National Healthcare Coalition Conference

December 11, 2014

You’re doing what... At Home?!?Engaging Home Healthcare Providers in Preparedness

Joseph “Jody” Moore, MBA, CEM, NC EEMSenior DirectorAdvanced Home Care, High Point, NC

@HealthCare_EM

#HomeCarePrep

“Janice”

Road to our Goals

✤ Establish a baseline

✤ Whats occurring in the home care arena today?

✤ Discussing the opportunities

• Durable Medical Equipment / Respiratory Therapy

• Home Health & Infusion Services

✤ The future of home care and emergency preparedness

✤ Bringing partners to the table

Why Home Care?

✤ Vulnerable Populations

✤ The acuity of the patient population is increasing

✤ Growing segment of patient impact

✤ Staff are accustom to working in “non-traditional” care environments

In the Post-Acute/Non-Acute Space✤ Home Health - Skilled

✤ Home Infusion

✤ Durable Medical Equipment (DME)

✤ Respiratory Therapy

✤ Nutrition

✤ Personal Care Services*

✤ ACA has driven growth and change in the Non-Acute Segment

Day to Day Goals of Home Care Agencies

✤ Shorten Length of Stay

✤ Reduce Readmissions for Referral Sources

✤ Maintain patients at home at highest level of function

✤ Maximizing the efficacy of home health visits

✤ Increase number of Rental Days while decreasing number of deliveries.

✤ Develop and maintain positive relationships with referral sources

DME Overview

✤ The number of DME Providers is shrinking via consolidation and shuttering

✤ Increased demand of compliance

✤ Products Provided:

✤ Wheelchairs

✤ Oxygen*

✤ Bent metal (i.e. canes, walkers, bedside commodes)

✤ Hospital Beds, Hoyer Lifts

✤ Wound Care (Negative Pressure)

Respiratory Overview

✤ More than just oxygen

✤ Supply chain complexities

✤ Service Provided:

✤ Oxygen - Liquid, Compressed, and Concentrated

✤ Sleep Therapy (C-PAP)

✤ Ventilators (Invasive and Non-Invasive)

✤ Nebulizers

Home Health Overview

✤ Growing with some consolidations, driven business due to changes in ACA

✤ Services may include:

✤ Skilled Nursing

✤ Occupational Therapy

✤ Physical Therapy

✤ Speech Therapy

✤ Social Work

Infusion Overview

✤ Quickly growing and includes major players like CVS and Walgreens

✤ Dramatic impact on what can be done in the home.

✤ Services Provide:

✤ Antibiotics

✤ Inotropes

✤ TPN

Opportunities to bring value

Creating contractual relationships with a vendor

or

Engage them as a partner

Surge Capacity

✤ Home Health Agencies

✤ Decompress hospitals

✤ Prioritize patients at home

Alternative Care Sites

✤ DME Providers can be key partners:

✤ Provide equipment

✤ Labor to set-up

✤ Home Health

✤ Supportive Staffing

Parallel Capabilities

✤ Key equipment caches

✤ Ventilators

✤ Infusion Pumps

✤ Information on Vulnerable Populations

✤ Extension of Public Health Epidemiological Surveillance

“Janice”Continued...

Bringing the Leaders to the Table

What is in it for them and their organization?

What do Home Care Leaders need?

✤ Disaster Planning Assistance

✤ Accreditation agencies require disaster planning by most home care providers, but they are not necessarily required to be accredited

✤ Logistic Assistance

✤ Accessing patients are key to home care operations and sometimes that is the biggest challenge

What do Home Care Leaders need? (cont.)✤ Training

✤ Customized training to organizations

✤ Inter-agency communications

✤ Risk Assessment

✤ Exercises

✤ Realistic table tops

How does the new CMS CoPs affect Home Care agencies?

✤ Draft Conditions of Participation around Emergency Preparedness for 17 Healthcare Providers released in December 2013

✤ Addressed Home Health Providers among many others

✤ Home Health providers are eligible for Alternative Sanctions for conditional deficiencies and Immediate Jeopardy depending on severity

✤ Alternative Sanctions can be monetary fines

ACA Initiatives

✤ Integrated Care Partnerships

✤ Share risk (and reward) across various

✤ Patient Center Medical Homes

✤ Accountable Care Organizations

✤ Community Benefit

Vendor Relationships

✤ More appropriate with for-profit organizations

✤ Setting up contract opportunities with pre-established rates and service level agreements

✤ Could be done as a part of a preferred provider agreement

When you get home...

✤ Consider contacting national trade organizations

✤ VNAA

✤ State Organizations

✤ NC Association of Homecare & Hospice

✤ Talk with local hospitals to identify existing key partners

Summary

✤ Home care is growing

✤ Home care as a partner

✤ Home care needs us

QuestionsJody.Moore@advhomecare.org

@HealthCare_EM

Acknowledgements

✤ Advanced Home Care

✤ Guilford County Emergency Management

✤ NC Office of EMS Healthcare Preparedness, Response, & Recovery Program

✤ Triad Regional Advisory Committee

Thank youJody.Moore@advhomecare.org

@HealthCare_EM