BAYADA Submits Opposition Letters to a Certificate of Need (CON) Carve-out

Last month, 100% of our Medicare offices advocated for maintaining a level-playing field and allowing patient choice by opposing a CON carve-out petition. After their four failed legislative attempts last session to receive a CON carve-out, LeadingAge Inc. – the association representing the Continuing Care Retirement Communities (CCRCs) – submitted a petition to the State Health Coordinating Council (SHCC) requesting CCRCs be allowed to open a Medicare home health office without meeting the requirements outlined in North Carolina statute regarding CON. LeadingAge contend their CCRC residents would rather receive home health services from someone with a CCRC name badge than an “outside” Medicare provider, like BAYADA. In their testimony, LeadingAge indicated that there is no access to care for their residents. Further, LeadingAge indicated they wanted to restrict choice to their on-site agency. The Department received comments to the petition and record 88 letters in opposition, 10 of which were from BAYADA. Each director submitted unique comments. SHCC will consider the comments before rendering a decision later this month.

If you have any questions about CON or what you can do to help advocate for policies beneficial to BAYADA and the home care industry in North Carolina, email me at ldobson@bayada.com.

Special High Five to our directors for taking a stand to maintain patient choice!

CAV – Rochelle Harbick
CV – Rochelle Harbick
DAV – Tonya Wishon
FSV – Alexa Ciancia
GAV – Tonya Steelman
GUV – Chelsea Nedwick
PRV – Kathleen Hanline
RV – Trekelia Chavis
SV – Alicia Wyatt

NC Primary Elections are Scheduled for May 8

For the first time in recent history, North Carolina has contests in every single district and for every single seat. Both the Democrats and Republicans report candidates in all races across the state. Primary elections are scheduled for May 8 where there are 74 legislative primary election and another 19 among the state’s congressional elections. County Boards of Elections report that absentee ballots are being distributed. Verify whether there is a primary in your voting district and download a sample ballot by visiting the State Board of Elections.

Preparing for NC’s Short Legislative Session

BAYADA Government Affairs Area Director Lee Dobson (right) poses with North Carolina Representative Mitchell S. Setzer (left).

On May 16, lawmakers will return to Raleigh for North Carolina’s 2018-2019 Legislative Session.  Issues are likely to move very quickly as this is the second year in the legislature’s two-year cycle. Unlike the cycle’s first year, this year’s purpose is to make budget adjustments and finalize any carry-over bills. GAO has been meeting with key members in leadership to garner necessary support for our 2018 priorities (see below). GAO hopes that primary elections, redistricting, and Medicaid Transformation do not consume all the oxygen in the room so that legislators can get some work completed before concluding in June.

2018 Key Legislative Priorities:

  • Technical correction to increase the Community Assistance Program for Disabled Adults (CAP-DA) rate from $13.88 to $15.60, effective October 1, 2018
  • Increase the Personal Care Services (PCS), Community Assistance Program from Children (CAP-C), and Community Assistance Program for Disabled Adults (CAP-DA) rates to $17.00 effective January 1, 2019
  • Protect Certificate of Need (CON) from elimination.

If you have any questions about our 2018 priorities or how you can help advocate, please email me at ldobson@bayada.com

Two Workgroups Formed to Explore Changes in the State Medicaid Reimbursement Model

Recent conversations with MCC Waiver Administrator Michelle White have revealed that the time is right to explore making significant changes in the nursing reimbursement model.  GAO has formed two workgroups to analyze and evaluate options to address Medicaid policy and its reimbursement model for nursing.

First, we’ve formed a BAYADA technical expert group representing the relevant practices and leadership to help inform BAYADA’s recommendations.  The second group is a larger provider workgroup within the SC Association for Home Care & Hospice. As a SCAHHC Board member, I have been asked to co-chair this workgroup to draft industry recommendations.  BAYADA will draw from its internal workgroup to inform the conversation with the industry and Medicaid.  This is a great opportunity to address the challenges and recommend a unified solution to DHHS that can be a win-win for providers, the state, and ultimately- clients.

Thank you to the SC Advisory Council and the workgroups! I look forward to working with you to develop recommendations that will lead to better outcomes for our staff, clients and their families!

Meeting with SC State Legislators to Increase Reimbursement Rates for our Medicaid Waivers

SC Representatives Bruce Bryant and Thomas Pope discuss home care, Hearts for Home Care advocacy
SC Representatives Bruce Bryant (left) and Thomas Pope (right) met with Lee Dobson and me (center) to discuss home care

Area Director, Government Affairs, Lee Dobson and I have been making the rounds and walking the halls at the state capitol to educate key legislators about home care.

Our meetings with SC Senators Mike Gambrell and Floyd Nicholson gave us the opportunity to educate them on our challenges with staffing and reimbursement rates.  Senator Gambrell stated, “I’m familiar with home health care. My dad had services after his hospital stay, and he has been able to recover quickly because of the nurses.”  We also met with Representatives Bruce Bryant and Tommy Pope who also shared their experience of home care.

Representative Tommy Pope, Ex Officio, stated “I understand the cost savings home care can offer, and feel people want to be home.”  We had an encouraging meeting with the Assistant Director for Budget Development Senate Finance Committee, Angie Willis.  She is very interested in learning more about home care needs for South Carolinians and how the state legislature can help.

We also had a productive meeting with House Ways and Means Chairman Brian White and his Chief of Staff Beverly Smith. Chairman White has supported home care for many years and was previously instrumental in passing the enhanced rate differential for nursing. He gave us great insight on the challenges and opportunities within the political process and has helped us shape our path towards higher reimbursement rates.  We look forward to working with these and other lawmakers as we increase awareness and garner support for BAYADA’s legislative priorities.

If you’d like to find out what you can do to help advocate for higher reimbursement rates, sign up to become a Heart for Home Care!

Health Care Summit Sponsored by US Congressman Ralph Norman

SC Lieutenant Governor Kevin Bryant at the Health Care Summit, Hearts for Home Care advocacy
SC Lieutenant Governor Kevin Bryant and me at the Health Care Summit

On Thursday, January 25, 2018 local lawmakers, state legislators, health care industry leaders, and constituents came together to attend the Health Care Summit. The Summit focused on federal and state health care updates, and local statistics. US Congressman Norman (R-SC) gave federal updates from Washington, and former Chairman Eric Bedingfield and Lt. Governor Kevin Bryant spoke on state and regulatory issues.

The summit enabled me to learn more about the challenges in health care on a state and federal level. As a new GAO director, the opportunity also afforded me a chance to meet several key players in the state’s healthcare field, which will be especially important as I establish and expand South Carolina’s government affairs program to benefit BAYADA, our staff, and our clients.

Educating New SC Legislator Rep. Nancy Mace about Home Care

New South Carolina representative Nancy Mace was sworn into office this past month. When new legislators are sworn in, it is important that we educate them about the importance of home health care and how it has enabled thousands of South Carolinians to stay at home with their loved ones. This is especially true for Rep. Mace-   Since she will be serving on the House Medical Committee, which oversees regulatory issues for the home care industry, it will be important for us to educate her on the challenges our relatively new offices are facing.

Rep. Nancy Mace recently won the special election for House District 99 in Charleston and Berkeley counties and is the first woman to ever win this seat. As a former business owner of a small public relations technology start-up, she understands the grit and determination needed to get a business off the ground. We are hopeful that her business experience and committee membership will spur her to become a legislative champion for our issues.

Legislative meetings are most effective with real life stories from constituents. If you are interested in joining me to meet Rep. Mace and tell her about what home care means to you and your clients, let me know!

Session in South Carolina: 3 Weeks In and Already Busy

south carolina state house hearts for home care advocacy

Just three weeks into South Carolina’s session and we are already seeing a flurry of activity. This week was filled with numerous meetings and Governor McMaster’s first State of the State address.

Several House Ways and Means budget subcommittees and Senate Finance subcommittees met this past week to hear state agency budget requests for the next fiscal year. Chairman of the Healthcare Committee Murrell Smith has requested that the South Carolina Department of Health and Human Services (DHHS) work with a consulting group to gather data and calculate the amount of funding the Department will need, which may impact BAYADA’s Medicaid clients.

Additionally, this past Wednesday, Governor Henry McMaster delivered his first State of the State address to a joint session of the General Assembly. He highlighted recommendations from his Executive Budget proposals and noted his priorities, including tax relieve, job creation, education, and health care.

In the Governor’s budget, he is proposing an increase of funds to support South Carolinians with traumatic brain injuries to be able to get the rehabilitative care they need. It’s exciting to see the Governor support a cause that is important to so many families in South Carolina.

PS- March is Brain Injury Awareness Month! If you’d like to contact the Governor about his support of traumatic brain injury patients, please email me.

Increasing Reimbursement Rates for RNs and LPNs in Delaware

At the end of June, 2017, through the efforts of our Ambassadors, our industry partners, our clients, and our legislative champions, the Rate Floor Bill passed the Delaware General Assembly.

This year, in the second year of Delaware’s two-year legislative session, our major legislative goal is to achieve an increase in the Medicaid fee schedule for RN and LPN hourly care. These two rates have stagnated since 2006. We are asking the legislature to update both according to the Consumer Price Index. Doing so would move LPN care from $46.14 to $56.01 and RN care from $51.50 to $62.51 per hour.

Our initial meetings with key members of the Joint Finance Committee have been very positive.  We are working with them to include increased funding for this request in this year’s budget. If successful, our MCO contracts would have to be renegotiated so that reimbursement would be equal to or greater than the new fee schedule amounts.

If you’d like to learn about how you can get more involved in our advocacy efforts, sign up to be a Heart for Home Care!

Plans for Healthcare Overhaul in Delaware

In his State of the State Address last week, Delaware Governor Carney said, “Here’s the bottom line.  We’re spending too much money on healthcare, and we’re not getting the best results.  We need to come to the table – state government and hospitals most of all – and be part of the solution… Now it’s time to make the hard decisions and change the way we deliver healthcare.”

We’ve heard Department of Health and Social Services’ (DHSS) Secretary Odom-Walker discuss similar issues over the last several months. In public hearings across the state, she has discussed health care reform in other states across the country and the need for fundamental changes to the way health care is delivered, how chronic health issues are prevented and treated and how funding can be used to encourage better coordination and more focused care to obtain good health outcomes.

Secretary Odom-Walker and Governor Carney have great faith that Delaware’s small size will enable quick transition to a new, more efficient delivery model. We are closely monitoring these developments and have reminded both the Secretary and the Governor of the importance of home health care in reducing costs and obtaining better outcomes for Delawareans.

If you have any questions about what’s going on in Delaware’s state capitol, let’s chat! Email me at sgahs@bayada.com.