September 23, 2019 Edition of The Situation Report

CDPAP-FI PAYMENT

WORKFORCE

HOSPICE

WORKPLACE SAFETY

A decision is expected soon following last week’s court hearing on a lawsuit targeting state reimbursement changes to fiscal intermediary services.

At Planning Council meeting, HCA brings findings, perspectives and proposals for home care, hospice workforce supports.

Alongside our work with Hospice & Palliative Care Assn. of NYS, HCA and the National Assn. for Home Care & Hospice are actively engaged on hospice legislation, program supports and reimbursement advocacy.

HCA is participating in a national workplace safety workgroup led

by ElevatingHOME/ VNAA and needs your ideas.

PAGE 6

PAGE 7

PAGE 7

PAGE 11

Your Source for HOME CARE News, Policy and Advocacy

UPCOMING PROGRAMS 3-Part Hospice Billing Webinar Series: Become an Elite Hospice Biller Sept. 30, Oct. 1 and Oct. 2 (10-11:30 a.m.)

Compliance Experts Lead October 17 HCA Symposium Oct.17 (Albany) PDGM Bootcamp for Clinical Managers and Quality Staff Oct. 23 (Fairport) Save The Date: 2020 Northeast Home Health Leadership Summit Jan. 28-30 (Boston) Find all the details and registration for our upcoming programs and events at https:// hca-nys.org/ events-education/ upcoming-events.

Vol. 4, Issue 33| September 23, 2019

DOH Proposals for DRSIP II Seek More Funds, Continuing Service Shift Initial review suggests opportunities, adversities, uncertainties The state Department of Health (DOH) last week posted for public comment a concept paper seeking to continue and, ultimately, amend the state’s 1115 federal Medicaid waiver and Delivery System Reform Incentive Payment (DSRIP) program. (See https:// www.health.ny.gov/health_care/medicaid/redesign/dsrip/2019/amendment_req.htm.)

DOH seeks another $8 billion for DSRIP, targeting “Performance, Workforce Development, Social Determinants of Health, and an Interim Access Assurance Fund.” The DOH plan contemplates a four-year waiver amendment it says will “further support the cost savings and quality improvements being driven through the DSRIP Promising Practices.”

The four-year plan, which would ultimately have to be approved by the federal government, proposes a continuation of DSRIP for the one-year balance of the current 1115 waiver that See DSRIP p. 3

8 Top Legal, Compliance Minds Lead Oct. 17 HCA Symposium Update: online registration available “If you think compliance is expensive, try non-compliance,” former U.S. Deputy Attorney General Paul McNulty once wisely observed. The toll is not just financial: as in government fines or penalties, civil liabilities, legal or recovery costs, or loss of licensure/operational privileges. Noncompliance costs can also be counted in the form of grave reputational risks to See COMPLIANCE p. 2

INSIDE DOH Proposes DRSIP II.................................................................................1 8 Top Legal, Compliance Minds Lead Oct. 17 HCA Symposium….....................1 Member Hiring Announcement…................................................................3 Court Outcome Expected Soon in Lawsuit Targeting FI Cuts.........................…6 LTC Planning Council Examines Workforce Issues, Ideas............................…7 HCA, State and Federal Partners Collaborate on Hospice..........................…7

House Intros Bill Aiming to Support Direct-Care Workforce...............................…8 Home Care Applications to Come Before PHHPC Committee Meeting....................9 OMIG Posts Updated 2019-2020 Work Plan.......................................................…9 HCA Seeks Ideas for Nat’l Association Workgroup On Workplace Safety................11 Emergency Preparedness Group for Home Health, Hospice to Meet…................12 Hospice Provider Preview Reports Now Available…..........................................13 Health Resources…........................................................................................14

The Situation Report: the Home Care Association of New York State COMPLIANCE from p. 1 your organization, straining or ruining relationships with referral sources or contractors at a time when state policies are imposing even greater restrictions and obligations on network contracts.

Most at stake is your hard-won trust with patients in the community.

HCA’s flagship Corporate Compliance Symposium provides your compliance officers and executive teams with the tools, resources, information and guidelines to overcome these risks. This includes procedural bestpractices for self-auditing, so that your own internal investigations can detect pitfalls instead of government or law enforcement doing so on your behalf, and at great expense to your organization.

Each session covers prominent compliance issues by eight highly esteemed legal and compliance minds, all available to you at one time and one place. Don’t miss out.

A full brochure and online registration are available on HCA’s events page at https://hca-nys.org/eventseducation/upcoming-events.

Volume 4, No. 33 September 23, 2019 

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 Rebecca Fuller Gray Executive V ice President for Clinical and Program Affairs rgray@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 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

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

2

Teresa Brown Administrative Assistant tbrown@hcanys.org

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

Volume 4, No. 33 September 23, 2019 

DSRIP from p. 1 ends on March 31, 2021, and conceptual agreement to an additional three years from April 2021 to March 31, 2024. If approved, the joint waiver/DSRIP plan would span from April 1, 2020 through March 31, 2024.

New York State secured and dedicated $8 billion for the existing DSRIP program, which began in the 2014-15 period, with funding commencing April 1, 2015. Twenty-five Performing Provider Systems (PPS) were approved, with funds substantially flowing through the PPS leads, nearly all led by hospitals.

HCA will be analyzing this new waiver and DSRIP plan and providing further details to the membership. But we urge every member to also review this document directly. It is important for all sectors within our membership, and indeed for all sectors of the system, to evaluate the concepts and themes the Department is eyeing in this potential waiver/DSRIP round because it will have system-wide impact. It also introduces conceptual areas for focus where all providers should be considering to make inroads.

The DOH waiver/DSRIP plan describes areas of focus as follows. 

“Higher-Value Practices Aligned with Federal Priorities,” comprised of:         

Expansion of Medication-Assisted Treatment into Primary Care and emergency department (ED) settings.

Partnerships with the justice system and other cross-sector collaborations.

Primary care and behavioral health integration.

Care coordination, care management, and care transitions.

Expansion of Mobile Crisis Teams (MCT) and crisis respite services.

Focus on patients transitioning from Institutions for Mental Disease (IMDs) to the community.

Focus on Seriously Mentally Ill/Seriously Emotionally Disturbed populations.

Addressing Social Determinants of Health through Community Partnerships.

Transforming Primary Care and Supporting Alternative Payment Models.

Continued on next page

HIRING: Clinical Assessment Managers (RNs) VNSNY is hiring Clinical Assessment (UAS) Managers to join our team. Use your clinical skills to assess member needs and identify solutions that promote high quality health care services. Option to work in any of the following counties: Monroe, Dutchess, Onondaga, Ulster, Orange, Oneida, Putnam, Delaware, Otsego, Sullivan, Rockland, Madison, Herkimer.

We offer: flexible schedules, comprehensive training and ongoing support, competitive pay rates, great benefits (for full time).

Qualifications:    

Current license to practice as an RN in NYS (BSN preferred) Minimum six months of utilization review or care management experience at a Managed Care Organization or discharge planning experience required Demonstrated success with conflict management skills Knowledge of Medicaid or Medicare regulations required

Apply full time: https://jobs.vnsny.org/job/brooklyn/rn-uas-assessment-upstate-new-york-counties/1238/13316863 Apply per Diem: https://jobs.vnsny.org/job/brooklyn/rn-uas-assessments-per-diem-upstate-new-york-counties/1238/12539568 VNSNY is the nation’s largest not-for-profit home- and community-based health care organization. For 125 years, VNSNY has been committed to meeting the health care needs of New Yorkers with compassionate, high-quality home health care. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life.

3

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

Volume 4, No. 33 September 23, 2019 

Continued from previous page 

“Value-Driving Entities” consisting of PPSs, provider, community based organization and managed care organization teams.



Integration of Qualified Entities (aka Regional Health Information Organizations) into the collaborative partnerships.



Identification of additional “high-need priority areas” including:   

    

Maternal Mortality Children’s Population Health Long Term Care Reform

Workforce Investment Coordinated Population Health Improvement Addressing the Opioid Epidemic Performance Measurement Establishing an Interim Access Assurance Fund

Few details are provided in this concept paper about how these items are envisioned, much less how they will be rolled out. This not only suggests further formative work ahead, but, in the meantime, it precludes stakeholders from being able to delineate and assess the Department’s proposals and intentions based on the information thus far provided.

Upon posting the document, DOH officials contacted HCA to discuss mutual overviews. We emphasized areas in the existing waiver/DSRIP that have yielded opportunities as well as concerns and referenced our recent public comments and recommendations to the Department on ways to build on the opportunities and rectify problems. We outlined how our recommendations benefit patient outcomes and improve the cost-effectiveness of state and federal funding.

Last month, HCA, as part of seven collaborating statewide health associations, submitted a comprehensive comment letter to Governor Cuomo’s office and DOH officials on potential waiver and DSRIP

4

successors. The letter (see https://hcanys.org/wp-content/uploads/2019/08/ Joint-Letter-1115-Waiver.pdf) outlines core issues, principles and recommendations that we request be followed in shaping any waiver/DSRIP amendments or program continuations.

Some of the themes in the posted DOH concept paper are consistent with themes in our letter, but the actual “details” are absent as to how these will ultimately look when delineated. The first round of DSRIP created disparities between the stated intentions for home and community based services versus the actual waiver roll out and experience. HCA and our collaborating state association partners are making clear that any next phase of the waiver or DSRIP should not repeat the shortfalls of the existing policies. We look forward to working hard to secure successful waiver authority and continued funding, and to contributing our ideas and expertise to this process. But we must be prepared to make a strong vocal and stand should the details take another contrary route.

HCA is currently working to schedule a meeting with the Governor’s Assistant Secretary for Health to discuss our issues and recommendations for the state’s waiver/DSRIP plan. We are also seeking meetings with the state Legislature and DOH officials.

HCA will soon announce a statewide call for members where we will review the Department’s plan and the host of state and federal dynamics converging over the health field in the upcoming ninemonth period between now and April.

These are all major and interrelated items that carry profound impact for the

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

Volume 4, No. 33 September 23, 2019 

system. During this member call, HCA will shed further light on these issues, as well as further insights on opportunities, concerns and advocacy needs with the DOH waiver/DSRIP plan.

Stay tuned for further analysis and our announcement of a statewide call.

Downstate public comment session DOH has announced a downstate public comment date for stakeholders to address the waiver on October 25 at Baruch College, 55 Lexington Ave. (Corner of 24th Street & Lexington Ave.), Room 4-220 (4th Floor).

We will keep the membership informed of any additional educational or comment opportunities as they are announced.

KNOWING THE DRILL

HCA’s “Know the Drill” conference on emergency preparedness last week brought together home care, hospice and MLTC representatives from across the state.

Top photo (right): HCA Executive Vice President Rebecca Fuller Gray outlines key requirements for home care and hospice emergency preparedness plans.

Middle photo (right): Patrick Byrne, Regional Representative from the Finger Lakes Office of Health Preparedness, and Gyongyi McQueston, an official at the Office of Health Emergency Preparedness, join HCA Vice President Andrew Koski for a session stressing the importance of getting involved with Health Emergency Preparedness Coalitions (HEPCs). Upcoming HEPC sessions are listed on HCA’s homecareprepare.org website at http://homecareprepare.org/events/list/.

Bottom photo (right): Dr. Debra Sottolano discusses top deficiencies found in surveys of home care and hospice emergency preparedness from her work as Lead for Healthcare Preparedness and Response in the Office of Primary Care and Health Systems Management at the state Department of Health (DOH).

5

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

Volume 4, No. 33 September 23, 2019 

Court Outcome Expected Soon in Lawsuit Targeting FI Cuts A lawsuit targeting the state’s implementation of reimbursement changes for consumer-directed care was heard again in Albany this past week at the State Supreme Court level.

At the conclusion of the hearing, the judge requested a transcript to review the arguments of both sides, with several legal analysts suggesting that these transcripts could be ready by tomorrow, September 24, and a decision soon afterward expected.

The plaintiffs are challenging the legality of the state’s change in payment for Fiscal Intermediaries’ (FIs) administrative services. FIs: provide payroll, benefits, consumer and personal assistant (PA) orientation; help to ensure that PAs obtain certain health tests; monitor the consumer’s ability to fulfill his or her responsibilities; and other functions under the Consumer Directed Personal Assistance Program (CDPAP).

The reimbursement change is being implemented to save $150 million in state and federal monies, moving to a per-member-per-month payment structure that is being implemented directly to FIs under fee-for-service contracts with local departments of social services and in contracts with Managed Long Term Care (MLTC) plans, effective September 1, as outlined in a set of policy guidance documents and rate tiers from the state Department of Health that were previously shared with the membership.

HCA has explained to reporters and officials the complex dynamics and consequences of these rate changes, noting a state of alarm and limbo gripping the system as it responds to the cuts while also awaiting a court outcome on the legality of the reimbursement changes.

HCA has collected reports from the field suggesting that some MLTC plans have issued contract amendments to FIs reflecting the new reduced rate tiers while others may be awaiting a court verdict and/or more guidance from the state Department of Health. Of greatest concern is the impact on PAs and consumers, with the Consumer Directed Personal Assistance Association of New York State (CDPAANYS) noting that several FIs have completed paperwork to close their operations as services hang in the balance. (See https://homehealthcarenews.com/2019/09/consumer-directed-regulatory-changes-triggerhome-care-layoffs-possible-closures/.)

HCA has argued for a further delay or “grace period” in the rates to accommodate the turnaround time required for contract amendments, and to gain further information about the state’s methodology and assumptions underpinning it. HCA also opposes expansion of current FI administrative duties absent changes in the rates for plans and FIs to appropriately cover these costs – a position we’ve stated in a recent letter to State Medicaid Director Donna Frescatore and other comments with state officials.

HCA will keep the membership closely apprised of all developments.

6

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

Volume 4, No. 33 September 23, 2019 

LTC Planning Council Examines Workforce Issues, Ideas The Cuomo Administration’s Long Term Care Planning Council convened last week to garner comments and ideas on workforce development.

The Council session, led by state Department of Health (DOH) Special Advisor Mark Kissinger, presented the Administration’s new $175 million Workforce Development Initiative and included a panel of labor, think-tank, aging services and worker training representatives. The session also spotlighted a Central New York initiative (the “Regional Health Care Workforce Consortium”) incorporating recruitment and training with antipoverty efforts.

The Workforce Development Initiative is a consolidation of several state-supported workforce programs and funding into a single new state office. It combines the goals of training, career advancement and improvement in economic security. Funds under the program may include subsidies for transportation, child care and other essentials during training. State representatives will also be conducting statewide and, eventually, regional data compilation and analysis of job opportunities. Information about the program, including the funding application portal, is at https://www.ny.gov/workforcedevelopment.

Panelists cited the well-documented state and national data showing the profound workforce needs in long term home and community-based services, particularly for aide personnel. Also discussed were the many barriers to recruitment and retention, the need for improved funding amid state/federal fiscal budget constraints, approaches to worker training and improved field-level support, technology to support worker efficiency and training, worker safety and injury prevention, and other issues.

HCA emphasized the need to also take up solutions for shortages in the professional disciplines. We stressed that these shortages are reverberating throughout the system with impacts on access to care.

HCA walked through some milestone state and federal policy changes that have expressly reshaped the health system to depend on home and community-based services in recent decades. Yet the ensuing fiscal and support structure, we noted, must also come to grips with these rightful changes if service needs are to be met. HCA identified some areas for improvement, citing our workforce proposal package that we will be introducing in greater depth to the LTC Council, the Administration and Legislature.

HCA looks forward to continuing our work with the Council in pressing for meaningful action on workforce needs for home care, hospice and MLTC services in the upcoming period.

HCA, State and Federal Partners Collaborate on Proactive Hospice Provisions Alongside our close collaboration with the Hospice and Palliative Care Association of New York State (HPCANYS), HCA is also working with the National Association for Home Care and Hospice (NAHC) on proactive measures supporting hospice at the national level.

Represented in each venue by HCA President Al Cardillo, HCA is a member of the NAHC Hospice Advisory Council, the NAHC Public Policy Committee, the NAHC Advocacy Council, and Subcommittee on Home Care, Hospice and Medicare Advantage. All of these venues are very actively addressing an array of national hospice priorities and are further supported by HCA’s ongoing collaborative work with HPCANYS and its President Carla Braveman.

Continued on next page

7

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

Volume 4, No. 33 September 23, 2019 

Continued from previous page Specifically, HCA and NAHC’s executive and policy teams are working to develop a strong, proactive policy response to the Office of Inspector General’s (OIG) recent audit report of hospice survey findings across the country.

This report, covered in the July 15 edition of The Situation Report, identified compliance, quality assurance and service issues in various hospices. Extensive work led by NAHC staff, and supported by the NAHC advisory bodies, is producing a set of major policy concepts that would be advanced by NAHC and advocated by HCA and state association partners.

These proposals work to promote a high-standards mindset. They surgically and responsibly focus on problem areas and/or significantly noncompliant entities, as exemplified in the OIG report, stressing increased surveillance and accountability for serious or repeat noncompliance, improved consistency and standards across surveyors (government and accreditors), targeted education and quality improvement assistance, and other features.

The focus is on areas and organizations needing improvement while seeking to preempt the move toward less effective, across-the-board and, ultimately, universally burdensome policy responses affecting all providers.

NAHC and HCA are also working to advocate on Congressional hospice legislation, like the Enhance Palliative and Hospice Education and Training Act (S.2080/H.R. 647), and developing proposals that respond judiciously to hospice recommendations made by the Medicare Payment Advisory Commission (MedPAC) – specifically MedPAC’s call for pilots of hospice carve-in to Medicare Advantage. We are also engaged in extensive advocacy with the U.S. Centers for Medicare and Medicaid Services (CMS) on hospice reimbursement, new policy and procedural rules, and regulatory flexibility.

Additionally, HCA Vice President Patrick Conole is just back from an extensive national meeting on hospice and home care and will have information and further insights for the membership based on these deliberations.

Questions on hospice program issues can be directed to Al Cardillo (acardillo@hcanys.org), Becky Gray (rgray@hcanys.org), or Alyssa Lovelace (alovelace@hcanys.org); and hospice reimbursement matters can be addressed to Patrick Conole (pconole@hcanys.org).

House Intros Bill Aiming to Support Direct-Care Workforce A bill newly re-introduced in the U.S. House of Representatives seeks to address workforce training, retention and supports for direct-care workers nationally.

The bill (H.R. 4397) is known as the Direct Creation, Advancement, and Retention of Employment (CARE) Opportunity Act. It would provide grant funding to fifteen entities to invest in strategies to recruit, retain and advance the direct-care workforce pipeline through a number of models including training, workplace learning and apprenticeship programs, among other initiatives.

Eligible entities include: a state; certain non-profit organizations, a labor organization, or entities with shared labor-management oversight; a nonprofit entity carrying out an apprenticeship program; or certain consortia.

Continued on next page

8

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

Volume 4, No. 33 September 23, 2019 

Continued from previous page A maximum of five percent of grant funds can be utilized for administrative purposes and at least five percent of grant funds must be used for direct financial assistance to direct-care workers.

Grants would be made through the U.S. Department of Health and Human Services. It is unclear whether a financial or appropriations amount has been determined.

Several elements of this bill echo proposals that HCA seeks to advance at the state level. These have been built into several legislative proposals advanced this year to support the home care and hospice workforce, stimulate interest in home care and hospice as a career field, create cross-training opportunities and systems, and much more.

Home Care Applications to Come Before PHHPC Committee Meeting The state Department of Health (DOH) has posted the agenda for the September 26 meeting of the Public Health and Health Planning Council (PHHPC) Committee on Establishment and Project Review.

The agenda and supporting documents are here: https://www.health.ny.gov/facilities/ public_health_and_health_planning_council/meetings/2019-09-26/index.htm.

Applications include: 

An existing Licensed Home Care Services Agency (LHCSA) with a site in Rockland County and a site in the Bronx, which seeks to acquire a LHCSA in Albany that serves 11 counties.



A for-profit LHCSA requesting approval to convert to a not-for-profit corporation.



An entity which seeks to obtain licensure as a LHCSA that will serve five counties under an exception to the existing LHCSA moratorium. The applicant will serve patients with implanted intrathecal pain pumps who suffer from severe, chronic pain and spasticity.

Once acted upon at the committee level, the applications will go to the full PHHPC for review at its October 10 meeting.

OMIG Posts Updated 2019-2020 Work Plan The state Office of the Medicaid Inspector General (OMIG) has posted its updated 2019-2020 Work Plan at https://omig.ny.gov/information/work-plan.

The report outlines three overall goals: 1) provider and managed care organization (MCO) compliance with the rules, regulations, and contracts of the state Medicaid program; 2) safeguarding Medicaid resources to ensure that the state can meet the needs of eligible recipients by “actively employing best practices and

9

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

Volume 4, No. 33 September 23, 2019 

state-of-the-art tools to address fraud, waste, and abuse”; and 3) recipient safety and promoting highquality patient care through program integrity initiatives.

Provider and Managed Care Organization (MCO) Compliance OMIG states that it will: 

Identify providers who do not fulfill mandatory compliance certification obligations for potential administrative action.



Audit providers within MCO networks to “ensure the accuracy of encounter claim submissions” and confirm compliance of provider records.



Analyze MCO compliance programs.



Conduct MCO program integrity reviews for adherence to contracts with the state of New York. (A list of applicable contractual obligations will be posted online, including benchmarks, prior to the reviews.)



Conduct on-site visits with managed long term care (MLTC) plans concerning integrity-related processes and procedures.



Audits of Medicaid Managed Care Operating Reports (MMCOR) with a focus on reported pertinent medical and administrative costs for accuracy and permissibility to ensure only proper costs were utilized.



“Continue to work with DOH on ensuring the integrity of value-based payments” (VBP) as they are reflected in the Medicaid data and to ensure access to information is readily available to OMIG to be able to audit and investigate in a VBP environment.

Safeguard Medicaid Resources OMIG states that it will: 

Continue to review and work collaboratively with DOH and the Department of Labor to ensure that home care providers are complying with wage parity laws.



Continue to conduct reviews and work with DOH to ensure that MCOs are appropriately passing on supplemental Medicaid payments (minimum wage, Fair Labor Standards Act funds) to home care providers, in compliance with DOH directives.



Continue to work with local departments of social services (LDSSs) and the New York City Human Resources Administration (HRA) to conduct reviews of pharmacy, durable medical equipment, transportation (ambulette, taxi and livery), long-term home health care and Assisted Living Programs.

Continued on next page

10

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

Volume 4, No. 33 September 23, 2019 

Continued from previous page 

Continue to analyze and evaluate the integrity of encounter data, performing comparative analyses of encounters and other plan-submitted data to evaluate the consistency and completeness of MCO encounter reporting.



Conduct audits of various fee-for-service (FFS) providers in areas of concern or to meet federal waiver requirements. Programs include, but are not be limited to: private duty nursing agencies, Traumatic Brain Injury and Nursing Home Transition and Diversion waivers, and health homes.



Review enrollment records, recipient plans of care, and claims data to determine if the MLTC plans are providing the specific services deemed medically necessary by those MLTC plans for their recipients. Additionally, OMIG will examine case/care management system notations to confirm that appropriate care management is also being rendered to its members.

Recipient Safety OMIG states that it will: 

Continue to conduct both CHHA FFS audits and CHHA Episodic Payment System (EPS) audits.



Continue to audit and investigate personal care services FFS Medicaid claims, as well as PCS services provided through MCOs.



Audit and investigate Consumer Directed Personal Assistance Program (CDPAP) providers to ensure compliance with rules and regulations for FFS and MCO services.

Compliance insights on all of these issues coming October 17 HCA’s October 17 Corporate Compliance Symposium offers six sessions which specifically address many of the issue areas outlined in the OMIG work plan. This alignment is all the more reason to participate in HCA’s once-a-year flagship compliance program for home care, hospice and Managed Long Term Care.

Please read the program brochure here: https://hca-nys.org/wp-content/uploads/2019/09/HCA-CorporateCompliance-Registration-Form-2019-FINAL.pdf. Online registration is here: https://events.eply.com/ 2019CorporateComplianceSymposium3089619.

HCA Seeks Ideas for Nat’l Association Workgroup On Workplace Safety HCA Director of Education Celisia Street has been tapped to participate in a workgroup recently launched

by ElevatingHOME/VNAA to develop evidence-based resources and information as part of its Blueprint for Excellence on workplace safety for staff in home health and hospice organizations. The Workplace Safety module will be launched at VNAA’s Annual Meeting on October 27-30 in San Diego.

The group is looking at safety risks ranging from infection and pest control, falls and injuries, to verbal or physical abuse. As the workgroup started researching the scope and depth of the problem, what emerged was a dearth of comprehensive data collection on worker safety issues. Anecdotal accounts suggest

11

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

Volume 4, No. 33 September 23, 2019 

further research and attention are needed to examine the issues and methods for ensuring workplace safety.

HCA asks that you share your workplace safety policies for use by the workgroup in the development of sample policies. If you have policies pertaining to specific issues such as protocols for handling bed bugs, animals or weapons in the home or other worker safety policies or programs, we want to hear from you.

This is an excellent opportunity to address an important industry topic and help us develop best-practices for improving workplace safety. Please share your information and sample policies with Celisia Street at cstreet@hcanys.org.

Emergency Preparedness Work Group for Home Health and Hospice Partners Holding First Meeting On September 26, from 1 to 2:30 p.m., the Western and Finger Lakes Region Health Emergency Preparedness Coalition (HEPC) will hold its first meeting of a Home Health and Hospice Workgroup.

The coalition is targeting providers who serve the following counties: Allegany, Cattaraugus, Chautauqua, Chemung, Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Schuyler, Seneca, Wayne, Wyoming, and Yates.

The meeting will be held at the Center for Hospice and Palliative Care (225 Como Park Blvd., Cheektowaga, NY 14227 at the IT Training Room in Clinical Building).

WebEx Information There will also be a webinar option for workgroup meetings; however, it is encouraged you try to attend in person. You must register for the session using the following link: https://meetny.webex.com/meetny/k2/j.php?MTID=t40a4cca8d3f07587fc4f2e8afb2dd611.

Audio: 1-844-633-8697 Session number: 648 812 619 The meeting will address workgroup objectives, future exercise opportunities and an overview of the HEPC. The goal of this workgroup is to address the following: 

Discussion of how to better engage home care and hospice providers in HEPC activities.



Identify gaps/vulnerabilities in current emergency preparedness plans.

Continued on next page

12

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

Volume 4, No. 33 September 23, 2019 

Continued from previous page 

Review appropriate emergency contacts.



Look at lessons learned from previous incidents.



Develop opportunities to replicate the home health/hospice tabletop exercise conducted earlier this year.

Questions about the workgroup should be directed to: Johnny Tolbert, Health Emergency Preparedness Representative, Western Region, Office of Health Emergency Preparedness, New York State Department of Health at (716) 847-4658 and Johnny.Tolbert@health.ny.gov; or to Patrick Byrne, BSN RN MEP CHEC, Regional Representative, Finger Lakes Office of Health Emergency Preparedness, New York State Department of Health at (585) 423-8066 or patrick.byrne@health.ny.gov.

Hospice Provider Preview Reports Now Available Updated Hospice provider preview reports and Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey provider preview reports are now available.

These two separate reports are available in your Certification and Survey Provider Enhanced Reports (CASPER) non-validation reports folder. Hospice providers are encouraged to review their Hospice Item Set (HIS) quality measure results from Quarter 1, 2018 to Quarter 4, 2018 and their facility-level CAHPS survey results from Quarter 1, 2017 to Quarter 4, 2018.

Providers have 30 days to review the HIS and CAHPS results (September 11, 2019 through October 11, 2019) prior to the November 2019 Hospice Compare site refresh, during which this data will be publicly displayed.

Providers may request the U.S. Centers for Medicare and Medicaid Services (CMS) review if they believe the denominator or other HIS quality metric is inaccurate, or if there are errors within the results from the CAHPS Survey data.

This process is outlined on the following websites:

13



“Public Reporting: HIS Preview Reports and Requests for CMS Review of HIS Data” (https:// www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Hospice-QualityReporting/Public-Reporting-HIS-Preview-Reports-and-Requests-for-CMS-Review-of-HISData.html).



“Public Reporting: CAHPS Preview Reports and Requests for CMS Review of CAHPS Data” (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospiceQuality-Reporting/Public-Reporting-CAHPS-Preview-Reports-and-Requests-for-CMS-Review-ofCAHPS-Data.html).

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

Volume 4, No. 33 September 23, 2019 

Health Resources “Disaster Response: FEMA and the American Red Cross Need to Ensure Key Mass Care Organizations Are Included in Coordination and Planning,” by the U.S. Government Accountability Office https://www.gao.gov/products/GAO-19526?utm_campaign=usgao_email&utm_content=daybook&utm_medium=email&utm_source=govdelivery “Health Care Quality: CMS Could More Effectively Ensure Its Quality Measurement Activities Promote Its Objectives,” by the U.S. Government Accountability Office https://www.gao.gov/products/GAO-19628?utm_campaign=usgao_email&utm_content=daybook&utm_medium=email&utm_source=govdelivery “The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data to Identify High-Risk Home Health Agencies,” by the Office of Inspector General https://oig.hhs.gov/oas/reports/region5/51700035.pdf

14