Home care battle never ceases
By Shaun Meyer, Director, Home Health Services
I am so glad to be back to writing in my column! I apologize it has been so long. I hope this finds each of you staying warm in this REALLY cold weather!
I wanted to write a little about what is happening in the home care world.
We have several senators in Nebraska who are realizing the value of what home care does to keep folks in their own home, where they want to be. Now, keep in mind, members of the home care field also realize there is a time and place for being in a facility as well.
Our job as home care providers has become more directed now to help keep patients from re-entering the hospitals or emergency departments, and that is a lot of responsibility sometimes.
But our efforts benefit not only the hospitals, but our agencies, as we both get penalized for readmissions. So it has become even more crucial for both entities to work together on accomplishing this, and in the meantime, provide top quality care for our patients.
Providing top quality care is our main priority and that can be quite frustrating when there are so many regulations and new paperwork that must be completed along with providing that top quality care!
Senator Jeremy Nordquist has worked with Nebraska Association of Home and Community Health Agency (NAHCHA) to propose language in Legislative Bill 1078, which requests reimbursement for use of telemonitoring technology in the home.
This week, Senators Bolz and Conrad worked with Senator Kathy Campbell to consolidate the bills into LB 1076.
The main purpose of this legislation is to help ensure adequate reimbursement to home health agencies for RN visits, resumption of care, OASIS assessment for SCIC related to a patient’s change in health status, and monthly supervision visits by RNs to monitor LPN staff members.
This assists in opening the door for NAHCHA to be able to work with the Nebraska Legislature’s Health and Human Services Committee to further amend the language of the bill and request reimbursement for the types of services outlined above.
On Jan. 17, I spoke with Courtney Miller, Deputy Director for the Nebraska DHHS Division Medicaid and Long-Term Care.
This was a follow-up to inquire about the status of the proposed changes that DHHS has requested to clarify the use of brief service and extended service codes for in-home health services provided by home health aides, private duty nursing services, and skilled nursing personnel.
If the regulation is changed, DHHS would pay for one Medicaid home health visit per day.
If multiple visits were made, agencies would be required to bill for the total number of hours per day at the extended hour rate.
DHHS submitted the transcript with all of the hearing testimony, a summary of the testimony, as well as DHHS’ comments and answers to questions to the attorney general’s office on Sept. 27, 2013.
Courtney said that if the attorney general’s office approves the changes requested by DHHS, they will be sent to the Governor’s Policy Research Office for review. Courtney said that historically, the GPRO does not respond to items during the first two weeks of the legislative session.
The 2014 legislative session began on Jan. 8.
We just received word that the approval process now has been stopped until a representative from the Governor’s Policy Research Office meets with NAHCHA representatives.
The Governor’s Policy Research Office will listen to the concerns and present them to the governor.
Our battle to defend home care is never ceasing, as it is with a lot of areas.
Our determination comes from knowing how much folks want and need to be cared for in their homes, when possible.
Finally, I have made the decision to finish my time on the Nebraska Home Care Board of Directors. The end of my term was Jan. 22. I have served on the Board of Directors since 2001.
I have come to realize there is a need for folks who are younger (ahhhh… can’t believe I am saying that!!) and have fresh ideas, to get in there, and help the industry move forward.
I was finding that I didn’t want things to change in the association; after all, I had worked so hard to get things to where they were! I also know that things never remain the same, and if they do, they become stagnant.
So, I find that it is a little bittersweet, after all, I feel some ownership after all of that time, but I feel happy to not have that responsibility now.
I am still representing the home care industry by serving on the CIMRO of NE Board of Directors.
I will try really hard now to write to you more often, and inform you of changes in the home care world, along with any other little thing I might want to share. Take good care.