HCA Revamps Physician Face-to-Face Guidance

The Home Care Alliance has newly revamped documents available for helping home health agencies work with physicians relative to the face-to-face encounter requirement.

Please feel free to utilize and distribute the documents below, which include a fact sheet on the requirement, a sample documentation guide, and a tip sheet for terms that can be used in the “brief narrative” portion of the document.

The Home Care Alliance continues to work with association partners such as the Massachusetts Medical Society, Massachusetts Hospital Association, Mass Senior Care, LeadingAge Massachusetts and others to ensure that physicians in every setting know about and properly cooperate with the requirement.

Return to www.thinkhomecare.org.

New Materials and Guidance for CMS Care Transitions Program

A pair of presentations with helpful information and resources regarding the CMS Community-Based Care Transitions Program have been made available.

For home health agencies interested in applying or just getting started with the process, this CMS PowerPoint provides a good summary of the information, helpful links and resources, and answers to some of the more frequently asked questions.

Another helpful set of presentations sponsored by the Commonwealth Fund is available and includes a webinar with audio featuring:

  • Anne-Marie Audet, M.D., M.Sc., moderator, vice president, Quality Improvement and Efficiency, The Commonwealth Fund
  • Eric Coleman, M.D., M.P.H., director, Care Transitions Program, and professor of medicine at the University of Colorado Health Sciences Center
  • Garry MacKenzie, M.D., medical director of cardiology services at McKay-Dee Hospital Center in Ogden, Utah
  • Janice Fitzgerald, R.N., director of quality and medical management at Baystate Medical Center in Springfield, Mass.
Lastly, there have been a lot of questions regarding how to proceed with the “root cause analysis” in the application. A very helpful resource to assist in this matter is available courtesy of the Care Transitions Quality Improvement Organization Support Center (QIOSC).
More updates and resources will be provided by the Home Care Alliance as they become available.

Disaster Prep – Is Your Agency Ready?

Home care agencies have unique responsibilities to their clients during disasters, epidemics, and terrorist attack.

But they also have unique resources. The simplest way to prepare for a disaster is to speak to your clients about the matter and to encourage them to take precautions and make plans.  A great starting point is the new Disaster Preparedness: For Seniors By Seniorsbrochure from the American Red Cross.  This handsome, 13-page brochure covers all the basics — with special attention to seniors including:

  • Building a disaster kit (including medications);
  • Planning an escape route;
  • Staying informed after a disaster takes place; and
  • Knowing what resources are available;

Best of all, the Massachusetts Dept. of Public Health is making copies available free of charge.  Just download the order form, send it in, and they’ll send you up to 500 copies.
Even more importantly, disaster preparedness is vitally important — literally — for home care agencies. That’s why the Alliance partnered with DPH to develop the the Home Health Care Emergency Preparedness Handbook. The Handbookpresents Alliance best practices for preparing for natural disasters, epidemics, and terrorism. Contents include:

  • Standards of Care;
  • Infection Control;
  • Patient Tracking Controls;
  • Emergency Communication Resources;
  • Home Health Care Emergency Planning Resources;
  • Emergency Planning Training Resources;
  • Volunteer Opportunities

The Handbook also contains extensive appendixes on:

  • Hazard Vulnerability Analysis
  • Biological Weapons Agents
  • Emergency Policies & Procedures
  • CMS Altered Standards of Care

The Handbook comes in a three-ring binder and is available to Alliance Members for $25/copy, or $100 for five copies.

Return to www.thinkhomecare.org.

Help HCA Celebrate National Nurses Week and National VNA Week

National Nurses Week

The Home Care Alliance and the Visiting Nurse Associations of America (VNAA) have plenty of material available to help people and organizations celebrate both National Nurses Week (May 6-12) and National VNA Week (May 8-15).

  • National Nurses Week:

For those looking to celebrate nurses, especially visiting nurses, and their work, the Alliance has a template press release that organizations may use.

  • National VNA Week:

Visiting Nurse Associations have a number of materials available, including:

Key messages and Fact Sheet

National VNA Week Poster

Sample Press Release

Return to www.thinkhomecare.org.

Home Care Accreditation Program Reaches Achievement

With 50 private pay home care agencies now approved for the Home Care Accreditation Program, the Home Care Alliance took the opportunity to distribute a media announcement to mark the occasion.

A blurb on the accreditation program milestone has run, so far, in the Milford Daily News and Metrowest Daily News. Please see the full announcement below:

Home Care Accreditation Program Hits Milestone

Home Care Alliance of Massachusetts Program Gains 50th Private Pay Home Care Agency

In less than one year, fifty private pay home care agencies have applied and been approved for a new accreditation program promoting quality, safety, and business standards set by the non-profit Home Care Alliance of Massachusetts

“We have been so pleased with the popularity of this program, which was conceived as a means to promote quality services, ethical business standards, and superior employment practices,” said Home Care Alliance Executive Director Patricia Kelleher. “This isn’t simply a stamp of approval. Private Home Care Accreditation has strict requirements agencies must meet because families have a level of expectation that their loved ones are receiving the best services possible.”

In the absence of meaningful licensure requirements for providers of home care services in Massachusetts, the Home Care Alliance established this Accreditation Program for Private Pay agencies (agencies who are not paid by Medicare or Medicaid).

The standards were developed over several months in consultation with 14 agencies throughout the Commonwealth.  These standards require that agencies submit an application and documentation to the Home Care Alliance of Massachusetts.  Alliance staff and member agencies then review the application to ensure that applicants meet all of the standards.

Agencies seeking accreditation answer questions in fourteen categories, including training requirements, administrative protocols, and business practices.  They are be required to show documentation in answer to questions regarding services plans between clients and the agency, procedures around responding to complaints, and their oversight of caregivers.

“We wanted to provide leadership for an area that is becoming more and more important in Massachusetts,” added Kelleher, “These standards will highlight our agencies’ best practices, which will help guide members of the public as they choose who will take care of their loved ones in their homes. We hope to one day sign up all private care agencies we possibly can in Massachusetts to prove our state’s commitment to quality home-based care.”

A full list of accredited agencies from across the state, and more information about the Accreditation Program standards, is available at www.thinkhomecare.org/accreditation.

Return to www.thinkhomecare.org.

New CMS Care Transitions Program Q&As, Open Door Forum

The Centers for Medicare and Medicaid Services (CMS) have released a new round of Questions & Answers in regards to the Community-Based Care Transitions Program.

See the full list of these helpful Q&A’s here, and below are a couple of the newest posts that may be of interest to home health agencies. One in particular about whether some of the responsibilities of the lead applicant can be subcontracted to other entities.

There is also an “open door forum” scheduled for May 5 and the Home Care Alliance strongly encourages all interested agencies to register and participate.

Yes that is acceptable; however, the applicant would need to demonstrate that each proposed subcontractor possessed expertise in the delivery of care transition services.

Experience with chronic care management/disease management is not synonymous with care transitions experience. The per eligible discharge rate is meant to cover a relatively short term intense intervention around admission to and discharge from an acute care hospital. This rate would not support an ongoing chronic care management program which usually requires a per member per month payment for an indefinite period.

Return to www.thinkhomecare.org.

MA House Approves Adult Day Health Funding, Fixes Treble Damage Law

An evening vote to approve the Health and Human Services portion of the House FY12 budget brought with it a restoration in funding for adult day health services, at least until the end of 2011.

The Governor had proposed in his initial budget a $55 million cut to the program, which would have eliminated the “basic” level of service that provides for roughly 11,000 people. The Home Care Alliance was part of a coalition of advocates led by the Massachusetts Adult Day Services Association that attracted a whopping 94 cosponsors out of 160 state representatives.

The amendment did eliminate the Health Promotion and Prevention (HPP) level of service, which is technically less intensive than the Basic level. It also directs Health and Human Services to impose a temporary moratorium on the enrollment of new adult day health providers as well as expansion of the certified capacity of already approved adult day health providers.

Moreover, the amendment tightens cost reporting reviews, sets up a study group to review and recommend improvements in rate setting methodology and program structure and future needs.

Another major step taken with the House budget was to include language limiting the current punitive treble-damages law to “willful” violations of the wage and hour statute only. The Home Care Alliance supported the amendment to the House budget regarding the treble damage law offered by Associated Industries of Massachusetts (AIM).

According to AIM, the current law penalizes companies that have done nothing outrageous, have not acted with an evil motive, and have not acted with reckless indifference to employees’ rights.  The same would be true in the case of a good-faith dispute over whether an employer owes commissions.

Aside from Adult Day Health, the House approved:

  • An additional $1 million (over the Governor’s proposed budget) for Elder Protective Services.
  • An additional $1 million for grants to Councils on Aging

The budget process will move on to the Senate where the Home Care Alliance will continue to push for Adult Day Health, the Treble Damage Law fix and other home health-related measures that were unsuccessful in the House. MassHealth rate restoration past 60 days of care, MassHealth reimbursement for telehealth, improvements to pediatric home care services, and improving care transitions will all be on the agenda.

Return to www.thinkhomecare.org.

Advocacy Alert: Help Support Home Health Budget Amendments

The Massachusetts House of Representatives begins debate on the FY12 budget TODAY!

Please see the pre-written email messages below that are available to send to your legislators. All you have to do is click “write your legislators” under the issue you care about, fill in your contact info and the message will automatically be sent to the State Representative who represents YOU.

HCA is trying to gain support for these important amendments so please send a message and forward this email to colleagues and friends who may be interested in taking action.

Support Pediatric Home Care
»  Write Your Legislators   
 Amendment # 529: Pediatric Home Care Services (Offered by Rep. Michael Brady)

  • This amendment does not increase any rate, but merely shifts existing payment recognizing a home health agency’s administrative requirements. Also, this amendment ensures safety and quality by allowing only registered nurses to care for multiple patients in a single setting.

Support Enhanced Care Transitions
»  Write Your Legislators 
 Amendment # 554: Patient Care Transitions (Offered by Rep. Kevin Honan)

  • This amendment establishes a special MassHealth rate to reward home health agencies that are successful in helping patients discharged from acute care avoid a costly re-hospitalization for the same condition for which they were originally hospitalized.
  • The hospitalization would have to be avoided for at least 30 days in order for the payment to be administered. The Secretary of Health and Human Services shall determine the rate, which will be based on a nurse-led team model.
  • This provision would increase the efficiency of care and save costs for the state in avoiding rehospitalizations.

Restore MassHealth Payment Rates to Home Health
»  Write Your Legislators 
Amendment  # 339: Home Health Rates    (Offered by Rep. David Sullivan)

  • The MassHealth home health payment rate was cut by 20 percent to patients receiving skilled nursing care past 60 days of care in December of 2008. This created a new payment category that goes from $86.99 to $69.59 for patients that require longer periods of care and who are at a greater risk of inpatient facility admissions or readmissions.  Since all of MassHealth’s home health services receive a 50 percent federal match, the actual state expenditures reflect only half of a $7.1 million budget increase.

Support Telehealth in the FY12 Budget
»  Write Your Legislators      
 Amendment # 681: Telehealth Reimbursement (Offered by Rep. John Mahoney)

  •   In recent years, several states have all moved forward with incorporating coverage of telehealth into their state plan, waiver home care programs, or have authorized funding for demonstration projects to support telemonitoring equipment purchases.
  •   The Centers for Medicare and Medicaid Services also recognize and define telehealth billing and reimbursement practices.
  •   Telehealth and remote care management programs are not only proven to reduce admissions to hospitals and nursing homes, but also reduce the frequency of home health visits.
  •   Such lower cost services increase communication with physicians and caregivers, which contributes to the enhancement of care. It also increases patient self-management and is widely regarding as a cost savings measure supported by a number of studies and pilot programs.

Support Home Health in FY12 Budget
»  Write Your Legislators      
 This email message supports all of the above amendments.

Return to www.thinkhomecare.org.

HCA Welcomes New Member: Nurses-At-Home

The Alliance is pleased to welcome its newest member, Nurses-At-Home, a private care agency in Wobrun, Massachusetts.

Return to www.thinkhomecare.org.

HCA Welcomes New Member: Happier In My Home, Inc.

The Alliance is pleased to welcome its newest member, Happier In My Home, Inc., a private care agency in North Dighton, Massachusetts.

Return to www.thinkhomecare.org.