James Fuccione, former Director of Legislative and Public Affairs for the Home Care Alliance, was extensively quoted in an article in the Springfield Republican today. The article, “Personal care attendants have less training, checks than other home care workers,” by Shira Schoenberg, Statehouse reporter for the Republican, compares background checks and training requirements for workers in the state Personal Care Attendant program with workers employed by home care agencies that provide services under the Executive Office of Elder Affairs home care program.
The Massachusetts Board of Registration in Nursing (BORN) has released proposed regulations that sets guidelines for, among other activities, delegation by nurses to “unlicensed personnel.” These guidelines are NOT a change in the nursing scope of practice around medication delegation, which requires a law approved by the legislature and signed by the Governor.
The BORN is merely aiming to establish a nurse delegation framework inclusive of much more specificity in areas such as training, supervision and documentation should nurse delegation practices become allowable in Massachusetts.
The proposed regulations also protect nurses by setting criteria for delegation that includes the following:
- Ensuring that the delegating nurse would not bear any responsibility for any deviation by the unlicensed personnel from the nursing directive, instruction, or plan of care.
- Formalizes the nurse’s role in knowing what is within the ability of the unlicensed personnel to carry out and what can be delegated that would not require judgment or assessment by the unlicensed personnel.
- The final decision to delegate is made by the nurse and not the employing healthcare provider.
- The employing healthcare provider must have the competencies of the unlicensed personnel documented for each nursing activity along with periodic validation of those abilities.
- The nurse can determine at any time that an activity can no longer be delegated based on the health status of the patient, the unlicensed personnel’s performance of the activity, or any other reason the nurse believes would jeopardize the health and safety of the patient.
The proposed regulation follows years of discussion and a BORN subcommittee report on the state’s readiness for potential changes to nursing practice.
One of the possible changes is a longstanding policy priority of the Home Care Alliance, which is to allow home health care nurses to delegate certain medication administration tasks to a trained and certified home health aide. The HCA has dubbed the proposed policy as the “Nurse Delegation Bill.”
This bill will not pass in the current legislative session that ends with the New Year in 2017, but the HCA plans to continue pursuing a change that would allow – not mandate – that home health and home care agencies can implement proper training and procedures to maximize the efficiency of their direct care staff.
It should be noted that this bill includes protections, such as the fact that delegation is limited to medications which are NOT controlled substances and are administered in the following methods:
- prefilled auto-injectables designed for self-administration
- Products which are administered by inhalation.
The legislation states that “delegation of intramuscular, subcutaneous, intradermal, intraosseous or intravenous administration of medication shall not be permitted.”
Although the Alliance has comments and suggestions for the BORN’s proposed regulations, HCA fully supports the move to ensure the state is prepared for laws that promote nurses practicing at the top of their licenses. The Alliance appreciates the BORN’s thoughtful approach that further solidifies the importance of nurses in healthcare delivery.
The BORN will hold a public hearing on October 4th and will accept written comments until October 11th.
Return to www.thinkhomecare.org.
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.
Registration is OPEN NOW for the first Community Health Worker (CHW) Registered Apprenticeship Program established in Massachusetts and one of only a few in the nation.
The Center for Health Impact TM (formerly known as Central MA AHEC) in Worcester, Massachusetts is delighted to report that the Fairlawn Foundation Fund of the Greater Worcester Community Foundation has awarded funds to establish the creation of a Community Health Worker (CHW) Registered Apprenticeship Program in Central Massachusetts.
Apprenticeship is a flexible training system that benefits both employers and workers through its structured on-the-job learning and job-related classroom instruction. (Learn more about Apprenticeship USA at: https://www.doleta.gov/OA/apprenticeship.cfm.)
The 150-hour course, anticipated to start on April 5th, 2016 (pending enrollment/subject to change) will be offered free of charge to qualified applicants in Central Massachusetts by the Center for Health Impact TM Outreach Worker Training Institute (OWTI) in Worcester. Participants will earn a certificate of course completion aligned with the requirements established by the Massachusetts Board of Certification of CHWs.
To qualify, an individual must be employed or about to be employed with an employer who will:
- Provide them 2200 hours of on-the-job paid apprenticeship learning and supervision in one calendar year
- Reward the apprentice for skills gained by an increase in pay within one calendar year
- Authorize the apprentice to attend the 150-Hour course (120 hours of class time; 30 hours of homework).
Benefits for employers:
- Access to free CHW core competency training for employees
- Access to incentives as an employer working with the CHW Registered Apprenticeship Program
- Well trained and job proficient employees who meet employers’ specific needs
- Enhanced employee retention
- Improved service delivery
For questions, or to request the registration package for the Community Health Worker (CHW) Registered Apprenticeship 150-Hour Certificate Course, please contact: Tatyana Gorodetsky, at firstname.lastname@example.org or by phone at: 508-556-1332.
This Spring, MassHealth is hosting several One Care outreach events to let individuals who may be eligible for One Care know about the benefits of the program.
One Care Presentations as well as Drop-In Events will be held throughout Suffolk and Worcester County between the dates of March 25th and April 13th. This is a great opportunity to learn more about One Care, particularly for clients who may have received notices indicating that they are being automatically assigned to a One Care plan. More information about One Care can also be found at: www.mass.gov/masshealth/onecare.
- View the Suffolk Events Flyer (in English and Spanish)
- View the Suffolk Events Directions (in English and Spanish)
- View the Worcester Events Flyer (In English and Spanish)
- View the Worcester Events Directions (in English and Spanish)
Please share this with individuals you serve who may be eligible for One Care and feel free to forward to colleagues and other providers.
Return to www.thinkhomecare.org.
The Massachusetts Hospital Association (MHA), Organization of Nurse Leaders of MA, RI, NH & CT (ONL) and Home Care Alliance of Massachusetts have publicly posted the latest available key national care quality performance measures for both hospitals and home healthcare agencies in Massachusetts. Data from Medicare’s Hospital Compare and Home Health Compare are now available on the PatientCareLink website for 77 Bay State hospitals and 89 Bay State home health agencies.
Reported measures for hospitals include best practices for heart attack or chest pain, heart failure, pneumonia care, influenza prevention, surgical care improvement, stroke care and blood clot prevention and treatment. For home care agencies, the reported measures include timely initiation of care, patient/family medication education, depression assessment, and more.
To view the updated reports, visit www.patientcarelink.org and click on the “Healthcare Provider Data” tab and then either the “Hospital Data” or “Home Health Agency Data” link, then “Individual Hospital Performance Measures” or “Select an Agency.”
The home health agency reports now incorporate data for the period June 2014 – July 2015 for all measures, and the hospital reports cover April 2014 – March 2015. In addition to each facility’s individual performance, the PCL pages also provide a comparison to state and U.S. “peer” facility averages.
“Providing high quality, safe patient care is a top priority for Massachusetts hospitals,” said Pat Noga, PhD, RN, Vice President of Clinical Affairs for MHA. “Our hospitals are also committed to publicly posting important quality and staffing information to provide patients and caregivers alike additional confidence in their care.”
Patricia Kelleher, Executive Director of the Home Care Alliance of MA, added that the partnership between hospitals and home health agencies on PCL furthers positive working relationships along the entire continuum of care, which can only improve patient safety and quality overall.
“Choosing in-home services can be a daunting task and that’s why we’re proud that PatientCare Link (PCL) website allows patients and their families to find high-quality care in the home setting that fits their needs,” Kelleher said. “PCL includes Medicare-approved agencies that meet certain federal health and safety requirements, and provides patients, caregivers, and families the tool to easily access home health agency quality data to take control of their care and their health.”
Massachusetts was the first state to voluntarily make hospital staffing and nursing-sensitive quality information public starting in 2006. Home Care Alliance of Massachusetts joined the PCL quality and patient safety transparency effort in 2013. The PatientCareLink website is a great resource and gives patients an open and transparent view of the hospitals providing them care.
Hospitals and home care agencies welcome transparency about their performance when performance measures are grounded in good science and are designed to make fair comparisons across institutions. Publicly reported performance data can offer several benefits, including:
- Offering useful information for making decisions about where to obtain healthcare
- Helping healthcare professionals and institutions improve the care they deliver; and
- Providing extra motivation to improve performance.
Return to www.thinkhomecare.org.
According to the Executive Office of Elder Affairs (EOEA), the Notice of Intent (NOI) Application will open on Monday, November 2nd and will remain opened until necessary in order to conduct system and/or document updates.
The Homemaker NOI is the process Home Care agencies must complete if they are interested in contracting with the State’s network of 26 Aging Services Access Points (ASAPs) to provide Homemaker and Personal Care services through the “State Home Care program.”
The posting for approved providers will be completed within 4-6 weeks of the submitted Application.
This link brings you to an update found on the NOI Announcements page:
Existing providers will need to confirm/update corporate data within their approved Application if any data has changed. If a Provider’s information is staying the same, no action needs to be taken. The EOEA will keep rejected NOI Applications available for 90 days from the rejection date for purposes of re-submission. Otherwise, a new application will need to be created and submitted.
For any providers that were previously rejected in FY 15 and did not re-submit a rejected NOI Application within the 90-day period, they must create/submit a new FY 16 Application.
Please note the NOI Announcements page includes a link to the MassHealth FEW Provider Enrollment documents, including an overview document.
Return to www.thinkhomecare.org.