IN THIS ISSUE
CALENDAR
brought to you by VNAs of Vermont
Thurs, May 11, 11:30am
Webinar 
Thurs, May 11, 1pm
Montpelier, VT 
presented by NAHC
Thurs, May 11, 2pm
Webinar 
presented by NHPCO
Thurs, May 11, 2pm
Webinar 
Sat, May 13, 9am
Colchester, VT 
Sat, May 13, 5:30pm
Brattleboro, VT 
When Grief is Complicated
presented by Brattleboro Area Hospice  
Mon, May 15, 2pm
Brattleboro, VT 
Thurs, May 18, 1pm
Montpelier, VT 
In Our Own Voice (a National Alliance on Mental Illness program)
presented by Bennington Area VNA & Hospice  
Thurs, May 18, 2:30pm
Bennington, VT
Mon, May 22, 8am
Lake Morey, VT 
June 1-27
6-Part Webinar Series 
EXECUTIVE DIRECTOR'S MESSAGE
Until Vermont's legislative leaders announced on Friday that the session would extend another week, we'd planned this week's newsletter as a final legislative wrap-up. At issue - and holding up resolution of the budget - is the governor's proposal on health insurance for teachers. The proposal is opposed by democratic leaders but nearly passed the House last week when a number of Democrats voted with the Republicans. I will leave the analysis of that situation to those who understand it far better than I do. For the VNAs of Vermont, it means uncertainty about the Medicaid and Choices for Care reimbursement increases included in both the House and the Senate budget packages. While we remain hopeful that the final budget will include an increase, in down-to-the-wire budget negotiations, everything can end up on the table. A gubernatorial veto of the budget is also a possibility and would almost certainly re-open budget negotiations unless the House voted to overturn the veto, an unlikely outcome given the current make-up of the body. Look for a special legislative wrap-up issue of the newsletter after adjournment.
 
In the meantime, join us in celebrating visiting nurses during National Nurses Week!
 
Jill Mazza Olson, Executive Director
FEDERAL UPDATE  

Late last week, the House passed the American Health Care Act (AHCA), billed as a repeal and replacement of the Affordable Care Act. The AHCA would repeal key portions of the Affordable Care Act and make dramatic changes to the Medicaid program that will have a significant impact on Vermont. The legislation provides no relief to VNAs from provisions of the Affordable Care Act that negatively impacted home health agencies. It neither repeals the home health payment rate cuts (known as "rebasing") nor adjusts the burdensome physician face-to-face certification requirement that has proven to be a barrier to access to care. The Senate is widely expected to make significant changes to the bill. We will be closely monitoring developments with our federal and state partners.
 
Home Health Care Planning Improvement Act (S. 445/H.R. 1825)
The Home Health Care Planning Improvement Act , a key priority for the home care community, would allow physician assistants (PA), nurse practitioners (NP), clinical nurse specialists, and certified nurse midwives to order home health services for Medicare beneficiaries. Currently, only physicians can do so. The bill is picking up co-sponsors in the Senate. Thank you to Vermont's Senator Patrick Leahy for signing on as a co-sponsor!

Proposed FY2018 Hospice Payment Rule 
The Centers for Medicare and Medicaid Services (CMS) have released a proposed hospice rule for FY2018. The rule includes a small reimbursement increase and outlines ideas for future changes to hospice quality reporting. The National Association for Home Care and Hospice (NAHC) is hosting a webinar this week to outline the changes. The webinar is free to NAHC members. Click here to register for this webinar.

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