The CHAMP program at the Center for Home Care Policy & Research of the Visiting Nurse Service of New York has developed a useful website that consolidates many evidence based tools and studies aimed at promoting high quality home based care. In a new posting on their community blog, Dr Eric Widera of the Division of Geriatrics at UCSF discusses the power home care agencies have to provide innovative care that can integrate the palliation of symptoms, care coordination and advance care planning earlier in a patient’s disease trajectory. Included in his discussion of this timely issue – given the STAAR and End of Life Care Expert Panel projects in Massachusetts – is a link to CHAMP’s Evidence Brief on Advanced Illness Management. Does this look like something your agency is already doing? Or could be? Comments welcome.
So You Want To Start A Home Care Agency?
Home care is one of the fastest-growing segments of the health & human services industries. Owning a home care agency can provide you with a meaningful and profitable career where you can be your own boss, make your own decisions, and decide your own future.
A successful homecare agency requires a careful business plan that considers start-up costs, local demand and competition, workforce recruitment, and marketing. And like all new businesses, new home care agencies have a high attrition rate during their first few years.
So You Want To Start A Home Care Agency? will answer your basic questions, help you think through the necessary steps, and provide you with links and references to additional information sources.
Return to www.thinkhomecare.org.
Care Transitions as a Reform Strategy
A key tenet of the Massachusetts Quality Improvement Initiative is an efforts to improve the flow of patients – and information – from one health care setting to another. The state’s broad plan is laid out in it’s recently released “Strategic Plan for Care Transitions.” Care transitions are an obvious choice as it is an area in which data indicate Massachusetts can do better. The federal AHRQ 2008 state rankings place Massachusetts seventh overall for health system performance, but 33rd in avoidable hospital admissions and costs. For your consideration: How can home health care contribute to an improved care transitions infrastructure? In terms of medication reconciliation? Chronic care symptom management? Screening for readmission risk? The state’s attention to this issue, can be home health’s opportunity to shine. Your comments and ideas are welcome.
Free Emerg. Prep Guide w/order of Standards of Care Handbook
Through the end of March, Alliance members who order our Standards of Home Health Clinical Practice Manual will receive a free copy of Home Health Care Emergency Preparedness Handbook.
The Standards of Practice manual represents the professional consensus of experienced home health practitioners in the fields of nursing, physical therapy, hospice, and quality improvement. Each standard was developed by a subcommittee and reviewed by the full workgroup and subject-matter experts. Each order includes a printed copy of the manual, as well as a CD containing the complete text in an Adobe PDF format. The table of contents is available for preview
The Standards of Practice Manual normally retails for $225, but is available to Alliance members for just $65.
The Alliance developed the Home Health Care Emergency Preparedness Handbook jointly with the Department of Public Health.
This essential reference not only covers what home care agencies can do to protect and care for their own clients in an emergency, but also details how their unique skills and knowledge base can help their entire communities.
Like the Standards of Care Manual, the Emergency Preparedness Handbook is neatly bound in a sturdy ring folder. The table of contents is also available for preview.
To order a copy of both guides, sign into our website and order a copy of the Standards of Care Manual; we will include a copy of the Emergency Preparedness Handbook at no additional charge. To order just a copy of the Emergency Preparedness Handbook, call HCA Membership coordinator Tom Meyer at (617) 482-8830.
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HCA Offers Comments on State HIT Plan
The Massachusetts eHealth Institute (MeHI) posted their draft of the state Health IT plan, a roadmap meant to guide Massachusetts towards establishing electronic health records (EHRs), and are accepting comments until February 16.
MeHI was recently designated by the Governor as the Regional Extension Center (REC) for the state. The REC, according to their website, “provides direct assistance and best practice tools to assist health care providers, especially primary care providers, in their meaningful adoption of EHRs.”
The Alliance suggests home care and home health agencies offer comments on the plan so that the industry can be more involved in the implementation process.
Here are the comments, by section, offered by HCA:
Section 1: Executive Summary
In improving “person focused” health care (Goal 1), improving the quality and safety of health care across all providers, and having that quality of care be consistent and predictable (Goal 2), home health should be looked upon to more effectively achieve that mission. The involvement of home health would further improve the efficiencies in HIT that will slow the growth of health care spending (Goal 3).We agree and support that interoperable health records (strategy 3) should be in all clinical settings and while 40 percent of providers use EHR’s, the number goes above 75 to 80 percent when dealing with home health agencies in Massachusetts.
Home health would also serve as an asset in supporting care coordination, patient engagement and population health (strategy 4).
Section 2: Intro
Typo under future state regarding prescriptions and refills.Section 3: Multi-Stakeholder Governance
Under the graphic of how Ad Hoc Workgroups participate in the decision making process (Figure 3.2), we hope that the workgroups will recognize home health as an “option for MeHI to pursue” and that we will be identified as a gap “in knowledge or representation.”Section 4: Establish a Privacy Framework to Guide the Devlopment of a Secure HIT Environment
Meaningful use care goals are reflected in home health. For instance, clinical decision support, enhanced care coordination and exchanging meaningful information across the health care team are a few areas of expertise for home health.Section 5. Implement Interoperable Electronic Health Records in all Clinical Settings and Assure They Are Used to Optimize Care
Since hospitals and doctors are priority providers, other providers could be a part of the loan program to jump-start their involvement.Section 6. Develop and Implement a Statewide HIE to Support Care Coordination, Patient Engagement and Population Health
Home health may not be involved in an HIE, but the experience of home health agencies’ use of EHR’s could also be looked to for lessons and guidance.Section 7. Create a Local Workforce to Support HIT Related Initiatives
No CommentsSection 8. Monitor Success
No CommentsSection 9. Path Forward
No Comments
Appendix A: Terms and Definitions
No CommentsAppendix B: Additional Services Considered for the Statewide HIE
No CommentsGeneral Comments
Realizing that home health is not a “priority provider,” and knowing that all provider types will eventually be roped in, I tried not to belabor each individual section with ties to how home health should be included.The state plan has to follow certain guidelines set by the ONC, but it is our hope that home health will be among the next round of providers that are implemented. With that said, we support the vision of implementing Health IT in all clinical settings (pg 32) for the purpose of better patient self-management.
Thank you for taking and considering our comments.
Return to www.thinkhomecare.org.
Alliance Releases New Pediatric Guide
Though home care is often thought of as exclusively for elders, its services actually benefit a much wider demographic.
With this in mind, the Alliance is pleased to announce the publication of the inaugural edition of the Guide to Pediatric Home Care Services. The Guide lists Alliance members who offer specialty programs in pediatric home care. The agencies listed in this directory self-reported the services they provide.
The Guide is available for free download directly to your computer; hard copies are also available for order.
Return to www.thinkhomecare.org.
New Advocacy Message: Support Nurse Delegation!
As previously posted on this blog and the Alliance’s February 5 newsletter, the legislature’s Joint Committee on Public Health advanced a major HCA legislative priority regarding nurse delegation.
The legislation, known as Senate Bill 860, An Act Relative to Home Health Aides, is now being considered by the Joint Committee on Health Care Financing.
The proposal, submitted by the Home Care Alliance and filed by State Senator Richard T. Moore, would refine the Commonwealth’s Nurse Practice Act (NPA) to allow nurses to delegate the administering of certain medications to qualified home health aides in the home setting.
To help this bill advance further, a new advocacy message is available on the HCA website’s Legislative Action page. Send and spread the message to help make home health care services more efficient.
To learn more, see HCA Board President Patricia O’Brien’s testimony to the Public Health Committee.
Return to www.thinkhomecare.org.
McGovern Sends Delegation Letter Requesting Meeting with CMS on TPL
Congressman Jim McGovern has sent a letter to CMS Acting Director Cyndy Mann with a request that Mann meet with him and the Home Care Alliance on continuing the Third Party Liability (dual eligible) demonstration project.
The demonstration allows decisions about the appropriate payer for home health services to Medicare/Medicaid dual eligible elders to be handled by a 200 case sampling rather than a case by case review.
“Annual review of two hundred cases per state has been a better systemic solution than previous practices in which thousands of cases, with immense red tape, make their way through multiple levels of review and appeal,” said the McGovern letter.
Joining Congressman McGovern in signing on from the Massachusetts Congressional Delegation were Representatives Capuano, Delahunt, Frank, Lynch, Markey, Olver and Tsongas.
MassHealth administrators have also written to CMS this week, urging that the demonstration project be extended.
The demonstration has been a tri-state effort with New York and Connecticut, whose associations have been working hard advocating for an extension as well.
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Major HCA Legislative Priority Advances
The state legislature’s Joint Committee on Public Health has favorably reported out Senate Bill 860, An Act Relative to Home Health Aides.
The proposal is a major legislative priority of the Home Care Alliance and would refine the Commonwealth’s Nurse Practice Act (NPA) to allow appropriate nurse delegation practices to include delegation of medication administered by home health aides in the home setting.
More information will follow soon, along with advocacy action, so be sure to check back.
Return to www.thinkhomecare.org.
2010 Resource Directory Available For Pre-Order
The 2010 Massachusetts Home Care Resource Directory is now available for pre-order on our Alliance’s website. Copies will begin shipping by the end of the month.
combines thoroughness with ease-of-use to give you the best guide to home care services in Massachusetts. If you’re a nurse, social worker, GCM, or anyone else who needs to find the best home care agency to fit your patient’s needs, this is the one resource you need.
The Resource Directory lists our 164 agency members alphabetically, complete with full contact information and a description of the services they offer. It also contains a detailed town-by-town cross reference that lets you find local agencies can provide service to your patient. Sample pages are available here.
Return to www.thinkhomecare.org.
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