Alliance Comments to CMS on CY2022 Home Health Rule

To ensure that home health agencies in Massachusetts can provide high-quality care to older adults, the Home Care Alliance of Massachusetts has submitted comments to the federal government regarding the proposed rule for next year’s Medicare home health rates. Our comments to the Centers for Medicare and Medicaid Services (CMS) address several sections of the proposed rule, including:

  • CMS’s flawed reasoning behind the -4.36% “behavioral adjustment” to the rates;
  • Concerns about a budget neutrality adjustment based on 2020 data skewed by COVID;
  • A market basket adjustment that does not account for ongoing costs related to COVID;
  • Protections for counties with large wage index reductions;
  • Modifications to the Value Based Purchasing model before it is implemented nationwide;
  • Greater flexibility around the five-day deadline to submit the new Notice of Admission;
  • Greater flexibility to allow therapist to conduct initial assessments; and
  • Expanded allowances for virtual aide supervisions.

Alliance Partners with RBC Ltd on OSHA Manual

Barbara Citarella
RBC’s Barbara Citarella

In response to the new OSHA Emergency Temporary Standard issued in June, the Alliance has teamed up with Barbara Citarella of RBC Limited to produce an e-book on Workplace Safety for Occupational Exposure to COVID-19. The document includes model policies and multiple forms in the addendum section that will be helpful as guidance for compliance with the OSHA Standard. The manual can also serve as a template for any other infectious communicable diseases. All documents may be used as is or may be personalized by using PDF editing software.

We will be working with RBC to market this new manual nationwide. Alliance members can be the first to purchase your copies here!

2021 Annual Report

Our 2021 Annual Report highlights the Alliance and Foundation’s achievements over the past 12 months, and looks forward to our post-COVID future.

Our 2021 Annual Report highlights the Alliance and Foundation’s achievements over the past 12 months.

Responding to COVID

Since the onset of the pandemic and the declarations of federal and state emergencies, the Home Care Alliance of Massachusetts shifted much of its attention and resources to COVID-19-related membership support. To that end,
the Alliance:

  • Distributed donated PPE valued at over $150,000 through multiple distributions of free hand-sanitizer, gloves, gowns, face shields, and other PPE through a partnership with the Massachusetts Health & Hospitals Association and offered PPE at a competitive group discount price through our partnership with American Advertising Specialties.
  • Published 50 special member newsletters devoted exclusively to COVID topics – issued daily during the height of the public health emergency.
  • Worked with the Betsey Lehman Center on a PPE video series specific to home care and prepared an accompanying CEU PowerPoint and test for agencies to use alongside the video, including: Don/Doff PPE, Infection Control in the Home, and Video Pre/Post Test with Answers.
  • Developed two educational flyers on COVID for members to leave in the homes of clients/patients. The “Safe Holiday” flyer encouraged safe social distancing during holiday celebrations, and the “Wear Your Mask” brochure reinforced safety with patient families when a home care worker was in the house. The “Wear Your Mask” brochure was also translated into Spanish.
  • Advocated on social media when home care was excluded from the first round of health care worker vaccines. This generated more than 150 tweets (from over 40 accounts) and resulted in Governor Baker recognizing home care at a press event and moving up vaccine access date.
  • Worked with the MHA Post-Acute Care Transitions workgroup on a universal pre-discharge COVID testing protocol.
  • Offered regular calls for CEOs of certified and private care agencies to share and learn from each other, as well as calls for clinical directors, HR mangers, and hospice directors.
  • Secured the continuation (post-COVID) State of Emergency of Medicaid coverage of telehealth visits.
  • Answered hundreds of member regulatory questions related to the pandemic.
  • Hosted a COVID-19 Resource page that includes Allied member COVID resource services and that generated more than 6,500 unique page views.

Other 2020-2021 Work

Among the member supportive services over the past twelve months, the Alliance and Foundation have:

  • Succeeding in passing a FY 21 budget request for $17 million in money for home health aides and homemakers.
  • Helped to establish, and was appointed to, a commission to create a framework for licensure of private home care for the state Legislature to consider.
  • Completely revamped both our Find-an-Agency and our Allied member online directories with more information per company, and in a more readily accessible, clearer format.
  • Hosted dozens of member webinars , such as: Paid Family Medical Leave Benefit, the Medicare Home Infusion Benefit, Payroll Protection Loans, ICD-10 Comprehensive Coding
  • Worked with Mass EOEA on a plan for EVV roll out
  • Worked with MassHealth on rewriting home health program regulations.
  • Featured video interviews with agency leaders of color for Black History Month.

Read the full report below.

Alliance Releases COVID-19 Vaccines Guidance

To help members stay abreast of developments regarding COVID-19 vaccines, the Alliance has developed a guide that puts everything you need in one place.

To help member agencies (and the public) stay abreast of developments regarding COVID-19 vaccines, the Home Care Alliance of Massachusetts has developed a reference guide that puts everything you need in one place.

What You Need to Know About the COVID-19 Vaccines is based on guidance from the Centers of Disease Control (CDC) and Massachusetts Department of Public Health (DPH).  We are committed to keeping this guidance updated as new information becomes available and as additional vaccine products are authorized.

Return to www.thinkhomecare.org.

Photo by CDC on Unsplash

Talking Home Care: Employment Law During a Pandemic with Angelo Spinola

Veteran litigator Angelo Spinola answers questions about how agencies are rising to meet the biggest employment law challenges they face, including those posed by the COVID-19 Pandemic.

Angelo Spinola and Pat Kelleher

Even in the best of times, human resource issues pose an enormous challenge to home care agencies. But when responding to a global pandemic, many agencies found themselves scrambling to address new questions. How do you help employees with childcare challenges? How do you handle on-boarding (and firing) when everyone is working off-site? Who pays for COVID tests, and how should time spent getting the test be compensated? Can employers require vaccinations?

For the 15th episode of Talking Home Care, Pat speaks with Angelo Spinola of Littler Mendelson, a leading employment law litigator about these and other issues. They also discuss the subscription-based, on-line Home Care Toolkit Littler developed and constantly updates. The Toolkit gives agencies access to a world-class HR resource, policy manual, and document library that’s like adding an expert to your staff.

The Home Care Alliance of Massachusetts has negotiated a special agreement with Littler to give our members access to the Toolkit at a great price, with a portion of all sales supporting the Alliance! To learn more or to order your subscription, contact Melissa Mann at MMann@littler.com or (404)760-3928.

You may listen to the podcast by clicking any of the platform images above, clicking “play,” or downloading it directly (Length: 40 minutes; Size: 29 MB).

If you enjoy the podcast, please subscribe and give us a five-star review so others can find it.

Return to www.thinkhomecare.org.

Talking Home Care: Home Care Heroes During a Pandemic

Front-line heroes share their stories about overcoming the challenges posed by the COVID-19 Pandemic.

The COVID-19 Pandemic has created huge challenges to healthcare systems across the globe, including here in Massachusetts. As part of National Home Care and Hospice Month, we collected first-hand stories from our members about the front-line challenges they faced, and how they overcame them.

For the 14th episode of Talking Home Care, we’ve collected these stories into a single podcast. They are introduced by Alliance Executive Director Pat Kelleher and are read by drama students at Winthrop Middle School.

You may listen to the podcast by clicking any of the platform images above, clicking “play,” or downloading it directly (Length: 41 minutes; Size: 29 MB).

If you enjoy the podcast, please subscribe and give us a five-star review so others can find it.

Return to www.thinkhomecare.org.

COVID-19: Where We Are and Where We Are Going

Dr. Ashish Jha of Brown University sees a difficult winter ahead in terms of battling COVID-19, but reasons to hope in the spring.

Dr. Ashish Jha

In mid-November, I had the pleasure of listening to a virtual presentation from Dr. Ashish Jha, Dean of the Brown University School of Public Health, as part of the Massachusetts Association of Health Plans Health Policy Speaker Series. At the time, people were finalizing their Thanksgiving plans while the Coronavirus Pandemic began its fall resurgence.

Dr. Jha expressed deep concern about our present situation. “The virus is in a very bad place,” he said at the beginning of his remarks. In his assessment, there is no doubt that there is more virus in the community today than during the springtime peak, and the current count of 200,000 new cases each day is unacceptable. However, he believes there is a path forward that will bring us to something like pre-pandemic normalcy in the near future, especially with the promise of effective vaccines. As such, he said, our priority must be to save lives during the winter months.

Jha put a great deal of focus on what he called “priorities,” noting that COVID-19 does not care about our priorities are.  In other words, he said, that while he was personally emphatic to our individual needs, the virus does not care that I prioritize seeing some family, but not others.  The virus will spread wherever and whenever it sees fit.

Jha also discussed priorities in the context of the public policy response to the pandemic. He believes maintaining fully operating schools and hospitals should be our sole societal priorities.  Yet, he said, just days before his talk, New York City shut down in-person learning, while continuing to allow people still to dine together indoors. This is, he called “upside-down.“

Jha was, however, not naïve to the fact that shifting our priorities to focus on schools and hospitals is expensive. It means large-scale federal support for restaurants and their workers to survive the winter months.  He recognized this decision is “politically challenging,” as broad economic shutdowns have been unpopular and politicized. But, in his opinion, it is the best way for us to save lives as we await distribution of vaccines.

The more hopeful part of Jha’s presentation centered around the rapid development of vaccines. At the beginning of the pandemic, he admits he hoped for a 50-60% effective vaccine. Now that early data shows two vaccine candidates with 90%+ efficacy, he is extremely hopeful. He also noted that scientific integrity was not compromised through this process, it was just expedited by conducting the typical steps all at once (e.g., simultaneous human and animal studies).

While he said that we must not lose sight of the short-term task at hand (containing the virus during the winter), Jha is hopeful that we could achieve 30% immunity by the end of January, at which point virus-spread tends to naturally slow. By April or May, he hopes anybody who wants to be vaccinated will be. This may sound ambitious, he noted, and distribution nuances as well as vaccine education, will surely slow any rollout; but he saw it as feasible.

In the meantime, he said we must continue to wear masks, get tested, and only see people from our own household.

2020 Annual Report

Our 2020 Annual Report highlights the Alliance and Foundation’s achievements over the past 12 months, including our response to the COVID-19 Pandemic.

Our 2020 Annual Report highlights the Alliance and Foundation’s achievements over the past 12 months.

2020 Annual Report of the Home Care Alliance and Foundation for Home Health

Responding to COVID

Since the onset of the pandemic and the declarations of federal and state emergencies, the Home Care Alliance of Massachusetts shifted much of its attention and resources to COVID-19-related membership support. To that end,
the Alliance:

  • Was the first state to create guidelines for members—both medical and non-medical—admitting COVID-positive patients. This guidance was adopted by many other states and shared by the National Association for Home Care & Hospice (NAHC)
  • Offered regular calls for CEOs of certified and private care agencies to share and learn from each other, as well as calls for clinical directors, HR mangers, and hospice directors
  • Published more than 50 COVID Updates, a new publication exclusively for our members
  • Advocated for, and secured, multiple Medicaid waivers, including full payment for remote visits, waiver of certain in-home assessment requirements, and allowance of a remote audio-visual face-to-face (F2F)
  • Successfully advocated for non-medical home care services to be deemed “essential” to continue operations in the early days of the pandemic as the Baker Administration was issuing business closures
  • Worked with MassHealth on guidance to keep telehealth waivers permanent
  • Hosted more than a dozen webinars on topics such as: accessing the PPP program, documenting telehealth visits for payment, unemployment and COVID, the CARES ACT, and Medicare stimulus funding
  • Advocated with the state for COVID support funding, resulting in Massachusetts being among the most generous states in passing federal Medicaid money to agencies in the form of 10% rate increases for home health, 20% rate increases for continuous skilled nursing, and 10% provider payment relief for providers in the State Home Care Program
  • Answered hundreds of member regulatory questions related to the pandemic
  • Developed and hosted a COVID-19 Resource page that includes Allied member COVID resource services, generating more than 1,500 page views between March and August
  • Secured Board of Registration in Nursing clarification, assuring that the federal change related to NPs and home health services will remain operative in Massachusetts after the State of Emergency
  • Worked with MassHealth on the new agency-directed PCA model program
  • Coordinated strategy with the Home Care Aide Council on expanded services and increased funding in the EOEA home care program
  • Worked with the Massachusetts Medical Society to educate physicians about audio-visual F2F assessment requirements
  • Worked with assisted living facilities and other acute and post-acute providers to educate them on the federal temporary changes to the Medicare homebound requirement
  • Worked with the Betsy Lehman Center on an infection control training and toolbox for use in homemaker and aide training

Other 2019-2020 Work

Among the member supportive services over the past twelve months, the Alliance and Foundation have:

  • Moved the entire Spring Conference and Trade Show to a virtual platform available to members on demand
  • Offered members a one-time 15% dues discount
  • Worked with state legislators and other stakeholders to advance an effective non-medical home care licensure bill; Legislation is unlikely to be signed into
  • law prior to the end of the 2020 Legislative Session
  • Produced a series of videos for our website and for members’ use on working with Private Care home care agencies
  • Provided Get Out the Home Care Vote materials for members to use with their employees
  • Hosted an EVV vendor webinar series
  • Hosted multiple sessions on operating under the PDGM payment system
  • Hosted a virtual Home Care Aide Recognition Day, engaging more than 1,000 people on Facebook and Twitter, honoring 120 aides from member agencies

Guidance for Home Health and Hospice Agencies on Admissions from Hospitals Related to COVID-19

The Alliance has unveiled detailed guidance for agencies regarding admissions from, and discharges to, hospitals related to COVID-19.

Today, the Home Care Alliance of Massachusetts unveiled detailed guidance for home health agencies regarding admissions from hospitals related to COVID-19. The guide is available as a Word document and providers are encouraged to create policies and procedures that reflect their own agencies’ operations, capabilities, and community/patient needs.

The guide was co-authored with Kimberly Skehan of Simione Healthcare Consultants. Because of the nature of the crisis, we are making this available to all agencies, regardless of current membership status.

Specific Topics Covered

  1. Screening and acceptance of home health or hospice patients who have been diagnosed with COVID19 from a hospital
  2. Denial of admission for a home health or hospice patient with known or suspected COVID-19
  3. Pre-visit COVID 19 Screening/Assessment
  4. In Home Visit Considerations for Known or Suspected COVID-19 Patients
  5. Personal protective equipment during home healthcare visits to patients and households with no signs and symptoms of COVID-19, or with a negative test
  6. PPE for a patient with signs and symptoms of COVID- 19, or with a positive COVID-19 test, or with pending test results:
  7. COVID-19: When to Discontinue Transmission-based Isolation Precautions
  8. Patient Education and Reassurance
  9. Hospice Inpatient Unit Considerations
  10. References (CDC guidelines)

For more on the novel Coronavirus, visit the Alliance’s COVID-19 Resource page. To learn more about how the Alliance serves its members and the home care industry, visit www.thinkhomecare.org/join.

COVID-19 Resources for Home Care & Hospice Agencies

To ensure members have access to information they can trust, the Alliance has put together a COVID-19 Resource Page, linking to federal, state, and other essential sources.

COVID-19

To ensure members have access to information they can trust, the Alliance has put together a COVID-19 Resource Page linking to federal, state, and other essential sources.

We’ll update it as new information becomes available.

Return to www.thinkhomecare.org.