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.

Save the Date: PHA Lobby Day is May 22nd!

BAYADA will again be supporting the Pennsylvania Homecare Association’s (PHA) Lobby Day in Harrisburg on May 22nd!

BAYADA office staff, field employees and clients will be joining industry colleagues to show state legislators just how large and impactful the home care industry is and, as in years past, we are committed to maintaining BAYADA’s historically large “sea of red” presence throughout the day.

Whether or not you’ve participated in a lobby day before, this is your chance to share your voice about issues that affect home care and let legislators know what can be done to alleviate some of the pressures that industry staff, clients families face daily. If you have any questions about what the day entails or how you can play a role, email lness@bayada.com.

Thank you to all PA staff, clients and families for your commitment to advocacy and for your participation in lobby days past and future.

Save the Date–May 22 is PHA Lobby Day in Harrisburg!

PA Offices Submit Home Health Aide Nominations to PA’s Direct Care Worker of the Year

2017 BAYADA Direct Care Worker of the Year Nominees

Each year the PA Department of Aging and the Pennsylvania Homecare Association select one home health aide to be named Pennsylvania’s Direct Care Worker of the Year.

Last year BAYADA nominated 14 Home Health Aides (HHAs) and one of our nominees, Anne Pannone, was selected at PA’s Direct Care Worker of the Year.  Since her selection, Anne was awarded a cash prize of $1,000 and has been invited to several statewide events to discuss the meaning of being a HHA and the value it provides to the state.

To help ease our service offices’ workloads, GAO is working with EMP to submit this year’s HHA nominations using information provided through our Hero program.  To date, over 15 home health aides have been nominated to be this year’s Direct Care Worker of the Year.

All nominees will be invited to the 2018 Direct Care Worker Forum, which includes a luncheon and half-day training program on March 28.  A stipend will be given to all HHAs attending the Forum.

PA Department of Human Services Announces Electronic Visit Verification Direction

Shortly after the new year the PA Department of Human Services (DHS) announced that the state will be moving forward with electronic visit verification (EVV) compliance by means of an open system with a clearinghouse. BAYADA advocated on behalf of adoption of an open system and we are extremely pleased with DHS’s announcement. The open system encompasses the best of both worlds for providers within the state: An open system will enable providers that currently have an EVV system to use their system to “talk” to DHS’s clearinghouse.  At the same time, it will also enable providers who do not currently use an EVV system to use the clearinghouse system as their provider.

BAYADA voiced its opinion in favor of an open system and discussed the detractors of a closed system during DHS’s comments period in May. Click here to read the EVV comments that BAYADA submitted to the state.

Next, BAYADA plans to participate in a survey DHS will be releasing for the Department to better understand how home and community based providers are currently using EVV systems.  DHS is also in the process of developing a request for information (RFI) to understand the features, challenges, and remedies in implementing the EVV clearinghouse.  If applicable, BAYADA plans to participate in the RFI as well.

Equalizing Access Legislation Approved in PA House Health Committee

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

On November 21, the House Health Committee met and unanimously voted to approve HB 1829. HB 1829 allows individuals to be presumed eligible for home health care. This practice is currently allowed for nursing homes but is not extended to home care. Because of this, Pennsylvanians often go without the help they need or are unnecessarily placed in a nursing home. The legislation approved included two amendments, which changes the name “presumptive eligibility” to “deemed eligibility”. It also extends this process to allow adult day centers to do presumptive eligibility as well. We are very pleased with this outcome. Next the bill will go to the House Appropriations Committee. The Government Affairs Office (GAO) is working to set up meetings with Appropriations Committee members to ask them to support this legislation.

PA Client Visit to Discuss BAYADA’s Advocacy Program

Submitted by Rick Hynick, Director, Client and Family Advocacy (GAO)

 On Friday, October 20, Chief Government Affairs Officer Dave Totaro and I met with adult Home Health Aide client, William Bezdziecki at his home near Wilkes Barre to discuss the BAYADA Hearts for Home Care program and different client advocacy opportunities.  Also, present at the meeting were William’s parents, Jack and Mary Lou Bezdziecki, Wilkes-Barre/Scranton (WBS) Clinical Manager Susan Youells, WBS CSM Kristie Spinello and Certified Nursing Assistant Gerald Stevenson.

PA Long-Term Care Council Workforce Committee Meets to Discuss Data Needs

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

Last week, the Long-Term Care Council met in Harrisburg along with the various sub-committees.  The Workforce Committee continued the discussion regarding how we continue to care the aging Pennsylvanians.  It was clear that direct care workers are the foundation of caring for older Pennsylvanians.  There was also the recognition that more direct care workers will be needed and recruited for the role.  The majority of our time was spent discussing the data needed to make the case for higher pay, better support, and professionalizing the profession.  The Government Affairs Office (GAO) is looking forward to continuing our work with the group.

Building the Client & Family Advocacy Program

Submitted by Rick Hynick, Director, Client and Family Advocacy (GAO)

 

On August 23, the Government Affairs Office (GAO) gathered in Philadelphia, along with a few office and field employees with advanced advocacy interests.  The goal of the day was to develop tactics to engage both clients and employees who enjoy advocacy to influence decision makers to support home health care.  Building awareness, Inspiring engagement and Empowering advocates were three main phases that were at the heart of our discussions related to grassroots advocacy efforts for our clients and families here at BAYADA and also for the many others who will be moved to join us from the community.

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.