March 19, 2018 Edition of The Situation Report

MEDPAC

SEPSIS

MedPAC’s Report to Congress again recommends HHA payment cuts and a blended pay model to align post-acute care (PAC) reimbursement across PAC sub-sectors.

HCA’s “Stop Sepsis at Home” has one training session left on Long Island: March 23.

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MEDICAID/MEDICARE ENROLLMENT REQUIREMENT Medicaid recipients must apply for Medicare, once eligible, to continue receiving Medicaid services; 12,000 NYC Medicaid recipients could still be affected, risking loss of services.

Donna Frescatore has been named as replacement for Medicaid Director Jason Helgerson, who is set to depart state service in April.

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Your Source for HOME CARE News, Policy and Advocacy

COMING UP Senior Financial Managers Forum March 22, 2018 Albany ‘Stop Sepsis at Home’ Regional Training Sessions NEW DATE: March 23, 2018 Port Washington

Vol. 3, Issue 12 | March 19, 2018

Senate, Assembly Stake One-House Budget Proposals MLTC Rate & Eligibility Changes, LHCSA Contracting, Infrastructure Funds, Telehealth and More As reported in an alert last week, each house of the State Legislature released its respective one-house budget bills and resolutions which together form the basis for each chamber’s positions relative to the Governor’s budget proposals.

Conference committees have convened to reconcile the two houses’ positions, kicking off work (mostly behind the scenes) to create a more unified position by the Legislature. A health conference committee update is expected as soon as today.

See BUDGET p. 3

Downstate LHCSA Forum March 27, 2018 NYC Register for these and other programs online at https://hcanys.org/eventseducation/ upcoming-events.

NEW MEDICAID DIR.

Join HCA, NAHC for Virtual Advocacy Day Tomorrow to Coincide with March on Washington HCA President Joanne Cunningham is joining colleagues at the National Association for Home Care and Hospice (NAHC) March on Washington this week, which includes a virtual advocacy day that NAHC and HCA urge all HCA members to take part in.

See VIRTUAL p. 2

INSIDE Senate, Assembly Stake One-House Budget Proposals.........................................1 Join HCA, NAHC for Virtual Advocacy Day Tomorrow..................................................1 Message From Sponsor RBC Limited....................................................................3 Register Now for HCA’s 40th Annual Conference on May 9-11................................7 PHHPC Establishment and Project Review Committee Agenda Posted..................7 MedPAC Calls For 5% Home Health Reduction, Uniform PAC Payments..................8 Register Now for Final HCA Sepsis Session This Friday in Port Washington..............9 Contract Limits, Live-In Hours, CDPAP & More at Upcoming LHCSA Forums..........10 Read HCA’s NGS Memo & Hear from NGS at HCA’s Finance Forum on Thursday......11

Medicaid Recipients Have to Apply for Medicare Upon Eligibility for Medicare........11 Donna Frescatore to Replace Helgerson as State Medicaid Director..................12 HRA Office Changes.........................................................................................13 Value Based Payment (VBP) Update..................................................................13 OPWDD Announces Public Forums...................................................................13 HCA Participates in Central NY HEPC Meeting...................................................14 CMS Posts New Version of Hospice HIS Record Reporting Tool............................14 Important Upcoming Deadlines......................................................................15 Resources................................................................................................................16

The Situation Report: the Home Care Association of New York State VIRTUAL from p. 1 NAHC’s online virtual advocacy day platform (click here: http:// p2a.co/zVV7RPe) offers background and legislative advocacy messages you can send to Congress tomorrow to coincide with in-person legislative advocacy visits being conducted by HCA and providers representatives nationally. All participants in the Virtual Advocacy Day should e-mail, call, or use social media to contact their members of Congress on behalf of home care and hospice and the millions of people who depend on those services.

As reported in recent editions of The Situation Report, HCA, NAHC, the Visiting Nurse Associations of America/ ElevatingHOME and other federal partners have directed our advocacy at technical corrections to the recent federal budget bill. Our core messages are as follows: 

Support clarifications to home health payment reform;

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Support the Home Health Care Planning Improvement Act, which would allow Nurse Practitioners, Advanced Practice Nurses, and Physician Assistants to sign Medicare home health care plans;

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Extend the Medicare home health rural add-on;

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Stop pre-claim review chaos before it spreads to other regions of the country;

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Maintain stability in the Medicare Hospice Benefit and reject further cuts or the imposition of copays or deductibles on Medicare hospice services;

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Oppose changes to the Companionship Services Exemption; and

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Repeal or revise the face-to-face physician encounter requirement.

Advocacy campaigns for each of these issues are on NAHC’s virtual advocacy day platform linked above. Please take action and look for additional grassroots advocacy from HCA as an extension to this week’s March on Washington.

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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Volume 3, No. 12 March 19, 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 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 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

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

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BUDGET from p. 1 The Legislature has altered several of the proposed payment and eligibility provisions for home care and Managed Long Term Care (MLTC). HCA will continue to urge alignment of these proposals with HCA’s positions. Additionally, the Senate, in particular, has inserted some of HCA’s proposals for home caredirected public health and workforce support initiatives. However, HCA is particularly concerned that the Legislature accepts variations of the Governor’s proposed Licensed Home Care Services Agency (LHCSA) contracting limits and pursues broad expansion of in-home telehealth coverage without necessary standards for delineating which provider types may deliver which services.

What follows is a summary of the HCA watch-items of impact or concern to home care, hospice and MLTC members thus far identified from our review of the one-house proposals.

Home Care Contracting Limits Background: The Governor’s budget includes an arbitrary cap on MLTC provider networks to 10 LHCSAs. HCA is strongly opposed to this cap, which: denies consumers and patients access to care and

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the choice of caregiver/provider who can meet specific cultural, linguistic and other distinct needs; ignores the reality that home care services are delivered locally; micromanages MLTCs’ ability to make care delivery determinations and undermines their operations; and dislocates staff. The Legislature proposes to adopt limits on LHCSA contracting, but each house would modify those limits differently.

Meanwhile, HCA has formulated and advanced counter proposals that provide for a more in-depth process and means of determining quality, compliance, access, and efficiency parameters for MLTC (LHCSA) contracting.

Thus far, the Governor and Senate have been working on proposals that would set numerical limits. The Governor’s action and position is being driven by SEIU 1199 and would be administratively implemented – i.e. without the

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The Situation Report: the Home Care Association of New York State Legislature – so that any counter proposals must be able to engage the Governor and both houses of the Legislature in a common agreement.

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Under the Senate proposal, all LHCSAs licensed as of April 1, 2018 would be prohibited from engaging in marketing practices until a review is complete and DOH has submitted a report to the Legislature.

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The Assembly does not reject the Administrative proposal to limit the number of LHCSAs that can contract with MLTC plans, but the Assembly proposal states that if a limit is instituted, it requires PHHPC approval “consistent with standards adopted by the Council to assure network adequacy.”

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The Assembly would also limit (for the period of April 1, 2018 to March 31, 2019) the approval of new LHCSA applications to those that involve consolidations, or to overcome lack of network adequacy, or due to lack of appropriate care, language and cultural competence, geographic coverage or special-needs services. By March 31, 2019, the Council “shall review and revise standards relating to adequate and appropriate care, language and cultural competence, geographic coverage and special-needs services, and needs methodology relating to the approval, closure or consolidation of LHCSAs to assure a statewide system that is financially viable.” It also adds language that the PHHPC shall not approve an application for licensure unless PHHPC is “satisfied as to the public need for the existence of the LHCSA.”

A summary of the Senate and Assembly bills follows. However, these positions can shift with the negotiation on this new Program Bill. 

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The Senate proposal requires the state Department of Health (DOH) and the Public Health and Health Planning Council (PHHPC) to conduct a review of LHCSAs “that looks at access, availability of workforce personnel, unique community needs, efficiency and affordability, regional needs and variations, an analysis of average number of contracts per plan based on region, and other factors.” Following the review, by October 1, 2018, DOH and PHHPC would establish the following LHCSA-MLTC contract limits for New York City, Long Island and Westchester: 75 contracts by October 1, 2018; 60 contracts

by October 1, 2019; and 50 contracts by October 1, 2020.

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The Senate would also require that a percentage of MLTC contracts with LHCSAs be with Quality Incentive/Vital Access Provider Pool (QIVAPP) providers or “providers who otherwise demonstrate a commitment to quality.” In addition, DOH/ PHHPC would review LHCSA services upstate and consider whether changes are needed in this region.

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The Senate proposal also calls for DOH and PHHPC to provide recommendations on incentives to encourage LHCSA consolidation through such mechanisms as financial assistance, an expedited certificate of need (CON) process for mergers and acquisitions, and other changes in the licensure or CON process.

During this review period, a moratorium would be imposed on LHCSA approvals, with certain narrow exceptions.

MLTC-home care eligibility, rates and proposed cuts Background: the Governor’s proposed budget includes cuts to MLTC administration/operations, cuts to MLTC reserve funding, the carve-out of MLTC patient transportation, a ban on provider marketing, and sweeping new penalties, fines and reporting mandates. It also would limit MLTC enrollment to only those patients that score 9 or

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

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community. It also modifies the Governor’s proposed limit on the ability of MLTC enrollees to change plans, allowing for a change of plan within 90 days of enrollment and allowing one additional change per annual enrollment period, or otherwise for good cause.

above on the Uniform Assessment System (UAS) and calls for a carve-out of nursing home services after six months. Many of these cuts and eligibility changes would be rejected or mitigated by the Legislature, as summarized below. 

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According to its budget resolution, the Senate would deny the Governor’s restrictions on MLTC eligibility to those with a UAS score of 9 or greater and to those that require continuous 120 days of community-based long term care. It would also “require DOH to provide oversight when individuals with high needs are transferred involuntarily between MLTC plans.” It additionally modifies the proposed transition of nursing home residents from MLTCs at six months with, instead, a transition at three months and “provides Olmstead protections.” It also would establish the MLTC transportation benefit as a plan-specific option, as recommended by HCA. The Senate resolution advances language to “ensure components included in the Medicaid managed care rates, including minimum wage, are adequate to insurers and appropriately passed on to providers, whether it be for reimbursement of home care services, hospice residences, nursing home services” and other services to “vulnerable populations.” HCA has long pushed for rate adequacy language for MLTC and home care and will be examining this provision more closely.

The Assembly’s budget bill rejects: the proposal to raise the UAS score from 5 to 9 for MLTC eligibility; the prohibition on community-based provider marketing and to restrict provider-based referrals; and the carve-out of transportation from MLTC. The Assembly language modifies the Executive proposals to transfer enrollees from MLTC to feefor-service Medicaid if they are permanently placed in a nursing home for a period of six months. The Assembly would, instead, suspend their enrollment after 90 days and allow a prorata payment should they return to the

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The Assembly accepts the Executive proposals to: require that someone needs 120 consecutive days of community-based care to be eligible for MLTC and grandfathers existing enrollees; authorize the Commissioner of Health to conduct a study on home and community-based services (HCBS) in rural areas (similar to the Senate) and to increase Medicaid rates in such areas. The Assembly also includes language to establish a highneeds rate cell for MLTC.

Infrastructure Funds Background: The Governor’s budget proposes $425 million in Phase III funding of the “Health Care Facility Transformation Program.” HCA has urged the Legislature to ensure that at least one-quarter of funds ($106.25 million) are for home care, hospice and other community health care providers.

The Legislature proposes to raise the total amount of this funding pool and includes dedicated funds for community-based providers, but with different levels of specificity, as summarized below. 

The Senate resolution modifies the Executive’s Health Care Facility Transformation program, increasing the amount from $425 million to $500 million. Of this $500 million, a minimum of $70 million must be provided to community-based health care providers (including diagnostic and treatment centers, mental health clinics, substance use disorder clinics, children’s residential treatment

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The Situation Report: the Home Care Association of New York State facilities or primary care providers); $20 million for assisted living facilities (ALPs) and hospice; $60 million for residential health care facilities; and $25 million for home care providers. 

Background: The Governor’s budget proposes a problematic expansion of the telehealth law that HCA has been working to better align with existing jurisdictional and licensure boundaries. We’ve advanced legislative language to modify the Governor’s telehealth proposal to ensure that services provided in the home via telehealth are in line with the providers’ lawful scope and license for in-person service. Thus, under HCA’s proposal, services currently limited to home care providers by law would not be circumvented by nonhome care providers using telehealth.

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The Assembly bill substantially repeals sections of existing public health law that broadened and delineated telehealth coverage by various sectors. New language proposed by the Assembly essentially mirrors for Medicaid the coverage standard that applies under commercial insurance, allowing providers to deliver a service via telehealth if the service is otherwise allowable through traditional means.

The Senate proposal substantially works from the Governor’s proposal.

Home care, public health and workforce HCA has urged the Legislature to adopt specific supports for home care, hospice and MLTC in the areas of public health and workforce, including the following HCA proposals that we have thus far

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identified as being recommended and affirmed by the Senate. 

The Senate resolution would implement a Public Health Priority Initiative, as recommended by HCA, “to facilitate and promote the role of home care in addressing public health priorities in New York, including sepsis, asthma, falls, health disparities, medication management, and opioid overuse/ misuse, and potential cost-savings/ health improvement.”

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HCA advanced a series of proposals to provide urgent assistance with workforce needs. We are disappointed in the lack of legislative response; however, one of our proposals has been included by the Senate. It advances HCA language to expand the health care worker retraining program to allow hospitals and home care and long term care agencies to collaborate for cross-training and crossutilization of direct-care personnel.

HCA will continue to work to gain legislative support after the budget is passed.

The Assembly provides an additional $100 million to the program, bringing it to $525 million. Included within this amount is a $75 million capital allocation for community-based health providers and a $20 million set-aside for Assisted Living Programs. It also adds OPWDD Article 16 clinics as “communitybased providers.”

Telehealth

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HCA has briefed the Board of Directors on these items and is incorporating the Board’s feedback on a responsive advocacy plan to address major areas of concern, with specific focus on the LHCSA-MLTC contract provisions, home telehealth, and other components of the various budget bills and resolutions now undergoing reconciliation.

With less than two weeks to go before the budget deadline, on April 1, this effort will require an intensive focus from the HCA policy and government affairs teams.

Please stay tuned for further information and grassroots advocacy instructions. Your voice is critical.

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

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Register Now for HCA’s 40th Annual Conference “40 Years Strong” on May 9-11 in Saratoga Springs Registration is now open for HCA’s milestone Annual Conference celebrating our 40th year as an association with the theme 40 Years Strong.

Please help make this the best celebration yet, by registering today using the form at the back of this week’s newsletter.

For this banner conference, we’ll be joined by special guest Bill Dombi, President of the National Association for Home Care and Hospice, as well as other expert presenters offering insights on all facets of home care operations.

These sessions, networking opportunities and more will help your organization plan for the future by: tackling emerging issues, enhancing your team’s performance, confronting public health and population health challenges, and optimizing your success with some of the biggest challenges happening to home care in decades.

40 Years Strong, HCA’s Annual Conference Date: May 9-11, 2018 Venue: Saratoga Hilton, Saratoga Springs Info: http://hcaannualconference.com/

PHHPC Establishment and Project Review Committee Agenda Posted The state Department of Health (DOH) has posted the agenda for the March 22 meeting of the Public Health and Health Planning Council (PHHPC) Establishment and Project Review Committee. The agenda, along with supporting documents, is at https://www.health.ny.gov/facilities/public_health_and_health_planning_council/ meetings/2018-03-22/. The applications include: 

One Certified Home Health Agency (CHHA) to establish one entity as its parent and another entity as its grandparent;

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One CHHA for a full asset merger of another entity into its operations;

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Five new Licensed Home Care Services Agencies (LHCSAs) that are affiliated with an assisted living program;

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Two existing LHCSAs for a change of ownership; and

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Eleven entities to establish new LHCSAs.

The March 22 meeting is webcast at https://www.health.ny.gov/events/webcasts/ and is scheduled to start at 10:15 a.m.

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

Volume 3, No. 12 March 19, 2018 

MedPAC Calls For 5% Home Health Reduction, Rebasing and Transition to Uniform Post-Acute Payment System The Medicare Payment Advisory Commission (MedPAC) has issued its annual March Report to Congress, calling for a 5 percent payment reduction to home health care in 2019. The report also recommends a twoyear rebasing of the home health payment system, beginning in 2020, and eliminating therapy visits as a factor in payment. The full report is available here: http://medpac.gov/docs/default-source/reports/ mar18_medpac_entirereport_sec.pdf?sfvrsn=0.

MedPAC’s report, issued each year, is non-binding. It reflects advisory recommendations that would require legislation from Congress and/or administrative action from the U.S. Centers for Medicare and Medicaid Services (CMS).

HCA has long challenged the underlying assumptions of MedPAC’s data analysis, in position papers to Congress and in our direct advocacy with both MedPAC and CMS. HCA has specifically noted MedPAC’s use of selective data sets that do not reflect the financial struggles of many home care providers, especially in states like New York where unique system and patient-demographic factors have resulted in providers operating at a loss on Medicare for fourteen years in a row, with an unweighted average margin of negative-16.36 percent in 2014 (the most recent year of data available to HCA).

In its 2018 report, MedPAC continues to support its recommendations using nationwide assessments of profit margins, specifically “the positive indicators for payment adequacy and freestanding home health agencies’ high margins.” In 2016, MedPAC says, Medicare margins for freestanding agencies averaged 15.5 percent. The projected margin for 2018 is 14.4 percent.

As reported in recent editions of The Situation Report, MedPAC has also more broadly been examining the development of a unified payment system for post-acute providers, including home care, as required under the federal Improving Medicare Post-Acute Care Transformation Act (IMPACT Act) of 2014. The purpose of this system is to overcome service and cost disparities across the various settings so that a service in one post-acute (PAC) setting would be comparatively paid in another.

“The cost of inaction is mounting,” MedPAC states in its report, recommending, as an initial step, a two-part blending of: 1) the relative weights in each of the setting-specific payment systems (i.e., the Home Health Prospective Payment System) with; 2) the weights delineated under the unified PAC system.

Under this blend, setting-specific relative weights would “count more” than the unified PAC relative weights at the outset, with the balance shifting so that the unified PAC relative weights increasingly count more until, in 2021, “the relative weights would be based entirely on the unified PAC prospective payment system (PPS) weights and the three-year transition to the unified PAC PPS would begin using the new system’s base rates.”

MedPAC addressed certain other aspects of this proposed new system in its most recent meeting, earlier this month, which included a discussion of “sequential stays,” defined as a unit of service or episode that is contiguous or separated by as much as 7 days. A “sequential stay” would include, for example, a scenario where a patient enters one PAC setting, such as a rehabilitation facility, but then transitions to another, such as home care. Among their findings, MedPAC staff indicated that medically complex patients often receive

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

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care in multiple PAC settings. Also, later “stays” in a sequence tend to be less costly, due to a reduction in care needs, prompting MedPAC to recommend reimbursement adjustments for late stays.

These recommendations all coincide with other major reimbursement changes already in motion, such as the Home Health Grouping Model (HHGM) which HCA is working to mitigate in advocacy with our federal partners. (See p. 1 story.) HHGM, as extensively reported, was included as part of last month’s Congressional budget bill. HCA has been specifically seeking technical corrections to the bill that would: anchor HHGM in a 30-day unit of payment, rather than a 30-day unit of service, to align HHGM with and maintain the existing 60-day service episode; require a data analysis based on actual, nor predictive, behavior for purposes of calibrating the various acuity factors and payment calculations; turn HHGM into an optional demonstration program, rather than a required, universal reimbursement change; and provide more time for the technical advisory panel to review these and other reimbursement changes prior to implementation.

Please stay tuned for further information on these and other developing payment policy initiatives.

Register Now for Last Scheduled HCA Sepsis Session This Friday, on March 23, in Port Washington HCA’s final scheduled Stop Sepsis at Home regional training session is this Friday, March 23, in Port Washington (Long Island).

This session is a rescheduled date, due to travel concerns from winter storms earlier this month, so we encourage as many home health providers and system partners to take advantage of this last opportunity if you haven’t yet attended one of these vital programs. Please pre-register by selecting the March 23 Port Washington date in the online form here: https://www.surveymonkey.com/r/LISepsisSessions.

These sessions are free of charge, and they provide you with both the broad perspectives as well as the detailed technical training to begin using HCA’s first-in-the-nation home care sepsis identification tool and protocols. This tool and protocols will make your agency a leader in combating the sepsis crisis as well as a valuable partner to hospitals, physician practices and payors.

Stop Sepsis at Home is supported by a grant from the New York State Health Foundation, with collaboration and technical support from IPRO, the Rory Staunton Foundation for Sepsis Prevention, the Sepsis Alliance, individual clinician leaders, and others on our project steering committee.

For the latest updates, please see the news section of our Stop Sepsis at Home website at http:// stopsepsisathomeny.org/news/.

Our “Tools and Resources” page offers further information at http://stopsepsisathomeny.org/tools-andresources. HCA will be adding additional resources to this page after the completion of our regional training sessions.

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

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Contract Limits, Live-In Hours/Wages, CDPAP & More at Upcoming LHCSA Forums Downstate Forum on March 27 in New York City; Upstate Forum on April 16 in Utica For home care, one of the biggest-impact proposals in this year’s state budget is the Governor’s call for an arbitrary limit of ten LHCSA contracts per MLTC plan. Other major LHCSA impacts include: across-theboard MLTC reimbursement cuts that affect contracted home care services; patient acuity changes affecting coverage of MLTC-home care services; and a proposed ban on provider/MLTC marketing.

These state budget issues – and many other burning topics for LHCSAs – will be discussed at HCA’s upcoming LHCSA Forums, with sessions for Downstate providers on March 27 and for Upstate providers on April 16.

If you are a LHCSA director, executive or operations manager concerned about these issues, then you or your staff can’t afford to miss our upcoming forums.

In addition to state budget issues affecting LHCSA contracts, payments and marketing, our Forums will provide you and LHCSA peers with the latest on:     

Medicaid enrollment requirements for LHCSAs that contract with Medicaid managed care plans; Uniform billing codes under managed care; The fiscal intermediary authorization (FI) process for LHCSAs wishing to provide FI services under the consumer directed personal assistance program; Regulatory issues; and Court cases/state regulations concerning compensable hours for “24-hour/live-in” services (a specific focus for our downstate session of the LHCSA Forum).

HCA’s Policy team will provide updates as well as an opportunity for your input on advocacy or program development to support you in all of these areas. We also want to know what concerns you are facing and ways that HCA can help.

Please register today for these critical forums by downloading the forms below.

Downstate LHCSA Forum (March 27, 2018) 9:30 a.m. to 1:30 p.m.

The Conference Center 130 East 59th Street (Near Lexington Avenue) 7th Floor, Rooms 706/708 New York, NY 10022 Download the registration form here: https://hca-nys.org/wp-content/uploads/2018/02/March-27-2018Downstate-LHCSA-and-HCC-Forum-Registration-Form.pdf Upstate LHCSA Forum (April 16, 2018) 10:30 a.m. to 2:30 p.m.

Mohawk Valley Health System Community Room 1650 Champlin Avenue Utica, NY 13502 Download the registration form here: https://hca-nys.org/wp-content/uploads/2018/02/HCA-Upstate-LHCSAForum-April-16-Registration-Form.pdf

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Read HCA’s Memo with NGS Updates; Hear from NGS at HCA’s Finance Forum on Thursday HCA has prepared a memo summarizing updates from National Government Services (NGS) during last week’s home health advisory meeting for HCA and other provider representatives in NGS’s jurisdiction 6 coverage area.

The memo (available at https://hca-nys.org/wp-content/uploads/2018/03/031618NGSHomeHealthMemo.pdf) summarizes several important updates from New York’s Medicare contractor and fiscal intermediary, including: Comprehensive Error Rate Testing (CERT) results and findings; the Home Health Targeted Probe and Educate (HHTPE) medical review process; the new Medicare Beneficiary Number Identifier (MBI) and Medicare cards; top denial and appeal denial reasons; and more.

NGS Representative at HCA Finance Forum: March 22 On a related note, it’s not too late to register for HCA’s Senior Financial Managers Forum in Troy (near Albany) later this week where NGS representative Lauri Domingo will provide details on the overall HHTPE process, how providers can avoid being identified for HHTPE, acceptable claim error rates, and impact statistics. She’ll also provide the latest medical review and appeals data review (including the top claim denial reasons), as well as tips to avoid those denials, along with other results that affect claims.

The Forum also falls just before the April 1 deadline for a state budget, providing you with the latest on all Medicaid reimbursement issues and budget policies affecting your agency’s finances. Plus, with the onset of a Home Health Groupings Model (HHGM) or other payment overhaul, federal policy and technical experts will be on hand to help you navigate the impending changes and forecast for the future.

Please register today at https://hca-nys.org/wp-content/uploads/2018/01/HCA-Senior-Financial-MgrForum-Registration-Form.pdf.

Medicaid Recipients Have to Apply for Medicare Upon Their Eligibility for Medicare State Social Services Law requires individuals who are eligible for benefits under Medicare to apply for such benefits as a condition of receiving assistance under the Medicaid program. This requirement applies to individuals who are eligible for payment of their premiums either through the Medicare Savings Program or as a fully eligible Medicaid recipient (without deducting the premium payment from income).

More information on this requirement is at https://www.health.ny.gov/health_care/medicaid/publications/ pub2017adm.htm.

These individuals received a series of notices from the state Department of Health (DOH) and New York City Human Resources Administration (HRA) beginning December 2017 and continuing through February 2018 informing them that they had to apply for Medicare as a condition of Medicaid eligibility. If they did not submit proof of applying for Medicare by February 7, their Medicaid coverage would be discontinued effective March 6, 2018.

Several affected individuals, including home care patients, attempted to comply with the requirement but had been unable to obtain the documentation they needed from the Social Security Administration (SSA) to show they had applied for Medicare or had been found ineligible.

Continued on next page

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Continued from previous page After intensive legal advocacy by Legal Services NYC Public Benefits advocates, Medicaid coverage was restored to all 2,204 New York City Medicaid recipients who had coverage terminated on March 6. In addition, DOH agreed to continue working collectively with legal services advocates to improve this process in the future so this vulnerable group of Medicaid recipients – the elderly, disabled, and limited English proficient – can maintain Medicaid coverage while also complying with the Medicare application requirement.

If home care providers encounter patients with problems related to this requirement, you can contact the Legal Services NYC Access Line at 917-661-4500, especially if the consumer’s Medicaid coverage is inactive.

Lastly, DOH estimates that more than 12,000 New York City Medicaid recipients still need to be notified to comply with the Medicare application requirement. Medicaid recipients who receive these mailings in the future should take immediate steps to apply for Medicare by calling the SSA at 1-800-772-1213.

They will be given an appointment to complete their Medicare application by phone or in person at a local SSA office. Clients should be advised to state to SSA, “I am calling because I need to apply for Medicare because HRA/Medicaid is requiring me to.”

Donna Frescatore to Replace Helgerson as State Medicaid Director The Cuomo administration has named Donna Frescatore as the replacement for outgoing State Medicaid Director Jason Helgerson.

Ms. Frescatore currently leads New York State of Health, which is the state’s insurance exchange as part of the Affordable Care Act. She is returning to a role she held in 2010, when she served as Medicaid Director in the Paterson administration.

The state’s Health Commissioner, Dr. Howard Zucker, wrote in a message about the appointment that Ms. Frescatore will continue to serve as Executive Director of New York State of Health. “In light of these and other responsibilities, I expect that she and I would lead a search for a new Medicaid Director in 2019.”

From 2011 to 2013, Ms. Frescatore was the Assistant Secretary for Health in Governor Cuomo’s Office. She first joined the Department of Health in 1998 as the Director of Managed Care Financing. Prior to that, she spent 17 years in the State Department of Civil Service.

HCA has worked with Ms. Frescatore in her past positions and looks forward to engaging with her as the new State Medicaid Director.

Mr. Helgerson announced he would be leaving in April, after the state budget is finished. He came to New York from the state of Wisconsin. His work has included oversight of the Medicaid Redesign Team changes which have had a profound impact on the delivery of home and community-based services, as well as program model and federal waiver changes to remake the health care system through the Delivery System Reform Incentive Payment (DSRIP) program, Value Based Payments (VBP) and other efforts.

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

Volume 3, No. 12 March 19, 2018 

HRA Office Changes The Home Care Services Program’s (HCSP) Central Intake Unit of the New York City Human Resources Administration (HRA) has new telephone and fax numbers.

Effective immediately, the HCSP Central Intake telephone number has been changed to (929) 221-8851; the new fax number is (212) 666-1459.

Calls to the old number, (212) 665-1893, will continue to be forwarded to Central Intake until April 30, 2018 only. After April 30, 2018, all callers must dial (929) 221-8851 in order to reach HCSP Central Intake.

The Unit remains at its current location: HCSP Central Intake, 132 West 125th Street, 5th Floor, NY, NY 10027.

The days and hours of operation are: Monday to Friday, 9 a.m. to 5 p.m. For cases that meet the immediate need processing criteria, the e-Fax number is: (917) 639-0665.

In addition, the HCSP Brooklyn CASA office, at 88 Third Avenue, 3rd Floor, Brooklyn, NY 11238, will be relocated, effective March 26, 2018, to: HCSP Brooklyn CASA, 404 Pine Street, 3rd floor, Brooklyn, NY 11208, with a new telephone number (718) 250-5631 and fax number (718) 250-4380. Operations run Monday to Friday, from 9 a.m. to 5 p.m.

In order to receive Medicaid Alerts and other helpful information from HRA, go to http://a069-marc.nyc.gov/ marc/default.aspx (you must first establish an account).

Value Based Payment (VBP) Update The New York State Department of Health (DOH) has released the “Managed Long Term Care (MLTC) – Use of the Potentially Avoidable Hospitalization (PAH) Measure for VBP Schematic.”

For MLTC plans and VBP Contractors, PAH measures help to assess whether a reduction in potentially avoidable hospital admissions among attributed members in VBP arrangements has occurred. The information depicted in the schematic explains how the PAH measures will be used in VBP. The schematic can be found in the VBP Resource Library at https://www.health.ny.gov/health_care/medicaid/ redesign/dsrip/vbp_library/ (go to VBP Quality Measures and then Measurement Year 2017).

Any questions can be sent to DOH at mltcvbp@health.ny.gov.

OPWDD Announces Public Forums The Office for People With Developmental Disabilities (OPWDD) is holding public forums to discuss its change from the Medicaid Service Coordination (MSC) program to Health Home Care Management beginning July 1, 2018.

As described in last week’s edition of The Situation Report, Health Home Care Management Services will be provided by Care Coordination Organizations (CCOs), new entities formed by existing providers of developmental disability services.

A list of forum dates and contact persons is at https://opwdd.ny.gov/news_and_publications/news/publicforums-now-available-individuals-and-families-learn-more-about-new.

13

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

Volume 3, No. 12 March 19, 2018 

HCA Participates in Central NY HEPC Meeting Last week, HCA participated in the Central New York Health Emergency Preparedness Coalition (HEPC) Full Regional Meeting.

HEPC meetings are held in various regions throughout the state and bring together county, state and local emergency preparedness officials and health care providers to plan and evaluate vital areas of emergency preparedness.

HCA works closely with each HEPC and participates in HEPC planning and local and statewide drills.

HCA encourages all members to get involved with their local HEPC to ensure that home care and hospice issues are addressed by HEPCs, to learn who your critical partners are, and to help fulfill your emergency preparedness responsibilities.

At last week’s Central New York HEPC, the following topics were addressed: lessons learned from the January 25 Coalition Surge Test and Interoperability Communication drill; emergency preparedness provisions in the new Medicare Conditions of Participation; findings of a survey on hazard vulnerability assessment; update on the hospital mutual aid memorandum of understanding; and conducting a business impact analysis.

Some upcoming HEPC meetings include: 

Western New York All-Partners HEPC Sub Regional meeting, March 21, 9 a.m. to 3 p.m.

(Cheektowaga);



Lower Hudson Valley HEPC Sub Regional meeting, March 22, 9 a.m. to 12 p.m. (Carmel); and



Long Island HEPC Sub Regional meeting, March 29, 9:30 a.m. to 12:30 p.m. (Bethpage).

For information on upcoming HEPC meetings, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.

Under a grant from the state Department of Health Office of Health Emergency Preparedness, HCA works with the New York State Association of Health Care Providers to support the roles of home care and hospice providers in emergency preparedness in the entire state.

CMS Posts New Version of Hospice HIS Record Reporting Tool The U.S. Centers for Medicare and Medicaid Services announced that the HART (Hospice Abstraction Reporting Tool) v1.4.0 is now available in the Related Links section on the Hospice Item Set (HIS) Technical Information webpage at https://www.cms.gov/Medicare/Quality-Initiatives-PatientAssessment-Instruments/Hospice-Quality-Reporting/HIS-Technical-Information.html.

HART is a Java-based software application that provides an option for Hospice facilities to collect and maintain facility, patient and HIS Record information for subsequent submission to the appropriate national data repository.

14

Volume 3, No. 12 March 19, 2018

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



Important Upcoming Deadlines

Requirement/Change

Effective/Due Date

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

Still being accepted, https://www.emedny.org/info/ProviderEnrollment/Manag but providers are edCareNetwork/index.aspx advised to submit now

Posting of OSHA Form 300A

February 1 to April 30

https://www.osha.gov/recordkeeping/RKforms.html

CMS Low Volume Appeals Settlement for CHHAs with NPIs ending in an even number

Expression of Interest must be submitted from February 5 to March 9

https://www.cms.gov/Medicare/AppealsͲandͲ Grievances/OrgMedFFSAppeals/AppealsͲSettlementͲ Initiatives/LowͲVolumeͲAppealsͲInitiative.html

Health Care Facility Transformation Program

Applications due March 22, 2018

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

Criminal history record check requirements apply to hospice

April 1, 2018

https://www.health.ny.gov/facilities/home_care/advanced _home_health_aides/docs/ahha_legislation.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/ConflictͲofͲInterestͲComplianceͲ ImplementationͲPlan.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 April 1, 2018 Services under Managed Care

https://www.health.ny.gov/facilities/long_term_care/reim bursement/letters/dal_2017Ͳ12Ͳ07_billing_codes.htm

Community First Choice Option Services Available to Medicaid Managed Care Enrollees

April 1, 2018

https://www.health.ny.gov/health_care/medicaid/redesig n/community_first_choice_option.htm

Healthcare Personnel Influenza Vaccination Report

May 1, 2018 for personnel employed from October 1, 2017 to March 31, 2018

immunize@health.ny.gov or (518) 473Ͳ4437

Changes in appeals system for Medicaid managed care enrollees

May 1, 2018

https://www.health.ny.gov/health_care/managed_care/pl ans/appeals/index.htm

May 16, 2018

https://nyshealthfoundation.org/rfp/2018ͲspecialͲ projectsͲ fund/?utm_source=Reminder+to+Apply%3A+2018+SPF+RF P&utm_campaign=2018+SPF%3A+2nd+Reminder+to+Appl y+%28w%2Fvideo%29+Feb+2018&utm_medium=email

NYS Health Foundation Special Funds RFP

15

More Information

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

Volume 3, No. 12 March 19, 2018 

Resources 

“Ready or Not? Assessing the Capacity of New York State Health Providers to Meet the Needs of Veterans,” by the Rand Corporation https://nyshealthfoundation.org/wp-content/uploads/2018/02/RAND-Ready-or-Not-Veterans-CareMarch-2018.pdf



“Reliance on Unverified Patient Lists Creates a Vulnerability in Home Health Surveys,” by Office of Inspector General https://oig.hhs.gov/oei/reports/oei-05-16-00510.pdf

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

16

HCA ANNUAL MEMBERSHIP CONFERENCE

HCA 2018 Annual Membership Conference HCA: 40 Years Strong May 9-11, 2018 Saratoga Springs, NY The Saratoga Hilton

The last 40 years have been quite a ride for home care.

We saw the birth of the “Nursing Home Without Walls” (aka Lombardi program) in the late 70s, an 80s rise in service capacity fueled by quicker hospital discharges and Medicare eligibility changes, followed by the contracting forces of 90s‐era reimbursement reforms. Promising new technologies, like home telehealth, have since extended in‐home chronic‐care capabilities … and, today, providers are still responding to the sweeping New York State Medicaid Redesign changes of the past couple of years.

Amid these trends – and countless new clinical models, funding battles, and regulatory experiments influencing New York’s home care system – HCA has been at the forefront of policy, education and advocacy, making us truly ‘40 Years Strong.’

Join us for this banner HCA Annual Conference in Saratoga Springs, celebrating our 40th year as an association. We’ll be joined by special guest Bill Dombi, President of the National Association for Home Care and Hospice, as well as other expert presenters offering insights on all facets of home care operations. These sessions, networking opportunities and more will help your organization plan for the future by tackling emerging issues, enhancing your team’s performance, confronting public health and population health challenges, and optimizing your success with some of the biggest changes happening to home care in decades.

May 9 – 11, 2018

1978 HCA is incorporated

1980 Article 40 established for hospice

1982 Katie Beckett Program authorized

THANKS TO ALL OUR GENEROUS SPONSORS!

Exhibitors AETNA BlackTree Healthcare Consulting Byram Healthcare Connect America Complia Health Fazzi Associates Forcura Home Healthcare Solutions, A Cardinal Health Company

Homecare Homebase Mass Mutual/Blue Ocean Wealth Solutions Medtronic Care Management Services, LLC NYSARC Trust Services One Group Quality in Real Time Sandata Technologies Simione Healthcare Consultants TSG Financial

Sponsorship and Exhibitor opportunities are still available. Visit:

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

1

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

Why not use the HCA Annual Conference as an educational retreat for your team?

Let us know if we can help make that happen!

1984 Home Care license created

1985 Home Care Medicaid copayments repealed

HOTEL INFORMATION The Saratoga Hilton, Saratoga Springs, NY is the site of the HCA Annual Conference. Rooms at the Saratoga Hilton are $175 per night. This discounted rate is available until April 7. After this date, higher rates will prevail. Parking is $5 per night. To make a reservation, call 888‐866‐3596.

The hotel’s check‐in time is 4pm and checkout is 11am. Luggage storage is available should your room not be ready prior to check‐in time.

2

1992 State aid to CHHAs for complex, rural, uninsured cases

HCA Annual Membership Conference

AGENDA

May 9 – 11, 2018 Saratoga Hilton, Saratoga Springs, NY

Wednesday, May 9, 2018 9:00am–5:00pm

1:30 – 4:30pm

Welcome Desk Open (Lower Lobby)

HCA Annual Corporation and Board of Directors Meetings

10:00am–12:00pm

Pre‐Conference: Compliance and Finance Considerations for Advanced Home Health Aides The Advanced Home Health Aide (AHHA) regulations go into effect in May of 2018. This new law, which authorizes home health aides to conduct an advanced set of tasks, opens up a whole set of operational and financing questions for providers getting ready to implement this major change in the designation, supervision, task‐ management, assignment, and, of course, reimbursement for AHHA services. With these changes set to go into effect by the end of May, this pre‐conference offers a well‐timed opportunity for provider executives, clinical managers and human resources or operations leaders to get information and insights to fine‐tune your AHHA implementation plans.

10:00am‐11:00am

AHHA Regulations and Compliance Considerations Rebecca Fuller Gray, DOH The state’s top authority on home care regulatory issues will provide an overview of the main compliance requirements that providers must adhere to when planning and operationalizing their use of AHHA services.

All HCA Members are invited and encouraged to attend the Annual Meeting of the Corporation, where members will actually vote on the slate of candidates for the HCA Board of Directors!

The HCA Board of Directors Meeting will follow. This is your opportunity to learn more about the governing body that shapes the direction of HCA policy, education, advocacy and operational priorities. The meeting will include a focus presentation about HCA’s work and research to consider the prospect of an HCA‐led Independent Practice Association (IPA) model for purposes of group contract negotiations.

Such a model has been the subject of recent board deliberations, and this initial research is now ready for a concept briefing to the full membership. Also, guest presenter Greg Olsen, Acting Director of the New York State Office for the Aging (NYSOFA), will meet with the board and discuss his office’s vision for supporting elderly New Yorkers – specifically, how home and community‐based services fit into NYSOFA’s vision and agenda.

4:30 – 6:00pm

Welcome Reception: HCA’s 40th Year Celebration

Rebecca Fuller Gray is Director of the Division of Home and Community‐Based Services at the New York State Department of Health.

Join HCA for cocktails and an opportunity to network with peers and exhibitors as we formally kick‐off our ‘40 Years Strong’ annual conference.

11:00am‐12:00pm

The Reimbursement Plan and Vision for AHHA Services

DINNER ON YOUR OWN

Erin Kate Calicchia, DOH The use of AHHA services will have a significant impact on labor costs and, thus, reimbursement needs. Some of these costs are obvious, and others not so much – from the competitive marketplace dynamics dictating AHHA compensation levels to the added nursing oversight, assessment, and patient education functions that will affect an agency’s bottom line. For this session, HCA has invited the Acting Deputy Director for the Division of Long Term Care to discuss some of the state’s plans for reimbursement changes in response to the new AHHA statute. This session will also offer an exchange of ideas about provider‐anticipated costs that can help inform the state’s reimbursement decisions in light of AHHA.

1995 Consumer Directed Personnel Assistant Program made statewide

Erin Kate Calicchia is Acting Deputy Director, Division of Long Term Care at the New York State Department of Health (Invited).

3

2002

Special rates created for recruitment, training & retention

AGENDA Thursday, May 10, 2018 7:30 – 8:30am

2007 HCA gains home care’s inclusion in palliative care training HCA’s home telehealth law signed

Strolling Breakfast with Exhibitors Enjoy a breakfast buffet and chance to browse the exhibitor hall for nutritional and mental nourishment to start the first full day of our conference.

8:30 – 9:15am

HCA Presidential Address: 40 Years Strong HCA President Joanne Cunningham provides her vision for HCA’s strategic plan to support the membership and advocate on your behalf during her annual address.

9:15 – 10:30am

Building the High‐Trust, High‐Performance Team and Organization Greg Hicks, Researcher, National Best‐Selling Author, and Co‐Founder of FosterHicks The FosterHicks leadership model has been tested and researched by none other than the esteemed Mayo Clinic, which found it to have significant correlations to successful and resilient team building. In this interactive session, the co‐founder of this pioneering leadership model will provide a practical and sustainable roadmap for leaders to create a high‐trust, high‐performance, motivated, and happy workplace culture within their organizations which translates into better care outcomes, efficiency and higher retention rates. These insights have been honed through interactions and training sessions at the Mayo School of Medicine and interviews with thousands of patients, doctors and medical professionals who have helped bring scientific methods to this proven model for successful leadership.

Greg Hicks is a pioneer in the research of individual and group well‐being and leadership; a national best‐selling author; and co‐founder of FosterHicks, a company that helps people and organizations achieve success. Since 1995, Greg and partner, Rick Foster, have traveled to all 50 states, 7 continents, and over 60 countries finding and interviewing people and communities that thrive. This acclaimed research has spawned the FosterHicks system of nine behaviors. Hicks is the author of several books and has teamed up with Stanford neuroscientists and behavioral scientists to bring scientific rigor to his methods. His work and commentary have been featured in the New York Times, Wall Street Journal, and magazines such as Health, Fitness, Self, Good Housekeeping, Fit, Working Mother, Redbook, Prevention, and Readers’ Digest.

10:30 – 11am

Extended Break with Exhibitors Enjoy a morning break and visits with the Exhibitors before you dive into the morning Workshops!

Fashion was a blend of patchwork prints and corduroy jumpsuits in the 70s! Bring a favorite photo of yourself from “the 70s” to share with us at the HCA Exhibit Booth, and we’ll enter it into our “70’s Fashion Contest!” The winner will be chosen based on a vote from our exhibitors. We’ll announce the winner later at the HCA PAC Reception.

Along with bragging rights, the winner will take home a fun 1978 throwback prize! You must be present at the Reception to win.

HCA Annual Membership Conference May 9 – 11, 2018 Saratoga Hilton, Saratoga Springs, NY

4

HCA Annual Membership Conference

AGENDA

May 9 – 11, 2018 Saratoga Hilton, Saratoga Springs, NY

Thursday, May 10, 2018 - continued 11am – 12pm

Breakout Workshops Optimizing Your Business & Technology Processes for CoP Success

What New York Employers Need to Know about Employee Leave

Craig Mandeville, CEO, Forcura and Charles Breznicky, MSN, MBA, Clinical Consulting Manager, BlackTree Healthcare Consulting

Kathleen Russell, PHR, SHRM‐CP, Human Resources and Employee Benefits Consultant, OneGroup Casey Cone, PHR, SHRM‐CP, Senior Human Resources Consultant, OneGroup

The new home health Conditions of Participation (CoPs) are the most sweeping changes in federal home care regulations since 1989, with many complex, interconnected components. While these changes add new tasks and responsibilities for providers, the overall intention is to drive quality in care and, ultimately, eliminate unnecessary procedural requirements.

However, in order to realize these potential benefits and upsides of CoP implementation, home health and hospice organizations must optimize their business and technology processes. Craig Mandeville, Forcura CEO, and Charles Breznicky, Manager of Clinical Consulting for Blacktree Healthcare Consulting, will share industry best‐ practices for adhering to these new requirements with technology today and in the future.

This session will offer an overview of New York’s Paid Family Leave Benefits Law, the Federal Family Medical Leave Act, and New York City’s Paid Sick Leave Law to provide important clarifications of the similarities, differences and interplay between the different leave types that will support your organization’s compliance.

The program will review employer and employee rights and obligations under each law and the impact on your agency’s leave practices and employee handbook policies.

Enhancing Quality of Life for Home Care Workers through an Innovative New Employee Benefits Model Josh Klein, Chief Executive Officer, Royal Care

Attendees will learn: • How to develop a business process to derive value from the revised CoPs. • What to consider in evaluating a technology solution to streamline CoP documentation requirements.

• How some of the larger home health and hospice organizations across the United States are managing these changes.

Your agency’s attention to worker quality of life issues affects staff retention and the stability of home care system services. It communicates to employees that they are valued, and it maintains a positive workplace culture that translates into an effective patient care culture. It’s also the right thing to do. In this session, you’ll hear how one agency created an innovative employee benefits model and supportive facilities and programs with specific goals for improving home health aide workplace quality, supporting work‐life balance and other factors.

Post‐Discharge Medication Reconciliation and High Risk Medications: Processes, Challenges, and Strategies for Home Health Care Anne Myrka, RPh, MAT, Director, Drug Safety, IPRO This presentation is designed specifically for home healthcare services and will: define medication reconciliation as a component of medication management and discuss the impact of discrepancies; define post‐discharge medication reconciliation as a patient safety priority and discuss challenges for home health care; describe the medication reconciliation process and provide strategies for successful implementation of post‐discharge medication reconciliation and medication support; and identify and resolve problems related to high‐risk drugs, with particular focus on opioids and anticoagulants.

2009 HCA gains cost‐ saving flexibility for medication pre‐fills

5

HCA Annual Membership Conference

Thursday, May 10, 2018 - continued

May 9 – 11, 2018 Saratoga Hilton, Saratoga Springs, NY

12 – 1:30 pm

2018 HCA Home Care

Awards Luncheon Since its incorporation in 1978, HCA has recognized home care leaders, direct‐care staff, legislators and policymakers for their commitment to patients and the home care system. These individuals are a big reason why HCA is “40 Years Strong.”

Join us for this special celebration as we present HCA’s annual awards to caregivers, leaders, advocates and exceptional allies, showcasing the acts of compassion, dedication, selflessness and resourcefulness that make us strong together.

To nominate someone for an HCA Award, please visit the conference website at

www.hcaannualconference.com or contact Jenny Kerbein at (518) 810‐0659 or at jkerbein@hcanys.org

1:30 – 2:15pm

Desserts with Exhibitors 6

AGENDA

HCA Annual Membership Conference

Thursday, May 10, 2018 - continued

May 9 – 11, 2018 Saratoga Hilton, Saratoga Springs, NY

2:15 – 3:15pm

Breakout Workshops Reducing Hospital Readmissions in the Elderly Population with Alzheimer's Disease and Related Dementias

Affordable Housing Improves Health Outcomes for Senior Residents Elizabeth Lynn, Assistant Vice President, Grants and Research, Selfhelp Community Services Mohini Mishra, CASP, LMSW, Managing Director of Housing and NORCs, Selfhelp Community Services

Dr. Amy Craven, PT, MS, DPT, Vice President, C&V Senior Care Specialists One in seven hospital admissions attributable to Alzheimer’s disease are potentially avoidable, unnecessarily costing Medicare $2.6 billion annually, according to the Alzheimer’s Association. Because of its effect on memory, thinking and behavior, Alzheimer’s disease can significantly interfere and complicate the management of other chronic conditions, increasing the risk for hospitalizations that may be preventable with proactive care. This presentation will address caregiver education to recognize the behavior issues and teach strategies to deal with those behaviors in ways that can ultimately reduce avoidable hospitalizations, improve patient outcomes, and lower costs. These lessons can be incorporated by your agency’s clinical directors as part of a cohesive approach to managing the risks of Alzheimer’s and other cognitive conditions.

Selfhelp Community Services, Inc., a NYC‐based multi‐ service agency, will describe the successes of its innovative affordable housing model. This model is a key component of Selfhelp’s overall program, which also includes home care, case management, care transitions, senior centers, and social adult day care to support independent living. Its outcomes are shown in a recently completed study suggesting that service‐enriched housing can save money to the health care system.

Selfhelp will discuss the results of this study based on Medicaid data and comparisons of health outcomes for Selfhelp residents and older adults in the same zip codes.

Different Modalities of Telehealth for Chronic Care

Advancing Better Patient Outcomes through Pharmacy‐Home Care Collaboration

Rhonda McGivney, Senior Director, Care Model Innovation, Medtronic Care Management Services

John Croce, RPh and Steve Moore, PharmD, Upstate‐NY Community Pharmacy Enhanced Services Network

Caring for your complex, chronic, co‐morbid population requires having the right patient information, at the right time, to make the right clinical decisions. While the definition of telehealth may vary, telehealth typically has four main modalities: Live Communication, Store & Forward Communication, Remote Patient Monitoring, and Mobile Health. This session will explore these modalities. It will also provide examples – such as linking a patient’s symptom and biometric data with telemedicine capabilities – to show how these modalities can work together in concert to help clinicians become more informed while making care decisions for their patients.

Upstate‐NY Community Pharmacy Enhanced Services Network (CPESN) is a clinically integrated network of community based pharmacies focused on providing enhanced services to health care providers in a collaborative arrangement to optimize medication therapies for shared patients, resulting in positive health outcomes.

The goal of Upstate‐NY CPESN, and its regional counterparts throughout New York State, is to: improve quality of care and patient outcomes related to medication use; enhance patients’ overall health trajectory; and reduce the total cost of care through active partnership with community providers including home care. This session will provide insights on the role pharmacists can play in supporting patient health and highlight ways to build successful collaborations that synchronize with many of the state and federal government provider partnership models, value based payments, and other care‐coordination initiatives.

2009 HCA negotiates insurance coverage for home care discharge 7

2011 HCA‐authored personnel & workplace development program signed into law

AGENDA

HCA Annual Membership Conference May 9 – 11, 2018 Saratoga Hilton, Saratoga Springs, NY

Thursday, May 10, 2018 - continued 3:30 – 4:30pm

Home Care’s Role in Advancing Public Health in New York State Dr. Howard Zucker, MD, JD, Commissioner, NYS Department of Health (Invited) As New York State Health Commissioner, Dr. Howard Zucker is a distinguished leader on public health and program issues that affect all New Yorkers, including many initiatives that hold extraordinary promise for the home care population. These include home care’s work on sepsis intervention (as demonstrated through HCA’s Stop Sepsis at Home initiative) and other core public‐health challenges that home care can – and does – address, such as the opioid crisis and addiction management, asthma, behavioral health and social determinants of health. HCA has invited Dr. Zucker to share his vision for home care as a solution in all of these areas, as well as discuss his specific concerns and ideas about how to positively impact the burgeoning home care workforce shortage.

Dr. Howard A. Zucker is Commissioner of Health for New York State. As the state's chief physician, Dr. Zucker leads initiatives to combat the opioid crisis, strengthen environmental health and end the AIDS epidemic in New York. Since his arrival at the helm of the NYS Department of Health, he has established a network of hospitals equipped to treat Ebola, implemented programs to address the threat of Zika and spearheaded efforts to combat antimicrobial resistance. He is board‐certified in six specialties/subspecialties.

4:30 – 6:00pm

HCA PAC Reception!

Join us for a flashback celebration to 1978 – the year HCA was born!

HCA’s PAC Reception is an annual highlight of our conference, offering fun, laughter, drinks, hors d'oeuvres and a chance to make an impact on the political front by contributing to HCA’s Political Action Committee (PAC).

Sponsored by:

A $50 HCA PAC donation at the door gets you groovin to the hit songs of 1978 – from artists like the Bee Gees , Foreigner, The Who, and the Grease soundtrack! Hustle your way on over to the Springs Lounge for a great kick‐off to a fun evening!

2012 Premium, rate adequacy amendments made for home care, MLTC

2013

Palliative care training support for home care & hospice

8

2015

Governor signs HCA’s Hospital‐ Homecare‐Physician collaboration law

HCA Annual Membership Conference May 9 – 11, 2018 Saratoga Hilton, Saratoga Springs, NY

AGENDA Friday, May 11, 2018 10:00 – 11:15am

7:30 – 8:30am – Breakfast Buffet

Washington Update from Bill Dombi William A. Dombi, Esq., President, NAHC

7:30 – 8:30am

HCA Town Hall Meeting

Bill Dombi is in a class of his own when it comes to knowledge about the federal issues affecting home care and hospice providers. He also has an uncanny ability to communicate about these issues and develop strategies for success. He’s been involved in nearly every major home care and hospice issue over the past 40 years, and has now begun taking on new responsibilities as the recently confirmed President of the National Association for Home Care and Hospice (NAHC). His insights offer a perfect capstone for the conference, drawing on a unique understanding of home care’s place in the last 40 years as well as where it is headed in an environment of political upheaval, Medicaid funding threats, the near‐certain prospect of a Home Health Groupings Model or other similar payment overhauls, the pivot toward uniform post‐acute care payment methodologies, and the continued struggles with federal regulatory burdens like Medicare face‐to‐face, limits on home care ordering and referring practitioners, as well as other issues at the focus of his attention.

HCA’s Town Hall Meeting is a casual, unscripted, no‐agenda panel session where you can ask the HCA team any questions on your minds about home care policy, regulations, reimbursement issues and advocacy positions, or to make recommendations for ways we can better support you. This is your chance to hear what’s on the HCA work plan, tell us what issues are keeping you up at night, and engage in a free‐rolling dialogue that better keeps us connected with your needs and concerns.

8:45 – 9:45am

Strategies to Recruit and Retain Quality Employees Eric Scharber, Principal, Simione Healthcare Consultants Question: Who knows best why people leave a job? Answer: The person who helped them find a new one! This presentation will provide words of wisdom from a successful recruiter about retaining key employees, which is among the top concerns for health care executives these days, especially in home care.

Attendees will also hear examples of successful strategies – as well as not‐so‐successful ones – as you work to attract top‐tier talent. You’ll also gain an overview of workforce trends specific to the home care and hospice industry that can help you get a handle on your workforce retention plan.

Bill Dombi is President of the National Association for Home Care & Hospice (NAHC). He previously served as the Vice President for Law at NAHC. Dombi specializes in legal, legislative, and regulatory advocacy on behalf of patients and providers of home health and hospice care. With nearly 40 years of experience in health care law and policy, Bill Dombi has been involved in virtually all legislative and regulatory efforts affecting home care and hospice since 1975, including the expansion of the Medicare home health benefit in 1980, the formation of the hospice benefit in 1983, the institution of Medicare PPS for home health in 2000, and the national health care reform legislation in 2010.

Eric Scharber is a Principal at Simione Healthcare Consultants, leading talent acquisition and employee retention efforts for the home care and hospice industry through Exact Recruiting, a Simione Talent Solution. He oversees executive search and non‐ executive recruiting services, as well as recruitment process outsourcing, compensation analysis and employee satisfaction survey services.

11:15am – Conference Adjourns

9:45 – 10:00am – Break

2017 HCA launches emergency preparedness sessions statewide

2017

NYS Health Foundation grant bolsters HCA sepsis effort

9

2018 Join us on May 9 – 11 to discover what’s ahead for your HCA Membership!

40th ANNUAL MEMBERSHIP CONFERENCE May 9 – 11, 2018, Saratoga Hilton, Saratoga Springs, NY

Conference Registration Form NAME ______________________________________________________________

TITLE ____________________________________________________

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

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How to Register

Please check one:

Return this completed registration form with your payment by fax to (518) 426-8788 or mail it to: HCA, 388 Broadway, 4th Floor, Albany, NY 12207. You may duplicate this form for additional attendees. Please save a copy for your records.

_____Check* Make payable to: HCA Education and Research and mail to: 388 Broadway, 4th Floor, Albany, NY 12207 Checks must be received by April 30th ________MasterCard

________Visa

________American Express

Registration Fee Please indicate your registration choice(s):

Credit Card No.________________________________________________ Name on Card_________________________________________________ Expiration Date __________________ Security Code _________________ _____________________________________________________________ Billing Address for Card _____________________________________________________________ City, State, Zip Authorized Signature____________________________________________

Cancellation Policy: We encourage you to attend the full three day conference for the best value. No credits can be given for meals not taken or unattended education programs. Cancellations received by April 18 will receive a full refund, less 25% of total due as an administrative fee. Cancellations received on April 19 or later will forfeit their registration fee, as will those who register and do not attend.

Substitutions are permitted.

Full Conference Registration Options • HCA Provider Member Primary Registration - Additional Registrant from Same Provider Member

$599  $549 

• Non-Member Provider

$749 

• HCA Vendor/Associate Member

$729 

• Non-Member Vendor

$879 

Note the following with your registration: I will attend Wednesday’s Pre-Conference Session (Included in my registration above)

Yes  No 

I will attend the PAC Reception (Personal donation to be submitted separately.)

Yes  No 

Pre-Conference Session Only • HCA Member

$139 

• Potential HCA Member

$239 

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

FAX THIS FORM TO (518) 426-8788

TOTAL DUE:

$_________

388 Broadway Fourth Floor Albany, New York 12207

40th ANNUAL MEMBERSHIP CONFERENCE May 9 – 11, 2018 TO: