May 15, 2017 Edition of the Situation Report

DATA

MLTC DEVELOPMENTS

HEALTH ADVISORY

EP

Members-only data page now has 2015 Cost Report Data spreadsheets.

MLTC Forum call and DOH meeting address key MLTC finance, eligibility, benefit and regulatory issues.

DOH sends advisory on drugresistant yeast that poses major health risks to patients with multiple underlying conditions.

HCA invites members to register for conference delving into intricacies of the new federal emergency preparedness rule.

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Your Source for HOME CARE News, Policy and Advocacy

Vol. 2, Issue 20 | May 15, 2017

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

HCA Gains Introduction of PhysicianHomecare Collaboration Legislation Senate Health Committee Chairman Kemp Hannon has introduced new HCA legislation that would facilitate physician-homecare collaboration for primary care, public health and medical management.

The new bill, S.6345, written by HCA, would add these physician-home care collaborative programs See LEGISLATION p. 4

Women Mentors & Colleagues: Special Discount and More for June Health Care Leadership Summit Skilled leadership at all levels is vital to the success of your agency in today’s complex health care environment. Research shows that women’s representation in leadership positions, especially, leads to marketplace and performance success.

See MENTORS p. 2

INSIDE HCA Gains Introduction of Physician-Homecare Collaboration Legislation...1 HCA Voices Support on CoP Delay Rule.........................................................1 Special Discount for June Healthcare Leadership Summit............................1 LHCSA Statistical Workgroup Update...........................................................6 HCA Data Webpage Hosts 2015 CHHA, LTHHCP Cost Report Data...................7 HCA Member Hiring Announcement............................................................7 MLTC Holds MLTC Forum Call-In Meeting to Discuss Developments..............8 HCA Stresses Requirements and Limits of New Offsite Clinic Services Law....10

HCA Voices Support on CoP Delay Rule HCA has submitted comments in support of a proposed rule by the U.S. Centers for Medicare and Medicaid Services (CMS) that would delay the effective date for the implementation of changes to the Conditions of Participation (CoPs) for home health agencies from July 13, 2017 to January 13, 2018.

HCA also voices support for: the proposal to delay implementation of the CoPs’ quality assessment and performance improvement See DELAY p. 3

DOH Health Advisory: Multidrug-Resistant Yeast Candida auris................11 Get Your Preparedness Plan CoP-Ready on June 28....................................12 Guidance Issued on In-Service Training for Aides..........................................13 NYC Legislation Signed to Limit Salary History Information...........................15 CMS Extends Deadline for Home and Community-Based Settings Rule..........16 UAS Version 1.3 To Be Released....................................................................17 New Mobile App for Older Adults................................................................17 HRA Medicaid Renewal Process Changes...................................................18 Agenda Posted for PHHPC Establishment and Project Review Meeting.........18 Resources..................................................................................19

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

 MENTORS from p. 1 Developing your internal talent has never been more critical to your agency’s future. HCA’s Women in Healthcare Leadership Summit on June 7-8 in Saratoga provides the opportunity to recognize and cultivate your agency’s internal talent.

To encourage such engagement, HCA is offering a special mentor/ mentee discount rate for your advanced level leadership to serve as a ‘mentor’ for other high potential leaders in your organization, enabling them to foster a positive and lasting catalyst for growth and development.

Up to five ‘mentees’ can accompany a mentor to the summit at a discounted rate.

Please click the links below for more information and online registration for this exciting conference which offers networking opportunities and insights from nationally recognized women in health care.

Download the brochure: http://hca-nys.org/wp-content/ uploads/2017/04/HCA-Women-In-Healthcare-LeadershipSummit-Brochure-2017.pdf Register online: https://www.eventville.com/Catalog/ EventRegistration1.asp?EventId=1012182

Volume 2, No. 20 May 15, 2017 

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

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

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Teresa Brown Administrative Assistant tbrown@hcanys.org

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Volume 2, No. 20 May 15, 2017 

 DELAY from p. 1 (QAPI) requirement from January 13, 2018 to July 13, 2018; and to not apply new home health agency administrator requirements in cases where administrators are employed by home health agencies (HHAs) prior to January 13, 2018 (instead of July 13, 2017).

In our comments (available at http://hca-nys.org/wp-content/uploads/2017/05/Medicare-CoPs-proposedrule-delay_comments_final_051117.pdf), we state: The final CoP changes are very comprehensive and necessitate HHAs to make major changes in many aspects of their operations. They include an array of new requirements and revised procedures related to: nursing, therapy and aide services; supervision; assessments; patients’ rights; care planning; quality improvement; clinical records; agency structural requirements; governance; management; and other provisions that dictate the operation and function of HHAs certified by Medicare (and Medicaid).

Along with HHAs needing further time to implement these changes, state survey departments need adequate time to review and understand CMS’s Interpretive Guidelines (which have not been issued yet) and train their staff. Subsequently, HHAs will need this additional time to understand their compliance obligations as well as how state surveyors will interpret and enforce the Interpretive Guidelines.

HCA has been advocating strenuously for a CoP delay. In March, New York Congressman John Faso issued an HCA-suggested letter to CMS calling for a six-month delay in the final Medicare home health CoP changes, and CMS shortly thereafter proposed such a delay.

As reported by HCA in numerous communications, the CoP revisions are the most extensive changes in Medicare home health regulations in over 20 years, affecting all aspects of an agency’s operation. HCA was the first state or national home care association that publicly called for a delay in the CoPs, and was quickly joined by dozens of state home care associations across the nation and then later by the National Association for Home Care and Hospice.

HCA spent much of January and early February educating Members of New York’s Congressional Delegation, including Rep. Faso, to seek a delay. (Please see our January 2017 briefing paper on this issue at http://hcaannualconference.com/wp-content/uploads/2017/03/CoPDelayJanuary2017.pdf.)

Rep. Faso’s letter to CMS, asking specifically for an extra six months, can be read at http:// hcaannualconference.com/wp-content/uploads/2017/03/FasoLetterCoPDelay.pdf.

We greatly appreciate Rep. Faso’s efforts, and encourage members to submit comments in support of the CoP delay. The proposed rule, along with submission information, is at https://www.gpo.gov/fdsys/pkg/ FR-2017-04-03/pdf/2017-06540.pdf.

HCA has already provided comprehensive education on the CoP changes and will provide additional programs in the future.

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

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 LEGISLATION from p. 1 to the Hospital-Homecare-Physician Collaboration law (PHL 2805-x). That law, also written by HCA, was passed by the Legislature in 2015. It facilitates and promotes provider collaborations through regulatory and procedural streamlining and flexibility. Through this new bill, the flexibility mechanisms in 2805-x would extend to the new physician-homecare collaborative provisions. This section of law also creates provisions for supportive funding as may be made available through the budget or other sources, and this would open the same future funding windows to the new physician-homecare collaboratives.

This legislation follows our efforts in this year’s budget process to facilitate home care’s participation in new models of care, such as value based payment, ACOs, DSRIP, bundles and other integrated models that are essentially structured on the physician-homecare relationship. In the now post-budget period, this legislation approaches the goal through a more direct, physician-homecare partnership design.

New state, federal and industry-led reforms are heavily focused on providing care and management in the community for patients across the continuum of need, with goals of improved quality, cost-effectiveness and reductions in preventable hospitalizations, emergency room use long term institutionalization and other high-cost medical services. A major impediment in home care participation is the overburden of the fee-forservice regulations that lay over providers and their potential partners, and that are not aligned with these models. This legislation would address those overburdens as they specifically relate to home care’s work with physicians in providing primary care, public health and medical management. These would be physician care plan cases assisted by home care; traditional home care cases where patients are formally admitted to home care are not the subject of this proposal (though regulatory streamlining at the state and federal levels is likewise warranted for traditional

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care as well). Prime examples of physicianassisted services envisioned under such partnerships are: 

Home care’s assistance with effective care transitions;

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In-home follow-ups to physician visits to check status/progress of the patient’s condition or medical intervention;

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In-home evaluation of a homebound or clinically frail patient in lieu of transport to the physician’s office or other out-ofhome medical setting, or for a prompt evaluation to avert deterioration or injury, and/or a home environmental assessment to evaluate for and/or mitigate medical risks associated with asthma, falls, or other patient health factors; and

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Provision of population health services, including, but not limited to, immunization, public health screening or medication review.

HCA will be further vetting this proposal with HCA members, partners at the State Medical Society (including our joint physician-home care taskforce), other physician representatives (e.g., the American College of Physicians, advanced primary care practices), and other strategic partners. HCA intends to further shape the current bill language to achieve our desired goal of facilitating physician-homecare service arrangements, and will keep members closely apprised of the developments.

This is major and potential game-changing opportunity for home care. For further information, please contact Al Cardillo at acardillo@hcanys.org.

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The Situation Report: the Home Care Association of New York State Continued from previous page More on HCA’s Bills and Other Post-Budget Legislation A host of additional bills directly or indirectly related to home care have been introduced by the legislature post budget. Some of these are HCA-drafted bills, others have been introduced based on priority input we have provided, and still others have been separately formulated by the individual legislative members or other entities of interest.

HCA will be providing further descriptions, analyses and updates on these and other new introductions, and advise on grassroots member advocacy, as the developments warrant. Summaries are below: Calculation of hours for 24-hour home care aides – A.7488 (Thiele) This legislation seeks to clarify the state policy on payment for live-in home care workers. The bill has been referred to the Assembly Labor Committee. It would provide that home care aides be paid for 13 hours per 24 hour period, provided that the employee is afforded: a) adequate sleeping facilities; b) 8 hours for sleep; c) at least 5 hours of uninterrupted sleep; and d) 3 hours for meals. The bill would essentially codify in statute what have been the state Department of Labor (DOL) guidelines for payment of live-in workers, as disputed via litigation and recent court rulings, extensively reported on by HCA. HCA is aggressively pursuing state remedy to this major priority concern, and will press for support at all levels, including legislation, action by DOH and DOL, and other means. The consequences of this issue are far-reaching for patients, providers, MLTCs, workers and the state.

Collaborative Programs for Community Paramedicine (S.5588 Hannon/A.2733-A Gottfried) This legislation would allow for a collaborative model of community paramedicine to be operated under partnerships comprised of a hospital-homecare-physician-EMS model. All partners would need to come together to design, establish their procedures for and operate the program. All current areas of licensure (home care, hospital, practitioner) would be maintained by this bill. This HCA co-drafted legislation is current the focal point for ongoing negotiations to see if an

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agreeable bill can be done this session. S.5588 is currently reported to the Senate Calendar; A.2733-A is referred to the Assembly Health Committee.

Home Health Information and Clinical Technology Act (S.5674 Hannon/A.5046-A Gottfried) This HCA-drafted legislation provides for comprehensive state fiscal and policy support for health information technology, health information exchange and clinical technology for home care and managed care. S.5674 is referred to the Senate Health Committee; A.5046-A has been reported to the Assembly Committee on Ways and Means.

Fiscal Intermediaries for Consumer Directed Personal Assistance Services (S.5544 Hannon/ A.7216 Gottfried) This legislation would delay until January 1, 2018 the date for a new Fiscal Intermediary to have to obtain state authorization for participation in the Consumer Directed program, and delay for up to one year authorization of existing Fiscal Intermediaries under the new authorization rules enacted in this year’s state budget. S.5544 has been reported to the Senate Calendar; A.7216 has been reported to the Assembly Committee on Ways and Means.

Modernization of Third-Party Coverage for Home Care A.00054 (Cahill) This HCA-drafted bill would update the current coverage terms for home care under state law, and bring private insurance coverage for home care in synch with home care’s current need and use in the overall health care system. This bill has been referred to the Assembly Insurance Committee.

For further information, please contact the HCA Policy staff.

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

Volume 2, No. 20 May 15, 2017 

LHCSA Statistical Workgroup Update HCA is making available materials distributed by the state Department of Health at the LHCSA Statistical Workgroup meeting held on May 1.

The materials are at http://hca-nys.org/wp-content/uploads/2017/05/LHCSA-Statistical-Report-workgrouphandouts_051017.pdf.

As reported in last week’s edition Situation Report, DOH has established a workgroup to streamline the LHCSA Statistical Report so that more agencies will complete it. This will allow DOH to obtain information needed to: formulate policies; identify potential workforce shortages and assist in developing ways to attract and retain home care workers; track trends; determine if agencies are serving the counties they are authorized to serve and if they are providing all of the services they are authorized to provide.

The workgroup meeting materials provide a review of the Statistical Report forms, including the topics and rates of completion; enforcement actions taken against agencies that did not complete it; issues with the information submitted; how the data is used; and additional topics.

At the first meeting, HCA and other provider associations and a number of HCA members (Any-Time Home Care; Bestcare; MZL Home Care Agency; Partners in Care; People Care; and the Visiting Nurse Service of Rochester and Monroe County) made a number of suggestions to improve compliance. DOH is open to additional agency members being part of the workgroup; those HCA members who are interested can contact HCA’s Andrew Koski at akoski@hcanys.org.

HCA has reached out to our LHCSA members for suggestions on ways to improve the Statistical Report before the next workgroup meeting on June 7, and HCA will also hold a conference call on May 23 to review the current Report.

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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Volume 2, No. 20 May 15, 2017 

HCA Data Webpage Now Includes 2015 CHHA & LTHHCP Cost Report Data This week, HCA posted to our HCA Data website an HCA-developed spreadsheet of the 2015 Medicaid Cost Reports for all non-hospital-based CHHAs and LTHHCPs operating in the state.

HCA Data is a members-only page that provides data reports to assist home care and hospice providers and managed care plans in their benchmarking efforts, understanding of system-wide trends, and access to reimbursement and premium rates. The page is not visible on our site unless you are logged in with an HCA member website account.

Our log-in page is here: http://hca-nys.org/login. Upon login, using your member username and password, the HCA Data link will appear in the site menu at the top right. You can also enter your e-mail address to obtain your password. Or, simply e-mail HCA’s Communications Director Roger Noyes at rnoyes@hcanys.org if you do not yet have an HCA website account.

HCA has also just received word from the state Department of Health (DOH) that the Department will only release the annual Medicaid Managed Care Operating Reports (MMCORs) to the Records Access Officer after the Office of Health Insurance Programs (OHIP) has completed the audit and filings are officially closed for submission. Quarterly MMCORS will be released no earlier than 45 days after the due date.

While we have submitted an official freedom of information law (FOIL) request for the fourth quarter 2016 MMCORs for each MLTC and Program of AllInclusive Care for the Elderly (PACE) plan in the state, we do not expect to receive our data request until late July or August.

Once received, HCA will prepare a spreadsheet summarizing key MMCOR data, including such items as: plan enrollments; permember-per-month premium revenue and premium income; unit costs; and other information.

HCA Data currently has 2015 MMCOR data available to members.

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

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DIRECTOR OF CLINICAL PRACTICE AND INNOVATION OVERVIEW: VNA Home Health is a CHHA providing services in Albany and surrounding counties.

At VNA Home Health, you will have a unique opportunity to apply your transformative skills to lead a caring, professional team.

We are seeking a dynamic homecare leader to fill the position of Director of Clinical Practice and Innovation. Reporting directly to the CEO, this senior leader will be responsible for overseeing the delivery of all Nursing, Rehabilitation, Social work, and home health aide services. He/she will develop and execute innovative clinical models and programs to promote excellence in clinical practice, optimal patient outcomes, and successful positioning for new and innovative reimbursement models; as well as lead the development of strategies to expand clinical programs and promote growth QUALIFICATIONS: We are looking for someone with strong organization, management, and communication skills, along with enthusiasm and creativity. The successful candidate must have a Baccalaureate Degree in Nursing, Master’s Degree in nursing or related field highly desirable; a current NYS RN license and a Minimum of five (5) years Supervisory/ Management experience, two (2) of which should be in Community Health. VNA Home Health is proud to offer an excellent compensation and benefits package including competitive salary, health/Dental and vision insurance, paid time off, life insurance and 403 (b) with employer match. Relocation Expenses are included. Candidates meeting the desired qualifications are encouraged to submit a cover letter, resume/CV and salary requirement to careers@vnaalbany.org.

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

MLTC Holds MLTC Forum Call-In Meeting to Discuss Developments HCA member MLTCs participated in an HCA call-in last week to discuss post-budget fiscal, program and legislative issues, along with several new HCA-led initiatives.

We discussed: 

The Department of Health (DOH) administrative cuts and actions affecting MLTCs, including several new insights and concerns about the lack of information on the scope, timing and methods of DOH’s rollout.

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The budget “side-letter” committing DOH to examine potential enhancements in MLTC financing through distinct rate cells for nursing home and high-cost enrollees. We discussed how these rate fixes could leverage our aims in overall discussions with state officials on payment adequacy and recognition of mounting state mandates, cuts and underfunding.

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The new state mandate for authorization of Fiscal Intermediaries (FI) for Consumer Directed Personal Assistance Program (CDPAP) enrollees, along with a post-budget bill to delay and stagger the implementation of these standards for existing and new FIs.

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The impact of a recent court case (Tokhtaman) affecting state Department of Labor (DOL) payment guidelines for live-in cases.

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A DOH advisory (DHDLTC DAL 17-04) mandating (effective May 15) hospital referral of Health Home-eligibles to these homes.

Eligibility includes Medicaid enrollment and: 1) two or more qualifying chronic conditions; or 2) one single qualifying condition of HIV/AIDS or serious mental illness; or 3) Health and Recovery Plan enrollees. Participants

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discussed concerns on the impact and added layers into the delivery system and referral process.

A host of additional issues were held for the next MLTC meeting, which HCA plans to schedule after the upcoming DOH managed care and value based payment meetings. These include new legislation; a new MLTC-Provider “Five Star Quality” initiative; enrollment problems with Maximus previously referred to DOH by HCA; new opportunities in Health Information Technology being advanced by HCA; Community First Choice Option implementation issues for MLTC/PACE; the status of uniform billing codes; and others.

Community First Choice Option (CFCO) Steering Committee HCA and members of the DOH Steering Committee on the CFCO option in mainstream plans, MLTC, and Programs of All-inclusive Care for the Elderly (PACE) also convened.

A primary focus and concern continues to revolve around the definition of each CFCO service – particularly social transportation – and sufficient parameters to determine the range, content and scope.

The committee also discussed how to best incorporate the array of CFCO services – e.g., moving assistance – which are not provided by Medicaid providers, but, rather, by various companies or organizations in the community.

HCA Executive Vice President Al Cardillo, who serves on the steering committee, cited the analogous services historically provided under the state’s waiver programs, principally the Long Term Home Health Care Programs (LTHHCP). To date, some MLTCs contract with LTHHCP providers for the full array of health services, analogous to CFCO, allowing an MLTC to contract with one entity, which then either

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directly provides or obtains and manages the subcontracts with the array of community support services.

Mr. Cardillo encouraged plans to consider existing waiver providers, LTHHCP providers, certified and licensed home health agencies for these roles. He also offered ideas for establishing service parameters. The plans asked DOH to invite the associations to work with the department toward this goal, which DOH expressed openness to do.

DOH Monthly MLTC Meeting Last week concluded with DOH’s monthly managed care planning meeting focused on finance and rate-setting developments, among others.

In recognition of National Nurses Week, the staff at HCR Home Care recently honored home care icon Lillian Wald, who is buried in the Rochester area.

HCR has assisted with the upkeep of Wald’s grave – planting flowers and maintaining the grounds – for more than 30 years. The organization also held a separate remembrance ceremony at its patient memorial garden to honor HCR patients who have passed away or touched the lives of staff members.

Wald is a Rochester native. She championed nursing education and a variety of social issues. Her Henry Street Settlement in New York City was a precursor to the Visiting Nurse Service of New York.

MLTCs raised extensive “Many of us in the nursing profession are deeply indebted to Lillian Wald, and questions and concerns with we are honored to follow in her footsteps,” said Elizabeth Zicari, President of DOH’s plans to impose HCR Home Care and a member of HCA’s Board of Directors. “HCR will continue “efficiency” modifications to to pay tribute to her memory and her legacy as our company’s mission is built MLTC rates. DOH was nonon her commitment to preventive health care and the preservation of health.” definitive on aspects of this evolving plan, and acknowledged many of the points and recommendations being made particularly by MLTC financial officers at the meeting. DOH indicated that these would be further considered as the department’s analysis and planning move forward.

MLTC rate components were discussed in detail, including the presence or limitation of adjustments for the minimum wage, wage parity and Fair Labor Standards Act mandates.

Much concern was expressed regarding the mixed communications from DOH over the inclusion of funding to pay for the new wage parity mandate for Consumer Directed Personal Assistance Program (CDPAP) personal assistants. It had been previously announced that $18 million in funds (combined state and federal) had been included in the new state budget for this new mandate. However, after indicating that funds were to be provided, DOH announced, and reaffirmed at last week’s meeting, that DOH had determined MLTCs could make these payments without addition of these moneys. MLTCs

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raised objections, including the overriding concern that mounting unfunded mandates and cuts risked compromising MLTC fiscal stability and the ability to make adequate payments generally.

DOH offered some positive news regarding the MLTC Quality Incentive Payment program. DOH reported that while it planned a $30 million reduction in this year’s allocation to the MLTCs as a state budget cut, (from $150 million to $120 million), the increased MLTC enrollment had produced an additional $30 million in the MLTC program. DOH said this additional $30 million would effectively enable the department to “net-out” the overall reduction, and fund the program at the $150 million level. DOH still plans to net-out the $30 million from individual MLTCs, suggesting it may target the reductions at the lowest tiers.

HCA will be seeking to further discuss concerns and suggestions with plan colleagues and the Department.

For further information, please contact Al Cardillo at acardillo@hcanys.org.

HCA Stresses Requirements and Limits of New Offsite Clinic Services Law The State Department of Health (DOH) filed a May 11 transmittal (DHDTC DAL 17-09) on legislation regarding offsite primary care services in patients’ residences. The DAL is at http://hca-nys.org/wp-content/ uploads/2017/05/ctrlaccamstmpNotification_22342.pdf.

Effective March 28, 2017, the legislation allows outpatient clinics of general hospitals and diagnostic and treatment centers (D&TCs) to provide off-site primary care services to patients at their residences. This does not include authority for these clinics and D&TCs to provide home care services.

HCA wrote amendments to the legislation that specifically limit the scope of offsite clinic authority to primary care, and to explicitly preclude any crossover into home care services under licensure. As a result, offsite clinic services are: 

Limited to primary care services ordinarily provided to patients on-site at the clinic or D&TC.

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Not home care services (nursing, home health aide, personal care) as defined in public health law Article 36, or home care agency professional services as defined in Article 36 (e.g., nursing services; home health aide services; and other therapeutic and related services which may include physical, speech and occupational therapy; nutritional services; medical social services; personal care services; homemaker services and housekeeper or chore services; and/or supportive nature to persons at home).

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Provided by a primary care professional to a patient with a pre-existing clinical relationship with the outpatient clinic or the health care professional providing the service; and

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Provided to a patient who is unable to leave his or her residence to receive services at the outpatient clinic or diagnostic and treatment center without unreasonable difficulty due to circumstances, including but not limited to, clinical impairment.

Continued on next page

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Continued from previous page The legislation also mandates that any state regulations or guidance which may be issued for the implementation must be developed in consultation with representatives of home care services agencies, and statewide associations representing such providers.

HCA has contacted DOH officials regarding the issuance and content of the DAL. We expressed concerns that the guidelines had not been vetted for consultation and input by the home care community as required under the law. Also, while the prohibition on clinics providing home care was noted only generally in the DAL, the DAL does not include sufficient detail to ensure that clinics are advised of all limitations.

While the bill seeks to increase primary care engagement for homebound individuals, the current climate has nevertheless seen increasing unlawful encroachment into home care and hospice by unlicensed entities.

This new authority must be thoroughly detailed and enforced, as HCA is pursuing.

HCA will keep members closely apprised of the developments. In the meantime, if you identify practices or planning activities that are inconsistent with the limitations or intent of this new statute, please contact both DOH and the HCA Policy staff.

For further information, please contact Al Cardillo at acardillo@hcanys.org.

DOH Health Advisory: Multidrug-Resistant Yeast Candida auris On May 5, the state Department of Health (DOH) released a Health Advisory to health care facilities regarding the emergence of a multidrug-resistant yeast, Candida auris. The advisory is available at http:// hca-nys.org/wp-content/uploads/2017/05/Notification_22315.pdf.

HCA has advocated for home care’s inclusion in the information flow from DOH and on future advisories, given that community-based patients could likewise require intervention or be impacted.

C. auris is a fungal infection that has become increasingly resistant to treatments, causing severe illness in patients who have serious underlying medical conditions. The Department’s update included information on infection control guidance from DOH and the U.S. Centers for Disease Control and Prevention (CDC).

Last Tuesday, May 9, DOH and the Commissioner of Health held a roundtable discussion in New York City with epidemiological experts for healthcare facilities. HCA was notified and invited to participate. HCA staff attended the video conference of this discussion in Albany, but Carol Durham of Selfhelp Community Services in New York City attended in-person on behalf of the association and the home care industry.

HCA and Ms. Durham, at the meeting, noted the significance of this issue for home care, and advocated that home care be included in the receipt of all advisories, education and recommendations related to the control of C. auris.

As of May 5, there had been 53 clinical cases in New York State, with an additional 18 screening cases which indicate a patient who has been found to be colonized with the infection but not showing symptoms.

Continued on next page

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Continued from previous page There have been 20 deaths among patient cases, but all of these patients had serious underlying medical conditions which has made it difficult to attribute any deaths specifically to this organism.

While cases have been concentrated among hospital patients and nursing home residents in the New York City area, one patient in Rochester was identified (although the patient had been previously treated in a New York City facility).

CDC first issued a clinical alert regarding C. auris in June 2016. This fungal organism is causing healthcareassociated infections with high mortality and it also has a high potential to cause outbreaks in healthcare facilities. These infections often do not respond to commonly used antifungal drugs, which makes treatment difficult. C. auris presents the greatest risk to patients with existing serious illness and multiple comorbidities, those who have had a long stay in an intensive care unit, or have a central venous catheter or other indwelling devices, and those who have previously received antibiotics or antifungal medications.

DOH has issued two previous health advisories regarding C. auris which can be accessed at the following links: 

DOH Health Advisory: Alert to New York State Healthcare Facilities regarding the Global Emergence of Invasive Infections Caused by the Multidrug-Resistant Yeast Candida auris (https:// www.health.ny.gov/press/releases/2017/docs/2016-08_candida_auris_advisory.pdf).

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DOH Health Advisory: Alert to New York State Clinical Laboratories Identification and Reporting of Suspected Candida auris Isolates (https://www.health.ny.gov/press/releases/2017/docs/201611_candida_auris_advisory.pdf)

It has been recommended that all facilities review interim recommendations from the CDC regarding C. auris and monitor the CDC website for new information and revisions. HCA urges all home care agencies to review these recommendations and stay informed as well.

The recommendations related to infection control can be viewed at https://www.cdc.gov/fungal/diseases/ candidiasis/recommendations.html, and an overview of the key recommendations is provided in the DOH Health Advisory linked above.

Please stay apprised of Health Commerce System (HCS) updates related to C. auris, and HCA will notify the membership as further information is released.

Contact Alexandra Fitz Blais at HCA with any questions or concerns at ablais@hcanys.org or (518) 810-0658.

Get Your Emergency Preparedness Plan CoP-Ready on June 28 Must-attend program to help home care executives, compliance staff and emergency preparedness managers prepare for sweeping new federal rules HCA invests significant resources assisting you with your emergency preparedness work in home care. This work is one of your most important long-term tasks to keep patients safe when disaster or other unforeseen contingencies strike, as they do with seemingly greater frequency.

Continued on next page

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Continued from previous page Many of you and your colleagues have participated in HCA’s regional emergency preparedness dialogue sessions with local emergency managers and other HCA-coordinated programs because you understand the importance of emergency preparedness.

Your task in this area is about to get much bigger, and more defined, now that the federal government is implementing a sweeping set of rules that require a series of new standards and procedures for continuityof-operations planning, communications with patients, preparedness drills, and much more. These requirements are set out in the new federal home health Conditions of Participation (CoP) changes but also in a separate multi-sector emergency preparedness federal rule that goes into effect even sooner: on November 16. This rule affects all home care providers, not just those who are subject to the CoPs. Given the stakes and the complexity of this new rule, HCA is holding a one-day program with emergency preparedness and operations expert Barbara Citarella, of RBC Limited, who will help you “Make Your Emergency Preparedness Plan CoP-Ready” on June 28 in Suffern, NY. A brochure at the link below contains further information on all of the elements that Ms. Citarella will be covering. A link to online registration is also below.

Please join HCA for this important opportunity to dialogue and learn all you can about the new emergency preparedness requirements, as well as strategies to implement them.

Make Your Emergency Preparedness Plan CoP-Ready on June 28 June 28, 2017 Crowne Plaza Hotel 3 Executive Boulevard Suffern, NY 10901 Download the brochure: http://hca-nys.org/wp-content/uploads/2017/04/Make-Your-EP-Plan-CoP-Ready-June-28-2017.pdf Register online: https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1012193

Guidance Issued on In-Service Training Requirements for Aides The state Department of Health (DOH) has posted a Dear Administrator Letter (DAL) about the in-service and annual performance requirements for aides employed by Licensed Home Care Services Agencies and Certified Home Health Agencies.

The DAL is at http://hca-nys.org/wp-content/uploads/2017/05/DAL_In-Service-TrainingRequirements_050917.pdf.

The DAL reviews the state and federal in-service education mandates that include 12 hours per year for home health aides (HHAs) and 6 hours per year for personal care aides (PCAs). The in-service requirement begins from the aide’s date of hire/employment. Agencies may fulfill the annual in-service requirements (6

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hours or 12 hours as applicable) on either a calendar year basis or employment anniversary basis. This should be specified in the agency’s in-service education policy.

Agencies are required to provide orientation for new staff (including aides) employed by the agency prior to provision of care. Orientation must be agency-specific and cannot be provided by other agencies. Training conducted for purposes of orienting new aides does not count toward meeting the annual 6 or 12-hour aide in-service requirement.

According to the DAL, “agencies are required to conduct an annual performance evaluation/review for each aide employed minimally every 12 months.” The annual performance evaluation must be conducted by an RN and must include an onsite home visit to the location where a patient is receiving care to observe and assess the aide while he or she is performing care.

If a deficiency in aide services, competency, or skill is identified by the RN during the onsite visit, then the agency RN must conduct, and the aide must complete, a competency evaluation in any task for which the aide is not considered competent. The aide must not perform any task without direct supervision by the RN until after he/she has received training in the task and successfully completed a subsequent evaluation.

The agency must maintain documentation of the aide’s competencies in the personnel file.

There must be evidence and documentation in each aide’s personnel file to support that the orientation, inservice, and annual performance evaluation requirements are met.

In-Service In-service training may be provided in a variety of settings and conducted by a variety of modalities or means. Training settings may include the patient’s home when the aide is furnishing care to the patient, agency location, or other appropriate locations. Modalities may include presentation, lecture, demonstration, videotape, webinar, and online trainings.

All in-service education/trainings regardless of setting or modality must: 

Be pertinent to the aide’s responsibilities;



Ensure sufficient RN supervision;



Include an opportunity for questions and answers; and



Include an evaluation by the RN that validates that learning took place.

In-service training for HHAs and PCAs may be offered by any organization provided that the in-service training includes documentation of content, hours, and RN supervision/evaluation and meets the criteria set forth in this directive.

If the agency uses online or webinar training methods, specific policies and procedures must be developed to ensure compliance with requirements and address password securities if applicable. A mechanism for aides to ask questions about the content must be readily available. The RN must have appropriate assessment and evaluation tools (i.e., tests to ensure knowledge retention of the covered material).

Continued on next page

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Continued from previous page Agencies are required to record and maintain training files for each in-service offered regardless of modality. Training in-service files should be retained for at least six years. At a minimum the following must be documented and maintained for each training/in-service offered: date; length of training; training location; training content, objectives and goals; materials used; post-test; attendance list; proof of completion; and RN supervisory oversight and sign off.

Questions should be directed to DOH at homecare@health.ny.gov.

Legislation Signed to Limit Salary History Information Affects NYC Employers On May 4, New York City Mayor Bill de Blasio signed into law legislation that will prohibit employers from inquiring about, relying upon, and verifying a job applicant’s salary history.

The legislation will apply to all employers in New York City, public and private and will take effect on October 31, 2017.

The legislation, Int. 1253-A (now Local Law 67), is at http://legistar.council.nyc.gov/ View.ashx?M=F&ID=5083445&GUID=1CDC0DBF-2D3E-4458-9657-8F560D3C1847.

As described in the May 1 edition of The Situation Report, the law prohibits an employer, employment agency, employee, or agent from: 1. Inquiring about the salary history of a job applicant; and/or 2. Relying on the salary history of a job applicant when determining the salary, benefits or other compensation for the applicant during the hiring process, including the negotiation of a contract.

There are some exceptions that employers should be aware of: 1. If applicants voluntarily and without prompting disclose their salary history to the prospective employer, an employer is permitted to consider salary history in determining a prospective employee’s salary, benefits, and other compensation, and may verify a job applicant’s salary history.

2. An employer, without inquiring about salary history, also is permitted to discuss salary, benefits, and other compensation expectations with the applicant, as well as any unvested equity or deferred compensation the applicant would forfeit or have cancelled by resigning his or her current employment.

3. The legislation does not apply to current employees applying for an internal promotion or transfer.

4. It does not apply to New York City employers acting pursuant to any federal, state or local law authorizing the disclosure or verification of salary history or requiring knowledge of salary history to determine an employee’s compensation.

Continued on next page

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Continued from previous page Home care providers should review their employment practices to ensure that they conform to this law.

This article is based on information provided by Jackson Lewis, the firm that employs HCA’s counsel.

CMS Extends Deadline for Home and Community-Based Settings Rule The U.S. Centers for Medicare and Medicaid Services (CMS) has announced a three-year extension – until March 17, 2022 – for state Medicaid programs to meet the Home and Community-Based Services (HCBS) setting requirements for settings operating before March 17, 2014.

According to CMS, the delay is “in response to states’ request for more time to demonstrate compliance with the regulatory requirements and ensure compliance activities are collaborative, transparent, and timely.”

As explained in many prior communications, the HCBS federal rule establishes criteria for what is considered a home and community setting under many Medicaid waiver programs, including managed long term care and mainstream Medicaid managed care.

The rule identifies settings or services that present institutional qualities and, therefore, do not meet the requirements necessary for Medicaid-funded home and community-based settings. These settings include those: located in a publicly or privately owned facility that provides inpatient treatment; that are on the grounds of, or immediately adjacent to, a public institution; or that have the effect of isolating individuals receiving Medicaid-funded HCBS from the rest of the community.

A state may only include such settings in its Medicaid HCBS programs if CMS determines that it has the qualities of an appropriate home and community-based setting. This is done through a “heightened scrutiny” process, which involves the state collecting information and input from the public supporting that the setting meets the qualities of being home and community based and does not have the qualities of an institution.

The rule has a great effect on programs like adult homes; assisted living; adult day; nursing homes; it can affect home care, however, if such care is being provided in one of these settings, and thus the delay is a positive development.

For more information on the delay, visit: http://www.medicaid.gov/Federal-Policy-Guidance/FederalPolicy-Guidance.html.

The state’s website on the federal rule is at http://health.ny.gov/health_care/medicaid/redesign/home_community_based_settings.htm.

CMS has also publicized a March 14 letter to Governors that lays out its vision for the Medicaid program, “where states have more freedom to design programs that meet the spectrum of diverse needs of their Medicaid population”. . . and “focus on improving quality, accessibility, and outcomes in the most costContinued on next page

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Continued from previous page effective manner.” The letter is at http://hca-nys.org/wp-content/uploads/2017/05/HHS-CMS-letter-togovernors-on-Medicaid_031417.pdf.

UAS Version 1.3 To Be Released The state Department of Health (DOH) has announced the upcoming release of the UAS-NY software to version 1.3.

The online upgrade will begin on May 31 at 5:30 p.m. and be completed by no later than June 1 at 8 a.m. During this time, both the online and offline applications will be unavailable.

Agencies that only use the UAS-NY online application do not need to take any action.

In addition to the online upgrades, DOH is also releasing version 1.3 of the Offline Client. This is a required upgrade for all Offline Client users.

Complete instructions for upgrading the UAS-NY Offline Application to version 1.3 will be available in the UAS-NY Training Environment References and Resources 8500 Online and Offline Application by close of business May 19, 2017. DOH asks that you read the instructions in their entirety before updating/ installing v.1.3 and not upgrade to offline version 1.3 before close of business May 31 as it will not work until the online upgrade is complete.

Any questions should be directed to the UAS-NY Support Desk at (518) 408-1021 or uasny@health.ny.gov.

Older Adults Mobile App Released Last week, the state announced the first statewide mobile app to connect older adults with resources and services in their communities.

The New York State Office for the Aging’s (NYSOFA’s) Aging Services app will provide New York’s more than 3.7 million older adults with easily accessible material about benefits, programs, and services, including information regarding health and wellness, housing, and transportation options. The app is compatible with and available with both iOS (https://itunes.apple.com/us/app/nys-aging/ id1220542271?mt=8) and Android (https://play.google.com/store/apps/details?id=gov.ny.its.NYSAging) platforms.

One primary goal of the app is to provide basic information addressing issues older New Yorkers and their families face and connect them to local resources that can help. Using the app’s “Near Me” feature, an older adult or caregiver anywhere in New York can immediately obtain address and contact information for local offices for the aging, senior centers, farmers’ markets, caregiver services, Alzheimer’s Association chapters, and more, within the closest proximity to their exact location.

The Aging Services app also links users with information and assistance through NY Connects, the state’s “no-wrong-door” system for community-based long-term services and supports, which is designed to help older adults and those with disabilities remain healthy and independent. Additionally, the app

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provides timely news and updates about state and federal programs that directly impact the lives of older New Yorkers and their families.

HRA Medicaid Renewal Process Changes The New York City Human Resources Administration (HRA) has posted an Alert to inform organizations working with disabled, aged and blind (DAB) consumers that HRA will mail a revised DAB renewal (recertification) form beginning this month.

The DAB renewal form will continue to be pre-printed with the client’s case information. This form must be used for the renewal process. HRA advises that consumers carefully review all of their information and update it as appropriate, or check “No Change” if the pre-printed information remains current.

Furthermore, all renewals must be signed; unsigned renewals will be returned for a signature.

With the introduction of this renewal form, DAB renewals will be made available for reprint on ACCESS NYC. Users can go to www.nyc.gov/accessnyc. From the landing page, once users have logged into an existing account or created a new account, they can navigate to the Medicaid Renewal page to view/reprint their renewal. This functionality is available for DAB renewals with a notice date of May 2017 or later. Earlier DAB renewals are not available via ACCESS NYC for reprint.

Consumers can also request a reprint of their renewal be mailed to them by calling HRA’s InfoLine (718) 557-1399.

This Alert, including a sample renewal form, and others are available at http://www1.nyc.gov/marc (registration required) under Medicaid Alerts.

Agenda Posted for PHHPC Establishment and Project Review Meeting The agenda has been posted for the May 18 meeting of the Public Health and Health Planning Council (PHHPC) Committee on Establishment and Project Review.

It, along with supporting documents, is at https://www.health.ny.gov/facilities/ public_health_and_health_planning_council/meetings/2017-05-18/.

The agenda includes applications by: 

An entity to become the active parent of a hospice;



A Certified Home Health Agency (CHHA) that serves some downstate counties to purchase a CHHA that serves Dutchess and Suffolk counties, and add personal care to its authorized services;



An entity to become the active parent of a CHHA; Continued on next page

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Continued from previous page 

A “special pilot” CHHA to extend its limited life operating certification for three years;



35 entities to establish Licensed Home Care Services Agencies (LHCSAs); and



Six LHCSAs for changes of ownership.

At the April 6 PHHPC meeting, DOH confirmed that it is now acting on all LHCSA applications and not just those that are affiliated with an Assisted Living Program (ALP), submitted by counties, or are changes of ownership.

The next full PHHPC meeting is June 8.

Resources 

“Medicare’s Bundled Payment Programs Suffer From Fatal Flaws, But There Is A Logical Alternative,” Health Affairs Blog (May 9, 2017) http://healthaffairs.org/blog/2017/05/09/medicares-bundled-payment-programs-suffer-from-fatalflaws-but-there-is-a-logical-alternative/



“State Telehealth Laws and Reimbursement Policies,” by the Center for Connected Health Policy http://tinyurl.com/kvgs3aj

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

19

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.

Thanks to our summit sponsors:

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

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______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