January 22, 2016 Edition of ASAP

ASAP

A Weekly Publication Of HCA Home Care Association of New York State

Legislative Issues  Public Policy



News

Volume 21, No. 3 January 22, 2016

Home Care Leaders – Like You – Are Needed in Albany on Feb. 1-2 for State Advocacy HCA’s State Advocacy Day and corresponding Political Action Committee (PAC) reception in Albany are less than two weeks away.

We need home care leaders, like you, to join us for this important program, on February 1-2, as we present legislators and key state officials at the Capitol with broad principles for urgently needed action on behalf of New York’s home care system.

See ADVOCACY p. 2

HCA Presses Minimum Wage and FLSA Funding HCA continued our vigorous efforts to provide policymakers with data on the cost of a minimum wage increase for home care agencies and to advocate for necessary funding.

Over the past two weeks, HCA, along with other health care provider associations, met with Senate Health Committee Chairman Kemp Hannon as well as key staff from the Assembly Ways and Means Committee, Senate Finance committee, and state Division of the Budget to discuss the cost impact of a proposed $15 per hour minimum wage increase on the entire home care industry.

Inside ASAP Home Care Leaders Are Needed in Albany for State Advocacy........1 HCA Presses Minimum Wage and FLSA Funding..............................1 HCA Files Complaint on Wrongful Dismissal from NAHC Board....3 DOH Provides Further Info on Surveillance Pilot Project...................4 U.S. DOL Releases Guidance on Joint Employment..........................6 HHCAHPS Data Submission Tool Unavailable for Two Weeks............6 Managed Care Update......................................................................7 DSRIP Update.................................................................................8 QIES System Downtime: March 16-21................................................8 HCA, Community Care Colleagues Urging Provider Investment......9 Member Hiring Announcements.......................................................9 HCA’s Popular CFO Forum on March 9 Has a New Name................10 Value Based Committee Sees Next Round of Recommendations..11 Home Care Emergency Preparedness.............................................11 Care At Home Update......................................................................13 MedPAC Issues Recommendations for Home Health, Hospice.....14 State DOL Proposes Rule on Sharing of Wage Information............14 UAS Offline Application to be Upgraded......................................15 Agenda Posted for PHHPC Committee...........................................15 2016 Mileage Rates for Business, Medical and Moving.................16 Updated FAQs Posted on Accountable Health Communities........16 NY State of Health Individuals at Age 65 Sent to LDSS...................17 CMS Home Health & Hospice Open Door Forum: January 27........18 NGS Education Programs...............................................................18 Publications..........................................................................................19

This proposal was included in the Governor’s Executive Budget, which is due to be finalized by April 1 after negotiations with the Legislature.

See FUNDING p. 4

Helping New Yorkers Feel Right At Home

Volume 21, No. 3 January 22, 2016

ASAP – a publication of the Home Care Association of New York State

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ADVOCACY from p. 1 In broad terms, these principles include: 1) fixes to the state’s reimbursement system for rate adequacy and coverage; and 2) a statutory and budget package that optimizes home care’s operation in the changing health care system.

Further details of this program are in the registration form at http://hca-nys.org/wpcontent/uploads/2016/01/ 2016HCAAdvocacyDayEventFlyerandRegistration.pdf.

You can also find a registration form in the back of this week’s ASAP.

Last week’s edition of ASAP previewed these main advocacy “asks,” along with some specific proposals.

We’ll present further details of our advocacy messaging and resources during a statewide conference call on the Governor’s budget ( January 26 from 3 to 4 p.m.), which sets the table for February 12 by informing you about the budget and priorities for home care in 2016. If you haven’t registered for this call, you can do so at https:// www.surveymonkey.com/r/2016-17Budget.

After registering, you’ll need to also schedule appointments with your legislators as soon as possible to meet with them on the afternoon of February 2 (1 p.m. or later) in their Albany offices. This, after all, is the main purpose of our program: to get you and members of HCA’s Board of Directors face-to-face with lawmakers on critical home care issues in the context of the state budget and new legislative session.

Even more importantly, please also register as soon as possible for our February 1-2 advocacy program, which begins with a Political Action Committee (PAC) reception for Senate Health Committee Chairman Kemp Hannon on February 1 (at 6 p.m.), followed by our main Advocacy Day event on February 2 at 9:30 a.m. when legislative health leaders and key state officials will address HCA members and our Board of Directors.

Please join us for all of these important events including our January 26 conference call, our February 1 PAC reception for Senator Hannon, and our February 2 Advocacy Day where HCA will be on hand to assist you and provide coaching for your meetings with legislators.

We’ll be sending you further resource documents soon, so please stay tuned.

ASAP is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in ASAP are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. President: Editor:

Joanne Cunningham, jcunningham@hcanys.org Roger L. Noyes, Director of Communications, rnoyes@hcanys.org Al Cardillo, Executive Vice President, Policy & Programs, acardillo@hcanys.org Patrick Conole, Vice President, Finance & Management, pconole@hcanys.org Andrew Koski, Vice President, Program Policy and Services, akoski@hcanys.org Alexandra Blais, Director of Public Policy, ablais@hcanys.org Laura Constable, Senior Director, Membership & Operations, lconstable@hcanys.org Celisia Street, Director of Education, cstreet@hcanys.org Mercedes Teague, Finance Manager, mteague@hcanys.org Jenny Kerbein, Director of Governance and Special Projects, jkerbein@hcanys.org Billi Hoen, Manager, Meeting and Events, bhoen@hcanys.org Teresa Brown, Administrative Assistant, tbrown@hcanys.org 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

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Volume 21, No. 3 January 22, 2016

ASAP – a publication of the Home Care Association of New York State

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HCA Files Legal Complaint Stemming from Wrongful Dismissal of HCA Representatives from NAHC Board HCA and its affected representatives have commenced legal action seeking relief for invalid actions taken to remove HCA’s representatives – HCA President Joanne Cunningham and HCA Board Member Laurie Neander – from the Board of Directors of the National Association for Home Care and Hospice (NAHC).

This week’s legal action rests on specific provisions of law in Washington, D.C. which allow individuals who are affected by a corporate action to challenge the action in court. The complaint was filed in the Civil Division of the Superior Court in Washington, D.C., where NAHC is headquartered.

The Plaintiffs contend that NAHC’s staff and legal representative, without due-process or involvement of the Board of Directors, “removed” HCA’s representatives from the NAHC Board of Directors in direct violation of NAHC’s own by-laws. Those by-laws require the removal of a director to be considered and voted on by the full Board, with an opportunity for the affected directors to attend the meeting and participate in the discussion. This did not occur in the Plaintiffs’ case. Rather, the removal action was communicated unilaterally by the legal representative of NAHC staff in letters sent to the Plaintiffs, with no opportunity to respond to the charges, as NAHC’s by-laws require.

The letters communicating Ms. Cunningham’s and Ms. Neander’s removal also charge the Plaintiffs with pursuing “alignment” with competitor organizations of NAHC. As you know, HCA works closely with many organizations on advocacy to support our members. Such charges are not only unmerited, but they are in no way consistent with the reasons for Board disqualification stated in NAHC’s own by-laws.

HCA and Plaintiffs have had a long working relationship with NAHC and we value our partnerships with national organizations to support our constituents in New York State. Please be aware that this lawsuit was filed reluctantly and only after every effort had been made to contest and reverse the removal action within NAHC’s organization. Those efforts, however, were of no avail, leaving Plaintiffs no other alternative for preserving HCA’s and New York’s representation on the NAHC board.

Furthermore, Ms. Cunningham was until recently a voting member of NAHC’s Board through her position as Chair of the Forum of State Home Care Associations, a group of executives from state home care associations, like HCA, nationwide. The Forum of State Home Care Association has issued a statement of strong objection to the dismissal actions, and this statement is included as an appendix in the legal complaint.

A copy of the complaint is available to any HCA member who would like a copy. HCA’s legal team, represented by Wilson Elser Moskowitz Edelman and Dicker, LLC, awaits discussions with the Defendants, at which point we will provide the membership with a further update.

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ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

FUNDING from p. 1 Presently, HCA, in concert with the New York State Association of Health Care Providers (HCP), Leading Age NY, The Healthcare Association of New York State (HANYS), and the New York State Health Facilities Association (NYSHFA), estimates the impact on the home care industry statewide to be $1.72 billion.

In those meetings, HCA emphasized that in order for the minimum wage to increase as proposed by the Governor, the initiative needs to be fully funded. Without full funding, this would be devastating to the ability of providers to deliver home care. Strong association and member advocacy will continue around this issue and you will be kept updated.

FLSA Survey This week, HCA, LeadingAge NY and HCP met with staff from the state’s Actuary, Mercer, and the state Department of Health (DOH) to review our detailed comments and concerns on a draft survey being developed to ascertain the new costs faced by home care providers due to changes in the Fair Labor Standards Act (FLSA).

The survey aims to measure additional expenses faced by agencies, including overtime, travel and live-in cases.

HCA has advocated that the survey: include a minimal number of questions that only relate to the FLSA new rules; include questions that are very clear as to what information is requested; and ask for data that agencies can obtain without taking much time or resources (see additional information on the progress of FLSA funding in the Managed Care Update story in this week’s ASAP).

DOH Provides Further Information on Offsite Surveillance Pilot Project This week, HCA held a members-only call, with LeadingAge NY, on the state Department of Health’s (DOH) newly announced LHCSA Offsite Surveillance Pilot Project.

Rebecca Fuller Gray, Director of the Division of Home and Community-Based Services at state DOH, reviewed this upcoming new surveillance activity that will start February 1 and be completed at the end of February.

DOH will be selecting 20 LHCSAs to participate in the mandatory off-site survey. They will be chosen based on: 1) having received a survey within the past 36 months; 2) having been found in substantial compliance at its most recent survey; and 3) not being a franchise entity.

Under the pilot, regional DOH regional office surveillance staff will conduct audits of 20 LHCSAs statewide, including those located in each DOH region, in only one of the following four areas: • • • •

Clinical records Emergency Preparedness and Health Commerce System (HCS) Personnel Records Quality Assurance and Complaints Review

Those selected for a review will receive a letter through HCS. Agencies will have until 5 p.m. of the date of notification to provide the initial information requested in the letter. On the members call this week, Rebecca Fuller Gray said that if an agency could not provide certain documentation by 5 p.m., the agency should contact the DOH regional manager to discuss the need for further time.

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ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

Continued from previous page As notification will be done through the HCS, agencies are advised to update their agency roles and e-mail contact information in the HCS. After the off-site audit, the agency will be issued a Statement of Deficiencies (SODs) from the DOH regional office and will have an opportunity to discuss it at an exit interview.

The SODs will be issued via the HCS’s Electronic Plan of Correction (EPOC) application. Again, agencies need to update their HCS contact information to ensure that the appropriate staff receive the EPOC. Questions about EPOC can be directed to DOH’s Melvin McClain at (518) 408-1638; questions related to the HCS can be directed to DOH’s John Huffaker at (518) 408-1638; or e-mails on either topic can be sent to homecare@health.ny.gov.

On this week’s conference call, Ms. Fuller- Gray discussed the types of documentation required under each review. For instance, under the Clinical Record review, LHCSAs will have to include a roster of active patients that encompasses start of care, patient diagnoses, patient services and frequency, payment status (managed care, private pay, etc.), and case management information. LHCSAs will also have to include a roster of patients discharged during the past six months (including name, discharge date and payment status).

DOH will select a random sample of two active and one discharged patient(s) and LHCSAs will have to provide data on: start of care; primary and secondary diagnoses; receipt of certain patient rights information; medical orders; initial and ongoing assessments; plan of care; clinical supervision; aide care plan; aide activity sheets; progress notes; and discharge summary.

Under the Emergency Preparedness and HCS review, LHCSAs will have to document that they have: an emergency response plan; policies and procedures relating to both emergencies and the HCS; and their current patient roster. DOH advised agencies to review title 10, sections 766.9(c) and 766.9(e) and all DOH guidance, including a Dear Administrator Letter issued in May 2005.

For the Personnel Record review, agencies were advised to review title 10, section 766.11. They will be asked to document that staff received certain health screenings and tests, criminal history background checks, and other information. They will have to provide their active personnel list and information on a sample of five employees.

Under Quality Assurance and Complaints review, DOH will request copies of the agency’s: Quality Assessment plan; Quality Improvement Committee meeting minutes for the past two years; complaint procedures; and complaint log for the past year.

After completing the initial Pilot Project, DOH will evaluate certain factors, including the effectiveness of this off-site survey process, the number of deficiencies identified, the time spent by DOH, and will then make recommendations about necessary changes and expansion.

DOH also intends to provide some written guidance on this process after it has been finalized.

HCA thanks DOH for reaching out to HCA on the new tool and taking the time to provide our members an initial look at the new surveillance process.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

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Volume 21, No. 3 January 22, 2016

ASAP – a publication of the Home Care Association of New York State

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U.S. DOL Releases Guidance on Joint Employment This week, the United States Department of Labor (U.S. DOL) issued guidance on joint employment that included an Administrator’s Interpretation, updated Fact Sheets, and Questions and Answers.

The materials are at http://www.dol.gov/whd/flsa/jointemployment.htm.

Joint employment exists when an employee is employed by two (or more) employers such that the employers are responsible, both individually and jointly, to the employee for compliance with a statute, such as the Fair Labor Standards Act (FLSA).

The most likely scenarios for joint employment are: 1. Where the employee has two (or more) technically separate but related or associated employers; or 2. Where one employer provides labor to another employer and the workers are economically dependent on both employers.

The updated Fact Sheets and new Administrator’s Interpretation discuss how to determine if joint employment exists under both above scenarios and the ramifications for the employers and employees.

The significance for home care agencies is that each of the joint employers must ensure that the employee receives all employment-related rights under the FLSA. This includes: payment of at least the federal minimum wage for all hours worked and overtime pay at not less than one-and-one-half the regular rate of pay for hours worked over 40 in a workweek. Also, joint employers must combine all of the hours worked by the employee in a workweek to determine if the employee worked more than 40 hours and is due overtime pay.

In June 2014, U.S. DOL issued another Administrator’s Interpretation, “Joint Employment of Home Care Workers in Consumer-Directed, Medicaid-Funded Programs by Public Entities under the Fair Labor Standards Act.” It is at www.dol.gov/whd/opinion/adminIntrprtn/FLSA/2014/FLSAAI2014_2.pdf.

HHCAHPS Data Submission Tool Unavailable for Two Weeks The Home Health CAHPS (HHCAHPS) Data Submission Tool will be unavailable for approximately two weeks, beginning January 25, to allow for ICD-10 transition.

Please advise your vendors to refrain from submitting data files until an announcement has been posted indicating that the Data Submission Tool is available again.

As a reminder, once the Data Submission Tool reopens, agencies should submit at least one data file containing ICD-10 codes prior to the April 21, 2016 deadline, to ensure that they are able to successfully submit with the new code format.

Please contact the HHCAHPS Survey Coordination Team if you have any questions at hhcahps@rti.org or (866) 354-0985.

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ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

Managed Care Update At this week’s Managed Care Policy and Planning meeting, the state Department of Health provided an update on managed care and related payment issues, including the Quality Incentive Vital Access Provider Pool (QIVAPP) and Fair Labor Standards Act (FLSA) funding.

QIVAPP HCA has learned that IPRO has not yet completed its audit of awardees under QIVAPP and is still conducting site audits. IPRO has found that more than half of those initially considered eligible for QIVAPP were determined to be ineligible based on IPRO’s audits. DOH is working on recalculating its list of eligible providers and their expected funding levels.

FLSA DOH reported that the state Division of Budget had just approved funding under Medicaid fee-for-service and managed care to help pay for new costs under the Fair Labor Standards Act (FLSA).

HCA is continuing to advocate that the funds be distributed from managed care plans to their home care contractors and will keep members informed on the status of these monies. (See p. 4 for the section of a story about a survey being developed to measure new costs under FLSA.) Managed Care Some managed care highlights are: •

The total number of MLTC plans include 32 Partially Capitated; 17 Fully Integrated Duals Advantage (FIDA); 8 Medicaid Advantage Plus (MAP); and 8 Program of All-Inclusive Care for the Elderly (PACE).

•

Total MLTC enrollment is 155,656 (December 2015), including 137,705 in partially capitated; 6,220 in FIDA; 6,240 in MAP; and 5,491 in PACE.

•

The next meeting of the Nursing Home Transition and Diversion and Traumatic Brain Injury Workgroup is January 27.

•

DOH held a webinar on FIDA reforms on December 22 and has posted the materials at http:// www.health.ny.gov/health_care/medicaid/redesign/docs/2015-12-22_fida.pdf.

•

DOH and the U.S. Centers for Medicare and Medicaid Services will be holding a FIDA educational event on January 27 in New York City.

•

DOH has revised the deadline for FIDA plans to submit their Alternative Payment Arrangements from January 1 to April 1, 2016.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

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Volume 21, No. 3 January 22, 2016

ASAP – a publication of the Home Care Association of New York State

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DSRIP Update

QIES System Downtime: March 16-21

The state Department of Health (DOH) has announced that the Independent Assessor has completed its reviews of the Second Quarterly Reports of DSRIP (Delivery System Reform Incentive Payment) program Year 1, covering all Performing Provider System (PPS) activity through September 30, 2015.

The U.S. Centers for Medicare and Medicaid Services (CMS) announced this week that the all Quality Improvement and Evaluation System (QIES) systems will be unavailable from Wednesday, March 16 after 8 p.m. through Monday, March 21, 2016.

The Second Quarterly Report for each PPS can be accessed through the PPS Quarterly Reports section of the DSRIP website at http:// www.health.ny.gov/health_care/medicaid/ redesign/dsrip/quarterly_rpts/index.htm.

This downtime will affect all QIES connectivity and systems. The national database, Certification and Survey Provider Enhanced Reporting (CASPER) reports, and quick reference will not be available during this time.

Following the validation of the Second Quarterly Reports, the PPSs earned $165,965,413 out of a possible $168,387,230 (98.5 percent) in DSRIP waiver funds for this period. The results of the Independent Assessor’s reviews and the breakdown of performance payments earned for each PPS can be found in the Achievement Value (AV) Scorecards posted to the PPS Quarterly Reports section of the DSRIP website at the site above.

The following submission systems will also be unavailable:

The AV Scorecards include a summary of the AVs and associated performance payments earned by each PPS for the Second Quarterly Report and details for each project being implemented by the PPS. This payment represents the second of three payments the PPSs may earn in DSRIP Year 1.

PPSs received their first payments of DSRIP Year 1 for the approval of the DSRIP Project Plan Application. PPSs will be eligible for the third performance payments of DSRIP Year 1 following the completion of the Fourth Quarterly Report.

•

Home health Outcome and Assessment Information Set (OASIS)

•

Hospice Item Set

•

Inpatient Rehabilitation Facility (IRF)-Patient Assessment Instrument (PAI)

•

Long-term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set

•

Minimum Data Set (MDS) and Payroll-Based Journal

Affected providers should make contingency plans to accommodate for this downtime.

For further information contact HCA’s Patrick Conole at (518) 810-0661 or at pconole@hcanys.org.

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ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

HIRING

HCA, Community Care Colleagues Urging Community Provider Investment

Title: Director of Performance Improvement and Staff Development at Winthrop University Hospital Home Health Agency

As the State Legislature and Executive gear up to assemble a new state budget, HCA and association colleagues are pinpointing a message that essential new health care financing initiatives negotiated in the budget must include support for community health care providers and services.

Winthrop seeks a Director of Performance Improvement and Staff Development for the CHHA, which services Nassau, Suffolk and Queens. The PI Director is responsible for the quality assessment/assurance program, compliance with DOH regulations and The Joint Commission standards as well as corporate compliance and the educational programs of the agency.

Minimum qualifications include: BSN, NYS RN license, two years professional nursing experience, two years supervisory experience in a CHHA or related program.

Knowledge of Performance Improvement and Quality Assurance, as well as a working knowledge of Joint Commission standards and DOH regulations, are a must. Master’s degree preferred.

Unlike last year, when state officials adopted a new budget that provided over $2 billion in new support for the institutional sectors – with little-to-no proportion for home and community based care – this year’s outcome must account for the needs and vital support of community health providers.

Efforts this week included key legislative outreach by HCA and colleagues pressing this message point, preparations for Monday budget testimony to joint Senate-Assembly hearing panels, and follow-up joint efforts to formulate and advocate budget proposals to support the community based system on a sector-wide basis, including home care, behavioral health, community health centers and other essential community services.

With the state’s overriding policies shifting health care services from institutional to community based settings, along with the onset of integrated models requiring increased community provider capacity, investment and support in community providers are vital.

Meanwhile, providers have been left increasingly fragile and without the resources to meet these new service and model demands. This dire situation will further take on devastating proportions if increased funds are not procured to meet the new costs of an increased minimum wage and the federal Fair Labor Standards Act rule.

Send résumés to Anne Calvo via e-mail to acalvo@winthrop.org.

Regional Program Director (RPD) – Albany Area Position Description: The RPD is responsible for the regional delivery and supervision of care management services provided for enrollees within the Managed Long Term Care Program (MLTC) in the Capital Region, in accordance with agency policy and procedures, and under the direction of the Senior Director of Care Management.

The RPD provides leadership and direction to the regional team ensuring that high quality, culturally sensitive and cost-effective services and benefits are provided.

Requirements: Bachelor’s degree from an approved school, acceptable to New York State Department of Health. Masters in Health degree in health-related field preferred 2 years’ experience as home care nurse in a health agency.

Current New York State driver’s license and automobile insurance.

Knowledge and/or experience in Long Term patient care and Chronic Disease Management.

HCA will be keeping members apprised of our advocacy progress, which begins with every HCA member participating in HCA’s State Advocacy Day meetings on February 2 (see related page 1 story).

Please sent résumés to Mary Cavanagh, Human Resources Manager, VNA Homecare at mcavanagh@477home.org.

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ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

HCA’s Popular CFO Forum on March 9 Has a New Name Finance issues are no doubt a top concern of your organization, reflected in the findings from our recent survey of the membership on reimbursement, billing, costs and operating-margin data.

As part of our ongoing efforts to support you in this big area, we are again offering our popular March program for CFOs and other finance leaders, but with a new name: HCA’s Senior Financial Managers Summit. (A registration form with full agenda is at the back of this week’s ASAP, but you can also find it on the “Education and Events” tab of our website.)

The Summit will be held in Albany on March 9 for a minimal charge of $99 to cover event costs, including lunch. This program is open to members only, a benefit of your continued membership in HCA. You’ve provided us the data in your survey responses on home care finances, and we’ve shared with you some initial reports on: aggregate home care and MLTC operating margins; billing issues; and payment lags.

Mindful of these major concerns, the Summit will help you plan for the future and understand the intricacies of these issues as the state’s fiscal year draws to a close, as a new state budget emerges, and as federal reimbursement/cost challenges continue to demand your attention.

At this program, you’ll gain updates from HCA’s policy staff, Department of Health officials and expert consultants and analysts on such topics as: •

The State Budget.

•

Next Steps with the Quality Incentive Vital Access Provider Pool (QIVAPP).

•

2016 Medicare Home Health Prospective Payment System (HHPPS) rule.

•

The Medicaid Rate-setting Process and Adjustments for QIVAPP, Wage Parity and Overtime Costs.

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Navigating Obstacles to Prompt Payment (at a time when providers report that less than half of Medicaid claims are paid within the prompt-pay timeframe).

•

New Data on Payment Innovations..

•

And More!

This is a great chance to discuss these issues in person and ask questions of the experts as you address major issues affecting the financial performance of your agency.

HCA’s Senior Financial Managers Summit March 9, 2016 9 a.m. to 3:15 p.m.

Albany Hilton Albany, New York 10

ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

Value Based Payment Committee Presented Next Round of Draft Recommendations The core Value Based Payment (VBP) model steering committee met this week to receive and discuss a host of remaining draft recommendations developed by VBP subcommittees.

In particular, the steering committee, on which HCA is a participant, received the recommendations of the combined subcommittee on Social Determinants of Health (SDH) and Community Based Organizations (CBOs). The recommendations spanned a wide range of areas where social determinants of health were recommended for VBP design and payment. Additionally, the recommendations addressed guidance, assistance, and financial needs of CBOs in support of VBP participation. Underlying both sets of recommendations is the need to finance them – both the cost of including/addressing SDHs, as well as financing the “readiness” and infrastructure costs of CBOs to viably participate in VBP. These are major outstanding issues.

Another is whether SDHs should be encouraged to be considered and incorporated by VBP partners in their models as quality/value elements, or whether they should become state-directed standards.

State Medicaid Director Jason Helgerson invited additional, written comments by committee members by the end of next Wednesday, January 27. The slide deck committee recommendations and other material are at http://hca-nys.org/wp-content/uploads/2016/01/VBPmaterialsJan222016.pdf.

HCA invites member comments to include in any further written comment we submit for the January 27 committee comment. Additionally, Mr. Helgerson indicated that the drafts will subsequently be posted for broad public comment, targeted for mid-March.

Comments can be emailed to HCA Executive Vice President, Al Cardillo at acardillo@hcanys.org.

Meanwhile, HCA continues to develop technical assistance resources, advocacy, and educational approaches that will assist the HCA membership in VBP participation. HCA providers are strongly encouraged to continue internal strategic discussions that would facilitate your participation in VBP, and to be actively reaching out to potential VBP partners, including managed care plans, hospitals, physicians, behavioral health providers, community clinics, and others.

For further information, please contact Al Cardillo at acardillo@hcanys.org, or Alex Blais at ablais@hcanys.org.

Home Care Emergency Preparedness In a week forecasting potentially monstrous winter storms, home care agencies should be ready as emergency preparedness needs and initiatives rise to the fore. Below are some recent developments and recommendations.

Review Update your HCS Emergency and Agency Role Contacts Home care and hospice providers are urged to review, update as necessary and otherwise ensure the accuracy of your agency point-people and roles on the Health Commerce System (HCS). This is vital year-round, but especially with the onset of the winter storm season.

Continued on next page

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Volume 21, No. 3 January 22, 2016

ASAP – a publication of the Home Care Association of New York State

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Continued from previous page Please review your emergency contact and all of your agency contact information posted to the HCS. This is especially critical as DOH has announced its intentions to conduct EP audits, mandatory emergency preparedness surveys during disasters, and drills – all of which demand reliable HCS information.

HCA Meets with Legislative Sponsors on Reintroduction of “Essential Personnel” Bill HCA met with Senator Andrew Lanza and Assemblyman Michael Cusick and their staff principals to discuss 2016 reintroduction of HCA’s “Essential Personnel” bill for home care and hospice emergency preparedness and response. The meeting took on the contextual relevance of the pending winter storm, only further underscoring the necessity of this bill.

Senator Lanza and Assemblyman Cusick have been the prime sponsors and legislative champions of this bill, having witnessed especially in their legislative districts (both represent Staten Island) the devastation of Hurricane Sandy. They have also conducted hearings and other oversight, gathering public and provider input on response challenges, needs and recommendations.

HCA worked with both sponsors to research, develop and draft the original and subsequent versions of the legislation to overcome the lack of recognition and treatment of home care and hospice personnel as “Essential Personnel.” This gap in designation has been a chief obstacle in emergency response, shown in many of the recent widespread public emergencies.

The 2015 legislation was vetoed in December by Governor Cuomo for reasons that are believed to be a misread of the bill.

This week’s meeting with Senator Lanza and Assemblyman Cusick focused on steps and plans for reintroduction and new passage of the bill, and working with the Governor to address any sources of concern or opposition in order to gain support and enactment into law.

HCA applauds the leadership of Senator Lanza and Assemblyman Cusick. We appreciate their continued close work with HCA to achieve this critical state policy change.

HCA Plans Upcoming EP Initiatives with State Department of Health HCA met this week with officials in the State Department of Health (DOH’s) offices of Health Emergency Preparedness (OHEP) and Primary Care and Health Systems Management (PCHSM) to discuss and plan important upcoming initiatives in home care emergency preparedness.

HCA will prepare and circulate a Memorandum with details; however, we note the following, for your information and planning: •

Coming in February, DOH will be conducting webinars (with HCA participation) on the implementation of the Transportation Assistance Levels (TALs) system in home care. Providers should consider participation in this webinar to learn more about this mandatory initiative which will be essential to emergency preparedness planning and response. TALs is a categorization and execution model for the planned evacuation of patients preparatory to an emergency, grouping patients by condition, transport 12

ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

resource need, transport personnel, and related considerations. TALs was implemented in hospitals, nursing homes and other facilities last fall. DOH has sought to work closely with the home care sector toward TALs compatibility with home care.

•

Also coming, as part of the February webinars, will be orientation to revisions in the DOH survey and reporting process for home care and hospice providers during emergencies. This is another critical reason why providers must plan to participate in the coming webinars. At least four dates are being planned in order to give provider staff ample opportunity to participate.

•

Coming in March or April is an active effort by HCA, DOH, the New York State Association of Health Care Providers, and regional officials to promote home care/hospice and local emergency manager connections at the county level. This effort will begin first in the 17 counties of the western New York region, with evaluation of experience and further planning to follow.

HCA Participates in Regional Emergency Preparedness Coalition and Tabletop EP Exercises This week, HCA participated in the Capital District Health Emergency Preparedness Coalition (HEPC) meeting, as well as in an emergency preparedness tabletop exercise with hospitals, public health officials and emergency responders on Ebola. HCA is a participant in HEPC meetings throughout the state. Ideas for drills from the HCA provider community can be forwarded to HCA Executive Vice President Al Cardillo at acardillo@hcanys.org or HCA Director of Policy Alex Blais at ablais@hcanys.org.

Care At Home Update The state Department of Health (DOH) has posted new guidance about the Care At Home (CAH) I/II Waiver retroactive eligibility period and CAH I/II application submission process.

The instructions are at http://www.health.ny.gov/health_care/medicaid/publications/pub2016gis.htm.

According to DOH, enrollment into the CAH I & II waiver program is determined by the date the local department of social services (LDSS) receives the Medicaid Waiver CAH I & II program application form signed by a parent/guardian.

In addition, paid or unpaid medical bills for the three-month period prior to the month of application may be eligible for payment/reimbursement.

The guidance also lists the documents needed to process a CAH I/II waiver application.

Questions can be directed to Linda Milano, CAH Coordinator, at 518-473-6020, or cah@health.ny.gov.

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ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

MedPAC Issues Recommendations for Home Health and Hospice Last week, the Medicare Payment Advisory Commission (MedPAC) met to finalize recommendations for 2017 provider pay rates which will be part of its annual report to Congress in March.

The recommendations include: •

Home health. Congress should direct the U.S. Centers for Medicare and Medicaid Services (CMS) to eliminate the pay update and rebase the pay system for two years, beginning in 2018. Congress should direct CMS to revise the pay system to eliminate the use of therapy visits as a factor in payment determinations, concurrent with rebasing.

•

Hospice. Congress should eliminate the pay update.

HCA will continue to advocate against these recommendations that are similar to past ones as part of our federal advocacy efforts.

State DOL Proposes Rule on Sharing of Wage Information The state Department of Labor (DOL) has issued a proposed rule to carry out a 2015 state legislative change that directs it to adopt standards “for reasonable workplace and workday limitations on the time, place, and manner for inquiries, discussions of, or the disclosure of wages.”

The proposed rule is at http://docs.dos.ny.gov/info/register/2016/january20/rulemaking.pdf (page 10).

One section of the proposal reads: An employer may, in a written policy provided to an employee either electronically, through publicly available posting, or by paper copy, place reasonable limitations on the time, place and manner that an employee may inquire about, discuss, or disclose wages. Such limitations must be justified without reference to the content of the regulated speech, narrowly tailored to serve a significant interest, and leave open ample alternative channels for the communication of information. An employer shall not impose restrictions on employees in such a way that unreasonably prohibit inquiry, discussion, or disclosure of wages at the worksite and/or during work hours, directly or in practice. An employer may prohibit an employee from discussing or disclosing the wages of another employee unless the other employee provides verbal or written consent, either directly or indirectly.

According to the announcement, employers who have policies establishing limitations on the inquiry, discussion, or disclosure of wages will be required to communicate such policies in writing and will also be required to maintain a copy of the policies for six years.

14

ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

UAS Offline Application to be Upgraded In conjunction with the February 1 upgrade of the UAS-NY online system to version 1.035, a new version (v.1.0.35) of the UAS-NY Offline Application must be installed.

After the online upgrade on February 1, 2016, version 1.0.35 of the Offline Application will be required in order to synchronize offline data.

For additional information about this upgrade, agencies should refer to the “UAS-NY Offline Application v1.0.35 Installation Guide” which will be available by close of business on January 22, 2016 in the Reference and Resources Section of the UAS-NY Training Environment Course 8500.

The Offline Application download will also be available in the UAS-NY Training Environment under Course 8500 Online and Offline Application by close of business Friday, January 22, 2016. Agencies are advised not to upgrade before January 30.

Due to the nature of the changes to the Offline Application, the state Department of Health (DOH) will be offering the following two “Savvy Sessions” to familiarize Offline Application Users with the new functionality.

Upgrading to the New Offline Client Wednesday, January 27, 2016 (11 a.m. to 12:15 p.m.): Event number: 643 289 576; Event password: uasny2016 https://meetny.webex.com/meetny/onstage/g.php?MTID=e37acf7a05137fc35b03515bfecc8276a Friday, January 29, 2016 (2 to 3:15 p.m.): Event number: 641 141 333; Event password: uasny2016 https://meetny.webex.com/meetny/onstage/g.php?MTID=e2d46ffbd3e038cbaffa5db29141ddea5 In addition, course “2300 – Using the Offline Application” has been updated, including the Quick Reference Guide; the new Course 2300 will be available the week of February 1, 2016.

Questions can be directed to the UAS-NY Support Desk at (518) 408-1021 or uasny@health.ny.gov.

Agenda Posted for PHHPC Committee on Establishment and Project Review The state Department of Health has posted the agenda for the January 28 meeting of the Public Health and Health Planning Council (PHHPC) Committee on Establishment and Project Review.

The agenda and supporting documents are at http://www.health.ny.gov/facilities/ public_health_and_health_planning_council/meetings/2016-01-28/.

The agenda includes applications by two counties (Orange and Saratoga) to establish LHCSAs and seven existing LHCSAs for changes in their ownership.

The January 28 meeting can be viewed by webcast at http://www.health.ny.gov/events/webcasts/. It will be followed by the full PHHPC meeting on February 11.

15

ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

2016 Standard Mileage Rates for Business, Medical and Moving Announced Rates Decrease from 2015 In mid-December, the Internal Revenue Service issued the 2016 optional standard mileage rates used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes.

Beginning January 1, 2016, the standard mileage rates for the use of a car (also vans, pickups or panel trucks) are: •

54 cents per mile for business miles driven, down from 57.5 cents for 2015.

•

19 cents per mile driven for medical or moving purposes, down from 23 cents for 2015.

•

14 cents per mile driven in service of charitable organizations

The announcement is at https://www.irs.gov/uac/Newsroom/2016-Standard-Mileage-Rates-forBusiness-Medical-and-Moving-Announced.

The business mileage rate decreased 3.5 cents per mile and the medical, and moving expense rates decreased 4 cents per mile from the 2015 rates.

The standard mileage rate for business is based on an annual study of the fixed and variable costs of operating an automobile. The rate for medical and moving purposes is based on the variable costs.

Taxpayers always have the option of calculating the actual costs of using their vehicle rather than using the standard mileage rates.

Updated FAQs Posted on Accountable Health Communities The U.S. Centers for Medicare and Medicaid Services (CMS) has posted updated Frequently Asked Questions (FAQs) on its Accountable Health Communities (AHC) Model.

The FAQs, along with a fact sheet and funding announcement, are at https://innovation.cms.gov/ initiatives/ahcm/index.html.

The AHC Model will examine whether systematically identifying and attempting to address health-related social needs of Medicare and Medicaid beneficiaries through referral and community navigation services can impact health care costs, reduce inpatient and outpatient health care utilization, and improve health care quality and delivery.

The AHC Model aims to identify and address beneficiaries’ health-related social needs in the following core areas: • •

Housing instability and quality; Food insecurity; Continued on next page 16

ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

Continued from previous page • • •

Utility needs; Interpersonal violence; and Transportation needs beyond medical transportation.

Applicants are highly encouraged to submit a non-binding letter of intent by February 8 to http:// innovationgov.force.com/ahc; applications are due March 31.

A webinar on the AHC Model application process will be held on: •

January 27, 2016 from 3 to 4:30 p.m. Register at http://tinyurl.com/z8nf27s.

Questions about the model and applications can be submitted to AccountableHealthCommunities@cms.hhs.gov or the help desk at 1-844-711-2664.

NY State of Health Individuals at Age 65 Sent to LDSS The state Department of Health (DOH) has issued guidance to inform local departments of social services (LDSS) of changes to the referral policy for NY State of Health (NYSOH) Medicaid recipients and Essential Plan consumers who turn age 65.

The guidance is at http://www.health.ny.gov/health_care/medicaid/publications/gis/16ma004.htm.

Until now, continuous coverage was provided to Medicaid recipients who turn age 65 and no longer qualify under the Modified Adjusted Gross Income (MAGI) category (i.e., are not a parent or caretaker relative).

Coverage for these individuals was continued until the end of their 12-month authorization period, and they were transferred at renewal from NYSOH to the LDSS. As outlined in previous instructions (GIS 15 MA/22), effective January 1, 2016, Medicaid recipients who turn age 65 and who no longer qualify under the MAGI category are not eligible for continuous coverage.

Due to this new policy, NYSOH will now refer these Medicaid recipients to the LDSS upon identifying them as turning age 65. Essential Plan consumers will also be referred to the LDSS upon identifying them as turning age 65.

Only those individuals whose 65th birthday falls within a certain period of their renewal cycle will be referred to the LDSS at renewal.

Home care providers should take into consideration this new policy if they serve affected individuals.

Other 2016 DOH guidance is at http://www.health.ny.gov/health_care/medicaid/publications/ pub2016gis.htm.

17

ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

CMS Home Health & Hospice Open Door Forum: January 27 The U.S. Centers for Medicare and Medicaid Services (CMS) will host a Home Health, Hospice and Durable Medical Equipment (DME) Open Door Forum on Wednesday, January 27 from 2 to 3 p.m.

It will include announcements and updates on: •

QIES System-Extended Systems Maintenance and CASPER Reports;

•

Home Health Compare (HHC) January Update and 2016 Schedule for HHC;

•

Interim QAO Reports

•

Home Health Value Based Purchasing (VBP) Project

•

Home health and Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS) Announcements

•

Advance Beneficiary Notice (ABN) and the Home Health Change of Care Notice (HHCCN) announcement

The dial-in number and code is: • •

Dial-in Number: 1-800-837-1935 Code: 37689253#

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

NGS Education Programs National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has recently posted the following educational webinars.

•

Home Health Billing Basics: January 26, from 2 to 3:30 p.m. Registration is at: https:// attendee.gotowebinar.com/rt/1971061881195217665.

•

Home Health Notices: ABN/HHCCN/NOMNC: January 28, from 2 to 3:30 p.m. Registration is at: https://attendee.gotowebinar.com/rt/6782070666040754689

•

Ordering and Certifying Medicare Home Health Services: January 29, from 3 to 4 p.m. Registration is at: https://attendee.gotowebinar.com/register/4348255498425786626.

For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

18

ASAP – a publication of the Home Care Association of New York State

Volume 21, No. 3 January 22, 2016 

Publications •

Revised Medicare Home Health Benefit Booklet – Includes information on (1) Qualifying for home health services; (2) Consolidated billing; (3) Therapy services and (4) Billing and payment. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNProducts/MLN-Publications-Items/ICN908143.html

•

“Medicare and Medicaid: Additional Oversight Needed of CMS’s Demonstration to Coordinate the Care of Dual-Eligible Beneficiaries,” by the Government Accountability Office http://www.gao.gov/assets/680/674340.pdf

•

“PECOS FAQs,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNProducts/Downloads/Internet-Based-PECOS-FAQs-Fact-Sheet-ICN909015.pdf

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

19

HCA State Advocacy Day EVENTS! REGISTRATION A confirmation email will be sent to you prior to the event with details on parking and building access.

Organization Name:____________________________________________________________________ ________________________________________ ___________________________________________ ____________________________________________ Participant’s Name Title Email ________________________________________ ___________________________________________ ____________________________________________ Participant’s Name Title Email

HCA’s PAC Fundraising Reception for Advocacy Day Tuesday, February 2, 2016 Senator Kemp Hannon Monday, February 1, 2016: 6:00 – 7:30pm HCA Office 388 Broadway, Fourth Floor Albany, NY 12207 Prior to our Advocacy Day, please join us on Monday evening for a fundraising reception for Senator Kemp Hannon, Chair of the Senate Standing Committee on Health. Regarded widely as an expert in health care public policy, Senator Hannon has worked to improve the quality of health care for all New Yorkers. The fundraising reception will be held at the HCA office. Refreshments and hors d’oeuvres will be provided. A

minimum $100 donation to “Citizens for Hannon” is requested.

Corporate and LLC checks are acceptable under NYS Election Law. 501 (c) (3) Organizations are prohibited from making political contributions.

HCA PAC Reception ____ Hannon Fundraising Reception @ $100 per person = $_________ (Please provide your payment information below for your donation)

Please make check payable to: Citizens for Hannon and mail to 388 Broadway, 4th Floor, Albany, NY 12207; or pay by credit card: _______ American Express

________ MasterCard

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9:30am – 12:30pm HCA Board of Directors Meeting with Legislators LOB 711A The HCA Board of Directors will welcome several key legislative leaders to present their vision for 2016. Invited are: Senator Kemp Hannon, Chair, Senate Health Committee Assemblyman Richard Gottfried, Chair, Assembly Committee on Health Senator James Seward, Chair, Senate Insurance Committee Assemblyman Kevin Cahill, Chair, Assembly Committee on Insurance Jason Helgerson, State Medicaid Director, DOH Paul Francis, Deputy Secretary of Health and Human Services, DOH Advocacy Day handouts will be provided for your afternoon legislative appointments.

12:30pm – 1:00pm – Lunch 1:00pm – 4:00pm Legislative Appointments Please schedule your legislative appointments as soon as you have registered to attend HCA’s Advocacy Day, or indicate on the registration whether you would like to join in HCA’s scheduled legislative visits.

(3 digit code on reverse) ________________ Exp. Date ____/____/____ Card Number ________________________________________________

HCA Board Meeting and Legislative Appointments

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Please indicate your participation below:

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Hotel Information

____ I will participate in HCA‘s afternoon legislative appointments.

____ I will schedule my own afternoon legislative appointments.

There are several hotels in the downtown area including:

Renaissance Hotel 144 State Street, Albany, NY Phone: (518) 992-2500

Hampton Inn Downtown Albany 25 Chapel St, Albany, NY Phone: (518) 432-7000

Hilton Hotel 40 Lodge St. (Corner of State), Albany, NY Phone: (518) 462-6611

FAX completed form to (518) 426-8788

SENIOR FINANCIAL MANAGERS SUMMIT March 9, 2016 9:00am – 3:15pm Albany Hilton Albany, New York

Join us!

HCA’s Senior Financial Managers Summit (formerly CFO Forum) is a must-attend program for home care financial managers, CFOs and other executive staff to hear from HCA policy staff, finance and reimbursement managers from the state Department of Health (DOH) and industry consultants on home care fiscal issues.

Kicking off the Forum, HCA staff will highlight key areas in the Governor’s proposed 2016-17 Executive Budget as well as many finance-related advocacy areas where we are working on your behalf – from the federal and state budget fronts to our work on the many rate packages and payment model implementation efforts occurring internally at the DOH and state Executive levels. DOH reimbursement officials will provide yet further details on all of these issues from the state’s perspective.

HCA has also invited a representative from the state Department of Financial Services (DFS) to review the requirements of the state’s Prompt Pay Law and how providers can file complaints with the state DFS concerning violations, and any other assistance provided by DFS. In addition, HCA has invited Ms. Margaret Willard from the state DOH to review the Department’s role in monitoring managed care plans, including the issuance of timely authorizations, re-authorizations and payments, and other issues.

Lastly, Ms. Audrey El-Gamil, from Dobson, DaVanzo & Associates, LLC. will provide highlights of an important study she conducted to identify the clinically appropriate and cost-effective placement of Medicare patients following discharge from the acute care hospital, and will offer suggestions on how home care can be utilized most effectively in the future. She has conducted extensive research on Medicare post-acute care payment policy and is a highly sought out expert.

Please do not miss out on this robust program which delves into several important areas relevant to your agency’s fiscal health.

SENIOR FINANCIAL MANAGERS SUMMIT

AGENDA

March 9, 2016 9:00am – 3:15pm Albany Hilton Albany, New York

March 9, 2016 9:00am – 9:30am HCA Registration & Continental Breakfast 9:30am – 10:30am HCA Update HCA staff will provide a state legislative update, which will focus on the Governor’s proposed 2016-17 Executive Budget and its impact on home care, along with an update on our advocacy efforts in Albany and in Washington. HCA staff will highlight our annual financial condition report as well as discuss the latest on Minimum Wage funding, DSRIP, Value Based Purchasing, QIVAPP and the 2016 Medicare Prospective Payment System (PPS).

10:30am – 11:30am Department of Health Update Tim Casey, Bureau of Long Term Care Reimbursement Daniel Carmody, Bureau of Managed Care Reimbursement Mr. Casey and Mr. Carmody will provide updates on the following: provisions in the 2016-17 Executive State Budget that impact home care, personal care and Medicaid managed long term care plans; the Medicaid Global Cap; CHHA Episodic Payment System (EPS) utilization data; premium rate adjustments to Managed Long Term Care (MLTC); QIVAPP funding, Wage Parity and Overtime adjustments to plans and home care providers; the CHHA, LTHHCP and Personal Care fee-for-service Medicaid rates; the 2015 Medicaid cost reports and other Medicaid reimbursement issues.

11:30pm – 12:30pm Navigating Obstacles to Prompt Payment John Powell, Acting Deputy Superintendent for Health, New York State Department of Financial Services (Invited) Margaret Willard, Director, Bureau of Managed Long Term Care, NYS Dept. of Health (Invited) Mr. Powell or another representative from the state Department of Financial Services (DFS) will review the requirements of the state’s Prompt Pay Law, how providers can file complaints with the state DFS concerning violations, and any other assistance provided by DFS. Ms. Willard will review the role of the state Department of Health (DOH) in monitoring managed care plans, including the issuance of timely authorizations, reauthorizations and payments, and other issues.

12:30pm – 1:15pm – Lunch 1:30pm – 2:45pm Medicare Post-Acute Care Payment Prognosis Audrey El-Gamil, Senior Manager, Dobson, DaVanzo & Associates, LLC Ms. El-Gamil has significant experience in health policy analysis and health services research with the majority of her recent research on Medicare post-acute care payment policy. For the home health industry, Ms. ElGamil was the project manager of a data-driven study that aimed to identify the clinically appropriate and costeffective placement of Medicare patients following discharge from the acute care hospital. During the session , Ms. El-Gamil will provide highlights of this study which examined how the Medicare home health benefit is currently serving Medicare beneficiaries but also investigated how Medicare's use of home health could better meet beneficiary needs and improve the quality and efficiency of care.

2:45pm – 3:15 HCA Closing Remarks & Adjourn

SENIOR FINANCIAL MANAGERS SUMMIT

March 9, 2016 9:00am – 3:15pm Albany Hilton Albany, New York

This is an HCA Members Only Program.

Payment of $99 per person

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Or, make checks payable to: HCA and mail to 388 Broadway, 4th Floor, Albany, NY 12207

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Cancellation Policy: Cancellations received by February 29th will receive a full refund, less 25% of total due as an administrative fee. Cancellations received on March 1st or later will forfeit their registration fee, as well as those who register and do not attend. Substitutions are permitted.

FAX TO: (518) 426-8788

Become an HCA Member If you are not currently an HCA Member, but wish to become one so you can take advantage of this and other educational programming, please contact Laura Constable at (518) 810-0660 or at lconstable@hcanys.org.

388 Broadway Fourth Floor Albany, New York 12207 PH (518) 426-8764 WEB www.hca-nys.org