Issuu

ASAP

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

Legislative Issues  Public Policy



News

Volume 20, No. 10 March 13, 2015

Senate, Assembly Present One-House Budget Bills and Resolutions Developments toward the adoption of a new state budget for 2015-16 reached another major milestone this week, as the Senate and Assembly introduced their own budget bills and resolutions. Each chamber’s measure stakes out its respective positions on the Governor’s original budget submission, as well as additional priority areas the individual houses will seek to advance. The next step in the process is the convening of joint legislative conference committees for reconciliation of each budget area, along with an overall joint Senate-Assembly leadership committee to which each of the joint conference committees will eventually report their recommendations. The leadership committee met late yesterday and thus commenced the discussion and negotiation process that will further lead to three-way reconciliation with the Governor. HCA continues to press for provisions in this year’s budget to support New York’s home care system as reflected in our previously shared advocacy documents. Iterations of our proposals were incorporated in either See BUDGET p. 2

As Congress Considers Medicare Cuts, Join Us for D.C. Advocacy on March 24 The ongoing ‘doc-fix’ issue in Congress continues to create new risks for Medicare payment-cutting offsets, including possible actions affecting home care payments. In this environment of enhanced risk, HCA needs to keep up our advocacy voice in Washington. On March 24, we will be holding our Federal Advocacy Day program to coincide with the National Association for Home See D.C. p. 5

Inside ASAP Senate, Assembly Present One-House Budget Bills & Resolutions....1 As Congress Considers Medicare Cuts, Join Us for D.C. Advocacy........1 Managed Care & QIVAPP Update........................................................6 Member Hiring Announcement............................................................6 Companionship Exemption Lawsuit Update......................................9 New ACO Model Offers Wider Risk-Reward Span..............................9 CMS Revises Enrollment Policies for Past Billing-Denial Patterns....10 Care at Home Eligibility Guidance Issued..........................................12 Comptroller: Medicaid to Grow $700M Annually Over 4 Years........13 State Releases December Medicaid Global Cap Report.................14 HCA Seeks HHA Experiences with MA In-Home Risk Assessments.......15 OPWDD Issues Rule on Late Cost Reports........................................16 NGS Updates.....................................................................................16 Publications.............................................................................................17

Helping New Yorkers Feel Right At Home

ASAP – a publication of the Home Care Association of New York State BUDGET from p. 1

Volume 20, No. 10 March 13, 2015 

or both of the legislative one-house measures this week, including proposals for a more flexible capital investment program, home care-managed care payment streamlining provisions, and legislation to encourage collaboration among home care providers, physicians and hospitals. (See charts on pages 3 and 4.)

The Senate rejects the Governor’s Advanced Home Health Aide proposals at this time, pending outcome of discussions and issues identified by the Department of Health’s Advanced Home Health Aide workgroup (of which HCA is a member); the Assembly, meanwhile, revises the Executive’s proposal with legislative provisions sponsored by Assemblywoman Glick providing for advanced aide services, as well as RN-to-aide ratios, nurse supervision frequency and other additional standards and requirements above the Executive’s model.

Also of consequence for home care, the legislative budget proposals either reject or limit the scope of the Executive’s provisions to: permanently extend and rebase the Certified Home Health Agency Episodic Payment System; implement a value based payment system for virtually all health care payments; permanently extend prior-year cuts and other reimbursement actions (e.g., the trend-factor elimination, Administrative and General caps); and permanently extend the Medicaid Global Cap.

The Assembly budget proposal would increase the state minimum wage to $10.50 effective December 31, 2016, with an increase up to $12.60 by December 31, 2018. The proposal would establish a New York City minimum wage of $12.50 effective December 31, 2016 that would increase up to $15 by December 31, 2018. All wages would be indexed to inflation in 2019.

In each of these cases, the Legislature opts to replace these permanent extensions with a more time-limited reauthorization or, in some cases, rejects or modifies the proposals altogether.

HCA continues to comb through each house’s bills and resolutions. While the bills and resolutions incorporate some important changes for home care, we stress that this remains a fluid process, and each item will require

Charts outline proposals

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 Laura Constable, Senior Director, Membership & Operations, lconstable@hcanys.org Lynda Schoonbeek, Director of Education, lschoonbeek@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

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

Volume 20, No. 10 March 13, 2015 

consensus from both houses and the Governor to be incorporated in the final agreement. Priorities can change up until the eleventh hour, and, given the uncertain nature of this process, HCA will keep up our engagement and advocacy on behalf of home care. Please see the charts on pages 3 and 4 for a list of the critical areas both directly and broadly related to home and community-based care in the Senate and Assembly one-house measures. HCA will keep you informed as developments occur. For more information, please contact a member of HCA’s Policy staff.

Senate and Assembly One-House Provisions that Impact Home Care Issue Area

Senate

Assembly

Capital Funding

Aggregates funding the Executive had proposed for predestined purposes and instead makes funding available for the continuum, including home care agencies. (HCA had advocated and submitted language for this purpose.) See also HIT below.

Accepts the Executive’s proposal buts sets aside $25 million for other delineated (nonͲhome care) purposes.

Payment Adequacy

Includes provisions to establish payment efficiencies through standardized codes and uniform billing (HCA had advocated and submitted language for this purpose) and electronic claims submission.

Includes provisions to require payment to managed care plans adequate for recruitment and retention of a qualified health care workforce, including adequacy for wages and benefits in both wage parity regions as well as other regions of the state; extends the same standards to rates plans would in turn be required to pay home care agencies. (HCA had advocated and submitted language for this purpose, with HCA language also covering additional, critical areas of payment adequacy for plans and providers.)

Advanced Home Health Aide (AHHA)

Rejects the Executive’s proposal at this time, pending outcome of discussions and issues identified by DOH AHHA workgroup. (HCA is serving on the workgroup and has submitted recommendations for elements needed for successful implementation by aides, RNs, agencies and managed care plans.)

Modifies Executive’s proposal with legislative provision sponsored by Assemblywoman Glick, providing for advanced aide services, as well as RN:aide ratios and other additional standards and requirements above the Executive’s model.

Health Information Technology (HIT)

Denies without prejudice Executive’s $55 million funding proposal for the Statewide Health Information NetworkͲNY (“SHINͲNY”) and repurposes funds to broader capital and HIT needs. Aggregates funding the Executive had proposed for predestined capital purposes and instead makes funding available for the continuum including home care agencies, and via a single application for HIT. (HCA had advocated and submitted language for this purpose.) Establishes a Health Technology Assessment Committee to consider factors related to technology and make recommendations to DOH related to Medicaid coverage for these devices. (HCA had advocated and submitted language for multiͲtier funding and support for home care clinical and health information technology.)

Includes Executive proposal for $55 million allocation to support the SHINͲNY, including provider participation in Regional Health Information Organizations (RHIOs). Also establishes a State Heath Information Technology Committee on coverage. (HCA had advocated and submitted language for multiͲtier funding and support for home care clinical and health information technology.)

Continued on next page 3

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

Volume 20, No. 10 March 13, 2015 

Senate and Assembly One-House Provisions (continued from p. 3) Issue Area

Senate

Assembly

Value Based Payments (VBP)

Rejects the Executive VBP proposal for Medicaid and all other payors. (HCA is participating with DOH and other sectors in a workgroup on VBP and presenting issues the home care sector would need addressed for VBP.)

Rejects the Executive VBP proposal for Medicaid and other payors. (HCA is participating with DOH and other sectors in a workgroup on VBP and presenting issues the home care sector would need addressed for VBP.)

CHHA Episodic Payment System (EPS) Rebasing

Includes Executive proposal, except that it extends Episodic Payment System for four years instead of permanently. (HCA advocated and submitted language to include base/rate enhancements for priority purposes – e.g., compensation, HIT, quality, mandate expenses, etc.)

Rejects Executive proposal; extends rebasing for 2 additional years and restores $15 million funding that would be reduced from rebasing. (HCA advocated and submitted language to include base/rate enhancements for priority purposes – e.g., compensation, HIT, quality, mandate expenses, etc.)

Medicaid Global Cap

Continues for an additional year, but rejects Executive proposal to make permanent. (HCA advocated against making permanent.)

MLTC Transportation CarveͲout

Rejects Executive proposal to carve transportation out of MLTC payment and jurisdiction and restores MLTC funding. (HCA advocated rejection/restoration.)

HospitalͲHome CareͲPhysician Collaboration Program

Establishes the HospitalͲHome CareͲPhysician Collaboration Program to support voluntary initiatives to improve patient care access and management, patient health outcomes, and community health. (This has been a major priority of HCA and grew out of our work with the Iroquois Healthcare Alliance.)

No provision

Prior Cost Saving Actions

Extends for two years, instead of permanently, many prior reimbursement actions, including Administrative and General (A&G) caps for CHHAs and LTHHCPs and Medicare Maximization targets; and extends for one year instead of permanently the elimination of the Medicaid trend factor.

Also extends prior reimbursement actions for a set period of time instead of permanently.

Spousal Refusal

Rejects Executive proposal to severely limit spousal refusal.

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Volume 20, No. 10 March 13, 2015 

D.C. from p. 1

Care and Hospice (NAHC) Policy Conference. If you are attending the NAHC conference, please save this date to join us on Congressional visits at the Capitol. (You can expect more details on our program in the coming week.) Doc-fix negotiations head for critical deadline The so-called ‘doc-fix’ is shorthand for a series of short-term patches that Congress has made in recent years to the Sustainable Growth Rate formula, or SGR, to prevent massive payment cuts to physicians.

While the debate about the SGR poses vulnerabilities, it also offers an opportunity for the addition of provisions sought by the home care community, including mitigation of the face-to-face requirement, extension of the Medicare rural add-on, and other provisions sought by HCA and NAHC. We need to use this opportunity to press the case for these critical home care priorities. Please save the date for March 24 in Washington, and stay tuned for further updates next week explaining how you can help us advocate for home care in this dynamic and challenging environment.

Find the latest HCA education programs at http://www.hca-nys.org/events.cfm

Each time the short-term patch expires – as the current one does on March 31 – Congress is compelled to avoid major physician payment cuts by revisiting payment offsets in other areas of health care, either through another short-term patch or by developing a longer-term legislative solution. NAHC reports that this latter option, a longer-term fix, is being considered by House and Senate leaders, at a cost of $210 billion over 10 years. Those costs would be reportedly offset, at least in part, by a reduction in Medicare rates, including the possibility of about a 1 point reduction in the market basket index which would affect home health and hospice providers. NAHC reports that the measure under consideration does not currently involve discussions of a home health or hospice copayment or other costsharing for beneficiaries, but these provisions remain an ongoing risk.

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

Volume 20, No. 10 March 13, 2015 

Managed Care & QIVAPP Update The state Department of Health (DOH) provided several updates on the Fully Integrated Duals Advantage (FIDA) program, the transition to Managed Long Term Care (MLTC) plans, and the Quality Incentive Vital Access Provider Pool (QIVAPP) monies at its recent Managed Care Policy and Planning Meeting. FIDA The first wave of “passive enrollment” for New York City and Nassau County (Region I) will be effective April 1, 2015, for: •

Non-Supplemental Security Income (SSI) individuals with an annual coverage authorization date between June and August 2015.

•

SSI individuals with a birthday between January and March.

The 90-day, 60-day, and 30-day notices that inform these individuals about the option to enroll in FIDA or “opt out” were already mailed to these individuals who are now being passively enrolled because the time has since expired for them to enroll or opt out. The second wave of “passive enrollment” for New York City and Nassau County (Region I) will be effective May 1, 2015, for: •

Non-SSI individuals with an annual coverage authorization date between September and November 2015.

•

SSI individuals that have a birthday between April and June. Continued on next page

HIRING VNA Home Care: Quality Assurance/Performance Improvement Manager The Quality Assurance/Performance Improvement Manager is responsible for the direct implementation of the Corporate Quality Improvement Plan including the identification of care outcomes and the development of appropriate intervention action plans throughout the Certified Home Health Agency (CHHA), Licensed Home Care Services Agency (LHCSA), Managed Long Term Care (MLTC) plan, and Social Adult Day Center (SADC). Qualifications: Current license as a Registered Nurse, Physical Therapist, or Occupational Therapist in New York State; Bachelor’s degree from an approved school, acceptable to the state Department of Health, Master’s Degree preferred; Two years of experience as a clinician in home and community based services. To learn more about the position and to apply, please visit http://477home.org/2015/02/quality-assuranceperformance-improvement-manager-syracuse-ny/.

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Volume 20, No. 10 March 13, 2015 

Continued from p. 6 The 90-day and 60-day notices were already mailed to these individuals and the 30-day notice will be sent from March 24 to 26. The state expects to passively enroll about 7,134 individuals into FIDA in April and 8,667 in May. Since the start of March, 749 individuals have enrolled into FIDA in Region 1 and 31,801 have chosen to “opt out.” Recently, DOH has released the final appeal and grievance notices and updated its FIDA website to include FIDA policy documents, brochures and Frequently Asked Questions. They are at http://www.health.ny.gov/health_care/medicaid/redesign/mrt_101.htm. DOH is reviewing current marketing rules to provide additional clarification based on plan questions. Officials indicated that plans should be actively engaged in marketing activities outlined in approved marketing plans, conducting outreach to existing MLTC members, and scheduling marketing events. DOH is developing an MLTC/FIDA comparison chart for plans to share as an explanation of FIDA benefits. FIDA for OPWDD The Office for People with Developmental Disabilities (OPWDD) is working with one managed care plan to develop a FIDA plan that will be offered voluntarily to certain populations served by OPWDD. This FIDA-IDD (individuals with developmental disabilities) plan will deliver integrated health care and long term care benefits to individuals with Medicare and Medicaid who reside in New York City, Long Island, Westchester and Rockland and who choose to participate in the Demonstration. The FIDA-IDD plan will be available in all of the above-mentioned counties at once; there will be no phased implementation. Plans will be responsible for coordination of all services (Medicare, Medicaid, specialty OPWDD services, and any others required to meet the individual’s needs). The Demonstration is currently scheduled to begin later in 2015 and continue through 2018. The state is working with the U.S. Centers for Medicare and Medicaid Services (CMS) to finalize a Memorandum of Understanding (MOU). Once the MOU is finalized, a three-way contract will be created between the plan, the state and CMS. The state expects to enroll about 2,000 individuals in the early years and more than 5,000 in later years. MLTC transition The areas that have not transitioned to MLTC plans and that await approval by CMS are: the Southern Tier counties of Allegany, Chautauqua, Chemung, Schuyler, Seneca and Yates; and the North Country counties of Clinton, Essex, Franklin, Hamilton, Jefferson, Lewis and St. Lawrence. Cattaraugus County was approved by CMS for transition in February. DOH has begun mailing of announcement notices to those individuals currently receiving community-based long term care services. Continued on next page 7

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Volume 20, No. 10 March 13, 2015 

Continued from p. 7 As of March 9, 2015, anyone newly seeking community-based long term care services will be directed to the enrollment broker, NY Medicaid Choice, for education on MLTC options. Also, anyone currently in an MLTC plan can remain in that plan or transfer to another MLTC plan but can no longer return to Medicaid fee-for-service. CFEEC The Conflict-Free Evaluation and Enrollment Center (CFEEC) is operational in the following counties: Bronx, Nassau, New York, Kings, Queens, Staten Island, Suffolk and Westchester. On March 1, 2015, CFEEC was implemented in the following counties (Region 4): Albany, Columbia, Dutchess, Erie, Fulton, Greene, Monroe, Montgomery, Onondaga, Orange, Putnam, Rensselaer, Rockland, Saratoga, Schenectady, Schoharie, Sullivan, Ulster, Warren and Washington. Under CFEEC, an entity (Maximus) provides independent and conflict-free evaluation, education, and enrollment services for new applicants in need of community-based long term care services. The CFEEC evaluates an individual’s eligibility for Medicaid communitybased long term care and enrollment into an MLTC plan. www.hcaannualconference.com DOH reported that 76 percent of all individuals evaluated and educated by Maximus, the Enrollment Broker, enroll in the plan that they ask to be referred to.

Visit HCA’s Annual Conference website for registration, sponsor information, session summaries and more!

QIVAPP At this week’s Managed Care Policy and Planning Meeting, DOH stated that MLTC plans have been sent the amount of their QIVAPP allocation for each of their eligible home care contractors. The plans will receive a state-share lump sum payment in cycle 1958 with a check release date of March 18, 2015. Plans will be required to pass through the entire amount of these funds to their eligible providers by April 15, 2015. DOH will be requesting that plans send information on the actual aide hours provided from June 2014 through February 2015 and estimates for March 2015. DOH will use this data to reconcile the amount owed to plans subject to CMS approval of its $35 million share of the QIVAPP monies. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

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

Volume 20, No. 10 March 13, 2015 

Companionship Exemption Lawsuit Update The National Association for Home Care and Hospice (NAHC) has provided a new update about pending litigation targeting the “companionship exemption” rule change. As extensively reported, the federal rule change would eliminate the current Fair Labor Standards Act (FLSA) “companionship exemption” for home care agencies. In the latest news, the Court of Appeals for the District of Columbia has set a briefing schedule that will be completed in early April. Oral argument before a three-judge panel has been scheduled for May 7. With such scheduling, it is very possible that a decision could be issued before the court goes on its July recess. Still, the timing of any possible ruling is very hard to predict. On February 27, numerous parties filed amicus briefs supporting the U.S. Department of Labor (DOL) in its defense of the rule. These parties include: unions; four states, including amici curiae by New York, Massachusetts, Illinois and New Mexico; advocacy organizations representing seniors and persons with disabilities; Members of Congress; and various advocacy groups. The states, in particular, support DOL’s arguable contention that extending wage and hour protections to home care workers will not vastly inflate state Medicaid costs but, rather, reduce long-term Medicaid expenditures for states by enhancing the quality of care. HCA has taken issue with this contention and pointed out that New York State, one of the amicus filers, has in the past acknowledged that the final rule will actually lead to increased Medicaid costs, prompting the state to seek HCA’s assistance in sharing cost estimates from a member survey we conducted on the impact of the rule. NAHC’s reply brief is due March 30. Thereafter, it is expected that numerous parties will submit amicus briefs in support of NAHC’s position. Among the expected supporters are disability advocacy groups, state Medicaid programs, members of Congress, and business groups. Supporters are expected to argue that Medicaid rates control worker compensation and that these rates are not rising to cover the cost of overtime. As a result, worker compensation is likely to suffer as employers restrict working hours to stay within the financial constraints imposed by Medicaid rates. Restrictions on work hours negatively impact home care consumers as they will see an increase in the number of workers needed to care for patients, triggering worker dissatisfaction and turnover. Indeed, a number of state Medicaid programs are restricting or planning on restricting working hours to avoid overtime costs. Stay tuned for further updates. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

New ACO Model Offers Wider Risk-Reward Span The U.S. Department of Health and Human Services (HHS) announced a new initiative known as the Next Generation Accountable Care Organization (ACO) model of payment and care delivery. Participants in the Next Generation ACO Model will take on greater performance risk than do participants in current ACO models, while also potentially sharing in a greater portion of savings. To support increased risk

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Volume 20, No. 10 March 13, 2015 

sharing, according to HHS, ACOs will have a stable, predictable benchmark and flexible payment options that support ACO investments in care improvement. This model is for ACOs that are experienced in coordinating care for populations of patients. It will allow these provider groups to assume higher levels of financial risk and reward than are available under the current Pioneer Model and Shared Savings Program. According to HHS, the new ACO model encourages greater coordination and closer care relationships between ACO providers and beneficiaries. ACOs will have a number of tools available to enhance the management of care for their beneficiaries. These tools include rewards to beneficiaries for receiving their care from physicians and professionals participating in their ACOs, coverage of skilled nursing care without prior hospitalization, and modifications to expand the coverage of telehealth and post-discharge services to support coordinated care at home. CMS has opened two rounds of applications in 2015 and 2016, with participation expected to last up to five years. Interested organizations must submit a Letter of Intent by May 1, 2015 and an application by June 1, 2015. Second round Letters of Intent and applications will be available in spring 2016. For more information, go to http://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/.

CMS Program Integrity Manual Revisions Strengthen Enrollment Policies for Past Billing Denial Patterns The U.S. Centers for Medicare and Medicaid Services (CMS) has recently issued change request (CR) 9065 that integrates Medicare Incentive Reward Program and Provider Enrollment Rule changes into Chapter 15 of the Medicare Program Integrity Manual. CMS’s CR specifically adds stronger enrollment policies related to denials and revocations. For example, reasons for denials related to existing overpayments now include providers and suppliers or owners that were previously the owner of a provider or supplier that had a Medicare debt. In addition, CMS includes several factors to be considered in determining if uncollected debt poses an undue risk of fraud, waste, or abuse. Another key provision expands the reason for revocations related to abuse of billing privileges. A provider or supplier could have their billing privileges revoked if they are shown to have a pattern or practice of submitting claims that fail to meet Medicare requirements. In making this determination, Medicare will consider such factors as: the percentage of past denied claims and the reason for those denials; the length of time this pattern has occurred; the provider or supplier’s past history of final adverse actions; and other considerations. CR 9065 can be downloaded at http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R581PI.pdf. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

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

Volume 20, No. 10 March 13, 2015 

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

Volume 20, No. 10 March 13, 2015 

Care at Home Eligibility Guidance Issued The state Department of Health (DOH) has issued guidance to clarify and reinforce current policy requirements regarding Medicaid eligibility for parents or legal guardians of children participating in the Office for People with Developmental Disabilities (OPWDD) Care at Home (CAH) III, IV and VI Waiver Programs. These waiver programs are available to families with children living at home who have severe disabilities or medical conditions. To be eligible, the child must: •

Be under 18 years of age;

•

Have a developmental disability as defined by the Mental Hygiene Law;

•

Demonstrate complex health care needs that are expected to last at least 12 months;

•

Be eligible for the level of care provided in an intermediate care facility (ICF) for persons with developmental disabilities;

•

Not be in a hospital, skilled nursing facility, ICF or other institution; and

•

Be eligible for Medicaid using only the child’s income or resources.

Parents or legal guardian of CAH enrollees must be ineligible for Medicaid In addition, the child’s parents or legal guardian must apply and be denied Medicaid due to excess income or resources. Once enrolled into any of the CAH III, IV or VI Waiver Programs, the child is required to re-certify for Medicaid annually. The case manager needs to assess and document in the child’s case record that the child has recertified for Medicaid coverage annually. The case manager also needs to verify that the child’s parents or legal guardian have remained ineligible for Medicaid coverage. The case manager needs to contact the local Department of Social Services (LDSS) in upstate counties and the Human Resources Administration (HRA) for counties within New York City on an annual basis to verify the Medicaid status of the parents or legal guardians. If the parents have been found eligible for Medicaid within the prior year, then the child is no longer eligible for the waiver. The child and family should be referred to OPWDD’s ‘Front Door’ to determine if alternative services or programs may be available for the child. If the parents have not applied for or been found eligible for Medicaid within the prior year, the case manager must then document these findings in the child’s record every year while the child is participating in one of the CAH III,IV and VI Waiver Programs. DOH’s guidance is at http://www.health.ny.gov/health_care/medicaid/publications/gis/15ma002.htm. Questions about it can be directed to Lynda Baum-Jakubiak, Statewide CAH Coordinator, at (518) 486-6466.

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Volume 20, No. 10 March 13, 2015 

Comptroller: Medicaid to Grow $700M Annually Over Next 4 Years The State Comptroller’s Office issued a report this week on the state’s Medicaid Redesign efforts and cost measures. While the report concludes that the effort to keep Medicaid growth at 2 percent has worked, it notes that Medicaid expenditures are still on track to increase by an estimated $700 million annually for the next four years. The report noted that the federal government paid 51.7 percent of New York’s $55.3 billion in Medicaid spending during fiscal year 2013-14. The state paid $18 billion or 32.5 percent, while New York City and county governments paid $8.8 billion, or 15.9 percent. Overall spending on the program rose by an average of 5.3 percent annually from 2001 through 2010. From 2010 through 2013, New York held average annual increases in spending to 1.7 percent. Medicaid enrollment in New York rose by more than 580,000 beneficiaries, or 12.3 percent, reaching 5.3 million, from 2010 through 2013. Total enrollment is expected to exceed 6.4 million by fiscal year 2016-17, and state-funded spending is projected to increase $2.8 billion by 2018-19, according to the Division of the Budget (DOB). While enrollment has risen steadily in recent years, particularly among lower-cost children and working age adults, spending per Department of Health (DOH) Medicaid enrollee in New York declined each year from 2009 through 2013. The $8 billion federal Medicaid waiver amendment approved in April 2014 by the U.S. Centers for Medicare and Medicaid Services provides incentives for cost controls and a broad restructuring of the state’s Medicaid system. For example, in the fourth and fifth years of the waiver, the state has agreed to limit the growth in total Medicaid spending – excluding growth in federal funding associated with the Affordable Care Act (ACA) – to the ten-year rolling average of the medical component of the Consumer Price Index. This cap currently only applies to state spending on DOH Medicaid services. (See related p. 14 story about the latest Medicaid Global Spending Cap report.) The report also found: •

Services for aged, blind and disabled beneficiaries represent approximately 60 percent of the state’s Medicaid expenditures, at an average per-patient cost of more than $22,000 in 2013, although fewer than one in four recipients are in these categories. Children and non-disabled adults, who make up 75 percent of beneficiaries, are responsible for less than 40 percent of program costs; and

•

Average spending per Medicaid enrollee fell each year from 2009 through 2013, with larger declines in 2011 and 2012.

The full report is at http://www.osc.state.ny.us/reports/health/medicaid_2015.pdf. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

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

Volume 20, No. 10 March 13, 2015 

State Releases December Medicaid Global Cap Report Home care and personal care spending slightly above projections The state Department of Health (DOH) has issued its December 2014 Medicaid Global Spending Cap report. It shows overall spending to be $9 million less than projected for the current fiscal year through December. (The current state fiscal year began on April 1, 2014 and ends March 31, 2015.) The actual spending amount for this seven-month period was $12.7 billion versus an estimated spending amount of $12.709 billion. The cap for the entire fiscal year is $17 billion. DOH’s report is at: http://www.health.ny.gov/health_care/medicaid/regulations/global_cap/monthly/ sfy_2014-2015/docs/dec_2014_global_cap_report.pdf. For reporting purposes, home care and personal care services are lumped into the category labelled “Other Long Term Care.” According to the report, that category was $7 million above projections for the eightmonth period ending December 31 – a difference between projected spending of $530 million and actual spending of $537 million. Medicaid Managed Care was $38 million over the projection of $9.151 billion for this period, according to the report. More specifically: •

Mainstream Managed Care was $84 million above projections, due to higher than expected paid claims through December.

•

Long Term Managed Care was $46 million under projections through December. Total enrollment in the program is approximately 4.2 percent below expected levels (by a difference of 5,900 recipients).

Medicaid enrollment reached 6,057,447 at the end of December 2014, an increase of 353,010 enrollees (or 6.2 percent) since March 2014. The report breaks down this data by managed care and fee-for-service enrollment, and enrollment totals for New York City and the “Rest of the State.” DOH’s report also provides other data on accounts receivable, Medicaid rate adjustments, enrollment in the state’s health care exchange, and various state Medicaid savings initiatives. As conveyed to members during a statewide budget conference call last month, HCA has expressed concerns to DOH about the impact of retroactive payments on the global cap. The state’s calculation of spending relative to the global cap is cash-based, meaning that any retroactive payments made to providers for services in one year could actually be measured against the cap in a later year, leaving the system vulnerable to spending overruns if the cap forecast doesn’t account for the payment delay. Such could be the case for the 2 percent across-the-board cut, which the state is seeking federal approval to eliminate, retroactive to April 1, 2014. HCA has discussed this issue with the Department and will be carefully assessing the reconciliation of funds relative to the cap. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

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

Volume 20, No. 10 March 13, 2015 

HCA Seeks Info on Provider Experiences Conducting In-Home Risk Assessments for Medicare Advantage Plans HCA is seeking information from any members who are conducting in-home risk assessments on behalf of Medicare Advantage (MA) managed care plans. The information will support our effort to seek flexibility in federal guidelines for MA plans to promote the use of home health agencies for this purpose. As noted in the February 27 ASAP, in mid-February, the U.S. Centers for Medicare and Medicaid Services (CMS) released proposed changes (in a “Call Letter”) for MA and Part D prescription drug plans. Of particular interest to home care providers, the 2016 Call Letter includes guidelines for in-home assessments that some MA plans conduct with physicians or non-physician practitioners. In the past, CMS has raised concerns that such visits were being used to report more diagnosis codes and increase payments for enrollees, and the federal agency questioned if members’ regular providers were receiving the information collected at the visits and using this to improve care. CMS, however, does recognize that in-home assessments can have a significant value for care planning and coordination. Thus, CMS is encouraging plans to adopt best practices for in-home assessments, including: •

In-home assessments be performed by physicians, or a qualified non-physician practitioner (NPP), specifically advanced practice registered nurses, nurse practitioners, physician assistants or certified clinical nurse specialists;

•

Medication review and reconciliation;

•

Scheduling appointments with appropriate providers and making referrals and/or connections for the enrollee to appropriate community resources;

•

Conducting an environmental scan of the enrollee’s home for safety risks and need for adaptive equipment;

•

A process to verify that needed follow-up care is provided;

•

A process to verify that information obtained during the assessment is provided to the appropriate plan provider(s);

•

Provision to the enrollee of a summary of the information, including diagnoses, medications, scheduled follow-up appointments, plan for care coordination, and contact information for appropriate community resources; and

•

Enrollment of assessed enrollees into the plan’s disease management/case management programs, as appropriate.

Since a lot of the above services are also provided by home health agencies (HHAs), HCA contacted the National Association for Home Care and Hospice (NAHC) to find out if they were planning to submit comments on the appropriateness and utility of employing HHAs to conduct the in-home risk assessments. NAHC did, in fact, 15

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

Volume 20, No. 10 March 13, 2015 

submit comments recommending that CMS permit MA plan flexibility to work with HHAs to coordinate and delegate several of the components within the in-home assessment. NAHC points out that HHAs have more extensive experience in conducting several of the elements in the proposed comprehensive assessment than physicians or NPPs. Under NAHC’s recommendations, physicians and NPPs would be responsible for assigning the diagnoses and any other required care provisions as delegated by the plan, and CMS could require that the HHA be part of the plan’s network in order to maintain better oversight of the agency’s involvement. HCA asks members to contact Andrew Koski at HCA if you have conducted in-home assessments for MA plans so we can learn of your experiences. He can be reached at (518) 810-0662 or akoski@hcanys.org.

OPWDD Issues Rule on Late Cost Reports The Office for People with Developmental Disabilities (OPWDD) has issued a proposed rule that would change the requirements for imposing a penalty on providers that fail to meet filing deadlines for cost reports. The proposed rule is at http://docs.dos.ny.gov/info/register/2015/march11/pdf/rulemaking.pdf (page 21). Existing OPWDD regulations require that providers file cost reports no later than 120 days after the last day of the reporting period, and allow for one 30-day extension for providers that are unable to meet the 120-day deadline. The regulations also require OPWDD to provide written notice to the provider when the provider fails to meet the applicable deadline, and allow a 15-day grace period for the provider to respond to the notice before being subjected to a reimbursement penalty. Lastly, the regulations allow for a waiver of the penalty for unforeseeable circumstances beyond the provider’s control. The proposed amendments would automatically impose the penalty after 120 days if the provider does not apply for a 30-day extension and eliminate both the written notice of failure to file a cost report and the 15-day grace period. Elimination of the 15-day grace period will result in the penalty being imposed earlier in the process. OPWDD will hold a hearing on April 27 in Albany to obtain feedback on the proposed changes and will also take comments until May 4.

NGS Updates National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has recently posted the following information to its website. •

2015 Annual User ID Recertification – All users of Direct Data Entry (DDE) systems are required to recertify their access annually. NGS has sent an access code to all active users during the week of March 9 to 13 to complete the recertification process. This recertification pertains only to your NGS user ID. If you have access to multiple regions within the NGS jurisdictions, you will be required to recertify for each of those regions. If you have access to a non-NGS region, you will need to check with the carriers of each region for their recertification procedures. Every user that has an active User/Login ID prior to December 31, 2014 must complete 16

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

Volume 20, No. 10 March 13, 2015 

the recertification. Users who were assigned a user ID or had their ID reinstated after December 31, 2014, will not need to recertify until 2016. If an access code is not received by March 13 (today) you should click on the recertification banner on NGS’s website to complete the Recertification Inquiry Form. •

Payment Penalties for Hospices that do Not Submit Quality Data – CMS has issued Change Request (CR) 9091 which summarizes penalties for hospice agencies that do not comply with the quality data submission requirements of Medicare. Make sure that your billing staff is aware of these changes. CR 9091 can be downloaded at: http://www.cms.gov/Outreach-and-Education/Medicare-LearningNetwork-MLN/MLNMattersArticles/Downloads/MM9091.pdf.

•

Reminder: EDI Gateway Password Change Requirement – Due to recent CMS policy changes, NGS will implement the Electronic Data Interchange (EDI) Gateway password reset security enhancements, beginning on March 15, 2015. NGS has posted to its website a list of new password security requirements that will be implemented with this requirement.

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

Publications •

“CMS Bundled Payments for Care Improvement (BPCI) Initiative Models 2 to 4: Year 1 Evaluation & Monitoring Annual Report,” by the Lewin Group http://innovation.cms.gov/Files/reports/BPCI-EvalRpt1.pdf

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

2015 Annual Membership Conference May 6 & 7, 2015 ACHE Leadership Institute May 8, 2015 Saratoga Hilton â€“ Saratoga Springs, NY

Dear Members and Friends of HCA,

Who Should Attend Chief Executive Officers, Executive Directors, Administrators, Finance Managers, Clinical Leaders or any other department leader who plays a key role in the success of your operation.

Why not use the HCA Annual Conference as an educational retreat for your team? Let us know if we can help make that happen!

NAB Continuing Education Clock Hours The HCA Annual Conference has been submitted, but not yet approved, for Continuing Education clock hours from the National Association of Boards of Examiners of Long Term Care Administrators (NAB/NCERS).

A sea of change is happening in health care, and we all have weathered its rough waters over the past two years. But with change comes renewed purpose. Today you are no doubt seeing this outcome as you run a tighter ship, diversify what you offer your community, and extend new lines of outreach well beyond the deck of your organization, engaging new players and partners in an increasingly coordinated system. On this new course, home care needs to ride the wave of opportunity, and avoid getting overwhelmed by the flow of new information, expectations and shifting currents. This takes skill, intelligence, strategic thinking, patience and courage. HCA’s 2015 Annual Membership Conference aims to support you in this effort by bringing you tips, tools and strategies to help you successfully point your ship in the right direction and embark on a course of positive change. Our conference is now a two-day event, on May 6 and 7, reducing the cost to you and limiting the amount of time spent away from your office while offering you the same caliber of excellent learning and networking opportunities that have always been a signature of our conference. Also new this year, we are adding a half-day Leadership Institute on May 8, brought to you by the American College of Healthcare Executives. You can choose to attend both programs – the HCA Annual Conference and the Leadership Institute – or only one. All programs will take place at the Saratoga Hilton, in Saratoga Springs, where we’ll have an exciting lineup of world-renowned speakers and industry experts offering thought-provoking ideas and valuable learning opportunities. The Annual Conference is an ideal setting to network with your peers, pay tribute to outstanding individuals in the industry through our awards program, and visit with an assortment of vendors who will be on hand showcasing their latest products or services. If you are new to home care, new to your agency or if your agency just recently joined HCA, the Annual Conference is a perfect way to get your feet wet, meet HCA’s team, make new contacts, and learn. To broaden your team’s learning experience, HCA is also offering one of your staff members the opportunity to attend the conference at half price and the leadership institute at the lowest price possible if they’ve never attended HCA’s conference before. To take advantage of this “first-timer” opportunity, you must register yourself and your staff person by April 6. This is a great way to show your appreciation to a valuable member of your staff. (Online registration for this offer is not available; please use the registration form in this brochure.) So what are you waiting for? Check out the agenda and register today! I look forward to seeing you there.

Joanne Cunningham President HCA

We also extend a special thanks to HCA’s Board of Directors who donate their time and talents for the success of HCA. Marie Andreacchio Allen Health Care Services Susan Brett, People Care, Inc. Maura Cahill-Bordas Hebrew Hospital Home, Inc. Anne Calvo, Winthrop University Hospital Home Health Agency

Hotel Information

Susan Caputo, Individual Member Northport, NY

The Saratoga Hilton, Saratoga Springs, NY is the site of the HCA Annual Conference. Rooms at the Saratoga Hilton are per night. This discounted rate is available until April 5. After this date, higher rates will prevail. Parking is $5 per night.

$162

To make a reservation, call 888-866-3596 or register online at https://resweb.passkey.com/go/HCANYS2015 The hotel’s check-in time is 4 p.m. and check out is 11 a.m. Luggage storage is available should your room not be ready prior to check-in time.

HCA graciously thanks those Sponsors and Exhibitors who have already committed to support you and this signature educational event.

Shelly Eggleton Lourdes At Home/Hospice At Lourdes Michael Feinman Any-Time Home Care, Inc. Ann Frisch, New York City HHC – Health & Home Care Bridget Gallagher Jewish Home Lifecare Ginger Hall, Jefferson County Public Health Services Pamela Joachim, Montefiore Medical Center Home Health Agency Orael Keenan Visiting Nurse Association of Long Island Kenneth Kilroy Progressive Home Health Services Sue Larman, VNA Home Health Russell Lusak Selfhelp Community Services Irina Mitzner, North Shore – Long Island Jewish Health Care Network

Sponsors Arthur J. Gallagher Risk Management Services, Inc. Hinman Straub, P.C. RBC Limited Healthcare and Management Consultants The Remington Report VNS Westchester

Laurie Neander Basset Healthcare Network: At Home Care

Exhibitors

Paul Rosenfeld, CenterLight Health System

Avanti Health Care Services Black Tree Healthcare Consulting Cardiocom, a Medtronic Company ContinuLink Delta Health Technologies, LLC Fazzi Associates Forcura Friedlander Group Homecare Software Solutions, LLC Mobile Health

MobilexUSA Mom’s Meals Nourish Care MyCNAjobs Philips Hospital to Home Quality in Real Time Senior Planning Services MLTC Simione Healthcare Consultants TSG Financial United Healthcare Community Plan

Sponsorship and Exhibitor opportunities are still available. Visit

www.hcaannualconference.com to learn about all the benefits you will receive as a supporter.

Karen O’Kane, Brookhaven Memorial Hospital Medical Center Mary Kate Rolf, VNA Homecare

Brian Schiel, Bestcare

Rae Szymanski, Visiting Nurse Association of Hudson Valley Vivian Torres-Suarez, Individual Member Bayside, NY Joseph Twardy, VNS of Northeastern NY Mary Wagner Metropolitan Jewish Health System Mary Zagajeski Dominican Sisters Family Health Service Elizabeth Zicari, HCR Homecare

Wednesday, May 6 8:00am – Hotel Lobby

HCA Registration Opens At the registration desk, you will obtain your conference program, name badge and directions to your first session. 9:00am to Noon

HCA Annual Board of Directors Meeting All HCA members are encouraged to attend the HCA Board of Directors Meeting and Annual Meeting of the Corporation to learn more about the governing bodies that shape the direction of HCA policy, education, advocacy and operational priorities. This event is an important tradition where HCA introduces newly elected members of the Board and opens the floor to a special invited guest speaker from the public policy arena. 1:30pm to 1:45pm – HCA Welcome 1:45pm to 2:45pm

The Healing of America: Opportunities for Home Care T.R. Reid, author of the national best-seller ‘The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care,’ will examine why all other industrialized democracies manage to provide high-quality universal health care but still spend half as much as the U.S. does. Mr. Reid’s PBS documentary, ‘U.S. Health Care: The Good News,’ reveals how some U.S. communities have found ways to improve the quality of care, and contain costs, by orchestrating their local health care providers to work together, rather than waiting for Washington to tell them what to do. T.R.Reid has become one of the nation’s best known reporters through his books, articles, and documentary films. His work includes reporting for the Washington Post, NPR’s Morning Edition and PBS. 3:00pm to 4:30pm

You Can Never NOT Communicate We all understand the importance of communicating effectively in the health care field. But do you realize that you can never NOT communicate? In this presentation, Janene Schneider will help you bring communication to the conscience level by focusing on nonverbal communication and providing you with tips to enhance your professional interactions. Janene Schneider is chair of the English Department for Franklin Academy in Wake Forest, NC. With a Master’s in Communication from the University of Iowa, she has developed a passion for nonverbal communication and is a frequent speaker for Duke University’s Population Care Coordinator Program. 3:00pm

Exhibit Gallery Opens HCA is pleased to have 31 exclusive vendors on hand to showcase the latest home health products and services expressly for HCA conference participants. Take advantage of this one-stop shopping opportunity – no appointment needed.

Wednesday, May 6 – continued 4:30pm to 6:00pm

Welcome Reception Before heading out to dinner at one of Saratoga’s many fine restaurants, be sure to take the time to visit with old friends and new, peruse the exhibits of our home health vendors and register for their great raffle prizes. Dinner is on your own this evening. 8:30pm to 11:00pm

PAC Beach Party and Trivia Night Join in the fun at this fundraiser for HCA’s Political Action Committee (PAC). Attendees who make a $50 minimum personal donation will get to enjoy drinks and light refreshments while making their best guesses for prizes in response to questions on pop culture, sports, geography, science, history and more. Anyone who has attended HCA’s popular PAC fundraisers in the past will know what a great time to expect at this year’s event, so please encourage your peers to join you.

Thursday, May 7 7:00am

Registration Opens The registration desk is open bright and early for those who haven’t yet obtained their conference program, name badge and directions. 7:30am to 8:30am

Exhibit Gallery Enjoy coffee while meeting with vendors to learn more about their latest products or services that support home health. 8:30am to 9:30am

HCA’s Breakfast of Champions During this morning’s breakfast, HCA pays tribute to recipients of the Ruth F. Wilson Award, the Caring Award and the Advocacy “Giraffe” Award – a highlight of our annual conference. Join your peers as we recognize these champions over an elegant breakfast. 9:30am to 10:00am

Catching the Wave – An Address by HCA’s President, Joanne Cunningham Home care is a vital line of support for the patients you serve, and HCA’s ongoing goal is to help you navigate potential obstacles, tie-up alongside partner organizations in integrated models, and keep home care in its flagship role as the driver of community-level support services. 10:15am to 11:15am

The Art of Audacity Can one person really change the world? National Geographic journalist Tom Clynes will bring us along on assignment to some of the most dramatic and intriguing places on Earth. Through his provocative stories and stunning photos, we’ll meet the extraordinary people who dared to challenge and change the status quo: The explorer whose Congo Basin expedition led to the biggest African conservation victory in decades … the “elephant whisperer” who rescued the animals in the Baghdad Zoo … as well as virus hunters, Ebola doctors, climatologists, and a pre-teen nuclear physicist. Along the way we’ll discover the life lessons behind the success of those who dared to follow their audacious dreams, and to shape once-ordinary lives into world-changing adventures. Tom Clynes is an author and photographer who covers the adventurous side of science, the environment and public health. He writes regularly for National Geographic and Popular Science where he is a contributing editor.

Thursday, May 7 – continued 11:15am to 3:00pm

Three Workshops in Two Sessions Session 1 (11:15am to 12:15pm) Session 2 (2:00pm to 3:00pm) All three of the programs summarized below are held concurrently from 11:15 a.m. to 12:15 p.m. (Session 1) and then repeated, again concurrently, from 2 to 3 p.m. (session 2). These workshops will help you gain further knowledge on: specific regulatory compliance issues like the Medicare face-to-face requirement, workforce recruitment and retention, and population health – all of which are vital to the success of your organization.

Session 1 & 2 Descriptions Certifying Home Health Services On January 1, the U.S. Centers for Medicare and Medicaid Services (CMS) changed the requirements for the face-to-face documentation mandate. New York’s Medicare Administrative Contractor, National Government Services (NGS), is your main point of interaction for Medicare payment and is empowered with enforcement activity related to face-to-face. Hear directly from a representative of NGS who will help you gain a greater understanding of patient eligibility, face-to-face encounters and certification requirements for home health. Attendees will receive NGS/CMS resources and the opportunity to ask questions. Shelly Bernardini, RN, CPHM, is the Medicare Home Health Clinical Consultant for Jurisdictions K and 6 at NGS where she provides outreach and education.

A Caregiver’s Perspective: Data-Driven Recruitment Get under the hood to discover the perspective of Certified Nursing Assistants and Home Health Aides on working in home care. This session will unveil key insights from a caregiver's point of view – gleaned from thousands of survey results – alongside key strategies to drive more caregivers to apply to your jobs, show up for the interview, entice them to want to work for you, and stay with your organization for the long run. Maggie Keen is Director of Customer Success for myCNAjobs. She is a national caregiver recruitment speaker, and key researcher behind The Caregiver Trend Report. Her team consults with home care recruiters across the country to optimize local recruitment efforts.

Population Health Explore how population health management can help your organization be best positioned to improve clinical and financial outcomes by coordinating care across settings, effectively analyzing patterns and addressing health care needs for your entire patient population. Sharron Rushton, MSN, MS, RN, CCM is Assistant Professor at Duke University School of Nursing. Her interests include case management of complex patients, multidisciplinary care coordination, patient navigation of the health care system and resource utilization.

Thursday, May 7 – continued 12:15pm to 1:15pm

Networking Buffet Lunch 12:30pm to 2:00pm

Desserts in the Exhibit Gallery While enjoying dessert, take advantage of this last opportunity to meet with vendors who are showcasing their products and services exclusively for you. 2:00pm to 3:00pm

Session 2 – Workshops Workshops from Session 1 (held at 11:15am) are repeated. Please refer to previous page for session descriptions. 3:00pm to 4:00pm

Physicians and Home Health: Partners in Care In this closing segment, you’ll discover new strategies for working more collaboratively with your local physician groups in achieving the same goals: better coordination of care for the patients you serve and reduced re-hospitalizations. Linda Lambert, CAE, is Executive Director for the New York Chapter of the American College of Physicians, the state's largest medical specialty organization representing over 12,000 internal medicine physicians dedicated to advancing the specialty of Internal Medicine and improving patient care through education, advocacy and quality improvement. 4:00pm Adjournment

Be sure to take advantage of HCA’s Leadership Institute on May 8!

Program Agenda Friday, May 8 7:30am to 8:30am

Breakfast Those attending HCA’s Leadership Institute can begin the day with a full breakfast buffet. (Coffee will be available beginning at 7:00 am.) 8:30am to 12:30pm

The Courage to Lead: Critical Skills for Healthcare Leaders This session, presented by the American College of Healthcare Executives (ACHE), is exclusively for HCA onlocation. Leadership is an applied skill, but too often it is left to chance as something to be picked up on the job. Progressing as a successful leader requires more. In this half-day session, designed for health care leaders at all levels of their careers, you will use proven tools and techniques to identify and develop your leadership philosophy and to develop your leadership skills even if you have little formal authority. You will also learn how to: • Create an action plan using course content through an illustrative case study, leadership tools and integrative discussions. • Increase your influence and effectiveness by becoming a quiet but strong leader. • Practice ways to recognize and reward employee contributions and build a winning team.

This program is presented by Jody Rogers, PhD, FACHE, visiting professor in the health care administration graduate program, Trinity University, San Antonio, TX. He has more than 30 years of experience as a health care executive in public and private health care organizations and is a certified master facilitator of The Leadership Challenge.

Accreditation Participants will receive ACHE Face-to-Face Education credits as well as contact hours from the National Association of Boards of Examiners of Long Term Care Administrators (NAB).

About the American College of Healthcare Executives The American College of Healthcare Executives is an international professional society of more than 40,000 health care executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE offers its prestigious FACHEÂŽ credential, signifying board certification in healthcare management. ACHE's established network of 80 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its career development and public policy programs. Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare executives dedicated to improving healthcare delivery. HCAâ€™s Leadership Institute can be purchased in conjunction with the Annual Conference registration which offers the best value. The Leadership Institute is also available for purchase separate from the HCA Annual Conference. See the registration form for fees and discounts.

2015 ANNUAL CONFERENCE REGISTRATION Catch the Wave! Are You Ready for the Turn-Around? Return this completed registration form with your payment by fax to (518) 426-8788 or mail it to 388 Broadway, 4th Floor, Albany, NY 12207. You may duplicate this form for additional attendees. Please save a copy for your records.

Register online at: www.eventville.com/hcanys CONFERENCE PARTICIPANT REGISTRATION NAME ______________________________________________________________

TITLE ____________________________________________________

AFFILIATION ____________________________________________________________________________________________________________________ ADDRESS ______________________________________________________________________________________________________________________ CITY/STATE/ZIP _________________________________________________________________________________________________________________ PHONE _____________________________________________________________ FAX _____________________________________________________ E-MAIL ________________________________________________________________________________________________________________________

METHOD OF PAYMENT:

REGISTRATION FEE:

Please select your method of payment: ________MasterCard

________Visa

________American Express

Credit Card No.________________________________________________

We encourage you to attend both the Annual Conference and ACHE Leadership Institute for the best value. No credits can be given for meals not taken or unattended education programs.

REGISTRATION FEE Seven Registration Options Please indicate your registration choice below:

Name on Card_________________________________________________

Expiration Date __________________ Security Code _________________ _____________________________________________________________ Billing Address for Card _____________________________________________________________ City, State, Zip Authorized Signature____________________________________________

_____Check* Make payable to: HCA Education and Research Mail to: 388 Broadway, 4th Floor, Albany, NY 12207 Checks must be received by May 2.

1. HCA Member – Annual Conf. and Leadership Inst.

$768 

2. HCA Member – Annual Conference Only

$489 

3. Non-Member – Annual Conf. and Leadership Inst.

$948 

4. Non-Member – Annual Conference Only

$599 

5. Leadership Institute Only (Members and Non-Members)

$349 

6. *First Time Attendee HCA Member – Annual Conf. Only

$244 

7. *First Time Attended HCA Member – Ann. Conf. & Ldr. Inst. $523  *Must register by April 6.

TOTAL DUE: $__________ Cancellation Policy: Cancellations received by April 22 will receive a full refund, less 25% of total due as an administrative fee. Cancellations received on April 23 or later will forfeit their registration fee, as will those who register and do not attend. Substitutions are permitted.

Beach and Trivia Night HCA PAC Party Wednesday, May 6th – Saratoga Hilton Lounge

In accordance with the Americans with Disabilities Act or special meal needs, please let us know how we can accommodate you: ___________________________________________________________ ____________________________________________________________

I will attend the HCA PAC Fundraiser My personal donation will be submitted separately.

FAX THIS FORM TO (518) 426-8788



388 Broadway Fourth Floor Albany, New York 12207