From the Executive Director
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This week, I was interested to see long-term care and independence at home get injected into national politics. Vermont Senator Bernie Sanders shared a Washington Post piece on Twitter about the challenges facing Maine’s long-term care system (lots of older people, fewer young people) and naming Vermont as a state facing similar challenges. Check out the piece, and the Senator’s comments, below in our
In the News
section. The news couldn’t have hit closer to home for me.
I’m 51. My husband is 56. Most of our friends are somewhere between 50 and 60. Twenty years ago, our social gatherings with friends often included keeping one eye on our young kids who were running around. We talked a lot about parenting. These days, it’s not unusual for our social gatherings to include someone’s octogenarian parent - or one of our own.
I’m nearing my third anniversary as the Executive Director of the VNAs of Vermont. This new role came at a time in my life when home health, hospice and long-term care were about to become central to my personal life, not just my professional one.
This summer has been a case-in-point. My mother-in-law and my mother each had a fall that resulted in a broken bone and the need for in-home services so they could maintain their independence.
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A new home health designation rule goes into effect on October 1, 2019. The rule is essentially a licensing regulation and covers the core services home health and hospice agencies provide including skilled home health (i.e., nursing and therapy services), hospice and long-term care at home. The existing rule has been in effect since 2007 and was out of alignment with federal regulations. The VNAs of Vermont supported the effort to revise the rule and believe it includes a number of improvements. Some elements of the rule reflect statutory requirements that are also out of date but cannot be adjusted without legislation. The new rule isn’t yet posted but a clean version is available
HERE
. The VNAs of Vermont is working on a crosswalk between the current rule and the final rule and will provide that to members when it is complete.
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On August 1, CMS released a final 2020 Hospice Payment Rule. The news for Vermont isn’t good. While technically the rule includes a rate increase for “routine” hospice care (the most common hospice service in Vermont), the increase is offset by other changes. In a nutshell, three other levels of hospice care are getting “rebased,” i.e., increased to better reflect the cost of care. While by itself that’s a positive development, because of Congressional budget-neutrality rules, those increases must be offset by a cut to routine hospice care.
Meanwhile, Vermont home health and hospice agencies continue to prepare for the biggest change to the Medicare home health payment system in decades—the Patient Driven Groupings Model. Vermont agencies are projecting a wide range of impacts with some agencies expecting to do worse under the new system and some hoping to fare a little better. For all agencies, implementing a new system has been costly as systems are upgraded and staff are re-trained. As we head into the fall, agencies will be reaching out to their physician colleagues to educate them about the changes.
The next cut to the Medicare home health rural add-on is slated for implementation on January 1. Agencies that were receiving a 3 percent “add-on” to their Medicare payments will see that cut to 2 percent. While our national partners continue to advocate for an extension of the special payment, the prospects for January appear increasingly dim.
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2019 Vermont & New Hampshire Ethics Needs Survey
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The Vermont Ethics Network is conducting a
survey
about the clinical ethics questions and/or concerns that arise in your organization, as well as staff training and/or resource needs that would be beneficial to you. Through this survey, the network hopes to better understand the nature of ethical issues encountered in Vermont and New Hampshire health care settings, and use that information to develop programming and services that support and promote ethics quality and healthcare improvement throughout our region.
Your input is valuable and all responses will be de-identified and handled confidentially. Thank you in advance for assisting us in understanding the ethics needs that exist in Vermont & New Hampshire.
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Jeff Stein, The Washington Post
Robert Holly, Home Health Care News
Cat Viglienzoni, WCAX
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Educational Opportunities
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VNAs of Vermont to Lead Session at VAHHS Annual Meeting
Last year, VNAs of Vermont held an engaging, highly interactive session at the Annual Meeting of the Vermont Association of Hospitals and Health Systems. The session, entitled "Navigating the Vermont Health System: the Video Game?" was so much fun, they invited us back. In the workshop (pictured above), participants move "avatar" patients through the trickier parts of finding care, learning from "zones" that represent providers, payers and other "players" in our health care system.
This year's meeting, called "Healthy Vermont Together: People, Passion, Promise," will feature sessions such as:
- a conversation with Sister Carol Keehan, who helped usher through the Affordable Care Act
- a talk by Benjamin Anderson, CEO of a small midwest hospital and parent of a child who needed complex are
- a Moth Story Hour about health care
- sessions on avoiding burn-out
- a panel on equity, diversity and inclusion
- a Women in Health Care Leadership panel fueled by Change the Story VT
You can register for the VAHHS Annual Meeting
here
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Materials Available Online
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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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August 27 | Noon to 1 p.m.
Hosted by OneCare
Webinar
Nine Month Program
Kick-Off Call August 20
Organized by
OneCare Vermont, the Vermont Department of Health (VDH), the Vermont Blueprint for Health, Support and Services at Home (SASH), Quality Innovation Network Quality Improvement Organization (QIN-QIO) and Blue Cross and Blue Shield of Vermont (BCBSVT).
September 4, 18
September 18
October 9, 23
November 6, 20
9 a.m. to 1 p.m.
Location TBD, Concord NH
Hosted by VNAs of Vermont
In-person event
September 10 | 11 to 12:30 p.m.
Hosted by VNAs of Vermont
Webinar
September 11 | 1 to 2:30 p.m.
Hosted by VNAs of Vermont
Webinar
September 26 | 12:30 – 4:30
New England Employee Benefits Company
15 Chenell Dr # 1, Concord, NH 03301
Hosted by VNAs of Vermont
In-person Event
September 30, October 1, 2
10 a.m. to 11:30 a.m.
Hosted by VNAs of Vermont
Webinar
Oct 3 | 8 a.m. to 4:30 p.m.
New Hampshire Health Care Association
5 Sheep Davis Drive, Pembroke
Hosted by VNAs of Vermont
In-person Event
October 10 | Noon to 1 p.m.
Hosted by VNAs of Vermont
Webinar
October 17, 24, 31, November 7
Noon to 1 p.m.
Hosted by VNAs of Vermont
Webinars
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