Tag: MassHealth

Massachusetts Medicare Program.

State Budget Process Moves to Conference Committee

As expected, the House and Senate Chairs of their respective Committees on Ways and Means will co-chair a six-member conference committee that will work out the differences between the House and Senate budget plans.

The House-approved plan calls for $36.32 billion while the Senate plan was set at $36.4 billion. Although they are similar in terms of total amounts, there are some important differences in both funding support and policy changes.

The Home Care Alliance sent a letter outlining those differences as they pertain to home care services in a letter to each conference committee member.

Here are the main bullet points from that letter where the HCA is asking for support:

  • Senate Amendment #929: Home Telehealth
    • This language was passed in the FY14 budget and allows MassHealth the policy support necessary to continue work on establishing rates and guidelines for home telehealth services.
    • Home Telehealth involves remote vital signs monitoring equipment. This service offers immediate cost savings by reducing the frequency of home health visits paid for by MassHealth, along with reduced hospitalizations through improved medication adherence, patient self-management and timely follow-up care.
  • Senate Amendment #683: Homemaker Wage Increase
    • Approved by a unanimous roll call vote in the Senate, this amendment increases pay by approximately $.75 cents per hour for homemakers and personal care homemakers serving clients enrolled in the Executive Office of Elder Affairs Home Care Program.
  • Senate Outside Section Relative to the Home and Community-Based Services Policy Lab
    • This language and corresponding funding would support the study of the cost-effectiveness of state-funded home and community-based services.
  • House Support for Elder Services Home Care Purchased Services (9110-1630)

The Alliance encourages home care agency members and advocates to contact the conference committee this week to ask for their support using the bullet points above. Here are the names and contact info for conference committee members:

Return to www.thinkhomecare.org.

Upcoming One Care Shared Learning Conference

MassHealth and UMass Medical School are hosting a One Care Shared Learning Conference at three different locations across the state in early June.

June 3, 2014 June 10, 2014 June 18, 2014
7:30 A.M. – 1:00 P.M.
Springfield Marriott
2 Boland Way,
Springfield, MA 01103Register for the
Springfield Conference
Before May 23, 2014		 7:30 A.M. – 1:00 P.M.
Best Western Royal
Plaza – Marlborough
181 Boston Post Rd. W,
Marlborough, MA 01752Register for the
Marlborough Conference
Before May 27, 2014		 7:30 A.M. – 1:00 P.M.
Four Points by
Sheraton – Norwood
1125 Boston Providence Turnpike,
Norwood, MA 02062Register for the
Norwood Conference
Before June 4, 2014

This conference will focus on “Integration of Primary Care, Behavioral Health and Community Supports in Real Life Cases: Developing and Implementing Person-Centered Care for People with Complex Health Care Needs.”

Who should attend?

This conference is primarily for primary care providers (PCPs), behavioral health clinicians, long term services and supports (LTSS) providers – including home care agencies – and other community based organizations involved in One Care.

This conference will focus on the collaboration among the members of an integrated care team, focusing on each of their roles in developing and implementing person-centered care for people with complex health care needs. There are a limited number of spots available, and One Care plan staff and their contracted providers will be given priority.

To register for one of these conferences or for more information, visit www.mass.gov/masshealth/onecare/learning

Download the Conference Agenda(https://onecarelearning.ehs.state.ma.us/pdf/One-Care-Conference-Flyer-Agenda.pdf

Return to www.thinkhomecare.org.

Advocacy Alert: Call and Email Your State Senator TODAY!

The budget amendments important to home care are up for debate today in the MA-State-HouseMassachusetts Senate.

The Home Care Alliance’s priority amendments include restoring the 20-percent rate cut for MassHealth home health visits past 60 days, creating a commission to study home health services and recommend oversight measures, and allowing MassHealth to continue their work to establish telehealth services provided by home care agencies.

We need calls and emails to be made NOW to senators to get support for the following amendments:

  • #684 – Senator Patricia D. Jehlen: Study Commission for Home Health Care Services and Oversight

Purpose: The Commonwealth is one of only five states without either licensure or a “determination of need” process for oversight of home health care. In recent years the Commonwealth has experienced rapid growth in the number of certified home health agencies. This proposal is in response to that growth and would help to identify the current number of home health agencies, services provided and available by region, and create recommendations for state oversight and quality standards.

  • #839 – Senator Kathleen O’Connor-Ives: Restoring Home Nursing Rates

Purpose: This budget language seeks to restore the MassHealth rate for home health nursing visits past 60 days of care to the payment level prior to the rate cut of December 1, 2008 so that patients with the most severe conditions can have their care continued and remain independent at home. This amendment creates a consistent rate for as long as an individual on MassHealth requires home health care.

  • #929 – Senator Richard T. Moore: Establishing Reimbursement for Telehealth Services Provided by Home Health Agencies

Purpose: Maintain language from the FY2014 budget that established MassHealth reimbursement for home telehealth services provided by a home health agency, immediately providing cost savings and more efficient care. MassHealth is in the process of building corresponding rates and guidelines.

The Alliance is also supporting the Homemaker Wage Increase (#683) and increased funding for the state’s elder services programs (#687).

A full update will be available when the Senate completes debate, but HCA members and advocates can still send an email to their state senator here and follow the Alliance on Twitter (@thinkhomecare) for updates.

Return to www.thinkhomecare.org.

State Senate Proposes $36.2 billion Budget Plan with New Opportunities for Home Care

The Massachusetts Senate’s Ways & Means Committee took their turn in the state budget-crafting process with a $36.2 billion proposal that increases total state spending by almost $1.7 billion from this year.

Although some programs in the Elder Services line items took a hit, as did the MassHealth Senior Care Account, the Senate proposed other new items that pose potential opportunity.

In what is known as an “outside section,” which is a section of an appropriation bill that can create new policies, the Senate created a Home and Community-Based Services Policy Lab. According to the language, the policy lab would start with $500,000 of state funds to evaluate and analyze the outcomes and effectiveness of home and community-based services under the Secretary of Elder Affairs. This includes the state Home Care Program administered through Aging Service Access Points (ASAP’s) that contract with Home Care Alliance members.

This “policy lab,” which appears to be a program evaluation of state government-funded home and community-based services, could be the beginning of proving the effectiveness of services such as those provided by home care agencies. More information on this will be released as details are released.

Also, in another “outside section,” the Senate Ways & Means Committee created a new Community First Trust Fund, which is intended for enhanced federal financial participation (FFP) funding for the state that is tied to the Balanced Incentive Payment program (BIP), among other programs. In a previous blog post, the HCA reported on the state’s intentions around the BIP initiative that will bring more support to non-institutional long-term care services.

More budget analysis will come out in the coming days, including the Home Care Alliance’s budget amendment priorities where HCA members can help by contacting their state senators. The Alliance plans on repeating proposals to advance telehealth in home care, better MassHealth rates, and a study commission of home health care services and possible oversight recommendations.

Return to www.thinkhomecare.org.

Advocacy Alert: Help Gather Support for Home Care Budget Amendments

The Home Care Alliance’s priority amendments in the House budget now have numbers, which means you can email or call your state representative and easily ask that they support these important policies to advance home care services!

  • Amendment #968: Rep. Sean Garballey’s amendment to restore the MassHealth rate for home health nursing visits past 60 days of care to the payment level prior to December 1, 2008 so that patients with the most severe conditions can have their care continued and remain independent at home. MassHealth cut the rate once a person was receiving home nursing for more than 60 days, which runs counter to the state’s goal of keeping people in the community and driving down the cost of care.
  • Amendment #89: Rep. Kate Hogan’s amendment to study home health service capacity in the Commonwealth and recommend policy strategies for better state oversight of home care agencies. Massachusetts is one of only five states without either licensure or a “determination of need” process for home health agencies. In recent years the Commonwealth has experienced rapid growth in the number of certified home health agencies. This proposal is in response to that growth and would help to identify the current number of home health agencies and their licensure and ensure high levels of quality home care.
  • Amendment #491: Rep. John Mahoney and Rep. Mark Cusack’s amendment that would establish MassHealth reimbursement for telehealth services provided by home health agencies. This amendment was successfully passed in last year’s budget and this year’s version will ensure MassHealth is statutorily able to finish their work in creating a regulatory and reimbursement structure.
  • Amendment #775: Rep. James O’Day’s amendment to reestablish the Homemaker Wage Increase account. This appropriation would provide an annualized wage increase of approximately 75 cents an hour to over 17,000 homemakers and personal care homemakers.

Our Legislative Action Center makes it easy to advocate. Just click on the FY15 budget message, fill in your contact info, and hit send! The system will automatically send the message to your state representative.

You can also call 617-722-2000 and press “2” to speak to an operator in the House of Representatives to urge your State Rep to support amendments #89, #491, #775 and #968. You can use the talking points above when speaking to an aide or leaving a message.

Contact James Fuccione at the Alliance with any questions.

Return to www.thinkhomecare.org.

House Ways & Means Releases Budget; Call Now To Support Amendments!

The state’s House Committee on Ways & Means this week released its proposed $36.2 billion fiscal year 2015 budget.

The House budget closely follows the Governor’s budget proposal in most line items related to home care providers, with slightly smaller allocations for MassHealth Senior Care Plans,boston-statehouse and EOEA Administration, and slightly more funding for local Councils on Aging. The House budget does not include the $1.2M Home Care Workforce Training Fund that was in the Governor’s budget.

Several legislative champions will be submitting amendments to the budget at the request of the Alliance. HCA members are encouraged to contact your local state representative TODAY and urge them to co-sponsor the budget priorities listed below.

A pre-written email is available on the Alliance’s Legislative Action webpage. For those choosing to call their local Representatives, please use the information below. Reps can offer formal support by contacting the office of the Representatives that are filing the amendments. Continue reading “House Ways & Means Releases Budget; Call Now To Support Amendments!”

Governor’s Budget Gives Big Support to ASAP, Home Care Programs

Despite having his state of the Commonwealth address delayed by a snowstorm, Governor Deval Patrick was required to release his budget proposal this past Wednesday to officially kick off budget deliberations for fiscal year 2015.

A huge win for elder home care services came in line items that support the Aging Service Access Points and state Home Care Program, which received an additional $16.9 million, according to Executive Office of Elder Affairs Secretary Ann Hartstein. Among those funds are increases of $9.8 million for the Enhanced Community Options Program (ECOP) and $7.5 million for the “basic” category of services.

Combined, according to Secretary Hartstein, those two line item increases will eliminate waiting lists through the end of fiscal year 2015. The funding boost works out to an additional hour of homemaking services per consumer per month on average, but Secretary Hartstein stressed that, in reality, the money would pay for whatever services people may need when they need them.

The Governor also put a $1.3 million increase to the Senior Supportive Housing account, which will expand “assisted living facility-type services” for seniors in public housing. Specifically, the money will add another 10 public housing sites where senior residents will be supported by home care services.

Another $1.2 million was added in a new line item titled “Home Care Workforce Training Fund.” This new account will support workforce training for Aging Service Access Points, although the administration is not yet clear on which workers will receive training. Case management, protective services and direct care workers are all on the table as potential recipients.

MassHealth experienced major changes in the budget, mostly related to federal healthcare reform. Since the MassHealth Basic and Essential programs were eliminated, a combined $706.3 million is now in populations with expanded coverage and in the new MassHealth plans.   The MassHealth Senior Care account was granted another $271.4 million by the Governor and the MassHealth Managed Care account saw an additional $336.7 million. The MassHealth Fee-for-Service line item was raised by $205 million. It is unclear how these increases might result in better reimbursement rates for home health agencies. A formal rate reassessment hearing is still being eagerly awaited.

Other items of note from the Governor’s budget include the following:

  • Applying the state sales tax to candy and soda. The administration estimates that would raise roughly $57 million for health promotion and prevention programs.
  • The Governor’s budget cuts the MassHealth Nursing Home Supplimental Rates by $20.7 million
  • Pediatric Palliative Care is essentially level funded at just over $1.5 million
  • The Governor’s budget includes a special fund for federal assistance (FMAP) relative to health reform and healthcare access expansion called the Health Insurance Expansion Fund.
  • The DPH budget gets an overall increase of 1% with details in Commissioner Cheryl Bartlett’s “Mass Public Health” blog post.

Stay tuned for more  budget-related news and advocacy alerts.

Return to www.thinkhomecare.org.

Mass. EOHHS Holding FY15 Budget Hearings

A pair of public hearings will take place in Amherst and Boston this month to help guide the state’s Executive Office of Health and Human Services as they look to shape their fiscal year 2015 budget.

It is well documented that approximately half of the state government’s budget goes to health and human services so the department is constantly encouraged to find ways to do more with less.

HCA members and advocates are encouraged to email written comments to eohhshearings@massmail.state.ma.us by the time of the Boston hearing on December 11th. Subjects should include and focus on the following:

  • Raising MassHealth rates for skilled nursing
  • Encouraging a certificate/determination of need process for home health agencies
  • Urging formal support for S.1064, An Act Relative to Home Health and Hospice Aides, which allows nurses to delegate limited medication administration tasks to home health aides and CNA’s. With the hearings focusing on the EOHHS budget, commenters should focus on potential cost savings potential of “nurse delegation” issue.
  • Highlighting your agency’s efforts to reduce readmissions and other cost-effective programs.

For those interested in attending the hearings, the Amherst hearing will take place on December 6th from 10:00am to 2:00pm at Commonwealth Honors College while the Boston hearing will take place from 2:00pm to 6:00pm on December 11th at the UMass Boston Campus Center.

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

Return to www.thinkhomecare.org.

Budget Passes With Telehealth, Pediatric Palliative Care Funding

After years of advocacy and passing budget items with weak language that did not compel MassHealth to act, the Governor signed off on the $33.6 billion FY2014 state budget with a provision that recognizes home telehealth as a reimbursable service.

There is still plenty of work to be done with MassHealth, but passing the telehealth language in the budget is the furthest the Home Care Alliance has gone towards achieving reimbursement for an established service known to create efficiencies, improve care, and reduce costs.

The Alliance will be including a push for telehealth in comments on the state’s proposed home health regulation changes. Any agencies or advocates interested in commenting with HCA in an attempt to have the state include telehealth reimbursement in regulation to ensure its permanence should have a letter in to MassHealth by the July 26th deadline. Agencies can contact James Fuccione at the Alliance for details.

Also included in the the final budget is $1.5 million for the Pediatric Palliative Care Network, which serves the unmet physical, emotional, social and spiritual needs of children in Massachusetts with life-limiting illnesses. This is more than $670,000 of additional funding over previous budgets.

The Alliance would like to thank all the agencies and advocates who sent emails, made phone calls, met with legislators and otherwise supported telehealth and the pediatric palliative care funding. These items passing in the final budget represent a huge victory for home care and prove that persistent advocacy pays off.

Return to www.thinkhomecare.org.

Advocacy Alert: Send a Message to Support Telehealth and Pediatric Palliative Care

The Massachusetts House and Senate have named members of a select “conference committee” that will work to negotiate differences between the House and Senate budgets for a final version to be sent to Governor Patrick.

Please visit the Home Care Alliance’s Legislative Action Center and send a message to the conference committee members to support two important budget amendments. The message will automatically be sent to conference committee members.

The first (Senate Amendment #718) would create MassHealth reimbursement for telehealth services provided by a certified home health agency.  Language was included in previous budgets with weaker language that did not compel MassHealth to act. This year we again seek the inclusion of this cost-saving service with the words “the commonwealth shall recognize telehealth remote patient monitoring provided by home health agencies as a service to clients otherwise reimbursable through Medicaid” as stated in Senate amendment #718.

The second amendment (Senate amendment # 629) would add $674,789 to the state’s pediatric palliative care program, which serves the unmet physical, emotional, social and spiritual needs of children in Massachusetts with life-limiting illnesses.

Since both of these amendments were approved in the Senate budget, but not the House, advocates have to urge that conference committee members support the inclusion of the amendments in their negotiated version. If you live in the area of one of the conference committee members and would like to advocate for these amendments directly, the committee members are listed below with link to their profile pages (including contact info) on the state legislature’s website.

It only takes a minute to send a message and advocate for these important issues!

Return to www.thinkhomecare.org.