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ADHC Update - Nov. 16, 2017

The following ADHC update was emailed to ADHCC members Nov. 16, 2017.

ADHC INDUSTRY NEWS:

  • DOH updates statewide transition plan for HCBS settings rule compliance (click here for attachment)
  • ADHCC attends Creating a Shift in Organizational Culture training- HCBS Settings Rule (click here for attachment)
  • DOH publishes preliminary nursing home and ADHC rates (click here for DAL)
  • ADHC Program Survey Report (PSR) not yet posted on the Health Commerce System (HCS)

ADHCC NEWS:

  • Volunteers needed for the 2018 ADHC Conference Committee; respond to Meg Everett if you would like to participate in the committee
  • ADHCC seeking request for presentations for 2018 educational programming (click here for attachment)
  • ADHCC looking for leaders to serve on the 2018 ADHCC Board of Directors (click here for attachment)
  • Save the Date: ADHCC Advocacy Day to be held Feb. 6, 2018.
  • Save the Date: 2018 ADHC Annual Conference to be held April 19-20, at the Embassy Suites in Saratoga Springs

FEDERAL UPDATE:

  • 2017 State Veterans Home Adult Day Health Care Act Passes Senate
  • House Proposes Elimination of Medical Expense Deduction

ADHC INDUSTRY NEWS:

DOH amends Statewide Transition Plan for HCBS settings rule compliance; regulatory changes planned for ADHC by 2021. New York’s Statewide Transition Plan (STP) for HCBS has been amended to reflect ADHC degree of compliance in the HCBS Settings Rule requirements. The STP for state agencies affected by the Rule can be found here. The ADHC compliance chart is found on pages 56-57 and attached to this email for your convenience. Taking a close look at this chart, you will see that there are several areas in our regulations that are “silent” on the Rule standard. For example, the HCBS Rule requirement to optimize and doesn’t regiment individual initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment and with whom to interact is marked “silent” and will require regulatory amendments to Part 425. DOH anticipates a Dear Administrator letter to be posted in spring 2018 and amendments to Part 425 by 2021. *Note DOH wrote in error that amendments will be made to Part 415. Nursing homes do not need to comply with the federal HCBS rule.

ADHCC communicates with DOH on a regular basis to share our concerns and offer assistance on person centered planning standards and regulatory changes. We hope to learn more detail about the regulatory changes in the next few months. Under the HCBS Settings Rule, ADHC programs in New York State are presumed institutional because of the nursing home sponsorship, co-location and shared services with the nursing home. DOH has yet to determine how they will mitigate this major challenge.    

Last week, ADHCC attended Creating a Shift in Organizational Culture training held by Public Consulting Group and DOH. During this short training, providers from the developmental disability and aging community discussed challenges providers face with implementing HCBS Rule standards and person centered planning (PCP) requirements. Some OPWDD providers have made significant progress to show compliance with the rule. PCG recognized that the HCBS Rule was written largely for a younger, disabled population and not the medically fragile senior and child/youth population.

During this training, DOH communicated that they plan to develop PCSP standards for ADHC and managed care organizations. Providers should note that they are not required at this time to make any programmatic or operational changes to comply with HCBS Settings Rule PCP requirements. ADHCC will continue to advocate for PCP requirements that are realistic and work within the ADHC regulatory environment. Once new standards are developed, we encourage DOH to provide training to ADHC staff. Click here for the presentation delivered at the training.

The Department of Health (DOH) posted draft preliminary Jan. 1, 2018 nursing home and adult day health care Medicaid rates on the Health Commerce System (HCS).

We recommend that you (and related NH administrator) review your draft rate, especially the capital for off-site programs that lease space, and bring any errors to the Department’s attention by emailing nfrates@health.ny.gov with “2018 ADHC Rate Inquiry” in the subject line. Click here to read the notice which contains the link to the proposed rates. If your program rents space off-site from the nursing home and found a change in your capital, please notify Anne Hill at ahill@leadingageny.org.

The Program Survey Report (PSR) has not yet been released. We have been getting a lot of phone calls about the 2017 PSR. Please note that it has not been posted on the Health Commerce System as of this morning. We will send an email as soon as it’s posted and will also post the PSR on our website, www.adhcc.org.

ADHCC NEWS:

Volunteers needed for the 2018 ADHC Conference Committee; respond to Meg Everett if you would like to participate in the committee.

We will be returning to the lovely Embassy Suites in Saratoga Springs for next year’s ADHC Annual Conference, Thursday and Friday, April 19 & 20, 2018. We have begun planning for the event and we need volunteers to join our ADHC Conference Committee to help develop the conference educational programming and select member award winners. Please join us and volunteer for this important work. Participation in this committee will require a 1-hour conference call in early Dec. to brainstorm education session ideas, and a 1-hour call in February to select award recipients. 

Email Meg at meverett@leadingageny.org by Mon., Nov. 27th if you or someone from your organization would like to volunteer. We will set up a conference call once the group is assembled. We would love to see new faces step up and participate!

Do you have expertise to share at the 2018 ADHC Annual Conference? The Adult Day Health Care Council is planning its educational offerings for 2018.  We are looking for engaging and timely presentations on a whole range of issues for the ADHC annual conference and educational events throughout the year. We encourage the membership and related professionals to consider their background knowledge, skill sets, and developing experience in novel approaches to ADHC care and services as you submit proposals for presentations. Many in the ADHCC membership have knowledge and advice that can benefit others. We welcome your proposals. For more information, please read the request for proposals (RFP) attached to this email. Proposals must be submitted by Fri., Nov. 17, 2017

Call for Nominations – ADHCC 2018 Board of Directors

ADHCC is seeking critical thinkers to help lead ADHCC in 2018. As a board member, you make an impact on ADHC policy and priorities statewide while networking and learning from others in your field.  Please consider nominating yourself or a colleague to one or more of the following leadership positions:

Chairperson Elect

Secretary

Treasurer

Regional Representative – Regions 1-8

ADHCC’s Call for Nominations memo is attached and provides more detail on board positions and the nominating process. The deadline for submitting nominations is Friday, Dec. 1, 2017.      

A great time to advocate for your ADHC program is during the fall and winter before your legislator must return to Albany for the legislative session. Please discuss your support for preservation of Method 1 transportation in the upcoming 2018-19 state budget during these meetings. ADHCC’s 2018 Advocacy Day will be held on Tuesday, February 6th, along with LeadingAgeNY’s nursing home and MLTC members. Members who are unable to attend are encouraged to visit members’ district offices during Presidents’ Week break, Feb. 20-24.

FEDERAL UPDATE:

2017 State Veterans Home Adult Day Health Care Act Passes the Senate! On November 8th, the U.S. Senate passed bi-partisan legislation which requires the Veterans Administration (VA) to enter into provider agreements or contracts with State Veterans Homes (SVHs) to provide ADHC to veterans with severe service-connected disabilities at rates above the VA’s current per diem rates. Sponsored by Senator Orrin Hatch, S.324 is the companion bill to New York Congressman Lee Zeldin’s legislation which passed the House in May 2017. Under the bill, VA would pay for ADHC at a higher rate equal to 65% of the prevailing rate for nursing home care.

The bill will now proceed to conference committee and later will likely head to the president’s desk. ADHCC and NADSA support this legislation and lobbied for it on the federal level. Jean Brand, program director, Long Island Veterans Home, continues to play a large role in advocating for this bill.

The bill has broad bipartisan support, including sponsorship by 16 of New York’s representatives and both its senators. 

Many State Veteran Homes across the country are interested in providing medical model ADHC services; however, the current basic ADHC per diem [paid to the SVH by VA] is not sufficient to cover the costs of this program. As a result, only three SVHs out of 153 SVHs nationwide provide ADHC programs. Those SVHs that provide ADHC programs are located in Stony Brook, New York; Minneapolis, Minnesota; and, Hilo, Hawaii.

Click here to see  H.R. 1005  and S.324 and its background documentation. 

House Proposes Elimination of Medical Expense Deduction. As many of you know, the House is considering eliminating the medical expense deduction in its tax overhaul bill, H.R.1. This move could put registrants and families of adult day health care and other frail, elderly and disabled individuals in considerable financial peril. For 75 years, Americans have been able to deduct medical expenses from their taxes, reducing the burden of paying for high healthcare costs. Currently, out-of-pocket medical costs for older adults are almost twice as high as the national average. This move would disproportionately affect people with high levels of need and care, chronic illness and disabilities and is particularly unconscionable.

ADHCC joins with LeadingAgeNY, LeadingAge National, and NADSA to voice opposition to this proposal. Take a moment now to reach out. Call your senators and representatives. Tell them to protect the medical expense tax deduction. The health and livelihood of millions rely on it.

If you have any questions or concerns on the contents of this update, please reach out to Anne Hill, ahill@leadingageny.org or Meg Everett, meverett@leadingageny.org.