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20 1 4 – 201 5 YEAR IN REVIEW – THE HIGHLIGHTS

Presented May 13, 2015

Message to our Members: Our 20 1 5 report of accomplishments spans the period June 1, 20 1 4 to our Annual Meeting held May 1 3 , 201 5 , at the Grand Traverse Resort in Acme, Michi g an. Reflected in this overview are examples of how we work and what we’ve all done to produce favorable results for our members and the home care industry in Michigan an d collaboratively with our association colleagues in Michigan and across the nation. What follows is a compilation of the activities and accomplishments reported by the committees that make up your Michigan Association for Home Care. Thank you for your continued support . --- Deb Holman, Board President, Barry Cargill, Executive Director.

Board of Dir ectors/Administration

· WE ARE STRATEGIC… Home Care is a resilient and continues taking action to become more efficient and or to diversify to reduce dependence on reimbursement from government reimbursed program. Private pay home care services are a growing industry and an important complement to government reimbursed services. The Michigan Association for Home Care is aggressively lobbying at the state and national levels of government to improve the Legislative and Regulatory environment for home care services. Collaborations with other organizations will continue to be an important strategy to meeting our advocacy goals and the challenges imposed upon our members by the current wage of health care reforms. In particular, we appreciate our positive working relationship with our national partners such as the National Association for Home Care and Hospice, the Partnership for Home Care, the American Association for Home Care, VGM, National Alliance for Complex Rehab Technology, National Government Services, and the Center for Medicare Services. At the state level we enjoy valuable relationships with the Michigan Hospital Association, Michigan Peer Review Organization, Area Agency on Aging, Leading Age, Health Care Association of Michigan, Michigan Medicare, Silver Key Coalition, Coalition to Protect Auto No-fault, the Michigan Health Council, the Michigan Society of Association Executives, and many more.

· MICHIGAN HOMECARE, BRAND . It was two years ago when our Board leadership engaged the Association in a branding campaign with the objective to bring all segments of our membership together as one umbrella organization. The following year in 2013, the membership approved the Board’s recommendation for the new name and brand.

T he Michigan Association for Home Care is the parent organization of the Michigan Foundation for Home Care (MFHC) and the Michigan Home Health Political Action Committee (PAC). All the combined entities combine to become our BRAND, Michigan Home Care. The Boards’ next step was to complement the brand with the tagline Health@Home, which describes what our member s do.

· SAME MISSION … In 33 years, the Michigan Association for Home Care has had three different names but our mission and purpose remains generally the same. Our name reflects the broad umbrella of all segment of home care including certified home health, home medical equipment, hospice, private duty and pharmacy infusion. After first meeting informally, our founding leaders formed the association in May of 1982, naming it the Michigan Home Health Assembly representing home health, hospice and private duty. In 1989 we embraced new home care segments into our membership including Home Medical Equipment and Pharmacy Infusion to accomplish representation of all segments of the home care industry under one organization. Our mission has withstood the “test of time”. Michigan Home Care Mission remains:

“The unified voice, principal resource and advocate for the success of our Member organizations as best practice providers of home health, hospice, private duty, home medical equipment and pharmacy-infusion services for the residents of Michigan”.

· Michigan Association for Home Care. The Michigan Association for Home Care is a business trade association. We aggressively represent our members by lobbying at the state and federal level to fight for the legislative and regulatory issues important to our members. We actively support for ethical best practices within the industry and provide education, training, networking in support of the interests of our members. The Michigan Association is the Parent Organization under which all our subsidiary organizations operate.

· Michigan Foundation for Home Care. The MFHC is a subsidiary Foundation operating under the Michigan Association for Home Care. It operates as a 501 c 3 Public Charity Foundation. This year, all our educational and scholarship programs operate under the Foundation as a means to maximize charitable contributions to support the educational and research needs of the home care industry her in our state.

· The third entity operating under the parent organization is the Michigan Home Health Political Action committee (PAC). The PAC is an independent committee organized to support candidates who support home care to state elected office.

Michigan Home Care is who we are.

Health @ Home is what we do .

· On-going Strategic Planning… Strategic Planning is not something the Board does every three-five years and then file and forgets it. The Board knows that home care is changing constantly and devotes a portion of the time at each meeting to discuss one or more topics of strategic importance.

· Keeping Up With Change…. Factors such as the Affordable Care Act, the aging population and continued decline of government reimbursement have sparked home care organizations into a phase of mergers and acquisitions. The Board is committed to continuing to position the association to offer support in meeting these challenges. With innovative new programs and access to resources we will continue to be there to support the interests of our members. Change is far from over and if you are a member of Michigan Home Care today, you are a survivor. You, your career and organization will be stronger because you are a member of Michigan Home Care. Board leaders believes firmly we all are in this together and are stronger when we hold together to fight unreasonable regulation and laws that threaten our industry but also offer opportunity for the future. We believe that the future of our industry is very bright and that a strong home care industry helps more patients choose to stay in their home.

Reimbursement Committee:

Committee Leadership: Chris Kisell, Crittenton Home Care

Amy Gill, Jessup Group.

· The Committee developed questions and raised them at quarterly liaison meetings with our fiscal intermediary (NGS).

· Provided representation on the Blue Cross Liaison Team, addressing timely questions to support the home care relationship with BC.

· Continued the Reimbursement Forum Listserv to share timely issues and information among financial managers, owners and agency leadership.

· Blue Cross speaker presented at the Billing Subcommittee.

· Continued to conduct a Billers Forum, which was met with strong attendance and positive response. Information about upcoming forums and highlights submitted through Bulletin Board.

· Participated in Legislative Day at the Capitol to help our lawmakers understand Homecare and its importance in the community.

· Conducted monthly review of multiple websites (Federal Register, CCH, etc.) to ensure coverage of all issues.

· Contributed Committee input to the design and implementation of Michigan Home Care’s schedule of workshops and seminars, as well as the Annual Conference.

· Responded to payer issues to find solutions.

· Continued monitoring of benchmarking statistics for certified line of business.

· Created a benchmarking survey for Certified agencies to improve the usefulness of the Benchmarking Report.

· Created a New Private Duty Benchmarking Report for agencies.

· Committee kept up to date regarding the transition of IACS for cost reporting.

· Assisted members with Medicare claim problems. Informed members of new episode rate and wage indexes for Certified, as well as new Hospice rates and wage index.

· The Billing Subcommittee continued the billing Forum listserv.

· Continued using teleconferencing to reduce agency costs and maximize member participation.

Clinical Operations Committee :

Committee Leadership: Sara Simonds, Mercy Home Health

Coleen Murphy-Deorsey, Optimal Care, Inc.

· Continued to support a clinical networking process for participating members with regular monthly meeting with conference connections for remote participation.

· Worked with liaison committees, including MDLARA, NGS, and BCBSM.

· Continued commitment and collaboration regarding new regulations with subcommittees: Psych, Rehab, Reimbursement, and Infection Control/Infusion.

· Participated and supported MPRO/KPRO initiatives for quality of care and outcomes with global Care Transitions projects.

· Submitted commends on CMS final Rule for Home Health.

· Face-To-Face discussion and implementation success strategies shared monthly and forwarded to the Regulatory Committee to develop evidenced based best practice.

· Monthly survey sharing segment with transparency to assist other agencies.

· Fraud and abuse discussions in support of the aggressive actions of Federal Agencies to fight Medicare Fraud in Michigan.

· Provided learning opportunity for available conferences through Michigan Association for Home Care.

· Monitored and provided comments on CMS and Michigan Medicaid programs such as Dual Eligibles Program, Medicaid expansion and others.

· Updates and discussions regarding impacts of imposed regulation and laws that affect home care.

Psychiatric Subcommittee:

Committee Leadership, Pam Wozniak

· We continue to work closely with the Clinical Ops Committee and have accomplished all goals, and assigned projects.

· We have reviewed and made necessary revision to previously published manuals, and all participants in the Psych training program have completed all requirements as set out in the program approved by NGS.

· The subcommittee remains available to meet as new Psych projects are directed by the Clinical Operations Committee.

Regulatory Subcommittee:

Committee Leadership: Valerie Ghaller, Reverence Home Health & Hospice

· Collaborated with other Michigan Home Care committees to report activities and outcomes to share committee experiences to the Board and other committees.

· Provide an atmosphere and opportunity for timely distribution and discussion of quality and regulatory information and membership responses.

· Compare Home Health Reporting and CMS Risk Adjustments from OASIS C data set.

· CHAPS - Monitor and Review.

· CARE – Work with the quality improvement organization.

· Reviewed OASIS C (Outcomes and Assessment Information Set) and the CMS OASIS C Guidance Manual, discussed best practice for process measures and education for clinicians.

OASIS C Audit tools -

Timely Initiation of Care

Drug Education – High Risk Meds at Start of Care

Drug education all meds in short term Episode of Care

Influenza Vaccine received current season

Pneumonia vaccine received ever.

· Agencies who are participating on the MI STAAR and MPRO Transitions of Care projects shared information and efforts to decrease acute care hospitalizations.

· Face-to-face implementation and monitoring of Michigan Home Care developed form and educational information.

· Diverse Hot Topics continue to be brought to the meeting for discussion, agencies representatives share solutions and/or request question to be taken to another committee such as MDCH & Rehab subcommittee.

· Responded to multiple issues brought by Michigan Home Care members to monthly meetings.

Rehab Subcommittee:

Committee Leadership: Andrea Herbert, Reverence Home Health & Hospice

· Served as a resource for Final Rule changes and the impact on therapy clinical practice.

· Served as a resource for the state licensing process of PTAs, OTs and SLPs.

· Continued to coordinate with the Education Committee to create a stronger therapy presence at the Annual Conference.

· Shared continuing education resources within our membership.

· Assisted members, insurance companies and individuals with rehab-specific questions by sending them information or directing them to appropriate resources.

· Continued to explore new areas to coordinate our efforts to benefit individual agencies and Michigan Home Care.

· Next year will merge the Rehab Subcommittee into the Clinical Ops Committee for expanded awareness of Rehab issues.

· Goals for 2014 will include continuation of membership support for insurance, licensing, documentation, best practice and continuing education presentations and requirements as they relate to home health therapy services.

I nfection Control Subcommittee :

Committee Leadership: Melody Ford, ABF Home Care

Debbie Opalewski, Henry Ford Home Infusion

· Continued to collaborate with other Michigan Home Care committees on crossover issues.

· Continued to monitor statistics through Strategic Healthcare Programs for Home Infusion, a benchmark company for Home Infusions.

· Focused on regulations, updates and new equipment in the infusion therapy field through relationships with INS (Infusion Nurses Society).

· Continued to focus on regulations and updates through the CDC related to pandemic preparation, as well as TB monitoring for home care agencies.

· Continued to focus on flu vaccine recommendations for Home Care Staff and patients. Used CDC website as reference for Infection Control Recommendations.

· Continued to focus on strategies to increase committee participation.

· A diligent effort continues on updating Michigan Home Care Infusion Policies and Procedures, and Protocols, referencing new INS Standards released early 2011.

Education / Training Committee :

Committee Leadership: Deborah Holman, Hart Medical Equipment

Coleen Murphy-DeOrsey, Optimal Care, Inc.

· Conducted numerous workshops at the Michigan Home Care offices on a wide variety of issues. Topics included ICD-9 & 10 Coding and OASIS. The workshops included training events to prepare participants for credentialing for certifications in OASIS and ICD-9 Coding as well as changes that will occur with the implementation of the Affordable Care Act.

· Provided multiple webinars to maximize participation and reach all segments of our membership, many who could not otherwise been able to participate because of travel limitations.

· Developed a three-day Annual Conference to provide all member segments CEU’s and learning opportunities from local and nationally recognized leaders in home care. Some 51 exhibitor booths were sold for the 2015 Conference at the Grand Traverse & Spa. The 2015 Home Care Conference is one of the best state home care conferences in the nation offering a diversity of topics, expert presenters and international professional speakers.

· Michigan Home Care University’s long-distance learning campuses continue to offer more than 70 courses with continuing education credit, and can be taken by employees at any time of any day in the year. We partner with Rochester Community Technical College to bring this long-distance learning program to Michigan and are the exclusive subscriber for the entire state, buying the program to make available free of charge as an exclusive benefit to Michigan Home Care members only. Enrolled Michigan Home Care members in over 4000 courses with a 98% satisfaction rate. We lead the nation in the number of home care employees enrolled and the number of courses completed