Category: Advocacy

Guest Blog Post: National Health Care Decisions Day is Apr. 16

The Home Care Alliance thanks John Albert, President and CEO of Home Health VNA and Merrimack Valley Hospice for his guest blog post.

On Monday, April 16, National Health Care Decisions Day, I urge you to take some time to have a thoughtful conversation with family members and loved ones about your end-of-life healthcare decisions, and to complete an advanced directive. By having these conversations and documenting your wishes in an advanced directive, your health care decisions will be respected by health care professionals and your personal wishes will be honored.

Discussing end-of-life decisions before they are needed can help you and your family prepare for any emergency.  By completing an advanced directive, you can provide useful guidance to loved ones, and health care providers so that your wishes will be honored in the event you cannot speak for yourself.  You can fill out an advanced directive without hiring a lawyer.  It is easy to do and it is free.

Massachusetts recognizes two main forms of advanced directives:

  • A “Massachusetts Health Care Proxy” is a simple, legal document that allows you to appoint someone you know and trust to make decisions on your behalf if you cannot speak for yourself
  • Five Wishes is a “living will” a legal document that instructs your family and your health care providers about your personal, emotional and spiritual needs and your medical wishes at the end of life

It is important to ask yourself: Who will speak for me and respect my health care choices if I am unable to do so?  You can find more information on advanced directives at www.nationalhealthcaredecisionsday.org.


Return to www.thinkhomecare.org.

Reminder: Submit Direct Service Worker Survey to EOHHS

Any home care agency receiving Medicaid funding to deliver services under the state’s Home Care Program is encouraged to fill out the Direct Service Worker Employer Survey distributed by the Executive Office of Health and Human Services (EOHHS).

The survey is a collaborative effort between EOHHS, the Home Care Alliance and the Mass Council for Home Care Aide Services. The survey itself is intended to collect state-specific data on the home and community-based direct service workforce including volume, stability, wages and compensation.

An online version of the survey is available. To access the online survey please go to https://www.research.net/s/MA-DSW-Employer-FE and type in your unique survey ID as provided in packet mailed to agencies by EOHHS.

If you have lost your survey packet with your unique survey ID or if you have any questions about the survey, please contact the Direct Service Workforce Resource Center toll-free at 1-877-822-2647.

More information is also available in this newsfeed post announcing the survey.

Return to www.thinkhomecare.org.

State Budget Update: House Ways and Means Releases Budget Proposal

The House Committee on Ways & Means released its proposal for the state’s fiscal year 2013 budget and while there are few changes in dollar amounts, here are the initial highlights:

  • The MassHealth Managed Careaccount (line item 4000-0500) follows the Governor’s proposal by increasing $183,988,029 over FY12 spending to $4,164,475,376.
  • The MassHealth Senior Care account (line item 4000-0600) also followed Governor’s budget blueprint by increasing $196,976,192 over FY12 spending to $2,763,630,662 .
  • The MassHealth Fee-for-Service Payments account (4000-0700) maintained the Governor’s proposal of increasing $129,850,745 over FY12 spending to $1,939,680,126.
  • Elder Enhanced Home Care Services (9110-1500) was given a bigger increase by House Ways & Means of $827,853 – as opposed to the Governor’s $672,147 – to a total of $47,289,340.
  • The Home Care Purchased Services account (9110-1630) is level funded at $97.8 million.
  • The Elder Nutrition account (9110-1900) is level funded at $6.3 million, which would restore a cut of $1.5 million made by the Governor.

This all essentially means that House Ways & Means followed the Governor when it came to the MassHealth accounts, which were increased with funding, but only to account for anticipated increases in enrollment. This budget proposal also shows a commitment to the state’s Home Care Program and restores the Elder Nutrition Program that funds “meals on wheels.”

What is not seen is increases to MassHealth home health rates or any language related to telehealth services, pediatric home care and a certificate of need process. The Home Care Alliance is pushing for amendments on these matters and will let member agencies, supporters and advocates know when they are officially submitted.

Additional items of note include a special commission to study elder protective services, increase public awareness of elder abuse, and establish reporting mechanisms.

Stay tuned as more information will be reported as it becomes available.

Return to www.thinkhomecare.org.

CMS Announces New Accountable Care Organizations in Massachusetts

Two out of the first 27 accountable care organizations (ACO’s) in CMS’ new Shared Savings Program reside in Massachusetts and will be online with its counterparts from across the country this month.

According to a press release by CMS, “The selected organizations have agreed to be responsible for improving care for nearly 375,000 beneficiaries in eighteen states through better coordination among providers.”

The CMS statement continues that all ACOs that succeed in providing high quality care may share in the savings to Medicare, as long as their performance reduces the cost of care and is sufficiently rated on 33 quality measures. The quality measures relate to, among other things, care coordination and patient safety, use of appropriate preventive health services, improved care for at-risk populations, and the patient experience of care.

The Massachusetts ACO’s include Jordan Community ACO and Physicians of Cape Cod AC. CMS provides summaries of each ACO and the Massachusetts initiatives are described here:

  • The Jordan Community ACO is a not-for-profit organization based in Plymouth, Massachusetts and founded in 2012. The Jordan Community ACO consists of more than 100 physicians from Plymouth Bay Medical Associates, Jordan Physician Associates, and a number of specialty physicians from Jordan Hospital. Together, the Jordan Community ACO physicians coordinate the healthcare of more than 6,000 Medicare beneficiaries in Plymouth and Barnstable Counties. This approach ensures that patients receive the right care from the right provider at the right time, making it possible to identify and address problems early, before hospital care becomes necessary.
  • Physicians of Cape Cod ACO has been coordinating care for beneficiaries through a managed care program for 10 years, and intends to bring the expertise developed in that program to the ACO model for fee-for-service beneficiaries. It is expected to serve approximately 5,000 beneficiaries living in Cape Cod, Massachusetts.

Five of the 27 ACO’s are also participating in the Advance Payment ACO program, although none of them are in Massachusetts. One project is located in northern New Hampshire and called the North Country ACO. These 27 ACO’s join the 32 “Pioneer ACO’s” that have 5 projects in Massachusetts.

CMS revealed they are reviewing 150 additional applications for the Medicare Shared Savings Program, of which more than 50 are aiming to be in the Advance Payment Model.

More information is available in CMS’ announcement.

Return to www.thinkhomecare.org.

HCA Encourages Participation in New Direct Service Worker Survey

Organizations receiving Medicaid funding to deliver services under the state’s Home Care Program should be receiving a survey that is part of a study on Direct Service Workers funded by CMS. The Home Care Alliance encourages agencies to complete the survey that will help guide policies towards workforce improvement initiatives.

The Centers for Medicare and Medicaid Services has asked Massachusetts’ Executive Office of Health and Human Services and Executive Office of Elder Affairs to gather and report basic information about the volume, stability, wages, and compensation of the direct service workforce (DSW).

This information will allow state and federal policymakers to:

► Identify and set priorities for long-term support and services reform and systems change.
► Inform policy development regarding direct service workforce improvement initiatives.
► Promote integrated planning and coordinated approaches for long-term supports and services.
► Create a baseline against which the progress of workforce improvement initiatives can be measured.
► Compare workforce outcomes for various programs and populations to better evaluate the impact of policy initiatives.
► Compare state progress with the progress of other states and with overall national performance (where data from other states are available).

According to a cover letter that accompanies the survey, the information in the survey will help agencies and organizations compare themselves to others in Massachusetts and elsewhere in the country.

The survey itself is available online and includes instructions and a summary of purpose. Any questions related to the survey should go to the Direct Service Workforce Resource Center, available toll-free at 1-877-822-2647.

Return to www.thinkhomecare.org.

HCA Goes to Washington

The Home Care Alliance and member agencies will join other associations and agencies from across the country for the annual NAHC March on Washington.

https://i0.wp.com/www.frumforum.com/wp-content/uploads/2011/11/congress.jpg

The annual conference provides a chance to lobby members of Congress on issues of concern and thank those who have supported our causes. For those who are not traveling to Washington DC, the Alliance has made materials available (see below) to use as a guide for a “virtual lobby day” on March 27th when HCA and members visit with the state’s congressional delegation.

Pre-written advocacy messages are available to send off on the virtual lobby day under “Federal/National Issues” on the Alliance’s Legislative Action Center and click any messages that are of concern or interest. The messages will automatically be sent to the correct member of Congress once the online form is filled out asking for contact information. There is also an option to “compose your own message” near the top of that webpage.

If HCA members and advocates choose to contact their

federal representatives by phone, the Alliance has assembled the following materials and fact sheets on some of home care’s priorities, but we invite you to share your own issues and concerns as well.

Finally, be sure to follow the Alliance’s activity in DC, including photos and updates, on Twitter.

Return to www.thinkhomecare.org.

State Making Changes to CORI Certification Process

On March 12, 2012, the Department of Criminal Justice Information Services (DCJIS) stopped accepting CORI Certification applications.

According to DCJIS, this change is necessary in order to transition to a new web-based iCORI system that will be implemented on May 4, 2012. The iCORI system will be available for wider use by the public, employers, landlords, professional licensing authorities and volunteer organizations.

All current CORI certifications have been extended through May 4, 2012. If your organization has a current CORI Certification, you will not be required to apply for re-certification.

An FAQ document with more information is posted on the DCJIS webpage, along with the proposed regulation. A public hearing is also scheduled for any interested in commenting and the notice for that hearing is also posted on the DCJIS website.

Return to www.thinkhomecare.org.

HCA Comments to CMS on Dual Eligible Services Demonstration

MassHealth is going full speed ahead with a demonstration proposal to integrate Medicare and Medicaid services for dually eligible individuals and the Home Care Alliance took the opportunity to comment to CMS, which was accepting testimony on the state’s project until March 19th.

The Alliance’s comments highlighted the extensive experience that home care agencies have in caring for dually eligible individuals and helping them to remain at home. According to MassHealth data, more than 13,600 dual eligibles received home care services in calendar year 2008. Given that nearly 80 percent of duals have a physical health diagnosis, the Alliance also noted that home care agencies have a vital role in assessment and clinical care management, not to mention being an integral part of the care team itself.https://i0.wp.com/vickstromlaw.com/wp-content/uploads/2011/07/masshealth.jpg

The goal of the project is to cut down on the cost of care by better care coordination and integration. The state’s proposal will do this, in theory, by naming five regional Integrated Care Organizations (ICO’s) that will receive both MassHealth and Medicare funding to then pay for services as appropriate and as determined by an assessment and care planning team.

The Alliance has joined other organizations like the Massachusetts Hospital Association, Massachusetts Medical Society and Massachusetts Association of Behavioral Health Systems in conveying that providers should be paid no less than Medicare rates for services they traditionally cover. That way, CMS and the state ensure that cost savings comes from better coordination and not from paying less than what providers are used to being paid.

See HCA’s full comments and visit MassHealth’s special webpage on the proposal for more information. There will also be an open public meeting on the project at 10:00am on April 9th in conference rooms 1,2, and 3 of the State Transportation Building (10 Park Plaza, Boston) for those interested in learning more.

Return to www.thinkhomecare.org.

Community-Based Care Transitions Program Announces New Participating Sites

A second round of participating sites were announced by CMS for the Community Based Care Transitions Program (CCTP) and two teams of providers are in Massachusetts.

Covering the central and western part of the state, the accepted projects are from Elder Services of Berkshire County, which includes Berkshire VNA as a partner, and Elder Services of Worcester, which includes a partnership with Metrowest Home Care & Hospice. A summary of the Berkshire County project has not been posted, but the Worcester/Metro West project summary was posted and notes the prior care transitions experience of Metrowest Home Care & Hospice. That project draws on the home care agency’s experience by including a transition RN, telephonic support above what the Coleman care transition model calls for, and also a palliative care component is implemented when necessary.

CMS continues to accept applications for the CCTP with dates for review listed below. The Home Care Alliance has resources available for any  home care agencies interested in applying or for entities looking to include agencies as partners. Those interested can contact James Fuccione at HCA.

  • March 27, 2012– Applications must be received by March 6th to be considered for this review
  • April 10 – Applications must be received by March 20th to be considered for this review
  • April 26 – Applications must be received by April 5th to be considered for this review
  • May 10 – Applications must be received by April 19th to be considered for this review
  • May 30 – Applications must be received by May 9th to be considered for this review
  • June 11 – Applications must be received by May 21st to be considered for this review
  • June 28 – Applications must be received by June 7th to be considered for this review

Return to www.thinkhomecare.org.

Comments Due on Dual Eligible Services Proposal

MassHealth’s final proposal for a State Demonstration to Integrate Care for Dual Eligible Individuals was submitted to CMS on February 16, 2012.  The final Demonstration Proposal and accompanying documents are listed on the demonstration’s webpage.

CMS is seeking public comment through a 30-day notice period.  During this time interested individuals or groups may submit comments to help inform CMS’ review of the proposal.   To be assured consideration, please submit comments by 5 p.m. EST, March 19. You may submit comments on this proposal to MedicareMedicaidCoordination@cms.hhs.gov.

The Home Care Alliance has offered formal suggestions prior to MassHealth’s submission of the proposal to CMS and will be submitting comments at this stage as well.  Any members interested in commenting can contact James Fuccione at the Alliance for guidance.

Return to www.thinkhomecare.org.