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ASAPVolume 20, No. 38 October 30, 2015

Inside Inside Inside Inside Inside ASAPASAPASAPASAPASAPSee BUDGET p. 2

Governor Cuomo Again Vetoes Essential Personnel Bill

Despite close work with the Governor’s office and others to address any outstanding issues, as well asvigorous outreach from HCA, our government-affairs representatives, the bill sponsors in the Legislature,and messages from many home care provider members, Governor Cuomo has again vetoed legislation togrant “essential-personnel” status to home care and hospice staff in emergency response and preparedness (A-5125-B/S.3482-B).

The bill had been unanimously passed by the Senate and Assembly, and its Assembly sponsor, MichaelCusick, was especially active in engaging with the Governor’s office to garner the Administration’s support

Federal Budget Deal Emerges –

Along With New House Speaker

Amid leadership changes in the U.S. House ofRepresentatives, Congress and the President havereached a federal budget deal. The deal, which hasalready won House and Senate approval, allowsfor an increase in the U.S. debt-limit, averting adefault on payments.

See VETO p. 3

Governor Cuomo Again Vetoes Essential Personnel Bill.....................1CMS Issues Final 2016 HHPPS...............................................................1Federal Budget Deal Emerges – Along With New House Speaker.......1HCA Meet-Ups Coming to Providers in Patchogue, NYC, Tarrytown......4HCA, Hospitals, Medical Society Team Up on F2F Rule Solutions.......6Quality Symposium: A Great Way to Celebrate Home Care Month.....7Member Hiring Announcement.............................................................7HCA Presents Quality Tool to DOH......................................................82016 State Wage Parity Levels to Be Announced..................................9HCA Meets with DOH on Vital Reimbursement Issues........................9Governor Signs Bills Affecting Providers, Employers.........................10DSRIP Update......................................................................................10Home Care Salary & Benefits Report Released..................................10MLTC Forum Strengthens Discussion of Payment, Policy Needs........11Progress Notes: The ICD-10 Transition So Far....................................12Influenza Resources Disseminated.....................................................12Weekly Influenza Surveillance Report.................................................13CMS Issues Proposed Rule on Discharge Planning................................13Minor Changes Eyed for Home Health Change-of-Care Notice.......14CMS to Host Home Health Open Door Forum: November 4............15Workers’ Compensation Assessment Rate Announced for 2016.......16Nonprofit Capital Investment Program RFA Released......................16Provider Training Available on NYMMIS..............................................17Rule Issued on Access to Covered Services for Medicaid...................18Publications.................................................................................18

See HHHPPS p. 4

CMS Issues Final 2016

Home Health HHPPS

The U.S. Centers for Medicare and MedicaidServices (CMS) yesterday issued its final rule forthe 2016 home health prospective paymentsystem (HHPPS). CMS projects a $260 million reduction in overallMedicare payments to home health agencies in2016.

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ASAP is a weekly publication of the Home Care Association of NewYork State (HCA). Unless otherwise noted, all articles appearing inASAP are the property of the Home Care Association of New YorkState. Reuse of any content within this newsletter requires permissionfrom HCA.

Joanne Cunningham, jcunningham@hcanys.org

Roger L. Noyes, Director of Communications, rnoyes@hcanys.org

Al Cardillo, Executive Vice President, Policy & Programs, acardillo@hcanys.org

Patrick Conole, Vice President, Finance & Management, pconole@hcanys.org

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

Alexandra Blais, Director of Public Policy, ablais@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 and Special Projects, jkerbein@hcanys.org

Billi Hoen, Manager, Meeting and Events, bhoen@hcanys.org

Teresa Brown, Administrative Assistant, tbrown@hcanys.org

President:

Editor:

388 Broadway, 4th Floor, Albany, NY 12207Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

ASAP – a publication of the Home Care Association of New York State

BUDGET from p. 1

Volume 20, No. 38 October 30, 2015

Impending debt-limit deadlines have been aperennial source of crisis negotiationsplaguing the federal government over the pastfew years, prodding a series of last-minutespending and budget actions – like the onereached this week – to raise the borrowinglimit and forestall a government shut-down.

Under the measure, spending would increase by$80 billion, offset by reductions and otherchanges, including an extension of the 2 percentcuts to Medicare provider payments,temporarily allocating payroll tax revenue fromthe trust fund for retired workers to theDisability Insurance Trust Fund, andamendments to the eligibility requirements ofthe Social Security Disability InsuranceProgram.

The deal also reduces a planned majorincrease in Medicare Part B premiums fornew enrollees and those who pay a higher“income-based” premium, and it repeals aprovision of the Affordable Care Act (whichwas, as of yet, not implemented) to requirecertain employers to automatically enrollemployees into a company-offered health

insurance plan if the company has 200 or more employees.

The agreement does not contain any direct threats to homecare, such as Medicare home health copayments or othercost-sharing impacts on beneficiaries, which have beenproposed in the past, drawing staunch opposition fromHCA and federal partners. However, the persistence of 2percent cuts to Medicare have been an ongoing concern anda target of HCA advocacy, as we continue to press forMedicare payments that meet the needs of serving patients.

This week’s deal came just after U.S. House Speaker JohnBoehner announced that he was stepping down, promptingvotes this week for his replacement. On Thursday, theHouse voted in favor of Rep. Paul Ryan to replace Boehner.Rep. Ryan was Mitt Romney’s running-mate in the lastPresidential election and a longtime chair of the HouseWays and Means Committee, which made him a topnegotiator over budget issues.

Meanwhile, the U.S. Centers for Medicare and MedicaidServices late this week has finalized its 2016 paymentprogram for home care under the Home Health ProspectivePayment System Rule (HHPPS). Please see the related p. 1story about the impact of this rule in 2016.

HCA will keep the membership posted of further updates fromWashington as they emerge, especially in the budget arena.

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throughout the legislative process. Assemblyman Cusick and Senator Andrew Lanza, the Senate sponsor,both represent Staten Island, a community hardest hit by devastating storms like Superstorm Sandy.

The veto message came at the eleventh hour, as the deadline for Executive action was approaching lateMonday night, amid wide support for the bill’s signature, and final outreach from HCA and our contractgovernment-affairs representatives at Wilson Elser who communicated directly to high-ranking Executive-level staff, urging the Governor’s signature of the bill.

Governor Cuomo’s veto comes as a stunning move, especially given the demonstrated need for this legislationrecognized within segments of the Governor’s own Administration, and in the context of emergencypreparedness and response measures otherwise being a hallmark of the Governor’s public policy work in theaftermath of major emergency disasters like Superstorms Sandy, Irene and Lee, as well as last November’sblizzard in Western New York. All of these events had compromised the efforts of home care and hospicestaff to reach vulnerable patients in need of care, relief, and services because this staff was not adequatelyrecognized for the work they are required to do under the umbrella of their emergency management plans.

The Governor’s veto asserts that there would be unfunded costs to municipalities, including costs stemmingfrom “consultation with potentially hundreds of home health and hospice organizations”; although, we stress,the state already requires “consultation” between government organizations and health care providers throughmechanisms like the Health Commerce System, eFinds, the Health Electronic Response Data System (HERDS),through regional and sub-regional Health Emergency Preparedness Coalitions, and County EmergencyOperations Centers (EOCs), or County Offices of Emergency Management, all of which are already staffed andequipped for handling duties related to communication with providers over emergency response. This multi-tieredarchitecture for “consultation” with providers during emergencies has long been a tenet of emergency preparednessfrom the local municipality level on up to the Governor’s own Administration.

The Governor’s veto message also cites “liability regarding the safety of medical personnel granted access torestricted emergency areas as well as those in need of care,” without recognizing the greater liability for access topatient care in the absence of some mechanism to allow a response from providers to meet the needs of theirpatients.

HCA and our government-affairs representatives are continuing to follow-up with high-ranking CuomoAdministration officials to delve into the rationale and basis of information upon which this bill has beenvetoed and to determine next steps for recognition of home care in state-mandated emergency preparednessand response activities so that the mistakes of prior disasters are not repeated in the future.

In absence of this legislation, it is imperative that state officials work now in the meantime with HCA toformulate an appropriate and efficient route for ensuring home care and hospice access to vulnerable patientsin need, an issue which was cited again and again in after-action reports by the government’s own emergencymanagement officials following major storms and natural disasters over the past three years.

Please stay tuned for further updates.

VETO from p. 1

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Volume 20, No. 38 October 30, 2015

HCA Regional Meet-Ups

Coming to Patchogue, NYC and

Tarrytown Next Week

HCA’s next round of regional meetings iscoming up next week, following our firstround in upstate New York.

The Meet-Ups, as they are called, will bringyou together with our executive team todiscuss regional experiences, needs, concernsand recommendations. These events arefree-of-charge, coming to Patchogue and

New York City on November 5 andWestchester on November 6.

The Meet-Ups will focus on how theregional DSRIP networks and otherpayment models are working for you. We’lluse your feedback to help leverage homecare’s role in the DSRIP programs of today,as well as the Value-Based Payment projectsof tomorrow. We’ll also open the floor forother payment or service issues affectingyour region.

Agencies in the Long Island, New York Cityand Westchester regions can RSVP toattend one of these Meet-Ups by completingthe form at https://www.surveymonkey.com/r/HCAmeetups.Specific locations are below:

• Patchogue: Brookhaven MemorialHospital Medical Ctr., 103 WestMain St. (entrance & free parkingon Lake St.), Patchogue, NY 11772.

• NYC: Hunter College BrookdaleCampus, Room W237 (2nd Floor),425 East 25th Street, Between 1stand FDR, New York, NY 10010.

• Tarrytown: VNA of HudsonValley, McCann Conference Room,3rd Floor, 540 White Plains Rd.,Tarrytown, NY 10591.

This decrease reflects the effects of: a 1.9 percentmarket-basket update ($345 million increase); a 0.97percent reduction for “nominal” case-mix growth (alsoknown as “case-mix creep”) occurring in 2012 through2014 ($165 million decrease); and a 3.45 percentdecrease in payments due to the third year (out of four)of rebasing adjustments ($440 million decrease).

The final rule includes some modest improvements onthe payment side, compared to the proposed rule, in thatit lowers the multi-year case-mix creep adjustment to2.88 percent, compared to a proposed 3.41 percent; italso phases in that reduction over three years rather thantwo. This phase-in begins with reductions of 0.97percent in 2016, 2017 and 2018, instead of the proposed1.72 percent reduction in 2016 and 2017.

However, the final rule adds yet another year of rebasingreductions, at 3.45 percent (applicable to the 2010rates), which is the regimen implemented in 2014 and2015 as part of the four-year rebasing process.

In dollar terms, this 3.45 percent rebasing cut amountsto a base episode rate reduction of $80.95 – againconsistent with the last two years of rebasing, and at theupper limit permitted by law (under the Affordable CareAct). CMS’s episodic base rate would be offset on the upsideby a market basket update (2.3 percent), which is itselfsubject to a downward productivity adjustment of 0.4percent, resulting in a net market basket update of 1.9percent.

Therefore, CMS’s final base episodic rate is $2,965.12for 2016, versus $2,869.27 in 2014 and $2,961.38 in2015. Please keep in mind, however, that a trend-linecomparison of the base episodic rate between 2014 and2016 can be deceiving. This is due to the fact that CMShas also reduced all of the case-mix weights by anaggregate 2.37 percent. And to achieve budget neutrality,as required by statute, CMS then had to offset the case-mix reductions through an upward adjustment in the

HHPPS from p. 1

Continued on next page

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base episodic rate by the same amount (an uptick of 2.37 percent). This means that the base episode ratecumulatively seems to trend higher between 2014 and 2016, but only because it includes the budget neutralityoffset to make up the difference for reductions separately made to the case-mix weights.

The final rule provides additional details on the full transition to a new wage index and very specific detailsabout the new rates, including calculations for outlier payments, Low Utilization Payment Updatepercentages, and more.

Home Health Value Based Purchasing Pilot Update

The rule also finalizes a new home health value-based purchasing pilot program in nine states. New York Stateis not one of the nine states selected for this pilot.

Beginning January 1, CMS will implement the pilot model among all Medicare-certified agencies inMassachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennesseewho will compete on value in the model, where payment is tied to quality performance.

Agencies in these nine states will have their payments adjusted by a maximum (upward or downward) adjustmentof: 3 percent in 2018; 5 percent in 2019; 6 percent in 2020; 7 percent in 2021; and 8 percent in 2022.

Compared to the proposed rule, the maximum payment reduction in the first year of the value-basedpurchasing program was reduced from 5 percent to 3 percent. CMS will continue to use 2015 as the baselineyear for performance, with 2016 as the first year of performance measurement.

HHQRP Update

CMS is finalizing, as proposed, one standardized cross-setting measure for 2016 under the “skin integrity andchanges to skin integrity” domain. Measures for the other domains will be addressed through futurerulemaking.

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 requires home health andother providers to submit standardized patient assessment data, as well as standardized data on qualitymeasures and resource use and other measures for purposes of interoperability and to improve quality,payment, and discharge planning, among other purposes. The rule also includes the establishment of aminimum threshold for submission of Outcome and Assessment Information Set (OASIS) assessments forpurposes of quality reporting compliance.

A CMS fact sheet with more information is at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-29-3.html.

Next Steps

Given that this very detailed final rule was just released yesterday, it will require HCA review and analysis as well asconversations with partner organizations to assess the full impact and next steps for advocacy. HCA will provideyou with a more detailed summary of the final rule once our review is complete, including greater detail on thepayment calculations, and any regulatory changes that will help you budget for 2016. For further information, contact Patrick Conole at (518) 810-0661 or pconole@hcanys.org.

Continued from p. 4

HCA, Hospitals, Medical Society Team Up on F2F Rule Solutions HCA convened a meeting this week of hospital and physician partners to discuss and set into motion acollaborative approach to streamlining and fulfilling face-to-face documentation and eligibility requirementsfor Medicare-covered home care services. The meeting included HCA, members of an HCA Face-to-Face Workgroup, the Healthcare Association ofNew York State (HANYS), the Iroquois Healthcare Alliance (or IHA, which is the upstate regional hospitalassociation), and the Medical Society of the State of New York (MSSNY). HCA and HCA Face-to-Face Workgroup members presented a draft document intended to serve as an“addendum” to a physician’s record to help fulfill Medicare face-to-face and home care eligibility certification.The draft addendum follows months of discussion and refinement by the workgroup, including vetting with theU.S. Centers for Medicare and Medicaid Services (CMS) fiscal intermediary and administrative contractorNational Government Services (NGS). Those efforts have been previously covered in ASAP and in othercommunications. At this week’s “partners” meeting, HCA, workgroup members and association colleagues delved into thechallenges of face-to-face compliance, including the further complications arising from the subjectivity of auditreviews. HCA described how the structure, content and use of the draft addendum could help mitigate thesechallenges. Workgroup members who have already engaged with affiliated hospitals on use of the draft described thepositive feedback they have received, and also cited systemic challenges. A main challenge is the integration offace-to-face and patient eligibility data elements into hospital, physician and home care provider electronichealth records, particularly in the context of other federal and state program changes. Other challengesinclude how to ensure that the documentation elsewhere in the physician’s record thoroughly supports andcomports with the information completed on the addendum and in CMS’s regulatory requirements; andseeking CMS’s support in the use of the form, particularly in its audit/compliance process. One across-the-board gain would be a concise, uniform document that all could adopt and use. Our respective associations agreed to continue working together toward a mutual goal of improving the face-to-face process within our available means (e.g., meeting CMS approval and support). HANYS, IHA andMSSNY will further review the HCA draft and reconvene with us in a couple of weeks to offer morefeedback and discuss ideas for next steps. Meanwhile, HCA will also continue to work at the federal level to seek substantial reform in the CMS face-to-face requirements. Among these efforts is HCA’s Congressional proposal to allow certification of face-to-face (and the medical criteria for Medicare coverage) via the physician’s signature on the “485”/plan of care,with the date of the face-to-face encounter. For further information, please contact Al Cardillo at acardillo@hcanys.org or Patrick Conole atpconole@hcanys.org.

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HIRINGPatient Relations Manager

Americare, New York’s leader in home health care, seeks a high energy, dynamic, self-starter for an exciting career opportunity in its patient relations department. The PatientRelations Manager’s primary responsibility will be to develop relationships and educateMDs about home care and the benefits to their patients. The ideal candidate will have 2-3years home care or pharmaceutical experience. An excellent compensation and benefitspackage is offered, including: 401K with company match, medical, dental and directdeposit.

E-mail résumé to hrrecruiter@americareny.com.

www.americareny.com.

EOE

Nov. 17-18 Quality Symposium: A Great Way to Celebrate

National Home Care Month with Staff Education

HCA’s last big conference of 2015, our Quality Symposium, falls in November, which is also NationalHome Care Month.

What better way to celebrate National Home Care Month than to focus on the quality of care provided toyour patients, and to inspire your staff in this direction?

This Symposium, on November 17 and 18, is a great opportunity to end the year by giving your staff thebenefit of learning from top experts in the quality-of-care field, a benefit that also accrues to your agency, asstaff return from the Symposium inspired and ready to meet the challenges and imperatives of home carequality in 2016.

This imperative is indeed changing, especially in the shifting marketplace of contract relationships, value-based payments and a new urgency for you to communicate your quality proposition to MLTC plans andother partners.

In fact, our Quality Symposium offers a full day of access to experts in the field about quality in the arena ofcontract relationships between CHHAs, LTHHCPs, LHCSAs and managed care plans we well as otherpartnerships. We’ll also provide: insights about specific clinical tools and protocols; model home carequality management programs; CMS Star Ratings; the link between home care quality and compliance; anda demo of HCA’s first-of-its-kind home care Quality Risk Tool (see related p. 8 story), which will help youtake a systematic approach to meeting the rubric of best-practices and regulatory requirements for qualityassurance.

This conference provides something for everyone, whether you are CHHA, LTHHCP or LHCSA. As you

prepare your end-of-year education commitments for staff, please consider this last big HCA conference

of the year. See the brochure at the back of ASAP for a detailed agenda and register online at:https://www.eventville.com/Catalog/EventRegistration1.asp?EventId=1011709.

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ASAP – a publication of the Home Care Association of New York State Volume 20, No. 38 October 30, 2015

HCA Presents Quality Measurement, Risk & Compliance Tool to DOH HCA presented our Quality Measurement, Risk and Compliance Tool (HQMT) to state Department ofHealth (DOH) officials in a meeting this week, seeking to vet our product and garner the Department’sfeedback, input, potential collaboration and support. HCA Board and Quality Committee member Laurie Neander, President and CEO of Basset HealthcareNetwork At Home Care, and HCA Executive Vice President Al Cardillo, presented HQMT in a jointmeeting with the DOH Office of Health Care Quality and the Division of Home and Community BasedServices. In the meeting, HCA discussed: the origins and evolution of HQMT, spurred by the HCA QualityCommittee and HCA Board of Directors; the comprehensive quality and compliance metricsincorporated into the tool; its proactive purposes and extensive capabilities; agency-specific andassociation goals for use of HQMT in the domain of quality best-practices and compliance; plannedsteps for implementation; and opportunities for state support. In September, HCA issued a Request for Proposals (RFP) for potential software and benchmarkingorganizations to enter into agreement with HCA to automate and offer data services to HCA agenciesthrough HQMT. Organizations are now responding to the RFP and HCA expects to begin reviewing theproposals soon. HCA also briefed the Department on several other quality initiatives that we have in motion, seekingDOH collaboration and support for home care innovations aimed at improving overall public/patienthealth and quality of care. HQMT demo at Quality Symposium on Nov. 17-18

HCA will be featuring a full updated presentation and status report on HQMT, along with a number ofour other quality initiatives, at HCA’s upcoming Quality Symposium on November 17-18 in Troy, nearAlbany. (See related p. 7 article and program brochure at the back of this week’s ASAP.) The Symposiumwill also feature key presentations from DOH quality leaders, and experts/innovators from throughoutthe field. For further information, please contact Al Cardillo at acardillo@hcanys.org.

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Volume 20, No. 38 October 30, 2015ASAP – a publication of the Home Care Association of New York State

2016 State Wage Parity Levels to Be Announced

HCA expects the state Department of Health (DOH) to post the state Home Care Worker Parity levels for2016 early next week.

The levels for New York City, covering the period March 1, 2016 to February 28, 2017, are expected to be thesame as for this year, while the levels for Long Island and Westchester for this period are expected to increase.The new levels will be posted at http://www.health.ny.gov/health_care/medicaid/redesign/mrt_61.htm (samesite for this year’s levels) and HCA will announce the amounts once they are released.

As described in previous ASAP articles and alerts (also, see the separate story below on an HCA reimbursementmeeting with DOH), HCA has made it a top priority to advocate that the state provide immediate compensationto home care agencies and managed care plans for their cost increases due to changes in overtime calculationand travel expenses. HCA has also asked the state to provide additional funding to home care providersoperating under Medicaid fee-for-service and managed care to address state and local living wage laws andincreases in workers’ compensation and other labor costs.

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

HCA Meets with DOH on Vital Reimbursement Issues

This week, HCA met with state Department of Health (DOH) Bureau of Long Term Care Reimbursementstaff to discuss a variety of payment issues affecting home care agencies and MLTC plans.

HCA asked to be briefed on the status of the 2014 and 2015 rate packages still awaiting approval from theU.S. Centers for Medicare and Medicaid Services (CMS) for MLTCs and Programs of All-Inclusive Care forthe Elderly (PACE).

HCA emphasized the adverse effects upon both plans and providers from these significant lags in adjustedpremiums. HCA urged expeditious approval of the premium increases and enhancements necessary for boththe plans and their providers to be adequately reimbursed.

DOH described its intentions to seek approval in the next week or so from the U.S. Centers for Medicare andMedicaid Services (CMS) for its $35 million share for the Quality Incentive Vital Access Provider Pool (QIVAPP)program. DOH acknowledged HCA’s concerns that the process of awarding and distributing QIVAPP funds hasbeen problematic (especially DOH’s payment reconciliation that will require some of the initially paid providers toreturn portions of their round-one QIVAPP funding) and invited HCA to offer suggestions for an improvedapproach. DOH confirmed that another $70 million will be available for the 2015-16 state fiscal year.

DOH confirmed that it is trying to obtain estimates on the new costs incurred by plans and providers forovertime (through its plan survey) and is drafting a Dear Administrator Letter to outline how DOH willprovide financial relief for these new expenses. HCA asked the state’s thoughts on establishing a “stop-losspool” to pay for new overtime costs instead of trying to calculate a premium adjustment which would have toaccount for so many variable factors and costs, possibly underfunding premiums and provider reimbursement.

HCA suggested that such a pool could ensure adequate reimbursement of plans and providers whilesimultaneously allowing for actual overtime experience and cost data to be collected, and to eventually use this

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more accurate data for premium/rate adjustment. Moreover,this might assist in the initial overtime reimbursement periodas the CMS premium rate approval process takes monthsto complete. DOH invited HCA to submit this concept inproposal form.

HCA also requested that DOH examine areas of MLTCpremiums that warrant adjustment for other new costs notreflected in the current premium base. For example, HCAstressed recent years’ exorbitant increases in workers’compensation costs, and expected increases in state workerWage Parity levels for Long Island and Westchester, whichare new costs not otherwise being factored into actuarialdeterminations of MLTC premium need.

HCA appreciates DOH’s engagement with us on theseissues, concerns and recommendations.

For more information, contact HCA Policy staff.

Governor Signs Bills Affecting Providers,

Employers

This week, Governor Cuomo announced that he signed thefollowing bills:

• Wage Deduction Extender (S.5623 Young/A.7594Titus). This extends for an additional three years(until November 2018) categories of permissiblewage deductions that an employer may take fromtheir employees with their written consent.

• CARE Act (S.676-B Hannon/A. 1323-BRosenthal). The Caregiver, Advise, Record andEnable (CARE) Act specifies requirements forcaregiver identification, training and support in thehospital discharge planning process. This legislationallows a patient to designate, upon entry to ahospital, a caregiver in the patient’s medical record;requires the hospital to notify and offer to meet withthe designated caregiver to discuss the patient’s planof care prior to discharge or transfer to anotherfacility; and requires the hospital to adequately trainthe designated caregiver in certain after-care tasksupon the patient’s discharge.

DSRIP Update

On Monday, November 9 and Tuesday,November 10, the Delivery System ReformIncentive Payment (DSRIP) ProjectApproval and Oversight Panel (PAOP)will hold a meeting of the upstate-basedDSRIP Performing Provider Systems(PPSs) in Albany. It will allow the non-New York City PPSs to give briefpresentations and answer any questionsfrom the panel.

The meeting is open to the public, but therewill be no public comment period at thesemeetings. No pre-registration is required.

Monday, November 9, will be a full-daymeeting, structured as an update session forthe panel members, and an opportunity forthe panel members to check in with each ofthe PPSs. Tuesday, November 10, will be ahalf-day meeting. The meetings will bewebcast at: http://www.health.ny.gov/events/webcasts/

Home Care Salary & Benefits

Report Released

The 2015-2016 Homecare Salary & BenefitsReport, published by Hospital &Healthcare Compensation Service, is nowavailable for purchase.

The 258-page report contains 64 jobs,reporting on salaries, bonuses, and hourlyand per-visit rates. Data are reported bystate, county, nine geographic regions,nationally, and according to agency type andrevenue size. Also included are 18 fringebenefits, planned percent increases,turnover rates, and personnel policies.

To order, visit the Hospital & HealthcareCompensation Service website atwww.hhcsinc.com or call (201) 405-0075.

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MLTC Forum Strengthens Discussion of Payment, Policy NeedsAnother set of Forums coming up for LTHHCPs, LHCSAs and HCC Members: Register Today!

HCA and MLTC members are meeting in New York City today for our MLTC Forum. The meeting is one ofseveral program-specific HCA Forums being held over the next few months. Other upcoming sessions includeHCA’s LTHHCP Forum on November 13; HCC Member Forum on November 16; and Downstate LHCSAForum on November 23.

Topping the agenda at today’s MLTC Forum are payment and premium issues affecting the plans and theircontracting home care providers alike.

This includes a planned discussion of 2014 and 2015 MLTC base premiums and adjustments, to draw inputfrom the plans about the adequacy of current rates, given many of the increased costs imposed upon the system.

The Forum is a great opportunity to engage with HCA’s MLTC plan members on specific concerns from the angleof HCA’s expertise in the community-based service realm, though these sessions also explore other MLTC concernsacross the spectrum of its benefit structure.

Home care comprises a significant portion of the MLTC portfolio, and home care-specific issues like the Wage ParityLaw, new overtime requirements under the Fair Labor Standards Act, workers’ compensation issues and other laborand wage issues have put strains on the payment system. HCA is engaging with members on all of these issues.

HCA is also briefing the group on discussions over standardized coding and billing practices in MLTC. Those discussionsstem from HCA-advocated legislation, which passed in the state budget, seeking uniformity and efficiency across thesystem. Uniform coding options are being explored by a workgroup of plans, providers and the state Department ofHealth for the purpose of easing the administrative complexity of provider and plan billing.

The Forum is also raising issues related to the processing of Quality Incentive Vital Access Provider Pool moniesfor meeting wage parity, as well as progress on other policy matters that affect the coordination and status ofMLTC services, such as the state’s proposal for an MLTC-plus model, value-based payments, the Delivery SystemReform Incentive Program and other issues.

Drilling down into specific changes and proposals on the horizon, HCA is also discussing new developmentssuch as the soon-expected flexibility in requirements for home care physician order timelines, state audit and complianceissues, quality innovations in home care, the prospect of advanced home health aide legislation reemerging in 2016, andother areas for legislative, policy, education and collaborative work on behalf of HCA’s MLTC members.

We thank Empire Blue Cross Blue Shield for hosting the location of this Forum, and the HCA MLTC membersfor taking part in an active exchange of ideas and updates.

Register for next slate of Forums

If you are an LTHHCP, LHCSA or Home Care Council of HCA member, please be sure to register for the nextset of Forums that relates to your provider type. Registration for the LTHHCP and LHCSA Forums are athttp://hca-nys.org/wp-content/uploads/2015/09/HCA-Combined-Forum-Registration-Form-2015.pdf.Registration for the HCC Forum is at http://hca-nys.org/wp-content/uploads/2015/10/HCCForumRegistrationForm111615.pdf.

For more information, please contact a member of HCA’s Policy staff.

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Progress Notes: The ICD-10 Transition So Far

The U.S. Centers for Medicare and Medicaid Services (CMS) this week provided a progress update on billingperformance under the transition to ICD-10, which went into effect on October 1.

CMS says it is monitoring claims processing post-October 1, but won’t have a more complete progress updateuntil November, given the lag of some claims being submitted and processed due to the 30-day billing allowanceand the legal requirement that Medicare must wait two weeks to remit payment, delaying the processing of claimsin certain cases.

Nevertheless, for the period October 1 to 27, CMS reported that a total of 4.6 million claims were submitted perday, with 2 percent rejected due to invalid or incomplete information.

Claims rejected due to invalid ICD-10 codes or invalid ICD-9 codes (i.e., for services prior to October 1) were:0.09 percent and 0.11 percent, respectively. Total claims denied during this period amounted to 10 percent of totalclaims processed.

For general ICD-10 information, visit CMS’s “Road to 10” website (http://www.roadto10.org/) andwww.cms.gov/icd10.

CMS says your first line for help with Medicare claims questions should be the Medicare AdministrativeContractor, which, in New York’s case, is National Government Services (NGS) at https://www.ngsmedicare.com.

Other help options are the ICD-10 Coordination Center at icd10@cms.hhs.gov or the ICD-10 Ombudsman,Dr. Bill Rogers, at ICD10_ombudsman@cms.hhs.gov.

For more information, please contact the HCA Policy staff.

Influenza Resources Disseminated

The state Department of Health (DOH) has disseminated a variety of resources to help providers with the fluseason, including resources targeted to National Influenza Vaccination Week (December 6 to December 12).These include:

• U.S. Centers for Disease Control and Prevention (CDC) resources at www.cdc.gov/flu/NIVW/resources.htm and www.cdc.gov/flu/index.htm.

• The CDC publication “No More Excuses – You Need a Flu Vaccine” fact sheet at http://www.cdc.gov/flu/pdf/freeresources/general/no-excuses-flu-vaccine.pdf.

• DOH’s Seasonal Influenza website at www.health.ny.gov/diseases/communicable/influenza/seasonal.

• DOH Provider Training and Education information at http://www.health.ny.gov/prevention/immunization/providers/training_and_education.htm.

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• DOH’s flu mask requirement at http://www.health.ny.gov/diseases/communicable/influenza/seasonal/providers/prevention_of_influenza_transmission/.

As reported in last week’s ASAP, DOH has not yet declared influenza to be prevalent and thus the flu maskrequirement is not in effect now. However, DOH has announced that the Healthcare Personnel InfluenzaVaccination Report will open on November 2 and must be submitted by May 1, 2016.

This year’s report covers personnel employed by or affiliated with a facility or agency from October 1, 2015

through March 31, 2016.

Weekly Influenza Surveillance Report

This week, DOH posted the first 2015-16 Weekly Influenza Surveillance Report, which covers the week endingOctober 17. Report highlights include:

• Influenza activity level was categorized as geographically sporadic. Sporadic activity has been reportedfor two consecutive weeks.

• There were 30 laboratory-confirmed influenza reports, an 11 percent increase over last week.

• Of the 995 specimens submitted to NYS WHO/NREVSS laboratories, 3 (0.3 percent) were positivefor influenza.

• Of the 13 specimens submitted to Wadsworth Center, none were positive for influenza.

• The number of patients hospitalized with laboratory-confirmed influenza was 10, a 17 percent decreaseover last week.

• There have been no influenza-associated pediatric deaths reported this season.

All Weekly Influenza Surveillance Reports are posted on the Health Commerce System athttps://commerce.health.state.ny.us/public/hcs_login.html.

CMS Issues Proposed Rule on Discharge Planning

On Thursday, October 29, the U.S. Centers for Medicare and Medicaid Services (CMS) released a proposedrule regarding discharge planning that would impact hospitals and home health agencies, among others.

According to CMS, its goal is to improve quality and outcomes while reducing avoidable complications andhospital readmissions by further engaging the patient in care transition planning. The proposed rule would alsoapply the elements of the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act) of 2014that relate to discharge planning.

The IMPACT Act requires hospitals (including inpatient rehabilitation facilities and long term care hospitals),critical access hospitals, and home health agencies to develop discharge plans in partnership with patients in

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order to reflect the individual patient’s needs, preferences, and goals. The proposal suggests that “patients andtheir caregivers frequently are not meaningfully involved in the discharge planning process and are unable toname their diagnoses; list their medications, their purpose, or the major side effects; cannot explain their follow-up plan of care; or articulate their treatment preferences and goals of care.”

The proposed rule sets a specific timeframe for discharge plan development, and would give hospitals 24 hoursfrom time of admission or registration to begin to identify the discharge needs for every inpatient, as well ascertain categories of outpatients. Further, these providers would have to supply discharge instructions to thosepatients being discharged, have a medication reconciliation process that seeks to improve patient safety withenhanced medication management, develop a follow-up process after discharges, and more. All of this wouldneed to be coordinated and evaluated by a registered nurse, social worker, or other qualified individual.

As noted above, the proposed rule highlights the significance of the patient’s engagement throughout dischargeplanning and aims to better prepare patients and families for the period post-discharge.

HCA will continue to review the proposed rule, particularly its impact on home care providers and patients,and provide more information in the weeks to come.

Minor Changes Eyed for Home Health Change-of-Care Notice

The U.S. Centers for Medicare and Medicaid Services (CMS) has announced its intent to make non-substantivechanges to the Home Health Change of Care Notice (HHCCN).

The notice, along with a revised HHCCN, Form Instructions and Supporting Statement, is at https://www.cms.gov/Regulations-and-Guidance/Legislation/PaperworkReductionActof1995/PRA-Listing-Items/CMS-10280.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=descending.

According to the notice, CMS will make non-substantive changes “which add language informing beneficiariesof their rights under Section 504 of the Rehabilitation Act of 1973 by alerting the beneficiary to CMS’snondiscrimination practices and the availability of alternate forms of this notice if needed.”

The actual new language, inserted at the bottom of the HHCCN, is as follows:

CMS does not discriminate in its programs and activities. To request this publication in an alternativeformat, please call: 1-800-MEDICARE or email: AltFormatRequest@cms.hhs.gov.

The HHCCN is used to notify beneficiaries of plan-of-care changes under fee-for-service or original Medicare.Home health agencies must provide the HHCCN whenever they plan to reduce or terminate a beneficiary’shome health services due to a physician ordered change in the plan of care, a lack of orders to continue the care,or limitation of the HHA in providing the specific service (i.e. staffing shortages or safety concerns in abeneficiary’s home).

The current HHCCN and accompanying instructions are athttps://www.cms.gov/Medicare/Medicare-General-Information/BNI/HHCCN.html.

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The HHCCN differs from the Advance Beneficiary Notice of Noncoverage (ABN). This form is given toindividuals prior to providing an item or service that is usually paid for by Medicare but may not be paid forin this particular case because:

• It is not considered medically reasonable and necessary;• The care is custodial;• The individual is not confined to the home; or• The individual does not need intermittent skilled nursing care.

Information on the ABN is at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.html.

CMS to Host Home Health Open Door Forum: November 4

The U.S. Centers for Medicare and Medicaid Services (CMS) will host the next Home Health and HospiceOpen Door Forum on Wednesday, November 4, 2015 from 2-3 p.m. Agenda items include:

• The 2016 Home Health Prospective Payment System Rate Update; Home Health Value-BasedPurchasing Model; and Home Health Quality Reporting Requirements.

• Prevention of ICD-10 Formatting Issues in ASIS.

• October and January Star Ratings and Individual Measure Preview Reports.

• Hospice Quality Reporting Program Updates: New Reports and Training Modules.

• IMPACT Website.

The dial-in and passcode is:

• Dial-In: 1-800-837-1935

• Passcode: 8112871

CMS recommends that participants call in 10 to 15 minutes before the scheduled 2 p.m. start time.

HCA members can submit question to CMS prior to the call atHomehealth_Hospice_DME_ODF-L@cms.hhs.gov.

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

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Workers’ Compensation Assessment Rate Announced for 2016

The Workers’ Compensation Board has announced the assessment rate for all employers, effective January1, 2016, to be 12.9 percent of the standard premium or premium equivalent.

The new rate shall be effective for policies renewing on or after January 1, 2016 and represents a decreasefrom the 2015 rate of 13.2 percent.

Any questions can be directed to the Workers’ Compensation Board at WCBFinanceOffice@wcb.ny.gov.

Nonprofit Infrastructure Capital Investment Program RFA Released

This week, the state released a Request for Applications (RFA) for the Nonprofit Infrastructure CapitalInvestment Program (NICIP).

The program – included in the 2015-16 final state budget – was created, according to the RFA, to supportthe work of the state’s nonprofit partners, including home care agencies.

The RFA is at http://hca-nys.org/wp-content/uploads/2015/10/NonprofitInfrastructureCapitalInvestment.pdf.

The program will make targeted investments throughout the state in capital projects that will improve ormaintain the quality, efficiency, accessibility, and reach of nonprofit human services organizations that providedirect services to New Yorkers through state contracts, state-authorized payments, and/or state paymentrates.

The NICIP grant will fund capital projects in the following areas:

• Technology upgrades that improve electronic records, data analysis, or confidentiality;

• Renovations or expansions of space used for direct program services;

• Modifications to make spaces more sustainable and energy efficient resulting in overall cost andenergy savings; and

• Accessibility renovations.

A total of $50 million is available; of that amount, $30 million will be reserved for projects that involveconstruction (renovations or expansions of program space, accessibility renovations, or energy efficiencymodifications); and $10 million will be reserved for projects related to technology. The remaining $10 millionof the available funding will be placed into a “base pool” to fund projects from either category.

NCIP will be administered by the Dormitory Authority of the State of New York (DASNY). The amount offunding available to applicants depends on the applicant’s annual revenue, as reported on the IRS form 990,and the type of project they are proposing.

Grants will range from a minimum of $50,000 to a maximum of $1 million for larger nonprofit humanservices organizations.

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Eligibility requirements are further spelled out in the RFA athttp://hca-nys.org/wp-content/uploads/2015/10/NonprofitInfrastructureCapitalInvestment.pdf.

The due date, using the Grants Gateway, is by 4 p.m. on December 23, 2015.

All questions must be e-mailed to the RFA Coordinator by 4 p.m. on November 10, 2015. Answers to allquestions of a substantive nature will be posted to the DASNY website (www.dasny.org) by December 2, 2015.

There will not be a Bidder’s Conference for this RFA.

Provider Training Available on NYMMIS

The state Department of Health (DOH) and Xerox Healthcare, LLC, announced that training opportunitiesare now available for the new New York State Medicaid Management Information System (NYMMIS).

The interim website, www.interimnymmis.com, is a source for the most current information on NYMMIS.The current schedule of training sessions is available under the Training and Events Calendar link on thewebsite.

Current training sessions include:

• Introduction to NYMMIS – a course for first-time users with a focus on understanding the basicsystem elements and how they work

• NYMMIS Features and Functionality – a course to learn the basic features and functionality ofNYMMIS.

• Introduction to Provider Enrollment (for new provider enrollments only) – learn how to use theNYMMIS to complete an electronic enrollment.

• Enterprise Login and Navigation – external users will be shown how to login and navigate the MMIS.

To sign up for training on the new system, send registration requests toUSA.all.nymmis.training.inquiries@xerox.com with the following information: attendee name, organization,e-mail address, phone number, requested date, time, and location. Classroom sizes are limited and will beconfirmed on a first-come, first-served basis.

In addition, to stay up-to-date on future announcements as well as additional training sessions and topics, youcan sign up for the ListServ on the above interim site.

In April of this year, DOH announced that Xerox State Healthcare, LLC was awarded a five-year contract toimplement and administer a new MMIS

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Rule Issued on Ensuring Access to Covered Services for Medicaid Beneficiaries

This week, the U.S. Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment periodto “strengthen access to essential health care services for Medicaid.”

The rule can be viewed at https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-27697.pdf.It will be available at this link until it is published in the Federal Register on November 2.

According to CMS, the goals of the final rule include: 1) measuring and linking beneficiaries’ needs and utilizationof services with availability of care and providers; 2) increasing beneficiaries’ involvement through multiplefeedback mechanisms; and 3) increasing stakeholder, provider, and beneficiary engagement when consideringproposed changes to Medicaid fee-for-service payment rates that could potentially impact beneficiaries’ ability toobtain care.

The final rule requires states to develop an access review plan that sets out the data elements and other informationto be used to ensure beneficiary access to mandatory and optional services. States must also establish newprocedures to review the effects on beneficiary access of proposed rate reductions and payment restructuring,and they must implement ongoing access monitoring reviews of key services, and additional services as warranted.

The final rule also strengthens CMS’s ability to review and ensure Medicaid payment rates are consistent withefficiency, economy and quality of care.

The final rule becomes effective on January 4, 2016, at which time states must meet the requirements establishedthrough the provisions of the rule. During the 60-day period, CMS will accept comments from the public on theaccess review requirements.

In conjunction, CMS has released a request for information (RFI) to solicit comments on additional approachesfor better compliance with Medicaid access requirements. This includes comments on the potential developmentof standardized core set measures of access, access measures for long-term care and home and community basedservices, national access-to-care thresholds, and resolution processes that beneficiaries could use. CMS willaccept responses to the request for information through January 4, 2016.

More information on the RFI is at https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-27696.pdf.

Publications

• “Leveling the Playing Field: Improving Technology Access and Design for People with IntellectualDisabilities,” by the President’s Committee for People with Intellectual Disabilitieshttp://www.acl.gov/programs/aidd/Programs/PCPID/docs/PCPID-2015-Report-to-President.pdf

• · “Medicaid Expenditures for Long-Term Services and Supports (LTSS) in FY 2013,” by Truven HealthAnalyticshttp://www.nasuad.org/sites/nasuad/files/LTSS%20Expenditure%20Report%202013.pdf

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

November 17 & 18, 2015

Hilton Garden Inn

235 Hoosick Street

Troy, NY 12180

The Quality Imperative: Raising the Bar in Home Health Care

Register Online at www.eventville.com/hcanys

November 17 & 18, 2015 Hilton Garden Inn

235 Hoosick Street Troy, NY 12180

Quality outcomes have always driven your work in home care. But today’s environment is making quality deliverables a more commanding imperative, and a linchpin for the success of your agency. CAHPS surveys, Home Health Compare, HQRP, OASIS … in many respects, these are the first legacy of quality improvement leverage points. They remain important concerns. But today, home care is faced with new and even bigger machinery for inducing quality enhancement that demand an equally vigorous response from CHHAs, LTHHCPs, and LHCSAs alike. All home care providers must focus their energies, resources and intellectual capital to understand and retool their organizations for the new quality imperative. HCA’s Quality Symposium presents an opportunity to learn the broad strokes and inner workings of New York State’s quality home care imperative. You’ll hear about concrete tools, resources and information that will arm agencies to effectively compete in this environment. You’ll also learn about interventions for specific clinical areas that align with the demands of MLTC, DSRIP, Value Based Payments and other new care models.

AGENDA Tuesday, November 17 – Day 1

8:30am Registration Opens with Light Breakfast

9:00am HCA Welcome

9:00 – 10:00am State Update on Quality & Payment Innovation Patrick Roohan, Director, Office of Quality and Patient Safety, NYS Department of Health

Hear from one of New York State’s most influential and thoughtful policymakers about the plans and vision of the State in designing state policy to encourage and promote quality health care. Mr. Roohan will discuss the State’s vision for quality innovation and improvement through policy changes that will affect how all health care providers (including home care) participate in the Medicaid marketplace.

10:00 – 10:45am HCA Quality Risk Tool Laurie Neander, Chief Executive Officer, Bassett Healthcare Network: At Home Care Al Cardillo, Executive Vice President, HCA

HCA, working with key home care leaders across New York State, has formulated and developed a quality of care risk tool that is currently in the RFP stages of development. This session will offer a look at this unique HCA quality risk tool that will be available to members in 2016. It will arm agencies with a thorough, methodical tool to measure risk areas in clinical, financial and operational quality oversight.

10:45 – 11:00am Break

The Quality Imperative: Raising the Bar in Home Health Care

Thanks to our Exhibitors:

11:00am – Noon Wound Care: There’s an App for that Nathan Ie, CEO, Co-Founder, Parable Lorraine Poliey RN, WCC, DAPWCA, Wound Care Program Manager, Montefiore Home Care This session will offer insights on a new App designed to help providers reduce the cost of and challenges associated with wound care. Parable (f/k/a Healogram) enables providers to more effectively and efficiently measure, monitor, and manage wound patients. Parable co-founder Nathan Ie and wound care program manager Lorraine Poliey, RN of Montefiore Home Care will outline details on Parable’s functionality and share practical insights on ease of implementation, impact on care delivery and potential for enhanced patient outcomes.

Noon – 12:45pm Lunch

12:45 – 1:45pm Quality Innovation in Managed Care and Home Care Tracy Langlais, Vice President, Medical Affairs Operations, CDPHP As New York’s health care system evolves, health plans including MCOs feel enormous pressure to meet the highest quality outcomes and benchmarks. Aligning home care’s emphasis and priorities on quality innovations and outcomes with the benchmarks that are of utmost importance to managed care plans can lower cost and improve care for patients. Learn from one of the state’s most innovative managed care plans about its priorities for quality innovation and alignment with home care partners.

1:45 – 2:45pm The Quality Compliance Connection Matthew Babcock, Assistant Medicaid Inspector General for Compliance, Office of the Medicaid Inspector General The aim of healthcare reform is to move from a fragmented healthcare delivery system to a lower cost and more efficient integrated model with better patient outcomes. Hear from one of the OMIG’s most knowledgeable health system compliance experts about how home care providers can structure their quality programs to meet the needs of an integrated system, while assuring compliance in an evolving system.

2:45 – 3:00pm Break

3:00 – 4:30pm CMS Star Rating System and NYS Home Care Quality Indicators Sara Butterfield, RN, BSN, CPHQ, CCM, Director, Upstate Health Care Quality Improvement, IPRO

Learn from one of New York State’s most knowledgeable quality innovation experts about the impact the Star Rating System has had on New York’s home care provider community, and steps that can be taken by agencies to improve their scores.

4:30 pm Wrap Up and Adjourn Day 1

November 17 & 18, 2015 Hilton Garden Inn

235 Hoosick Street Troy, NY 12180

The Quality Imperative: Raising the Bar in Home Health Care

Tuesday, November 17 – Day 1 - continued

Hotel Information Hilton Garden Inn 235 Hoosick Street Troy, NY 12180 HCA has reserved a limited block of rooms at

the rate of $129 per

night. To make a reservation for the evening of Monday, November 16 or Tuesday, November 17, please call (877) 782-9444 before November 2, and ask for the HCA Quality Symposium group rate.

Day 2 Agenda continued on next page…

The Quality Imperative: Raising the Bar in Home Health Care

Wednesday, November 18 – Day 2

8:00am Registration and Light Breakfast 8:30-10:00am Quality Care Values in Contracted Home Health Care Services

Marki Flannery, Executive Vice President and Chief of Provider Operations, Visiting Nurse Service of New York Maureen Forster, Empire Blue Cross Blue Shield Health Plus

This session will offer insights, tools, and innovative program models for enhancing the quality of your home health care services in areas valued by health plans and contracting agencies. Learn from health plan and contracting agency representatives about their current quality initiatives and the quality related indicators/ measures they are seeking in an optimal contracted Licensed Home Care Service Agency to inform your strategic planning toward sustainability and growth in an increasingly competitive service delivery environment. Attendees will have an opportunity for questions and answers with panelists.

10am – 10:15am Break

10:15am – 11am Quality Care Innovations in LHCSA Delivery James P. Rolla, Vice President, People Care, Inc. Michelle Mazzacco, Vice President/Director, Eddy Visiting Nurse Association/St. Peter’s Health Partners

An executive panel from agencies providing licensed home care services will outline their quality care innovation efforts and provide guidance, tools and tips for planning and implementing quality initiatives. Attendees will have an opportunity for question and answers with panelists.

11:00am – Noon Common Areas of Quality Risk (and Remedy) Identified in Surveillance

Rebecca Fuller Gray, Director, Division of Home and Community Based Services, NYS Department of Health (Invited)

This session will provide invaluable insights from the state surveillance of home care agencies and proactive opportunity for quality promotion/risk mitigation from the State’s Director for home care services. In this presentation, Ms. Fuller-Gray will examine areas of quality risk and/or deficiency identified in DOH surveys and present recommendations for remedy, and most importantly, prevention/mitigation of these risk areas and overall quality promotion.

Noon Wrap Up and Adjourn

REGISTRATION FORM Registration Deadline is November 2.

Name: _____________________________________________ Title:_______________________________________________ Agency:____________________________________________ Address:____________________________________________ City/State/Zip:_______________________________________ Phone:_____________________________ Ext._____________ Email: ______________________________________________ (Required)

Full Symposium (Nov 17 & 18)

HCA Member Rate Per Person $259 □

HCA Member Group Rate (3 or more) $239 □

Non-Member Rate $339 □ November 17 Only

HCA Member Rate $199 □

Non-Member Rate $279 □ November 18 Only

HCA Member Rate $ 89 □

Non-Member Rate $159 □

TOTAL: $___________

PAYMENT Please check method of payment: (Checks must be received by date of program).

____MC ____VISA ____ AM EXP ____ Check*

*Make checks payable to : HCA Education and Research and mail to: 388 Broadway, 4th Floor, Albany, NY 12207

Credit Card #: _________________________________

Exp. Date:______________ Security Code: _________ ______________________________________________Name and/or Company Name on Card

______________________________________________ Billing Address of card (including City, State and Zip Code)

______________________________________________Authorized Signature

Cancellations received in writing via email to info@hcanys.org by November 2, are refundable less a 25% administrative fee. No refunds after this date or for no shows. Substitutions are permitted.

Please fax to: (518) 426-8788

FEE SCHEDULE

November 17 & 18, 2015 Hilton Garden Inn

235 Hoosick Street Troy, NY 12180

Register Online at

www.eventville.com/hcanys

Thanks to our Exhibitors: