Category: Advocacy

Mass. Thanks HCA and Members for Survey Participation

The state’s Executive Office of Health and Human Services thanked the Home Care Alliance and member agencies who participated in the recently completed Direct Service Workers (DSW) Survey.

A comprehensive report of the survey results is underway and those results will be available Fall 2012. Results will be shared with all providers who received the survey. Below is part of the ‘thank you’ statement:

Thanks in large part to outreach assistance provided by Home Care Alliance of Massachusetts, we received a survey response rate of 36%.  We’re happy to announce that the federal contractor, The Lewin Group, who has provided assistance through the survey process, is preparing a report which will include an analysis of the Massachusetts survey results. The Lewin Group anticipates this report will be ready for distribution by the end of September and we plan to share the report, along with additional survey results and analysis, with all providers who received the DSW Employer Survey.  We will distribute the report by email and will send a postcard to all providers asking them to submit an email address for this purpose.

The Direct Service Worker Employer Survey is a collaborative effort with the Home Care Alliance of Massachusetts and Massachusetts Council for Home Care Aide Services, Inc. to collect state-specific data on the home and community-based direct service workforce including volume, stability, wages and compensation.

According to EOHHS, information from this survey will be used to develop ways to attract more workers and keep workers longer.  The information from this survey can also assist organizations in understanding how they compare to other organizations in Massachusetts, and how organizations in Massachusetts compare to those in other states. Survey results will be used to better understand the current state of the direct service workforce in Massachusetts and areas for policy improvement.

Return to www.thinkhomecare.org.

Last Chance to Apply for CMS Community-Based Care Transitions Program

The final deadline for applications for the Community Based Care Transitions Program, administered by the Center for Medicare and Medicaid Innovation (CMMI), is quickly approaching.

Any interested applicants must have their proposals in by September 3rd to make the final panel review on September 20th. Any interested home health agencies can contact James Fuccione at the Home Care Alliance for assistance. Additionally, CMMI has made a slide deck available with everything health care providers and community-based organizations need to know for the application process.

Recently, there were 17 proposals that were accepted in the third round of site selections and, again, a Massachusetts project was among them. Here is the “site summary:”

Somerville-Cambridge Elder Services, a Massachusetts-designated Aging Services Access Point (ASAP) and an Area Agency on Aging (AAA), is partnering with Mystic Valley Elder Services,  two large integrated hospital networks (Cambridge Health Alliance and Hallmark Health System) and dozens of community-based health and social service providers to provide care transitions services to high-risk Medicare beneficiaries throughout Middlesex County, Massachusetts.

For more on HCA’s work on care transitions issues, see these blog posts.

Return to www.thinkhomecare.org.

‘Home Care Votes’ Program is Back

With the deadline to register to vote rapidly approaching on August 17, the state primary election just around the corner (September 6), and the state’s general elections not far past that (November 6), the Home Care Alliance is encouraging its member agencies across the state to help “get out the vote.”  

The Alliance has a fact sheet with instructions and a sample press release (available upon request) for those agencies willing and interested in helping their homebound patients obtain absentee ballots so they can vote in the upcoming elections. With important policy issues looming, this program is a great way to mobilize a population that may not otherwise have the chance to have their voices heard.

For those interested in obtaining the sample press release, contact James Fuccione at the Alliance.

Return to www.thinkhomecare.org.

Healthcare Bill Summary

The MA legislature shifted into overdrive during the last few days of the 2011/2012 legislative session, which ended on July 31. Healthcare cost containment was among the major pieces of legislation that were approved during the last days of the session, and several provisions of the bill have significant impacts on home care providers.

Section 142 of the bill will significantly ease the burden of the Fair Share Contribution (FSC) requirement that employers offer health insurance to their workers. Under this section, any employees that have health insurance through a spouse’s coverage, military, disability, or Medicare will not be included in the calculation of an employer’s compliance with the FSC mandate. This change should be a relief to many home care agencies. Section 51 of the bill establishes appeal processes for employers faced with a FSC audit.

The bill also includes a number of provisions related to home health’s role within Accountable Care Organizations and names the Alliance to a couple of new advisory panels.

The Alliance has prepared a more detailed summary of the bill’s provisions: http://www.thinkhomecare.org/associations/1892/files/HealthcareCostContainmentSummary.pdf.

HCA Responds to Questionable Northwestern U Study on Private Pay Home Care

The Home Care Alliance has responded to a Northwestern University report, titled “Hiring and Screening Practices of Agencies Supplying Paid Caregivers to Older Adults” that confuses different models of private pay home care and asserts that most aides are not properly screened or trained.  The report, from researchers at the NU Feinberg School of Medicine, appeared in the most recent issue of the Journal of the American Geriatrics Society.

The study authors telephoned agencies in Illinois, California, Florida, Colorado, Arizona, Wisconsin, and Indiana, pretending to be looking for home care for a family member.   The information provided by the agencies over the telephone was analyzed and some broad and negative conclusions were drawn about the lack of industry standard practices for background checks, training requirements, and supervision. The report was discussed this week in the New York Time’s “New, Old Age” blog in a post called “Who’s Watching Mom?”

Please see the Home Care Alliance’s response to this report and feel free to use this in the event that your agency receive media inquiries.

Return to www.thinkhomecare.org.

Request for Responses for Consumer Consultants

MassHealth released an RFR to recruit “consumer consultants” that will assist with the review of applications from potential Integrated Care Organizations managing care for dual eligible individuals.

The demonstration project to better integrate and coordinate care for dual eligibles is still set to begin in January 2013 and the state remains on an aggressive pace to get the initiative underway. The RFR for Integrated Care Organizations (ICO’s) is due at the end of the month, and this separate RFR for “consumer consultants” is due July 20th.

These “consumers” must receive medical services, behavioral health services and/or long term services and supports (LTSS) from the state and will form a paid advisory subcommittee that shares its experiences and expertise with MassHealth and the state’s Executive Office of Health and Human Services.

The RFR is available on the state procurement website Comm-PASS as Document Number 13CBEHSCONSUMERCONSULTANTRFR and at this site on the Integrating Medicare and Medicaid for Dual Eligibles website under Related Information.

For those home care agencies that have patients with positive experiences of the care and services that have been delivered to them and that may be interested, please encourage them to apply.

Return to www.thinkhomecare.org.

Home Care Alliance, National Organizations Make Statements on Supreme Court Decision

In light of the Supreme Court’s decision to uphold the Affordable Care Act, the Home Care Alliance of Massachusetts and other organizations representing health care providers and consumers had this to say:

“Today’s decision of the US Supreme Court has established the Affordable Care Act as the law. With their ruling, the Supreme Court has removed enormous uncertainty – particularly in states other than Massachusetts and for those involved in ACA funded demonstrations – as to whether to move forward. They now can, and we think they must.  While some parts of the law will impact Massachusetts far less directly than other states, there is evidence that our state has already benefited by some provisions. Most notably, 62,000 seniors and people with disabilities in Massachusetts have seen significant savings on their prescription drugs because the law was upheld.

All providers, including home health care, were subject to Medicare rate reductions in the ACA in order to expand coverage and pay for reform demonstrations.  These cuts have not been easy to absorb. With this ruling, we must now get to work to deliver on the promise in our state not just of universal access to insurance, but to a better coordinated, and ultimately more cost effective delivery system.”

-Patricia Kelleher, HCA Executive Director

Statement from the National Association for Home Care & Hospice (NAHC):

“NAHC has long supported reforms that increase access to health care for all in the United States and supports health delivery reforms and the expansion of Medicaid eligibility. The ACA rightly shifts the focus of care from inpatient services and institutional care to the community setting, which home health agencies and hospices have effectively served for decades.

NAHC believes that the Affordable Care Act can and should be improved. Accordingly, NAHC will continue to work with both Democrats and Republicans to improve the legislation. NAHC will ask that its implementation date be delayed for two years so that states have the time to prepare for implementation, including the creation of exchanges. This delay will also save approximately $200 billion, which can be applied to deficit reduction, extending the SGR “doc fix” and avoiding the need for any further cuts to Medicare. NAHC will continue to argue that home health care has been cut disproportionately and will oppose the imposition of copayments or additional cuts. NAHC believes that a good case can be made for expanding the scope of Medicare home health services to reduce hospitalization costs and improve services for the 5 percent of Americans who are responsible for 50 percent of total U.S. health care costs.”

-Val Halamandaris, NAHC President

Here are other statements from the following organizations:

And statements from political leaders:

Return to www.thinkhomecare.org.

Dual Eligible Services Demo RFR Now Available

The state’s Executive Office of Health and Human Services (EOHHS) has released the Request for Responses relative to the demonstration project to integrate care for dually eligible individuals.

The RFR is a solicitation for potential Integrated Care Organizations, or ICO’s, that will manage the integration of services and payment for dual eligibles aged 21-64. The Home Care Alliance is holding a special event for all agencies interested in this initiative. Please see the event in our Calendar section titled “Building Partnerships with Managed Care Plans for Dual Eligible Care” where special guest speakers will educate attendees on the demonstration and how agencies can play a key role. Potential ICO’s have also been invited for discussion and networking.

For those interested in viewing the  solicitation and corresponding materials, the instructions are below:

1)  In your browser, enter the URL for the Commonwealth’s procurement web page: www.comm-pass.com.

2)  Near the bottom of the page, click on the hyperlink that reads: “Search for Solicitations.”

3)  When the Search page comes up, scroll down to the section that says “Search by Specific Criteria” and in the document number box, enter the following: 12CBEHSDUALSICORFR.

4)  The Search result will appear as a hyperlink at the top of the new page. It should read: “There is 1 solicitation(s) found that match your search criteria.”  Click on this sentence and it will take you to the Comm-PASS listing for this solicitation.

5)  Click on “view” (the eyeglasses on the right) and you will get the summary page for the Request for Responses for Integrated Care Organizations.

6)   Click on the blue folder-type tab called “Specifications” and you will see the RFR documents and appendices that have been posted for this topic. In addition, the required forms that Respondents to the RFR will need to provide are available under the “Forms and Terms” tab.  To view the documents, click on the eyeglasses to the right of the title of each document,  .

The documents will also be posted shortly on our duals demonstration website, www.mass.gov/masshealth/duals, under “Information for Organizations Interested in Serving as ICOs.”

Responses to the RFR will be due to MassHealth by 4:00 PM (EDT), July 30, 2012.

Return to www.thinkhomecare.org.

State Budget Advocacy Needed on Telehealth

The FY13 state budget conference committee that will meld the House and Senate budget proposals are in negotiations and HCA needs your help in advocating so that we can achieve MassHealth reimbursement of telehealth services and adequate funding in the state home care programs.  (According to Mass Home Care, there were 935 elders on the Enhanced Community Options program waiting list as of May, 2012.)

Members and advocates can do their part by calling or emailing the members of the conference committee and asking them to:

  1. Support Senate budget amendment #692 which would direct Masshealth to reimburse for telehealth services
  2. Support the House funding proposal over the Senate’s for Enhanced Community Options Program (ECOP), line-item 9110-1500.  The House budget proposal gives the ECOP program $1.327 million more than the Senate.
  3. Support House funding proposal over the Senate’s for Elder Home Care Purchased Services, line-item 9110-1630.  The House budget gives almost $500,000 more dollars to this account which funds the Basic Elder Home Care program.

Here are the names, email addresses and phone numbers of the conference committee:

The telehealth amendment language, data, and talking points are all available on a fact sheet prepared by the Alliance.  Please contact these legislators today, even if they do not represent your area.  Please urge your legislators to do all he/she can to support this funding. In addition, when you speak to your Senator’s office, be sure to thank the Senate for adding this critical funding to their FY13 budget proposal.

If you or the legislators you speak with have any questions, contact James Fuccione at HCA.

Return to www.thinkhomecare.org.

HCA Achieves Gains for Home Care in House Health Care Bill

With the passage of a major health care payment reform bill by both the state’s senate and house of representatives, the Alliance will advocate for the successes gained in each version as the proposals advance.

In the recently passed House version, the Alliance was successful in advocating that home health and hospice services are included in the definition of “health care services” under an Accountable Care Organization able to accept global payments.

Other provisions achieved, include:

  • An amendment to strengthen the relationship between Patient-Centered Medical Homes and federally-certified home care agencies by ensuring that those agencies are available through the medical home to provide “after-hours” availability to home care patients.
  • An amendment that  improves the state’s “fair share contribution” calculation for determining an employer’s percentage of insured workers. With this amendment, any employee insured through a spouse, parent, Medicare/Medicaid, a veterans’ plan or disability plan would NOT be counted towards the employer’s test by the state and thus reduces the chance the employer would have to pay the “fair share contribution” penalty ($295 per employee).
  • An amendment adding “a community-based organization or group of community-based organizations” to those entities available to receive funding from the Prevention and Wellness Trust Fund.
  • An amendment ensuring that community-based behavioral health providers are included in the state’s health information technology planning process and that providers who serve high proportions of public payer clients will be given priority in receiving funding through a “health information technology revolving loan fund.”

The Alliance will continue to advocate for these provisions, in addition to those gained in the Senate, which can be seen in our blog post on the Senate’s passage of their payment reform bill.

Return to www.thinkhomecare.org.