Category: Caregiving

Guest Blog Post: Discussing Care Choices on Advancing Illnesses

The following is a guest blog post from JoAnne Nowak MD who is Medical Director at Merrimack Valley Hospice. They are promoting a publication from the Massachusetts Department of Public Health, titled “Know Your Choices:  A Guide for Patients with Serious Advancing Illness.” The guide is meant to help healthcare providers adhere to a new state regulation that requires they inform patients with advancing illnesses about their care options and choices. This publication, which Merrimack Valley Hospice has adapted this publication for their use, lists the Home Care Alliance of Massachusetts as a resource and the Alliance encourages further promotion and distribution.

As a hospice and palliative care physician, I know that decisions about end of life care are deeply personal, and based on individual values and beliefs.  I’ve also seen first-hand how advance care planning can be an invaluable gift to those you love. Taking the time to talk with your family, close friends and your healthcare providers while you are in good health are all important steps in an advance care planning conversation.

In Massachusetts, a newly implemented regulation requires that all licensed hospitals, clinics, and long-term care facilities provide information about advance care planning, palliative care, hospice care, and other end of life care options to adults with serious illness.  The goal is to help patients start the conversation and make their end of life care wishes clearly known.

To help you begin, the Massachusetts Department of Public Health recently created “Know Your Choices:  A Guide for Patients with Serious Advancing Illness.” Merrimack Valley Hospice would like to make it easy for you to obtain this guide by making it available on our website because it contains important information about a variety of healthcare choices.  For your free copy, go to http://www.homehealthfoundation.org/patients-resources.  You can also call 978-552-4186 to receive a copy by mail.

It’s time for all of us to start the conversation.

JoAnne Nowak MD
Medical Director, Merrimack Valley Hospice

Return to www.thinkhomecare.org.

DLS Posts Notice for Long-Term Care Insurers

As of December 19, the Massachusetts Department of Labor Standards (DLS) no longer requires private-pay home care agencies to register for licenses. Several Alliance members report that DLS has already rejected and returned their licensure renewal applications.  DLS has also posted a notice to long term care insurers on their website in response to concerns raised about recent regulations proposed separately by the Division of Insurance (DOI).

In the absence of a licensure or registration standard, the DOI regulators have indicated they will issue a regulation that leaves the door open to future state oversight policies. The Alliance has spoken with one major long-term care insurance company that has said this change would not have an impact on getting their clients the home care services they need since many states they operate in lack licensure standards as well. The insurer said that they would simply seek a general business license through the Secretary of State’s office and may potentially look to other accreditations and credentials.

The fear that private pay home care agencies would not receive long-term care insurance reimbursement in the void left by the recent DLS regulations appears to be less of a concern that previously believed. However, the Home Care Alliance will continue to monitor the situation and will work with private-pay home care members, the Home Care Aide Council and other organizations in pushing for a solution at the legislative level.

Return to www.thinkhomecare.org.

CDC, Mass DPH Release Updated Ebola Guidance for Healthcare Workers

On October 20th, the federal Centers for Disease Control and Prevention (CDC) released stricter guidance on Personal Protective Equipment (PPE) recommended for healthcare workers treating patients with the Ebola virus.

The new enhanced guidance from CDC is centered on three principles:

  • All healthcare workers undergo rigorous training and are practiced and competent with PPE, including putting it on and taking it off in a systemic manner
  • No skin exposure when PPE is worn
  • All workers are supervised by a trained monitor who watches each worker putting PPE on and taking it off.

These principles and other guidance listed on the new advisory appear to be geared towards healthcare facilities and are based on lessons learned from those hospitals and clinics that have treated Ebola cases in the US thus far, including Emory University Hospital, Nebraska Medical Center and National Institutes of Health Clinical Center.

Also on October 20th, the Massachusetts Department of Public Health (DPH) and Boston Public Health Commission released updated clinical guidance on sending in patient specimens for laboratory testing for suspected Ebola cases. According to DPH, prior to sending a sample, the facility should consult the MDPH Hinton State Laboratory Institute for specimen collection, handling, packaging and transport advice via the 24/7 lab number (617-590-6390).

More information will be shared as it becomes available.

Return to www.thinkhomecare.org.

MA Cancer Prevention & Control Network Readying Palliative Care Survey for Home Care

The Massachusetts Comprehensive Cancer Prevention & Control Network (MCCPCN) is putting the finishing touches on a survey on palliative care geared towards treating cancer patients.

The Home Care Alliance is a part of an MCCPCN task force that built the survey, which will be distributed to agencies via email form DPH.  Agencies are strongly encouraged to take the time to respond. MCCPCN is under the Department of Public Health and a cover letter from Commissioner Cheryl Bartlett explains the reasoning and background to the survey as well as how it will help advance palliative care services.

Questions on this issue can be directed to James Fuccione at the Alliance.

Return to www.thinkhomecare.org.

 

Ebola Preparedness Info and Resources Released by DPH

Through press conferences and announcements, state officials have repeatedly stressed that the likelihood of an Ebola case is Massachusetts is “very low,” but that does not mean local healthcare providers should not be prepared and the general public should not be educated on the issue.

The Massachusetts Department of Public Health has posted information and resources on a special webpage  with guidance for clinicians and other helpful information. Misinformation about the disease has caused some of the concern, but the state continues to monitor the situation.

Here is part of a recent Public Health Advisory:

Massachusetts is well prepared to handle an incidence of Ebola, in the unlikely event that a case should occur in the Commonwealth. The public can have full confidence that our hospitals have the expertise, preparedness and capacity to handle such a situation. The infectious disease controls in Massachusetts and the United States are world class. Should a patient present Ebola symptoms, the patient would be quickly isolated and treated to prevent the spread of this disease.

Please see the resources below that are listed on mass.gov/dph/ebola.

DPH Guidance for Clinicians

General Information About Ebola Virus

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.

Return to www.thinkhomecare.org.

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.

Return to www.thinkhomecare.org.

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.

Return to www.thinkhomecare.org.

One Care Initiative Launches Ombudsman Program

The Massachusetts One Care Initiative, which aims to better coordinate care and services for dually eligible individuals ages 21-64, officially launched the One Care Ombudsman program (OCO). Home health agencies involved in One Care should be aware of this new resource.

According to a notice sent by the state, the OCO:

  • Is an independent program operated by the Disability Policy Consortium (contracted by EOHHS) and its partners, Health Care For All (HCFA) and Consumer Quality Initiatives (CQI);
  • Addresses concerns and helps resolve conflicts regarding members’ enrollment in One Care or access to covered benefits and services so they can receive the benefits and exercise the rights they are entitled to in One Care; and
  • Works with members and their representatives, as well as MassHealth and the three One Care plans, to find resolutions to members’ concerns or complaints.

The OCO does not duplicate or replace other resources that are already available to help people with One Care (such as the SHINE program, the One Care plans’ member services, and MassHealth Customer Service). The OCO is an additional resource to support members who need or request independent problem-resolution assistance beyond what is available now. The OCO provides three main types of services: Continue reading “One Care Initiative Launches Ombudsman Program”

More on ‘The Agency Advantage’

CG_logo_for_webCaregiver.com published an excellent article by Rona S. Bartelstone, LCSW, BCD, CMC, describing the advantages of working with a home care agency as opposed to the risks and responsibilities of direct-hire:

As the employer, the individual or family paying for the private home health aide would be held liable for any work-related injury that occurs on the job. This can include the cost of all medical expenses and any disability payments that might become applicable.

Since the home-care industry is noted for work-related injuries, this can be a huge risk, especially if the caregiving tasks include lifting, transferring or bathing. There are also risks related to communicable diseases if the aide does not abide by universal precautions that are required by all licensed agency personnel.

Furthermore, the employer retains any liability that arises out of an injury to the person being cared for or any other person on the premises. If the home health aide were to cause an accident, for example, in which other family members suffered any harm or losses, the employer would bear the full responsibility for all costs and compensation.

The article also contains case examples that illustrate these advantages in real-world situations. It makes an excellent, long-form companion to the Alliance’s 4 Reasons to Choose A Home Care Agency brochure, which is always available at no charge.

Return to www.thinkhomecare.org.