May 8, 2017 Edition of the Situation Report

FLU MASKS

PERSONAL CARE RATES

NPR REPORT

WOMEN’S SUMMIT

Now that flu season is officially over, the mask requirement is no longer in effect.

The state Department of Health has posted the interim fee-forservice personal care rates with details on the reimbursement calculations.

HCA was interviewed last week by NPR’s national show “Marketplace Weekend Edition” about the serious implications of workforce shortages in home care.

Remember how great last year’s women’s summit was?

It’s back again in June, so be sure to register today!

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COMING UP Moving Beyond Personal Care to Meet the Challenge & Opportunities of Value-Based Care New York City, NY May 18, 2017 Second Annual Women in Healthcare Leadership Summit Saratoga Springs June 7-8, 2017 For more information on these and other programs, please visit the education and events section of HCA’s website at http://hca-nys.org/ events-education/ upcoming-events

Your Source for HOME CARE News, Policy and Advocacy

Vol. 2, Issue 19 | May 8, 2017

House Passes ACA Repeal-Replace Bill Fate of measure uncertain in Senate The U.S House of Representatives last week rebooted efforts to repeal and replace the Affordable Care Act (ACA), voting 217 to 213 on a new bill that broadly reflects, with adjustments, many of the themes incorporated in a prior, stalled, repeal-and-replace attempt.

Much like its predecessor from several weeks ago, the new bill would: eliminate the tax subsidies underpinning ACA; claw back See HOUSE p. 5

Enjoyed HCA’s Annual Conference last week? We have pictures on pages 13-14. Also, please see information about our next exciting signature conference, the second annual Women in Healthcare Leadership Summit on June 7-8. Details are on page 7.

HCA, Members Weigh-in at DOH Statistical Report Workgroup Meeting LHCSA member feedback sought On May 1, HCA participated in the first meeting of the state Department of Health’s (DOH’s) Licensed Home Care Services Agency (LHCSA) Statistical Report Workgroup.

According to DOH, the goal of the workgroup is to “redesign and restructure the report to increase the timely and accurate submission of information by identifying areas of reporting that can be streamlined to increase compliance and accuracy in data reporting.”

See REPORT p. 2

INSIDE House Passes ACA Repeal-Replace Bill…............................................................1 HCA, Members Weigh-in at DOH Statistical Report Workgroup Meeting…...........1 A Message from HCA Sponsor Sandata…..............................................................3 Flu Mask Requirement No Longer In Effect….........................................................4 Change in Payment to Medicare Managed Care Providers…................................4 Member Hiring Announcement…........................................................................5 DOH Posts Initial 2017 Personal Care Rates…......................................................6 NPR Brings HCA’s Voice on Workforce Issues to National Audience....................….6 Second Annual Women in Healthcare Leadership Summit............................…7 Make Your Emergency Preparedness Plan CoP-Ready on June 28.......................…8

PERM Reviews on Improper Medicaid Payments to Occur Soon........................…9 New Webinar on Financial Management Aspects of the New OASIS C2................9 Due Date for FLSA Attestations Changed to June 9…..........................................10 Update on Fiscal Intermediary Authorization Process…...................................11 Congressman Adriano Espaillat V isits Homebound VNSNY Patient...................12 Annual Conference Award Winners and Photo Gallery............................13-14 HCS Access Changes.......................................................................................15 New Process to Access NYSE-CON.....................................................................16 Guidance Issued on CDPAS Provided Out-of-State..........................................…16 Funding Available for Air Conditioners..............................................................17 Resources…...........................................................................................................17

The Situation Report: the Home Care Association of New York State  REPORT from p. 1 The goals of the workgroup are: 

Increase the compliance rates for the LHCSA Statistical Report (last year only about 54 percent of agencies completed and submitted the entire report);

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Capture data relevant to service delivery;

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Ensure quality data is collected in a timely manner;

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Ensure terminology in the report is used universally across the industry; and

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Streamline data reporting.

The meeting was attended by DOH staff, provider associations and a number of HCA members (representatives from Any-Time Home Care, Bestcare, Partners in Care, People Care, and the Visiting Nurse Service of Rochester and Monroe County).

DOH reviewed the low rate of LHCSA report completion and the workgroup discussed some reasons. DOH said it has taken enforcement actions against the 350 LHCSAs that have not submitted any of the forms or submitted only the LSR1-Agency Form.

DOH also examined the Statistical Report forms and went over missing data, internal inconsistencies, and “reasonableness failures” (negative numbers in the wages column, very large numbers, etc.).

DOH stated that it uses the Statistical Report data to: formulate policies; identify potential workforce shortages and assist in developing methods to attract and retain home care workers; track trends; determine if agencies are serving the counties they are authorized to serve; and determine if agencies are providing all of the services they are authorized to provide.

DOH suggested some additional items to add to the report, including: number of worker’s compensation cases; any employer pension plans; access to care measures; reasons for not being able to accept a case; and transportation issues.

The Workgroup discussed ways to streamline the Statistical Report, including combining the Report with a soon to-bedeveloped LHCSA Medicaid Cost Report. HCA recommended 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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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 Jenny Kerbein Director of Governance & Special Projects jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org

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that DOH hold a webinar to review the Statistical Report each time it is released and DOH agreed to do so.

At HCA’s suggestion, DOH also agreed to share with the associations a list of those LHCSAs who did not submit the Report.

DOH stated that it has already released a draft managed care cost report data element to supplement the state’s Medicaid Managed Care Operating Report (MMCOR) and it plans to release a draft LHCSA Cost Report in July (HCA had already asked DOH for an opportunity to review any draft LHCSA Cost Report and will advocate for this again). These actions were announced during earlier discussions with the associations around state funding for the recent minimum wage increases.

DOH requested written feedback on the LHCSA Statistical Report prior to its next meeting on June 7 and also said it is open to additional interested LHCSAs participating in the Workgroup. HCA has already communicated with its LHCSA members about reviewing the Report and sending us their comments. We will A message from HCA sponsor Sandata hold a conference call on May 23 to discuss the Report. DOH intends to release the 2016 Statistical Report in August; it will be similar to the 2015 Report. DOH hopes to incorporate changes to the 2016 Report in time for the 2017 Report that will come out in summer 2018.

The LHCSA Statistical Workgroup was an outgrowth of a Task Force charged by the Governor to work with labor and community organizations, businesses and business coalitions and other advocacy groups in certain industries where workforce vulnerabilities exist.

According to its 2016 report (https:// www.governor.ny.gov/sites/governor.ny.gov/ files/atoms/files/EWTF_Report_7-2016_Final.pdf), the Task Force will explore enhancing enforcement of wage standards in the home health care industry.

A representative from DOH’s legal department spoke about the Task Force and said that it is concerned with the lack of compliance with the statistical reports, especially as it relates to wages and hours worked.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org, or Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

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Commissioner Declares End to Flu Season, Mask Requirement No Longer In Effect New York State Health Commissioner Dr. Howard A. Zucker, M.D., J.D., has declared that influenza is no longer prevalent in New York State for the 2016-17 influenza season, as of May 4, 2017.

Accordingly, at this time, section 2.59 of the New York State Sanitary Code (10 NYCRR § 2.59) no longer requires all health care and residential facilities and agencies regulated pursuant to Article 28, 36, or 40 of the Public Health Law to ensure that all personnel must wear a surgical or procedure mask while in areas where patients or residents are typically present if the personnel have not been vaccinated against influenza. This declaration shall remain in effect until the Commissioner declares influenza to be prevalent in New York State.

Frequently Asked Questions regarding the regulation and other resources are available at http://health.ny.gov/FluMaskReg. For more information, please direct questions to FluMaskReg@health.ny.gov.

Change in Payment to Medicare Managed Care Providers The state Department of Health (DOH) has revised the Medicaid reimbursement methodology for claims containing Medicare Part C (Medicare Advantage managed care) co-payment and/or co-insurance liabilities.

Retroactive to July 1, 2016, Medicaid will no longer reimburse the full Medicare Part C copay or coinsurance amount. The 2016 change to Social Services Law regarding Medicaid payment of Medicare Part C copay or coinsurance will: 

Be implemented on or about May 25, 2017 by New York State Medicaid;

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Reimburse 85 percent of the copay or the coinsurance;

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Affect both institutional and professional claims, as well as pharmacy claims for drugs and supplies when submitted via a National Council for Prescription Drug Programs (NCPDP) transaction or as a professional claim; and

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Will be retroactive to July 1, 2016.

At the time of implementation, providers will be informed via eMedNY, and eMedNY will begin reprocessing claims retroactively to July 1, 2016, using the new methodology. There will be no change to the reimbursement of the Medicare Part C deductible. Medicaid will continue to reimburse the full deductible. There will be no change to Medicare Part C inpatient claims.

The provider is required to accept the Medicare Part C health plan payment and any Medicaid payment as payment in full for the service. The consumer may not be billed for any Medicare Part C copayment or coinsurance amount that is not reimbursed by Medicaid.

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HOUSE from p. 1 the Medicaid expansions elected by states like New York; and set in motion a schedule of tax credits for individuals procuring insurance on the private market, eliminating the mechanism of the governmentadministered health insurance marketplace exchanges set forth by ACA. Similar provisions were contained in a prior repeal-and-replace bill that House Republicans set-aside six weeks ago as it became clear that the House didn’t have the votes to get it passed then.

It appears that a mix of substantive changes and political persuasion helped draw support of the new bill from Republicans who were divided between representatives of the Freedom Caucus (seeking more aggressive funding changes) and moderates concerned about the loss of coverage for citizens and/or the political ramifications of coverage changes.

The most consequential change in the new bill, intended to garner conservative support, is a controversial provision that would eliminate requirements for coverage of essential benefits, and give states the freedom to allow insurers to charge more for pre-existing conditions.

Of major concern to home care in New York, and to the overall Medicaid program in the state, is a provision to “block-grant” the federal Medicaid allotments given to states. Instead of an open-ended entitlement, matched by a cost-share from the federal government, states would receive a lump-sum payment to use for their Medicaid programs. For New York State, this could put a multi-billion-dollar hole in the state’s finances, which would require the state to meet this fiscal deficit by pursuing other revenue sources to meet its existing Medicaid service levels (i.e., plan and provider payment reductions) or changes in benefits that could reduce access to care.

As reported in the April 24 edition of The Situation Report, HCA joined a major, broad, multi-sector coalition of some 30 organizations in health care to oppose the bill.

Given the stakes for New York’s budget, Governor Cuomo joins many of his peers in opposing the effort as well, as the outcome has largely fallen along partisan lines.

The bill faces an uncertain future in the Senate which has a tighter margin of votes and likely resistance from the more moderate wing of the Republican caucus who are expected to advocate changes from the House bill.

HCA will continue to keep you informed of all significant developments as we work with our federal lobbyist, Brett Heimov of Envision Strategy, to continue relaying our objections and gaining updates from the Hill.

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DOH Posts Initial 2017 Personal Care Rates The state Department of Health (DOH) recently posted the initial 2017 Medicaid fee-for-service (FFS) rates for Personal Care programs outside of New York City.

The initial Personal Care rates reflect a zero “roll” factor adjustment as well as an overall zero trend factor for the rate period January 1, 2017 through December 31, 2017. Furthermore, the final 2017-18 state budget eliminated the possibility of any Medicaid trend factor through March 31, 2019.

DOH also issued a Dear Administrator Letter (DAL) that accompanied the initial rates. The DAL for Personal Care rates provides additional information on the statewide aggregate Administrative and General (A&G) cap, which is limited to no more than 28 percent of total costs. The A&G cap specifically for consumer directed services continues to be 18 percent. The DAL also discusses aide and training ceilings; criminal history record check reimbursement; capital costs; profit/surplus percent; worker recruitment and retention adjustment add-on of 8.16 percent; and the rate appeals process.

Also included in the 2017 recruitment and retention percentage add-on of 8.16 percent is the adjustment to reimburse non-NYC personal care providers for the uniform additional hourly Fair Labor Standards Act (FLSA) add-on amount as determined in the FLSA adjustment rates effective October 13, 2015.

Effective October 13, 2015, $0.34 was added to the personal care rates which was reimbursed as part of the Recruitment and Retention percentage of 8.70 percent for the 2015 rate. Because the 2017 rates are based on the agencies’ 2015 cost reports, approximately 2.5 months of increased FLSA costs are already included in the base year cost data. Consequently, the recruitment and retention percentage for non-NYC personal care rates for 2017 has been revised to 8.16 percent (9.5 X 12 months (8.70%-6.08%) + 6.08%).

However, DOH notes that the final 2017 recruitment and retention allocation percentage may be adjusted at the completion of the 2017 hotline rate process, based on the latest complete 2015 cost report information.

HCA expects that the final 2017 Personal Care rates for January 1 through December 31, 2017 will be posted to the Medicaid Management Information System (MMIS) sometime during the late second or third quarter of 2017.

For rate questions, non-NYC Personal Care and Consumer Directed members can e-mail DOH at: Bltcr-pc@health.ny.gov.

NPR’s Marketplace Brings HCA’s Voice on Workforce Issues to National Audience The National Public Radio (NPR) program “Marketplace Weekend Edition” reached out to HCA last week about the serious workforce infrastructure challenges in home care.

This issue has gained national prominence, in part due to a recent public hearing by the state Assembly’s core committees on Health, Aging, Labor and the Task Force on People with Disabilities, chaired by Assembly Health Committee Chairman Richard Gottfried. HCA Executive Vice President Al Cardillo testified at the hearing, prompting the NPR interview request.

In the interview, Mr. Cardillo described the stresses of workforce recruitment and retention challenges on: workforce continuity; the patient experience of care; and system costs, especially at a time of continued,

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enormous fiscal pressures on the home care industry. These pressures all coincide as the need “far exceeds the number of workers,” Mr. Cardillo said. He provided concrete examples of ways in which workers need to be matched to the individual and his or her specific care needs, amid the workforce shortage.

“What we find in our own statistical observations is that recruitment is a challenge but retention is an even greater challenge in many areas,” Mr. Cardillo says in the report, “so it’s really important for the system to be structured to support workers in many ways in the work that they do in this field,” including social supports, given the demands of the work. He also stressed the toll of informal caregiving on families who have stepped in to fill the access gap – an unrecognized burden in discussions about access and costs that is not wholly visible or accounted for in the data on workforce needs.

One prong of HCA’s state budget advocacy this year included a provision to initiate a stakeholder process to examine and promote a multi-factorial approach on the workforce issues affecting home care throughout the state. While the provisions were among many that did not get included in an unusually fitful budget negotiation process this year, home care workforce issues remain a priority of HCA’s post-budget advocacy and our continued talks with the Legislature and Governor’s office from multiple angles.

You can listen to the full NPR report at https://www.marketplace.org/2017/05/05/health-care/home-healthaide-shares-her-experience-caring-others.

Second Annual Women in Healthcare Leadership Summit Own Your Voice: Leading with Strength, Certainty & Style June 7-8, 2017 Excelsior Springs at the Courtyard Marriott 47 Excelsior Avenue Saratoga Springs, NY 12866 Building on the success of last year’s inaugural program, HCA is excited to present the second annual Women in Healthcare Leadership Summit on June 7-8 to help women leaders from across the health care spectrum cultivate their unique talents and strengths as leaders.

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Were you among the number who attended last year's Summit?

Be sure to join us again this year, and bring a colleague!

The Situation Report: the Home Care Association of New York State Continued from previous page Hear from women executives, leadership consultants and other engaging presenters who will help you leverage tools and insights for professional advancement, enhance your potential for leadership growth, and further develop your talents as women leaders in health care.

More information, including online registration and a full conference brochure are at the links below.

Download the brochure: http://hca-nys.org/wpcontent/uploads/2017/04/ HCA-Women-InHealthcare-LeadershipSummit-Brochure2017.pdf Register online: https:// tinyurl.com/l5n6p5a

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Make Your Emergency Preparedness Plan CoPReady on June 28 The new federal Conditions of Participation (CoP), along with a separate federal rule, have established sweeping new emergency preparedness requirements for 17 types of providers, including home care and hospice – an historical first!

This regulation goes into effect on November 16, despite a delay in other CoP provisions for home health, requiring providers to plan adequately for natural and manmade disasters, with a specific focus on patients and employees.

On June 28, in Suffern, NY (conveniently located for upstate and downstate agencies alike), HCA is hosting RBC President and emergency preparedness expert Barbara Citarella for a comprehensive workshop to assist agencies in: understanding the four major components of this regulation; planning for continuity of operations (COOP); operationalizing policies and procedures; communication; and conducting/testing a training program related to your emergency plans.

An agency’s entire emergency plan must be built on a hazard vulnerability assessment platform using an all-hazards approach to ensure continuity of services to patients. In addition, planning and communication should include a collaborative partnership with a health care coalition. This session will focus on the major components of COOP and its correlation to the new Emergency Preparedness regulations.

Learn more and register by downloading the form at http://hcanys.org/wp-content/uploads/2017/04/Make-Your-EP-Plan-CoP-ReadyJune-28-2017.pdf.

Make Your Emergency Preparedness Plan CoP-Ready!

June 28, 2017 Crowne Plaza Hotel 3 Executive Boulevard Suffern, NY 10901

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PERM Reviews on Improper Medicaid Payments to Occur Soon

New Webinar on Financial Management Aspects of the New OASIS C2

The U.S. Centers for Medicare and Medicaid Services (CMS), with the state Office of the Medicaid Inspector General (OMIG), will be measuring improper payments in the Medicaid and State Child Health Insurance programs under the Payment Error Rate Measurement (PERM) program. This will be the fourth time New York State will be participating. The state last participated in federal fiscal year 2014.

Webinar is open to all, but is free of charge to members who attended HCA’s Senior Financial Managers Forum in April

Documentation for medical review of randomly selected home care and other health care claims will be requested by Chickasaw Nation Industries (CNI) Advantage, LLC, the new CMS review contractor. If claims you submitted are selected, the CMS contractor will request from you, in writing, documentation to substantiate claims paid in federal fiscal year 2017 (October 1, 2016 to September 30, 2017).

You will be asked to submit copies of the specific medical documents for the patient, as requested in the letter you receive from the CMS contractor. Copies must be sent directly to the CMS contractor with a second copy to OMIG. For home care providers, this can include: physician orders; physician certifications/ recertifications; initial/intake assessment; nursing care plan; home health aide notes; therapy assessments; and others.

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On May 11, HCA is offering a unique webinar opportunity for all members, but it’s free of charge for those who attended or paid for our April Senior Financial Managers Forum. The webinar, on Financial Management Aspects of the New OASIS C2, was originally scheduled as part of the April Forum; but flight delays prevented our speaker from presenting.

This is why HCA has invited Melinda Gaboury – a favorite national speaker and the cofounder and Chief Executive Officer of Healthcare Provider Solutions, Inc. (HPS) – to present the session as a webinar on May 11, free for those who attended the Senior Financial Managers Forum, as well as for a small fee open to all other registrants.

All health care finance managers know the important connection between clinician activities and budgeting. Now that the OASIS C2 is in effect, this parallel understanding of clinician assessment procedures and their cost impact will help drive top-to-bottom improvements in the function and efficiency of your organization.

Requests for documentation are expected to be sent in the next two months and will cover claims paid between October 1, 2016 and September 30, 2017. Requests and subsequent receipt or non-receipt of documentation will be tracked. Failure to provide requested records will result in a determination of erroneous payment and OMIG may pursue recovery of payment for this claim.

During this webinar, Ms. Gaboury will review how to calculate the HHRG, corresponding HIPPS code and determine case-mix weight, all of which are fundamental to a home care agency’s operationwide understanding of the clinician’s role in patient care and financial outcomes. The webinar will also establish processes that agencies need to strengthen regarding OASIS-C2 completion and review, as well as the specific OASIS-C2 M items that have a direct impact on patient outcomes and costs.

Questions can be directed to OMIG PERM Project staff at (518) 402-7041, (518) 474-3499 or PERMNY@omig.ny.gov.

Learn more and register at http://hca-nys.org/wpcontent/uploads/2017/04/Financial-Mgmt-Aspectsof-New-OASIS-C2-Webinar.pdf.

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Due Date for FLSA Attestations Changed to June 9 As announced to members at last week’s HCA Annual Conference and a follow-up e-mail alert, the state Department of Health (DOH) announced that it has delayed the due date for the Fair Labor Standards Act (FLSA) attestations from May 5 until June 9.

It is our understanding that the attestation due date was delayed to allow DOH to address certain issues raised by plans and providers.

In mid-April, DOH had posted guidance on funds intended for use in meeting the 2015 FLSA changes, including an April 2017 Dear Colleague Letter on FLSA Implementation and accompanying attestation forms available at https://www.health.ny.gov/health_care/medicaid/redesign/ fair_labor_standards_act.htm.

The April 14, 2017 DOH letter states that DOH has included FLSA-intended funding in both the April 2016 and October 2016 managed long term care (MLTC) premium rate packages. DOH further states that the “per hour” amount for fee-for-service providers was factored into rate adjustments, retroactive to October 13, 2015.

For purposes of this guidance, providers are defined as Licensed Home Care Services Agencies (LHCSAs), Certified Home Health Agencies (CHHAs), Long Term Home Health Care Programs (LTHHCPs), and Consumer Directed Fiscal Intermediaries (FIs) for both managed care and fee-for-service.

DOH is requiring that plans and providers alike sign and submit attestations by June 9, 2017 directly to the Department (FLSA@health.ny.gov). DOH strongly encourages providers to also send their attestations to their contracted managed care plans. Plans are directed by DOH to distribute and obtain all signed attestations from their contracted providers and retain them for their records. The submitted attestation, according to DOH, confirms that funds received were disbursed in compliance with its letter.

HCA has significant concerns regarding this guidance as it raises issues and complications for plans and providers. HCA has requested a meeting with DOH to discuss our concerns and the significant confusion and difficulties the letter has generated for plans and providers.

These funds are intended to cover the following FLSA-related costs:

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Requirements to pay overtime at time-and-a-half of the aide’s regular rate of pay instead of timeand-a-half of the minimum wage.

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Pay for travel expenses.

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Pay for more than 13 hours on 24-hour/live-in cases if the aide did not receive at least 8 hours of sleep, including at least 5 uninterrupted hours of sleep, and at least three hours for meals/breaks.

As we’ve reported to members, and discussed at length during last week’s HCA Annual Conference, the wage calculations for 24-hour/live-in cases are the subject of recent litigation on which HCA is likewise engaging vigorous advocacy efforts.

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Continued from previous page HCA will continue its aggressive advocacy on this important issue and will communicate new information regarding this guidance as it becomes available. Comments can be communicated to the HCA policy team at akoski@hcanys.org. In addition, questions for DOH staff should be e-mailed to FLSA@health.ny.gov.

Update on Fiscal Intermediary Authorization Process DOH has advised HCA that “new” Fiscal Intermediaries who want to provide services (for the first time) under the Consumer Directed Personal Assistance Program (CDPAP) will have to initially obtain “authorization” from the state under a recent provision of the final state budget.

Existing FIs, however, can continue to provide such services and accept new cases.

DOH intends to issue guidance pending the outcome of subsequent post-budget legislation, described below, which could impact the FI authorization language in the budget.

Background During budget discussions, when this authorization concept was first proposed, HCA advocated for changes in the proposal to streamline such an authorization process for Licensed Home Care Services Agencies (LHCSAs), in recognition of the fact that they already met many of the new requirements. We also pushed for a reasonable time period to allow existing FIs to continue to operate before they had to obtain the state’s authorization.

While the one-house Assembly and Senate budget bills both included a one-year “grace period” to allow existing FIs to obtain such authorization, the final budget did not include this language or our other suggested revisions and, instead, applied the authorization process to existing and new FIs as of April 1, 2017.

HCA is supporting legislation (S.5544/Hannon/A.7216 Gottfried) that would move the effective date of this new requirement to January 1, 2018 and provide a one-year grace period so that entities operating as FIs prior to April 1, 2017 could continue to provide services without any interruption to patient care during the time that they sought to obtain this newly required DOH authorization.

S.5544 passed the Senate Health Committee last week and was reported to the Senate floor, while A.7216 passed the Assembly Health Committee last week and was reported to the Assembly Ways and Means Committee.

HCA will keep members informed of any new developments with DOH’s treatment of the FI authorization process as well as any changes that may culminate from the legislative process.

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Congressman Adriano Espaillat Visits Homebound VNSNY Patient The following story was contributed by Visiting Nurse Service of New York who responded to a request from Congressman Adriano Espaillat, facilitated by HCA and our federal lobbyist Brett Heimov, to host a home care visit. We thank VNSNY and Rep. Espaillat for this excellent exchange and demonstration of caregiving in action. We also encourage other HCA members to let us know if you’d like to arrange a home care visit, or if we can assist in supporting these kinds of events, which are vital in educating and reinforcing knowledge about home care.

As Lorenzo Nieves sits in his wheelchair, Soraya Gomez, a nurse with the Visiting Nurse Service of New York (VNSNY), stands by his side. A short time earlier, she had checked Nieves to make sure no worrisome symptoms had arisen since her previous visit. Now she kept watch over her patient as he chatted with his guest: Congressman Adriano Espaillat, who represents New York’s 13th District—an area stretching from Manhattan’s Upper West Side and Harlem up through Washington Heights in northern Manhattan and a slice of the Bronx.

The fact that Rep. Espaillat can visit Mr. Nieves in his apartment is a win for everyone. Mr. Nieves has multiple chronic conditions which place him at high risk for hospital admission. In July 2016, after yet another of his many inpatient stays, he was referred to VNSNY’s adult care program. Since then, his health has improved substantially thanks to the ongoing care coordination provided by nurse Gomez, combined with the Activities of Daily Living (ADL) assistance provided by the personal care worker from VNSNY CHOICE Managed Long Term Care (MLTC) health plan, which administers his adult care program.

Working together, the interdisciplinary care team has kept Mr. Nieves safely at home and out of the hospital for almost a full year. “He used to go the hospital once a month,” said Gomez. ”But since

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Rep. Adriano Espaillat, VNSNY patient Lorenzo Nieves and VNSNY nurse Soraya Gomez. (Photo courtesy of VNSNY). we took on his care, he hasn’t had to go to the hospital once.”

Rep. Espaillat noted that home- and community based health services like those provided by VNSNY are essential in helping his constituents and other New Yorkers sustain their daily lives in the face of challenging medical issues. Last year, approximately 15,000 residents of his district received home care services through VNSNY, and 13,000 of his constituents participated as members of the VNSNY CHOICE MLTC health plan. Another 1,000 residents of the district received VNSNY home hospice services during that time.

“I’m grateful to VNSNY for the high quality care it provides to residents like Mr. Nieves, throughout the 13th district and in communities around New York State,” Rep. Espaillat said. “VNSNY provides a broad range of invaluable home health care services to residents, especially to our seniors and individuals in need.”

The visit over, Rep. Espaillat thanked Mr. Nieves for the opportunity to visit and thanked nurse Gomez for the excellent care she was providing to his constituent. “I was delighted to visit with Mr. Nieves,” added the Congressman, “and I’m committed to ensuring that we enact policies in Congress that continue to address and support the need for quality, cost-effective professional home care that benefits us all.”

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

Volume 2, No. 19 May 8, 2017 

HCA extends a big congratulations to our Annual Award winners, pictured above with their colleagues, family and HCA staff at last week’s award ceremony in conjunction with HCA’s Annual Conference. Counterclockwise from top left are: Caring Award winner Amy Bowerman, Director of Patient Services/Director of Quality Home Care Services, at VNA of Utica/Senior Network Health MLTC; Caring Award Winner Eileen Crawford, Home Health Aide at Visiting Nurse Services in Westchester; Advocacy Award Winners from the clinical team at Mid-Hudson Regional Certified Home Health Services of Westchester Medical Center; Advocacy Award Winner Russell Lusak, Senior Vice President at Selfhelp Community Services; and Ruth F. Wilson Award Winner Sara Butterfield, Senior Director, Health Care Quality Improvement at IPRO. Read more by downloading the awards program at http://hca-nys.org/ wp-content/uploads/2017/05/2017-Awards-Program.pdf.

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

Wage Parity Certification Forms Due March 1

Annual Conference Photo Gallery Just a few of the many moments caught on camera from last week’s HCA Annual Conference Above: HCA President Joanne Cunningham Leads a panel discussion with her counterpart home care association executives from other states about “what’s keeping us awake at night” in the home care policy, program, regulatory, financial and management arena. From left are Timothy Rogers, President and CEO, Association for Home & Hospice Care of North Carolina; Pat Kelleher, Executive Director, Home Care Alliance of Massachusetts; and Bobby Lolley, RN, Executive Director, Home Care Association of Florida.

Top Right: Dr. Bernie Lee, Associate Chief Medical Officer at Metropolitan Jewish Hospice and Palliative Care, discusses medical marijuana.

Middle Right: Morris (Moe) Auster, Senior Vice President for Legislative and Regulatory Affairs with the Medical Society of the State of New York (MSSNY), discusses collaborative work with HCA and home care during HCA’s Annual Conference Board of Directors meeting.

Bottom Right: New Yorker staff writer and Author Kathryn Schulz discusses insights from her book Being Wrong: Adventures in the Margin of Error.

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Volume 2, No. 19 May 8, 2017 

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

Volume 2, No. 19 May 8, 2017 

HCS Access Changes: Service Now Requires Specific Operating Systems, Browsers Please share this information with your IT staff to facilitate necessary upgrades The Health Commerce System (HCS) will be discontinuing access for computers running Windows XP and Microsoft Internet Explorer 9 (IE9) and older web browsers because, according to the state Department of Health (DOH), they pose a security risk to HCS applications.

Windows XP users must upgrade their operating system and IE9 users must upgrade their browser by June 1, 2017 to continue using the HCS, as the HCS will block connections from computers running Windows XP and IE9 browsers (or older versions).

HCS access is required for all providers. Lack of access will affect your ability to: comply with New York State Public Health and Education laws; obtain critical information and data; and receive HCS technical support.

Without the correct operating systems or browser, you will not be allowed access to the following specific HCS applications:      

The Health Electronic Response Data System (HERDS); The New York State Immunization Information System; Evacuation of Facilities in Disasters System (eFINDS); Patient narcotic histories (i-STOP/PMP); E-Prescribing waivers; and other mission-critical applications.

If you are using Windows XP or IE9, you must upgrade your PC to a modern, secure operating system as soon as possible, and upgrade your IE9 or older web browser. DOH suggest that you perform the following actions to upgrade your PC and browser: 1. OPERATING SYSTEM: To upgrade to a current Windows operating system, visit http:// www.microsoft.com to determine if your computer can be upgraded. To upgrade, follow the instructions on the Microsoft website. Please note that Windows 10 users will still need to use Microsoft Internet Explorer 11 or Google Chrome, given that most HCS applications do not yet support the Microsoft Edge browser, which is the default browser for Microsoft 10.

2. BROWSER: If you are not sure which Internet browser you are using, visit http:// whatsmybrowser.org to determine your browser and version.

On the Windows platform, the HCS currently supports Microsoft Internet Explorer and Google Chrome, and offers partial support for Mozilla Firefox. You may download the latest version of these browsers from the following links: Microsoft Internet Explorer: http://windows.microsoft.com/en-us/internet-explorer/download-ie Google Chrome: https://www.google.com/chrome/browser/desktop/ Mozilla Firefox: https://www.mozilla.org/en-US/firefox/new/

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

Volume 2, No. 19 May 8, 2017 

Continued from previous page Users of MacOS, OSX, Windows 7, Windows 8, or Windows 10 and users of Google Chrome, Microsoft Internet Explorer 10 or newer, or Safari on the Mac platform, are not affected by this change.

Please contact hcsxpeol@health.ny.gov for questions or assistance.

If necessary, please also share this information with your IT departments or vendors so that they can facilitate any necessary upgrades throughout your organization.

New Process to Access NYSE-CON Since April 28, 2017, there is a new account-creation and sign-in process to access the Public Authenticated portal of the New York State Electronic Certificate of Need (NYSE-CON) system.

Prior to April 28, applicants used their state Department of Health (DOH) Public User ID or Health Commerce System (HCS) User ID to log into NYSE-CON via the Public Authenticated portal. Beginning April 28, 2017, this method of public sign-on was replaced by NY.gov, a cross-agency, single sign-on process which permits individuals, business, and organizations to securely access multiple government online services.

The first time you attempt to access the Public Authenticated NYSE-CON system on or after April 28, 2017, you will be redirected to the NY.gov website where you must create a NY.gov account (if you don’t already have one) and log in.

During the initial sign-on, you will be prompted to link your DOH Public ID with your new NY.gov account. If you have open and active CONs that were submitted through Public Authenticated NYSE-CON, you must follow the instructions at http://hca-nys.org/wp-content/uploads/2017/05/NYgovInstructions.pdf to access those projects. The instructions also have information for creating your new NY.gov account and linking your current Public Authenticated NYSE-CON projects.

Your initial sign-on to NY.gov will be your only opportunity to automatically link your CONs to your new NY.gov account. The opportunity to automatically link your CONs will only be available for 60 days.

Therefore, you must create your new NY.gov account and link your existing DOH Public ID account within 60 days from April 28, 2017. Afterward, you will not be able to see your projects without contacting the Bureau of Project Management at (518) 402-0911 for assistance.

If you have questions about the process, call the Bureau of Project Management at (518) 402-0911.

Guidance Issued on CDPAS Provided Out-of-State The state Department of Health (DOH) has posted guidance on the authorization protocol for consumers in the Consumer Directed Personal Assistance Program (CDPAP) who attend an out-of-state college.

The instructions are at https://www.health.ny.gov/health_care/medicaid/publications/docs/gis/ 17ma006.pdf.

Continued on next page

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

Volume 2, No. 19 May 8, 2017 

Continued from previous page While the guidance covers the procedures that consumers, fiscal intermediaries (FIs) and local Departments of Social Services must take when a consumer pursues education outside of New York, it may be helpful for those FIs who have questions about providing CDPAP services to someone who temporarily leaves the state.

The guidance includes a mailbox to send questions (services@health.ny.gov), and HCA suggests that inquiries go there (and copy Andrew Koski at akoski@hcanys.org).

Funding Available for Air Conditioners The state has announced that $3 million is available for individuals with serious health issues to receive assistance to purchase air conditioners through the Home Energy Assistance Program (HEAP).

Individuals eligible for assistance can apply at their local department of social services (http://otda.ny.gov/ programs/heap/contacts/) beginning May 1.

To qualify, applicants must meet existing HEAP guidelines (http://otda.ny.gov/programs/heap/), which vary by household size, and have at least one member of the household that suffers from a documented medical condition exacerbated by extreme heat. Households that already have a working air conditioner less than five years old, and households that have received a HEAP-funded air conditioner within the past 10 years, are not eligible.

Cooling assistance will be provided on a first-come, first-served basis. Local departments of social services will accept applications through August 31, or until funding runs out.

Resources 

“Facts for Features: Older Americans Month: May 2017,” by the U.S. Census Bureau https://www.census.gov/content/dam/Census/newsroom/facts-for-features/2017/cb17-ff08.pdf



“Strategic Assessment of New York State’s Regional Population Health Investments,” by the NYS Health Foundation http://nyshealthfoundation.org/uploads/resources/strategic-assessment-new-york-state-regionalpopulation-health-investments-may-2017.pdf



“Benefits Checklist for Older Adults,” by the Brookdale Center for Healthy Aging https://brookdale.org/tools-resources/benefits-checklist/



“Medicaid Personal Care Services: More Harmonized Program Requirements and Better Data Are Needed,” by the U.S. Government Accountability Office http://www.gao.gov/assets/690/684424.pdf



“Medicaid Demonstrations: Federal Action Needed to Improve Oversight of Spending,” by the U.S. Government Accountability Office http://www.gao.gov/assets/690/683888.pdf Continued on next page

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

Volume 2, No. 19 May 8, 2017 

Continued from previous page 

“Quality Measurement Approaches of State Medicaid Accountable Care Organization Programs,” by the Center for Health Care Strategies http://www.chcs.org/media/QM_Medicaid-ACOs_matrix__050217.pdf



“State Strategies: Value-Based Payment for Medicaid Populations with Complex Care Needs,” by the Robert Wood Johnson Foundation http://www.statenetwork.org/wp-content/uploads/2017/04/Value-Based-Payment-Models_4.10.pdf

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

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June 7 & 8, 2017 Excelsior Springs at the Courtyard Marriott 47 Excelsior Avenue Saratoga Springs, NY 12866

The Second Annual

Own Your Voice: Leading with Strength, Certainty & Style

The Second Annual

Own Your Voice: Leading with Strength, Certainty & Style

Building on the success of last year’s inaugural program, HCA is excited to present the second annual Women in Healthcare Leadership Summit on June 7-8 to help women leaders from across the health care spectrum cultivate their unique talents and strengths as leaders.

Hear from women executives, leadership consultants and other engaging presenters who will help you leverage tools and insights for professional advancement, enhance your potential for leadership growth, and further develop your talents as women leaders in health care.

June 7 & 8, 2017

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

The Second Annual

Wednesday, June 7, 2017 Courtyard by Marriott Saratoga Springs Canfield & Carousel Rooms (Main Hotel – lower level) 5:00 – 7:00 PM

Tell Me About It: Networking & Cocktail Reception Mix and mingle with like-minded power-house women in the healthcare industry while you enjoy hors d'oeuvres, a cocktail (or two) and peruse items from Stella & Dot and LuLa Roe.

Finding your fit… Brassiere Consultation We women spend a lot of time, effort and money to look professional and polished, yet many of us have never invested in a custom bra fitting! Here is your opportunity to get measured and pick up a high-quality bra that fits you perfectly and helps you look your best! Don’t miss this opportunity to discover a healthier, more stylish and COMFORTABLE fit for this everyday necessity. Consultations provided by Madame Pirie: www.madamepirie.com

Inspiring & Indulgent Door Prizes We will be hosting pop-up prize drawings throughout the event starting with our networking reception giving you the opportunity to win one of our inspiring and indulgent door prizes, but you must be present to win!

The Second Annual

Thursday, June 8 Programming will be held in the Excelsior Springs Building located at 47 Excelsior Avenue.

8:00-9:00AM

Women of Influence Networking Breakfast 9:00 – 9:15 AM

HCA President’s Welcome 9:15-10:45AM

Staying the Course: Leadership Through Challenge & Uncertainty Panel Discussion – Presenters TBA As leaders and executives, we all face challenges that teach us lessons about our strengths and weaknesses and, most importantly, how to improve and advance.

Listen to this panel of dynamic women leaders in the health care field who have climbed the executive ladder and learned valuable leadership lessons along the way.

Hear insights, strategies and lessons learned that will enlighten and equip you to face your own challenges and difficulties head on.

10:45-11:00AM

Break 11:00-Noon

DIY Leadership Edition: Use Existing Skills & Resources to Customize Your Own Leadership Experience Katherine Detwiler, Strategic Alliances Manager, Relias Learning Founder & Co-Chair, Relias Women’s Leadership Initiative President, NC Triangle Chapter of Ellevate In an ongoing study by leadership consultancy Zenger Folkman, women are consistently rated by their peers, bosses, direct reports and other associates as better overall leaders than their male counterparts. Further, two of the measures on which women outscore men to the highest degree — taking initiative and driving for results — have long been thought of as particularly male strengths.

While the lack of gender diversity in leadership remains one of the biggest challenges for organizations, our opportunities to lead don’t have to depend solely on corporate structure or title changes! In this interactive session, find out how to uncover leadership opportunities where you are right now, leverage existing resources at work and in your community, and create your own path to becoming the leader you are meant to be.

Noon-1:30PM

Networking Luncheon & Leadership Roundtables Enjoy a sumptuous lunch with your colleagues as you explore a leadership topic of your choice such as managing work/life balance, the rewards of joining a board, negotiating compensation, engaging men in the advancement of women leaders, and more.

Katherine Detwiler is passionate about the transformative power of lifelong learning and committed to the holistic and patient-centered missions of home care and hospice. Raised on several continents including Africa and Europe, her professional background includes a degree in education as well as 10 years of home care experience with multiple software companies, in a variety of roles ranging from support to process improvement and business development.

As Strategic Alliances Manager at Relias Learning, Ms. Detwiler leverages her passions for education and the home care / hospice industry by building relationships that make meaningful education readily accessible to all learners. Ms. Detwiler also serves as President of the NC Triangle Chapter of Ellevate: a global professional women's network dedicated to helping women advance in the workplace, both for themselves and the greater good.

The Second Annual

Thursday, June 8 – continued 1:30-3:30PM

DO less and BE More— Courageous Leadership Corey Jamison, President & CEO, Corey Jamison Consulting Courageous leadership calls us to a higher level of competence and commitment to serve people and organizations. It calls us to do less, and BE more. It calls us to be COURAGEOUS as women, leaders, team members and human beings, in good and challenging times.

With the pressure of external forces on healthcare we are all facing, a Transformational Leader mindset is essential to positioning the right people, to do the right work at the right time in our organizations. Transactional Leaders manage process, Transformational Leaders focus on effectively leading, engaging and inspiring human beings at all levels so that they can sustain momentum, change and evolve to serve our clients with the highest level of care.

Join us for this thought provoking, interactive (and FUN!) session where we will explore our own courage to live and model the 3 Key Practices of Transformational Leaders.

3:30-4:00PM

Laughter Recharges Us – Plus, Chicks are Funny!

Professional women today are juggling their careers along with the needs of loved ones, personal commitments and community responsibilities. With so many serious responsibilities, we all need to laugh with each other to unwind, recharge and refresh. Comedienne Erin Harkes will round out the Women’s Leadership Summit with some humor we can all relate to, keeping you laughing on your drive home.

4:00PM

Closing Remarks and Adjournment

Corey Jamison brings more than 25 years of experience partnering with executives and teams around the globe to drive dramatic, sustainable organizational transformation. She has worked with leaders at all levels of some of the largest brands, and offers a level of experience, acumen, partnership, and courage that inspires leaders and teams toward the hard work of taking it to the next level. Corey is a world-class facilitator who can turn even the most challenging teams toward shared accountability and new levels of productivity. She is a dynamic and sought-after speaker and appears frequently at professional conferences and seminars. In addition, Corey has been interviewed and quoted by National Public Radio, Good Morning America, and the New York Times.

Corey received a bachelor’s degree from Vassar College and a master’s degree in education from Fitchburg State College. She is a doctoral candidate in psychology at Walden University.

The Second Annual

Courtyard by Marriott Saratoga Springs 11 Excelsior Avenue Saratoga Springs, NY 12866 Phone: (866) 210-9325 HCA has reserved a limited block of rooms at the Courtyard by Marriott Saratoga Springs for the night of Wednesday, June 7th at a discounted rate of $159 per night. To receive this special rate, please call (866) 210-9325 prior to Wednesday, May 10th and ask for the Home Care Association of NYS group rate.

$159/night The new state-of-the-art lobby at Courtyard by Marriott Saratoga Springs provides greater flexibility and choices for their guests, including spaces to work or relax in, free Wi-Fi throughout and easy access to the latest news, weather and airport conditions via the GoBoard. The highlight of the new lobby experience is The Bistro - Eat. Drink. Connect. which provides guests with healthy food and beverage offerings in the morning and evening dinner service with cocktails. The hotel is just a few minutes walk to downtown Saratoga. The hotel offers complimentary local shuttle service, a well equipped fitness center, indoor pool and whirlpool. A 24-hour business center and boarding pass printing service are also available and train access is nearby.

The Second Annual

June 7 & 8, 2017

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

REGISTRANT INFORMATION – Please register by May 25.

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

HCA REGISTRATION FEE HCA encourages participants with advanced level leadership experience to serve as a ‘mentor’ for a colleague who is a high-potential leader and invite them to join you at the summit at a discounted ‘mentee’ rate. Each mentor may sponsor up to 5 mentees at the discounted rate.

□ HCA Member/Mentor $279 per person $___________ □ HCA Member/Mentee $229 per person $___________ Mentee Name(s):_______________________________________

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

PAYMENT – Please check method of payment: _______VISA

______American Express

______Check*

*Make checks payable to: HCA Education and Research and mail to 388 Broadway, 4th Floor, Albany, NY 12207. Checks must be received by June 5. _____________________________________________________________________________ Card Number _______________________________________ Expiration Date

HCA registration cancellations received by May 26 are refundable less a 25% administrative fee. No refunds will be issued after this date.

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

Substitutions are permitted.

□ Non-Member/Mentor $379 per person $___________ □ Non-Member/Mentee $329 per person $___________ Mentee Name(s):_______________________________________

________MasterCard

HCA Cancellation Policy

_________________________________ Security Code

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

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

_______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________

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

388 Broadway Fourth Floor Albany, New York 12207 Ph (518) 426-8764 W www.hca-nys.org