ACL/CMS Webinar: Addressing Vaccine Hesitancy Among Direct Service Workers

Vaccine uptake among direct service workers (DSWs) is particularly important for personal health and safety and to the many individuals that DSWs support, due to the high contact, personal nature of home care. However, DSWs experience many barriers to vaccination including culturally competent and accessible information, paid sick leave and/or time off, and transportation.

In this webinar, experts in the field will discuss demographics of the DSW workforce, barriers to vaccination, strategies to increase vaccine confidence and uptake, and promising practices.

Panelists:

  • Cory Nourie, Director of Community Services, Delaware Division of Developmental Disabilities Services
  • Ramu Iyer, National Alliance of Direct Support Professionals Advisory Council Member
  • Robert Espinoza, Vice President of Policy, PHI
  • Trudy Rebert, Federal Policy Counsel, National Domestic Workers Alliance

Questions? Please contact Meredith Raymond

The 2021 Home Care and Hospice Conference and Expo Will Be the Industry Event of the Year

The 2021 Home Care and Hospice Conference and Expo will be the biggest industry event of the year and we hope you will join us October 3-5 in one of the world’s greatest cities, New Orleans.

Why should you attend the biggest and most important gathering of home care and hospice owners, operators, and leaders? Because it is the best way to:

  • access more than 80 hours of the industry’s best education, taught by the experts you respect, and designed specifically to help your agency reach new levels of excellence in patient care and financial performance;
  • take advantage of countless opportunities to network with peers, industry experts, and other professionals;
  • find the products, services, and solutions your company needs in the industry’s biggest and best Expo;
  • hear from keynote speakers who will inform, inspire, and challenge conventional thinking.

New Orleans is a city that fought through great adversity to reach its own higher ground, something we believe everyone in home care and hospice can understand and appreciate after the events of the last year.

On higher ground we can see how far we’ve come this past year.

On higher ground we can better see the challenges we will face ahead.

On higher ground, we can rest for a moment, celebrate our successes, and recover our strength to persevere.

Please watch this video for even more information about the 2021 Home Care and Hospice Conference and Expo.

Focus on Leadership: “What’s on your dashboard?”

Organizations in private duty home care are increasingly embracing the use of data dashboards to measure and manage performance and  benchmarking is becoming commonplace. The goal of course is for these dashboards to help us make well-informed business decisions and understand how we perform overall in relation to our strategic priorities and goals. They should be geared towards learning rather than judgement. However, this all starts with the premise that we already know as leaders what kind of information we need and what we should include on these dashboards.

A recent session from The Studer Group’s Gratitude Symposium presented by Robert Lloyd, Ph.D., Vice President of the Institute for Healthcare Improvement, focused in on organizational dashboards and why some of us might not be creating in our dashboards in a way that can be the most beneficial. His session entitled: So, What’s on Your Dashboard? Focused on the things that leaders should consider when constructing as well as utilizing these important tools in the best and most valuable way possible.

Start by Choosing Data Over Information:

Lloyd noted that for some, there can be a tendency to confuse data and information when beginning their journey on organizational dashboard creation. “Data refers to raw facts and figures…versus information which is defined as data that has been processed and analyzed in a way making the results directly useful (Austin, 1983).” Many organizations create dashboards that are only about outcomes rather than the processes and cultural elements that drive them and its important to remember to choose data that incorporates the elements of Structures+ Processes+ Culture and then Yield Outcomes.

Then, Assess Your System

Does your organizational dashboard have a balanced, cascading system of measurement with related and connected metrics and are they balanced?

Not every role in an organization needs the same kind of information. However, what information that is presented should be simplistic, meaningful, and actionable.

Think about this scenario- Patient/Client Experience Scores. The organization wants to improve these scores- but how does this happen for each role through a dashboard? What does each role need to know in order to have the best chance of success?

Senior leaders need information at the Macro level- they might need a dashboard that shows performance on the Likelihood to recommend question.

Middle managers or emerging leaders need information presented at the Meso level- they might need information about a specific key driver of the likelihood to recommend question- like timeliness of service or promptness of care deliver as their dashboard metric.

Line level staff need information presented at the Micro level- metrics that might have to do with the tasks they conduct with each patient and family.

Now, think about how long your metrics/information stay in place on your dashboard?

Dashboards are living, breathing, documents. They should be constantly evolving based on your organization’s goals and strategic plans.  You want the most meaningful information, not just what you have always had on hand because internal and external variables will impact what you need and what is most important.

Your metrics should be reviewed and evaluated at a minimum on annual basis. However, it shouldn’t just be about what we need to add from a metric standpoint as part of the review it should also be about what you should be removing measures when they are no longer useful or valuable based on business goals. As a best practice-measures should never be carved into stone.

Finally, how are you presenting this information?

A cascading, balanced, dashboard will be less about rating and rank which can lead to judgement (Scorecard Approach), and more about where we are and also how we can go in the future “in real time” which brings us into the learning sphere.

“The instrument panel or dashboard has an entirely different aura than that of the report card. It has vitality, timeliness, and a clear-cut utility that is absent from report card thinking. A key feature is providing critical, real-time information to the user to prompt wise decisions and, if need me, make rapid midcourse corrections.” Eugene Nelson

Your dashboard should ideally have only the essential indicators. There are a lot of things that can be interesting to know, but on a dashboard, you should choose those indicators that can be not only interesting but impactful and tied to your strategic objectives. Always ask yourself- WHY is this useful? (Sometimes more is not better when it comes to dashboards- its just more noise)

How do you display the data you selected?
Lots of people like red/yellow/green graphics. We especially like them in healthcare for some reason. However, Lloyd reminds us that the “stoplight” method often only works if you are looking at data for judgment. If you want data for learning and improvement you are going to need to create something else. He recommends looking at data overtime and sharing it in a way where you can still see things at a glance. This will help you not only make a judgement, but also make informed decisions. He highly recommends choosing a statistical process control chart in order to see true improvement and normal common cause, variation. This type of presentation of the information will also be able to help you make causal connections.

Benchmarking Illuminated

Ok, so now you have a fully-evaluated dashboard. Lloyd explains that today the most popular question now is- What about benchmarking?

In healthcare people often look at benchmarking as a NOUN– a number that we received from somewhere- targets and goals that become benchmarks. These are often from a national source or report and for an organization seem like the “holy grail” of performance. But these types of indicators are not leading you to learning, they tend to only lead you to more judgement.

“Occasionally there is some confusion over the correct use of the term “benchmark.” A benchmark is a measure of best performance against which an organization’s performance is compared. A benchmark, however, should never be derived from average or aggregate performance, or a lagging indicator. Because it represents the BEST, a benchmark must refer to the performance of only one organization.”- The Mihalik Group, 2003

Benchmarking should really be a- VERB- concerned with Identifying best practices, creating a new culture, focusing on the processes that produce excellence. Benchmarking is a beginning not an end, all about the journey. Lloyd explains that rather than looking at national “benchmarks,” choose to instead look at an organization you aspire to be like. Look their performance and their metrics and decided to use that performance as your rue benchmark for success on your dashboard. This is not about the aggregate of performance but more about choosing ONE guiding star for achievement.

For example- in the hospitality world, people often choose to look at The Ritz-Carlton performance as their benchmark- not the whole industry or the industry in the aggregate- but one organization to serve as measurement for success.

 

Overall, dashboards and information/metrics can be very valuable tools for an organization when they are utilized in a way that supports informed decision-making and learning rather than judgement.  What’s on your dashboard?

Pre-Order the 2021 Home Care Benchmarking Study (We’ve got a discount code!)

The Benchmarking Study from Home Care Pulse is the home care industry’s most comprehensive national study — featuring over 175+ insights and benchmarks inside six categories: Sales & Marketing, Recruitment & Retention, Finance, Operations, Technology, and Client & Caregiver Experience.

A few insights that you can look forward to are:

  • Which recruitment sources yielded the most caregivers in 2020
  • Data on what kinds of benefits and training other agencies are offering
  • Analysis on how COVID-19 impacted home care over the last 14 months and how other agencies’ operations have been affected
  • A full financial analysis showing the average expenses that other agencies are paying, broken out by state and size of agency
  • Hiring analysis showing how many of their applicants other agencies are hiring 

“Each year Home Care Pulse works diligently to collect qualitative data from the home care industry to produce their annual benchmarking study,” says Private Duty Home Care at NAHC Executive Director Emilie Bartolucci. “This study provides valuable insights into specific industry trends, key performance indicators, and the overall health of the industry, including information about employee and consumer experience and retention, and more. This study assists those operating in the space to understand the national landscape and how they might perform in comparison to their peers as well as highlight areas of opportunity for the future. We are delighted to partner with Home Care Pulse this year and offer to our members the ability to access the study at a discounted rate. Data matters, as we all strive towards quality care and service delivery to some of the nation’s most vulnerable.”

Learn More & Pre-Order Your Copy Today using the discount: NAHCPREORDER for $125 OFF

Please Participate in the 2021‑2022 Home Care Salary & Benefits Study

Hospital & Healthcare Compensation Service (HCS) announced the 2021‑2022 Home Care Salary & Benefits study is now underway.  The study are published by HCS in cooperation with the National Association for Home Care & Hospice (NAHC).

The published results cover marketplace data for 60 jobs and 21 fringe benefits. The results cover job data by salary, hourly, and per visit rates with data breakouts by auspice, revenue size, region, state, and CBSA. Planned salary increases, turnover, caseload, and shift differential data are also covered.

NAHC encourages all members to participate in the Home Care Salary & Benefits Study so that the information will be as comprehensive and helpful as possible. In addition, if you participate, you get a 50 percent discount on the price. You can’t beat that.

Directions to Participate in the Home Care Salary & Benefits Study:

  1. Download the questionnaire from the HCS website: https://www.hhcsinc.com
  2. Email Rosanne Zabka, HCSRZabka@hhcsinc.com to confirm your planned participation.
  3. Email your completed questionnaire to Rosanne by August 2nd.

Study participants save over 50% off the Report price. The pre-paid participant rate is $185 (payment due by 8/31/2021); the billed participant rate is $205. The nonparticipant rate is $375.

Home Care Submission Deadline:  August 2nd

Pre-Paid Participant Price:  Home Care $185; Hospice $160.

Billed Participant Price:  Home Care $205.

Participant rates are based on the survey completed. 

All individual data will be kept confidential. No information that identifies a specific agency will be released to any persons, agencies, state or national organizations.

The Reports are recognized as the authoritative source for comprehensive marketplace data for home health + hospice agencies. Last year’s Home Care Report contained data from 1,049 home health agencies and will be published in October.

Policymakers Debate $400 Billion Boost to HCBS

While it is impossible to determine with certainty whether President Biden’s proposal to increase funding for Medicaid home and community-based services (HCBS) by $400 billion will ultimately be included in one of a number of expected large legislative packages, NAHC is encouraged by recent signaling that the HCBS boost continues to be a priority for the Administration.

The latest indication of support for the increased HCBS funding was its inclusion in the President’s FY2022 budget, released on Friday, May 28th. The budget asks Congress to appropriate the $400 billion investment in HCBS over 10 years, the same proposal Biden has been pushing for as part of his infrastructure-focused American Jobs Plan.

The HCBS proposals currently lack detail, but much of the public positioning on the plan emphasizes supporting the direct care workforce by increasing wages, benefits, and career ladder opportunities. The President’s budget states “The President’s plan makes substantial investments in the infrastructure of America’s care economy, starting by creating new and better jobs for caregiving workers. It would provide home and community-based care for individuals who otherwise would need to wait as many as five years to get the services they badly need.”

While the President’s budget is not a binding document, and Congress is under no obligation to craft legislation that tracks the budget’s requests, it does typically have more influence when there is unified control of Congress and the Presidency, as there is now with the Democratic party. Many observers expect that the President’s budget will serve as the blueprint for congressional leaders’ efforts to craft their own budget resolution, which would be the first step in the process towards passing a massive infrastructure package along party lines using the complex process called “budget reconciliation”.

However, President Biden has not yet definitely signaled that he supports the “reconciliation” route at this time. He continues to engage with a group of Republican lawmakers in an effort to determine if there is a bipartisan deal to be had on an infrastructure bill.

Notably, the latest Republican counterproposal to Biden’s plan, released on May 27th, does not include any HCBS provisions. In an earlier memo from the Administration to the group of GOP negotiators, Biden again called out HCBS as a critical component of an infrastructure vehicle.

While timelines remain fluid, it is expected that if significant progress is not made within the next week or two on a bipartisan compromise, Democratic lawmakers will begin the reconciliation process in earnest, working under the assumption that a large infrastructure package will need to pass with Democratic votes only.

NAHC continues to advocate with policymakers to support HCBS proposals that will benefit our members, their workforce, and the patients and families they serve in every community across the country. We will update our membership as the negotiations unfold and a clearer path on major legislation emerges.

Great Private Duty Content at the 2021 Financial Management Conference

The Financial Management Conference (FMC) is the only conference designed for executives and financial professionals in home care and we’re excited to offer even more content this year for our private duty home care community.

Click on the links below to learn more about private duty-focused programming at FMC 2021.

204. Private Duty and Medicare Advantage
404. Diversifying Lines of Business Into Private Duty
503. Build Connected Teams During A Crisis: Leading with Excellence
603. Develop an Engaged Workforce: Resources for Recruitment, Retention and Leadership 
604. Performing Financial Analysis and Measuring Performance in Private Duty
704. Staffing a Private Duty Home Care Agency

Also, please have a look at this video for more information on how FMC 2021 will benefit your business and your career.

For more information, visit http://www.nahc.org/fmc2021.

CMS to Bolster Payments for At-Home COVID-19 Vaccinations for Medicare Beneficiaries

The Centers for Medicare & Medicaid Services (CMS) today announced an additional payment amount for administering in-home COVID-19 vaccinations to Medicare beneficiaries who have difficulty leaving their homes or are otherwise hard-to-reach.

There are approximately 1.6 million adults 65 or older who may have trouble accessing COVID-19 vaccinations because they have difficulty leaving home.

To better serve Medicare beneficiaries who have great difficulty leaving their homes or face a taxing effort getting around their communities easily to access vaccination in these settings, Medicare will pay an additional $35 per dose for COVID-19 vaccine administration in a beneficiary’s home, increasing the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose. For a two-dose vaccine, this results in a total payment of approximately $150 for the administration of both doses, or approximately $70 more than the current rate.

“This is a very positive step forward. We thank the White House and CMS for the productive discussions on vaccinating homebound patients in the past few weeks,” said NAHC President Bill Dombi, in reaction to the news. “We look forward to continuing our partnership with them in getting vaccines to a very vulnerable group of individuals who cannot otherwise secure the life-saving Covid vaccines.”

Said CMS Administrator Chiquita Brooks-Lasure: “CMS is committed to meeting the unique needs of Medicare consumers and their communities – particularly those who are home bound or who have trouble getting to a vaccination site. That’s why we’re acting today to expand the availability of the COVID-19 vaccine to people with Medicare  at home. We’re committed to taking action wherever barriers exist and bringing the fight against the COVID-19 pandemic to the door of older adults and other individuals covered by Medicare who still need protection.”

Delivering COVID-19 vaccination to access-challenged and hard-to-reach individuals poses some unique challenges, such as ensuring appropriate vaccine storage temperatures, handling, and administration. The Centers for Disease Control and Prevention (CDC) has outlined guidance to assist vaccinators in overcoming these challenges. Today’s announcement now helps to address the financial burden associated with accommodating these complications.

The additional payment amount also accounts for the clinical time needed to monitor a beneficiary after the vaccine is administered, as well as the upfront costs associated with administering the vaccine safely and appropriately in a beneficiary’s home. The payment rate for administering each dose of a COVID-19 vaccine, as well as the additional in-home payment amount, will be geographically adjusted based on where the service is furnished.

How to Find a COVID-19 Vaccine

As today’s action demonstrates, a person’s ability to leave their home should not be an obstacle to getting the COVID-19 vaccine. As states and the federal government continue to break down barriers – like where vaccines can be administered – resources for connecting communities to vaccination options remain key. Unvaccinated individuals and those looking to assist friends and family can:

  1. Visit vaccines.gov (English) or vacunas.gov (Spanish) to search for vaccines nearby.
  2. Text GETVAX (438829) for English or VACUNA (822862) for Spanish for near-instant access to details on three vaccine sites in the local area.
  3. Call the National COVID-19 Vaccination Assistance Hotline at 1-800-232-0233 (TTY: 1-888-720-7489) for assistance in English and Spanish.

Coverage of COVID-19 Vaccines

The federal government is providing the COVID-19 vaccine free of charge or with no cost-sharing for all people living in the United States. As a condition of receiving free COVID-19 vaccines from the federal government, vaccine providers cannot charge patients any amount for administering the vaccine.

Because no patient can be billed for COVID-19 vaccinations, CMS and its partners have provided a variety of information online for providers vaccinating all Americans regardless of their insurance status:

  • Original Medicare and Medicare Advantage: Beneficiaries with Medicare pay nothing for COVID-19 vaccines or their administration, and there is no applicable copayment, coinsurance or deductible.
  • Medicaid and the Children’s Health Insurance Program (CHIP):State Medicaid and CHIP agencies must cover COVID-19 vaccine administration with no cost sharing for nearly all beneficiaries during the COVID-19 public health emergency (PHE) and for over a year after it ends. For the very limited number of Medicaid beneficiaries who are not eligible for this coverage (and do not receive it through other coverage they might have), providers may submit claims for reimbursement for administering the COVID-19 vaccine to underinsured individuals through the COVID-19 Coverage Assistance Fund, administered by the Health Resources and Services Administration (HRSA), as discussed below. Under the American Rescue Plan Act of 2021 (ARP), signed by President Biden on March 11, 2021, the federal matching percentage for state Medicaid and CHIP expenditures on COVID-19 vaccine administration is currently 100% (as of April 1, 2021), and will remain 100% for more than a year after the COVID-19 PHE ends. The ARP also expands coverage of COVID-19 vaccine administration under Medicaid and CHIP to additional eligibility groups. CMS recently updated the Medicaid vaccine toolkit to reflect the enactment of the ARP at https://www.medicaid.gov/state-resource-center/downloads/covid-19-vaccine-toolkit.pdf.
  • Private Plans: The vaccine is free for people enrolled in private health plans and issuers COVID-19 vaccine and its administration is covered without cost sharing for most enrollees, and such coverage must be provided both in-network and out-of-network during the PHE. Current regulations provide that out-of-network rates must be reasonable as compared to prevailing market rates, and the rules reference using the Medicare payment rates as a potential guideline for insurance companies. In light of CMS’s increased Medicare payment rates, CMS will expect health insurance issuers and group health plans to continue to ensure their rates are reasonable when compared to prevailing market rates. Under the conditions of participation in the CDC COVID-19 Vaccination Program, providers cannot charge plan enrollees any administration fee or cost sharing, regardless of whether the COVID-19 vaccine is administered in-network or out-of-network.

The federal government is providing free access to COVID-19 vaccines for every adult living in the United States. For individuals who are underinsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine through the COVID-19 Coverage Assistance Fund administered by the Health Resources and Services Administration (HRSA) after the claim to the individual’s health plan for payment has been denied or only partially paid. Information is available at https://www.hrsa.gov/covid19-coverage-assistance.

For individuals who are uninsured, providers may submit claims for reimbursement for administering the COVID-19 vaccine to individuals without insurance through the Provider Relief Fund, administered by the Health Resources and Services Administration (HRSA). Information on the COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured Program is available at https://www.hrsa.gov/CovidUninsuredClaim.

More information on Medicare payment for COVID-19 vaccine administration – including a list of billing codes, payment allowances and effective dates – is available at https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment.

More information regarding the CDC COVID-19 Vaccination Program Provider Requirements and how the COVID-19 vaccine is provided through that program at no cost to recipients is available at https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html.

Private Duty Home Care at NAHC Extends our Congratulations to our Newest Certified Agencies!

The National Association for Home Care and Hospice unveiled its Private Duty Home Care Certification Program late last year, and we are excited and delighted to extend our congratulations to or two newest certified agencies!

Companion Extraordinaire Nursing Network, Inc.

Henrico, VA 23228

As Close As Family, LLC

Rainsville, AL 35986

This program is the only national certification created by private duty leaders, exclusively for the private duty community. Certification offers providers the opportunity to demonstrate their commitment to quality and service delivery excellence through formal certification and requires each agency location to conduct a comprehensive examination relating to nineteen (19) separate but interrelated aspects of business and operations providing documentation and an attestation statement showing adherence to all Certification program standards in each category in order to achieve the distinction.

NAHC Private Duty Home Care Certification
List of Certified Agencies

The NAHC Private Duty Home care standards of certification were developed by private duty home care industry leaders. Many of these leaders serve on the NAHC Private Duty Home Care Advisory Board, Advocacy Council, and NAHC Board of Directors. In addition, the NAHC Private Duty Home Care Certification Program has been modeled after elements within the NAHC Private Duty Accreditation program, and successful state certification programs in Massachusetts and California developed by The California Association for Health Services at Home and the Home Care Alliance of Massachusetts.

Congratulations to those newly certified and we look forward to welcoming additional agencies in the near future!

To learn more about how your agency can become certified please visit: https://www.nahc.org/wp-content/uploads/2020/10/Certification-Program-Overview_Nov2020.pdf

Or contact PDCertification@nahc.org

Pre-Order the 2021 Home Care Benchmarking Study (We’ve got a discount code!)

The Benchmarking Study from Home Care Pulse is the home care industry’s most comprehensive national study — featuring over 175+ insights and benchmarks inside six categories: Sales & Marketing, Recruitment & Retention, Finance, Operations, Technology, and Client & Caregiver Experience.

A few insights that you can look forward to are:

  • Which recruitment sources yielded the most caregivers in 2020
  • Data on what kinds of benefits and training other agencies are offering
  • Analysis on how COVID-19 impacted home care over the last 14 months and how other agencies’ operations have been affected
  • A full financial analysis showing the average expenses that other agencies are paying, broken out by state and size of agency
  • Hiring analysis showing how many of their applicants other agencies are hiring 

“Each year Home Care Pulse works diligently to collect qualitative data from the home care industry to produce their annual benchmarking study,” says Private Duty Home Care at NAHC Executive Director Emilie Bartolucci. “This study provides valuable insights into specific industry trends, key performance indicators, and the overall health of the industry, including information about employee and consumer experience and retention, and more. This study assists those operating in the space to understand the national landscape and how they might perform in comparison to their peers as well as highlight areas of opportunity for the future. We are delighted to partner with Home Care Pulse this year and offer to our members the ability to access the study at a discounted rate. Data matters, as we all strive towards quality care and service delivery to some of the nation’s most vulnerable.”

Learn More & Pre-Order Your Copy Today using the discount: NAHCPREORDER for $125 OFF