LHCSA STAT REPORTS
REGULATORY CALL
SURVEY
LHCSA, HCC FORUMS
LHCSAs have until November 3 to complete the newly posted 2016 Statistical Report.
HCA’s September 20 call will focus on emerging and developing risks and opportunity areas stemming from state-level discussions on proposed regulatory changes.
HCA reminds members to complete our very brief survey on critical access issues to support advocacy for emergency preparedness in home care.
HCA’s Downstate LHCSA Forum and HCC Forum provide an opportunity to gain updates on critical areas specific to your agency.
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Your Source for HOME CARE News, Policy and Advocacy
COMING UP Optimizing Your Agency’s Revenue Cycle for Improved Financial Performance September 13, 2017 New York City Home Care Council of HCA Member Forum September 19, 2017 10 a.m. to 12:30 p.m. New York City Are You Prepared? Emergency Preparedness Essentials in Home Care & Hospice Settings September 27, 2017 Albany All HCA programs and registrations are posted at http://hca-nys.org/ events-education/ upcoming-events
Vol. 2, Issue 32 | September 11, 2017
HCA Joins Council of State Associations for Major D.C. Policy Summit & Advocacy Push on Federal Issues HCA President Joanne Cunningham and peers from the Council of State Home Care Associations are in Washington this week for the Council’s Public Policy Summit and Capitol Hill advocacy program. Ms. Cunningham is a member of the Council, which is a collective of state home care association executives and their members working together on advocacy, education and federal policy. See PUSH p. 2
DOH Announces QIVAPP Awards Monies not available yet
New Minimum Wage Survey Expected to be Out This Week
Last week, the state Department of Health (DOH) announced the amounts that will be given to managed long term care (MLTC) plans and then passed on to their eligible contracted home care providers under the Quality Incentive Vital Access Provider Pool (QIVAPP) program. See QIVAPP p. 3
At last week’s HCA Senior and Financial Manager’s Retreat, state Department of Health (DOH) staff said that they expect to post a new minimum wage survey for home care providers and hold a webinar on the new survey sometime this week. See WAGE p. 4
INSIDE HCA, Council Advocate in D.C. on Federal Issues..............................................1 DOH Announces QIVAPP Awards......................................................................1 New Minimum Wage Survey Expected This Week..............................................1 TBI Waiver Renewal Update............................................................................3 HCA Addresses Public Health Council Retreat on Critical Planning Areas..........5 Upcoming Education Programs ................................................................7-8 2016 LHCSA Statistical Report Ready for Completion......................................9 DOH Hurricane Alert......................................................................................10
Important Upcoming Deadlines....................................................................10 Sept. 20 HCA Call on Article 36, Developing Regulatory Areas..........................11 Must-Complete Emergency Preparedness Survey..........................................12 Firm Featured in CBS Report to Present at Oct. 19 Compliance Symposium......13 Join HCA for LHCSA & HCC Member Forums.....................................................14 Hospice QRP Data Specs Now Available..........................................................14 VBP Bootcamps Announced...........................................................................15 Resources....................................................................................................16
The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
PUSH from p. 1 On day two of the program – tomorrow – each state association is meeting with its respective Congressional Delegation. Ms. Cunningham and HCA members at the Summit will be meeting with lawmakers and/or staff of the New York Delegation to gain vital legislative relief and action on a series of federal reimbursement, regulatory, and policy priorities. Foremost among these is the ongoing threat to Medicaid, posed by Congressional attempts to repeal and replace the Affordable Care Act, as well as the new Home Health Groupings Model (HHGM) that the U.S. Centers for Medicare and Medicaid Services (CMS) has proposed for 2019, with cuts of up to $1 billion from the system. HCA is also pressing for: continuation of the Medicare rural addon; Congressional opposition to hospice rebasing; and relief from regulatory burdens like the Medicare face-to-face rule, pre-claim review, and the current limits on practitioners permitted to order and refer for home care services. HCA has prepared a series of advocacy documents to guide our visits with lawmakers and their staff. We encourage you to read these for a review of HCA’s messaging. Please also share them with your Congressional contacts to encourage their action on critical home care federal priorities. Each of the documents titled below is posted as a PDF on HCA’s website at http://hca-nys.org/ general-news/sept-2017-federal-documents-on-hhgm-rural-addon-hospice-medicaid-and-regulatory-issues.
“Home Care Advocacy Ask: Regulatory Relief for Home Care Providers”
“2018 Proposed Rule: Reject Drastic New HHGM Payment System for Home Care”
“Continue 3% Medicare Add-On for Rural Home Health”
“CMS Should Collaborate with Industry to Evaluate Impact of Hospice Payment Reform Before Implementing Any Rebasing Initiatives”
“Why Medicaid Works – and Why AHCA Cuts are Wrong”
HCA will provide a further report and updates in the next edition of The Situation Report.
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 Vice President acardillo@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@hcanys.org Laura Constable Senior Director, Membership & Operations lconstable@hcanys.org Celisia Street Director of Education cstreet@hcanys.org Mercedes Teague Finance Manager mteague@hcanys.org Jenny Kerbein Director of Governance & Graphic Design jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org
The Situation Report: the Home Care Association of New York State QIVAPP from p. 1 The MLTC plans have not gotten the funds yet but once they do, we will notify members about the amounts and the timeframe to distribute the monies. The recently announced funds cover the period of April 1, 2016 to March 31, 2017 and are based on the number of aide hours provided. Since the funding became available in the 2014-15 state fiscal year, the state has provided QIVAPP to help agencies meet their costs from the state Wage Parity Law. QIVAPP is available to home care providers who contract with MLTC plans to provide aide services in New York City. Certain other criteria apply. These include:
Home care agencies receive at least $18.50 per hour from MLTC plans.
The home care agency maintains or participates in a specialty training program for home health aides (HHAs) and personal care aides (PCAs) that exceeds DOH’s training requirements (the standard 75 hours of training for HHAs or 40 hours for PCAs and/or the annually required in-service training of 12 hours for HHAs and 6 hours for PCAs).
The agency has a written, implemented and currently active quality assurance program.
The agency participates in a health benefit fund for its home health care and/or personal care aides and/or provides comprehensive health insurance coverage to its employees that meets certain requirements outlined by DOH.
At least 30 percent of the agency’s total New York City workforce is enrolled in the health benefits coverage.
For 2016-17, DOH decided to award QIVAPP monies to those providers who were eligible for funding in 2015-16. HCA has received a list of how much each eligible home care provider will receive from each plan. If you would like a personalized report, with QIVAPP funding amounts specific to your agency, please e-mail HCA’s Andrew Koski at akoski@hcanys.org. More information on QIVAPP for past years is at https:// www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm.
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Volume 2, No. 32 September 11, 2017
TBI Waiver Renewal Update As a follow up to last week’s Situation Report announcement that the U.S. Centers for Medicare and Medicaid Services (CMS) has approved renewal of the Traumatic Brain Injury (TBI) waiver program (effective September 1, 2017), the state Department of Health (DOH) has provided further information. DOH has made available a copy of the waiver renewal application. It is at http://hca-nys.org/wp-content/ uploads/2017/09/Approved-TBIWaiver-Application-9-1-17.pdf. DOH is currently developing a PowerPoint presentation to be offered to providers and stakeholders later this month. Once the Regional Resource Development Centers (RRDCs) are fully trained in the application requirements, they will schedule town meetings at the regional level for participants and families. DOH states that many of the application changes will be invisible to participants. RRDCs have been instructed to direct all provider/stakeholder questions to the TBI mailbox at: tbi@health.ny.gov. As previously reported, approval of the application will set off a series of discussions that center on: changes in the application content; definition of Conflict of Interest (COI) and compliance criteria; and quality improvement and audit functions. In addition, cost reporting training will be offered by the Rates unit.
The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
WAGE from p. 1 Once posted, providers will have only a short time to complete the survey. HCA will alert members about the process. As reported to members in an Alert on August 30 and in the September 5 Situation Report, DOH is requiring that agencies complete a registration process with the state Office of Pool Administration (OPA) before providers will be able to complete and submit the new survey. The survey will be used to determine minimum wage payments and is a requirement for minimum wage funding apportionments. OPA is developing the new electronic “Home Care Provider Minimum Wage Reconciliation Survey” on behalf of DOH and is assisting with data collection. Home Care Provider agencies required to submit the survey include CHHAs, LHCSAs, LTHHCPs and Consumer Directed Personal Assistance program Fiscal Intermediaries. DOH has confirmed that even home care providers who don’t employ aides but contract for such services are required to complete the survey. Home care agencies that completed a previous minimum wage survey in February were e-mailed instructions two weeks ago for completing the registration, and all other providers were sent hard copy letters via U.S. mail informing them of this process. The Home Care Provider Reconciliation Survey will capture worker wage details, the number of employees impacted by title grouping, contractual relationships between home care agencies and managed care plans, as well as contractual relationships amongst the home care agencies. In its communication to home care providers, DOH stated that the purpose of the survey is to “reconcile actual Medicaid minimum wage costs to actual Medicaid minimum wage funding distributions. While minimum wage projections have been included in current rates, effective 12/31/16, those figures will be reconciled using data from the survey. Data from the survey will also be used to assist in determining funding to include in future Medicaid Managed Care and Fee-for-Service rates.” Furthermore, “Medicaid minimum wage funding levels, including funding already received, will be dependent on submission of a satisfactory survey. Funding received in excess of needed funding documented in the survey must be returned to the State. Similarly, providers receiving inadequate funding for Medicaid services will be eligible to receive additional payments.” HCA, members and provider representatives participated in a LHCSA Statistical Report Workgroup meeting in June where DOH reviewed a draft of this survey. HCA then shared the draft with a group of members and submitted comprehensive recommendations that included: revisions to make it easier to complete; the need for an adequate timetable for submission; and a webinar to walk through its completion. While it did not initially plan to do so, DOH agreed to hold a webinar on the new form after HCA and other provider associations advocated for the necessity of such a program. Home care providers will need to establish an OPA account with a User ID and Password to access and submit the “Home Care Provider Minimum Wage Reconciliation Survey.” If you have difficulties establishing an OPA account, contact OPA at webpools@hcrapools.org or at (315) 671-3800.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
HCA Addresses Public Health Council Retreat on Critical Planning Areas HCA addressed the state Public Health and Planning Council (PHHPC) last Thursday as part of the Council’s comprehensive health planning retreat. As reported in last week’s edition of The Situation Report, PHHPC focused on a full range of issues, from prevention, to health reforms, new models, certificate of need, quality and more. Related to home care, the PHHPC agenda also focused very specifically on: the post-acute hospital-tohome care continuum; redefining standards for determining the need for care agencies; and incorporating quality in licensure/Certificate of Need (CON) determinations for long term care beds and home care agencies. State Department of Health (DOH) Advisor to the Commissioner, Mark Kissinger, provided an overview of these issue areas, and presented a set of discussion questions for the PHHPC, HCA and three other participating associations: LeadingAge NY, the Continuing Care Leadership Coalition (CCLC) and the New York State Health Facilities Association. Al Cardillo, Executive Vice President, represented HCA. Mr. Cardillo discussed the need for state regulatory review and streamlining, as well as policy actions to facilitate collaboration among hospitals, home care agencies and physicians, as necessary to the goals of effective acute-to-home care transition and ongoing health management. He also stressed that policies must likewise encompass pre-acute, primary and population health collaboration among hospitals, home care and physicians, so that patient health and health promotion are truly the center of focus, and so that the goals of preventing avoidable hospitalizations, rehospitalizations and ER episodes can be realized. Mr. Cardillo provided extensive background on HCA’s proactive measures in these areas, which he urged be considered as tools that the PHHPC and DOH could utilize in advancing essential changes to help the system and system partners achieve priority goals. These included:
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HCA’s joint work with hospital association representatives to create the state’s HospitalHomecare-Physician Collaboration law, public health law section 2805-x, adopted by the Legislature and Governor in 2015, and now a focal point in the state reform discussions, providing regulatory flexibility and potential fiscal support for a wide array of collaboration initiatives.
HCA’s authorship of Chapter 444 of the Laws of 2011, now worked on for implementation by DOH, to provide innovative regulatory and procedural waivers for home care agencies and hospitals.
HCA’s most recent legislative and administrative effort to provide flexibility for establishment of Physician-Homecare Collaboratives for Primary Care, Public Health and Medical Management. HCA succeeded in gaining legislative introduction for this initiative, and on further suggestion
The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
of the Legislature, has been working with the Administration to implement it under the standing authority of PHL 2805-x. Mr. Cardillo indicated that these policy and program initiatives also seek to provide essential guidance on how the critical parts of the system – hospital, home care, physician, managed care and other – can and should work together for true integration, seamlessness and effectiveness. He stated that current reform policies (e.g., the Delivery System Reform Incentive Payment program and Value Based Payments) require guidance on how hospital, home care and physician partners can optimally collaborate and on the roles of each collaborating sector. He noted, in particular, the confusion occurring for hospitals and physician groups and their involvement in home care, stressing the function of Article 36 as governing the provision of “in-home” care. With regard to CON, HCA affirmed that the changing system, including the strong focus on integrated service delivery, warrants a relook at the need methodologies and the priority criteria that should be considered in project approvals. Mr. Cardillo also stressed that, in any revamp, the meeting of “need” should not be viewed as a matter of mere “numbers” of agencies or facilities, but more importantly as a matter of whether the existing and prospective resource of agencies and facilities are adequately supported in reimbursement, workforce, infrastructure (particularly health information technology and exchange), regulatory flexibility and governmental policy to meet patient, system and community need. He noted the significant agency needs in these areas that must draw supportive policies if public need and state health goals are to be met. The ensuing PHHPC discussion also focused widely on the broader issues before the Council, particularly nursing home/long term care bed issues, and quality concerns in the CON process, such as in changes of ownerships. The Council was to bring this information into their next day’s discussion as recommendations are contemplated, and the Chair emphasized that the discussion was the “first of many” to be held on these subjects. Meanwhile, the DOH workgroups on post-acute care management, telehealth, and other areas continue, with the next post-acute meeting planned for September 18 and the next telehealth meeting planned for some time in October. HCA will be continuing to engage the membership, DOH, the Governor’s Office and other partners in strategically approaching these next critical workgroup discussions and deliberations. HCA has scheduled a statewide member call on these activities for September 20 at 11 a.m. See related p. 11 story for details. 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
Volume 2, No. 32 September 11, 2017
HCA Education We have a lot in store over the next few months. Please share these programs, forums, webinars and conferences with your colleagues and be sure to register yourself. Registration information is all online at http://hca-nys.org/events-education/upcoming-events. Optimizing Y our Agency’ oved Financial Performance Your Agency’ss Revenue Cycle for Impr Improved September 13, 2017 New York City
This workshop, led by an expert on end-to-end revenue cycle management, will show how to analyze and target under-performing areas of the revenue cycle through the use of metrics as an efficient and effective means of improving revenue and cash flow. Webinar to Outline ICD-10 Changes Effective in October September 13, 2017
Approximately 3,392 new ICD-10 codes are coming in October 2017 for the 2018 fiscal year. Is your team ready? This webinar, hosted in conjunction with the Home Care Association of New Hampshire, will identify the coding changes that affect home health and hospice, with a review of changes to case-mix diagnoses, updates and changes to the Coding Guidelines, and case examples to illustrate the new coding changes. Home Care Council of HCA Member Forum September 19, 2017 New York City
Please join the staff of HCA and member colleagues from the Association and the home care community for the next Home Care Council of HCA Member Forum. Participation in HCA Member Forums gives you an opportunity to interact with HCA staff and members, and exchange valuable information with your colleagues. Ar e Y ou Pr epar ed: Emer gency Pr epar edness Essentials in Home Car e & Hospice Settings Are You Prepar epared: Emergency Prepar eparedness Care September 27, 2017 Albany
HCA presents a comprehensive full-day program on September 27 in Albany that will delve into all critical and timely aspects of home care and hospice emergency preparedness affecting your operation. The program features state health and emergency preparedness officials. Most urgently, with the fast-approaching November 16 effective date for the new emergency preparedness Conditions of Participation (CoPs), we’ll also have state DOH officials helping you to sort out the differences between the new federal CoP requirements and existing state regulations so that you know how much work is ahead of you in order to ramp up fully for federal compliance. Plus, join us for a tabletop exercise that meets one of the new CoP requirements!
Continued on next page
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
Continued from previous page Downstate LHCSA Forum October 11, 2017 New York City
Please join your LHCSA and HCC colleagues, HCA staff and Board Members for this exchange of valuable information, advocacy concerns and recommendations for action. Corporate Compliance Symposium October 19, 2017 Albany
One of our signature conferences, the Corporate Compliance Symposium draws CEOs, COOs, corporate compliance officers and other managers who have responsibility for planning, operationalizing, and establishing a compliance-conscious culture at your organization. From big-picture considerations to the concrete mechanics of maintaining a compliance program, this conference will: emphasize the focus areas targeted by government auditors (i.e., OMIG and OIG); provide takeaways and best-practice guidance based on real-world cases of HIT- and HIPAA-related breaches and enforcement actions; help you overcome exposure and identify new risks introduced by your participation in new integrated models of care; and examine growing segments of the home care continuum that are drawing scrutiny and new regulatory activity from state compliance agencies. Blueprint for OASIS Accuracy OASIS C-2 Data Set October 23 & 24 (Workshop) October 25 (Optional COS-C exam) New York City
Clinician leaders from OASIS Answers are bringing the acclaimed Blueprint for OASIS Accuracy C-2 Data Set workshop to New York City on October 23 and 24, with the option to take the COS-C exam at the same location on October 25. Through guided, expert instruction, problemsolving discussions and application scenarios, participants will achieve mastery of the OASIS items, conventions and the latest data collection rules. Webinar: From Frailty to Functionality: Evidence-Based Rehabilitation Strategies for Deconditioned Patients November 1, 2017
Deconditioning is a complex process of physiological change following a period of inactivity that results in functional losses including mental status, continence and ability to accomplish activities of daily living. This webinar will delve into the operational definitions for frailty and deconditioning as well as examine the scope and prevalence of the problem in today’s patient populations compared to similar patients ten or twenty years ago. Although these limitations are exacerbated with physiological consequences of low activity levels and extended bed rest, gains can be achieved and maintained by developing an evidenced-based practice for re-conditioning.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
2016 LHCSA Statistical Report Ready for Completion Due on November 3 On September 8, 2017, the state Department of Health (DOH) activated the 2016 LHCSA Statistical Report and the 2016 Assisted Living Program (ALP) LHCSA Statistical report. The report will be available for completion until November 3, 2017. After November 3, 2017, the 2016 LHCSA Statistical Report will no longer be available. All LHCSAs are required to complete and submit the 2016 LHCSA statistical report. LHCSAs providing services to ALP residents are required to submit the 2016 ALP LHCSA statistical report. If your LHCSA serves both ALP patients and non-ALP patients, you should submit both reports. A separate Statistical Report is required for each site with an operating certificate. Dear Administrator Letter No. DHCBS 17-02 has been posted on the Health Commerce System (HCS) (https:// commerce.health.state.ny.us/public/hcs_login.html) with information regarding the 2016 LHCSA Statistical Report, including how to access and complete the Report and Frequently Asked Questions. It is also available at http://hca-nys.org/wp-content/uploads/2017/09/LHCSA-StatisticalReport_2016_DAL_090817.pdf. Additionally, a recorded training webinar has been posted on the HCS. To view the training webinar, go to My Content on the top tool bar, then click on:
Documents by Group; View all Document Groups; and Long Term Care Training.
Parts 1-4 of the training webinar will be on the bottom half of the page. Questions can be sent to hcstatrpts@health.ny.gov (please copy Andrew Koski at akoski@hcanys.org). As highlighted in numerous editions of The Situation Report, HCA and a group of members and other provider associations have been part of a DOH Workgroup that was organized to: 1) increase the compliance rates for the LHCSA Statistical Reports; 2) capture data relevant to service delivery; 3) ensure quality data is collected in a timely manner; 4) streamline data reporting; and 5) ensure terminology in the report is used universally across the industry. HCA had submitted extensive comments on the Report based on valuable feedback from members. In addition to general comments, we urged DOH to hold a webinar on the form and made recommendations for each section of the Statistical Report. HCA understands that the 2016 Report includes a few of our recommendations, but the 2017 Report will incorporate many more changes. For additional information, contact Andrew Koski at akoski@hcanys.org or (518) 810-0662; or Patrick Conole at pconole@hcanys.org or (518) 810-0661.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
DOH Hurricane Alert: Immediate Action for Home Care, Hospice Preparedness The state Department of Health (DOH) last week sent a brief alert to LHCSAs, CHHAs and Hospices (see http://hca-nys.org/wp-content/uploads/2017/09/ctrlaccamstmpNotification_22860.pdf) on “immediate action” to be taken for Hurricanes Irma and Jose preparedness efforts. These actions include required updates and corrections to your agency’s contacts in the Health Commerce System (HCS), as well as provider readiness to use the HCS to assist in possible DOH survey efforts. In the event of severe weather, all home care agencies and hospices must: •
•
Ensure complete and up-to-date contact information for individuals assigned to management roles in the HCS Communications Important Upcoming Deadlines Directory, to assure they receive critical Effective/ Requirement More Information Due Date notifications. Ensure that staff are ready to complete Health Emergency Response Data System (HERDS) surveys that will be requested of agencies to determine their status and needs, their patient census and available/needed capacity should an evacuation become necessary. If these surveys are activated, all agencies and hospices must complete the surveys and submit their data.
Comments on 2018 Proposed Rule for Medicare Home Health Prospective Payment System
Sept. 25, 2017 https://www.gpo.gov/fdsys/pkg/FRͲ2017Ͳ07Ͳ28/pdf/2017Ͳ15825.pdf
LTHHCP 2016 Medicaid Cost Report (LTHHCPs that only bill under CHHA EPS must file a CHHA Medicaid Cost Report, which was due August 15)
Sept. 30, 2017 https://commerce.health.state.ny.us/public/hcs_login.html
Applicability of State Home Care Worker Wage Parity Law to Oct. 13, 2017 Consumer Directed Personal Assistance Program
https://www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm
2016 LHCSA Statistical Report
Nov. 3, 2017
https://commerce.health.state.ny.us/public/hcs_login.html
Federal Emergency Preparedness Rule in Effect
Nov. 16, 2017
https://www.gpo.gov/fdsys/pkg/FRͲ2016Ͳ09Ͳ16/pdf/2016Ͳ21404.pdf
Revised Medicare Home Health Conditions of Participation in Effect
Jan. 13, 2018
https://www.gpo.gov/fdsys/pkg/FRͲ2017Ͳ01Ͳ13/pdf/2017Ͳ00283.pdf
Please note that the following HCS Communications Directory Roles for agencies and hospices must be assigned to staff with HCS accounts to grant them access to the HERDS application: Administrator; Data Reporter; Director of Patient Services/Director of Homecare Patient Services; Emergency Response Coordinator; and HPN Coordinator. Your HCS Coordinator can assign staff to these roles.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
Sept. 20 HCA Call to Discuss Article 36 and Other Developing State Regulatory Focuses, Risks, Opportunities As reported in an alert last week, on September 20, from 10 to 11 a.m., HCA is holding a statewide, members-only call to brief you on several areas (and venues) of developing regulatory and policy changes that could have monumental implications (opportunities as well as risks) for providers and MLTCs. To register for the call, please complete the online form at the following link and HCA will send you dial-in instructions in advance: https://www.surveymonkey.com/r/Sept20StatewideRegCall. Background The state Public Health and Health Planning Council (PHHPC) engaged in an intensive retreat last week (see related p. 5 story), where it focused on continuum-wide policy and regulatory changes, including some agenda items providing a specific focus on the following areas of home care: parameters of Article 28 (e.g., general hospitals) and Article 36 post-acute models (e.g., home care); “redefining standards” for determining need for long term care beds and home care agencies; quality standards in Certificate of Need (CON) licensure/establishment determinations; and other areas with potentially major consequences for providers and MLTC partners. Still other broader recommendations under consideration could also lead to consequential, system-altering proposals. The retreat also focused on such items as: PHHPC operational structures and the standards for PHHPC decision-making about critical program and capacity issues; CON; regulatory changes and flexibility; the role of quality in character and competence evaluations; facility governance and ownership structures; and more. The Council’s meeting coincides with other major state Department of Health (DOH) regulatory reviews and changes, including a Regulatory Modernization initiative that raises potentially significant opportunities and concerns regarding the parameters of state public health law for Article 28 facilities and Article 36 providers, specifically in post-acute care management. September 20 Call HCA’s September 20 call will brief you on the latest developments from these meetings and other forums for deliberation over consequential regulatory issues in home care. HCA Executive Vice President Al Cardillo addressed the PHHPC at its retreat and will provide a summary of its deliberations. Mr. Cardillo and HCA President Joanne Cunningham will also provide a report on some of the work HCA is doing in these and other venues to shape regulatory changes in ways that properly abide existing jurisdictional boundaries and create constructive opportunities for partnerships across the continuum of care.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
Must-Complete Survey: Data Needed to Substantiate Extent of Patients at Risk, Supporting Emergency Preparedness Legislation, Policy Development In the wake of Hurricanes Harvey and Irma, home care providers are urged to provide us with data as soon as possible, so that we can substantiate the need for legislation and other supports when similar disasters strike New York. As reported in last week’s edition of The Situation Report newsletter (http://hca-nys.org/wp-content/uploads/ 2017/09/SitRep090517.pdf; see p. 15), HCA specifically needs your data on the number and extent of “Priority One” patients in home care. This data, already sought in a recent HCA survey, is critical for supporting several HCA emergency preparedness initiatives that require data demonstrating home care’s critical response role for vulnerable patients in need. Specifically, HCA and legislative sponsors (Senator Andrew Lanza and Assemblyman Michael Cusick) worked once again this year to secure unanimous legislative passage of HCA’s “Essential Personnel” bill (S.5016-A/ A.6549-A). We’ve set important groundwork in demonstrating why the Governor must sign this bill into law, allowing home care and hospice personnel to reach patients in emergencies (when access restrictions would otherwise apply). The bill also includes home care and hospice in local emergency preparedness planning efforts. However, to truly substantiate this need, and garner the Governor’s support, all home care providers must complete our survey (which was initially sent to providers in July) asking for your data on the types of patients for whom this bill would provide vital relief during emergencies. HCA thanks the agencies who participated in the survey; however, the agency response rate was far from adequate. Please complete the survey now at https://www.surveymonkey.com/r/2HHZXJ. Emergency Preparedness Month As you know, September is Preparedness month, and we hope that providers are taking this opportunity to engage in outreach to the public, the media and local emergency managers to elevate the work you do to support patients in home care and hospice when disaster strikes. September 27 Emergency Preparedness Conference To further assist providers during Preparedness Month, HCA is holding a daylong conference on Emergency Preparedness Essentials in Albany (September 27). Seats are filling up very fast for this conference that will offer you key engagement with state emergency preparedness planners, information on the upcoming Conditions of Participation (CoPs) for emergency preparedness, and a tabletop exercise that qualifies for meeting one of the new CoP requirements. More information is at http://hca-nys.org/general-news/are-you-prepared-emergency-preparedness-essentials-inhome-care-hospice-settings.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
Firm Featured in CBS Report on Health Care IT Hacking to Present at Oct. 19 Compliance Symposium A recent CBS This Morning Report (see https://www.cbsnews.com/news/cbsn-on-assignment-hackerstargeting-medical-industry-hospitals/) illustrated the extensive damage caused by hackers to one upstate hospital’s trauma center, which lost its computer system for six weeks. The cybersecurity firm that got the hospital’s services back running, GreyCastle Security, is a featured presenter at HCA’s Corporate Compliance Symposium on October 19, where Vice President of Services Dan Didier will discuss “Lessons Learned from Recent HIPAA Privacy Rule and Security Rule Enforcement Actions.” As one of Mr. Didier’s colleagues said in the CBS report: “I think it gets a little scarier from here, honestly. Imagine that physicians, clinical staff, nurses came in one day and instead of data being encrypted or unavailable, it was all wrong: prescriptions, allergies, which leg to amputate ... and you didn’t know it was wrong.” The risks are, indeed, frightening, not only for the accuracy of your data but also for the protection of your patients’ sensitive health information. The increased use of mobile technologies and applications by all health care providers, including home and community based clinicians, provides new risk areas that leave organizations incredibly vulnerable, absent a strong compliance plan that protects against data breaches and other HIT risks. In recent months, the federal government has increased its scrutiny and oversight in these areas and has imposed millions of dollars in fines and penalties. On October 19, Mr. Didier will discuss lessons learned from these cases. You’ll also gain strategies, tools and resources that home care providers and other covered entities can use to reduce compliance risk and increase protections. This segment is just one of several expert sessions providing insights and updates to your leadership and compliance teams on the laws that impact your financial integrity, your audit vulnerability and your reputation. Who should attend? CEOs, COOs, corporate compliance officers and other managers who have responsibility for planning, operationalizing and establishing a compliance-conscious culture at your organization. From big-picture considerations to the concrete mechanics of maintaining a compliance program, HCA’s signature Compliance Symposium will: emphasize the focus areas targeted by government auditors (i.e., OMIG and OIG); provide takeaways and best-practice guidance based on real-world cases of HIT- and HIPAA-related breaches and enforcement actions; help you overcome exposure and identify new risks introduced by your participation in new integrated models of care; and examine growing segments of the home care continuum that are drawing scrutiny and new regulatory activity from state compliance agencies. Register today at http://hca-nys.org/general-news/hcas-oct-19-compliance-symposium-addresses-your-topworries-concerns-needs.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
Join HCA for LHCSA & HCC Member Forums to Gain Critical Updates The next HCA member Downstate LHCSA Forum and HCC Forum are coming up later this month and next in New York City. Participation in HCA member forums gives you an opportunity to interact with HCA staff and fellow members, and exchange valuable information with your colleagues. Coming up first is the HCC of HCA Member Forum for LHCSAs who were formerly members of the Home Care Council (HCC). It’s being held at a new location this time (Selfhelp Community Services, 520 Eighth Avenue, 5th Floor Board Room) on September 19 from 10 a.m. to 12:30 p.m. Our Downstate LHCSA Forum, on October 11, is also being held at a new location, VNSNY’s Corporate Office Auditorium (107 E. 70th Street), from 10 a.m. to 2:30 p.m. The Forums will cover a range of topics distinct for each audience. The HCC Forum will specifically include an update on HRA contracts and other related issues. Both forums will address FLSA funding; 24hour/live-in cases; QIVAPP monies; the CDPAP fiscal intermediary authorization process; and other regulatory issues. Registration forms and further information for both Forums are at the links below. Please register today! HCC Forum: http://hca-nys.org/wp-content/uploads/2017/08/HCC-Forum-9-19-17-Registration-Form.pdf Downstate LHCSA Forum: http://hca-nys.org/wp-content/uploads/2017/08/October-11-2017-DownstateLHCSA-and-HCC-Forum-Registration-Form.pdf
Hospice QRP Data Specs, Effective April 1, 2018, Now Available The final version of the Hospice Item Set (HIS) data submission specifications (v2.01.1) is now available. This version of the specifications will go into effect on April 1, 2018. It can be obtained in the downloads section of the HIS Technical Information webpage at https:// www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-QualityReporting/HIS-Technical-Information.html. Note that there have been no additional changes since Errata V2.01.1. This version of the data specifications consists of the following files:
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Hospice data specs overview (v2.01.1) FINAL 08-15-2017.pdf Hospice data dictionary (v2.01.1) FINAL 08-15-2017.zip Hospice data specs CSV files (v2.01.1) FINAL 08-15-2017.zip Hospice data specs HTML files (v2.01.1) FINAL 08-15-2017.zip Hospice data specs PDF files (v2.01.1) FINAL 08-15-2017.zip
The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
VBP Bootcamps Announced The state Department of Health (DOH) has announced additional Value Based Payment (VBP) bootcamps. VBP bootcamps are a regional learning series to equip VBP contractors and interested parties (such as Managed Care Organizations, Providers, Associations, and Community Based Organizations) with the knowledge necessary to implement payment reform. The VBP bootcamps will consist of a day-long session in five regions across the State, tentatively scheduled for 9 a.m. to 5 p.m. The same subjects and content will be covered in every region. The bootcamps will include breakout sessions and workshops on VBP Financing; VBP Contracting; VBP and the Social Determinants of Health/Community Based Organizations; VBP Quality Measures; and VBP for Managed Long Term Care. The schedule and locations for VBP bootcamps are as follows: Date
Region
Location
Address
Oct. 10, 2017**
Capital Region**
The EggͲSwyer Theater**
1 Empire State Plaza, S Mall Arterial, Albany, NY 12203
Oct. 18, 2017
New York City
The New York Academy of Medicine
1216 5th Ave, New York, NY 10029
Oct. 23, 2017
North Country
High Peaks Resort
2384 Saranac Ave, Lake Placid, NY 12946
Nov. 3, 2017
Central New York
Rochester Radisson Riverside
120 E Main St, Rochester, NY 14604
Nov. 15, 2017
Long Island
The Long Island Marriott
101 James Doolittle Blvd, Uniondale, NY 11553
**All of the sessions for the Capital Region VBP bootcamp will be webcast live and recorded. The link will be provided when it becomes available. Registration for each region will open approximately three weeks in advance of the session and close one week before the event. The registration link will be announced when it becomes available. Space will be limited for each region, and space will be on a first-come first-served basis. DOH asks that all organizations limit participation to no more than four participants. As a reminder, VBP bootcamps are being considered the ‘4th semester’ of VBP University. If you attend a VBP bootcamp, and have completed all 3 semester quizzes of VBP University with a passing grade of 80 percent or higher, you will receive a printed copy of your ‘VBP University diploma’ at the session you attend. To learn more and participate in VBP University, visit www.health.ny.gov/VBP. Any questions should be sent to VBP@health.ny.gov.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 32 September 11, 2017
Resources
“Private Duty Nursing Manual Prior Approval Guidelines (updated in August 2017),” eMedNY https://www.emedny.org/ProviderManuals/NursingServices/index.aspx
“Public Health Information Technology: HHS Has Made Little Progress toward Implementing Enhanced Situational Awareness Network Capabilities,” by the U.S. Government Accountability Office http://www.gao.gov/assets/690/686971.pdf
For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
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