AHHA
CDPAP FIs
EMERGENCY PREP
DEADLINES
All home care providers need to prepare for next year’s rollout of Advanced Home Health Aides (AHHA). Learn more about what’s to come at our November Quality & Technology conference.
HCA has learned that the state will soon post application requirements for new and existing CDPAP FIs that will require a quick response.
This week’s newsletter includes several updates on Emergency Preparedness (EP) education, a new state-mandated drill and a webinar on the federal EP rule.
Mark your calendar for upcoming deadlines and effective dates for reports, programs and regulatory requirements.
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Your Source for HOME CARE News, Policy and Advocacy
COMING UP Quality & Technology Symposium Nov. 16 & 17 Suffern The Second Annual Women in Health Care Leadership Summit Dec. 7 & 8 Saratoga Springs Northeast Home Health Leadership Summit Jan. 16-18, 2018 Boston Registration for all HCA programs is online at http:// hca-nys.org/ events-education/ upcoming-events.
Court of Appeals to Hear Case Brought by HCA & Others to Challenge Executive Order 38 The New York State Court of Appeals, the state’s highest appellate court, has granted leave to appeal and established the schedule for hearing the appeal brought by HCA and other associations and providers to challenge the requirements of Executive Order No. 38 (EO 38). See EO 38 p. 2
MLTC-Home Care QIVAPP Amounts Revised The state Department of Health (DOH) has informed HCA that it has revised the amounts that managed long term care (MLTC) plans will receive to pass on to their home care contractors who are eligible for Quality Incentive Vital Access Provider Pool (QIVAPP) monies. See QIVAPP p. 4
INSIDE Court of Appeals to Hear EO 38 Challenge.....................................................….1 MLTC-Home Care QIVAPP Amounts Revised..................................................….1 Imminent DOL Statement a Basis for Next Steps on 24-Hour/‘Live-in’ Relief...........1 Member Hiring Announcement.......................................................................4 LHCSA Statistical Report due Nov. 3…...............................................................5 Relief Organizations for Puerto Rico................................................................5 DOH’s Becky Gray to Discuss AHHA at HCA Quality, Tech. Symposium…...............6 FI Authorization Application Process Imminent….............................................7
Vol. 2, Issue 38 | October 23, 2017
Imminent DOL Impact Statement a Basis for HCA’s Legal, Regulatory & Legislative Next Steps on 24-Hour/‘Live-in’ Relief Strategy discussion planned at HCA Board meeting later this week With the state expected to issue a pivotal regulatory impact statement on Wednesday in the New York State Register, HCA’s Board of Directors is gathering later this week for a welltimed strategy and planning session where it will discuss (among other issues) next steps on the legal, regulatory and legislative fronts to resolve the massive retroactive and prospective liability concerns – as well as ongoing regulatory confusion – regarding the status of 24-hour/‘Livein’ cases. See DOL p. 3
CMS, National Hospital Leaders Confer on Sepsis Intervention…......................8 CMS and DOH Host Future of Integrated Care Meeting…........................................9 HCA Local Home Care/Hospice Emergency Management Sessions Planned….....10 Important Deadlines and Effective Dates…........................................................11 DOH Posts CHHA Special Needs Reports for 2016 and 2017...............................…12 DOH Announces Emergency Response Drill, Posts Webinar on Federal Rule…......12 Registration Open for Rochester VBP Bootcamp…...............................................14 New DSRIP V ideo Available….............................................................................15 OPWDD to Hold Forums on ‘People First Care Coordination’….............................15 HCA Provides Memos on NGS Home Care and Hospice Updates ….........................16 Resources....................................................................................................................17
The Situation Report: the Home Care Association of New York State EO 38 from p. 1 EO 38 places limits on the amounts that state-governmentfunded entities can use for executive compensation and administrative service costs, as opposed to program-related costs. As reported in the June 26, 2017 edition of The Situation Report, the New York State Appellate Division, Third Department, struck down part of the EO 38 regulations as they pertain to the socalled “soft cap,” which includes restrictions on the use of nonstate funds for executive compensation and administrative expenditures. The court, however, upheld the remainder of the EO 38 regulations, including the so-called “hard cap,” which limits the payment of executive compensation and administrative expenses from state-only funds and stateauthorized payments. This created a split between the Second and Third Departments, as the Second Department earlier held all of the regulations to be valid.
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
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
November 16-17 Suffern, NY Register Today at https://hca-nys.org/
Home Care Association of New York State (HCA) 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org
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Patrick Conole Vice President, Finance & Management pconole@hcanys.org
The Court of Appeals has scheduled the initial brief by HCA to be due on December 18 and for all briefs to be filed by March 5, 2018. HCA and its coappellants will strenuously argue that both Departments were mistaken in finding any part of the EO 38 regulations to be valid. HCA will continue to provide updates as the case progresses.
Volume 2, No. 38 October 23, 2017
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. 38 October 23, 2017
DOL from p. 1 Wednesday’s regulatory impact statement is expected to provide further context, implications and intent on the state Department of Labor’s (DOL’s) recent emergency regulation that appears to reaffirm DOL’s long-standing “13-hour standard” for compensation of 24-hour/ ’live-in’ cases – a standard that has been rejected by the courts. HCA has written extensively about this issue and has fielded numerous media inquiries, including a report last week in Home Health Care News where we provided additional context about the matter and our positions. (See here: https://homehealthcarenews.com/2017/ 10/home-health-provider-eye-24-hourpayments-in-new-york-state/.) As reported in last week’s edition of The Situation Report, HCA has joined an amicus brief to support the appeal effort in Tokhtaman v. Human Care, LLC, one of the cases which has ongoing implications for the cost obligations of 24-hour/‘livein’ home care services. While this issue has winded through the courts, HCA pressed the Governor’s Office, state Department of Health and DOL for guidance that would protect providers from the disjunction in state guidance and regulation at the heart of this recent litigation. In response, DOL two weeks ago issued an emergency regulation offering some ostensible relief for providers; yet this coming Wednesday’s expected regulatory impact statement will be pivotal for better understanding the degree and extent of relief. During a special HCA Board of Directors meeting on Thursday and Friday, HCA will be presenting the regulatory impact
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HCA’s Corporate Compliance Symposium last week drew over 120 executives, compliance officers, managers and clinicians to hear about: OMIG and OIG audit focus areas; HIPAA Privacy and Security Rule considerations; compliance and integrity issues under value-based payments; insights for active management of your compliance monitoring operations; and a specific look at compliance pitfalls for CDPAP fiscal intermediaries. The program raised several compliance-related questions and provider needs that HCA will be exploring as part of our member offerings.
statement and/or other relevant regulatory components for discussion with the Board and our legislative affairs representatives on next steps based on the most up-todate information available, including any further legal, regulatory or legislative means. The Governor’s Office has assured HCA that the language and intent of the regulatory impact statement should, arguably, provide protection for any retroactive implications of the 24-hour regulation. However, the exact wording will be crucial, and the document will be an important point for decision-making on next steps with our Board and partners. HCA also expects to soon announce a statewide member conference call to discuss the regulatory impact statement, once it is issued, to provide you with the latest information on the legal and regulatory framework for 24-hour/‘live-in’ services. Please stay tuned for an alert later this week.
The Situation Report: the Home Care Association of New York State QIVAPP from p. 1
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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 inservice 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.
This action was taken to address some discrepancies in the numbers of hours reported to DOH. HCA has been advised that the hours did not change significantly and thus the amounts that qualifying home care providers will receive should not change a lot. DOH next has to send the amounts to the state Division of the Budget (DOB) for its approval. Once approved, then the monies have to be issued to the MLTC plans for expected passthrough to their contracted home care providers. HCA will keep members informed of when DOB acts and the monies are issued. In September, HCA had sent personalized statements to our qualifying members that listed the amounts they would receive for the period April 1, 2016 to March 31, 2017. QIVAPP is available to home care providers who contract with MLTC plans to provide aide services in New York City and meet certain criteria that include:
Home care agencies receive at least $18.50 per hour from MLTC plans.
More information on QIVAPP for past years is at https:// www.health.ny.gov/health_care/medicaid/redesign/ mrt_61.htm. For more information, contact Andrew Koski at akoski@hcanys.org.
CHIEF FINANCIAL OFFICER The Chief Financial Officer assists the Chief Executive Officer in the administration of all financial aspects of the Visiting Nurse Service & Hospice of Suffolk, Inc. The Chief Finance Officer provides overall direction and supervision of all finance and related budgetary functions, and participates in agency strategic planning. Qualifications: x Graduation from an accredited college with a Bachelor’s degree in Accounting or Finance. x Master’s in business administration preferred. x CPA desirable. x Five years progressive financial responsibility. x Two years experience in health care finance preferred. x Demonstrated ability to utilize data processing systems. x Demonstrated ability to communicate. A complete job description may be viewed at https://secure3.entertimeonline.com/ta/6140706.jobs?ShowJob=151203473&prevScreenX=0&prevScreenY=0 To apply for this position, please email your résumé to jobs@vnshs.org Visiting Nurse Service and Hospice of Suffolk offers a rich benefits package and a competitive salary commensurate with credentials and experience. EOE
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LHCSA Statistical Report due Nov. 3 HCA reminds members that the 2016 Licensed Home Care Services Agency (LHCSA) Statistical Report is due November 3. All LHCSAs are required to complete and submit the 2016 LHCSA Statistical Report. LHCSAs providing services to Assisted Living Program (ALP) residents are required to submit the 2016 ALP LHCSA Statistical Report. Failure to complete a Statistical Report will result in enforcement action including liability for civil penalties. The state Department of Health (DOH) has recently started enforcement actions against LHCSAs who did not submit the 2015 LHCSA Statistical Report, and similar action is expected for those who don’t submit the 2016 Report. DOH posted Dear Administrator Letter No. DHCBS 17-02 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-Statistical-Report_2016_DAL_090817.pdf. Some important points about the Report are:
A separate Statistical Report is required for each site with an operating certificate.
Only people in the Administrator, Director of Home Care Patient Services, Data Reporter, or HCS Coordinator roles can access the forms.
Only the person in the Administrator Role on HCS is able to submit the Report.
A recorded webinar has been posted on the HCS. To view it, go to My Content on the top tool bar, then click on: Documents by Group; View all Document Groups; Long Term Care; and Training. Parts 1-4 of the training webinar will be on the bottom half of the page. Questions about the Statistical Report can be sent to hcstatrpts@health.ny.gov (please copy Andrew Koski at akoski@hcanys.org). Continued on next page
Relief Organizations for Puerto Rico With the devastating losses, destruction and ongoing relief effort in the aftermath of Hurricane Maria, HCA provides the following resources for you to assist families, medical professionals and organizations operating in Puerto Rico. The American Red Cross: https://www.redcross.org/donate/1017c United for Puerto Rico: http://www.unidosporpuertorico.com/en/ United Nations Children’s Fund: https://www.unicefusa.org/donate/disaster-relief-help-protectchildren-harm/32787
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Continued from previous page Statistical Report Workgroup As highlighted in numerous past editions of The Situation Report, HCA, 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 that 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 comprehensive feedback on the report based on extensive comments from members. In addition to general comments, we urged DOH to hold a webinar on the form and we made recommendations for each section of the Statistical Report. DOH made some revisions in the 2016 Report based on our recommendations and is expected to incorporate many more changes for the 2017 Report. The next Workgroup meeting will be on November 13 and HCA will report on the meeting in a future edition of The Situation Report. 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.
DOH’s Becky Gray to Discuss Advanced Home Health Aide (AHHA) Impact and Opportunities for Care Planning at HCA Quality & Tech. Symposium A new, upcoming designation for Advanced Home Health Aides (AHHA) has been in the works legislatively over the past few years, with countless stakeholder work sessions, bill drafts, and configurations for permitting aides to conduct additional tasks. And now, the law (passed in 2016) is soon coming to home care providers for implementation. On November 16, at HCA’s signature Quality and Technology Symposium, one of the state Department of Health’s most prominent regulatory experts, Becky Gray, will help flesh out the next steps for this major change affecting your organization’s preparation, oversight and direction of home health aide services in the coming year. As extensively reported to the membership, the AHHA law was enacted last year but will undergo an implementation process in 2018 allowing AHHAs to perform advanced care functions, including some tasks that otherwise fall under the scope of nursing practice. DOH’s Director of the Division of Home & Community Based Care, Becky Gray, will discuss 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. Continued on next page
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Continued from previous page These are insights that all home care agencies need to account for in the assignment, delivery and coordination of aide services in 2018! This segment is just one of ten clinical- and technology-focused sessions at the Quality and Technology Symposium, a signature annual HCA program, 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 in the home care, managed care and hospice arenas. Read the full brochure and register today at the links below. Download the brochure at https://hca-nys.org/wp-content/uploads/2017/10/2017-Quality-and-TechnologySymposium-Brochure.pdf. Register online at https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1012269.
FI Authorization Application Process Imminent At this week’s HCA Corporate Compliance Symposium, the state Department of Health (DOH) indicated that it expects to soon post the application required for Consumer Directed Personal Assistance Program (CDPAP) fiscal intermediaries (FIs) to fulfill the authorization process requirement that was included in this year’s final state budget. Once the application is posted, existing FIs will have a quick turnaround time to complete it and submit to DOH. Existing FIs, however, who have submitted the application will be able to continue to operate until DOH has made a determination on their application. As reported to members in numerous communications, the state Legislature established a new authorization process that DOH says will “improve oversight of the program and the FIs that play a vital role in CDPAP.” The process also:
Defines the responsibilities of FIs and what they are not responsible for;
Grants DOH the authority to revoke, suspend, limit or annul an FI’s Authorization in the event the FI is found to be out of compliance; and
Provides FIs with the option to challenge determinations by DOH to revoke, suspend, limit or annul an FI’s Authorization.
HCA had provided feedback at different stages of the then-proposed authorization process (and a previously proposed certification process). Continued on next page
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Continued from previous page The final authorization application is expected to be similar to the application for a new Licensed Home Care Services Agency as it will include the following information that was in the state budget language:
The name and employer identification number of the entity, including any subsidiary corporations, if applicable, and any name under which the entity does business;
All addresses where the organization operates;
The names, titles and contact information of all officers and directors in a not-for-profit company or business, or managers in a limited liability company, as well as the name and employment history of the individual ultimately accountable for operation of the fiscal intermediary; and, for a not-for-profit entity, the number of director positions set by the company’s by-laws, and how any are currently filled;
A history of the organization, along with an overview of the organization and all services it offers, including any relationships with outside agencies that may influence in any way the ability of the organization to provide fiscal intermediary services consistent with the manner described in its application;
All policies and procedures of the fiscal intermediary, including any contracts or other documents used in communications with consumers; and
A written sworn statement by an officer of the entity disclosing any pending litigation, unsatisfied judgments or penalties, convictions for fraud or sanctions imposed by government authorities.
DOH has established a website with information on the authorization process at https://www.health.ny.gov/ health_care/medicaid/redesign/mrt_10003.htm. Once the application is available, HCA will notify members and will consider providing an education program. For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
CMS, National Hospital Leaders Confer on Sepsis Intervention Focus on avoidable hospital admissions, behavioral health, pressure ulcers, disparities, and malnutrition – all areas where home care can make an impact Last week, the U.S. Centers for Medicare and Medicaid Services (CMS) convened a national meeting of leading hospitals and quality improvement organizations on sepsis intervention and several other key conditions that present major challenges to the health system and to population health. HCA was asked to participate in this national meeting to share information on our sepsis initiative through home care, and to discuss the initiative’s potential role in addressing this deadly condition for patients, as well as avoidable hospital admissions and readmissions, care transitions and population health goals stemming from sepsis treatment. The vast majority of the conference was devoted to sepsis and the urgent need for early identification and treatment – which is the exact purpose of HCA’s sepsis initiative and its focus on the high-risk home care
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population. The conference also focused on post-discharge care of sepsis survivors to address the lifelong, ongoing needs of sepsis survivors upon return to the home. Behavioral health, pressure ulcers, disparities, malnutrition A number of other key conditions (some directly interrelated with sepsis) were also prominently discussed. These included the challenges of behavioral health, pressure ulcers, disparities and malnutrition as they relate to hospital admissions, readmissions, care transition, discharge and overall population health. HCA Executive Vice President Al Cardillo, who is directing HCA’s sepsis initiatives under its New York State Health Foundation grant, described HCA’s efforts, its potential role in addressing the problems discussed by conferees, and access to HCA sepsis educational resources. To learn more about HCA’s sepsis screening tool and related efforts, please write to sepsistool@hcanys.org. Mr. Cardillo emphasized models of hospital-homecare-physician collaboration (including behavioral health providers) to address these issues, and referenced HCA’s proactive model work in New York State. He also discussed New York’s GoldSTAMP program – an evidence-based, best practice, collaborative model for preventing, reducing and managing pressure ulcers – and the role of home care in this initiative. These national level discussions underscore just some of the many critical role opportunities for home care in contributing to urgent needs and solutions in the health care system. For further information, please contact Al Cardillo at acardillo@hcanys.org.
CMS and DOH Host Future of Integrated Care Meeting The U.S Centers for Medicare and Medicaid Services (CMS) and the state Department of Health (DOH) hosted its third meeting on the Future of Integrated Care in New York City last week. HCA participated to discuss the home care perspective on New York State integrated care initiatives. Meeting participants included Association representatives, such as HCA, home health and other network providers, health plan representatives and consumer advocates. Prior to the meeting, DOH made available “draft” slides that reviewed provider and managed care network structures, participant rights and protections, marketing rules, flexibilities, and quality standards and measures. HCA members can review the meeting slides at https://www.health.ny.gov/health_care/medicaid/ redesign/fida/mrt101/webinars/index.htm. DOH specifically engaged participants on the question of establishing standards for a minimum number of providers in a managed care plan’s network. During this discussion, a participant suggested that any provider network adequacy policy should include telehealth or telemedicine which is not only preferred by many patients but also saves the system money by helping to avoid hospitalizations. DOH then asked participants if there were any regulatory relief opportunities that should be offered to help with network adequacy and access to care. Among other areas, HCA discussed the burdens that Medicare certified home health agencies face when contracting with a Fully Integrated Managed Care plan in that Medicare
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regulations for home care agencies are not aligned with regulations governing plans in such areas as frequency of patient supervision and the assessment instrument that must be used to measure the acuity of the patient. Next Future of Integrated Care Stakeholders Meeting DOH and CMS will be convening the fourth meeting of this stakeholder series on November 16 from 11:30 a.m. to 2 p.m. Stakeholders are invited to either attend in person at One Commerce Plaza (99 Washington Avenue), 16th floor, Room 1613, Albany, NY 12210, or via webinar/conference call. Space is limited and only two people from each organization will be permitted to attend in person. Once in-person attendance has reached maximum capacity, RSVPs will be asked to join this meeting via webinar/conference call. If you plan on attending in person, please RSVP no later than close of business on November 14 with the first and last names of attendees to futureofintegratedcare@health.ny.gov. If you would like to participate via webinar/call, you need to register at https://meetny.webex.com/meetny/ onstage/g.php?MTID=eb0c5cd8b1a02ce32aa63ce1b8fcf283a. DOH intends to hold another stakeholder meeting on December 8 in New York City and will provide more information at a later date. Materials from past Integrated Care Stakeholder meetings are at https://www.health.ny.gov/health_care/ medicaid/redesign/fida/mrt101/webinars/index.htm. For further information, contact HCA’s Patrick Conole at (518) 810-0661 or at pconole@hcanys.org.
HCA Local Home Care/Hospice Emergency Management Sessions Planned Central New York and Lower Hudson Valley are November/December focus In conjunction with our statewide work to help members prepare for implementation of the new Conditions of Participation and related emergency preparedness requirements, HCA is also readying a series of local emergency preparedness sessions in late November/early December. These sessions will be targeting home care, hospice and local emergency preparedness partners in the Central New York and Lower Hudson Valley regions as part of our state-federal emergency preparedness deliverables plan, funded with support from the state and the U.S. Department of Health and Human Services. The sessions, led by HCA and the New York State Association of Health Care Providers (HCP), build on those we have been conducting over the past year, which began in western New York and moved across the state covering 34 counties in the western, central, northeastern, capital and northern Hudson Valley regions. The plan is to next cover New York City and Long Island. The sessions are specifically for home care and hospice providers, partner representatives and representatives from county health departments and county emergency managers. Their aim is to provide opportunity for partners to exchange information, contacts and recommendations related to preparedness and response. Participants will receive updates and additional resources helpful to their EP planning and efforts. Each session will include HCA and HCP updates, as well as presentations from county managers, regional offices of the state Department of Health and the state Department of Homeland Security. Sessions participants
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will also break out into small groups matching providers with their county partners, followed by a regroup, report and recommendations. The meetings are targeted for the end of November (in Central NY) and early December (in the lower Hudson Valley), with two sessions in each region. Further information on dates, locations, agendas and registrations will be announced imminently. For further information, please contact Al Cardillo at acardillo@hcanys.org or Andrew Koski at akoski@hcanys.org.
Important Upcoming Deadlines
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Requirement
Effective/Due Date
More Information
Applicability of State Home Care Worker Wage Parity Law to Consumer Directed Personal Assistance Program
October 13, 2017
https://www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm
2016 LHCSA Statistical Report
November 3, 2017
https://commerce.health.state.ny.us/public/hcs_login.html (HERDS application)
Emergency Response Drill
November 6Ͳ8
https://commerce.health.state.ny.us/public/hcs_login.html (HERDS application)
Federal Emergency Preparedness Rule in Effect
November 16, 2017
https://www.gpo.gov/fdsys/pkg/FRͲ2016Ͳ09Ͳ16/pdf/2016Ͳ21404.pdf
2016 & 2017 CHHA Special Needs Semi Annual Reports
November 17, 2017
https://commerce.health.state.ny.us/public/hcs_login.html (HERDS application)
Implementation of Universal Billing Codes for Home and CommunityͲ Based Long Term Care Services under Managed Care
January 1, 2018
https://www.health.ny.gov/facilities/long_term_care/reimbursement/letters/dal_ 2017Ͳ09Ͳ22_billing_codes.htm
Revised Medicare Home Health Conditions of Participation in Effect
January 13, 2018
https://www.gpo.gov/fdsys/pkg/FRͲ2017Ͳ01Ͳ13/pdf/2017Ͳ00283.pdf
Start of Transition Period for Using Health Insurance Claim Number (HICN) or Medicare Beneficiary Identifier (MBI)
April 1, 2018
https://www.cms.gov/Medicare/NewͲMedicareͲCard/index.html
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DOH Posts CHHA Special Needs Reports for 2016 and 2017 The state Department of Health (DOH) Division of Home and Community Based Services (DHCBS) has activated the 2016 and the 2017 CHHA Special Needs Semi Annual Reports on the HERDS application of the Health Commerce System (HCS). These surveys consist of three forms: 1) the Header; 2) the January 1-June 30 form; and 3) the July 1December 31 form. Special Needs CHHAs should complete all three forms with data from calendar year 2016; the Header and the January 1-June 30 form should be completed with data for calendar year 2017. Responses to this survey must be submitted by November 17, 2017. Instructions on how to navigate to the survey on the HERDS application can be downloaded at https://hca-nys.org/wp-content/uploads/ 2017/10/ctrlaccamstmpNotification_23110.pdf. Individuals assigned to the Administrator, Director of Patient Services, HCS Coordinator and Data Reporter roles in the HCS Communications Directory may enter data into the reports. Only an Administrator may submit the data. Questions and requests for assistance can be sent to DOH at: HCStatRpts@health.ny.gov.
DOH Announces Emergency Response Drill for November 6-8, Posts Webinar on Federal Rule The state Department of Health (DOH) has posted a Dear Administrator Letter (see https://hca-nys.org/ wp-content/uploads/2017/10/DHCBS-17-04-Emergency-Response-Drill.pdf) announcing an emergency response drill it is requiring of providers starting on November 6, 2017 and ending on November 8, 2017. It has also posted webinars for Certified Home Health Agencies (CHHAs) and Hospices on the upcoming federal rule for emergency preparedness. Drill All CHHAs, Long Term Home Health Care Programs (LTHHCPs), Licensed Home Care Services Agencies (LHCSAs) and Hospices are required to participate in the November drill or face a deficiency citation and possible enforcement action. All communications between DOH and providers for this drill and during a real emergency will be done via the Health Commerce System (HCS) Integrated Health Alert Notification System (IHANS). Agencies will receive notification of the drill and what the nature of the drill will be on November 6, 2017 via IHANS. According to DOH, the purpose of the drill is to simulate an emergency event for the following reasons:
To allow providers to implement all aspects of their emergency preparedness plan, document participation and activities conducted, and to evaluate their plan’s effectiveness, and for federal providers to execute the required After Action Report; Continued on next page
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Continued from previous page
To allow providers the opportunities to contact their community partners and test their communication plan/systems. When contacting community partners, the agency should clearly state that “This is an exercise”;
To familiarize providers with the communication methods and information needed by DOH during and after an emergency event, helping agencies develop systems to enable quick access to this information;
To familiarize providers with the revised survey tool used to collect information: the Health Electronic Response Data System (HERDS) Home Care Emergency Response Survey; and
To allow DOH to test the communication and data collection systems prior to a real emergency event.
Questions about this emergency drill or the HERDS Emergency Response survey should be directed to HCEmergency@health.ny.gov. Webinar on Federal Emergency Preparedness Rule for CHHAs & Hospices DOH’s webinars on the federal emergency preparedness rule can be viewed at any time. Instructions are at https://hca-nys.org/wp-content/uploads/2017/10/ctrlaccamstmpNotification_23141.pdf. The CHHA webinar material is at https://hca-nys.org/wp-content/uploads/2017/10/EP_Medicare-CoPs_DOHTraining_CHHAs_101917.pdf; the Hospice webinar is at https://hca-nys.org/wp-content/uploads/2017/10/ EP_Medicare-CoPs_DOH-Training_hospice_101917.pdf. The webinar is largely geared for CHHAs and Hospices. It highlights the current state emergency preparedness requirements. It also introduces the CMS rule and its four main areas (development of an all-hazards emergency plan; policies and procedures; communication planning; and training and testing program). In addition, the webinar discusses DOH’s surveillance process for compliance with the rule as well as the DOH communication system and changes made to the HERDS Home Care Emergency Response Survey to assist agency compliance with reporting requirements. As reported in last week’s edition of The Situation Report, HCA is also working with the Department to develop further guidance on the extent of a LHCSA’s responsibility for aide and other staff training in emergency preparedness, and how these responsibilities will be addressed in CHHA-LHCSA contracts, among other areas where the federal emergency preparedness rules may apply for LHCSAs. In addition, we have sought clarity on MLTC plan implications arising from these new federal/state rules. HCA will provide updates as more information becomes available.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 38 October 23, 2017
Registration Open for Rochester VBP Bootcamp Registration is now open for the Value Based Payment (VBP) Bootcamp in Rochester. Registration will close on October 27, 2017. The VBP Bootcamp in Rochester will take place on November 3, 2017 at The Radisson Hotel Rochester Riverside (120 East Main Street, Rochester, NY 14604) from 8 a.m. to 4:30 p.m. VBP Bootcamps are a regional learning series created by the state Department of Health (DOH) to equip VBP contractors and interested parties (such as Managed Care Organizations, Providers, Associations, and Community Based Organizations) with the knowledge to implement payment reform. The daylong 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 asks that all organizations limit registration to no more than four participants. The schedule and locations for the remaining VBP Bootcamps are as follows:
Date
Region
Nov. 3, 2017
Rochester Central Radisson New York Riverside
Long Nov. 15, 2017 Island
Location
The Long Island Marriott
Address
Registration Link
120 E Main St, Rochester, NY 14604
https://www.eventbrite.com/e/vbpͲ bootcampͲ20ͲcentralͲfingerͲlakesͲ westernͲticketsͲ37811517266
101 James Doolittle Blvd, Uniondale, NY 11553
Registration coming soon
VBP Bootcamps are being considered the ‘4th semester’ of VBP University. If you attend a VBP Bootcamp, and have completed all three 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. Any questions can 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. 38 October 23, 2017
New DSRIP Video Available The state Department of Health (DOH) has posted another video in its whiteboard series, titled “Best Practices in DSRIP Year 3.” In this video, State Medicaid Director Jason Helgerson describes best practices currently happening among Performing Provider Systems (PPS) in DSRIP Year 3. Key categories include establishing an innovation fund, adopting best practices with data, addressing social determinants of health, adopting a regional approach to crisis intervention, and mobilizing around high priority community health needs. A supplemental document with additional examples of care delivery innovations from all 25 PPSs is at https:// hca-nys.org/wp-content/uploads/2017/10/Whiteboard-5-Best-Practices-in-DSRIP-Year-3_CompanionDocument.pdf. The video is at https://www.youtube.com/watch?v=2NQnaqK6160. Questions can be sent to DSRIP@health.ny.gov.
OPWDD to Hold Forums on ‘People First Care Coordination’ The Office for People With Developmental Disabilities (OPWDD) is holding five regional forums across the state to provide information about next year’s transition to People First Care Coordination. To register for the forum nearest to you, call or e-mail the regional office staff listed below by Friday, October 27. The location and registration information follow: Date
Region
Location
Address
Registration Information
November 2, 2017 5Ͳ7 p.m.
Western New York
Buffalo
Mount Olive Baptist Church 701 East Delavan Ave.
Mahogany Cook: 716Ͳ517Ͳ 2010 mahogany.l.cook@opwdd.ny.gov Debra Griepsma: 585Ͳ241Ͳ 5760 debra.griepsma@opwdd.ny.gov
November 6, 2017 5Ͳ7 p.m.
Capital District
Albany
Empire State Plaza, meeting room 6
Karen Francisco: 518Ͳ388Ͳ 0431 Karen.Francisco@opwdd.ny.gov
November 8, 2017 5Ͳ7 p.m.
Long Island
Hauppauge
OPWDD Regional Office 415ͲA Oser Ave
Michelle Giuliano: 631Ͳ416Ͳ 3838 michelle.giuliano@opwdd.ny.gov Stephanie Ginsberg: 631Ͳ416Ͳ 3903 stephanie.r.ginsberg@opwdd.ny.gov
November 9, 2017 5Ͳ7 p.m.
New York City
Manhattan
Council on Developmental Disabilities Agencies (IACDDA), 15th Floor 150 W 30th St
Kathleen Kingston: 646Ͳ766Ͳ 3385 KATHLEEN.KINGSTON@opwdd.ny.gov
November 13, 2017 5Ͳ7 p.m.
Central New York
Syracuse
Art & Home Bldg, Martha Sandra Leigh Smith: 315Ͳ473Ͳ6901 Eddy Room, NYS Fairgrounds, Sandra.Leigh.Smith@opwdd.ny.gov 581 State Fair Blvd.
Continued on next page
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 38 October 23, 2017
Continued from previous page Each forum will be hosted by OPWDD’s Regional Office Director and will include OPWDD representatives to answer any questions. If you can’t make it to your region’s forum in person, the presentation will be made available on the OPWDD website at https://opwdd.ny.gov/opwdd_services_supports/ care_coordination_organizations. People First Care Coordination will integrate the coordination of services for individuals with developmental disabilities with the coordination of health, wellness, and behavioral health services through a single and individualized Life Plan. Implementation is planned for July, 2018 with the establishment of Care Coordination Organizations (CCOs) with experience in providing and coordinating services for individuals with intellectual and developmental disabilities. More information on People First Care Coordination is at https://opwdd.ny.gov/ opwdd_services_supports/care_coordination_organizations.
HCA Provides Memos on NGS Home Care and Hospice Updates New York’s Medicare Administrative Contractor, National Government Services (NGS), held two advisory meetings last week with updates to the home care and hospice provider communities. HCA Vice President Patrick Conole participated in both of these meetings, collecting information and providing feedback to NGS. Memos summarizing both meetings are posted at the links below. Home health memo: https://hca-nys.org/wp-content/uploads/2017/10/ 102017NGSHomeHealthMemo.pdf. Hospice memo: https://hca-nys.org/wp-content/uploads/2017/10/ 102017NGSHospiceMtgSummary.pdf. The memos provide information on Medicare payment and regulatory issues. The home care memo has specific insights about the upcoming “Targeted and Probe” audit initiative as well as Comprehensive Error Rate Testing (CERT) data findings that will assist providers in responding to these reviews and ensuring compliance. The hospice memo similarly provides audit and reimbursement updates, medical review and appeals data and more. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.
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The Situation Report: the Home Care Association of New York State
Volume 2, No. 38 October 23, 2017
Resources
“Medicaid Eligibility Verification System (MEVS) and Dispensing Validation System (DVS) Provider Manual,” by eMedNY https://www.emedny.org/ProviderManuals/5010/MEVS/MEVS_DVS_Provider_Manual_(5010).pdf.
“Medicare Part D: A First Look at Prescription Drug Plans in 2018,” by the Kaiser Family Foundation http://files.kff.org/attachment/Issue-Brief-Medicare-Part-D-A-First-Look-at-Prescription-Drug-Plans-in-2018
“Medicare Advantage 2018 Data Spotlight: First Look,” by the Kaiser Family Foundation http://files.kff.org/attachment/Issue-Brief-Medicare-Advantage-2018-Data-Spotlight-First-Look
“Clarifying Signature Requirements,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R751PI.pdf
For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org.
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