116 US Reps Sign on to Prior Authorization Letter to CMS

May 31, 2016

Even though the public comment period for CMS’ proposed prior authorization demonstration ended on April 5th, the Home Care Alliance has been active in its continuing advocacy to oppose the measure.

Joining national associations and advocates from across the country, the HCA helped spearhead a congressional letter to CMS opposing prior authorization, which gained 116 signatures and was co-led by Massachusetts Congressman Jim McGovern. All but one member of the state’s congressional House delegation signed on. The Alliance thanks Congressmen Stephen Lynch, Joseph Kennedy, Bill Keating, Richard Neal, Seth Moulton and Congresswomen Niki Tsongas and Katherine Clark for their support.

The proposed five-state pilot includes Massachusetts, Florida, Texas, Illinois and Michigan and those five states have been lobbying members of Congress, but many others nationwide have joined in the fight realizing that a demonstration could, and likely would, lead to wider implementation.

In late February, the Home Care Alliance began its advocacy of the proposal by traveling to Washington DC to deliver a letter outlining the organization’s comments to members of Congress. The HCA and all others who gathered in opposition to the prior authorization demonstration await a response from CMS.

Return to www.thinkhomecare.org.


Senate Advances Home Care Commission in Budget

May 27, 2016

In a $39.5 billion budget, the Senate advanced Home Care Alliance priorities, namely a special commission that will study and make recommendations for state oversight of home care.

The commission would create a separate set of recommendations for certified home health and also private pay agencies. The group would include three representatives from each type of agency (certified and private-pay) as part of the membership along with policymakers, administration officials, and many others. During the Senate’s deliberations on more than 1,300 amendments, the Massachusetts Nurses Association and the MA Chapter of the National Academy of Elder Law Attorneys.

Unfortunately, efforts to gain payment increases for home health aides and homemakers were not approved despite collaboration with the Home Care Aide Council, Mass Home Care, and several dedicated Senate offices. Senator Joan Lovely (D-Salem) spoke well in debate on behalf of a home health payment review and Senator Barbara L’Italien (D-Andover) fought for inclusion of home health aide payment, in particular. Senator Patricia Jehlen (D-Somerville) and Senator Sal DiDomenico (D-Everett) also helped lead an effort to advance home care rates.

On a positive note,an amendment was defeated that would have created a publicly-available registry of home care workers that aimed to list private information.

In addition, the Senate approved a pilot program of just over $1 million that expands income eligibility standards for services coordinated through Aging Service Access Points.

Other notable items in the Senate’s budget include the following:

  • A feasibility study on allowing spouses to be paid caregivers under MassHealth.
  • Allowing a leave of absence for nursing home residents under MassHealth (20 medical leave days and 10 non-medical leave days).
  • A fund created from fines and penalties relative to patient abuse in nursing homes that funds the prevention of such action through staff training and education, enhanced inspections, and relocating residents to other facilities.
  • $20.5 million for the Nursing Home Quality Jobs Initiative as part of SNF Supplemental Rates.
  • $200,000 for Geriatric Mental Health Services.

The HCA thanks its members for the hundreds of emails and phone calls to Senators during the past two weeks. The state budget process moves on to a conference committee process where the House and Senate negotiate differences between their two FY17 proposals. The Alliance will continue to push for the commission to establish oversight measures as well as other items to strengthen home care.

Return to www.thinkhomecare.org.

 


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

May 20, 2016

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

May 11, 2016

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.


Zdogg to Nurses: You’re Appreciated

May 6, 2016

In celebration of Nurse’s Week, Zubin Damania, MD — aka Zdogg — has a message for all the nurses who do so much for those under their care:

Return to www.thinkhomecare.org.


Our Time To Shine: Nominations Open!

May 4, 2016

Our Time to Shine - Annual Meeting and Innovation & Star AwardsYou know at your agency that your clinical staff, aides, and managers are great. Isn’t it time to let the rest of the health care industry know that? The Home Care Alliance is looking for nominations for our annual Innovation and Star Awards.

Awards will be presented on June 14th at a brunch and reception to be held at the Granite Links Golf Course in Quincy. Marie Pazinski, MD — neurologist and noted author of Beautiful Brain, Beautiful You — will emcee the awards. And there is  plenty of free onsite free parking!

Nomination forms and other event information is available here.

Return to www.thinkhomecare.org.


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

May 2, 2016

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.

 


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