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.

State Senate Releases FY14 Budget Proposal

The Senate Committee on Ways & Means continued the state budget-making process today by releasing their version of the FY14 budget, which will be debated before the full Senate next week.

The $33.92 billion proposal is a $1.4 billion increase over estimated FY13 spending, but $904.3 million less than what the Governor proposed. The Senate Ways & Means version is also $67.5 million less than what the full House of Representatives approved in their budget last month.

Here are some items of note:

  • $4.5 billion for the MassHealth Managed Care line item – $39.5 million over the final House budget.
  • $2.9 billion for the MassHealth Senior Care line item – $42.5 million over the final House budget.
  • $187.2 million to fully fund the elder home care programs, an additional investment of $6.2M over FY 2013, to eliminate the current waitlist of 1,500 seniors. This includes $98.7 million for Home Care Purchased Services.
  • $10.5 million for Grants to Councils on Aging, increasing support to $8 per elder, marking the highest ever level of state support for councils on aging.
  • $2.1 billion for the MassHealth Fee-for-Service line item – $7.2 million LESS than the final House budget.
  • Level-funding the Pediatric Palliative Care Program.

The Home Care Alliance will again be working with Senators to file three budget amendments to create a home health certificate of need program, establish MassHealth reimbursement of home telehealth, and strengthening pediatric home health.

As the Alliance works over the next few days to submit these amendments, association members and advocates should be on the lookout for “advocacy alerts” with message templates that can be sent to Senate offices. Of course, more information on budget development will be released as it becomes available.

Return to www.thinkhomecare.org.

Home Care & Telemedicine

NPR’s Talk of the Nation had a lengthy segment on the growing use of telemedicine, especially in home care.  In addition discussing the benefits to patients with limited mobility or access to specific services they need and Medicare’s current refusal to reimburse for remote doctor consultations, the segment included a letter from the Alliance’s own James Fuccione, starting at 19’09”:

[HOST NEAL] CONAN: Here’s an email question that has some aspects of that that I wanted to ask you about, this from James [Fuccione] in Massachusetts: The Home Care Alliance of Massachusetts is advocating for Mass Health, [the] state Medicaid program, reimbursement of telehealth used by home health agencies.

Many agencies part of our association use telehealth already because it improves their quality and efficiency. They use wireless weight scales, blood oximeter, blood pressure cuffs, et cetera, and depending on their condition. So in other words you can collect data over these same circuits.


CONAN: Do you use that as well?

EDISON: Yes, so we do a lot of telehome care and remote monitoring here in Missouri. One of our large home health agencies in the southwest part of the state is probably the leader in that area. One of the challenges, of course, is the inter-operability of the health information systems. So as health information technology matures, and the companies become more inter-operable, they can talk to each other and transmit information easily.

You know, as that gets – as that whole industry matures, this is going to get easier and easier so that instead of the home health agency monitoring those patients, actually the patients – patient-centered health care home or medical home, their actual health providers would be monitoring those patients on a daily basis.

You may download the entire show by clicking here.

Best Around the (Home Care) Web II

Each week, the Alliance scours the blogospherefor the news affecting the home care industry.  Here are highlights from this week:

Not All Procedures Are Created Equal: Top Five to Avoid

The Choosing Wisely campaign, an initiative by the American Board of Internal Medicine Foundation in partnership with Consumer Reports… is an attempt to alert both doctors and patients to problematic and commonly overused medical tests, procedures and treatments.

It took an elegantly simple approach: By working through professional organizations representing medical specialties, Choosing Wisely asked doctors to identify “Five Things Physicians and Patients Should Question.”

The idea was that doctors and their patients could agree on tests and treatments that are supported by evidence, that don’t duplicate what others do, that are “truly necessary” and “free from harm” — and avoid the rest.

Among the 18 new lists released last week are recommendations from geriatricians and palliative care specialists, which may be of particular interest to New Old Age readers. I’ve previously written about a number of these warnings, but it’s helpful to have them in single, strongly worded documents. — via, NYT New Old Age Blog

Are Video Games Therapeutic? Wii Think So!

Researchers asked 140 people aged 63 and older how often they played video games, if at all. The study participants then took a battery of tests to assess their emotional and social well-being. 61 percent of study participants played video games at least occasionally, with 35 percent of participants saying they played at least once per week.

The study found that participants who played video games, including those who only played occasionally, reported higher levels of well-being. Those who did not play video games reported more negative emotions and a tendency toward higher levels of depression. — via Medical News Today; original paper available for purchase here.

Skype Care: Families Prefer Check-ins By Video

For the study, 34 families were broken up into three groups: one receiving standard [pediatric] home healthcare, a web group receiving home healthcare supplemented with a web app; and a video group with home healthcare supplemented by Skype. Participating families and nursing staff completed questionnaires about the information and communication technology’s (ICT) usefulness.

The web application was easy to use, participants said, and Skype was useful for all surveyed, too. Nearly 90 percent said that video calls were better than regular phone calls. Meanwhile, 33 percent in the web group and 75 percent in the video group thought that home visits should be less frequent with the advent of Skype. Fifty percent in the web group and 100 percent in the video group said they felt more confident in caring for their child after using the technology. — via HCAF

Making Home Gardens Accessible For Seniors

It is now our turn as caregivers to share new, accessible gardens and the fulfillment of getting our hands dirty again with our senior loved ones as they age. Many seniors find that the effects of aging on joints, muscles and the freedom of movement have prohibited them from tending to their beloved gardens — via Senior Care Corner (includes a how-to video on making senior-friendly vertical planters).

Return to www.thinkhomecare.org.

Guest Post: Your Legislators Need to Hear From You

By: Beverly Pavasaris
President, Brockton Visiting Nurse Association
President, Home Care Alliance Board of Directors

MA-State-HouseWith six home care-related bills working their way through the State House and budget meetings in progress, now is an ideal time to get to know your legislators and speak with them about the importance of home health in their districts.

Here are four things you can do to make a difference:

Talk to your Representatives

State representative and senators (find them here) rely on informed constituents to help them understand the legislation before them.  Don’t assume that they know what home health care is or why it’s important. Be prepared to educate your legislators or their health care staff. It is well worth your time.

Your congressmen and senators, also have district offices near you, whose staff you can speak with. Make it a point to reach out to them when they are in their home district offices.

Before you contact your legislators, be sure to read up about the home care-related bills proposed in this session (and which the Home Care Alliance endorsed):

  • An Act Relative to Home Health and Hospice Aides (S.1064) sponsored by Senator Richard T. Moore.
  • An Act Establishing a Certificate of Need for Home Health Care (H.1028) sponsored by Rep. Kate Hogan
  • An Act Allowing Out of State Physicians to Order Home Care Services (S.1042) sponsored by Senator Michael Knapik
  • An Act Relative to Telehealth (Senate Docket 1771) sponsored by Senator Harriette Chandler
  • An Act Relative to Pediatric Home Care Services (H.1007) sponsored by Rep. Michael Brady
  • An Act Relative to Vehicles of Home Health Clinicians (H.1864) sponsored by Rep. John Mahoney

Be sure to contact both your personal representatives – i.e., those who represent the district you live in – and those who represent the district where your business is located.

Schedule a Home Visit

Invite legislators – both state and federal – to come with you on a home visit. Seeing how home care works is more powerful than hearing description over the phone, and also gives them a chance to meet with constituents and get a good photo op.  If you would like assistance in setting up a visit, contact the Alliance’s James Fuccione.

Recruit Your Board & Employees

Your board members and employees can also be powerful advocates for home care. Inform them about the issues and have them make phone calls to their representatives as well.

Attend Lobbying Events

  • March 17th through the 20th is NAHC’s March on Washington;
  • Massachusetts Lobby Day at the State House on March 28th; and
  • VNAA Public Policy Leadership Conference is on September 18-19, 2013 in Washington.

If you have any questions about contacting your legislators, contact James Fuccione, the Alliance’s Director of Legislative and Public Affairs.

Good luck and see you at the State House and in Washington!

Return to www.thinkhomecare.org.

HCA Sets Improved State Policy Agenda

With a new two-year state legislative session, the Home Care Alliance has set an improved policy agenda that would strengthen the industry and asks for assistance from member agencies and fellow advocates in gathering legislative support.

boston-statehouseThe Alliance’s legislative priorities include re-filed items like the “Nurse Delegation” bill, which would allow visiting nurses to delegate certain medication administration tasks to home health and hospice aides in the home setting only. New items include establishing a “certificate of need” process for certified home health care and a state program allowing cities to grant parking leniency to clinicians visiting patients in those communities.
HCA members, friends, and advocates can assist our mission by contacting their local state senators and state representatives and ask that they cosponsor these bills. If you are unsure who represents your agency or place of residence, please visit www.wheredoivotema.com and type in your address, or contact James Fuccione at the Alliance.

Over the coming weeks, HCA will be alerting members about bills filed by other organizations and interest groups and will be asked to weigh in. The Alliance will, of course, continue to monitor and provide updates on the state’s health care payment reform law as it is implemented. Alliance staff and several member agencies sit on key boards, commissions and advisory groups and important information will be provided as it becomes available on those issues.

For more on HCA’s legislative priorities and how you can help, contact James Fuccione at the Alliance.

Return to www.thinkhomecare.org.