March 18, 2019 Edition of The Situation Report

NAHC MARCH

TPL

MLTC UPDATES

CHHA FORUMS

NAHC’s March on Washington is in two weeks. Join HCA for NAHC’s federal briefings and Hill visits that we can schedule on your behalf.

Most CHHAs should have received a letter (dated March 13) outlining yet another stage of semi-annual demand billing requirements for TPL appeals.

MLTC advisory meeting provides key updates on enrollments, Community First Choice Option rollout, wage parity, value-based payments and more.

Join HCA for our upstate and downstate CHHA forums focused on critical reimbursement updates, from PDGM to Medicaid rate stabilization, and other issues.

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Your Source for HOME CARE News, Policy and Advocacy

UPCOMING PROGRAMS Senior and Financial Managers Summit March 19, 2019 (Troy) Hospice and Palliative Nurse Certification March 25-26, 2019 (Holyoke, MA) March 28-29, 2019 (Lawrence, MA) WEBINAR: Clinical Documentation Improvement (CDI) April 11, 2019 Upstate and Downstate CHHA Member Forums Upstate: April 3, 2019 (Albany) Downstate: April 10, 2019 (NYC)

Vol. 4, Issue 11| March 18, 2019

Senate, Assembly One-House Budgets Seek to Withdraw Governor’s Cuts, Add HCA Rate Transparency Provisions HCA advocacy targeted at rate stabilization and transparency language, while bolstering Legislature’s stance on cuts Last week, the Senate and Assembly issued and adopted their one-house budget proposals, resolutions and bill language, triggering the next phase of negotiations toward a new budget by the April 1 deadline.

These measures include the withdrawal of items HCA has strongly opposed in the Governor’s budget. The measures also include items recommended and urged by HCA in our proposed amendments and Article VII mark-ups previously summarized for the membership.

See BUDGET p. 2

President’s Budget Calls for $1.5T Medicaid Block-Grant Spending Caps, Over $800B in Medicare Cuts Proposal is sure to meet stiff opposition in Congress, and a long road of political debate The Trump administration has released its $4.7 trillion federal budget proposal.

For health care, and home care providers specifically, the budget calls for $1.5 trillion in structural changes to Medicaid, akin to prior “block-grant” or “per-capita spending cap” proposals, along with over $800 billion in Medicare cuts over ten years. The proposed budget also calls for a unified post-acute care payment system.

See PRESIDENT p. 5

INSIDE Legislature’s Budgets Seek to Withdraw Cuts, Add HCA Provisions.............1 President’s Budget Calls for $1.5T Medicaid, $800B in Medicare Cuts..........1 Member Hiring Announcements.................................................................4 Join HCA for Advocacy During April 1-2 NAHC March on Washington.............6 HCA Appointed to Strategic NAHC Advisory Committees..............................6 OMIG Resumes Semiannual TPL Case Requests Using Traditional Appeals...7

DOH Provides Update on MLTC Policy Issues.............................................8 HCA Memo Outlines NGS Home Health Updates...................................10 Emergency Preparedness Exercises, HEPC Updates and More.................10 CHHA Forums Offer Critical Reimbursement, Operational Updates.........12 Upcoming Deadlines and Due Dates..........................................................13 Input Still Sought on Draft OMIG Protocols on Private Duty Nursing...........14 Health Resources.................................................................................14

The Situation Report: the Home Care Association of New York State BUDGET from p. 1 These important restorations and supports have been a main pillar of HCA’s advocacy. However, at a time of major financial challenge in the industry, HCA continues to vigorously press the case for both houses to also include our rate update and benchmarking proposals for Certified Home Health Agencies (CHHAs), alongside state rate transparency and adequacy requirements – already embraced by the Senate bill – that would ensure sound reimbursement for Managed Long Term Care (MLTC) plans, contracting Licensed Home Care Services Agencies (LHCSAs) and CHHAs. We’ve focused squarely on the CHHA rate update/benchmark and the rate transparency for MLTCs/providers in legislative meetings throughout the past week, sharing data from our finance and trends report along with summaries of our proposals, the costs of which would be offset by HCA’s asthma management proposal that the Senate already included in its adopted one-house budget. (See additional details below.)

Along these lines, HCA issued a grassroots advocacy campaign on Friday for you to act on, urging lawmakers to stand firm on the rejection of cuts and to adopt HCA’s rate proposals. If you haven’t sent this advocacy message, please do so now at https://p2a.co/ PQCDPqI. For further background, HCA has created a chart comparing the Governor’s budget with the Senate and Assembly’s one-house proposals. (See https://hca-nys.org/wp-content/uploads/2019/03/ OneHouseBudgetComparisonChart.pdf).

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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. Al Cardillo President and CEO acardillo@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@hcanys.org Alyssa Lovelace Director for Policy and Advocacy alovelace@hcanys.org Lauren Ford Director of Program Research, Development and Policy lford@hcanys.org Laura Constable Senior Director, Membership & Operations lconstable@hcanys.org

In More Detail: Cuts, mandates rejected Importantly, both houses of the Legislature appear to have rejected the following proposals from the Governor’s budget: the 0.8-percent across-the-board Medicaid cut to providers; the National Provider Identifier (NPI) mandate; the repeal-and-replace of the Consumer Directed Personal Assistance Program (CDPAP); and the transportation carve-out from Managed Long Term Care, with the Senate instead proposing to allow MLTCs the option to directly provide transportation services or utilize the transportation manager.

HCA opposed each of the Governor’s proposals in these areas, as outlined in our Article VII amendments and advocacy materials.

Continued on next page 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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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

Volume 4, No. 11 March 18, 2019

The Situation Report: the Home Care Association of New York State Continued from previous page It is critical to note that rejected proposals and cuts, though kept off the table thus far by the Legislature, are always in the potential mix and could materialize in the original or modified form until the final budget is complete.

HCA rate transparency language, asthma program, ICS Closure The Legislature also variably embraces new language written, presented, and pursued by HCA to support the home and community-based care system.

Importantly, the Senate includes HCA’s proposal requiring state transparency in its reimbursement of MLTCs and providers for their costs of compliance with state requirements.

This would mean that in order for the state to declare rates to be “actuarially sound,” the state would have a new burden of proof to show it is adequately covering all mandated costs (prior and newly proposed), including wages and labor compliance costs, as well as other statutory, regulatory and program costs imposed on MLTCs and network providers. In effect, the state would be required to provide the calculations of cost and funding amounts to MLTCs and providers.

The language would also provide protection against unfunded mandates foisted upon MLTCs and providers, requiring that, to the extent permitted by law, such mandates do not take effect until and unless the rates are adjusted to compensate for the costs.

The Assembly budget seeks a similar goal, but with varied language.

As earlier noted, the CHHA rate update and benchmark provisions have yet to be incorporated in either of the one-house bills, but HCA continues full-press advocacy with the house’s health leaders on this area.

The Senate’s resolution also recommends that the Department of Health “ensure that all health care providers who have engaged with

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Independence Care System (ICS) be made whole,” following the recent announcement that ICS’s MLTC plan is closing. HCA has been appealing to the State Division of Budget and Legislature for making all providers whole for any outstanding payments as a result of ICS’s withdrawal from the MLTC market.

As earlier noted, the Senate also eagerly included a Home Care Asthma Management proposal developed by HCA, which Senate Finance scores at $13 million in savings. HCA has requested that these savings be reinvested back into the home care system to cover the state-share of expenses for HCA’s proposed CHHA Episodic Payment System (EPS)/pediatric rate increases and benchmark.

HCA is currently evaluating an Assembly proposal to create a high-need rate cell for home and community-based service providers, along with each house’s disposition of additional budget proposals advanced by the state Office of the Medicaid Inspector General (OMIG), and other variables between the Senate and Assembly bills.

More details will follow in a later update.

What’s next These one-house budget measures form the Legislature’s response to the Governor’s budget and are a framework for further negotiations as conference committees convene to negotiate a final budget, due April 1. These one-house measures now put into focus HCA’s next advocacy steps: pressing the Legislature to hold firm on its rejection of proposals opposed by HCA, as outlined earlier in this article, and working across houses to reach a consensus for adopting rate transparency for MLTCs and home care, along with urgent increases in CHHA rate funding. We will also look for every avenue to continue urging our proposals to support the home care/hospice workforce, infrastructure needs, and public health innovation (such as the new asthma program, support for home care’s work in sepsis, and other key areas).

While the Legislature’s actions help restore some of the Governor’s proposed cuts, the Legislature

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and Governor have reported different views on revenue projections, with the Governor’s office indicating that any revenue previously unaccounted for in his initial budget would be devoted to reserve funds. Press reports throughout the past week have suggested that the Governor’s office is also open to changes across the budget to make up for any additional federal revenue shortfalls in health care, meaning that the Executive could stand firm on its proposed cuts or consider other adverse actions. This makes it absolutely vital that all HCA members remain engaged.

HCA’s budget meetings and direct outreach to members of the Joint Senate-Assembly Budget Committee on Health continue this morning and remain ongoing. HCA urges every member to vigorously participate in this budget advocacy through the mechanisms provided by HCA’s Legislative Action Center, as well as through visits and calls to your local officials. We will be advising members of additional advocacy steps you can take as the budget negotiations progress. Over the weekend, HCA received updates from members of the Board regarding their continued outreach in-person with legislators. We applaud these efforts and encourage the same from all members.

HIRING Director of Patient Services Lourdes Home Care Description: Lourdes is looking for a Director of Patient Services for our home health and hospice (home care) program. The director will work with a robust team of experienced clinical managers to guide the strategic direction and growth of the home care program. Focus will include collaboration with the Lourdes Palliative Medicine Program and with other community based programs offered at Lourdes and in the community at large. The director will be responsible for the achievement of clinical/quality and financial goals, as well as maintaining a culture of safety and accountability. Both programs are growing, and we attribute that to low turnover and effective leadership. We are looking for a leader who will embrace shared governance and the principles of servant leadership.

The ideal candidate is a registered professional nurse, with a minimum of 5 years’ experience in home care and at least two years of experience in leadership/management. A Master’s degree or combination of Bachelor’s degree and experience preferred.

President of Home Care & Hospice The Position: Head strategic Home Care and Hospice operations for the health system, including growing specialty programs. Pave the way for clinical and technological innovation in both the home care and hospice programs including a heart failure readmission reduction program, implementation of a new EMR, growing the current telehealth program, expansion of community and facility based palliative care programs, and support for value based purchasing (VBP) initiatives. Must possess prior CHHA executive experience, financial/budgetary experience, and a familiarity with Population Health strategies and initiatives. RN and/or Nurse Practitioner with Master’s degree required.

The Organization: Lourdes Home Care is a Certified Home Health Agency and Hospice that provides mission-based care to patients across Broome, Tioga, Chenango, and Delaware counties. Lourdes continues our 90+ year legacy of serving individuals in our community as part of Ascension, the largest nonprofit health system in the U.S and world’s largest Catholic health system. As a part of this system, Lourdes is able to access resources, tools, and best-practices from Ascension ministries across the country.

The Organization: Catholic Health Services of Long Island includes six hospitals, three skilled nursing facilities, a regional home care service, a certified hospice and a community-based agency for persons with special needs. The 1,928-bed system prides itself on the values of Integrity and Compassion. CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping individuals live their final years in comfort, grace, and dignity. At Catholic Health Services, there are 358,805 annual home care visits and 125,636 annual hospice days-of-care.

If you’d like additional information, please contact Ann Fattarusso, our Lourdes Ascension Recruiter: ann.fattarusso@ascension.org; m: (607)206-5839.

To apply, please visit our website at: https:// www.besmith.com/job-details/farmingdale-new-yorkhome-health-1256636/.

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PRESIDENT from p. 1 The President’s massive proposed spending cuts – not only for health care but also the trillions in cuts aimed at other domestic programs – will encounter stiff opposition in the Democrat-led U.S. House of Representatives. As such, this budget announcement is an initial salvo in a lengthy process of debate, counterproposals from Congress, hearings and months of deliberation.

While the fiscal year begins on October 1, political deadlock in recent budget cycles has staggered the timetable, resulting in a series of stop-gap continuing-resolutions and, most dramatically, the 35-day government shutdown from December to January.

Specifically, for health care, the President’s Medicaid proposal would repeal the Obamacare Medicaid expansion and institute $1.2 trillion in “market-based” block grants (or per-capita spending caps), moving away from an open-ended entitlement, where states have traditionally received a federal match based on state Medicaid spending. The proposal would also mandate universal Medicaid work requirements that some states have already begun adopting through waivers.

As previously reported to the membership, post-acute payment reform has been continually examined by the Medicare Payment Advisory Commission (MedPAC) in an effort to align payments on the basis of clinical needs rather than the site of care. The Trump Administration proposal would lower annual payment updates from fiscal year 2020 to 2024, and, in 2025, establish a “site-neutral” system of payment applicable to skilled nursing facilities, home health and inpatient rehabilitation facilities. This provision is marked as saving $101.2 billion over ten years.

A briefing document from the U.S. Centers for Medicare and Medicaid Services (CMS) outlines some other provisions of note, including: technical changes to Administrative Law Judge hearing procedures; use of patient encounter data for Medicare Advantage risk scores; expansion of Medicaid audit and Medicare targeted education and medical review activities; strengthened oversight of Medicare Advantage; expansion of Medicare prior-authorization across fee-for-service lines; prepayment controls to prevent inappropriate personal care service payments; allowing CMS to publish surveys for all accredited facilities, including hospices; reduction in the maximum allowable home equity for Medicaid eligibility; providing CMS flexibility in determining the frequency of Program of All-inclusive Care for the Elderly (PACE) reviews; making Medicaid non-emergency medical transportation an optional benefit; and several other specific provisions.

To read more about these proposals, see https://www.hhs.gov/sites/default/files/fy-2020-budget-in-brief.pdf.

At a time of declining fiscal margins, an already austere Medicaid budget landscape, a crush of regulatory burdens on home care, and the onset of a Patient Driven Groupings Model that is overhauling the Medicare home health reimbursement structure in 2020, HCA will be working to bolster opposition in Congress to any further severe impacts on the home care system, as proposed in this budget.

We look forward to working with New York’s Congressional Delegation and supporting Congressional efforts to counter these draconian cuts to Medicare and Medicaid services.

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Join HCA for Congressional Visits During April 1-2 NAHC March on Washington The National Association for Home Care and Hospice (NAHC) is holding its “March on Washington” in just two weeks. HCA invites you to join HCA President Al Cardillo alongside NAHC for this program, which will include federal updates on April 1, followed by a day of advocacy visits with New York’s Congressional Delegation on April 2.

Our major advocacy priorities include: pre-empting the “behavioral adjustment” cut under the Patient Driven Groupings Model (PDGM); flexibility in the regulations for non-physician practitioners to order and refer for home health service; and supports for rural home health through the rural add-on.

Additionally, as reported elsewhere in this edition of The Situation Report, the President’s recently released budget proposes massive cuts to both Medicaid and Medicare. While this budget will face stiff opposition in Congress, it is important for home health providers to use the April 2 opportunity to bolster opposition to Medicare and Medicaid cuts within Congress, while also making the case for our other cost-effective or costneutral priorities.

Registration for the March on Washington is at https://www.eventbrite.com/e/national-association-for-homecare-and-hospice-2019-march-on-washington-registration-55922682248.

If you plan on attending and need assistance with scheduling Congressional appointments on April 2, please contact HCA’s federal government affairs contractor Brett Heimov at Brett@en-visionstrategy.com who will work to schedule all of the Congressional visits for HCA members.

Also, if you haven’t yet done so already, please use our Legislative Action Center now to write Congress in support of U.S. Senate legislation (S.433) that would eliminate the $1 billion “behavioral adjustment” cut under PDGM. That action item is here: https://p2a.co/6edUDeQ. We look forward to seeing you in Washington.

HCA Appointed to Strategic NAHC Advisory Committees Public Policy Committee & Hospice Advisory Council The National Association for Home Care and Hospice (NAHC) has appointed HCA President Al Cardillo to two of its critical national policy and program committees: The Public Policy Committee and Hospice Advisory Council.

Mr. Cardillo is tapped for these committees as a leader who brings nearly four decades of experience in legislative policy direction for home care, hospice, and other health sectors.

These opportunities provide new and important pathways for HCA to help shape national policies and gain valuable insights from our national peers that we can circle back to the HCA membership.

HCA’s participation will support and raise the profile of our home care, MLTC and allied member organizations association-wide while offering a great new asset for our hospice and palliative care

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members specifically. We look forward to this mutually beneficial exchange of insights, experiences, ideas and strategy with NAHC and fellow committee leaders.

Forum of State Home Care Association Executive Committee Along with these new committee roles, Mr. Cardillo was also recently selected to serve on the Forum of State Home Care Associations Executive Committee. The Forum is comprised of state associations, like HCA, from across the U.S. and is a major venue for national advocacy, multi-state exchange of ideas, information and strategy.

The Forum is convening for strategic sessions on March 31 and April 1 in Washington, D.C., accompanying a series of Congressional meetings on April 2 for NAHC’s March on Washington. Mr. Cardillo and HCA members attending these Capitol Hill meetings will be urging key New York Congressional Delegation members to support legislation curtailing presumptive cuts to home health agencies under the Patient Driven Groupings Model (PDGM) for home care taking effect in 2020, along with other core federal policy needs.

HCA urges our member agencies to join these meetings (see page 6 story for details).

OMIG Resumes Semiannual TPL Case Requests Using Traditional Appeals The state Office of the Medicaid Inspector General (OMIG) has resumed its semi-annual demand billing process for the second half of federal fiscal year (FFY) 2018.

Details are outlined in a letter (mailed via UPS on March 13, 2019) that most Medicare-certified home care providers should have received from OMIG and its Third Party Liability (TPL) contractor, the University of Massachusetts Medical School (UMMS).

The letter identifies which cases have been selected to undergo appeals (through demand billing), with dates of services that occurred in the

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third and fourth quarters of FFY 2018 only (April 1, 2018 through September 30, 2018 or the end of the episodic period billed to Medicaid). The cases selected include both fee-for-service and Episodic Payment System (EPS) claims.

UMMS’s letter also says providers should continue monitoring the status of their demand bill claim(s) once submitted. Providers are required to correct any claims that are rejected or suspended by the Medicare Administrative Contractor (MAC), National Government Services (NGS). In addition, providers are required to timely submit a complete medical record to NGS once the Additional Development Request (ADR) is issued.

A final remittance advice for each episode billed (by demand bill) will be issued within 60 days of the final bill submission to Medicare. Upon receipt of the final remittance advice, providers must send copies of the following documents to the TPL contractor, UMMS, within 10 business days: 

A copy of the original claim submitted to the MAC for each 60-day episode billed.

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A copy of the final claim remittance advice sent to you from the MAC.

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A copy of each medical record your agency submitted to the MAC upon the ADR request.

HCA members interested in knowing whether they should have received a letter from OMIG can e-mail HCA at info@hcanys.org.

For specific questions about the letters, contact UMMS’s Laurie Burns at (866) 626-7594.

DOH Provides Update on MLTC Policy Issues Last week, the state Department of Health (DOH) briefed managed long term care (MLTC) plans and MLTC member associations on a variety of policy issues. The following are highlights from the meeting.

MLTC Statewide Enrollment The following MLTC enrollment figures are from February 2019: 

MLTC Partial Cap Plans – 226,352 members, a 12.73 percent Increase from February 2018.

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PACE – 5,809 members, a 2.18 percent increase from February 2018.

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MAP – 14,473 members, a 52.43 percent increase from February 2018.

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FIDA – 3,027 members, a 26.48 percent decrease from February 2018.

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FIDA IDD – 1,193 members, a 56.15 percent increase from February 2018.

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Total – 250,854 members, a 13.58 percent increase from February 2018.

Continued on next page

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Continued from previous page Community First Choice Option (CFCO) As requested by MLTC plans and their association representatives, the Department will be setting up weekly calls to discuss the implementation process for CFCO. DOH is in the process of reviewing a list of questions submitted by one of the associations and will be providing guidance on those questions during these calls.

DOH will also be issuing guidance regarding the process for CFCO desk readiness reviews and what plans can expect during these reviews.

DOH will be conducting encounter training for plans on the CFCO services in mid-April as well as providing training on the person-centered service planning statewide initiative throughout 2019. Additional information can be found on the CFCO website at https://www.health.ny.gov/health_care/medicaid/redesign/ community_first_choice_option.htm.

4th Quarter MMCOR Reminder On February 12, the Department posted the fourth quarter 2018 Medicaid Managed Care Operating Report (MMCOR) software to the Health Commerce System (HCS) and plans are reminded that those reports are due back to DOH by April 10, 2019. We remind members that HCA’s members-only data page includes spreadsheets summarizing the 2017 MMCOR data along with cost reports and other statistical information.

Home Care Worker Wage Parity The Department recently e-mailed the 2019 Home Care Worker Wage Parity Certification Forms to managed care plans and associations. The forms have also been made available online in the MRT 61 section of DOH’s website under “Wage Parity Reminders” at https://www.health.ny.gov/health_care/medicaid/redesign/ mrt_61.htm.

Ongoing compliance with the Home Care Worker Wage Parity law in New York City, Nassau, Suffolk and Westchester counties began on March 1, 2019. Forms certifying compliance with the law must be e-mailed to DOH at HCWorkerParity@health.ny.gov.

Workforce Investment Program DOH reported that there are ten MLTC plans participating in partnerships with Long Term Care Workforce Investment Organizations (LTC-WIOs). The Department will be making a distribution of $61.4 million to the various plans participating in the near future. WIO dollars must be used to support initiatives to retrain, recruit and retain health care workers in the long-term care sector.

More information about the program and related announcements can be found on the Workforce Investment Program website at https://www.health.ny.gov/health_care/medicaid/redesign/2017/mltc_invest.htm.

MLTC Value Based Payment (VBP) A recent DOH analysis of the VBP Tracking Report (VBPTR) indicated that not all plans were reporting expenditure data accurately. In response, DOH held a MLTC VBP refresher webinar on March 8, which

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reviewed MLTC VBPTR reporting requirements, Social Determinants of Health (SDH) and community-based organization (CBO) requirements for Level 2 VBP arrangements.

MLTC VBP guidance and the presentation from the webinar are available in the MLTC section of the VBP Resource Library at https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_library/index.htm.

DOH reminded plans that by April 1, 2019: 

MLTC partially capitated plans must have at least 5 percent of their total Medicaid expenditures in Level 2 VBP arrangements.

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Fully capitated plans must have at least 15 percent of their total Medicaid expenditures in Level 2 VBP arrangements.

MLTC plans should submit their Level 2 contracts to MLTCContract@health.ny.gov.

Other VBP questions can be directed to MLTCVBP@health.ny.gov

HCA Memo Outlines NGS Home Health Updates HCA participated in a home health advisory meeting with National Government Services (NGS) representatives last week. The meeting provided a briefing for associations in the Medicare contractor’s jurisdiction 6, which includes New York.

HCA Vice President for Finance and Management Patrick Conole participated in the meeting to gather updates, pose questions and advocate on behalf of the membership. A memo summarizing the meeting is at https://hca-nys.org/wp-content/uploads/2019/03/031519NGSHomeHealthMemo.pdf.

This home health memo follows a similar communication for hospice providers which followed an equivalent NGS meeting earlier in the month.

The home health memo covers audit and reimbursement issues, important instructions for claims related to home health rural add-on payments, top reason codes for claim denials and reiterations from the Medicare regulations to avoid denials, Comprehensive Error Rate Testing (CERT) results, NGS education and new online functionalities, and other important items.

Emergency Preparedness Exercises, HEPC Updates and More HCA has reached out to emergency preparedness officials and coalitions in New York City (NYC) to delve more deeply into their engagement with home care providers, as we continue to educate agencies and Managed Long Term Care (MLTC) plans about state-led emergency preparedness exercises that have largely been targeted to providers outside of NYC. As part of this effort, HCA participated recently in a meeting of the Emergency Preparedness Coalition of Manhattan; attended a symposium of the NYC Health Care Coalition and NYC Department of Health and Mental Hygiene Office of Emergency Preparedness and Response Bureau of Healthcare System Readiness;

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and had discussions with preparedness officials from the NYC Department of Health and Mental Hygiene.

HCA encourages members to become engaged with their local coalitions.

As extensively report in recent editions of The Situation Report, the state has been holding a series of emergency drills in various regions outside of New York City. Some of the drills are on specific preannounced dates, while others will occur within an approximate window of time without advance notice of the specific dates.

The two drills and upcoming dates are as follows: 

Coalition Surge Tests (CST) involve a simulated emergency where up to three hospitals have to evacuate patients to other settings, including home care. These will be held sometime between April 1-12 in Western New York and the Capital Region. Home care providers may be contacted by a hospital as part of the drill asking if the agency can take some patients.

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Interoperable Communications (IOC) drills test the ability of providers to use a primary and back-up communications system. This type of drill is held on specific dates and is connected to a separate medical countermeasures exercise (not for providers) which involves a simulated anthrax outbreak.

IOC drills will occur on April 4 in Western New York, April 11 in the Capital District, April 18 on Long Island and May 9 in the Lower Hudson Valley, with instructions sent through the HCS Communications Directory.

More information on these drills are in webinar slides here: https://hca-nys.org/documents/ Integrated%20Exercise%20Non-acute%20Partners%20Webinar%20FINAL.pdf.

HCA has extensively covered each of these drills in past editions of The Situation Report. HCA also recently joined with the New York State Association of Health Care Providers (HCP) in a state association meeting with DOH emergency preparedness officials to discuss these drills and deliverables from our grant to support home care and hospice in emergency preparedness.

Western Region Home Care Tabletop Exercise In addition to the CST and IOC drills, HCA encourages home care and hospice providers in the Western Region to participate in an Emergency Preparedness Virtual Tabletop Exercise that will be held on April 8, from 1 to 3 p.m. and April 11, from 10 a.m. to 12 p.m. (you only need to participate on one of these days).

Registration information is at https://hca-nys.org/wp-content/uploads/2019/03/Western-NY-EP-HomeCareTabletop-Exercise_April-2019.pdf.

The exercise is for the following counties: Niagara, Erie, Chautauqua, Cattaraugus, Orleans, Genesee, Wyoming, Allegany, Monroe, Livingston, Steuben, Wayne, Ontario, Yates, Seneca, Schuyler and Chemung.

The exercise will explore the abilities of home care and hospice agencies to: share information; activate ahead of, or in response to, a significant event; and request resources.

Continued on next page

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Continued from previous page HEPC Statewide Meeting Last week, HCA participated in a planning session for the HEPC Statewide Meeting that will be held on March 20 and March 21. Health Emergency Preparedness Coalitions (HEPCs) are comprised of health care providers, local and state emergency management and local public health preparedness officials. HCA and HCP are responsible for participating in HEPC meetings across the state, including one we attended in the Capital Region last week.

The statewide conference will discuss emerging issues and state policies in emergency preparedness and the roles of all the health care sectors.

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org or Alyssa Lovelace at (518) 810-0658 or alovelace@hcany.org.

CHHA Forums Offer Critical Reimbursement, Operational, Marketplace Updates Upstate Forum on April 3 in Albany, Downstate Forum on April 10 in NYC HCA’s upcoming CHHA Forums come at a critical time, as HCA advances vitally needed CHHA rate stabilization and transparency proposals in the state budget, and as we fight to curtail the unfounded “behavioral adjustment” cut to CHHAs under the Patient Driven Groupings Model (PDGM).

These are just a few of the many issues commanding CHHAs’ attention, and HCA’s attention, on the reimbursement, workforce, marketplace and operational fronts.

Get the latest updates on all of these issues, including fresh information from the April 1 start of the new state budget fiscal year, at HCA’s CHHA Member Forums in April. Registration is at the following links. 

Upstate CHHA Forum (April 3 in Albany): https://hca-nys.org/wp-content/uploads/2019/03/ CHHAForum-4-3-19-Registration-Form.pdf.



Downstate CHHA Forum (April 10 in NYC): https://hca-nys.org/wp-content/uploads/2019/03/ CHHAForum-4-10-19-Registration-Form.pdf.

These Forums will cover: 

The latest on the state budget outcome for CHHAs, as well as updates on the Episodic Payment System, fee-for-service rates, rate add-ons, the current payment landscape and its transition to PDGM.



Data on the financial condition of CHHAs and ways that HCA is addressing core fiscal and infrastructure challenges, including the impact of state and federal actions on the CHHA and managed care marketplace.



Any specific issues you want to raise or ask about in the company of your peers and HCA’s expert policy team.

This is a vital opportunity to connect with HCA and exchange information on specific CHHA concerns for incorporation into HCA’s advocacy agenda as we seek federal/Congressional support for CHHAs, rate stabilization and benchmark language, regulatory relief, workforce recruitment and retention solutions and conduct other critical CHHA-focused advocacy.

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Volume 4, No. 11 March 18, 2019

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



Upcoming Deadlines and Due Dates

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Requirement/Change/Meeting

Effective/Due Date

More Information

Posting of OSHA Form 300A: Summary of WorkͲRelated Injuries and Illnesses

February 1 to April 30, 2019

https://www.osha.gov/recordkeeping/RKform s.html

Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) Cost Reports due

March 31, 2019

1915CR@health.ny.gov

Coalition Surge Test (CST) Exercise for Western NY and the Capital District

Sometime between April 1 and April 12, 2019

Andrew Koski at akoski@hcanys.org or (518) 810Ͳ0662

Interoperable Communications/Medical Countermeasures (IOC/MCM) exercise – Western NY

April 4, 2019

Shaun.sharp@health.ny.gov

Virtual Tabletop Exercise for Home Health Agencies – Western region

April 8, 2019 from 1 to 3 p.m.

https://tinyurl.com/yymwldwo

Virtual Tabletop Exercise for Home Health Agencies – Western region

April 11, 2019 from 10 a.m. to 12 p.m.

https://tinyurl.com/y6tkoqcs

IOC/MCM exercise – Capital District

April 11, 2019

Maureen.casaleͲreidt@health.ny.gov

Coalition Surge Test (CST) Exercise for Long Island

Sometime between Andrew Koski at akoski@hcanys.org or (518) April 15 and April 26, 2019 810Ͳ0662

IOC/MCM exercise – Long Island

April 18, 2019

Drew.Fried@health.ny.gov

Coalition Surge Test (CST) Exercise for Lower Hudson Valley

Sometime between April 29 and May 10, 2019

Andrew Koski at akoski@hcanys.org or (518) 810Ͳ0662

IOC/MCM exercise – Lower Hudson Valley

May 9, 2019

gyongyi.mcqueston@health.ny.gov

Transition Period for Using Health Insurance Claim Number (HICN) or new Medicare Beneficiary Identifier (MBI)

April 1, 2018 to December 31, 2019

https://www.cms.gov/Medicare/NewͲ MedicareͲCard/index.html

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

Volume 4, No. 11 March 18, 2019 

Input Still Sought on Draft OMIG Protocols on Private Duty Nursing HCA is still seeking comments on draft audit protocols on private duty nursing (PDN) that have been developed by the state Office of the Medicaid Inspector General (OMIG).

OMIG shared the draft protocols with HCA, which apply to PDN services by Licensed Home Care Services Agencies (LHCSAs). They can be read at https://hca-nys.org/wp-content/uploads/2019/03/OMIG-LHCSAPDN-Draft-Audit_Protocols_030519.pdf.

The draft protocols would revise the current ones at https://omig.ny.gov/images/stories/audit_protocols/LHCSA_protocols_12_8_16.pdf.

The revisions include two new protocols: “Incorrect Procedure Code Billed” and “Excluded Individual Providing Service.” They also eliminate the prior “Professional Assessment Not Documented” protocol, and add new language for the “Tuberculosis Test” protocol.

HCA sent the protocols to members we identified as providing PDN services, but encourages all members to review the draft protocols and provide feedback to Alyssa Lovelace at alovelace@hcanys.org or Andrew Koski at akoski@hcanys.org.

Health Resources 

“Emerging Technologies to Support an Aging Population,” by the Task Force on Research and Development for Technology to Support Aging Adults http://www.nasuad.org/sites/nasuad/files/Emerging-Tech-to-Support-Aging-2019.pdf



“Pathways to Progress on Difficult Decisions in Post-Acute Care,” by the United Hospital Fund https://nyshealthfoundation.org/wp-content/uploads/2019/03/UHF-Pathways-to-Progress031319.pdf



“Ensuring Only the Active Billing Hospice Can Submit a Revocation,” by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2019-Transmittals-Items/ R4254CP.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending

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

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FORCE for the FUTURE

ANNUAL

CONFERENCE Force of the Future!

May 8-10, 2019

Saratoga Hilton Saratoga Springs, NY

ANNUAL CONFERENCE FORCE for the FUTURE May 8-10, 2019 Saratoga Hilton Saratoga Springs, NY To truly soar, an aircraft needs the right design, equipment, personnel and conditions. These elements come together in a precise balance of weight and lift, drag and thrust, all maneuvered by a flight crew’s skilled and steady hand to navigate the environment.

As your agency seeks to be a Force for the Future, it needs a similar sense of balance, structure and expert guidance to overcome – and, even, gain advantage from – countervailing forces, external pressures, and environmental turbulence, making for a truly spectacular display! HCA’s Annual Conference is ready to help set your navigational system away from the rigid lane of volume‐based care to the flightpath of value, giving you the tools for a smooth, secure and stunning take‐off in service to your patients.

Hotel Information The Saratoga Hilton, Saratoga Springs, NY is the site of the HCA Annual Conference. Rooms at the Saratoga Hilton are $175 per

night. This discounted rate is available until April 7, 2019. After this date, higher rates will prevail.

Our ‘navigation experts’ will help you get the right crew in place – one that can see new horizons beyond the cloud line of transitioning to PDGM and other challenges. We’ll show you how to glide in tandem with system partners and make a smooth connection for the benefit of improved patient care coordination. Technology experts will reveal some exciting solutions that offer field‐level clinical data and operational analytics, enhancing the efficiency of your “flight time” and your clinical outcomes. And we’ll help you become more productive by reclaiming “white space” … so that you can look clear‐eyed at the vast expanse of opportunity and priorities before you out the cockpit window.

Parking is $5 per night. The hotel’s check‐in time is 3pm and checkout is 11am. Luggage storage is available should your room not be ready prior to check‐in time.

To make a reservation, call 888‐

866‐3596 and ask for the Home Care Association of NYS rate.

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Sponsors and Exhibitors

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Pre-Conference Wednesday, May 8, 2019 10:00AM – Noon

Pre-Conference

Creating Better Patient Outcomes: The Power of New Partnerships Under the structure of the state’s relatively new Hospital‐Home Care‐Physician Collaboration statute, HCA members are already beginning to pioneer flagship home care‐facilitated partnership models. These localized models involve new, innovative structures with hospitals, physicians and, in some cases, managed care partners to support improved care management, outcomes and cost‐savings. This recent statute – enacted in 2015 and implemented through a December 2017 Dear Administrator Letter – also invites regulatory waivers and/or reimbursement flexibility to help streamline procedures or other restrictions impeding this kind of collaboration. Importantly, the Department of Health guidance implementing this program requires the involvement of at least two collaborative entities, one of which must be a home care provider if services are delivered in the home, putting home care at the center.

Panelists will discuss this partnership statute, the process for applying, some factors for consideration in developing a collaborative model (including possible waiver areas), and examples of specific projects being advanced by pioneers in the field to help you consider the possibilities for the benefit of your patients or expanded networks in the community.

Moderator: Al Cardillo, LMSW, President, HCA Panelists: TBA 12:00PM – 1:30PM

Lunch Enjoy Lunch on Your Own in Downtown Saratoga Springs 1:30PM – 4:30PM

HCA Annual Corporation and Board of Directors Meetings All HCA Members are invited and encouraged to attend the Annual Meeting of the Corporation, where members will vote on the slate of candidates for the HCA Board of Directors.

The HCA Board of Directors Meeting will follow immediately. This is your opportunity to learn more about the governing body that shapes the direction of HCA policy, education, advocacy and operational priorities.

4:30PM – 6:00PM

Welcome Reception – Sponsored by: DINNER ON YOUR OWN

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Program Agenda

Thursday, May 9, 2019 7:30AM – 8:30AM

Strolling Breakfast with Exhibitors 8:30AM – 9:30AM

Home Care: The Force for the Future of Health Care!

Al Cardillo, LMSW, President, HCA Al Cardillo makes his inaugural Annual Conference address as President sharing his vision for HCA’s future – and the role that members will play in that enterprise.

Al Cardillo

9:30AM – 10:30AM

Breaking Through the Clouds: Activity is NOT Productivity Raising Execution… Reclaiming WhiteSpace Heather Sager, WhiteSpace

Heather Sager Every executive and team have only a select handful of true priorities. And they'll do anything to move them forward quickly and triumphantly. But when talented workers are lost in unnecessary e‐mails, meetings, reporting and other low‐value tasks, they crawl toward these pivotal objectives.

Distraction, interruption and unnecessary complexity further addle their creative spark. And they have no time to think.

Imagine, instead, a workplace where a majority of time is spent on tasks of true importance; where thoughtful time is a priority; and where norms and habits protect employees from touching work that drains them. This is a WhiteSpace culture — and its creation may be more possible than you think.

In this high‐energy session, Heather Sager will examine the critical difference between activity and true productivity, between cramming in more tasks and selectively choosing to dive into the right ones with thoughtfulness.

She’ll also introduce you to what she calls the “thieves of productivity,” a group of positive assets that can often run amuck. By examining the surprising downside of these attributes, we create a customized road map toward more WhiteSpace at the individual, team and organizational level.

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Heather Sager had her entrepreneur clients in mind when she hired WhiteSpace at Work to do a business growth keynote session in 2015. She was an executive at a management company for independent medical practices, overseeing recruiting, onboarding and training programs for more than 2,500 individuals. After personally incorporating WhiteSpace concepts into her daily practice, she saw a reduction in busyness, which lead to greater focus and performance. Sager left her executive role to join WhiteSpace at Work as its lead trainer, bringing 17 years of presentation and facilitation skills to the WhiteSpace team.

Program Agenda Thursday, May 9th – continued 10:30AM – 11:00AM

Extended Break with Exhibitors 11:00AM – Noon Separating Myth from Reality: Innovation Possibilities Within the Current Regulatory Environment

Morning Breakout Workshops Pre‐Flight Risk Assessment Checklist – Wage Parity and Employee Benefits

Speaker TBA

Paul Essner, CFP, CLU, ChFC, Principal, TSG Financial, A Division of Risk Strategies Emina Poricanin, Partner, Home Care Practice Leader, Hodgson Russ

We all know that the home care system is heavily regulated under a comprehensive set of state and federal standards for care and operations. Within this structure, however, are several options – many of them obscure or overlooked – that offer opportunities for flexibility, innovation and operational efficiency.

Eight years after being instituted and seven years after implementation, the Wage Parity law continues to present fiscal challenges and pressures. In that time, we’ve also seen how the statute has been enforced, including key areas that providers should be aware of in their internal compliance monitoring.

This session features a top expert who will discuss, with examples, some surgical ways that agencies can innovate their programing and operations within the current regulatory environment. Providers and MLTCs can also raise their own ideas for program innovations or flexibility and get pointers on which regulatory steps or directions are most suitable for possibly proceeding.

Emina Poricanin, Esq. and Paul Essner, CFP CLU ChFC will present a timely discussion on all of these issues, especially for LHCSAs and CDPAP FIs, covering the current audit and regulatory environment in NYS with respect to wage parity compliance, the importance of plan compliance with state and federal guidelines, and an overview of compliant approaches to satisfying your Wage Parity requirements.

Mission Control: Marshalling Positive and Lasting Change in your Home Health, Hospice Organization Jennifer Maxwell, M Ed, Co‐Founder and President, Maxwell Healthcare Associates With regulations, technology and research consistently evolving, how do you best manage change in your organization to ensure the change is worthwhile, relevant and long lasting?

Organizations that can adapt and evolve better and faster than the competition are best positioned to succeed and surmount the challenges of a modern health care marketplace. While many health care providers have established processes for rolling out changes and training team members accordingly, oftentimes the process falls short. This typically occurs when team members’ behaviors are only superficially adjusted.

Organizations will only realize lasting and positive change when they learn the secrets to transforming human behavior at its core.

Paul Essner Paul Essner, CFP CLU ChFC, Principal at TSG Financial, brings 27 years of experience to his position. In addition to his career‐long involvement in employee benefits, corporate and personal financial planning and individual insurance, he coordinates the TSG Financial Homecare Specialty Group, along with fellow Principal Bryan Pendrick, providing employee benefit design and consulting services to the home and community based care industry.

Jennifer Maxwell, co‐founder and president of Maxwell Healthcare Associates, works with the nation’s top home health and hospice providers through technology implementations, regulatory compliance initiatives, clinical efficiency evaluations and more. Ensuring success through these undertakings requires a formula to positively Jennifer Maxwell affect change.

Emina Poricanin Emina Poricanin is a Partner at Hodgson Russ LLC, where she leads the firm’s home care practice and provides counsel for public and private employers in all aspects of labor and employment law at both the state and federal levels.

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AWARDS PROGRAM 12:00PM – 1:30 PM

2019 HCA Home Care Awards Luncheon Nothing compares to the cathartic feeling of celebrating your peers, your staff or your mentors who are shining examples of the work you’ve committed yourself to do every day on behalf of patients. Join us in the celebration and hear their remarkable stories of compassion, caring, activism and vision.

1:30PM – 2:15PM

Desserts with Exhibitors

Caring Advocacy Physician Champion Quality and Innovation Ruth F. Wilson Submit your nomination online at: https://www.surveymonkey.com/r/2019‐HCA‐Awards

2:15PM – 3:15PM

Afternoon Breakout Workshops Breaking the Distance Barrier: Medicare and Medicaid Remote Patient Monitoring Regulatory Review and Case Examples Katy Cook, MS, CTC, Telehealth Project Manager, Adirondack Health Institute Rich Curry, MS, PT, MBA, VP of Business Development, Health Recovery Solutions Home telehealth, under Medicaid and Medicare, is in a dynamic state of flux and redefinition. At this crossroads, providers need to take stock of the current landscape as they consider their future investments in this important technology, especially as non‐home care sectors see the value of telehealth and seize upon new regulatory flexibilities to get into a space traditionally pioneered by home care and hospice. Katy Cook and Richard Curry will provide that vital perspective.

They’ll review updates in the current state of Medicare telehealth reimbursement policy. They will also discuss the direction of Medicaid regulations and reimbursement for telehealth, case studies, future expectations for Medicaid policy and reimbursements, and tips on what agencies should be doing now for telehealth adoption.

Katy Cook, MS, CTC, has been with the Adirondack Health Institute (AHI) as the Telehealth Project Manager since late 2016.

Alongside the Fort Drum Regional Health Planning Organization, she oversees the North Country Telehealth Partnership, northern New York’s leading agency focused on increasing access to health care through the innovative use of telehealth and telemedicine technology. Prior to AHI, Cook has worked in health care for over six years, both in the for profit and not for profit sector.

Rich Curry, MS, PT, MBA has over 14 years’ experience as a home health physical therapist and is the VP of Business Development for Health Recovery Solutions (HRS), a telehealth company that works with over 100 home health agencies in 34 states. Besides growing HRS’s customer base and developing business relations in the home health industry, he has also helped directly support agencies’ telehealth programs by developing research‐based approaches for various post‐acute programs.

Katy Cook

Rich Curry

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Thursday, May 9th – continued Afternoon Breakout Workshop 2:15PM – 3:15PM PDGM: All Fun and Games? Exercise Your Competitive Edge Rochelle Eggleton, RN, BS, MBA, Director of Clinical Consulting, Quality In Real Time According to Psychology Today, learning is a physico‐chemical process. Our brains love novelty. Are you tired of lectures and traditional slide presentations? Want to learn in a fun, relaxed atmosphere? PDGM may be the biggest and most complex payment overhaul in decades but that doesn’t mean it can’t be explained in manageable units.

Join us as we learn about PDGM using America’s favorite game show approach: PDGM Jeopardy. Our Jeopardy board will look into easy (i.e., 100‐dollar) topics all the way up to the big payoff or 500‐dollar PDGM challenges! This program will delve into the OASIS components of PDGM, questionable or non‐valid primary codes, diagnoses groups, how the payment model works, and some of the financial impacts of the new proposed payment model.

Rochelle (Shelley) Eggleton, RN, BS, MBA, is Director of Clinical Consulting at Quality In Real Time, supporting home care and hospice agencies across the country. Eggleton Rochelle Eggleton understands the challenges faced by executives and employees in the post‐acute industry in providing individual patient care.

Eggleton earned her BS Degree from Binghamton University with a concentration in community health and her MBA with a concentration in health care management through the University of Phoenix. She is a fellow of the Advisory Board Company Leadership Academy in Washington, DC and has served on HCA’s Board of Directors as well as HCA’s Quality and Policy Committees.

Your Office Team – Why They Matter and How to Shore Up a Successful Future Anne‐Lise Gere, SPHR, President, Gere Consulting Associates While caregivers are the lifeblood of your agency, the office staff is its backbone. Yet too often we fail to grasp the impact this office team has on patient satisfaction and caregiver recruitment and retention. Because they set the tone for your agency, your office staff determine its trajectory, either towards growth or stagnation. For your agency to be a force for the future, make 2019 the year that you pay closer attention to the office and what’s happening around you. You will likely find that it is time to upscale your office team. During this lively presentation, HR advisor and consultant Anne‐Lise Gere will share a few pointers on staffing the office for success, creating a culture of accountability, managing performance, and keeping the best when you find them.

Anne‐Lise Gere, SPHR works with home care agencies across the country to provide HR guidance, focused on creating strong recruitment plans and solid retention strategies.

She writes weekly blogs on HR issues in home care, employment compliance and employee relations for small and growing businesses (www.GereConsulting.com/blog).

She previously worked in HR at Siemens Automotive, and Procter & Gamble in Europe and the U.S. Since 2010, she’s served as a subject matter expert with Anne-Lise Gere the HR Certification Institute where she contributes to exam development for the SPHR, aPHR, SPHRi designations.

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Value Based Payments – Clinical, Operational and Revenue Cycle Success Strategies for LHCSAs Andrea Brown, RN, President/CEO, AB Coaching and Consulting, Inc. Phil Feldman, VP Revenue Management Solutions, Sandata Technologies, Inc. The state’s VBP program continues toward increasing levels of shared risk arrangements for home care, MLTC and other payors and providers.

While VBP remains a new concept to many LHCSAs in this early period of adoption, MLTCs will be required to meet higher risk thresholds of Level 1 and Level 2 for FY 2019‐20, making VBP an integral aspect of contracting with home care partners – and consequently a vital area for your strategic planning. This session will provide LHCSA leaders and management some foundational principles for adapt to the VBP arena, from goals‐focused client management to an understanding of key patient outcomes and financial data to be collected and analyzed internally and used to enhance your profile with external partners and payors. Keep your clinical, operational and fiscal teams apprised of performance shortfalls and successes to avoid missed VBP bonus opportunities.

Andrea Brown is the President/CEO of AB Coaching and Consulting, Inc. Brown provides coaching and consulting services to help people reach their professional goals and help organizations improve and transform themselves to meet the changing needs of the health care delivery system and the patients they serve. Prior to starting her coaching and consulting business, she spent 32 years in health care with more than twenty‐five years in home care.

In addition to providing direct care as a Registered Nurse, she has held several leadership positions in home care operations, clinical care and service delivery, staff education, quality management and compliance.

Phil Feldman is a CPA with over twenty years of experience with progressively increasing responsibility in operational and financial management for national home health care agencies. Feldman is presently Vice President, Revenue Management Solutions at Sandata Technologies, LLC, where he has executive responsibility for this Sandata business unit that provides end‐to‐end revenue cycle management services to home care agencies to improve revenue and cash flow.

Program Agenda Thursday, May 9th – continued 3:30PM – 4:30PM

Workforce for the Future: Planning for and Managing in Times of Transition Wayne Regan, Director of Interim Management, Simione Healthcare Consultants Eric Scharber, Principal, Simione Healthcare Consultants Talent is your organization’s most valuable asset. When key team members leave an organization or agencies re‐organize, the changes can dramatically affect overall performance. The key to address such challenges is to plan ahead for workforce transitions by constantly cultivating talent throughout the ranks in home health, hospice, and private duty care.

Simione talent acquisition experts will detail the industry’s expected “talent crisis,” including such factors as rapid growth, unexpected vacancies, changing market dynamics and agency integration.

Participants will learn key strategies and the importance of:  Succession planning  Options for addressing a vacancy  Managing organizational growth  Retention strategies for success Join us and gain a competitive edge for times of transition –– whether planned or unexpected –– in home‐based care!

Wayne Regan

Eric Scharber

Wayne Regan is Director of Interim Management for Simione Healthcare Consultants, which he joined in 2015. Regan’s broad experience in operations, strategic planning, business development, and interim management includes roles all the way up to the C‐ Suite with some of the nation’s largest providers. His primary focus is overseeing Simione’s interim management services to assist post‐acute organizations with leadership transitions that support strong business performance and strategic growth.

Eric Scharber is a Principal at Simione Healthcare Consultants, leading all talent acquisition and employee retention efforts for the home care and hospice industry through Exact Recruiting, a Simione talent solution. He oversees executive search and non‐executive recruiting services, as well as all retention services including compensation analysis and employee satisfaction survey services. He is a regular speaker on the topics of talent acquisition and retention, specific to the home care and hospice industry.

4:30PM – 6:00PM

HCA “Force for the FuturE” PAC Party @ 534 Bistro HCA’s Political Action Committee party is always festive, always fun, and it supports the work you do in home care by helping to politically support candidates who champion home care. Help make HCA’s PAC a true political force for the future with your contribution.

A $50 donation to HCA’s PAC is requested for this event. Donations will be accepted at the door. Pre‐registration is appreciated, but not required.

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Program Agenda Friday, May 10, 2019 7:30AM – 8:30AM

10:30AM – 11:45AM

HCA Town Hall Meeting

Window Seat on the National Landscape: A Forecast for the Future

No script, no agenda, no topic off the table … this freewheeling session is your opportunity to say what’s on your mind, present ideas and pose questions to HCA’s Policy team about any home care, hospice and MLTC issues confronting your organization.

William A. Dombi, Esq., President, National Association for Home Care & Hospice (NAHC) With PDGM on the horizon, NAHC President Bill Dombi has led a vigorous campaign of nationwide PDGM summits to educate providers, along with advocacy and legislative proposal development to mitigate some of the serious methodological assumptions under PDGM that would impose massive, unjustified cuts in provider reimbursement. He’s been at the vanguard of every major federal home care reimbursement battle or program change in the last 40 years, and is able to offer the most direct insight on the federal landscape for home health and hospice services, from payment to regulations to the intricacies of the home health Conditions of Participation, and much more. This closing keynote session will give you a window seat to observe all of the major home care and hospice developments on the national front.

8:45AM – 10:15AM

Technologies You’ve Never Heard of, but Desperately Need, to Stay Competitive Tim Rowan, Consultant and Editor of Home Care Technology Report As reimbursement rates shrink and competition grows, it is clear that some providers of in‐home care will not long survive. What are the characteristics of the agencies that will thrive? They will be using the latest technologies. Simply put, your agency is greatly at risk of folding if: you are not using data analysis systems that help you predict when it is time to have the hospice conversation; you are not using systems that improve care plans, reduce medical errors, and protect your agency against payment denials and surveyor dings; or, most importantly, you are not raising your visibility to the top of search engine results. Twenty‐five‐year home care technology consultant and Editor of Home Care Technology Report Tim Rowan will bring you the benefit of his experiences with every kind of software tool suited for post‐ acute care organizations. You will leave with at least one idea to improve your bottom line and your competitive positioning.

William A. Dombi, Esq. is President of the National Association for Home Care & Hospice (NAHC). He previously served as the Vice President for Law at NAHC. Dombi specializes in legal, legislative, and regulatory advocacy on behalf of patients and providers of home health and hospice care. With nearly 40 years of experience in health care law and policy, Dombi has been involved in virtually all legislative and regulatory efforts affecting home care and hospice since 1975, including the expansion of the Medicare home health benefit in 1980, the formation of the hospice benefit in 1983, the institution of Medicare PPS for home health in 2000, and the national health care reform legislation in 2010.

Tim Rowan is the Founder and President of Rowan Consulting Associates and serves as Editor of the Home Care Technology Report. Rowan holds a Master of Arts degree in Education from Loyola University, Chicago. After ten years in adult religious education positions, he moved to the computer and network hardware and software industry in the fledgling personal computer era, eventually landing back in adult education for a technical training firm. It was there that Tim was introduced to home health care through one of his training clients, who lured him aboard as their first CIO.

William A. Dombi 11:45AM

Conference Adjourns Tim Rowan 10:15AM – 10:30AM Break 10

ANNUAL CONFERENCE May 8 – 10, 2019 Saratoga Hilton Saratoga Springs, NY Register online at: https://events.eply.com/HCA2019AnnualConference2875611 or complete this form and fax back to HCA at the number indicated below.

Registration Form

NAME ______________________________________________________________

TITLE _________________________________________________________

COMPANY_____________________________________________________________________________________________________________________________ ADDRESS ______________________________________________________________________________________________________________________________ CITY/STATE/ZIP _________________________________________________________________________________________________________________________ PHONE _____________________________________________________________

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Method of Payment

How to Register

Please check one:

Return this completed registration form with your payment by fax to (518) 426‐8788 or mail it to: HCA, 388 Broadway, 4th Floor, Albany, NY 12207.

You may duplicate this form for additional attendees. Please save a copy for your records.

_____Check* Make payable to: HCA Education and Research and mail to: 388 Broadway, 4th Floor, Albany, NY 12207 Checks must be received by April 30th ____MasterCard ____Visa ____American Express

Registration Fee Please indicate your registration choice(s): (Includes Pre‐Conference) Pre‐Registration At Door Rate Rate

Full Conference Registration Options Credit Card No._____________________________________ Name on Card______________________________________

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Expiration Date ___________ Security Code ___________

• Non‐Member Provider

$749 

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__________________________________________________ Billing Address for Card

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Note the following with your registration:

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Cancellation Policy:

We encourage you to attend the full three day conference for the best value. No credits can be given for meals not taken or unattended education programs. Cancellations received by April 18 will receive a full refund, less 25% of total due as an administrative fee. Cancellations received on April 19 or later will forfeit their registration fee, as will those who register and do not attend. Substitutions are permitted.

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

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388 BROADWAY FOURTH FLOOR ALBANY, NEW YORK 12207

FORCE for the FUTURE

ANNUAL CONFERENCE May 8-10, 2019 Saratoga Hilton Saratoga Springs, NY

To: