Advocacy Win! Home Care Employee Christine Detweiler’s Advocacy Efforts Lead to New SMA Law

Christine’s advocacy efforts led to the ultimate win: a new law that will benefit families!

Rep. Marguerite Quinn’s home visit with a five-year old client with SMA led her to introduce a bill about newborn screening for the disease!
Rep. Marguerite Quinn’s home visit with a five-year old client with SMA led her to introduce a bill about newborn screening for the disease!

Pennsylvania Hearts for Home Care Ambassador Christine Detweiler has always been a diligent advocate, but recently, her efforts have proven that home care employees can truly go beyond the call of duty for clients and staff by serving as their voices in our state capitals.

“Home care is important to so many Pennsylvanians, and many aren’t as readily able to meet with legislators to share their stories,” said Christine. “I see advocacy as an extension of why I do what I do as a home care employee: We need to make sure we get out there to be a voice for those who don’t have one!”

Christine has been progressively adding more interactions to her advocacy portfolio—Over the past year-and-a-half she focused on meeting legislators in their district offices, and in the past few months she has hosted multiple home visits. Home visits are the most impactful way to demonstrate the importance of home care to legislators because it gives them a chance to see firsthand how clients receive services. To say Christine’s home visit resonated with Pennsylvania state Representative Marguerite Quinn is an understatement.

A few months ago, Christine led the representative on a home visit with five-year old client Gideon M. who suffers from Spinal Muscular Atrophy (SMA). His mother shared their heartwarming story and opened up about their family’s challenges and Gideon’s ever-growing needs. Her story impacted the representative so deeply that shortly after the visit, Rep. Quinn emailed Christine to further assess the family’s needs and determine how she could help them obtain a transportation cart that would make Gideon’s care easier. The outreach didn’t stop there.

Rep. Quinn recently reported to Christine that she has arranged for a builder to come into the family’s home to build custom doors to create a private area for Gideon downstairs. She also reported that she contacted a rotary to find out if the family can be provided with a generator so that they do not need to constantly worry about their home’s power going out. It is truly remarkable how Christine’s efforts have impacted her client and his care.

In addition to her efforts for Gideon’s family, Rep. Quinn introduced a bill that would add SMA screening to the newborn screening list to help diagnose this disease before a child is even born. After introducing this legislation, Rep. Quinn encouraged the state Newborn Screening Advisory Board to support the measure. As a result of her continued efforts, this past month Secretary of Health Dr. Rachel Levine signed the recommendation.

The Hearts for Home Care Team can’t be prouder of the impact that Christine has made! Her passion and tenacity has reached the hearts of many legislators, and she is truly making a name for herself in Harrisburg as a tireless advocate!

A special thanks to Rep. Quinn for her work to get this law on the books on behalf of all of Pennsylvania’s future families. Click here to read the opinion piece that Gideon’s mom, Ruth M., authored, and The Intelligencer published!

To learn more about how your office can host a home visit, or ways you can get involved with advocacy on behalf of all home care staff and clients, email advocacy@bayada.com today.

Pictured: Christine Detweiler (left) poses with fellow home care advocates and state Representative Craig Staats during The Pennsylvania Home Care Association’s Advocacy Day
Pictured: Christine Detweiler (left) poses with fellow home care advocates and state Representative Craig Staats during The Pennsylvania Home Care Association’s Advocacy Day

Advocate Spotlight: Christine Detweiler is a Voice for Her Pediatric Client Gideon

From home visit to house bill: Christine’s advocacy efforts lead to a bill introduction!

Pictured: Christine Detweiler (left) poses with fellow home care advocates and state Representative Craig Staats during The Pennsylvania Home Care Association’s Advocacy Day
Pictured: Christine Detweiler (left) poses with fellow home care advocates and state Representative Craig Staats during The Pennsylvania Home Care Association’s Advocacy Day

Pennsylvania Hearts for Home Care Ambassador Christine Detweiler has always been a diligent advocate, but recently, her efforts have proven that home care employees can truly go beyond the call of duty for clients and staff by serving as their voices in our state capitals.

“Home care is important to so many Pennsylvanians, and many aren’t as readily able to meet with legislators to share their stories,” said Christine. “I see advocacy as an extension of why I do what I do as a home care employee: We need to make sure we get out there to be a voice for those who don’t have one!”

Christine has been progressively adding more interactions to her advocacy portfolio—Over the past year-and-a-half she focused on meeting legislators in their district offices, and in the past few months she has hosted multiple home visits. Home visits are the most impactful way to demonstrate the importance of home care to legislators because it gives them a chance to see firsthand how clients receive services. To say Christine’s home visit resonated with Pennsylvania state Representative Marguerite Quinn is an understatement.

A few months ago, Christine led the representative on a home visit with five-year old client Gideon M. who suffers from Spinal Muscular Atrophy (SMA). His mother shared their heartwarming story and opened up about their family’s challenges and Gideon’s ever-growing needs. Her story impacted the representative so deeply that shortly after the visit, Rep. Quinn emailed Christine to further assess the family’s needs and determine how she could help them obtain a transportation cart that would make Gideon’s care easier. The outreach didn’t stop there.

Rep. Quinn recently reported to Christine that she has arranged for a builder to come into the family’s home to build custom doors to create a private area for Gideon downstairs. She also reported that she contacted a rotary to find out if the family can be provided with a generator so that they do not need to constantly worry about their home’s power going out. It is truly remarkable how Christine’s efforts have impacted her client and his care.

In addition to her efforts for Gideon’s family, Rep. Quinn recently introduced a bill that would add SMA screening to the newborn screening list to help diagnose this disease before a child is even born. As of today, the Spinal Muscular Atrophy Bill (HB 2484) has been introduced and placed in the Health Committee for consideration. Representative Quinn reached out to her House colleagues and asked for co-sponsors for the important resolution and to bring awareness to this condition and to assist families across Pennsylvania with early intervention. We are looking forward to this bill passing through committee once legislators are back in Harrisburg.

The Hearts for Home Care Team can’t be prouder of the impact that Christine has made! Her passion and tenacity has reached the hearts of many legislators, and she is truly making a name for herself in Harrisburg as a tireless advocate!

To learn more about how your office can host a home visit, or ways you can get involved with advocacy on behalf of all home care staff and clients, email advocacy@bayada.com today.

Rep. Marguerite Quinn’s home visit with a five-year old client with SMA led her to introduce a bill about newborn screening for the disease!
Rep. Marguerite Quinn’s home visit with a five-year old client with SMA led her to introduce a bill about newborn screening for the disease!

Problems Emerge in Community HealthChoices in Southwest PA

A special guest article by the Pennsylvania Health Law Project (PHLP)

In January 2018, 11,000 older adults and people with disabilities in Southwest PA who had been receiving Medicaid long term services and supports in the community, started receiving those services, including personal assistance services (PAS), from one of three Community HealthChoices (CHC) managed care plans: UPMC Community HealthChoices, PA Health & Wellness, and AmeriHealth Caritas.

For the first six months of the roll-out, CHC participants were entitled to keep receiving the same amount of long term services and supports they had been receiving prior to CHC with the providers they had been using. This six-month “continuity of care period” in the Southwest ended on June 30.

PHLP has been hearing from CHC participants about actions CHC plans are taking to reduce services in this post-continuity of care period. After speaking with these participants and reviewing CHC plan notices and service plans, it appears CHC plans are violating the rights of participants and not following the terms of their agreement with the state.

The problems CHC participants are experiencing include deficient notices reducing services they had been receiving and a lack of appropriate person-centered service planning. Most of the problematic service reduction notices involve PAS.

Notices Sent to Participants Are Inadequate: CHC plans are sending reduction and denial notices to participants that do not include any explanation or reasons for why services are being reduced or why requests for new or increased services are not approved. CHC plans are required to send their members written notice of reductions and denials of services. These notices must detail the reasons for the change or denial. Justifications, which PHLP has documented, like “you have been assessed to need less PAS hours” or “the services are not medically necessary” without any further explanation are insufficient. The CHC participants who have contacted PHLP are receiving notices that do not explain why the CHC plan decided they do not need the services, what has changed to warrant a service reduction, or how requested services are not medically necessary.

Lack of Person Centered Planning: Person-centered service planning is at the core of CHC. It is supposed to be a process in which the CHC participant, working with their service coordinator and anyone else the participant wants involved, identifies her needs, preferences, and goals. This informs the development of a service plan. The person-centered service plan process is so central to the CHC program that home and community-based services, including PAS, received under continuity of care cannot be changed until the process is complete. Yet, PHLP has heard from participants who are being denied services when they have not gone through the service planning process. Others have gone through the process but have not been given a copy of the service plan that was developed. Still others have had incomplete service plans, such as unsigned plans or not having any goals listed at all.

PHLP has shared its concerns with the Department of Human Services (DHS)and will continue to do so as new examples of problems surface. DHS reacted swiftly to the information and specific examples PHLP provided.  All three CHC plans have been put in corrective action. As a result, the CHC plans are retraining service coordinators on person-centered planning and submitting to the state for review all notices issued to members when services are denied or reduced. DHS has assigned staff to review every service denial notice until it is satisfied that each CHC plan is complying with the CHC agreement. Moreover, DHS and staff from its Office of General Counsel are meeting in July with senior leadership from each CHC plan to review the minimum content required for a service denial notice when plans deny or reduce a CHC participant’s services.

However, regardless of he corrective actions described above, vigilance from CHC participants and their providers in the Southwest is needed to ensure the CHC program moves into its next phase in the region in a way that does not harm participants but assures their needs are met. CHC participants, their family members or other supports, and providers are encouraged to read notices denying or changing services carefully. These notices include information about how to file an appeal. CHC participants should appeal decisions if they do not agree with them. Appealing quickly will ensure they continue to receive services at the previously approved level while they go through the appeal process.

PHLP strongly encourages CHC participants or their providers or advocates to call the PHLP Helpline at 1-800-274-3258 or email us at staff@phlp.org for advice or help with their appeal. Information about appealing a CHC decision can also be found on PHLP’s website (www.phlp.org). You can also sign up here for the second part of PHLP’s CHC Appeals webinar series which will be held on July 17.

PA Budget Record: First Early Budget in Over Four Years!

 

 

 

 

 

 

 

For the first time in over four years, the Pennsylvania General Assembly completed the FY 2018-2019 budget ahead of the constitutionally mandated June 30 deadline.

During our Advocacy Day in Harrisburg, House Appropriations Chairman Stan Saylor announced he was working to get us an increase in personal assistant services (PAS) provided under the Office of Long-Term Living. This was Pennsylvania’s primary legislative priority for BAYADA in 2018.

After this announcement the Government Affairs Office (GAO), home care advocates, and the Pennsylvania Homecare Association (PHA) worked at breakneck speeds to make it a reality. In the month leading up to the final budget we met with Chairman Saylor and staff several times, spoke with key leadership, and touched the entire legislature several times. Unfortunately, the legislature passed, and the Governor signed, the FY 2018-2019 budget without this increase.

We have been working towards this increase since 2014 and we have made incredible progress. We will continue to ensure this remains top of legislators’ minds. This summer we will begin our work to ensure we receive a rate increase in next year’s budget.

Thank you for your support, and for the time that you took participating in our efforts, whether it was by emailing legislators through our action alert, which generated over 430 emails to legislators, or through your attendance at PHA’s Advocacy Day in Harrisburg. All of these efforts showed legislators just how widespread and important this issue is, and we have heard directly from many who told us how impactful our efforts continue to be.

PA State Advocacy Day Attracts Big Hearts and Big Numbers

BAYADA employees, clients, and families gather in Harrisburg to advocate for better home care policies.

On May 22, 160 employees donned their best “BAYADA red” and gathered at the Pennsylvania state capitol in Harrisburg. Employees came from 30 divisions, 18 offices, and 9 practices, with the common goal of shining light on the importance of home care.

Along with BAYADA employees and other industry professionals, home care clients and family members joined in the efforts as well. We attracted big hearts: Each individual attended because they felt that it was their duty to advocate on behalf of themselves, their staff and clients, or their loved ones. When advocates share their unique and compelling home care experiences with legislators, it enables legislators to remember our clients’ faces and stories when they make policy decisions that affect care.

Hearts for Home Care advocates met with more than 200 legislators to educate them on the needs of the home care industry. They advocated for changes in hiring standards within the Older Adult Protective Services Act, a need for deemed eligibility to keep more seniors at home, and an increase in pay for direct home care workers.

If you missed out on 2018’s Advocacy Day, there are still opportunities to connect with legislators and to be a voice for those who cannot advocate for themselves. Employees can set up and host home visits, legislative office visits, or simply make phone calls or send emails to demonstrate the importance of home care to legislators. Please reach out to me at lness@bayada.com to learn about the many ways you can connect with legislators in support of our goals.

 

Hundreds of Home Care Advocates Attend Pennsylvania Homecare Association’s Annual Advocacy Day

Home care employees, clients, and families participate in Advocacy Day in Harrisburg, PA

Last Tuesday, May 22, more than 200 home care employees, clients, and clients’ family members came together with the Pennsylvania Homecare Association (PHA) for their annual Advocacy Day in Harrisburg, PA. Advocates came from a variety of agencies and backgrounds across the state to discuss the importance of home care with their legislators.

Advocates met with more than 200 legislators to educate them on the need for deemed eligibility to allow more of Pennsylvania’s seniors to remain at home, increasing pay for home care workers, and the importance of maintaining strict hiring standards within the home care industry. Advocates used their passion and first-hand experience to demonstrate the necessity of these initiatives to legislators and made lasting impressions through their stories.

And advocates’ hard work paid off! During PHA’s press conference, Rep. Stan Saylor, Chair of the House Appropriations Committee, stated that he would support a rate increase for Medicaid personal assistance services (PAS). Additionally, PHA has been in touch with staff from the Senate Appropriations and Health Committees about bringing deemed eligibility legislation to the Senate floor for a vote.

Advocacy is a vital part of a democracy and allows for legislators to hear about issues their constituents routinely face from a different perspective. Through BAYADA Home Health Care’s Hearts for Home Care Ambassador Program, BAYADA employees are educated on the issues facing their states, strategies to advocate effectively for home care staff and clients, and the tools necessary to make a lasting impression.

Advocacy is just another way of ensuring the highest quality care is provided to those who need it. Below, please find quotes from some of those who attended this year’s Advocacy Day on why they chose to participate, as well as a reaction from Pennsylvania State Representative Donna Bullock.

 “When I was approached several years ago to be a Hearts for Home Care Ambassador, I was hesitant. There is so much about politics I don’t understand, but what I do believe in is what we do at BAYADA! We have such an amazing opportunity to be the voices for those who don’t have them and if we believe in what we are speaking too, it’s really not that hard! Advocacy, to me, just means I’m standing up for what I believe in and sharing it with those who have the ability to make change.” –PA Hearts for Home Care Ambassador Christine Detweiler

“Advocacy in home care is really about our government representatives seeing the faces and hearing the voices of the people. These interactions help legislaotrs know what our needs are so they can do their best to help my family and the many other families who need a nurse or an aide at home.” –Amy Zemek, Mother of client Alexa D.

“What I found special about attending Advocacy Day in Harrisburg was that the real people we serve every day did not need to rely on anyone else to tell their story. They were allowed to advocate for themselves. We just need to listen more and allow their powerful story to speak loud and clear. Advocacy Days allow those we serve the opportunity to tell their powerful story and for our elected officials to hear and listen to their stories, because those we serve can often advocate for themselves far better than we can.” –Home Care employee Jarod Champeaux

“What is advocacy to me? Advocacy is the look on the faces of the people we serve, the love, the commitment, and the lives we change by the amazing work that we do!” -PA Hearts for Home Care Ambassador Candice Proctor

“Affordable healthcare is a top priority of mine and is critical in safeguarding the well-being of our communities. I share BAYADA’s Home Health Care’s passion and devotion to ensuring anyone who qualifies for home care service receives the proper treatment they need and deserve. I thank them along with the many other advocates for traveling all of the way to Harrisburg to fight for our cause. Together, we can instill change, protect families and achieve our goals.” –State Representative Donna Bullock, 195th District

Thank you to the many home care employees, clients, and families that participated in Advocacy Day!

Client Resource: Pennsylvania Health Law Project (PHLP): A Free Resource for Families Who Need Help Appealing Service Denials

By Danna Casserly, Staff Attorney, Pennsylvania Health Law Project

The Pennsylvania Health Law Project (PHLP) is a statewide center of legal expertise and advocacy devoted to increasing access to publicly-funded health care coverage and services. PHLP provides free advice and representation to individuals across the state who are experiencing problems with their Medical Assistance (MA) services, including their home health services.

If MA denies, reduces, or terminates a client’s home health services, the client has a right to challenge that denial by filing an appeal.

The MA appeal process can be complicated. There are multiple levels of appeal, including a grievance, an external review, and a fair hearing. PHLP understands that families often don’t have the time to take on these appeals on their own, or they may feel confused, daunted, or frustrated by the

process. PHLP will work with families, along with their home health agency, doctors, and other providers to try and get the denial overturned through the appeal process.  In some cases, PHLP may even go with the family to the appeal hearing.

There is no income limit to qualify for help from PHLP and all services are completely free of charge.

If your client’s MA services are denied, please urge them to call PHLP’s Helpline at 800-274-3258 for assistance. More information can be found on PHLP’s website at www.phlp.org.

BAYADA Honors Direct Care Workers at the Direct Care Worker of the Year Awards

 

 

 

 

 

 

 

BAYADA Staff at the Direct Care Worker of the Year Awards

Each year the PA Department of Aging and the Pennsylvania Homecare Association (PHA) request nominations for the Direct Care Worker (DCW) of the Year Awards.  The DCW is an individual who goes above and beyond in their work and provides essential services to older Pennsylvanians and disabled adults.

This year there were over 195 nominations. BAYADA nominated 16 aides from our offices.

The award was given at PHA’s Direct Care Worker Forum in Harrisburg. Each aide that was nominated was invited to attend. The day consisted of professional development, a motivational speaker and a DCW survey on the challenges of the profession.

This year GAO also hosted a pre-event for our aides to educate them about BAYADA’s Hearts for Home Care program and to honor BAYADA’s Home Health Aide 2017 Hero and 2017 PA Department of Aging DCW of the Year Anne Pannone.

Although, one of our BAYADA aides did not win the award in 2018 each aide felt recognized, energized and supported.  Thank you to all our office who submitted nominees.

Thank you to all of our home health aides for the important work that you do!

BAYADA Submits Comments on Electronic Visit Verification (EVV) to the Department of Human Services (DHS)

GAO recently worked with the Partnership for Medicaid Home-Based Care and internal stakeholders to submit comments to the Department of Human Services (DHS).

DHS released a Request for Information (RFI) to receive feedback on the technical specifications that should be considered when establishing an electronic visit verification (EVV) system.  DHS reinforced the message we had heard before stating that the state is moving towards an open implementation system with a standard clearing house.

BAYADA’s comments reinforced our position that an open system is imperative to foster innovation and enhance client care.  We look forward to continuing to work with the state to support the implementation of an open EVV system within the state.

If you have any questions about EVV or other mandates, please do not hesitate to reach out to me at lness@bayada.com.

PA Commonwealth Court overturns HealthChoices Contracts

HealthChoices—Pennsylvania’s managed care program for physical health, which includes our pediatrics practice—announced its newly rebid contracts in early 2017. For the past several years, this rebid process has been fraught with issues due to Managed Care Organizations’ (MCOs) protests. The newly announced contracts proved to be no different, as United submitted a contract bid protest shortly after this announcement.

United submitted this protest due to their belief that the state made an improper contract decision. Recently, Pennsylvania’s Commonwealth Court took up this protest and ruled in favor of United. The Court found that DHS met with MCOs during the black out period, thus ruling in favor of United’s protest.

DHS has not yet announced its next steps, but it is possible that the department will have to rebid all of HealthChoices’s contracts again. Because HealthChoices represents over $12 billion in contracts for potential MCOs, this ruling has created unprecedented waves in the state’s healthcare community. GAO will continue to monitor the outcomes of this ruling and will update the pediatric practice as more information becomes available.