Great news for our NC Habilitation offices that operate under Partners Behavioral Health, a Local Management Entity/Managed Care Organization (LME/MCO) that oversees Medicaid’s Innovation Waiver in western North Carolina. After more than of a year of advocating for rate parity for like services, Partners announced yesterday rate increases for community-based services. The Community Living & Support rate will see a 9% increase, bringing it to $20.28 effective August 1, 2018.
This much-needed increase will allow BAYADA to hire and retain more qualified professionals and take care of more individuals at home and in the community. While this is a great step forward, our work is not done yet. BAYADA, along with our Hearts for Home Care advocates, will continue to push towards more rate increases so that we can ensure that North Carolina has enough high-quality caregivers to meet the growing demand for home care services. Our field staff deserve better wages, and our clients and all of those who wish to remain at home in North Carolina deserve better access to quality services.
Thank you to all our advocates who supported this increase through your input and your contact with legislators. We truly are #StrongerTogether.
This year has proven to be anything but normal at the General Assembly. Instead of adjournment with sine die, which indicates that no future business schedule this session, the Republican majority passed House Joint Resolution 1101, which calls back lawmakers on November 27. This political power move gives the Republican super-majority one last session no matter what happens on election day.
Despite this unusual legislative session, BAYADA managed to accomplish the following legislative priorities:
Secured a 12.37% aide rate increase for CAP-DA, effective Jan 2019
Protected Certificate of Need from elimination for our Medicare offices
Secured a 9% rate increase from Partners Behavioral Health for our Habilitation offices, effective August 1, 2018
Thank Youto our many ambassadors and advocates that helped us achieve these goals. We could not have done it without your passionate voices coming together to support all of North Carolina’s home care employees and clients.
GAO and our North and South Carolina Ambassadors met in Charlotte, NC on March 14th for a day packed with thoughtful discussion about the scope, significance, and impact of our advocacy efforts. Whether they discussed legislative priorities, advocacy strategies and techniques, or the relationships that drive the work they do, our Ambassadors made it increasingly clear that they are passionate and prepared to be the voice for their clients, for their client’s families, and for themselves.
Among the day’s highlights was a visit from Representative Carla Cunningham, a former hospice nurse who represents North Carolina’s 106th district. Representative Cunningham has been a staunch advocate for health care, mental health, seniors, women, and children. Representative Cunningham offered our ambassadors a window into the legislative process and encouraged them to be dedicated, prepared, collaborative, and respectful. We were joined also by Wilburn, who has been a BAYADA client for 11 years. Wilburn spoke of the deep connections he shares with his caregivers and with the people he has met in his own advocacy efforts.
Our ambassadors are ready to move forward and be the competent, dedicated, and reliable voices that BAYADA needs to ensure that Wilburn and all our clients receive the care they deserve. It only takes one action, taken by only one person to make a difference. You can be that person today. Email firstname.lastname@example.org to see how you can get involved!
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 email@example.com
Legislative successes, like the NC Medicaid rate increase for nursing in 2015 and 2016 and the home health aide increase this past year, don’t magically happen. Legislative successes start with an identified need — low Medicaid rates made it impossible to pay people what they are worth — and end with legislators supporting jobs in the community and keeping families together by investing in home health care. Every step along the way our Hearts for Home Care Advocates carried our unified message to decision-makers. Our cumulative actions over the years, including home and district visits, legislative round tables with lawmakers, responding to calls to action, attending lobby days, etc., made all the difference. Individually and collectively our shared voices got results. Join us to be a Heart for Home Care Advocate.
Last month the North Carolina Department of Health and Human Services (DHHS) submitted an amendment to the 1115 demonstration waiver application, originally submitted in June 2016. This amendment is the next step in the transformation of NC Medicaid and NC Health Choice programs to managed care, driving the state’s goal to implement reform. This system will address both the physical and behavioral health of North Carolinians. The proposed program design seeks to implement changes that advances high-value care, improves population health, engages and supports providers, and establishes a sustainable program with predictable costs. Our BAYADA workgroup, made up of technical experts and leadership from across the organization, has reviewed and provided formal comments to both the program design and waiver application. Our comments focus on: ensuring beneficiary access to care; the viability of the provider network; minimizing administrative burden, and establishing meaningful metrics that support and reward quality.
Special thanks to our review BAYADA teams for sharing their insight and operational experience.
Last month I attended an event honoring StateRepresentative Dean Arp (R-Union). Rep. Arp serves as Chairman of the House Appropriations Committee, the committee responsible for crafting North Carolina’s state budget. Chairman Arp will be critical in allocating sufficient funds to the Medicaid budget for the increases we are seeking this legislative session. During the event we discussed the importance of getting the rates up prior to Medicaid’s transition to managed care, which is targeted for July 2019. In addition to supporting our issues in the past, Rep. Arp has been on a home visit and understands the importance of home care in the continuum.
With Sen. Tucker’s recent retirement announcement, it is critical we have allies in the Senate to help carry our message as well. Senator Joyce Krawiec is next in line. To educate her on our issues, we are in the process of identifying a client in her district to host a home visit early in 2018.
Last month the GAO Advisory Committee met to evaluate our 2017 efforts and to plan for 2018. The Advisory Committee is made up of representation of every practice in NC as well as representation from CMO and GAO. Below is a summary of their findings and the priorities for 2018.
2017 Legislative Accomplishments With your help we accomplished the following:
• Secured an increase for Medicaid aide services under the Personal Care Services (PCS) Program and the Community Alternatives Program for Children (CAP-C) from $13.88 to $15.52, effective August 1, 2017, and to $15.60 effective January 1, 2018. BAYADA impact: $300K annually. These increases will allow us to hire and retain more quality staff. • Protected Certificate of Need (CON) and prevented its elimination from health care. Also prevented the Continuing Care Retirement Communities (CCRCs) from operating a home health agency without a CON. The CCRCs were seeking a carve-out from CON statute. Four separate bills were filed to eliminate this statute. BAYADA impact: Protected 5 service offices that serve Medicare clients. This issue is likely to re-surface in 2018. • Secured a 7.5% tax exclusion for health care services on all revenue. BAYADA impact: All 54 NC service offices will save a collective $12.6M annually.
2018 Key Legislative Priorities:
• Amend the Community Alternatives Program for Disabled Adults (CAP-DA) budget neutrality language to allow the aide rate to be increased from $13.88 to $15.60 to align with the PCS and CAP-C rate increases effective Oct. 1, 2018, by Q4-2018. • Secure a $1.40 increase for all Medicaid aide services from $15.60 to $17.00 effective Jan. 1, 2019, by Q3-2018. • Prevent the elimination of Certificate of Need (CON) for home health or hospice by Q3-2018. • Ensure that the Medicaid Transformation waiver includes a rate floor provision and language that ensures access to quality care and minimal administrative burden by Q4-2018.
Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)
Often we talk about sharing our message, making our point, and communicating our value proposition. Those are things we, in the Government Affairs Office (GAO), must do as we seek support for our issues with lawmakers. One such conversation was had with Representative Nelson Dollar earlier last week, where Chief Government Affairs Officer Dave Totaro and I thanked him for his past support on the rate increases and continued our conversation around our priorities for the year to come.
If we are to continue to be successful in building a strong advocacy base, it is not enough to build relationships with lawmakers. We must also get to know our internal BAYADA customers–our staff and clients. As such, we visited six home health offices on the I-85 corridor. It was great to be able to provide a legislative update, share advocacy information, and solicit feedback. It helps ground our efforts and put things into perspective.
Special thanks to Division Director Richard Hopson, Area Director Shad Morgheim, and the office directors for allowing us to visit. We really enjoyed visiting with staff at CV, CHF, GAV, CAV, SC, DAV, RV, and DRF.
Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)
Last week, North Carolina’s Department of Health and Human Services (DHHS) released two requests for information (RFI) as their next step towards Medicaid Managed Care. Both requests, statement of interest and financial operations, focus on the organizations that intend to bid to be a pre-paid health plan (PHP) for Medicaid. “This RFI is an important step toward implementing the proposed program design that DHHS released in August,” said DHHS Assistant Secretary for Medicaid Transformation Jay Ludlam. “We look forward to continued input and collaboration from health care providers, health plans, and other stakeholders as we build the strongest possible Medicaid program for North Carolina.” Comments are due to DHHS on November 22. Our BAYADA workgroup’s next opportunity to provide input is on the proposed 1115 Waiver application, which is slated to be released at the end of this year or early 2018.