February 2021
Announcements & Updates
Extension of National ESRD Initiatives and Facility Agreement of Participation
In 2015, the Centers for Medicare & Medicaid Services (CMS) released the quality oversight contracts for ESRD Networks that would last a period of five years ending 11/30/20. In the past, when contracts are set to be re-evaluated, a process begins 4 months before the contract ends to coordinate contractors for the next period of contract work. Due to the COVID-19 pandemic, CMS was unable to undertake that process this past June and in November opted to extend the ESRD Network contracts until 2/28/21. In January, CMS notified the ESRD Networks that an additional extension was needed until 4/30/2021 to finalize contract awards. 
This two-month extension has added some new work, as well as applied additional changes to the work with a focus on keeping ESRD facility burden low while still targeting important health and quality of life outcomes for ESRD patients. This two-month extension will also mean that the current Facility Agreement of Participation previously signed with the ESRD Network will remain valid until 4/30/21. Please save the Letter to Dialysis Facility Leadership with your current executed copy of the Network/Facility Agreement of Participation to document the revised end date. 
Call for Technical Expert Panel (TEP) Members: Practitioner Level Measurement of Effective Access to Kidney Transplantation
The Centers for Medicare & Medicaid Services (CMS) has contracted with the University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) to develop practitioner-level measures in the area of access to kidney transplantation for dialysis patients. As part of its measure development process, the UM-KECC convenes groups of stakeholders who contribute direction and thoughtful input to the measure developer during measure development and maintenance.

UM-KECC is seeking individuals with differing perspectives and areas of expertise, such as:
  • Transplant process expertise (from candidate evaluation through to transplantation) including transplant nephrologists, transplant surgeons, social workers, transplant coordinators/nursing
  • Dialysis facility perspective on referral to transplant evaluation including nephrologists, nurses, social workers
  • Transplant policy expertise
  • Individuals with consumer/patient/family perspective and consumer and patient advocates; specifically, patients with experience with transplant work-up, time on the waitlist, transplantation and failed transplants
  • Individuals with research expertise with Medicare data and issues pertaining to access to kidney transplantation
  • Individuals with perspectives on healthcare disparities in access to transplantation;
  • Expertise in performance measurement and quality improvement

TEP Expected Time Commitment:
4 - 6 virtual meetings, each being between 1 to 4 hours long. Meetings are tentatively scheduled in April 2021 and subsequent meetings in May thru July 2021.

How to Apply:
Patient Services
2/24/21 Vocational Rehabilitation Webinar: Ticket to Work Work Incentives Seminar Event (WISE) 
Each month the Social Security Administration's Ticket to Work program hosts the Work Incentives Seminar Event (WISE), which are free webinars on vocational rehabilitation services for eligible populations. They are held on the fourth Wednesday of each month. Past WISE webinars can be accessed On Demand. The next webinar is:

Title: Expanding Your Job Search with Ticket to Work
Date: 02/24/2021
Time: 3:00 p.m. - 4:30 p.m. Eastern

Patients may be eligible for additional benefits even if they receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). The Home Dialysis Central article, Working on Home Dialysis: What Dialysis Staff Should Know, outlines potential opportunities for patients of all modalities. Additional information and resources about vocational rehabilitation can be found on the IPRO ESRD Network Program website at https://esrd.ipro.org/patients-family/patient-education/vocational-rehab/.
Mental Health Resources for Adults with Chronic Conditions
Mental Health America (MHA) released a new report “Creating Better Care for Adults with Comorbid Chronic Conditions,” which explores the experiences of adults with co-occurring physical and mental health conditions and provides recommendations for providers to address barriers to initiating treatment, improve patient engagement, and create better care. As a result of these findings, they have created a five page worksheet to assist patients when discussing their mental health concerns.
From March-August 2020, MHA surveyed adults ages 35-65+ with co-occurring physical and mental health conditions about their first experiences in care, their current care experiences, and what they want to receive from their providers. Key findings include:

  • Reported Barriers to Initiating Care
  • Initiating conversations about mental health
  • Fear of discussing mental health
  • Managing multiple chronic conditions
  • Costs of care
  • Fear of burdening caregivers
  • What patients want from their providers
  • Effective Engagement
  • Tools to manage their own health
  • More information on causes, symptoms, treatment options, and costs for mental health care
An Anonymous Internal Grievance Process
CMS is requesting for the Network to assure that all facilities are aware of the need to offer an anonymous method to file a grievance and that they are educating their patients on this option. Patients have a right to file a grievance without the fear of retaliation. In efforts to reduce this identified fear, the IPRO ESRD Network Program encourages facilities to develop an internal process for patients to file a grievance anonymously as well as educate and communicate that process to your patients. If the grievant does not feel comfortable filing a grievance with the facility a grievance may be filed directly with the Network.

The Network has created resources to educate the ESRD community on an anonymous grievance process. In the month of January 2021, the Network released a resource “A Guide for Dialysis Facilities, Grievance Process Questions & Answers”. The Network created a grievance resource that is to be shared with patients, “Grievance Process Guide: A guide for Patients and Families”. You can access these materials by visiting our website at https://esrd.ipro.org/patients-family/grievances-concerns/. Additionally, the grievance posters (in both English and Spanish) that have been provided in the past must be displayed in your facility in an area that is accessible to all patients and visitors. If your facility does not have the Speak Up! posters, please contact the Network to request copies. The resources are to help support dialysis providers with understanding the anonymous grievance process, and ensure that all patients, family members, and care partners are aware of how to file a grievance internally at the facility, with the Network, and/or with the State Department of Health Services (DHS).
New Resources to Help Engage and Include Patients in Their Care
The ESRD National Coordinating Center (NCC) just released new resources to help facility staff engage and include patients in their care. As a reminder, facilities should be inviting patient representatives to participate in QAPI meetings and actively including them in continuing planning of their dialysis care. These resources can help!

Please reach out to the Patient and Family Engagement Team at the IPRO ESRD Network should you need any assistance with ideas or strategies for engaging patients in care planning and QAPI. Learn more about our patient and family engagement program at our website here: https://esrd.ipro.org/patients-family/pfe/
Understand Transplantation through Peer Mentoring
Peer mentoring represents a unique opportunity for mentors and mentees to connect based on shared experiences. In some cases engaging in transplantation or becoming a part of the transplant list has sometimes presented as a difficult and stressful activity for many ESRD patients as well as their caregivers.

Peer mentors can be activated as patients that have already successfully gone through the transplantation process or even as caregivers that accompanied the process. Engaging in a peer mentoring program while completing the transplant process can be helpful to patients and ensure a safe space for confidential conversations with individuals that have first-hand knowledge about the transplant experience. Peer mentor pairings can be helpful in understanding the overall transplant process, setting healthcare goals, and engaging in conversations about transplant with one’s nephrologists.

Download and print the Trailblazing Towards Transplant: A Transplant Patient Peer Program Guide for more information on the Peer Mentoring process.
Quality Improvement Initiatives
Covid-19 Vaccine, Understanding the Facts
The End Stage Renal Disease Population (ESRD) is more likely to experience severe illness or death due to COVID-19. For the future health and safety of our vulnerable patient population it is vital to ensure a >80% vaccination rate for staff and patients.

The IPRO ESRD Network Program hosted a webinar COVID-19 Vaccine: Facts Over Fiction, on Tuesday, January 26, 2021 to provide education, credible resources, and tips to to have transparent fact based discussions regarding the COVID-19 vaccine effectiveness. Please review and share the webinar slides and recording with facility staff. The facts presented in this program will help dispel many of the myths associated with the vaccine and provide resources to bolster understanding and acceptance.

COVID-19 Vaccine: Facts Over Fiction
Increasing Home Dialysis Performance with the Implementation of Universal Staff Education Modules
The IPRO ESRD Network Program would like to thank dialysis facility staff for their hard work and efforts during the challenging times experienced over the past several months. The ongoing commitment to improve the quality of life of ESRD patients, in spite of the COVID public health crisis, is extraordinary and appreciated! The Network of the Ohio River Valley has transitioned 3,131 patients to a home modality, surpassing the CMS goal, and shows that the success of these initiatives is due to dialysis facility staffs hard work and dedication. We thank you for all you do! 

As we celebrate the progress made in 2020, we also want to keep the momentum going of increasing home therapy initiation rates and remain steadfast in our efforts to bring better outcomes to the ESRD patient population we serve by encouraging providers to share the Home Dialysis Change Package - Universal Staff Education that will educate staff on home modality treatment options. 

The Universal Staff Education is a 3-module educational resource for in-center dialysis staff to increase their knowledge and confidence in educating patients for home dialysis. Each module takes about 30 minutes to complete, and it offers 1.5 CEU for CCHT, RN, RD and SW. Facility staff must log-in by submitting their name, job title, facility name and email address to gain access to the modules. At the end of module 3, a link to a quiz will be available in order to gain access to the CEU certificate. 

We encourage providers to utilize these educational modules in your focus areas and determine if they will assist you in reaching home dialysis goals and improve home initiation rates through ongoing educational opportunities regarding home modality options.
Lifetime Transplant Drug Coverage and New Patient Resources
Historically, patients under 65 years of age with Medicare coverage only have 36 months of transplant related drug coverage after transplantation. This has caused financial hardship among many ESRD patients interested in pursuing a kidney transplant. The US House of Representative and the Senate have passed a bill that would extend drug coverage to all patients with kidney transplant under the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act.

If approved, this will mean that starting in 2023, patients under 65 years of age will have lifetime transplant medication coverage. The program is being proposed to start at a monthly premium of $243 in the first year, and increasing gradually up to $345 by 2030.

Reducing financial barriers to kidney transplant will be a tremendous milestone for the kidney community. Now more than ever educating patients about transplant as a treatment option is a crucial role of dialysis providers. To support your efforts, the ESRD Forum and their Patient Advisory Committee have put together the Is a Kidney Transplant Right for Me? Toolkit and supporting video. Use these resources to educate your patients about kidney transplant from a patient perspective:

  • Is a Kidney Transplant Right for Me? Toolkit
  • Is a Kidney Transplant Right for Me? Video

The Network would like to thank you for all that you do for our community and extend our sincere appreciation for your hard work in getting patients to the Transplant Waitlist. Despite the pandemic, and through dialysis facility staff efforts, Network 9 added 1,265 patients to the transplant waitlist in 2020!
Data Systems and Reporting
Information Systems Technical Assistance
The IPRO ESRD Data Department provides technical assistance using a customer support system. This is one place for your data submission needs for various systems such as EQRS, NHSN, Dialysis data or Quality Incentive program. In order to meet the needs of our facilities, the new system will provide support:

  • Email: To reach the Network Data Support Team by email, send requests for assistance to IPROESRDHelp@iproesrdnetwork.freshdesk.com. The help can be a return email providing information about the data submission from our knowledge base or a phone call from the staff.

  • Support Portal: By registering for the IPRO ESRD Network Support Portal, you will be able to quickly and easily submit questions and requests for assistance directly to the Network Data Support staff. You can register for the portal by going to http://help.esrd.ipro.org and selecting “Sign Up”.

  • Knowledge Base: The Network Data Team has documented answers to a multitude of “Frequently Asked Questions” and have posted them to the Knowledge Base on the Support Portal. You can browse the different knowledge items, and if you still need help, you can register for the portal and submit a ticket for help. The Knowledge Base can also be located at http://help.esrd.ipro.org.

NOTE: When submitting a request to the Network, you should NEVER include any patient-specific information such as Name, Date of Birth, Social Security Number, Medicare Claim Number, etc. The only patient identifier that can safely be communicated is the Unique Patient Identifier (UPI) from CROWNWeb.

For more information, please visit the Network website.
Network Staff Directory
Victoria Cash, MBA, BSN, RN
Executive Director
(216) 755-3051

Deborah DeWalt, MSN, RN
Quality Improvement Director
(216) 755-3053

Andrea Bates, MSW, LSW
Patient Services Director
(216) 755-3055

Jaya Bhargava, PhD, CPHQ
Regional Operations Director
(203) 285-1215

Mac Bulloch, MBA
Data Analyst
(216) 755-3052
Maria Johnson
Contract Coordinator
(216) 755-3059

Susan Swan-Blohm, BS,OCDT
Quality Improvement Coordinator
(216) 755-3054

Julia Dettman, SW
Patient Services Coordinator
(203) 285-1223

Laura Rodriquez-Carbone, MPA
Community Outreach Coordinator
(216) 755-3056

Shasha Aylor, MBA
Data Analyst
(919) 463-4520