Graham-Cassidy Health Bill Withdrawn From Vote · Most astonishingly, the CBO updated its...

COMING UP Your Source for HOME CARE News, Policy and Advocacy Vol. 2, Issue 35 | October 2, 2017

Downstate LHCSA andHCC Member ForumOct. 11, 2017New York City

Corporate ComplianceSymposiumOct. 19, 2017Albany

Blueprint for OASISAccuracy OASIS C-2Oct. 23 & 24 (Workshop)Oct. 25 (Optional COS-Cexam)NYC

Quality & TechnologySymposiumNov. 16 & 17Suffern

The Second AnnualWomen in Health CareLeadership SummitDec. 7 & 8Saratoga Springs

All HCA programs andregistrations are postedat http://hca-nys.org/events-education/upcoming-events

See BILL p. 2

See HHGM p. 4

Graham-Cassidy Health Bill Withdrawn From VoteGOP pivots to tax reform but weighs future legislative maneuvers targeting ACA

With at least three crucial Republican Senators saying they would vote “no,” the Senatelast week shelved its latest plan to repeal and replace the Affordable Care Act (ACA).

This latest effort, known as the Graham-Cassidy bill, included disastrous proposed cuts toMedicaid. It was a target of vigorous HCA opposition, including our involvement in a

HCA Continues Full Court Presson HHGM AdvocacyBipartisan Group of Senators AdvocatesAgainst HHGM Proposal

A bipartisan group of 49 senators,including New York Senator KirstenGillibrand, wrote last week to U.S.Secretary of Health and Human Services(HHS) Tom Price and Centers forMedicare and Medicaid Services (CMS)Administrator Seema Verma seeking

INSIDE

Graham-Cassidy Bill Withdrawn From Vote..................................................1HCA, Senators Advocate Against HHGM Proposal..........................................1HCA Briefs Members on Advocacy in Response to Hour/Live-in Cases............1Member Hiring Announcements...................................................................3Register Now: Nov. 16 and 17 Quality and Technology Conference...................5HHS Secretary Resigns..................................................................................6Minimum Wage Survey Extended to Oct. 16...................................................7HCA Emergency Preparedness Program Draws Overflow Audience................7DOH Working on, Finalizing, Contracting Template for MLTC VBP.....................9DOH Holds Major Webinar for MCOs, PPS Hospitals on HCA Sepsis Tool..........10

Participate in Home Care Workforce Survey & Report..............................11DOH Issues Final 2017 Non-NYC Personal Care Rates................................12Upcoming CMS Call on Quality Star Rating Algorithm..................................12Changes to Disability Benefits Claim Process...........................................13Need Updated OASIS Credentials or COS-C Exam Certificate?....................13Get Insights on VBP Compliance Planning at Oct. 19 Symposium................14VBP Bootcamp in NYC Open for Registration..............................................14VBP University, Semester 3 Launched.......................................................15CMS Guidance for Hospice Claim Adjustments..........................................16State Outlines Activities Related to Issuance of New Medicare Cards .........17Medicare Appeal Threshold Amounts for 2018 Announced........................17Resources............................................................................................................18

PAGE 12

SEPSIS & MLTC

HCA was on the faculty of aDOH webinar with MLTCs,MCOs and DSRIP PPSs toconvey the value of utilizingHCA’s sepsis screening tool.

PAGE 10

VBP

DOH continues towork on Level I VBPcontracting templateto assist MLTCs andhome care agencies.

PAGE 9

PERSONAL CARE RATES

DOH has issued the 2017personal care rates for non-NYC providers. Get all thedetails and informationfrom the rate sheets.

QUALITY CONFERENCE

HCA’s Quality & Technology Symposiumis now open for registration! We have astellar line-up of topics, from QAPIplanning to Advanced Home HealthAides, to palliative care, and “disruptivetechnologies.”

PAGE 5

HCA Briefs Members onDevelopments, HCA Advocacy inResponse to Court Cases Regarding24-Hour/Live-in ServicesHCA pursues regulatory redress, immediateDOH/DOL protection/coverage in interim

Last week, HCA held a statewide membercall about three pivotal court cases – all thesubject of recent appellate divisiondecisions – pertaining to the wage, overtime

See CASES p. 6

http://hca-nys.org/events-education/upcoming-events

2

The Situation Report is a weeklypublication of the Home CareAssociation of New York State (HCA).Unless otherwise noted, all articlesappearing in The Situation Report arethe property of the Home CareAssociation of New York State. Reuseof any content within this newsletterrequires permission from HCA.

Joanne CunninghamHCA President

[email protected]

Roger L. NoyesDirector of Communications,Editor of The Situation Report

[email protected]

Al CardilloExecutive Vice President

[email protected]

Patrick ConoleVice President,

Finance & [email protected]

Andrew KoskiVice President,

Program, Policy & [email protected]

Laura Constable Senior Director,

Membership & [email protected]

Celisia StreetDirector of [email protected]

Mercedes Teague Finance Manager

[email protected]

Jenny KerbeinDirector of Governance &

Graphic [email protected]

Billi Wilson Manager, Meetings & Events

[email protected]

Teresa BrownAdministrative Assistant

[email protected]

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

The Situation Report: the Home Care Association of New York State Volume 2, No. 35 October 2, 2017

BILL from p. 1

coalition of more than 30 New York provider associations, laborand consumer groups that has regularly engaged Congress onopposing this bill – and its predecessors – aimed at ACA’srepeal-and-replacement. This latest version, in particular, hadbeen widely assailed by insurers, health care providers andseveral Governors nationally for the severity of its cuts.

Indeed, an analysis by the Congressional Budget Office (CBO)laid bare the numbers in stark terms. The bill’s proposal to block-grant Medicaid would save the federal government at least $133billion over the next ten years. But this would come at the costof “millions” of Americans losing health coverage – an amountthat the CBO couldn’t pinpoint with precision, given that the“block-grants” would leave many decisions up to the statesregarding their use of federal funds and waiver options.

Most astonishingly, the CBO updated its projections last week tofind that the bill would have cut Medicaid by $1 trillion over tenyears.

According to the Center on Budget and Policy Priorities, the bill’sblock-grant policy and the Medicaid per capita cap would cutfederal spending to New York State by $18.9 billion through 2026– an amount that the state could not absorb, according toGovernor Cuomo.

Now that this latest ACA repeal-and-replace effort has withered,Republican leaders in the House and Senate have pivoted theirfocus toward comprehensive tax reform, which the GOPoriginally devised as a follow-up to ACA’s repeal. However, thereremains some talk that the two issues – overhauling taxes andhealth care – may be paired in a legislative maneuver that buysCongress more time for a vote on health care through thereconciliation process. It remains to be seen whether this is aviable approach for Republican leaders to continue on therepeal-and-replace path.

Meanwhile, over the past several months, TennesseeRepublican Senator Lamar Alexander and Washington DemocratSenator Patty Murray had been working on a bipartisan effort tostabilize insurance markets and address premium hikes,separate from the broader actions on ACA. That effort wasstalled as Graham-Cassidy drew away political oxygen. It is

mailto:[email protected]











http://www.hcanys.org

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

3

Volume 2, No. 35 October 2, 2017

unclear, especially in the currentpolitical environment, whether thosebipartisan talks will resume – and towhat extent.

HCA will continue to keep youapprised of these critical decisions inCongress on both the Medicaid andMedicare fronts.

Telehealth, Chronic Care LegislationPasses Senate

At virtually the same time that theGraham-Cassidy bill fizzled, the Senatelast week unanimously passed healthcare legislation on a rare bipartisanbasis: The Creating High-QualityResults and Outcomes Necessary toImprove Chronic (CHRONIC) Care Act.

CHRONIC, which passed the Senate on September26, would expand coverage of telehealth servicesin Medicare Advantage managed care and certaintypes of Accountable Care Organizations.

Presently, Medicare only covers telehealth incertain circumstances, including for beneficiariesresiding in rural areas. CHRONIC would expandtelehealth coverage to include people with chronicconditions.

CHRONIC would also extend the MedicareIndependence at Home (IAH) demonstration bytwo years. (The demo was set to expire onSeptember 30.) IAH, which began in 2012, letsmedical practitioners like nurses and doctorsdeliver in-home primary care for certain applicableMedicare beneficiaries.

The bill would also direct CMS to assignbeneficiaries to certain types of ACOs at thebeginning of the year, instead of retrospectivelyattributing beneficiaries to ACOs.

HCA will report on any further action with this billif or when it is taken up by the U.S. House ofRepresentatives.

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 part-

time 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: [email protected].

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

SUBJECT TO REVIEW FOR PURPOSES OF ADAAA

JASA is committed to Equal Opportunity Employment

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

Experienced home health financial leader with McKesson Horizon IS experience, preferred

MS Office and accounting software experience required

A clear and concise communicator, written and oral

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: [email protected]


http://www.jasa.org/careers



4


HHGM from p. 1

withdrawal of the Home Health GroupingsModel (HHGM) proposal. The letter is inresponse to an intense advocacy campaignled by HCA, its state home care associationcounterparts across the nation, the Councilof State Home Care Associations, as well asthe National Association for Home Care andHospice (NAHC), Elevating Home, and thePartnership for Quality Home Health.

HCA had visited with the offices of SenatorGillibrand and Senator Charles Schumer thisweek and in early September to advocate foraggressive advocacy in opposition of theHHGM. In response, Senator Gillibrandsigned the bipartisan letter to CMS/HHS andSenator Schumer’s office vowed to use hisleadership position as Minority Leader ofthe Senate to communicate HCA’s and thehome care community’s concerns aboutHHGM.

The September 26 Senate letter follows oneday after the comment deadline for CMS’sproposed 2018 Home Health ProspectivePayment System (HHPPS) rule, whichincludes the HHGM. According to a report inHome Health Care News, this process drewover 1,300 public comments, including HCA’s(available at http://hca-nys.org/letters-and-comments/hca-comments-on-2018-hhpps-with-focus-on-hhgm-payment-cuts). In theweeks leading up to September 25, HCAstrongly encouraged HCA provider membersto issue comments of their own (which manydid), given the severity of the proposedHHGM payment cuts, estimated at $950million nationally. (In broad strokes, thesecuts would be achieved by changing the unitof payment for home health episodes from60 days of care to 30 days.) We also urgedmembers to write to Congress using ourLegislative Action Center.

“We have heard from a number of stakeholders who areconcerned that the proposed rule lacks sufficientinformation and data points to allow home healthagencies to accurately estimate the impact of theproposed HHGM,” states the Senators’ letter, which wasspearheaded by Florida Senators Marco Rubio, aRepublican, and Bill Nelson, a Democrat. “It is importantthat those most affected by the proposed rule have theopportunity, as well as the necessary information, toevaluate any consequences prior to the Centers forMedicare and Medicaid Services’ finalizing the proposedreforms.”

From left: Michael Freytag of Blacktree Consulting,Nathan Constable of Elevating Home, HCA PresidentJoanne Cunningham, June Castle and Andrea Lazarek-LaQuay of Nascentia Health, and Representative ClaudiaTenney (R-NY).

Continued on next page

http://hca-nys.org/letters-and-comments/hca-comments-on-2018-hhpps-with-focus-on-hhgm-payment-cuts

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“While we support efforts to increase efficiencies inMedicare, we believe this must be done in a prudentmanner that does not compromise access to care for theincreasing number of seniors who depend on theseservices to remain healthy and at home in theircommunities,” the letter adds.

CMS’s plan for HHGM – and the 2018 HHPPS proposedrule as a whole – was first made public on July 25, weekslater than usual. This timetable has allowed only twomonths for provider input, by last week’s commentdeadline, before HHGM could possibly be codified inCMS’s upcoming final HHPPS rule, expected in November,even though the HHGM provisions are set to go intoeffect in 2019.

In our advocacy to Congress and CMS, HCA has notedthat this enormous, untested overhaul to home care’s 18-year-old Medicare reimbursement system would fall ontop of yearly destabilizing home health reimbursementcuts since 2014. Home health rebasing cuts and othershave left New York home health agencies in the red, onaverage, operating at a negative-6.97 percent Medicareoperating margin overall in 2015 (the most recent year ofdata available).

Among our primary concerns is the fact that CMS’s HHGMproposal is not budget-neutral, “an important protectionagainst system-wide fiscal destabilization that CMShasunwisely rejected in this instance,” we note in ourcomments.

In visits this week with Members of the New YorkCongressional Delegation, HCA and its memberscontinued to highlight the need for the HHGM to beopposed by Congress, and advocated for New York’sRepresentatives to sign a similar letter in the House ofRepresentatives that is expected to be released soon forsignatures. HCA appreciates the advocacy of HCA BoardMember June Castle and her colleague Andrea Lazarek-LaQuay both of Nascentia Health Options (formerly VNAHomecare), Dan Lowenstein of VNSNY and MichaelFreytag of Blacktree Consulting, all of whom attendedmeetings with HCA President Joanne Cunningham thisweek.


Register Now: November16 and 17 Quality andTechnology Conference

Registration is now open for HCA'sQuality and Technology Symposiumon November 16 and 17!

See the registration form at the backof this week's newsletter.)

Be sure to invite your clinicalmanagers, Directors of PatientServices, quality improvement officers,and other strategic planners (includingthe leadership executives at youragency) who needto know the latest trends, policydevelopments, quality programrequirements, and technologicalopportunity areas to fulfill yourmission at the fundamentalintersection of quality and technologyin the home care, managed care andhospice arenas.

Continued from previous page


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HHS Secretary Resigns

U.S. Health and Human Services(HHS) Secretary Tom Priceresigned from his Cabinet-levelposition on Friday followingallegations about his privateuse of government flights.

As of press time for TheSituation Report, a replacementhas not been named, thoughseveral media reports pointedto the possibility that U.S.Centers for Medicare andMedicaid Services (CMS)Administrator Seema Vermamay be on the list ofcandidates. CMS is a divisionwithin HHS.

Repeal-and-replacement ofObamacare was among HHSSecretary Price’s top focuspoints, in addition to overseeingthe HHS Department and itsmany divisions, including CMS,which determines payment andregulatory policies affecting arange of home and community-based programs, among others.HHS has also played a largerole in regulatory reform,including bundled paymentsand accountable careorganizations.

With the repeal-and-replaceeffort effectively stalled yetagain – and Congress pivotingtoward a tax overhaul (seerelated p. 1 story) – HCA will bewatching closely to determinethe impact of leadershipchanges within HHS on thecontinuing debates over healthcare policy.

and “spread-of-hour” requirements for 24-hour/live-in services.

The call with HCA members was led by HCA’s executive and policy teams,our General Counsel Frank Fanshawe at Jackson Lewis, and our contractlobbyist, Sean Doolan, at Hinman Straub, all of whom are engaged on amulti-part strategy to reach a solution for providers in the face of enormouscost exposure and ambiguous state directives related to these courtdecisions and the underlying issues that prompted them.

HCA has written extensively about the three cases, two of which upheldlower court rulings and one of which rejected a lower court ruling. All three,however, reached similar conclusions about the conflict between a stateDepartment of Labor (DOL) “opinion letter” and DOL’s own underlyingregulations pertaining to 24-hour/live-in cases.

In effect, the courts have ruled that DOL’s guidance stipulating a 13-hourstandard for live-in workers – which providers have followed in good-faith,based on a 2010 DOL opinion letter – is in conflict with its actual regulationlanguage. The courts have, thus, determined that, based on the regulationlanguage itself, non-residential aides should be paid the minimum wage forall 24 hours of their shifts, regardless of whether they were afforded 8hours for sleep (including 5 hours of uninterrupted sleep time) and threehours for meals (aka, “13-hour rule”).

The cases open up major exposure for massive wage liabilities that can goback six years. In communications with DOL, the state Department ofHealth (DOH) and the Governor’s office, HCA has stressed the gravity ofthis issue, urging an immediate, emergency action that: 1) protectsproviders, plans, workers and patients in the form of either fully protectiveguidance (i.e., protecting against fiscal and other liability to providers andplans) or reimbursement to compensate workers and hours commensuratewith the court’s ruling, while the case is adjudicated; and 2) regulatoryclarification affirming DOL’s own interpretive guidance, both retroactive andprospective.

HCA continues stressing that this issue has the potential to decimate thehome care system and adversely impact individuals who need home care. We are informed that the crisis is receiving urgent attention from highlevels within the Cuomo administration, given the huge risks to the state,patients, the home health and managed care system, the workers, and,ultimately, the state’s vital authority for interpreting its own rules andexpectations.

HCA also advises members to consult their own counsel on how to proceedand will continue to provide you with updates as necessary, via e-mail alert.

CASES from p. 1

Minimum Wage SurveyExtended to Oct. 16HCA obtains additional Information for

members to complete the survey

As reported to members last week, thestate Department of Health (DOH) hasextended the deadline for completingthe ”Home Care Provider MinimumWage Reconciliation Survey” for anadditional two weeks. The new duedate is Monday, October 16, 2017.

HCA had requested an extension dueto the difficulty of completing such acomplex survey in such a short time,including the occurrence of religiousholidays during the original timeperiod. We appreciate DOH’sextension.

In response to numerous questionsraised by HCA and member agencies,what follows are some additionalclarifications obtained by HCA forcompletion of the Home Care MinimumWage survey. (Previous editions of TheSituation Report have providedadditional information.)

Survey structure

The attestation was posted on Monday,September 25. Some users may not beseeing it if they have not completedthe survey yet. Before starting thesurvey, their dashboard will say “StartSurvey.” If they start the survey, butthey don’t work their way through tothe end, the dashboard will say“Continue Survey.” Once they worktheir way through the entire survey tocompletion, the dashboard will changeto “Pending” and that is when they will

On September 27, HCA drew an overflow audience of more than150 home care, hospice and MLTC providers for our conference onEmergency Preparedness Essentials. The program included a panelsession with state and local health emergency preparednessofficials (bottom photo) stressing the importance of: localpartnerships; surge capacity planning; mutual service agreements;and other issues for emergency preparedness, including questionsabout evacuation procedures and transportation assistance levelsfor ensuring the safety of patients in the event of an emergency.The program also delved into the provisions of the upcomingConditions of Participation (CoPs) for emergency preparednessaffecting CHHAs.

Attendees also learned about Incident Command Principles, andhow these structures can be adopted within the provider structureto ensure a smooth chain of command and operationalarchitecture to respond to disasters. The program closed with atabletop drill that fulfilled one of the requirements of theupcoming CoPs.Continued on next page


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see a button to print their survey/attestation form. Once they have printed, signed, and scanned it, they canupload the attestation from the dashboard as well.

Other helpful information includes:

DOH has posted a revised Frequently Asked Questions (FAQs) document after HCA pointed out certaininaccuracies in the material. It is on the Office of Public Administration website (“what’s new”section): http://www.hcrapools.org//home_care_whats_new.cfm.

LHCSAs completing the survey will see CHHA as one of the revenue sources in question 1a, andshould enter all hours billed to the CHHA on the CHHA line. They should NOT assume where thosebilled hours go to even if they know the insurance status of the members they served.

In question 1a, home care providers who receive revenue from other sources, such as Expanded In-home Services for the Elderly (EISEP), hospice and Title XX, can include these under “CommercialPayer.” Billable hours under Medicare managed care should be included under “Medicare.” Long terminsurance coverage can go under commercial and out-of-pocket can go under private pay.

In questions 2b/3b/4b, under wage hours, agencies should include all hours paid under all revenuesources listed in question 1a.

In questions 2b/3b/4b, under wage hours, you should not include any direct care or administrativestaff whose hourly wage is above $14.99.

In questions 2b/3b/4b, under wage hours, agencies should include all hours paid for work, includingovertime or holidays, but at the base hourly wage not the overtime/holiday wage.

In questions 2b/3b, under “dollars spent on additional taxable wages,” if an aide is paid at a higherrate than the base rate (for example, $15 instead of $13), then the incremental difference above thebase wage ($2 in previous example) is counted.

In questions 2b/3b, under “dollars spent on additional taxable wages,” the agency can includeaccrued sick and vacation pay not already paid.

Paid time off (PTO) should not be included in either questions 4b or 4c.

DOH has stated that the purpose of the survey is to “reconcile actual Medicaid minimum wage costs toactual Medicaid minimum wage funding distributions. While minimum wage projections have been includedin current rates, effective 12/31/16, those figures will be reconciled using data from the survey. Data from thesurvey will also be used to assist in determining funding to include in future Medicaid Managed Care andFee-for-Service rates.”

Agencies required to submit the survey include CHHAs, LHCSAs, LTHHCPs and Consumer Directed PersonalAssistance program Fiscal Intermediaries (FIs). DOH has confirmed that even home care providers whodon’t employ aides but contract for such services are required to complete the survey.

The survey can be accessed at https://www.hcrapools.org/HomeCare_RCR/HomeCare_login.cfm. Agenciesmust first register with the state Office of Pool Administration (OPA) at https://www.hcrapools.org/HomeCare_RCR/registration_new_hc_contact.cfm. A separate OPA account is required even if you already


http://www.hcrapools.org//home_care_whats_new.cfm

https://www.hcrapools.org/HomeCare_RCR/HomeCare_login.cfm

https://www.hcrapools.org/HomeCare_RCR/registration_new_hc_contact.cfm

9


have one under the Health Facility Cash Receipts Assessment Program. If you have difficulties establishing anOPA account, contact OPA at [email protected] or at (315) 671-3800.

Webinar and Further Guidance

DOH recently held a webinar on the survey, along with screenshots to assist in its completion. HCA provideda summary of key updates from the webinar in last week’s edition of The Situation Report. (See p. 5 athttp://hca-nys.org/wp-content/uploads/2017/09/SitRep092517.pdf.) The webinar is posted at http://www.hcrapools.org//home_care_whats_new.cfm.

DOH has also posted at this site some short briefs on: How to Create an Account; How to Add an Entity; Howto Retrieve a Forgotten User ID and/or Password; and How to Complete the Survey.

Submitting Questions

Members are strongly encouraged to submit questions. HCA has submitted questions of our own and hasgotten helpful responses.

Questions about the survey should be sent to: [email protected] (please copy Andrew Koskiat [email protected], so that HCA can collect questions and responses for further member communications).

DAL

DOH has posted a Dear Administrator Letter (DAL) about the survey on the Health Commerce System. It doesnot include any new information, but reinforces some of the above, and members are encouraged to keep itfor your records of DOH’s official guidance. HCA has posted the DAL to our website at http://hca-nys.org/wp-content/uploads/2017/09/DAL_Minimum-Wage-Survey_092717.pdf.

For more information, contact Andrew Koski at (518) 810-0662 or [email protected].

DOH Working on, Finalizing, Contracting Template for MLTC VBP

The state Department of Health (DOH) continues working on a basic Level I value based payment (VBP)contracting template to assist managed long term care plans (MLTCs) and home care agencies.

The template, when finalized, is intended to provide a basic format and method for targeting Level Iperformance incentive payments to plans, and, in turn, to network providers for achieving quality metrics. Particularly emphasized will be metrics the Department highly correlates with potentially avoidablehospitalizations – e.g., sepsis, urinary tract infections, respiratory infections, heart failure, electrolyteimbalance and anemia. As contemplated, performance would be calculated on a comparison of a baselineperiod with a period (or periods) of service/patient experience under the VBP contract.

Informed by the discussions with our MLTC and agency members, HCA has been providing input to DOH withrecommendations for assisting plans and providers in the transition to VBP, including considerations relatedto the draft template. Additionally, HCA, in conjunction with plan and provider members, has offered ideas tootherwise assist the achievement of VBP Level I contracting milestones and timetables, particularly as it isbeing required by DOH for a January 1 effective date. Our input and engagement is ongoing.



http://hca-nys.org/wp-content/uploads/2017/09/SitRep092517.pdf

http://www.hcrapools.org//home_care_whats_new.cfm



http://hca-nys.org/wp-content/uploads/2017/09/DAL_Minimum-Wage-Survey_092717.pdf


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Details will follow upon DOH’s finalization of this template, which is intended to provide a useful foundationfor MLTCs and providers to proceed. Over and above the template, there is much room and need for guidanceand assistance, which is part of our priority planning for assistance to plans and providers. For example, onFriday, HCA and partners joined DOH (see related story below) on a statewide webinar for MCOs, MLTCs andlead hospital performing provider systems (PPSs) to receive a detailed presentation of HCA’s Sepsis Toolwhich offers a concrete method of approaching the VBP potentially avoidable hospitalization metrics forsepsis, as well as the other avoidable hospitalization measures.

Later today, HCA will be participating in a major meeting of the state’s VBP steering committee, and willreport to the membership on the proceedings.

HCA will keep members closely apprised of the developments with the VBP template as well as all otherrelevant VBP developments.

For further information, please contact Al Cardillo at [email protected].

DOH Convenes Major Webinar for MCOs and PPS Hospitals on HCA Sepsis Tool

The state Department of Health (DOH) hosted a major webinar Friday on the HCA Sepsis Tool.

Originally targeted to all of the managed care plans and managed long term care plans in the state, theDepartment also notified and invited all of the Performing Provider Systems (PPSs) leads under the DeliverySystem Reform Incentive Payment (DSRIP) program to participate.

The webinar faculty included HCA, DOH, the U.S. Centers for Disease Control, IPRO, HCA-provider and MLTCmember Mohawk Valley Health System (MVHS), and the National Sepsis Alliance.

The webinar provided detailed background on:

The problem of sepsis.

Its priority concern in the health care system – in terms of cost, mortality, morbidity, hospital andemergency room use, quality of care and life.

The role of sepsis and the HCA tool in relation to potentially avoidable hospitalizations and costs, andto VBP and DSRIP overall.

The development of the tool.

The tool’s inclusion in the CMS/IPRO special innovations program in New York State (where over 9,000clinicians have already been trained in its use).

The tool components, clinical algorithm and protocol.

Guidance for agency adoption.





Next steps.

In terms of next steps, and as announced in last week’s edition of the Situation Report, HCA has just beenawarded a major grant by the New York Health Foundation to support implementation of the HCA toolstatewide through in-depth training for home care clinicians and agency leaders, coordination of clinicalpartners across sectors (home care, hospitals, physicians, EMS, etc.), data compilation and sharing to supportagencies and potential state policy development, public outreach and communications, and other keyelements. Much more will be announced about the benefit of the grant to the home and health caresystem in the coming weeks. HCA’s sepsis initiative steering committee will also soon convene, consisting ofall of the major sector representatives, as well as CDC and other officials.

Meanwhile, organizations across the country – home care, hospitals, medical record vendors and others –continue to contact HCA to engage on the initiative.

Providers and plans can obtain direct information on how to adopt and use the HCA tool by [email protected].

HCA thanks DOH, CDC, IPRO, Sepsis Alliance and MVHS for their leadership in this issue and in the MCO/MLTC/PPS presentation. We also thank the many managed care and hospital representatives who participatedin Friday’s webinar.

For further information, please contact Al [email protected].

Participate in Important Home Care Workforce Survey & ReportWith workforce shortage and emphasis, provider participation is vital

Recently, the Center for Health Workforce Studies (CHWS) at the University at Albany’s School of Public Health,collaborating with HCA input, mailed out a survey (via postal mail) asking for your assistance in obtainingmore timely information on health workforce employment for an upcoming report. The mailing consisted of aone-page survey that, once completed, may be either faxed back at (518) 402-0252 or mailed back in thepostage-paid envelope that was enclosed with the survey.

CHWS monitors annual health care employment trends in the state of New York and issues a report of itsfindings each year. Its most recent report, The Health Care Workforce in New York, 2015-2016: Trends in theSupply and Demand for Health Workers, can be found on its website at http://www.chwsny.org/.

The primary purpose of the survey is to better understand the current recruitment and retention problemsfaced by home health agencies. CHWS indicates that individual answers to the survey will be kept strictlyconfidential, though your responses will be aggregated and reported at regional and state levels. CHWSestimates the survey should take 5-10 minutes to complete.

The survey is due back by November 17, 2017. Your participation will contribute to increased understanding ofcurrent and emerging health workforce issues in New York. The final report will be released at the end of thisyear and will be available on CHWS’s website. Questions can be directed to Lauren Boyd at (518) 402-0250 [email protected]. Thank you for your support of this important study.


11



http://www.chwsny.org/



DOH Issues Final 2017 Non-NYC Personal Care Rates

The state Department of Health (DOH) posted to the Health Commerce System (HCS) the final 2017“hotline” Medicaid rates for Personal Care and/or Consumer Directed program providers.

The rate calculations sheets are located in the “Rate Publication Selection List” drop-down section of theHCS, dated September 21, 2017.

These rates, effective January 1, 2017, reflect the application of a zero percent roll factor adjustment. Therates also reflect an 8.16 percent uniform percentage rate add-on payment to personal care providers insocial service districts which do not include a city with a population of over one million persons. To beeligible for this rate add-on, a personal care provider must have submitted to DOH a signed certificationstatement on the use of these funds.

The 2017 recruitment and retention add-on of 8.16 percent also includes adjustments to reimburse non-NewYork City (NYC) personal care providers for the uniform additional hourly Fair Labor Standards Act (FLSA) add-on amount as determined in the recently published FLSA adjustment rates effective October 13, 2015.

These 2017 rates also include an adjustment to the live-in ceilings for both personal care and consumerdirected services to be based on 13 hours of care, consistent with the requirements of MLTC Policy 14-08and consistent with the published rate effective October 13, 2015; however, this is not consistent with therecent decisions in the Andryeyeva v. New York Health Care Inc., and Moreno v. Future Care Health Services,Inc. court findings. (See related p. 1 story.)

Personal Care and Consumer Directed program providers have 30 days to file an appeal with DOH but onlyin cases where the 2017 final rates have changed from the 2017 initial rates.

For specific questions about your rates, contact DOH’s Richard Kappes or Kathy Omencinsky at (518) 473-4421.

For further information, contact Patrick Conole at (518) 810-0661 or [email protected].

CMS to Hold Oct. 10 Conference Call for CHHAs on Quality of Patient Care StarRating Algorithm

The U.S. Centers for Medicare and Medicaid Services (CMS) has scheduled a call on Tuesday, October 10from 2 to 3 p.m., so that Medicare certified home health agencies (CHHAs) can learn about modificationsand proposed changes to the way the Quality of Patient Care star rating is calculated, including the removalof the influenza measure.

During the call, CMS will present the rationale, proposed timing, and impact of the changes. A question andanswer session will follow CMS’s presentation. Your can register for the call via CMS’s Medlearn MattersNetwork website at https://blh.ier.intercall.com/.

12


https://blh.ier.intercall.com/


Changes Made to the Disability Benefits Claim Filing Process

The New York State Workers’ Compensation Board is making changes to the disability benefits claim filingprocess to “simplify filing and capture more information earlier in the life of a disability benefits claim.”

To reduce the number of forms used to file disability benefits claims, the Notice and Proof of Claim forDisability Benefits (Form DB-450) and the Notice of Proof of Claim for Disability Benefits of UnemployedClaimant (Form DB-300) have been combined into a new Form DB-450, entitled Notice and Proof of Claim forDisability Benefits. Claimants will now use the revised Form DB-450 to file all disability benefit claims withthe Board or insurance carriers, regardless of their employment status.

Other filing instructions have been clarified, as well, and questions have also been added to the new FormDB-450 to collect whether the claimant’s disability was the result of a motor vehicle accident.

The new Form DB-450 is available at http://www.wcb.ny.gov/content/main/forms/db450.pdf. Use of the newForm DB-450 is effective immediately. The old form will continue to be accepted until December 22, 2017.

Need Updated OASIS Credentials or COS-C Exam Certificate for OASIS Mastery inHome Health? Are you in need of contact-hours and OASIS training?

Do you or your staff need to renew your COS-C exam certificate? OASIS data collection is the measurement of your patients’ clinical needs, intensity and outcomes. And, likeany measurement, the practice of OASIS assessment is only as good as the eye “reading the scale” andthe hand entering its values.

Your agency’s reimbursement, its Home Health Compare ratings, and its overall profile of clinical findingsand outcomes all hinge on OASIS accuracy. On October 23 to 25 in New York City, HCA is offering the last of our Blueprint for OASIS Accuracy sessionsin 2017, providing your clinicians, field data collectors and their supervisors with the tools to master thelatest data-collection rules, conventions and applications.

The program includes a two-day workshop on October 23 and 24, led by experts at OASIS Answers, alongwith an optional COS-C (Certificate for OASIS Specialist-Clinical) certification exam at the same location onOctober 25. Learn more by downloading the flyer, or register online, both at the links below. Don’t miss this final opportunity for rigorous OASIS data collection training and best-practices broughtto you through HCA.

Download the flyer: http://hca-nys.org/wp-content/uploads/2017/05/Blueprint-for-OASIS-NYC-2017.pdf.

Register online: https://www.eventville.com/catalog/eventregistration1.asp?eventid=1012204.

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http://www.wcb.ny.gov/content/main/forms/db450.pdf

http://hca-nys.org/wp-content/uploads/2017/05/Blueprint-for-OASIS-NYC-2017.pdf

https://www.eventville.com/catalog/eventregistration1.asp?eventid=1012204


Get Insights on VBP Compliance Planning, an OMIG Alert Focus, with HANYS’ JeffGold at Oct. 19 HCA Compliance Symposium

The compliance questions for providers and managed care plans under Value Based Payments (VBP) are sovast that OMIG recently issued a VBP-specific alert urging all providers to “closely review reimbursementmethodologies so they can identify where they may need to update risk-assessment activities,” accountingfor VBP. (OMIG’s alert is at https://omig.ny.gov/images/stories/compliance_alerts/Compliance_Alert_2017_01.pdf.) Value Based Payments are fast becoming the dominant paradigm for all state Medicaid services. This newparadigm is fundamentally changing the nature of compliance planning and activities, as reinforced byOMIG. However, OMIG’s alert, which is light on details, raises many questions. Thankfully, HCA has one of thestate hospital association’s top VBP experts on the program for our upcoming Corporate ComplianceSymposium (October 19) to discuss the many issues related to “Program Integrity in a Value BasedEnvironment.” Jeffrey Gold, Senior Vice President and Special Counsel, Insurance and Managed Care at the HealthcareAssociation of New York State (HANYS), will discuss new areas of compliance emphasis that haveimplications on a broad scale for home care providers and other VBP partners. This session will put youahead of the curve by understanding how VBP program integrity is impacting home and community basedservice partners in the VBP model.

Download the conference brochure here: http://hca-nys.org/wp-content/uploads/2017/09/HCA-2017-Corporate-Compliance-Brochure-and-Registration.pdf.

Register online here: https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1012248.

VBP Bootcamp in NYC Open for Registration

Registration for the Value Based Payment (VBP) Bootcamp in New York City is now open.

The VBP Bootcamp in New York City will take place on October 18, 2017 at The New York Academy ofMedicine (1216 5th Ave, New York, NY 10029) from 8 a.m. to 5 p.m. Registration will close on October 11,2017.

VBP Bootcamps are a regional learning series created by the state Department of Health (DOH) to equipVBP contractors, managed care organizations, providers, associations, and community based organizationswith the knowledge to implement payment reform. The day-long VBP Bootcamp is designed to be aninteractive training session that will give participants a thorough understanding of VBP.

This event is free and open to all interested parties. Space is limited, and on a first-come, first-served basis.DOH requests that organizations limit participation to no more than four participants.


14

https://omig.ny.gov/images/stories/compliance_alerts/Compliance_Alert_2017_01.pdf

http://hca-nys.org/wp-content/uploads/2017/09/HCA-2017-Corporate-Compliance-Brochure-and-Registration.pdf

http://hca-nys.org/wp-content/uploads/2017/09/HCA-2017-Corporate-Compliance-Brochure-and-Registration.pdf

https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1012248


The schedule and locations for all VBP Bootcamps are as follows:

As a reminder, VBP Bootcamps are being considered the ‘4th semester’ of VBP University. If you attend a VBPBootcamp, and have completed all 3 semester quizzes of VBP University with a passing grade of 80 percent orhigher, you will receive a printed copy of your ‘VBP University diploma’ at the session you attend. Participationin VBP University is recommended but not required to attend a VBP Bootcamp. To learn more and participatein VBP University, visit www.health.ny.gov/VBP.

Questions can be directed to [email protected].

VBP University, Semester 3 Launched

The state Department of Health (DOH) has announced that Semester 3 of Value Based Payment (VBP)University has been launched.

VBP University is an online, educational resource created to raise awareness, knowledge and expertise in themove to VBP. It combines informational videos and supplemental materials that stakeholders interested inVBP can use to advance their understanding of this massive transformation effort.

Semester 3 Overview

Semester 3 is designed to educate users on specific, important topic areas, including Social Determinants ofHealth, Community Based Organizations (CBOs), and Contracting VBP. The curriculum for semester 3 includesvideos on each of the topics as well as detailed guidance documents targeted towards Managed CareOrganizations, providers, and CBOs.

Date Region Location Address Registration Link

Oct. 10, 2017 Capital Region The Egg Swyer Theater**

1 Empire State Plaza,

S Mall Arterial,

Albany, NY 12203

Registration open until October 3, 2017

at https://www.eventbrite.com/e/vbp

bootcamp 20 the capital region mid

hudson southern tier tickets

37649773486

Oct. 18, 2017 New York CityThe New York Academy

of Medicine

1216 5th Ave, New

York, NY 10029

https://www.eventbrite.com/e/vbp

bootcamp 20 new york city tickets

37805168276

Oct. 23, 2017 North Country High Peaks Resort

2384 Saranac Ave,

Lake Placid, NY

12946

Registration coming soon

Nov. 3, 2017 Central New YorkRochester Radisson

Riverside

120 E Main St,

Rochester, NY 14604Registration coming soon

Nov. 15, 2017 Long Island The Long Island Marriott

101 James Doolittle

Blvd, Uniondale, NY

11553

Registration coming soon



15

https://www.eventbrite.com/e/vbp-bootcamp-20-the-capital-region-mid-hudson-southern-tier-tickets-37649773486

https://www.eventbrite.com/e/vbp-bootcamp-20-new-york-city-tickets-37805168276

http://www.health.ny.gov/VBP



Date of Release Area of Study

Semester One Released in July 2017 Background and foundational information on VBP

Semester Two Released August 2017Topic specific information such as governance, business strategy,

stakeholder engagement, finance, and data

Semester Three September 2017 Now Live! VBP Contracting and VBP & The Social Determinates of Health

Semester Four** October and November 2017** VBP Bootcamps**

**VBP Bootcamps will take place in October and November 2017 in locations throughout the state. More information including

dates and locations can be found at

https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_bootcamp/2017_sessions.htm.

The schedule and details for VBP University semesters are as follows:

To watch an overview of the VBP University curriculum from NYS Medicaid Director, Jason Helgerson, clickhere: http://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_u/docs/vbpu_welcome_overview.mp4.

How to Graduate from VBP University

Semesters one through three conclude with a quiz on the topics covered. Those who pass all three quizzeswith a grade of 80 percent or higher will receive a certificate of completion. You may take the quiz multipletimes until you pass. Results are automatically sent to the Department of Health. If you attend a VBPBootcamp, you will receive a printed copy of your certificate. If you are unable to attend a Bootcamp, a copyof your certificate will be e-mailed to you.

To view semesters one, two and three of VBP University, please visit www.health.ny.gov/VBP.

Any questions can be sent to [email protected].

CMS Issues Guidance on Process for Hospices to Submit List of Claims RequiringAdjustments

The U.S. Centers for Medicare and Medicaid Services (CMS) has recently posted a Medlearn Matters (MLN)article that instructs hospices on how to submit a list of claims to be adjusted to their MedicareAdministrative Contractor (MAC) if they have information identifying payment errors

CMS’s MLN article can be downloaded at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE17029.pdf.

In an effort to reduce provider burden, and maintain accuracy, CMS now instructs hospices to submit a list ofclaims to their MACs to be adjusted. Hospices should notify their appropriate staffs of these changes and thedetailed instructions for submission.


16

https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_bootcamp/2017_sessions.htm.%ED%AF%80%ED%B0%83%ED%AF%80%ED%B0%83

http://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_u/docs/vbpu_welcome_overview.mp4

http://www.health.ny.gov/VBP


https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE17029.pdf



State Outlines Activities Related to Issuance of New Medicare Cards

In preparation for the issuance of new Medicare cards to all people with Medicare beginning in April 2018,the state Department of Health (DOH) is working to make programmatic changes in eMedNY in advance ofthe October 2017 testing deadline.

DOH anticipates working with its Medicaid managed care organizations, providers, and other stakeholdersto ensure a smooth transition, and describes its activities in the September Medicaid Update (https://www.health.ny.gov/health_care/medicaid/program/update/2017/sep17_mu.pdf)

Provider systems and business processes must be ready to accept the new Medicare number (which iscalled the Medicare Beneficiary Identifier, or MBI) by April 2018 for transactions, such as billing, claimstatus, eligibility status, and interactions, with their Medicare Administrative Contractors (MACs).

There will be a transition period when providers can use either the Health Insurance Claim Number (HICN)or the MBI to exchange data and information with the MACs. The transition period will start April 1, 2018and run through December 31, 2019. However, systems must be ready to accept the new MBI by April 1,2018.

For more information regarding the New Medicare Card replacement initiative, see the following links:

CMS’s Press Release: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-05-30.html

General Information Portal: https://www.cms.gov/medicare/new-medicare-card/nmc-home.html

Information for State Medicaid Agencies: https://www.cms.gov/Medicare/New-Medicare-Card/States/States.html

Information for Providers: https://www.cms.gov/Medicare/New-Medicare-Card/Providers/Providers.html

Medicare Appeal Threshold Amounts for 2018 Announced

The U.S. Department of Health and Human Services has announced the annual adjustment in the “amountin controversy” threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review underthe Medicare appeals process.

The amounts will be $160 (same as 2017) for ALJ hearings and $1,600 (up from $1,560 in 2017) for judicialreview in 2018.

More information is at https://www.gpo.gov/fdsys/pkg/FR-2017-09-29/pdf/2017-20883.pdf.

17

https://www.health.ny.gov/health_care/medicaid/program/update/2017/sep17_mu.pdf

https://www.health.ny.gov/health_care/medicaid/program/update/2017/sep17_mu.pdf

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-05-30.html

https://www.cms.gov/medicare/new-medicare-card/nmc-home.html

https://www.cms.gov/Medicare/New-Medicare-Card/States/States.html

https://www.cms.gov/Medicare/New-Medicare-Card/Providers/Providers.html

https://www.gpo.gov/fdsys/pkg/FR-2017-09-29/pdf/2017-20883.pdf


Resources

“Unpaid Eldercare In The United States — 2015-16: Data From The American Time Use Survey”(September 2017)www.bls.gov/news.release/elcare.toc.htm

“2017-2018 Influenza (Flu) Resources for Health Care Professionals,” by the U.S. Centers for Medicareand Medicaid Serviceshttps://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE17026.pdf

“Accepting Hospice Notices of Election via Electronic Data Interchange,” (September 26, 2017Transmittal), by the U.S. Centers for Medicare and Medicaid Serviceshttps://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3866CP.pdf

For more information, contact Andrew Koski at (518) 810-0662 or [email protected].

18

http://www.bls.gov/news.release/elcare.toc.htm


https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3866CP.pdf


Crowne Crowne Crowne Crowne Plaza HotelPlaza HotelPlaza HotelPlaza Hotel3 Executive Blvd.

Suffern, NY 10901

TechnologyQuality

AND

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.

Health care technologies, for their part, are only useful to the extent that they support the qualityof 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.

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.

Crowne Crowne Crowne Crowne Plaza HotelPlaza HotelPlaza HotelPlaza Hotel

3 Executive Blvd.

Suffern, NY 10901

AGENDAAGENDAAGENDAAGENDA

Thursday, November 16

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

‘Disruptive Technologies’ in Home HealthCarl 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.

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.

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 InterventionsJoe 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.

12:00 – 1:00PM Lunch

1:00 – 2:00PM

Opportunities for Advanced Home Health Aides to Support Quality OutcomesRebecca Fuller Gray, Director, Division of Home & Community Based

Services, NYSDOH

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.

2:00 - 3:00PM

How One Home Care Provider Used a Novel Health IT Platform to Achieve Concrete Quality OutcomesBrian 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

3:30 – 4:30PM

Integrating Behavioral Health with Chronic Care to Improve Patient OutcomesKatherine 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 Day One Wrap Up and Adjourn

Friday, November 17

8:00AM Light Breakfast

8:30-9:30AM

Best Practices for Quality ManagersTBA

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.

9:30-10:45AM

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

assessments 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.

10:45 – 11:00AM Break

11:00AM – Noon

The Quality and Value Proposition for Palliative Care in Home CareMadeline 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.

12:00- 12:30PM Lunch

2

Friday, November 17 - continued

12:30 – 4:00PM

Implementing QAPI Program Requirements for Senior ManagersBarbara 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 organization-

wide 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:

• 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 Wrap Up and Adjourn

3

Hotel InformationCrowne 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:

To make your overnight accommodations, call the hotel

directly at 1-800-227-6963 before October 25th and ask for the group code HCA.

$119/night

4

Thanks to our Thanks to our Thanks to our Thanks to our

Sponsors!Sponsors!Sponsors!Sponsors!

Thanks to our Thanks to our Thanks to our Thanks to our

EXHIBITORS!EXHIBITORS!EXHIBITORS!EXHIBITORS!

Registration Registration Registration Registration Registration Deadline: November 6

PLEASE FAX THIS COMPLETED REGISTRATION TO (518) PLEASE FAX THIS COMPLETED REGISTRATION TO (518) PLEASE FAX THIS COMPLETED REGISTRATION TO (518) PLEASE FAX THIS COMPLETED REGISTRATION TO (518) 426426426426----8788; 8788; 8788; 8788;

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Full Conference (November 16 & 17)

� HCA Member Rate $299

� Prospective HCA Member Rate $429

One-Day Pass (Indicate date and rate)

�� November 16 or ��November 17

� HCA Member Rate $169

� Prospective HCA Member Rate $259

Cancellation Policy:

Cancellations received in writing via email to [email protected] by

November 7 are refundable less a 25% administrative fee. No refunds are

permitted after this date or for no shows. Substitutions are permitted.

Pay by Check:

Make checks payable to HCA and mail to 388 Broadway, 4th Floor, Albany, NY 12207. Checks must be received by November 6th.

Pay by Credit Card:

� Amex �MasterCard � VISA

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In accordance with the Americans with Disabilities Act or special meal

needs, please let us know how we can accommodate you:

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