Feb. 20, 2017 Edition of The Situation Report

WAGE

LTHHCP

WORKFORCE

NOMINATE

CHHA EPS adjustments for minimum wage, and new DOH survey, due March 3, to calculate provider wage impacts.

HCA has invited state health officials for a member call to provide details on LTHHCP operating roles and to explain LTHHCP billing of EPS.

The Assembly is holding two hearings (in NYC and Albany) on home care workforce issues. HCA urges members to testify.

HCCA has opened up the process for our annual awards nominations.

Nominate a colleague or staff member today!

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COMING UP Home Care Council of HCA Member Forum March 6, 2017 10 a.m. to 12:30 p.m.

Hunter College Brookdale Campus 425 East 25th Street, NYC The Osborn Room (Mezzanine Level) Successfully Acting as a Fiscal Intermediary in CDPAP (9:30 a.m. to noon) & Upstate LHCSA Forum (Noon to 3 p.m.)

March 9, 2017 Mohawk Valley Health System Sogg’s Room (1650 Champlin Avenue) Utica, NY Registration for these programs and other events are at http://hcanys.org/eventseducation/upcomingevents.

Your Source for HOME CARE News, Policy and Advocacy

Vol. 2, Issue 8 | February 20, 2017

HCA Budget Testimony Stresses Payment, Regulatory, Workforce and Infrastructure Needs On Thursday, HCA Executive Vice President Al Cardillo delivered compelling testimony before a panel of the state Assembly and Senate on the Health and Medicaid portions of the proposed state budget. HCA’s written testimony is posted to our website at http://hca-nys.org/wpcontent/uploads/2017/02/ HCABudgetTestimonyFebruary162017.pdf.

The hearing drew testimony from multiple sectors of health care, with stakeholders commenting on the Governor’s Executive Budget proposals and pursuing issues for the Legislature’s consideration in its own one-house budgets and/or resolutions.

See TESTIMONY p. 2 EDITOR’S NOTE: The deadline for this week’s edition of The Situation Report was on the afternoon of Friday, February 17. For any late-breaking developments occurring over the weekend, HCA will send an alert or addendum to the membership as needed. Our offices are closed on February 20 for the President’s Day holiday.

INSIDE HCA Budget Testimony Stresses Priorities..........................................................1 DOH Makes Wage Adjustment to CHHA EPS for NYC............................................3 DOH Posts Minimum Wage Survey....................................................................3 MLTC Update...................................................................................................5 Statewide Call on LTHHCP Reimbursement, Roles.............................................5 HCA Members Urged to Testify at Assembly Workforce Hearing...........................6 Upcoming Emergency Preparedness Exercise for CHHAs & LTHHCPs...................7 Vital Home Care Finance Info at March 15 Senior Financial Managers Forum.......7 Summary of DSRIP Testimony, Oversight Panel Review Available .........................8 Regulations Proposed for Paid Family Leave......................................................8

Ordering/Prescribing/Referring Providers Must Revalidate...................9 Blueprint for OASIS Accuracy: OASIS C-2...................................................9 HCA Provides Memos on NGS Home Care and Hospice Updates.............10 Nominate Your Staff, Colleagues for 2017 HCA Home Care Awards.........10 HCA Bootcamp: Establishing and Maintaining a Compliance Program...10 HCA Member Discounts on Wound Care Education...............................11 Join HCA for Upstate Programs: CDPAP and LHCSA Forum.....................11 HCC of HCA Member Forum: March 6 in New York City...........................12 National Health Spending Study Results Posted...............................12 Resources.............................................................................13

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TESTIMONY from p. 1 Legislators also received testimony from officials at the state Department of Health, office of the State Medicaid Inspector General, Department of Financial Services and other offices representing the Executive on various components of the Health and Medicaid budget.

The Legislature addressed some important and sometimes pointed questions to state officials on issues of relevance to home care. These included: the state’s management of the Medicaid global cap and related Executive “super-powers” for rate changes; the state’s distribution of minimum wage funds to home care; the purview of the Governor’s proposed Health Care Regulation Modernization Team; and other issues.

In his testimony, Mr. Cardillo reinforced HCA’s call for payment adequacy and actuarially sound MLTC and provider rates for cost coverage, including stable and complete funding of the minimum wage mandate. He also called for the Legislature’s rejection of MLTC cuts and eligibility changes that have a continuum-wide impact.

He also alerted the Legislature about the actions of non-homecare providers seeking to enter the home care regulatory space (in Article 36) and the associated risks to patient care and safety and service duplication. His written testimony called on the Regulation Modernization Team and budget process to examine this issue, along with long-needed regulatory relief measures for home care providers to facilitate their effective participation in new integrated models as duly licensed Article 36 entities.

He also presented HCA’s requests for investment in home care infrastructure, beyond the $30 million community care allotment (out of a total $500 million pool for all sectors) that is proposed in the Governor’s budget. In addition, he urged the Legislature’s action on a plan for supporting home care workforce recruitment, retention and capacity to address shortages, turnover, and the growing need for citizens to access home care.

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 V ice President acardillo@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & 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

Each of HCA’s recommendations has been presented to the Legislature and Executive in the form of draft budget language, and additionally summarized in a series of reports presented to the Legislature during HCA’s February 7 Advocacy Day.

Jenny Kerbein Director of Governance & Special Projects jkerbein@hcanys.org

In a related development, the Governor has released his 30-day amendments to his budget. HCA will be analyzing these

Billi Wilson Manager, Meetings & Events bwilson@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

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Teresa Brown Administrative Assistant tbrown@hcanys.org

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Volume 2, No. 8 February 20, 2017 

amendments for any changes affecting home care and Managed Long Term Care, reporting back to you in future communications.

We will continue to keep you apprised of all important developments in this process.

DOH Makes Minimum Wage Adjustment to CHHA EPS for NYC Providers The state Department of Health (DOH) has posted to the Health Commerce System (HCS) a Dear Administrator Letter (DAL) notifying CHHAs that the 2017 CHHA Episodic Payment System (EPS) for New York City providers is revised effective January 1, 2017, to account for the increase in minimum wage as of December 31, 2016.

According to the DAL, the home health aide payment rates for New York City (NYC) providers were adjusted to a minimum of $20.95 per hour, beginning March 1, 2014, to enable CHHAs to meet the “wage parity” requirements in Section 3614.14 of the state Public Health Law (PHL).

Subsequently, retrospective to January 1, 2017, DOH has adjusted the minimum home health aide payment rate for NYC CHHAs to $22.28 to additionally reflect the scheduled increase in the minimum wage in NYC. The additional amount consists of $1.00 per hour in wages and $0.33 cents per hour in payroll taxes and fringe benefits.

However, with regards to CHHA EPS, DOH states that it was necessary to convert the determined $22.28 per hour adjustment to a percentage adjustment to the 60-day episodic payment structure. As a result, each of the 110 CHHA EPS rate codes is being increased by a 6.18 percent uniform adjustment (effective January 1, 2017) for NYC providers. CHHAs in NYC can access those rates at https://www.health.ny.gov/facilities/ long_term_care/reimbursement/episodic/2017-01-01_nyc_rate_adj.htm.

DOH has made the determination that the CHHA EPS rates do not have to be adjusted yet for CHHAs outside of the five boroughs of NYC since it believes that those CHHAs are still paying, on average, more than the new minimum wage requirements. HCA will be monitoring this situation closely, especially as the minimum wage requirements increase annually in NYC but also on Long Island, Westchester and the rest of the state.

The updated CHHA EPS rates for NYC have been forwarded to the Department’s eMedNY system for payment.

It is our understanding that providers’ EPS claims that have already been paid between January 1, 2017 and the present rates will be retrospectively adjusted by eMedNY, once the new rates hit the system.

DOH Posts Minimum Wage Survey March 3 is the deadline for completion The state Department of Health (DOH) has posted a survey to help DOH to determine the financial impact of the minimum wage increase legislation for state fiscal year 2017-18 (and beyond). DOH indicates that this survey is to “assist in developing a reimbursement methodology that will respond to the benchmarks of the Minimum Wage statute.”

The survey, due March 3, can be accessed at http://www.surveygizmo.com/s3/3300538/Minimum-WageSurvey-Home-Care-Final.

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Continued from previous page DOH’s survey asks agencies to report the number of hours that employed staff were paid at various wage levels, and the percentage of wages currently spent on payroll taxes and other benefits which are provided and paid as a percentage of wages and impacted by the wage increase. The information for 2016 is requested to be divided by: 1) New York City; 2) Long Island; 3) Westchester; and 4) the rest of the state.

DOH advises agencies that if they do not respond to the survey, this may impact the minimum wage rate adjustment on behalf of their agency/facility/program.

HCA has obtained PDF copies of the survey (see http://hca-nys.org/wp-content/uploads/2017/02/ Minimum-Wage-Survey_DOH_Final_021417.pdf) and the survey’s accompanying attestation form (see http://hca-nys.org/wp-content/uploads/2017/02/Minimum-Wage-SurveyAttestation_DOH_Final_021417.pdf).

We suggest that you first print out the PDF version of the survey form and complete the hard copy before filling it out online. This will simplify the process, as the online version of the survey must be completed all at once and does not allow the user to save sections and return at a later time.

We also want to inform members that the attestation, once signed by your CEO or CFO, needs to be uploaded to your computer and sent along with the completed survey.

HCA obtained and provided DOH with member feedback on draft versions of the survey, along with our HCA staff input. Some of this input was incorporated, including streamlining of the survey and its request for 2016, not 2015, data. DOH also incorporated our suggestion that the survey need not include agencies that contract out for all personal care and home health aide services.

Agencies that provide fiscal intermediary services are asked to complete a separate survey for personal assistants.

Questions about the survey should be sent to mltcrsmw@health.ny.gov (please copy HCA’s Andrew Koski at akoski@hcanys.org).

HCA and other stakeholders have asked DOH to hold a webinar on the survey and we have again made that request.

DOH has stated that it will be working toward a formal cost report system to capture necessary data not obtained from the survey, and we have asked DOH to be involved in development of this mechanism.

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

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Volume 2, No. 8 February 20, 2017 

MLTC Update At the February 9 Managed Long Term Care Policy and Planning meeting held by the state Department of Health (DOH), HCA received the following updates: 

One Fully Integrated Duals Advantage (FIDA) plan has been approved to begin opt-in enrollment in Suffolk and Westchester – the first plan for this region.

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Additional FIDA plans are expected to be phased in this spring for Suffolk and Westchester, contingent on final plan network review. DOH is considering an outreach campaign to promote FIDA in this area.

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There will be a plan discussion of recommended policy changes for FIDA, with the first meeting expected to have been held on February 17 and a public discussion about the future of integrated care at a later date.

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Implementation of the Community First Choice Option (CFCO) has been postponed from July 1, 2017 until January 1, 2018. Two workgroups developed to address vital CFCO issues – Provider Management and Benefit Management – met in early February. Two other workgroups – Clinical Management and PACE – and the Steering Committee have not met yet.



The transition of the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) waiver programs to managed care has been delayed from January 1, 2018 to April 1, 2018.

Among other outstanding issues are questions on social transportation and service coordination.

For more information, contact the HCA Policy staff

Statewide Call on LTHHCP Reimbursement, Roles with DOH: Feb. 23 at 3:30 p.m.

HCA has scheduled a statewide call for members with state Department of Health officials on the new reimbursement system and roles for Long Term Home Health Care Program (LTHHCP) providers. The call is this Thursday, February 23 at 3:30 p.m.

The call will provide an opportunity for LTHHCP members to review and have a Q&A session with DOH officials regarding the Department’s updated LTHHCP policies (see https://www.health.ny.gov/ health_care/medicaid/redesign/mrt90/2016-08-10_qandas_lthhcp.htm) and new Episodic Payment System (EPS) reimbursement capability for LTHHCPs, as well as the continuing and new roles permitted for LTHHCPs under the policy. HCA reported on this issue and the recent affirmation of EPS billing for LTHHCPs on page 8 of the January 23 edition of The Situation Report at http://hca-nys.org/wp-content/uploads/ 2017/01/SitRep012317.pdf.

All LTHHCPs with operating certificates (regardless of current census) should participate in this call, as well as MLTCs, LHCSAs and other current or potential LTHHCP partners.

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Continued from previous page Based on the information provided in this call, LTHHCP providers, sponsors and partners may want to evaluate their plans and new options using LTHHCP in the changing system.

Please register for this important call by completing the online form below, and dial-in information will be sent to you in advance of the call.

HCA appreciates DOH’s assistance to providers through this call.

Register for the call here: https://www.surveymonkey.com/r/LTHHCPStatusBilling.

HCA Members Urged to Testify at Assembly Hearings on Home Care Workforce State Assembly representatives will be hosting two upcoming public hearings to address Home Care Workforce Issues. HCA members are strongly urged to testify at this critical forum, which will be drawing attention and potential support for your agency’s urgent workforce needs.

The hearings are sponsored by the Assembly Committees on Health, Aging, and Labor, and the Assembly Task Force on People with Disabilities. Their purpose, as described in the Hearing Notice (see http://hcanys.org/wp-content/uploads/2017/02/Home-Care-Workforce-Hearing-Notice.pdf), is: “To examine the growing need for home care and personal care, and to examine the obstacles to recruiting, employing, and retaining an adequate home care workforce.”

One hearing will take place in New York City on Wednesday, February 22 at 11 a.m. at 250 Broadway on the 19th Floor in the Assembly Hearing Room. The second will be held in Albany on Monday, February 27 at 11 a.m. in Hearing Room C of the Legislative Office Building.

The hearings will focus on: 

Obstacles to recruitment, employment, and retention of sufficient workforce including, but not limited to, training, wages and benefits and geographic coverage of services;

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Medicaid Managed Care payment rates;

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Funding for Expanded In-Home Services for the Elderly Program (EISEP);

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Role of Managed Care Organizations in directing the resources toward patient-centered care; and

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Increasing demand for home care services.

These hearings present an opportunity for member agencies to elevate HCA’s messages about significant workforce shortage (recruitment and retention) issues in home care to the Legislature, complementing HCA’s budget request to establish and implement a home care workforce plan on these issues. Members are encouraged to use this forum for testimony that addresses the growing demand on the system and an inability for provider agencies across the state to meet that demand based on the current workforce availability.

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The Situation Report: the Home Care Association of New York State Continued from previous page Any HCA members who plan to testify should focus on their individual agency perspectives and experiences with recruitment and retention, but also address wide-ranging systemic concerns.

If you would like to testify, but want some guidance or assistance with developing your testimony, HCA would be glad to help you. Please contact Alex Fitz Blais at ablais@hcanys.org.

Testimony is limited to ten minutes, and anyone testifying should bring ten copies of any prepared material for distribution to the panel. The Committees have asked for prepared statements in advance. If you are interested, please complete and submit the last page of the Hearing Notice (at http://hca-nys.org/wp-content/uploads/2017/02/ Home-Care-Workforce-Hearing-Notice.pdf). It contains a “reply form” for individuals intending to testify. Please also notify HCA so that we are aware of your plan to testify.

Upcoming Emergency Preparedness Exercise for CHHAs & LTHHCPs The state Department of Health (DOH) released a notice that in the next several weeks it will be conducting a large-scale, statewide exercise called Outbreak Unchecked (OUREx).

OUREx will simulate the spread of an influenza pandemic.

Certified Home Health Agencies (CHHAs) and Long Term Home Health Care Programs (LTHHCPs) are encouraged to participate. Participants will not know the exact date in advance, but it will take place in the next few weeks.

HCA urges members to participate in this full-scale exercise as it is excellent experience working with your regional emergency preparedness colleagues and will help you to satisfy the exercise requirement in the new U.S. Centers for Medicare and Medicaid Services Emergency Preparedness Final Rule, which will be implemented on November 15, 2017.

Volume 2, No. 8 February 20, 2017 

Vital Home Care Finance Info at March 15 Senior Financial Managers Forum With state budget negotiations in full swing, and intense federal activity on health policy, HCA invites member CEOs, CFOs, finance managers and other senior staff to our popular Senior Financial Managers Forum in Albany on March 15.

This rigorous, information-loaded Forum, for HCA members only, brings together HCA Policy staff, Department of Health officials, finance consultants, and federal analysts to inform your budgeting, projections and understanding of all significant Medicaid and Medicare payment, reimbursement and finance factors affecting your bottom line as a home care provider or MLTC plan.

See our brochure at the link below for the lineup of must-hear speakers, including a new segment on the implications of OASIS C2, which will give home care finance officers some important considerations to make in their oversight of cost factors related to clinician activities. HCA staff and presenters will also be providing updates on state Medicaid and Medicare reimbursement; the Medicaid Global Cap; fee-for-services and MLTC reimbursement changes; adjustments for minimum wage, the Fair Labor Standards Act (FLSA) and other labor costs; state budget updates; benchmarking data; and more.

See the formal notice here: http://hca-nys.org/wp-content/ uploads/2017/02/CHHAexerciseannouncementfinal.pdf.

Please return your registration soon, to assure a seat at this important annual event offering focused information for you and your finance teams. A registration form is below.

Questions about the OUREx exercise can be directed to hcemergency@health.ny.gov. Please copy Alex Fitz Blais, ablais@hcanys.org, on any e-mails to DOH so that HCA can potentially assist other members if similar inquiries arise.

Register at: http://hca-nys.org/wp-content/ uploads/2017/02/Senior-FinancialManagers-Forum-Registration-FormMarch.pdf.

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Volume 2, No. 8 February 20, 2017 

Summary of DSRIP Testimony, Oversight Panel Review Available on DOH Website As previously reported, the state Department of Health hosted a January 31 public comment day on the Delivery System Reform Incentive Payment (DSRIP) Program at which HCA testified.

Subsequently, the DSRIP Project Approval and Oversight Panel (PAOP) met from February 1 through 3 to review the DSRIP mid-point assessment reports and recommendations with all 25 Performing Providers Systems (PPS) present. The PPSs are the entities through which DSRIP funds and projects are directed.

A summary of all testimony from the public comment day is available here: https://www.health.ny.gov/ health_care/medicaid/redesign/dsrip/project_approval_oversight_panel.htm.

A summary of all PAOP meeting proceedings and PPS recommendations (voted on by PAOP) are available here: http://www.health.ny.gov/health_care/medicaid/redesign/dsrip/project_approval_oversight_panel.htm.

In addition, the archived webcast of the entire four days can be accessed here: http://www.health.ny.gov/ events/webcasts/archive/.

Please contact Alex Fitz Blais at ablais@hcanys.org with any questions.

Regulations Proposed for Paid Family Leave The state Workers’ Compensation Board has proposed regulations to implement New York’s Paid Family Leave program.

The regulations are described at https://docs.dos.ny.gov/info/register/2017/feb22/toc.html (see page 23).

Paid Family Leave is required under legislation passed in 2016. When fully implemented, it will provide employees up to 12 weeks of paid family leave to: 1) care for a family member (including a child, parent, grandparent, grandchild, spouse or domestic partner) with a serious health condition; 2) bond with an employee’s newborn or newly placed adoptive or foster child during the first 12 months following birth or placement; or 3) address any qualifying exigency to a spouse, domestic partner, child or parent who is serving on active military duty.

To be eligible, employees must have been employed at least twenty-six consecutive weeks. There is no minimum requirement regarding the number of hours worked; therefore, both part-time and full-time employees may be eligible.

Benefits will be phased in, starting on January 1, 2018, at which time employees may receive up to eight weeks of paid benefits in 2018. Benefits will be paid at 50 percent of the employee’s average weekly wage, not to exceed 50 percent of the state average weekly wage. These benefits will gradually increase until January 1, 2021, when they will provide 12 weeks of coverage at 67 percent of the employee’s average weekly wage.

Coverage may be obtained by the State Insurance Fund or, in some cases, the employer may self-insure for paid family leave benefits. The law also provides certain job protections, entitling an employee who returns to work

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The Situation Report: the Home Care Association of New York State to be restored to the same or a comparable position. Benefits will be financed by employee contributions as a payroll deduction and not by employers.

Employers will be required to offer written guidance on paid family leave and a notice with information about the benefits as well as how to file a complaint.

The state Department of Financial Services (DFS) has also issued a proposed rule that requires family leave coverage to be “community rated” and subject to a risk adjustment mechanism. That rule is at https://docs.dos.ny.gov/info/register/2017/feb22/pdf/ Rule%20Making.pdf (page 13).

Under the proposed rule, DFS intends to set the maximum employee contribution on or before June 1, 2017, and annually thereafter on or before September 1.

Ordering/Prescribing/Referring Providers Must Revalidate for Claims to be Paid Home care agencies are reminded that ordering/prescribing/ referring (OPR) providers must revalidate for agencies to be paid for claims.

The state Department of Health (DOH) has determined that many providers are at risk for not being paid for their services because the OPR provider has not complied with the revalidation requirement.

DOH urges you to reach out and encourage your OPR providers to revalidate their enrollment. You should confirm that your OPR provider is enrolled before rendering service by going to www.emedny.org/info/opra.aspx.

The Claim Adjustment Reason Code for non-enrolled OPR provider on your 835 remittance will be: B7 – This Provider was Not Certified/ Eligible to be Paid For this Procedure/Service on this Date of Service.

If performing a claim status, look for Claim Status Code 91 with Entity Code 1P. The required revalidation form and instructions are available at https://www.emedny.org/info/ProviderEnrollment/revalidation/ index.aspx. The completed form must be mailed, with all required documentation and fee (if required), to the address provided on page 2 of the form.

Questions should be addressed to the eMedNY Call Center at 800343-9000, Option 2.

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Volume 2, No. 8 February 20, 2017 

Blueprint for OASIS Accuracy: OASIS C-2 April 19-20 Workshop, 8 a.m. to 4 p.m.

April 21 COS-C Exam, 9 to 11:30 a.m.

Doubletree by Hilton 100 Nott Terrace Schenectady, NY 12308 This two-day OASIS-C2 data collection workshop provides effective, up-to-the-minute education targeted for field data collectors, their supervisors and those preparing for the COS-C Exam.

Experience the comprehensive and nationally acclaimed two-day Blueprint for OASIS Accuracy workshop and learn to confidently teach, audit and collect OASIS items accurately. Through guided, expert instruction, and participation in problem-solving discussions and application scenarios, participants will achieve mastery of the OASIS items, conventions, and the latest data collection rules. Rather than provide opinions, assumptions, or unfounded interpretations, the “Blueprint” presenters will model reliance on U.S. Centers for Medicare and Medicaid Services (CMS) guidance documents and provide and demonstrate strategies for how to find defendable answers to your OASIS questions.

Individuals may register for the workshop, the exam or both. Please note the exam fee is in addition to the two-day workshop fee.

Registration is at http://hca-nys.org/ events-education/upcoming-events.

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

HCA Provides Memos on NGS Home Care and Hospice Updates New York’s Medicare Administrative Contractor, National Government Services (NGS), held two advisory meetings this week with updates to the home care and hospice provider communities. HCA Vice President Patrick Conole participated in both of these meetings, collecting information and providing feedback to NGS. Memos summarizing both meetings are posted at the links below.

Hospice memo: http://hca-nys.org/wp-content/uploads/2017/ 02/NGSHospiceMemo021717.pdf.

Home health memo: http://hca-nys.org/wp-content/uploads/ 2017/02/NGSHomeHealthMemo021717.pdf.

The memos provide information on Medicare payment and regulatory issues. The home care memo has some specific insights about the “probe-and-educate” audit process for face-to-face documentation requirements as well as Comprehensive Error Rate Testing (CERT) data findings that assist providers in responding to these reviews and ensuring compliance. The hospice memo similarly provides audit and reimbursement updates, medical review and appeals data, CERT results and findings, and more.

For further information, contact Patrick Conole at (518) 8100661 or pconole@hcanys.org.

Nominate Your Staff, Colleagues for 2017 HCA Home Care Awards HCA is now accepting nominations for our 2017 home care awards. Please make your nominations online here: https:// www.surveymonkey.com/r/2017HCAAwards. A detailed description of each award category is provided at the link.

Award winners will be honored during a special reception at our 2017 Annual Conference in Saratoga on May 3-5. This year’s theme is Rediscover, Reimagine, Reinvent.

Look for more information about the conference coming soon at www.hcaannualconference.com. In the meantime, help make this year’s awards ceremony something truly special by submitting your nominations. The due date is March 20.

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Volume 2, No. 8 February 20, 2017 

HCA Bootcamp: Establishing and Maintaining an Effective Compliance Program March 23, 2017 Visiting Nurse Service of New York 107 East 70th Street (between Park and Lexington Ave) New York, NY 10021 9:30 to 10 a.m. (registration and continental breakfast) 10 a.m. to noon (program) HCA is holding a bootcamp session on March 23 in New York City (from 9:30 a.m. to noon) to help providers establish and maintain an effective compliance program — a topic that is all the more important during a time of heightened compliance scrutiny and multiple audits by state and federal agencies.

This program, presented by compliance expert Rachel HoldWeiss of the Arent Fox Health Care Group, will convey why a compliance program is needed, state and federal requirements for compliance programs, the eight required elements of a compliance program, staff training, state and federal audit protocols, the disclosure process, compliance program testing, and more.

Registration is at http://hcanys.org/events-education/ upcoming-events.

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Volume 2, No. 8 February 20, 2017 

HCA Member Discounts on Wound Care Education Courses for Clinicians Online course and 5-day onsite courses in East Elmhurst and Buffalo HCA has partnered with the Wound Care Education Institute to provide HCA members with discounts on courses for wound and skin care management. These include an online class as well as upcoming five-day onsite courses being offered on April 1014, 2017 in East Elmhurst and on April 24-28, 2017 in Buffalo.

These courses offer an evidence-based approach to wound management, along with an opportunity for certification.

We’ve devoted a special page on our website for further information at http://hca-nys.org/hca-and-wcei-partner-on-wound-care-education-courses.

Join HCA for March 9 Programs Upstate on CDPAP and LHCSA Forum On March 9, HCA is holding two programs upstate for LHCSAs and for all home care agencies looking to participate or are acting as fiscal intermediaries under the Consumer Directed Personal Assistance Program (CDPAP). The March 9 sessions will be held at the Mohawk Valley Health System Sogg’s Room (1650 Champlin Avenue) in Utica.

The first program is entitled Successfully Acting as a Fiscal Intermediary in the Consumer Directed Personal Assistance Program, starting at 9:30 a.m. with registration and breakfast followed by a 10 a.m. to noon program. Immediately following this event, HCA is hosting a members-only Upstate LHCSA Forum at the same location from noon to 3 p.m., beginning with lunch.

A statewide Medicaid program, CDPAP empowers consumers by giving them flexibility and freedom to choose who provides their care and how it is provided. LHCSAs can participate in this growth by becoming a Fiscal Intermediary (FI). At this morning session, you will get important information about CDPAP, including: consumer eligibility requirements and obligations; the process to become an FI; advantages and disadvantages of LHCSAs serving as FIs; requirements and obligations of the FI; policies and procedures; required contracts; wage and hour issues facing FIs; potential risk areas; and best practices of a successful program. The program will be presented by Michael Weiner, a partner in the law firm of Glaser & Weiner, LLP. For more than 20 years, Mr. Weiner has been a trusted advisor to his clients, providing them with practical legal counsel and business advice.

LHCSAs are encouraged to participate in this program and to stay for the noon Upstate LHCSA Forum for an exchange of valuable information, advocacy concerns and recommendations for action on: state budget developments; federal legislative issues; uniform billing codes; the minimum wage increase and state funding; CDPAP; the Delivery System Reform Incentive Payment Program (DSRIP) and value based payment; and issues in your region.

Participants should register for either one or both programs. Separate registration forms are at http://hca-nys.org/events-education/upcoming-events.

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

Volume 2, No. 8 February 20, 2017 

Home Care Council of HCA Member Forum: March 6 in New York City Please join the HCA staff and member colleagues for the next Home Care Council (HCC) of HCA Member Forum. The HCC of HCA members include personal care providers who formerly were members of the Home Care Council of New York City.

Participation in HCA Member Forums gives you an opportunity to interact with HCA staff and members, and exchange valuable information with your colleagues. Some of the vital issues to be covered include:         

Update on HRA contracts and other important topics; State Budget proposals that impact home care; Funding for minimum wage increase; Minimum wage survey; QIVAPP final awards; Spread of hours requirements; Uniform billing codes; Other policy changes; and Future education programs.

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

Download the registration form: http://hca-nys.org/wp-content/uploads/2015/01/HCC-Forum-3-6-17Registration-Form.pdf.

National Health Spending Study Results Posted National health expenditure growth is expected to average 5.6 percent annually over the 2016 to 2025 period, according to a report published by Health Affairs and authored by the U.S. Centers for Medicare and Medicaid Services’ (CMS) Office of the Actuary (OACT).

The report is at https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ NationalHealthExpendData/NationalHealthAccountsProjected.html.

Some additional findings include: 

Medicare spending growth is projected to accelerate to 5.9 percent in 2017, from 5.0 percent in 2016.

This trend is due to spending associated with Medicare physician and clinical services (5.3 percent growth in 2017, up from 3.9 percent in 2016) and Medicare hospital services (4.9 percent growth in 2017, up from 4.2 percent in 2016).

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Medicare spending growth is expected to average 7.1 percent for 2018-19. It is projected to peak in 2020 at 8.0 percent and grow at an average rate of 7.6 percent for 2020 to 2025, up from an average of 7.1 percent for 2018-19. Driving growth in Medicare spending is continued strong enrollment from baby boomers (averaging 2.8 percent) and the aging of the existing Medicare population. Both of these effects contribute to increases in growth in the use and intensity of medical services.

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

Volume 2, No. 8 February 20, 2017 

Continued from previous page 

Medicare spending on home health from 2018 to 2025 is expected to increase by about 7.5 percent per year.

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Medicaid spending growth is projected to accelerate to an average of 5.9 percent for 2018-19 (up from 3.7 percent in 2017) largely because of more rapid projected growth in the use and intensity of care required to meet the needs of Medicaid’s increasingly larger proportion of aged and disabled enrollees (who tend to be comparatively more expensive). Spending growth is expected to average 5.7 percent for 2017-2025.

Resources 

“Social Risk Factors and Equity in Medicare Payment,” New England Journal of Medicine (February 9, 2017) http://www.nejm.org/doi/pdf/10.1056/NEJMp1700081

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“Medicaid: CMS Needs Better Data to Monitor the Provision of and Spending on Personal Care Services,” by the U.S. Government Accountability Office http://www.gao.gov/assets/690/682046.pdf

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“How Can We Increase The Use Of Palliative Care In Medicare?” Health Affairs Blog (February 13, 2017) http://healthaffairs.org/blog/2017/02/13/how-can-we-increase-the-use-of-palliative-care-inmedicare/

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

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