The 2020 Legislative season begins.
The legislative session got off to a fast start last week. The minimum wage bill (S.23) and the paid family leave bill (H.107) were left unresolved at the end of the last session. Because 2020 is the second year of the biennium, legislators procedurally pick up where they left off in 2019. Already, both bills have been sent to conference committees, where differences between the House and Senate versions will be resolved.
A detailed summary of the differences between the House and Senate versions of H.107 is available
HERE.
Meanwhile, the Joint Fiscal Office released a
memo detailing its efforts to calculate the cost of increasing the minimum wage under S.23. The estimate has a number of significant limitations, many of which are described in the memo. Significant to home health:
- The estimate hasn’t been “translated” into payments to providers through the existing reimbursement system – which means the estimate is significantly lower than it should be.
- The estimate doesn’t account for the investments that agencies have already made in wages. VNAs of Vermont members are already spending 27 percent more to provide services in the Choices for Care program than they receive in payment – adding up to nearly $5 million in losses.
- The estimate doesn’t address recruitment and retention challenges. Home health agencies are competing for the Choices for Care workforce against employers who offer far less taxing work than personal care, often with better wages. Home health agencies are already experiencing a 50 percent turnover rate and a 25 percent vacancy rate in the Choices for Care programs.
- All home health agencies pay a 4.23 percent provider tax on every dollar in revenue for home health aides, personal care and homemaker services.
This week, several members of the Rural Health Services Task Force, including VNAs of Vermont Executive Director Jill Mazza Olson, will present the group’s report and recommendations to the House Health Care Committee. The group presented to the
Green Mountain Care Board last week.
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January 1 marked the start date of several significant Medicare reimbursement changes that impact home health and hospice agencies:
- Reduction of the rural add-on: Seven member agencies will see a cut to the “rural add-on” – a special Medicare payment that offsets the higher costs of rural care.
- Implementation of the Patient-Driven Groupings Model (PDGM): All home health and hospice agencies are implementing the most significant change to home health Medicare payment in decades.
Services for Veterans at Risk
Vermont’s home health agencies are part of the Veterans Health Administration (VA) “community care network.” The network was created to expand health care access for veterans by allowing them to receive care from community providers like Vermont’s home health agencies. Agencies are paid through “third-party administrators" (TPAs) – private organizations having contracts with Medicare to process claims. Region 1 (which includes Vermont) has been transitioning from one TPA (TriWest) to another (Optum) since July. The transition has not gone well. Home health agencies across the region are reporting a variety of concerns. Some agencies haven’t been loaded into the VA system properly, despite having taken the necessary administrative steps. The result is that referrals from physicians are being denied, delaying services for veterans. Agencies are also reporting long delays for claims submitted under TriWest. More recently, Vermont’s home health agencies discovered that the VA slashed reimbursement rates for personal care services for Vermont veterans in half – possibly unintentionally. Thank you to the staff in Senator Leahy’s office, who have intervened and made significant progress toward resolving the personal care issue. We will continue to work with our federal delegation and federal partners at NAHC to resolve all the outstanding concerns.
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Rural Health Services Task Force
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Derek Brouwer
(Seven Days)
and
Emily Corwin
(VPR)
Vermont Business Magazine
Emily Korwin,
VPR
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Educational Opportunities
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Materials Available Online
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Home Health Aide/LNA Training Materials
Caring Connection newsletters and support materials are available for your use in supplementing in-house staff training.
Additionally, we offer a few recorded webinar series on specific topics that are pertinent to LNAs, aides and other direct care providers. Here are some examples with the first video in each series unlocked so you and your team can determine if online learning appeals to them:
I
nstructors:
Katherine Vanderhorst, RN, BSN and Amy Craven, PT, MS, DPT from C & V Senior Care Services. They are experts in behavioral health and dementia treatment in home care settings.
Purchase entire series
here
Instructors:
Jennifer Gullison, RN, MSN, COS-C, is the Clinical Director at Cornerstone VNA, Rochester, NH.
Elizabeth DeFeo RN, WCC, OMS, CWOCN, is the Wound, Ostomy & Continence Specialist
Purchase entire series
here
There is no limit to the number of views or staff that can be trained from your agency once purchased.
Other Materials Available Online
Video of classroom session available for purchase
Hosted by NAHC
"Opiods: What You Need to Know" training materials
Compiled by SASH
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Webinars and In-person Events
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January 28 to 30
Revere Hotel, Boston, Massachusetts
In-person event
February 3 to 7
Orleans Essex VNA & Hospice, Inc.
46 Lakemont Rd. | Newport, VT 05855
Hosted by Orleans-Essex VNA and Hospice
February 4, 2020
11 to 12:30 p.m.
Hosted by VNAs of Vermont
Webinar
Part of the Caring Connections Monthly Aide and LNA series
March 12, 2020
3 to 4 p.m.
Hosted by VNAs of Vermont
Webinar
Part of the Caring Connections Monthly Aide and LNA series
April 9, 2020
3 to 4 p.m.
Hosted by VNAs of Vermont
Webinar
Grappone Conference Center
Concord, NH
November 21, 2019
8 a.m. to 4 p.m.
Hosted by the Home Care, Hospice and Palliative Care Alliance of New Hampshire
In-person event
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