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.

 

Ambassador Spotlight – KSP recruiting manager has the “Wright” stuff when it comes to Advocacy!

Submitted by Mike Sokoloski, Manager, Grassroots Advocacy

Lindsey Wright is the Ambassador that is always looking to help, like the first time I met her. -GAO Director Laura Ness and I were on our way to the PA Art Museum, next to the PA State Capitol. As we approached, there was Lindsey.  She was waiting on the sidewalk and on the phone talking and guiding a colleague to the building for our PA Legislative Day.

At the 2017 PA Legislative Day, Lindsey was able to spend 45 minutes with Senator Daylin Leach.  -It was a very candid conversation addressing all of our concerns, but specifically presumptive eligibility and an increase in the PAS rate for home care employees who work so hard for our clients.  Lindsey fostered this relationship with the senator.  She kept in touch with the district office director for Senator Leach, Judy Trombetta.  Lindsey worked diligently with two BAYADA Pediatric offices (PAO and WGP) to provide sponsorship for Senator Leach’s Kids Fair in Philadelphia, and Lindsey volunteered at the event!

In July, GAO coordinated a Client and Family Day at Temple University Kiva Auditorium.  GAO staff, CRO Division office and field employees, clients, and families had interactions with Philadelphia area elected state government legislators and discussed the pressing needs of our field staff, clients, and families.  The first person at the auditorium that day to assist with anything we needed: Lindsey Wright.

 

Presumptive Eligibility Legislation Introduced in the House and Senate

Submitted by Laura Ness, Director, Government Affairs (GAO)

The work of the Pennsylvania Homecare Association, Pennsylvania Health Law Project, and the Elder Law Attorneys has led to presumptive eligibility legislation being officially introduced in Pennsylvania’s General Assembly. The bill numbers are S.912 and H.1829.  The legislation will allow individuals to be presumed financially eligible for home care services. This will greatly expedite the process and allow individuals to access the care they want when they want it. Since being introduced GAO has been working to obtain additional co-sponsors for both pieces of legislation. So far, we have 24 House sponsors and 16 Senate sponsors.

More work is still needed.  Please take a moment to email your state legislators and ask them to support the legislation.

Click here to tell your legislators to support equalized access to home and community based services.

See the full list of sponsors here:

 

 

 

 

Progress on Transforming Medicaid

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

Ten months into her new job Secretary of Health & Human Services, Dr. Mandy Cohen has been working to move her Medicaid Transformation plan forward. She hired an implementation guru from Missouri, Jay Ludlam as the Assistant Secretary for Medicaid Transformation to lead the process. Medicaid’s hope is to address the physical and behavioral health of North Carolinians. The goal is to improve overall health by creating an innovative and well-coordinated Managed Care environment that addressed the whole-person. The program design calls for three state-wide commercial plans and up to twelve provider-led entities (PLE) as regional plans.  The department’s aggressive timeline will release request for proposals (RFP) in early 2018, with a targeted transition in 2019, pending CMS approval.  BAYADA has been invited to participate in stakeholder discussions as Medicaid develops their Pre-paid Health Plan (PHP) model. Our goal, related to home care, is to ensure level of services and provider adequacy remains central in the program design and waiver application. GAO has involved technical experts from across our various practices to ensure our feedback is sound and supports BAYADA’s overall mission.

Lotus Ladies Connect with the Republican Women of the PA House of Representatives

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

Government Affairs Office (GAO) Senior Associate Alisa Borovik, Senior Manager Emilie Bartolucci and I spent an evening at the Pennsylvania Homecare Association headquarters near Harrisburg with house republican Representatives.  During the event, we had the opportunity to thank our current sponsors of our presumptive eligibility legislation and discuss the need to increase the personal assistant services rate for our aides.  The event was well attended by over 10 republican legislators.

“649 Days Until Medicaid Managed Care Go-live” – Will Medicaid Meet Its Goal in NC?

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

 Last week, I attended the Medical Care Advisory Council (MCAC) meeting where Jay Ludlam the new NC Department of Health and Human Services (DHHS) Assistant Secretary for Medicaid Transformation presented the department’s program design for taking Medicaid into a managed care environment.  Having been on the job for less than three weeks, Ludlam said, “649 days until the Medicaid Managed Care go live date!”  While many steps need to occur before “go live”, including formal approval by Centers for Medicare and Medicaid Services (CMS), the department is aggressively working towards that goal.  I spoke with Mr. Ludlam after the meeting, not only to introduce BAYADA but also to express our concerns with the fast pace, and lack of details for how long-term services and supports will be incorporated into reform.  As you may recall, BAYADA formed a review team and has already submitted comments to the program design. The Government Affairs Office (GAO) will continue to participate in the discussion as the state formulates its plan.  Click to read Jay Ludlam’s complete bio.

Photo of Jay Ludlam link to his bio
Photo of Jay Ludlam link to his bio

Government Affairs Delaware Office Tour

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

All of our Delaware service offices kindly opened their doors to Chief Government Affairs Officer Dave Totaro, Manager of Grassroots Advocacy Mike Sokoloski, and me this week.  The Government Affairs Office (GAO) team was able to share current information about our state and federal advocacy efforts.  We had good conversations with office teams about what BAYADA’s official positions are and how office and field employees are getting more involved in advocacy for our clients.  Thank you all for such warm receptions!

Aides Cried Tears of Joy for Much-deserved Raises throughout North Carolina’s Assistive Care State Programs Offices

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO) and Shannon McCarson, Regional Director, Dogwood Group (DOG)

We worked together and made it possible. After many years of advocating for higher reimbursement rates within the state Medicaid programs, we finally received an increase in the hourly rate for personal care services (PCS). This achievement was made possible through the persistent advocacy efforts of our employees, clients, families, and government affairs team. Our Hearts for Home Care Advocates participated in email campaigns, home visits, legislative roundtables, home care lobby days in Raleigh, and professional lobbying efforts.

As a result of working together, this week assistive care state programs directors throughout the state were thrilled to pass along an increase to our deserving CNAs and HHAs who care for our Medicaid clients and have stuck with us through thick and thin.

Directors have been personally speaking to staff to share the great news. “One by one, as I spoke to our aides, I heard the same thing – gratitude, appreciation, tears of joy, and, yes relief, too,” said Mimosa (MIM) Division Director Joe Seidel. “The low Medicaid reimbursement rate made it impossible to pay more. I am glad to do it now.” This rate increase is a good place to start, and more needs to be done.

Let’s keep the momentum going by joining to be a Hearts for Home Care Advocate. We believe our aides deserve even more for the important work they do in keeping our clients safe at home. If you are not already part of our advocacy group, join today at heartsforhomecare.com to receive alerts that could influence future efforts to increase pay rates.

 

Busy Week for the Government Affairs Office in Washington D.C.

Submitted by Dave Totaro, Chief Government Affairs Officer (GAO)

Last week, I was elected to the Board of the Partnership for Quality Home Health (PQHH) replacing Chairman and Founder, Mark Baiada, who stepped down upon his retirement.  PQHH is an alliance of major home health providers dedicated to the development of policy to improve the quality of life and care of all home health patients.  I am also a board member and Chairman of the Partnership for Medicaid Home-based Care (PMHC), an alliance of major Medicaid providers, managed care organizations, state and national home care associations and interested business affiliates dedicated to the development of policy to enhance Medicaid reform.

Also, following each Board meeting, the Partnerships held events to honor the support for Medicaid and Medicare shown by home health care champions U.S. Senator Bob Casey (D-PA) and U.S. Senator John Cornyn (R-TX).

And, last week, the Government Affairs Office supported the PQHH Action Alert to urge the Centers for Medicare and Medicaid Services (CMS) to withdraw their Home Health Groupings Model (HHGM), a proposed new payment model for home health services that would significantly cut home health revenues by more than 15%.  As of September 14,  759 BAYADA colleagues have sent 2334 messages to 156 legislators.  Thank you to everyone who took action and who participated in this very important and necessary alert.

Photo: Dave Totaro and Senator Bob Casey at the Partnership for Home-based Care Board Meeting in Washington, DC.

New Secretary of Pennsylvania’s Department of Human Services

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

On August 17, Governor Tom Wolf announced that he asked the current Insurance Commissioner Teresa Miller to take over as the Secretary of the Department of Human Services (DHS).  Miller accepted and took over as Acting Secretary on August 21, replacing Secretary Ted Dallas.

Secretary Dallas has been out on medical leave since mid-June.  It is expected that Dallas will join Wolf’s executive office staff when he returns.  Secretary Miller was already tapped by Governor Wolf to lead the proposed unified department of health and human services that has yet to be approved by the legislature.  In the coming weeks, the Government Affairs Office (GAO) plans to meet with Secretary Miller to introduce her to BAYADA.