The New York Times

“Every day across New York State, thousands of part-time workers visit the homes of developmentally disabled people to teach them simple tasks, like grooming or how to take a bus.

For their work, which requires no special credentials, the employees typically earn $10 to $15 an hour.

But when the nonprofit organizations that employ those workers bill the state, they collect three and four times that amount — with some having received as much as $67 an hour.”

Read the full story

A proposed emergency regulation would permit Managed Care Organizations to circumvent the established process for determining need for additional Certified Home Health Agencies (CHHAs).  The regulation would allow MCOs to expedite the creation of their own Certified Home Health Agencies (CHAAs).  Existing fee-for-service CHHAs would then be forced to compete with the new CHHAs.  These new CHHAs would enjoy a very substantial competitive advantage since they would be part of large MCOs with far superior capital reserves and infrastructure; a preferred relationship the State, and, significant risk management capabilities.

The Home Care Association of New York State is opposed to the emergency rule calling it “a significant and abrupt departure from a decades-long state policy that strictly linked the establishment of new CHHA service capacity first and foremost to public need.”

The Cuomo Administration is requiring all CHHAs to convert to managed care by April 1, 2012.

State wants to certify more home health agencies

With little notice to the state’s home health care industry, the state Department of Health is seeing approval of an emergency rule that would allow it to boost the existing number of Certified Home Health Agencies, overturning the state’s current moratorium on new CHHAs. The emergency rule will be considered at today’s Public Health and Health Planning Council Codes Committee meeting, and is opposed by the industry.

The Home Care Association of New York State said yesterday that the emergency rule “is a significant and abrupt departure from a decades-long state policy that strictly linked the establishment of new CHHA service capacity first and foremost to public need.”

The state said it is seeking the change because of the speed with which it is implementing Medicaid Redesign Team initiatives, and because new CHHAs wouldn’t be approved under the current methodology. The MRT is moving Medicaid patients who need more than 120 days of home care services from fee-for-service programs to managed long-term care plans and other types of care coordination models. “[MLTCPs] are facing an immediate influx of members who require services that may more easily be provided” if the MLTCPs can run their own CHHAs, the Department of Health wrote.

The home care industry group said the proposal “fosters a hugely unfair and inappropriate competitive advantage for MLTCPs” if they can create their own CHHAs to directly provide services instead of contracting with existing CHHAs. The current agencies would be disadvantaged in negotiations for network participation, rates and other contract terms, HCA said.

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“Many mature and successful service providers continue to find their identity in the heritage of moving people with developmental disabilities out of public institutions. Significant achievements such as providing residential alternatives to large facilities do not immune providers from criticism emerging from a growing demand for individualized supports. The Individualized Supports Think Tank, a group of self-advocates, parents, and service providers convened by the Self-Advocacy Association of New York State (2007) expressed this demand:

‘We define individualized supports as an array of supports, services and resources that are person-centered, based on the unique interests and needs of the person, afford the person as much control over their supports as they desire, and are adaptable as the person’s life changes. This means that supports are created around an individual’s distinct vision for their [sic] life rather than created around a facility or funding stream.’

From this perspective, some would claim that the most dominant forms of accomplishments of the era of deinstitutionalization look like mini-institutions that offer few and constricted options. These options tend to consign people to full time clienthood, where they are excessively controlled by caregivers and are prevented from fully participating in community life. As the full responsibility for the quality of people’s lives continues to be delegated to service providers by families, communities, and generic services, the growing demand for long-term supports challenges the sustainability of developmental disability systems.”

Read the full article (requires AAIDD membership)

“Slips, trips and falls are the second leading cause of injury in the workplace”

• Identification & Assessment
• Strategies & Improvement
• Prevention Training
• Program Management Documents

Presenter

Cindy Bohan
Senior Training Consultant
Risk Management Department
Travelers Insurance Company

Creating a Transitional Return to Work Program

“You can’t afford not to have a RTW Program”

• Psychological Aspects of Return to Work
• Introduction of BHL’s Transitional Work Injury Management Program

Presenter

Ron Glasgow, CSP, ARM
Senior Risk Management Consultant
Bailey, Haskell & LaLonde

This program is being offered at the following two locations for your key people at no cost, with lunch provided.

October 12, 2011 – 9:00 A.M. to 2:30 P.M.  Bailey, Haskell & LaLonde Offices 5232 Witz Drive North Syracuse, NY 13212

October 13, 2011 – 9:00 A.M. to 2:30 P.M.  Travelers Insurance Albany Offices 900 Watervliet-Shaker Road Albany, NY 12205

To register, please RSVP by October 7th to Bob Nosik (315) 413-4455 or bnosik@bhlinsurance.com

Note: Full names of attendees and site choice is required