Florida Association of Homes and Services for the Aging
December 13, 2007 Vol 15, Issue 2
Hands  FAHSA LINK
 
Welcome to this week's edition of the FAHSA Link.
 

First Series of FAHSA Regional Meetings Scheduled:  Mark your calendar now to participate in this exciting value-added service -- One of the "Big Ideas" adopted by the FAHSA Board is to hold periodic regional meetings throughout the state that give members an opportunity to network and learn while earning continuing education credit.  At each of these meetings, an educational presentation will be made on a topic that is of interest to all members.  In addition, attendees will have the opportunity to participate in a roundtable discussion for their membership type.  The first group of regional meetings will feature Morrison Senior Dining's "Voice to the Silent Generation".  Tentative dates for these meetings are as follows:

  • February 26-  Southeast Florida Regional Meeting (Districts 7 and 8)
    11:00am to 3:15pm, John Knox Village of Florida, Pompano Beach
  • February 27- Southwest Florida Regional Meeting (Districts 9, 10, 11 and 12)
    11:00am to 3:15pm, Shell Point Retirement Community, Ft. Myers
  • February 28-  Central Florida Regional Meeting (Districts 4, 5, 6, and 13)
    11:00am to 3:15pm, Village on the Green, 500 Village Place, Longwood
  • February 29-  North Florida Regional Meeting (Districts 1, 2, 3, and 14)
    11:00am to 3:15pm, River Garden Hebrew Home for the Aged, Jacksonville

TaxWatchPicture


Taxation and Budget Reform Commissioner Unveils Proposal at TaxWatch Meeting
- 
Janegale Boyd, President/CEO, attended the Florida TaxWatch Board of Directors meeting on December 12th.  FAHSA is a member of TaxWatch, which is a 501 (c)(3) nonprofit, nonpartisan research institute, focusing on pertinent property tax, health care, and a wide variety of issues which affect FAHSA members' services and care for seniors.  During yesterday's TaxWatch presentations, Commissioner Carlos La Casa of the Florida Taxation and Budget Reform Commission spoke about his proposal for restructuring Florida's property tax system.  This proposal would be a substitute for the proposed constitutional amendment on property tax reform that passed during the last special session of the Florida Legislature and would include the following:

 

·         Homeowner receives tax exemption worth half the property's market value.

·         Increase state sales tax from six cents to seven cents to cover resulting $12 billion loss to schools.  Would sunset in three years.

·         Non-homestead property owner limit of assessed value growth to 5 percent annually.

 

This does not replace former Senate President John McKay's proposal to eliminate some existing sales tax exemptions.  Discussions were held on how this would affect and change Florida's tax structure to allow the collection of more revenue to meet state obligations.  From FAHSA's membership perspective, elimination of certain sales tax exemptions could be very detrimental to residents who are service-dependent.  A periodic review would be more palliative.

 

Additionally, FAHSA members Litha Berger, Secretary (Douglas Gardens Senior Housing);  David Grofic, Associate Member Representative (Sandhill Cove); and Sr. Mary Ann Dennehy and Thomas Peterson (Lourdes-Noreen McKeen Residences) attended the Florida TaxWatch luncheon.   Lieutenant Governor Jeff Kottkamp, Chief Financial Officer Alex Sink and Speaker of the House Marco Rubio made presentations. Members attending thanked Alex Sink, CFO for office positive intervention on member issues.  

 

HIV/AIDS Education Glitch Bill Passes First House Hurdle

- Thanks to the initiative of our House Sponsor, Joyce Cusack (D-DeLand), HB 153 was the first bill to be heard in the House Health Quality Committee.  HB 153, which would eliminate the biennial HIV/AIDS training mandate for employees of facilities licensed under Chapters 395, 400, and 429, Florida Statutes, passed unanimously out of its first committee of reference this week with 14 cosponsors.  Should the bill become law, employers would still have the option of requiring additional training on HIV/AIDS if they feel it is necessary. 
 
Legislative Committee Meetings Focus on Bills Filed for 2008 Regular Session
- Although the 2008 Legislative Session does not begin until March 4, several bills on various topics were heard in substantive committees this week.  In preparation for Session, the results of legislative Interim Study Reports were also presented in the Senate.  (See related article on Home Health Agency Interim Study.)
In This Issue
District and Membership News
Education News
General News
Housing News
Home and Community-Based Services News
Legislative News
Nursing Home News
Preferred Business Associates News
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Group Purchasing Organizations
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FAHSA Quick Links
District and Membership News

Annual Membership Survey Underway - If you haven't filled out this year's Annual Membership Survey, please take a moment to do so now.Check your E-mail in-box for the Annual Membership Survey link. This vital survey will help us better serve you in the coming year.

 

US Representative Jeff Miller Visits Azalea Trace - This week, Congressman Jeff Miller (R- District 1) paid a quickly-arranged visit to Azalea Trace.  Miller initiated the visit to the Panhandle continuing care retirement community which he has toured in the past. Executive Director Jeff Rock discussed a number of federal funding issues with the Congressman, using a briefing paper on nursing home and affordable housing funding prepared jointly by FAHSA and AAHSA public policy staff.  The staff and administration at Azalea Trace always do a great job of educating state and local elected officials about issues that affect elder Floridians.

 

Vicar's Landing Recommended for Gold Seal - Congratulations to Vicar's Landing!  At the December 10, 2007 meeting of the Gold Seal Panel, the Vicar's Health Center was recommended for Nursing Home Gold Seal Award.

 

District 5 Meeting a Success - Richard Lewis, District 5 Chair, held their annual holiday luncheon on December 5.  Eighteen FAHSA members attended the meeting. The guest speaker was Michele Morales from Quintairos, Prieto, Woods & Boyer, PA, who gave a presentation on hiring the best employees to fulfill your mission. Thanks and congratulations to Richard for an interesting and successful meeting.  District Chairs who are interested in learning more about the topics presented at the meeting and replicating the program locally should contact their FAHSA staff liaison.

 

District 10 Meeting Held at Plymouth Harbor - FAHSA's District 10 Chair Dorothy Barichak hosted a holiday luncheon and District 10 meeting at Plymouth Harbor yesterday.  Erwin Bodo, Ph.D., FAHSA's COO and Gail Matillo, FAHSA's Director of Housing and Program Development gave an overview of Florida Senior Care, affordable housing issues, and an update on FAHSA public policy priorities. Approximately sixteen FAHSA members attended the meeting.

 

State Senator Addresses District 7 Members - Sen. Dave Aronberg (D-Greenacres) spent 30 minutes with District 7 members who met at the MorseLife campus for a luncheon meeting this week.  Aronberg, a frequent visitor at Morse, discussed a number of public policy issues with the eight facilities represented at the meeting.  In addition, Teresa Lim from AON Work Solutions (a FAHSA Preferred Business Associate) was on the agenda to speak.  Congratulations to Mo Funk for a planning a successful well-attended district meeting.

 

Upcoming Membership Events:

  • January 8 & 9 - FAHSA Board of Trustees Meeting, Boca Raton Resort & Club, Boca Raton
  • January 15 & 16 - Advanced Leadership for Nurse Leaders, Safety Harbor Resort & Spa, Safety Harbor
  • February 26 -  Southeast Florida Regional Meeting (Districts 7 and 8)
    11:00am to 3:15pm, John Knox Village of Florida, Pompano Beach
  • February 27 - Southwest Florida Regional Meeting (Districts 9, 10, 11 and 12)
    11:00am to 3:15pm, Shell Point Retirement Community, Ft. Myers
  • February 28 -  Central Florida Regional Meeting (Districts 4, 5, 6, and 13)
    11:00am to 3:15pm, Village on the Green, 500 Village Place, Longwood
  • February 29 -  North Florida Regional Meeting (Districts 1, 2, 3, and 14)
    11:00am to 3:15pm, River Garden Hebrew Home for the Aged, Jacksonville
  • April 14 - FAHSA Board of Trustees Meeting, Wingate Inn, Tallahassee
  • April 15 & 16 - FAHSA's Legislative Workshop, Tallahassee Leon County Civic Center, Tallahassee
Education News

FAHSA's 5th Annual Dynamic Directions Advanced Nurse Leadership Workshop will be held on January 15-16, 2008 at the Safety Harbor Resort & Spa.  Don't miss this opportunity to gain knowledge from the experts.  READ THE BROCURE and REGISTER ONLINE.

 
FAHSA's Next Webinar -- Medicaid Billing with Florida's New Fiscal Agent, EDS, takes place on January 22. The current Medicaid fiscal agent contract with ACS will end on February 29, 2008. The new fiscal agent, EDS, will begin claims processing on March 1, 2007, so it's important to make this training a part of your "To Do" list. READ THE BROCHURE and REGISTER ONLINE.

 

Upcoming Educational Events:
  • January 15 & 16 - Advanced Leadership for Nurse Leaders, Safety Harbor Resort & Spa, Safety Harbor
  • January 22 - Webinar - Medicaid Billing with Florida's New Fiscal Agent - EDS,  2:00 p.m. EST
  • January 29 - Webinar - FAHSA's CCRC Occupancy Issues, 2:00 p.m. EST
  • April 15 & 16 - FAHSA's Legislative Workshop, Tallahassee Leon County Civic Center, Tallahassee

FAHSA Calendar of Events

General News

User Fees Likely to Replace Lost Revenues from Property Tax Cuts - It looks like some cities will be adopting user fees and special assessments to replace lost property tax revenues. Seven cities in Volusia County recently announced that they are looking at an assessment for fire and medical rescue services to cover expenditures that traditionally have been paid with general property taxes.  Elsewhere, cities are considering new fees or increases in existing fees for water, sewer use, storm water drainage, garbage pickup, development impacts, building permits, burial plots, library use, park and pool use -- and more.

For many local governments, last summer's legislative-mandated cuts in property taxes were manageable. But the upcoming statewide Jan. 29 ballot issue that further lowers taxes for homesteaded properties could cut into funding for basic services. Estimates suggest the Jan. 29 plan, if passed by voters, would save a homesteaded property owner an average of $240 in the first year. There is a possibility that some residents could end up paying more in user fees.

Now is the time to keep an eye on what is happening in your city and county. If a user fee or special assessment is proposed, attend public hearings with your residents and testify about the impact on your organization and the elders you serve. Ask for your community to be exempt or assessed a lower fee.  If you provide affordable housing with below-market rents, you probably have a fair chance of obtaining relief. Most importantly, don't think that someone else will carry the message for you.

Housing News

FAHSA Members Meet with HUD Officials - On Monday, December 10, Janegale Boyd, FAHSA's President/CEO; Gail Matillo, Director of Housing; Alma Ballard, FAHSA's Chair and Executive Director of Family Housing Management, Inc.; Litha Berger, FAHSA's Secretary and Director of Douglas Gardens Senior Housing; James F. Emerson, AAHSA's Housing Cabinet and CEO of Westminster Communities of Florida; and Steve Protulis, CEO of EHDOC met with the following Jacksonville HUD Office staff:  James Branson, Field Director, Laurelei McKnight, Supervisory Project Manager, and Vonceil Williams, Project Manager.  Our members discussed preservation of affordable housing units, the sale of non-profit buildings, and the loss of points in funding competition. 

 

By the year 2014, more than 18,000 units of affordable housing stock could possibly disappear to companies that are eager to purchase the property to build luxurious condominiums or to "flip" the buildings in a few years to make a large profit.  FAHSA is concerned about the low-income residents living in these communities, especially if the new owners begin changing to a variable rent structure, or tiered rent structure to include higher-income tenants.  Developers are contacting some boards of directors of FAHSA-member communities directly about possibly purchasing your property.  If you receive any calls from companies wishing to purchase your property, please notify Gail Matillo by E-mail: gmatillo@fahsa.org. 

 

Two New Items of Interest on HUD Web site -- HUD has posted two new items on its multifamily housing Web site.  The first is a national list of physical inspection scores, and the second is a link where sites can post information about housing vacancies.  Look up your most recent score. You can also look for where owners and management agents can list vacant units at HUD insured/assisted properties on for the new Rental Vacancies System. 

 

FAHSA Housing Alert Page

Home and Community-Based Services News

Senate Interim Report Recommends Cap on Licenses for New Home Health Agencies - This week, the Senate Committee on Health Regulation was provided with a presentation by its staff on the results of an Interim Study on regulatory requirements for home health agencies.  As expected, legislative staff is recommending a time-limited cap or moratorium on the licensure of new agencies by geographic region.  The cap would slow the growth in home health agencies that has occurred since the certificate of need requirement was repealed in 2000.  (As of Aug. 23, 2007, there were 1,865 licensed home health agencies.)

 

Other staff recommendations included in the report are as follows:

·         Require both the home health agency and director of nursing to notify the Agency for Health Care Administration (AHCA) of a change in the director of nursing prior to or on the date of change.

·         Require the Department of Health and the AHCA to cooperatively develop a rule addressing standards of care related to responsibilities of a director of nursing for home health agencies.

·         Limit the number of patients for which a director of nursing may be responsible.

·         Require AHCA to conduct surveys of home health agencies more frequently, especially within the first 9-15 months of operation.

·         Enhance the administrative penalties that may be imposed for deficiencies.

·         Require AHCA to review the pre-certification process for authorizing visits by home health agencies in excess of the 60 visits per lifetime cap, conduct an audit of the contract provider performing this function, and modify contractor performance expectations.

·         Require AHCA to assure that the Medicaid payment system disallows payment for home health services paid for by Medicare to a dually-eligible recipient during the same 60-day episode.

View the report, which contains an excellent summary of home health agency regulatory requirements.
 

AHCA Calls for More Stringent Regulation of HHAs Including Hefty Fine for In-Kind Services to ALF Residents - A spokesperson for AHCA addressed the Senate Health Regulation Committee this week.  He talked about the proliferation of home health agencies, particularly in Miami Dade County since the certificate of need was abolished in 2000.  He spoke about cavalier attitudes of licensees and a decline in the quality of care.  Among other things, AHCA is recommending limiting new licenses to five per month in each AHCA service area; increasing fines for violations; limiting administrators and directors of nursing to serving no more that two agencies simultaneously; creating a $5,000 fine for failure to follow a physician order; creating a fine of up to $1,500 for providing in-kind services to ALFs and adult day care centers in return for referrals; and adding fines for falsely billing and falsifying documents related to staff training and health status.

 

Health Regulation Chair Senator Jeff Atwater (R-N. Pam Beach) asked if a bill could be drafted by January.  The allegations of fraud and other problems were considered to be alarming by committee members and in need of immediate action by AHCA and the Legislature.

 

Hospice Rule Revisions Proposed - The November 30 issue of the Florida Administrative Weekly contains a proposed hospice rule that does the following:

 

·         Expands information that must be included in an application for change of ownership.

·         Amends administrative policy to require that verbal orders for treatment or medication must be signed by the physician within 30 calendar days from the date of the order.

·         Effective 2009, requires hospices to electronically file an annual report no later than March 31 with the Dept. of Elder Affairs on outcome measures.

·         Adopts form H-002 (Hospice Demographic and Outcome Measures Report). The FORM may be downloaded from DOEA's Web site.

·         Requires hospices to conduct the National Hospice and Palliative Care Organization Patient Family Satisfaction Survey. The acceptable measure for satisfaction is an affirmative response of at least 50% on pain control management and recommending the hospice to others.

·         Mandates that hospices maintain documentation of compliance with national initiatives by the Centers for Medicare and Medicaid Services.

·         For the purpose of quality assurance, provides examples of "high risk" and "problem prone" activities.

·         Incorporates advance directive Form SCHS-4-2006 into the rule by reference.  

 

If requested, a rule hearing will be held on January 3, 2008. READ THE RULE

Legislative News

Update on Federal Legislative Issues - 

This past week, Congressman Jeff Miller (R) visited Azalea Trace, a Pensacola continuing care retirement community. In preparation for the meeting, Barbara Gay (AAHSA Director of Advocacy Information) provided us with an update on affordable housing and elder care issues pending in Congress.  The summary, to be use when speaking with members of Florida's Congressional Delegation, follows:

 

·         Nursing Home Survey Revisit User Fee: Revisits occurring between October 1 and December 14 are subject to the user fee. AAHSA is making every effort to get the fee terminated, but if there is another continuing resolution to keep the government in operation while Congress and the President work out spending issues, the user fee may get continued along with current funding for federal programs.

 

·         Medicare Payment Freeze: The freeze was removed from the Children's Health Insurance Program bill, and that legislation was vetoed in the end. Nursing homes and home health agencies received their annual payment update October 1. This issue has resurfaced, however, because the Senate Finance Committee is working on Medicare legislation to prevent a big pay cut for doctors. President Bush does not want to offset the cost of the doctor fix with any cuts to Medicare Advantage plans, so Congress may fall back on cuts to skilled nursing facilities (SNFs) and home health by canceling the payment update they received. AAHSA is urging Congress not to cut payments to SNFs or home health. Congressional action on this issue is anticipated this week or next.

 

·         Medicare Therapy Caps: While AAHSA believes that Congress should repeal these caps, their current effort is to get the exceptions process extended for another year. This allows beneficiaries who have a demonstrated medical need for therapy above the level of the caps to have the excess covered by Medicare. AAHSA expects that Congress will incorporate an extension of the therapy caps exceptions process into the Medicare legislation fixing doctor reimbursement.

 

·         Funding for Senior Housing and Home and Community-Based Services: Congress is probably going to pass a large omnibus spending bill covering most federal programs including Section 202 housing and the Older Americans Act.  AAHSA is urging Congress not to cut funding for these programs below 2007 levels. AAHSA staff continues to point out that the need for services continues to grow rapidly.

 

·         Section 202 Housing Reform Legislation: The good news is that last week the House passed the legislation AAHSA initiated, HR 2930, to preserve the current supply of affordable senior housing and encourage the development of more units.  Rep. Tim Mahoney (D-16) from Florida is the primary sponsor of HR 2390.  Rep. Ginny Brown-Waite (R-5), also from Florida, is one of the co-sponsors. The bill would permit owners to refinance for rehabilitation or improvement of current Section 202 housing, and would also allow more flexibility to use savings for supportive services to tenants. The bill passed under suspension on a voice vote and must now be introduced in the Senate.

Nursing Home News

Medicaid Director Tom Arnold Assumes New Role -- Last week, Tom Arnold (Florida's Medicaid Director) resigned.  He will be assuming the position of Deputy Secretary of the Department of Health.  Tom has worked with FAHSA public policy staff for many years.  He has always been receptive to our comments and suggestions and has been especially helpful with reimbursement issues. We look forward to working with Tom in his new position.

 

Senate Health Regulation Committee Focuses on NH Regulation & Corporate Business Models - This week, AHCA Long-Term Care Bureau Chief Molly McKinstry presented the outcome on an internal review and report on nursing homes to members of the Senate Health Regulation Committee.  The study was completed after a major newspaper article disclosed the pending sale of Manor Care to Carlisle, a private equity company.  The New York Times article alleged cutbacks in staffing, care, and services in Carlisle-owned homes and other homes owned by private equity companies.  Read more about this issue and those listed below in the latest Nursing Home Alert, NH 07-35. 

 

Other Nursing Home Issues:

·         AAHSA Survey & Certification Task Force Recommendations

·         Latest Florida QIS Status

·         AAHSA Response to CMS Distribution of Complete List of SFFs

·         Lawmakers Call for Release of Complete List of Poor Performing Nursing Homes

·         Enforceability of Residency Arbitration Agreement

·         Florida Senior Care Web Page Updated

·         MedWatch Alerts and Warnings

·         Advisory Group Recommends Freeze on Medicare Marketbasket for Nursing Homes in 2009

·         US Senator Grassley Calls for Probe into Nursing Home Use of Antipsychotics

·         Three Drugs Lead to Elderly Hospitalizations

·         Governor Crist Appoints Moore to BONHA

Preferred Business Associates News
 

CoupleWithDollarFAHSA Welcomes Newest PBA -- FAHSA's Provider/Shared Services Committee recently approved Plante & Moran Clinical Group, LLC as a new Preferred Business Associate (PBA). 

 

The Plante & Moran Clinical Group would like to introduce all FAHSA Members to the MxManage tool, called MxManage Quality and Financial STAT (pronounced 'Max-Manage'), a Web-based, real-time, MDS analytical tool compatible with any MDS software. For more details about Plante & Moran Clinical Group and MxManage click HERE.

 

Congratulations and welcome to Plante & Moran Clinical Group!

 
Play it Safe this Holiday at the ATM -- As holiday shopping season gets under way, you may find yourself in need of extra cash. ATMs can be an easy target for criminals. Click HERE to read these safety tips the next time you visit the ATM for some quick cash. This article was provided by Hunt Insurance Group, one of FAHSA Preferred Business Associates.
 
FAHSA's Preferred Business Associates Program (PBAs) -- A list of PBAs can be found by on the FAHSA Web site www.fahsa.org and selecting Preferred Business Associates from the left side menu bar or clicking on the FAHSA Preferred Business Associates Page hyperlink. FAHSA members can also use the on-line directory to search for PBAs by specialty.
 
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Job-Mart
 FAHSA is pleased to provide an opportunity for you to advertise your "position wanted" or "position available" through the FAHSA Link newsletter and on our Web Page.

FAHSA members may use the Job Mart services at no charge. A nominal fee of $25 will be charged to nonmembers.

Your Job Mart advertisement will be displayed on our Web site for approximately three months. The FAHSA Link is published weekly and distributed to our membership which is comprised of nursing homes, CCRCs, HUD housing, assisted living facilities, independent living facilities and companies/firms.

To reserve advertisement space in our Job Mart program, please complete the application and fax it to FAHSA at (850) 671-3790 or E-mail Erin Steele at esteele@fahsa.org

FAHSA's Group Purchasing Organizations

FAHSA is pleased to tell you about the FAHSA Group Purchasing Organization (GPO).  The GPO program further enhances the value you receive from your membership and is required for us to be in compliance with Medicare Safe Harbor requirements The FAHSA GPO program, in conjunction with the AAHSA, Care Purchasing (CPSI), and FMS Purchasing and Services (FMS) GPOs offer you the opportunity to save daily purchases from over 200 vendor partners.  To view these vendor partners please click on the Preferred Business Associated Guide and go to pages 22-25.

 

FAHSA members participating in these programs are saving from seven to 50% off list prices.  In addition to these savings, your participation allows FAHSA to receive non-dues revenue based on your purchases.  This revenue assists FAHSA to provide the educational programs and advocacy you expect while keeping membership dues' to a minimum.

 

There is no obligation or commitment on your part to participate in the FAHSA GPO programs. This is simply a value added member benefit. Our program is also not exclusive; you can belong to one or all three GPOs.  We simply ask that you look at all of the FAHSA programs and decide the best savings for you. 

 

We have three (3) Enrollment Agreements and ask that you complete one or all and fax the completed enrollment to the GPO at the number listed on the form. Click below to obtain the enrollment form. 

  1. AAHSA Enrollment Form
  2. Care Purchasing Enrollment Form
  3. FMS Purchasing & Services Enrollment Form

If you are already enrolled in one of the GPOs, you are still required to complete a new enrollment form in order to have the FAHSA GPO covered under the Medicare Safe Harbor Laws.

 

If you have any questions, please call Julie Copeland, Vendor Relations Coordinator or Janegale Boyd, President/CEO (850) 671-3700.  Thank you for your continued support of FAHSA.

Save 10%

Use FAHSA's Self-Study Training Modules to Meet Regulatory Requirements - If your community is looking for an efficient and cost-effective way to ensure that new and existing staff meet mandatory educational training requirements, consider purchasing one or more of FAHSA's training Videos/DVDs:

·        HIV/AIDS Prevention & Treatment

·        Domestic Violence

·        Medical Errors

·        OSHA Universal Precautions & Infection Control

·        Resident Abuse Prevention Program

The advantage of using the training series is that individuals can work at their own pace and complete the training on their own or as part of a group.  For new hires, this option in invaluable.  It not only saves time, it saves money in regulatory problems!

To order please click HERE for order form.

Offer Expires: December 31, 2007