October 16, 2017 Edition of the Situation Report

SEPSIS GRANT NEXT STEPS

ESSENTIAL PERSONNEL

HCA-MSSNY PROGRESS

GLOBAL CAP REPORT

As recently reported, HCA has received a prestigious Health Foundation Grant for sepsis screening/prevention. Learn more about next steps and how you can participate.

PAGE 5

HCA’s Essential Personnel bill for emergency response has been sent to the Governor.

Look for further advocacy information on this bill.

HCA and the state Medical Society have been working closely on physician-home care partnership and engagement issues.

The state’s most recent Medicaid Global Cap report finds that most categories exceeded projections so far for the fiscal year through July.

PAGE 7

PAGE 14

PAGE 15

Your Source for HOME CARE News, Policy and Advocacy

Vol. 2, Issue 37 | October 16, 2017

COMING UP Corporate Compliance Symposium Oct. 19, 2017 Albany Blueprint for OASIS Accuracy OASIS C-2 Oct. 23 & 24 (Workshop) Oct. 25 (Optional COS-C exam) NYC Quality & Technology Symposium Nov. 16 & 17 Suffern The Second Annual Women in Health Care Leadership Summit Dec. 7 & 8 Saratoga Springs

Registration for all HCA programs is online at http:// hca-nys.org/ events-education/ upcoming-events.

HCA Joins Amicus Brief in 24-Hour/Live-in Court Appeal HCA, the New York State Association of Health Care Providers (HCP) and the Home Care Association of America (HCAOA) joined together to file an amicus brief on October 13 to support the appeal effort in the Tokhtaman v. Human Care, LLC case, which has ongoing implications for the cost obligations of 24-hour/”live-in” home care cases.

Amicus briefs are submitted by persons or groups that are not parties to the legal action but have a strong interest in the matter and are petitioning the court to state their position.

See BRIEF p. 4

Call, Write Congress to Stop Disastrous HHGM Legislation On October 6, HCA sent you a special, early edition of The Situation Report with breaking news about a disastrous bill making its way through Congress to codify the Home Health Groupings Model (HHGM) – and its home care payment cuts – legislatively.

We followed up last week with an alert asking you to immediately contact your member of Congress, especially if that Representative serves on the House Ways and Means Committee, to stop this bill, which is moving very quickly through the Committee.

See HHGM p. 2

INSIDE HCA Joins Amicus Brief in 24-Hour/Live-in Court Appeal..........................................1 Call, Write Congress to Stop Disastrous HHGM Legislation....................................1 HCA Sepsis Grant Activities Underway..................................................................5 HCA Member Hiring Announcements...................................................................6 HCA Presses for Support on Essential Personnel Bill Delivered to Governor.............7 DOH Monthly Meeting and Report on MCO/MLTC Developments............................8 DOH Releases VBP Template for MLTC-Home Care..................................................9 Learn to “Do Less, Be More” at Dec. 7-8 Women’s Summit....................................11 Population Health Management System Highlighted at Quality Conference........12

CMS Reminder: Home Health Claims Will Be Returned When No OASIS Is Found...13 DOH Emergency Prep Guidance in Works for LHCSAs/Patients Refusing Evac.......13 Medical Society-HCA Task Force Assesses Progress, Next Steps.........................14 PHHPC Approves LHCSA Applications................................................................15 State’s Medicaid Cap: $20M Variance from Projections In April through July.........15 CMS Issues Corrections on Hospice NOEs via Electronic Data Interchange..........16 Upcoming NGS Education Programs..................................................................16 Paid Family Leave Forms Posted.......................................................................17 TBI Waiver Webinar Held..................................................................................17 Social Security Benefits to Rise by 2 Percent.......................................................18 Resources.............................................................................................................18

The Situation Report: the Home Care Association of New York State HHGM from p. 1 If you have not acted on this advocacy campaign, please do so now.

Background This new bill, H.R. 3992 (see https://www.congress.gov/115/bills/ hr3992/BILLS-115hr3992ih.pdf) is troubling for a number of reasons.

First, as you know, the HHGM was already included in the Home Health Prospective Payment System rule proposed by the U.S. Centers for Medicare and Medicaid Services (CMS) and open for public comment. HCA and national association partners have been unified and resolute in calling on CMS to reject this proposal from the HHPPS. However, as the CMS rulemaking process has drawn energy, it appears that certain factions within Congress have been also quietly maneuvering to include this very same HHGM proposal in legislative form, circumventing the rule-making process and creating a firm ground for HHGM payment cuts to become law.

Even worse, we have learned that the “savings” (i.e., cuts) envisioned by this bill are designed to shore up funds for tax cuts. Congress must not make home care providers bear the brunt for its plan to overhaul the nation’s tax code. This is immensely irresponsible.

What’s more, the bill seemingly attempts to insulate home care industry opposition by including a provision to extend the home health rural add-on, even going so far as to call the bill the “Rural Home Health Extension and Relief Act.” This is a gross misnomer, as the HHGM payment cuts in this bill would severely cut rural home care providers and, indeed, all providers. Plus, a bipartisan plan was already in the works in both houses to reauthorize the rural add-on, separate from this bill, making the bill’s rural add-on extension a mere token gesture.

A bipartisan group of U.S. Senators has already written to CMS urging CMS’s withdrawal of HHGM from its proposed rule and a similar letter is being prepared in the U.S. House of Representatives. While we need to keep up the pressure on the CMS front to achieve withdrawal of the rule, H.R. 3992 has created a new and especially urgent front for home care advocacy to stop HHGM from being codified in actual law.

Continued on next page

Volume 2, No. 37 October 16, 2017 

The Situation Report is a weekly publication of the Home Care Association of New York State (HCA). Unless otherwise noted, all articles appearing in The Situation Report are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. Joanne Cunningham HCA President jcunningham@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Al Cardillo Executive Vice President acardillo@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@hcanys.org Laura Constable Senior Director, Membership & Operations lconstable@hcanys.org Celisia Street Director of Education cstreet@hcanys.org Mercedes Teague Finance Manager mteague@hcanys.org Jenny Kerbein Director of Governance & Graphic Design jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org

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

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

Volume 2, No. 37 October 16, 2017 

Continued from previous page Act Now We need you to keep up the pressure in Congress on this issue: 

All home care providers should use our Legislative Action Center to write their Member of Congress and urge opposition against this bill. Please visit http://p2a.co/4XYyf01, enter your contact information, and hit “send.” It takes less than a minute of your time, so all home care providers should act immediately.



Also, if your Congressional Representative is Joseph Crowley, Tom Reed or Brian Higgins (all members of the Ways and Means Committee), please pick up the phone now and use the script below urging them to put a stop to this bill in the Ways and Means Committee.

Script for Contacting Congress Rep. Crowley: (202) 225-3965 Rep. Reed: (202) 225-3161 Rep. Higgins: (202) 225-3306

3



The House Ways and Means Committee is poised to mark-up a new bill, sponsored by Rep. Kristi Noem of South Dakota, which is disastrous for home care providers.



The bill, called the “Rural Home Health Extension and Regulatory Relief Act,” is gravely mislabeled. It would actually cut home care by $1 billion, in an attempt to shore up funds for tax cuts, while providing only token relief for rural health care in the form of a payment change that was already being developed separately on a bipartisan basis.



The bill attempts to legislatively codify an untested, fundamentally flawed overhaul to the home care reimbursement system that is already being considered under a federal rulemaking process through the U.S. Centers for Medicare and Medicaid Services (CMS). Home care providers, their representatives and members of the House and Senate have already gone on record in a bipartisan manner to call on CMS to reject this reimbursement change, known as the Home Health Groupings Model. But it appears that this new legislation is designed as a way to circumvent this rule-making process in a way that more firmly subjects the industry to an untested payment overhaul.



This payment overhaul would destabilize patient care for the purpose of extending tax cuts, which is irresponsible.



Home care providers in New York State cannot endure further cuts, especially of this magnitude, as New York home care providers are on average operating in the red under current Medicare payments for the 15th year in a row, with an un-weighted average margin of negative-6.97 percent in 2015 (the most recent data available).



In the strongest possible terms, I ask that you voice your opposition to this bill with your colleagues on the Ways and Means Committee and urge them to join you in rejecting this disastrous proposal. Please specifically discuss your position with the bill’s sponsor, Rep. Kristi Noem of South Dakota, seeking her withdrawal of the bill. Thank you.

The Situation Report: the Home Care Association of New York State BRIEF from p. 1 The brief calls on the Court of Appeals to “grant leave to appeal and review” the Appellate Division, First Department’s decision, stating several arguments. Among these, the brief argues that a previous ruling by the First Department “fundamentally misconstrues the term ‘hours worked’ in a manner that breaks with decades of settled federal law and badly misinterprets State law” and risks “directly imperiling the health and wellbeing of the hundreds of thousands of elderly and disabled citizens.”

HCA has written extensively about the Tokhtaman case and two others in the Appellate Division, all three of which reached similar conclusions on the status of compensation for 24-hour/live-in cases.

These Appellate rulings have essentially determined that “non-residential aides” should be paid the minimum wage for all 24 hours of their shifts, not just 13 hours, regardless of whether they were afforded 8 hours for sleep (including 5 hours of uninterrupted sleep time) and three hours for meals (aka, the “13-hour rule”). This reading of the regulations has stood in conflict with a 2010 Department of Labor (DOL) opinion letter establishing the “13-hour standard” that the Medicaid program, managed care plans and providers have followed in good-faith.

Volume 2, No. 37 October 16, 2017 

from hours worked under the Fair Labor Standards Act of 1938, as amended, in accordance with sections 785.19 and 785.22 of 29 C.F.R. for a home care aide who works a shift of 24 hours or more.” The emergency regulation is at https://labor.ny.gov/formsdocs/wp/CR142.pdf.

While the emergency revised regulations appear to provide some basis for the 13-hour standard, they do not address the massive retroactive legal or cost exposure for providers, and possibly managed care plans and the state, prompted by these court decisions.

HCA awaits an imminent regulatory impact statement from DOL charting the necessity of the emergency regulation. This statement, expected to be included in the Notice of Proposed Rulemaking posted in the State Register on October 25, may provide a further basis for understanding the implications of the emergency rule. The State Register can be accessed at https:// www.dos.ny.gov/info/register/2017.html.

HCA has been pressing for an early release of the impact statement (prior to it being available in the State Register on October 25) and will notify the membership as soon HCA receives it and analyzes its implications for the provider and plan community. HCA and its representatives have been assured by officials in the Governor’s Office that the language and intent of the regulatory impact statement should, arguably, provide protection for any retroactive implications of the 24 hour regulation.

The amicus brief comes as DOL has recently posted emergency revised regulations in response to the ongoing litigation and strenuous efforts by HCA and others to address this issue, as plans and providers continue to find themselves in limbo over the inconsistencies in state regulations/guidance that have been called into question as part of these court decisions.

The emergency regulation lasts 90 days initially and then can be renewed for additional 60-day periods (which is standard for state rulemaking).

DOL’s emergency regulatory posting, shared with the membership earlier this week, includes the following operative language: “Notwithstanding the above, this subdivision shall not be construed to require that the minimum wage be paid for meal periods and sleep times that are excluded

Please stay tuned for more information as HCA continues our analysis of DOL’s emergency regulation and ongoing legal options. HCA will be convening a state-wide conference call as soon as the impact statement is available. Please look for details of this announcement.

4

HCA has been working vigorously with partners for an urgently needed solution on the status of 24-hour/”livein” home care services that have remained in limbo as a result of the recent Appellate Division rulings.

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

Volume 2, No. 37 October 16, 2017 

HCA Sepsis Grant Activities Underway Mark your calendars and stay tuned for details HCA is moving ahead with next steps to begin implementing the recent New York State Health Foundation grant award supporting statewide implementation of our sepsis screening and intervention tool through home care.

Major Steering Committee A major partner steering committee is being convened to advise on and assist with aspects of the program.

The committee will first convene later this month, and will include partners from: IPRO, the U.S. Centers for Disease Control and Prevention, the national Sepsis Alliance, the Rory Staunton Foundation for Sepsis Prevention, the Health Care Association of New York State, the Iroquois (regional) Hospital Association, the Medical Society of the State of New York, state and national sepsis physicians, the New York Health Plan Association, Blue Cross-Blue Shield, the Statewide Senior Action Council, the National Association for Home Care and Hospice, the Visiting Nurse Associations of America, HCA member home care and health plan leaders, and others. In addition, state health officials, key legislative offices and other leaders have been invited.

Virtual and In-person Project Launch Sessions To provide background and ensure all potential providers are informed of the project, HCA will conduct two pre-training orientation and project launch sessions.

One session will be held on November 16 as part of HCA’s two-day Quality Symposium in Suffern (see symposium details in the brochure at the back of this week’s newsletter). This session opens with a compelling presentation by a sepsis survivor, underscoring the health and life-saving implications of sepsis education, prevention, early identification and immediate treatment.

Our virtual session, for those unable to attend the in-person symposium, is being scheduled via webinar for November 3 at 10:30 a.m. Details, registration and log-in will follow.

Regional Training and Cross-Continuum Coordination These first sessions will be followed by in-depth regional training sessions for home and community based care clinicians and organizational leaders, as well as sessions for cross-sector coordination in HCA’s screening tool and overall sepsis response efforts, bringing together home care, hospitals, physician practices, EMS, health plans and other key partners.

These regional sessions are anticipated to begin in Western and Central New York in December, followed by sessions in Albany and the Hudson Valley in December, New York City in February, and Long Island in March.

Individuals not able to make a session in their region on the date planned will be able to register for another location that works with their schedule.

Faculty will include IPRO, HCA, home care clinicians, national sepsis leadership organizations, and others.

Continued on next page

5

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

Volume 2, No. 37 October 16, 2017 

Continued from previous page Special Sepsis Program Website To facilitate information about the program, and about sepsis generally, HCA is launching a special home care sepsis website. It will provide sepsis-tool users and others with easy access to information, including resources to further support their efforts. The website will link to national and special sepsis resources and leaders, such as Sepsis Alliance, the Rory Staunton Foundation, CDC, IPRO, the state Department of Health and other key sources.

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

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

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

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

Data Sharing HCA and IPRO will soon be announcing a training webinar on the data-sharing component of this program. This datasharing component will allow for aggregation of non-identified information garnered from the sepsis screens/ interventions. This data can be shared back with organizations using the sepsis tool to support their efforts, evaluate and support the tool and initiative, and contribute to state and national policy efforts.

Public Outreach HCA – through this program, the website, and collaboration with key partners – will provide tools for agencies, health plans and others to conduct much-needed community outreach and public health education regarding sepsis, including your efforts via this initiative to prevent or intervene in this personal and systemic health emergency.

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

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

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

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

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

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

More information will be provided soon. In the meantime, please mark your calendars and be ready to participate in this major, first-of-a-kind initiative.

To learn more about how to access, adopt and use the HCA sepsis tool, write to: sepsistool@hcanys.org.

6

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

Volume 2, No. 37 October 16, 2017 

HCA Presses for Support on Essential Personnel Bill Delivered to Governor The State Legislature has formally delivered HCA’s home care and hospice “essential personnel” legislation to the Governor for his signature. The Governor has a matter of days to act on this bill, developed by HCA and legislative sponsors Senator Andrew Lanza and Assemblyman Michael Cusick.

This legislation (S.5016-A/A.6549-A) was unanimously passed by both houses of the Legislature this year following a series of amendments aimed at gaining the Governor’s support to overcome past veto actions on similar versions of the measure.

The bill, as extensively reported to members, would provide home care and hospice input into local emergency management plans, including for procedures granting “essential personnel” status for home care and hospice to reach patients during declared emergencies when curfews or evacuation orders may otherwise be in effect. It would assist in providing overall vital support for elderly, disabled and medically fragile home and hospice care patients and their providers in the local emergency management planning process.

With word that the bill is now at Governor Cuomo’s desk, HCA and our legislative-affairs representatives at Hinman Straub have immediately reached out to the bill sponsors, coordinating further communications of support directly to the Governor, as well as to key officials in the Cuomo administration pressing the case for him signing this bill into law.

Our outreach was further bolstered by compelling new data received from HCA members and other providers in a survey conducted over the past several months to quantify the number of “Priority Level 1” patients on home care rosters.

As providers know, “Priority Level 1” is a required state designation for those patients: 1) who must have uninterrupted care; 2) who have a highly “unstable condition” that would very likely lead to inpatient admission if the patient is not seen; and 3) for whom “every possible effort must be made to see this patient.”

Our survey included data from 105 providers (out of approximately over 1,000 licensed entities in New York State) showing that these 105 providers alone have over 10,000 priority “level 1” patients on their collective rosters – a number that is many times larger than 10,000 if extrapolated to all home care agencies in New York.

Yet another recent data compilation – from an emergency preparedness exercise in Western New York – identified more than 2,300 Level 1 patients in Erie County and its mostly rural surrounding counties, again comprising a subset of patients who cannot go without care during an emergency.

This data further underscores the importance of extending essential access to home care and hospice personnel in emergencies. Not only are these patients at extreme risk without home care, but the alternatives – i.e., emergency transport to other care delivery locations (by local EMS and hospital assets) and management by local emergency management assets – have profound implications and divert scarce resources at times of emergency prioritization.

Advocacy instructions Look for further advocacy instructions this week to echo your support and bolster HCA’s work to get this bill signed into law.

7

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

Volume 2, No. 37 October 16, 2017 

DOH Monthly Meeting and Report on MCO/MLTC Developments The state Department of Health (DOH) provided a number of important updates at its October monthly meeting with managed care organizations (MCOs), managed long term care plans (MLTCs) and member associations, held Thursday in Albany. HCA is among the MLTC-PACE member associations regularly participating in these meetings.

8



NYS Department of Labor Emergency Regulation: The filing of the Department of Labor emergency regulation on live-in home health aide cases was raised. (See related p. 1 story.) DOH emphasized the significance of the issue and concern on the part of the Executive, but refrained from other details on the status of this issue, plans or public statements at the meeting.



MLTC/Provider VBP Template: DOH reported on then-imminent (and now finalized) basic template prepared for MLTC and providers to use for level 1 Value Based Payment (VBP) contracting. The templates are not mandatory, but are made available as an option to assist in achieving level 1 contracting required by December 31. (See related p. 9 story.) DOH reiterated its schedule of VBP bootcamps which began last week in Albany and are planned throughout the state. The next meeting is October 18 in New York City, at the NY Academy of Medicine; the full schedule was provided in the October 6 edition of The Situation Report.



Minimum Wage: DOH indicated there would be amounts established for plans, but that, like last year, provider-specific minimum wage (MW) distribution would be determined between plans and providers. MLTC stakeholders again emphasized the importance of avoiding the complexities and problems faced last year by plans and providers in receiving and distributing funding from the state for MW increases.



Delivery System Reform Incentive Payment (DSRIP) Program Update: DOH presented an “Integrated Behavioral Health Site Contracting and Credentialing Tracker,” an update on integrated payments, and a DSRIP Dashboard with PHI export fields. While the dashboard was presented with a mainstream managed care focus, DOH indicated that it could be made available to all MCOs, including MLTCs. The slide deck addressing the integrated care, dashboard and multiple additional DSRIP updates is at http://hca-nys.org/wp-content/uploads/ 2017/10/10-12-FINAL-DSRIP-updates-MMCO-mtg-_-004.pdf.



Enrollment: MLTC partial capitation enrollment grew to 189,071 in September, with total MLTC/ PACE/FIDA/MAP enrollment reaching 208,561. Of the total, 5,701 were Program of All-Inclusive Care for the Elderly (PACE) enrollees; 4,566 were Fully Integrated Duals Advantage (FIDA) enrollees; 625 were FIDA plans for persons with intellectual and developmental disabilities; and 8,598 were Medicaid Advantage (MAP).



FIDA: DOH reported that five plans are leaving FIDA (Aetna, Guildnet for Nassau County, Fidelis, ICS and Northwell-LIJ); one additional plan is in the approval process to serve Westchester and Suffolk; ten plans continue in the program; and the FIDA contract has been amended to reflect reforms made in the program.



MLTC Market Transition: DOH reported on the MLTC Transition Plan process that it has released, addressing transition of enrollees and their care in the event of plan closures, service

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

Volume 2, No. 37 October 16, 2017 

area reductions or withdrawal or mergers/acquisitions. (HCA summarized the transition plan and HCA’s comments on it in the October 6 edition of The Situation Report). 

Future of Integrated Care Initiative: The third stakeholder workgroup session on the “Future of Integrated Care” (part of a DOH/CMS exploration) is planned for today in New York City. The focal areas for this meeting are: network adequacy and access; participant rights and protections; marketing rules and flexibilities; and quality standards and measures. HCA is a participant in this workgroup process.



Waiver Transition: The Traumatic Brain Injury (TBI) Waiver was extended for five years, effective September 1. However the TBI and Nursing Home Transition and Diversion waivers are both planned for transition to MLTC on January 1, 2019. Persons interested in participating in stakeholder meetings may e-mail waivertransition@health.ny.gov.



CDPAP Wage Parity Compliance: Wage parity compliance for the Consumer Directed Personal Assistance Program (CDPAP) is effective as of October 13.



New “Harm Reduction” Benefit in MCO – Responding to the added catalyst of the opioid epidemic, DOH unveiled plans to incorporate a new “harm reduction” benefit in MCO. Harm reduction is aimed at preventing/mitigating disease transmission associated with illegal injection drug use, as well as providing a “safe/encouraging” venue for drug users to be supported in potential treatment, recovery and broader (work/life/family/community) reintegration efforts.

Syringe exchange is not among the formally covered benefits, but is nevertheless seen as a component. There are currently 23 approved needle-exchange sites within New York State, which are envisioned to be utilized with the program. Much more exploration and details are to come.

DOH Releases VBP Template for MLTC-Home Care The state Department of Health (DOH) has released a basic template (available at http://hca-nys.org/ wp-content/uploads/2017/10/LHCSA-VBP-Template-10-12-17.docx) to assist managed long term care (MLTC) plans in contracting with Certified Home Health Agencies and Licensed Home Care Services Agencies for Value Based Payments (VBP).

As described in the October 2 edition of The Situation Report (page 9 story), the template is being made available to plans and providers as an option for their use in contracting for VBP level 1. In the new document, DOH notes that the templates can be modified, are not to be considered guidance, and are not intended to be inclusive of every possible VBP contracting arrangement.

DOH has required that 100 percent of MLTC-home care contracts move to VBP level 1 by December 31, 2017.

The template predicates VBP payments on MLTC-home care agency performance improvement corresponding to a defined set metrics, using a base-period to performance-period comparison.

DOH requires use of Potentially Avoidable Hospitalization (PAH) metrics in the MLTC-provider VBP arrangement and incentive payment. The balance of MLTC performance metrics currently used under the

9

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

Volume 2, No. 37 October 16, 2017 

MLTC Quality Incentive program will also be used and available for VBP subject to MLTC-provider determination.

MLTC-provider performance on the PAH measures will be calculated using data from the Statewide Planning and Research Cooperative System, which tracks inpatient hospital use data, among other sources. The six categories used in the PAH measures are: 1.

2.

3.

4.

5.

6.

Sepsis Respiratory Infection Urinary Tract Infection Electrolyte Imbalance Congestive Heart Failure Anemia

(DOH hosted a webinar for MCOs and MLTCs on September 29 drawing connection between these metrics and the heightened screening/intervention capability via use of the HCA sepsis tool, which contains a screening mechanism either directly or indirectly pointing to all of these conditions. Contact HCA at sepsistool@hcanys.org for information on accessing and using this tool.)

To link performance measures for MLTC enrollees and individual providers, DOH is requiring MLTCs to provide DOH with a listing that attributes the plan’s enrollees to the providers rendering care. DOH, in turn, will provide performance data to the plans for the attributed patients and providers. (HCA has requested that the measures be made available both to plans and providers.) The performance measure will compare baseline data for each provider for a base period beginning October 2017 (and consisting of June to December 2016 performance data), versus defined time periods for 2017 and 2018.

Separate methodologies are offered by DOH for performance calculations for agencies with very small (fewer than 30 patients) attributed census, including “pooling” together the data for all such smaller census agencies, or allowing plans and providers to use the data from a “lead” or “model” agency of sufficient census size as a data proxy.

HCA has weighed in extensively with regard to methods and content contained in the VBP template, and the considerations which we believe MLTCs and providers need in this swift move to VBP. Some of our suggestions are incorporated and others not, and we will continue to pursue further guidance, clarification and policy elements that address MLTC and provider needs.

DOH is planning to conduct a webinar to walk through the template and contracting process, and HCA will notify members as soon as the webinar date, time and other specifics are announced.

Meanwhile, HCA continues to urge providers and plans to engage and accelerate your VBP discussions, and we continue to move forward on ways to assist in this effort.

Members should look to attend the upcoming VBP boot camps being conducted by DOH (listed in last week’s edition of The Situation Report), the HCA Quality Symposium on November 16 and 17, and to participate in all other HCA and related DOH VBP preparatory activity. Additionally, several speakers, including DOH, will be speaking to VBP at HCA’s upcoming Corporate Compliance Symposium (on Thursday).

For further information, contact acardillo@hcanys.org.

10

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

Volume 2, No. 37 October 16, 2017 

Learn to “Do Less, Be More” and See What’s Trending at Dec. 7-8 Women in Healthcare Leadership Summit Register by November 21 and make your hotel reservations by November 7 ... or encourage a colleague to do so!

HCA’s second annual Women in Healthcare Leadership Summit, on December 7 and 8, is our final signature event for 2017, and a perfect capstone for professional development leading into 2018.

We offer this unique program to reach, inspire and provide tools for women leaders in healthcare, a field where women are highly represented but nevertheless need dedicated leadership training to meet their full potential. Please join us or encourage a colleague to do so.

One of our featured speakers, highly sought-after leadership consultant Corey Jamison, has been quoted

by NPR, Good Morning America and the New York Times for her insights. In Jamison’s segment at the Summit, women leaders will learn how to “DO less and BE More” as effective leaders, managers and motivators. #What’s Trending for Women Leaders Building on Jamison’s do-less-be-more mantra in the countdown to our conference, HCA is launching a new, biweekly e-mail feature called “#What’s Trending for Women Leaders.”

This special distribution will simply include links to workplace efficiency tips, articles about leadership topics and technological solutions to help you “Do Less and Be More,” and build excitement for the conference.

Be on the lookout for this special feature starting next week, brought to you by the Women in Healthcare Leadership Summit.

Our “#What’s Trending for Women Leaders” is just one of several new ways we plan to reach, inform, engage and excite you in the lead-up to this year’s summit featuring Corey Jamison and other women leaders, consultants and executives who will be sharing their expertise.

Please consider joining the summit with a colleague by taking advantage of our discount mentor/ mentee rate.

Details are in the brochure at http://hca-nys.org/wp-content/uploads/2017/09/HCA-Women-In-HealthcareLeadership-Summit-Brochure-2017.pdf.

Online registration is at https://www.eventville.com/catalog/eventregistration1.asp?eventid=1012182.

11

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

Volume 2, No. 37 October 16, 2017 

Leading LHCSA to Highlight Successful Population Health Management System at Nov. 16 & 17 HCA Quality and Technology Symposium As reported in a searchhealthit.com news article, HCA member Bestcare, Inc. employs an exciting disease-management technology platform and protocols that hold promise for LHCSA peers and other home care agencies to improve critical outcomes.

Learn more about this platform, eCaring, as well as Bestcare’s case studies and its successes with its population health system, during a special session at HCA’s upcoming Quality and Technology Symposium on November 16 and 17.

“In one particular program that we were involved in, the length of hospitalizations for a target group decreased from 10 days on average before usage of the device, to three days on average after using the device,” says Bestcare Vice President of Field Operations Brian Schiel in the searchhealthit.com article (see http://searchhealthit.techtarget.com/feature/Home-healthcarecompany-uses-eCaring-to-stave-off-ER-visits).

These kinds of exceptional outcomes are vital for home care’s partnerships under DSRIP and value based payments.

At HCA’s Symposium, Mr. Schiel, an HCA Board Member, will be joined by Bestcare’s Vice President of Clinical Services, Ilyne Rabinowitz, and eCaring’s founder and CEO, Robert Herzog, to give providers a detailed look at how the eCaring platform uses tablets in the home for capturing home health aide and/or family-directed progress communications. This information is uploaded to the care management system and sent in real time to nurse care managers to arrange appropriate interventions in a timely manner.

According to Mr. Herzog, eCaring has been able to reduce ER visits by 30 to 40 percent.

This segment is just one of ten clinical- and technology-focused sessions at the Quality and Technology Symposium, a signature annual HCA program, designed for home care clinical managers, Directors of Patient Services, quality improvement officers, and other strategic planners (including the leadership executives at your agency) who need to know the latest trends, policy developments, quality program requirements, and technological opportunity areas to fulfill your mission in the home care, managed care and hospice arenas.

Read the full brochure and register today at the links below.

Download the brochure at http://hca-nys.org/wp-content/uploads/2017/10/2017-Quality-and-Technology-Symposium-Brochure.pdf.

Register online at https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1012269.

12

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

Volume 2, No. 37 October 16, 2017 

CMS Reminder: Home Health Claims Will Be Returned When No OASIS Is Found The U.S. Centers for Medicare and Medicaid Services (CMS) is reminding providers that, until matching errors are corrected, Medicare systems will Return to Provider (RTP) home health claims when no Outcome and Assessment Information Set (OASIS) is found. When these claims are returned with reason code 37253, agencies should use the F9 function to resubmit their claim after taking one of these actions: 

Update the Health Insurance Claim (HIC) number on the OASIS assessment to match the current information;



Correct the assessment completion date reported in the claim treatment authorization code to match the OASIS assessment; and



Resubmit using condition code 21 and Type of Bill 320 if the assessment was not submitted.

DOH Emergency Prep Guidance in the Works: LHCSA Role under New CoPs, and Protocols for When Patients Refuse Evacuation With one month to go before new federal emergency preparedness requirements go into effect, HCA and the state Department of Health (DOH) have discussed potential guidance to help sort out the various lines of responsibility among LHCSAs, CHHAs and MLTCs. HCA is also seeking further direction from the state on expectations for when patients refuse to evacuate during emergency situations despite good-faith efforts by the provider to facilitate and document their attempts at evacuation assistance.

Both issue areas were raised during HCA’s September 27 conference on Emergency Preparedness Essentials, our Downstate LHCSA Forum on October 11, and in other recent venues.

Effective November 15, providers must comply with new federal Conditions of Participation (CoPs) for emergency preparedness that include additional emergency planning policies and procedures, communications planning requirements, and training and testing mandates. The state is responsible for enforcing the new CoPs and, thus, has an important role in guiding providers who seek to navigate the new federal requirements and existing state regulations.

While the CoP changes directly govern the operations of Medicare-certified agencies (i.e., CHHAs and LTHHCPs), more information is needed on the expectations for LHCSAs who partner to deliver services in conjunction with CHHAs or who directly serve patients under managed care contracts.

Specifically, we are seeking to determine the extent of a LHCSA’s responsibility for aide and other staff training in emergency preparedness, and how these responsibilities will be addressed in CHHA-LHCSA contracts, among other areas of CoP applicability. In addition, we have sought clarity on MLTC plan implications arising from these new federal/state rules.

HCA and the Department have also fielded several inquiries about the state’s requirements or expectations when patients refuse evacuation during emergencies. The Department says it expects to soon provide guidance on how agencies should address this issue in their internal policies, including: staff instruction and

13

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

Volume 2, No. 37 October 16, 2017 

support; communications with patients and families; outreach to local authorities (i.e. adult protective services); and documentation of patient refusals.

HCA will immediately inform the membership of any specific guidance or policy directives in each of these areas as we work with DOH on the framing of these important issues.

Medical Society-HCA Task Force Assesses Progress, Next Steps on Physician-Home Care Issues The State Medical Society-HCA Task Force met on Wednesday to assess progress and plan next steps on our goals and initiatives.

The Task Force, led by the Medical Society’s Long Term Care Committee Chair, Dr. Evelyn Dooley-Seidman, is comprised of key State Medical Society physicians, several members of the HCA Board and HCA MLTC Forum, and HCA-Medical Society executive and policy staff members.

The Task Force has been meeting periodically throughout the past year to formulate ways of promoting physician-homecare engagement and partnership, including mitigation of regulatory and procedural barriers, and innovation of new models and approaches to care delivery and management. Physician members of the Task Force have been extremely vocal in support of home care within the State Society, in advocacy to the state Department of Health, and in outreach and advocacy at the federal level, including through the American Medical Association.

This past year has seen HCA and the Medical Society partnering to provide the Department of Health with a streamlined procedural approach to Medicaid Face-to-Face rule implementation in New York State (substantially drafting the basis for a guidance document ultimately issued by DOH), as well as partnering for Face-to-Face relief change at the federal level for Medicare services.

We have also partnered in advocacy on our mutual goals in meetings with the Governor’s office, state Health Department/Value Based Payment committee, Legislature and other venues.

The physician members of the Task Force expressed major concerns about denied Medicare payments to home care agencies for faithfully rendered services, when denials are due to physician documentation reviews and auditor “take-backs.”

The Task Force also extensively discussed the state’s move toward “regulatory modernization” and implications for both opportunity and risk areas for home care, physicians and patients. HCA discussed its work in creating the Hospital-Homecare-Physician Collaboration law and that law’s current focus as a potential foundation for innovation in the evolving health system, including the regulatory modernization process.

HCA appreciates the support of our Board members and MLTC Forum in the work of this Task Force, and the ongoing extremely supportive collaboration of the State Medical Society.

Stay tuned for more progress reports on the Task Force. HCA invites all members to submit ideas or issues you would like to see taken up by the group. You can e-mail either: acardillo@hcanys.org or pconole@hcanys.org.

14

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

Volume 2, No. 37 October 16, 2017 

PHHPC Approves LHCSA Applications This past week, the Public Health and Health Planning Council (PHHPC) met and approved a number of new Licensed Home Care Services Agencies (LHCSAs) and changes in ownership of existing LHCSAs. These were: 

21 entities to establish new LHCSAs, including one with an Assisted Living Program; and



Eight existing LHCSAs for a change of ownership.

The meeting agenda and materials are at https://www.health.ny.gov/facilities/ public_health_and_health_planning_council/meetings/2017-10-11/.

A webcast of the meeting is at https://www.health.ny.gov/events/webcasts/archive/.

State’s Medicaid Cap Report Shows $20M Variance from Projections In April through July The state’s latest Medicaid Global Cap Spending Report (for the current fiscal year through July) finds that overall spending was $20 million above the global cap estimate for this period ($7.032 billion).

The fiscal year begins on April 1 and ends on March 31.

Nearly all of the provider and plan categories were above the cap projections. “Other Long Term Care” (which includes home care) was $12 million above projections. DOH notes that there were 1,095 – or 5.9 percent – more personal care recipients during this period, driving the costs. Long Term Managed Care, $29 million over projections, saw a 1.2 percent increase of 2,160 more recipients than anticipated during the report period.

Overall Medicaid enrollment fell by a net 12,417 enrollees from the end of March to July, reaching 6,101,150.

The report contains multiple other data, including tables or summaries of: Vital Access Provider program award amounts; enrollment estimates; the status of accounts receivable balances; and more.

The full report is at https://www.health.ny.gov/health_care/medicaid/regulations/global_cap/monthly/ sfy_2017-2018/docs/july_2017_report.pdf.

15

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

Volume 2, No. 37 October 16, 2017 

CMS Issues Corrections to Hospice Transmittal 3866: Accepting Hospice NOEs via Electronic Data Interchange In September, the U.S. Centers for Medicare and Medicaid Services (CMS) issued Transmittal 3866/Change Request (CR) 10064, which rescinded and replaced Transmittal 3813/CR 10064.

Transmittal 3866 can be downloaded at: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3866CP.pdf.

Transmittal 3866 makes a technical correction to the Discharge Reason Code table in Section 30.3 of the chapter (contained on page 22 of the transmittal). Transmittal 3813’s original table incorrectly identified “Condition Code 52” as “Occurrence Code 52” and also incorrectly identified “Occurrence Code 42” as “Condition Code 42”. Hospices should make a note of this correction. All other material contained in the revised transmittal remains the same.

Hospices are also reminded that CR 10064 expands significantly upon material previously contained in Chapter 11 of the Medicare Claims Processing Manual, and HCA encourages hospice members to give the information a close review.

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

Upcoming NGS Education Programs National Government Services (NGS), New York’s Medicare Administrative Contractor (MAC), will be hosting the following upcoming webinars: 

Provider Enrollment: Submitting Revalidations via PECOS (Tuesday, October 17, from 2 to 3 p.m.).

Registration is at: https://register.gotowebinar.com/register/2054589594312774913.



Targeted Probe and Educate for Home Health Providers (Tuesday, October 24, from 1 to 2 p.m.).

Registration is at: https://register.gotowebinar.com/register/8859988227704875522.



Home Health Billing Basics (Tuesday, October 24, from 2 to 3:30 p.m.). Registration is at: https://register.gotowebinar.com/register/4288830207142380033.



Hospice Targeted Probe and Educate Process (Thursday, October 26, from 11:30 a.m. to 12:30 p.m.).

Registration is at: https://register.gotowebinar.com/register/7009020875346234883.

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

16

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

Volume 2, No. 37 October 16, 2017 

Paid Family Leave Forms Posted The New York Workers’ Compensation Board (WCB) recently released three key forms associated with Paid Family Leave (PFL): 

PFL-Waiver: “Employee Opt-Out of Paid Family Leave Benefits (https://www.ny.gov/sites/ny.gov/files/atoms/files/PFLWaiver.pdf)



PFL-135: “Employer’s Application for Voluntary Coverage” – No Employee Contribution (https://www.ny.gov/sites/ny.gov/files/atoms/files/PFL-135.pdf)



PFL-136: “Employer’s Application for Voluntary Coverage” – Employee Contribution Required (https://www.ny.gov/sites/ny.gov/files/atoms/files/PFL-136.pdf)

These are the first forms (in addition to fact sheets) that the WCB has formally published in connection with PFL. As communicated in numerous articles and a June education program, PFL, when fully implemented (starting January 1, 2018 and phased in over 2018 to 2021), will provide employees up to 12 weeks of paid family leave in any given 52-week benefit period. Leave can be used to: 1) care for a family member (including a child, parent, grandparent, grandchild, spouse or domestic partner) with a serious health condition; 2) bond with an employee’s newborn or newly placed adoptive or foster child during the first 12 months following birth or placement; or 3) address any qualifying exigency to a spouse, domestic partner, child or parent who is serving on active military duty.

PFL is employee-funded, through payroll deductions, with the exception of any administrative costs incurred by employers. Employee participation is also mandatory, with certain exceptions.

More information is at https://www.ny.gov/programs/new-york-state-paid-family-leave.

TBI Waiver Webinar Held On October 12, the state Department of Health (DOH) held a webinar to discuss changes to the Traumatic Brain Injury (TBI) waiver program that are part of the renewal application approved by the U.S. Centers for Medicare and Medicaid Services, effective September 1, 2017.

The materials should be posted soon at https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/index.htm.

The webinar reviewed the eligibility screening tools (UAS); TBI definition for eligibility; additional eligibility criteria; service plan development; service plan review; notices and fair hearings; serious reportable incidents; recordable incidents; modifications to service definitions; and cost reporting.

DOH plans to post Frequently Asked Questions; revise the TBI Program Manual and forms; provide additional webinars; and hold regional forums for participants and families.

Continued on next page

17

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

Volume 2, No. 37 October 16, 2017 

Continued from previous page The waiver renewal application is at https://www.health.ny.gov/health_care/medicaid/reference/tbi/docs/1915c_waiver_application_2017.pdf.

Questions about the TBI program can be directed to DOH at tbi@health.ny.gov or (518) 474-5271.

Social Security Benefits to Rise by 2 Percent The Social Security Administration has announced that Social Security and Supplemental Security Income (SSI) benefits will increase 2.0 percent in 2018.

A fact sheet is at https://www.ssa.gov/news/press/factsheets/colafacts2018.pdf.

Information about Medicare changes for 2018 will be available soon and covered in a future issue of The Situation Report.

Resources 

“2020 Roadmap: Improving Health Care in Our Communities,” by the New York eHealth Collaborative http://www.nyehealth.org/nyec16/wp-content/uploads/2017/07/SHIN-NY-2020-Roadmap_July-2017.pdf



“State Strategies to Reduce the Risk of Long-Term Nursing Home Care after Hospitalization,” by AARP Public Policy Institute http://www.longtermscorecard.org/~/media/Microsite/Files/2017/ reducingtheriskoflongtermnursinghomecareafterhospitalization.PDF

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

18

Quality AND

Technology

Crowne Plaza Hotel 3 Executive Blvd.

Suffern, NY 10901

AGENDA Crowne Plaza Hotel 3 Executive Blvd.

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

Registration and Light Breakfast

9:00 AM

HCA Opening Remarks

9:15 –10:15AM

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

10:15 – 11:15AM

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

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

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

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

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

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

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

•

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

•

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

•

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

Continued…

1

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

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

Friday, November 17 8:00AM

Light Breakfast

8:30-9:30AM

Best Practices for Quality Managers TBA

Opportunities for Advanced Home Health Aides to Support Quality Outcomes

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

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

9:30-10:45AM

12:00 – 1:00PM

Lunch

1:00 – 2:00PM

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

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

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

2:00 - 3:00PM

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

3:00 – 3:30PM

Extended Break & Exhibitor Networking

Break

11:00AM – Noon

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

3:30 – 4:30PM

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

4:30PM

10:45 – 11:00AM

Day One Wrap Up and Adjourn 2

12:00- 12:30PM

Lunch

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

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

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

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

Hotel Information

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

4:00PM

Crowne Plaza Hotel 3 Executive Blvd.

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

$119/night

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

ask for the group code HCA.

3

Thanks to our Sponsors!

Thanks to our EXHIBITORS!

4

Registration

Payment Information

Registration Deadline: November 6 Pay by Check:

Full Conference (November 16 & 17)

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

Checks must be received by November 6th.

HCA Member Rate $299 Prospective HCA Member Rate $429

Pay by Credit Card: Amex

One-Day Pass

MasterCard

VISA

(Indicate date and rate)

November 16 or

November 17

HCA Member Rate $169 Prospective HCA Member Rate $259

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

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

_______________________________________ Phone

_____________________________________________________________ _____________________________________________________________

_______________________________________ Credit Card Number _________________ Expiration Date

_________________ Security Code

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

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

_______________________________________ Name on Card _______________________________________ Authorized Signature

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

November 16 & 17, 2017 Crowne Plaza Hotel 3 Executive Blvd.

Suffern, NY 10901 388 BROADWAY FOURTH FLOOR ALBANY, NY 12207

TO:

Crowne Plaza Hotel 3 Executive Blvd.

Suffern, NY 10901

December 7 & 8, 2017 Excelsior Springs at the Courtyard Marriott 47 Excelsior Avenue Saratoga Springs, NY 12866

The Second Annual

Own Your Voice: Leading with Strength, Certainty & Style