Tag Archives: Home care

New AHCCCS Policy Supports IC Model for Home Care

There are big changes ahead for the elderly and disabled in Arizona, and the organizations that support them in providing their care. Dara Johnson, AHCCCS’s Long-Term Care Program Development Manager confirmed, “The implementation of the system and operational changes to allow for the use of Independent Contractor business model by direct care service agencies is planned for January 2018.”

When it comes to taking care of our most vulnerable population, Arizona is leading the nation in innovation and action. Wendy Swager, CEO of Soreo, Southern Arizona’s largest provider of In-Home Support Services to Medicare and Medicaid recipients added, “This is an exciting time for providers and agencies in Arizona as AHCCCS rolls out new policy and regulations that accommodate the use of direct care workers who elect to be independent contractors.”

Julie Pace, Senior Member of the Cavanagh Law Firm, named as one of America’s and Arizona’s Leading Lawyers for Business, Labor and Employment Law, further emphasized Arizona public policy is, and should remain, that Arizona state government agencies provide fair treatment of individuals and businesses who choose to utilize independent contractor business models for a variety of legitimate reasons. The Governor has supported and the Arizona Legislature has enacted multiple bills in recent years to clarify, confirm, and expand the flexibility and choice exercised by individuals and businesses to achieve the mutual benefits of independent contractor relationships. 

Those benefits can include:

  1. Greater income and flexibility for direct care workers
  2. Greater ability for businesses to operate within the payment parameters of AHCCCS
  3. More cost-effective delivery of services for taxpayers
  4. Superior services for clients, due in part to the ability to attract and motivate service providers who can be economically successful while providing the challenging services expected of direct care workers

Below are specific policy updates that took effect on October 1, 2017, impacting the Independent Contractor business model. For more details on these revisions, you may refer to an AHCCCS memo share on September 20th regarding the AHCCCS Medical Policy Manual (AMPM).  

Chapter 1200, Policy 1250-D, Respite Care
AMPM Policy 1250-D was revised relative to the ALTCS EPD Contract effective 10/01/17. Policy changes were made to accommodate the use of the Independent Contractor business model, align with AMPM 1240-A, and adopt new fingerprint clearance and background check requirements. Lastly, technical corrections were made to standardize and align terminology across AHCCCS policies, adopt new formatting and improve clarity.

Chapter 1200, Policy 1240-E, Habilitation Services
AMPM Policy 1240-E was revised to align with the FY 2018 ALTCS EPD Contract, accommodate the use of the Independent Contractor business model and adopt new fingerprint clearance and background check requirements. It was also modified, with input from the ASD Advisory Committee, to reflect person-centered language, as well as to streamline and clarify content.

Chapter 1200, Policy 1240-G, Home Health Services
AMPM Policy 1240-G establishes criteria for medically necessary home health services for ALTCS members. Substantive policy changes were made to align with the ALTCS EPD Contract effective 10/01/17, accommodate the use of the Independent Contractor business model by DCW Agencies, and revise to streamline, clarify and reorganize content.

With a powerhouse organization such as AHCCCS behind the Independent Contractor model, we anticipate seeing major changes in the industry that may breathe new life into care providers in Arizona.

Independent Caregiver Management Tools

As a market leader, Openforce empowers Home Care agencies and providers through its modern technology platform assisting with onboarding, settlement, compliance, and other administrative tasks allowing care providers to better respond, grow and deliver the highest level of care. 

When Mosaic, an organization serving people with intellectual disabilities, decided to incorporate independent caregivers, the senior leadership team knew about the labor shortages, minimum wage issues, and health care reform challenges facing home care agencies and host home providers. But Mosaic was mainly thinking about its clients. Read how Mosaic addressed their pressing need to adopt a modern technology platform to help dramatically streamline operations while delivering high-quality member care.

Exclusive Deals & Discounts for Openforce Members

As an Openforce member, you already have access to incredible savings at your fingertips. Because of our purchasing power, we are able to pass through valuable benefits, programs and services for our members. A great example is the Working Advantage network, which allows Openforce members to save up to 60 percent on ticketed events and online shopping.

blog-graphic-summer-offers.pngHow Do I Get Access?

  1. Login to your Member Benefits in the self-service online portal and click on the ‘Entertainment’ tab
  2. Click on the ‘Working Advantage’ icon
  3. Call the 800-number or click on the link for access to the Working Advantage website to register
  4. Be sure to enter the Member ID located on the page

By extending some budget-saving tips to your vacation planning, you won’t be stuck breaking the bank with your summer getaway. Sure, it might take a little more preparation ahead of time, but knowing you got a nice deal will help you relax the time away. Happy planning and vacationing this summer!

Life as an Independent Caregiver

ejay.pngI recently had the pleasure of meeting Ejay Bustamante, an independent caregiver at Mosaic’s Partners & Possibilities event in Phoenix. Standing near the entrance of a busy city restaurant, I took in the sight of a man with a warm, engaging smile, his arms firmly wrapped around a young man clearly in need of his full attention. He spoke softly but firmly in his ear, helping him to understand and enjoy this unfamiliar environment. Very near to him, one on each side of Ejay were two more boys, excited and chatting easily with Ejay about their festive evening ahead. A family, in every sense of the word, out for the evening just like any other family might be.

Although I had never met Ejay and his boys before, I could instantly understand the complexity of what his daily life must look like. Inside this world, time stands still as you become lost in the minutia of getting through the day. Any small activity we may take for granted, like brushing our teeth, can take on a whole new meaning when it becomes a milestone of someone’s successful accomplishment. Drawing from my own personal experience of raising my daughter with autism and intellectual disabilities, I know caregiving can be complicated and is often exhausting.

Sometimes we just need help, another caring pair of hands to do the hard work that’s required to wash and to feed, to sing songs and to care for the beautiful souls that can’t take care of themselves. I know that there is no more worthwhile pursuit in life than to give of your time and energy in this way. Ejay knows this, too. Here is a man who understands, who gives without counting the cost. And I hope that by sharing this brief interview with Ejay Bustamante, you will also have the chance to get to know a little more about what spurs him on to be the light in the world of three boys.

Here is the story of Ejay and his incredible host home family.

Can you tell us a little bit about your background and how you transitioned into caregiving?

After 35 years as a Respiratory Therapist working in Pediatric & Neonatal Pulmonary ICU, the physician that I worked under and I both decided to retire. My best friend had opened a Day Program for special needs adults and needed someone to oversee his staff’s training department. I have always enjoyed teaching, so it was a great fit. And now 17 years later, I still do some of the staff training.

One day a young man was brought to the Day Program in search of a host home. Something just told me that he needed me and I could do it. I asked the Mosaic manager that accompanied him what I needed to do to be that home. Now here I am, over 10 years of being a Host Home Provider for three men.

mosaic-logo.jpgIn your experience, what are some benefits of being an independent caregiver with Mosaic?

I think that the best benefit for me is all the support that I receive. My manager is always there when I need her, even when I just need to talk. The Mosaic team are like family to me, especially since I don’t have family here in Arizona.

I also really like the self-service tools in the Openforce self-service portal. I’m able to see and print anything that has to do with my settlements. It’s helpful to be able to print and have proof of my settlements any time I need it. It’s also very convenient to have all my documentation in order in one spot.

Please share a little bit about your three boys and how you came into each other’s lives.

Anthony (Tony) was the young man I mentioned previously. He was brought to the Day Program where I worked and needed a home. Again, I just felt something that told me he needed me or I needed him.

When I learned of Kenneth (Kenny), his mother at the time was a case worker for the state of Arizona. One day she asked me if I ever thought of bringing another person into my home and if I would consider Kenny. Kenny also was attending the Day Program. Not too long after, I moved into a larger home and had more room. That’s when I contacted Kenny’s mother and in about a month, Kenny moved into my family.

I also had a room that I was using as an office. While I was in no hurry to add to our family, after some time I decided to start looking for a third person. Then one day I got a call from Mosaic. There was a young man, Victor, whose family was elderly and could not continue to care for him. Mosaic asked if I would consider meeting with him and his family, so I gladly met with them for a couple of hours.

At the end of the visit, Victor decided that he would like to live with me, and his mother asked that I consider it. I immediately shared that I didn’t have to think about it and that my decision was already made. Again, I just had that feeling in my heart and said yes. A month later, Victor moved in and became part of this family.

What does your typical day look like for you?

My morning starts early around 4:45 a.m. with a daily morning prayer, a shower, and I get myself ready for the day. That’s quickly followed by packing the boy’s lunches and getting things prepped for breakfast.

At 6:00 a.m., Tony is first to get up. I’ll brush his teeth, get him dressed, and then he goes out to watch some television in the family room. Next I wake Kenny and Victor, then start to make breakfast. I’ll brush Kenny’s teeth, get him dressed, and he’ll go back to his room to watch television. Finally, I help Victor brush his teeth and he’s able to dress himself. With everyone ready, the boys take their medications and have breakfast.

Around 8:00 a.m., we’ll leave together for the Day Program and while the boys are in the program, that’s when I’m off to work. I pick up the boys from the program about 4:00 p.m. and we all head home. As soon as we get home, I start making dinner while the boys relax from the day. We enjoy dinner together and I clean up afterwards.

From 6:30 to 8:30 p.m., our evenings are filled with different activities with the boys that can range from hobbies at home or nights out with the bowling league. It just depends on the night and what’s on the schedule. Later in the evening, Tony, Victor, and Kenny take their medications and shower before bed. By then it’s around 10:00 p.m. and I’ll pick up the house, work in some laundry, and end the day with a nightly prayer before bed. Outside of the activities, it’s structured for the most part, but that works well for all of us.

What are your biggest challenges as a caregiver?

I don’t consider anything as a big challenge. I look at things as just a speed bump in life. Any challenge can be conquered with time.

What are the biggest gains your boys have made in the past year?

Each of the boys have made great strides this past year. Tony started speech therapy to help him follow directions easier. He’s made a lot of progress and can now follow two- to three-step directions. Kenny is now able to look up some things on a computer. He loves YouTube. And Victor and I have joined a bowling league, which he enjoys and it’s also increasing his social skills.

email-ancor-logo.pngANCOR Recognizes Ejay Bustamante

I recently returned from the 2017 American Network of Community Options and Resources (ANCOR) conference in San Antonio, which brought together hundreds of attendees who represent private community providers for individuals with intellectual and developmental disabilities.

Since 2007, ANCOR has honored exceptional Direct Support Professionals (DSP) with the Direct Support Professional Recognition Award for exemplary work in furthering community inclusion and full participation for the many Americans living with intellectual, developmental, and other disabilities.

It was wonderful to see Ejay recognized from this year’s field of 245 nominees as ANCOR’s Direct Support Professional (DSP) of the Year for Arizona. His story just scratches the surface of the amazing work caregivers do each day to provide compassionate care that is more dependable and fulfilling. Congratulations, Ejay! You truly deserve to be celebrated for opening a life of possibilities for your host home family.

Technology Drives Savvy Home Care Agencies to Succeed

A good place to start is with a backend technology solution. The best platforms offer built-in independent care model infrastructure that helps navigate specific challenges and mitigate risk. At the same time, using technology solutions can reduce operating costs and help match service capacity with patient needs.

Modernizing Operations to Meet Internal & External Demands

Following are three ways technology-driven solutions can help you streamline both operational and compliance practices:

1. Prescreen Independent Caregivers
Posting vacancies on recruitment sites, manually reviewing each candidate, and evaluating qualifications is a cumbersome process that leaves many agencies struggling to move independent caregivers through this process and into the field. By implementing an automated prescreening process, organizations can leverage various compliance workflows according to certifications, locations, and a variety of other screening services to expedite the vetting process. This helps ensure that caregivers are compliant and qualified to provide services prior to allocating valued time and resources to move them to onboarding.

2. Navigate Negotiations
Treating independent caregivers as an extension of the agency rather than as a separate business entity can lead to costly compliance violations. Recording the negotiation process prevents exploitation of either entity and minimizes potential compliance issues. Leveraging software with an interactive negotiation platform provides a neutral landscape to digitally capture the negotiation interaction. If the negotiating parties establish a deal or contract using this type of solution, the agreement is documented with clearly established terms that are acceptable for each of the negotiating parties.

3. Establish an Audit Trail
Regulations, labor laws, litigation and audits are constantly in the media. As such, providers need to ensure the defensibility of their compliance strategies. Clear implementation of best practices and documentation of those practices are essential components to withstand regulatory scrutiny. Having a complete end-to-end audit trail tracking the entire independent caregiver interaction lifecycle can seem like an arduous process. But with caregiver management software, agencies can digitally track necessary interactions to provide supporting evidence of its compliance plan and limit vulnerabilities.

Overall, leveraging technology allows agencies to take a proactive approach. Additionally, implementing a tailored solution to ensure your best practices are consistently followed through custom-built workflows helps you work smarter, reduce risk, and streamline operations.

See it in Action with Mosaic
Read how a modern technology platform enabled Mosaic to migrate more than 600 host home independent caregivers across 36 agencies in 10 states into a new, automated system, allowing them to better respond, grow and succeed in home care.

Download the Whitepaper


Can You Survive the Changes Facing the Home Care Industry?

*PHI: U.S. Home Care Workers

blog-homecare-stats.pngWhat’s the Impact?

A significant care gap is emerging. The greater demand for home care services, and a labor force that’s experiencing little growth is resulting in a short supply of caregivers to provide home care services. Furthermore, the matter of quality of care becomes more important than ever.

If that wasn’t enough, two additional factors are ramping up the demand for home caregivers:

  1. The Affordable Care Act (ACA)
    In 2010, President Obama signed the Affordable Care Act (ACA), which put in place comprehensive health insurance reforms that put consumers back in charge of their health care. Ever since the U.S. Supreme Court declared the ACA constitutional, healthcare organizations have been scrambling to recreate their business models. Now that incentives are centered on keeping patients out of the hospital, rather than maintaining capacity, organizations are being forced to run much leaner, and much more cost effectively than ever before.

    Furthermore, the ACA has caused a surge in the number of individuals and families seeking adequate healthcare coverage. While this has helped to provide health insurance to previously uninsured Americans, it has also emphasized the growing health care workforce shortage and created somewhat of an overburdened healthcare system.

  2. Minimum Wage Increase
    At the start of 2017, minimum wages increased in 19 states, a shift that will lift pay for millions of individuals. According to the Economic Policy Institute, about 4.3 million low-wage workers across the nation are slated to receive a raise. Though the federal minimum is supposed to rise with inflation the last significant change was in 2009, when it was set at $7.25 an hour. Thus, the shortage of home health care workers is being blamed on wages that have driven some providers out of the industry. Take Wisconsin, for example:

    A survey conducted by the Survival Coalition of Wisconsin Disability Organizations shows that 95 percent of individuals needing home health care have a hard time finding workers. The survey also showed that 1 in 5 people are thinking about moving out of their home and into a nursing facility because of the workforce crisis.

Alternative Ways to Cut Cost & Meet Demand

Many home health providers have begun to feel immense pressure to reduce operating costs, and as such, have turned to alternative staffing strategies and independent caregiver management software to reduce operating costs and match service capacity with patient needs.

Independent caregiver management software allows home care companies to:

  1. Remove the burdens of back-office administration and accelerate onboarding and processing related to pay with real-time verifications.
  2. Capture all contractual and compliance documentation in an automated, web-based environment with the ability to create custom enrollment workflows that can accommodate a variety of complex compliance requirements.
  3. Tracks back and forth communication in an audit trail, and captures the final negotiated rate safeguarding both parties from any ‘hearsay’ issues related to the agreement.

Additionally, as the workforce shortage continues to become more prominent, independent caregivers can offer home care organizations with supplemental resources. Not only will this provide additional support, but it will allow organizations to help ‘fill the gap’ in relation to the workforce shortage, and alleviate a great deal of the operational burdens faced by today’s providers.