Author: Roger Noyes

COVID-19 Impact on Home Care by the Numbers

HCA last week shared with state health officials the findings of a home care provider survey on COVID-19. It uncovered that the vast majority of home and community-based providers (68%) do not have access to adequate personal protective equipment in their COVID-19 response.

Almost half (48%) report instances where patients and/or family members refuse entry of staff in the home due to concerns about the virus at a time when home health agencies are working vigorously to screen caregivers and patients alike for the safety of both.

Continue reading “COVID-19 Impact on Home Care by the Numbers”

City & State: Home care attendants helping elderly, disabled lacking equipment

“More than 80% of providers reported that they were in high need of hand sanitizer, according to a recent survey the Home Care Association of New York State, which represents home care agencies, sent to state health officials on March 18,” reports City and State News. “Nearly as many said they had a similar demand for face masks, with most respondents saying they lacked sufficient personal protective equipment. This shows how difficult it may be for home care workers to abide by state guidance encouraging people visiting at-risk people to don face masks.”

“Some other guidance has also been difficult to implement. Home care providers have been pushed to take the temperature of their staff, but that can be difficult given that workers tend to go directly to their patients’ homes rather than to a central office, said Roger Noyes, director of communications for the Home Care Association of New York State. There has been flexibility given on other regulations however, allowing mandated in-home supervision from nurses to be done through ‘indirect means’ such as by telephone or video calling to reduce in-person interactions.”

New COVID-19 Telehealth Guidance More Explicitly References Home Care 

The state Department of Health (DOH) has updated its previous Medicaid Update on COVID-19 telehealth/telephonic billing and services allowances to more explicitly include home care and each discipline within home care following multiple appeals from HCA.

The new Medicaid Update, dated March 23, is here and may undergo future updates that providers should watch for. Continue reading “New COVID-19 Telehealth Guidance More Explicitly References Home Care “

State Medicaid Guidance Authorizes Telehealth, Telephonic Services and Billing for COVID-19 Emergency

A special edition of the state’s Medicaid Update issued last night (see here) includes a guidance broadly expanding the use of telehealth, telephonic services and other communications methods by Medicaid providers during the COVID-19 state of emergency.

Effective for dates of service after March 1, and for the duration of the state of emergency, “New York State Medicaid will reimburse telephonic assessment, monitoring, and evaluation and management services provided to members in cases where face-to-face visits may not be recommended and it is appropriate for the member to be evaluated and managed by telephone.” HCA has confirmed with DOH officials that the guidance applies to Article 36 home care providers.

Continue reading “State Medicaid Guidance Authorizes Telehealth, Telephonic Services and Billing for COVID-19 Emergency”

Statement From HCA President Al Cardillo on Today’s Medicaid Redesign Team (MRT) Vote

“At a time when long term care providers and programs are overburdened by a crushing global health crisis, the Medicaid Redesign Team (MRT) moved forward today on recommendations that disproportionately impair these safety-net services through yet-further across-the-board cuts and program restrictions.”

“The COVID-19 crisis has impaired home care’s workforce capabilities, created new vulnerabilities for patients at home, and brought enormous, unprecedented stresses on the entire health care support system.”

“Right now, our data shows that home care providers are serving at least 14,000 level I patients at home, defined as those in need of uninterrupted care. Out of all 900,000 patients in New York’s home care system, these are individuals who would otherwise require care in a hospital or nursing home because they are technology dependent or severely ill.” Continue reading “Statement From HCA President Al Cardillo on Today’s Medicaid Redesign Team (MRT) Vote”

Politico New York: MRT II sends recommendations to Legislature, governor

“[HCA President Al Cardillo] asked the Legislature to ‘look hard at MRT recommendations for which cost savings are disputable at the levels assigned; consider alternative cost-savings measures advanced by HCA but declined by the MRT; and explore new revenue opportunities from federal aid and other sources to better realign an impact that otherwise would be borne disproportionately by the long term care sector,'” writes Politico New York.

HHCN: Home Health Industry Watches On As New York Providers Navigate Coronavirus Minefield

“To get a sense of what the situation on the ground looks like for home health and home care agencies, the Home Care Association of New York State (HCA-NYS) recently surveyed hundreds of providers,” reports Home Health Care News.

“‘Different states and regions are at different stages in surveillance and monitoring,'” Roger Noyes, director of communications at HCA-NYS, told Home Health Care News. ‘Certainly due to our population and the size of our home care programs, the situation in New York can be instructive for other states, including the scale of remedies under consideration and how well they’ve worked.'”

“Broadly, home health and home care agencies in New York are already experiencing challenges that many others throughout the continuum of care are as well, including hospitals. That’s particularly alarming because the need for home-based care will likely rise in the coming weeks, especially as quarantines become stricter and more patients are sent home from institutional settings.”

“Among its findings, the HCA-NYS survey found that most home-based providers lack access to adequate personal protective equipment (PPE). More than 300 home health, home care and hospice agencies participated in the survey, conducted over a roughly 40-hour period this week.”

Press Statement: Home Care Needs Priority Supplies, Regulatory Flexibility & Emergency Aid for COVID-19 Response

A Statement from HCA President and CEO Al Cardillo 

“The home care population includes the elderly and individuals with multiple underlying chronic conditions who are at greatest risk from COVID-19. Individuals in quarantine, as well as those self-isolating and possibly living with COVID-19 undetected, are residing at home in most cases.”

“While hospital surge capacity concerns are, of course, extremely vital in this massive public health crisis, essential access to supplies, regulatory flexibility and emergency aid are needed for home care providers serving 900,000 individuals at home all across New York State. A great many of these individuals are at risk and require vital services to protect their health and safety.”

“In a just-completed HCA survey on the crisis, nearly 300 home care providers in every region of New York State report that they collectively serve more than 14,100 priority level 1 patients in the community. These are patients who, without home care, would face a rapid, immediately life-threatening deterioration in their existing health condition or would need to be transferred to another setting, such as hospitals or nursing homes already stretched to capacity. Many of these most at-risk patients are homebound, or dependent on technology or ventilators, with severe life-limiting conditions.” Continue reading “Press Statement: Home Care Needs Priority Supplies, Regulatory Flexibility & Emergency Aid for COVID-19 Response”

COVID-19: Respond Now on Survey for Urgent DOH Assistance Request

Discussions have escalated in the last 24 hours on long-sought state COVID-19 guidance and assistance for home care and hospice. Throughout the weekend, HCA has again discussed with state officials a list of pressing requests for regulatory relief waivers, priority access to supplies, procedural guidance, and financial support to help providers amid the pandemic.

A just-released Dear Administrator Letter for Certified Home Health Agencies and Licensed Home Care Services Agencies (see here) provides some information on screening of patients and staff, as well as on the responsibilities of personnel in observing patients at home. It followed another guidance, sent earlier today (see here), with regulatory guidance for 1915(c) waiver programs (addressed to providers serving children and youth under the Children’s Waiver). Continue reading “COVID-19: Respond Now on Survey for Urgent DOH Assistance Request”

MRT Reviews Detailed Slate of Proposals for Consideration

The Medicaid Redesign Team (MRT) met today in New York City for a second time to review a consolidated list of proposals from among over 2,200 submissions by the public.

The dozens of proposed recommendations discussed today were wide ranging, such as: changes to the global cap methodology; program integrity provisions; health information technology reforms; new approaches to care management, social determinants of health, transportation, and workforce supports; revenue raisers (such as insurance and health care taxes); and program-specific structural, enrollment, procedural or payment recommendations for various sectors, including additional proposals advanced by a long term care advisory committee. 

Many of these areas would touch the home care, hospice and Managed Long Term Care (MLTC) provider and plan infrastructure in a variety of ways. Continue reading “MRT Reviews Detailed Slate of Proposals for Consideration”

HCA Discusses Sepsis on WNYT News Channel 13 ‘Health Beat’ Program with Benita Zahn

HCA President Al Cardillo recently discussed sepsis with anchor Benita Zahn for her Health Beat program on Capital Region NBC affiliate WNYT.

The interview, on behalf of partners at Sepsis Alliance, was prompted by new research on sepsis, finding a 40 percent increase in sepsis cases among the Medicare population.

During the segment, which aired March 9, Cardillo discussed the latest sepsis research, signs and symptoms of sepsis, and screening efforts like HCA’s Stop Sepsis at Home protocols.

Watch the segment here:

Deadline Extended to March 12 for HCA 2020 Awards Nominations

HCA has extended the deadline to March 12 for our 2020 awards nominations. Don’t miss this opportunity to recognize an exceptional colleague or staff member at your organization.

Our award categories invite nominations for all staff roles, from front-line caregivers to prominent leaders in the field, from physician champions of community-based care to the most ardent advocates and program innovators. Awards are presented at HCA’s Annual Conference on May 6-8 in Saratoga Springs.

To learn more and make your nomination, use our online questionnaire here.

If you have any questions or want to e-mail information directly to HCA, please contact Jenny Kerbein at or (518) 810-0659.

Your nomination helps shine a light on home care’s most talented, honorable and commendable individuals. Their stories help bring visibility to what home care is, how it works, how it helps, and what makes it great. Please help tell this story in all of its many unique, individual ways, and join us in celebrating home care’s leading lights.

HCA Submits Comments on FI PMPM Proposed Rule

Last week, HCA submitted comments to the state Department of Health (DOH) on its proposed rule that would establish a per member per month (PMPM) payment for administrative services provided by Fiscal Intermediaries (FIs) under the Consumer Directed Personal Assistance Program (CDPAP).

Our comments are at Continue reading “HCA Submits Comments on FI PMPM Proposed Rule”

ICYMI: Feb. Capitol Report on MRT, Mental Health Bill, Sepsis Study, VNSNY’s Singing Nurse, and UR Medicine Therapist

In case you missed it (ICYMI), the February 2020 edition of HCA’s Capitol Report newsletter (circulated to the State Legislature on Wednesday) highlights HCA’s State Advocacy Day and our proposals to the Medicaid Redesign Team (MRT). We also note the Senate’s passage of HCA-developed legislation to support coordination of home care and mental health services.

The TODAY Show recently profiled VNSNY hospice nurse Kathleen Sarnes, whose vocal gift is providing calm and comfort to hospice patients, plus we share a similarly powerful look at the therapy care provided by UR Medicine Home Care’s Chris Joyce to help patients like Nick Wright recover after a fall. We thank VNSNY and UR Medicine for proactively garnering and producing these important media representations of home care and hospice.

Also, HCA President Al Cardillo recently spoke to anchor Benita Zahn of Capital Region NBC affiliate WNYT about a new study, profiled in the February Capitol Report, showing the immense public health toll of sepsis as well as the opportunity area for home care to intervene using protocols like HCA’s Stop Sepsis at Home initiative.

Coronavirus Planning for Home Care, Hospice

“No one should be surprised when we have positive cases” of novel coronavirus in New York State, remarked Governor Cuomo yesterday about the illness that has spread rapidly from its initial origins in China.

COVID-19 has now reached 37 countries, including 60 confirmed cases in the U.S. (at the time of this writing), with one case (announced yesterday) involving a person who “did not have relevant travel history or exposure to another known patient with COVID-19,” according to the U.S. Centers for Disease Control and Prevention (CDC).

While 83 people have been reportedly quarantined on a voluntary basis in Nassau County, there are no as-of-yet confirmed cases of the virus in New York State to date, according to reports. Yet national public health officials have warned of possible “community spread” in the future, the importance of preparation for such an event, and the prospect of future containment measures by public health or preparedness officials. Continue reading “Coronavirus Planning for Home Care, Hospice”

Governor: Feds Deny $8B DSRIP Extension

In a press conference today, Governor Cuomo announced that the federal government has denied New York’s request to continue the multi-billion-dollar Delivery System Reform Incentive Payment (DSRIP) program.

This means the state will be unable to use $625 million in unspent funds for the current $7.4 billion DSRIP waiver, as sought in a request to extend the program through March 2021. Also denied is a second phase of DSRIP, which would have provided $8 billion in federal reinvestment funds also sought by the Cuomo Administration through 2024.

Continue reading “Governor: Feds Deny $8B DSRIP Extension”

HCA Report Outlines Fiscal Pressures Facing Home Care, Hospice, MLTC

HCA has issued our 2020 State of the Industry report. Consistent with past reports, we find that the vast majority of community-based providers and Managed Long Term Care (MLTC) plans are operating with negative or negligible margins.

Providers carry an average accounts receivable of 69 days outstanding. Also, about a quarter of direct caregivers leave home care organizations for a variety of reasons, with turnover rates as high as 63 percent, imposing major unreimbursed costs on organizations.

“The fiscal pressures facing New York’s Medicaid budget are rightfully an area of concern that HCA readily shares,” HCA concludes. “However, state policymakers should not overlook other correlative trends impacting home and community-based services,” noting new obligations and responsibilities like minimum wage  changes and the expansion of MLTC benefits for which “state Medicaid funds … have fallen short while nevertheless adding to the state’s budget pressures.” Continue reading “HCA Report Outlines Fiscal Pressures Facing Home Care, Hospice, MLTC”

A Statement from HCA President & CEO Al Cardillo on HCA’s State Advocacy Day, Medicaid, the MRT

“The home care system, which serves close to 900,000 New Yorkers, needs to be represented on the Governor’s Medicaid Redesign Team (MRT), a process that, very swiftly, is expected to devise $2.5 billion in Medicaid cost savings.”

“Today, HCA is meeting with legislators during our state advocacy day in Albany to bolster support for productive cost-savings proposals in Medicaid. These warrant consideration.” Continue reading “A Statement from HCA President & CEO Al Cardillo on HCA’s State Advocacy Day, Medicaid, the MRT”

Times Union Letter: Home care shortage needs solutions now

The February 4 Times Union includes a letter to the editor from HCA President Al Cardillo in response to an article on home health aide workforce shortages in the Adirondacks.

“The Home Care Association of New York State has long called for a partnership effort by state agencies and the home care industry on a comprehensive statewide analysis of home care workforce shortages,” he writes. “These shortages exist in many communities involving the full scope of home care practice disciplines, from home health aides to nurses to therapists.”

“The system needs actionable steps, and now. The state also needs a comprehensive statistical assessment of the locally specific factors that cause critical-access gaps. These gaps shift the balance toward higher-cost services such as longer hospital stays.”

Read the full letter here

HCA Presents Testimony as Senate, Assembly Panel Examines Medicaid Budget

A Senate and Assembly joint legislative committee convened today in Albany for a hearing examining the Governor’s state Medicaid budget proposals.

HCA President and CEO Al Cardillo submitted testimony, available here. It explains the vital role of home and community care, Medicaid budget trends involving home and community care (including new obligations and responsibilities on plans and providers), as well as HCA’s recommendations for offsetting Medicaid costs in place of cuts to assure the viability of vital programs and services. Continue reading “HCA Presents Testimony as Senate, Assembly Panel Examines Medicaid Budget”

Jan. 2020 Capitol Report Outlines Budget Proposals, Bills on the Move, Wound Care, and Workforce in the Adirondacks

The January 2020 edition of HCA’s Capitol Report for state officials responds to the Governor’s budget proposals, including his charge given to a second iteration of the Medicaid Redesign Team (MRT) for devising $2.5 billion in savings – a venue where HCA’s “cost offsets and reforms merit a voice.”

In the budget article, HCA reasserts for legislative offices our proposals that would control utilization, allow for more flexible management of service options, and maximize coverage by other, non-Medicaid, payors which have dual responsibility.

We also highlight three HCA bills on the move in the Senate which embrace home care capabilities to provide a coordinated plan of care in conjunction with mental health providers, incorporate home care in policies and programs in public health, and involve home care in the state’s comprehensive care eating disorder program.

In addition, our monthly innovations feature spotlights UR Medicine Home Care’s in-home wound care program, and we draw attention to a recent news report on the serious home care workforce and access issues plaguing the Adirondacks, as in many regions of the state.

Archives of the Capitol Report are here.

A Statement from HCA President and CEO Al Cardillo Regarding Governor Cuomo’s Proposed Budget

The Governor today proposed a sequel to the Medicaid Redesign Team (MRT) process of 2011 as an approach to restructuring Medicaid and ensuring its long-term sustainability.

HCA understands the magnitude and seriousness of New York’s budget circumstances. This is why we have already presented the Governor’s office and Legislature with ready proposals to support Medicaid cost efficiencies and relief.

These cost offsets and reforms merit a voice at the MRT table. They leverage the capabilities of New York’s home and community-based care system to save millions of dollars through improved coordination of Medicare-Medicaid covered benefits, avoidance of higher-cost service utilization, enhancements in chronic disease management, efficient care transitions and direct cost-control and efficiency reforms. Continue reading “A Statement from HCA President and CEO Al Cardillo Regarding Governor Cuomo’s Proposed Budget”

Use Our Grassroots Advocacy Toolkit

HCA’s grassroots advocacy seeks to enlist you, as an expert in the field and as a constituent, to lobby with local, state, or federal lawmakers on behalf of an issue or cause, with HCA providing guidance, messaging (i.e., what to say or write), and tools for action. To provide you with more information on this process, as well as tips and resources, HCA’s Director of Public Policy and Advocacy Alyssa Lovelace has developed a Grassroots Advocacy Toolkit: Inform, Mobilize and Engage. Continue reading “Use Our Grassroots Advocacy Toolkit”

HHCN Quotes HCA on “Extremely Alarming” Budget Cuts

Home Health Care News reports on the state’s 1% across-the board cuts to Medicaid. These come at a time when home care providers have not had a Medicaid cost-of-living rate adjustment in 10 years, and as providers operate on wafer-thin margins or losses in the majority of cases.

“In that light, this 1% reduction is extremely alarming,” HCA says in the article; and the cuts’ “timing, just before the release of a new budget proposal in only a few weeks, is a harbinger of just how serious the state’s fiscal outlook is — and what else is yet to come amid a projected $6 billion deficit.”

Dec. Capitol Report: Greetings from Dr. Zucker, HCA’s Advocacy Day, Telehealth and Aide Training Innovations

The December edition of HCA’s Capitol Report marks one year of our monthly communication to state officials.

This month’s edition shares recent remarks from State Health Commissioner Dr. Howard Zucker, M.D., J.D., who greeted home care and hospice providers and staff, recognizing their vital role.

We also direct attention to HCA’s upcoming February 5 state Advocacy Day, including what legislative offices can expect in preparation.

As part of our monthly innovations feature, we highlight the work of Essex County Department of Health’s home care unit, which has helped reduce admissions by as much as 60 percent using telehealth and expeditious case management.

Lastly, we share a news report from the USA Today network of affiliates featuring the organizational partnerships being forged by HCA home care provider members to deliver a more robust level of home health aide training and peer mentoring to address turnover rates and the need for workforce readiness. The in-depth article provides a window into how the training programs work, like those offered at NYC-based Selhelp Community Services, to teach transferring and other techniques in a way that uniquely connects with trainees.

Year-End Message From Health Commissioner Dr. Zucker to Home Care, Hospice


On behalf of HCA and the membership, New York State Health Commissioner Dr. Howard Zucker, M.D., J.D. has provided a meaningful and poignant year-end video message to home care and hospice providers.

“As we turn the calendar from 2019 to 2020, I extend warm thanks and appreciation to the many individuals delivering vital care at home to over half a million New Yorkers,” says Dr. Zucker.

He adds: “I also commend the Home Care Association of New York State for supporting this work through its mission: to ‘promote and enhance the quality and accessibility of health care and support at home.’”

HCA has posted the video to Facebook and YouTube. HCA members, colleagues and all organizations with Facebook accounts are strongly urged to share the video as widely as possible. In doing so, please join HCA in returning the thanks to Dr. Zucker for such powerful sentiments about the important work we do in community-based care.

November Capitol Report Features HCA Budget Measures, Home Care Month, Sepsis, Disparities

The November edition of HCA’s monthly Capitol Report for the state Legislature features some of HCA’s budget reform and relief proposals that we’ve advanced as a first-resort cost offset to address the state’s multi-billion-dollar Medicaid budget overruns.

The report, circulated to State Legislative and Executive staff on November 26, also shares some of the work done by HCA and providers to recognize National Home Care and Hospice month, plus some resources for legislative staff who were unable to attend the Senate and Assembly sponsored legislative seminar, led by HCA, on the sepsis medical emergency.

We also write about a new study which finds racial disparities in the discharge process to home care settings versus rehabilitation facilities for joint replacement care. Continue reading “November Capitol Report Features HCA Budget Measures, Home Care Month, Sepsis, Disparities”

Medicare Providers Must Sign Required MOA: Delinquencies Reported to CMS after Dec. 31

Livanta, the new Medicare Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), reports to HCA that many health care providers, including home health and hospice providers, have not signed a required Memorandum of Agreement (MOA) mandated of Medicare providers under Section 1866(a)(1)(E) of the Social Security Act.

Providers in New York were required to sign the MOA by June 8, 2019. Livanta has set a deadline of December 31, 2019 after which “instances of non-compliance will be reported to CMS,” Livanta states.

HCA has written about this requirement in our weekly newsletter, most recently on October 28, 2019, noting that 92 percent of home health agencies and 95 percent of hospices have not submitted the required form.

In the latest update, Livanta explains that unless you received an e-mail confirmation from the BFCC-QIO on October 1, 2019, your organization’s MOA has not been received. It is urgent that all Medicare providers complete this requirement of the Conditions of Participation (CoPs).

We also stress that all previously signed agreements were invalid as of June 7, 2019, so a new MOA must be completed if you have not done so already for this present period. Information about Livanta’s MOA process is available in this flyer or see the following web pages:

If you have any questions, please contact the Livanta Communications team here.

HCA Op-Ed: Home health aides are the eyes and ears of more than 500,000 NY patients

“Home health agencies provide interdisciplinary health care to individuals at home,” writes HCA President Al Cardillo in a viewpoint piece for the Legislative Gazette. “You may be familiar with some forms of this care. Thousands of exceptional people with specialized training make it happen, working together to overcome countless medical, social and environmental hurdles in too-often untold ways.”

Read the piece here.

Winter Storm Season Alert Posted

The state Department of Health (DOH) has posted information on the actions that providers should take to prepare for the upcoming winter weather season. See here.

DOH recommends that all facilities and agencies review their Emergency Response and Evacuation Plans to ensure procedures are up to date and understood by staff and that contact information for all key staff and response partners is current. Providers should be ready to activate these plans when needed. Continue reading “Winter Storm Season Alert Posted”

News10 WTEN Examines Local Tragedy, Sepsis and Home Care

With sad and tragic news this week of a young boy passing from sepsis in Cohoes, NY, the Capital Region’s ABC affiliate, News 10 WTEN, spoke to HCA and medical experts on Tuesday about sepsis, including a bill that passed the State Legislature in June to support the work of home care providers in screening for this deadly condition.

“Our goal, particularly with the home health system, is to work not only to monitor, but teach the individual and the family what to look for and how to prevent” sepsis, said HCA President Al Cardillo in the interview. Watch the clip here and learn more about the legislation here. The bill (S.1817/A.3839) awaits action by the Governor.

HCA Op-Ed on PDGM Bill

“Say your employer takes 8 percent from your paycheck this week as a penalty for you possibly being late to work sometime next week, despite a long record of punctuality,” writes HCA President and CEO Al Cardillo in an op-ed for the Albany Times Union last week, setting up an analogy: “That’s what the federal government is doing for Medicare-covered home health services in 2020 with cuts of $1 billion nationwide,” referring to the so-called “behavioral adjustments” under the Patient Driven Groupings Model (PDGM).

He further describes the inherent faults of the “behavioral adjustment” cuts that ride along with PDGM, urging action on a bill to curtail those cuts: H.R. 2573/S.433.

Eight Top Legal, Compliance Experts Lead October 17 HCA Symposium 

“If you think compliance is expensive, try non-compliance,” former U.S. Deputy Attorney General Paul McNulty once wisely observed.

The toll is not just financial: as in government fines or penalties, civil liabilities, legal or recovery costs, or loss of licensure/operational privileges, which are bad enough. Noncompliance costs can also be counted in the form of grave reputational risks to your organization, straining or ruining relationships with referral sources or contractors at a time when state policies are imposing even greater restrictions and obligations on network contracts.

Most at stake is your hard-won trust with patients in the community.

HCA’s flagship Corporate Compliance Symposium provides your compliance officers and executive teams with the tools, resources, information and guidelines to overcome these risks. This includes procedural best-practices for self-auditing, so that your own internal investigations can detect pitfalls instead of government or law enforcement doing so on your behalf, and at great expense to your organization.

Each session covers prominent compliance issues by eight highly esteemed legal and compliance minds, all available to you at one time and one place. Don’t miss out.

Times Union, Crain’s, Politico and HHCN Coverage of Bill Capping Home Care Hours

HCA fielded several media calls for comment last week following a press conference in New York City on September 5 where State Senator Roxanne Persaud (D-Brooklyn) and supporters pressed for action on a bill to place limits on home care hours worked. A companion bill is being sponsored by Assemblyman Harvey Epstein (D-Manhattan).

This bill has arisen in the wake of litigation, emergency rulemaking and, most recently, a New York Court of Appeals decision on the issue of 24-hour home care over the past several months.

News reports quoting HCA on the matter are at the links below:

Statement: Attorney General James Settlement For 100 Home Health Aides

A Statement from Home Care Association of New York State (HCA) President and CEO Al Cardillo

“I echo Attorney General Letitia James’s sentiments regarding the tireless, vital work of home health aides in caring for the most vulnerable New Yorkers. Not knowing all circumstances of this case, HCA is not able speak on those specifics. However, there is no place in New York’s home care system — or in the broader health care system — for any organization to deliberately engage in unlawful practices described in the AG’s press release, or to exploit an individual’s immigration status as has been charged. HCA supports the efforts of law enforcement in breaches of these laws in home care as in any sector.”

HCA Comments on Home Health Rule, PDGM

HCA Vice President for Finance and Management Patrick Conole yesterday sent comments to the U.S. Centers for Medicare and Medicaid Services (CMS) on its proposed 2020 payment rule for home health.

The proposed rule includes updates on a mix of longstanding payment-related programs and structures, alongside the major structural overhaul known as the Patient-Driven Groupings Model (PDGM).

CMS is expected to finalize the rule, following the comment period, in November, with the rule going into effect on January 1, 2020.

Continue reading “HCA Comments on Home Health Rule, PDGM”

September is Sepsis Month: Thousands Now Screened by Home Care RNs for Life-Threatening Sepsis Using Innovative Tool

Everything you need to know about sepsis detection protocols that are saving lives and reducing costs through home care — plus next steps for broader application (  

September is “Sepsis Awareness Month,” and the Home Care Association of New York State’s national-first sepsis screening program for home care nurses and providers is making major strides in addressing this medical emergency — sepsis — a condition that claims a life every two minutes (according to Sepsis Alliance) and is more likely to occur in the home and community than in a hospital.

“Data suggests that 80% to 90% of sepsis cases actually originate in the home or community,” says HCA President and CEO Al Cardillo. “This fact alone is one of many reasons why home care’s involvement in sepsis screening is so vital, and why protocols, like HCA’s program, are incredibly important when it comes to improving outcomes and saving lives in a home care population that is especially vulnerable. All sectors of the health care system have a responsibility to intervene — and, wherever possible, prevent — the tragic loss of life, morbidity and life-altering effects of this condition. The home care system is especially equipped to do so.” Continue reading “September is Sepsis Month: Thousands Now Screened by Home Care RNs for Life-Threatening Sepsis Using Innovative Tool”

HCA, Partners Assert 1115 Waiver Recommendations 

Today, HCA and six other prominent health care associations wrote to the state’s Deputy Secretary for Health and Human Services Paul Francis with core recommendations and key amendments that the state should consider in its multi-billion-dollar 1115 Medicaid waiver renewal process. (See the letter here.)

Section 1115 of the Social Security Act gives the U.S. Secretary of Health and Human Services the authority to approve state-level experiments, pilots, or demonstration projects in Medicaid and the Children’s Health Insurance Program (CHIP) programs.

Continue reading “HCA, Partners Assert 1115 Waiver Recommendations “

RFI Response: HCA Makes Recommendations on Home Health, Hospice Regulatory Relief to CMS

In response to an RFI soliciting public comments on regulatory relief, HCA on Monday provided the U.S. Centers for Medicare and Medicaid Services (CMS) with a set of recommendations to ease home care and hospice regulations.

Our recommendations include such areas as the retrieval of records, use of actual patients (versus pseudo-patients) in aide competency evaluations, coordination of documentation requirements with physicians, and a range of other proposals that, we believe, will align with CMS’s aim to make the health care system more effective, simple and accessible.

Prepare Now for Emergency Drill to be Held Next Week  

Sometime next week, without advance notice, the state Department of Health (DOH) will hold an Interoperable Communications (IOC) drill for the entire state.

However, the drill will take place on a rolling basis in staggered stages. As mentioned previously, the IOC drill will be targeted to home care, hospice and other providers across the entire state; though voluntary, it can be used to fulfill federal and/or state requirements for agencies to hold emergency preparedness exercises.

Continue reading “Prepare Now for Emergency Drill to be Held Next Week  “

HCA DATA: 1,000s of Data Points for Your Home Care, Hospice, MLTC Business Planning


HCA holds a vast repository of over 100 reports – and thousands of home care, hospice and MLTC data cells – available exclusively to HCA members through our web-based HCA DATA platform.

These reports provide a major advantage for HCA members in their business and operations planning. They support and inform your financial benchmarking, local market analysis, strategic plan development, contract negotiations, consulting work, and many more functions across various departments.

Through HCA Data, you’ll find everything from big picture trends on statewide home care financial performance to operational data on every individual CHHA, MLTC, LHCSA and Hospice in the state. This data includes operating revenues and expenses across payors, cost factors for salaries and wages, payor mix, visit totals by discipline, caseload capacity by county, unit costs, medical expense ratios, live discharge data (for hospice), and many more items.

Give your CFOs, financial managers, chief strategy officers, operations managers and business planners the keys to this powerful resources today. Learn more and obtain an account here today!



Newsday: Demand for home care workers outstripping supply

Newsday published a comprehensive report yesterday on the demand for home care workers on Long Island. As part of the report, HCA and members noted some of the local dynamics, including competitive pressures from New York City (where the comparative ease of public transportation and higher state-mandated wage parity levels draw workforce from areas of Nassau County), as well as staff vacancy levels that exist system-wide due to policy and economic trends.

“Roger Noyes, communications director for the Home Care Association of New York state, said that starting in 2011-12, the state required higher wages for its Medicaid home care cases, with a $3-an-hour higher minimum wage in New York City compared to Long Island and Westchester, plus an extra $1 in benefits. The resulting wage differential made it harder to recruit for Nassau County, he said, in particular for home health aides, nurses and physical therapists.”

“Noyes said his group recently surveyed its membership of home care providers and found that more than 17 percent of home health and personal care aide cases went unfilled. It also found a 20 percent shortfall in nurses, and another 20 percent shortfall in therapists.”

Home Care Responds to NYC-Area Power Outage, Heat Wave

New York City home care agencies put their emergency preparedness plans into action earlier this month during two July power outages that left tens of thousands of New Yorkers in the dark on two consecutive weekends: on July 14 and July 21.

Nurses, home health aides and other home care personnel play a vital role for patients during emergencies like these — just as they provide critical supports to vulnerable populations at home each day. This includes New Yorkers who are among the 2.5 million individuals nationally relying on home medical equipment, like in-home respiratory ventilators, that require reliable power to function.

Home care providers have plans in place to assist these and other patients living at home who are vulnerable to heat-related illness or environmental conditions during a disaster, especially a situation like the recent power outages coinciding with a wave of near-record high temperatures that gripped the metropolitan region.

Learn more by reading our recent blog post here.

Write Congress NOW: S.433/H.R. 2573 Imperative as Home Care Faces 8% Cuts

“Your action to protect New York’s Medicare home health system (S.433/H.R. 2573) just reached a dramatically new level of urgency,” says an advocacy campaign message posted today on HCA’s Legislative Action Center.

Please send this message to Congress now, and share this action item widely with your staff and colleagues so that they act as well. It takes less than a minute of your time. Continue reading “Write Congress NOW: S.433/H.R. 2573 Imperative as Home Care Faces 8% Cuts”

Utica Observer-Dispatch: ‘Initiative having impact on sepsis’

“An initiative to fight a potentially deadly disease began in New York with help from a local nurse. Now, it’s taking off across the state — and around the country,” writes Amy Roth in the July 2 edition of the Utica Observer-Dispatch.

“Stop Sepsis at Home, an initiative of the Home Care Association of New York State, uses the nation’s first screening and intervention tool to identify home care patients who are at risk for sepsis, who are in the early stages and need treatment, and who have severe sepsis and need emergency care. It also involves training for health care providers and education for patients and families.”

NY Legislature Passes Nation’s First Sepsis Education and Support Initiative for Home Care

Bill would support education and widespread use of screening tool to determine sepsis risk

ALBANY – HCA applauds the New York State Legislature for passing the nation’s first sepsis education and support initiative rooted in the home health care setting and practice. It comes at a time when this so-called “silent killer” is raising alarms across the health care continuum, from the CDC to state and local health departments.

Sepsis is a life-threatening condition caused when the body’s immune system wages an over-aggressive response to an infection, often causing injury to the body’s organs. It affects more than a million Americans annually – 15 to 30% of whom will die.

Only a few states have gradually begun standardizing sepsis protocols for hospitals. New York did so through legislation pioneered in 2013, known as “Rory’s Regulations,” named after Rory Staunton, a boy who tragically died of sepsis in 2012. Continue reading “NY Legislature Passes Nation’s First Sepsis Education and Support Initiative for Home Care”

HCA’s Sepsis, In-Service Bills Pass Both Houses

The state Legislature remains in session at the time of this writing to consider a range of final bills, with an expected adjournment sometime tomorrow, according to reports.

Two HCA bills cleared both houses this week with votes in the Assembly yesterday following earlier passage in the Senate. They include HCA’s aide in-service tracking bill and our sepsis legislation.

HCA also participated in a press conference and media outreach yesterday, along with representatives from 20 other community-based provider associations and Assembly Health Committee Chairman Richard Gottfried, on a third bill related to health care transformation funds. Continue reading “HCA’s Sepsis, In-Service Bills Pass Both Houses”

21 Organizations Urge Immediate Action on Community Care Investment Bills

ALBANY – Advocates representing twenty-one primary care, mental health, substance use disorder, developmental disability and home care provider associations were joined today by Assembly Health Chair Richard Gottfried and Senate Health Chair Gustavo Rivera urging legislation (A.7977A/S.6376) assuring that a minimum dedicated share of funds is allocated to community-based providers from an existing pool known as the Health Care Transformation Fund (HCTF).

HCTF was enacted as part of the state fiscal year 2018-19 budget. It requires funds to be used “to support care delivery, including for capital investment, debt retirement or restructuring, housing and other social determinants of health, or transitional operating support to health care providers.”  Continue reading “21 Organizations Urge Immediate Action on Community Care Investment Bills”

HCA’s Stop Sepsis at Home Initiative to Receive 2019 Sepsis Hero Award

HCA is receiving one of five Sepsis Heroes awards from Sepsis Alliance in recognition of our Stop Sepsis at Home initiative.

The award honors “Sepsis Heroes who have made a significant contribution to sepsis awareness and education among both the general public and health care professionals.” Awards are presented at an annual gala in New York City on September 12 during Sepsis Awareness Month. Learn more about the event here.

HCA’s Stop Sepsis at Home initiative has been adopted in 55 of New York’s counties where nurses are using the screening tool to potentially identify life-threatening cases of sepsis and help triage follow-up protocols.

HCA thanks Sepsis Alliance for this recognition, and we hope it elevates the importance of this initiative for the 80% of home care cases that originate in the home and community-based setting.

HCA Presses Bills for Home Care, Hospice, MLTC Rate Stability, Workforce Support & Cost-Saver Programs

ALBANY – With one week left before the State Legislature adjourns, HCA is urging action on several priority bills for home care, hospice and Managed Long Term Care services and supports.

HCA has worked with legislative offices and partners on bills that would provide for: Medicaid rate stability and benchmarks; efficiencies in home care aide in-service reporting; workforce supports; sepsis prevention; and public health and health disparities initiatives. (Background on each of these bills and their rationale are shown in a table at

“System-wide underpayments and fund-flow shortfalls need to be addressed throughout New York’s home care system,” said HCA President and CEO Al Cardillo. “Meanwhile, major workforce demands for nurses, therapists and home health aides must be met in order to ensure access to services, especially for individuals needing care after hospitalizations, or to prevent institutional care episodes.” Continue reading “HCA Presses Bills for Home Care, Hospice, MLTC Rate Stability, Workforce Support & Cost-Saver Programs”

Caregivers, Physicians & Public Servants to be Presented Home Care and Hospice Excellence Awards

Media invited to awards ceremony on May 9 in Saratoga Springs, NY

Albany, May 06, 2019 — HCA is presenting awards this week to eight exceptional individuals and programs, recognizing their excellence in the home care and hospice fields across New York State.

“HCA’s award recipients are not only exemplary individuals, but each person has contributed to the home care and hospice fields in distinct ways,” said HCA President and CEO Al Cardillo. “They’ve gone to extraordinary lengths helping a particular patient on a particular day. They’ve improved a patient’s overall experience of care. And they’ve influenced broader changes in the very way that home care and hospice are delivered.” Continue reading “Caregivers, Physicians & Public Servants to be Presented Home Care and Hospice Excellence Awards”

Business Review Roundtable Eyes Home Care Workforce Issues and More

HCA President Al Cardillo joined a recent home care Industry Roundtable hosted by the Law firm Hodgson Russ and the Albany Business Review.

Check out the Business Review’s transcript of the program offering perspectives on the home care workforce challenge statewide, including approaches that providers and HCA, through legislation, are taking to address it, plus the role of technology and other issues confronting the field.

“The federal system that was created to fund home care was created in the 60s, and in the 70s in New York State,” says Mr. Cardillo in one part of the exchange. “It’s a very different world today in terms of who goes into the hospital, how sick they are when they come out, who goes into nursing homes, and who we want being cared for in the community.”

He adds: “The funding structure that wraps around home care needs to be modernized to the way that services are provided today.”

HCA Appoints Rebecca Fuller Gray to Executive Role

National home care, hospice expert brings unmatched experience and skills to HCA

HCA President Al Cardillo and the HCA Board proudly and enthusiastically announce the appointment of state and national home care expert Rebecca Fuller Gray as HCA’s new Executive Vice President for Clinical and Program Affairs. Ms. Gray starts her position on May 1.

Continue reading “HCA Appoints Rebecca Fuller Gray to Executive Role”

A Statement from HCA President Al Cardillo on the Court of Appeals Opinion in Andryeyeva and Moreno

This ruling upholds the law as interpreted by the state Department of Labor, as applied by the state Department of Health, and as followed in good-faith by providers who have been directed to comply with the 13-hour rule.

HCA continues to support a structure of regulations and reimbursement that ensures proper compensation and coverage of direct-care staff.

We also continue to fervently advocate for state, federal and commercial payor reimbursement to provide wages and benefits reflecting the vital nature and value of the care our home care workers render every day.

In fact, several of our proposals have been advanced for consideration in the current state budget and legislative process. These include a set of bills that would pilot funds to support personnel needs such as transportation, child care, training and education. This package of bills would also require state agencies to conduct a competitive market and labor analysis leading to reimbursement levels necessary for competitive recruitment, retention and compensation of home care and hospice staff.

We call on the State Legislature and Governor to embrace these proposals.

Buffalo Business First Examines Home Care Workforce Shortages in WNY

HCA and our Western New York members, Catholic Health Home Care and Visiting Nursing Association of WNY (VNA), were featured in a Buffalo Business First article on the impact of home care labor shortages. Catholic Health Home Care describes a workforce drop of 500 to 335, and VNA similarly reports a decline in home health aide employment due in large part to competition from other fields and wage policies. Citing our annual report on home care trends, HCA notes: “Our data shows that some of the shortages that exist are having an impact on starting care; hospitals’ need to discharge patients; and agencies not being able to always admit the patient or be able to provide services in a timely basis.”

Home Care: A Major Partner for Tackling Health Disparities

Home care is uniquely positioned as a model to address health care disparities. Disparities are defined as “differences in health outcomes among different groups of people.”

In many instances, home care providers are the main conduit between patients and their physicians and other providers. They offer special care training and assignment, including language and cultural competencies.

What’s more, in-home telehealth interventions are designed to support the clinician’s work addressing disparity-prone conditions such as diabetes, asthma, hypertension, cardiovascular disease, mental health, maternal and child health, HIV/AIDS and others.

Read our publication on Home Care: A Major Partner for Tackling Health Disparities to learn more.

State DOL Employee Scheduling Rule Put on Hold

HCA has learned that the “Employee Scheduling” rule, which was proposed by the state Department of Labor (DOL), will not be promulgated at this time, due to comments raised by HCA and other organizations who argued that the approach was impracticable to certain industries or sectors, like home care and hospice.

The rule, first proposed on November 22, 2017 and then revised on December 12, 2018, would have required employers to pay additional hours for “unscheduled shifts,” “cancelled shifts,” “on-call” and “call for schedule.” HCA had argued that the proposal was incompatible with how care at home is delivered, where hours are started, increased, decreased or eliminated due to reasons unique to home care and hospice and their patients, and beyond the control of the employer.

Continue reading “State DOL Employee Scheduling Rule Put on Hold”

Report Shows Financial, Workforce Struggles of Home & Community Care Sector Amid State Budget Talks

ALBANY — Coinciding with today’s state legislative hearing on the health and Medicaid budget, the Home Care Association of New York State (HCA) today released the findings of our annual financial and trends report for the home and community-based care sector, which serves approximately 500,000 patients and families in New York State.

The report is culled from the latest available state Medicaid financial reports and a survey of providers. It shows: financial margins; revenue and cost cycle and accounts receivable data; workforce turnover and vacancy rates; access issues; and more.

“The data reveals urgent vulnerabilities and needs in the vital in-home safety-net,” said HCA President Al Cardillo in prepared testimony to the Legislature today. (The report is here; HCA’s testimony is here.)

Continue reading “Report Shows Financial, Workforce Struggles of Home & Community Care Sector Amid State Budget Talks”

HCA Testimony on the State Budget

At today’s health and Medicaid budget hearing, HCA President Al Cardillo delivered testimony revealing the financing, workforce and overall support needs of the home care, hospice and Managed Long Term Care sector using data from our just-issued financial and trends report.

Crain’s NY Business: Home Care Agency plans layoffs in challenging market

“Brooklyn-based Metropolitan Jewish Home Care, doing business as MJHS Home Care, plans to lay off more than 100 employees amid significant business challenges,” writes Crain’s New York Business, quoting HCA on some of the financial challenges faced by the industry. See the report here.

“Certified home health agencies have been especially vulnerable to costly mandates, inadequate payor rates and exposure to systemwide volatility in the home and community-based marketplace,” said Roger Noyes, director of communications at the Home Care Association of New York State, in an email.

Continue reading “Crain’s NY Business: Home Care Agency plans layoffs in challenging market”

Home Care Emergency Preparedness Toolkit

HCA and the New York State Association of Health Care Providers (HCP) offer an Emergency Preparedness Toolkit for home care and hospice providers, their patients and families.

This compilation of resources is for agencies to use in assisting patients and families on preparations for any type of emergency situation. The information can be provided to patients and their families at the time of admission so that the planning process is begun and in place as intended – well before an emergency event takes place.

The resources address a variety of issues and considerations necessary for effective preparedness planning. This Toolkit should also assist agencies and patients under the new federal Conditions of Participation for emergency preparedness, which require patient-specific emergency plans.

Slide Presentation: Legislative Forum on Home and Community Care Services

On January 8, HCA, the Hospice and Palliative Care Association of New York State and the New York State Association of Health Care Providers held a forum for state legislators and their staff offering background on home and community care services – in particular, home care, hospice/palliative care and MLTC – that may aid in:

  • Assisting constituents, families and communities with their health care needs.

Continue reading “Slide Presentation: Legislative Forum on Home and Community Care Services”

Home Care 101 for Legislators, Staff on January 8

The Home Care Association of New York State, the Hospice and Palliative Care Association of New York State, and the New York State Association of Health Care Providers are jointly holding a January 8 Home and Community Care Services Open Forum for State Legislators and their staff at the Legislative Office Building in Albany. Details are in the flyer here. Continue reading “Home Care 101 for Legislators, Staff on January 8”

Comparison Table of DOL’s Dec. 2018 and Nov. 2017 Call-in Pay Proposed Regs

Last week, HCA alerted members that the state Department of Labor (DOL) posted revisions to already-proposed employee scheduling (“call-in pay”) regulations.

HCA has prepared a document that compares the previously proposed regulations with the newly released regulations. It is posted at

The newly proposed rule can be found on the DOL website at

An initial version of these regulations was proposed on November 22, 2017, requiring employers to provide additional pay when a shift is cancelled or not scheduled within a certain advanced time requirement. It would also mandate additional pay for employees who are required to be in contact with the employer about a possible upcoming shift. HCA commented and delivered testimony on the original proposals earlier this year (see

The revised regulations will trigger yet another comment period where HCA will reiterate our call for the state to carve-out the home care, hospice and MLTC sectors from the proposed regulations should they be adopted.

HCA Seeks Home Care Exemption in Federal “Public Charge” Rule Change

Rule would limit, deny immigration for those on public assistance, with implications for home care patients and the individuals who support them

HCA today commented on a new federal proposal that would limit or deny permanent legal status to immigrants if they rely on a wide range of government services, such as Medicaid, food assistance, and housing assistance. Our comments seek exemptions of individuals employed or seeking employment as home care or personal care aides. Continue reading “HCA Seeks Home Care Exemption in Federal “Public Charge” Rule Change”

Home Care Association Appoints New Policy Directors to Boost Advocacy, Research Functions

ALBANY – The Home Care Association of New York State (HCA) has appointed two policy directors, Alyssa Lovelace and Lauren Ford, with experience in health policy research and association advocacy to further enhance HCA’s efforts in both areas.

“Alyssa Lovelace and Lauren Ford are two exceptional and experienced health care leaders who will help HCA advance our policy and advocacy functions in several critical areas,” said HCA President and CEO Al Cardillo.  Continue reading “Home Care Association Appoints New Policy Directors to Boost Advocacy, Research Functions”

Document Drop: Co-Sponsor and Pass Bipartisan Bills to Protect Medicare Home Health under PDGM

The U.S. Centers for Medicare and Medicaid Services (CMS) has finalized the biggest change in funding and reimbursement for Medicare home health services in two decades.

Of nationwide concern, this new system is front‐loaded with provider cuts tucked in by unverified CMS predictions about future provider behavior in a system not even yet implemented. Home care in New York State needs your support on bipartisan legislation (H.R. 6932, S.3545 and S.3458) to ensure that this reimbursement overhaul does not jeopardize services for seniors who rely on home care.

Read our white paper to learn more here.

HHCN Q&A with HCA President Al Cardillo

Home Health Care News conducted a wide-ranging Q&A interview with HCA’s new President Al Cardillo, covering his background in health care, as well as specific topics like wage-and-hour rules, compliance, value based payment, a new Medicare home health payment reform model and more. Read the interview here.

NYS Home Care Association Appoints HCA Executive Al Cardillo as President and CEO

ALBANY, NY — The Home Care Association of New York State’s (HCA) Board of Directors has appointed Al Cardillo as its next President and CEO.

“HCA is very fortunate to have Al Cardillo’s experience, level of expertise and talent from within its ranks to lead the association forward,” said HCA’s Board of Directors Chair Susan Larman, BSN, MBA, Chief Executive Officer of Albany-based VNA Home Health/Visiting Nurses Home Care.

“Al has brought to HCA many years of experience and true formative involvement in the home care field encompassing nearly four decades,” she added. “Since coming to HCA in the role of Executive Vice President in 2007, HCA members have relied on Al’s knowledge and skills in program, policy, legislation, budget and advocacy. He continues and further elevates these assets in the President’s role.”

“I thank the Board of Directors for the honor and privilege of serving as HCA’s President and CEO, and for their confidence in me,” said Al Cardillo. “Each day, HCA’s members provide vital health and supportive services to hundreds of thousands of patients at home. I am proud of their work and to do all I can to support their mission.” Continue reading “NYS Home Care Association Appoints HCA Executive Al Cardillo as President and CEO”

Saluting Veterans in Home Care and Hospice

For Veterans Day, the Home Care Association of New York State (HCA) joins its home care, hospice and managed long term care provider members throughout New York State in recognizing exceptional individuals who have made the ultimate sacrifice through military service.

Our observance of veterans also coincides with National Home Care and Hospice Month in November.

HCA honors the wishes of patients, including our nation’s veterans, to live independently, with dignity, and with the medical,
social or assistive services to help them fulfill those wishes in the community setting.

If you are a veteran – or if your veteran constituents need care – HCA is proud to be a resource for services at (518) 426‐8764.

Oct. 3 Sepsis Summit to Coordinate Response on Lethal Condition Claiming Quarter-Million U.S. Lives, Costing $27 Billion Annually 

ALBANY – HCAIPROHANYS, the Rory Staunton Foundation for Sepsis Prevention,Sepsis Alliance, and nine additional partner organizations are holding a first-of-its-kind All-Sector Sepsis Summit for health care organizations and representatives on October 3 in Albany.

Registration, a program agenda and additional information are here.

Media are invited to learn more about the human toll and health care implications of sepsis. (Media announcements about the event are also appreciated.)

The daylong program at the Albany Hilton includes top state health officials, physician experts, representatives of all health sectors, public policy and education partners, and quality and clinical experts. Capital Region media representative Benita Zahn, an anchor at WNYT NewsChannel 13, is also among the scheduled speakers. Continue reading “Oct. 3 Sepsis Summit to Coordinate Response on Lethal Condition Claiming Quarter-Million U.S. Lives, Costing $27 Billion Annually “

Join HCA, IPRO, HANYS and Partners for Major Cross-Sector Sepsis Summit on Oct. 3 in Albany

HCA, IPRO, HANYS, the Rory Staunton Foundation for Sepsis Prevention, Sepsis Alliance and partner organizations invite you to register for a first-of-its-kind All-Sector Sepsis Summit on October 3 in Albany.

Click the event page here for online registration and to download the brochure for the full agenda, which includes top state health officials, physician experts, representatives of the various health sectors, public policy and education partners, and quality and clinical experts.

Continue reading “Join HCA, IPRO, HANYS and Partners for Major Cross-Sector Sepsis Summit on Oct. 3 in Albany”

HCA’s Testimony Opens State DOL Hearing on 24-hour/live-in Rule

HCA led off the testimony at the July 11 state Department of Labor (DOL) hearing on proposed standards for 24-hour shift compensation provided to workers, including home health aides.

The DOL-proposed standards outline compensation requirements to explicitly exclude sleep time and meal periods from compensable hours. However, such standards for home care have been the subject of recent litigation, as extensively described for the membership and in our testimony, available hereContinue reading “HCA’s Testimony Opens State DOL Hearing on 24-hour/live-in Rule”

Home Health Care News: NY Moves Forward on Advanced Home Health Aide Designation

Home Health Care News recently reported on the movement of new regulations to create an advanced home health aide designation in New York State. “The new regulations deal mostly with medications,” says HCA. “The real opportunity area seems to be for patients who are unable to self-administer medications, due to memory issues or the complexity of their medication needs.”

“A lot depends on how an agency opts to utilize this new designation,” HCA adds. “Right now, it’s unclear whether any potential new costs will outweigh the savings. It’s also unknown how [payers] and workforce dynamics will drive this cost calculation.”

HCA Submits Comments on State DOL 24-Hour Rule

HCA submitted comments last week on a state Department of Labor (DOL) proposed rule that would exclude sleep time and meal periods from compensable hours for an “employee” – not limited to a home care aide – who works on shifts of 24 hours or more.

This proposed rule is similar to a home care-specific emergency rule issued by DOL in October 2017 and renewed numerous times under which DOL codified “the Commissioner’s long-standing and consistent interpretation that compensable hours worked under the state Minimum Wage law do not include meal periods and sleep time of home care aides who work shifts of 24 hours or more.” Continue reading “HCA Submits Comments on State DOL 24-Hour Rule”

HCA Submits Comments on FY 2019 Hospice Proposed Rule

Yesterday, HCA submitted extensive written comments on the Fiscal Year (FY) 2019 proposed rule for Medicare hospice payment updates, wage index changes and quality reporting. The proposed rule was posted in April by the U.S. Centers for Medicare and Medicaid Services (CMS) and previously summarized to the HCA membership in our newsletter.

Our comments can be downloaded here.

Continue reading “HCA Submits Comments on FY 2019 Hospice Proposed Rule”

Document Drop: HCA Seek Fixes to Medicare Payment Reform, NPP Authorizations & Continued NY Exemption from Pre-Claim Review

HCA is seeking technical corrections that would mitigate the financial and service impact of this change for providers and beneficiaries. We also urge a piloting mechanism so that the payment reforms are tested first on a demonstration basis. These and other recommendations are included in a new HCA piece being shared with Congressional offices, titled Vital Corrections, Safeguards Needed in 2018 Home Health Payment Reform Act (see here).

Continue reading “Document Drop: HCA Seek Fixes to Medicare Payment Reform, NPP Authorizations & Continued NY Exemption from Pre-Claim Review”

Your Action Needed NOW on HCA Bills to Support Home Care, Hospice and MLTC

This year’s state legislative session is expected to wind down very quickly in terms of the timeline and level of legislative activity, especially given statewide elections in the fall which will likely drive an early beginning to the summer campaign season.

As reported in several recent editions of The Situation Report newsletter, HCA has written a slate of proactive bills to support the home care, hospice and MLTC membership. HCA’s measures are designed to position the home and community based system favorably given the current political environment in which the Legislature and Governor are expected to concentrate on only a select range of issues for action.

Today, we need your grassroots help in writing to the legislative sponsors, bolstering their support for our initiatives while helping to raise the visibility of issues that affect home care, hospice and MLTC organizations.

What We Need You to Do Now

HCA has created a new landing page on our Legislative Action Center with seven messages of support for HCA’s bills that all members must send to the legislative sponsors as soon as possible.

Please act on all seven of these messages, each of which takes less than a minute of your time to send by entering your contact information and pressing a button on each action item. Your action will significantly augment our chances of success.

So, click the link to our Legislative Action Center, where you’ll see boxes for each action item. Click “add your voice” on each action item, read the short summary, enter your contact information, and send the messages today. Please do this for all seven messages.

With our Legislative Action Center, we’ve worked to make this process quick and easy for you, so your participation is imperative. Please also use the messages as a basis for making phone calls to the legislative sponsors as well. The more ways that they hear from you, the better our chances of success.


In Letter to CMS, HCA Opposes Thresholds Exempting States from Having to Submit Monitoring Plans of Medicaid Access

HCA has submitted comments to the U.S. Centers for Medicare and Medicaid Services (CMS) urging CMS to maintain its existing requirement for states, like New York, to submit an access monitoring review plan that holds states accountable on Medicaid access to care.

Under a rule known as the “equal access provision,” states are required to set Medicaid fee-for-service (FFS) rates to ensure access to services for Medicaid beneficiaries at a comparable level to non-Medicaid FFS-insured individuals. To hold states accountable for keeping competitive rates, CMS in 2015 began requiring states to submit an access monitoring review plan (or AMRP) every three years when rate changes occur (among other factors) to fee-for-service entities like Certified Home Health Agencies (CHHAs) and other FFS providers. Continue reading “In Letter to CMS, HCA Opposes Thresholds Exempting States from Having to Submit Monitoring Plans of Medicaid Access”

DOH Issues Notice on Investigation into Reliability of Glucose, Potassium Results by Lab Provider

The state Department of Health (DOH) has posted a notice to home care agencies, medical directors and other provider representatives on the Health Commerce System (HCS) regarding an investigation into the reliability of a laboratory service provider’s glucose and potassium test results that could affect HCA members.

The notice, available here, states the following:

On 5/22/2018 the New York State Department of Health (Department) issued an Order for Summary Action against a laboratory service provider, Modern Diagnostic Laboratory Inc. due to findings of an investigation by the Wadsworth Center’s Clinical Laboratory Evaluation Program. The investigation determined that glucose and potassium test results were not reliable and in some instances falsely reported.

Today (5/23/2018), the Department issued an Amended Order for Summary Action against MDL. The Amended Order enables MDL to resume providing services under existing contracts. The Amended Order requires that MDL meet certain requirements, including but not limited to, the immediate employment of an independent consultant who will be approved by the Department, and the cessation of any inappropriate testing and reporting practices.

For providers seeking to contract with an alternative laboratory, a list of other approved laboratories can be found at the following link:

No other information is available at this time regarding actions that providers should take for lab services affected by these findings. HCA remains in communication with the Department for further information, which we will share in an alert to the membership or in our newsletter as necessary.


Agencies in Limbo as 13-Hour Rule Back in Legal Spotlight

HCA was recently quoted in an article for Home Health Care News on new litigation affecting compensation 24-hour/live-in services. “Going forward, the issue is, if aides get paid for every hour, it will cost the system an incredible amount of money,” said Andrew Koski, HCA’s vice president for program policy and services. “If that funding should not be available or if the aides are not paid adequately, then you’re going to have basically very hard-to-find agencies and aides that are going to work these [24-hour care] cases… The only alternative [for patients] is to go without care, get less care than you need or go into an institution.” Read the full article here.

Home Care & Hospice Awards Go to Ten Clinicians, Caregivers, Quality Leaders, Advocates and Physicians across NYS and Nationally

HCA to present awards at 40th Annual Conference on 5/10; awardees are from NYC, Rochester, Capital Region and Washington, D.C.

At its 40th Anniversary Annual Conference in Saratoga Springs, NY on May 10, the Home Care Association of New York State (HCA) is presenting its 2018 annual awards to ten exceptional home care and hospice clinicians, caregivers, leaders in quality innovation, advocates, and physicians at the state and national levels.

The awardees are listed below. For a full summary of each award winner’s accomplishments, please see our conference website at

HCA’s two highest honors are presented to a national leader on the home care stage, as well as one of New York State’s most thoughtful and expert regulatory policymakers.

HCA’s Advocacy Award recipient is Bill Dombi, President and longtime policy leader at the National Association for Home Care and Hospice (NAHC). “Bill Dombi has influenced every significant change in the Medicare home health benefit, reimbursement, regulations and the legal frameworks governing home care over the last 30 years,” said HCA President Joanne Cunningham. “He truly is the leading home care and hospice advocate for our state, for every state, and for the country.”

HCA’s highest honor is the Ruth F. Wilson Award, named for an early organizational leader in New York’s home care system. It is being presented to Rebecca Fuller Gray, Director of the New York State Department of Health’s Division of Home and Community Based Services. “Becky Gray is not only an exceptional leader committed to doing what’s right for home care patients, but she also approaches every issue and challenge with the instincts and problem-solving acumen of a nurse, serving as a cornerstone of home care and hospice policymaking for nearly 15 years.”

Overall, HCA’s 2018 awards are among the most diverse yet, in terms of the ways that each luminary has touched the world of home care and hospice

“Our Caring Award winners represent the very best in compassionate care to patients with debilitating illnesses, rehabilitation needs and during end-of-life care,” Ms. Cunningham said. “We are also pleased to honor a home care agency leader who has invested in a unique facility to reward his workforce.”

Ms. Cunningham added: “We are also thrilled this year to recognize the specialized work of nurses who are making a difference through home-based primary care and in spearheading New York City’s first – and only – dedicated program to support the home care needs of patients recovering from gender reassignment surgery.”

For the first time, HCA is also recognizing physician champions in home care.

“Doctors play a vital role in the authorization of home care services, from the initiation of physician orders to the documentation of medical necessity and collaboration with home care providers,” Ms. Cunningham said. “Doctors Kevin Costello and John McIntyre, however, are true home care champions, very actively supporting patients at home during the often fragmented discharge-planning process from the hospital, helping home care organizations reimagine their case-conferencing of at-risk patients, raising the visibility of home care among their peer physicians, and so much more.”


Caring Awards are being presented to:

  • Vicky Gentile, Home Health Aide at New York City-based Selfhelp Community Services
  • Amy Marshall-Uber, Home Health Aide at Eddy Licensed Home Care Agency, which is part of St. Peter’s Health Partners and serves New York’s Capital Region
  • Julio Vega, Doctor of Physical Therapy at HCR Home Care, based in Rochester, New York
  • Josh Klein, CEO of New York City-based Royal Care

‘Triple-Aim’ Quality and Innovation Awards are presented to:

  • Kim Gendron, Family Nurse Practitioner at St. Peter’s Health Partners Medical Associates/Eddy VNA Home Based Primary Care, which serves New York’s Capital Region
  • Shannon Whittington, Interdisciplinary Care Team Manager and Director of the Gender Affirmation Program at New York City-based Visiting Nurse Service of New York

Physician Champion Awards are being presented to:

  • Kevin Costello, MD, Albany Medical Center Internal Medicine, Albany, New York
  • John “Jack” McIntyre, MD, Medical Director, HCR Home Care, based in Rochester, New York

Advocacy Award is presented to:

  • William Dombi, President and CEO of the National Association for Home Care and Hospice (NAHC), based in Washington, DC

Ruth F. Wilson Award is presented to:

  • Rebecca Fuller Gray, Director of the Division of Home and Community Based Services, New York State Department of Health (DOH), based in Alban


The Home Care Association of New York State (HCA), the state’s premier home care association, represents more than 400 providers, individuals, and associate members who collectively serve thousands of New Yorkers.


Roger Noyes

Home Care Association of New York State

(518) 810-0665 (office); (518) 275-6961 (cell)

HCA’s 2018 Award Recipients

Caring Awards

The Caring Award recognizes a staff person of an agency who has exhibited the compassion, skills and service that sets his or her contribution apart and/or whose actions on a particular day or over a period of time exemplify caring in home care.

Vicky Gentile, Home Health Aide at New York City-based Selfhelp Community Services

“Vicky Gentile embodies the caring, dedicated spirit we wish to be associated with our name,” says Selfhelp Community Services, noting Ms. Gentile’s exceptional care to patients.

Continue reading “HCA’s 2018 Award Recipients”

Managed Care Plans Forced to Limit Home Care Contracts in New York

HCA was quoted in a Home Health Care News article about a state budget provision limiting the number of contracts that a Managed Long Term Care plan can have with a Licensed Home Care Services Agency. “We are very concerned about the impact of arbitrary contract limits on continuity of care and individualized contracting relationships that might have specific clinical, cultural or language value, even if the LHCSA does not have the case volume to help an MLTC stay within its contract limit,” HCA says in the article, which can be read in full here.

WNY HCA Members Write to Rep. Collins on NPP Authorization Bill

HCA members serving Buffalo, Rochester and surrounding counties sent a letter this week to Western New York Congressman Chris Collins bolstering his support for legislation (H.R. 1825) to allow non-physician-practitioners (NPPs) to order and refer for home health services.

Rep. Collins is sponsor of this priority bill and has indicated his support to move it forward this Congressional session. The bill has widespread bipartisan co-sponsorship, including from 11 members of the New York House Delegation. Please see the list of House cosponsors here. If Representatives serving your patients are not on this list, please contact their offices to urge their co-sponsorship of H.R. 1825 so that we can keep up momentum on this priority bill. If you need any assistance, please contact HCA’s Communications Director Roger Noyes at Continue reading “WNY HCA Members Write to Rep. Collins on NPP Authorization Bill”

Register Now for HCA’s 40th Annual Conference “40 Years Strong” on May 9-11

Conference40 Years Strong, HCA’s Annual Conference

Date: May 9-11, 2018

VenueSaratoga Hilton, Saratoga Springs



Registration is now open for HCA’s milestone Annual Conference celebrating our 40th year as an association with the theme 40 Years Strong.

Please help make this the best celebration yet, by registering today using the form at the back of our brochure here.

For this banner conference, we’ll be joined by special guest Bill Dombi, President of the National Association for Home Care and Hospice, as well as other expert presenters offering insights on all facets of home care operations.

These sessions, networking opportunities and more will help your organization plan for the future by: tackling emerging issues, enhancing your team’s performance, confronting public health and population health challenges, and optimizing your success with some of the biggest challenges happening to home care in decades.

HCA Voices Support for Proposal Allowing MA Coverage of Non-skilled, In-Home Supports

HCA this week voiced support for a proposal to add non-skilled in-home supports as a supplemental benefit under Medicare Advantage (MA).

Our comments — to the U.S. Centers for Medicare and Medicaid Services (CMS) — also include recommendations for implementation of this potentially transformative change. HCA’s comments can be downloaded here.

CMS recently announced the proposal in a notice to MA plans on 2019 payment changes, saying that it intends to expand the scope of the “primarily health related supplemental benefit standard.” Such an expansion would cover services or items that “diagnose, prevent, or treat an illness or injury, compensate for physical impairments, act to ameliorate the functional/psychological impact of injuries or health conditions, or reduce avoidable emergency and health care utilization.”

HCA Testifies at Health State Budget Hearing on Behalf of Home Care, Hospice and MLTC 

Underscores adverse impact of proposed cuts, eligibility changes, structural limits and urges support for process improvements, home care licensure standards, workforce and infrastructure

ALBANY — HCA President Joanne Cunningham testified today before a joint legislative panel on the Medicaid and health areas of the state budget. Her testimony, on behalf of HCA’s home care, hospice and Managed Long Term Care providers and plans, is available at

Of primary concern in this Executive Budget are the proposed cuts and program changes that impact MLTCs and home care, Ms. Cunningham said.

“Virtually the entire long term care Medicaid and Medicare patient population in New York State has been moved under the care of MLTCs and their providers. The Administration has removed most other options,” Ms. Cunningham said. Continue reading “HCA Testifies at Health State Budget Hearing on Behalf of Home Care, Hospice and MLTC “

HCA Issues State Legislative Proposals, Finance Report on the Home Care, Hospice and Managed Long Term Care Sectors

ALBANY — Leading up to its state advocacy day on Tuesday, February 6, the Home Care Association of New York (HCA) has issued its budget and legislative proposals for home care, hospice and Managed Long Term Care (MLTC) plans.

Accompanying these proposals is a 2018 report on the finance and program trends within the home care, hospice and MLTC sectors. This report is based on a statistical analysis of state-required financial documents, a survey of HCA’s membership, and other data sets. It provides aggregate data on financial margins, accounts-receivable balances, direct-care staffing vacancies and turnover rates, and other important findings within New York’s home care, hospice and MLTC sectors.

“The proposed state budget contains funding cuts, limits on who can access the home care system and other constraints that would further squeeze a vital but already financially stressed system, as shown in our reports and addressed by our proposals,” said HCA President Joanne Cunningham.

She added: “HCA supports the Governor’s funding for direct-care workers in home and hospice care, but providers desperately need a more efficient, workable and transparent process for disseminating adequate funds to health plans and then to providers. This is a fix that is overdue and needed now.”

“The home care system also needs urgent support to recruit and train home care staff to meet the burgeoning need for care, especially given state and federal reforms that are incentivizing a shift in care to the home,” Cunningham said. “HCA’s legislative proposals aim for a robust plan to increase and support the home care workforce.”

She added: “New York’s home care providers are also leading the way in several public health areas and we ask for the state to support this role – specifically in areas of great concern like sepsis, asthma and opioid addiction management, and health disparities. Home care providers can help bend the cost curve and improve quality in each of these public health challenges.”

“HCA’s legislative proposals also seek to sustain New York’s dedication to high standards of care provided in the home,” she said. “We urge the state to continue to enforce the laws and rules that govern who delivers this care and how it is provided. Home care providers are clinical experts in care delivery in the home and the scofflaws functioning without licensure need to be stopped.”

Both reports are linked below.

HCA’s 2018 Budget and Legislative Action Proposals 

Home Care, Hospice and Managed Long Term Care Financial and Program Trends 2018


HCA’s 2018 Budget and Legislative Action Proposals

HCA has issued our 2018 Budget and Legislative Action Proposals. These include the following broad areas:

  • Reject Budget Cuts and Harmful Program Actions to MLTCs and Home Care
  • Support Budget Proposals to Reimburse Minimum Wage & Health Care Infrastructure
  • Develop Appropriate, Actuarially Sound and Timely Payment for MLTCs and Providers Address Workforce Needs in Home Care and Hospice
  • Maintain NY Licensure Standards for Home Care — and Act Against Scofflaws
  • Utilize Home Care’s Expertise to Yield Savings in Community and Public Health

Home Care, Hospice and Managed Long Term Care Financial and Program Trends 2018

HCA has prepared a 2018 report on the finance and program trends within the home care, hospice and MLTC sectors. This report is based on a statistical analysis of state-required financial documents, a survey of HCA’s membership, and other data sets. It provides aggregate data on financial margins, accounts-receivable balances, direct-care staffing vacancies and turnover rates, and other important findings within New York’s home care, hospice and MLTC sector.


POLITICO PRO: Proposal to expand role of EMS pits hospitals against nurses

POLITICO PRO sought HCA’s comment on a state budget proposal to allow for community paramedicine. HCA has, in the past, expressed concerns with community paramedicine legislation because these past proposals seemed to encourage the circumvention of existing licensure requirements for care provided in the home. This prompted a multi-association effort to draft a new bill based on existing licensure roles. The Governor’s proposal appears to largely track with the spirit of this multi-association approach, favored by HCA.

“HCA appreciates the direction of Governor Cuomo’s community paramedicine proposal,” said Roger Noyes, a spokesman for the group. “We specifically appreciate its recognition of needed collaboration between EMS and duly-licensed home care providers for any services that would occur in the home setting. … HCA is optimistic about the approach included in the Governor’s budget and needs to review it further for possible syncing with other existing collaboration initiatives and approaches.”

You can read the article here.

Act Now on Home Health Rural Add-on, NPP Authorization of Home Care

The national push for extension of the home health rural add-on continues, as Congress considers extension bills and other fiscal matters amid the ongoing debate over the continuing budget resolution.

In a separate but important federal matter, HCA has also learned that key leaders are considering a priority bill for authorization of home care services as part of an omnibus package. The bill is sponsored by Buffalo-area Congressman Chris Collins and has strong support from New York’s Congressional Delegation who we need to press Congressional leaders for final adoption of this measure.  Continue reading “Act Now on Home Health Rural Add-on, NPP Authorization of Home Care”

Webinar Offers Premium Legal Guidance for Home Care HR/Execs on Sexual Harassment Law, Procedures

For a low cost of $149/$249 (member/non-member rate), HCA is offering an unlimited number of your HR, executive and management staff to get guidance from top legal experts on the law, policies-and-procedures, and staff training to address sexual harassment in the workplace and reduce your organization’s exposure to costly legal liabilities. Join our webinar on January 30 from 10 to 11 a.m.  Continue reading “Webinar Offers Premium Legal Guidance for Home Care HR/Execs on Sexual Harassment Law, Procedures”

Bomb Cyclone Hits Home Care Providers in Northeast

Home Health Care News has reported on the impact of major winter storms on home care providers, including the work of HCA member Visiting Nurse Service of New York (VNSNY) to reach patients in need.

HHCN reports:

In addition to meeting the new emergency prep regulations at the federal level, agencies in New York are already required to meet a set of ‘pretty robust state regulations, according to Roger Noyes, director of communications of the New York State Home Care Association (HCA-NYS). Providers have “needed to fine tune their existing protocols, policies and procedures” to meet the additional federal requirements, he told Home Health Care News.

The state also recently enacted a law that requires input from home care providers in county emergency management plans. The association worked to link up providers with local emergency management officials in a statewide campaign that has so far reached 40 of the 62 counties in New York.

HCA Submits Comments and Senate Testimony on Proposed Scheduling Rule

Yesterday, HCA submitted comments to the state Department of Labor (DOL) and testimony for a state Senate Hearing on DOL’s proposed scheduling/call-in pay rule, which would have major implications for health care providers, especially home care. Our comments are here and our testimony is here.

As described in numrous communications, the rule would impose the following requirements on employers (with certain exceptions):

An employee must be paid an additional two hours of call-in pay if reporting for a shift that was not scheduled 14 days in advance.

An employee whose shift is canceled within 72 hours of the scheduled start time must be paid at least four hours of call-in pay. Continue reading “HCA Submits Comments and Senate Testimony on Proposed Scheduling Rule”

Urgent Action Alert: Take 1 Minute to Write Congress Opposing BIG End-of-year Home Health Cuts

End-of-the-year Congressional activity is putting home care at risk, and we need your action now to reach your Congressional Representatives in Washington. 

Amid the flurry of activity is extender legislation that reportedly includes some version of the Home Health Groupings Model (HHGM) or other cuts that may be as high as $3 billion to $6 billion nationally over ten years, according to our partners at the National Association for Home Care and Hospice (NAHC).

Continue reading “Urgent Action Alert: Take 1 Minute to Write Congress Opposing BIG End-of-year Home Health Cuts”