Also in this week`s HCP Insider... - New York State Association of

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Also in this week`s HCP Insider... - New York State Association of
November 1, 2013 13-42
HCP Advocacy Underway to Fund Next Level of Wage Parity
and Home Care Costs
2
Flu Vaccination Report Opens on HCS with November 15
Submission Deadline; Training Webinar Available
4
DOH Offers MLTC Implementation Update, Revises MLTC
Policies and CMAS Contract Documents
5
Also in this week’s HCP Insider...
HCP Congratulates Newly Elected Officers........ 3
CHC Call for Candidates.................................. 3
Upcoming HCP Chapter Meetings..................... 4
DOL Hosts Webinar on Changes to FLSA,
Companionship Exemption.............................. 5
MLN Matters.................................................. 6
Olmstead Cabinet Releases Report on Findings.... 7
HCP Unveils Managed Care Resource Guide at
HCP Conference............................................. 8
Don’t Miss the Nov. 5 New York Post ‘Health
at Home’ Special Section................................ 8
HCP’s Annual Conference, Adjusting the Sails,
Draws Providers from Across New York State... 9
Public Policy Sessions Offer Managed Care and
Health Benefit Exchange Update.................... 12
Adjusting the Sails Photo Gallery.................... 13
Governor Signs Legislation Requiring DOH
Oversight of Individuals Transitioning to MLTC... 15
DOH Issues DAL Clarifying Comprehensive
Assessment Requirements for CHHAs/LTHHCPs...15
October Medicaid Update Offers Additional
Details on ICD-10 Transition.......................... 16
Medicaid Spending Remains Under Global
Cap as of August......................................... 18
NYS Identifies $496M in Home Health Medicaid
Error Payments; OMIG Recovers $211M
from Feds.................................................... 19
Heroes in the Home™ Honored at HCP Annual
Conference.................................................. 20
Recognize Your Workers During National Home
Care & Hospice Month.................................. 20
OSHA’s Updated Hazard Communication Rule
Training Deadline is December 1.................... 21
HCP Participates in National Home Care &
Hospice Lobby Day, Advocates on Proposed
Changes to the 2014 HH PPS and F2F
Mandate...................................................... 21
Contributors
Christy Johnston, President, ext. 813 Megan Tangjerd, Senior Associate for Public Policy, ext. 818
Claudia Hammar, Senior Vice President, ext. 809
johnston@nyshcp.org
tangjerd@nyshcp.org
hammar@nyshcp.org
HCP, 20 Corporate Woods Blvd, 2nd Floor, Albany, NY 12211
(P) 518.463.1118 (F) 518.463.1606 www.nyshcp.org
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HCP Advocacy Underway to Fund Next Level of Wage Parity and Home
Care Costs
In anticipation of the announcement of the third home care wage parity increase for New York City and
the second for Nassau, Suffolk and Westchester counties, which will go into effect March 1, 2014, HCP
has been meeting and speaking with the Administration, New York State Department of Health, legislators
and their staff and other stakeholders since this summer and throughout the fall. The manner in which the
third year increase for New York City is calculated creates even greater financial pressure and implications
for providers, payers and the State of New York than prior years. HCP has been stressing the urgency of
ensuring that these increases are adequately funded.
HCP is also joining other groups to increase the voice and pressure to ensure that home care providers
throughout New York State have the cash flow and predictable, adequate payments in the new managed
care environment and ongoing fee-for-service reimbursement to meet the financial pressure associated with
unfunded wage and benefit mandates including wage parity, living wage, minimum wage and overtime
increases and insurance mandates related to the Affordable Care Act (ACA).
DOH Issues Home Care Worker Wage Parity Letters for NYC, Nassau, Suffolk and Westchester
The New York State Department of Health (DOH) posted on November 1, 2013, official notice of Home
Care Worker Wage Parity Minimum Rates of Total Compensation for both New York City and Nassau,
Suffolk and Westchester counties, for the period March 1, 2014 through February 28, 2015. The letters,
dated October 31, 2013, are available on the Department’s website at http://www.health.ny.gov/health_
care/medicaid/redesign/mrt_61.htm.
The letters, which are addressed from New York State Medicaid Director Jason Helgerson, indicate the
following wage parity requirements:
• New York City: For the period of March 1, 2014 and beyond, the minimum rate home care
aide total compensation will be $14.09, consisting of a base wage of at least $10.00 per hour,
additional wages of up to $1.69 per hour, and supplemental (benefit) wages of up to $2.40 per
hour. Overtime is not included in the above rates, and must be paid as required pursuant to State
and Federal Law.
• Nassau, Suffolk and Westchester: For the period of March 1, 2014 to February 28, 2015, the
minimum rate home care aide total compensation will be $10.93, consisting of a base wage of at
least $9.50 per hour and supplemental (benefit) wages of up to $1.43 per hour, plus overtime.
The HCP Insider is published weekly for the sole benefit of HCP members. Copyright © 2013 New York State Association of Health Care Providers, Inc.
All rights reserved. No part of this document may be reproduced without written permission from the publisher.
The HCP Insider • New York State Association of Health Care Providers, Inc. • 20 Corporate Woods Blvd., 2nd Floor • Albany, NY 12211 • 518.463.1118 • hcp@nyshcp.org
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Both notices include a document outlining what is included
in the rates for the upcoming wage parity compliance
period, including an overview of overtime rates for both
Federal Fair Labor Standards Act (FLSA) exempt employees
and all others (based on base rate assumptions and the
increase in minimum wage for the coming year).
HCP Congratulates Newly
Elected Officers
The document further specifies how providers can
satisfy the “Total Compensation” rate, and applicable
limitations. For Nassau, Suffolk and Westchester, this can
be achieved through wages, or through a combination
of wages and supplemental wages. For New York City,
“Total Compensation” can be satisfied through wages, or
through a combination of wages, additional wages and
supplemental wages.
Base wage is defined as “the minimum amount of the Total
Compensation that must be paid directly to workers as
regular hourly wages for all hours worked.”
Supplemental wages are defined as “the maximum amount
of Total Compensation that employers may satisfy indirectly,
for example, by providing health insurance required by Federal
law.”
Additional wages (for New York City) are defined as the
“amount of the Total Compensation that employers may
satisfy through additional payments directly to workers for
hours not worked and for differentials and premiums other than
overtime. Examples include paid leave (vacation, holiday, sick
and personal days) and differentials or premiums for certain
shifts (nights, weekends and holidays) or assignments (sleepin or live-in work, care for multiple clients during the same
shift). Additional wages do not include overtime compensation
required under FLSA or State minimum wage orders or
extra compensation creditable toward required overtime
compensation for hours worked in excess of normal, regular or
maximum daily or weekly hours.”
The change in the New York City wage parity rate represents
a substantial increase for home care providers that are already
struggling to meet the current wage parity rate of $10.93
($9.50 per hour, plus $1.43 supplemental benefit rate). Rates
now stand to increase by $3.16 per hour in the region, an
amount which will put providers in even more financial distress
and further risk their ability to continue providing quality
services and cover weekly payroll obligations.
• Mary Winters, RegionCare, Inc.,
Executive Vice Chairperson
• Annette Horvath, All Metro Health
Care, Vice Chairperson, LHCSA
• Richard Schaefer, Better Home
Health Care, Secretary
All positions are 2 year terms
11/1/2013 – 10/31/2015
CHC Call for Candidates!
The Board of Directors of Community
Health Care Services Foundation
(CHC) is seeking interested candidates
for Board positions that will be
available effective January 1, 2014.
An affiliate of HCP, CHC solicits
grants and projects that benefit the
home care industry and manages all
educational programming for HCP.
Throughout the year CHC provides a
wide variety of timely programs in the
areas of management/clinical, legal,
regulatory, paraprofessional training
and more. A position on the CHC
Board is a great opportunity to get
involved and play an important role in
CHC’s activities. If you are interested,
please contact Jill Counihan for more
information at 518.463.1118 ext
806, or counihan@nyshcp.org.
Moving ahead, and in preparation for the 2014 Legislative Session, HCP will continue to explore various
avenues to help providers manage as this unfunded mandate expands and increases, and will continue
to communicate the danger an unfunded rate increase of this magnitude will have on an industry that
is already in the midst of massive transition. Particularly at a time when many providers are struggling
every day to secure timely and adequate reimbursement from the managed care plans they are contracted
with, as well as comply with other burdensome and costly unfunded mandates and regulations. HCP will
continue to press for financial support for providers to help alleviate the fiscal pressure they are facing.
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HCP members should watch for Action Alerts in the
coming weeks to ensure that State Legislators are
aware of these changes and prepared to fight to
support home care in the coming year.
Questions should be directed to HCWorkerParity@
health.state.ny.us. Members may also contact HCP
Public Policy staff with questions.
Flu Vaccination Report Opens on
HCS with November 15 Submission
Deadline; Training Webinar
Available
Beginning today, November 1, providers may access
the Health Care Personnel Influenza Vaccination
Report through the Health Electronic Response Data
System (HERDS) on the Health Commerce System
(HCS) at https://commerce.health.state.ny.us/.
Upcoming
HCP Chapter
Meetings
Long Island Chapter
Wednesday, November 6, 2013, 8:30 am
Hofstra University Club, Uniondale, NY
Sponsored by: Brinster & Bergman
$25 pp breakfast charge
Contact: Rick Schaefer, Better Home Health
Care Agency, Inc., rick@betterhomecare.com
Western New York Chapter
Thursday, November 21, 2013, 9:00 am
The Red Cross Training Building,
Delaware Avenue, Buffalo, NY
Contact: Alice Riggs, HEALTH FORCE,
716.855.2273
In accordance with the State’s new flu mask
regulation that became effective July 31, 2013,
health care providers/facilities that are licensed
or certified under Article 28, 36 and 40 of the
Public Health Law are required to document the number of personnel they employ that are vaccinated/
unvaccinated against influenza. Personnel that are unvaccinated will be required to wear a surgical or
protective mask when in direct contact with patients during times the Commissioner of Health deems
influenza to be “prevalent.”
Providers have until November 15 to complete the report on the HCS. A second report is expected to be
released before the end of the 2013-14 influenza season.
In order to complete the report, an individual must have an HCS account, and one of the following
HCS roles: HERDS Data Reporter/Data Reporter/Nursing Home Data Reporter; Administrator; Director,
Nursing; HPN Coordinator; Infection Control Practitioner; Medical Director. If you do not yet have an
HCS account, then you will need to register for an account at https://apps.health.ny.gov/pub/usertop.
html. Follow the steps in the “Quick Reference Guide” for more information.
To assist providers in completing the report, the Department of Health (DOH) has released a series of
frequently asked questions (FAQs) and an instructions guide on its website, http://www.health.ny.gov/
diseases/communicable/influenza/seasonal/providers/prevention_of_influenza_transmission/, which were
recently updated (HCP Insider, 10/18/13).
DOH Posts Flu Vaccination Report Training Webinar
The Department has also made available a training webinar to assist providers in preparing for and
completing the first Health Care Personnel Influenza Vaccination Report. It offers an overview of the new
regulation, associated reporting requirements, how to complete the report, and also reviews a number of
FAQs. The hour-long, pre-recorded webinar may be accessed at https://nysdoh.webex.com/nysdoh/lsr.
php?AT=pb&SP=TC&rID=65254202&act=pb&rKey=1717a277e87d173f. The PowerPoint slides are
available at http://www.nyshcp.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=9776.
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HCP members are strongly encouraged to view the
training webinar for further details and information.
Questions on the report should be directed to
DOH’s Bureau of Immunization at 518.473.4437 or
immunize@health.state.ny.us. Questions about the
HCS should be directed to 518.473.1809 or
hcsoutreach@health.state.ny.us. Questions about the
flu mask regulation should be directed to
flumaskreg@health.state.ny.us. Members may also
contact a member of HCP’s Public Policy staff.
DOH Offers MLTC Implementation
Update, Revises MLTC Policies and
CMAS Contract Documents
The New York State Department of Health (DOH)
last week provided a series of updates on the
mandatory managed long term care (MLTC) transition
during an implementation conference call hosted
by Director of Long Term Care, Mark Kissinger.
The Department also released three MLTC policy
revisions pertaining to the definition of CommunityBased Long Term Care (CBLTC) services, guidance on
Care Management Administrative Services (CMAS)
agreements, and the provision of Durable Medical
Equipment (DME) supplies through pharmacies, and
posted updated CMAS contract documents.
MLTC Implementation Conference Call
DOL Hosts Webinar on Changes to FLSA,
Companionship Exemption
The United States Department of Labor (DOL),
Wage and Hour Division, this week hosted a
webinar for home care agencies on the Final
Rule, issued Tuesday, September 17, 2013,
which makes changes to the longstanding
companionship services exemption under the
Fair Labor Standards Act (FLSA), effective
January 1, 2015.
The hour-and-a-half long webinar provided
an overview of the changes made to FLSA,
the Federal law that requires employers to
pay employees minimum wage and overtime.
Specifically, the webinar reviewed the updates
made to the FLSA exemptions applicable to
companionship services and live-in domestic
service employees. For more information on
these changes and their applicability to home
care providers in New York State, see the
September 20 edition of the HCP Insider.
To view the detailed PowerPoint presentation
from the webinar, please click here. The DOL
has indicated that the presentation, along with
the transcript and audio from the webinar, will
be posted on its website at http://www.dol.
gov/whd/homecare after the last FLSA webinar
takes place on November 14. The website also
includes many helpful resources for employers,
workers and individuals and families.
Key updates provided on last week’s conference call
include the following:
• Effective September 23 in Rockland and Orange counties, the Department “shut the door” to dual
eligibles in need of home and community-based services for 120 days or more. These individuals
are now required to enroll in a MLTC plan in order to receive these services.
• The start of the mandatory transition in Albany, Erie, Monroe and Onondaga counties remains
on track for December 1, 2013; however, the State has yet to receive final approval from the
Centers for Medicare & Medicaid Services (CMS). Kissinger noted that DOH has been involved
in conversations with MLTCs in operation in these areas to help ensure they are appropriately
prepared for the transition to commence.
• The Department has posted revised CMAS contract documents to its website, including updated
guidance and Question and Answer (Q&A) documents (see further details below).
• Kissinger reminded MLTC plans that October 24 was the deadline for plans to review their
contracts with social day care programs and determine the appropriateness of their contracts with
these entities. Plans are required to send an updated list of social day care program contractors to
the Department.
• MLTC plans with more than 10,000 enrollees were informed that they will be receiving a notice
from the Department directing them to submit a fraud and abuse plan.
• The Department will soon be issuing directions to MLTC plans on their quarterly reporting
requirements.
• Three new MLTC plans have been approved by the State, including Hamaspik Choice, Montefiore
HMO, LLC and North Shore Long Island Jewish Health Plan.
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The date of the next MLTC implementation conference call
has not been confirmed. HCP will keep members updated
on any MLTC-related developments in the meantime.
DOH MLTC Policy Revisions
MLTC Policy 13.03-CBLTC Definition
The update to policy 13.03 further clarifies the definition
of CBLTC services. Specifically, policy 13.03(a) specifies
that DOH-issued MLTC policies are directed, as applicable,
to all three types of MLTC plans operating under the
authority of Article 4403-f. It further indicates that these
plans must abide by the current CBLTC definition:
Consumers must demonstrate need for CBLTC
Services for more than 120 days, and these
services are defined as: Nursing Services in the
Home, Home Health Care (which is further defined
as traditional Certified Home Health Agency (CHHA) services such as therapies or home health aide
service in the home), Personal Care Services in
the home (excluding Level 1), Consumer Directed
Personal Assistance Services, Adult Day Health
Care (ADHC), and Private Duty Nursing.
MLN Matters
New:
MM8444 – Home Health - Clarification
to Benefit Policy Manual Language on
“Confined to the Home” Definition
http://www.cms.gov/Outreach-andEducation/Medicare-Learning-NetworkMLN/MLNMattersArticles/downloads/
MM8444.pdf
SE1336 – 2013-2014 Influenza (Flu)
Resources for Health Care Professionals
http://www.cms.gov/Outreach-andEducation/Medicare-Learning-NetworkMLN/MLNMattersArticles/Downloads/
SE1336.pdf
Revised:
MM8039 – Enrollment Denials When
Overpayment Exists
http://www.cms.gov/Outreach-andEducation/Medicare-Learning-NetworkMLN/MLNMattersArticles/Downloads/
MM8039.pdf
The policy further emphasizes that the need for 120 days
or more of CBLTC services is a baseline requirement for
enrollment in a Partially-Capitated MLTC plan; Nursing Home Level of Care is an additional condition of
enrollment required for enrollment in both PACE and MAP plans.
The revised MLTC policy can be found at http://www.health.ny.gov/health_care/medicaid/redesign/docs/
mltc_policy_13-03a.pdf.
MLTC Policy 13.17-CMAS Agreement Guidance
Revisions to MLTC policy 13.17 reiterate the protocols that must be met by each MLTC plan, and the
key standards that must be addressed in each CMAS agreement submitted to DOH.
The original 13.17, which is available at http://www.health.ny.gov/health_care/medicaid/redesign/
docs/policy_13_17_cmas_agree_guide.pdf, lists 20 standards which must be included in each CMAS
agreement. The revised policy reiterates and clarifies nine of the 20 standards, including:
•
•
•
•
•
•
Timelines and documentation requirements for care management visits and phone contact;
Identified methods of enrollee education;
Minimum required response time for enrollees/member contacts;
Ratio of care managers to enrollees;
Minimum employment qualifications for care managers; and
Ensuring the level and degree of care management and the Plan of Care address the needs of the
enrollee.
The revised policy states that all MLTC plans, regardless of whether the plan provides care management
services directly or contracts with another entity to do so, must either submit an attestation to
compliance or a redlined copy of the agreement addressing any changes to the protocols within 60 days
of October 18.
DOH also released additional guidance on the submitting of CMAS agreements. Effective immediately,
these agreements must provide sufficient detail to accurately reflect each unique administrator-to-MLTC
plan relationship (templates are no longer allowed). Contracts and/or material amendments to contracts
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that were submitted prior to issuance of the above
stated guidelines and those previously detailed in
13.17, must be amended to comply with these
guidelines no later than December 31, 2013. The
updated CMAS contracts should specifically address:
(i.) which entity is responsible for completing
assessments and reassessments; (ii.) which
entity is providing 24/7 access to care
management staff; (iii.) the requirements and
process for Administrator to prepare and
submit reports to the MCO; and (iv.)
standards for adherence to MCO’s Care
Management Protocols, and MCO evaluation
of Administrator performance.
If a compliant CMAS agreement has already been
submitted, regardless of whether or not it is a
template, and meets the revised requirements,
no amendment is required; however, the plan
must submit an attestation of compliance to the
Department, subject to sanction.
For a more detailed overview of the CMAS
agreement protocols required for MLTC plans,
the full policy is available at http://www.health.
ny.gov/health_care/medicaid/redesign/docs/mltc_
policy_13_17.pdf. Additionally, DOH has published
a Q&A fact sheet regarding this update, which can
be found at http://www.health.ny.gov/health_care/
medicaid/redesign/docs/mltc_policy_13_17a.pdf.
MLTC Policy 13.20-Provision of DME Supplies
through Pharmacy
Olmstead Cabinet Releases Report on
Findings
In November 2012, Governor Cuomo created
the Olmstead Development and Implementation
Cabinet (Olmstead Cabinet) to develop a plan
for compliance with the decision of Olmstead v.
L.C.. The cabinet met with over 160 stakeholder
organizations and received over 100 position
papers over the course of nearly a year. The
results of the Olmstead Cabinet’s work are
contained in a recently issued report.
The report identifies specific actions State
agencies are responsible for taking when providing
services to people with disabilities and what it will
take to serve people with disabilities in the most
integrated setting, including:
• Assisting in transitioning people with
disabilities out of segregated settings and
into community settings;
• Changing the way New York assesses and
measures Olmstead performance;
• Enhance the integration of people in their
communities; and
• Assuring accountability for serving people in
the most integrated setting.
The report in its entirety can be found at http://
www.governor.ny.gov/assets/documents/
olmstead-cabinet-report101013.pdf.
Policy 13.20 previously directed MLTC plans
to contract with pharmacies to provide DME to MLTC plan enrollees. These contracts were necessary
to avoid inappropriate fee-for-service billing that was occurring outside of the capitated rate structure.
However, recent feedback from MLTC plans has indicated problems with establishing the contracts with
pharmacies by the DOH-instituted November 1 deadline. As such, the revised policy removes this deadline,
but directs plans to continue to work on establishing the needed contracts without a deadline. The policy
may be accessed at http://www.health.ny.gov/health_care/medicaid/redesign/docs/mltc_policy_13-20_
revised.pdf.
DOH Updates CMAS Agreement Documents
In November 2012, DOH released a set of three documents to help MLTC plans establish CMAS
Agreements with provider entities. To reflect the changes in updated MLTC policy 13.17 (see above),
these three documents have been updated accordingly. Specifically, the updated documents require more
information on the requirements of a care manager, what protocols must be met by MLTC plans, and the
requirements that must be met for agreement submittal. The three documents may be accessed by clicking
on the respective title below.
• CMAS Contract Statement and Certification
• Standard Clauses for CMAS Contracts
• CMAS Contract Guidelines for MLTC Plans
Please direct any questions to HCP Public Policy staff.
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HCP Unveils Managed Care
Resource Guide at HCP’s 2013
Annual Management Conference &
Exhibition
During last week’s 2013 HCP Annual Management
Conference & Exhibition, Adjusting the Sails, HCP
Public Policy staff announced the development of a
new resource guide to assist HCP members as they
work to adjust to the new managed care paradigm.
The HCP Managed Care Resource Guide constitutes
one element of HCP’s strategy to support members
undergoing the transition to managed care by
streamlining the massive amounts of information
available and packaging it in user-friendly ways that
make it easier for providers to identify what they
need to know in a timely manner.
In the summer of 2011, prior to the commencement
of the managed care transition, HCP Public Policy
staff developed a Managed Care Primer, which
included overviews of Medicaid managed care
(MMC), managed long term care (MLTC), the
contracting process, wage parity, and more. Much
has changed since then, and while there are still
many things that remain a mystery with regard to the
transition, there is much more that is known now than
Don’t Miss the November 5 New York Post
‘Health at Home’ Special Section!
The upcoming New York Post ‘Health at Home’
Special Section is out November 5, just in time
for National Home Care, Hospice Awareness and
National Family Caregivers Month (see related
article on page 20).
HCP is proud to have once again partnered
with the New York Post to publish the ninth
installment of this popular section. Offering
a broad range of perspectives, each edition
helps raise the visibility and awareness of home
care by highlighting the value of home and
community-based care services, and sharing the
stories of consumers, their families, and home
care workers.
Don’t forget to pick up your own copy of the
New York Post on Tuesday, November 5!
Additional information and past ‘Health at Home’
sections are available at http://nyshcp.org/
content.aspx?id=4554.
two years ago.
Similar to the Managed Care Primer, the new Resource Guide offers general background and introductory
information on the Medicaid Redesign Team (MRT) initiatives established prior to the 2011-12 State
Budget, most notably the transitions to MMC and MLTC. New components include overviews of the key
issues and challenges providers have faced since the transition began—as well as HCP’s strategies and
endeavors to help its members successfully adapt to the State’s new health care delivery environment.
Alongside the general overviews provided on different components of the managed care transition, HCP
has included direct links to key resources that may be difficult for providers to identify quickly on the
Department of Health’s (DOH) website. For instance, Department-issued MMC guidelines documents, as
well as the various MLTC plan model contracts are easily accessible through links in the Resource Guide.
What is particularly helpful in the Resource Guide is that, in addition to linking members directly to DOHdeveloped documents, HCP has developed a series of more in-depth supplementary pieces to help
members identify need-to-know information on key issues. For example, members can link to an HCP
document that offers an in-depth overview of the many DOH MLTC policies that have been issued since
January 2013. Within the document, providers will find a brief summary of each DOH policy, which they can
then directly link to for more detail. Throughout the Resource Guide, members will also find links to HCPdeveloped documents outlining managed care provider complaint processes; wage parity, local living wage
and minimum wage requirements; the FIDA demonstration program; and the OPWDD People First Waiver.
As the transition progresses and information continues to be made available, HCP staff will update
the Resource Guide accordingly to ensure it remains reflective of the key resources and guidance your
agency needs to successfully operate in the new managed care environment.
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Please note, the HCP Managed Care Resource Guide is a HCP member benefit and will be distributed
directly to HCP members in good standing in the coming week. If you have not yet renewed your HCP
membership, please do so today. If you have questions about your membership, please contact Claudia
Hammar.
To renew your HCP Provider membership, click here.
To renew your HCP Associate membership, click here.
HCP’s Successful 2013 Annual Conference, Adjusting the Sails, Draws
Providers from Across New York
HCP’s highly anticipated Annual Management Conference & Exhibition, “Adjusting the Sails,” proved to be
a highly successful event that drew attendees from across New York State. The Conference, which was
held October 22-24 in Albany, New York, received outstanding reviews from attendees and exhibitors.
“I look forward to HCP’s Conference every year,” said a provider from New York City. “This year HCP had
many great sessions, but the ones on wage and hour laws, the regulation on executive compensation and
administrative expenses, and the Affordable Care Act were exceptional! I really learned a lot!”
“HCP always makes exhibitors feel they are important to the Conference,” said a long-time exhibitor. “We
spoke with many attendees who were very interested in our new product. And the Nautical Flags contest
was fun and helped me speak with lots of attendees!”
This year’s Conference featured lively, engaging
sessions from renowned national speaker Jim
Mathis from The Mathis Group, who inspired
attendees with his thought-provoking sessions on
reinventing yourself in a challenging market. Larry
Kryske from Your Finest Hour Leadership Programs
shared his perspective on trust and creativity – all
while creating a painting on stage which was later
offered as one of HCP’s raffle prizes.
Tuesday’s Public Policy sessions featured Mark
Kissinger, Director of the Division of Long Term Care
at the New York State Department of Health, who
offered his thoughts on the status of the transition
to managed long term care and answered many
questions from the audience. Donna Frescatore,
Executive Director at New York State of Health, The
Official Health Marketplace for the New York State
Department of Health, gave attendees an update
on New York State’s Health Benefit Exchange, and
discussed the how the essential benefit package
effects home health coverage.
Wednesday and Thursday offered a wide range
of insightful legal, marketing and business topics.
Speakers and industry experts provided practical,
useful information and resources to help attendees
manage their organizations more effectively and
understand more fully new regulations and how
to implement new laws. The Exhibit Hall gave
The HCP Insider
November 1, 2013
TWO ALL NEW WEBINARS!
Lawsuit-Free Discipline and
Termination of Employees
Thursday, Nov. 14, 11:00 am - 12:00 pm
Download the flyer with complete details and
registration form.
Click here to register now.
Understanding the Impact of the
Elimination of the Companionship
Exemption Under FLSA for
Home Care Providers
Tuesday, Dec. 17, 11:00 am - 12:30 pm
This webinar is offered exclusively for HCP members
at a special discounted rate. Be sure to renew your
membership so that you can attend this important
program!
Download the flyer with complete details and the
registration form.
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attendees the opportunity to relax and interact with exhibitors
that came to network, build relationships and provide
information and demonstrations about their products and
services.
HCP Business Meeting
HCP President Christy Johnston provided HCP members with
an update and overview of the Association, and members
voted and re-elected officers for the HCP Board:
• Mary Winters, RegionCare, Inc. re-elected Executive
Vice Chairperson
• Annette Horvath, All Metro Health Care, re-elected
Vice Chairperson, LHCSA
• Richard Schaefer, Better Home Health Care, reelected Secretary
HCP Annual Awards Luncheon
Several prestigious awards were presented at the Annual
Awards Luncheon.
20 Corporate Woods Blvd, 2nd Fl.
Albany, NY 22
58.463.8
Fax 58.463.606
www.nyshcp.org
Managed Care Resource Guide
October 2013
The 2011-12 State Budget initiated a dramatic
increase in the use of managed care models for
the delivery of Medicaid services. This aggressive
agenda has resulted in significant changes for home
and community-based care providers, thus making
preparation and an understanding of evolving
managed care policies and their related challenges
and opportunities critical to adapting to new care
delivery and payment models.
!
The second major shift that occurred was mandatory
enrollment in a managed long term care (MLTC)
plan for dual-eligible individuals, ages 21 years
and up, and in need of home and communitybased care services for more than 120 days. The
phase-in of mandatory MLTC was originally
scheduled to begin in New York City on April 1,
2012; however was delayed until July 1, 2012. As
of September 2013, MLTC is currently mandatory
in New York City, Nassau, Suffolk, Westchester,
Orange and Rockland counties, and the transition
continues to expand into upstate counties, with
the remaining major metropolitan county areas to
start transitioning before the end of 2013 (Albany,
Syracuse, Rochester, Buffalo).
ls
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ew ry s O
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Su H
Medicaid managed care (MMC) has been an
approach used by the State since the late 1980s
to deliver necessary care in a more cost-effective
manner. What began as a voluntary program is
now mandatory Statewide for many beneficiary
categories and programs. Managed long term care
(MLTC) has also been a model used by the State
for many years, albeit on a much smaller scale. A
mandatory MLTC model is currently being phasedin throughout New York State. These changes have
directly impacted long term care services.
The Medicaid Redesign Team (MRT), which was
established prior to the 2011-12 State Budget to
propose Medicaid savings initiatives, made greater
use of the managed care model as a center-piece
of the State’s cost-reduction and care delivery
strategies with “care-management for all” as the
theme. Among the providers and beneficiaries
impacted by this strategy are home care agencies
and programs and those receiving home and
community-based care. Up until these policy
changes, most home and community-based care and
home care populations and services were “carvedout” of the Managed Care system.
The first significant change for home care occurred
on August 1, 2011, with the addition of personal care
(PC) services to the Medicaid managed care benefit.
The benefit change impacted current MMC enrollees
and the providers that traditionally delivered PC
services for a Local Department of Social Service
(LDSS). The August 1 date did not include any
major changes to populations with mandatory MMC
enrollment; however, a variety of both populations
and services traditionally carved-out of the MMC
benefit package have since been added.
October 2013
Provider Challenges Mounting as
Transition Progresses
The 2011-12 State Budget tasked the Department of
Health (DOH) with developing and implementing
several significant changes to the State’s Medicaid
program. DOH and the MRT have provided the
framework for many of the changes, including
Table of Contents
Provider Challenges Mounting .......................................... 1
HCP Leading Advocate for Home Care............................ 2
HCP Efforts Initiate HCBC Workgroup............................ 2
Carve-in of Populations/Benefits to MMC....................... 3
Services Provided by MMC ................................................ 3
MMC Guidelines .................................................................. 4
Mandatory Enrollment: MLTC........................................... 4
Beneficiares Eligible to Enroll in MLTC ............................ 4
Services Provided by Partial-Cap MLTC, PACE/MAP.. 5
MLTC Model Contracts/CMAS Contracts....................... 6
MLTC Plan Data on Service Reductions ........................... 6
Provider Complaint Process ............................................... 7
DOH MLTC Policies............................................................. 7
Home Care Worker Wage Parity........................................ 7
What’s to Come: FIDA, OPWDD People First Waiver ... 8
Next Steps .............................................................................. 9
®
Home care. Health care.
Your care . . for life.
• Susan Allen from Spencerport, NY received the Edna
A. Lauterbach Scholarship Award;
• The HCP Long Island Chapter awarded its annual Norma Recco Advocate of the Year Award to
Roz Wilkins from Aides at Home, Inc.;
• Hodgson Russ, LLP was awarded the HCP Associate Member of the Year Award;
• HCP’s Excellence in Public Relations Award was awarded to Rebecca Leahy of North Country
Home Services, Inc.;
• Fran Schafer of Wellness Home Care received the HCP Founders’ Spirit Award; and
• Andrea Brown from Progressive Home Health Services, Inc. received the Edna A. Lauterbach
Member of the Year Award.
During the Luncheon, HCP also recognized and honored the Class of 2013 Heroes in the Home™,
outstanding caregivers that have been singled out for special recognition by HCP member agencies and
HCP Chapters during the past year (see related article on page 20).
Special Events
HCP/CHC thanks everyone that attended and participated in the Conference Special Events.
The HCP PAC Fundraiser Happy Hour, “Oktoberfest,” was held at The City Beer Hall, and attendees
sampled flights of various micro beers and an array of Oktoberfest-inspired appetizers. Several brave
attendees took a spin on the mechanical bull during the festivities, which proved to be a big hit for
everyone.
The CHC Fundraiser Murder Mystery, “A Cruise to Die For,” held by HCP affiliate, Community Health Care
Services Foundation, Inc. (CHC) was a huge success. Attendees joined in the fun, participating in a wild
talent show that rocked the State Room, with attendee acts in costume performing songs that included
Diana Ross and The Supremes’ “Stop in the Name of Love,” Men at Work’s “YMCA,” the Beach Boys’
“Surfing USA,” Elton John’s “Crocodile Rock,” and more. There was also a murder during the talent
show that attendees needed to solve. This rollicking event was voted “the best ever” by many attendees.
Proceeds from the event support CHC’s educational programs.
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10
The CHC Super Raffle
CHC sold a total of 94 tickets to the CHC Super 50/50 Raffle, and the winners were drawn during the
Dessert Reception and Exhibitor Raffle. The Grand Prize winner was Susan Hechtman of Aides at Home
who won $3,150; the 2nd Prize winner was Tami Seidler of WILLCARE who won $1,250; and the 3rd
Prize winner was Gary Carpenter of Grassi & Co., who won $310. The remaining proceeds of the Super
Raffle, $4,690 went to CHC to support its educational program. CHC thanks all those that participated in
the CHC Super Raffle and supported CHC this year. Another CHC Super Raffle will be held next year with
hopes to sell all 150 tickets so that the Grand Prize will be $5,000.
HCP’s 2014 Annual Conference will be held October 28 and 29 at the Long Island Marriott in Uniondale,
New York.
Thank you to all HCP 2013 Conference Exhibitors
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Advanced Data Source (ADS)
Brinster & Bergman
Crescent Computer Health Services
Emerson Reid & Co.
Friedlander Group
Grassi & Co.
HHA eXchange
Hagedorn and Company
Health Care Answering Services (HCAS)
MetLife
Mobile Health Management Services
National Allotment Insurance
S C Health Care Consulting
Sandata Technologies
The Signature Group of Companies
Sterling National Bank
T C Services USA
Total Program Management
Union Community Health Center
Thank you to all HCP 2013 Conference Sponsors
Conference Bags – S C Health Care Consulting
Custom Conference Hotel Room Keys - The Signature Group of Companies
Concurrent Sessions- The Signature Group of Companies
Name Badge Neck Wallets– Hagedorn & Company
Aluminum Sports Bottles– Sandata Technologies
Wednesday Morning Breakfast – HCP Long Island and Northeastern New York Chapters
Wednesday Morning and Afternoon Coffee Breaks – Sandata Technologies
Wednesday Networking Lunch – The Signature Group of Companies
Wednesday Exhibit Hall Grand Opening & Exhibitor Reception – Weingarten, Reid & McNally
Thursday Morning Coffee with Exhibitors – The New York Post
Thursday Coffee & Treats with Exhibitors – HCP Hudson Valley Chapter
Thursday Dessert Reception and Exhibitor Raffle – Healthcare Finance Group and the HCP
Northeastern New York Chapter
• Thursday Closing Session – The Signature Group of Companies
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11
Public Policy Sessions Offer Managed Care and Health Benefit
Exchange Updates
HCP’s 2013 Annual Conference & Exhibition kicked off with informative public policy sessions presented
by New York State Department of Health (DOH) officials. On Tuesday, October 22, DOH Director of
Long Term Care, Mark Kissinger, offered an update on the State’s mandatory transition to managed long
term care (MLTC). Following Kissinger’s presentation, Donna Frescatore, Executive Director of New York
State of Health, The Official Health Plan Marketplace, provided the latest details on New York’s new
Health Benefit Exchange.
Kissinger Talks MLTC, CoPs, Wage Parity, and More
During the MLTC session, Kissinger presented an overview of the mandatory MLTC transition to date,
including the various types of MLTC plans, enrollment phases, transitioning programs, the most recent
enrollment figures, a look at recent accomplishments and what’s to come. Conference attendees
also heard from Kissinger on other long term care initiatives underway, including the Fully Integrated
Duals Advantage (FIDA) demonstration program, Balancing Incentive Program (BIP), Money Follows
the Person (MFP) and Uniform Assessment System for New York (UAS-NY). Additionally, Kissinger
provided details on the work of the Home and Community-Based Care Workgroup established in the
2013-14 State Budget, and the upcoming Home Care Worker Wage Parity increase.
During a robust question and answer (Q&A) period, conference attendees emphasized the need for
adequate reimbursement to be provided to MLTC plans and the need for DOH to ensure those funds
are promptly passed through to providers so they are able to cover costs and maintain a sufficient
cash flow. Questions also focused on the Federal Conditions of Participation (CoPs); specifically, the
ability of managed care plans to contract for professional and skilled services with entities that meet
the CoPs. Kissinger remarked on the complexity of the issue and reported that the State is currently
involved in an active debate with its Federal counterparts, assuring attendees that clarification and
further guidance would be forthcoming.
Additionally, attendees questioned the potential for DOH to extend the personal care contracting
transition rates past March 1, 2014, and whether the transition rates will be regionally extended as the
mandatory MLTC transition progresses to upstate counties. Kissinger stated that no final decisions have
been made in either case; however, a decision on the extension of rates past March 1 would likely be
announced in February, and that the transitional rates would likely be applied upstate, but no telling for
how long. Session participants stressed the need for decisions on these fiscal matters to be made sooner
rather than later, noting that the information is critical as agencies make plans for the upcoming year.
Frescatore Overviews NY State of Health and Its Coverage of Home Care
Tuesday’s program wrapped up with Donna Frescatore, Executive Director of New York’s Health
Benefit Exchange, New York State of Health, who provided an overview of the Exchange and the
home health care benefits covered under the essential benefits package. Frescatore discussed
enrollment forecasts, assistance available to consumers in the shopping process, financial assistance
available to consumers, State health plan options, and the home health services covered under the
essential benefits package. Conference attendees were also given links to video demonstrations that
provide a detailed step-by-step enrollment guide for both individuals and small businesses.
The session ended with questions focused on the Exchange and how best to cover employees. Several
members asked Frescatore about sending employees to the website to individually shop for insurance
versus purchasing one or multiple plans to cover the entire office. Specifically, members were curious
about how their employees could obtain the best coverage at the lowest price—through Medicaid,
individually shopping, or through a company policy. Concerns were raised that providing coverage
for employees might jeopardize their Medicaid eligibility or an employee’s ability to receive financial
assistance. Frescatore acknowledged the complexity of the situation, but addressed several work
arounds to help ensure coverage and financial assistance eligibility for employees.
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12
ADJUSTING THE SAILS
HCP 2013 Annual Management Conference & Exhibition
October 22 - 24 w Albany Hilton w Albany, NY
Educational Sessions
Exhibitors
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13
ADJUSTING THE SAILS
HCP 2013 Annual Management Conference & Exhibition
October 22 - 24 w Albany Hilton w Albany, NY
Awards Luncheon
HCP PAC Fundraiser “Oktoberfest”
CHC Fundraiser Murder Mystery
“A Cruise to Die For”
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14
Governor Signs Legislation
Requiring DOH Oversight of
Individuals Transitioning to
MLTC
IF YOU HAVE NOT RENEWED
YOUR MEMBERSHIP, THIS IS
YOUR LAST HCP INSIDER!
On October 21, Governor Andrew Cuomo
signed into law S.3912-A (Hannon-R-Garden
City)/A.7636 (Gottfried-D-Manhattan), which
requires the New York State Department
of Health (DOH) to provide oversight of the
transition of individuals to managed long term
care (MLTC). In accordance with the legislation,
the Department is directed to oversee the MLTC
transition by ensuring:
If you have a November 1st renewal and have
not yet renewed your HCP membership, your
membership EXPIRES TODAY!
If you do not renew your membership now:
• You will no longer receive the HCP Insider;
• You will lose access to HCP staff for your
questions;
• You will not receive the all new Managed Care
Resource Guide next week;
• You will not be able to attend the upcoming
members-only webinar on the elimination of
the Companionship Exemption;
• All HCP member benefits will be suspended.
• Access to quality care by requiring
network transparency and choice
among MLTC plans, allowing patients
to choose the plan that best fits their
Click here to download the 2013-14 HCP Provider
needs;
membership renewal and send it in now with
• Transparency and accountability from
your payment so that you continue to remain an
providers, including a mechanism
HCP member! Associate members click here to
by which staff, residents and family
download the Associate member renewal.
members can safely and anonymously
report concerns relating to quality and
If you have any questions, please contact Claudia
waste;
Hammar.
• Low staff turnover in nursing homes
by promoting and encouraging fair pay;
and
• Plans and providers are assessed
periodically for efficiency, with
incentives provided for a variety of
indicators, including but not limited to smooth patient transitions, high staff retention and positive
health care outcomes achieved at a low cost.
The legislation was originally introduced in the Senate during the 2012 Session, where it passed the full
Senate and was delivered to the Assembly. It remained in the Assembly Health Committee as the 2012
Session ended. During the 2013 Legislative Session, the bill was again introduced in the Senate, with a
same-as bill introduced in the Assembly. After being amended in early May, the legislation was passed by
both the Senate and Assembly in late May and June, respectively.
As the shift to managed care progresses and expands throughout the State, the legislation will play a key
role in helping ensure that individuals making the transition, both voluntarily and mandatorily, are provided
with additional protections. The legislation takes effect immediately, and HCP will provide members with
more information on the mechanisms the Department will be putting in place to fulfill the new requirements
as it becomes available.
DOH Issues DAL Clarifying Comprehensive Assessment Requirements
for CHHAs/LTHHCPs
The New York State Department of Health (DOH) last week issued a Dear Administrator Letter (DAL),
HCBS 13-17, to clarify the requirements related to comprehensive assessments for certified home health
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15
agencies (CHHAs) and long term home health care
programs (LTHHCPs), particularly in relation to their
applicability within the transition to managed long
term care (MLTC). The DAL, which is dated October
22, 2013, has been posted on the Health Commerce
System (HCS) at https://commerce.health.state.
ny.us, and is also available at http://www.nyshcp.
org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=
9778.
The DAL reviews the Federal Conditions of
Participation (CoP) 484.85, which specifies that
an agency must provide each patient, regardless
of payment source, with a patient specific
comprehensive assessment that identifies the need
for home care and medical, nursing, rehabilitative,
social and discharge planning needs. It further
reviews the requirements related to the integration
of OASIS data items into the comprehensive
assessment for all patients receiving skilled services
(nursing and therapies).
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Positions in the HCP Insider!
Running a classified ad in the HCP Insider is an
easy, cost effective way to reach hundreds of
key decision-makers at HCP member agencies
across New York State for your open positions.
Advertise for nurses, administrators, chief
executive and financial officers, accounting and
marketing staff, and more!
Find out more! Contact Claudia Hammar at
518.463.1118, ext. 809, or hammar@nyshcp.org.
Specific to the MLTC transition, the DAL indicates that CHHAs/LTHHCPs should be aware of the following
requirements and information:
• For the agency’s adult patients transitioning into MLTC, the Federal comprehensive assessment
and OASIS requirements still apply during the 90 day transition period.
• For agencies continuing to provide skilled services through a contract with the MLTC plan, the
Federal comprehensive assessment and OASIS requirements still apply.
• A new start of care (SOC) comprehensive assessment is typically NOT required when a patient is
transitioning into a MLTC plan unless required by the plan.
• The schedule for updating the comprehensive assessment continues based on the original SOC
date and the already established 60 day recertification assessment cycle. The agency is simply
required to indicate that the payment source has changed to “Medicaid (HMO/managed care)” on
OASIS Item M0150 on the next scheduled recertification assessment.
• The payment source identifies all payers to which any services provided during the home care
episode and included on the plan of care will be billed.
• OASIS data collection and submission requirements continue until the patient is discharged from
the agency.
The DAL goes on to state to MLTC plans are responsible for ensuring compliance with the requirements of
the State’s new Universal Assessment System for New York (UAS-NY).
Questions on the DAL may be directed to DOH’s Division of Home and Community-Based Services at
OASIS@health.state.ny.us. Questions related to the UAS-NY may be directed to uasny@health.state.
ny.us.
October Medicaid Update Offers Additional Details on ICD-10
Transition
The State Department of Health (DOH) has released the October 2013 edition of the New York State
Medicaid Update. It is available at http://www.health.ny.gov/health_care/medicaid/program/update/2013/
oct13_mu.pdf. Of particular interest to the home and community-based care industry are the following
articles:
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16
Medicaid Moving Toward ICD-10 Code Sets
Implementation (pg 3) – The article offers
general background information on the upcoming
transition, which is set to occur on October 1,
2014, and will encompass the replacement of
ICD-9 diagnosis and procedures code sets with
ICD-10 code sets.
The State Medicaid Program and its fiscal
contractor, Computer Sciences Corporation
(CSC), are working diligently to ensure that
transition activities are completed in a timely
manner and in advance of the October 1, 2014
transition date, and offer the following tips and
information for transitioning providers:
DID YOU KNOW?
HCP members can access MEMBERSONLY information about Federal and
NYS State regulations and legislation
on the HCP website!
• Visit www.nyshcp.org
• Log in using your HCP user name
and password
• Click on the Public Policy tab
• Make a selection from the dropdown
menu
• Providers that utilize the services of a
QUESTIONS?
vendor or clearinghouse are strongly
Contact C l a u d i a H a m m a r
encouraged to start communicating
with these entities early in the transition
process to ensure the availability of
products, services and resources necessary to ensure the transition to ICD-10 does not have an
adverse impact on their reimbursement and does not interrupt their productivity or work flow.
• Providers are urged to visit www.cms.gov/icd10 for a complete list of all Centers for Medicare
& Medicaid Services (CMS) resources, including: applicable statues and regulations, ICD-10
implementation guides and timelines, Frequently Asked Questions (FAQs) and a myriad of other
valuable information, and to sign up for CMS ICD-10 industry email updates.
• Claims with dates of service prior to October 1, 2014 must be sent with ICD-9 codes; claims
with dates of service on or after October 1, 2014 must be sent with ICD-10 codes. Retroactive
claims will be processed based on the date of service.
• Claims (electronic and paper) that contain a combination of ICD-9 and ICD-10 coding will fail Edit
02230-A Mix of ICD-9 and ICD-10 Submitted on the Same Claim and will appear as denied on
provider’s remittance advice.
• The Provider Testing Environment (PTE) will be available for ICD-10 testing on August 25, 2014
for electronic transactions only. Testing will not be mandated, but trading partners are urged to
test early and as soon as PTE is available. Providers who currently receive PDF remittances will
be sent a paper remittance tin test. ICD-10 test files cannot contain more than 50 claims per file
and there is a file limit of two files per user/per day. Providers who use ePACES to submit claims
should not submit a test file as ePACES is not available in the PTE.
For more information, view the full ICD-10 article in the October 2013 New York State Medicaid Update.
Additional information is available via the FAQs recently-issued by eMedNY (HPC Insider, 10/18/13) at
https://www.emedny.org/Notice/2013-10-16_eMedNY_ICD10_FAQ.pdf, and will also be published in
subsequent Medicaid Update editions, through the eMedNY website and the eMedNY ListServ. Stay on top
of the latest developments by signing up for the eMedNY ListServ at www.emedny.org.
Ordering/Referring Editing Implementation in Fee-for-Service Medicaid (pg 6) – A reminder that the
October 1, 2013 implementation of new claims editing requiring Medicaid enrollment for ordering/
prescribing/referring/attending (OPRA) physicians and healthcare professionals has been delayed until
January 1, 2014. The delay is intended to allow more time for OPRA providers to request and obtain
enrollment in the New York Sate Medicaid program.
• To determine if a physician or healthcare professional is enrolled in Medicaid, use the search
feature at https://www.emedny.org/info/opra.aspx.
• Provider Enrollment forms and instructions are available at https://www.emedny.org/info/
ProviderEnrollment/index.aspx.
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17
• For provider enrollment assistance and status checks, please call the eMedNY Call Center at
800.343.9000
• To view OPRA FAQs, visit https://www.emedny.org/info/ProviderEnrollment/ProviderMaintForms/
Core_OPRA_FAQs.pdf.
• For updates on OPRA implementation, sign up for eMedNY General Updates via the eMedMY
LISTSERV at https://www.emedny.org/Listserv/eMedNY_Email_Alert_System.aspx.
HCP is continuing discussions with CSC staff to clarify the changes and how they will affect home care
providers. Specifically, HCP is looking further into how claims submitted by personal care providers, and
others, will be impacted; particularly those that currently submit claims which do not document an OPRA
practitioner’s NPI. HCP will update members as more information becomes available.
Mandatory Compliance Program Certification Requirement Under 18 NYCRR §521.3(b) (pg 13) – A
reminder from the State Office of the Medicaid Inspector General (OMIG) for all required providers
subject to the State Social Services Law §363-d Mandatory Compliance Program Requirement: The NYS
Social Service Law Compliance Program Certification Form for 2013 will be made available on the OMIG
website on Sunday, December 1, 2013.
Regulation requires that persons subject to Articles 28 or 36 of the State Public Health Law, to Articles
16 or 31 of the State Mental Hygiene Law, and other persons, providers or affiliates who provide care,
services or supplies under the Medicaid program, or who submit claims for care, services or supplies
for or on behalf of another person or provider, must certify in December of each year that they have
adopted, implemented and maintain an effective compliance program.
Required providers must certify on OMIG’s website (www.omig.ny.gov) that their compliance program
meets the requirements of the applicable law and regulations.
OMIG will host a webinar on November 21 to provide more information on the new 2013 Certification
Form. Providers should check OMIG’s LISTSERV (sign-up via the OMIG website), Facebook page and
Twitter feed (follow @NYSOMIG) for webinar registration information.
Questions may be directed to OMIG’s Bureau of Compliance at 518.408.0401, compliance@omig.
ny.gov.
Medicaid Spending Remains Under Global Cap as of August
The New York State Department of Health (DOH) recently released the August Medicaid Global Cap
report, which reports Medicaid expenditures totaled $7.180 billion. This is 0.4% under the projected
$7.209 billion. Nearly 50% of the savings can be attributed to the $40 million lower than projected
fee-for-service spending, of which long term care made up $24 million dollars. Inpatient and Outpatient/
Emergency Department spending also accounted for a combined $29 million fee-for-service spending
decrease.
Through August, mainstream managed care and MLTC spending was $39 million, about 1% above
projections. The quicker transition of fee-for-service populations into managed care can account for
$20 million of this variation. The remaining $19 million is attributed to higher per member per month
payments to MLTC plans than expected. As of August, all transitions from fee-for-service to managed
care are reported by the Department to be on time.
State’s Accounts Receivable Balance for R/R Owed Continues to Drop
The accounts receivable balance for retroactive rates owed to the State through the end of August
was $292 million. This reflects a reduction of $108 million since April 2013. HCP worked with the
Department to help ease the hit on home care providers as they were attempting to address years of
stacked recoupments on rates that were not processed in a timely manner. In general, if providers are
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18
subject to retroactive adjustments, Medicaid checks are reduced by 15% until the amount is paid in full
and interest begins to accrue if the amount is not paid in full within 10 weekly payment cycles. Some
providers were able to participate in the “amnesty” program the Department was offering earlier in the
year (see HCP Insider, 6/21/13).
Medicaid Enrollment Up 2.2% Since March 2013
As seen in the table below, enrollment in Medicaid managed care increased by 2.7% between March and
August 2013, while enrollment in Medicaid fee-for-service rose only 0.8%. Interestingly, August is the
only month since March that has had a positive % change in fee-for-service enrollment.
Managed Care
New York City
Rest of State
Fee-For-Service
New York City
Rest of State
TOTAL
New York City
Rest of State
New York State Medicaid Enrollment Summary
FY 2014
March 2013
August 2013
Increase/
(Decrease)
3,963,431
4,041,320
104,889
2,613,330
38,555
2,574,775
1,361,656
1,427,990
66,334
1,314,647
1,324,952
10,305
21,640
626,980
648,620
(11,335)
687,667
676,332
5,251,078
5,366,272
115,194
3,201,755
3,261,950
60,195
2,049,323
2,104,322
54,999
% Change
2.7%
1.5%
4.9%
0.8%
3.5%
-1.6%
2.2%
1.9%
2.7%
The entire August Medicaid Global Cap report can be viewed at http://www.health.ny.gov/health_care/
medicaid/regulations/global_cap/monthly/docs/august_2013_report.pdf.
NYS Identifies $496M in Home Health Medicaid Error Payments;
OMIG Recovers $211M from Feds
The New York State Office of the Medicaid Inspector General (OMIG) this week announced that New York
State has identified $496 million in Medicaid erroneous payments and recovered $211 million from the
Federal government for errors relating to home care recipients who are dually-eligible for both Medicare
and Medicaid funds. Medicaid is the “payer of last resort” for Medicare/Medicaid eligible recipients, and the
overpayments reflect bills for home health care patients that were inadvertently sent to Medicaid before
first being sent to Medicare.
The $211 million recovery is the largest that OMIG has ever secured, and is the result of work done
through the Third-Party Liability Home Health Care Demonstration Project, a Federal project looking
at home health care involving dual-eligible recipients, conducted in conjunction with the University of
Massachusetts Medical School. New York’s portion of the money reflects project efforts during the years
2007-10 and totals more than $496 million, with $211 million in State share funds. The project was first
initiated in 2000, and includes participation by New York, Massachusetts and Connecticut.
The recovery was not unexpected; the press release states that the $211 million has been a planned part
of the Medicaid Global Cap and will further help the State contain Medicaid program costs.
View the full press release at http://www.omig.ny.gov/latest-news/697-496-million. HCP will provide
additional information as it becomes available.
The HCP Insider
November 1, 2013
© All Rights Reserved
back to at-a-glance
19
Heroes in the Home™ Honored at HCP Annual Conference
At the Annual Awards Luncheon on October 24 at the HCP 2013 Annual Management Conference
& Exhibition in Albany, HCP honored over 80 caregivers that were recognized by their agencies as
outstanding caregivers, or by HCP Chapters at their caregiver award ceremonies for providing excellent
home care services.
During the month of November as we celebrate National Home Care & Hospice Month, HCP will recognize
these individuals by region in the HCP Insider.
The following individuals were honored from the Hudson Valley Region:
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Nana Ackah, HHA, Recco Home Care Service, Inc.
Edward Adjei, HHA, Concept: CARE, Inc.
Barbara Bukanowska, HHA, Osborn Home Care
Jonathan Bustle, HHA, Unlimited Care, Inc.
Yvonne Campbell, HHA, Concept: CARE, Inc.
Christine Circelli, PCA, Wellness Home Care, Ltd.
Judeen Clarke, HHA, Concept: CARE, Inc.
Priscilla J. Cocks, HHA, New York Health Care
Rebecca C. Doku, HHA, Concept: CARE
Bonnie Donnelly, PCA, Wellness Home Care, Ltd.
Donna Dyer, HHA, Westchester Caring Services
Norma Facey, HHA, Personal Touch Home Care, Inc.
Susan Faranda, RN, BSN, Osborn Home Care
Mabel Frances, HHA, Concept: CARE, Inc.
Cherry Francis, HHA, Bestcare, Inc.
Corine D. Gayle, HHA, Westchester Jewish Community Services
Shauna Gibbon, HHA, Access Nursing Services
Sandra Looknarain, HHA, Concept: CARE, Inc.
Charity McCottrell, PCA, New York Health Care
Hazel McDavid, HHA, Concept: CARE, Inc.
Elenaor Nsiah, HHA, Concept: CARE, Inc.
Agnes Nyarko, HHA, Concept: CARE, Inc.
Bernarda Ponce, HHA, Family Service Society of Yonkers
Omella Randall, HHA, Concept: CARE, Inc.
Carol Reynolds, HHA, Concept: CARE, Inc.
Peace Tackie, HHA, Osborn Home Care
Colette Welch-Mason, HHA, Concept: CARE, Inc.
Mabeline White, HHA, Personal Touch Home Care, Inc.
Recognize Your Workers During National Home Care & Hospice Month
Every day as a provider, you see people that have made a difference in the lives of others. Your nurses,
home care aides, and personal care aides work tirelessly, sometimes without recognition, to mitigate
the impact of being bed ridden, frail, and sick, or assist clients on the road to recovery. Many of your
workers are an inspiration for the people they care for and their families. And when your agency receives
accolades, it is often because of the care and commitment of your workers.
November is National Home Care & Hospice Month, a time set aside to highlight the essential work
done every day by dedicated home care providers like you and the thousands of workers that provide
outstanding care. We encourage you to take time during the month of November to show appreciation to
those in your agency that go “above and beyond” every day caring for your clients.
The HCP Insider
November 1, 2013
© All Rights Reserved
back to at-a-glance
20
Some simple ideas to recognize the contribution of your workers can make a world of difference for
your caregivers. Create special gift items honoring outstanding caregivers, coordinators, schedulers,
administrative, professional and paraprofessional staff. Make it fun by distributing buttons, ribbons or
other wearable specialty items. If your agency does not currently have a home care worker recognition
program, develop one that highlights the contributions of your outstanding workers. Send out a press
release to your local community newspapers about the work your agency is doing and highlight your
outstanding workers. Click here to download a sample press release honoring your outstanding caregivers
that can be customized for your agency.
November is an ideal time to recognize the many contributions of the home care industry and its workers.
The comfort of home and all that it embodies is an integral part of our holiday traditions. In the coming
weeks we will gather with family and friends to celebrate and give thanks for all of our blessings. As
providers, let us be sure to bring that message home to all those in our agencies that help make being in
the comfort of their homes a reality.
OSHA’s Updated Hazard Communication Rule Training Deadline is
December 1
After a multi-year process of working with other countries, the Occupational Safety and Health
Administration (OSHA) aligned its Hazard Communication Standards (HCS) with the Globally Harmonized
System of Classification and Labeling Chemicals. The final rule, released in March of 2012, requires MSDS
(material safety data sheets) labeling standards to be replaced by SDS (safety data sheet) standards and
employers to train workers on this new labeling format.
The first compliance date of the revised HCS is December 1, 2013. By that time employers must have
trained their workers on the new label elements and the SDS format.
Two topics that must be covered in training are label elements and label format. The former of these
trainings must detail the types of information an employee will see on the new label, including product
identification, signal words, pictograms, hazard statements, precautionary statements and contact
information; and how employees might use the labels in the workplace. The latter of the trainings must
detail the standardized 16-section SDS format and how the different parts of the label need to be jointly
interpreted.
A quick fact sheet on the requirements for the training can be found at https://www.osha.gov/
Publications/OSHA3642.pdf.
OSHA also has a page on its site that has links to the rule itself, a quick reference wallet card for
employees, and other materials related to Hazard Communication Standards. This can be found at https://
www.osha.gov/dsg/hazcom/.
For questions on OSHA Hazard Communication Standards and its affect on home care, please contact
Frank McStay.
HCP Participates in National Home Care and Hospice Lobby Day,
Advocates on Proposed Changes to the 2014 HH PPS and F2F Mandate
A national Home Care and Hospice Community Lobby Day took place this past Thursday, October 31, in
conjunction with the National Association of Home Care & Hospice’s (NAHC’s) 2013 Annual Meeting.
Industry stakeholders from across the country convened on Washington—both in person and virtually—to
communicate the importance of home and community-based care and advocate on a variety of key issues
that could have a major impact on consumer access to care, home care worker jobs, and the overall
stability of the industry.
The HCP Insider
November 1, 2013
© All Rights Reserved
back to at-a-glance
21
In collaboration with NAHC, its State counterparts and other industry stakeholders, HCP has been
involved in ongoing industry advocacy efforts over the past months to voice opposition to the Centers for
Medicare & Medicaid Services’ (CMS) proposed changes to the 2014 Home Health Prospective Payment
System (HH PPS), as well as support of modifications to the Face-to-Face (F2F) Physician Encounter
Documentation mandate.
This week, as Congress is currently engaging in budget negotiations, HCP asked all members to take
action and contact their Congressional representatives and urge them to help ensure appropriate and
adequate reimbursement for Medicare home health services, and support the elimination of burdensome,
costly, duplicative and confusing documentation requirements that create a disincentive for physicians to
recommend home health care services.
If adopted, CMS’s proposed changes to the CY 2014 HH PPS will result in an overall payment reduction
of 1.5% for home care agencies in 2014, or $290 million. Even more alarming, a proposed reduction
to the national, standardized 60-day episode rate of 3.5% in each year CY 2014 through CY 2017, will
account for a total reduction of 14% over four years. Such changes will have a devastating impact on the
home care industry, and HCP and others have worked diligently to voice concern and opposition to the
proposed changes, including submission of formal comments and recommendations, directly contacting
Congress Members and CMS officials through written correspondence, and asking members to participate
in grassroots advocacy efforts.
Further, HCP has worked to gain support of New York’s Congressional delegation for modifications to the
F2F mandate, which is being implemented under the Affordable Care Act (ACA). As currently structured,
the mandate imposes duplicative and burdensome requirements on health professionals seeking to
authorize and deliver cost-effective home and community-based care services. It requires that a physician
document, sign and date an additional form verifying that the physician has had an in-person encounter
with the patient before a home care agency can bill Medicare for services.
HCP supports changes that would permit the use of the existing 485 form, which is already utilized by
physicians and home care agencies to document a patient’s complete plan of care and provides detailed
information to support physician certification of a patient’s homebound status as well as their medical
needs, and must also be obtained prior to billing Medicare for home health services. This modification
would in no way jeopardize the intent of the requirement and would provide crucial regulatory and fiscal
relief for home care agencies, thereby ensuring that Medicare beneficiaries can continue to access vital
home care services.
For those who haven’t yet taken action, it’s not too late! Visit HCP’s Legislative Action Center (LAC)
today to access a sample e-letter you can edit and send directly to your Congressional representatives.
Just a few moments of your time can make a MAJOR difference for the home and community-based care
industry in New York State and throughout the nation. Remember, any cuts to home care reimbursement
and services impact the entire home care delivery system, whether directly or indirectly by reducing access
to care and compromising the stability of the service delivery infrastructure.
Click here to visit HCP’s LAC and Take Action Today!
The HCP Insider
November 1, 2013
© All Rights Reserved
back to at-a-glance
22
CHC Webinar
Lawsuit-Free Discipline and Termination of
Employees
Thursday, November 14, 2013 • 11:00 am – 12:00 pm ET
Who Should Attend
The process of disciplining and terminating employees is laced
with legal risks. From the outset of an investigation into
employee misconduct through the end of the disciplinary
process, home care providers must be aware of employment
laws that protect employees from unlawful adverse actions by
their employers.
This webinar will examine employees’ rights in unionized and
non-unionized workplaces during investigations, Federal and
State laws that protect employees against discriminatory or
retaliatory adverse employment actions, such as discipline or
termination, and the legal – and illegal – reasons for disciplining
and terminating employees. Employee misconduct in the digital
age, and how employers should handle work-related
misconduct occurring on the internet and social media will also
be discussed.
Register now to attend this very important webinar!
Presenter:
Emina Poricanin, Esq., Associate, Hodgson Russ
Emina Poricanin counsels public and private sector employers
in all aspects of labor and employment law. She represents
employers in arbitration proceedings and before the State
Division of Human Rights, Equal Employment Opportunity
Commission, and Federal and State courts. She also counsels
employers regarding the Family and Medical Leave Act,
Americans with Disabilities Act, Federal and state wage and
hour laws, worker misclassification issues, discrimination laws,
workplace policies and handbooks, discipline and discharge,
union avoidance, and unemployment insurance.
Owners, Executives, Administrators,
Supervisors, CEOs, COOs, Financial
Personnel, Supervisors & Managers
All NEW Webinar Pricing!
CHC has reduced Webinar pricing
to make these programs more
affordable for providers!
HCP Chapter Members: $179 $139
HCP Members: $189 $149
Non-Members: $289 $249



Price includes one connection.
Additional fees will be charged for
multiple log-in connections.
Cancellations received no later than
five days prior to the event will
receive a refund, less a $50
administrative fee. No refunds will
be issued after that date; no refunds
for no-shows. Printed handout
materials ONLY will be provided for
no-shows upon request.
Click here to register now.
Or, complete the attached registration
form and return with your payment.
Visit www.chcfoundation.org and click
on Educational Seminars for a
complete listing of upcoming CHC
programs and to download flyers and
registration forms.
nd
20 Corporate Woods Blvd., 2 Floor • Albany, NY 12211
(P) 518.463.1167 • (F) 518.463.1606 • www.chcfoundation.org
CHC is a non-profit 501 (3)(c) affiliate organization of the New York State Association of Health Care Providers, Inc. (HCP).
CHC Webinar Registration
Lawsuit-Free Discipline and Termination of Employees
Thursday, November 14, 2013 • 11:00 am – 12:00 pm Eastern Time
Complete and return the form below with your payment, or register online at www.chcfoundation.org. Fee includes
program tuition and downloadable materials. Log-in instructions will be emailed.
ALL NEW LOWER CHC PROGRAM PRICING!
HCP Chapter Members: $179 $139
HCP Members: $189 $149
Non-Members: $289 $249
Price includes one connection. Additional fees will be charged if there are multiple
connections.
Cancellations received no later than five days prior to the event will receive a refund,
less a $50 administrative fee. No refunds will be issued after that date; no refunds for
no-shows. Printed handout materials ONLY will be provided for no-shows upon
request.
Please PRINT CLEARLY OR TYPE. Use a separate form for each registrant.
Name: _______________________________________________ Title:______________________________________
Organization: ____________________________________________________________________________________
Street Address: __________________________________________________________________________________
City: ________________________________________________________ State: _____ Zip: ___________________
Phone: _____________________ Fax: ____________________ Email: _____________________________________
Payment Information
Amount Enclosed: $_________
Make checks payable to “CHC.”
Please complete for credit card payments:
 MasterCard
 Visa
 Discover
Card #: ___________________________________________
Exp. Date:_________ 3 or 4-digit security code: ________ (located on front or back of card)
Cardholder Name (Print): ____________________________________________________________________
Cardholder Signature: _________________________________
Mail registration with payment to:
CHC
20 Corporate Woods Blvd., 2nd Floor
Albany, NY 12211
Presented by:
Or FAX with credit card
payment to 518.463.1606
1114133058
Audio Conference
The Aide’s Role in Understanding
Body Mechanics
Thursday, November 14, 2013
3:00 – 4:00 pm ET
Who Should Attend
 Paraprofessionals
 Nursing Supervisors
 Directors of Education
This program is presented by the Association for Home & Hospice Care of North Carolina in partnership with
Community Health Care Services Foundation, Inc. (CHC). New York State providers will benefit from this
presentation, while understanding that New York State laws and regulations may differ from the information
included in this presentation. CHC customers outside of New York State and North Carolina are advised to
adhere to all pertinent state and local laws.
The Aide’s Role in Understanding Body
Mechanics
Presenter
Audio Conference
Dave Tushar, PT, MBA
Every day, challenges exist in patient care that can
cause injury to the back, arms and legs.
Dave Tushar has a BS in Physical
Therapy from Ohio State University and
MBA from Wake Forest University. He
has 23 years experience as a physical
therapist with 21 years in the home care
environment.
Paraprofessionals attending this program will learn
how to help patients while reducing the risk of injury to
themselves. In addition to using these skills in the
workplace, attendees will also learn how to incorporate
these techniques into their everyday lives.
Dave is currently the Rehab Manager
for University of North Carolina Home
Health and Rex Home Services.
The Aide’s Role in Understanding Body Mechanics
Audio Conference
Presented by:
Dave Tushar, PT, MBA
Thursday, November 14, 2013
****3:00 pm to 4:00 pm ET****
THREE SIMPLE WAYS TO REGISTER
BE SURE TO INCLUDE ALL INFORMATION REQUESTED BELOW:
1. Register Securely On-line at: www.chcfoundation.org
2. Fax this completed form below to 518.463.1606
3. Mail completed form and payment to CHC, 20 Corporate Woods Blvd., 2nd Floor, Albany, NY 12211
Payment must be received in full in advance.
Please register by November 8 to ensure that you receive e-mailed confirmation details.
Please type or print legibly all information below.
Agency:
Contact Person:
Address:
City/State/Zip Code:
Phone:
Fax:
(
(
)
)
E-mail (mandatory field):
Number of Participants Expected to Attend from your Agency:
Registration Fees
This fee includes one dial-in connection. Additional fees will be
charged if there are multiple dial-ins. Cancellations received five
days prior to the event will receive a refund, less a $50
administrative fee. No refunds will be made after that date. There
are no refunds for no-shows.
[__] HCP Chapter Member – $129 per line
[__] HCP Member – $139 per line
NEW
LOWER
PRICING!
[__] Non-Member – $239 per line
PAYMENT METHOD
[__] Check (payable to CHC)
[__] VISA
[__] MasterCard
[__] Discover
Cardholder’s name (print) ____________________________________________________________________________
Card Number_____________________________________3-4 Digit Security Code _______ Exp. Date ______________
Cardholder Signature__________________________________________________________________
nd
CHC, 20 Corporate Woods Blvd., 2 Floor, Albany, NY 12211 www.chcfoundation.org
CHC is a non-profit affiliate organization of the New York State Association of Health Care Providers, Inc. (HCP)
1114133054
Audio Conference
The Aide’s Role in Customer
Service and Patient-Centered Care
Thursday, December 12, 2013
3:00 – 4:00 pm EST
Who Should Attend
 Paraprofessionals
 Nursing Supervisors
 Directors of Education
This program is presented by the Association for Home & Hospice Care of North Carolina in partnership with
Community Health Care Services Foundation, Inc. (CHC). New York State providers will benefit from this
presentation, while understanding that New York State laws and regulations may differ from the information
included in this presentation. CHC customers outside of New York State and North Carolina are advised to
adhere to all pertinent state and local laws.
The Aide’s Role in Customer Service
and Patient-Centered Care
Presenter
Audio Conference
Kathie Smith, RN
Health care providers recognize that greater client
satisfaction leads to both better agency financial and
clinical outcomes. Patient-centered care actively
involves the client in planning and implementing care,
and takes into account what the client needs as well as
what they want. Customer service and patientcentered care are linked in focusing on the client as
the center of care, and paraprofessionals are an
essential part of the process.
Kathie Smith has held several
management level positions in home
care and has experience as a Home
Health Nurse Aide Supervisor. She
was the Manager of Home Care
Initiatives for the NC Division of
Medical Assistance, where she
assisted in overseeing home care
policy. Kathie has extensive
experience in Medicare and Medicaid
home health compliance and
regulatory requirements, is certified in
integrated chronic disease
management, is a master training in
Coaching Supervision, and serves on
the North Carolina management team
for the Personal and Home Care Aide
State Training (PHCAST) grant which
has developed Home Care Specialty
training for NC aides.
This audio program will assist paraprofessionals in
understanding the importance of good customer
service, review what it means to provide patientcentered care and how that can lead to greater client
satisfaction and better agency outcomes.
The Aide’s Role in Customer Service and Patient-Centered Care
Audio Conference
Presented by:
Kathie Smith, RN
Thursday, December 12, 2013
****3:00 pm to 4:00 pm EST****
THREE SIMPLE WAYS TO REGISTER
BE SURE TO INCLUDE ALL INFORMATION REQUESTED BELOW:
1. Register Securely On-line at: www.chcfoundation.org
2. Fax this completed form below to 518.463.1606
3. Mail completed form and payment to CHC, 20 Corporate Woods Blvd., 2nd Floor, Albany, NY 12211
Payment must be received in full in advance.
Please register by December 6 to ensure that you receive e-mailed confirmation details.
Please type or print legibly all information below.
Agency:
Contact Person:
Address:
City/State/Zip Code:
Phone:
Fax:
(
(
)
)
E-mail (mandatory field):
Number of Participants Expected to Attend from your Agency:
Registration Fees
This fee includes one dial-in connection. Additional fees will be
charged if there are multiple dial-ins. Cancellations received five
days prior to the event will receive a refund, less a $50
administrative fee. No refunds will be made after that date. There
are no refunds for no-shows.
[__] HCP Chapter Member – $129 per line
[__] HCP Member – $139 per line
NEW
LOWER
PRICING!
[__] Non-Member – $239 per line
PAYMENT METHOD
[__] Check (payable to CHC)
[__] VISA
[__] MasterCard
[__] Discover
Cardholder’s name (print) ____________________________________________________________________________
Card Number________/________/_________/_________3-4 Digit Security Code _______ Exp. Date ______________
Cardholder Signature__________________________________________________________________
nd
CHC, 20 Corporate Woods Blvd., 2 Floor, Albany, NY 12211 www.chcfoundation.org
CHC is a non-profit affiliate organization of the New York State Association of Health Care Providers, Inc. (HCP)
1212133052
Offered ONLY to HCP
members as a member
benefit!
CHC Webinar
Understanding the Impact of the Elimination of
the Companionship Exemption Law Under
FLSA for Home Care Providers
Tuesday, December 17, 2013 • 11:00 am – 12:30 pm Eastern Time
The U.S. Department of Labor (DOL) has released its final rule eliminating
the companionship exemption for caregivers employed by third party
agencies. As a result, beginning January 1, 2015, home care agencies
across the country will be required to pay minimum wage and overtime
payments to these workers.
Attend this informative webinar to learn more about how this change will
impact New York agencies and your clients. The webinar will cover:
 How the changes impact New York minimum wage and overtime
requirements
 What the changes are for live-ins
 How the change impacts CDPAP
 A review of the new travel time payment requirements
 New developments in the home care Wage Parity Law and their effect
on wage and benefit obligations
 What agencies should do to prepare for compliance
Presenters:
David Prager, Esq., and John Ho, Esq., Bond Schoeneck & King
David Prager has extensive experience in all facets of labor and employment
law and litigation, particularly in the home care and health care fields,
including defending discrimination claims, litigating employment contract,
non-competition and restrictive covenant cases and other employmentrelated claims, before both Federal and state courts and agencies. He also
has published extensively on employment discrimination and labor and
employment law topics.
John Ho exclusively represents management in all aspects of Labor and
Employment Law, with specific experience in wage and hour matters
including the FLSA and the New York State Labor Law; the Occupational
Safety and Health Act; FMLA; discrimination claims; federal and state
Department of Labor audits; collective bargaining, arbitrations and workplace
investigations.
Both Mr. Prager and Mr. Ho were selected by their peers for inclusion in this
year’s publication of New York Metro-area “Super Lawyers” in the Labor and
Employment field.
THIS PROGRAM IS
EXCLUSIVELY BEING
OFFERED ONLY TO HCP
MEMBERS AS AN HCP
MEMBER BENEFIT.
Who Should Attend
Owners, Administrators,
Supervisors, CEOs, and
Managers
Webinar Pricing
Special Member Pricing: $99
 Additional fees will be charged
for multiple log-in connections.
Cancellations received no later
five days prior to the event will
receive a refund, less a $50
administrative fee. No refunds
will be issued after that date; no
refunds for no-shows.
Register now!
You must be an HCP member in
good standing to attend this
program. To register, please
complete the attached registration
form and fax with your credit card
payment or mail with your
check/credit card payment.
20 Corporate Woods Blvd., 2nd Floor, Albany, NY 12211
(P) 518.463.1167 • (F) 518.463.1606 • www.chcfoundation.org
CHC is a non-profit 501 (3)(c) affiliate organization of the New York State Association of Health Care Providers, Inc. (HCP).
Offered ONLY to HCP members
as a member benefit!
CHC Webinar Registration
Understanding the Impact of the Elimination of the Companionship
Exemption Law Under FLSA for Home Care Providers
Tuesday, December 17, 11:00 am – 12:30 pm Eastern Time
SPECIAL HCP MEMBER PRICING: $99
Pricing includes one log-in connection to the Webinar. Additional fees will be charged for multiple login connections. Cancellations received no later than five days prior to the event will receive a refund
less a $50 administrative fee. No refunds will be issued after that date; no refunds for no-shows.
Complete and return the form below with your payment. Fee includes program tuition and downloadable
materials. Log-in instructions will be emailed.
You must be an HCP member in good standing to attend this program.
Please PRINT CLEARLY OR TYPE. Use separate form for each registrant.
Name: _______________________________________________ Title: ________________________________________
Organization: _____________________________________________ ________________________________________
Street Address: ____________________________________________ ________________________________________
City: _________________________________________________ ________________
State:
Zip:
__
Phone: _____________________ Fax: ____________________ Email: _____________________________________
Payment Information
Amount Enclosed: $_________
Make checks payable to “CHC.”
Please complete for credit card payments:
 MasterCard
 Visa
 Discover
___
Card #: _____ ___________________
Exp. Date:_________ 3 or 4-digit security code: ________ (located on front or back of card)
Cardholder Name (Print): ___________________________________________ _________________________________
Cardholder Signature: _____________________________________________ _________________________________
Mail registration with payment to:
CHC
20 Corporate Woods Blvd, 2nd Fl
Albany, NY 12211
Presented by:
Or FAX with credit card
payment to 518.463.1606
1217133060
Northeast Home Health
Leadership Summit
January 21 – 23, 2014
Colonnade Hotel, Boston, MA
Resilient Leadership
AGENDA-AT-A-GLANCE
The Northeast Home Health Leadership Summit, now in its twelfth year, is designed for
home health and hospice agency leaders. It is hosted by the seven state home care
associations throughout New England and New York. This year’s theme, Resilient
Leadership, aims to support these executives to embrace leadership behaviors,
strategies, and management practices that will spell success in a new era of health
care. Join your peers at to learn, network and advance home care at this exciting
event - registration is now open!
The Colonnade Hotel
The Northeast Home Health Leadership Summit will be held at The Colonnade Hotel, 120 Huntington
Avenue, Boston, MA 02116. Room rates at the Colonnade are $169 per room, per night. The
deadline for this special rate is January 2, or until rooms in our block are sold out. Call (800) 962-3030
and ask for the NE Leadership Summit rate. For more information on the hotel visit
www.colonnadehotel.com
The Summit Website
Visit www.nehomehealthsummit.com often for the latest information on this valuable and affordable
program including exhibit and sponsorship information.
PRE-CONFERENCE SESSION
Resilient Leadership
Tuesday, January 21
11:00am
Conference Registration Opens
1:00pm
Taking Home Care to the Next Level
Health care is changing and with it come opportunities for home care, especially for those agencies who
can get ahead of the reform curve. Come join an inspiring trio of home health leaders in exploring
programmatic models that are showcasing home care’s competencies to meet the cost and outcome
demands of referral partners, and that are placing home care at the center of a redefined healthcare
system. (There is an additional fee to attend this program as noted on the registration form).
The Reinvention of Community Based Care: A 21st Century Imperative
Tracey Moorhead, President and CEO, Visiting Nurse Association of America
The Evidence is In: Advance Illness Management at Sutter Care At Home
Marcia Ressig, RN, MS Chief Executive Officer, Sutter Care At Home
Palliative Care: Leading the Way in Your Agency and Community
Jeanne Ryan, MA, OTR, CHCE, COS-C Executive Director, VNA & Hospice of Cooley Dickinson/
Cross-Continuum Services
5:00pm
Wine and Cheese Reception
AGENDA-AT-A-GLANCE
Resilient Leadership
Wednesday, January 22
8:00am
Registration Opens
Pick up your conference program book and spend a little time with our generous sponsors.
9:30am to 10:00am
Welcome to the 12th annual Northeast Home Health Leadership Summit
10:00am to 11:30am
Resilience Bestselling author, Andrew Zolli, will share his observations on what makes people,
communities and systems resilient when they experience unforeseen shocks and surprises.
11:30am to 12:30pm
Enhancing Your Business Model
Select one of three workshops to learn tips, tools and strategies that will help you sustain your business.
• Launching a Successful Behavioral Health Program – Rose Madden-Baer, Visiting Nurse Service
of New York
• Positioning for Managed Long Term Care – Margaret Wallingford, M.A. Wallingford & Associates
• Enriching Patient Care – Speaker to be confirmed
12:30pm to 1:30pm
Lunch – Time to network with new friends and old
1:30pm to 3:45pm
Enhancing Your Business Model – Part 2
Select one of three workshops to learn tips, tools and strategies that will help you sustain your business.
• Behavioral Health – Rose Madden-Baer, Visiting Nurse Service of New York
• Positioning for Managed Long Term Care – Margaret Wallingford, M.A. Wallingford & Associates
• Enriching Patient Care – Speaker to be confirmed
AGENDA-AT-A-GLANCE
Resilient Leadership
Wednesday, January 22 – continued
3:45pm to 4:45pm
Times of Our Lives
Legendary singer and songwriter, Judy Collins, will share experiences that have tested her resilience as a
performer and a mother.
4:45pm to 6:30pm - Reception
6:30pm - Group Dinner
Join your peers at the Red Lantern, a sophisticated Asian inspired restaurant, for an exclusive dinner for
Summit attendees. The cost is $85 per person and seating is limited.
Thursday, January 23
7:00am - Networking
Breakfast
8:30am
Staying Current - The Future of Health Care Policy
Susan Dentzer, Senior Policy Adviser at the Robert Wood Johnson Foundation and an Analyst on Health for
the PBS NewsHour, cuts through the rhetoric and examines the latest health care policy changes and explains
what they mean for the future.
10:00am
Hanging Tough – Gaining a Seat at the Health Care Table
Better understand where home care fits in as this new era of healthcare unfolds for Americans and discover
potential opportunities for continuing to be a vital player as presented by Barbara McCann, Chief Industry
Officer, Interim Healthcare
11:15am
Bouncing Back – A Personal Story with a Universal Message
Julia Fox Garrison, a patient advocate and stroke survivor will share her personal triumph against
overwhelming odds and the importance of patient advocacy. Ms. Fox Garrison will also make her book, Don’t
Leave Me This Way, available to conference participants following her presentation.
12:30
Closing Lunch
Northeast Home Health Leadership Summit
Resilient Leadership
January 21 - 23, 2014 – The Colonnade Hotel - Boston, Massachusetts
Registration Form
Two-Day Registration Fee Includes:
Please indicate your state association membership
affiliation:
______ I am not a member of any Association
______ Connecticut Association for Home Care & Hospice
______ Home Care & Hospice Alliance of Maine
______ Home Care Alliance of Massachusetts
______ Home Care Association of New Hampshire
______ Home Care Association of New York State*
Please Note:
Members of the same agency may not share the two day
registration fee. Each individual must be pre-registered to attend.
Members
Provider Member of a Sponsoring State Association
Non‐Members
_________________________________________________________________
Name
_________________________________________________________________
Title
_________________________________________________________________
Agency
_________________________________________________________________
Address
_________________________________________________________________
City
State
Zip
_________________________________________________________________
Email
_________________________________________________________________
Phone
Fax
Education programs, handouts and food and beverage events where noted.
The Pre-Conference session on January 21st is additional.
Early Bird Two-Day Fee (until 12/20/13)
$499 ________
Two-Day Fee
$549 ________
(after 12/20/13)
Vendor Member of a Sponsoring
State Association
$569 ________
Non-Member Providers
Early Bird Two-Day Fee (until 12/20/13)
$699 ________
Two-Day Fee (after 12/20/13)
$749 ________
$769 ________
Non-Member Vendors
Pre-Conference Session
Pre-Conference Session
$129 ________
(In addition to above Registration)
______ New York State Association of Health Care Providers*
Pre-Conference Session ONLY
Member: $239 ________
______ Rhode Island Partnership for Home Care
Pre-Conference Session ONLY
Non-Member: $339 ________
______ Vermont Assembly of Home Health Agencies
______ Member of both HCA and HCP-NY*
Registration Deadline and Cancellation Policy
Cancellations up to January 3 will receive a full refund less 25% administrative fee by
emailing info@hcanys.org. No refunds will be given after January 3.
Changes or substitutes within the same agency are acceptable by notifying HCA
Education and Research by January 10th.
Questions? Contact HCA at (518) 426-8764 or info@hcanys.org.
In accordance with the American with Disabilities Act or special
meal needs, please let us know how we can accommodate you:
Networking Dinner – Limited Seating!
_____ Yes, I will attend dinner on January 22
Total Registration Fee
$ 85 ________
$________
Method of Payment
____ American Express
____ MasterCard
____ VISA
(3 digit security code) _____________ Exp. Date _____/_____/_____
Card Number _____________________________________________
___________________________________________________________________
Cardholder’s Name _________________________________________
___________________________________________________________________
Billing Address ____________________________________________
Three Ways
to Register
Online:
www.eventville.com/hcanys
_________________________________________________________
By Fax:
Fax your registration form with credit card
payment to (518) 426-8788
City __________________________ State_______ Zip __________
By mail:
Send your payment and registration form to
HCA Education and Research
388 Broadway, 4th Floor
Albany, NY 12207
www.nehomehealthsummit.com
Signature _________________________________________________
____ Check (must be received by Jan 13) made payable to:
HCA Education and Research
388 Broadway, 4th Floor
Albany, NY 12207
November is National
Home Care and
Hospice Month—Show
Your Support!
THERE’S STILL TIME TO
JOIN THE CLUB!
November is Home Care and Hospice Month, a
time to commemorate the power of caring, both at
home and in our local communities. And, with a new
year and a new Legislative Session right around the
corner, there’s no better time to invest in the future
of home care in New York State!
HCP’s Political Action Committee—New York’s
Strongest Home Care PAC! Your support of the
Health Care Providers Political Action Committee (HCP
PAC) is about more than earning recognition from your
colleagues—contributing to the HCP PAC is a smart
investment in home care’s future. As the first PAC in
New York State dedicated solely to the interests of the
home care industry, the HCP PAC has been a strong and
powerful voice in New York’s Capitol for nearly 30 years!
Member
Contributions up to $500
Chairperson’s Club
Contributions of $501 to $1,000
Premier Club
Contributions of $1,001 to $2,500
Champion’s Club
Contributions of $2,501 or more
Don’t delay! Contributions MUST be received by
December 31 to count toward 2013 fundraising!
Here’s my HCP PAC contribution!
Name _____________________________________________________________________________________________________
Organization ______________________________________________________________________________________________
Address ___________________________________________________________________________________________________
City __________________________________________________________________ State_________ Zip _________________
Phone ____________________________________ Email __________________________________________________________
Home Address _____________________________________________________________________________________________
___ A check, made payable to “HCP PAC,” is enclosed.
___ Please bill my personal or corporate credit card (please circle one).
Card
Card
Card
Card
Type
___ Visa
___ Master Card ___ Discover
Security Code _______________________________
Number _______________________________________________ Exp. Date ___________________________________
Holder Name _________________________________________________________________________________________
Holder Signature _____________________________________________________________________________________
Not for profit organizations can not make political contributions, however, individuals may. Political contributions are not
tax deductible for Federal Income Tax purposes. Corporations are limited to $5,000 in political contributions in any one
year and individuals may contribute no more than $150,000 per year.
HCP PAC
Send contributions to: HCP PAC • 20 Corporate Woods Blvd., 2nd Fl • Albany, NY 12211
518.463.1118, Ext. 818 Fax 518.463.1606
nyshcp.org/members/pac

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