October 2, 2017 Edition of the Situation Report

QUALITY CONFERENCE

VBP

SEPSIS & MLTC

PERSONAL CARE RATES

HCA’s Quality & Technology Symposium is now open for registration! We have a stellar line-up of topics, from QAPI planning to Advanced Home Health Aides, to palliative care, and “disruptive technologies.”

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DOH continues to work on Level I VBP contracting template to assist MLTCs and home care agencies.

HCA was on the faculty of a DOH webinar with MLTCs, MCOs and DSRIP PPSs to convey the value of utilizing HCA’s sepsis screening tool.

DOH has issued the 2017 personal care rates for nonNYC providers. Get all the details and information from the rate sheets.

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COMING UP

Your Source for HOME CARE News, Policy and Advocacy

Vol. 2, Issue 35 | October 2, 2017

Downstate LHCSA and HCC Member Forum Oct. 11, 2017 New York City

Graham-Cassidy Health Bill Withdrawn From Vote

Corporate Compliance Symposium Oct. 19, 2017 Albany

With at least three crucial Republican Senators saying they would vote “no,” the Senate last week shelved its latest plan to repeal and replace the Affordable Care Act (ACA).

Blueprint for OASIS Accuracy OASIS C-2 Oct. 23 & 24 (Workshop) Oct. 25 (Optional COS-C exam) NYC Quality & Technology Symposium Nov. 16 & 17 Suffern The Second Annual Women in Health Care Leadership Summit Dec. 7 & 8 Saratoga Springs All HCA programs and registrations are posted at http://hca-nys.org/ events-education/ upcoming-events

GOP pivots to tax reform but weighs future legislative maneuvers targeting ACA

This latest effort, known as the Graham-Cassidy bill, included disastrous proposed cuts to Medicaid. It was a target of vigorous HCA opposition, including our involvement in a See BILL p. 2

HCA Continues Full Court Press on HHGM Advocacy Bipartisan Group of Senators Advocates Against HHGM Proposal A bipartisan group of 49 senators, including New York Senator Kirsten Gillibrand, wrote last week to U.S. Secretary of Health and Human Services (HHS) Tom Price and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma seeking See HHGM p. 4

INSIDE Graham-Cassidy Bill Withdrawn From Vote..................................................1 HCA, Senators Advocate Against HHGM Proposal..........................................1 HCA Briefs Members on Advocacy in Response to Hour/Live-in Cases............1 Member Hiring Announcements...................................................................3 Register Now: Nov. 16 and 17 Quality and Technology Conference...................5 HHS Secretary Resigns..................................................................................6 Minimum Wage Survey Extended to Oct. 16...................................................7 HCA Emergency Preparedness Program Draws Overflow Audience................7 DOH Working on, Finalizing, Contracting Template for MLTC VBP.....................9 DOH Holds Major Webinar for MCOs, PPS Hospitals on HCA Sepsis Tool..........10

HCA Briefs Members on Developments, HCA Advocacy in Response to Court Cases Regarding 24-Hour/Live-in Services HCA pursues regulatory redress, immediate DOH/DOL protection/coverage in interim Last week, HCA held a statewide member call about three pivotal court cases – all the subject of recent appellate division decisions – pertaining to the wage, overtime See CASES p. 6

Participate in Home Care Workforce Survey & Report..............................11 DOH Issues Final 2017 Non-NYC Personal Care Rates................................12 Upcoming CMS Call on Quality Star Rating Algorithm..................................12 Changes to Disability Benefits Claim Process...........................................13 Need Updated OASIS Credentials or COS-C Exam Certificate?....................13 Get Insights on VBP Compliance Planning at Oct. 19 Symposium................14 VBP Bootcamp in NYC Open for Registration..............................................14 VBP University, Semester 3 Launched.......................................................15 CMS Guidance for Hospice Claim Adjustments..........................................16 State Outlines Activities Related to Issuance of New Medicare Cards .........17 Medicare Appeal Threshold Amounts for 2018 Announced........................17 Resources............................................................................................................18

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Volume 2, No. 35 October 2, 2017 

BILL from p. 1 coalition of more than 30 New York provider associations, labor and consumer groups that has regularly engaged Congress on opposing this bill – and its predecessors – aimed at ACA’s repeal-and-replacement. This latest version, in particular, had been widely assailed by insurers, health care providers and several Governors nationally for the severity of its cuts.

Indeed, an analysis by the Congressional Budget Office (CBO) laid bare the numbers in stark terms. The bill’s proposal to blockgrant Medicaid would save the federal government at least $133 billion over the next ten years. But this would come at the cost of “millions” of Americans losing health coverage – an amount that the CBO couldn’t pinpoint with precision, given that the “block-grants” would leave many decisions up to the states regarding their use of federal funds and waiver options.

Most astonishingly, the CBO updated its projections last week to find that the bill would have cut Medicaid by $1 trillion over ten years.

According to the Center on Budget and Policy Priorities, the bill’s block-grant policy and the Medicaid per capita cap would cut federal spending to New York State by $18.9 billion through 2026 – an amount that the state could not absorb, according to Governor Cuomo.

Now that this latest ACA repeal-and-replace effort has withered, Republican leaders in the House and Senate have pivoted their focus toward comprehensive tax reform, which the GOP originally devised as a follow-up to ACA’s repeal. However, there remains some talk that the two issues – overhauling taxes and health care – may be paired in a legislative maneuver that buys Congress more time for a vote on health care through the reconciliation process. It remains to be seen whether this is a viable approach for Republican leaders to continue on the repeal-and-replace path.

Meanwhile, over the past several months, Tennessee Republican Senator Lamar Alexander and Washington Democrat Senator Patty Murray had been working on a bipartisan effort to stabilize insurance markets and address premium hikes, separate from the broader actions on ACA. That effort was stalled as Graham-Cassidy drew away political oxygen. It is 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

Volume 2, No. 35 October 2, 2017 

unclear, especially in the current political environment, whether those bipartisan talks will resume – and to what extent.

HCA will continue to keep you apprised of these critical decisions in Congress on both the Medicaid and Medicare fronts.

Telehealth, Chronic Care Legislation Passes Senate At virtually the same time that the Graham-Cassidy bill fizzled, the Senate last week unanimously passed health care legislation on a rare bipartisan basis: The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act.

Chief Financial Executive Oneonta, New York Bassett Healthcare Network: At Home Care, Inc. (AHC), a nationally recognized and progressive Medicare Certified Home Health Care agency, seeks to hire an executive level financial leader.

Operating across five predominantly rural counties in Central NY, AHC is an integral healthcare network partner. With a data driven integrated financial and clinical leadership approach, the individual will be responsible for planning, oversight and directing all fiscal operations of the organization.

Candidate Qualifications x Experienced home health financial leader with McKesson Horizon IS experience, preferred x MS Office and accounting software experience required x A clear and concise communicator, written and oral x Education: bachelor’s degree in accounting or finance required; Masters or CPA, preferred Competitive salary and benefit package offered.

For more information, or to submit a CV in confidence, please direct to: Patricia Brown, Director HR; 25 Elm Street, Oneonta NY 13820 Or, E-mail: pbrown@ahcnys.org

CHRONIC, which passed the Senate on September 26, would expand coverage of telehealth services in Medicare Advantage managed care and certain types of Accountable Care Organizations.

Presently, Medicare only covers telehealth in certain circumstances, including for beneficiaries residing in rural areas. CHRONIC would expand telehealth coverage to include people with chronic conditions.

CHRONIC would also extend the Medicare Independence at Home (IAH) demonstration by two years. (The demo was set to expire on September 30.) IAH, which began in 2012, lets medical practitioners like nurses and doctors deliver in-home primary care for certain applicable Medicare beneficiaries.

The bill would also direct CMS to assign beneficiaries to certain types of ACOs at the beginning of the year, instead of retrospectively attributing beneficiaries to ACOs. HCA will report on any further action with this bill if or when it is taken up by the U.S. House of Representatives.

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SEEKING ASSISTANT DIRECTOR OF HOME CARE New York, NY 10018 Responsible for managing the day-to-day Home Care operation for NY City-based not-for-profit organization. Provides direct supervision of the Service Manager and In-take Department. This includes ensuring that the quality and quantity of service provided is consistent with agency mission, policies, and goals, plus compliance with all relevant government regulations.

WHY WORK FOR US? JASA is a challenging and rewarding place in which to work.

Professional employment possibilities are available to those who have the requisite skills, experience, and commitment to our essential mission. In addition to a competitive salary, JASA offers a comprehensive benefits package to its full-time and regular parttime employees. This includes major medical, dental, and life insurance; 401k tax-deferred savings plan; flexible spending account; pre-tax transit; and a generous leave policy.

CHECK OUR WEBSITE FOR THE FULL JOB DESCRIPTION FOR THIS POSITION http://www.jasa.org/careers HOW TO APPLY Email résumé and cover letter to: jobs@jasa.org.

Indicate Assistant Director - Home Care - Manhattan in subject line.

SUBJECT TO REVIEW FOR PURPOSES OF ADAAA JASA is committed to Equal Opportunity Employment

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Volume 2, No. 35 October 2, 2017 

HHGM from p. 1 withdrawal of the Home Health Groupings Model (HHGM) proposal. The letter is in response to an intense advocacy campaign led by HCA, its state home care association counterparts across the nation, the Council of State Home Care Associations, as well as the National Association for Home Care and Hospice (NAHC), Elevating Home, and the Partnership for Quality Home Health.

HCA had visited with the offices of Senator Gillibrand and Senator Charles Schumer this week and in early September to advocate for aggressive advocacy in opposition of the HHGM. In response, Senator Gillibrand signed the bipartisan letter to CMS/HHS and Senator Schumer’s office vowed to use his leadership position as Minority Leader of the Senate to communicate HCA’s and the home care community’s concerns about HHGM. The September 26 Senate letter follows one day after the comment deadline for CMS’s proposed 2018 Home Health Prospective Payment System (HHPPS) rule, which includes the HHGM. According to a report in Home Health Care News, this process drew over 1,300 public comments, including HCA’s (available at http://hca-nys.org/letters-andcomments/hca-comments-on-2018-hhppswith-focus-on-hhgm-payment-cuts). In the weeks leading up to September 25, HCA strongly encouraged HCA provider members to issue comments of their own (which many did), given the severity of the proposed HHGM payment cuts, estimated at $950 million nationally. (In broad strokes, these cuts would be achieved by changing the unit of payment for home health episodes from 60 days of care to 30 days.) We also urged members to write to Congress using our Legislative Action Center.

From left: Michael Freytag of Blacktree Consulting, Nathan Constable of Elevating Home, HCA President Joanne Cunningham, June Castle and Andrea LazarekLaQuay of Nascentia Health, and Representative Claudia Tenney (R-NY).

“We have heard from a number of stakeholders who are concerned that the proposed rule lacks sufficient information and data points to allow home health agencies to accurately estimate the impact of the proposed HHGM,” states the Senators’ letter, which was spearheaded by Florida Senators Marco Rubio, a Republican, and Bill Nelson, a Democrat. “It is important that those most affected by the proposed rule have the opportunity, as well as the necessary information, to evaluate any consequences prior to the Centers for Medicare and Medicaid Services’ finalizing the proposed reforms.”

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Continued from previous page “While we support efforts to increase efficiencies in Medicare, we believe this must be done in a prudent manner that does not compromise access to care for the increasing number of seniors who depend on these services to remain healthy and at home in their communities,” the letter adds.

CMS’s plan for HHGM – and the 2018 HHPPS proposed rule as a whole – was first made public on July 25, weeks later than usual. This timetable has allowed only two months for provider input, by last week’s comment deadline, before HHGM could possibly be codified in CMS’s upcoming final HHPPS rule, expected in November, even though the HHGM provisions are set to go into effect in 2019.

In our advocacy to Congress and CMS, HCA has noted that this enormous, untested overhaul to home care’s 18year-old Medicare reimbursement system would fall on top of yearly destabilizing home health reimbursement cuts since 2014. Home health rebasing cuts and others have left New York home health agencies in the red, on average, operating at a negative-6.97 percent Medicare operating margin overall in 2015 (the most recent year of data available).

Among our primary concerns is the fact that CMS’s HHGM proposal is not budget-neutral, “an important protection against system-wide fiscal destabilization that CMS hasunwisely rejected in this instance,” we note in our comments.

In visits this week with Members of the New York Congressional Delegation, HCA and its members continued to highlight the need for the HHGM to be opposed by Congress, and advocated for New York’s Representatives to sign a similar letter in the House of Representatives that is expected to be released soon for signatures. HCA appreciates the advocacy of HCA Board Member June Castle and her colleague Andrea LazarekLaQuay both of Nascentia Health Options (formerly VNA Homecare), Dan Lowenstein of VNSNY and Michael Freytag of Blacktree Consulting, all of whom attended meetings with HCA President Joanne Cunningham this week.

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Register Now: November 16 and 17 Quality and Technology Conference Registration is now open for HCA's Quality and Technology Symposium on November 16 and 17!

See the registration form at the back of this week's newsletter.)

Be sure to invite your clinical managers, Directors of Patient Services, quality improvement officers, and other strategic planners (including the leadership executives at your agency) who need to know the latest trends, policy developments, quality program requirements, and technological opportunity areas to fulfill your mission at the fundamental intersection of quality and technology in the home care, managed care and hospice arenas.

The Situation Report: the Home Care Association of New York State  CASES from p. 1 and “spread-of-hour” requirements for 24-hour/live-in services.

The call with HCA members was led by HCA’s executive and policy teams, our General Counsel Frank Fanshawe at Jackson Lewis, and our contract lobbyist, Sean Doolan, at Hinman Straub, all of whom are engaged on a multi-part strategy to reach a solution for providers in the face of enormous cost exposure and ambiguous state directives related to these court decisions and the underlying issues that prompted them.

HCA has written extensively about the three cases, two of which upheld lower court rulings and one of which rejected a lower court ruling. All three, however, reached similar conclusions about the conflict between a state Department of Labor (DOL) “opinion letter” and DOL’s own underlying regulations pertaining to 24-hour/live-in cases.

In effect, the courts have ruled that DOL’s guidance stipulating a 13-hour standard for live-in workers – which providers have followed in good-faith, based on a 2010 DOL opinion letter – is in conflict with its actual regulation language. The courts have, thus, determined that, based on the regulation language itself, non-residential aides should be paid the minimum wage for all 24 hours of their shifts, regardless of whether they were afforded 8 hours for sleep (including 5 hours of uninterrupted sleep time) and three hours for meals (aka, “13-hour rule”).

The cases open up major exposure for massive wage liabilities that can go back six years. In communications with DOL, the state Department of Health (DOH) and the Governor’s office, HCA has stressed the gravity of this issue, urging an immediate, emergency action that: 1) protects providers, plans, workers and patients in the form of either fully protective guidance (i.e., protecting against fiscal and other liability to providers and plans) or reimbursement to compensate workers and hours commensurate with the court’s ruling, while the case is adjudicated; and 2) regulatory clarification affirming DOL’s own interpretive guidance, both retroactive and prospective.

HCA continues stressing that this issue has the potential to decimate the home care system and adversely impact individuals who need home care.

We are informed that the crisis is receiving urgent attention from high levels within the Cuomo administration, given the huge risks to the state, patients, the home health and managed care system, the workers, and, ultimately, the state’s vital authority for interpreting its own rules and expectations.

HCA also advises members to consult their own counsel on how to proceed and will continue to provide you with updates as necessary, via e-mail alert.

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Volume 2, No. 35 October 2, 2017 

HHS Secretary Resigns U.S. Health and Human Services (HHS) Secretary Tom Price resigned from his Cabinet-level position on Friday following allegations about his private use of government flights.

As of press time for The Situation Report, a replacement has not been named, though several media reports pointed to the possibility that U.S. Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma may be on the list of candidates. CMS is a division within HHS. Repeal-and-replacement of Obamacare was among HHS Secretary Price’s top focus points, in addition to overseeing the HHS Department and its many divisions, including CMS, which determines payment and regulatory policies affecting a range of home and communitybased programs, among others.

HHS has also played a large role in regulatory reform, including bundled payments and accountable care organizations.

With the repeal-and-replace effort effectively stalled yet again – and Congress pivoting toward a tax overhaul (see related p. 1 story) – HCA will be watching closely to determine the impact of leadership changes within HHS on the continuing debates over health care policy.

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Minimum Wage Survey Extended to Oct. 16 HCA obtains additional Information for members to complete the survey As reported to members last week, the state Department of Health (DOH) has extended the deadline for completing the ”Home Care Provider Minimum Wage Reconciliation Survey” for an additional two weeks. The new due date is Monday, October 16, 2017.

HCA had requested an extension due to the difficulty of completing such a complex survey in such a short time, including the occurrence of religious holidays during the original time period. We appreciate DOH’s extension.

In response to numerous questions raised by HCA and member agencies, what follows are some additional clarifications obtained by HCA for completion of the Home Care Minimum Wage survey. (Previous editions of The Situation Report have provided additional information.)

Survey structure The attestation was posted on Monday, September 25. Some users may not be seeing it if they have not completed the survey yet. Before starting the survey, their dashboard will say “Start Survey.” If they start the survey, but they don’t work their way through to the end, the dashboard will say “Continue Survey.” Once they work their way through the entire survey to completion, the dashboard will change to “Pending” and that is when they will Continued on next page

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On September 27, HCA drew an overflow audience of more than 150 home care, hospice and MLTC providers for our conference on Emergency Preparedness Essentials. The program included a panel session with state and local health emergency preparedness officials (bottom photo) stressing the importance of: local partnerships; surge capacity planning; mutual service agreements; and other issues for emergency preparedness, including questions about evacuation procedures and transportation assistance levels for ensuring the safety of patients in the event of an emergency.

The program also delved into the provisions of the upcoming Conditions of Participation (CoPs) for emergency preparedness affecting CHHAs. Attendees also learned about Incident Command Principles, and how these structures can be adopted within the provider structure to ensure a smooth chain of command and operational architecture to respond to disasters. The program closed with a tabletop drill that fulfilled one of the requirements of the upcoming CoPs.

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Continued from previous page see a button to print their survey/attestation form. Once they have printed, signed, and scanned it, they can upload the attestation from the dashboard as well.

Other helpful information includes: 

DOH has posted a revised Frequently Asked Questions (FAQs) document after HCA pointed out certain inaccuracies in the material. It is on the Office of Public Administration website (“what’s new” section): http://www.hcrapools.org//home_care_whats_new.cfm.

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LHCSAs completing the survey will see CHHA as one of the revenue sources in question 1a, and should enter all hours billed to the CHHA on the CHHA line. They should NOT assume where those billed hours go to even if they know the insurance status of the members they served.

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In question 1a, home care providers who receive revenue from other sources, such as Expanded Inhome Services for the Elderly (EISEP), hospice and Title XX, can include these under “Commercial Payer.” Billable hours under Medicare managed care should be included under “Medicare.” Long term insurance coverage can go under commercial and out-of-pocket can go under private pay.

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In questions 2b/3b/4b, under wage hours, agencies should include all hours paid under all revenue sources listed in question 1a.

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In questions 2b/3b/4b, under wage hours, you should not include any direct care or administrative staff whose hourly wage is above $14.99.

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In questions 2b/3b/4b, under wage hours, agencies should include all hours paid for work, including overtime or holidays, but at the base hourly wage not the overtime/holiday wage.

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In questions 2b/3b, under “dollars spent on additional taxable wages,” if an aide is paid at a higher rate than the base rate (for example, $15 instead of $13), then the incremental difference above the base wage ($2 in previous example) is counted.

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In questions 2b/3b, under “dollars spent on additional taxable wages,” the agency can include accrued sick and vacation pay not already paid.

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Paid time off (PTO) should not be included in either questions 4b or 4c.

DOH has 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.”

Agencies required to submit the survey include CHHAs, LHCSAs, LTHHCPs and Consumer Directed Personal Assistance program Fiscal Intermediaries (FIs). DOH has confirmed that even home care providers who don’t employ aides but contract for such services are required to complete the survey.

The survey can be accessed at https://www.hcrapools.org/HomeCare_RCR/HomeCare_login.cfm. Agencies must first register with the state Office of Pool Administration (OPA) at https://www.hcrapools.org/ HomeCare_RCR/registration_new_hc_contact.cfm. A separate OPA account is required even if you already

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have one under the Health Facility Cash Receipts Assessment Program. If you have difficulties establishing an OPA account, contact OPA at webpools@hcrapools.org or at (315) 671-3800.

Webinar and Further Guidance DOH recently held a webinar on the survey, along with screenshots to assist in its completion. HCA provided a summary of key updates from the webinar in last week’s edition of The Situation Report. (See p. 5 at http://hca-nys.org/wp-content/uploads/2017/09/SitRep092517.pdf.) The webinar is posted at http:// www.hcrapools.org//home_care_whats_new.cfm.

DOH has also posted at this site some short briefs on: How to Create an Account; How to Add an Entity; How to Retrieve a Forgotten User ID and/or Password; and How to Complete the Survey.

Submitting Questions Members are strongly encouraged to submit questions. HCA has submitted questions of our own and has gotten helpful responses.

Questions about the survey should be sent to: mltcrsmw@health.ny.gov (please copy Andrew Koski at akoski@hcanys.org, so that HCA can collect questions and responses for further member communications).

DAL DOH has posted a Dear Administrator Letter (DAL) about the survey on the Health Commerce System. It does not include any new information, but reinforces some of the above, and members are encouraged to keep it for your records of DOH’s official guidance. HCA has posted the DAL to our website at http://hca-nys.org/wpcontent/uploads/2017/09/DAL_Minimum-Wage-Survey_092717.pdf.

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

DOH Working on, Finalizing, Contracting Template for MLTC VBP The state Department of Health (DOH) continues working on a basic Level I value based payment (VBP) contracting template to assist managed long term care plans (MLTCs) and home care agencies.

The template, when finalized, is intended to provide a basic format and method for targeting Level I performance incentive payments to plans, and, in turn, to network providers for achieving quality metrics.

Particularly emphasized will be metrics the Department highly correlates with potentially avoidable hospitalizations – e.g., sepsis, urinary tract infections, respiratory infections, heart failure, electrolyte imbalance and anemia. As contemplated, performance would be calculated on a comparison of a baseline period with a period (or periods) of service/patient experience under the VBP contract.

Informed by the discussions with our MLTC and agency members, HCA has been providing input to DOH with recommendations for assisting plans and providers in the transition to VBP, including considerations related to the draft template. Additionally, HCA, in conjunction with plan and provider members, has offered ideas to otherwise assist the achievement of VBP Level I contracting milestones and timetables, particularly as it is being required by DOH for a January 1 effective date. Our input and engagement is ongoing.

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Continued from previous page Details will follow upon DOH’s finalization of this template, which is intended to provide a useful foundation for MLTCs and providers to proceed. Over and above the template, there is much room and need for guidance and assistance, which is part of our priority planning for assistance to plans and providers. For example, on Friday, HCA and partners joined DOH (see related story below) on a statewide webinar for MCOs, MLTCs and lead hospital performing provider systems (PPSs) to receive a detailed presentation of HCA’s Sepsis Tool which offers a concrete method of approaching the VBP potentially avoidable hospitalization metrics for sepsis, as well as the other avoidable hospitalization measures.

Later today, HCA will be participating in a major meeting of the state’s VBP steering committee, and will report to the membership on the proceedings.

HCA will keep members closely apprised of the developments with the VBP template as well as all other relevant VBP developments.

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

DOH Convenes Major Webinar for MCOs and PPS Hospitals on HCA Sepsis Tool The state Department of Health (DOH) hosted a major webinar Friday on the HCA Sepsis Tool.

Originally targeted to all of the managed care plans and managed long term care plans in the state, the Department also notified and invited all of the Performing Provider Systems (PPSs) leads under the Delivery System Reform Incentive Payment (DSRIP) program to participate.

The webinar faculty included HCA, DOH, the U.S. Centers for Disease Control, IPRO, HCA-provider and MLTC member Mohawk Valley Health System (MVHS), and the National Sepsis Alliance.

The webinar provided detailed background on:

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The problem of sepsis.

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Its priority concern in the health care system – in terms of cost, mortality, morbidity, hospital and emergency room use, quality of care and life.

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The role of sepsis and the HCA tool in relation to potentially avoidable hospitalizations and costs, and to VBP and DSRIP overall.

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The development of the tool.

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The tool’s inclusion in the CMS/IPRO special innovations program in New York State (where over 9,000 clinicians have already been trained in its use).

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The tool components, clinical algorithm and protocol.

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Guidance for agency adoption.

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Continued from previous page 

Next steps.

In terms of next steps, and as announced in last week’s edition of the Situation Report, HCA has just been awarded a major grant by the New York Health Foundation to support implementation of the HCA tool statewide through in-depth training for home care clinicians and agency leaders, coordination of clinical partners across sectors (home care, hospitals, physicians, EMS, etc.), data compilation and sharing to support agencies and potential state policy development, public outreach and communications, and other key elements. Much more will be announced about the benefit of the grant to the home and health care system in the coming weeks. HCA’s sepsis initiative steering committee will also soon convene, consisting of all of the major sector representatives, as well as CDC and other officials.

Meanwhile, organizations across the country – home care, hospitals, medical record vendors and others – continue to contact HCA to engage on the initiative.

Providers and plans can obtain direct information on how to adopt and use the HCA tool by e-mailing sepsistool@hcanys.org.

HCA thanks DOH, CDC, IPRO, Sepsis Alliance and MVHS for their leadership in this issue and in the MCO/ MLTC/PPS presentation. We also thank the many managed care and hospital representatives who participated in Friday’s webinar.

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

Participate in Important Home Care Workforce Survey & Report With workforce shortage and emphasis, provider participation is vital Recently, the Center for Health Workforce Studies (CHWS) at the University at Albany’s School of Public Health, collaborating with HCA input, mailed out a survey (via postal mail) asking for your assistance in obtaining more timely information on health workforce employment for an upcoming report. The mailing consisted of a one-page survey that, once completed, may be either faxed back at (518) 402-0252 or mailed back in the postage-paid envelope that was enclosed with the survey.

CHWS monitors annual health care employment trends in the state of New York and issues a report of its findings each year. Its most recent report, The Health Care Workforce in New York, 2015-2016: Trends in the Supply and Demand for Health Workers, can be found on its website at http://www.chwsny.org/.

The primary purpose of the survey is to better understand the current recruitment and retention problems faced by home health agencies. CHWS indicates that individual answers to the survey will be kept strictly confidential, though your responses will be aggregated and reported at regional and state levels. CHWS estimates the survey should take 5-10 minutes to complete.

The survey is due back by November 17, 2017. Your participation will contribute to increased understanding of current and emerging health workforce issues in New York. The final report will be released at the end of this year and will be available on CHWS’s website. Questions can be directed to Lauren Boyd at (518) 402-0250 or lboyd@albany.edu. Thank you for your support of this important study.

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DOH Issues Final 2017 Non-NYC Personal Care Rates The state Department of Health (DOH) posted to the Health Commerce System (HCS) the final 2017 “hotline” Medicaid rates for Personal Care and/or Consumer Directed program providers.

The rate calculations sheets are located in the “Rate Publication Selection List” drop-down section of the HCS, dated September 21, 2017.

These rates, effective January 1, 2017, reflect the application of a zero percent roll factor adjustment. The rates also reflect an 8.16 percent uniform percentage rate add-on payment to personal care providers in social service districts which do not include a city with a population of over one million persons. To be eligible for this rate add-on, a personal care provider must have submitted to DOH a signed certification statement on the use of these funds.

The 2017 recruitment and retention add-on of 8.16 percent also includes adjustments to reimburse non-New York City (NYC) personal care providers for the uniform additional hourly Fair Labor Standards Act (FLSA) addon amount as determined in the recently published FLSA adjustment rates effective October 13, 2015.

These 2017 rates also include an adjustment to the live-in ceilings for both personal care and consumer directed services to be based on 13 hours of care, consistent with the requirements of MLTC Policy 14-08 and consistent with the published rate effective October 13, 2015; however, this is not consistent with the recent decisions in the Andryeyeva v. New York Health Care Inc., and Moreno v. Future Care Health Services, Inc. court findings. (See related p. 1 story.)

Personal Care and Consumer Directed program providers have 30 days to file an appeal with DOH but only in cases where the 2017 final rates have changed from the 2017 initial rates.

For specific questions about your rates, contact DOH’s Richard Kappes or Kathy Omencinsky at (518) 473-4421.

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

CMS to Hold Oct. 10 Conference Call for CHHAs on Quality of Patient Care Star Rating Algorithm The U.S. Centers for Medicare and Medicaid Services (CMS) has scheduled a call on Tuesday, October 10 from 2 to 3 p.m., so that Medicare certified home health agencies (CHHAs) can learn about modifications and proposed changes to the way the Quality of Patient Care star rating is calculated, including the removal of the influenza measure.

During the call, CMS will present the rationale, proposed timing, and impact of the changes. A question and answer session will follow CMS’s presentation. Your can register for the call via CMS’s Medlearn Matters Network website at https://blh.ier.intercall.com/.

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

Volume 2, No. 35 October 2, 2017 

Changes Made to the Disability Benefits Claim Filing Process The New York State Workers’ Compensation Board is making changes to the disability benefits claim filing process to “simplify filing and capture more information earlier in the life of a disability benefits claim.”

To reduce the number of forms used to file disability benefits claims, the Notice and Proof of Claim for Disability Benefits (Form DB-450) and the Notice of Proof of Claim for Disability Benefits of Unemployed Claimant (Form DB-300) have been combined into a new Form DB-450, entitled Notice and Proof of Claim for Disability Benefits. Claimants will now use the revised Form DB-450 to file all disability benefit claims with the Board or insurance carriers, regardless of their employment status.

Other filing instructions have been clarified, as well, and questions have also been added to the new Form DB-450 to collect whether the claimant’s disability was the result of a motor vehicle accident.

The new Form DB-450 is available at http://www.wcb.ny.gov/content/main/forms/db450.pdf. Use of the new Form DB-450 is effective immediately. The old form will continue to be accepted until December 22, 2017.

Need Updated OASIS Credentials or COS-C Exam Certificate for OASIS Mastery in Home Health?

Are you in need of contact-hours and OASIS training?

Do you or your staff need to renew your COS-C exam certificate?

OASIS data collection is the measurement of your patients’ clinical needs, intensity and outcomes. And, like any measurement, the practice of OASIS assessment is only as good as the eye “reading the scale” and the hand entering its values.

Your agency’s reimbursement, its Home Health Compare ratings, and its overall profile of clinical findings and outcomes all hinge on OASIS accuracy.

On October 23 to 25 in New York City, HCA is offering the last of our Blueprint for OASIS Accuracy sessions in 2017, providing your clinicians, field data collectors and their supervisors with the tools to master the latest data-collection rules, conventions and applications.

The program includes a two-day workshop on October 23 and 24, led by experts at OASIS Answers, along with an optional COS-C (Certificate for OASIS Specialist-Clinical) certification exam at the same location on October 25.

Learn more by downloading the flyer, or register online, both at the links below.

Don’t miss this final opportunity for rigorous OASIS data collection training and best-practices brought to you through HCA. Download the flyer: http://hca-nys.org/wp-content/uploads/2017/05/Blueprint-for-OASIS-NYC-2017.pdf.

Register online: https://www.eventville.com/catalog/eventregistration1.asp?eventid=1012204.

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

Volume 2, No. 35 October 2, 2017 

Get Insights on VBP Compliance Planning, an OMIG Alert Focus, with HANYS’ Jeff Gold at Oct. 19 HCA Compliance Symposium The compliance questions for providers and managed care plans under Value Based Payments (VBP) are so vast that OMIG recently issued a VBP-specific alert urging all providers to “closely review reimbursement methodologies so they can identify where they may need to update risk-assessment activities,” accounting for VBP. (OMIG’s alert is at https://omig.ny.gov/images/stories/compliance_alerts/ Compliance_Alert_2017_01.pdf.)

Value Based Payments are fast becoming the dominant paradigm for all state Medicaid services. This new paradigm is fundamentally changing the nature of compliance planning and activities, as reinforced by OMIG. However, OMIG’s alert, which is light on details, raises many questions. Thankfully, HCA has one of the state hospital association’s top VBP experts on the program for our upcoming Corporate Compliance Symposium (October 19) to discuss the many issues related to “Program Integrity in a Value Based Environment.”

Jeffrey Gold, Senior Vice President and Special Counsel, Insurance and Managed Care at the Healthcare Association of New York State (HANYS), will discuss new areas of compliance emphasis that have implications on a broad scale for home care providers and other VBP partners. This session will put you ahead of the curve by understanding how VBP program integrity is impacting home and community based service partners in the VBP model.

Download the conference brochure here: http://hca-nys.org/wp-content/uploads/2017/09/HCA-2017Corporate-Compliance-Brochure-and-Registration.pdf.

Register online here: https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1012248.

VBP Bootcamp in NYC Open for Registration Registration for the Value Based Payment (VBP) Bootcamp in New York City is now open.

The VBP Bootcamp in New York City will take place on October 18, 2017 at The New York Academy of Medicine (1216 5th Ave, New York, NY 10029) from 8 a.m. to 5 p.m. Registration will close on October 11, 2017.

VBP Bootcamps are a regional learning series created by the state Department of Health (DOH) to equip VBP contractors, managed care organizations, providers, associations, and community based organizations with the knowledge to implement payment reform. The day-long VBP Bootcamp is designed to be an interactive training session that will give participants a thorough understanding of VBP. This event is free and open to all interested parties. Space is limited, and on a first-come, first-served basis.

DOH requests that organizations limit participation to no more than four participants.

Continued on next page

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Volume 2, No. 35 October 2, 2017

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



Continued from previous page The schedule and locations for all VBP Bootcamps are as follows:

Date

Region

Location

Address

Registration Link

Registration open until October 3, 2017 at https://www.eventbrite.com/e/vbpͲ bootcampͲ20ͲtheͲcapitalͲregionͲmidͲ hudsonͲsouthernͲtierͲticketsͲ 37649773486

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

https://www.eventbrite.com/e/vbpͲ bootcampͲ20ͲnewͲyorkͲcityͲticketsͲ 37805168276

Oct. 23, 2017

North Country

High Peaks Resort

2384 Saranac Ave, Lake Placid, NY 12946

Registration coming soon

Nov. 3, 2017

Central New York

Rochester Radisson Riverside

120 E Main St, Rochester, NY 14604

Registration coming soon

Nov. 15, 2017

Long Island

The Long Island Marriott

101 James Doolittle Blvd, Uniondale, NY 11553

Registration coming soon

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. Participation in VBP University is recommended but not required to attend a VBP Bootcamp. To learn more and participate in VBP University, visit www.health.ny.gov/VBP. Questions can be directed to VBP@health.ny.gov.

VBP University, Semester 3 Launched The state Department of Health (DOH) has announced that Semester 3 of Value Based Payment (VBP) University has been launched.

VBP University is an online, educational resource created to raise awareness, knowledge and expertise in the move to VBP. It combines informational videos and supplemental materials that stakeholders interested in VBP can use to advance their understanding of this massive transformation effort.

Semester 3 Overview Semester 3 is designed to educate users on specific, important topic areas, including Social Determinants of Health, Community Based Organizations (CBOs), and Contracting VBP. The curriculum for semester 3 includes videos on each of the topics as well as detailed guidance documents targeted towards Managed Care Organizations, providers, and CBOs. Continued on next page

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

Volume 2, No. 35 October 2, 2017 

Continued from previous page The schedule and details for VBP University semesters are as follows:

Date of Release

Area of Study

Semester One

Released in July 2017

Background and foundational information on VBP

Semester Two

Released August 2017

Topic specific information such as governance, business strategy, stakeholder engagement, finance, and data

Semester Three

September 2017ͲNow Live!

VBP Contracting and VBP & The Social Determinates of Health

Semester Four** October and November 2017**

VBP Bootcamps**

**VBP Bootcamps will take place in October and November 2017 in locations throughout the state. More information including dates and locations can be found at https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_bootcamp/2017_sessions.htm.

To watch an overview of the VBP University curriculum from NYS Medicaid Director, Jason Helgerson, click here: http://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_u/docs/ vbpu_welcome_overview.mp4.

How to Graduate from VBP University Semesters one through three conclude with a quiz on the topics covered. Those who pass all three quizzes with a grade of 80 percent or higher will receive a certificate of completion. You may take the quiz multiple times until you pass. Results are automatically sent to the Department of Health. If you attend a VBP Bootcamp, you will receive a printed copy of your certificate. If you are unable to attend a Bootcamp, a copy of your certificate will be e-mailed to you.

To view semesters one, two and three of VBP University, please visit www.health.ny.gov/VBP. Any questions can be sent to MRTUpdates@health.ny.gov.

CMS Issues Guidance on Process for Hospices to Submit List of Claims Requiring Adjustments The U.S. Centers for Medicare and Medicaid Services (CMS) has recently posted a Medlearn Matters (MLN) article that instructs hospices on how to submit a list of claims to be adjusted to their Medicare Administrative Contractor (MAC) if they have information identifying payment errors CMS’s MLN article can be downloaded at https://www.cms.gov/Outreach-and-Education/Medicare-LearningNetwork-MLN/MLNMattersArticles/downloads/SE17029.pdf.

In an effort to reduce provider burden, and maintain accuracy, CMS now instructs hospices to submit a list of claims to their MACs to be adjusted. Hospices should notify their appropriate staffs of these changes and the detailed instructions for submission.

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

Volume 2, No. 35 October 2, 2017 

State Outlines Activities Related to Issuance of New Medicare Cards In preparation for the issuance of new Medicare cards to all people with Medicare beginning in April 2018, the state Department of Health (DOH) is working to make programmatic changes in eMedNY in advance of the October 2017 testing deadline.

DOH anticipates working with its Medicaid managed care organizations, providers, and other stakeholders to ensure a smooth transition, and describes its activities in the September Medicaid Update (https:// www.health.ny.gov/health_care/medicaid/program/update/2017/sep17_mu.pdf) Provider systems and business processes must be ready to accept the new Medicare number (which is called the Medicare Beneficiary Identifier, or MBI) by April 2018 for transactions, such as billing, claim status, eligibility status, and interactions, with their Medicare Administrative Contractors (MACs).

There will be a transition period when providers can use either the Health Insurance Claim Number (HICN) or the MBI to exchange data and information with the MACs. The transition period will start April 1, 2018 and run through December 31, 2019. However, systems must be ready to accept the new MBI by April 1, 2018.

For more information regarding the New Medicare Card replacement initiative, see the following links: 

CMS’s Press Release: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/ 2017-Press-releases-items/2017-05-30.html



General Information Portal: https://www.cms.gov/medicare/new-medicare-card/nmc-home.html



Information for State Medicaid Agencies: https://www.cms.gov/Medicare/New-Medicare-Card/ States/States.html



Information for Providers: https://www.cms.gov/Medicare/New-Medicare-Card/Providers/ Providers.html

Medicare Appeal Threshold Amounts for 2018 Announced The U.S. Department of Health and Human Services has announced the annual adjustment in the “amount in controversy” threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process.

The amounts will be $160 (same as 2017) for ALJ hearings and $1,600 (up from $1,560 in 2017) for judicial review in 2018.

More information is at https://www.gpo.gov/fdsys/pkg/FR-2017-09-29/pdf/2017-20883.pdf.

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

Volume 2, No. 35 October 2, 2017 

Resources 

“Unpaid Eldercare In The United States — 2015-16: Data From The American Time Use Survey” (September 2017) www.bls.gov/news.release/elcare.toc.htm



“2017-2018 Influenza (Flu) Resources for Health Care Professionals,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/ downloads/SE17026.pdf



“Accepting Hospice Notices of Election via Electronic Data Interchange,” (September 26, 2017 Transmittal), by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3866CP.pdf

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

18

Quality AND

Technology

Crowne Plaza Hotel 3 Executive Blvd.

Suffern, NY 10901

AGENDA Crowne Plaza Hotel 3 Executive Blvd.

Thursday, November 16 Suffern, NY 10901 8:30AM

Registration and Light Breakfast

9:00 AM

HCA Opening Remarks

9:15 –10:15AM

NYS Vision & Directions in Quality Marcus Friedrich, MD, MBA, Chief Medical Officer, Office of Quality and Patient Safety, New York State Department of Health In this opening session, Dr. Marcus Friedrich will present the state’s overall vision and direction for quality. He will address: quality in the evolving health care system; priority areas of quality focus; priority state policies and initiatives; and implications for each sector, including home care, managed care and hospice. The session will also describe tools, resources and supports that the state envisions for providers and managed care plans to help achieve these priority goals.

10:15 – 11:15AM

To be truly effective, all health care quality programs must embrace innovative technological solutions for achieving process improvements, data sharing, and communication capabilities that drive improvements in patient care, analytics and oversight.

‘Disruptive Technologies’ in Home Health Carl Queton, Vice President, Sales & Marketing, OperaCare As governments continue to squabble over the future of health care, home care remains the victim of constant regulatory change. With the advent of Value Based Purchasing, our industry is not just forced to evolve but to innovate. However, the path to innovation is compounded and complicated by three top issues already facing home care: 1) shrinking margins; 2) an unprecedented caregiver shortage; and 3) a cascade of regulatory requirements.

Health care technologies, for their part, are only useful to the extent that they support the quality of care that you deliver to patients – which is the lifeblood of your overall mission and a marker of your agency’s reputability and viability in an increasingly competitive health care marketplace.

Within this environment, third-party software and hardware vendors are rising to the top, focusing their work on how to help fix one – or all – of these problems. These new approaches can be characterized as “disrupters,” which simply means a kind of innovation that upends traditional markets, models, or value systems in the business world.

HCA’s signature Quality and Technology Symposium, on November 16 and 17, is designed for home care clinical managers, Directors of Patient Services, quality improvement officers, and other strategic planners (including the leadership executives at your agency) who need to know the latest trends, policy developments, quality program requirements, and technological opportunity areas to fulfill your mission at this fundamental intersection of quality and technology in the home care, managed care and hospice arenas.

This session will discuss some of these marketplace competitive factors, as well as innovations and opportunities, including many that are already available to home care providers, such as: •

The role that telehealth, telemedicine and remote patient monitoring plays in reducing readmissions;

•

How artificial intelligence and predicative analytics can remove variables that lead patients to enter the hospital in the first place;

•

The place of online education, not just for the caregiver but also for the client; and

•

The growth of private-duty home care, and how it is becoming “Uber-ized” through new business models that are potentially circumventing traditional methods of home care delivery.

Continued…

1

Thursday, November 16 - continued 11:15AM – 12:00PM

Surviving Sepsis: a Cautionary Tale & Insights for Community-Based Interventions Joe Caruso, Sepsis Survivor (Invited) Alan Sanders, M.D. (Invited) After spending a week in a coma and experiencing significant organ failure, Joe Caruso triumphantly emerged from his life-threatening battle with sepsis. Hear his firsthand account of how hours and minutes made the ultimate difference in surviving this brutal condition. This session will also highlight the critical role of early sepsis recognition and treatment protocols in community-based settings. These insights will offer a compelling framework for home care to tackle the sepsis crisis head-on, including through HCA’s first-in-the-nation community-based sepsis screening tool, which is one component of a New York State Health Foundation grant recently awarded to HCA for clinical efforts in sepsis prevention.

Friday, November 17 8:00AM

Light Breakfast

8:30-9:30AM

Best Practices for Quality Managers TBA

Opportunities for Advanced Home Health Aides to Support Quality Outcomes

Quality alignment among collaborating clinical partners – and, indeed, across the continuum – is crucial in coordinating, measuring, and promoting excellence in care. This is especially true under integrated systems and in models like DSRIP, value based payments and managed care. What should quality directors working in each sector be doing to best align and facilitate quality and performance with their clinical and organizational partners? This session will discuss strategies, protocols and best-practices for achieving seamlessness in your clinical partnerships.

Rebecca Fuller Gray, Director, Division of Home & Community Based Services, NYSDOH

9:30-10:45AM

12:00 – 1:00PM

Lunch

1:00 – 2:00PM

Climbing Out of Chaos – A Roadmap to Sanity for Clinical Managers

In 2018, the state will be implementing a new law (enacted last year) to authorize Advanced Home Health Aides (AHHAs). Under an RN’s supervision, AHHAs will be able to perform advanced care functions, including some tasks that otherwise fall under the scope of nursing practice. Hear how the use of AHHAs in a home care plan-of-care can support quality patient care, and what quality procedures are critical to consider in this process.

Barbara Katz, RN, MSN, BK Health Care Consulting For home care clinical managers, juggling constant change while running an effective clinical operation is a daunting and exhausting task. This interactive seminar will use selfassessments and class exercises to provide managers with a toolkit of practical techniques for staying sane while working efficiently in the new world of health care. Participants will leave knowing how to: balance change and daily work; use data to distinguish real work from wasted effort; apply proven time management techniques to gain control of their time; and create a personal resilience recipe.

2:00 - 3:00PM

How One Home Care Provider Used a Novel Health IT Platform to Achieve Concrete Quality Outcomes Brian A. Schiel, Vice President, Bestcare, Inc. and Ilyne Rabinowitz, RN, Vice President, Clinical Services, Bestcare, Inc. (Invited) Case studies of the real-time disease management platform, eCaring, are demonstrating positive results in preventing unnecessary health care utilization, as well as increasing employee and patient satisfaction. Hear from a home care agency that is using this platform, and learn about the agency’s experiences and promising preliminary outcomes with this innovative technology.

3:00 – 3:30PM

Extended Break & Exhibitor Networking

Break

11:00AM – Noon

The Quality and Value Proposition for Palliative Care in Home Care Madeline Jacobs, MPA, Center to Advance Palliative Care Palliative care can be the most critical factor in the quality of a patient’s care and life. It is also critical in preventing avoidable hospitalizations and emergency care episodes, containing costs, and promoting achievement of priority quality goals, which are core elements of virtually all new health care models. In this session, we will learn about palliative care as a serious illness strategy for improving quality and value in home care.

3:30 – 4:30PM

Integrating Behavioral Health with Chronic Care to Improve Patient Outcomes Katherine Vanderhorst, RN, BSN, President, C&V Senior Care Specialists Patients with chronic medical conditions often face “double jeopardy” in the form of co-occurring behavioral health issues. This session will cover the steps for a successful behavioral health program that improves patient care, outcomes and, ultimately, the agency’s star rating by integrating behavioral health into a patient’s care plan.

4:30PM

10:45 – 11:00AM

Day One Wrap Up and Adjourn 2

12:00- 12:30PM

Lunch

Friday, November 17 - continued 12:30 – 4:00PM

Implementing QAPI Program Requirements for Senior Managers Barbara Katz, RN, MSN, BK Health Care Consulting The new Medicare Home Health Care Conditions of Participation (CoPs) require senior leaders to develop, implement and lead a robust and effective organizationwide Quality Assurance/Quality Improvement (QAPI) Program. This program must monitor and address the full scope of agency services, clinical outcomes and patient service gaps.

During this practical and interactive program, senior leaders will learn how to structure an effective QAPI program, create a quality indicator monitoring system, identify high-impact performance gaps, and launch and guide process improvement teams that can meet the CoP requirements for Performance Improvement Projects (PIPs). Participants will leave with a specific and detailed action plan for implementing QAPI requirements in their own organizations.

By the end of this program, senior leaders will be able to: • • • • • • •

Hotel Information

Explain Medicare QAPI CoP requirements; Create a QAPI structure that meets requirements; Build or refine a quality key indicator system; Choose priority areas for improvement and identify two potential PIP projects; Implement a QAPI committee; Create mechanisms for launching and guiding quality teams; and Develop a process for sustaining improvements

4:00PM

Crowne Plaza Hotel 3 Executive Blvd.

Suffern, NY 10901 A small block of rooms has been secured at the Crowne Plaza Hotel for the evenings of November 15 and November 16 at a discounted rate of:

$119/night

Wrap Up and Adjourn To make your overnight accommodations, call the hotel directly at 1-800-227-6963 before October 25th and

ask for the group code HCA.

3

Thanks to our Sponsors!

Thanks to our EXHIBITORS!

4

Registration

Payment Information

Registration Deadline: November 6 Pay by Check:

Full Conference (November 16 & 17)

Make checks payable to HCA and mail to 388 Broadway, 4th Floor, Albany, NY 12207.

Checks must be received by November 6th.

HCA Member Rate $299 Prospective HCA Member Rate $429

Pay by Credit Card: Amex

One-Day Pass

MasterCard

VISA

(Indicate date and rate)

November 16 or

November 17

HCA Member Rate $169 Prospective HCA Member Rate $259

_______________________________________ Registrant/Contact Name _______________________________________ Company Name _______________________________________ Email (required for confirmation details)

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

_______________________________________ Phone

_____________________________________________________________ _____________________________________________________________

_______________________________________ Credit Card Number _________________ Expiration Date

_________________ Security Code

_______________________________________ Billing Address of Card Holder _______________________________________ Floor/Suite _______________________________________ City, State, Zip

Cancellation Policy: Cancellations received in writing via email to info@hcanys.org by November 7 are refundable less a 25% administrative fee. No refunds are permitted after this date or for no shows. Substitutions are permitted.

_______________________________________ Name on Card _______________________________________ Authorized Signature

PLEASE FAX THIS COMPLETED REGISTRATION TO (518) 426426 - 8788; or register online at ht tp://event ville .com/hcanys