This document provides information about the Home Health Documentation and Program Improvement Act of 2015 (S. 1650). The legislation aims to address unworkable Medicare documentation requirements related to home health "face-to-face" visits that have resulted in a high rate of denied claims. It would standardize documentation, accept forms completed by home health agencies and signed by physicians, and provide relief from past denied claims. Supporters argue it will reduce paperwork burdens and inappropriate claim denials while ensuring access to necessary home health services.
The document discusses rural health challenges in North East LHIN, a region covering 400,000 square kilometers in Northern Ontario. The region has a dispersed population of 560,000 people that is declining and aging. Compared to provincial averages, the region has higher rates of smokers, heavy drinkers, obesity, and chronic disease. There is also a shortage of health care professionals. The region is served by over 200 health service providers across several sub-regions.
Talks On the Hill about the ACA and Primary care transformation by : Kevin Grumbach, University of California, San Francisco; Paul Grundy, IBM; Craig Jones, Vermont Blueprint for Health; and Jeffrey Schiff, Minnesota Department of Human Services. Melinda Abrams of The Commonwealth Fund and Ed Howard of the Alliance co-moderated.
The document discusses two pieces of kidney legislation - the Dialysis PATIENT Act (H.R. 5506/S. 3090) and the ESRD Choice Act (H.R. 5659). It provides details on what each bill aims to do, including expanding coordinated care and insurance choice for end-stage renal disease patients. It encourages patients to schedule meetings with their legislators during the upcoming summer recess to discuss these bills. Guidelines are provided on requesting meetings and how to hold effective meetings to advocate for improving care coordination and access to Medicare Advantage plans for dialysis patients.
Resources on the river vendorapplication finalToddy Wobbema
Providing knowledge and education on resources for healthcare, financial, insurance, housing and many other needs for seniors and their families and caregivers in Acadiana.
Well City Overview Professional DimensionsArvid_Tillmar
The document discusses chronic diseases and their impact on health care costs in the United States and Wisconsin. It notes that chronic diseases account for most deaths and health care spending, and prevention and management of chronic diseases could significantly reduce costs. Adopting healthy lifestyles and creating incentives for employee wellness are presented as ways to lower health care costs.
Linda Rosenberg, President and CEO of the National Council for Community Behavioral Healthcare, discusses the increased demand community mental health centers will face under healthcare reform and the Affordable Care Act. An estimated 1.5 million new patients will enter treatment, increasing caseloads by over 20%. However, cuts to public mental health services have also occurred. She asks Congress to support the Community Mental Health and Addiction Safety Net Equity Act to provide reimbursement parity for community behavioral health centers. She also asks Congress to ensure people with mental illness can benefit from provisions in the Affordable Care Act, including its Health Home State Option, and receive equal access to health information technology.
This document summarizes an agenda and call for Advocates for Ohio's Future regarding the state budget. Representatives from various advocacy organizations discuss funding needs and cuts to programs supporting mental health, child welfare, aging services, food assistance, and more. They request restoring proposed budget cuts and investing additional funds in these areas using any new revenue. Attendees are encouraged to contact their state senator to advocate for prioritizing health and human services programs.
The document discusses rural health challenges in North East LHIN, a region covering 400,000 square kilometers in Northern Ontario. The region has a dispersed population of 560,000 people that is declining and aging. Compared to provincial averages, the region has higher rates of smokers, heavy drinkers, obesity, and chronic disease. There is also a shortage of health care professionals. The region is served by over 200 health service providers across several sub-regions.
Talks On the Hill about the ACA and Primary care transformation by : Kevin Grumbach, University of California, San Francisco; Paul Grundy, IBM; Craig Jones, Vermont Blueprint for Health; and Jeffrey Schiff, Minnesota Department of Human Services. Melinda Abrams of The Commonwealth Fund and Ed Howard of the Alliance co-moderated.
The document discusses two pieces of kidney legislation - the Dialysis PATIENT Act (H.R. 5506/S. 3090) and the ESRD Choice Act (H.R. 5659). It provides details on what each bill aims to do, including expanding coordinated care and insurance choice for end-stage renal disease patients. It encourages patients to schedule meetings with their legislators during the upcoming summer recess to discuss these bills. Guidelines are provided on requesting meetings and how to hold effective meetings to advocate for improving care coordination and access to Medicare Advantage plans for dialysis patients.
Resources on the river vendorapplication finalToddy Wobbema
Providing knowledge and education on resources for healthcare, financial, insurance, housing and many other needs for seniors and their families and caregivers in Acadiana.
Well City Overview Professional DimensionsArvid_Tillmar
The document discusses chronic diseases and their impact on health care costs in the United States and Wisconsin. It notes that chronic diseases account for most deaths and health care spending, and prevention and management of chronic diseases could significantly reduce costs. Adopting healthy lifestyles and creating incentives for employee wellness are presented as ways to lower health care costs.
Linda Rosenberg, President and CEO of the National Council for Community Behavioral Healthcare, discusses the increased demand community mental health centers will face under healthcare reform and the Affordable Care Act. An estimated 1.5 million new patients will enter treatment, increasing caseloads by over 20%. However, cuts to public mental health services have also occurred. She asks Congress to support the Community Mental Health and Addiction Safety Net Equity Act to provide reimbursement parity for community behavioral health centers. She also asks Congress to ensure people with mental illness can benefit from provisions in the Affordable Care Act, including its Health Home State Option, and receive equal access to health information technology.
This document summarizes an agenda and call for Advocates for Ohio's Future regarding the state budget. Representatives from various advocacy organizations discuss funding needs and cuts to programs supporting mental health, child welfare, aging services, food assistance, and more. They request restoring proposed budget cuts and investing additional funds in these areas using any new revenue. Attendees are encouraged to contact their state senator to advocate for prioritizing health and human services programs.
The document summarizes highlights from Ohio's proposed state budget bill HB 153 for fiscal years 2012-2013. It discusses funding cuts to areas like education, Medicaid, and mental health services while Medicaid caseloads increase. Concerns are raised that more cuts may come in the next budget and the long-term impacts on health and human services are uncertain given over 5,000 pages of policy changes with little detail. Advocates call for more investment in areas like child welfare, mental health, and foodbanks to adequately meet growing needs.
The Ohio legislature is currently negotiating the biennial state budget bill that will determine funding for vital public services and supports over the next two years. Passing a new state budget presents a big opportunity to advocate to strengthen Ohio’s families and communities. Over the next several months AOF and our partners will focus on helping Ohioans be safe in their homes, afford the basics, and find good jobs that ensure family stability.
Webinar speakers Tara Britton and William Tarter, Jr. of The Center for Community Solutions discussed how the state budget is negotiated, where to find budget resources and how to use them, what it means to be an effective advocate, and ways to get involved in efforts to strengthen Ohio’s human services programs.
Prepared by Helene Andre and Luka Grujic for French Tech Hub
The aging population is expected to sky rocket in the next decade and the United States has to rethink how it will deliver care for its elderly.
With recent advancements in technology, Aging in Place has emerged as strong solution to address this pressing need.
In this presentation, French Tech Hub explores the dynamics of the U.S. aging population and gives an overview of the solutions that are being developed for Aging in Place.
1) Community-based mental healthcare services are more effective than institutional care by allowing for greater family involvement, being less restrictive, and producing better outcomes at a lower cost.
2) Integrating community-based services helps with early detection and treatment of mental health issues while reducing hospitalization needs and helping patients live successfully in their communities.
3) Studies show that average monthly spending per person for home and community-based services is much lower than for institutional care like nursing homes.
Advocates for Ohio's Future works to maintain public services like health care, human services, and early childhood education through the state budget. It supports a budget solution that protects vulnerable groups. The last state budget cut $196 million from mental health and addiction services and $25 million from services for people with developmental disabilities. The next budget faces a $6-8 billion shortfall and may require 20% across-the-board cuts, eliminating some programs and limiting others. Advocates for Ohio's Future aims to elevate the importance of these services and highlight efficiencies to do more with less funding.
Ohio Speaks is a new collaborative project of local and statewide health and human service organizations working to collect and highlight stories of struggle and hope. The stories will illustrate the value of human needs programs that support Ohio's most vulnerable children, families, seniors, and people with disabilities. Ohio Speaks will also put a human face on budget cuts and show the effect of budget cuts in our communities. The stories will be used in our advocacy and education work with lawmakers, the media and the public to highlight the impact of human needs programs.
Design Challenge: Aging in Place,Silicon Valley at the 2014 Positive Aging ForumChris Kennedy
The document summarizes presentations from a 2014 forum on aging in place in Silicon Valley. It includes discussions on:
- Creating a new affordable model of home care and support services for aging in place.
- Expanding a CCRC's service model into home settings through services like care coordination, transportation and meals.
- Developing social enterprises to support aging in place, like a culinary services program.
- The programs and services provided by the Santa Clara County Department of Aging and Adult Services, including increases in clients served.
The document summarizes key points from a meeting of Advocates for Ohio's Future regarding the state budget. Key policy priorities discussed include preserving Medicaid eligibility and services, adequately funding programs for the elderly, food access, behavioral health, and early childhood education. Concerns were raised that the budget cuts funding for important social services and does not direct new revenue towards health and human services. Advocates were urged to contact state legislators and express that any new revenue should support programs for health, nutrition, and vulnerable groups.
Learn more about what is at stake in the “Super Committee” and the federal deficit-reduction deal for children, families, seniors and people with disabilities in Ohio. Leading statewide advocates will discuss how we work to maintain vital programs, such as SNAP, Medicaid, and Medicare.
Advocates for Ohio’s Future and our partners are also gearing up for a statewide “call-in day” on Wednesday, Sept 28 to Senator Portman’s offices in Columbus, Cincinnati, Cleveland, Toledo, and D.C. to make sure the Super Committee’s deficit-reduction plan does not increase poverty or income inequality.
You’ll hear from:
* Lisa Hamler-Fugitt, Executive Director of the Ohio Association of Second Harvest Foodbanks
Luke Russell, Associate State Director for Advocacy, AARP Ohio
Cathy Levine, Executive Director of UHCAN Ohio and Co-Chair of Ohio Consumers for Health Coverage
Deborah Nebel, Director of Public Policy, Linking Employment, Ability, and Potential
Wendy Patton, Senior Associate with Policy Matters Ohio
Will Petrik, Outreach Director with Advocates for Ohio’s Future
The document summarizes various events and initiatives undertaken by CEHURD, a non-profit organization, over the past month. It discusses the successful launch of campaigns to reform abortion laws, including the #LetHerSpeak campaign and an effort to collect one million signatures for a petition. It also outlines CEHURD's work establishing a legal support network of volunteer lawyers and holding an advocacy meeting on improving access to medicine in Uganda. Additionally, it notes that CEHURD staff visited the organization's upcoming permanent home currently under construction and received recognition from management for their work and progress on activities.
The document provides information on the 2014 Public Health Advisory Council and Board of Health for Snohomish County, Washington. It lists the members of each group and notes that the Snohomish Health District works with these partners to promote public health in the community. The document then summarizes the Health District's strategic plan update and priorities for evolving its programs and services. It also provides some statistics on the services provided and funding challenges faced by the Health District.
The document summarizes the Debt Ceiling Deal passed by Congress and its potential impacts. It establishes a bipartisan committee to cut $1.2-1.5 trillion in spending over 10 years, with automatic cuts taking effect in 2013 if no deal is reached. Many programs are exempt from these cuts, but discretionary programs and entitlement reforms are on the table. The deal could reduce funding for services like nutrition assistance and Medicaid, threatening vulnerable populations. Advocates encourage engaging with members of Congress to prioritize critical social programs in further deficit reduction efforts.
The document argues that Medicaid expansion is an essential economic and public health opportunity for Mississippi. It notes that Medicaid expansion would provide coverage to around 310,000 Mississippians and help create around 9,000 jobs. The federal government would cover a large portion of the costs. Failing to expand Medicaid could harm hospitals and communities, and put Mississippi at a competitive disadvantage compared to surrounding states that are expanding Medicaid. The document concludes that Mississippi faces a choice between expanding Medicaid or losing out on these benefits.
The document discusses several options and models that allow older adults to age in place rather than moving to nursing homes. It describes nursing home occupancy rates and limitations. Alternative models discussed include Green House communities, MedCottage temporary living structures, Naturally Occurring Retirement Communities (NORCs), and universal design principles that make homes more accessible for aging. The document argues that these alternatives can allow seniors to remain in their communities at a lower cost than nursing home care and change attitudes about aging.
Operation Access is a nonprofit organization that coordinates donated medical care for low-income uninsured patients. In 2014, they coordinated services valued at over $15 million for 1,527 patients. The annual report discusses how the organization continues to fill gaps in care despite the expansion of insurance coverage under the Affordable Care Act. It also highlights individual patient stories and provides statistics on the types of services provided, funding sources, volunteer and patient satisfaction surveys, and the financial picture of the organization.
In recent weeks, Governor Kasich introduced a Mid-biennium Review bill (MBR) to propose budget and policy ideas to transform Ohio. It has been split into 14 different pieces of legislation and is currently being discussed in a number of House committees. Learn more about the MBR and changes to health and human services, education and workforce development in Ohio.
Phillipines Health Report Presentation HSOC 010Ade Jackson
This document proposes a two-phase community health program. Phase 1 involves selecting and training local community health workers who return to serve their own communities. Phase 2 establishes a collaborative health database to record administrative activities. The program aims to improve health care and increase community involvement across low-resource regions through a network of community health workers supported by doctors and funded jointly by governments, NGOs, and the private sector. The proposal includes timelines, incentives, and addresses some potential critiques.
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
State leaders update Ohioans on the status of Medicaid expansion in the budget. They share talking points that are working, identify key lawmakers to contact, and discuss ongoing advocacy efforts and the next steps for action.
This document provides information about HeNan KaiLun Chemical CO.,Ltd, including its location in Henan, China, contact information for manager Liu Huijun, website and social media links. It then summarizes that KaiLun is one of China's earliest and largest producers of rubber chemicals, with an annual production of 20,000 tons across various product lines. The document proceeds to include pictures of KaiLun's factory facilities and products, descriptions of quality certifications and standards for main products including various types of rubber antioxidants, accelerators, and insoluble sulfur.
Srinivas Thadi is seeking a position that utilizes his skills in a competitive field offering professional growth. He has over 4 years of experience as a Production Engineer at Opto Circuits (India) Ltd. He leads a production team for medical electronic products and is responsible for production planning, quality control, and customer issue resolution. Srinivas has a diploma in Industrial Engineering and Management and a B.Tech in Electronics and Communication Engineering.
The document summarizes highlights from Ohio's proposed state budget bill HB 153 for fiscal years 2012-2013. It discusses funding cuts to areas like education, Medicaid, and mental health services while Medicaid caseloads increase. Concerns are raised that more cuts may come in the next budget and the long-term impacts on health and human services are uncertain given over 5,000 pages of policy changes with little detail. Advocates call for more investment in areas like child welfare, mental health, and foodbanks to adequately meet growing needs.
The Ohio legislature is currently negotiating the biennial state budget bill that will determine funding for vital public services and supports over the next two years. Passing a new state budget presents a big opportunity to advocate to strengthen Ohio’s families and communities. Over the next several months AOF and our partners will focus on helping Ohioans be safe in their homes, afford the basics, and find good jobs that ensure family stability.
Webinar speakers Tara Britton and William Tarter, Jr. of The Center for Community Solutions discussed how the state budget is negotiated, where to find budget resources and how to use them, what it means to be an effective advocate, and ways to get involved in efforts to strengthen Ohio’s human services programs.
Prepared by Helene Andre and Luka Grujic for French Tech Hub
The aging population is expected to sky rocket in the next decade and the United States has to rethink how it will deliver care for its elderly.
With recent advancements in technology, Aging in Place has emerged as strong solution to address this pressing need.
In this presentation, French Tech Hub explores the dynamics of the U.S. aging population and gives an overview of the solutions that are being developed for Aging in Place.
1) Community-based mental healthcare services are more effective than institutional care by allowing for greater family involvement, being less restrictive, and producing better outcomes at a lower cost.
2) Integrating community-based services helps with early detection and treatment of mental health issues while reducing hospitalization needs and helping patients live successfully in their communities.
3) Studies show that average monthly spending per person for home and community-based services is much lower than for institutional care like nursing homes.
Advocates for Ohio's Future works to maintain public services like health care, human services, and early childhood education through the state budget. It supports a budget solution that protects vulnerable groups. The last state budget cut $196 million from mental health and addiction services and $25 million from services for people with developmental disabilities. The next budget faces a $6-8 billion shortfall and may require 20% across-the-board cuts, eliminating some programs and limiting others. Advocates for Ohio's Future aims to elevate the importance of these services and highlight efficiencies to do more with less funding.
Ohio Speaks is a new collaborative project of local and statewide health and human service organizations working to collect and highlight stories of struggle and hope. The stories will illustrate the value of human needs programs that support Ohio's most vulnerable children, families, seniors, and people with disabilities. Ohio Speaks will also put a human face on budget cuts and show the effect of budget cuts in our communities. The stories will be used in our advocacy and education work with lawmakers, the media and the public to highlight the impact of human needs programs.
Design Challenge: Aging in Place,Silicon Valley at the 2014 Positive Aging ForumChris Kennedy
The document summarizes presentations from a 2014 forum on aging in place in Silicon Valley. It includes discussions on:
- Creating a new affordable model of home care and support services for aging in place.
- Expanding a CCRC's service model into home settings through services like care coordination, transportation and meals.
- Developing social enterprises to support aging in place, like a culinary services program.
- The programs and services provided by the Santa Clara County Department of Aging and Adult Services, including increases in clients served.
The document summarizes key points from a meeting of Advocates for Ohio's Future regarding the state budget. Key policy priorities discussed include preserving Medicaid eligibility and services, adequately funding programs for the elderly, food access, behavioral health, and early childhood education. Concerns were raised that the budget cuts funding for important social services and does not direct new revenue towards health and human services. Advocates were urged to contact state legislators and express that any new revenue should support programs for health, nutrition, and vulnerable groups.
Learn more about what is at stake in the “Super Committee” and the federal deficit-reduction deal for children, families, seniors and people with disabilities in Ohio. Leading statewide advocates will discuss how we work to maintain vital programs, such as SNAP, Medicaid, and Medicare.
Advocates for Ohio’s Future and our partners are also gearing up for a statewide “call-in day” on Wednesday, Sept 28 to Senator Portman’s offices in Columbus, Cincinnati, Cleveland, Toledo, and D.C. to make sure the Super Committee’s deficit-reduction plan does not increase poverty or income inequality.
You’ll hear from:
* Lisa Hamler-Fugitt, Executive Director of the Ohio Association of Second Harvest Foodbanks
Luke Russell, Associate State Director for Advocacy, AARP Ohio
Cathy Levine, Executive Director of UHCAN Ohio and Co-Chair of Ohio Consumers for Health Coverage
Deborah Nebel, Director of Public Policy, Linking Employment, Ability, and Potential
Wendy Patton, Senior Associate with Policy Matters Ohio
Will Petrik, Outreach Director with Advocates for Ohio’s Future
The document summarizes various events and initiatives undertaken by CEHURD, a non-profit organization, over the past month. It discusses the successful launch of campaigns to reform abortion laws, including the #LetHerSpeak campaign and an effort to collect one million signatures for a petition. It also outlines CEHURD's work establishing a legal support network of volunteer lawyers and holding an advocacy meeting on improving access to medicine in Uganda. Additionally, it notes that CEHURD staff visited the organization's upcoming permanent home currently under construction and received recognition from management for their work and progress on activities.
The document provides information on the 2014 Public Health Advisory Council and Board of Health for Snohomish County, Washington. It lists the members of each group and notes that the Snohomish Health District works with these partners to promote public health in the community. The document then summarizes the Health District's strategic plan update and priorities for evolving its programs and services. It also provides some statistics on the services provided and funding challenges faced by the Health District.
The document summarizes the Debt Ceiling Deal passed by Congress and its potential impacts. It establishes a bipartisan committee to cut $1.2-1.5 trillion in spending over 10 years, with automatic cuts taking effect in 2013 if no deal is reached. Many programs are exempt from these cuts, but discretionary programs and entitlement reforms are on the table. The deal could reduce funding for services like nutrition assistance and Medicaid, threatening vulnerable populations. Advocates encourage engaging with members of Congress to prioritize critical social programs in further deficit reduction efforts.
The document argues that Medicaid expansion is an essential economic and public health opportunity for Mississippi. It notes that Medicaid expansion would provide coverage to around 310,000 Mississippians and help create around 9,000 jobs. The federal government would cover a large portion of the costs. Failing to expand Medicaid could harm hospitals and communities, and put Mississippi at a competitive disadvantage compared to surrounding states that are expanding Medicaid. The document concludes that Mississippi faces a choice between expanding Medicaid or losing out on these benefits.
The document discusses several options and models that allow older adults to age in place rather than moving to nursing homes. It describes nursing home occupancy rates and limitations. Alternative models discussed include Green House communities, MedCottage temporary living structures, Naturally Occurring Retirement Communities (NORCs), and universal design principles that make homes more accessible for aging. The document argues that these alternatives can allow seniors to remain in their communities at a lower cost than nursing home care and change attitudes about aging.
Operation Access is a nonprofit organization that coordinates donated medical care for low-income uninsured patients. In 2014, they coordinated services valued at over $15 million for 1,527 patients. The annual report discusses how the organization continues to fill gaps in care despite the expansion of insurance coverage under the Affordable Care Act. It also highlights individual patient stories and provides statistics on the types of services provided, funding sources, volunteer and patient satisfaction surveys, and the financial picture of the organization.
In recent weeks, Governor Kasich introduced a Mid-biennium Review bill (MBR) to propose budget and policy ideas to transform Ohio. It has been split into 14 different pieces of legislation and is currently being discussed in a number of House committees. Learn more about the MBR and changes to health and human services, education and workforce development in Ohio.
Phillipines Health Report Presentation HSOC 010Ade Jackson
This document proposes a two-phase community health program. Phase 1 involves selecting and training local community health workers who return to serve their own communities. Phase 2 establishes a collaborative health database to record administrative activities. The program aims to improve health care and increase community involvement across low-resource regions through a network of community health workers supported by doctors and funded jointly by governments, NGOs, and the private sector. The proposal includes timelines, incentives, and addresses some potential critiques.
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
State leaders update Ohioans on the status of Medicaid expansion in the budget. They share talking points that are working, identify key lawmakers to contact, and discuss ongoing advocacy efforts and the next steps for action.
This document provides information about HeNan KaiLun Chemical CO.,Ltd, including its location in Henan, China, contact information for manager Liu Huijun, website and social media links. It then summarizes that KaiLun is one of China's earliest and largest producers of rubber chemicals, with an annual production of 20,000 tons across various product lines. The document proceeds to include pictures of KaiLun's factory facilities and products, descriptions of quality certifications and standards for main products including various types of rubber antioxidants, accelerators, and insoluble sulfur.
Srinivas Thadi is seeking a position that utilizes his skills in a competitive field offering professional growth. He has over 4 years of experience as a Production Engineer at Opto Circuits (India) Ltd. He leads a production team for medical electronic products and is responsible for production planning, quality control, and customer issue resolution. Srinivas has a diploma in Industrial Engineering and Management and a B.Tech in Electronics and Communication Engineering.
This document discusses customizable segmentation of morphologically derived words in Chinese. It presents a system that can segment words in different ways to meet various user-defined standards. The system represents all morphologically derived words as word trees, where the root nodes are maximal words and leaf nodes are minimal words. Each non-terminal node has a resolution parameter that determines if its daughters are displayed as a single word or separate words. Different segmentations can then be obtained by specifying different combinations of these resolution parameters. This allows a single system to be customized for different segmentation needs.
1. The document provides instructions for using Dropbox to store and share files across devices. It explains how to install Dropbox on computers and mobile devices, upload and access files from any device, and share files and folders with others by generating links or setting up shared folders for collaboration.
2. Dropbox allows users to automatically backup files to the cloud and access them from any device. The app can be installed on Windows, Mac, iOS and Android devices. Files can be uploaded through the desktop or mobile apps or through the Dropbox website.
3. The document also describes how to send large files through Dropbox by generating shareable links and how to collaborate on documents by creating shared folders and adding other users to work on files simultaneously.
This document provides information about ignition interlock devices (IIDs) and mobile alcohol monitoring. It defines IIDs, describes how they work and their components. It discusses the purpose of IIDs, specifications for common models, anti-circumvention features, installation, and the 2013 NHTSA standards. Reporting features of IID management software are summarized. Terminology used in IID logs is defined. The document also introduces mobile alcohol monitoring as a less intrusive alternative to SCRAM, describing its basic functioning and potential advantages.
This document summarizes notes about mental illness, specifically bipolar disorder. It discusses high suicide rates among those with bipolar disorder and schizophrenia. Firearms are a highly lethal method of suicide. The document outlines symptoms of bipolar disorder like suicidal thoughts, addictions, spending binges, and difficulty with relationships. It provides tips for managing bipolar disorder like maintaining stable routines, exercise, social support, and avoiding firearms.
Artemis Valanis is a Dipl. Rural and Surveying Engineer with over 15 years of experience in 3D laser scanning, photogrammetry, and 3D modeling of cultural heritage sites and engineering projects. They have extensive experience processing laser scan and image data to create high-resolution 3D textured models and orthophotomosaics, and have worked on documentation projects for the Acropolis Restoration Service and Astrolabe Engineering. Their professional experience also includes work with Norconsult AB on 3D modeling and orthophotomosaics of the Royal Palace of Stockholm.
There are several basic camera shots and techniques used in filmmaking. An establishing shot establishes the location and is usually wide. A long shot shows the entire subject and surroundings. A medium shot displays both characters and scenery to show actions or interactions. A close-up tightly frames a person or object, while an extreme close-up only shows a detail like eyes. Camera angles like high angles and low angles can influence how powerful or vulnerable a subject seems. Tracking follows a moving subject, while pans and tilts rotate the camera horizontally or vertically. Zooms change the focal length during a shot.
Statistically-Enhanced New Word IdentificationAndi Wu
This document discusses a method for identifying new words in Chinese text using a combination of rule-based and statistical approaches. Candidate character strings are selected as potential new words based on their independent word probability being below a threshold. Parts of speech are then assigned to candidate strings by examining the part of speech patterns of their component characters and comparing them to existing words in a dictionary to determine the most likely part of speech based on word formation patterns in Chinese. This hybrid approach avoids the overgeneration of rule-based systems and data sparsity issues of purely statistical approaches.
As part of the Australian Visualisation Colloquium, Nathan Bailey explores why today's students need 3D educational experiences.
The University of the Sunshine Coast has a unique suite of immersive and 3D immersive environments for teaching. Today's students need the high quality engagement, conception and visualisation skills these environments provide to understand and solve the complex, multi-faceted problems and opportunities we face.
Jayro Sales Co., Inc. is a manufacturers' representative firm founded in 1969 in California that specializes in representing companies in the health/beauty, stationery, housewares, and food industries to dollar stores in Southern California. The company's president, Bob Van Grove, has decades of experience in marketing and sales. Jayro aims to aggressively promote its clients' products to new and existing retailer accounts through fresh sales approaches and dedicating time to presenting and following up on product lines. The document provides contact information for both companies Jayro currently represents and major dollar store accounts.
This document discusses various types of line markings that can be applied in parking lots and facilities, including markings for parking spaces, exclusion zones, logos, speed controls, pedestrian safety, and traffic directional markings.
This document provides a calendar of important dates from September 2015 through August 2016 to help businesses plan their content strategy for their blog and social media channels. It includes national holidays, cultural events, and suggestions for content that is relevant to customers and promotes socially responsible business practices. Businesses can use this calendar to outline or enhance their content strategy and marketing goals.
This paper presents a method for automatically detecting and correcting erroneous characters in Chinese text. The method treats typo correction as an integral part of syntactic analysis. It considers both the original character and possible replacement characters from a list of confusable pairs during sentence parsing. The character that results in the best parse is identified as correct. The approach achieves substantially higher recall and precision than existing Chinese proofreaders, which do not perform a full syntactic analysis. An evaluation on 50 character pairs found an overall precision of 86.9% and recall of 96.3%. Cases involving characters that can only form words together tended to have perfect scores, while characters that can stand alone were more difficult to correct.
Medicaid Expansion has ushered in new challenges for those working in the Medicaid Industry. At the 2014 Medicaid Summit, join Medicaid Directors and industry leaders to discuss solutions to the challenges that are surfacing with Medicaid Expansion. Be a part of the discussions on the Medicaid regulations and access to care and their impact on the Medicaid industry for state operators, providers and Medicaid health plans.
http://bit.ly/MedicaidSummit
Advocacy for the New York Health Act: Statewide Lobby Day 2016Katherine Robbins
On Sunday, May 22, 2016 at 7pm EST, we will have a conference call to prepare for the statewide lobby day in Albany for the New York Health Act on Tues. May 24th, 2016. Join us to help prepare for the big day!
Call #(302) 202-1110
Conference Code: 298370
Questions? Email annette@nyhcampaign.org
The document discusses advocacy efforts for Medicaid expansion in South Carolina, including messaging around the importance of expanded access to care and treatment for people living with HIV, ongoing discussions in the state around essential health benefits and benchmark plans, and next steps advocates can take like meeting with stakeholders, elected officials, and participating in coalitions and sign-on letters.
The 2014 Medicare Summit will feature a comprehensive, timely offering of sessions focused on key issues currently impacting the industry including the Dual Eligible population, ACOs, the sustainable growth rate, Medicare Advantage and star ratings. As the landscape of healthcare policy and reform continues to change at a rapid pace, it is imperative for hospitals, health systems, physicians, administrators, and health plans to stay well-informed so they can remain profitable.
http://www.worldcongress.com/events/HL14026/
The 2014 Health Insurance Exchanges Summit features a timely agenda focused on leveraging current “knowns” and progress to derive practical strategies for successful future participation in HIXs. Health plan executives, state and federal exchange officials, providers, and other policy experts convene to discuss business and operational considerations in a changing marketplace.
http://www.worldcongress.com/events/HL14022/
Leadership austin presentation chenven april 24 2015_pdfAnnieAustin
The document discusses healthcare costs and reforms in the United States. It provides an overview of Austin Regional Clinic, including the number of patients, locations, physicians, and specialties. It then discusses various challenges facing the US healthcare system like the costs as a percentage of GDP, the Affordable Care Act, deficits, uninsured Americans, increasing costs, and sustainability issues. Alternative payment models like accountable care organizations and medical homes are presented as ways to better manage costs for high-risk populations through care coordination and preventive care. The challenges of transitioning payments from fee-for-service to these alternative models is also noted.
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Presented by: Ryan Clarke – Partner (Division Lead, Advocacy & PR) at EVERSANA
In this webinar:
The Canadian Cancer Survivor Network is pleased to have Ryan Clarke from CRG-Eversana Canada Inc., a company advancing life sciences towards a healthier world. He will be discussing the topic of: “How to Have Your Voice Heard During the September 20, 2021, Federal Election.”
The outcomes for the webinar will be:
1. In the context of the current federal election, attendees will better appreciate the delineation between federal and provincial roles in healthcare.
2. People will be taken through some specific advocacy engagement tactics aimed at candidates, including developing your own key messages.
3. Everyone will understand the importance of reaching out to the newly (re)elected MPs after September 20.
Watch the YouTube video: https://youtu.be/-PAyBsO5OtU
To learn more about CCSN, visit us at survivornet.ca
Follow CCSN on social media:
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Dr. Riley approaches the steps to the congressmans office. She reDustiBuckner14
Dr. Riley approaches the steps to the congressman's office. She reflects on her journey and knows she has the information needed and the political competence to present a thorough and compelling argument about her health care policy position. She enters the office and is greeted by one of the congressman's legislative aides.
Hello, my name is Dr. Sarah Riley and I have a meeting this morning with Congressman Akin. Oh, Yes, nice to meet you, Dr. Riley. The congressman is expecting you. Please follow me.Congressman, it is a pleasure to meet you. My name is Dr. Sarah Riley. Welcome Dr. Riley. I have read the policy brief you sent over to the office yesterday and have some thoughts.
Congressman, as a family nurse practitioner and a DMP practice scholar, my journey to our meeting began with exploring how I could secure additional funding for my rural clinic. Along the way, I discovered the impact social detriments of health have on the quality of life for people in our community.
The socioeconomic issues facing people who live in your district are significant and are reflected in the number of homeless people. I met with a homeless woman at the tent camp just down the road. Her story is tragic, but what is more important is the circumstances that left her homeless were mostly out of her control.
She was unable to find a job with a livable wage. One of the major factors in her homelessness was transportation. The community has limited bus routes and people living in the more rural areas have no access to transportation. They cannot get to the grocery store, the health department and in many cases have a hard time getting to my clinic.
While I want to solve all these problems with you, my focus today is addressing the issues with House Bill 255. Yes, I know we have some challenges in my district, and I am committed to resolving these issues. However, as you know, Dr. Riley, it takes time, money and the will of the people to make swift change to improve the quality of life within this district.
After reading your brief yesterday, I made a call to the mayor, and we talked about adding two bus routes to the service to more rural parts of the district. This has been on the agenda for the district for many months, and the mayor said she was looking at funding for the additional routes.
It is my understanding from the mayor that one additional route is funded, and will provide transportation to the rural parts of the district. Another route is proposed, but funding is the primary concern at this point. Congressman, this one route alone will provide service to many people who otherwise would not have transportation.
Thank you for your advocacy on this issue and I look forward to seeing the second round added soon. If we could turn our attention now to House Bill 255, I wanna thank you for authoring such a comprehensive bill and providing additional funding to rural clinics through the expansion of this Medicaid program.
Nurse practitioner led clin ...
CFPHD Guest Speaker Dr. Chisholm: Nursing Home Quality and Financial PerformanceCFPHD
This study examined the relationship between nursing homes' racial composition of residents and financial performance, and whether financial performance influenced the relationship between racial composition and quality of care. The results showed that nursing homes with no black residents had better financial outcomes and quality outcomes than homes with high proportions of black residents. Financial performance partially influenced the relationship between racial composition and quality. The study recommends increasing Medicaid payments to homes with many minority residents, implementing pay-for-performance programs, and addressing trends like residential segregation and occupancy rates.
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Norman Chenven, founder and CEO of Austin Regional Clinic, presented on healthcare costs and reforms to the Leadership Austin program. Austin Regional Clinic serves over 350,000 patients across 21 locations with 1,750 employees including 335 physicians. Chenven discussed the unsustainable growth of healthcare costs, key provisions and uncertainties of the Affordable Care Act, and strategies to shift payments from fee-for-service to models emphasizing quality and value through accountable care organizations and medical homes.
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Since its expansion in 2014, Ohio’s Medicaid program has played a critical role in cutting the number of uninsured Ohioans almost in half. With talk of repealing the Affordable Care Act at the federal level, what are the implications on Ohio’s budget process?
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Attendee Program: 2015 VNAA Public Policy Leadership Conference
1. Visiting Nurse Associations of America
PUBLIC P OLICY LEADERSHIP CONFERENCE
SEP T. 16-17, 2015 | WASHINGTON, D.C.
AT TENDEE PROGR AM
#PPLC2015
2.
3. 32015 PUBLIC P OLICY LEADERSHIP CONFERENCE
CONFERENCE AGENDA
2015 VNAA CONGRESSIONAL CHAMPIONS
SENATE PRIORITIES
HOUSE PRIORITIES
BACKGROUND ON KEY LEGISL ATION AND INITIATIVES
• PROTECT AND PRESERVE ACCESS TO HOME-BASED
SERVICES
• HOME HEALTH DOCUMENTATION AND PROGR AM
IMPROVEMENT ACT
• HOME HEALTH PL ANNING AND IMPROVEMENT ACT
• CARE PL ANNING ACT
• PALLIATIVE CARE AND HOSPICE EDUCATION AND
TR AINING ACT
U .S. CAPITOL COMPLEX MAP
4
7
8
9
11
20
TABLE OF CONTENTS
4. 4 VISITING NURSE ASSOCIATIONS OF AMERICA
AGENDA
7:30 AM
8:00 - 8:30 AM
8:30 - 8:45 AM
8:45 - 9:45 AM
9:45 - 10:15 AM
10:15 - 11:00 AM
11:00 - 11:30 AM
Registration Opens
Breakfast Buffet
Welcome: Overview of Conference and VNAA Policy Agenda
• Tracey Moorhead
Visiting Nurse Associations of America
• Norene Mostkoff
HCI Care Services, VNS of Iowa
Session 1: Federal Initiatives in Advanced Care Planning and Palliative Care
• Margaret Franckhauser (Facilitator)
Central New Hampshire VNA & Hospice
• Andrew MacPherson
Coalition to Transform Advance Care
• Keysha Brooks-Coley
American Cancer Society Cancer Action Network
Networking Coffee Break
Sponsored by Philips
Session 2A: Congressional Staff Panel
• Sarah Bogdan (Facilitator)
Visiting Nurse Associations of America
• Kristen Shatynski, Ph.D. (invited)
Rep. Greg Walden (R-OR)
• Kristen Donheffner (invited)
Rep. Earl Blumenauer (D-OR)
• Michael Barnard (invited)
Sen. Bob Menendez (D-NJ)
• Jane Lucas (invited)
Sen. John Thune (R-SD)
Session 2B: Presidential and Congressional State of Play
• Sarah Bogdan (Facilitator)
Visiting Nurse Associations of America
• Neleen Rubin
Rubin Health Policy Consulting
• Chris Fox
Venn Strategies
WEDNESDAY, SEPT. 16
5. 52015 PUBLIC P OLICY LEADERSHIP CONFERENCE
Lunch Buffet
Session 3: Federal Program Integrity Initiatives and Future Direction
• Molly Smith (Facilitator)
Visiting Nurse Associations of America
• John Morse
Centers for Medicare and Medicaid Services
• Latesha Walker
Centers for Medicare and Medicaid Services
• Erin Bliss
HHS Office of Inspector General
Hill Visits
Congressional Reception
Location: 902 Hart Senate Office Building
11:30 AM - 12:00 PM
12:00 - 1:00 PM
1:00 - 5:00 PM
5:00 - 7:00 PM
7:30 - 8:15 AM
8:15 - 8:45 AM
8:45 - 10:00 AM
10:00 - 10:30 AM
10:30 - 11:15 AM
THURSDAY, SEPT. 17
Breakfast Buffet and Topic Tables
Keynote: Policymaker Perspective
• Rep. Earl Blumenauer (D-OR)
Session 4: The Post-Acute Continuum of the Future and The Role of Home-based Care
• Erin Denholm (Facilitator)
Trinity Home Health Services
• Rochelle Archuleta
American Hospital Association
• Marci Nielsen
Patient-Centered Primary Care Collaborative
• David Introcaso
National Association of Accountable Care Organizations
Networking Coffee Break
Sponsored by Philips
Session 5: Home Health & Hospice Payment Reforms
• Laurence Wilson
Centers for Medicare and Medicaid Services
6. 6 VISITING NURSE ASSOCIATIONS OF AMERICA
Session 6: VNAA Value-based Purchasing Toolkit
• Molly Smith
Visiting Nurse Associations of America
Lunch Buffet Opens
Session 7: Innovation in Care Delivery and Payment Models
• Sean Cavanaugh
Centers for Medicare and Medicaid Services
Networking Coffee Break
Sponsored by Philips
Session 8: Issues in State Advocacy: Medicaid
• Lena O’Rourke (Facilitator)
O’Rourke Health Policy Strategies
• Kate Rolf
VNA Homecare of Central New York (NY)
• Tray Wade
HCI Care Services (IA)
• Dwight Wilson
Mission Hospice and Home Care (CA)
Session 9: Quality Measurement for Home Health and Hospice
Sponsored by CHAP
• Liza Greenberg (Facilitator)
Visiting Nurse Associations of America
• Karen Collishaw
CHAP
• Mary Pratt
Centers for Medicare and Medicaid Services
11:15 AM - 12:00 PM
12:00 - 12:30 PM
12:30 - 1:30 PM
1:30 - 1:45 PM
1:45 - 3:00 PM
3:00 PM - 4:00 PM
7. 72015 PUBLIC P OLICY LEADERSHIP CONFERENCE
CONGRESSIONAL CHAMPIONS
Each year, the Visiting Nurse Associations of America recognizes a select group of Congressional Champions for
outstanding leadership and support of home health and hospice. VNAA is pleased to introduce the Class of 2015: Sen.
Pat Roberts (R-KS), Sen. Mark Warner (D-VA), Rep. Earl Blumenauer (D-OR) and Rep. David McKinley (R-WV).
Please join VNAA and your colleagues from across the nation in honoring these Champions at a special reception
from 5:00 to 7:00 p.m. in Room 902 of the Hart Senate Office Building following Day One of this year’s Public Policy
Leadership Conference.
Sen. Pat Roberts (R-KS)
Roberts has addressed Medicare
documentation problems and sought
much-needed relief to the documentation
burdens of a face-to-face visit.
Sen. Mark Warner (D-VA)
Warner has worked hard to develop
solutions to improve health outcomes for
Medicare patients with chronic conditions
and promoting advanced care planning.
Rep. Earl Blumenauer (D-OR)
Blumenauer has been a leader in
advanced care planning policy and is
dedicated to improving quality of life for
all patients.
Rep. David McKinley (R-WV)
McKinley has spearheaded work to
promote policies to improve care for
seniors, including home-based care.
8. 8 VISITING NURSE ASSOCIATIONS OF AMERICA
Members of the Senate and their staff need to hear directly from home health and hospice agencies about the issues
that will impact beneficiaries and providers in their district. Listed below are key time-sensitive messages to share
with your Senator’s office. You are welcome to use these messages, or put them in your own words. This resource
is intended to support you in your conversations with the Senator and his or her staff. In a separate folder we have
provided additional information on each of these messages that you can give to the offices for their reference.
HOME HEALTH
1. Protect and Preserve Access to Home-Based Services
• The Centers for Medicare and Medicaid Services (CMS) has proposed to reduce home health payments by
$350 million in FY 2016.
• This cut is in addition to sequestration and two years of payment reductions due to the rebasing of home health
payment rates.
• We ask that all Members of Congress tell CMS that a cut of this magnitude puts beneficiary access to care at
risk and exceeds the statutory limits Congress placed on rebasing home health payment rates.
2. Cosponsor the Home Health Documentation and Program Improvement Act of 2015 (S.1650)
• Introduced by Sens. Robert Menendez (D-NJ) and Pat Roberts (R-KS), this legislation provides common-sense
improvements to currently unworkable and administratively burdensome rules regarding Medicare home
health “face-to-face” documentation requirements.
3. Cosponsor the Home Health Planning and Improvement Act (S. 578)
• Introduced by Sens. Susan Collins (R-ME) and Charles Schumer (D-NY), this legislation would allow nurse
practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants, to order home health
services under Medicare in accordance with state law.
• This legislation would improve access to important home health care services, and potentially prevent
additional hospital and nursing home admissions.
HOSPICE
1. Cosponsor the Care Planning Act of 2015 (S.1549)
• This bipartisan legislation would establish Medicare reimbursement for healthcare professionals to provide
a voluntary discussion about the goals and treatment options for individuals with serious illness, resulting in
a documented care plan that reflects the informed choices made by patients in consultation with members of
their health care team, faith leaders, family members and friends.
• This legislation also provides resources for public and professional education materials about care planning.
2. Sponsor a Senate version of the Palliative Care & Hospice Education and Training Act (PCHETA)
• This legislation would establish education centers and career incentive awards to improve the training of
doctors, nurses, physician assistants, social workers and other health professionals in palliative care.
• This legislation (H.R. 3119) has been introduced in the House by Reps. Eliot Engel (D-NY), Tom Reed (R-NY)
and Emanuel Cleaver (D-MO).
SENATE PRIORITIES
9. 92015 PUBLIC P OLICY LEADERSHIP CONFERENCE
HOUSE PRIORITIES
Members of the House of Representatives and their staff need to hear directly from home health and hospice agencies
about the issues that will impact beneficiaries and providers in their district. Listed below are key time-sensitive
messages to share with your Representative’s office. You are welcome to use these messages—or put them in your own
words. This resource is intended to support you in your conversations with the Representative and his or her staff. In a
separate folder, we have provided additional information on each of these messages that you can give to the offices
for their reference.
HOME HEALTH
1. Protect and Preserve Access to Home-Based Services
• The Centers for Medicare and Medicaid Services (CMS) has proposed to reduce home health payments by
$350 million in FY 2016.
• This cut is in addition to sequestration and two years of payment reductions due to the rebasing of home health
payment rates.
• We ask that all Members of Congress to tell CMS that a cut of this magnitude puts beneficiary access to care
at risk and exceeds the statutory limits Congress placed on rebasing home health payment rates.
2. Cosponsor Home Health Planning and Improvement Act (H.R. 1342)
• This bipartisan bill would allow nurse practitioners, clinical nurse specialists, certified nurse midwives, and
physician assistants, to order home health services under Medicare in accordance with state law.
• This legislation would improve access to important home health care services, and potentially prevent
additional hospital and nursing home admissions.
HOSPICE
1. Cosponsor the Palliative Care & Hospice Education and Training Act (PCHETA) (H.R. 3119)
• This legislation would establish education centers and career incentive awards to improve the training of
doctors, nurses, physician assistants, social workers and other health professionals in palliative care.
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11. 112015 PUBLIC P OLICY LEADERSHIP CONFERENCE
PROTECT AN D PR ESERV E ACC ES S
TO HO ME-BA SED SERVICES
The Visiting Nurse Associations of America (VNAA) urges Members of Congress to protect beneficiary access to
home-based care by telling the Centers for Medicare and Medicaid Services (CMS) to stop proposed cuts to home
health payments. CMS intends to reduce home health payments by $350 million in FY16. This cut is in addition to
sequestration and two years of payment reductions due to the rebasing of home health payment rates.
VNAA urges all Members of Congress to tell CMS that a cut of this magnitude puts beneficiary access
to care at risk and exceeds the statutory limits Congress placed on rebasing home health payment
rates.
BACKGROUND
On July 6, 2015, CMS issued a proposed rule that would cut Medicare payments to home health agencies by $350
million in 2016. Current law requires CMS to “rebase” home health payment rate over four years (2014-2017) to
“better align” payments with costs. In implementing this policy, CMS may not reduce home health payments by more
than 3.5 percent per year over the four-year transition. As expected in the FY16 rule, CMS rule proposes to fully
implement the 3.5 percent rebasing cut in 2016.
Alarmingly, CMS also proposes to make an additional cut on top of rebasing. CMS reported that the average case
mix—or payment adjustment for the increased costs of treating higher-need patients—for home health agencies has
increased steadily. According to CMS, the case mix increase was due to home health agencies inappropriately
“upcoding” rather than actual changes in patient severity. To account for this, CMS is proposing to reduce home health
payments by an additional 1.72 percent in both 2016 and 2017. However, patient severity is already one of the factors
used to determine the rebasing adjustment. In other words, CMS is attempting to further rebase payments through a cut
of another name. This proposed cut goes beyond the limits that Congress outlined in the law.
CMS’ calculation is also flawed. Specifically, CMS used data from 2000 and 2010 to develop its estimates. Analysis
using the data from the actual time period (2012-2014) shows that the level of payment changes that have occurred fall
well below increases that would be needed to demonstrate upcoding had occurred in the payment system.
WHY THESE CUTS PUT PATIENTS AND PROVIDERS AT RISK
• Mission-driven, home health agencies operate on slim margins. Any further cuts threaten their ability to continue
providing services to vulnerable beneficiaries.
• Home health agencies costs are predominantly workforce-related (unlike brick-and-mortar providers such as
hospitals and physicians). Cuts to home health payment rates are more likely to reduce available jobs, wages,
employee benefits, programs for patients, and potential innovation projects.
VNAA urges Congress to tell CMS to eliminate the inappropriate “case mix adjustments” and work to
ensure Medicare beneficiaries can continue to have access to high-quality, home health services.
13. 132015 PUBLIC P OLICY LEADERSHIP CONFERENCE
HOME HEALTH DOCUMENTATION AND PRO G R AM
IMPROVEMENT ACT OF 2015 (S. 1650)
The Visiting Nurse Associations of America (VNAA) strongly supports the Home Health Documentation and Program
Improvement Act of 2015 (S.1650). This bill was introduced by Sens. Robert Menendez (D-NJ) and Pat Roberts (R-KS).
This legislation provides common-sense improvements to currently unworkable and administratively burdensome rules
regarding Medicare home health “face-to-face” documentation requirements. The legislation also provides relief from
past claims denials and improves the approach the Centers for Medicare and Medicaid Services (CMS) uses to collect
evidence that beneficiaries are eligible for home health services moving forward.
VNAA urges all Senators to cosponsor this critical, bipartisan legislation that will help ensure
home health agencies can continue to provide physician-ordered, medically necessary services to
beneficiaries in their homes without fear of inappropriate denial of payment.
BACKGROUND
Due to recent regulatory changes, home health agencies are frequently denied payment due to poorly designed and
frequently misunderstood Medicare documentation requirements. Current law requires a physician to document that
a face-to-face encounter between an authorized provider and a beneficiary occurred in order to certify eligibility for
home health services. This provision is intended to ensure that beneficiaries are being referred to the most appropriate
care setting and to reduce the potential for waste, fraud and abuse within the home health benefit. Unfortunately, the
implementation of the requirement has resulted in negative unintended consequences for providers and beneficiaries
and has resulted in an unprecedented level of home health claim denials and a significant backlog of appeals. VNAA
estimates the number of claims pending appeals to be in the tens of thousands.
Face-to-face claim denials are often overturned on appeal. In the meantime, unpaid claims for care that is medically
necessary and appropriate make it hard for home health agencies to meet payroll and keep their doors open.
WHY THIS LEGISLATION IS CRITICAL TO PATIENTS AND PROVIDERS
• Significantly relieves the paperwork and regulatory burden on home health agencies, and reduces the risk of
inappropriate denials of care;
• Requires CMS to develop a standardized form (in consultation with stakeholders) that can be used to document a
beneficiary’s eligibility for home health services;
• Requires CMS to accept forms completed by the home health agencies that are reviewed and signed by the
referring physician;
• Exempts home health agencies from collecting documentation for beneficiaries who have been discharged from a
hospital or skilled nursing facility within 14 days prior to the initiation of such home health services;
• Requires contractor education to ensure fair and uniform application of the policy nationwide;
• Provides a mechanism for home health agencies to resubmit claims that were denied solely due to the currently
unclear and unworkable face-to-face documentation rules; and
• Requires a study of audit contractor performance on Medicare documentation for home health services and denial
and appeal rates.
VNAA urges Senators to cosponsor this important legislation to ameliorate the negative and
unintended consequences of the face-to-face requirement. Swift passage of this bill will ensure that
home health agencies can focus their resources on providing medically necessary care to beneficiaries
in their homes, and not fighting paperwork appeals.
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15. 152015 PUBLIC P OLICY LEADERSHIP CONFERENCE
HOME HEALTH CA RE PL A N N I NG I M PROVEMENT
ACT OF 2015 (S. 578 / H.R. 1342)
The Visiting Nurse Associations of America (VNAA) urges Members of Congress to cosponsor the Home Health
Planning and Improvement Act of 2015 (S. 578/H.R. 1342). This bill was introduced by Sens. Susan Collins (R-ME)
and Charles Schumer (D-NY) and Reps. Greg Walden (R-OR), Earl Blumenauer (D-OR), Mike Kelly (R-PA), Patrick
Tiberi (R-OH), Todd Young (R-IN), Lynn Jenkins (R-KS), Ron Kind (D-WI), Mike Thompson (D-CA), Danny Davis (D-IL),
Gregg Harper (R-MS), David McKinley (R-WV), Bill Johnson (R-OH), Janice Schakowsky (D-IL), Peter Welch (D-VT),
Lois Capps (D-CA), and Kurt Schrader (D-OR).
This legislation would allow nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician
assistants, to order home health services under Medicare in accordance with state law.
VNAA urges all Members of Congress to cosponsor this important legislation that will dramatically
improve access to home health services, and potentially prevent additional hospital and nursing
home admissions.
BACKGROUND
Physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives (otherwise known
as advanced practice registered nurses (APRNs) play a critical role in providing home care services to Medicare
beneficiaries, particularly in rural and underserved communities. While these providers are allowed to order nursing
home care and prescribe some medicines, they are not allowed to certify patients as needing or qualifying for home
health care. This legislation would improve access to Medicare home care services by allowing nurses and other
providers to certify Medicare patients for home health services.
WHY THIS LEGISLATION IS CRITICAL TO PATIENTS AND PROVIDERS
• Allows nurse practitioners, clinical nurse specialists, certified nurse midwives and physician assistants to order
home health services under Medicare in accordance with state law.
• Improves Medicare beneficiaries’ access to high-quality, Medicare home care services.
VNAA urges Congress to cosponsor this important legislation to allow advanced practice registered nurses to order
home health services for Medicare beneficiaries. Its timely passage will help Medicare beneficiaries across the
country, and in rural and underserved communities, access home health services.
16.
17. 172015 PUBLIC P OLICY LEADERSHIP CONFERENCE
CARE PL ANNING ACT OF 2015
(S. 1549)
The Visiting Nurse Associations of America (VNAA) strongly supports the Care Planning Act of 2015 (S. 1549). This
legislation would ensure that patients with advanced illness receive extra support and care that reflects their wishes. The
bill was introduced by Sens. Mark Warner (D-VA) and Johnny Isakson (R-GA).
Specifically, the legislation provides Medicare coverage of voluntary, team-based discussions of prognosis and
care options for Medicare patients throughout the progression of advanced illness, not just at the end of life. The bill
requires that providers’ quality be evaluated based on whether the care provided aligns with the patient’s values. The
legislation also encourages the use and portability of advance directives across care settings and state lines.
VNAA urges all Senators to cosponsor this critical, bipartisan legislation that ensures Medicare
patients with advanced illness and at the end of life have access to better-coordinated and higher-
quality care.
BACKGROUND
Individuals with advanced illness, including those near the end of life, are frequently faced with difficult decisions
about treatment and medical care options. Today, patients often receive treatment for physical illness without adequate
consideration of emotional and spiritual health. Too often, caregivers must make decisions for their loved one when
the patient can no longer communicate and it can be devastating for everyone involved. Patients feel helpless and
burdensome; families worry that their choices may exacerbate their loved one’s suffering; providers know that they are
not providing the best care possible. Advanced care plans enable individuals to document their wishes while they are
still able to communicate for themselves.
WHY THIS LEGISLATION IS CRITICAL TO PATIENTS AND PROVIDERS
• Creates a Medicare benefit called Planning Services for those with serious or life-threatening illness that includes
team-based discussion of goals of care and values, explanation of disease progression, exploration of a relevant
range of treatment options, and a documented care values and preferences.
• Directs the Center for Medicare and Medicaid Innovation (CMMI) to conduct an Advanced Illness Coordination
Services demonstration, which will deliver wrap-around, home-based services to beneficiaries who need
assistance with two or more progressive disease-related activities of daily living.
• Directs HHS to develop quality measures that measure alignment between a patient’s goals, values and
preferences and the documented plan, treatment delivered, and outcomes.
• Provides grants to develop materials and maintain a website with information about advance care planning,
portable treatment orders, palliative care, hospice, and planning services.
• Requires health care facilities to assure that care plans made while an individual receives care are appropriately
documented prior to discharge and sent to appropriate providers and facilities.
VNAA urges Senators to cosponsor this important legislation to assist patients, families and
caregivers facing important choices at the end of life. When enacted, this legislation will help millions
of Medicare beneficiaries make advanced care plans that reflect their life and their choices—and give
them peace of mind and dignity.
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19. 192015 PUBLIC P OLICY LEADERSHIP CONFERENCE
PALL IATIVE CARE & H OS PI CE ED U CAT I O N AND
T R A I N I NG ACT (H.R. 3119)
The Visiting Nurse Associations of America (VNAA) strongly supports the Palliative Care & Hospice Education and
Training Act (PCHETA) (H.R. 3119). The bill was introduced by Reps. Eliot Engel (D-NY), Tom Reed (R-NY) and Emanuel
Cleaver (D-M0).
This legislation would establish education centers and career incentive awards to improve the training of doctors,
nurses, physician assistants, social workers and other health professionals in palliative care. PCHETA would also
strengthen clinical practice and improve health care delivery for patients living with serious illness, as well as their
families, by directing funding toward palliative care research. PCHETA would direct the implementation of a national
education and awareness campaign so that patients, families, and health professionals understand the essential role of
palliative care in ensuring high-quality care for individuals facing serious or life-threatening illness.
VNAA urges all Representatives to cosponsor this legislation to advance the practice of palliative care
and improve health care delivery for patients living with life-threatening diseases.
BACKGROUND
Palliative care improves quality, controls cost, and enhances patient and family satisfaction for the rapidly expanding
population of individuals with serious or life-threatening illness. The goal of palliative care is to prevent and relieve
suffering and to support the best possible quality of life for patients and their families, regardless of the stage of
the disease or treatment. It focuses on relief of the pain, symptoms, and stress of serious illness and on improving
communication with patients and families. Provided by a team of clinicians and specialists who work with the patient’s
regular physicians to provide an extra layer of support, palliative care is appropriate at any age and at any stage of
serious illness. It can be provided wherever a patient is seen, including in the patient’s home, and can be provided
together with curative treatment.
WHY THIS LEGISLATION IS CRITICAL TO PATIENTS AND PROVIDERS
• Establishes Palliative Care and Hospice Education Centers to improve the training of interdisciplinary health
professionals in palliative care; support continuing education; provide students with clinical training in appropriate
sites of care; and provide traineeships for advanced practice nurses.
• Implements fellowship programs within the new Palliative Care and Hospice Education Centers to provide short-
term intensive courses focused on palliative care. Supporting the team approach to palliative care, the fellowships
will provide supplemental training for faculty members in medical schools and other health professions schools,
including pharmacy, nursing, social work, chaplaincy and other allied health disciplines so providers who do
not have formal training in palliative care can upgrade their knowledge and skills for the care of individuals with
serious or life-threatening illness.
• Authorizes grants or contracts to schools of medicine, teaching hospitals and GME programs to train physicians
(including residents, trainees, and fellows) who plan to teach palliative medicine.
• Creates special preferences in existing nurse education law to include hospice and palliative nursing in education,
practice and quality grants, workforce development, and nurse retention projects. Also provides grants or contracts
for eligible health professionals who agree to teach or practice in the field of palliative care for at least five years.
VNAA urges all Representatives to support this important legislation which takes critical steps to
ensure our nation’s medical professionals have the necessary resources and training to provide high-
quality care to patients with advanced illness or at the end of life, and that patients and their families
are able to access needed palliative care.
20. H A R T S E N A T E
O F F I C E B U I L D I N G
U N I O N S T A T I O N
M E T R O