August 26 ASAP

ASAP

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

Legislative Issues  Public Policy



News

Volume 21, No. 30 August 26, 2016

Associations Unite Around Minimum Wage Funding Implementation Guidelines Next step is vetting by plans and all-out effort to ensure funding adequacy As extensively reported in previous editions of ASAP and alerts, HCA has been working tenaciously since late last fall to assess the cost impact on the home care sector of the first-proposed, now-enacted, minimum wage increase, and then advocated doggedly for funding to providers that will cover the associated costs of compliance. Once it was determined that there would be some money allocated to compensate providers for the wage increase, HCA began pressing for adequate, timely, and a transparent distribution of funds.

See WAGE p. 3

Is Your Inner Critic Limiting Your Potential? Learn How to Squash It on Sept. 28-29 Many of us harbor an inner critic, but this voice in your head is not only personally limiting ... it can also derail your career in ways you don’t even realize. It prevents you from seeking what you want, blaming yourself for mistakes, and repeating cycles of negative workplace relationships.

Inside ASAP

See SUMMIT p. 2

Minimum Wage Funding Implementation Guidelines Update...........1 HCA Submits Comments on HHPPS Rule...........................................1 Learn How to Squash Your Inner Critic at HCA Women’s Summit.........1 More LTHHCP Policy Details in Progress.............................................3 Important Deadlines..........................................................................3 Reminder about EO No. 38 Legal Cases, Implications........................4 2015 LHCSA Statistical Report Posted................................................5 Wage Parity Certification Forms Due Sept. 1........................................6 Value Based Payment Bundles and Quality Metrics Revealed.............6 GoldStamp Resource Webinars – Equipping for VBP, DSRIP............7 Member Hiring Announcements..........................................................8 Q&As Posted on Funding RFA for Infrastructure Program...................9 CMS Hosts Home Health and Hospice Open Door Forum Call.......10 CMS to Hold Webinar on new Bundled Payment Models.................11 IMPACT Act Information Posted........................................................12 DOH Issues DAL on Hospice Regulatory Changes...........................12 HCA Launches New Pediatric Care Workgroup................................13 PACE Proposed Rule Explained........................................................14 NYC Council Passes Two Caregiver Bills..........................................16 Funding Announcement Posted for Palliative Care Program...........17 NY Connects RFA Released...............................................................17 Advertising Options in HCA Membership Directory..........................18 NGS Closed for Labor Day...............................................................19 Publications........................................................................19

HCA Submits Comments on HHPPS Rule HCA this week submitted extensive comments on the U.S. Centers for Medicare and Medicaid Services’ (CMS) proposed rule for the 2017 Home Health Prospective Payment System (HHPPS). Our comments addressed various components of the rule, such as: 

Continued methodology flaws in CMS’s rebasing of Medicare home health rates, including the incorporation of a “casemix-creep” adjustment that appears to See RULE p. 4

Helping New Yorkers Feel Right At Home

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

Volume 21, No. 30 August 26, 2016 

SUMMIT from p. 1 As Dr. Jacqueline Hornor Plumez explains it, too many of us live with a litany of self-defeating self-criticisms. She calls this the “Bitch in your head.” And while some may think this inner critic is motivating, in truth, it keeps us from meeting our career goals and professional accomplishments. It can actually “derail your career,” says Dr. Plumez.

At HCA’s Women in Healthcare Leadership Summit, Dr. Plumez will explore insights from her entertaining and enlightening book on the subject, The Bitch in Your Head: How to Finally Squash Your Inner Critic, offering tools and techniques to rid yourself of negative thinking in every area of your life. You can learn more about the book and Dr. Plumez at http://thebitchinyourhead.com.

Dr. Plumez is just one of several top-tier speakers scheduled for our summit, which is coming up in just over a month (on September 2829) in Saratoga. Whether you work in the C-Suite or on State Street, this program will help you strengthen your skills at the negotiating table, in the boardroom or during your big pitch, as some of the nation’s top women professional development speakers and thought-leaders share skills, tools and insights.

Plus ... get a free professional head-shot, and browse our mini-expo of vendors.

Register online at https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1011975.

A brochure is published at the back of this week’s ASAP with a full agenda.

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 Fitz 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 Wilson, Manager, Meeting and Events, bwilson@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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ASAP – a publication of the Home Care Association of New York State WAGE from p. 1

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More LTHHCP Policy Details in Progress

Most recently, this summer, HCA has worked with the state Department of Health (DOH) as well as both plan and provider association colleagues in attempts to reach agreement on a dollar amount increase to managed care plan rates that will account for these increased costs, as well as to determine a mutually acceptable mechanism for ensuring that the funds be passed through to home care providers.

This week, HCA and home care association colleagues collaborated once again to unite around minimum wage funding implementation guidelines that will next be vetted by the plan associations. If consensus is reached with the plan associations, the draft guidelines will be returned to DOH in hopes they will be adopted as the official guidance related to the impending funding disbursement. If this level of unanimity can be achieved, it will be a significant success for all parties, and one that would provide some level of assurance and coverage to HCA members facing the reality of the December 31, 2016 minimum wage increase.

As always, HCA will continue to relentlessly represent the interests of our members and keep you informed of new developments as they unfold. If you have any questions about this issue, please contact any member of HCA’s Policy staff for more information.

Further policy updates are in progress for LTHHCP providers, following the recent release of the state Department of Health’s (DOH) new policy Q&A for the LTHHCP. These next policy items relate to LTHHCP reimbursement rates and billing. They include direction as to whether LTHHCP billing for direct admission and service under the new policy Q&A should be: 1) under the Episodic Payment System (EPS) and at the EPS rates established for CHHAs; or 2) under the 2016 fee-for-service rates DOH has issued for LTHHCPs. HCA is also seeking direction on how LTHHCP cost reports should be completed under the new policies.

HCA requested this further guidance upon the issuance of DOH’s new policy Q&A for LTHHCP, and has asked for a quick turnaround to assist LTHHCPs. HCA is also pursuing specific items raised by LTHHCPs during HCA’s statewide LTHHCP conference call last week. LTHHCPs should further note DOH’s invitation to send inquires directly to DOH at homecare@health.ny.gov.

This new affirmation of LTHHCP provider status, capacity and roles amid state health reforms is a major accomplishment shepherded over many months by HCA, the HCA LTHHCP Statewide Forum and key DOH officials. See p. 1 of the August 12 ASAP. LTHHCP providers should send further questions to any member of the HCA Policy team. If sending questions directly to the DOH inquiry site, please copy HCA. HCA will work to assist prompt turnaround of these items and will be reporting to members on related developments.

Upcoming Deadlines

REQUIREMENT or OPPORTUNITY

DUE DATE

FLSA Provider Survey LHCSA Wage Parity Certification Form

Aug. 26 Sept. 1

Personal Care Cost Report CHHA Cost Report

Sept. 15 Sept. 15

CHHA, Personal Care Executive Order 38 Disclosure Form Health Care Facility Transformation Program RFA Nonprofit Infrastructure Capital Investment Program RFA LHCSA Statistical Report

Sept. 15 Sept. 16 Sept. 29 Oct. 15

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RULE from p. 1 adjust the rebasing cuts to a level beyond that authorized by Congress. 

Need for CMS action to address the lack of a comprehensive impact analysis for rebasing and the failure of rebasing to incorporate all usual and necessary indirect and direct costs in CMS’s analysis.



CMS’s silence, in the proposed 2017 rule, on the question of Medicare face-to-face documentation issues which continue to plague providers with administrative costs, payment problems, and accessto-care burdens.



Concern with CMS’s proposal to calculate outlier payments, using a cost-per-unit approach rather than a cost-per-visit approach. Along with this cost-per-unit change, CMS proposes to limit the amount of time per day (summed across the six disciplines of care) to 8 hours or 32 units per day when estimating the cost of an episode for outlier calculation purposes.



Ongoing concerns with: CMS’s value-based purchasing demonstration project; the proposed wage index; payment for negative pressure wound therapy using a disposable device; and the lack of funding for Health Information Technology/Exchange and other aspects of the rule.

For each area of concern, HCA outlines specific recommendations. Members can read HCA’s comments by visiting the “Letters and Comments” section of our website at http://hca-nys.org/category/letters-andcomments.

A final rule is anticipated by November 2016, with the 2017 HHPPS going into effect on January 1, 2017.

To learn more about the impact of the rule, members should be sure to attend HCA’s Senior and Financial Manager’s Retreat on September 8 and 9 at the Mohonk Mountain House resort in New Paltz. Colin Roskey of The Partnership for Quality Home Healthcare will devote much of his presentation to this topic, along with other federal policy updates.

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

Reminder about EO No. 38 Legal Cases and Implications for Compliance As previously and extensively reported to the membership, Executive Order (EO) No. 38 and its implementing regulations have been upheld by the New York State Appellate Division, Second Department in two separate decisions, both of which the New York State Court of Appeals declined to review.

Given the upcoming deadlines for CHHA and Personal Care EO No. 38 disclosure forms (September 15), HCA wanted to just provide a quick recap of the requirements and the implications of these recent rulings in terms of provider obligations, specifically in Nassau County.

We previously reported that one of these court decisions overturned an earlier Nassau County Supreme Court decision that had struck down EO No. 38. After that Nassau County Supreme Court Decision, New York State posted a “legal notice” on its EO No. 38 website, which advised covered providers conducting business in Nassau County that they need not file EO No. 38 disclosures. Despite the two Second 4

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Department decisions upholding EO No. 38 and its implementing regulations, this legal notice remains posted on the State’s EO No. 38 website in two locations (http://executiveorder38.ny.gov/ and https:// www.eo38.ny.gov/xo/login).

Although this legal notice from New York State cannot be disregarded, the Second Department’s court decisions nevertheless uphold the New York State Department of Health’s (DOH) authority to enforce the implementing regulations of EO No. 38. These decisions, therefore, would allow DOH to enforce the EO No. 38 regulations in Nassau County, notwithstanding the legal notices posted on the EO No. 38 website.

We encourage you to contact your legal counsel to discuss these issues and get guidance on filing EO No. 38 Disclosure Forms. The next CHHA and Personal Care Provider Disclosure Forms are due September 15, 2016.

This article was prepared for HCA by Damian Privitera, Attorney at Law at Wilson Elser, the firm for HCA's Counsel. For more information, contact HCA Policy staff.

2015 LHCSA Statistical Report Posted The state Department of Health (DOH) has posted the 2015 LHCSA Statistical Report on the Health Commerce System (HCS).

It must be completed and submitted by October 15, 2016. DOH has also posted Frequently Asked Questions on the LHCSA Statistical Report and form instructions. These documents, along with a Dear Administrator Letter (DAL), are posted in one PDF here: http://hca-nys.org/wp-content/uploads/2016/08/ 2015LHCSAStatReportDocs.pdf.

LHCSAs that exclusively serve patients in the Assisted Living Program (ALP) must complete the 2015 ALP LHCSA Statistical Report. LHCSAs that serve non-ALP patients must complete the 2015 LHCSA Statistical Report. LHCSAs that serve both ALP and non-ALP patients must complete both forms.

According to the DOH DAL: Failure to submit all required information in the appropriate format may subject the licensed operator to an enforcement action under Section 12 of the Public Health Law resulting in the agency being liable for civil penalties of violations of Article 36 of the Public Health Law and New York State Medical Facilities Code. Administrators should be aware that the department’s ability to make an affirmative statement to the LHCSA operator’s character and competence will be negatively impacted if an enforcement action for failure to submit is pursued. Furthermore, any licensure applications currently in process for agencies determined to be delinquent for this submission will not be processed.

LHCSAs are advised to submit their Statistical Reports as early as possible to avoid any potential system delays and wait-times for support. Only the person with an Administrator role on the HCS is able to submit the report, and only people in the Administrator, Director of Home Care Patient Services, Data Reporter or HPN Coordinator can access the forms.

Any questions should be submitted to HCStatRpts@health.state.ny.us.

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Wage Parity Certification Forms Due Sept. 1 The next round of state-required vendor Home Care Worker Wage Parity certification forms are due September 1. This applies to LHCSAs and other entities that contract with Managed Care Organizations (MCOs), CHHAs and/or LTHHCPs serving New York City, Long Island and Westchester.

MCOs, CHHAs and/or LTHHCPs that contract with LHCSAs are required to obtain a written certification on a quarterly basis from the LHCSA or other entity which attests to its Wage Parity compliance for defined certification periods and on a prospective basis. The form due September 1, 2016 covers the period September 1, 2016 through November 30, 2016 and is sent to the MCO, CHHA and/or LTHHCP, not the state Department of Health (DOH).

The 2016 certification forms are at http://www.health.ny.gov/health_care/medicaid/redesign/2016/201602-17_wage_parity_alert.htm. In completing the form, HCA recommends adding a date after the signature and noting on the form that the certification covers the September 1, 2016 to November 30, 2016 period.

The Home Care Worker Wage Parity rates for March 1, 2016 through February 28, 2017 are available at http://www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm.

Since the inception of the Wage Parity Law, HCA has advocated for full wage parity funding. With the transition of most cases to managed care plans, HCA has advocated that the plans receive rates sufficient for them and their home care contractors to meet wage parity and that Medicaid fee-for-service (FFS) rates be increased to account for the wage requirements. HCA has also been involved in two different legal challenges to the Wage Parity Law (one federal and one state) which have been previously reported to the membership.

With the statewide minimum wage set to increase, effective December 31, 2016, HCA will be determining the impact of this new minimum wage statute on the existing Wage Parity Law, including future reporting expectations. As with the Wage Parity Law, HCA has engaged on multiple fronts to urge a commitment of full and timely state funding to pay for the upcoming minimum wage increases (effective December 31, 2016) and to ensure that the funds go to home care providers. (See related p. 1 story.)

Value Based Payment Bundles and Quality Metrics Revealed The State Value Based Payment (VBP) core committee met in Albany yesterday to review and provide preliminary comment on proposed quality metrics and an initial set of VBP bundles recommended by the project’s Clinical Advisory Groups.

The proposed framework for selection of quality measures included:       

Alignment with the Delivery System Reform Incentive Payment (DSRIP) program; Prioritizing outcome measures to reduce “drowning” in items; Measuring the quality of the total cycle of care of the VBP arrangement; Relevance for patients and providers; Alignment with Medicare and linking to point-of-care registration (electronic health records); Alignment with the State Health Innovation Plan’s Advanced Primary Care measure set; and Transparency of process, measures and outcomes.

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Continued from previous page The Clinical Advisory Groups recommended further categorization by Clinical Relevance, Feasibility, and Validity and Reliability.

Alignment and priority of quality measures across sectors and integrated partners are an imperative that HCA and HCA’s Quality Committee have long been working to advance. HCA raised and emphasized this point at the very onset of the state’s VBP project, and well before in our recommendations and work to create a priority alignment of quality metrics for home care and MLTC. Among the prospective service and payment bundles reviewed at yesterday’s meeting were bundles for maternity populations (prenatal and post-partum) and HIV/AIDS patients. Additional bundling recommendations are still in the formative stage for MLTC populations, behavioral health, and other areas.

A newly forming Clinical Advisory Group will be convening on Children’s Health, including all aspects.

HCA will be securing participation by representatives of our new Pediatric Workgroup (see related page 13 article) on this group.

Also being convened is a Program Integrity subworkgroup, for which HCA participation has already been tapped, to consider areas of alignment between VBP and state audit/compliance requirements. This is particularly important given new and changing care patterns conducive to VBP versus longstanding, specific regulatory criteria which may necessitate modification or flexible interpretation in order to be compatible.

The slide deck with further details on yesterday’s VBP meeting can be viewed at http://hca-nys.org/wpcontent/uploads/2016/08/08252016VBPWorkgroupPresentation.pdf.

GoldStamp Resource Webinars – Equipping for VBP, DSRIP HCA is working with the GoldSTAMP project team at the state Department of Health and the University at Albany School of Public Health on forthcoming resource webinars to help guide home care agencies, hospitals and nursing facilities to incorporate the GoldSTAMP evidenced-based model for preventing/ reducing pressure ulcers.

The GoldSTAMP model has been a demonstrated success in improving health and quality outcomes and reducing the severe costs associated with pressure ulcers in patients. The model functions in a collaborative of hospitals, nursing homes and home care, along with engaged physicians.

In addition to guiding providers on GoldSTAMP adoption, the webinars and resources will be geared to assisting providers in applying the pressure-ulcer prevention/reduction programs in the value based payment and Delivery System Reform Incentive Payment (DSRIP) reforms and marketplace.

This will be a key opportunity for providers and ultimately for patient/public health. HCA is an active member of the state’s GoldSTAMP coordinating committee, and promotion of this evidenced-based model with home care has been a further initiative of the HCA Quality Committee, and featured at HCA’s statewide quality symposia.

Stay tuned for coming information on the resource webinars. In the meantime, providers and MLTCs are encouraged to view the further background and resources at the GoldSTAMP homepage: www.goldstamp.org.

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HIRING Essex County Dept. of Public Health’s Certified Home Health Agency (CHHA) HIRING: DIRECTOR OF PATIENT SERVICES Essex County Nursing Services, Elizabethtown, New York, located in the heart of the Adirondacks is seeking an experienced individual who has the will and determination to successfully lead the agency in today’s home health care environment.

This position involves planning, organizing, directing, coordinating and evaluating patient care services provided by the certified home health agency. The Director of Patient Services is responsible for the professional and financial operations of the agency; provides and ensures that quality improvement is the main focus of the agency.

MINIMUM QUALIFICATIONS: A Masters or Baccalaureate Degree in Nursing from an approved program, or from a nonapproved program supplemented by content which can be equated to an approved program, and either: A) Two years of experience in a management level position in a certified home health agency; or B) A combination of education and experience which is deemed equivalent to the experience requirement as specified in (a) by the State Office of Health Systems Management.

BENEFITS: Excellent county/government benefits including New York State Retirement System. Great team of professionals to work with.

Candidates must possess a limited permit to practice or licensure and current registration to practice as a Registered Professional Nurse in New York State at the time of appointment.

LAST DATE TO FILE FOR PROVISIONAL APPOINTMENT IS SEPTEMBER 14, 2016.

Qualified candidates will be subject to a civil service examination to be announced at a later date. Applications will be accepted until the announced closing date for the examination.

Please go to www.co.essex.ny.us/job.asp to complete an application and to view a complete job description.

Director of Patient Services – Full Time Living Resources Certified Home Health Agency in Albany is growing and we are seeking a dynamic leader to fill this pivotal position.

This position is responsible for overall strategic, clinical, operational and financial leadership to the CHHA and ensures high quality, cost effective care. This individual will work in collaboration with the Living Resources Corporation’s CEO and Associate Executive Director to ensure the integrity of the agency in accordance with the goals and objectives of the agency as set forth by the Board of Directors.

Qualifications: Current RN license, required Bachelor’s degree, Master’s degree preferred; minimum of three years of management experience in home health care or related field.

For immediate consideration, please forward résumé/cover letter and salary requirements in confidence to Lisa Razanousky at lrazanousky@livingresources.org.

Additional opportunities available: Clinical Manager, RNs, Physical Therapists, Occupational Therapists, Home Health Aides and PCAs.

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Q&As Posted on Funding RFA for Health Care Transformation Program The state Department of Health (DOH) has posted Questions and Answers (Q&As) related to the Health Care Facility Transformation Program request for applications (RFA) available at http://hca-nys.org/wpcontent/uploads/2016/08/QAsHealthcaretransformationRFA.pdf. The program contains HCA-sought funding dedicated for home care and other community-based providers, which HCA urged during the most recent state budget negotiations.

HCA had submitted a series of questions, some of which are covered in the Q&As. Among several issues, the Q&As address:        

Use of funding for technology-related expenses; Capital vs. non-capital projects; Date that awards will be announced (late 2016); What is meant by the requirement that “creation of a financially sustainable system of care should be associated with a merger, consolidation or significant restructuring activity”; Expectations for community engagement and community needs assessment; Ineligibility of fiscal intermediaries for funds; Funding availability for training and education (unclear); and Lack of requirements for letters of support and matching funds.

Under this RFA, a minimum of $30 million is dedicated for home care and the community-based sector as part of the entire $195 million pool otherwise available for all sectors. While the $30 million minimum is dedicated to home and community-based providers, specifically, these entities are also eligible for funding in the remainder of the pool as well.

As reported in numerous communications, the goal of this program is to provide grants that primarily support capital projects (but it may include non-capital expenses such as debt restructuring) “for the purpose of strengthening and protecting continued access to health care services in communities throughout New York State and associated with a merger, consolidation or significant corporate restructuring activity that is part of an overall transformation plan intended to create a financially sustainable system of care.”

Non-capital projects, in addition to debt restructuring, that may be eligible for funding include general operating expenses directly connected to the eligible project for which funding is sought as well as non-capital expenses in cases where the RFA does not explicitly mention them as excluded. Those excluded are general operating expenses applicable to day-to-day operations and unconnected to the eligible project for which funding is being sought.

The overall pool is open to health care providers fulfilling a health care need for acute inpatient, outpatient, primary, home care or residential health care services in a community. Home and community-based providers, eligible for at least $30 million of this total amount, are defined as home care providers, diagnostic and treatment centers, mental health and alcohol and substance abuse treatment clinics, and primary care providers.

The RFA is at https://grantsgateway.ny.gov/intelligrants_NYSGG/module/nysgg/ goportal.aspx?NavItem1=4&ngoID=5000607.

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DOH held a webinar on July 29. The materials are at http://hca-nys.org/wp-content/uploads/2016/08/ SHCFTP-RFA-Applicant-Webinar-8-8-16.pdf. The recording is at http://tinyurl.com/z7esohv.

Applications must be submitted in the Grants Gateway by 4 p.m. on September 16, 2016. If you don’t have a Grants Gateway account, you should plan on about five business days to obtain one.

Updates From CMS Home Health and Hospice Open Door Forum The U.S. Centers for Medicare and Medicaid Services (CMS) hosted a Home Health and Hospice Open Door Forum call this week on a variety of issues affecting home health and hospice providers.

Several of the updates have already been reported in recent editions of ASAP, including the fiscal year (FY) 2017 hospice wage index and rate update final rule, as well as a new hospice condition code to use when hospice recertification is untimely. The following are some new highlights from the call.

Home Health Payment Reform – The Home Health Groupings Model (HHGM) The Affordable Care Act (ACA) requires CMS and/or its contractors to examine costs associated with Medicare home health beneficiaries who are low-income, live in underserved areas and have a high severity of illness. During the call a representative from Abt Associates reported on its study which found that the current home health prospective payment system (HHPPS) produced lower payment margins for patients who:       

Need parenteral nutrition Have traumatic wounds or ulcers Required substantial assistance in bathing Were admitted to home health following an acute or post-acute stay Have a high Hierarchical Condition Category score Had certain poorly controlled clinical conditions Were dually eligible

Because of these findings, Abt Associates is in the process of developing a new Home Health Groupings Model (HHGM) for CMS. The proposed or draft HHGM would categorize each home health episode into different subgroups within five categories related to: Timing (early or late); Referral source (community or institutional source); Clinical grouping (musculoskeletal rehab, neuro/stroke rehab, wounds, Medication Management Teaching and Assessment, behavioral, or complex nursing care); Functional/cognitive level; and Comorbidity adjustment.

In total, HHGM produces 128 different payment subgroups. CMS will consider these proposed groupings in future payment reforms. The proposal can be found in the Abt Associates presentation at: http:// abtassociates.com/AbtAssociates/files/e8/e81bd5e3-b676-40d0-b286-590fc0daaa09.pdf Home Health Value Based Payment Demonstration Update CMS’s Home Health Value-Based Purchasing (HHVBP) model, previously described for members, is undergoing some changes in the pilot states during 2017 (New York is not one of them). These changes include establishing a minimum of eight home health agencies as a cohort for measure application and removing four measures (care management, prior function, influenza vaccine data collection, and reason 10

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pneumococcal vaccine not received) that had not been fully developed. CMS is also changing the reporting period, instituting an appeals process and other technical changes.

IMPACT Act A series of update calls and education sessions on the Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act) have been scheduled. The IMPACT Act requires home health agencies, skilled nursing facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), and Long-Term Care Hospitals (LTCHs) to submit standardized patient assessment data, data on quality measures and data on resource use and other measures. (See p. 12 story.)

CMS will host a conference call on Wednesday, August 31 from 1:30 to 3 p.m. to discuss how data elements are used in measure development with the IMPACT Act. A Special Open Door Forum on the IMPACT Act is also scheduled for Thursday, September 15.

Registration information will be posted in the near future at https://www.cms.gov/Medicare/QualityInitiatives-Patient-Assessment-Instruments/Post-Acute-Care-Quality-Initiatives/IMPACT-Act-of-2014/ Spotlights-and-Announcements-.html.

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

CMS to Hold Webinar on new Bundled Payment Models The U.S. Centers for Medicare and Medicaid Services (CMS) Innovation Center will host a webinar to present various aspects of the Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model proposals.

Home care agencies are strongly encouraged to take part in the webinar to learn more about these opportunity areas for home care providers who will play a pivotal role in the success of these models.

The webinar will be held on Wednesday, August 31, 2016, from noon to 1 p.m. Agencies can register at https://innovation.cms.gov/resources/epm-overview.html.

As covered in the July 29 ASAP, CMS has proposed new bundled payment models for hospitals that work with home care and other post-acute care providers. The program is scheduled to run for five years, from 2017 to 2021.

According to CMS, three new EPMs would test the effectiveness of making participants financially accountable for the quality and cost of episodes of care for: 

An acute myocardial infarction (AMI), including both medical therapy and percutaneous coronary intervention (PCI);



A coronary artery bypass graft (CABG); and



A surgical hip/femur fracture treatment, excluding lower extremity joint replacements (SHFFT).

In addition, the Cardiac Rehabilitation (CR) incentive payment model for EPMs and Medicare fee-for-service participants would test financial incentives for Inpatient Prospective Payment System (IPPS) hospitals that 11

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encourage the management of beneficiaries following an AMI or CABG toward greater utilization of CR services.

Lastly, CMS is proposing refinements to the Comprehensive Care for Joint Replacement (CJR) model.

More information is in HCA’s July 29 ASAP and at https://innovation.cms.gov/initiatives/cardiacrehabilitation

IMPACT Act Information Posted The U.S. Centers for Medicare and Medicaid Services (CMS) has posted a new Frequently Asked Questions (FAQs) document and video on the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act).

The FAQ document reflects questions received by CMS’s help desk and on several national provider calls. It is intended to provide guidance on IMPACT Act-related questions.

The IMPACT Act mandates the standardization of patient assessment data across post-acute care settings including home health agencies (HHAs), skilled nursing facilities, inpatient rehabilitation facilities, and long term care hospitals in order to improve quality of care and quality of life.

One question of significance to HHAs in the FAQs states that the Outcome and Assessment Information Set (OASIS) will not be replaced but will be modified to allow for the collection of a core set of standardized patient assessment items.

The IMPACT Act requires reporting on certain quality measures. Some of these measures and the date by which they must be reported by HHAs are: skin integrity and changes ( January 1, 2017); medication reconciliation ( January 1, 2017); incidence of major falls ( January 1, 2019); communicating the existence of and providing for the transfer of health information and care preferences ( January 1, 2019); and functional status, cognitive function, and changes ( January 1, 2019).

See https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Post-Acute-CareQuality-Initiatives/IMPACT-Act-of-2014/IMPACT-Act-Downloads-and-Videos.html for the FAQs and other resources, including an announcement and materials for an upcoming CMS IMPACT Act forum.

DOH Issues DAL on Hospice Regulatory Changes The state Department of Health (DOH) this week posted to the Health Commerce System (HCS) a Dear Administrator Letter to inform hospice providers of important regulatory changes to the New York Codes Rule and Regulation.

The regulations will also be posted on DOH’s website at: http://www.health.ny.gov/regulations/recently_adopted/.

HCA offered comments to DOH during the formative phase of the regulations to help shape them in support of hospice providers and to: broaden patient access to hospice services, streamline the regulations, and ueg consideration of the costs and reimbursement needs of hospices in the implementation of the new regulations.

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Continued from previous page DOH asks that hospice providers access and review these revised regulations. The Department expects providers to be compliant with them on the effective date, August 21, 2016. The amended regulations: 

Make the state operational rules for hospices consistent with federal regulations.



Expand the definition of terminal illness from six-months to 12-months life expectancy and address the difference in terminal illness definition for different payor sources (Medicare and Medicaid).

This change, supported by HCA in our comments and other outreach, is intended to expand the Medicaid hospice benefit by allowing individuals to access hospice care earlier in their terminal illness to manage symptoms on an ongoing basis and reduce the need for more costly emergency room visits and hospital stays.



Increase the hospice residence maximum capacity from eight beds to 16 beds.

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Reinforce the definition of palliative care as being provided to a person with an advanced, life limiting illness.

DOH plans to issue information and guidance related to changes in Medicaid reimbursement for hospice care in a future issue of the “Medicaid Update” newsletter.

Hospice providers that have questions or need clarification related to these regulatory changes, should send an email to DOH’s Division of Home and Community Based Services at: homecare@health.ny.gov.

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

HCA Launches New Pediatric Care Workgroup This week, HCA held the first meeting of our new Pediatric Care Workgroup, a committee of member agencies who have long been stressing the need to focus on this often neglected area of home care. The meeting was extremely fruitful, focusing initially on issues such as:        

Pediatric workforce capacity and staffing Reimbursement Authorization Commercial coverage limitations Program sustainability Need for expansion of pediatric based services Potential for pediatric care bundles Need to develop quality benchmarks

HCA policy staff is in the midst of drafting an actionable work plan and next steps with the goal of addressing areas of significant need for some of the state’s most vulnerable children. Next steps may include legislative, budgetary, administrative, and/or programmatic strategies to mitigate many of the current conditions limiting care to this population. HCA has already engaged DOH on the recommendation to include home care training in pediatrics as part of the coming $245 million state workforce training and 13

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education initiative. Additionally, there will be representation from this new committee on a new Value Based Payment (VBP) Clinical Advisory Group on children’s health that the state is in the process of initiating. (See VB story on p. 6.)

If you would like to be a part of future meetings and work conducted by this group, please contact Alex Blais or Al Cardillo.

PACE Proposed Rule Explained HCA has reviewed the U.S. Centers for Medicare and Medicaid Services (CMS) proposed rule that makes changes to the Program for All-Inclusive Care for the Elderly (PACE) as outlined in the August 12 ASAP. The proposed rule is at https://www.gpo.gov/fdsys/pkg/FR-2016-08-16/pdf/2016-19153.pdf; a CMS Fact Sheet is at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/ 2016-08-11.html.

Comments are due October 17 and HCA is currently considering the submission of comments.

The rule would: 

Require each PACE Organization (PO) to have a compliance program that is responsible for monitoring and auditing its organization for compliance with CMS regulations and have measures that prevent, detect and correct non-compliance with CMS’s program requirements and measures that prevent, detect and correct fraud, waste and abuse.



Allow staff to engage in direct participant contact in cases where they don’t have one year of experience working with frail or elderly individuals but they meet all other requirements and receive appropriate training from the PO.



Enable the PO to determine whether an individual’s contact with participants would pose a potential risk because the individual has been convicted of one or more criminal offenses related to physical, sexual, drug or alcohol abuse or use.

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Add a restriction that a PO must not employ individuals or contract with organizations or individuals who have been found guilty of abusing, neglecting, or mistreating individuals by a court of law or who have had a finding entered into the state nurse aide registry concerning abuse, neglect, mistreatment of residents, or misappropriation of their property.



Allow a PO to have one individual fulfill a maximum of two separate roles on an Interdisciplinary Team (IDT) when the individual meets applicable state licensure requirements and is qualified to fill each role and able to provide appropriate care to meet the participant’s needs.



Expand the primary care physician role on the IDT to include other providers, including communitybased physicians, physician assistants and nurse practitioners. These other providers would have to be licensed under state law and practice within their scope of practice with regard to oversight, practice authority and prescriptive authority.

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Continued from previous page 

Exclude those community-based physicians who are proposed to be on the IDT from the requirement that they service primarily PACE participants.



Allow the plan of care to be developed within 30 days of the date of the individual’s enrollment (would replace the current requirement that it be developed promptly following enrollment); and clarifies which members of the IDT are required to develop the plan of care.



Require that the plan of care: utilize the most appropriate interventions (for example, care improvement strategies) for each of the participant’s care needs that advance the participant toward a measurable goal and desired outcome; identify each intervention and how it will be implemented; and identify how each intervention will be evaluated to determine progress in reaching specified goals and desired outcomes.



Require the IDT to document in the participant’s plan of care the reasons services are not needed and are not being included in cases where the IDT determines from its assessment that any services associated with the mandated comprehensive assessment criteria do not need to be included.



Delete the requirement for annual reassessments by the physical therapist, occupational therapist, dietician, and home care coordinator and keep the requirement that PACE participants be reassessed semiannually, every six months.



Change the list of IDT members that must conduct the semiannual assessment to include the primary care provider, registered nurse, Master’s level social worker, and any other IDT members actively involved in the development or implementation of the participant’s plan of care, as determined by the IDT members.



Permit involuntary disenrollment if the participant, after a 30-day grace period, fails to pay or make satisfactory arrangements to pay any applicable Medicaid spend-down liability or any amount due under the post-eligibility treatment of income.



Permit involuntary disenrollment in situations where the participant’s caregiver engages in disruptive or threatening behavior.



Ensure that the Medicaid rate paid under the PACE program agreement is not only less than what would otherwise have been paid outside of PACE for a comparable population, but is also sufficient for the population served under the PACE program. CMS indicates that this means not lower than an amount that would be reasonable and appropriate to enable the PO to cover the anticipated service utilization of the frail elderly participants enrolled in the program and adequate to meet PACE program requirements.



Ensure that the monthly capitation amount be consistent with efficiency, economy and quality of care.



Replace the requirement for onsite review every two years with the requirement that CMS, in cooperation with the state administering agency, will conduct reviews of the operations of POs as appropriate, by utilizing a risk assessment as the means of selecting which POs will be audited each year.

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Continued from previous page 

Extend from six to ten years the period that POs must retain records.



Prohibit marketing by any individuals other than employees of the PO, unsolicited door-to-door marketing or other unsolicited means of direct contact, including calling or e-mailing a potential or current participant without the individual initiating the contact.

The rule also requests public comment on potential changes to CMS’s PACE center requirements, including whether to revise the current regulatory requirements and allow greater flexibility with regard to the settings in which IDT members provide PACE services.

PACE is a Medicare and Medicaid program that provides comprehensive medical and social services that enable older adults to live in the community instead of a nursing home or other care facility. To qualify, individuals must: be 55 or older; live in the service area of a PACE organization; need a nursing home-level of care; and be able to live safely in the community with help from PACE. In New York, there are 9 PACE plans that serve 5,512 individuals ( July 2016).

More information on PACE can be found at https://www.medicare.gov/your-medicare-costs/help-payingcosts/pace/pace.html.

NYC Council Passes Two Caregiver Bills Last week, the New York City Council passed and sent to Mayor de Blasio two bills that affect paid and unpaid caregivers.

The first, 1084-A (http://legistar.council.nyc.gov/LegislationDetail.aspx?ID=2576392&GUID=632A33319DC6-4348-ADB6-AD9FFF5F03A7&Options=ID%7cText%7c&Search=int.+1084), would establish a new Division of Paid Care within the Office of Labor Standards. The Division would:    

Conduct public outreach campaigns and informational clinics to inform paid care workers of their rights; Collect and publish information useful for paid care workers; Coordinate with governmental agencies, advocacy groups, and other stakeholders; and Develop related policies and programs.

The Division would house an advocate, who would develop an intake and referral system for paid care workers to submit labor- and employment law-related complaints and would notify appropriate agencies about potential systemic legal violations. The Division would post on its website and submit to the Council certain information annually.

The second bill, 1081-A (http://legistar.council.nyc.gov/ LegislationDetail.aspx?ID=2576390&GUID=F5DBDC17-F205-4C9C-BBC3083C9B3E757F&Options=ID|Text|&Search=1081), would: 

Require the Department for the Aging (DFTA) to develop and conduct a survey, no later than February 15, 2017, of unpaid caregivers and service providers to assess existing unpaid caregiver services and identify the needs of unpaid caregivers; and Continued on next page 16

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Continued from previous page 

Require DFTA to deliver to the Mayor and Council and publish on its website a comprehensive plan with recommendations to address the needs of New York City’s unpaid caregivers by August 30, 2017.

In the development of the plan, DFTA would be required to consult with the Human Resources Administration, the Mayor’s Office for People with Disabilities, the Department of Health and Mental Hygiene, and other agencies, as well as unpaid caregivers, academic experts in caregiver issues, service providers, and advocates for senior citizens and individuals with disabilities.

Finally, DFTA would be required to submit to the Mayor and the Speaker of the City Council a report detailing progress made on the recommendations resulting from the plan. This report must be submitted two years after the submission of the original plan and every five years after.

HCA will be following the implementation of both bills and keep members updated.

Funding Announcement Posted for Palliative Care Program The Patient Centered Outcomes Research Institute (PCORI) has posted the funding announcement for a project to: 1) support care planning for adult patients with advanced illnesses over time that is consistent with the goals and preferences of adult patients and their caregivers; and 2) support the delivery of coordinated, community-based palliative care that effectively implements those care plans.

PCORI seeks to fund multiple, large, multi-site, community-based comparative effectiveness research (CER) studies to generate evidence in support of these goals. Research institutions and consortia with expertise and experience in clinical comparative effectiveness research (CER)/patient-centered outcomes research (PCOR) and community-based palliative care delivery are encouraged to apply for this funding.

The deadlines are September 14, 2016 for Letters of Intent, and December 19, 2016 for applications.

Awards will be announced in June 2017.

The announcement is available at http://www.pcori.org/sites/default/files/PCORI-PFA-2016-Cycle-3Palliative-Care.pdf. More information is posted at http://www.pcori.org/funding-opportunities/ announcement/community-based-palliative-care-delivery-adult-patients-advanced.

NY Connects RFA Released The New York State Office for Aging (NYSOFA) has released a Request for Applications (RFA) that would expand and enhance NY Connects. The RFA is at https://grantsgateway.ny.gov/ IntelliGrants_NYSGG/module/nysgg/goportal.aspx?NavItem1=2.

NY Connects is designed to help individuals and their family caregivers gain access to the right long term services and supports, at the right time, in the right setting.

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Continued from previous page NYSOFA will select through this RFA process, and contract with, up to six Independent Living Centers (ILCs) and/or not-for-profit Community Based Organizations (CBOs) to perform NY Connects functions in a specified region. Applicants and subcontractors, if applicable, must have a thorough knowledge of providing Information and Assistance and Options Counseling/Person-Centered Counseling on long term services and supports to individuals of all ages and abilities and meet all of the following criteria: 

The applicant is an ILC or other not-for-profit CBO;



The applicant is physically located in New York State and has a bricks and mortar presence in the region it proposes to serve.



The applicant has a minimum of five years of experience with the basic core components of providing Information and Assistance and Options Counseling/Person-Centered Counseling as delineated in the NY Connects Standards, or demonstrated comparability with these standards.



The ILC or CBO is registered and pre-qualified with the NYS Grants Gateway portal.

The initial contract period is fifteen months, running from January 1, 2017 to March 31, 2018 with the possibility of a three-year renewal, subject to the availability of funds and at the discretion of NYSOFA. Questions on the RFA must be submitted by September 8; answers will be posted by September 16.

Letters of intent are due September 20 and applications must be submitted by September 30.

Advertising Options in Membership Directory Offers you Exposure to Discharge Planners and Care Managers Options are in addition to free member listing By now, HCA members may have received a notice about advertising options for our Membership Directory and Reference Guide. This guide is produced each year as a publishing arrangement between HCA and Naylor Associate Solutions.

Once published, the guide will be sent to discharge planners, local districts and other case managers as a special member marketing benefit, listing all HCA member home care agencies, free of charge, so that referral sources know where to turn to arrange for home care services with your agency. Your agency will be listed by geographic region in alphabetical order, with contact information and a listing of the services you provide, based on the information HCA has on file for you, so that key case managers and referral sources can reach you. The guide will be published and circulated in late November.

In addition to your free agency listing, HCA and Naylor are offering some options for home care agencies to promote their brand even further among referral sources with full-color advertisements in the guide, targeted to your region of the state. We encourage members to review the options for additional exposure by reviewing the advertisement selection form.

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Continued from previous page If you have not received this form yet, you can download it from HCA’s website at http://hca-nys.org/wpcontent/uploads/2016/08/HCNR0017PDischargePlannerGuide.pdf. The deadline to reserve an ad is September 29, 2016.

For questions about the guide, please contact Naylor’s Ashley Benton at abenton@naylor.com or HCA’s Membership Director Laura Constable at (518) 810-0660 or lconstable@hcanys.org.

NGS Closed for Labor Day National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), will be closed on September 5 for Labor Day. This includes the Electronic Data Interchange (EDI) Help Desk, Provider Contact Center, Provider Enrollment Line, and Telephone Reopening Unit. Electronic claim files transmitted after 5 p.m. on Friday, September 2 will have a claim receipt date of Tuesday, September 6. EDI front-end acknowledgement transactions will be created as expected as EDI claim files are received. The FISS/DDE Provider Online System will be operational on September 5 during regular hours, though no support will be available.

Providers will be able to access NGS Connex and use the Interactive Voice Response (IVR) system at: 1-866275-3033.

Publications 

“Similar But Not the Same: How Medicare Per Capita Spending Compares For Younger and Older Beneficiaries,” Kaiser Family Foundation http://files.kff.org/attachment/data-note-Similar-But-Not-the-Same-How-Medicare-Per-CapitaSpending-Compares-For-Younger-and-Older-Beneficiaries



“Updates to the Clarifying Questions and Answers Related to the July 6, 2015, CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Medicare/Coding/ICD10/Clarifying-Questions-and-Answers-Related-tothe-July-6-2015-CMS-AMA-Joint-Announcement.pdf



“Preventing Central Line-Associated Bloodstream Infection (CLABSI) in the Home Care Setting,” by the United Hospital Fund http://www.uhfnyc.org/assets/1485

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

19

HCA Introduces‌

September 28 & 29, 2016 Excelsior Springs at the Courtyard Marriott 47 Excelsior Avenue Saratoga Springs, NY 12866

While New York State is home to some of the nation’s premier women leaders in healthcare, women are still vastly underrepresented in top executive leadership roles, despite research indicating that women offer tremendous skills, talents and track records to the executive team.

Let’s change this!

The Home Care Association of New York State is proud to present the inaugural Women in Healthcare Leadership Summit. This educational symposium offers transferable skills and insights to empower and enlighten women leaders from all areas of healthcare, not just home care. Whether your career is in the provider sector, finance, lobbying, government policymaking, strategic analysis, or elsewhere, this Summit offers you and other women leaders the opportunity to network and learn from colleagues in other fields and leadership arenas.

You’ll gain new skills for communication, strategy, negotiation, overcoming obstacles and meeting new challenges. We’ll delve into life-balance issues, career choices, and tools to help you to reach your greatest potential. The program also offers time to reenergize and renew your commitment to personal improvement.

HCA has carefully constructed this program to be thought-provoking and insightful, creative and interesting, while offering some fun networking opportunities. Don’t miss it!.

AGENDA Wednesday, September 28, 2016 1:00 PM – 1:15PM HCA Welcome – Joanne Cunningham, President, HCA 1:15 – 2:30 PM Vision, Voice and Victory: The Changing Face of Women’s Leadership Miriam Hawley, CEO, Enlignment, Inc. The ground-breaking book Our Bodies, Ourselves shifted the national and international dialogue about women’s health, sexuality and power. Miriam Hawley, a founder of the Boston Women’s Health Book Collective, Inc. that is responsible for writing this best-seller, has played an instrumental role in building the women’s movement and transforming the global conversation about women’s health and sexuality. In 2016, the 45th year following this pioneering publication, the vision and voice of female leadership has evolved. This session for today’s women executives will offer insights about the timeless and essential ingredients to leadership growth, success and collectively cracking the glass ceiling in the healthcare industry and beyond.

2:30 – 3:30 PM Reaching the Heights of Personal and Professional Success – Strategies and Negotiating Tips Bethany Gilboard, CEO, Innovative Health Alliance of New York and Alliance for Better Healthcare, LLC Bethany Gilboard, a successful veteran of healthcare industry strategy and one of the state's most prominent women healthcare leaders, will share her unique perspective on tackling tough professional and personal challenges and dilemmas and offer women leaders strategies, tips and advice to negotiate the highest levels of professional advancement and personal balance and success.

3:30 – 6:00 PM

Women’s Mini-Expo Explore an array of fashion, lifestyle, and health & wellness vendors (make-up, chair massages, product demos and more).

3:30-4:15 PM Wine & Appetizer Pairing – Time to Unwind and Relax Sample a variety of wines while learning about wine selections and pairings from a seasoned wine connoisseur.

3:30-6:00 PM Executive Headshot Station

4:15-5:00 PM Cooking Demo

An exceptional headshot can promote a positive and professional image for all women leaders. It’s a fairly simple concept, but many women find it timeconsuming to seek out the most professional and flattering photographic look. Come dressed to impress for this not-to-be missed photo-op with an expert photographer from The Booth for Business, a company that was recently tapped to photograph attendees at the first United State of Women Conference. This is a FREE opportunity for all conference attendees.

5:00 – 6:00 PM Women-Who-Lead Networking Reception

Learn (and sample) some easy, creative, and simpleto-make appetizer recipes from an expert chef who will show you some stress-free menus to entertain with flair.

Mix and mingle with like-minded power-house women in the healthcare industry while you enjoy a cocktail (or two) and hors d'oeuvres featured in the cooking demo.

AGENDA Thursday, September 29, 2016 8:00-8:45AM Women of Influence Executive Breakfast

Noon-1:30PM Making HERstory Luncheon and Keynote Address

8:45-9:00AM HCA Welcome

1:30-2:30PM The Bitch in Your Head: Become More Empowered and Confident by Squashing Your Inner Critic

9:00-10:15AM Creating Your Path to Leadership Success Vicky Hines, Chief Operating Officer, University of Rochester Medical Faculty Group Career choices offer new opportunities; but they also can involve risk-taking and a whole lot of uncertainty.

Some degree of calculated risk is necessary for leaders to develop or reach career success. Hear from a home care leader veteran about career avenues, how to create new paths for higher-level executive opportunities, and tips for professional development that can lead to the best choices.

10:15-10:30AM Break 10:30-Noon Communicating with Impact: Purpose, Power and Presence Karen Friedman, Chief Improvement Officer, Karen Friedman Enterprises, Inc.

Learn how women leaders can tap their unique perspectives as women to contribute and communicate with maximum impact across diverse audiences. This workshop – featuring on-the-spot coaching and interactive exercises – will provide practical strategies and easy-to-use techniques that you can apply as soon as you leave the room. Be better positioned to express ideas, command attention and project greater presence, whether you are talking to management, co-workers or customers. By leveraging the three Ps ― purpose, power and presence ― you’ll empower listeners, influence key audiences, and come across as the leader you want others to see.

Dr. Jacqueline Hornor Plumez Too many of us live with a litany of self-defeating selfcriticisms like: You’re too fat! How could you be such an idiot? Don’t even try; it will never work. Some people hear this “Bitch” in their head and think it is motivating. But in truth it keeps us from having a good day or a good night’s sleep, from getting the love we want or the raise we deserve.

This presentation, based on Dr. Plumez's entertaining and enlightening book The Bitch in Your Head: How to Finally Squash Your Inner Critic, will offer tools and techniques to rid yourself of negative thinking in every area of your life – and in every era of life, spotlighting attitudes for success in the workplace.

AGENDA Thursday, September 29, 2016 – continued 2:30-2:45PM

Break

2:45-4:15PM Advancing Your Career with the Sponsorship Effect Rachel Soares, Director of Research, Catalyst Women’s representation on boards and in leadership positions is changing, but at a glacial pace. Intentional action from individuals, leaders, and organizations alike are needed to accelerate progress for women. Catalyst research has found that mentoring is essential to leadership development but it is not enough, on its own, to help women advance. A more influential and direct professional relationship for career acceleration exists: it’s called sponsorship. Whether you are considering your next promotion or want to become a board member of an organization, sponsorship is a powerful tool for women’s advancement. In this session, attendees will learn about the importance of sponsorship and concrete strategies to get sponsored and be a sponsor yourself. By creating a culture of sponsorship for your own teams, you’ll see how paying it forward pays back for the sponsor, protégé, and the organization at large.

4:15PM Closing Remarks and Adjournment

Hotel Information Courtyard Marriott 11 Excelsior Avenue Saratoga Springs, NY 12866 A room block has been made at the Courtyard Marriott, which is located directly next door to the summit venue The Excelsior Springs, for the evening of Wednesday, September 28th at the reduced rate of $169 per room. To make your reservation, call 866-210-9325 and ask for the Home Care Association of NYS group rate. The deadline for reservations at the group rate is August 17; after this time, prevailing rates will apply.

Catalyst is the leading nonprofit organization with a mission to accelerate progress for women through workplace inclusion.

With offices in Australia, Canada, Europe, India, Japan, and the United States, Catalyst is dedicated to creating workplaces where employees representing every dimension of diversity can thrive.

Meet Our 2016 Thought Leaders

Karen Friedman is an international communications expert and author of the best-selling book ‘Shut Up and Say Something’ (Praeger Publishing). She heads Karen Friedman Enterprises, Inc. which for 19 years has been teaching professionals how to become more compelling communicators.

Her expertise was recognized by former Secretary of State Hillary Rodham Clinton who tapped Karen to provide media and political training for women in South and Central America. Since then, her firm has worked across industries, with a specialty in life sciences and pharmaceuticals, coaching executives and key opinion leaders, and teaching patient advocates how to share their stories with impact.

Karen spent more than two decades as an award-winning major market television news reporter whose breaking coverage of local and national events aired on ABC, CBS, NBC, CNN, the Today Show, Good Morning America and Nightline. Her last stop was ABC-TV Action News in Philadelphia. Today, she continues to write as a columnist for the Philadelphia Business Journal and her articles are syndicated nationwide. Karen is also adjunct faculty at Smith College’s prestigious executive education programs for women where she teaches leadership communications. In addition, she hosts the popular Internet TV and radio series on ReachMD which helps health care professionals improve their communication skills.

Bethany Gilboard is Chief Executive Officer of both the Innovative Health Alliance of New York LLC, a Medicare Shared Savings Program ACO and a Clinically Integrated Network in Albany, NY and the Alliance for Better Health Care, LLC a performing provider system participating in the New York State DSRIP program. The goal of the DSRIP program is to redesign the New York State Medicaid program and in doing so transform the current payment systems to reward value, quality and patient outcomes Ms. Gilboard has been on the forefront of population health management.

She has a proven track record of developing successful ACOs and building statewide and local collaborations with physicians, hospitals, health plans and key constituents in Massachusetts and now New York. Ms. Gilboard was also the former Director of the Massachusetts Regional Extension Center, a program to help support small physician practices in their adoption of electronic health record technology.

The Federal program was funded under the Affordable Care Act. Ms. Gilboard earned a bachelor’s degree from the University of Rochester, Rochester, NY and a master’s in public administration, health policy and planning from New York University Graduate School of Public Administration. She received advanced program certification in health care negotiation and conflict resolution from Harvard School of Public Health, and the Leadership Academy at Tufts University School of Medicine

Nancy Miriam Hawley is CEO of Enlignment®, Inc. She and her husband, Jeffrey McIntyre, work individually and in partnership with executive management teams and entrepreneurial individuals, couples and families to cultivate strong relationships through clear communication in order to develop and sustain thriving businesses. Miriam and Jeffrey co-authored The Seven Intelligences of Leadership®, an integrative approach to visionary leadership that was featured at the International Coaches Federation of New England 2008 Annual Conference.

Miriam is a founder of the Boston Women’s Health Book Collective, Inc. (BWHBC), the organization responsible for writing the best seller Our Bodies, Ourselves, a book that shifted the national and international dialogue about women’s health, sexuality and power. The BWHBC continues to thrive globally as an educational and activist organization forty years after its inception. As a catalyst for global transformation, Miriam is a highly regarded keynote speaker and facilitator of dialogues to unleash visionary leadership at work, at home, in the community and in the world, with a commitment to sustainable relationships and extraordinary results.

Victoria G. Hines was appointed Chief Operating Officer for the University of Rochester Medical Faculty Group (URMFG) in August 2014. URMFG is the 1,200-member faculty practice group of the University of Rochester Medical Center (URMC), generating approximately $400 million in annual revenue. She is responsible for setting strategic direction, providing leadership and driving successful change to business models that will make URMFG world class in terms of access to care, patient and family-centered care delivery, and cost efficiency.

Prior to her role as COO, Ms. Hines served as the President and CEO of Visiting Nurse Service of Rochester and Monroe County, Inc., and of Finger Lakes Visiting Nurse Service, Inc. for 13 years.

Ms. Hines is actively engaged in redesigning the system of care. She serves on the New York Public Health and Health Planning Council and has served as the Board Chair for several organizations devoted to advocacy and access to quality services for seniors, including the Alzheimer’s Association, the Home Care Association of New York State, and the Finger Lakes Visiting Nurse Service.

Dr. Jacqueline Hornor Plumez has received both the Distinguished Psychologist and Distinguished Service award from The Westchester County Psychological Association.

In May 2015, she received Bucknell University’s 2015 Service to Humanity award.

Dr. Plumez is a practicing psychologist and career counselor in Larchmont, New York.

In addition to The Bitch in Your Head: How to Finally Squash Your Inner Critic, Dr. Plumez is also the author of Successful Adoption; Divorcing a Corporation; and Mother Power. She has appeared on The Today Show and Good Morning America, and her articles have appeared in Ladies’ Home Journal and The New York Times Magazine.

Rachel Soares directs research to identify the global gender leadership gap, investigate myths that restrain women’s advancement into corporate leadership, and explore how diversity, leadership and performance intersect. As a core member of the Catalyst Research Center for Equity in Business Leadership, Ms. Soares oversees the annual Catalyst Census reports of the Fortune 500 and researches how different countries are taking action to increase gender diversity on Boards of Directors. She has also contributed to Catalyst’s research on corporate social performance. Drawing on her research experience, Ms. Soares speaks about corporate governance and women in leadership.

She is also a member of Catalyst’s Work-Life Issue Specialty Team. Through her current role at Catalyst and prior positions, she has extensive experience working with quantitative and qualitative research methods to address questions relating to leadership, organizational change and effectiveness, and work-family contexts.

September 28 & 29, 2016

Excelsior Springs at the Courtyard Marriott - 47 Excelsior Avenue - Saratoga Springs, NY 12866

Hotel Information

REGISTRANT INFORMATION – Please register by Sept. 16.

Name: __________________________________________________________________________ Title:____________________________________________________________________________ Agency:_________________________________________________________________________ Address:_________________________________________________________________________ City/State/Zip:____________________________________________________________________ Phone:________________________________ Ext._________ Fax: _________________________ Email: ___________________________________________________________________________ (Required)

□ HCA Members

$279 per person

$___________

□ Non-Member

$379 per person

$___________

______American Express

______Check*

*Make checks payable to: HCA Education and Research and mail to 388 Broadway, 4th Floor, Albany, NY 12207. Checks must be received by Sept. 26.

______________________________________________________________________________ Card Number _______________________________________ Expiration Date

Phone: (866) 210-9325

Located directly next door to the summit venue, the Courtyard Marriott offers a reduced rate of $169 per room if booked before August 17th.

Please contact them directly at the number above to make your reservation.

HCA registration cancellations received by Sept. 7 are refundable less a 25% administrative fee. No refunds will be issued after this date.

Cancellations must be received in writing at info@hcanys.org.

Substitutions are permitted.

PAYMENT – Please check method of payment: _______VISA

Saratoga Springs, NY 12866

HCA Cancellation Policy

HCA REGISTRATION FEE

________MasterCard

Courtyard Marriott 11 Excelsior Avenue

___________________________________ Security Code

______________________________________________________________________________ Mailing Address of Card Holder ______________________________________________________________________________ City, State, Zip ______________________________________________________________________________ Name on Card

______________________________________________________________________________ Authorized Signature

Please note Courtyard Marriott’s cancellation policy when making your reservation.

Special Needs In accordance with the Americans with Disabilities Act, or special dietary needs, please let us know how we can accommodate you:

_______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________

Register online at www.eventville.com/hcanys or FAX completed form to HCA at (518) 426-8788

For more information on this or other HCA Educational Programs contact Celisia Street, Director of Education, at (518) 810-0656.