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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
Acknowledgements
✤ Advanced Home Care
✤ Guilford County Emergency Management
✤ NC Office of EMS Healthcare Preparedness, Response, & Recovery Program
✤ Triad Regional Advisory Committee