In The News

Supreme Court Declines to Hear Case Against Home Health Certificate of Need Laws

Home Health Care News | By Andrew Donlan
 
A home health care company hoping to operate in Louisville, Kentucky has hit a road block in its fight against Certificate of Need (CON) laws.
 
CON laws vary by state. Some have home health CON barriers, while others do not. That results in some states having far more home health agencies than others.
 
Because Kentucky has CON laws in home health care, Dipendra Tiwari and Kishor Sapkota – two Nepalese immigrants – were met with resistance when they tried to open up an agency specifically tailored to the Nepali speaking people of Jefferson County and Louisville.
 
Due to language barriers, Tiwari and Sapkota believed that there was a need for home health care services in the community, and were hoping to keep more Nepali-speaking people out of nursing homes by offering up these services. The agency was to be dubbed Grace Home Care.
 
After a request for a CON was denied by the state of Kentucky, Tiwari and Sapkota filed a lawsuit. The lawsuit was dismissed, however, and eventually, they requested for the U.S. Supreme Court to review their case. They failed to convince the court, however.
 
“In these cases, the challengers often mischaracterize what CON laws do, what they represent and how they actually function,” Matt Wolfe, a shareholder at the law firm Baker Donelson, told HHCN in an email. “Each state’s CON law operates a little differently, but every CON law allows for and encourages public input, involves various stakeholders – including businesses, providers, and patients – and is flexible to adapt its approach to the changing needs of the communities it covers.”
 
CON laws have undergone much legal scrutiny in the past, something that Wolfe does not think will stop just because of this case in Kentucky.
 
Home Health Care News has reported on the pros and cons of certificate of need laws in the past. While some believe that CON laws uphold quality in home health services, others argue that it hurts access and also deters competition. In Tiwari and Sapkota’s case specifically, they were trying – in part – to argue CON laws are unconstitutional.
 
“There is a coordinated and well-funded campaign by ‘free market’ special interest groups to continue to bring these types of legal challenges to the constitutionality of CON laws in federal and state courts,” he said. 
 
And while the cases against CON laws often make intellectual sense, Wolfe does not believe that the evidence has created a good case against them.
 
“CON laws play an important role in ensuring access to quality, affordable care,” he said. “The reality is that health care is not provided in a free market. Repealing or substantially limiting CON laws would do nothing to address access issues. In fact, in states that have repealed CON laws, we have seen a proliferation of providers with no appreciable improvement in access. Instead, home health agencies experience small and unsustainable patient censuses.”
 

Do We Choose When We Die?

Barbara Karnes

Dear Barbara, my mother suffered from dementia. She passed away in 2019. I was at her side and saw her take her last breath. Does a person with dementia know that she is dying? Neither of my sisters made it over before she died but I believe that she waited for them until the last minute.

You asked if I think your mother waited for your sisters to arrive before she died even though she had dementia. Yes, I do believe a person has some limited control over the time that they die, even if they have dementia.

If you are present with a person at the moment they take their last breath, you are there because they wanted you there. If you are not there, just missed the moment, tried to be there but weren’t, that was a choice also. Generally, it is a choice of love and protection. For some reason the dying person thought it would be better if you weren’t there. Being there and not being there are both gifts.

I believe we are more than our physical body, that there is a “driver” to this vehicle we call our body. It is the “driver” that has control beyond the physical. The “driver” does not have dementia, so the “driver” is aware.

Know that the driver is working very hard to release from a non-functioning body. I do not believe what we would think of as “normal thoughts” are going through the person’s mind, whether they have dementia or not.

Read Full Article
 

New Resource Available: PHQ-2 to 9 Cue Card

CMS is offering a cue card to assist providers in coding the Patient Health Questionnaire (PHQ-2 to 9) as referenced in the coding guidance for D0150. This resource is intended to be utilized during the Patient Mood Interview as a supplemental communication tool that provides a visual reference to assist patient selection of symptom frequency.

The cue card is offered in two sizes which can be viewed or printed and is available in the Downloads section of the HH QRP, IRF QRP, and LTCH QRP Training pages.

If you have questions about accessing the resources or feedback regarding the trainings, please email PAC Training. Content-related questions should be submitted to the HH QRP Help Desk, IRF QRP Help Desk, or LTCH QRP Help Desk.
 

REVISED: Case Management Redesign (CMRD) Rule RevisionStakeholder Feedback Meeting Series

Based on the progress in meetings held so far, the Department has made some changes to the schedule of the CMRD Rule Revision stakeholder meeting series. Please see the current schedule below.

The Department wants to hear from stakeholders about each of the rule revision topics listed below to ask questions and receive feedback based on your knowledge and experience with navigating HCBS rules. The goal is to make these rule revisions work for all HCBS stakeholders. The Department will post the section of rule or waiver to be discussed on the CMRD webpage one week prior to each meeting. Stakeholder engagement, feedback, and Department responses will be tracked through listening logs posted on the CMRD webpage.

Note: The 2023 meetings below will be posted on the OCL Stakeholder Engagement Calendar before the end of December, 2022.

 

The meeting access information for all the CMRD meetings is the same:

Join via Zoom

Meeting ID: 873 9014 4539, Passcode: 597847

Join via Phone:

Toll-free: 1-877 853 5257

 

Tuesday Dec. 20, 2022 & Tuesday Jan. 3, 2023

THESE TWO MEETINGS HAVE BEEN CANCELED

 

Tuesday Jan. 17, 2023
9:00 -11:00 a.m. MT

Case Management Agency Requirements. This meeting provides explanation and review of changes/updates to the Case Management Agency Requirement rules as it relates to CMRD, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.

 

Tuesday Jan. 31, 2023
9:00 -11:00 a.m. MT

Case Management Requirements and client Rights and Responsibilities. This meeting provides explanation and review of changes/updates to the Case Manager's Requirements and client Rights and Responsibilities rules as it relates to CMRD, including stakeholder feedback and responses as they relate to the rule language, clarity and flow. 

 

Tuesday Feb. 14, 2023
9:00 -11:00 a.m. MT

Case Management Rules / Follow-up Sessions / Halfway Point Check-in. We will do a review of everything we have gone over in the sessions that proceeded regarding case management rules as they relate to CMRD, including stakeholder feedback and responses as they relate to the rule language, clarity and flow. 

 

Tuesday Feb. 28, 2023
9:00 -11:00 a.m. MT

HCBS Benefits and Services Rules, Part One. This is the first of a three-part explanation and review of changes/updates to the HCBS Benefits and services rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow. 

 

Tuesday March 14, 2023
9:00 -11:00 a.m. MT

HCBS Benefits and Services Rules, Part Two. This is the second of a three-part explanation and review of changes/updates to the HCBS Benefits and services rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow. 

 

Tuesday March 28, 2023
9:00 -11:00 a.m. MT

HCBS Benefits and Services Rules, Part Three. This is the third of a three-part explanation and review of changes/updates to the HCBS Benefits and services rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow. 

 

Tuesday April 11, 2023
9:00 -11:00 a.m. MT

HCBS Provider Requirement Rules. Explanation and review of changes/updates to the HCBS Provider requirement rules, including stakeholder feedback and responses as they relate to the rule language, clarity and flow. 

  

Tuesday April 25, 2023
9:00 -11:00 a.m. MT

Wrap-up, Follow-up, Next Steps in the Process. We will wrap up everything we have gone over and discussed regarding the changes and updates to the HCBS rules and explain what happens next, including stakeholder feedback and responses as they relate to the rule language, clarity and flow.
 

FRIDAY DEADLINE to Submit 2023 Speaker Proposals!

The HHAC conference is known for offering up to date education on relevant topics within Home Care, Hospice, Private Duty and general topics that cover all three of these tracks. Do you have a hot topic that you would like to submit to present at the 2023 Conference in Beaver Creek, CO, May 17-19, 2023? Take a look at what you will need during the submission process and submit your proposal before December 9, 2022 in order to be considered during the review process.

DEADLINES:

Submission Deadline: December 9, 2022
Review Period: December 10, 2022 – January 5, 2023
Accepted Presenters Notified By: January 18, 2023

Submission Materials:

  • Lead presenter information (Name, Contact Information, Bio and Headshot)
  • Any Fees that are charged for the presentation
  • Presentation title
  • Presentation description
  • 3 learning objectives
  • Applicable track the the presentation would fall under
  • Level of the content
  • Target Audience

Other Information

  • For the annual conference, the primary presenter will receive a 50% discount on conference registration.  A second presenter will receive a 25% discount on conference registration.  Additional presenters must pay applicable conference registration fees in full. Speakers are required to register for conference if they plan on attending any sessions outside of their presentation.
     
  • If selected to speak at the annual conference, you will be contacted by the Meeting Planner for the conference to complete the Speaker Agreement and provide all of the required information.  

CLICK HERE for more information & to submit proposal.
 
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