March 25, 2016 Edition of ASAP

ASAP

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

Legislative Issues  Public Policy

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News

Volume 21, No. 12 March 25, 2016

Budget Nears Completion, yet Details Scant as HCA and Members Must Keep up Pressure for Wage Funding, Home Care Support Throughout the close of this week, HCA received word that negotiations on minimum wage were intensifying and that funding to cover the costs of any minimum wage increase was in jeopardy.

While several news reports kept an ear to the ground on this issue, little, if any, specific insights are known at this time except that voices from all angles of the wage discussion have remained at a high pitch over the last few days, eager for word from legislators and the Governor.

HCA has sent the membership several alerts this past week and continued sharing the message of our multi-association press release, circulated to the media on Monday. In that press release, HCA, LeadingAge New York, the Healthcare Association of New York State and the New York State Health Facilities Association all called for full funding of the minimum wage hike.

News outlets such as the Kingston Daily Freeman, the Saratogian, the Forbes Magazine blog, trade journals and other outlets all picked up quotes from the press release, and several other media outlets have incorporated our message into their reporting; yet inside budget negotiators remain quiet on the status of this core issue, and others.

“The proposed minimum wage hike must not and cannot reasonably move forward without funding to fully offset its costs,” the coalition of four associations (including HCA) stated in Monday’s press release.

“The services we provide are a public good, to large degree supported by reimbursement from public programs that have long provided a safety net for low-income and elderly New Yorkers.”

See BUDGET p. 2

Inside ASAP State Budget Nears Completion..........................................................1 HCA Pursues New Method for Distribution of FLSA Funds.................3 List of Qualified QIVAPP-eligible Agencies Released..........................4 HCA Presses Implementation of Managed Care Billing Codes..........5 HCA Seeks Member Feedback on CMS Prior Authorization Demo....5 Value Based Payment Roadmap First Update Draft Underway............6 Legal Update on OCR Phase II Audits for HIPAA.................................7 Bootcamp: HIPAA eRisks and Responses for Home Care Agencies....7 DOH Announces New CDPAP Law........................................................8 Skin & Wound Care Management Live Training Courses.........................8 Weigh In on ‘Home Care Planning Improvement Act’..........................9 Member Hiring Announcements.........................................................10 DOH Extends Date for Comments on PACE......................................11 FIDA Appeal FAQs Posted; Managed Care Enrollment Data............11 NYS Health Foundation Announces RFPs...........................................12 Agenda Posted for PHHPC Committee Meeting...............................13 Statewide Session on Emergency Preparedness Collaboration.......13 DOH Posts TALs Resources and Test Survey.......................................15 NGS Updates......................................................................................16

Helping New Yorkers Feel Right At Home

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BUDGET from p. 1 We add: “Without adequate state support for any wage increase, many organizations will close, worker hours will be reduced or eliminated, access to care will be imperiled, and some of our communities will suffer the loss of quality healthcare services.”

Speculation also lingered over possible alternatives, such as changes to the wage-hike schedule, carve-outs or a different wage requirement for upstate versus downstate. The details of these alternatives, their level of serious consideration, or their momentum in the process all remain unknown.

Legislators at this week’s budget conference committee did voice some concerns about the Medicaid and health budget, including the need for funding to implement an increased minimum wage or protections for home care against the minimum wage hike. But this is an incredibly dynamic negotiation environment, with lots of pressure to get a budget done on time, and an enormous push from all sides regarding the wage increase.

What we do know is that the wage issue is commanding a lot of attention and, once it is decided, other components of the state budget will quickly fall into place. These finalized details could be completed as early as tonight, over the weekend or by Monday. The need for your voice right now is urgent.

HCA’s messages at this time remain clear and simple: The minimum wage hike MUST be adequately funded and home care must be supported and funded in the budget. In addition to the wage issue, HCA and providers need the Legislature to adopt budget language ensuring the adequacy of home care and MLTC rates and the inclusion of dedicated funding for home care, all critical components of our home care asks.

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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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Continued from previous page Today and throughout the weekend, HCA needs you to do two things: First, send a message using our Legislative Action Center at http://p2a.co/tcC4nBq, and second, call your legislators, especially if your elected representatives are members of the budget conference committees. Those key members are listed at the end of this article.

If any of these members represent you or your agency, please call them immediately with the three messages HCA sent to you throughout the past week: 1) support payment adequacy language for home care-managed care; 2) adopt the Assembly’s $200 million allocation for community-based providers, with dedicated funding for home care; and 3) fully fund the minimum wage hike or reject it.

To call your legislator, use the Legislature’s switchboard at Senate (518-455-2800) and Assembly (518455-4100). Please do so immediately.

Carl E. Heastie (Co-Chair) John J. Flanagan (Co-Chair) Herman D. Farrell, Jr. Jeffrey D. Klein Joseph Morelle John A. DeFrancisco Earlene Hooper Catharine M. Young Jeffrion Aubry James Seward Brian Kolb Andrea Stewart-Cousins Look for more updates early next week as budget negotiations head into the final phase.

HCA Pursues New Method for Appropriate Distribution of FLSA Funds After last week’s meeting with State Medicaid Director Jason Helgerson and state Department of Health (DOH) officials (see the March 18 ASAP), HCA immediately followed up by reaching out to various stakeholders for support on an alternative method of distributing funds to address the Fair Labor Standards Act (FLSA) changes.

At that meeting, HCA pointed out how the current distribution methods outlined in the March 7 Frequently Asked Questions (FAQs) are unclear and burdensome to the point of being unworkable for both MLTC plans and home care providers, and how the FAQs and required attestation forms are not consistent with prior administration communications.

Mr. Helgerson had indicated a willingness to consider alternative ways to distribute the funds, as well as changes to the attestation forms, if all groups (home care, managed care and unions) developed an agreedupon proposal.

This week, HCA and our public affairs firm contacted other associations representing home care providers, groups that represent MLTC plans and unions to seek support for distributing the funds as a $0.34 add-on to each hour of aide services rendered during the October 13, 2015 through March 31, 3

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2016 period. Many HCA members have told us that this is the preferable way to deliver the FLSA funds to them.

HCA’s goal is to obtain as much consensus as possible on a timely basis and then contact Mr. Helgerson.

Meanwhile, HCA continues to field questions from members on how they can respond to their partner MLTC plan requests for documentation of overtime hours.

DOH FLSA Survey This week, HCA was sent the revised version of a survey that DOH and Mercer, its contractor, are developing to ascertain the anticipated/incurred new costs due to the FLSA changes.

Some of the revisions include a new comprehensive section on travel expenses. HCA has shared prior versions of the survey with select members and we’ve given comprehensive feedback to DOH. Our goal has been to institute a survey that will not be too burdensome for members to complete.

Once the survey is finalized and distributed, results will be used by DOH to determine any additional funding under Medicaid fee-for-service and managed care to compensate home care providers for their FLSA compliance.

HCA will keep members informed of any further developments on the FLSA funding and survey.

For more information, contact the HCA Policy staff.

List of Qualified QIVAPP-eligible Agencies Released Late last Friday, after the March 18 ASAP was published, the state Department of Health (DOH) sent HCA a list of those agencies serving New York City who qualify for Quality Incentive Vital Access Provider Pool (QIVAPP) monies following recent audits by IPRO. The funds are intended to address costs related to the State Wage Parity Law’s effect in New York City.

Since there is a finite amount of funds to be distributed ($70 million), the amount that each qualifying agency will receive is dependent on the number of awardees, how much they may have already received, and how much they are eligible for. Some agencies will receive additional funds, while others may be asked to return funds they already received. The state has not released those amounts at this time; HCA will notify members once it does.

QIVAPP is targeted to home care agencies that provide aide services in New York City and meet certain criteria as outlined in the April 23, 2014 Dear Administrator Letter (see http://www.health.ny.gov/health_care/ medicaid/redesign/docs/2014-04-23_dal_qual_incent_vap_pool.pdf ).

The funds are intended to be a per-hour add-on based on the hours provided between April 1, 2014 and March 31, 2015. DOH has indicated that it will share information about QIVAPP funding for post-March 31, 2015 once these funds have been distributed.

HCA has continuously advocated that the funds be distributed fairly so that all agencies in New York City who are affected by increased wages and benefit costs can receive them. We strongly objected to some of the eligibility 4

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criteria, particularly that a minimum of 30 percent of an agency’s total workforce must be enrolled in the health benefit.

HCA also assisted numerous members with their responses to the multiple requests they received from IPRO for documentation.

Agencies who have questions about the application process, including why they are not on the final list, should contact DOH – not IPRO – at HCWorkerParity@health.ny.gov.

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

HCA Presses Implementation of Uniform Managed Care Billing Codes This week, HCA and other provider associations met with the state Department of Health (DOH) to continue discussions on meeting the 2014-15 state budget requirement that uniform billing codes be established for home and community-based services under Medicaid managed care.

This change was sought by HCA to help home care agencies and their contracted managed care plans simplify their billing procedures as well as help agencies receive payments more timely. While discussions have been going longer than anticipated, HCA has sought to move this process along expeditiously at every step and will continue to advocate for completion of the codes.

In order to advance this goal, associations agreed to initially develop another list of codes for personal care services based on feedback from managed care plans (and later target nursing, therapies and other services).

Once completed, DOH will seek final comments from the plans and then promulgate the agreed-upon codes.

For additional information, contact the HCA Policy staff.

HCA Seeks Member Feedback on CMS Proposed Home Health Prior Authorization Demonstration In early February, the U.S. Centers for Medicare and Medicaid Services (CMS) proposed a demonstration program regarding prior authorization of Medicare home health services in Florida, Texas, Illinois, Michigan, and Massachusetts.

According to CMS, one major goal is to reduce fraud in home health services and assure that payments for home health services are appropriate before the claims are paid. While the demonstration is not proposed in New York at this time, the concern is that it will ultimately make its way to New York.

Under the demonstration, CMS proposes to perform prior authorization before processing home health claims within the five participating states.

HCA intends to submit comments that will detail our major concerns with the demonstration and call for it to be rescinded. Some concerns are that this added administrative step would result in extensive delays for patients receiving home health services, and also for home health agencies receiving payments. This may also 5

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lead to unnecessary hospital and nursing home stays, and would further burden physicians and home health providers with administrative tasks that provide little or no return. Instead, these efforts will create issues with access to care and timely reimbursement. HCA will point out that home health services are already well targeted by a variety of program integrity initiatives, and this new demonstration is redundant and unmanageable.

CMS states that the prior authorization pilot would be similar to the Prior Authorization of Power Mobility Device (PMD) Demonstration, which was implemented in 2012. The pilot would also follow and adopt prior authorization processes that currently exist in other health care programs such as TRICARE, certain state Medicaid programs, and in private insurance.

CMS issued the proposal as part of a Paperwork Reduction Act notice in the Federal Register which can be found at https://www.federalregister.gov/articles/2016/02/05/2016-02277/agency-informationcollection-activities-proposed-collection-comment-request.

More information is at https://www.cms.gov/Regulations-and-Guidance/Legislation/ PaperworkReductionActof1995/PRA-Listing-Items/CMS10599.html?DLPage=3&DLEntries=10&DLSort=1&DLSortDir=descending.

In order to inform our comments, HCA asks those members who have concerns and/or recommendations about this proposed demonstration to contact Alex Blais at ablais@hcanys.org or Andrew Koski at akoski@hcanys.org. We need your feedback by Thursday, March 31, as comments are due April 5.

Value Based Payment Roadmap First Update Draft Underway The New York State Value Based Payment (VBP) steering committee, which includes HCA, has been invited to provide input to the first draft annual update of the state’s VBP Roadmap.

The terms of the Roadmap, approved last July by the U.S. Centers for Medicare and Medicaid Services (CMS), provide for review and annual update of the Roadmap. Underway is the first such annual update.

The committee has been provided with an initial update draft, a Reader’s Guide to the update, and a draft of the many VBP subcommittee recommendations from the past nine months for input. The committee’s comments and written feedback are due by April 8, 2016. As a member of the committee, HCA is making the draft available to the membership to invite your comments. Please e-mail them directly to HCA Executive Vice President Al Cardillo at acardillo@hcanys.org.

The draft update, accompanying guide and subcommittee draft can be viewed at http://hca-nys.org/wp-content/uploads/2016/03/VBPUpdate.pdf.

The Roadmap is also soon expected be posted for public comment. KPMG indicates that an announcement will be sent through the MRT listserv to notify the public.

A meeting of the VBP committee to discuss the update and status of the state’s VBP initiative overall is being scheduled for the end of April.

Beyond our efforts on the VBP committee, HCA continues working at additional, multiple levels – policy, legislative, budget, education, collaboration with other sectors, and more – to support the home care 6

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community’s core needs and strategies for participation in VBP. Providers are strongly encouraged to continue your own internal work toward VBP readiness and offerings, and to be pursuing VBP partnerships with physicians, hospitals, managed care plans, behavioral health providers, nursing homes and other partners.

Mark Your Calendars for HCA’s June 17 VBP Education Summit!

HCA is putting together a major education summit on VBP for June 17 at the Doubletree Hotel and Conference Center in Nanuet, New York. The conference will feature state, federal, research and stakeholder presentations on all aspects of VBP. Mark your calendars for this must-attend conference and stay tuned for further details.

For more information, contact Al Cardillo at acardillo@hcanys.org.

Legal Update on Office of Civil Rights Phase II Audits for HIPAA HCA’s legal counsel team at Wilson Elser has prepared a memo regarding a newly announced Phase 2 audit program being conducted by the Office of Civil Rights (OCR) within the U.S. Department of Health and Human Services (HHS) for compliance with the Health Insurance Portability and Accountability Act (HIPAA) requirements.

The memo is available at http://hca-nys.org/wpcontent/uploads/2016/03/ MemoPhase2OCRaudits.pdf.

OCR’s Phase 2 audit program will consist of about 200 desk and on-site audits of both covered entities and business associates to determine their compliance with the Privacy, Security, and Breach Notification Rules. By contrast, the Phase 1 pilot audit program that OCR conducted in 2011 and

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Bootcamp: HIPAA eRisks and Responses for Home Care Agencies June 15, 2016 130 East 59th Street (near Lexington Ave.) 7th Floor New York, NY 10022 9:30 a.m. to noon On June 15, HCA is holding a bootcamp on “HIPAA eRisks and Responses for Home Care Agencies” in New York City. A registration form is published at the back of this week’s ASAP. The complexities of the HIPAA and HITECH regulatory framework, including cyber security, are one of the most critical compliance issues facing home care and other health care providers.

In an environment where data breaches occur with increasing frequency, federal regulators have amplified their auditing and investigations of provider compliance with the HIPAA/HITECH. Recent violations have resulted in substantial financial penalties levied against providers.

This workshop will review what constitutes Protected Health Information (PHI) and the regulations related to the sharing of PHI. Most importantly, you will learn about the critical aspects of cybersecurity compliance, common areas for HIPAA violations, compliance with the HIPAA Privacy, Security and Breach Notification Rules and what’s required (from a compliance perspective) when the inevitable data breach occurs, such as a stolen laptop or lost thumb drive that contains protected health information.

Presenter Frank Fanshawe, HCA’s counsel, is a Partner and an integral part of the Health Care Law practice in Wilson Elser’s Albany office. He has practiced health care law for 25 years, including significant real-world legal and executive-level experience with a nationally recognized health insurer in the northeastern United States, where he was responsible for HIPAA/HITECH compliance.

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2012 targeted only covered entities, and involved just 115 audits.

According to an OCR press release, Phase 2 will include “a broad spectrum of audit candidates” that OCR will randomly select from pools that “represent a wide range of health care providers, health plans, health care clearinghouses and business associates.” The OCR press release said further that OCR has already started sending out communications to covered entities “of various types” to verify their contact information for future communications HCA members are encouraged to read the memo, by counsels Frank Fanshawe and Damian Privitera, esqs., for more about the case, including procedural details about how the audits will be communicated and conducted, as well as how agencies can prepare. Please also consult with your legal counsel regarding compliance with the HIPAA Privacy, Security and Breach Notification Rules.

DOH Announces New CDPAP Law The state Department of Health (DOH) announced in its March 2016 Medicaid Update that beginning April 1, 2016, and in accordance with Chapter 511 of the laws of 2015, changes will go into effect that modify who can work as a Consumer Directed Personal Assistance Program (CDPAP) personal assistant for an eligible participant.

The purpose of these changes is to permit parents of adult children to be hired and work as CDPAP personal assistants. Specifically, this amendment to Social Services Law Section 365-f made the following changes: •

The new law bars persons from being hired as CDPAP assistants if they are legally responsible for the eligible individual’s care and support. This means that an adult who is not legally responsible for the eligible individual’s care and support may be a CDPAP assistant for that eligible individual. In particular, this means that a parent of an adult child (21 years of age or older) may serve as that adult child’s CDPAP assistant. Parents of children who are younger than 21 cannot be hired as that minor child’s CDPAP assistant. Consistent with current

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Skin & Wound Care Management Live Training Courses HCA Members receive a discounted rate ($300 off standard rate) for four and five day trainings offered at various locations throughout New York State by The Wound Care Education Institute.

Both courses are designed for LPN/LVNs, RNs, NPs, PAs and OTs and offer the opportunity to take a certification exam. Use the discount code “HCANYS”.

The Four-Day Skin & Wound Management Course will be held April 14 to 16, 2016 in Elmhurst, NY. The Five-Day Skin & Wound Management Course will be held on the following dates: •

April 25-29, 2016 in Buffalo, NY

•

July 11-15, 2016 in Uniondale, NY

•

October 24-28, 2016 in Elmhurst, NY

Also available free to HCA members through the Wound Care Education Institute is an array of on-demand webinars using the code HCANYS. Learn more at http://hca-nys.org/eventseducation/upcoming-events.

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regulations, spouses and designated representatives (whose role is to “instruct, supervise and direct the consumer directed personal assistant) also cannot be hired as CDPAP assistants.

•

Any other adult relative of the CDPAP-eligible individual may serve as the individual’s CDPAP assistant. In all cases, the CDPAP authorization is based on the eligible individual’s assessed needs.

This applies regardless of whether the CDPAP assistant is a parent or other adult relative of the individual or not related to the individual.

DOH will be issuing additional guidance on this change in the near future.

For specific questions, contact the Division of Long Term Care at (518) 474-5888.

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

Weigh In With Congress on ‘Home Care Planning Improvement Act’ Legislation cosponsored by U.S. Senator Charles Schumer – that would allow non-physician practitioners to order and certify Medicare home health services – continues to gain a spotlight.

This bill, the “Home Care Planning Improvement Act,” is a big component of HCA’s federal advocacy (alongside Medicare home health reimbursement advocacy and opposition to beneficiary copays), and it enjoys support from home care organizations nationwide as well as nursing groups, like the American Nurses Association.

HCA has extensively reported on the measure. It would allow nurse practitioners, physician assistants, clinical nurse specialists and other advance practice professionals to order and certify Medicare home health services.

Most recently, the legislation (S.578/H.R.1342) garnered further support in the form of a statement from its U.S. House sponsor Greg Walden of Oregon. The statement, posted in the Congressional Record, says that the bill is needed to “ensure that our Medicare beneficiaries get the home health care they need in a timely manner,” stressing that the legislation “would help deliver needed care to patients, especially in areas where access to health care is limited.”

HCA continues to engage members of New York’s Congressional Delegation in support of this bill and appreciates Senator Schumer’s efforts to champion this commonsense solution to care planning. You can get on record in support of this bill, too, using our Legislative Action Center. Just click http://p2a.co/ z6HUax7 and send a message to Congress today.

Please also plan to join us on July 11-13 for HCA’s Federal Advocacy Program where this bill and other federal measures will be a feature of our push for home care support on Capitol Hill. Save the date and be on the watch for registration information soon.

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HIRING Job Position: Director of Finance (Montefiore Home Health Agency) Position Summary: The Director of Finance is responsible for the financial and reimbursement functions of the Montefiore Home Health Agency, managing accounts receivable/payable, billing, third party payers, cost reports, annual budget, grants and special funds. The Director will work closely with the Executive Director and Agency Management to: set financial operation and effectively manage financial resources; ensure efficient work flow process and effective billing compliance with all regulatory and accrediting bodies; and provide financial analysis and recommend plan of action. The Director is responsible to uphold compliance with agency policies and procedures, standards and regulatory requirements.

Required Qualifications: Bachelor of Science in Accounting required (MBA and or CPA preferred); minimum of two years’ experience in home health financing/accounting or three years’ hospital finance plus two years’ administrative management experience, preferably in a health care setting.

Additional Qualifications: Demonstrated skill in training and working with building high performance teams; high levels of analytical ability; leadership and creativity in management/ development of staff; ability to develop and lead the strategic plans; strong written and verbal communication skills.

Please send résumés and cover letters to: www.montefiore.org/ careers. Résumés without cover letters and applicants who do not meet the requirements will not be accepted. No phone calls, please.

Job Position: Director of Performance Improvement and Staff Development (Winthrop University Hospital Home Health Agency) 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 overseeing 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 home health program; working knowledge of Performance Improvement/ Quality Assurance, The Joint Commission standards and DOH regulations. Master’s degree preferred.

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

Job Position: Director of Patient Services (Montefiore Home Health Agency) The Director is responsible for directing, planning, coordinating and evaluating patient care services, providing supervision of professional staff, and recruiting/hiring an adequate number of professional staff to ensure quality. The Director will evaluate the performance of Patient Service Managers and support staff supervisors at stated intervals. The Director will participate in administration of the annual budget and personnel policies. The ideal candidate will manage all clinical functions.

Required Qualifications: Current NYS RN License and Registration; Master’s in Nursing or Health Related Field; five years of senior and direct management experience within a CHHA. Additional Qualifications: Knowledge of clinical documentation protocols, home health regulations and standards; skill in training, working with building high performance teams; ability to develop and lead strategic plans; strong written and verbal communication skills.

Please send résumé & cover letter to chenley@montefiore.org with “Director of Patient Services” and your name in the subject line. Résumés without cover letters and applicants who do not meet requirements won’t be accepted. No phone calls, please.

MMC is an equal opportunity employer and will not discriminate against any employee or applicant for employment because of race, color, religion, gender, sexual orientation, or national origin.

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DOH Extends Date for Comments on PACE The state Department of Health (DOH) has extended the deadline until April 29 to submit comments on its Request for Information (RFI) regarding future changes to the Program of All-inclusive Care for the Elderly (PACE).

The RFI and a brief questionnaire are at http://www.health.ny.gov/health_care/medicaid/redesign/ mrt90/2016-03-21_pace_model_expansion.htm.

The PACE Innovation Act authorizes the Secretary of Health and Human Services (HHS) to waive requirements under section 1934 of the Social Security Act to design and test new models. As a result, CMS allows providers and other entities not currently PACE providers to consider adapting the model to serve new populations in innovative ways. The Act creates opportunity for these new populations – previously not qualified for PACE programs – to be served by this model. In addition, in June of 2015, CMS used its waiver authority to allow for-profit entities to operate PACE demonstration programs.

DOH intends to use the RFI responses to develop a comprehensive analysis of the impact of PACE on long term services and supports in New York and develop possible strategies to expand the current PACE model.

Any questions should be directed to BIP@health.ny.gov.

FIDA Appeal, Grievance FAQs Posted; Also Managed Care Enrollment Data The Fully Integrated Duals Advantage (FIDA) Integrated Appeal and Grievance Process Frequently Asked Questions (FAQs) document was recently updated, along with enrollment data for managed care.

The revised FAQs can be found at http://www.health.ny.gov/health_care/medicaid/redesign/fida/201603_fida_ia-gp_faq.htm.

They cover: providers’ use of the integrated appeal process; required notices to participants; when ‘aid continuing’ applies; transportation to in-person reviews and hearings; applicability of integrated appeal process to Medicaid drug benefits; and more.

MLTC Enrollment Data DOH has also posted March enrollment data on individuals in mainstream Medicaid managed care and MLTC plans.

It is at http://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/.

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NYS Health Foundation Announces RFPs The New York State Health Foundation (NYSHealth) has announced a Request for Proposals (RFP) for its newest priority area, Empowering Health Care Consumers, and an RFP under its ongoing Special Projects category.

The Empowering Health Care Consumers RFP is at http://nyshealthfoundation.org/uploads/rfps/empowering-health-care-consumers-rfp.pdf.

Through this RFP, NYSHealth expects to fund large-scale projects or studies that may: create new tools and resources for consumers; make the health care system easier to navigate; identify effects of consolidation; or address systemic, repeated problems. More specifically, projects can include efforts to: • • • • • • • • • • •

Provide state-specific findings regarding consolidation or competition; Increase health literacy and consumer activation; Improve patients’ ability to navigate the health system with fewer burdens; Develop price and quality comparison tools; Promote public policies that encourage transparency; Make existing relevant data more accessible to consumers, reporters, or policymakers; Equip patients with access to their own personal health information; Encourage patients to be active partners in their care; Develop and share quality measures that matter to consumers; Increase information-seeking behavior by consumers; and Improve or establish effective systems for consumer protection.

How to Apply All applicants are required to complete an online inquiry form. The deadline for the online inquiry form is May 17, 2016, at 1 p.m. A link to the online inquiry form will be available on April 18, 2016.

After reviewing all inquiry forms, NYSHealth staff members will select applicants to submit a full proposal.

Selected applicants will be e-mailed specific submission instructions. The deadline for the full proposal is July 26, 2016, at 1 p.m.

For additional information on this funding opportunity and the application process, please consult the Frequently Asked Questions at http://nyshealthfoundation.org/faq-empowering-health-care-consumersrfp-2016.

Special Projects Fund NYSHealth is also accepting proposals for its 2016 Special Projects Fund. NYSHealth Special Projects Fund awards are one-time, nonrenewable funding opportunities consistent with the Foundation’s mission to improve the health of all New Yorkers but outside of its main priority areas.

Applicants must submit an online inquiry form to determine whether a proposed project fits the funding criteria. The deadline for the online inquiry is April 7, 2016. Selected organizations will be invited to submit full applications, which will be reviewed on a rolling basis with a deadline of May 25, 2016.

Continued on next page

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Continued from previous page The RFP is at http://tinyurl.com/zldvatj.

Agenda Posted for PHHPC Committee Meeting The state Department of Health (DOH) has posted the agenda for the March 31 meeting of the Public Health and Health Planning Council (PHHPC) Committee on Establishment and Project Review.

It is at http://www.health.ny.gov/facilities/public_health_and_health_planning_council/meetings/201603-31/docs/exhibits.pdf.

The only applications related to home care are five applications by existing LHCSAs for changes of ownership. The LHCSAs serve Long Island, Capital District, New York City, Central New York and the Southern Tier.

HCA has confirmed with DOH that no new LHCSA applications will be considered even though past meetings have included many applications to establish new LHCSAs.

Statewide Planning Session Emphasizes Emergency Preparedness Collaboration Last week, HCA, state and regional Department of Health (DOH) officials, and representatives from all health care sectors engaged in a two-day planning summit to discuss and formulate visions to further advance emergency preparedness collaboration and integration in the state.

The meeting, hosted in Saratoga by the DOH Office of Health Emergency Preparedness, brought together a core working group of DOH and health sector representatives to review the state’s emergency preparedness program and initiatives, identify challenges, and recommend ways of deepening emergency preparedness collaboration and integration.

HCA played an active role in planning and conducting this working session and in sharing our vision for supporting preparedness in the state. HCA was a primary promoter of the collaboration/integration focus of the summit, emphasizing throughout the critical importance of recognizing and supporting each sector’s roles and resources – both individually and mutually – in state and regional preparedness and response activity. Among other points, HCA also emphasized: •

The need for resource support for provider emergency preparedness;

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State coordination of its program, regulatory and fiscal policies with its emergency preparedness goals and “wants” of providers;

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System and public education of the diverse and unique emergency preparedness needs of home care and hospice patients and providers;

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Implications of the new role played by managed care; and 13

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The need for both financial support for EP and for bringing payors into the EP planning and support process.

HCA encourages agencies to examine the slide decks covering the statewide meeting, which can be viewed at http://hca-nys.org/wpcontent/uploads/2016/03/ StatewideEPadminplanningmarch2016.pdf.

Mass Casualty/Mass Fatality Focus of Capital District HEPC Session Mass casualty/fatality brings its own immense and often devastating challenges to emergency response.

HCA Executive Vice President Al Cardillo presents at last week's emergency preparedness meeting

This week, HCA participated in a meeting and webinar conducted by the Capital District Health Emergency Preparedness Coalition (HEPC) on this complex subject area.

Highlights of the compelling issues and topics presented are covered in the slide decks viewable at http://hcanys.org/wp-content/uploads/2016/03/HEPCSessionmasscasualtiesMarch2016.pdf.

Still Time to Register for April 5 Emergency Preparedness Meetings in Western NY There is still time to register for April 5 sessions on emergency preparedness for home care, hospice and emergency managers in Western New York counties, jointly sponsored by HCA and the New York State Association of Health Care Providers (HCP).

These sessions, announced in HCA-HCP direct communications with western New York agencies, newsletters (see March 11 ASAP) and our joint registration flyers, will focus on the unique needs and challenges of home and hospice care providers and emergency management staff in emergency preparedness and response. Their prime purpose is to facilitate the further building of critical, local relationships and collaboration essential to effective, mutually supportive processes during emergencies.

These free-of-charge meetings are beginning in Williamsville and Rochester on April 5, and continuing in Elmira on April 26. DOH, HCA and HCP plans are to gradually conduct these sessions across all of the state’s regions and localities.

These first sessions in Western New York, grouped by county, are: •

April 5 – for home care, hospice, local public health and emergency management offices serving Monroe, Genesee, Livingston, Ontario, Orleans and Wayne Counties: 9 to 11 a.m., at the Public Safety Training Center, 1190 Scottsville Road, Rochester, NY 14624. Download the flyer at http:// hca-nys.org/wp-content/uploads/2016/03/Collaborating-on-Emergency-Preparedness-MeetingRochester-April-5-2016.pdf.

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April 5 – for entities serving Allegany, Cattaraugus, Chautauqua, Erie, Niagara, and Wyoming Counties: 1 to 3 p.m., at the Main Transit Banquet Hall, 6777 Main Street, Williamsville, NY 14221. Download the flyer at http://hca-nys.org/wp-content/uploads/2016/03/Collaboratingon-Emergency-Preparedness-Meeting-Williamsville-April-5-2016.pdf.

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April 26 – for entities serving Chemung, Schuyler, Seneca, Steuben and Yates Counties: 10:30 a.m. to 12:30 p.m., at Chemung County Health Center, 103 Washington Street, Elmira, NY 14901. Download the flyer at http://hca-nys.org/wp-content/uploads/2016/03/Collaboratingon-Emergency-Preparedness-Meeting-Elmira-April-26-2016.pdf.

Your attendance is vital in helping to further build working relationships and increase mutual understanding of home care, hospice and local emergency manager roles and needs in your counties as well as the needs of your patients during emergencies.

Download the flyers for more information, including individual agendas.

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

DOH Posts TALs Resources and Test Survey The state Department of Health (DOH) has posted materials and a test survey related to the implementation of Transportation Assistance Level (TAL) classifications for home and hospice emergency preparedness.

The resources include: TALs & Home Care Emergency Survey Webinar Recording (March 11, 2016) and Power Point presentation; Dear Administrator Letter (March 4, 2016); Resident Evacuation Critical Information and Tracking Form; TALs Guidance Document; and TALs’ labels.

To obtain these materials, sign on to the Health Commerce System (HCS) at https:// commerce.health.state.ny.us/public/hcs_login.html and click on: My Content on top tool bar; Documents by Group; View all Document Groups on the blue tool bar; Long Term Care; Preparedness; Resources; and then TALs group on the top of the page.

In addition, the Health Electronic Response Data System (HERDS) Home Care Emergency Survey forms are available on the HCS. A test activity has been set up for all users to review and test the forms.

To access the test HERDS Home Care Emergency Response Survey, follow these steps: 1. Sign on to the HCS 2. Click on HERDS under My Applications on the left side of the screen If you do not have the HERDS application listed under “My Applications” on the left side of the screen: 1. Click on My content on the top tool bar 2. Click on All Applications and then the letter H Continued on next page 15

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Continued from previous page 3. Click on Home and Community Based Care (HERDS) 4. Click the Facility level (if this question is asked) The activity entitled Test/Demo of Home Care Emergency Long Form should appear on this screen. If it does not, click the Data Entry tab, select the Activity entitled Test/Demo of Home Care Emergency Long Form, select your organization and select the form you wish to test.

Questions regarding this information can be directed to Homecare@health.ny.gov.

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

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April “Dark Days” for the Common Working File – For the upcoming April 2016 Release, the Common Working File (CWF) will be observing one business “dark” day on Friday, April 1 for processing, installation of the April 2016 Release and scheduled data center maintenance. The CWF Hosts will also be observing a “dark” day on Saturday, April 2.

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Updated PECOS Fact Sheet now Available – The U.S. Centers for Medicare and Medicaid Services (CMS) has updated its internet-based Provider Enrollment, Chain and Ownership System (PECOS) fact sheet at: http://tinyurl.com/hvdpmbm. The fact sheet includes information on the following: 1) the Medicare enrollment application submission options; 2) how to complete an enrollment application using PECOS; and 3) PECOS user ID and password helpful hints.

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

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HIPAA eRisks and Responses for Home Care Agencies June 15 9:30am – Noon Frank Fanshawe, Partner, Wilson Elser The complexities of the HIPAA and HITECH regulatory framework including cyber security are one of the most critical compliance issues facing home care and other healthcare providers.

June 15, 2016 130 East 59th Street (near Lexington Ave.) 7th Floor New York, NY 10022 9:00 to 9:30am Registration and continental breakfast

9:30am to Noon Program

Fee: $79 HCA Members $139 Non-Members Thanks to our program sponsor:

In an environment where data breaches occur with increasing frequency, Federal regulators have amplified their auditing and investigations of provider compliance with the HIPAA/HITECH. Recent violations have resulted in substantial financial penalties levied against providers.

This workshop will review what constitutes Protected Health Information (PHI) and the regulations related to the sharing of PHI. Most importantly you will learn about the critical aspects of cyber security compliance, common areas for HIPAA violations, compliance with the HIPAA Privacy, Security and Breach Notification Rules and what's required from a compliance perspective when the inevitable data breach occurs, such as a stolen laptop or lost thumb drive that contains protected health information.

Hear the answers to pressing questions like: What are best practices for responding to a data breach? What can we expect in a federal investigation of a breach? and… How do we respond to an investigation to minimize exposure to financial penalties?

Frank Fanshawe, HCA’s counsel, is a Partner and an integral part of the Health Care Law practice in Wilson Elser’s Albany office. He has practiced health care law for 25 years, including significant real-world legal and executive-level experience with a nationally recognized health insurer in the northeastern United States, where he was responsible for HIPAA/HITECH compliance. Frank previously served as a senior adviser to the New York State Senate Health Committee chair on legislative and public policy issues in connection with New York's deregulation of the hospital payment methodology system (Health Care Reform Act) and other major health care initiatives. He also practiced law with other national law firms, where he represented hospitals, medical groups, independent practice associations, physician organizations, home health agencies and other health care providers. Frank’s practice includes a focus on HIPAA/HITECH and data security and privacy.

REGISTRATION – (Deadline June 8th)

REGISTRATION FEE

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*Make checks payable and mailed to:

City/State/Zip:___________________________________________ Phone:______________________________ Ext._______________ Email: _________________________________________________ Cancellations received by June 8th are refundable less a 25% administrative fee.

Cancellations must be received in writing via e-mail to info@hcanys.org. No refunds after that time or for no shows. Substitutions are permitted.

FAX TO: (518) 426-8788

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HCA Education and Research 388 Broadway, 4th Floor, Albany, NY 12207

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