A Salute to Our Stars!

This week as the entire health care community pauses to recognize the commitment, value and professionalism of our nation’s nurses, the Home Care Alliance would like to acknowledge the seven individuals who were recognized with Star Awards at our annual celebration in Boston on April 28th.  In the words of HCA of MA President Jeanne Ryan,  these seven individuals  “show us the breadth of what home care is at its best.”

The 2015 Star Award Winners are:

Clinicians of the Year:  Janet Fuller, RN Case Manager, Medical Resources Home Health, Newton, and Patricia G. Martin, RN, Hospice Nurse, Community Nurse & Hospice Care, Fairhaven

Aide of the Year:  Judith Clervil, Lead Certified Nursing Assistant, Residential Support Services, Inc., Chelsea

Manager of the Year:  Michelle Landry, Rehabilitation Manager, Brockton VNA, Brockton

Physician of the Year:  Cara Chevalier, MD, Medical Director, Hallmark Health VNA & Hospice, Malden

Legislator of the Year:  US Senator Elizabeth Warren

Home Care Champion:  Tim Burgers, Associate Director, Home Care Alliance of MA

Truly these individuals stand in for all the home care nurses, therapists, aides, physicians and managers who bring so much care and comfort to the ill and afflicted.

Congratulations to you all!  we will be proud to feature our Clinicians and Aide of the Year on the covers of our 2016 Resource Directories!

Pat Kelleher
Executive Director, HCA of MA

House Approves Budget Plan with Little Support for Home Care

This week, the Massachusetts House of Representatives quickly buzzed through nearly 1,100 amendments to their FY2016 budget proposal and came out with roughly $38.1 billion spending plan.

The House included little from all corners of the advocacy spectrum and the same was true for home care. None of the Home Care Alliance’s priority items and many of those the organization supported were not advanced so HCA will be among many groups relying on the Senate to step up when their budget plan comes out early next month.

Among the items that were approved and supported by the HCA was an initiative to shape a comprehensive Mobile Integrated Health plan for the state, which named the Alliance to an advisory panel for that effort.

Also, $200,000 was approved for the Department of Higher Education’s “Nursing and Allied Health Workforce” account that has, in the past, spurred a home care nurse residency program. The Governor’s budget had zeroed out that line item.

Other notable items approved in the House budget include the following:

  • $8.8 million increase for MassHealth Nursing Home Supplemental Rates.
  • $500,000 for a pilot program in the “greater Quincy area” to implement a model of field triage of behavioral health patients under medical control by specially-trained emergency medical services providers and transport of appropriate, non-medically complex patients to a behavioral health site of care for most effective treatment rather than to an acute hospital emergency department.
  • $50,000 to establish Financial Abuse Specialist Teams (FAST) to improve the ability of elder protective services programs to investigate and respond to reports of financial exploitation.
  • $750,000 for the Meals on Wheels program, which brought that item to $7.1 million – still below the Governor’s proposed funding for that initiative.
  • A prospective, global payment pilot program established under MassHealth under which Medicaid contracts with risk-bearing provider organizations for the provision and coordination of health care services for their attributed members beginning not later than September 1, 2016. The pilot would require that such risk-bearing provider organizations shall be able to provide coordinated care through the provider’s network of primary care providers and that such providers shall have experience and demonstrated capabilities to provide behavioral health services including psychiatric and substance abuse beds. Under the proposed program, Medicaid shall reimburse such providers on a prospective monthly basis provided that these organizations obtained a risk certificate or a waiver from the Division of Insurance.

Stay tuned to learn more about HCA’s advocacy around the Senate budget process and how you can weigh in to support better rates for visiting nurses, home health aides, and other workers along with establishing a commission to study private pay home care oversight options.

Return to www.thinkhomecare.org.

 

Paid Sick Time Proposed Regs Need Comments from Home Care Agencies

The Attorney General’s office released proposed regulations for the paid sick time law passed via ballot question and due to be effective on July 1, 2015.

The law essentially states that workers employed by companies with eleven or more employees can earn and use up to 40 hours of paid sick time per calendar year, while employees working for smaller employers can earn and use up to 40 hours of unpaid sick time per calendar year.

A full summary of the law, along with the proposed regulations and a list of public hearing dates are available on a special “Earned Sick Time” webpage on the Attorney General’s website. Associated Industries of Massachusetts (AIM) conducted a quick analysis of the draft regulations posted on their blog.

The Alliance will be testifying on these regulations at the Boston hearing on May 18th so the Alliance strongly encourages home care agencies to review the draft regulation and send comments to James Fuccione so the HCA can formulate testimony. We further encourage agencies to attend and comment at the other hearings and listening sessions to be held across the state and to notify HCA if you’re planning to do so in order for the comments to be consistent.

A full list of the hearing dates and locations are below:

Friday, May 8, 2015
Brockton Listening Session
Location: Brockton Public Library
(304 Main Street, Brockton, MA 02301)
Time: 10:00 am – 1:00 pm

Monday, May 11, 2015
Salem Listening Session
Location: City Hall Annex Building, 3rd Floor Conference room
(120 Washington Street, Salem, MA)
Time: 10:00 am – 1:00 pm

Friday, May 15, 2015
Lowell Listening Session
Location:  Lowell  Lowell Federal Building
(50 Kearney Square, Lowell, MA)
Time: 10:00 am – 1:00 pm

Monday, May 18, 2015
Boston Public Hearing
Location: Saltonstall Building, 2nd floor Conference Rooms C & D
(100 Cambridge Street,  Boston, MA)
Time- 10:30 am – 1:30 pm

Friday, May 22, 2015
Framingham Public Hearing
Location: Framingham Town Hall, Memorial Building, Ablondi Room
(150 Concord Street,  Framingham, MA 01702)
Time: 10:00 am – 1:00 pm

Friday, May 29, 2015
Springfield Public Hearing
Location: 1350 Main Street – 3rd Floor Community Room
Time: 10:30 am to 1:30 pm

Friday, May 29, 2015
Pittsfield Public Hearing
Location: Pittsfield City Hall – Council Chambers
(70 Allen Street, Pittsfield, MA)
Time: 10:00 am – 1:00 pm

Monday, June 1, 2015
Fall River Public Hearing
Location: City Hall: 1 Government Center – The Hearing Room
(1 Government Center, Fall River, MA 02722)
Time: 1:30 pm – 4:30 pm

Friday, June 5, 2015
Worcester Public Hearing
Location: Main Library- Saxe Room
(3 Salem Square, Worcester, MA 01608)
Time: 10:00 am – 1:00 pm

Return to www.thinkhomecare.org

Advocacy Alert: Email State Reps to Gain Support for Home Care in the House Budget!

The Home Care Alliance has been busy working with state representatives to file amendments to the recently released House version of the state’s FY16 budget. Now that those proposals are submitted, it is time to gain crucial support by asking other reps to cosponsor these amendments.

The amendments include the following proposals:

  • An increase in MassHealth rates for visiting nurses (filed by Rep. Sean Garballey)
  • Creating a commission to study state oversight options for private-pay home care agencies (filed by Rep. Mark Cusack)
  • An increase in MassHealth rates for home health aide services (filed by Rep. Chris Walsh)
  • A study of MassHealth’s Third Part Liability Billing process (filed by Rep. Paul Brodeur)

Agencies and advocates can send an email through HCA’s Advocacy Center just by clicking on the message, filling out the contact info form, and hitting “send.” The message will automatically shoot off to the correct Representative based on the address you enter.

Private pay home care agencies can send their own message for just the Study Commission language here, or a message can be sent for all the Alliance’s priorities here.

Any questions can be directed to James Fuccione at the Alliance.

Return to www.thinkhomecare.org.

FY16 State Budget Plan Released by House

The House Committee on Ways & Means released their version of the state’s fiscal year 2016 budget with most accounts important to home care level funded. Out of the $38 billion in the proposed budget, $15.3 billion is spent on MassHealth, the state’s Medicaid program.

Since language proposed by the Home Care Alliance to establish a commission to study options for agency oversight was not included, the HCA will be working with state representatives to file amendments to the budget for a number of items, including establishing commissions to study and make recommendations on state oversight options for private pay agencies and certified agencies. The Alliance will also be seeking an increase of $3.1 million in payment rates for home health aides as well as a restoration of MassHealth home health nursing rates.

The Alliance will also be supporting a number of budget amendments spearheaded by other organizations to raise home care worker wages, seek relief from the impending paid sick time mandate and restore the line item funding the Nursing and Allied Health Education Workforce Development program.

Additionally, the Alliance will support efforts to increase funding for elder home care purchased services from Aging Service Access Points. The House Ways & Means budget reduced that line item from what the Governor proposed earlier this year by more than $3 million.

Stay tuned as the Alliance will be sending out advocacy alerts on how agencies and advocates can urge support of these important issues.

Return to www.thinkhomecare.org

 

One Care Program Provides Update, Amends Financial Protections for Plans

The One Care initiative provided stakeholders with an update on enrollment population as well as the financial methodology governing the program and survey results illustrating enrollee opinions and satisfaction with services and the care team.

One Care, which coordinates Medicare and MassHealth services for dually eligible individuals between 21 and 64 years old, reported that the program has spent 14 percent – or $19.4million – on home and community-based services, including home health. This number reflects the life of the program thus far since it launched in October 2013. Pharmacy services represents the largest piece of the spending pie at 25 percent ($34.36 million).

The program has also conducted a round of enrollee surveys that found the following:

  • Over 80% of enrollees had met with their PCP; most are satisfied with the PCP
  • Over 70% had met with their Care Coordinator; 90% are satisfied
  • There was confusion about the role of the LTS Coordinator
  • When asked if they needed/wanted LTS Coordinator, many said no, or not sure;
  • Only 39% said they needed/wanted an LTS Coordinator;
  • Less than 45% had met with an LTS Coordinator

One Care administrators worked with CMS to update the financial methodology that was intended to protect the three plans (Commonwealth Care Alliance, Fallon Total Care, Network Health) and that info, along with the broader report to stakeholders, is available in a PowerPoint presentation.

Return to www.thinkhomecare.org.

Deborah Wilson Shares Experience Treating Ebola Patients

debbiewilson055Deborah Wilson, a nurse with the Berkshire VNA, this week shared her story of treating Ebola patients in Liberia.  The HCA members attending the “Hot Topics” breakfast on “infection Control Best Practices” were mesmerized by her words and pictures.

In the best community health tradition, Wilson talked of challenges that were clinical and treatment related as well as educational.

“Death is a powerful motivator,” She said of village chiefs who were initially skeptical of community health workers who they feared were bringing Ebola in, not treating it.  Most eventually let educators in, she said, but not before six education workers were stoned to death in Guinea.

Wilson talked of work on the 120 bed ward, which consisted of patients lying on a concrete floor.  The devastation across families was so great, she said, because families often contracted disease by washing the dead bodies of loved ones. “Just after death is when a body can be most contagious,” she said.

Her stories and pictures capture the challenges associated with the life-saving Personal Protective Equipment they wore.  Clinicians were often only able to work in the ward for an hour at a time before clothing was soaked through and goggles were too fogged to see.

But Wilson noted that the community health initiative was effective:  the death rate while she was there went from over 80% to 60%.

Her amazing pictures are HERE!

Some of the great articles written from her experience are HERE!

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Special Open Door Forum on F2F Template; Alliance Seeks F2F Data

CMS hosted a Special Open Door Forum call yesterday to provide an opportunity for physicians/practitioners, home health agencies and/or all other interested parties to provide feedback on both a paper clinical template and an electronic clinical template for face to face documentation.

Many questions were raised and often the presenters were unable to answer the audience’s questions; the presenters stated they would provide answers during at the April call. The PowerPoint presentation (see slide 5) raised many more questions on which physicians could actually certify homecare; the hospitalist or the community physician. Again the presenters were unable to clarify the regulation for the audience. The presenters were actually debating among themselves whether a discharge planner or physician’s staff could assist completing the documentation for the face to face. A caller confirmed that this was acceptable and CMS had already addressed this issue in the CMS Face to Face Questions, question number 8.

CMS is seeking public comment on this voluntary paper clinical template. Feedback and questions can be sent to: HomeHealthTemplate@cms.hhs.gov.

Additional Special Open Door Forum calls on the templates will be held on April 8 and May 6, 2015, both at 1:00 PM Eastern Time.

In the Alliance’s continued advocacy on the Physician Face-to-Face Requirement, agencies that have ongoing appeals of claims denied for “invalid” F2F documentation are encouraged to send the number of denials, amount of money tied up in those claims, and the status of the appeals to James Fuccione at HCA.

We will share these data by congressional district with the Massachusetts federal delegation so that they can follow up with CMS. Months after a letter was sent from US Senators from the New England region on the same subject, CMS has failed to respond and the Alliance wants to make sure this issue gets the attention it deserves.

Please send this information, along with any questions, to James Fuccione at the Alliance.

Return to www.thinkhomecare.org.

Governor Releases State Budget Proposal With MassHealth Savings

In his first budget as governor, Charlie Baker’s administration made sizable shifts within Health and Human Services, which accounts for 53 percent of the overall budget proposal. These shifts were done without negatively impacting most provider rates, including home health services.

In a conference call with provider and advocacy organizations, Executive Office of Health and Human Services Secretary Marylou Sudders announced that there was a 5.6 percent growth over FY15 in the total EOHHS budget and that line items in the Elder Affairs accounts governing the Aging Service Access Point network saw a 2.1 percent increase overall. This includes the following highlights:ma budget pie chart pic

  • A nearly $5.6 million increase over FY15 spending in the Elder Enhanced Home Care Services Program.
  • Level funding for the Home Care Purchased Services line item ($106.6 million), which governs contracts with home care providers.
  • A reduction of $13.7 million in the MassHealth Senior Care Account that includes, among other things, the Senior Care Options or SCO program. On the call with Secretary Sudders, it was explained that this was an adjustment on caseloads after re-determinations.
  • A continued reduction ($68,360,305) in MassHealth Fee-for-Service payments to “meet projected need.”
  • An increase of $768,713,676 in MassHealth Managed Care spending.
  • Level funding of grants to councils on aging and to the elder nutrition program.
  • A nominal increase in spending over FY15 on Pediatric Palliative Care.

For more information on the Governor’s proposed budget, visit the administration’s FY16 budget webpage.

Return to www.thinkhomecare.org.

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.