Reflecting on South Carolina’s and Georgia’s First Year with a Full-Time GAO Program

By: Melissa Allman, GAO Director for South Carolina and Georgia

Thank you to the many advocates that contributed to SC and GA’s successes in 2018!

What a difference a year makes. This time last year I was just transitioning out of my role as Division Director for the Palmetto Division and into my new role directing our advocacy activities in South Carolina and Georgia. I didn’t know I was in for so much! As I reflect back on 2018, my thoughts go immediately to two things: First, the successes that we were able to generate for our staff and clients and secondly, the many BAYADA leadership, staff, and clients that shared their voices and helped us win!

South Carolina

This year not only were we able to achieve an 8.2% rate increase for all personal care Medicaid waiver services in South Carolina, but we made so much headway engaging our office staff, field staff, and clients. As one person running around in the state house, I can only do so much. It is your stories and your voices that truly have made our first full-time year in South Carolina a remarkably successful year.

Aside from our rate increase, South Carolina advocates hosted five home visits with state lawmakers, hosted two legislative roundtables, and enabled Speaker Pro Tempore Tommy Pope attended a Hero Ceremony for his constituent—a home health aide from RHS. In addition, we attended several events to support our champions. Then-CLP Director, Haley Keisler was named South Carolina Home Care and Hospice Association’s (SCHCHA) 2018 Professional of the Year, and ROC client Mitchell H.’s mom and caregiver, Tammy Roberts, was recognized as the SCHCHA 2018 Caregiver of the Year. 

Left: SCHCHA Executive Director Tim Rogers (left) and I (right) pose with SCHCHA’s 2018 Caregiver of the Year Tammy Roberts (center) and her grandson.

Right: SCHCHA Executive Director Tim Rogers (left) and I (right) pose with SCHCHA’s 2018 Professional of the Year, former CLP director and current AVL director Haley Keisler and her family.

Additionally, we were able to engage a record 25 Hearts for Home Care ambassadors and advocates to Lobby Day, where we connected BAYADA staff to lawmakers to share why our families deserve to be able to stay together through home care.

A record breaking Lobby Day in Columbia

Georgia

As I reflect back on the past year, my heart is full of gratitude for all of Georgia’s leadership, Ambassadors, and advocates. Your support and advocacy made all the difference! Not only were we able to generate a rate increase for private duty nursing (PDN) services under the Georgia Pediatric Program (GAPP) waiver, but we’ve made our voices heard and our industry and company better known in the state capitol. We are truly set up for a stellar 2019!

So far in 2019 we have already began meeting with Georgia’s House and Senate leadership and the Georgia Department of Community Health (GCH). We are seeking to further increase the RN and LPN rates under the GAPP program and gain enhancements for PDN waivers for the adult population under the New Options Waiver (NOW), Comprehensive Supports Waiver (COMP) and Independent Care Waiver (ICWP) programs. We will be seeking even further involvement from our GA advocates, and I am excited to see what we can accomplish together!

Meetings are already underway for 2019: I can’t wait to see what we can accomplish together for GA!

It was a true honor to work along side of you all, and I’m looking forward to working with you as we continue to raise awareness for our state’s most vulnerable children and adults. Thank you to the many advocates that made 2018 a success, and that will help pave the way for more successes in South Carolina in 2019 and beyond!

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!

South Carolina Representative Garry Smith Visits Local Family to Learn How Home Care Impacts his Constituents

Rep. Garry Smith (left) visits home health care client Emma (held), mom Gina (right) and their in-home BAYDA nurse Danielle (second from left).
Rep. Garry Smith (left) visits home health care client Emma (held), mom Gina (right) and their in-home BAYDA nurse Danielle (second from left).

 

South Carolina State Representative Garry Smith (R, District 27) visited a local family in his district to learn how his constituents and many South Carolinian families rely on home care to keep their loved ones together at home and out of more expensive settings. Rep. Smith is one of the many legislators that Hearts for Home Care advocates bring into home care clients’ homes to show them how federal, state, and local policies affect home care recipients and their families.

During his visit, Rep. Smith met 21-month old BAYADA Home Health Care client Emma Ferguson, Emma’s mother Gina, and Emma’s in-home BAYADA Nurse Danielle Rian. Emma was born with a Chronic Lung Disease of Prematurity, which causes Emma to experience severe breathing problems, pain, and other symptoms. At her young age, Emma has already had several surgeries and currently still requires use of a Gastrostomy-Jejunostomy (G-J) Tube to assist with her feedings and medication management throughout the day. At birth, state Medicaid authorized Emma to receive private duty nursing (PDN) services in her home so that Emma can remain safely and comfortably at home with her mother.

In March, Emma’s PDN services were terminated when Medicaid determined that her skill level no longer qualified her to receive care in her home. From March until May, Emma attended a local day care facility for children with complex needs so that her mother could continue to work. During this time, Emma was hospitalized on several occasions and required ventilator support due to respiratory illness. In May 2018, Emma’s mother Gina reapplied for PDN services, and Emma was able to start receiving care at home again. Emma currently receives 32 hours of PDN services in her home, and since the reauthorization, she has not been readmitted to the hospital.

Emma’s mother Gina stated, “I’m grateful Rep. Smith was able to visit our home to see how Emma and other medically-complex children can grow up and thrive with in-home nursing. These kids deserve some normalcy in their lives, and I have seen first-hand how much better she does when she can be with me at home rather than in an institution. She only receives 32 hours a week, and this allows her to receive the care she needs in the best place–her home–and allows me to be able to work to support my family.”

After the home visit, Rep. Smith said, “visiting sweet Emma and her family has opened my eyes to what home care means to my constituents and to the many South Carolinians who depend on Medicaid home care to stay with their families and out of higher-cost settings. I look forward to exploring ways we can help keep families together while at the same time effectively managing the state’s budget.”

“One-on-one nursing services have allowed Emma to remain safely at home under the Medically Fragile Children’s Medicaid Nursing Waiver. This program is an alternative to nursing home placement at a lower cost to the state,” said Melissa Allman, Hearts for Home Care advocate and Director of Government Affairs for BAYADA. “In-home nursing care helps minimize deterioration and can prevent costly hospitalizations as staff can address subtle changes in the medical condition before it becomes serious. I hope that more legislators continue to learn about how cost-effective these services are to the state, and how valuable they are in keeping South Carolinian families together.”

Home visits like this one really give elected officials a better understanding of how their decisions on key issues like Medicaid impact real people who are seeking to remain safely at home with their families. To find out ways in which you can participate in a home visit with a local legislator, or other ways you can advocate, email advocacy@bayada.com.

Advocate Spotlight: Joe Davis

‌Joe Davis (Left) with Senator Corman

Joe Davis has been the director of BAYADA’s State College (STC) pediatric office for the past six years.  In addition to the many responsibilities that come with running a busy service office, Joe always takes time to advocate on behalf of his staff and clients.

As his office’s Hearts for Home Care Ambassador, part of his role is to inform state legislators about BAYADA and the home care industry and to educate them about our legislative priorities. Joe has hosted state Representative Kerry Benninghoff in the STC office to discuss the importance of home care within Rep. Benninghoff’s district and throughout the state. He also recently met with state Senator Jake Corman to advocate for deemed eligibility and a rate increase. Joe hopes to someday serve on a government-appointed committee to represent home care.

Thank you, Joe, for all your advocacy efforts. Your hard work on behalf of your staff and clients serve to create a better tomorrow for all of BAYADA’s staff and the many clients and families we serve.

PA GAO: 2017 Wrap Up and 2018 Planning

2017 proved to be another eventful year for home care in Pennsylvania.  Notably, MCO implementation of the increased pediatric rate went into effect on January 1, 2017. As a result, our pediatric offices have been able to implement various programs for our nurses including increased wages, benefits, and bonuses throughout the year.

Early in 2017 the PA Government Affairs Office (GAO) worked with NJ GAO Director Louise Lindenmeier to lobby against New Jersey Governor Christie’s intent to end the NJ/PA tax reciprocity agreement. We were successful in getting the over 40-year agreement reinstated, thus saving BAYADA employees over $6 million in taxes.

Throughout the year we were active participants in PA’s move towards full implementation of Community Health Choices (CHC).  Our participation, as well as that of others in the industry, resulted in a temporary rate floor for personal assistance services. The rate floor ensures that implementation of CHC will not result in rate cuts for services within the program.

In May we submitted comments in favor of an “open” electronic visit verification (EVV) system, which would be more beneficial to our employees and to BAYADA than a closed system. The administration heard our concerns and is now planning to implement an open system. See our next article to learn more about PA’s EVV system.

Finally, PA took unprecedented steps by introducing legislation which would allow deemed eligibility for home care.  This legislation takes a big step toward equalizing access to home and community based services as it would allow those who appear to financially qualify for nursing home services to be deemed eligible for home care services as well.  After the legislation was introduced it was voted unanimously out of the House Public Health and Appropriations Committees and was voted out of the full House unanimously. Next up in the long and winding legislative process: The bill will now be considered in the Senate.

Towards the end of 2017 the PA GAO conducted a needs assessment with our PA division directors. Upon completion of the needs assessment our PA GAO Advisory Council met and recommended the following priorities for 2018:

  • Increase the personal assistance service rate by an average of 10%, creating a statewide reimbursement rate of $20.58 by 6/30/18.
  • Pass deemed eligibility for home care through legislation by 4Q18 (continuation of 2017 goal).
  • Allow physician signatures to be obtained within 30 days instead of 7 days.
  • Include requisite reimbursement increases in any state minimum wage increase.
  • Pass drug disposal legislation for Hospice.
  • Support the passage of Pennsylvania Orders for Life-Sustaining Treatment (POLST) legislation.
  • Lay the foundation for rate floor legislation in Pennsylvania.

Our PA legislative priorities have been approved by BAYADA’s Chief Executive Officer. We are looking forward to an exciting and challenging year ahead! Thank you to all PA staff, clients and families for your support and commitment to advocacy. Your efforts are paramount to our efforts to ensure that all Pennsylvanians can live a safe home life with comfort, independence, and dignity.