Jan. 22, 2018 Edition of The Situation Report by Home Care Association of New York State

MEDICAID ENROLLMENT REQUIREMENT

GOVT. SHUTDOWN

RAC REVIEWS

WORKFORCE TRAINING CENTERS

NGS announces that claims will continue to be processed as normally during the partial government shutdown; HHS issues contingency plan with other details.

As extensively reported, providers must be enrolled in Medicaid to serve patients under Medicaid Managed Care. DOH is developing a termination plan for providers that aren’t enrolled.

Performant will begin home health reviews for documentation and medical necessity in NY and other states in RAC Region 5.

MLTC agreements with Workforce Investment Organizations are due Friday; funds expected by March 31.

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COMING UP Stop Sepsis at Home Training Sessions Jan. 24, 2018 Capital Region

Vol. 3, Issue 4 | January 22, 2018

Governor Issues 2018-19 State Budget Proposal HCA schedules conference call tomorrow at 11 a.m. to brief members – still time to register!

Webinar: Sexual Harassment Prevention in the Workplace Jan. 30, 2018 10-11 a.m.

Governor Cuomo last week released his State Executive Budget proposal, which totals $168.2 billion for the fiscal year (FY) 2018-19 and increases spending by 2.3 percent from FY 2017-18. HCA has reviewed the Article VII budget language and other formal briefing documents to create a more detailed analysis of the Governor’s budget proposal. This memo analysis can be downloaded at https://hca-nys.org/wp-content/uploads/2018/01/ Proposed-201819-Budget-Summary-Memo.pdf. See BUDGET p. 5

State Advocacy Day, PAC Reception Feb. 5-6, 2018 Albany

Last Call for Cap. Region Sepsis Session: 1/24

Coming up: Bronx (2/8), Manhattan (2/9), Long Island Session I (3/8), Long Island Session II (3/9) Supported by a grant from the NYS Health Foundation, HCA and sepsis leaders (including IPRO, national Sepsis Alliance, Rory Staunton Foundation for Sepsis See SEPSIS p. 2

INSIDE Governor Issues 2018-19 State Budget Proposal............................................1 Last Call for Capital Region Sepsis Session: Jan. 24.........................................1 HCA Files Amicus Brief on Challenge to DOL 24-Hour Emergency Rule...............1 Medicare Claims-Processing Continues during Govt. Shutdown.....................4 Member Hiring Announcement.....................................................................4 CMS Issues Statement on Expired Medicare Legislative Provisions................8 CMS Issues CoP Tools in Absence of Final Guidelines......................................9 CMS Open Door Forum Probes CoPs, CAHPS, Quality Reporting...................10 Termination in Works for Providers Not Meeting Enrollment Requirement.........11 RAC to Conduct Home Health Reviews.......................................................11 DOH Posts Workforce Investment Program Funding Methodology...............12

HCA Files Amicus Brief on Challenge to DOL 24-Hour Emergency Rule Today, HCA, along with the New York State Association of Health Care Providers (HCP), filed an amicus brief in support of the state Department of Labor’s (DOL) emergency rule for “24hour/live-in” cases. See AMICUS p. 3

Webinar Offers Legal Guidance on Sexual Harassment Law, Procedures.......14 MMC Transition for Enrollees Gaining Medicare..............................................14 Guidance Issued on Accrediting Organizations & Loss of Deemed Status........15 DOH Posts Revised Conflict of Interest Form....................................................16 2018 Poverty Levels Released.......................................................................16 OIG Issues Updated Work Plan.......................................................................17 PHHPC Committee Meeting Agenda Posted.....................................................17 OMIG Posts Final CDPAP Audit Protocols, Seeks Input on OPWDD Protocols......18 VBP Bootcamp Update..................................................................................18 BPCI Advanced Open Forum Scheduled...........................................................19 Resources.............................................................................................................................19 Important Upcoming Deadlines....................................................................20

The Situation Report: the Home Care Association of New York State

SEPSIS from p. 1 Prevention, and others) are holding in-depth training sessions across New York State for all home care and applicable providers on sepsis, steps for provider adoption and clinical application of the sepsis screening tool, clinical case application, integration into agency procedures and records, and more. This effort is called “Stop Sepsis at Home.” Our next “Stop Sepsis at Home” session is on January 24 – this coming Wednesday – for providers in the Capital Region from 9 a.m. to 2:45 p.m. at The Eddy Village Green Standish Center, 9 Pasinella Way, Cohoes, NY 12047. The most recent session, in the Hudson Valley, drew a packed audience. A news item about the session is on our “Stop Sepsis at Home” website: http:// stopsepsisathomeny.org/vns-westchester-hosts-hcas-stop-sepsisat-home-ny-hudson-valley-regional-training-session/. Please register for this session and upcoming sessions in the Bronx, Manhattan and on Long Island using the online form here: https:// www.surveymonkey.com/r/SepsisRegionalTrainings. More information about this initiative is online at www.stopsepsisathomeny.org.

Volume 3, No. 4 January 22, 2018 

The Situation Report is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in The Situation Report are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. Joanne Cunningham HCA President jcunningham@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Al Cardillo Executive Vice President acardillo@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@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 & Graphic Design jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org

Home Care Association of New York State (HCA) 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

AMICUS from p. 1 As communicated to members, the Urban Justice Center is challenging the emergency rule before the New York State Industrial Board of Appeals (IBA). The IBA, an independent review board made up of five attorneys appointed by the Governor, has the authority to review and modify or revoke all DOL rules, regulations, and orders. An IBA hearing on the challenge was held on January 5 and a decision is expected early this week. HCA and HCP had earlier requested “leave from the Board to be heard or intervene” in the challenge to DOL’s October regulation, and last week the Board granted our request to appear as an amicus. Our brief states the following: The Emergency Regulation correctly establishes the standards for determining the hours of work for aides who are assigned to shifts of 24 hours or more. Thus, the Petition should be dismissed because the Petitioner failed to prove that the Department’s Emergency Regulation is unreasonable or invalid. The Board must dismiss (the Justice Center’s) Petition and allow home care providers to continue providing these critical services to New York’s elderly and disabled individuals in accordance with the Emergency Regulation.

DOL’s “13-hour standard” for compensation in “24-hour/live-in cases.” Plaintiffs in those cases have argued that the standard was at odds with underlying statutes. Under this standard, set forth in a 2010 DOL opinion letter, an aide may be paid for 13 hours of a 24-hour shift, provided the aide is afforded 8 hours of sleep time, 5 of which are uninterrupted, and 3 hours for meals. HCA and colleague associations had worked tirelessly to compel DOL’s issuance of the October emergency rule and a corresponding impact statement which stated strongly that the purpose of the emergency regulation is to “preserve the status quo” (i.e., the “13hour standard”), prevent the collapse of the home care industry, and avoid unnecessary institutionalization of patients in the face of the recent court decisions. This issue has been among the top items of concern addressed by HCA in recent meetings with the Governor’s office and the Legislature, among other interrelated funding issues for wages and labor costs, including the increasing state minimum wage and a newly proposed set of compensation requirements for certain scheduling circumstances.

The Department’s position was clearly communicated in numerous Opinion Letters, administrative guidance, and in its enforcement actions. In good faith reliance on the Department’s position, the entire home care industry, including the Medicaid reimbursement system, has been structured to compensate 24-hour shifts at 13-hours of work, assuming the sleep and meal period requirements were met. There is simply no basis for reversing the Department’s longstanding position on this issue. The Emergency Regulation is based on decades of policy and law. The Petition, seeking to invalidate the Emergency Regulation, should be denied.

Related to the “13-hour standard” and litigation, HCA has joined amicus briefs for two of the three court cases on this matter, in addition to: our advocacy for relief from the Executive and Legislature; our successful call for an emergency regulation definitively reinforcing the 13-hour standard that providers have been following in good faith; and, now, our action before the IBA.

DOL’s emergency rule was finalized in October 2017 amid a series of court cases taking aim at

We will inform the membership once the IBA issues a decision.

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

Medicare Claims-Processing Continues during Govt. Shutdown The U.S. Department of Health and Human Services (HHS) last week released a contingency plan that anticipates a federal government shutdown like the one that began on Friday as Congress and the President did not reach a deal on the federal budget. As of press time for The Situation Report, the government shutdown reached its third day, though the Senate is expected to reconvene today for a vote to fund the government through February 8. The HHS plan states the following about the U.S. Centers for Medicare and Medicaid Services (CMS): 

CMS would continue key Federal Exchange activities, such as open enrollment eligibility verification, using Federal Exchange user fee carryover.

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In the short term, the Medicare Program will continue largely without disruption during a lapse in appropriations. Additionally, other non-discretionary activities including Health Care Fraud and Abuse Control, and Center for Medicare & Medicaid Innovation activities would continue. States will have sufficient funding for Medicaid through the second quarter, due to the continuation of authority under the continuing budget resolution (CR) for appropriated entitlements.

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CMS will maintain the staff necessary to make payments to eligible states from remaining Children’s Health Insurance Program (CHIP) carryover balances.

Although Medicare claims processing is not specifically mentioned, National Government Services (NGS), which is New York’s Medicare Administrative Contractor, announced in a circulation this morning that: “During the time that the partial government shutdown is in effect, Medicare Administrative Contractors will continue to perform all functions related to Medicare fee-for-service claims processing and payment.” Additional information on HHS’s contingency plan can be found at: https://www.hhs.gov/about/ budget/fy-2018-hhscontingency-staffing-plan/ index.html.

Montefiore Home Care is currently seeking, Patient Service Managers and Registered Nurses for full time Home Care staff positions. QUALIFICATIONS: Current NYS Registered Nurse License/Registration; Two years or more experience as a home care RN; Current NYS Driver’s License/Registration and automobile insurance; Experience in long term patient care and chronic disease management.

The Situation Report: the Home Care Association of New York State BUDGET from p. 1 The following is an overview of the Governor’s proposed budget, gleaned from his address, accompanying budget documents and initial conversations with state officials. Please note that this article and our memo provide some technical and fiscal impact updates from the alert sent to members on January 16. Division of Budget documents pertaining to the Governor’s plan are at https:// www.budget.ny.gov/pubs/archive/fy19/exec/ index.html. Overall Much of the Governor’s budget speech focused on the complex, interrelated policy and fiscal changes occurring in Washington that have a direct, profound, and still-unpredictable impact on state finances. Foremost among these are: 1) a potential $2 billion hole to New York’s health care system that the Executive projects as part of the federal Affordable Care Act (ACA) cuts; and 2) the federal tax law changes that disproportionately affect New York. The latter has prompted a whole series of structural changes that the Governor proposes to New York’s tax code which will require further analysis by HCA separate and distinct from the Governor’s direct proposals for Medicaid and other programs in his budget proposal. All told, the Governor forecasts a $4.4 billion deficit for the coming fiscal year, which, according to the Executive’s budget documents, is estimated (prior to savings actions) to grow to $6.4 billion in FY 2020, $8.1 billion in FY 2021, and $8.4 billion in FY 2022.

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provisions,” allowing the commissioner and budget director to limit or reallocate Medicaid spending, if the department and budget director project that spending will exceed the annual allocations provided in the state fiscal plan. To offset the previously mentioned federal cuts, and maintain the global cap index, the Governor has proposed a series of revenueraisers, including $750 million gained from the proceeds during transactions where not-forprofit health care insurers convert to for-profit entities through sales or mergers. (This figure is cited in the Governor’s slides presented with his speech, though other documents cite a $500 million revenue gain annually over four years.) Other revenue raisers include: deferral of certain large corporate tax credits; establishment of a “Healthcare Insurance Windfall Profit Fee” imposing a 14 percent surcharge on the gains made by health insurers from the recent federal tax changes ($140 million); and a surcharge on opioid drugs; among others. In addition to mitigating the deficit, revenues from the aforementioned insurance conversions would initially be used to establish a proposed $1 billion Health Care Shortfall Fund. The fund would be a reserve to “ensure the continued availability and expansion of funding for quality health services and mitigate risks associated with loss of federal health care funds.” Specific Areas of Opportunity, Concern

The Medicaid Outlook Broadly

On a broad level for health care and the state’s Medicaid program, the Governor proposes to maintain a spending increase in line with the Medicaid global cap projection of 3.2 percent (a $593 million increase in state-share funds only), with a total projected allfunds Medicaid expense of $70 billion.

In broad strokes, the budget appears to maintain spending in line with the established trajectory of the existing Medicaid global cap. However, as anticipated, there are many provisions that create opportunity areas as well as serious concerns for the HCA membership.

The proposed budget also extends through 2019-20 the Department of Health (DOH) “superpower

Of major concern is a proposal to limit the number of contracts that health plans can have

Volume 3, No. 4 January 22, 2018

The Situation Report: the Home Care Association of New York State with LHCSAs to no more than 10 agency contracts per MLTC so as “to bring consolidation to the marketplace and reduce variation in service authorization.” HCA has learned that this proposal is expected to net Medicaid savings/reductions of $27.4 million. We will need to learn more in order to respond to this provision in a way that seeks protections for the existing safety-net of providers, continuity of care for patients, and access to care. The budget also proposes several MLTC actions to “reduce administrative reimbursement,” ban contracting provider marketing, eliminate contracts with “poor performing” social adult day care providers and increase the eligibility threshold for providing MLTC services (summarized below). HCA had strongly opposed several constraints and cuts imposed on MLTCs and contracting providers as proposed in last year’s budget. (Such proposals were eliminated from the final budget, with the understanding that they would be pursued through administrative action rather than legislatively, and some were ultimately mitigated.) HCA will continue to oppose or seek modification of any adverse actions to MLTC and providers as proposed in this year’s budget.

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obtain such information from providers on behalf of the state. 

Restricting the ability of an MLTC enrollee from changing MLTC plans during the 12 months following enrollment in the plan, except during an initial period of 30 or 45 days from the date of enrollment or for “good cause.”

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Requiring that MLTC enrollees who are not utilizing personal care aide or home health aide services within 30 days of enrollment to either shift to a fully integrated plan or enroll in another, alternate model.

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Limiting the MLTC nursing home benefit to 6 months; enrollees needing care beyond that time would revert to fee-for-service Medicaid.

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Carving transportation and transportation funding out of MLTC, except for Program of All-Inclusive Care for the Elderly (PACE) plans.

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Allowing MLTC plans to manage the social adult day benefit more efficiently by eliminating contracts with poor performing providers, adjusting member utilization as necessary, and taking other actions.

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Imposing fiscal penalties on MLTCs which do not meet value-based payment contract targets (a projected $20 million Medicaid reduction).

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Penalizing managed care providers that don’t submit a Performing Provider System (PPS) partnership plan by July 1, 2018.

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Expand the authority of the Office of the Medicaid Inspector General (OMIG) to recover overpayments to Medicaid managed care organizations (MCOs) by: broadening OMIG’s fining authority; requiring MCOs to report all potential fraud, waste or abuse; providing that

Specifically for MLTC and contracting providers, the Governor proposes: 

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Changing the qualifying criteria patients must meet for MLTC eligibility, from the current 120 day to 120 continuous days of need and requiring a score of 9 or above on the Uniform Assessment System (UAS) for purposes of MLTC eligibility. (Existing patients would be grandfathered, but, if discharged, must meet the new standard to be eligible for reenrollment.) Prohibiting community-based long term care provider marketing and restricting referring providers from acting as the service provider. Authorizing the Department to require any provider to report costs by the provider in serving Medicaid patients and allowing the Department to require managed care plans to

The Situation Report: the Home Care Association of New York State

payments made by Medicaid to a managed care plan, and from a plan to any subcontractor or provider, are considered “public” funds; and requiring that overpayments from contractors or providers are applicable to audit/recovery action when identified by a state audit or investigation. 

Recouping from MLTCs the amount by which a plan’s financial reserves are above the minimum required contingent reserve amount.

In terms of additional funding, the budget includes $450 million to cover minimum wage costs in MLTC, home care and hospice, as well as $425 million in capital investment for health care providers “to transition into fiscally sustainable systems” and to support capital projects, debt retirement, working capital and other non-capital projects. Of this amount, $60 million will be directed to community-based providers (i.e. clinics, home care, assisted living, primary care providers) and $45 million will be directed to Residential Health Care Facilities. This builds on and renews infrastructure funds from the last two fiscal year budgets, including the community-based allotment which HCA and a coalition of community health care organizations were instrumental in obtaining.

Authorize in-home telehealth services by non-Article 36 providers; HCA will be scrutinizing this proposal for what could be objectionable crossover by nonhome care entities into home care/ Article 36 sanctioned authority.

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Provide $396 million in continuing funding to support critical health care providers through the state’s Vital Access Provider (VAP), Vital Access Provider Assurance Program (VAPAP)

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and Value Based Payment Quality Improvement (VBP QIP) programs. 

Create a model of community paramedicine that would require home care as a collaborative partner with hospitals, Emergency Medical Services (EMS) and physicians, for delivering in-home care. The proposal is based on a concept constructed by HCA and passed last June by the state Senate.

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Propose a 10 percent increase to the hospice residences rates, as well as specialty weights in the weighted average rate calculation.

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Direct the DOH Commissioner to conduct a study on home and community-based services to Medicaid patients in rural areas of the state. The proposal and study would review and analyze factors affecting the availability of services, such as transportation costs, cost of direct-care personnel, and opportunities for telehealth and technological advances to improve efficiencies. It would also authorize the commissioner to provide targeted Medicaid rate enhancement for fee-forservice personal care rates and rates under Medicaid waiver programs, up to $3 million minus the cost of the study, subject to federal financial participation (FFP).

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Apply criminal history record check (CHRC) provisions to Health Homes and certain waiver service providers, and also include these providers in the eligibility for CHRC cost reimbursement. Similar requirements are proposed for these providers to check the child abuse registry under the social services law, and also include these providers in the child abuse reporting law requirements.

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Make multiple reforms to the Early Intervention (EI) program: seek increased private health insurance coverage for services; expand provider appeal rights; and require insurers to consider a written order or referral from a child’s provider, as well as the

In other items, the budget also would: 

Volume 3, No. 4 January 22, 2018

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

Individualized Family Services Plan in determining authorization for coverage. 

Support and expand the Assisted Living Program (ALP) by allowing existing ALPs to apply for up to nine additional beds while authorizing applications for up to a total of 500 new ALP beds in counties that meet certain criteria.

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Replace the longstanding spousal responsibility requirement (that permits Medicaid coverage in the absence of spousal spend-down) with one that essentially requires spousal payment. This is similar to the proposals that have been systematically rejected by the Legislature in the past.

HCA has also identified references to a hospital-hospice initiative and a Health Home reform plan. These provisions will require further analysis as we review the budget language and accompanying documents. HCA will also obtain further detail to gauge the impacts of the Governor’s proposed opioid surcharge (we would be concerned with actions which impair pain management for post-surgical/trauma, palliative care and hospice patients, among others), and his proposed surcharge on health plans. Next Steps The budget release initiates a process of negotiations with the Legislature on a final budget, due by April 1. HCA continues our detailed analysis of the budget as well as the development of responses and message points for our upcoming State Advocacy Day on February 6. We encourage members to register for this important event by downloading the flyer at https://hca-nys.org/wp-content/uploads/2017/12/2018-HCAAdvocacy-Events-Registration-Form.pdf. Conference Call on Tuesday To further brief you, HCA is holding a members-only conference call tomorrow, January 23, at 11 a.m. Please register for the call by completing the online form at https://www.surveymonkey.com/r/ cuomobudgetcall. It’s not too late to register. Stay tuned for further information and updates in the coming days.

CMS Issues Statement On Expired Medicare Legislative Provisions Includes updates on Home Health Rural Add-On and Outpatient Therapy Cap Several Medicare legislative provisions affecting providers and beneficiaries recently expired, including exceptions to the outpatient therapy caps, add-on payments for home health rural services, the Medicare physician work geographic adjustment floor, payments for low volume hospitals, and payments for Medicare dependent hospitals. The U.S. Centers for Medicare and Medicaid Services (CMS) reported last week that it is implementing these payment policies as required under current law. However, CMS says it is taking steps to limit the impact on Medicare beneficiaries by holding claims affected by the therapy cap changes for a short period of time beginning on January 1, 2018. CMS is not holding any other claims except those affected by the outpatient therapy caps. If legislation regarding the therapy caps is not enacted imminently, then CMS will release and process the therapy claims

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accordingly. Under current law, CMS may not pay electronic claims sooner than 14 calendar days (29 days for paper claims) after the date of receipt, but it generally pays clean claims within 30 days of receipt. HCA’s Advocacy on Rural Add-On HCA continues to seek a revival of the rural add-on, which expired on December 31, and asks members to keep writing Congress for the add-on’s reauthorization and extension. A straightforward extension – with no strings attached – is already embodied by legislation in the Senate (S.353 Collins/Cantwell) that should be a model for both houses to act upon. An advocacy message on this issue is already loaded on our online platform and it takes less than a minute of your time to act now. Simply click the link (http://p2a.co/HQThryo), enter your contact information and hit “send” to reach New York Senators Charles Schumer and Kirsten Gillibrand as well as your Member of Congress. Please urge your staff to do the same. HCA has been in regular contact with New York’s Delegation on this matter, specifically with repeated outreach to Senator Schumer’s office, so it is very important for members to amplify this outreach.

CMS Issues CoP Tools in Absence of Final Guidelines While the home care industry awaits the release of federal Interpretive Guidelines for the home Health Conditions of Participation (CoP), the U.S. Centers for Medicare and Medicaid Services (CMS) has released new survey protocols and fielded questions during a recent Open Door Forum (see related p. 10 story). CMS also presented a training video to state surveyors. The newly posted protocols are distinct from the final Interpretative Guidelines, which will offer more detail for compliance and state survey enforcement of the new CoPs. Providers are currently left with a draft version of the Interpretive Guidelines. CMS reports that a final version is in the clearance process, but with no scheduled release date. As extensively reported, CMS has also halted the imposition of civil monetary penalties in certain instances for CoP non-compliance, up to a year, as agencies adjust to the changes, though other sanctions remain in effect. The newly released protocols (https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/ SurveyCertificationGenInfo/Downloads/QSO-18-13-HHA-.pdf) have new G tags assigned and incorporate the updated CoPs into the protocol scheme. CMS’s video on the new CoPs can be found at: http:// surveyortraining.cms.hhs.gov/pubs/VideoInformation.aspx?id=161&cid=0CMSHHACOP_UD_Archived. Slides from a December update to home health agencies on the new CoPs are at https:// s3.amazonaws.com/surveyor-training-content2/data/161/ HHA_UpdatedCoPs_Dec%207_WebinarSlides.pdf.

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 ď Žď€

CMS Forum Probes CoPs, CAHPS, Quality Reporting for Home Care, Hospice A recent Home Health and Hospice Open Door Forum, hosted by the U.S. Centers for Medicare and Medicaid Services (CMS), provided updates on the home health Conditions of Participation, quality reporting requirements and consumer assessment surveys, among other issues, as summarized below. Home Health Conditions of Participation (CoPs) CMS officials reminded participants that the CoPs went into effect January 13, 2018. The Electronic Code of the Federal Regulations webpage has not been updated to reflect the new regulations but should be updated with the next refresh. CMS did not indicate when the CoP Interpretative Guidelines would be released, but said the Guidelines are in final clearance. CMS has separately provided additional resources and a video for state surveyors on the CoPs. (See related p. 9 story.) HCA will notify the membership as soon as CMS issues the Home Health CoP Interpretative Guidelines. Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey CMS has released the latest issue of the HHCAHPS quarterly newsletter with information for monitoring HHCAHPS data submissions (see: https://homehealthcahps.org/General-Information/CTQR-Newsletters). CMS also said it will be releasing updates to the patient mix adjusters on January 24. Additional information can be found on the HHCAHPS website at https://homehealthcahps.org/. CMS is reviewing the HHCAHPS survey questionnaire for potential improvements in the survey questions. HHCAHPS contractors will soon be conducting interviews with patient advocates and providers to solicit input. Home health agencies interested in participating may contact RTI at HHCAHPS@RTI.org. As a reminder, HHCAHPS introductory Survey Training Sessions are scheduled for January 30 (Session 1) and January 31, 2018 (Session 2). Both sessions will run from 1 to 5 p.m. Also, an update Training Session will be held on February 2, 2018, from noon to 2 p.m. Registration for these training sessions can be found at: https://homehealthcahps.org/Training/Registration-Form. Home Health Quality Reporting Program (HHQRP) CMS announced that the Influenza Immunization measure will be removed from the Home Health Star Rating, but will continue to be reported on Home Health Compare. This measure will be monitored in the coming quarters to ensure rates do not decrease. The first preview report using an updated methodology will be provided to agencies in mid-January 2018. Home Health Compare refresh updates for the Star Rating will occur in April 2018. All measures (OASISand claims-based) will report on data from July 1, 2016 to June 30, 2017. Medicare Care Choices Model (MCCM) Beginning January 1, the second cohort of hospice programs participating in the MCCM began enrolling patients for the program. Between the first and second cohorts, CMS has 99 providers participating. As

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of December, over 1,500 patients were enrolled. Questions about the MCCM may be e-mailed to: carechoices@cms.hhs.gov. Hospice Quality Reporting Program (HQRP) Training & Education CMS will be releasing two HQRP training and education modules sometime in March. One module will provide guidance on navigating the new HQRP website and another will provide coding guidance for the Hospice Item Set (HIS) based on frequently asked questions that have been submitted to the HIS HELP Desk.

Termination Guidance in the Works for Providers Not in Compliance with Required State Medicaid Enrollment if Serving Medicaid Managed Care Enrollees At the January 11 Managed Care Policy and Planning meeting, the state Department of Health (DOH) gave an update on its enforcement of the federal requirement that home care and other agencies must be enrolled in the Medicaid program by January 1, 2018 if providing services to Medicaid managed care plans. DOH is the process of developing guidance for managed care organizations (MCOs) regarding mandatory provider terminations and other actions for non-compliance. According to DOH, there are currently 13,000 fee-for-service (FFS) Medicaid enrollment applications pending with the Bureau of Provider Enrollment. While DOH has announced April 1, 2018 as the deadline for MCOs to have made terminations, federal financial participation will continue to be made by CMS for un-enrolled providers until July 1, 2018, making this DOH’s firm date for termination or non-payment. By law, MCOs are required to provide health care entities with 60 days of prior written notice for network terminations. HCA has communicated to members numerous times about the January 1, 2018 Medicaid provider enrollment requirement and was able to obtain an extension until mid-December for submission of enrollment applications. Again, home care and other providers who have not submitted Medicaid enrollment applications will be eventually terminated from their MCO contracts. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

Recovery Audit Contractor to Conduct Home Health Reviews The Recovery Audit Contractor (RAC) Performant Recovery, Inc. will be conducting home health reviews for documentation and medical necessity, according to a January 10 announcement from the U.S. Centers for Medicare and Medicaid Services (CMS). The review will be for all of RAC Region 5 with certain exclusions. New York home health agencies are included in this region. Continued on next page

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Volume 3, No. 4 January 22, 2018 

Continued from previous page Claims having a “claim paid date” which is more than three years prior to the additional document request (ADR) date will be excluded. The review will include revenue codes 027X, 042X, 043X, 044X, 055X, 056X, 057X. HCA has reached out to the RAC for more information about this issue. Providers are advised to visit Performant’s website at https://performantrac.com/ to update their contact information and avoid any misdirected correspondence. RACs normally follow up within 10 to 15 days of mailing ADR letters to providers. A Region 5 outreach presentation from February 2017 also provides additional information at: https:// performantrac.com/wp-content/uploads/2017/04/performant-RAC.pdf. It is not known at this time when the RAC audits would begin, according to officials. The annual ADR limit is one-half of one percent (0.5 percent) of the provider’s total number of paid Medicare claims from the previous year. The number of paid claims is determined by the 6-digit CMS Certification Number (CNN) and the provider’s National Provider Identifier (NPI). According to Performant, home health and hospice providers are eligible for reimbursement for medical records at rates shown on page 22 of the Region 5 outreach presentation at the aforementioned link. For additional information, contact Melissa Biggs-Endres, Customer Service Specialist II, at (866) 201-0580, ext. 6286, or mbiggs-endres@performantcorp.com.

DOH Posts Workforce Investment Program Funding Methodology The state Department of Health (DOH) has posted a funding methodology document for the MLTC Workforce Investment Program Year 1 (DSRIP Year 2). See https://www.health.ny.gov/health_care/medicaid/redesign/ 2017/docs/2018-01-12_wip_funding_methodology.pdf. As extensively reported, this program involves increases in rate capitation for MLTCs to work with Long Term Care Workforce Investment Organizations (LTC-WIOs) to provide workforce training. MLTC network providers, including home care, are, in turn, eligible to send their staff to the LTC-WIO for the training. According to DOH, the final Year 1 amounts awarded to each LTC-WIO and MLTC plan partnership will be determined after partnership agreements between LTC-WIOs and MLTCs are received and reviewed by the state. LTC-WIO/plan agreements are due by close of business on Friday, January 26, 2018 and are sent to MLTCWorkforce@health.ny.gov. The final amount awarded the LTC-WIO/plan partnerships will be indicated in a Letter of Agreement between the state and plan. Funds will be issued once the Letter of Agreement is signed and returned. Funds are scheduled to be issued before March 31, 2018.

Continued on next page

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

Continued from previous page The state has provided the LTC-WIOs and plans with an “agreement language framework” which includes the minimum criteria for an acceptable agreement and related roles and responsibilities summary. This agreement is an outline – not to be considered a template – which includes the essential elements for agreements executed by LTC-WIOs and plans. The agreement must also include the two-page document which demonstrates the LTC-WIO/plan partnership’s capacity and approach to support the achievement of value-based payment (VBP) goals. A list of designated LTC-WIOs by region is at https://www.health.ny.gov/health_care/medicaid/redesign/ 2017/2017-11-28_ltcwio_designation.htm. As previously mentioned, significant diversity exists among the designated LTC-WIOs, in terms of innovation and curricula as well as available platforms and suggested metrics. Plans should consider these diversities in determining the LTC-WIOs best suited for the needs of their workforce – and the workforce of their network providers – when developing partnerships. Plans may form partnerships with multiple LTC-WIOs and are encouraged to reach out to the LTC-WIOs of interest directly. As communicated to members on numerous occasions, this program is making available up to $245 million (during 2018-2020) for “initiatives to retrain, recruit and retain health care workers in the long term care (LTC) sector.” DOH will require MLTC plans to contract with the DOH-designated LTC-WIOs to: invest in initiatives to attract, recruit and retain LTC workers; develop plans for reducing health disparities; analyze the training needs of each region; and support the expansion of home care and respite care, “enabling those in need of LTC to remain at home and reduce Medicaid’s costs associated with LTC.” Funds will be allocated to each plan based on its share of overall plan enrollment and distributed via increases to the plans’ capitated rates. Plans will need to notify their participating providers that they can send workers to LTC-WIOs to participate without charge. Plans will distribute funds to the LTC-WIOs with which they contract to reimburse them for providing workforce development initiatives. HCA members should review the list of eligible MLTCs and LTC-WIOs in your regions to prepare for your staff’s participation in these training opportunities, where applicable, and reach out to your plan contractors regarding eligibility for LTC-WIO training for your staff. Questions and comments can be submitted to MLTCWorkforce@health.ny.gov. For more information about this program, please visit https://www.health.ny.gov/health_care/medicaid/redesign/2017/mltc_invest.htm.

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

Webinar Offers Premium Legal Guidance for Home Care HR/Execs on Sexual Harassment Law, Procedures For a low cost of $149/$249 (member/non-member rate), HCA is offering an unlimited number of your HR, executive and management staff to get guidance from top legal experts on the law, policies-and-procedures, and staff training to address sexual harassment in the workplace and reduce your organization’s exposure to costly legal liabilities. Join our webinar on January 30 from 10 to 11 a.m. While recent headlines have focused on sexual harassment in the entertainment industry, studies show the prevalence and risk in health care: 

According to a December article in Becker’s Hospital review, approximately 12% of health care practices have no sexual harassment policy whatsoever.



A searchable database at Buzzfeed finds that, over a 20-year period, the U.S. Equal Opportunity Commission (EOC) received 363 sexual harassment claims from ”home health care services workers” and those delivering “services for the elderly and persons with disabilities.” This statistic doesn’t count other related categories of home care workers, nor does it count non-EOC actions.

Indeed, Governor Cuomo has made sexual harassment prevention a signature issue of his just-unveiled State of the State Address and budget proposals, including a proposal to mandate that private companies doing business with the state must report sexual assault and harassment statistics. Long story short, if you don’t feel confident about your protocols or haven’t revisited them recently, it is vital that you do so. Vincent E. Polsinelli and Kristi Rich Winters are Principals at Jackson Lewis, one of the country’s preeminent workplace law firms. They’ll be leading this one-hour webinar that you and your staff can view conveniently at the office, with no travel time required, and no limits on the number of your staff who can participate by speaker phone and a single computer line connection. This is a great way to gather your relevant managers, executives and HR officials for shared learning on the steps you should take to ensure your organization has practices in place to prevent harassment in the workplace, and to address it meaningfully and effectively if and when it does occur. Learn more and register at https://hca-nys.org/wp-content/uploads/2017/12/Sexual-Harrassment-Prevention-inthe-Workplace-Webinar-Registration-Form-Jan-30-2018.pdf.

Medicaid Managed Care Transition for Enrollees Gaining Medicare The state Department of Health (DOH) has posted a guidance to advise local departments of social services (LDSS) of the Medicaid Managed Care (MMC) transition process for enrollees who gain Medicare eligibility. The guidance is at https://www.health.ny.gov/health_care/medicaid/publications/docs/gis/18ma001.pdf. Continued on next page

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

Continued from previous page New York Medicaid Choice (NYMC) will process all managed care transfers and disenrollments for recipients with Medicare to ensure that enrollees who are receiving long term services and supports (LTSS) do not experience a lapse in services when they are disenrolled from MMC due to receipt of Medicare. Each month, NYMC performs an electronic search to identify MMC enrollees with current Medicare or Medicare that will become effective within the next 60 days. Once identified, NYMC contacts the Medicaid managed care plans to have the plans identify those enrollees in receipt of LTSS. If in receipt of LTSS, NYMC will enroll eligible recipients into an MLTC plan. If a recipient is receiving LTSS and is excluded from MLTC, NYMC will disenroll the consumer from MMC and notify the MMC plan that the recipient is excluded from MLTC. The MMC plan is required to provide the current service authorization plan to the local district managed care coordinator to coordinate the delivery of LTSS through fee-for-service Medicaid. Ideally, LDSS should have information concerning an individual’s disenrollment from MMC or transition to MLTC (due to receipt of Medicare) in time to redetermine eligibility and issue a timely notice concerning the individual’s ongoing eligibility by the first day of the month following the individual’s 65th birthday. However, if the district does not have the necessary MMC information concerning the individual’s disenrollment or transition to a MLTC plan, the district is advised to contact NYMC to obtain this information prior to taking any action on the eligibility redetermination. The resource documentation requirements will be different for an individual transitioning to MLTC or needing community-based long-term care than the requirements will be for a person who is not in need of long-term care services. If the district is not able to make the new eligibility determination and provide timely notice by the first day of the month following the individual’s 65th birthday, Medicaid coverage must be extended until timely notice is provided.

Guidance Issued on Accrediting Organizations and Removed Deemed Status The U.S. Centers for Medicare and Medicaid Services (CMS) has posted information to clarify an Accrediting Organization’s role when a provider or supplier’s deemed status has been temporarily removed. See https:// www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QSO18-12.pdf. CMS may temporarily remove deemed status (and therefore accrediting organization jurisdiction) when a state agency or federal survey team identifies condition-level non-compliance through sampling or a survey, at which point the provider remains under state agency jurisdiction until it either demonstrates substantial compliance or CMS terminates its Medicare participation. During this time, when a provider or supplier is under state agency jurisdiction, CMS will not accept accreditation decisions or recommendations made by an accrediting organization based on a Medicare accreditation survey. The accrediting organization has no jurisdiction or authority from a Medicare perspective. Further details are provided in the link above.

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

DOH Posts Revised Conflict of Interest Form Late last week, the state Department of Health (DOH) posted a revised Conflict of Interest (COI) Compliance Implementation Plan form that needs to be used by Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waiver programs. The form was changed so that the provider can indicate whether it is completed for NHTD or TBI. The new form is at https://hca-nys.org/wp-content/uploads/2018/01/Conflict-of-Interest-ComplianceImplementation-Plan-1.docx. As mentioned in last week’s edition of The Situation Report, federal regulations, known as the home and community-based services (HCBS) settings rule, require that person-centered service plan development cannot be performed by the individual’s provider of direct services unless there is no other willing and qualified entity available to that individual. Case managers, however, are able to develop service plans, as case management is not considered to be direct service in conflict with person-centered planning. (See further details in last week’s newsletter at https://hca-nys.org/wp-content/uploads/2018/01/SitRepo011218.pdf.) Entities providing services under NHTD and/or TBI must complete one Compliance Implementation Plan form for each region in which they provide NHTD and one form for each region in which they provide TBI services. The forms must be submitted to the appropriate Regional Resource Development Center (RRDC) by March 1, 2018 and the RRDCs must submit the forms to DOH by April 1, 2018. Those who don’t submit their forms by March 1 will be put on “vendor hold” by DOH. Last week, the state Department of Health (DOH) held a webinar on the COI standards that will affect services delivered in the NHTD and TBI waiver programs. The webinar materials are at https://hca-nys.org/wp-content/uploads/2018/01/COI-Compliance-ImplemenationPlan-Power-Point.pdf and https://hca-nys.org/wp-content/uploads/2018/01/Conflict-of-Interest-ComplianceImplementation-Plan.docx

2018 Poverty Levels Released The U.S. Department of Health and Human Services has released the 2018 federal poverty levels. These amounts, along with amounts from prior years, are posted at https://aspe.hhs.gov/poverty-guidelines. The annual levels are: $12,140 (up from $12,060 in 2017) for individuals and $16,460 (up from $16,240) for couples. These levels are used to calculate one of the charity care requirements for Certified Home Health Agencies and to determine eligibility for the Medicare Savings Programs and other federal benefits.

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

OIG Issues Updates Work Plan The federal Office of Inspector General (OIG) has updated its Work Plan (https://oig.hhs.gov/reports-andpublications/workplan/updates.asp). HCA has identified a few new items of interest. For one, OIG explains it will determine the extent to which diagnoses solely generated by health risk assessments and chart reviews were associated with higher risk scores and higher Medicare Advantage (MA) payments. In addition, this study will determine the extent to which diagnoses removed by chart reviews were associated with lower risk scores and lower MA payments. Under another topic, “Potential Abuse and Neglect of Medicare Beneficiaries,” OIG says it will determine the prevalence of the potential abuse or neglect of Medicare beneficiaries in a patient’s home, medical facility or other location.

PHHPC Committee Meeting Agenda Posted The state Department of Health (DOH) has posted the agenda for the January 25 meeting of the Public Health and Health Planning Council (PHHPC) Committee on Establishment and Project Review. The agenda and supporting documents are at https://www.health.ny.gov/facilities/ public_health_and_health_planning_council/meetings/2018-01-25/. Some of the applications include:  One by an existing CHHA for a 3-year extension to its limited life operating certification.  Six applications by existing LHCSAs for changes in ownership.  One application by an entity to become a LHCSA affiliated with an assisted living program.  Seventeen applications to establish new LHCSAs. The Committee’s recommendations on these applications will be considered by the full PHHPC at its February 8 meeting. Both Committee and full PHHPC meetings can be viewed at https://www.health.ny.gov/events/webcasts/.

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

OMIG Posts Final CDPAP Audit Protocols, Seeks HCA Input on OPWDD Protocols The Office of the Medicaid Inspector General (OMIG) has posted final audit protocols for the Consumer Directed Personal Assistance Program (CDPAP) and seeks HCA input on draft audit protocols for supported employment services under the Office for People With Developmental Disabilities (OPWDD). The final CDPAP protocols are at https://omig.ny.gov/images/stories/audit_protocols/ CDPAP%20PROTOCOL%20Posted%20copy%20-%201-16-18.pdf. HCA had reached out to members for feedback on the then-draft CDPAP audit protocols and followed up, along with other provider associations (the New York State Association of Health Care Providers, LeadingAge NY and the Consumer Directed Personal Assistance Association of New York State), to submit comments on the protocols. A few of our suggestions were incorporated in the final protocols and OMIG added a new protocol entitled “Missing Authorization or Reauthorization.” The other protocols include: missing documentation of service; missing recipient record; billed more units than documented or authorized; services performed by a precluded individual; failure to complete required health assessment; missing certificate of immunization; missing documentation of PPD; missing personnel records; and failure to process consumer directed personal assistant’s wages and benefits. OPWDD Supported Employment Protocols Some of the areas covered in the OPWDD protocols include: missing recipient record; no documentation of supported employment services; no diagnosis of developmental disability; missing copy of individualized service plan; missing habilitation plan for supported employment services; missing elements of the narrative monthly summary note; billing for non-reimbursable service time; and more. If you would like to review these draft protocols and/or provide feedback, contact Andrew Koski at (518) 8100662 or akoski@hcanys.org.

VBP Bootcamp Update The state Department of Health (DOH) has completed six Value Based Payment (VBP) Bootcamps. If you were unable to attend the VBP Bootcamps, the webcast recording of the Albany Bootcamp session, all course presentations, and supplemental materials are at: https://www.health.ny.gov/health_care/medicaid/ redesign/dsrip/vbp_bootcamp/2017_sessions.htm. More VBP University semesters will be released in the near future. DOH advises agencies to continue to complete semesters 1 to 3 and quizzes to receive a certificate of completion. Certificates will be sent via email on a quarterly basis. For more information on VBP University, visit https://www.health.ny.gov/health_care/medicaid/redesign/ dsrip/vbp_u/index.htm. Questions can be sent to VBP@health.ny.gov.

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

BPCI Advanced Open Forum Scheduled The U.S. Centers for Medicare and Medicaid Services (CMS) has scheduled an Advanced Open Door Forum on the new Bundled Payments for Care Improvement Advanced (BPCI Advanced) model for January 30, 2018, from 12 to 1 p.m. Registration is at https://engage.vevent.com/rt/cms2~01302018. Under this new model, as mentioned in the January 12 edition of The Situation Report, participants can earn additional payment if all expenditures for a beneficiary’s episode of care fall below a spending target which factors in quality. Participants bear financial risk, have payments tied to quality performance, and are required to use Certified Electronic Health Record Technology. Participants may receive payments for performance on 32 different clinical episodes, such as major joint replacement of the lower extremity (inpatient) and percutaneous coronary intervention (inpatient or outpatient). Participants will start on October 1, 2018, and the Model Period Performance will run through December 31, 2023. CMS will provide a second application opportunity in January 2020. The following link provides more information about the model and its requirements, along with a Request for Applications (RFA) document, the application template, and the necessary attachments: https:// innovation.cms.gov/initiatives/bpci-advanced. Applications must be submitted via the Application Portal (https://app1.innovation.cms.gov/ bpciadvancedapp) which will close at 11:59 p.m. on March 12, 2018.

Resources 

“Medicare Advantage Encounter Data Show Promise for Program Oversight, But Improvements Are Needed,” by the Office of Inspector General https://go.usa.gov/xnv4v



“Medicaid: CMS Should Take Additional Steps to Improve Assessments of Individuals’ Needs for Home- and Community-Based Services,” by the U.S. Government Accountability Office https://www.gao.gov/assets/690/689053.pdf



“Beneficiaries Dually Eligible for Medicare and Medicaid,” by MedPAC and the Medicaid and CHIP Payment and Access Commission http://medpac.gov/docs/default-source/data-book/ jan18_medpac_macpac_dualsdatabook_sec.pdf?sfvrsn=0

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

The Situation Report: the Home Care Association of New York State

Volume 3, No. 4 January 22, 2018 

Important Upcoming Deadlines

Requirement/Change

Effective/Due Date

More Information

New York State Paid Family Leave program starts

January 1, 2018

https://www.ny.gov/newͲyorkͲstateͲpaidͲfamilyͲ leave/paidͲfamilyͲleaveͲinformationͲemployers

Home Care and other providers who contract with Managed Care Organizations must be enrolled in Medicaid

January 1, 2018

https://www.emedny.org/info/ProviderEnrollment /ManagedCareNetwork/index.aspx

Managed Care Annual Program Integrity Report

January 1 to January 31, 2018

https://omig.ny.gov/information/mcoͲreports

Medicare Advantage Disenrollment Period during which individual can switch from Medicare Advantage managed care plan to feeͲforͲservice Medicare

January 1 to February 14

www.medicare.gov

Revised Medicare Home Health Conditions of Participation in Effect

January 13, 2018

https://www.gpo.gov/fdsys/pkg/FRͲ2017Ͳ01Ͳ 13/pdf/2017Ͳ00283.pdf

2017 Adult Care Facility 4th Quarter Statistical Information Report

January 31, 2018

https://commerce.health.state.ny.us

HCA State Advocacy Day

February 6, 2018

https://hcaͲnys.org/wpͲ content/uploads/2017/12/2018ͲHCAͲAdvocacyͲ EventsͲRegistrationͲForm.pdf

Submission of Conflict of Interest (COI) Compliance Implementation Plan forms by NHTD/TBI providers to their Regional Resource Development Centers

March 1, 2018

https://hcaͲnys.org/wpͲ content/uploads/2018/01/ConflictͲofͲInterestͲ ComplianceͲImplementationͲPlanͲ1.docx; https://hcaͲnys.org/wpͲ content/uploads/2018/01/COIͲComplianceͲ ImplemenationͲPlanͲPowerͲPoint.pdf

Health Care Facility Transformation Program

Applications due March 14, 2018

https://grantsgateway.ny.gov/intelligrants_NYSGG /module/nysgg/goportal.aspx?NavItem1=4&ngoID =5000979

Medicare Bundled Payments for Care Improvement Advanced model

Applications due March 12, 2018

https://innovation.cms.gov/initiatives/bpciͲ advanced

Criminal history record check requirements apply to hospice

April 1, 2018

https://www.health.ny.gov/facilities/home_care/a dvanced_home_health_aides/docs/ahha_legislatio n.pdf

Submission of COI Compliance Implementation Plan forms by Regional Resource Development Centers to state Department of Health

April 1, 2018

https://hcaͲnys.org/wpͲ content/uploads/2018/01/ConflictͲofͲInterestͲ ComplianceͲImplementationͲPlan.docx https://hcaͲnys.org/wpͲ content/uploads/2018/01/COIͲComplianceͲ ImplemenationͲPlanͲPowerͲPoint.pdf

Start of Transition Period for Using Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI)

April 1, 2018

https://www.cms.gov/Medicare/NewͲMedicareͲ Card/index.html

Implementation of Universal Billing Codes for Home and CommunityͲBased Long Term Care Services under Managed Care

April 1, 2018

https://www.health.ny.gov/facilities/long_term_c are/reimbursement/letters/dal_2017Ͳ12Ͳ 07_billing_codes.htm

State Advocacy Events February 5 & 6, 2018 - Albany, NY

DAY ONE Monday, February 5, 2018 Renaissance Albany Hotel – DeWitt Ballroom 144 State Street, Albany, New York 12205

10AM – 12PM

12PM – 4:30PM

HCA Policy Council Meeting

HCA Board of Directors Meeting

(Council Members Only)

(Board Members Only)

Mark Kissinger, Special Advisor to the Commissioner, Long Term Care, NYS DOH, and Rebecca Fuller-Gray, Director, Division of Home and Community Based Services, NYS DOH, will discuss the Administration’s Regulatory Modernization Initiative.

The HCA Board of Directors Meeting will begin with lunch at 12PM. In addition to the regular business of the Board, Sean Doolan, Esq., Principal, Hinman Straub, will provide an overview of the budget environment and prepare Board Members for scheduled legislative visits. HCA will review Advocacy Day meeting material including specific priorities, and legislative/budget “asks” for 2018.

FUNDRAISING DONATION INFORMATION* ___________________________________________________ Name

5:00 PM – 6:30 PM

HCA PAC Fundraising Reception Renaissance Hotel – DeWitt Ballroom 144 State Street, Albany, New York 12205 (Open to ALL HCA Members) HCA will hold a special PAC fundraising event to support Senate Majority Leader John Flanagan and Senate Health Committee Chairman Kemp Hannon. Attendees are asked to make a minimum $100 donation to the campaign of each Senator, and HCA’s PAC will match participants’ contributions for its own contribution to the Senators’ campaigns. Your support for each of these key legislators will help ensure favorable engagement in the political arena for home care’s future. Drinks and plentiful hor d’oeuvres will be served.

___________________________________________________ Organization ____________________________ _____________________ Email Phone: ______

I will attend the Fundraising Reception on February 5th (See instructions below)

______

I cannot attend but would like to make a donation as indicated. (See instructions below)

A minimum $100 donation to EACH campaign is requested. Please make your donation checks payable to: “Friends of Flanagan” for Senator John Flanagan “Citizens for Hannon” for Senator Kemp Hannon Checks will be accepted at the door that evening. However, if you are unable to attend but would like to make a donation, please mail your donations to: HCA, 388 Broadway, 4th Floor, Albany, NY 12207

TO ATTEND THE FUNDRAISING RECEPTION - FAX THIS COMPLETED FORM TO (518) 426-8788

State Advocacy Day DAY TWO Tuesday, February 6, 2018 8:00AM – 4:00PM

HCA State Lobby Day Room 711-A Legislative Office Building 198 State Street Albany, New York 12210 Parking for Legislative Office Building If you are driving and would like to park at the Empire State Plaza, we recommend the V-Lot which is closest to the Legislative Office Building, where we will be meeting. Elevators are accessible in the V-Lot to the Concourse level. Identifications must be shown when entering to park in the V-Lot.

ID Required for Access to LOB The Legislative Office Building is a Government building; therefore you will need to go through a security check point to access this area. Please be sure to bring a valid photo ID and allow additional time to go through the security process.

8:00 AM – 12:00PM

State Leaders Address HCA Board and Members Invited Legislative Leaders include: - Senator Jeffrey Klein - Assemblyman Richard Gottfried - And other influential policy leaders 12:00PM – 12:30 PM

Lunch 12:30 PM – 4:00 PM

HCA Board Member Agency Appointments HCA will arrange specific appointments with key legislators for HCA Board Members.

HCA Provider/Associate Members Breakfast and Lunch Provided

HCA encourages Provider and Associate Members to schedule their own legislative visits.

A light breakfast will be provided at the beginning of the meeting. A deli style lunch will be available at 12:00pm in Room 711A.

REGISTRATION Participant’s Name:_________________________________________________

Meeting Room Day Access You are welcome to utilize Room 711A throughout the day as needed and light refreshments will be available in the afternoon.

Organization:______________________________________________________ Email:_________________________________ Phone:____________________ #_______ Additional guests will attend Advocacy Day with me from my organization.

TO ATTEND ADVOCACY DAY, PLEASE FAX COMPLETED FORM TO (518) 426-8788