Tag Results: "HCBS Report"
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Adult Day Health Care Centers in Calif. will live to see another day. A federal district court issued an injunction halting California’s plans to implement new, restrictive eligibility criteria for low-income seniors and individuals with disabilities who attend adult day care centers throughout the state. The court found various violations, including against the Medicaid Act, the American with Disabilities Act, and the Constitution of the United States.
Missouri’s Department of Social Services has learned that it will be sanctioned by the Centers for Medicare & Medicaid Services (CMS) for requiring that consumers be “confined to the home” to qualify for Medicaid-covered home health services. Requiring someone to be homebound in order to receive home health services covered by Medicaid violates federal Medicaid law, specifically the Olmstead decision.
On Apr. 2, 2010, the Medicare Payment Advisory Commission (MedPAC) met to discuss integrated care programs for dually eligible beneficiaries. According to MedPAC, States that have developed integrated Medicare/Medicaid programs faced resistance from provider groups and beneficiary advocates during program development.
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which creates a 3 percent add-on to payments made for home health services to patients in rural areas. The add-on applies to episodes ending on or after Apr. 1, 2010, through Dec. 31, 2016.
AAHSA member Otterbein Homes (the
Lebanon campus) is planning on opening
an adult day center and a child learning center in the fall of 2010. The
day center would allow for 25 to 30 clients to participate in a wide
range of health and wellness programs as well as indoor and outdoor
recreation and therapeutic activities. Otterbein is also working on incorporating a pre-school in the
facility that would provide intergenerational activities for those in
the day program.
The health care reform bill added a 3-percent additional payment for rural home health agencies for the period April 1, 2010 to Jan. 1, 2016. To see how your facility will fare under the home health prospective payment system, and for rural providers the additional rural add on payment, use AAHSA’s home health calculator. It takes all these separate components into account to automatically compute your facility’s payment rate for each separate Home Health Resource Groups (HHRG).
The Centers for Medicare & Medicaid Services (CMS) is sharing more than $15 million in savings with 166 home health agencies (HHAs) based on their performance during the first year of the Medicare Home Health Pay for Performance demonstration. All Medicare-certified home health agencies in seven states were invited to participate in the demonstration. The demonstration is still being evaluated, with results expected later in 2010.
On March 8, 2010, a U.S. District Court judge ruled
in the case Ball v. Betlach that Arizona’s Medicaid program
failed to follow the court’s prior orders by not implementing a
statewide hotline for beneficiaries to report gaps in critical home-care
services and by failing to require its program contractors to have
backup workers on call to substitute for times when a gap in critical
services occurs.
The U.S. Dept. of Health and Human Services (HHS) Office on Disability announced the award of over $6 million under the American Recovery and Reinvestment Act (ARRA) of 2009, to establish a Center of Excellence in Research on Disability Services, Care Coordination and Integration. The main goal is aimed at building the infrastructure necessary to support and conduct research on the effectiveness and comparative effectiveness of systems of care for people with disabilities.
On May 20, 2010, Georgia Gov. Sonny Perdue (R) signed
into law House
Bill 1040, legislation aimed at helping peoples
with disabilities remain in their homes by allowing registered nurses
train caregivers to perform certain medical tasks such as tube feeding,
bladder and bowel care, and medication administration.
The Rosalynn Carter Institute for Caregiving is offering a cash award to support the efforts of groups in implementing effective caregiver interventions at the community level. The winning team will be announced at the RCI's National Summit to be held Oct. 20-22 at Georgia Southwestern State University in Americus, Ga. Former First Lady Rosalynn Carter will present the winning team with a statuette and a cash award of $20,000 to the winning partnerships. July 10 is the deadline for proposals.
Mississippi Gov. Haley Barbour on May 21, 2010, signed
legislation that requires the state Division of Medicaid to develop a
plan that meets the national standards for the Program for All-Inclusive
Care for the Elderly (PACE). The plan must be submitted to the Centers
for Medicare and Medicaid Services (CMS) by the end of 2010.
Three new briefs from the Center for Health Care Strategies (CHCS) have been released on Long-Term Services and Supports (LTSS). The first summarizes the current publicly funded long-term care environment and the barriers to rebalancing LTSS by outlining initial policy recommendations for reforming Medicaid LTSS to support more cost-effective and consumer-oriented options. The second provides a detailed overview of current LTSS by addressing the state rebalancing and reform activities across the nation and broadly outlines opportunities and obstacles for LTSS reform. Finally, the third report presents an array of innovative initiatives from across the nation offering alternatives for reforming the delivery of Medicaid-funded long-term care. It includes both innovations that have been implemented as well as promising practices for more effectively delivering community-based long-term supports and services.
A report, published by the Lewin Group, states that if the cuts to adult day health care (ADHC) proposed by Gov. Schwarzenegger are approved, Calif. would lose millions of dollars and 10,000 jobs. The Gov. goal is to save money, but the report found that the cuts would result in an immediate cost to the state of more than $51 million in FY 2010-11, growing to $72 million by 2020-21. According to the report, the increase in costs relate to participants in ADHCs having to enter nursing homes or having to enroll in other, more costly, state-funded programs.
Determining levels of home health care that will be approved by Medicaid is under a drastic change. As of April 1, 2010, these decisions are being made by a Seattle company instead of Nebraska Department of Health and Human Services workers. Proponents of the change believe that current participants will be shifted into other programs, such as waivers, and care will be more coordinated. Opponents are worried that this change will result in more denials for necessary home health care that is currently allowing older adults and people with disabilities to stay in their own homes and communities.
Medicare beneficiaries across the country will receive copies of a
brochure titled, “Medicare
and the New Health Law – What it Means for You.” The mailing from the Centers for Medicare and Medicaid Services (CMS)
outlines key provisions of the Patient Protection and Affordable Care
Act for people with Medicare as well as members of their families.
Metropolitan Jewish Health System purchased the hospice and palliative care services of Continuum Health Partners, which includes its contracts with more than twenty-four nursing homes and other facilities, as well as the 18-bed inpatient hospice and palliative care unit at Beth Israel Medical Center. This transaction will make Metropolitan Jewish Health Systems the largest nonprofit hospice and palliative care program in the state of New York. Hospice is a cost-effective quality service that promotes person-centered care. This change may have a positive impact on increasing the use of hospice and palliative care services in New York State.
On June 3, 2010, the U.S. Department of Health and Human Services (HHS) announced a new grant program totalling $60 million for states and communities to create coordinated statewide systems of information, counseling, and access that will help people find health and long-term care services that will meet their needs. The Administration on Aging (AoA) and Center for Medicare and Medicaid Services (CMS) will coordinate the implementation and monitoring of this grant.
U.S. News and World Report’s blog on end of life care discussed the importance of Programs of All-Inclusive Care for the Elderly (PACE) for palliative and end of life care. It highlights the two PACE centers operated by Riverside Health System in Newport News, Va. Advance directives are an integral part of the PACE model, and more than 90 percent of Riverside PACE participants have advance directives in place.
The National Center on Senior Transportation (NCST) and Easter Seals Project ACTION will be presenting a two-week, online program to discuss issues relating to the Americans with Disabilities Act (ADA) and paratransit services. The dialogue will run from July 26 through Aug. 6, 2010. This is a great opportunity for AAHSA members who provide transportation services to join the discussion.
The Interim Final Rule on Medicare enrollment, ordering, and referral released by the Centers for Medicare & Medicaid Services (CMS) states that CMS will prohibit Medicare coverage of home health beginning July 6, 2010, unless the physician ordering the care is separately enrolled in the Provider Enrollment, Chain and Ownership System (PECOS). Fortunately, a number of members of Congress have contacted CMS with concerns about this rule. These actions prompted CMS to release a notice on June 30, 2010, saying that for now it would not automatically reject claims because of PECOS, and that they are working on making it easier for physicians to register in PECOS.
The U.S. District Court for the Western District of Oklahoma ruled that the calculation method employed by the Department of Health and Human Services (HHS) that counts a hospice beneficiary only once during a single fiscal year, regardless of whether that beneficiary has received treatment over multiple fiscal years is not legal. There was a similar case in the U.S. District Court for the Northern District of Texas that reached a similar conclusion. The process of how Medicare beneficiaries receiving hospice care are counted impacts how hospice providers are reimbursed.
The Medicare Payment Advisory Commission (MedPAC) released its June 2010 Report to the Congress: Aligning Incentives in Medicare. The report focuses on how implementing an incentive system in the Medicare program can promote cost effective quality care. The report also assesses current approaches to offering integrated care for dual-eligible beneficiaries.
The National Center on Senior Transportation (NCST) released the findings of their survey of Area Agencies on Aging concerning the transportation needs of older individuals. The report covers funding sources for transportation, mobility management and travel training, older driver safety and transition, and access to information about transportation options. One of the major findings confirms that older adults in rural areas have inadequate and inappropriate transportation options.
The Centers for Medicare and Medicaid Services (CMS) has issued a new Survey and Certification Letter providing advance notice that it will issue a solicitation for federal matching grants to all states and U.S. territories for its multi-year National Background Check Program for Patient Protection for all direct care employees of long-term care facilities and other providers. This grant program is important for AAHSA members because it includes direct care workers in nursing homes, home health agencies, hospices, adult day care programs, and more. There
Medicare instructions regarding delivery of non-routine supplies intended for use over an extended period of time have changed. Now suppliers are instructed to report the delivery date as the ‘from’ date and the date by which the supplies will be used in the ‘to’ date.
The Indiana Family and Social Services Administration is planning to cut services under the Community and Home Options to Institutional Care for the Elderly and Disabled (CHOICE) plan by 15 percent. CHOICE helps families care for older adults and the disabled in their own homes and communities. Among many other services, the program provides: adult day care, transportation services, congregate meals, respite care, and more. Findings have shown that the program saves thousands of dollars by providing home and community-based care.
The New Jersey Hospital Association ’s (NJHA) Institute for Quality and Patient Safety will be replicating a program by the Philadelphia-based Health Care Improvement Foundation where a group of southeastern Pennsylvania hospitals, physicians, nursing homes, and other caregivers collaborated to reduce hospital re-admissions to reduce health-care costs. With Congress placing more and more of an emphasis on reducing preventable hospital readmissions, AAHSA believes that this collaborative spirit between hospitals and home and community-based services providers will continue to grow.
The U.S. Dept. of Health & Human Services (HHS) announced $250 million in grant funding for health and prevention programs from the Patient Protection and Affordable Care Act. HHS is providing $126 million to community and clinical prevention activities at the federal, state, and local levels. In addition, HHS will designate $70 million to support the public health infrastructure, including the capacity to respond to infectious diseases; $31 million will go to data collection and analysis and to strengthen existing task forces; and $23 million will be used to expand the public health workforce and training centers run by the Centers for Disease Control and Prevention.
Mathematica Policy Research, Inc. has issued a report entitled,The National Evaluation of the Money Follows the Person (MFP) Demonstration Grant Program: Reports from the Field
.This report gives background information on the state of long-term services and supports before the implementation of the MFP program. It gives detailed information on state by state differences in terms of a state's rebalancing activities. This report provides a solid baseline that will be used as a comparison point as MFP programs continue across the country.
The health care reform bill extends the Money Follows the Person (MFP) Demonstration Program through Sept. 30, 2016, and appropriates an additional $450 million for each fiscal year 2012 through 2016, totaling an additional $2.25 billion. The bill also expands the definition of who may be eligible for the demonstration. CMS will post a grant solicitation in late July to offer states not currently participating an opportunity to apply for an MFP Demonstration Program Grant. AAHSA members should be involved with determining your state’s MFP plan to transition individuals from nursing homes back into the community.
U.S. Department of Health and Human Services (HHS) Secretary Kathleen
Sebelius announced on June 22, 2010, the Housing Capacity Building Initiative for Community
Living, which provides $3.2 million for states to build innovative
systems to link persons with disabilities to affordable housing.
Sen. Ron Wyden (D-Ore.) and Rep. Edward J. Markey (D-Mass.) asked CMS to implement the “Independence at Home” (IAH) program that was included as part of the health care reform law within the next six months. Independence at Home is not supposed to begin until Jan. 2012. Under the three-year demonstration project, Medicare beneficiaries with chronic conditions would have primary care provided in their home by teams of providers.
Sen. Susan Collins introduced the Home Health Care Planning Improvement Act to help ensure that Medicare beneficiaries get the home health care that they need by allowing physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives to order home health services. Rep. Allyson Schwartz introduced the House version of the bill. Under current law, only physicians are allowed to certify or initiate home health care for Medicare patients, even though they may not be as familiar with the patient's case as the non-physician provider. This situation can lead to needless delays in getting Medicare patients the home health care that they need.
AAHSA lauds OAA anniversary and calls for support of OAA programs.
There are twenty plus reasons for HCBS providers to attend the American Association of Homes and Services for the Aging Annual Meeting and Conference from October 31, 2010 to November 3, 2010. They include networking and learning what is new in home and community-based services by attending the following educational sessions at the conference.
On July 2, 2010, the Centers for Medicare and Medicaid Services (CMS) announced that it has offered contracts to 364 of the 1,011
Durable Medical Equipment (DME) suppliers who submitted bids as part of
the demonstration, which affects beneficiaries in nine markets.
According to the study, “Lessons for the New CMS Innovation Center from the Medicare Health Support Program,” published in the July issue of the journal Health Affairs, the Centers for Medicare & Medicaid Services (CMS) could learn from the Medicare Health Support demonstration project including how to better target potential participants and providers to achieve maximum program savings.
An article in McKnight’s reports that a large number of personal and home care aides (PHCA) are being paid wages that are close to poverty level income.
The good news is that Nevada adult daycare centers will not receive a cut in Medicaid funding, but there are new concerns about the funding of transportation to and from the day center.
Jan Werner Center in Amarillo, Texas, completed a nearly $3 million renovation project that will build the new “Memory Care Center,” a facility that offers specialized care for those who have Alzheimer's disease or other forms of dementia.
The Pennsylvania Association for Non-Profit Senior Services (PANPHA) announced that they have retained Michele Brague of Brague Health Care Consulting, LLC, to assist the Association to position their members to compete in the changing senior care and services delivery system.
The Centers for Medicare and Medicaid Services (CMS) released in the July 23, 2010, Federal Register the proposed rule for 2011 Medicare payments to home health in order to promote efficiency in payments, implement provisions of the Affordable Care Act (ACA), and enhance program integrity. The proposed rule implements a 4.75 percent decrease in Medicare payments to home health agencies (HHA) for calendar year (CY) 2011.
The Centers for Medicare & Medicaid Services (CMS) announced on July 16 that hospices will see an estimated 1.8 percent increase in their payments for fiscal year (FY) 2011.
On July 16, 2010, the departments of Justice (DOJ) and Health and Human
Services (HHS) announced charges
against 94 people for their alleged participation in
submitting more than $251 million in false claims to the Medicare
program. The charges stem from an investigation by the
Health Care Fraud Prevention and Enforcement Action Team (HEAT) Medicare
Fraud Strike Force. The investigation charged providers in Miami, Baton
Rouge, Brooklyn, Detroit, and Houston.
The Adult Day Health Care (ADHC) Council of New York produced an award-winning nine minute DVD on adult day health care program services in New York. This amazing video demonstrates the person-centered care for individuals served by ADHC programs.
On July 26, 2010, the U.S Department of Health and Human Services (HHS)
and Centers for Medicare and Medicaid Services (CMS) announced
$2.25 billion in grants from
the Affordable Care Act to extend the “Money
Follows the Person (MFP) Rebalancing Demonstration”
that will transition Americans with disabilities and frail older adults
in nursing homes back to the community.
Addus HomeCare Corporation, a provider of comprehensive in-home social and medical services acquired Advantage Health Systems, Inc., which provides these services in South Carolina and Georgia. Advantage Health Systems, doing business as CarePro Health Services, serves approximately 1,200 patients in its five locations in South Carolina and one in Georgia. The company offers personal care, private duty, home health and hospice services.
On June 22, 2010, Oregon Gov. Ted Kulongoski (D) proposed a 9 percent cut across the board for home care programs in the state, scheduled to take effect Aug. 1, 2010. One of the programs that would be affected is the Oregon Project Independence program, which allows older adults to remain in their own homes and communities. The Medicaid Personal Care program would also be wiped out.
Daily Living Centers, an AAHSA adult day services provider, has won the 2010 Leading-Edge Care and Services Award, along with Baptist Village Communities and Oklahoma City Housing Authority. These three organizations have formed a vibrant partnership to bring services to older adult and disabled residents of public housing. This partnership is the first of its kind in Oklahoma, and stands as an outstanding model of collaboration and quality service provision for subsidized housing communities across the nation.
National Adult Day Services Week is Sept. 19-25. This week is set aside to raise awareness of adult day programs nationwide that assist older individuals and people with disabilities to remain in their own homes. AAHSA has 600 members who operate quality adult day services. The theme this year is "Adult Day Services: A Smart Choice." Use this opportunity to plan special activities that week. Invite your local, state and national representatives to your center. Maybe even sponsor a candidate forum for the upcoming elections?
Veterans in Illinois will be receiving assistance from a new program, the Veterans Independence Program, to help them age in place. The program began on July 1, and will provide 20-25 eligible veterans with anywhere between $1,600 and $3,160 a month to help pay for home health care, transportation, meals, and many more activities. The program is part of a partnership between the U.S. Dept. of Veterans Affair and the U.S. Administration on Aging.
Your calls and letters to your members of Congress paid off. On July 28 the U.S. Senate Labor Health and Human Services Appropriations subcommittee approved an additional $30 million in funding above the president’s 2011 budget request for meal programs. This funding is a 5 percent increase over the 2010 funding. The increase in funding will help meal programs continue most of the services that they provided as a result of the additional funds from the Recovery Act.
We need your help in getting more co-sponsors for the Home Health Care Planning Improvement Act, HR4993. This bill would instruct the Centers for Medicare & Medicaid Services (CMS) to allow nurse practitioners, clinical nurse specialists, certified nurse midwives, physicians’ assistants and other appropriate clinicians to certify and make changes to home health care plans. Introduced by Rep. Allyson Schwartz (D-Pa) on April 13, it currently has 95 co-sponsors, representing 30 states, the District of Columbia, and Guam, but we need your help to get more legislators to sign on so that this bill can move forward in the House.
On Aug. 5, 2010, the U.S. Department of Health and Human
Services (HHS) announced$159.1
million for workforce training, including 85 awards totaling $29.5
million to fund three geriatric education and training programs at
accredited health professions schools.
Senior Independence, Columbus, Ohio, won the “Best of Show Award” at the 19th Annual National Mature Media Awards for their iCaregiver Guide. This award show honors the best in advertising, marketing and educational materials produced for older adults.
Mathematica has released its report, “Aging in Place: Do Older Americans Act Title III Services Reach Those Most Likely to Enter Nursing Homes?” based on responses from the Fifth National Survey of OAA Program Participants. The report concludes that “Title III participants are at higher risk of nursing home placement than others in their age group nationally, based on common predictors of nursing home entry.” Given the demographics of Title III participants, this finding could be attributed to the fact that these individuals tend to be older, have more chronic health conditions, and have less familial and social support.
On Aug. 6, 2010, the Centers for Medicare and Medicaid Services
(CMS) senta letter to state
Medicaid directors informing them how the changes from the
Affordable Care Act to the 1915 (i) Medicaid waiver can improve access
to home and community-based services (HCBS). According to the letter,
effective Oct. 1, states can allow access under certain circumstances to
HCBS before Medicaid recipients need skilled care.
The Centers for Medicare & Medicaid Services (CMS) has released MLN Matters Article #MM7014 to alert Home Health Agencies (HHAs) that edits will be in place, effective for services on or after Jan. 1, 2011, to prevent them from billing competitively-bid Durable Medical Equipment (DME) items in competitive bidding areas and consequently, preventing the inappropriate payment of competitively-bid DME items to HHAs.
"Short-Term Mortality Associated With Failure To
Receive Home Care After Hemiarthroplasty," a
study published on Aug. 16, 2010, in the Canadian Medical Association Journal,
reported that seniors who underwent a partial hip replacement and
were discharged to home, where they received added care, were 43
percent less likely to die within 3 months of the procedure than those
discharged to home without home health care.
In a study, Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer, published in the New England Journal of Medicine, showed that patients with terminal lung cancer who began receiving palliative care immediately upon diagnosis were not only happier, more mobile and in less pain as the end neared, but they also lived nearly three months longer.
A Penn State University study found that home health aides who were given safety training were less likely have an injury on-the-job. The researchers also found that home health aides who did not have on-the-job injuries had a higher rate of job satisfaction and lower turnover
State governors must apply for their share of the $16.1 billion in added Medicaid money under the education-Medicaid aid funding measure by Sept. 24. Higher levels of Medicaid funding were first made available in the 2009 economic stimulus law and were set to expire Dec. 31. The new state-aid package extends added funding to through June 30, 2011, although at lower levels than in the original stimulus package.
On Aug. 16, 2010, the Missouri Department of Health and Senior
Services (DHSS) announcednew
income guidelines for free and reduced-price meals served at
Missouri adult day care centers. The income guidelines are used to
determine eligibility for free and reduced-price meals.
Catholic Health Initiatives (CHI) of Denver has agreed to acquire Consolidated Health Services Inc. (CHS), a Cincinnati-based home health care service company, a move that will help the Denver-based nonprofit health system expand home care services throughout the nation.
In August of 2010, AAHSA released a technical assistance brief,
"Non-Medical Homecare: A First Step to Providing Home
and Community-Based Services," to serve as a practical guide
for members who wish to expand into non-medical homecare.
A practical guide for members who wish to expand into non-medical homecare.
Development of a Common Outcomes Measurement Data Set for MS Adult Day Programs
The Beverly Foundation announced the completion of its “2010 STAR Search/STAR Awards.” The 2010 STAR Search report gathered data on 1,300 Supplemental Transportation Programs (STPs) for seniors from all 50 states, plus the District of Columbia and Puerto Rico. The Foundation awarded $150,000 to its 2010 STAR Award winners.
The A.M. McGregor Group has entered into a strategic partnership with Senior Independence to develop home and community-based services for older adults in the Cuyahoga County, Ohio. The partnership will allow the A.M. McGregor Group to complement its existing offerings of senior housing, assisted living and health care with additional services designed to meet the needs of older adults who wish to live at home.
In Development of a Common Outcomes Measurement
Data Set for MS Adult Day Programs,” a report from RTI International, researchers describe best
practices for determining outcomes and benefits in adult day service
centers that offer services for individuals with Multiple Sclerosis.
More than 5,000 disabled Oklahomans have their names on a Department of Human Services waiting list as their families seek help for everything from in-home care to diapers. This next group of people awaiting services have been on the waiting list since 2006.