Tag: Home Health Care

2016 “Our Time to Shine” Innovation & Star Awards a Success!

HCA-assets(1)The Home Care Alliance of MA hosted their Annual “Our Time to Shine” event on Tuesday, June 14, 2016 at the Granite Links Golf Club in Quincy, MA. With 10 Star Award winners, 3 Innovation winners, and over 150 in attendance it was a great day to celebrate home care!

*Preview just some of the pictures for the event below. More photos to come!*

Congratulations to our winners:

 

Clinicians of the Year:
Anne Luippold, RN, BSN, ONC, Salmon VNA & Hospice, Milford
Michelle Michaud, RN, Circle Home Care, Lowell
Mary NDegwa, RN, Comfort Home Care, Methuen

Aide of the Year:
Jane Rizza, Home Care Inc., (Home Health VNA), Westwood

Leadership & Collaboration Award:
Roxanna Harper & Jo Ann Wagner, Baystate VNA & Hospice, Springfield

Manager of the Year:
Darlene Connolly, RN, Steward Home Care, Lawrence

Physician of the Year:
Dr. David Green, Emerson Hospital Home Care, Concord

Legislator of the Year:
Senator Barbara L’Italien, D-Andover

Home Care Champion:
Meg Doherty, NVNA & Hospice, Norwell

Innovation in Staff Development:
Comfort Home Care, Psychiatric Nursing Board Certification Program

Innovation in Patient Care Deliver:
Partners Health Care at Home, Mobile Observation Unit

Commitment to an Innovation Culture:
South Shore Hospital Home Care Department, The MakerNurse Project

Here’s just a preview of pictures from this great event!

Advocacy Alert: Gain Support for the Home Care Oversight Commission

The roughly $40 billion that will make up the legislature’s FY17 proposal must first go through a six-member “conference committee” that will negotiate on differences between the House and Senate budget versions.

Included in the Senate version was a special commission that will study, discuss, and make recommendations on separate policies for state-based oversight of home health and private-pay home care agencies. It will take advocacy to ensure that this important provision is included in the conference committee’s negotiated budget, and action can be taken through the HCA’s Advocacy Center.

Simply fill out the contact forms and hit “send” to help gain support for the Home Care Commission!

The Commonwealth is one of five states without either licensure or a “certificate of need” process for home health care services. Massachusetts has also recently experienced rapid growth in the number of “certified” home health agencies. The related and significant spike in MassHealth spending has forced the state to establish program integrity measures on these agencies.

Likewise, private-pay home care agencies across the state that provide mostly non-medical support services in the home have no state oversight and a study commission is needed to determine the best solution.

The Alliance will continue to update it’s members on this proposal.

Return to www.thinkhomecare.org.

Advocacy Alert: Help Gain Support for Home Care in the Senate Budget

ma budget pie chart picThe Massachusetts Senate is taking their turn in the fiscal year year 2017 state budget process with a $39.49 billion proposed starting point.

Senators have filed just over 1,100 amendments seeking to add a combination of funding and policy language that will be debated next week, but advocacy is needed to gain support for the issues critical to home care agencies.

The Home Care Alliance’s Advocacy Center features prepared emails focused on these issues that can automatically be sent to your state senator. Click here to send a message on all of HCA’s priorities – OR send a specific message to urge support for improved home health aide reimbursement or a study of MassHealth reimbursement for all home health services.

Here are explanations of the Alliance’s priority items:

MassHealth Reimbursement to Home Health Aides – Amendment #596 (Senator Barbara L’Italien)

  • Home Health Aide Rates have not been reviewed since 2007.
  • This amendment raises the rate MassHealth reimburses home health agencies for home health aide services by 12% at a cost to MassHealth of $3.66 million which after federal match becomes $7.32 million.
  • This increase would also effect the purchase of home health aide services ordered through the state network of Aging Service Access Points (ASAPs) at a cost of $5.25 million.

MassHealth Home Health Reimbursement Review – Amendment #470 (Senator Joan Lovely)

  • Home health care is a cost-effective service that allows people of all ages – from maternal-child health services and pediatric patients to the elderly –to remain independent in their homes where they are most comfortable and at a lesser expense to their families and the Commonwealth.
  • Payment rates have not been reviewed since 2007. Current rates are based off of 2005 data and were cut in 2008.

Homemaker Wage Increase – Amendment #591 (Senator Michael Barrett)

  • On average, this request will provide an increase of $.50 per hour to homemakers and personal care homemakers providing care to clients enrolled in the Elder Home Care Program
  • This budget request will include language to raise the EOEA average compensation mandate in ASAP contracts from $12.69 per hour to $13.19 an hour for FY17

The Home Care Alliance appreciates that the Senate Committee on Ways & Means included language for the Home Care Oversight Commission, which seeks to convene legislators and stakeholders to recommend separate standards for licensure for private-pay home care and Medicare-certified home health.

The HCA is also supporting amendments, including #597 (Sen. L’Italien) to expand eligibility for in-home elder services and #622 (Sen. Humason) to bring Massachusetts into the Nurse Licensure Compact.

Other noteworthy items in the Senate budget include the following:

  • $2.6M for Pediatric Palliative Care, an increase of $800K over FY 2016 funds to meet the needs of terminally ill children and their families and eliminate the wait list for these critical services.
  • $200,000 for the Nursing and Allied Health Workforce initiative through the Mass. Department of Higher Education. Senator Michael Moore has proposed an amendment (#136) to raise the amount to $400,00, but this item from Senate Ways & Means goes a long way to ensuring that the item will be funded at previous levels.
  • Following the Governor’s lead, the Senate consolidated the Elder Enhanced Home Care (ECOP) line item and moved that funding to other accounts.
  • Nursing Homes secured $30 million (half of which will come from an added assessment on facilities) for added CNA reimbursement.
  • Nursing Home Supplemental Rates matched the Governor’s FY17 proposal at $332.9 million, which is $15 million below what the House approved.
  • The Home & Community Based Services Policy Lab also received funding not included in the House budget, which will help the state study the cost-effectiveness of certain long-term services and supports.

Return to www.thinkhomecare.org.

Special Guest Blog Post: Recognition and Advocacy During National Nurses Week

by Diane Jeffery, Executive Director of American Nurses Association – MassachusettsANA-MA

In celebrating National Nurses Week (May 6-12), we are, of course, taking the time to appreciate and recognize the daily contribution that nurses make to improving patients’ lives, but we are also focused on improving and advancing nursing as a profession – this week, and every week.

The theme of 2016 National Nurses Week is “A Culture of Safety – It Starts with YOU!” With that in mind, the American Nurses Association (ANA) is asking nurses to take personal responsibility in helping make their workplaces safer to enhance patient care and nurses’ health and well-being. We invite home health agencies to visit NursingWorld.org to view resources on how you can celebrate and recognize your nurses.

We are also pleased to carry out that vision in our advocacy. At the national level, ANA supports the Home Health Planning Improvement Act, which would allow Advanced Practice Nurses – including nurse practitioners, clinical nurse specialists and certified nurse midwives – to sign home health plans of care and certify Medicare patients for the home health benefit.

While APRNs satisfy Medicaid’s face-to-face requirement needed before home health can be authorized, APRNs are prohibited from signing home health plans of care and certifying Medicare patients for the home health benefit. This creates unnecessary delays and places impediments between an individual and the in-home care that they prefer and medically deserve.

At the state level, ANA-Massachusetts has long been a supporter of An Act Relative to Home Health and Hospice Aides, better known to some as the “Nurse Delegation” bill. It would allow, but not mandate, that a nurse may delegate certain medication administration tasks to a trained and certified home health or hospice aide.

Massachusetts is behind 36 other states that allow some type of delegation. If we are to care for an aging population, reduce costs by strengthening healthcare in the home and create efficiencies in our healthcare workforce, we need to elevate nurses to practice at the top of their license and elevate the aides that are critical team members.

Return to www.thinkhomecare.org.

Boston Globe’s ‘Salute to Nurses’ Recognizes Home Care

Home care had a prominent place in this year’s “Salute to Nurses,” a special section published every year in the Boston Globe recognizing the work of nurses in every health care setting.

The compassionate and high-quality care of nurses from several home care agencies were recognized, including CareGroup Parmenter Home Care & Hospice, Comfort Home Care, Emerson Hospital Home Care, Hallmark Health VNA & Hospice, and Home Health VNA. Many more stories from patients, their families and nurse colleagues highlighted cases where a nurse from a setting other than home care arranged for post-acute services or follow-up in some way.

Although it wasn’t from a traditional home care agency, another article was dedicated to Allison Neff, a  nurse in Boston Medical Center’s “Elders Living at Home” Program. The article explains:

Neff joined the Elders Living at Home Program, which prevents homelessness among seniors, in 2008. Her job is to conduct home visits to ELAHP patients who don’t qualify for visiting nurse services provided by the state, but who need assistance with some aspect of their health. Many of her patients are at imminent risk of losing their housing, or were homeless and are now transitioning into housing.

The Home Care Alliance will be recognizing all levels of home care staff at the annual Innovation Showcase & Star Awards on June 14th. Clinicians, aides, managers, physicians and other home care champions can be nominated for recognition at the event’s website.

Return to www.thinkhomecare.org.

 

House Releases FY17 Budget Plan and Rearranges Elder Services Funding

With a $39.4 billion FY17 state budget plan, the House Committee on Ways & Means kick-started the legislature’s budget deliberations.

As always, a significant portion of that total – $15.4 billion in proposed spending – is allocated for MassHealth programs. In their executive summary, House budget writers noted that MassHealth spending growth has been limited to 5%. They also mention that their budget plan “supports enhancements to the eligibility systems, caseload management and program integrity efforts, especially in the area of long term care, which ensures that our significant investments are being well spent, which is crucial to providing healthcare to some of the Commonwealth’s most vulnerable residents.”ma budget pie chart pic

That “support” could be part of the $8 million increase in the EOHHS administration line item (400-0300) as it does not show up in the line item specifically set aside for audits of MassHealth providers and utilization review (4000-0301). That item was actually set by the House at $413,000 less than FY16 spending.

Meanwhile, the House restored the Enhanced Home Care Services Program (ECOP) that Governor Charlie Baker consolidated into other items. With ECOP funded at $74.3 million, it comes in at $3.7 million above the FY16 spending level. That leaves some items noticeably lower than Governor Baker’s budget plan, but it also falls below what the state spent in FY16.

For example:

  • Elder Home Care Purchased Services is $3.1 million below FY16 spending
  • Elder Home Care Case Management and Administration is $2.6 million below FY16 spending
  • Elder Nutrition (Meals on Wheels) is more than $746,000 below what was even set in the FY16 budget

Other newsworthy items from the House Ways & Means budget proposal include the following:

  • $250 million assessment on hospitals that will support new MassHealth accountable care organization (ACO) incentive payments, which the Hospital Association supports with certain conditions.
  • $5.7M for the Supportive Senior Housing Program, an item not included in budgets of previous years.
  • $15 million above the Governor’s proposed spending for Nursing Home Supplemental Rates.
  • $4.5 million above FY16 spending for Elder Protective Services.

The entire House Ways & Means budget can be found here. The Home Care Alliance will be working with State Reps to sponsor amendments creating a home care licensure commission, increasing MassHealth reimbursement for home health aides, and for EOHHS to conduct a full review of home health reimbursement. The Alliance will be fully partnering with other organizations to push a homemaker wage increase, expanding income eligibility for elder home care services, and other items.

More information on advocacy efforts will be released soon and the budget items will be a focus of HCA’s lobby day at the state house on April 28th. Contact James Fuccione at the Alliance for details.

 

Return to www.thinkhomecare.org

 

Unique, Grant-Funded Training Opportunity for Central Mass. Home Care Workers

Registration is OPEN NOW for the first Community Health Worker (CHW) Registered Apprenticeship Program established in Massachusetts and one of only a few in the nation.

The Center for Health Impact TM (formerly known as Central MA AHEC) in Worcester, Massachusetts is delighted to report that the Fairlawn Foundation Fund of the Greater Worcester Community Foundation has awarded funds to establish the creation of a Community Health Worker (CHW) Registered Apprenticeship Program in Central Massachusetts.

Apprenticeship is a flexible training system that benefits both employers and workers through its structured on-the-job learning and job-related classroom instruction. (Learn more about Apprenticeship USA at: https://www.doleta.gov/OA/apprenticeship.cfm.)

The 150-hour course, anticipated to start on April 5th, 2016 (pending enrollment/subject to change) will be offered free of charge to qualified applicants in Central Massachusetts by the Center for Health Impact TM Outreach Worker Training Institute (OWTI) in Worcester. Participants will earn a certificate of course completion aligned with the requirements established by the Massachusetts Board of Certification of CHWs.

To qualify, an individual must be employed or about to be employed with an employer who will:

  • Provide them 2200 hours of on-the-job paid apprenticeship learning and supervision in one calendar year
  • Reward the apprentice for skills gained by an increase in pay within one calendar year
  • Authorize the apprentice to attend the 150-Hour course (120 hours of class time; 30 hours of homework).

Benefits for employers:

  • Access to free CHW core competency training for employees
  • Access to incentives as an employer working with the CHW Registered Apprenticeship Program
  • Well trained and job proficient employees who meet employers’ specific needs
  • Enhanced employee retention
  • Improved service delivery

For questions, or to request the registration package for the Community Health Worker (CHW) Registered Apprenticeship 150-Hour Certificate Course, please contact: Tatyana Gorodetsky,  at tatyana@centerforhealthimpact.org or by phone at: 508-556-1332.

Health Care Innovation Grant Opportunity Released by HPC

After months of planning, the state’s Health Policy Commission has released the RFP for their Health Care Innovation Investment Program (HCII).

An initial round of $5 million will be distributed to applicants that partner with other organizations to propose innovative, multi-stakeholder payment and care delivery models with an emerging evidence base of cost savings. Among the focus areas are post-acute care, end-of-life care, behavioral health integration and social determinants of health.

Since this is being administered by the HPC, aside from the benefit of getting a grant any successful applicants will have the added benefit of having their project be high-profile and also a higher likelihood of influencing policy for others.

The HPC has posted the following schedule for due dates and information sessions:

  • Information Sessions:  

    March 16, 2016 – 10:45 AM, HPC Offices

    March 25, 2016 – 10:45 AM – Webinar (Register Here)

  • Letter Of Intent Due Date: April 8, 2016 by 3:00 PM EDT
  • Proposal Due Date: May 13, 2016 by 3:00 PM EDT
  • Anticipated Awardee Announcements: July 2016
  • Anticipated Period of Performance: October 2016 to September 2018

The Home Care Alliance strongly encourages both home health care and private pay home care agencies to apply. More information is available on the HPC’s HCII webpage and any questions or guidance on the program can be directed to James Fuccione at the Alliance.

Return to www.thinkhomecare.org.

HCA Applauds Tele-monitoring Support from MassHealth

After years of advocacy with the legislature and working collaboratively with MassHealth, the Home Care Alliance proudly testified at a public hearing on proposed remote patient monitoring (RPM) payment rates and regulations this week.

Alliance Legislative and Public Affairs Director James Fuccione commented that reimbursement for RPM will strengthen the ability of home health agencies to carry out their mission of keeping people healthy at home and commended MassHealth for including a broad definition that will allow agencies to be creative in their use of the service. Dana Sheer, NP of Partners Healthcare at Home, also submitted comments in support of RPM and offered recommendations on clarifying language.

The Alliance asked for clarification on a number of points, including whether an “installation/removal” fee of $50 would be paid by MassHealth for both or on each end of the set-up and removal of RPM equipment. HCA suggested that the fee be raised to $75 and paid on both ends. Additionally, the Alliance asked for guidance on how to proceed when multiple patients in the same setting could benefit from RPM services. Comments from the Alliance suggested that RPM could go a long way in assisting patients with behavioral health and substance abuse issues as well.

In his testimony, Mr. Fuccione raised the ongoing concern regarding MassHealth rates for nursing, therapy, and home health aide visits, and urged MassHealth to expedite a review and update of those rates.  He noted that the Alliance has had several recent meetings with MassHealth staff focusing on that very subject. However, the hearing was centered on the tele-monitoring proposal and the Home Care Alliance is thrilled to have spearheaded the push for reimbursement.

Massachusetts is one of only a few state Medicaid programs with financial support for RPM, which will be effective this November. MassHealth explained at the hearing that they expect a savings just within the home health program of $1.4 million.

The Alliance’s comments are available here and more updates on any changes MassHealth may make based on our comments will also be sent to member agencies.

Return to www.thinkhomecare.org.

Notice of Observation Status Law Signed by President

Legislation requiring hospitals to notify Medicare beneficiaries when they are technically in an outpatient “observation” status was recently signed into law by President Obama.

The NOTICE ACT (Notice of Observation Treatment and Implication for Care Eligibility) requires hospitals to inform patients of their status when they are in observation, but not officially admitted, for more than 24 hours and classified as an outpatient. A written notice must, among other points, state that the beneficiary’s outpatient stay will not count toward the three-day inpatient stay required for the individual to be eligible for Medicare coverage of a stay a skilled-nursing facility. Hospitals will have until August 2016 to comply with the new law.

The NOTICE Act is good news for the home health agencies because tracking the status of the patient hospital stay proved to be a challenge. Patients were often unaware of whether their stay with the hospital was an inpatient admission or an observation stay leaving the HHA uncertain if Transfer/ROC OASIS were needed. Now with the implementation of this notice the HHA will be able to determine an observation stay and know that a Transfer/ROC OASIS is not needed. An Agency may choose to complete a “Significant Change in Condition” OASIS (Reason for Assessment, 5- Other follow-up) based on their agency policy.

Return to www.thinkhomecare.org.