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  HCA Policy Positions
The following are correspondence and memoranda on several issues of concern to the home care community. For members-only policy memoranda, visit our member memorandum page. For the latest news and updates on an issue-specific level, visit our issues page.
2010 State Legislative Session Memoranda of Support/Opposition
Memo of Support: Legislation to Establish OMIG Auditing Standards (A.10630-A/S.7821-B)
Memo of Opposition: Legislation to create a rebuttable presumption of adult care facility licensure (A.11231/S.7844)
Memo of Support: Extends the authorization of physical therapy assistants to provide services in home care settings (A.10137/S.7121)
Memo of Support:
New York State Telehealth/Telemedicine Development Act (S.3198-B/A.11415)
Memo of Opposition: Incident Reporting Bill for Home Care (A.1724/S.3906)
Memo of Support: Article 6 Reimbursement for County Home Care and Hospice
Providers (S.7916/A.1170)
Joint Association Letter on Home Care Reimbursement Workgroup
July 15, 2009
Hon. Richard F. Daines, MD
Commissioner of Health
NYS Department of Health
Corning Tower, 14th Floor
Empire State Plaza
Albany, New York 12237
Dear Commissioner Daines:
We are writing on behalf of the Home Care Association of New York State (HCA), the Healthcare Association of New York State, the New York State Association of Health Care Providers and the New York Association of Homes and Services for the Aging, collectively representing Certified Home Health Agencies (CHHAs), Long Term Home Health Care Programs (LTHHCPs), Licensed Home Care Services Agencies (LHCSAs), AIDS Home Care Programs (AHCPs), Managed Long Term Care Programs (MLTCPs), Hospices, Hospitals, Nursing Facilities and other health care services throughout the state.
As the Department begins to convene the Home Health Care Reimbursement Workgroup, we write to express our interest in collaboratively working with the Department and the Legislature to improve the state's home health care reimbursement methodology. Working together, on the right timetable and with
openness to the essential issues (as subsequently enumerated in this letter), we are confident that progress and improvements can be made to the benefit of all New Yorkers, and we are committed to such a cooperative effort.
»Download the complete letter
Memo of Support: OMIG Auditing Standards Bill
June 29, 2009
Memorandum of Support
A.7448-A Schimminger, S.4218-A Stachowski
Places due process standards on OMIG's withholding of payment to a medical assistance program provider
This legislation amends the Public Health Law to provide critical due process standards Medicaid providers subject to audit by the Office of the Medicaid Inspector General (OMIG).
The Home Care Association of New York State (HCA) supports this critical public integrity legislation and urges its enactment. This legislation amends the auditing standards and procedures of the OMIG by prohibiting State Department of Health from withholding Medicaid provider payments on the basis of a preliminary finding of the pending audit, unless the OMIG has made a made written finding, based on probable cause, that the provider committed fraud or other criminal conduct involving the claims subject to the audit.
»Download the memorandum
Memo of Support: Managed Care Consensus Bill
June 29, 2009
Memorandum of Support
A.8402-A (Morelle), S.5472-A (Breslin)
The Home Care Association of New York State (HCA) strongly supports the enactment of the managed care consensus bill, A.8402-A (Morelle), S.5472-A (Breslin).
This legislation is the result of extensive, broad based discussions between the health care community, consumers, insurers, the Administration and the Legislature. Its provisions will improve the interface between health care providers and health plans/insurers in a number of significant areas and promote the mutual goal of supporting access, coverage and delivery of health care services to the consumer.
»Download the memorandum
Letter to New York's Congressional Delegation on Health Reform
June 25, 2009
Dear Member of New York Congressional Delegation:
On behalf of the Home Care Association of New York State (HCA), I write to express strong opposition to the U.S. House of Representatives' draft health reform legislation which contains dramatic and far-reaching Medicare and Medicaid policy changes as well as catastrophic cuts to the Medicare home care program.
»Download the complete letter
Flawed MedPAC Recommendations on Home Health
April 29, 2009
HCA and NAHC Urge Opposition to Home Care Cuts
The Home Care Association of New York State (HCA) and the National Association for Home Care and Hospice (NAHC) urge Congress to reject the proposed cuts to home care which will further widen the gap between reimbursement and the cost of providing care to Medicare patients.
MedPAC Assertions versus Reality
MedPAC's Assertion: MedPAC's recommendation to reduce home health payments is based on its claim that home health agencies' operating margins on Medicare services are an estimated 12.2 percent.
The Reality: HCA and NAHC data contradicts MedPAC as described below.
1. MedPAC's analysis of the data does not include any consideration of the 1,626 agencies (21 percent) nationally that are part of a hospital or skilled nursing facility. In some states, hospital-based home health agencies comprise a significant percentage of home health providers. In New York, facility-based home health agencies represent more than 25 percent of Medicare certified agencies. Nationally, facility-based agencies have an average Medicare operating margin of negative-6.19 percent, while in New York that number is negative-11.43 percent (based on 2007 Medicare cost reports).
2. MedPAC's analysis uses a weighted average that overstates the positive margins of large individual agencies and, therefore, does not accurately represent the margins of all individual agencies. It further misrepresents a single national operating margin for freestanding agencies as representative of all — over 9,700 very diverse — home health agencies.
»Download the complete paper
HCA's Home Care Accessibility and Efficiency Improvement Act
March 6, 2009
As the State Budget negotiation process accelerated greatly this week — with the Legislature proceeding to develop its own budget bills and/or resolutions and urgently requesting HCA's proposals for home care — HCA on Wednesday shared our proposed "Home Care Accessibility and Efficiency Improvement Act" (HCA-EIA) with the leadership in the State Senate and Assembly.
The legislation offers comprehensive and constructive proposals for increasing consumer accessibility to home care services, creating efficiencies in the delivery of care, and improving the policy/regulatory environment for the operation of the home care system in the state. This legislation was developed after an intensive, months-long policy development process involving the HCA Board of Directors, Policy Council, regional meetings and individual member meetings.
HCA-EIA, a comprehensive thirty-three section legislative proposal, provides a major and concrete contribution to the home care legislative and budgetary discussions in the run-up to approval of a final State Budget by the anticipated April 1 deadline.
In direct contrast to Governor David Paterson's proposed half-a-billion dollars (state/federal shares) in home care funding cuts and attempts at home care system overhaul, HCA's legislation affirmatively taps home care's cost-saving potential to both improve the system and help accomplish the state's goal of making the Medicaid program more efficient.
»Download a summary of the bill
HCA Testimony Brings Case against Seismic Home Care Cuts
February 6, 2009
In testimony presented this week to the Senate Finance and Assembly Ways and Means Committees, HCA urged the panel's rejection of a half-billion dollars in proposed State Budget cuts and changes to the infrastructure of home care delivery.
HCA's testimony was delivered by Victoria Hines, Vice Chair of HCA's Board of Directors and President and CEO of HCA-member agency Visiting Nurse Service of Rochester and Monroe County. Ms. Hines' testimony is available online at http://www.hca-nys.org/documents/FinalHCABudgetTestimonyFeb2009.pdf.
HCA's Letter to Governor's Office on Home Health Registry Bill
September 23, 2008
Ms. Terryl Brown Clemons
Acting Counsel to the Governor
Executive Chamber-State Capitol
Albany, NY 12224
Re: A.11468/S.8449 Statewide Registry of Certified Home Health Aides and Personal Care Aides
Dear Ms. Clemons:
On behalf of the Home Care Association of New York State (HCA), a statewide association
representing New York State's home care community, I write to express support for the
above-referenced legislation, which has passed both Houses of the Legislature and has been
delivered for action by Governor Paterson.
HCA's membership is comprised of more than 400 home care providers and affiliated
members dedicated to the provision of high quality home care services. HCA's members
include certified home health agencies, licensed home care services agencies, long-term home
health care programs, managed long term care programs and hospices.
Our membership is committed to the establishment of a statewide registry of home health aides and personal care aides and has been working with allied state health care organizatios for the past year on legislation to create a statewide registry of home health aides and personal care aides. We have advocated legislation to mend critical gaps that exist in the state Health
and Education Departments' home health aide and personal care aide training and certification structure, and to ensure a more effective process on behalf of providers, workers and patients.
»Download the complete letter
In Letter to Congressional Delegation HCA Seeks Fair Share for New York in FMAP Formula
September 10, 2008
H.R. 5268 is needed to address a historical inequity in the percentage of FMAP contribution that New York receives. While Medicaid is jointly funded by states and the federal government, New York receives a FMAP contribution of only 50% for most services, while the federal government pays up to 76% of other states' Medicaid costs. In fact, New York's federal contribution is the lowest amount for any state and shared by only twelve other states. This is despite the tremendous disparity between the amount of tax revenue New York sends to the federal government and how much federal funding is returned.
»Download the complete letter
HCA Expresses Concern, Seeks Extension on Supplement to 2007 LHCSA Report
September 5, 2008
Dr. Richard F. Daines, M.D.
Commissioner
New York State Department of Health
Empire State Plaza
Corning Tower, Room 1408
Albany, New York 12237
Dear Dr. Daines:
On behalf of the Home Care Association of New York State, I am writing to express our serious concern
that the State Department of Health (DOH) last week to activate a Supplement to the 2007 Licensed
Home Care Services Agency (LHCSA) Statistical Report on the Health Provider Network (HPN) without
providing a promised opportunity for industry comment. It is additionally perplexing and disturbing that
this apparent "rush" to issue the report comes after more than five years since the Legislature passed the enabling statute.
»Download the complete letter
HCA Testimony on Certificate of Need (CON) Reform
July 23, 2008
The CON process is unquestionably critical to and intertwined with the state's framework for health care policy, financing and state/local system operation. The implications of this reform inquiry, and any changes instituted in response, may be significant for all stakeholders, most importantly the consumers. HCA appreciates the importance, potential opportunities and possible consequences of this effort.
»Download the complete testimony
HCA's Input on Bad Debt/Charity Care to State Public Health Council
July 9, 2008
William Streck, MD, Chairman
New York State Public Health Council
c/o Ms. Colleen Frost, Executive Secretary
New York State Public Health Council
Corning Tower, Room 1441 - Empire State Plaza
Albany, New York 122397
Dear Dr. Streck:
On behalf of the Home Care Association of New York State, I am writing in regard to the State Health Department's report to the Public Health Council on Bad Debt/Charity Care (BD/CC) provided by Certified Home Health Agencies (CHHAs), which is being presented at the July 11, 2008 Council meeting. We
respectfully offer and appreciate this opportunity to share our comments and recommendations with the Council.
»Download the complete letter
»Download the State Health Department's report to the Public Health Council on BD/CC
HCA and Allied Associations Write Letter Urging Governor's Support for LTHHCP Enancements
July 9, 2008
Honorable David A. Paterson
Governor, State of New York
State Capitol
Albany, New York 12224
Dear Governor Paterson:
On behalf of the Home Care Association of New York State (HCA), the Healthcare Association of New York State (HANYS), the New York Association of Homes and Services for the Aging (NYAHSA) and the New York State Association of Health Care Providers (HCP), we write to ask for your support for enhancements to the Long Term Home Health Care Program (LTHHCP) through the upcoming waiver renewal process.
The LTHHCP is supported by a federal Medicaid home and community-based services waiver, which must be renewed by the end of 2008. We are extremely pleased that the State Department of Health (DOH) will be proceeding with the preparation and submission of the LTHHCP waiver renewal, and support the strongest possible renewal for this program. We understand that DOH is proceeding with a September date for submission of the renewal application.
»Download the complete letter
HCA MEMORANDUM OF SUPPORT
Legislation to Create a State Home Health Aide Registry
June 12, 2008
The Home Care Association of New York State (HCA) supports the establishment of a statewide registry of home health aides and personal care aides. Such a mechanism will mend critical gaps in the state Health and Education Departments' home health aide and personal care aide training and certification structure. The improved state structure will better equip providers and patients with reliable, consistent and timely information on state-approved training programs and individuals credentialed through those programs, assist workers in the verification of their credentials, and further support the home care community's efforts to ensure the best possible patient care.
»Download the complete memorandum
HCA Comments on CMS HCBS Rule
June 3, 2008
Centers for Medicare and Medicaid Services
Department of Health and Human Services
Attention: CMS-2249-PP.O.
Box 8016
Baltimore, MD 21244-8016
RE: File Code CMS-2249-P
Dear Sir/Madam:
The Home Care Association of New York State (HCA) appreciates the opportunity to submit comments on CMS' proposed rule (CMS-2249-P) that would implement section 6086 (Expanded Access to Home and Community-Based Services for the Elderly and Disabled) of the Deficit Reduction Act (DRA) of 2005.
HCA is a statewide not-for-profit organization representing over 400 health care providers, allied organizations and individuals concerned with the provision of home care in New York State. HCA and its home health provider members work to promote excellence and support high-quality, cost-effective home care and community services to individuals who have Medicaid, Medicare, and/or private insurance coverage.
»Download the complete letter
HCA on Physician Override in Determining LTHHCP Eligibility
May 20, 2008
HCA and Allied Associations urge continuation of the physician override of DMS-1 "predictor scores" so that the examining physician can continue to use his or her discretion in determining whether a patient should be eligible for LTHHCP services.
»Download HCA and Allied Associations' letter to Health Commissioner Daines urging action to preserve the physician override.
ALLIED ASSOCIATIONS MEMORANDUM OF SUPPORT
Enhancing New York's Long Term Home Health Care Program (S.8092)
May 16, 2008
The Long Term Home Health Care Program (LTHHCP), also known as the "Nursing Home Without Walls," has for thirty years delivered comprehensive, cost-effective nursing-home level of care to patients in their own homes, serving as a national and state model for meeting the needs of chronically ill, disabled and medically frail patients within the community.
LTHHCP costs are capped at 75 percent of the rate of nursing home care, though the program has historically on average achieved a rate of 50 percent the cost of nursing home care, meeting the state's focus on promoting community-based options that offer a truly cost-effective alternative to institutional care. The LTHHCP presently serves about 25,000 patients statewide — pediatric, adult and aged individuals — and is provided by 108 health care providers.
The Home Care Association of New York State (HCA), Healthcare Association of New York State (HANYS), New York Association of Homes & Services for the Aging (NYAHSA) and New York State Association of Health Care Providers (HCP) have joined together in support of legislation (S.8092) recently introduced by state Senate Health Committee Chairman Kemp Hannon to enhance LTHHCP patient access and program operation.
»Download the complete memorandum
HCA's Comments to SHRPC on LHCSA Regulations
March 10, 2008
Thomas E. Holt, Chair
Codes Committee
State Hospital Review and Planning Council
c/o Sandra Haff
Headly Park Place
433 River Street
Troy, New York 12180
Re: March 13, 2008 Codes Committee Agenda Item: Regulations amending sections 763.12, 766.10 and 766.12 of Title 10 NYCRR relating to Licensed Home Care Services Agencies and Certified Home Health Agencies
Dear Chairman Holt:
On behalf of the diverse home care agencies that comprise the membership of the Home Care Association of New York State (HCA), I write to submit comments with respect to the agenda item before the Codes Committee amending sections 763.12, 766.10 and 766.12 of Title 10 NYCRR in relation to Licensed Home Care Services Agencies (LHCSAs) and Certified Home Health Agencies (CHHAs). These rules would require CHHAs and LHCSAs to compile and submit annual reports on the type, frequency and reimbursement of services provided, and would impose upon LHCSAs the annual administrative and general (A&G) cost limitations applied to CHHAs.
»Download the complete letter
HCA's Response to Proposed CHHA/LHCSA Reporting Regulations
February 17, 2008
Ms. Katherine E. Ceralo
New York State Department of Health
Office of Regulatory Affairs
Corning Tower, Room 2438
Empire State Plaza
Albany, New York 12237-0097
Re: Licensed Home Care Services Agency Regulations, ID No. HLT-01-08-00022-P
Dear Ms. Ceralo:
On behalf of the diverse home care agencies that comprise the membership of the Home Care Association of New York State (HCA), I write to submit comments with respect to the notice of proposed rulemaking, amending sections 763.12, 766.10 and 766.12 of Title 10 NYCRR, published by the New York State Department of Health (DOH) in the State Register on January 2, 2008. These rules would require Certified Home Health Agencies (CHHAs) and Licensed Home Care Services Agencies (LHCSAs) to compile and submit annual reports on the type, frequency and reimbursement of services provided, and would impose upon LHCSAs the annual administrative and general (A&G) cost limitations applied to CHHAs.
»Download the complete letter
HCA MEMORANDUM OF OPPOSITION
Nurse Overtime Legislation
June 19, 2007
The Home Care Association of New York State, Inc. (HCA) is compelled to oppose legislation A.1898, S.6342, and S.6362 which would create explicit statutory limitations on the working schedules for nurses in an array of employer settings, including home care. While HCA applauds and supports the sponsors' goals of promoting quality of care and the overall working environment for nurses, the proposed legislation is geared to facility-based settings and is thus incompatible with the provision of care in the home. The dynamic nature of the health care environment and the practice of nursing as it relates to the provision of care in the home are inherently distinct from facility settings. HCA recommends that home care be excluded from this bill.
»Download the complete memorandum |
