Advocacy Alert: Contact Your State Rep. Today to Support Home Care in FY13 Budget

The Massachusetts House of Representatives begins work on their version of the FY13 State Budget today and the Home Care Alliance needs your help sending emails to support home care’s priorities!

Visit our Legislative Action Center or see the issues below to send any of the pre-written messages that concern you and your agency. It only takes ONE MINUTE to enter your contact information, review your information, and the system will automatically send the message to the state representatives for your area.

Urge your state representative to support the following issues:

Restore Home Health Rates

»  Write Your Legislators    »  Read About This Issue  

Support Telehealth Reimbursement from MassHealth

»  Write Your Legislators    »  Read About This Issue  

Support Certificate of Need for Home Care

»  Write Your Legislators    »  Read About This Issue  

Support Pediatric Home Care

»  Write Your Legislators    »  Read About This Issue 

OR

Compose Your Own Message

»  Write Your Legislators

 

Return to www.thinkhomecare.org.

State Budget Update: House Ways and Means Releases Budget Proposal

The House Committee on Ways & Means released its proposal for the state’s fiscal year 2013 budget and while there are few changes in dollar amounts, here are the initial highlights:

  • The MassHealth Managed Careaccount (line item 4000-0500) follows the Governor’s proposal by increasing $183,988,029 over FY12 spending to $4,164,475,376.
  • The MassHealth Senior Care account (line item 4000-0600) also followed Governor’s budget blueprint by increasing $196,976,192 over FY12 spending to $2,763,630,662 .
  • The MassHealth Fee-for-Service Payments account (4000-0700) maintained the Governor’s proposal of increasing $129,850,745 over FY12 spending to $1,939,680,126.
  • Elder Enhanced Home Care Services (9110-1500) was given a bigger increase by House Ways & Means of $827,853 – as opposed to the Governor’s $672,147 – to a total of $47,289,340.
  • The Home Care Purchased Services account (9110-1630) is level funded at $97.8 million.
  • The Elder Nutrition account (9110-1900) is level funded at $6.3 million, which would restore a cut of $1.5 million made by the Governor.

This all essentially means that House Ways & Means followed the Governor when it came to the MassHealth accounts, which were increased with funding, but only to account for anticipated increases in enrollment. This budget proposal also shows a commitment to the state’s Home Care Program and restores the Elder Nutrition Program that funds “meals on wheels.”

What is not seen is increases to MassHealth home health rates or any language related to telehealth services, pediatric home care and a certificate of need process. The Home Care Alliance is pushing for amendments on these matters and will let member agencies, supporters and advocates know when they are officially submitted.

Additional items of note include a special commission to study elder protective services, increase public awareness of elder abuse, and establish reporting mechanisms.

Stay tuned as more information will be reported as it becomes available.

Return to www.thinkhomecare.org.

Governor Releases FY13 Budget Blueprint

Governor Deval Patrick released his proposal for the state’s fiscal year 2013 budget, which sets the stage for the legislature to work out their own versions and come to an eventual agreement over the next six months.

The Governor’s budget does not include any projected increases or cuts for home health, as is the case with most programs (MassHealth Nursing Home Supplemental Rates are reduced from FY12 spending by more than $300 million in the Governor’s proposal).  The MassHealth line items are almost all increased to “meet projected need,” which just translates to level funding. Here is a list of the line-items of note, including the MassHealth accounts.

  • MassHealth Managed Care (line item 4000-0500) increased $183,988,029 over FY12 spending to $4,164,475,376
  • MassHealth Senior Care (line item 4000-0600) increased $196,976,192 over FY12 spending to $2,763,630,662 .
  • MassHealth Fee-for-Service Payments (4000-0700) increased $129,850,745 over FY12 spending to $1,939,680,126.
  • Home Care Purchased Services (9110-1630) had a short increase just over $2,000 to $97,783,061.
  • Elder Enhanced Home Care Services (9110-1500) increased $672,147 to $46,461,487 .

The Governor’s office provides more details on health care costs and reasoning for those decisions here. The Home Care Alliance will continue to provide more information as further analysis is completed. The Alliance will once again be advocating for line items of concern as the budget process moves forward, including on issues like payment rates and telehealth reimbursement from Medicaid.

For more general information, several articles from sources like Boston.com and MassLive.com are available that explain some of the Governor’s budget as well.

Return to www.thinkhomecare.org.

 

EOHHS Hosting FY2013 Budget Hearings

The Home Care Alliance is collecting written testimony and encouraging those interested to present oral testimony for upcoming hearings being hosted by the Executive Office of Health and Human Services (EOHHS) on the upcoming Fiscal Year 2013 budget.

Indications have been made that the upcoming budget will be just as difficult as those in previous years so it is important that home care agencies show up and submit written comments to convey the significance and value of the services they provide. EOHHS is seeking input about the best ways to preserve core services to the fullest extent possible without additional expenditures. As such, the Alliance suggests that agencies promote work in care transitions, disease management, and the general value of keeping people independent at home. The Alliance is also pushing for MassHealth coverage of telehealth technology as well as legislation on nurse delegation of medication administration, which we encourage people testifying to include in their comments.

Secretary JudyAnn Bigby, M.D., and the Assistant Secretaries at EOHHS will be on hand for both hearings so comments should begin by addressing them accordingly. The two hearings will be held this week and next week at the following dates and locations:

Friday, December 2, 2011 from 3:00-6:00 p.m.
Department of Mental Health Western Massachusetts Area Office
Northampton Haskell Building
1 Prince Street
Northampton, MA 01061

Friday, December 9, 2011 from 2:00–6:00 p.m.
Agganis Arena at Boston University
Francis D. Burke Club Room
925 Commonwealth Avenue
Boston, MA 02215-1204

Due to the number of individuals anticipated to attend the hearings, oral testimony will be limited to three minutes per individual. In the interest of time, representative panels are welcome and will be limited to a total of five minutes of oral testimony. If a number of home care agencies are interested, they will be added to a panel as HCA will be attending and testifying at the Boston hearing on December 9th. HCA asks that you also inform us if you sign up to attend or submit written comments on your own.

If you need accommodations please call 617-573-1600 and let the receptionist know.  Additionally, if you are planning to present oral testimony at the Boston hearing, please note that you must be in the building by no later than 5:50 p.m.

Written testimony can be sent to the Home Care Alliance to be submitted collectively, or may be mailed to:

Secretary JudyAnn Bigby, EOHHS
One Ashburton Place, Room 1109, Boston, MA 02108
Or emailed to:  eohhshearings@massmail.state.ma.us

Return to www.thinkhomecare.org.

Gov. Patrick Signs FY12 State Budget

Governor Deval Patrick signed the state’s fiscal year 2012 budget amounting to $30.6 billion with a victory for home health.

Language that would move MassHealth one step closer to reimbursing home health agencies for telehealth services was included in the “MassHealth Managed Care” line item:

…for purposes of long-term health care cost savings and enhanced patient care, the commonwealth may recognize telehealth remote patient monitoring provided by home health agencies as a service to clients otherwise reimbursable through Medicaid

The key word in this language is “may.” MassHealth is not directly instructed in the budget to reimburse for telehealth (as if the word “shall” was used), but it presents the state with the option to do so, which means that continued advocacy will be required to push the state towards that end. This is a solid victory for the Alliance’s budget advocacy thanks to the hundreds of emails that were sent from the HCA website’s Legislative Action Center and to the office of Senator Richard Moore.

Another item of interest is in regards to Adult Day Health where the Governor approved a budget that makes “no changes prior to December 31, 2011 in the clinical eligibility or level of reimbursement paid to providers of adult day health services for basic and complex levels of care.”  The budget also imposes a temporary moratorium on enrollment of new Adult Day Health providers until such time that a study is completed by the Executive Office of Health and Human Services. The study, due to the Legislature by December 31, 2011, will provide a basis for new licensure and rate structure and also will provide a needs assessment of ADH services going forward.

For more information, the full budget is available on Mass.gov.

Return to www.thinkhomecare.org.

State Senate Budget Includes Telehealth

The state senate this week passed a $30.5 billion state budget for FY 2012 that included a major priority of the Home Care Alliance.

An amendment instructing MassHealth to reimburse for telehealth remote patient monitoring provided by a home health agency was adopted by the Senate.  That provision must now survive a conference committee made up of House and Senate members who will work out differences between the House and Senate budget proposals and send the finished version to the Governor for his approval.

The amendment passage is a victory for home health care and reflects a greater understanding from the state legislature on issues important to the industry. Moreover, the adoption of the telehealth amendment, while only a first step in the process, is also recognition of the cost savings that home health agencies and the use of technology can provide.

Most of the 599 budget amendments proposed in the Senate did not make it through, including restoration of MassHealth rates of payment for home health past 60 days, a pediatric home care amendment, and another that would have established a special care transitions rate for home care agencies.

Two amendments regarding adult day health were also adopted.  One would establish licensure standards for adult day health providers and the other would require MassHealth to notify the legislature of any changes to rates or clinical eligibility criteria for adult day health services.

Other amendments of note include:

  • An amendment was adopted that would require MassHealth to annually notify each beneficiary over 65 about their options regarding enrollment in voluntary programs, including Program of All Inclusive Care for the Elderly (PACE) plans, MassHealth Senior Care Options, Frail Elder Home and Community Based Waiver Program and “any other voluntary elected benefit to which such beneficiary is entitled to supplement or replace such beneficiary’s MassHealth benefits.”
  • An amendment was rejected that would allow nursing homes to place a hold on beds for residents who are transferred to the hospital for emergency care.
  • An amendment was adopted to provide an additional $1 million for elder protective services (total amount: $16,250,554).
  • An amendment was adopted to provide an undisclosed amount of funding to elder pre-admission options counseling.
  • An amendment was adopted providing an additional $4 million for Day Habilitation Services
  • The Salary Reserve for human service workers was not approved, but the Senate did approve a substitute amendment enable human service provider agencies to purchase health insurance through the Commonwealth Health Insurance Connector for their employees earning less than $40,000/year.

For any questions or further information on the state budget, contact James Fuccione at the Alliance.

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.

Help Support Home Health Amendments in MA House Budget

A new email message is available on the HCA Legislative Action Center that anyone can send to their local state representatives to help support amendments to the FY12 House budget proposal benefiting home health care.

For those unfamiliar with the Alliance’s advocacy emails, the messages are pre-written and will automatically go to the legislator based on the contact information submitted. Once that information is entered, the message is available for review and can be sent and shared with colleagues, friends, and anyone else interested in taking action.

For those preferring to call their elected officials, but may not have their contact information or know who their state rep is, you can type in your information here to find out.

Below is a list of amendments the Home Care Alliance is supporting:

  • Amendment 529: Pediatric Home Care Services, filed 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.

  • Amendment 554: Patient Care Transitions, filed 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 to 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.

  • Amendment 339: Home Health Payment Rates, filed 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 for patients that require longer periods of care and who are at a greater risk of inpatient facility admissions or readmissions. This amendment would restore that rate.

  • Amendment 681: Telehealth Reimbursement, filed by Rep. John Mahoney.

~This amendment would establish MassHealth reimbursement for telehealth (remote patient monitoring) technology.
~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.

  • Amendment 131: Adult Day Health Services, filed by Rep. Alice Wolf.

~A $55 million cut to ADH services was proposed in the Governor’s budget and this amendment would freeze the level of reimbursement to prevent that from occurring. The amendment would also impose a moratorium on new ADH facilities.

See the full list of House budget amendments here.

Return to www.thinkhomecare.org.

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