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.

Delaware Department of Health and Social Services Continues Toward Development of Total Cost of Care Model

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

Secretary Kara Odom Walker held a public hearing on how the state can focus on the Total Cost of Care this week.  Thought leaders from across the country, and representatives from states that have undertaken these sorts of efforts, already gave presentations and shared lessons.  Secretary Odom Walker is intent on building a data-driven system based on nationwide best practices.  As this effort moves forward, the Government Affairs Office (GAO) will work with our division directors and state government leaders to ensure that the value and importance of home health care in this effort is recognized.

 

New Addition to DE Managed Care Organizations and Increased Focus on Value-Based Payments

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

The Department of Health and Social Services (DHSS) announced that United Healthcare will no longer participate in the state’s managed Medicaid program and that AmeriHealth Caritas will take its place beginning January 1, 2018.  DHSS also announced a target of linking payments to quality of care rather than quantity of hours provided, a trend the Government Affairs Office (GAO) has seen in other states and programs.  GAO will partner with other BAYADA support teams to help ensure that this shift is beneficial to our clients and the work we do.

 

It’s In DE Governor John Carney’s Hands

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

The rate floor bill we’ve worked so hard on, now sits on Governor John Carney’s desk.  Many bills passed in the last days of session, at the end of June, each requiring his consideration before he signs them into law or vetoes them.  HB200, which sets a “rate floor” or minimum reimbursement rate for Registered Nurse (RN) and Licensed Practical Nurse (LPN) level nursing care equal to the Delaware Health and Social Services (DHSS) fee for service rates, would help ensure home health care clients across the state have access to care.  We have sent him information about why this bill is so important to our clients and employees and we await his decision.  The bill becomes law and is effective upon his signature.

 

Disability Rights of Filed Lawsuit to Support Community Integration in North Carolina

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

A federal designated protection and advocacy organization, Disability Rights of North Carolina (DRNC), has filed a lawsuit against the Department of Health and Human Service (DHHS) focused on supporting individuals living with intellectual and developmental disabilities (ID/DD).

The focus is to ensure individuals are able to receive the services they need through community integration. DRNC is not asking for a set of service definitions, nor are they trying to close organizations, but rather they are focused on building community capacity. They are asking DHHS to adhere to a state statute that calls for community integration and person-centered planning to address the needs of individuals living with ID/DD, regardless of payor. This is the first step in a long legal battle.

We are encouraged that DRNC has filed this state complaint on behalf of our ID/DD families. While this case progresses through the state court system, work continues as normal. We will keep you posted.

Delaware Rate Floor Bill Passes

Submitted by Shannon Gahs, Associate Director, DE Government Affairs (GAO)

The General Assembly, in the wee hours of the morning on the last day of session, passed the rate floor bill! This measure will ensure that Managed Care Organizations (MCOs) hourly home health care rates for registered nursing (RN) and licensed practical nursing (LPN) care will never fall below Delaware Health and Social Services (DHSS) hourly rates. This will help to ensure access to home health care for Delawareans with disabilities, and giving providers the ability to make informed business decisions. Dedicated effort by our BAYADA team of clients and employees, in partnership with the Delaware Association for Home and Community-Based Care and other home health care providers, made this possible. Thank you for your emails, phone calls, and attendance at Advocacy Day in Dover. This bill will go into effect when Governor John Carney signs it.

Delaware Rate Floor Bill Passes House Committee

Submitted by Shannon Gahs, Associate Director, DE Government Affairs (GAO)

Following compelling testimony by clients Nancy and Christopher Lemus, Delaware Association for Home and Community-based Care (DAHCC) President Bob Bird, Delaware Pediatrics (DP) Associate Director Mandy Brady, and myself, the House Health & Human Development Committee passed a bill that would set a minimum reimbursement rate paid by Medicaid managed care organizations (MCOs) to home health care providers for skilled nursing services.
Representatives asked probing questions, sparking true debate over the measure. The vote was 10-0 with 4 additional members absent. The bill must still pass the full House, the Senate Health, Children & Social Services Committee, and the full Senate. The legislature closes on June 30. If this bill passes, MCOs would not be able to pay any less than the Department of Health and Social Services (DHSS) pays for the same care, giving DHSS the ability to ensure access to needed services.

Nancy Lemus giving testimony at the hearing