Brief Analysis: U.S. Senate’s Better Care Reconciliation Act

June 29, 2017

The United States Senate released its version of a new health care bill on June 22nd. Titled the Better Care Reconciliation Act (BCRA), the bill was met with energized advocacy groups immediately dispelling the measure. Earlier this week Congress’ nonpartisan budget referee, the Congressional Budget Office (CBO), estimated that 22 million people would be without insurance by 2026, 1 million less than the House bill which was passed in early May. Facing defeat in a floor vote, with nearly 8 Republican Senators coming out against the bill, Majority Leader Mitch McConnell (R-KY) delayed the vote until after the 4th of July Recess.

Here is a brief analysis of key provisions of the Senate Bill:

  • Medicaid Funding: The bill, like its House counterpart, vastly rolls back Medicaid expansion and phases out federal funding between 2021 and 2023 and further reductions would begin in 2025. The CBO estimates that Medicaid enrollment would fall by more than 15 million people by 2026. Like the House version, this bill would create a block grant mechanism calculated on a per capita basis. Governor Charlie Baker has expressed concern for this and noted that it could cost Massachusetts billions in federal Medicaid funding and leave nearly 264 thousand residents without insurance. The Governor also estimates that the state could face a $8.2 billion shortfall by 2025.
  • Pre-Existing Conditions: Unlike the House bill, insurance companies would be required to accept all applicants regardless of health status. That said, the bill allows states to ask permission to reduce required coverage of essential health benefits. This could result in massive increases for people who want to purchase a plan with essential health benefits. While the CBO estimates that some will see lower premiums, they will also see fewer benefits.
  • Adults Over 50: The Affordable Care Act (ACA) prevented insurers from charging older people more than 3 times what younger enrollees pay. Under the Senate Plan, insurers can charge five times more than younger people and ACA subsidies to help the lower income and elderly pay for insurance would be drastically lower.

What to watch? Since Congress is going through this process under a budget reconciliation rule, the Senate Bill must only have the same amount of savings on the deficit as the House version. Thus, since the Senate version saves over $320 billion over the next 10 years, and the House version saves approximately $100 billion over ten years, the Senate has roughly $200 billion to spend in order to build support with current ‘no’ vote Senators. Keep an eye on states that rely heavily on Medicaid funding, or states heavily impacted by the opioid epidemic. These are some of the Senators currently opposed to the bill, and Leadership may direct additional funding to their states to bring them to a ‘yes’ vote.

For more information or any questions, please contact Jake Krilovich at jkrilovich@thinkhomecare.org


New 2017-2018 Monthly Aide Webinar Schedule Announced

June 27, 2017

Why Participate? An investment in staff education is an investment in quality customer service for all types of agencies. For home health and hospice agencies, these hour-long webinars can be used to help meet the 12 hours per year educational requirements under the Medicare Conditions of Participation. For all providers, an educational investment in your staff pays off in quality care!

July 13, 2017
TOPIC: The Aide’s Role in Falls Prevention Risks
Speaker: Cheryle Atwater, PT
Description: Statistics show that 30% of those greater than 65 years old fall each year; and, one- half (50%) of those will suffer multiple falls. Emergent care due to injuries secondary to falls is one of the most frequently occurring adverse events reported for our home health population. This session will explore the risk factors contributing to falls and methods for identifying and addressing these factors by in home aides, in collaboration with other members of the interdisciplinary team.

August 10, 2017
TOPIC: The Aide’s Role in Cultural Diversity
Speaker: Kathie Smith, RN
Description: The United States has long been seen as a “melting pot” of people from many countries and cultures; this diversity will continue to increase. Misunderstandings caused by lack of cultural sensitivity and skills can lead to poor interaction with patients and their families. This webinar will cover basic principles of cultural diversity understanding in patient care.

September 14, 2017
TOPIC: The Aide’s Role in Quality Improvement Activities
Speaker: Heather Jones, MPH, CHES, COS-C
Description: What is QAPI? This session will describe the requirement for home health and hospice agencies to conduct Quality Assessment and Performance Improvement (QAPI) activities including a family satisfaction survey. How your agency performs on these measures is available to the public. In-home aides will learn how they play a role in supporting QAPI.

October 12, 2017
TOPIC: The Aide’s Role in Maintaining Professional Boundaries
Speaker: Cindy Morgan, RN, MSN, CHC, CHPN
Description: During this presentation the participant will discover: the meaning of professional boundaries, and the importance of maintaining professional boundaries. We will identify some red flags or indicators that give warning to boundary issues and strategies to prevent boundary issues.

November 9, 2017
TOPIC: The Aide’s Role in Communication & Conflict Resolution in the Workplace
Speaker: Kathie Smith, RN
Description: Basic principles of communication include verbal and non-verbal communication. We are communicating, even when we are not using words, with our body language. This webinar will cover communication skills and ways to communicate to help with conflict resolution such as effective listening; self-management; self-awareness and how emotions affect communication.

December 14, 2017
TOPIC: The Aide’s Role in Understanding Depression
Speaker: Cindy Morgan, RN, MSN, CHC, CHPN
Description: The CDC estimates that one in ten adults in the United States reports depression. About 25 million Americans will have an episode of major depression this year alone but only half of them receive treatment. Depression is a leading cause of disability worldwide and represents a public health challenge. This disease may be experienced by people of any age group, any nationality or any socioeconomic level. Many times depression is not detected and therefore goes unmanaged. This presentation will focus on the manifestations of depression that patients may exhibit and the aide’s role in caring for the depressed patient.

January 11, 2018
TOPIC: The Aide’s Role in Recognizing & Reporting Patient Abuse
Speaker: Kathie Smith, RN
Description: According to the National Center on Elder Abuse, every year an estimated 5 million older Americans are victims of elder abuse, neglect, or exploitation. And that’s only part of the picture. Experts believe that for every case of elder abuse or neglect reported as many as 23 cases go unreported. According to the National Children’s Alliance, in 2015, an estimated 1,670 children died from abuse and neglect in the United States. This webinar will provide information on recognizing signs of patient abuse and neglect both for adults and children and the importance of reporting appropriately.

February 8, 2018
TOPIC: The Aide’s Role in Dealing with Combative Dementia Patients
Speakers: John Conrad and Libby Hart, RN
Description: Our aides often notice that some elderly patients demonstrate behaviors that include paranoia, delusions, hallucinations and/or aggression. Each patient with aggressive behavior brings a unique challenge as caregivers attempt to assist with ADL/IADL care in the home. This presentation is intended for aides and caregivers to minimize the risk of injury when providing care for patients with dementia who demonstrate some form of combative behaviors. We will provide education and instructions regarding positions and techniques to avoid physical confrontations with those patients who have the tendency to hit, push, kick, spit or grab those providing care. We will address some of the causes of these combative behaviors and provide valuable tips and techniques to ameliorate each occurrence.

March 8, 2018
TOPIC: The Aide’s Role in Confidentiality and HIPAA
Speaker: Michelle White, MSN, RN
Description: This workshop will focus on assisting your In-Home Aides in understanding HIPAA and confidentiality guidelines. This workshop will offer practical tips to ensure that the para-professional adheres to the required privacy standards. Also included: the impact of social media such as Facebook, My Space, YouTube and cell phones, text messages, etc.

April 12, 2018
TOPIC: The Aide’s Role in Assisting a Patient with Chronic Pain
Speaker: Cindy Morgan, RN, MSN, CHC, CHPN
Description: Our world is aging. The elder population may falsely believe that because they are aging that pain is a normal part of living and is therefore not reported or managed. Since the majority of our patients seen in the home are elderly, this webinar will provide an overview of symptoms the aide may observe and the aide’s role in providing care to those patients experiencing pain.

May 10, 2018
TOPIC: The Aide’s Role in Infection Control in Home Care & Hospice
Speaker: Michelle White, MSN, RN
Description: This workshop will focus on understanding the basic principles of infection prevention and control. This workshop will also focus on Blood Borne Pathogens and the principles surrounding transmission and methods in which the aide can protect themselves and the patient.

June 14, 2018
TOPIC: The Aide’s Role in Enhancing the Patient’s Experience with the Home Care Bill of Rights
Speaker: Sherry Thomas, BSN, MPH
Description: The Patient Bill of Rights (BOR) sets forth requirements that ensure that patients and families are engaged in their home care and have good outcomes and experiences from their services. This webinar will review key BOR areas common to all home care settings that if not met by agency staff most often lead to disgruntled patients, complaints and a surveyor at your agency’s door.

CLICK HERE FOR MORE INFORMATION ON THESE 

FOR MORE INFORMATION ON ALL OF OUR UPCOMING PROGRAMS GO TO:

www.thinkhomecare.org/page/education


So… You Want to Start a Home Care Agency?

June 26, 2017

What does it take to start a home care agency in Massachusetts? This downloadble brochure — updated for 2017 — covers the basics, including: What regulatory issues pertain; How to get paid; How to bill insurers; Where to get more help; and How the Home Care Alliance of Massachusetts can serve you one you’re up and running.

View this document on Scribd

Return to www.thinkhomecare.org.


2017 Annual Report of the Alliance and Foundation

June 19, 2017

The Report documents the companies’ activities, finances, awardees, and accomplishments for the 2016-2017 year.

View this document on Scribd

Copies of the report are available for digital download.

Return to www.thinkhomecare.org.


2017 Private Care Guides Available

June 12, 2017

Now in its 11th edition, the Guide to Private Home Care Services has connected tens of thousands of families with the home care agencies that best meet their needs. While the Resource Directory is intended for professionals and others who make regular referrals to home care, the Private Care Guides are designed for consumers and are always available at no charge.

Click the images above to order.

The Guides contains county-by-county cross-references, as well as short essays about: What home care is; How to pay for it; How to choose an agency, and; What the advantages are of working with an agency over other options.

Return to www.thinkhomecare.org.


2017 Star Awards, Innovation Showcase Winners Announced!

June 2, 2017

The Home Care Alliance of Massachusetts is pleased to announce its 2017 industry innovators and stars. Awardees will be celebrated during the Innovations Showcase & Star Awards on June 20 at the Granite Links Golf Club, Quincy.

The 2017 honorees include:


Aides of the Year

Gach Clamp, HHA, Emerson Hospital Homecare, Concord

Nancy Quinlan, CNA/HHA, Aberdeen Home Care, Danvers


Clinicians of the Year

David Ahearn, MSW, Baystate Home Health, Springfield

Carlton Jorge, RN, Community Nurse Home Care, Fairhaven


Managers of the Year

Arline McKenzie, Nursing Manager, Walpole Area VNA

Susan Proulx-Galster, Hospice & Palliative Care Program Manager, Circle Home, Lowell


Physician of the Year

David Prybyla, MD, Orthopaedics Surgical Associates, North Chelmsford


Home Care Champion

MA Pediatric Home Nursing Care Campaign


Legislator of the Year

Representative Aaron Vega (D-Holyoke)


Innovation Winners

HouseWorks, Newton:  Instant Hire Event

Southcoast VNA, Fairhaven:  Camp Angel Wings

Brockton VNA:  Lean Process Management


These awards celebrate the exceptional accomplishments of the everyday heroes in our midst who make incredible differences in the lives of their patients/clients and their families. Though there are too few opportunities to recognize all who deserve one, a STAR award brings well-deserved recognition for both the agency and the individuals.

Granite Links

Granite Links Golf Club

Please join us on June 20 as we salute and celebrate the best programs and people in our industry today!

Return to www.thinkhomecare.org.


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