May 14, 2018 Edition of The Situation Report

DOL RULE SUIT

AWARDS

PALLIATIVE CARE

COST REPORT CHANGE

The state DOL’s emergency rule on 24-hour/live-in cases is again a target of litigation, plus a July 11 hearing is set to consider extending rule on meal/sleep compensation to all employers.

HCA’s awards ceremony was a highlight of last week’s Annual Conference, as nearly 300 attendees cheered on home care’s best.

New report, stemming from HCA legislation, recommends boost to nursing, social work and other areas of education and practice enhancement in palliative care.

HCA has gained an extension in the 2017 personal care cost report due date and is seeking a similar extension to the CHHA report.

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Your Source for HOME CARE News, Policy and Advocacy

COMING UP Webinar: Surveys Under the New CoPs May 31, 2018 11:30 a.m. to 1 p.m.

Virtual Integrated Care Management (ICM) Training WEBEX Training Dates June 5: 1-3 p.m.

June 12: 1-3 p.m.

June 19: 1-3 p.m.

June 26: 1-3 p.m.

Driving Decisions with Data: A Seminar for Clinical Managers June 6, 2018 Albany Registration for these and other HCA programs are on our Education and Events page at: https://hcanys.org/eventseducation/upcomingevents

Vol. 3, Issue 20 | May 14, 2018

HCA Legislative Initiatives Take Root HCA has been steadily discussing with the membership our plans to write and move forward on critical proposals to support MLTCs, home care and hospice providers, workers and patients in the wake of the newly adopted state budget.

The last several editions of the Situation Report have described HCA’s work to draft bills with this intention. These proposals were presented in legislative meetings over the past week by HCA Executive Vice President Al Cardillo and Caron O’Brien Crummey of HCA’s government-affairs firm, Hinman-Straub. HCA is pleased that our entire slate of proposals has been accepted for introduction by the State Senate, or See ROOT p. 2

State Health Commissioner Dr. Howard Zucker, M.D., spoke to HCA’s Board of Directors at our Annual Conference last week stressing the importance of home care, innovation in service delivery to elder populations, and state initiatives to create age-friendly communities, among other priorities. Dr. Zucker specifically gave accolades to HCA on its sepsis screening tool and training programs, and discussed ways that home care can play a more robust role in other public health initiatives. His closing advice was for home care to elevate its visibility and work closely with educational institutions for solutions. At left is HCA President Joanne Cunningham and at center is HCA Board Chair Susan Larman, CEO of VNA Home Health.

INSIDE HCA Legislative Initiatives Take Root….................................................................1 Lawsuit Filed Over State DOL 24-hour/Live-in Rule…............................................4 A Message from HCA Sponsor RBC Limited….........................................................4 HCA Awards Go to 10 Leaders, Practitioners, Caregivers..................................….5 New State Report on Palliative Care Stems from HCA-Developed Bill.................….9 2017 Personal Care Cost Report Due Date Extended to July 30...........................10 DOH Issues Guidance on LHCSA Moratorium Including Exceptions…...................11 CMS to Host Home Health, Hospice Open Door Forum: May 15............................12

Recent State Budget Provisions Highlighted in May Medicaid Update….....12 Agenda Posted for PHHPC Committee Meeting.....................................…13 NGS Posts Updates on New MBI Number...............................................….13 CHHAs Must Report Changes in Ownership............................................….14 Upcoming Deadlines and Due Dates.....................................................….15 NYC Anti-Sexual Harassment Legislation Signed........................................16 May 21 & 25 Webinars Provide Q&A on Paid Family Leave..........................16 OSHA Revises Form Submission Requirement...........................................17 Resources..........................................................................................17

The Situation Report: the Home Care Association of New York State ROOT from p. 1 Assembly, or both. HCA efforts to secure introduction of these bills in both houses continues this week.

These proposals include: 

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A health worker retraining/cross-training program to authorize hospitals and nursing home collaboratives with home care and hospice providers to retrain and cross-train staff for service in facility and community care settings (S.8613/Hannon).

A recruitment, training and retention rate add-on targeting shortage areas and disciplines. This would include special pilots for personnel support in critical areas like transportation, education, training, child care, career ladder opportunities, peer support, and others (S.8687/Serino).

A labor competitive market study, examining and yielding policy and reimbursement recommendations for securing home care and hospice recruitment and retention (S.8559/Serino).

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The Situation Report is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in The Situation Report are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. Joanne Cunningham HCA President jcunningham@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Al Cardillo Executive Vice President acardillo@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org

State promotion of occupations and career choice in home care and hospice, including entrance, practice, career development and retention for nursing, home health aide, physical therapy, occupational therapy, social work and others (S.8559/Serino).

Andrew Koski Vice President, Program, Policy & Services akoski@hcanys.org

MLTC rural service area nursing home benefit option, which is a joint proposal of LeadingAge NY and HCA to amend the state budget provision that has limited MLTC nursing home coverage eligibility to three months. Our provision would allow MLTCs in rural areas the ability to retain the ongoing nursing home benefit with the Commissioner’s approval (S.8488/Little and A.10688/Jones).

Celisia Street Director of Education cstreet@hcanys.org

Strategic integration of home care into state public health, prevention and primary care priorities, supporting home care intervention in such public health priorities as sepsis, asthma, diabetes, health disparities, obesity, polypharmacy, falls, pressure injuries, and others, and reinvesting “shared savings” of the state into the home care public health effort (S.8620/Hannon).

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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Volume 3, No. 20 May 14, 2018

Laura Constable Senior Director, Membership & Operations lconstable@hcanys.org

Mercedes Teague Finance Manager mteague@hcanys.org Jenny Kerbein Director of Governance & Graphic Design jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org

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

Volume 3, No. 20 May 14, 2018 

Continued from previous page 

Support for the HCA home care sepsis screening and intervention initiative, by advancing EHR integration of the sepsis tool, provider/clinician training, public education, health information exchange across continuum partners and crosssector collaboration to foster seamless, timely response to sepsis (S.8669/Hannon).

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Home care-mental health provider collaboration, building on work that HCA and the state Office of Mental Health (OMH) have been partnering on to promote coordination, integration and improved access of health and mental health services for individuals with co-occurring mental health and physical health needs (S.8632/Ortt).

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Addressing health disparities through home care collaboration models with physicians, hospitals and other partners, which is a joint proposal of HCA and the State Medical Society (S.8656/Hannon and A.2925/Peoples-Stokes).

This slate of legislation not only addresses important home care, hospice and MLTC needs in new and different ways, but it also positions, supports and affirms providers’ and plans’ key roles in health care priority areas. The legislation also promotes home and community based provider and plan contributions as solutions for access, quality and cost-effective care in the state’s health system.

A more detailed, printable summary of this HCA legislative slate is at https://hca-nys.org/wp-content/ uploads/2018/05/Summary-of-HCA-Post-Budget-BillsIntroduced.pdf.

This legislative agenda combines with our separate postbudget, regulatory, policy and program action plan to form a comprehensive advocacy platform for the field, which we will be reporting on in detail as matters progress throughout the course of the remaining weeks of the state legislative session. Please also be on alert for grassroots advocacy instructions to support these important initiatives.

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

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During her speech kicking-off HCA’s Annual Conference, HCA President Joanne Cunningham took members on a tour through HCA’s history over the last 40 years, from the merger of three statewide associations serving 80 members under the leadership of HCA’s first Executive Director Janet Starr to today’s work serving hundreds of members across the entire continuum of care. She also reminded members about the vital need for grassroots advocacy – being a constant presence in lawmakers’ offices; using data; avoiding jargoned language in your messaging; and taking time to meet with officials when you don’t necessarily have something to ask for. In other words, in addition to times when you have a specific advocacy ask, it’s also good to also carve out time to tell lawmakers about an exceptional service your organization offers to constituents. She also described HCA’s efforts to finish the state legislative session strong. (See related p. 1 story.)

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

Volume 3, No. 20 May 14, 2018 

Lawsuit Filed Over State Department of Labor 24-hour/Live-in Rule A lawsuit (Article 78 proceeding) was filed on May 4 against the state Department of Labor (DOL) over its emergency regulation covering 24hour/live-in aide cases.

As covered in many communications and education programs, state DOL promulgated an emergency rule initially on October 25, 2017, and renewed it twice since then, that codified “the Commissioner’s longstanding and consistent interpretation that compensable hours worked under the State Minimum Wage Law do not include meal periods and sleep time of home care aides who work shifts of 24 hours or more.”

In December, this rule was challenged by the Urban Justice Center, on behalf of certain parties, before the New York State Industrial Board of Appeals (IBA). In late January, IBA denied the challenge based on jurisdictional grounds and did not consider the merits of the regulation.

The plaintiffs in the May 4 lawsuit, who seek to invalidate DOL’s emergency regulation, are similar to those who pursued the IBA challenge (Chinese Staff and Workers Association, National Mobilization Against Sweatshops, and five aides).

HCA will be following this case closely and continue our active involvement in trying to obtain a successful resolution of the 24-hour/live-in issue.

This has included submitting amicus briefs on relevant Court cases and challenges before the IBA; urging state DOL to address this issue; and advocating that the state Department of Health recognize the potential retroactive and prospective costs to providers and plans in the Medicaid program if aides

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must be paid for all 24 hours of work even if they have meals and sleep time.

As mentioned in the April 30 edition of The Situation Report, state DOL extended the emergency rule until June 3. It has also announced a proposed rule that would not count meals periods and sleep time for any employee (not just home care aides) who works a shift of 24 hours or more. Furthermore, there will be a hearing on July 11 at the state Department of Labor’s office in Brooklyn on this proposed rule. Comments on this proposed rule will be accepted until July 16.

Registration to testify at the July 11 hearing is at https:// www.labor.ny.gov/workerprotection/sleep-time.shtm.

In early March, the Second Department, Appellate Division granted a motion to appeal in Andryeyeva v. New York Health Care, Inc., permitting the case to be considered by the Court of Appeals, which is New York’s highest court. In that case, the Second Department ruled that DOL’s policy exempting certain meal and sleep periods from compensable hours is inconsistent with the plain language of underlying state regulation.

HCA intends to submit an amicus to the Court of Appeals and will keep members informed of any new developments on the 24-hour/live-in issue.

Volume 3, No. 20 May 14, 2018

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

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HCA Awards Go to Ten Clinicians, Caregivers, Quality Leaders, Advocates and Physicians across NYS and Nationally HCA presented awards at 40th Annual Conference on 5/10 At our 40th Anniversary Annual Conference in Saratoga Springs, NY on May 10, HCA presented our 2018 annual awards to ten exceptional home care and hospice clinicians, caregivers, leaders in quality innovation, advocates, and physicians at the state and national levels.

For a full summary of each award winner’s accomplishments, please see our conference website at http://hcaannualconference.com/ 2018-award-winners/.

Advocacy Award Winner and closing keynote speaker Bill Dombi.

HCA’s two highest honors were presented to a national leader on the home care stage, as well as one of New York State’s most thoughtful and expert regulatory policymakers.

HCA’s 2018 Advocacy Award recipient is Bill Dombi, President and longtime policy leader at the National Association for Home Care and Hospice (NAHC). “Bill Dombi has influenced every significant change in the Medicare home health benefit, reimbursement, regulations and the legal frameworks governing home care over the last 30 years,” said HCA President Joanne Cunningham. “He truly is the leading home care and hospice advocate for our state, for every state, and for the country.”

Ruth F. Wilson Award Winner Becky Fuller Gray (second from right).

HCA’s highest honor is the Ruth F. Wilson Award, named for an early organizational leader in New York’s home care system. It was presented to Rebecca Fuller Gray, Director of the New York State Department of Health’s Division of Home and Community Based Services. “Becky Gray is not only an exceptional leader committed to doing what’s right for home care patients, but she also approaches every issue and challenge with the instincts and problem-solving acumen of a nurse, serving as a cornerstone of home care and hospice policymaking for nearly 15 years.”

Overall, HCA’s 2018 awards are among the most diverse yet, in terms of the ways that each luminary has touched the world of home care and hospice.

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HCA drew a big audience of nearly 300 people for our awards ceremony at the HCA Annual Conference.

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

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Continued from previous page “Our Caring Award winners represent the very best in compassionate care to patients with debilitating illnesses, rehabilitation needs and during end-of-life care,” Ms. Cunningham said. “We are also pleased to honor a home care agency leader who has invested in a unique facility to reward his workforce.”

Ms. Cunningham added: “We are also thrilled this year to recognize the specialized work of nurses who are making a difference through home-based primary care and in spearheading New York City’s first – and only – dedicated program to support the home care needs of patients recovering from gender reassignment surgery.”

Colleagues from Selfhelp Community Services accept the Caring Award on behalf of Vicky Gentile. Pictured second from right is recent HCA Board Member Russell Lusak, Senior Vice President, Administration, Selfhelp.

For the first time, HCA is also recognizing physician champions in home care.

“Doctors play a vital role in the authorization of home care services, from the initiation of physician orders to the documentation of medical necessity and collaboration with home care providers,” Ms. Cunningham said. “Doctors Kevin Costello and John McIntyre, however, are true home care champions, very actively supporting patients at home during the often-fragmented discharge-planning process from the hospital, helping home care organizations reimagine their caseconferencing of at-risk patients, raising the visibility of home care among their peer physicians, and so much more.”

Josh Klein, holding award at center, is flanked by colleagues and staff from Royal Care to receive HCA’s Caring Award.

Awardees Caring Awards winners are: 

Vicky Gentile, Home Health Aide at New York City-based Selfhelp Community Services

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Josh Klein, CEO of New York City-based Royal Care Continued on next page

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Volume 3, No. 20 May 14, 2018 

Continued from previous page

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Amy Marshall-Uber, Home Health Aide at Eddy Licensed Home Care Agency, which is part of St. Peter’s Health Partners and serves New York’s Capital Region

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Julio Vega, Doctor of Physical Therapy at HCR Home Care, based in Rochester, New York

‘Triple-Aim’ Quality and Innovation Award winners are: 

Kim Gendron, Family Nurse Practitioner at St. Peter’s Health Partners Medical Associates/ Eddy VNA Home Based Primary Care, which serves New York’s Capital Region

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Shannon Whittington, Interdisciplinary Care Team Manager and Director of the Gender Affirmation Program at New York City-based Visiting Nurse Service of New York

HCR Home Care’s award winners include HCR Medical Director Dr. Jack McIntyre, MD, winner of our inaugural Physician Champion Award (third from right), and Julio Vega (second from right), winner of our Caring Award. Also pictured, second from left, is HCA Board Member Liz Zicari, President of HCR Home Care.

Physician Champion Award winners are: 

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Kevin Costello, MD, Albany Medical Center Internal Medicine, Albany, New York John “Jack” McIntyre, MD, Medical Director, HCR Home Care, based in Rochester, New York Continued on next page

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VNSNY leaders join HCA in celebrating our inaugural ‘TripleAim’ Quality and Innovation Award presented to VNSNY’s Shannon Whittington (third from right). Also present is HCA Board Member Sandy Merlino, Vice President of Hospital Market Development, Integrated Delivery Systems, at VNSNY (fourth from right), as well as VNSNY President and CEO Marki Flannery (far right).

The Situation Report: the Home Care Association of New York State Continued from previous page

HCA’s Advocacy Award winner is: 

William Dombi, President and CEO of the National Association for Home Care and Hospice (NAHC).

HCA’s Ruth F. Wilson Award winner is: 

Rebecca Fuller Gray, Director of the Division of Home and Community Based Services, New York State Department of Health (DOH).

Top photo: VNA Home Health joins HCA in presenting our inaugural Physician Champion Award to Dr. Kevin Costello, M.D. Joining Dr. Costello is HCA Board Chair Susan Larman, CEO of VNA Home Health (third from right), alongside members of her team.

Bottom Photo: Two exceptional individuals at St. Peter’s Health Partners’ home and communitybased programs received a 2018 Caring Award and the inaugural ‘Triple-Aim’ Quality and Innovation Award. At far left is Caring Award winner Amy Marshall-Uber, and second from right is ‘Triple-Aim’ Quality and Innovation Recipient Kim Gendron. Second from left is HCA Board Member Michelle Mazzacco, Vice President/Director of Eddy Community Services/St. Peter's Health Partners.

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Volume 3, No. 20 May 14, 2018 

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

Volume 3, No. 20 May 14, 2018 

Major State Report Recommends Govt., Educational & Provider Support of Palliative Care Stemming from HCA-Developed Legislation A state council has released a major report and comprehensive set of recommendations for government, educational and provider support of palliative care that is a direct result of 2014 legislation developed by HCA in conjunction with our Hospice and Palliative Care Forum.

The report can be read at https://hca-nys.org/wpcontent/uploads/2018/05/NYS-Palliative-Care-EducationTraining-Council-Recommendations.pdf.

HCA’s Hospice and Palliative Care Forum has engaged in intensive efforts involving state Department of Health officials, top medical experts, and our membership to probe access and utilization barriers to hospice and palliative care in New York.

This discussion identified potential areas for improving access by increasing palliative care training and clinical competency among RNs and Masters of Social Work (MSWs) throughout health care settings to better engage patients, families and clinical teams on discussions about hospice and palliative care and improve the supply of clinicians credentialed to provide these services.

National Hospice and Palliative Care Organization President Edo Banach speaks at HCA’s Annual Conference last week, just as the state releases a major report recommending enhancements to some of the palliative care issues Mr. Banach discussed with attendees at the conference.

In 2014, HCA drafted a bill to implement recommendations from the forum. The bill – sponsored by the Senate and Assembly’s Health Committee Chairmen, Senator Kemp Hannon and Assemblyman Richard Gottfried (S.7601-B/A.9966), and signed by Governor Cuomo – charged the state Palliative Care Education and Training Council to examine palliative care capacity and education/training support opportunities and needs for RNs and MSWs in the state’s professional schools and health settings, and to make recommendations to the Governor, Legislature, Commissioners of Health and Education, and the SUNY Chancellor. The bill also added social work and home care representation “seats” to the council.

As this Council initiative broke ground, HCA and our member Forum worked to supply it with data and other elements to support the Council’s progress. The final report, several years in the making, establishes a series of recommendations for continuing education in palliative care content, legislation to develop new models of palliative care education, and other specific curricula changes.

The report contains innumerable recommendations aimed at educational institutions, health care providers and state government. A few of these include: 

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Require that every educational institution granting degrees in nursing and degrees in social work have in place an articulation agreement with a health care organization that provides hospice and/

The Situation Report: the Home Care Association of New York State or palliative care to ensure that students will have opportunities for exposure to this field and to develop skills to provide primary (generalist) palliative care. 

Support the creation of standards for schools of nursing and social work to incorporate a conceptual framework for palliative care into the required content at the undergraduate and graduate level.

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Support the development of educational models that can meet the needs of nurses and social workers at all levels of practice while including essential palliative care content.

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Provide regular continuing education for nurses employed in generalist settings who treat seriously ill/medically complex individuals, based on the components of the core End of Life Nursing Education Consortium (ELNEC) curriculum, the National Quality Forum (NQF) domains, or comparable national guidelines.

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Provide social workers who serve seriously ill/medically complex individuals with regular continuing education based on the 2004 “Standards for Palliative and End of Life Care.”

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Incentivize participation in continuing education with palliative care content in concert with the recently developed requirement for continuing education as a condition of continued licensure for social workers in New York State.

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Support attainment of national certification in palliative care for nurses and MSWs working in specialty appropriate settings such as inpatient palliative care settings or hospice programs.

These recommendations and others in the report will be discussed in full with our Hospice and Palliative Care Forum during its next meeting on May 23 and HCA will provide a further report on next steps for HCA and the Forum to support implementation of the principles in this report. We extend our appreciation to the Palliative Care and Education Council for this strong report, our Hospice and Palliative Care Forum for its vision in moving these recommendations forward, and the Legislature and Governor for embracing our legislation to this end.

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Volume 3, No. 20 May 14, 2018 

HCA Obtains Extension on 2017 Personal Care Cost Report Due Date to July 30, 2018 Similar extension sought for CHHA report due date HCA has obtained an extension to July 30 in the due date for the 2017 personal care cost report. We are also seeking a similar extension for Certified Home Health Agencies (CHHAs).

The state Department of Health (DOH) recently posted the 2017 Medicaid cost report software for non-hospital based CHHAs and personal care providers. In each case, DOH set the cost report, operator’s certification, and accountant’s certification due date at July 16, 2018. For the second year in a row, this is significantly earlier than previous years’ cost reports.

HCA immediately contacted DOH and requested that the Department grant an extension, allowing at least 90 days to complete both reports. Last week, DOH sent a notification of the new July 30 due date for the personal care report, but has not announced a change in the CHHA cost report due date. HCA is seeking a similar extension for CHHAs and will notify the membership as additional information becomes available.

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

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

Volume 3, No. 20 May 14, 2018 

DOH Issues Guidance on LHCSA Moratorium Including Exceptions As reported in an alert to members last week, the state Department of Health (DOH) has circulated further details of a recently enacted state budget provision placing a two-year moratorium on the processing and approval of LHCSA applications, effective April 1, 2018 to March 31, 2020. The guidance is available for download at https://hca-nys.org/wp-content/uploads/2018/05/Licensed-Home-Care-Services-AgencyMoratorium-Guidance.pdf.

It spells out certain exceptions to the moratorium, including the permissibility of applications for licensure of a LHCSA that is submitted with an application for an Assisted Living Program (ALP).

Also allowed are: an application seeking approval to transfer/change ownership for an existing LHCSA that has been licensed and operating for a minimum of five years for the purposes of consolidating the licenses of two or more LHCSAs; and an application seeking licensure of a LHCSA where the applicant demonstrates, to the satisfaction of the Commissioner of Health, “that it would be appropriate on the grounds that the application addresses a serious concern such as a lack of access to home care services in a geographic area or lack of appropriate care, language and cultural competence or special needs services.”

Revised LHCSA application and instructions are now available at https://www.health.ny.gov/facilities/cons/.

Applicants with already-submitted applications will be contacted individually with instructions, the guidance says. Individuals with questions can e-mail homecareliccert@health.ny.gov.

Any members who submit questions to DOH are invited to copy HCA on the e-mail message or alert us to your questions so that we can track DOH’s response or otherwise support you in gaining clarification. In doing so, please cc or contact Andrew Koski at akoski@hcanys.org.

HCA’s Annual Meeting of the Corporation at our 2018 Annual Conference included the confirmation of members to new seats on our Board of Directors (from left): Bridget Gallagher, Jacob Victory, Lina Scacco, Melissa Allard, Mark Tsiames, Marianne Grady and Roni E. Glaser. HCA welcomes our new Board Members.

To read their bios, please download our profile sheet at https://hcanys.org/wp-content/ uploads/2018/05/2018New-Board-ProfileSheet.pdf.

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

Volume 3, No. 20 May 14, 2018 

CMS to Host Home Health, Hospice Open Door Forum: May 15 The U.S. Centers for Medicare and Medicaid Services (CMS) is hosting its next Home Health and Hospice Open Door Forum on Tuesday, May 15, 2018 from 2 to 3 p.m.

To participate, use the dial-in number and conference code below:  

Dial-In: 1-800-837-1935 Conference ID: 33245710

Agenda items, summarized below, will be followed by a question-and-answer session.

Home Health Agenda Items   

Updates on Home Health Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey; Home Health Claims Processing Update; and Recent Updates to the home health Quality Reporting Website.

Hospice Agenda Items 

Fiscal Year 2019 Hospice Payment Update;

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Proposed regulatory changes recognizing physician assistants (PAs) as designated hospice attending physicians;

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Hospice Quality Reporting Program (QRP) announcements;

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Updates on Hospice CAHPS; and

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Hospice Claims Processing Update.

Recent State Budget Provisions Highlighted in May Medicaid Update In its May issue of the Medicaid Update, the state Department of Health (DOH) includes a summary of some of the state budget changes that affect home care providers and Managed Long Term Care (MLTC) plans.

The May Update, along with prior issues, is at https://www.health.ny.gov/health_care/medicaid/program/ update/main.htm.

This month’s articles cover:   

Limits on the number of Licensed Home Care Services Agencies (LHCSAs) that can contract with MLTC plans; New LHCSA moratorium; New LHCSA registration process; Continued on next page

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Continued from previous page  

MLTC plan closure oversight; and Changes to the Health Home program.

HCA is submitting questions to DOH on most of the above issue areas and other provisions that were part of the final state budget. Once we obtain answers, we will inform the membership.

For more information, contact the HCA Policy staff.

Agenda Posted for PHHPC Meeting of Committee on Establishment and Project Review The state Department of Health (DOH) has posted the agenda for the May 17 meeting of the Public Health and Health Planning Council (PHHPC) Establishment and Project Review Committee. The agenda and supporting documents are at https://www.health.ny.gov/facilities/ public_health_and_health_planning_council/meetings/2018-05-17/.

On the agenda are applications by:       

One hospice to merge with another hospice; An existing Certified Home Health Agency (CHHA) for a 3-year extension to its limited life operating certification; An existing CHHA to purchase another CHHA; A CHHA for a transfer of ownership; A CHHA for a change in indirect ownership; A not-for-profit corporation to become the sole corporate member of an existing CHHA; and Five entities to establish a Licensed Home Care Services Agency (LHCSA) with an Assisted Living Program.

These will be the first LHCSA applications considered since the release of guidance on the recently imposed two-year moratorium, with limited exceptions, on the processing and approval of new LHCSA applications.

(See related p. 11 article.)

The May 17 meeting can be attended in person or watched by webcast at https://www.health.ny.gov/events/ webcasts/.

NGS Posts Updates on New Medicare Beneficiary Identifier (MBI) Number National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), has posted the following notices that relate to the new Medicare Beneficiary Identifier (MBI) Number.

CMS Post FAQs on New Medicare Beneficiary Identifier (MBI) Number The U.S. Centers for Medicare and Medicaid Services (CMS) has recently posted an updated version of its frequently asked questions (FAQs) regarding the New Medicare Card rollout and the MBI that is replacing the

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Volume 3, No. 20 May 14, 2018 

Social Security Number-based Health Insurance Claim Number (HICN). The questions pertain to all Medicare providers. They discuss crossover, claim submission, eligibility checks and much more.

HCA members can view the updated FAQs at: https://www.cms.gov/Medicare/New-Medicare-Card/NMC-FAQs5-18.pdf.

Fiscal Intermediary Shared System / Direct Data Entry Display Issue Medicare claims originally submitted for processing with an HICN as the beneficiary identifier are being incorrectly displayed in the direct data entry (DDE) with the new Medicare Beneficiary Number (MBI). Claims should be displaying in DDE with the original identifier submitted on the claim (either the HICN or MBI). CMS will resolve this issue no later than May 29, 2018.

To avoid confusion, please do not use a beneficiary’s MBI until one of these occurs:   

The beneficiary presents his or her new Medicare card (which will contain the MBI); The MBI is available through NGS’s secure portal; or Their MBI is shared through the remittance advice starting in October 2018.

CHHAs Must Report Changes in Ownership The U.S. Centers for Medicare and Medicaid Services (CMS) reminds Certified Home Health Agencies (CHHAs) that they must update their enrollment information to reflect changes in ownership within 30 days.

Owners are individuals or corporations with a 5 percent or more ownership or controlling interest. Failure to comply could result in the revocation of a CHHA’s Medicare billing privileges.

Some helpful resources include:

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Timely Reporting of Provider Enrollment Information Changes (https://www.cms.gov/Outreach-andEducation/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1617.pdf)



Updated Manual Guidelines for Electronic Funds Transfer Payments and Change of Ownership (https:// www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/ Downloads/SE17012.pdf)



PECOS Enrollment Tutorial – Change of Information for an Organization/Supplier (https:// www.youtube.com/watch?v=U0fJnhQ0egk&amp%3Blist=PLaV7m2zFKpia1McB1WKKkw2esAdiZRem&amp%3Bindex=4)

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

Volume 3, No. 20 May 14, 2018 

Upcoming Deadlines

Requirement/Change

Effective/Due Date

More Information

Home Care, Fiscal Intermediaries and other providers who contract with Managed Care Organizations must be enrolled in Medicaid

Enrollment still being accepted, but providers are advised to submit now

https://www.emedny.org/info/ProviderEnrollment/Manage dCareNetwork/index.aspx

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/NewͲMedicareͲ Card/index.html

Submission of Expression of Interest for the Medicare Low Volume Appeals Initiative

Due April 12 to June 8

https://www.cms.gov/Medicare/AppealsͲandͲ Grievances/OrgMedFFSAppeals/AppealsͲSettlementͲ Initiatives/LowͲVolumeͲAppealsͲInitiative.html

Changes in appeals system for Medicaid managed care enrollees

May 1, 2018

https://www.health.ny.gov/health_care/managed_care/pla ns/appeals/index.htm

Changes to NYC Paid Sick Leave Law Become Effective

May 5, 2018

http://www1.nyc.gov/site/dca/about/paidͲsickͲleaveͲ law.page

2018 Medicaid Managed Care Plan Readiness Attestation Form

Due May 14, 2018

https://hcaͲnys.org/wpͲcontent/uploads/2018/05/2018Ͳ MegaͲRuleͲAttestation.docx

NYS Hospice Survey

Due May 16, 2018

https://www.surveymonkey.com/r/HospiceUtilization

NYS Health Foundation ‘Patients as Partners’ RFP

Due May 16, 2018 for online inquiry form

https://nyshealthfoundation.org/rfp/patientsͲasͲ partners/?utm_source=Patients+as+Partners+RFP+Release+ April+2018&utm_campaign=Patients+as+Partners+RFP+Rele ase&utm_medium=email

Long Term Care Planning Council Survey

Due June 18, 2018

https://www.surveymonkey.com/r/HM9DM97

Health Workforce Retraining Program RFA

Due June 22, 2018

https://www.health.ny.gov/funding/rfa/17842/index.htm

OSHA 2017 Form 300A form (A Summary of WorkͲRelated Injuries and Illnesses)

Due July 1, 2018

https://www.osha.gov/injuryreporting/index.html

Hearing on state Department of Labor’s proposed rule to exclude meals and sleep time July 11, 2018 for all employees

www.labor.ny.gov

Certified Home Health Agency 2017 Cost Report

Due July 16, 2018; HCA is seeking an extension

https://commerce.health.state.ny.us/public/hcs_login.html

Personal Care Provider 2017 Cost Report

New Due Date: July 30, 2018

https://commerce.health.state.ny.us/public/hcs_login.html

15

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

Volume 3, No. 20 May 14, 2018 

NYC Anti-Sexual Harassment Legislation Signed On May 9, New York City Mayor Bill de Blasio signed a package of legislation that targets sexual harassment in the workplace.

As highlighted in the April 23 edition of The Situation Report and a detailed memo summarizing this and recent state legislation (https://hca-nys.org/wp-content/uploads/2018/04/ 042318SexualHarrassmentMemoJacksonLewis.pdf), the Stop Sexual Harassment in NYC Act: mandates employer training on sexual harassment prevention (for employers of 15 or more employees); expands New York City Human Rights Law coverage for gender-based harassment claims to all employers; extends the statute of limitations for gender-based harassment claims under the Human Rights Law from one to three years; and extends protections to non-employees in the workplace.

The New York City Commission on Human Rights will create an online interactive training module that will be post on its website (the legislation did not set forth a timeframe for this). Employers may use the Commission model training module (to the extent it is available) or develop their own training.

New employees will need to complete training within 90 days of initial hire, but only if they have not received qualifying training within the previous year from a former employer. If an employee received training at a previous employer, additional training will not be necessary until one year has elapsed from the date of the employee’s most recent training.

State Legislation On a state level, the state budget includes provisions that require all employers to: adopt a sexual harassment prevention policy and provide related training; extend sexual harassment protections to nonemployees in the workplace; ban enforcement of arbitration clauses for sexual harassment claims; set forth a mandatory waiting period and revocation period for non-disclosure agreements related to sexual harassment claims; and require entities that bid for state contracts to affirm compliance with sexual harassment training laws.

HCA will keep members informed on any training modules and guidance that are issued under the city and state legislation.

May 21 & 25 Webinars Provide Q&A on Paid Family Leave New York State Workers’ Compensation Board has announced two upcoming, live question and answer (Q&A) webinars for employers with questions about New York’s Paid Family Leave requirements.

Each session will begin with a brief review of the top 10 most frequently asked questions from employers, with the remaining part of the hour open to Q&A. Click the registration links below for wither of the upcoming sessions. Once you click the link, your browser will be directed to a general information page. You must click ‘Register’ on the bottom of that page to sign up.  

Monday, May 21, noon to 1 p.m. Register at https://tinyurl.com/yb44r777.

Friday, May 25, noon to 1 p.m. Register at https://tinyurl.com/y9m583lv.

Continued on next page

16

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

Volume 3, No. 20 May 14, 2018 

Continued from previous page Further information is available at ny.gov/PaidFamilyLeave, including request forms, downloadable guides, videos and more.

Employers can also call the Paid Family Leave Helpline at (844) 337-6303, Monday through Friday, (8:30 a.m. to 4:30 p.m.) for more information or assistance.

OSHA Revises Form Submission Requirement The Occupational Safety and Health Administration (OSHA) has revised the submission requirements for certain forms.

Employers with 250 or more employees are not required at this time to submit the 300 log (Log of WorkRelated Injuries and Illnesses) or the 301 forms (Injury and Illness Incident Report). However, establishments with 250 or more employees are still required to provide their 2017 Form 300A form (A Summary of WorkRelated Injuries and Illnesses), and this must be done by July 1, 2018.

OSHA has also announced that it will issue a notice of proposed rulemaking (NPRM) to reconsider, revise, or remove provisions of the “Improve Tracking of Workplace Injuries and Illnesses” final rule, including the collection of the Forms 300/301 data. The agency is currently drafting that NPRM and will seek comment on those provisions.

More information is at https://www.osha.gov/injuryreporting/index.html.

Resources 

“Paying For Value: Lessons From The Medicare Hospice Benefit,” Health Affairs Blog https://tinyurl.com/yblfu4zx



“Healthcare Workforce 2025 Part II Trends In The Healthcare Workforce,” by Mercer https://hca-nys.org/wp-content/uploads/2018/05/Workforce-Study_Mercer_2018.pdf



International Classification of Diseases, Tenth Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs), by the U.S. Centers for Medicare and Medicaid Services https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNmattersArticles/downloads/MM10622.pdf



“MLTSS for People for Intellectual and Developmental Disabilities: Strategies for Success,” by the National Association of States United for Aging and Disabilities and the National Association of State Directors of Developmental Disabilities Services http://nasuad.org/sites/nasuad/files/2018%20MLTSS%20for%20People%20with%20IDD%20Strategies%20for%20Success.pdf



“Most of New York’s Claims for Federal Reimbursement for Monthly Personal Emergency Response Service Charges Did Not Comply With Medicaid Requirements,” by the Office of the Inspector General https://oig.hhs.gov/oas/reports/region2/21501019.pdf

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

17

Driving Decisions with Data A Seminar for Clinical Managers

June 6, 2018 – Albany Marriott Hotel – Albany, NY

Driving Decisions with Data A Seminar for Clinical Managers

Meet the Presenter Barbara Katz, RN, MSN President, BK Health Care Consulting

Barbara is an experienced clinician, manager, trainer and health care consultant. She is a graduate of the Yale School of Nursing, She has a Certificate in Training and Development from Fairfield University and a Coaching Certification from the American Talent Development Association. Barbara was the 2013 winner of the Connecticut Association for HealthCare at Home’s Judith A. Hriceniak Award for Excellence in Nursing Leadership.

Barbara has been a hospital nurse, an APRN, a training manager, a director of quality improvement and a clinical manager for a group of medical practices. She has also been a marketing director for a home health care agency and has managed operations for a private duty home care agency.

She has designed and taught seminars on process improvement, data analysis, management, motivational interviewing and team-building. Barbara frequently speaks on topics including the practical use of data to improve outcomes, motivational interviewing, health literacy, collaboration and care transitions and adapting to the new world of health care.

Driving Decisions with Data A Seminar for Clinical Managers June 6, 2018 Albany Marriott 189 Wolf Road, Albany, NY 12205 Registration & Continental Breakfast: 8:30AM Program: 9 – 4:30PM

Home health care agencies will survive and thrive in the new value based health care world if their clinical managers use data to improve population health outcomes, lower costs, reduce waste in work and improve the patient and clinician experience. The new Medicare Conditions of Participation for home health care also require agencies to adopt a data driven approach to Quality Assurance/Quality Improvement (QAPI).

This practical and interactive seminar will help managers understand their role in using data to drive decisions for both the agency QAPI process and in daily clinical work.

Managers will leave with essential tools and techniques for obtaining data, step by step data analysis methods and practical methods for achieving target goals. Participants will have an opportunity to analyze clinical and business data, to develop action plans and to apply data-driven decisions to real operational work problems.

By the end of this program, participants will be able to:  Explain why data-driven decisions are vital in the new world of health care  Describe the role of data in meeting the Medicare Conditions of Participation for QAPI  List key home health care measures  Describe four key steps to making data-driven management decisions  Utilize basic data analysis techniques to turn data into actionable information  Use data to solve operational problems and to achieve agency QAPI goals

Driving Decisions with Data – A Seminar for Clinical Managers June 6, 2018 – Albany Marriott Hotel – Albany, NY HOTEL INFORMATION Albany Marriott 189 Wolf Road, Albany, NY 12205 HCA has reserved a limited block of rooms at the Marriott – Wolf Road, Albany, NY for the night of Tuesday, June 5 at a discounted rate of $139 per night. To receive this special rate, please call 1‐800‐228‐9290 prior to May 16, and ask for the Home Care Association of NYS group rate.

REGISTRANT INFORMATION – Please register by May 22 Name: __________________________________________________________________________ Title:____________________________________________________________________________ Agency:_________________________________________________________________________ Address:_________________________________________________________________________ City/State/Zip:____________________________________________________________________ Phone:________________________________ Ext._________ Fax: _________________________ Email: ___________________________________________________________________________ (Required)

HCA REGISTRATION FEE* ____ HCA Member Fee

 $239

____ Non‐Member Fee

 $389

*Fee includes continental breakfast and lunch.

PAYMENT – Please check method of payment: ________MasterCard _______VISA ______American Express ______Check* *Make checks payable to: HCA Education and Research and mail to 388 Broadway, 4th Floor, Albany, NY 12207. Checks must be received by May 30. ______________________________________________________________________________ Card Number _______________________________________ __________________________________ Expiration Date Security Code ______________________________________________________________________________ Mailing Address of Card Holder ______________________________________________________________________________ City, State, Zip ______________________________________________________________________________ Name on Card ______________________________________________________________________________ Authorized Signature

FAX to 518-426-8788

HCA Cancellation Policy HCA registration cancellations received by May 23 are refundable less a 25% administrative fee. No refunds will be issued after this date.

Cancellations must be received in writing at info@hcanys.org.

Substitutions are permitted.

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