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HCAOA WEEKLY NEWSLETTER
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The HCAOA Weekly is a brief update that will be distributed to HCAOA members each week. This communication complements our quarterly newsletter, The Voice, and will provide a vehicle for ensuring a regular flow of information on a more frequent basis. With ever evolving information in the home care industry, we want to ensure the lines of communication remain open and members have a source for quick, valuable news at their fingertips.
Table of Contents

Member News

Chapter News

Congressional Update

Congressional Corner

Member News

Thank You for Making the 2018 Annual Leadership Conference Another Great Success!

HCAOA would again like to thank all of the attendees, exhibitors, sponsors and speakers for making the conference such an overwhelming success. We value your membership and commitment to the home care industry.

During the event an audience of over 300 attendees watched and listened as Chief Confidence Officer and co-founder of the American Confidence Institute, Alyssa Dver delivered her skill-building keynote address, The Science of Confidence: Understand. Build. Spread. Having built a successful career as the CMO for seven tech companies and the CEO for an international marketing firm, Dver drew upon that experience to explain the impact that daily workplace challenges can have on one's energy, leadership, and confidence. Attendees of this session gained a better understanding of how the brain processes confidence, the triggers that can either fuel or challenge it, and high-performance techniques to sustain their confidence.


During his General Session presentation, Aaron Marcum, founder and CEO of the leading satisfaction management and performance benchmarking firm Home Care Pulse, shared five proven strategies that home care leaders use to disarm the top industry threat -- the shortage of caregivers. As a former successful home care owner, Marcum offered guidance based on his own experiences, in addition to best practices from Best of Home Care® leading providers, satisfaction data from Home Care Pulse, and the 2018 Home Care Benchmarking Study.
 
President of The Federal Group, Inc. and HCAOA Lobbyist, Patrick Cooney also led one of the General Sessions, during which he discussed HCAOA's agenda and how the 2018 elections may impact advocacy efforts. This session examined federal issues such as the companion care exemption, health reform developments, workforce challenges and more. Participants learned how they can engage in the political system to benefit their businesses, as well as the clients and families they serve.
 
The Technology Showcase returned this year, offering an insightful analysis of how the latest technology is impacting the home care industry and changing the way seniors receive in-home care. A panel of speakers shared their unique perspectives on how these innovations have aided family caregivers in administering care to their loved ones.
 
Each year the business meeting includes elections for the HCAOA Board of Directors. The following members were elected to the HCAOA Board: 
  • Matt Boever, Home Instead Senior Care 
  • Emma Dickison, Home Helpers
  • Steve Greenbaum, ComForcare 
  • Michael Juceam, Right At Home - Sarasota 
  • Julianne Roth, Companions for Living
2018 HCAOA Caregiver of the Year Award – Cereta Tyndale, Companions For Living
The following awards were presented during the business meeting:
  • Cereta Tyndale, a home care aide for Companions for Living, received the 2018 HCAOA Caregiver of the Year Award. This award was developed in 2011 to recognize a caregiver from a member company who demonstrates extraordinary commitment to the delivery of care to clients and their families.
  • Krystal Wilkinson of Adultcare Assistance Homecare received the Allen Hager Legislative Advocacy Award in recognition of her distinguished service in legislative advocacy for the home care industry and HCAOA.
  • Gale Bohling of BrightSpring Health Services received the Sheila McMackin Leadership Award, in recognition of his exceptional leadership qualities within the association on behalf of the home care industry.
Our exhibit hall had a great turnout; nearly fifty leading vendors were in attendance at this year's conference, demonstrating how their latest products and services can be of value to the home care industry.
 
Throughout the conference, attendees took time between sessions to visit the exhibit hall and learn more about trending technologies, practices, and strategies.

Congressional Lobby Day

On September 25, HCAOA members took to Capitol Hill to alert Members of Congress and their staffs to the challenges facing seniors, individuals with disabilities, and their family caregivers. Over the course of the day, 120 HCAOA members met with seventy-six (76) House offices and fifty-two (52) Senate offices.
 
HCAOA members focused their meeting on four key topics: 1) existing and impending workforce challenges, 2) expanding Health Saving Accounts to include home care expenses (H.R.6813), 3) the need to address long-term care with aging in place policies, and 4) redressing the FLSA companion care exemption.
 
These meetings help guide Congress in the final days of the 115th Congress and as a new Congress comes into office next January.
 

Save the Date!


For those HCAOA members who were unable to attend the conference this year, we hope to see you at the 2019 Annual Leadership Conference, September 22-23 in Tucson, AZ! 
Join hundreds of private duty executives at DecisionHealth's Private Duty National Conference & Expo! Hear from a powerful lineup of star presenters who will take your agency to the next level in revenue and profits. Improve caregiver retention, ensure client satisfaction, and grow your business! Full details at privatedutyconference.com.

HCAOA to Present at the 2018 Society for Social Work Leadership in Health Care Conference

 
HCAOA will roll out its Safe Home Care Initiative with a presentation during the 2018 Society for Social Work Leadership in Health Care Conference, taking place in Oregon on October 3-6.
 
During this presentation, licensed clinical social worker and spokesperson for the initiative, Cameron Svendsen will be explain how this new educational resource will aim to better inform consumers of home care services, and professionals referring these services, so that they are equipped to make informed decisions on what is in the best interest of the care recipient and his or her family.

Stay tuned for more information regarding this initiative – in the meantime, please visit www.safehomecare.org.
 


Medicare Advantage Plans Announced

 
On September 28, the Centers for Medicare & Medicaid Services (CMS) announced the release of the Medicare Advantage and Part D Prescription Drug Plan (PDP) landscape files for contract year (CY) 2019. These data files contain information on Medicare Advantage plan options, premiums, and benefit designs available to beneficiaries during the Open Enrollment Period (October 15 – December 7, 2018) for the 2019 coverage year.
 
CMS projects that enrollment in Medicare Advantage in 2019 will increase 11.5% over 2018, with 22.6 million Medicare beneficiaries (or 36.7%) expected to enroll in Medicare Advantage. Meanwhile, the average Medicare Advantage monthly premium in 2019 will be $28.00, a 6.5% decline from $29.81 in 2018.
 
CMS also announced that almost 270 Medicare Advantage plans will offer new and expanded health-related supplemental benefits in 2019, including adult day care services and in-home support services, caregiver support services, as well as reduced cost-sharing and additional benefits for beneficiaries with certain conditions, such as diabetes and congestive heart failure. These new benefits will impact and estimated 1.5 million seniors.
 
Please see the following resources for more details:


The 50 Best Workplaces for Aging Services

 
On September 27, Fortune published its first list of the top 50 workplaces in the aging services sector, giving several home-based care providers a chance to shine and flaunt their company culture.
 
Care Indeed, Cherished Companions Home Care and 24Hr HomeCare are among the home care companies to make 2018’s top workplaces list, compiled by Activated Insights, a Great Place to Work subsidiary focused on senior care.
 
Click here to view the list.
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New York

 
NY DOL Emergency Rule Decision
 
As many may know, a petition was filed in the NY Supreme Court to invalidate the emergency regulation which amended the Wage Order to permit home care agencies to pay home care aides 13 hours of a 24-hour shift, so long as meal and sleep periods were provided.  The NY Supreme Court issued a decision invalidating the emergency regulation, essentially finding that there was no need to issue the regulation on an emergency basis.  HCAOA and the Save NY Health Care Coalition are hopeful that the permanent regulation is released soon, as the DOL followed the required process for amending the regulations on a permanent basis. We are also hopeful that the Court of Appeals issues a favorable ruling in Andryeyeva and Moreno so we have finality to this issue.  The DOL can appeal the recent order, so we have to wait and see what happens next.  In the meantime, we are once again in a position where the DOL’s guidance was invalidated by a Court order. 
 
Click here to read more. 
 
 
NY Need Methodology RFI – Comments Due Next Week
 
As mentioned in the Fall 2018 issue of The Voice, the New York Department of Health (DOH) issued a request for information (RFI) to develop a public need methodology for the approval of Licensed Home Care Services Agencies (LHCSAs). Responses are due by October 12, 2018. The DOH has provided a list of questions from which commenters can utilize to formulate their responses, however, information in addition to the prescribed questions is welcome.
 
HCAOA is planning to respond to the RFI with comments and recommendations to the DOH by the October 12 deadline. Please contact info@hcaoa.org if you have any questions.
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2018 Home Care Benchmarking Study

Get the latest insights, trends, and analyses of the private duty home care industry. For the 9th year, Home Care Pulse has partnered with the HCAOA to produce the most comprehensive national study for the industry. The study includes reports on finance, sales & marketing, operations, recruiting & retention, and client experience aspects of home care businesses. It also includes articles from industry experts providing, their insight on successfully navigating through the challenges home care owners are facing and on positive trends impacting home care.
 
Click here to order your copy today!
Chapter News

HCAOA California

 
Governor Brown Signs AB 2455 Into Law
 
Despite our best efforts, we regret to report that CA Governor Jerry Brown signed AB 2455 into law over the weekend. There was no special announcement coinciding with the bill signing. It was part of a larger announcement regarding bill signings and vetoes. We would like to acknowledge and thank all of our HCAOA members and their caregivers for your assistance in our efforts to urge Governor Brown to veto the bill.
 
Next Steps and Options
The bill is set to take effect July 1, 2019. Leading up to that date the California Department of Social Services (DSS) will be required to adopt regulations and/or administrative procedures to implement the bill, including updating the registration process to include a notice that home care aide (HCA) information may be disclosed, that the HCA has a right to opt-out and will include instructions on the opt-out process. DSS will have to build the architecture to manage the opt-outs and the processes for disclosing the names/cell numbers, etc. of HCAs who do not opt out.

HCAOA will have the opportunity to intervene with DSS during the development of these regulations/procedures while reserving the right to be a party to litigation that challenges the constitutional authority of California to implement such a statute.
 
In that regard, please see the legal analysis letter that we commissioned Littler Law firm to send (dated September 7, 2018) to Governor Brown on our behalf as he was considering his decision whether to sign the bill. The letter concluded with Littler's legal opinion that should AB 2455 become law, it would be subject to a possible legal challenge on three separate constitutional grounds: invasion of privacy, denial of equal protection, and violation of the Supremacy Clause. As a result, we are considering our options for a possible legal challenge to the legislation on constitutional grounds. Furthermore, we are planning to develop a Q&A guidance document on AB 2455 that will be available to members and their caregivers as a resource going forward and will update accordingly as DSS structures a regulatory framework from the legislation.
 
Please contact info@hcaoa.org if you have any comments or questions.

HCAOA Connecticut

 
Chapter Successfully Opposes Regulation That Would Have Identified Caregiver Personal Information
 
Last month, HCAOA Connecticut opposed a regulation proposed by the Connecticut Department of Social Services that would have authorized the agency to require home care providers participating in the Connecticut Medical Assistance Program to provide individually identifiable information about the provider’s employees to the department or its agent. HCAOA Connecticut argued to lawmakers that the regulation may have exceeded the department’s authority, violated state policy and caregivers’ privacy and could have led to registration of home care workers with the state.
 
While the department plans to resubmit the regulation, it has agreed to remove the language HCAOA Connecticut objected to. Meanwhile, HCAOA Connecticut will continue to monitor the regulation. Please see the original position statement HCAOA Connecticut submitted to the committee and individual members when the regulation was proposed.
 
HCAOA Connecticut members and company owners deserve recognition and gratitude for contacting their lawmakers to express concerns and opposition. This grass roots approach to advocacy helps shape state policy directly affecting the home care industry and their businesses, illustrating another benefit of membership in the organization.
 
If you have any questions, please contact info@hcaoa.org

HCAOA Virginia

 
Join Us for the First HCAOA Virginia Meeting!
 
HCAOA Virginia will be hosting its first meeting on October 30! The meeting will be held simultaneously in two locations -- one in Yorktown, VA and one in Annandale, VA. Join us for this opportunity to network with fellow home care providers in your area, learn how you can contribute to future chapter efforts, and discover the benefits this new chapter will provide to the home care industry in Virginia.
 
Date: Tuesday, October 30
Time: 9:30 am - 12:00 pm
Locations: 
  • The Crossings on the Peninsula, 3540 Victory Blvd, Yorktown, VA 23693
  • Bright View - Woodburn, 3450 Gallows Rd, Annandale, VA 22003
If you have any questions please contact Manager of Chapter Services, Nataly Schwartz at nataly@hcaoa.org or 202-508-3872.

Click here to register!

HCAOA Arizona


There's Still Time to Register for Tomorrow's HCAOA Arizona Meeting!

Date: Thursday, October 4
Time: 11:30 am - 1:00 pm
Location: Home Assist Health | 3737 N 7th Street, Suite 203, Phoenix, AZ 
Luncheon: Free for chapter members, $50 for non-members
Topic: Medical Marijuana: What Employers Should Know
Guest Speaker: Roscoe Mutz, Attorney from Farhang & Medcoff Law Firm

Roscoe Mutz is an attorney in the litigation practice group at Farhang & Medcoff, where he focuses primarily on employment law, including both disputes and handbook/policy drafting, legal compliance issues involving HIPAA, wage and hour issues, and the Arizona Medical Marijuana Act, and commercial litigation. 
 
There will also be updates from the HCAOA Annual Leadership Conference and a follow-up on legislative outreach efforts.

If you have any questions please contact Manager of Chapter Services, Nataly Schwartz at nataly@hcaoa.org or 202-508-3872.
 
Click here to register!
Congressional Update

Expanding Health Saving Accounts to Cover Home Care Services

 
Recently, Rep. Sam Johnson (R-TX) and Rep. John Larsen (D-CT) introduced H.R.6813 on September 13 to expand Health Saving Accounts (HSAs) to include home care services.
 
HCAOA members were on Capitol Hill last week urging members of Congress to cosponsor this bill. This is a practical way to improve access to the care many need to help them stay in their home for as long as possible and avoid institutionalized care.
 
Traditional government health care programs and our current system of institutional care cannot meet the needs of the tens of millions of elderly Americans who will require some form of assistance. Private-pay home care fills a critical gap for seniors and individuals with disabilities who are between hospital stays, nursing home care, and care provided by family members and loved ones.
 
The HSA is a tax-advantaged medical savings account available to taxpayers who are enrolled in a high-deductible health plan. The funds contributed to an account are not subject to federal income tax at the time of deposit. Unlike a flexible spending account (FSA), HSA funds roll over and accumulate year to year if they are not spent. HSA funds may currently be used to pay for qualified medical expenses at any time without federal tax liability or penalty.

White Collar Exemption Regulations - Public Listening Session

 
The Department of Labor announced on October 3 it will conduct a public listening session to gather views on the Part 541 white collar exemption regulations. The session is scheduled for October 17 at 10 am. HCAOA staff will be in attendance of this listening session.
 
The Fair Labor Standards Act (FLSA) generally requires covered employers to pay their employees at least the federal minimum wage (currently $7.25 an hour) for all hours worked, and overtime premium pay of not less than one and one-half times the employee’s regular rate of pay for any hours worked over 40 in a workweek. The FLSA exempts from both minimum wage and overtime protection “any employee employed in a bona fide executive, administrative, or professional capacity” and delegates to the Secretary of Labor the power to define and delimit these terms through regulation.
 
Back in July of 2017 HCAOA submitted comments to the DOL as it sought to solicit public comment on this issue.

GAO Report: Medicaid Home- And Community-Based Services

Selected States’ Program Structures and Challenges Providing Services

 
Recently, the Government Accountability Office (GAO) recently released an August 2018 report on Medicaid Home and Community Based Services. (GAO-18-628)
 
The need for LTSS to assist individuals with limited abilities for self-care is expected to increase, in part due to the aging of the population. Medicaid is the nation's primary payer of LTSS, with spending estimated at $167 billion in 2016. State Medicaid programs are generally required to cover LTSS provided in institutions, such as nursing homes, but coverage of the same services outside of institutions—that is, HCBS—is generally optional. In recent years there have been efforts to shift the balance of LTSS away from institutions through the expanded use of HCBS. National spending for HCBS has increased and now exceeds that for services in an institution. However, the extent to which Medicaid programs cover HCBS varies by state, as does the structure of states’ HCBS programs.
 
GAO was asked to review the approaches states use to provide coverage for HCBS in the Medicaid program. For selected states, this report describes (1) decisions that influenced the structure of Medicaid HCBS programs, and (2) challenges providing HCBS to Medicaid beneficiaries and efforts to respond to these challenges. GAO reviewed information and conducted interviews with officials from a non-generalizable sample of five states, which GAO selected to obtain variation in the percentage of total Medicaid LTSS expenditures used for HCBS, geography, and other factors. GAO also reviewed information and interviewed officials from four MCOs—two in each of the two selected states that used managed care to provide HCBS. The MCOs varied in enrollment size and population served.
 
Highlights of Report Findings
 
All state Medicaid programs finance coverage of long-term services and supports (LTSS), which help beneficiaries with physical, cognitive, or other limitations perform routine daily activities, such as eating, dressing, and making meals. When these services are provided in beneficiaries’ homes or other community settings instead of nursing homes, the services are known as home- and community-based services (HCBS). The structure of the 26 HCBS programs reviewed in five states—Arizona, Florida, Mississippi, Montana, and Oregon—reflected decisions about which populations to cover, whether to limit eligibility or enrollment, and whether to use managed care.
  • Populations: Four of the five states had multiple HCBS programs that targeted specific populations. For example, Mississippi had separate HCBS programs for aged or physically disabled individuals and individuals with intellectual or developmental disabilities. The fifth state, Arizona, had one program that targeted two specific populations.
  • Eligibility: All five states had at least one HCBS program that limited eligibility to beneficiaries whose needs would otherwise require care in a nursing home or other institutional setting.
  • Enrollment: Four of the five states limited enrollment in one or more of their HCBS programs; 19 of the 26 programs had enrollment caps, and 12 of these programs maintained a waiting list.
  • Managed care: Two of the five states used managed care to provide HCBS, paying managed care organizations (MCO) a fixed fee for each beneficiary rather than paying providers for each service delivered. State and MCO officials identified several challenges providing HCBS and described their efforts to respond to them:
    • HCBS workforce: Officials cited challenges recruiting and retaining HCBS providers, particularly given the low wages these providers typically receive. To respond to this, officials from Mississippi, Montana, and two of the MCOs reported offering providers higher payment rates.
    • Complex needs: Officials described challenges serving beneficiaries with complex medical and behavioral health needs, including individuals who display aggressive or other challenging behaviors. Officials from Montana and one MCO reported responding to this challenge by providing behavioral health training for providers.
    • HCBS funding: State officials reported that limitations on overall HCBS funding levels posed a challenge, which they responded to by providing their state legislatures with information on the projected need for HCBS to inform future funding decisions, and leveraging other available resources, such as federal grants.
Congressional Corner

Rep. Sam Johnson (R-TX)

Before there was a Freedom Caucus, Tea Party Caucus or the Republican Study Committee there was the Conservative Action Team, known popularly as the CATs. The CATs were every bit as confrontational as the more recent groups. Sam Johnson was one of the original founders of the CATS -- which later became the RSC -- in 1995.

 
Now, almost two decades later, Johnson, who began the 115th Congress as its third-oldest House member, is still regarded as an elder statesman of the movement, albeit seldom front-and-center in either their rhetoric or legislative strategy sessions.

Johnson’s father worked for an insurance agency, and his mother was a Western Union office manager. When he was in high school, ROTC was mandatory. He continued on with ROTC in college at Southern Methodist University. During the Korean War, his entire ROTC class was activated. “I signed up to become a fighter pilot, even though I had never set foot on a plane—I thought it sounded exciting,” he said. He was trained as an Air Force pilot, flew combat missions in Korea, and then decided to make the military his career.
 
In addition to combat service in both Korea and Vietnam, flying F-86s and then F-4s, Johnson was a member of the Thunderbirds precision flying team and directed the Air Force fighter training school. His imprisonment left him with leg and hand injuries.
 
Three operations on his right hand enabled him recover enough to resume flying. “My POW years shaped my perspective on faith and service unlike any other experience in my life,” he said in his Politico op-ed criticizing Trump. “I learned firsthand that the trying times do have a purpose and that we must choose to let them make us stronger.”
 
Johnson retired from the Air Force in 1979 and started a home-building business. He was elected to the Texas House in 1984 and was re-elected three times. In 1991, when Representative Steve Bartlett resigned to become mayor of Dallas, Johnson entered the special election race to replace him. Johnson won a close runoff election against another Republican to win the seat. In the solidly Republican district, Johnson has had no trouble winning re-election. He won 61 percent of the vote in 2016.
 
Johnson announced in January 2017 that he would retire at the end of the 115th Congress.

Home Care Association of America
444 N. Capitol Street NW, Suite 397, Washington, DC 20001
Phone: 800-22-HCAOA Email: info@hcaoa.org  Website: www.hcaoa.org

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