00 PM, Lenox Library, 18 Main St.,Lenox
  • Oct. 23, 2:00-4:00 PM, UMass Medical School, 333 South St., Shrewsbury
  • Nov. 6, 1:00-3:00 PM, Flint Public Library, 1 S. Main St., Middleton
  • Nov. 20, 2:00-4:00 PM, UMass Medical School, 333 South St., Shrewsbury
  • Dec. 4, 2:00-4:00 PM, Forbush Memorial Library, 118 Main St.,Westminster
  • Dec. 11, 2:00-4:00 PM, UMass Medical School, 333 South St., Shrewsbury

To RSVP, please contact the HCBS Provider Network Administration Unit at (855) 300-7058 or email to ProviderNetwork@umassmed.edu.

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One Care Initiative Hosting Webinar on Independent LTS Coordinators

The One Care demonstration project that coordinates and combines services for dually eligible individuals in Massachusetts hosts periodic webinars to educate the One Care Plans as well as service providers to help the program be successful.

The latest in that series is a free webinar on the role of the Long Term Services and Supports Coordinator, which will take place on Thursday, September 18th from noon to 1:00pm. During this webinar, the One Care Learning Team will discuss making referrals to Independent Living and Long-Term Services (LTS) and Supports Coordinators, ways to explain this role to One Care enrollees, and the benefits of engaging LTS Coordinators on Interdisciplinary Care Teams. An overview of the vision of MassHealth for the role of LTS Coordinator will be outlined and highlighted with examples of how LTS Coordinators are working with enrollees and interdisciplinary care teams.

Check out this video for an overview of the Independent Living LTSS Coordinator role and meet two of the webinar presenters.

Previous webinars have been recorded and can be viewed here.

Return to www.thinkhomecare.org.

Join Us for Falls Prevention Awareness Day on Sept. 23rd

As part of the Massachusetts Falls Prevention Coalition, the Home Care Alliance of Massachusetts will be co-hosting the 8th annual Falls Prevention Awareness Day, which is taking place in the Great Hall of the State House in Boston on September 23rd from 10:00am to 1:00pm.

The event will follow the National Council on Aging’s theme of Strong Today, Falls Free® Tomorrow and includes a list of speakers and presenters. HCA’s Legislator of the Year Senator Patricia Jehlen will be giving welcoming remarks and Executive Office of Elder Affairs Secretary Ann Hartstein will be a featured speaker. Informational tables will line the Great Hall for legislative staff and members of the public to gather helpful resources on falls prevention strategies and local programs across the state.

There is no cost to attend this event. For more information, see the official flier for Falls Prevention Awareness Day.

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HCAs Home Health & Hospice Emergency Prep Workbook Now Available

HCA’s new Home Health Care & Hospice Emergency Preparedness Workbook, co-published with RBC Limited, is now available!

The workbook incorporates all of the Emergency Preparedness requirements in the proposed new regulations recently developed by CMS, and includes a number of sample policies and tools to make compliance easier.

Barbara Citarella of RBC Limited will conduct a series of two webinars on August 27 and September 3 to discuss the proposed regulations and orient home health and hospice providers to the new manual.

You can purchase the Workbook and register for the webinars here.

Webinars will be held on the following dates:

Part I August 27, 2014
10:00 – 11:30 AM

Part II September 3, 2014
10:00 – 11:30 AM

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Uniform Adult Guardianship Bill Signed into Law

Massachusetts joined 37 other states, the District of Columbia and Puerto Rico in streamlining adult guardianship rules when the Governor signed into law S.2249, the Uniform Adult Guardianship and Protected Persons Jurisdiction Act.

According to advocates, including Deb Thompson of the PASS Group, this new law addresses the difficulty of coordinating guardianships where two or more jurisdictions are involved.  If an individual in need of a guardian lives in one state and the potential guardian lives in another state there is currently no way to coordinate guardianship proceedings in those separate jurisdictions.

This legislation-turned-law creates criteria for determining which jurisdiction is appropriate as well as to allow courts to request the assistance of other courts in filing motions, taking depositions and determining the appropriateness of a potential guardian or conservator.  It would also avoid the costly and time-consuming requirement of litigating guardianships in multiple jurisdictions.

For more information on this issue, visit the National Center for State Courts’ Center for Elders and the Courts webpage on adult guardianship and the Uniform Law Commission.

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Money Follows the Person Project Team Hosting Technical Assistance Sessions

University of Massachusetts Medical School, the Department of Developmental Services, and Home and Community Based Services (HCBS) Provider Network Administration Unit is recruiting service providers to serve people with disabilities and/or elders who live in the community and eligible for services under the Money Follows the Person Demonstration project (MFP).

The Provider Network Administration Unit is hosting Waiver Service Provider Technical Assistance Sessions. The sessions will give providers an overview of the HCBS Waivers and services offered, as well as an in-depth review of the application forms and submission requirements/process.

The MFP sessions will be held as follows:

Date

Time

Day

Location

Address

City

Conference Room
8/19/14 2:00-4:00 PM Tuesday Forbes Library 20 West St. Northampton Community Room
8/28/14 2:00-4:00 PM Thursday UMASS Medical School 333 South St. Shrewsbury USA
9/16/14 1:00-3:00 PM Tuesday Taunton Public Library 12 Pleasant St. Taunton See Reception Desk
9/18/14 1:30-3:30 PM Thursday Boston Lower Mills Library 27 Richmond St. Dorchester See Reception Desk
9/30/14 2:00-4:00 PM Tuesday UMASS Medical School 333 South St. Shrewsbury USA
10/7/14 1:00-3:00 PM Tuesday Lenox Library 18 Main St. Lenox Welles Gallery
10/23/14 2:00-4:00 PM Thursday UMASS Medical School 333 South St. Shrewsbury USA

 

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Alliance Comments on Proposed LTC Insurance Regulations

Fresh off the heels of the Department of Labor Standards’ decision to drop private-pay home care licensing, the state’s Division of Insurance is accepting comments on regulations related to long-term care insurance.

The Home Care Alliance offered oral and written testimony on proposed amendments to 211 CMR 65.00 at a public hearing on August 1st. The regulations aim to set new standards for long-term care insurance policies, rate setting and cost controls and creates various consumer protections.

More importantly for home care agencies, they propose that home care agencies must meet standards set by the Executive Office of Elder Affairs in order to be covered under long-term care insurance plans. Given the impending gap in state oversight with DLS’ new regulations, the fact that those agencies with elder services contracts represent a fraction of private pay home care agencies, and that many agencies relying on long-term care insurance do not work with Aging Service Access Points, the Alliance suggested the following measures:

  • The Home Care Alliance’s Accreditation Program and unexpired DLS licenses should be placeholder requirements for long-term care insurance coverage until the state and advocates can pass meaningful licensure measures.
  • Home Care Alliance Accreditation allows workers who are not home health aides/certified nursing assistants to provide certain services in the home and DOI’s regulations should reflect that flexibility.
  • In the “sample definitions,” the Activities of Daily Living do not include “grooming and personal hygiene,” which is a traditional ADL and one that is vital to the well-being of people wishing to avoid facility-based care.

More details are available in the full copy of HCA’s comments, which can be obtained by contacting James Fuccione at the Alliance.

Those agencies or advocates wishing to comment have until 5:00pm on Friday, August 15th. Comments can be emailed to doidocket.mailbox@state.ma.us and the subject line should read “Docket No. G2014-0.”

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CMS Establishing Star Rating System for Home Health Care

In an effort to be consistent with quality reporting measures for various health care providers, the Centers for Medicare and Medicaid Services (CMS) are reportedly beginning to bring home health care, hospitals and dialysis facilities into the five-star rating system used for other sectors.

Already, nursing homes, Medicare health plans with Part B coverage, Medicare Advantage plans, physician group practices, and accountable care organizations use the star rating system. According to Visiting Nurse Associations of America (VNAA), CMS hopes to transition home health care to the five star rating by the end of 2014, or at latest, the beginning of 2015. However, the Home Health Quality Improvement Campaign (HHQI) reports that hospitals will be the next provider group to get the star rating system and home health will come online in 2016.

Nursing homes are rated on staffing, health inspections and a set of 9 quality measures on the Nursing Home Compare website. Home health agencies and other providers each have their own range of quality criteria. Currently, there are no details on how CMS plans to determine the star ratings for home health agencies.

More information on this topic will be reported as it becomes available.

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Alliance Presents Comments on DLS Proposal to Drop Private Home Care Agencies

A gap in the state’s oversight of private pay home care agencies will result from regulatory changes proposed by the Massachusetts Division of Labor Standards (DLS), a division within the Executive Office of Labor and Workforce Development.

Currently, DLS registers private pay home care agencies and has been falsely classifying them with employment and staffing agencies. After years of advocacy, DLS recognizes the misrepresentation and makes the appropriate change in their proposed regulatory changes.

The Home Care Alliance offered written and verbal comments at a public hearing in Boston held by DLS, which is making changes sparked by a mandate to update regulations relative to the “Temporary Workers Right-to-Know” Law, which became effective more than a year ago.

In addition to incorporating provisions of the new law into the Staffing Agency regulations, DLS is updating all of their regulations and proposing to drop home care agencies from their definition of “Employment Agencies” and to redefine “Domestic Employee” as a worker paid directly by a household or a family, among other changes.

The Alliance’s Private Care Advisory Committee reviewed the implications of this change for member agencies an approved comments on behalf of the association. These comments include the following:

The proposed changes from the Department of Labor Standards (DLS) recognize that home care agencies do not belong in the same oversight structure as employment, staffing and placement agencies. As much as this shift is welcomed, we must also acknowledge that Massachusetts lacks any other licensure or state oversight for home care agencies. The certified sector is subject to oversight from the Department of Public Health in their role as a federal quality and compliance agent. With an aging population, private-pay home care is a rapidly-growing sector with a rapidly growing workforce. In fact, the federal Bureau of Labor Statistics places home care aides as one of the fastest growing occupations over the next decade.

With these significant factors in mind, and the gap in state oversight, we urge a commitment from and partnership with DLS and the Executive Office of Labor and Workforce Development (EOLWD) to collaborate with the Home Care Alliance, its private pay agency membership, and other organizations to help transition away from DLS registration.

As part of the partnership and collaboration proposed by the Alliance with DLS is joint education and outreach to agencies regarding current state rules and regulations, information for agencies about the Alliance’s Home Care Accreditation Program, helpful information for consumers, and assistance in advocating other state offices and the legislature on the need for agency oversight.

The proposed regulations and a summary are available on the DLS website. Any home care agency interested in commenting can request the Alliance’s full comments and send a supporting letter to James Fuccione at the Alliance who will collect and submit any comments received. If agencies wish to submit comments directly, they can be mailed to Heather Rowe, Director, Department of Labor Standards, 19 Staniford Street, 2nd floor, Boston, MA 02114.

Return to www.thinkhomecare.org.