Membership Value Statement. HCA The Right Choice, The Right Direction

Transcription

1 Membership Value Statement HCA The Right Choice, The Right Direction 2009

2 The Home Care Association of New York State Our Mission: Supporting Your Mission Home care, a safety net of comprehensive services that supports the entire health care system, is a vital and essential part of our communities. Home care services enable the frail-elderly, children, persons with disabilities and chronically ill patients of all ages to receive quality services in the home. These services support the healing process for patients recovering from care in a hospital, the rehabilitation needs of patients leaving hospitals and nursing homes, and the chronic-care management requirements of patients receiving long term care at home. HCA has a long history of supporting the mission of our members to provide such high quality services to New Yorkers in need of home care. This mission is alive and strong, and HCA s membership, in the face of new and daunting challenges every day, works vigorously to ensure first and foremost that patients receive the life-enhancing and life-sustaining care they urgently need in a home setting they prefer. The same mission conferred to HCA at its inception still rings true today: to promote and enhance the quality, accessibility and availability of home care by enabling our members to meet the needs of the individuals and communities they serve. HCA, working closely with the Membership and our Board of Directors, tirelessly supports the provision of home care services through an array of top quality and innovative programs and services. For more than thirty years, HCA has been your Association, committed to the ideals of home care service while aiming to support the practice of these ideals through public policy development, advocacy, education and information. Every day, HCA works on your behalf to achieve that mission and to assist you in fulfilling your own organization s mission of supporting quality home care services. Making Our Organization Strong from the Inside Over the past two years, HCA has taken a strategic look at our own internal operation and has made significant changes to ensure that we are structured in the best, most advantageous way to meet the needs of New York s home care community. To that end, with the guidance and wisdom of our Board of Directors, HCA strengthened our internal committee, board, and governance structures to allow for a more focused and engaged board and membership. We also made several necessary refinements to our bylaws. Along these lines, one of the most significant internal changes at HCA during the last year was our creation of a 501(c)6 corporation to complement and work collaboratively with our existing 501(c)3 organization. This move has made HCA stronger as an association by allowing us, through the 501(c)6 designation, to fortify our advocacy firepower and launch a Political Action Committee (HCA PAC) that adds to our arsenal of resources, lobbying munitions, and other tools to aggressively advocate for home care in every state policy venue. Our structural reorganization also allows HCA to continue to tap grant and education revenues that fuel our mission of providing quality education and learning services. This was made possible through our retooled 501(c)3 operation now called HCA Education and Research which is distinct from the newly created 501(c)6 advocacy arm of HCA. Both are not-for-profit. 1

3 HCA State Policy Leadership Aggressive Advocacy on Your Behalf In every possible facet of home care reimbursement and regulatory oversight, HCA has vigorously and strategically advanced the best interests of the home care community with an eye toward long-term outcomes and with a view of the big picture as it relates to home care s position as part of the overall continuum of care. Adding further clout to HCA s influence as your advocate in Albany is the fact that our state contract lobbying firm, Wilson Elser Moskowitz Edelman & Dicker, LLP, is among the most preeminent and renowned lobbying firms in New York State. They have served mightily as HCA s go-to professionals in helping us: gauge the inside political dynamics of the moment, assess how these ever-changing dynamics relate to our advocacy strategy, assist HCA staff in meeting directly with key state officials, and support HCA s efforts to ensure that the issues of importance to our members are effectively heard by policymakers in the State Legislature and Executive. By all accounts, this past year has been one of incredible challenge for the home care community, especially in the context of a state legislative process that was interrupted and challenged when elected leaders in the Senate struggled publicly for control over the chamber was also a year of challenge because of the fiscal difficulties facing the state, and the fact that the home care community encountered both massive cuts to reimbursement as well as unsound structural changes to the home care system. In waging battle against multiple threats to the survival of New York s home care system, HCA marshaled our advocacy resources like no other year prior. In the height of state budget and legislative negotiations, HCA held our most successful State Advocacy Day to date, with a record turnout of HCA members and participating legislative leaders. During our Advocacy Day, HCA s home care members visited with more than 100 legislators to urge restoration of the proposed home care state budget cuts and to hear from the Legislature s top state health care policymakers who addressed the membership during HCA s Advocacy Day program another important opportunity for mass engagement and interaction with the legislative process. 2

4 HCA s Legislative and Advocacy Successes Playing Offense and Defense to Advance Home Care in New York State O ver the course of the budget and legislative session, HCA achieved many successes that have resulted in mitigating the worst of the damaging cuts and reforms proposed in the State Budget. In addition, HCA had the opportunity to win proactive legislative advances that favorably positioned the home care community in New York State. This mix of aggressive advocacy both on the defense and on the offense is what HCA does best, and we have a long track record to prove it. Among our major successes at playing defense this year were: Elimination of Seventy Percent of Devastating Cuts Proposed by Governor Paterson: Governor Paterson s Executive State Budget Proposal represented the most massive assault on home care in memory, with a proposed $475 million (state and federal shares) in cuts to home care programs. Due to the unrelenting advocacy of HCA and our partner associations, strong grassroots advocacy by the membership, and support from the State Legislature, the final budget package rejected the majority of the Governor s $475 million in proposed home care funding cuts, leading to a nearly 70% restoration of funding. Rejection or Scaling Back of Damaging Home Care Restructuring Proposals: Along with the cuts, the Governor s Executive State Budget proposed several untested, far-reaching, and in some cases reckless structural changes to the home care system. Among these changes was the creation of a new prospective payment system (PPS) for Medicaid Certified Home Health Agency (CHHA) patients, as well as a proposal that would have prohibited CHHAs, Long Term Home Health Care Programs (LTHHCPs) and AIDS Home Care Programs (AHCPs) from subcontracting with Licensed Home Care Services Agencies (LHCSAs) for home health aide services. HCA believes the prohibition on subcontracting was reckless and, therefore, we aggressively and successfully fought to defeat it. HCA s position was to oppose the PPS because of its flawed structure, unsound methodology and the fact that it was built on a model that cut $200 million (state and federal shares) out of the home care system by underfunding care for the most high need patients. HCA was successful in this effort as well, and the final result was the creation of a workgroup to study the PPS and file a consequent report to the Legislature, as opposed to the actual implementation of a PPS. HCA, while precluded from participating on the workgroup, is actively monitoring the workgroup s activities, as it is anticipated that the PPS proposal may crop up again in the upcoming budget cycle. 3

5 Strong Opposition Against New Cuts to Home Care in Mid-Year Deficit-Reduction Plan (DRP): In recent years, lawmakers have been compelled to revisit the budget after its enactment at the start of the fiscal year (April 1) to make corrections to the state s fiscal plan because of worsening economic forecasts. As part of these Deficit Reduction Plans (DRPs), home care, like other sectors of the health care system, has been a target for budget cuts. A DRP proposed by Governor Paterson this year has targeted home care for another round of untenable, massive cuts that amount to $184 million (state and federal shares) for the remainder of the fiscal year approximately a 10% across-the-board cut. HCA is actively working to defeat these cuts and to offer ideas for home care program efficiencies that would generate savings to the Medicaid program through improvements in care delivery as a counter to draconian cuts. Supporting our direct advocacy, and in anticipation of the fall 2009 DRP, HCA also launched a multi-faceted advertising, mediaoutreach and advocacy campaign called Enough is Enough. With the tagline Enough with home care cuts, enough with unfunded home care mandates, and enough with destructive home care system reforms, our campaign sought to illustrate the compounding effect of prior-year funding reductions and other fiscal pressures on home care in the advent of a new round of cuts. The campaign, housed at features advocacy resources, a home care fiscal-conditions report, as well as news updates and an online petition. Vigorous Opposition to Legislation Negatively Affecting Home Care Providers: HCA took a very active and visible role opposing legislation introduced in the Senate and Assembly that would have had tremendous negative consequences for home care agencies in their efforts to provide care to patients, including legislation to restrict nurse overtime in home care settings, safe-patient-handling requirements for health care facilities (including home care agencies) and incident reporting requirements for home care agencies legislation that HCA believed was either incompatible to the home care setting or would place undue burden on the home care community with no additional funding support. 4

6 W hile playing defense is critically necessary in the state association world, HCA also takes a very active and engaged role in advancing creative ideas and proactive legislative initiatives to address the needs of New York State s home care community. No other association representing home care is as aggressive or successful as HCA in getting legislation introduced and enacted to the benefit of the home care community in New York State. In addition to our defensive role as an association, we play a hard offense as well. Among our greatest proactive achievements in 2009 were: Enactment of HCA-Drafted Home Care Protections for Providers Working with Managed Care: One of the most dramatic wins for home care this year was the enactment into law of far-reaching protections for home care agencies in their interface with managed care organizations. The home care provisions of this new law were drafted and negotiated by HCA and include provisions that would: help ensure home care coverage; tighten plan-authorization timeframes of major benefit to home care providers, especially in Friday afternoon or holiday discharges from the inpatient setting; and offer agencies explicit and expedited appeal rights when managed care plans deny coverage. The home care provisions of this new law were drafted by HCA in direct response to member concerns about issues encountered in their interactions with managed care plans. Home Care Accessibility, Efficiency and Improvement Act (HCA-EIA): This landmark comprehensive bill, S.5179, was created, drafted and advanced by HCA and introduced by Senator Craig Johnson. It was developed to offer the Legislature and Governor s Office an array of creative ideas for efficiencies and improvements to the home care system that would generate Medicaid program cost savings, without the disruption of care and services that results from resorting to across-the-board budget cuts aimed at reimbursement. Provisions of the bill emanated from ideas put forth by HCA members and our Board of Directors to improve the efficiency and functioning of the home care system. At the time of this writing, components of the bill are actively being considered as alternatives to reimbursement cuts by the Legislature, Governor s Office and State Department of Health (DOH). Reformed Method of Recognizing Charity Care Provided by Home Care Agencies: HCA-drafted charity-care legislation, introduced last year by Senator Kemp Hannon (S.7809), was incorporated into the final State Budget. The legislation updates the process for agencies to qualify for charity care funding. In addition, the adopted HCA language aims to reduce the minimum percentage threshold that constitutes home care agency charity care. The legislation also better defines, through the establishment of a community service plan requirement, the array of charitable services performed by agencies toward fulfillment of charity-care obligations. 5

7 Relief from the Regressive A&G Cap/Access to Capital for Home Care Providers: HCA developed and secured the introduction of legislation that is essential to home care provider operability. A.1804 / S.4430, introduced by Assembly Health Committee Chairman Richard Gottfried and Senator Craig Johnson, recognizes the necessity for home care agencies to have access to capital for investment in patient care and quality improvement by creating an allowance for strategic home care capital investment as part of an agency s reimbursement rate. Meanwhile, A.1807 / S.2253, introduced by Assemblyman Gottfried and Senator Jeff Klein, would address a critical issue for home care agencies the misleading definition of what is required to be reported by agencies under their Administrative and General (A&G) cost category. The lack of an accurate definition for A&G means that costs borne by agencies for certain activities directly related to patient care (such as case management, scheduling) must fall under the A&G catch-all, which is subject to a regressive cap under the home care payment methodology. This needed legislation would clarify certain costs as being patient-care-related, providing needed relief for agencies under the A&G. Hospital Based CHHA Workforce Recruitment and Retention Rate Adjustment: HCA s advocacy secured important funding to hospital-based CHHAs. When the formula for the distribution of the Workforce Recruitment, Training and Retention (RT&R) funds, intended for all CHHAs and other home care providers, was originally announced, hospital-based CHHAs were omitted from the allocation. HCA identified the omission and through negotiation and continued advocacy with the department secured the provision and distribution of these funds. Federal-State Medicare Shared Savings Partnership: This HCA-initiative (part of HCA-EIA, S.5179) would create a federal-state partnership to create and promote Medicare cost-savings innovations, benefit Medicare recipients through improved care management and patient outcomes, and share with the state the savings achieved through partnership activities. This concept has also been drafted as a federal bill by HCA and is being advanced in Congress by Rep. Joseph Crowley (D-Queens). Comprehensive Telehealth/Telemedicine Legislation: HCA developed and will advance as part of our 2010 Legislative Agenda, the New York State Telehealth/Telemedicine Development Act which offers a comprehensive framework for the administration, development, financing, provision and research of telehealth and telemedicine in the state. This initiative would make major strides in access to technology-based health care and patient management. 6

8 Regulatory Advocacy HCA Follows Through to Ensure That Regulations and State Audits are Workable for Home Care Agencies Significant HCA resources and expertise are needed to meet the task of ensuring that regulations governing the implementation of a program, law or initiative are workable. Among HCA s most pressing regulatory challenges over the course of 2009 were: Advocacy on Home Care Registry Draft Regulations: Following intense advocacy related to the adoption of a bill that created a home care worker registry, HCA has been continuously engaged with DOH providing extensive comments and recommendations on DOH's draft regulations, implementation guidelines and operational aspects of the registry. HCA continues to press DOH for changes to remove major obstacles, impediments and other problems, and to otherwise improve the registry for providers, workers and patients. Advocacy to Assure Fair Audit Processes and Practices: Advocating on behalf of members undergoing audit at the OMIG remains a top priority for HCA. HCA continues to work intensively with Medicaid Inspector General James Sheehan and his key deputies to secure fair and workable audit protocols that serve as the governance for OMIG audit activity. In response to HCA s advocacy and requests, the OMIG continues to make changes to their audit protocols and has agreed to postpone audits under certain circumstances to accommodate providers. Supporting the Renewal of the LTHHCP Waiver: Over the past year, HCA has worked diligently and persistently to support DOH in its efforts to navigate the renewal of the LTHHCP waiver. HCA also took a leadership role in working with DOH to ensure a solution to maintain the existing spousal-impoverishment protections and enhancements to the program. Recently, DOH announced another in a series of approved extensions of the LTHHCP waiver through to the end of December 2009, to give time to resolve the status of Medicaid spousal-impoverishment protections within the waiver. DOH will request an extension into Traumatic Brain Injury Waiver Program (TBI): In direct response to persistent advocacy by HCA, DOH provided clearer guidance and flexibility for provider participation in the TBI program, addressing many of HCA's members issues and concerns. In addition, HCA succeeded in gaining a postponement in the implementation of the new TBI manual and the accompanying forms from April to October 2009 to accommodate sought-after changes and provider participation. Provision of Home Care in Adult Homes and Shelters: HCA has been pressing DOH to review policies regarding the provision of home care services to individuals in adult homes and shelters, to ensure improvements and clarifications regarding access. As a result of HCA s advocacy and inquiry to DOH on this issue, DOH has been working with HCA to develop concrete guidance for providers who serve patients in these settings. 7

9 HCA S Proactive Federal Advocacy Agenda HCA has ramped up our policy and advocacy at the federal level by fostering a new level of strong partnership and collaboration with the New York Congressional Delegation. Assisted by our Washington lobbyist Brett Heimov Partner at Winning Strategies, one of Washington s premier boutique lobbying firms HCA routinely meets with and communicates with the health care staff and members of the New York Congressional Delegation on issues affecting New York s home care agencies. In addition, HCA has also opened up new channels of communication with officials at the U.S. Centers for Medicare and Medicaid Services (CMS) to discuss and advocate key issues affecting New York s home care community. While HCA continues to build a solid reputation in Washington, our aggressive and proactive federal advocacy agenda focuses on working closely with partners at the National Association for Home Care and Hospice (NAHC) on issues that globally affect the home care community. HCA has a particularly strong connection and partnership with NAHC this year, especially through our work with NAHC Board Chair Michele Quirolo, President and CEO of HCA-member agency Visiting Nurse Association (VNA) of Hudson Valley. NAHC has taken an especially aggressive stance and approach in the federal health reform debate to decrease the level of Medicare home care cuts that have been included in the various health reform bills, and to secure additional provisions that would be advantageous to the home care community. HCA has worked side-by-side with NAHC, educating every member of the New York Congressional Delegation about the tremendous negative impact of massive cuts in Medicare reimbursement for home care services provided to New York patients. In addition, HCA has also developed a very assertive federal agenda that includes other initiatives that would benefit New York State s home care community: Continuation of the Third-Party Liability (TPL) Demonstration: Since the TPL ended in October 2007, HCA has led the way in working to secure its continuation, either through an extension of the Demonstration program, or through the permanent establishment of this program. HCA s efforts first focused on convincing CMS to continue this worthwhile program. Those efforts ramped up considerably in recent months through our work to secure support from the New York Congressional Delegation on HCA s legislative solution to make the TPL permanent. Senator Kirsten Gillibrand has taken the lead in the U.S. Senate on efforts to secure passage of HCA s TPL fix. Meanwhile, in the U.S. House of Representatives, Reps. Nita Lowey (D-Westchester) and Charles Rangel (D-Harlem) are working hard as well to advance our TPL bill. HCA has marshaled every resource at our disposal to ensure success on this issue. HCA has teamed up with the state s Medicaid Inspector General and Governor Paterson s Washington Office to secure the state s active support for the HCA TPL solution. In addition, HCA has acquired the active support of our counterpart home care association leaders in Connecticut and Massachusetts to activate a broader advocacy push in states that are also affected by the TPL s expiration. 8

10 Reducing the level of Medicare Cuts to Home Care: HCA has communicated staunch opposition to massive cuts in earlier versions of the federal health reform legislation, specifically the $57 billion in devastating across-the-board cuts over ten years under the U.S. House plan including $3 billion in cuts that would severely jeopardize care for New York s home care patients. Securing a Continuation of Spousal Impoverishment Protections for Patients in Home and Community Based Care Programs: A top federal priority for HCA has been to secure federal legislation, or a CMS determination, clarifying that patients being served in programs such as the LTHHCP have the same level of spousal income protections as those being served in institutional sectors. HCA has achieved the introduction of federal legislation, H.R. 3055, introduced by Reps. Eliot Engel (D-Bronx) and Peter King (R-Seaford) that would accomplish this important clarification and ensure adequate income protections for individuals whose spouses are patients in home and community based services programs. Provisions based on this language have been included in several of the health reform bills, and HCA continues to press for passage of H.R or its inclusion in a health care reform measure. Dual Waiver Services: HCA has steadfastly opposed a CMS policy that precludes home care patients from obtaining different services by two waiver programs. Our advocacy on this issue has specifically focused on pressing CMS to reverse its policy. We have also worked to educate the New York Congressional Delegation on how this policy affects patients and the providers that care for them. In response, two members of the New York Congressional Delegation have been especially proactive in pressing CMS to reverse this policy. Reps. Engel and King have taken HCA s concerns directly to CMS to press for a solution that will allow patients to be rightly served by two different waiver programs. Home Health Compare: HCA continues to press for changes to the Home Health Compare quality outcome data reporting and comparison provisions, with a specific focus on segregating CHHA and LTHHCP data. Assisted by HCA s partnership with Syracuse University s Maxwell School through HCA Board Member and Maxwell School Professor Thomas Dennison, PhD our advocacy efforts on datareporting issues are now armed with quantifiable evidence that the Home Health Compare data are misleading and inappropriate for use in comparing quality of care. Medicare Telehealth and Technology Demonstration Program: In response to an invitation by Rep. Steve Israel (D-Long Island), HCA has drafted legislation to create a Medicare telehealth and technology demonstration program. The legislation includes the creation of a new Medicare telehealth rate, access to capital for new technology, and a research and evaluation component. HCA will continue to work closely with Rep. Israel to secure its enactment. Help us Choose Home National Media Campaign: Working with NAHC and the Forum of State Associations within NAHC, HCA played a key role in initiating a national campaign to highlight the role of home care. This campaign, Help Us Choose Home, aimed to promote the value of home care as a vital centerpiece of health care reform and policy discussions. 9

11 Building Partnerships Leadership on Your Behalf To advance the home care community s agenda, HCA uses the collective power of the membership and every association resource available to us. To that end, in 2009 we continued to foster and build partnerships and relationships that assist in advancing our aggressive policy and advocacy agenda. HCA s association partners include the Healthcare Association of New York State, the New York Association of Homes & Services for the Aging, the New York State Association of Health Care Providers, the Hospice and Palliative Care Association of New York State, the New York State Health Facilities Association, the Medical Society of the State of New York, and the Health Plan Association. By working together, finding common ground, and developing common solutions, HCA s voice on behalf of home care in New York State is stronger than ever. HCA also continues to leverage important partnerships and relationships with key organizations that have an important public policy role and voice, including the Center for Health Workforce Studies at the State University of New York at Albany s School of Public Health, the Rural Health Association, the Commission on Rural Resources, the Area Health Education Centers, and others. HCA also works closely with officials at all levels of state government to forge positive and productive working relationships to further the HCA legislative and policy agenda. HCA is the go-to home care resource for policymakers in Governor David Paterson s administration, the Division of Budget, the Department of Health, the State Insurance Department, the Office of the Attorney General, the Office of the Medicaid Inspector General, and both the majority and minority offices of key leaders in the State Legislature. These relationships have helped to ensure that policymakers in each of these influential areas understand and appreciate the important role that home care plays in the health care continuum, and the impact that their respective policies have on the home care system in the state. 10

12 Education and Enhanced Learning Opportunities A primary focus of HCA s energy and resources is to deliver high-caliber education programming on an array of relevant topics and in many formats to the membership. This year, in response to the membership s desire for more distance learning opportunities, HCA redesigned our entire educational programming, presenting dozens of programs using either web-based or audio technology while hosting programs in multiple locations across the state. Distance Learning Opportunities HCA University: As part of HCA s effort to bring more education to you at your agency, HCA launched the HCA University, an online education portal, through our partnership with Care2Learn, a leader in providing online courses on clinical, leadership, and management topics. Care2Learn has a proven track record in the health care industry, delivering elearning courses to over 2,000 health care facilities and 225,000 health care workers. Through this partnership, members have access to high quality distance learning opportunities, at a discounted rate. HCA Signature Events: HCA also continues to offer signature events the HCA Annual Membership Meeting, the HCA Senior and Financial Managers Retreat and the Clinical and Technology Conference. These flagship conferences and education programming sessions resulted in hundreds of HCA members receiving knowledge, resources, and skills development on relevant important topics. HCA also offers blockbuster education conferences on managed care, quality initiatives, clinical topics, corporate compliance, and other topics, hosting policymakers, state officials, professional consultants, industry representatives and other leaders who provide a depth of information that cannot be found in any other venue. Member Forums and Briefings: HCA also reaches out directly to the membership to solicit input on the effects of home care policy developments through frequent member forums and briefings, held in every region of the state. Through these briefings and forums, HCA has the opportunity to hear from hundreds of members, and to provide input and answer questions on the impact of proposed policy changes. 11

13 Staff Trailblazing on Your Behalf As a team, the HCA staff is well positioned to advocate effectively on behalf of the home care community in New York State and we take advantage of every opportunity to do so by actively employing creative ideas, unparalleled technical and policy expertise, problem-solving acumen, and an abiding commitment to member service. HCA is proud to trailblaze in many areas of home care by advancing a proactive and visionary agenda and seizing every opportunity to highlight progressive home care services. In addition, HCA s positioning to play a hard defense helps to stop bad policy ideas from taking hold and reshapes existing policies so that they respond beneficially to the needs of home care agencies and patients in New York State. HCA s seasoned team of professionals brings added value to your membership and is a resource for both you and for policymakers, other provider associations, and the entre home care community. Our leadership in this area includes: Guidance and Intel: HCA has the best intelligence about what policymakers are thinking related to home care, and understands the policy dynamics in Albany and Washington like no other statewide home care association. HCA also provides guidance to members about navigating a complex policy environment in both Capitols. Advice: HCA is your eyes and ears in Albany and Washington, offering member agencies policy advice and guidance that may be necessary to complete your mission to offer an array of home care services to patients in need. Troubleshooting: One of HCA s best skills is the ability of policy staff, with years of experience working with policymakers on home care issues, to identify areas of potential vulnerability for the home care community and troubleshoot to work out solutions that will meet the needs of providers. Technical Assistance: HCA spends countless hours each year working on member issues and problem-solving on behalf of the association. HCA s expert and experienced staff are seasoned problem solvers who understand how to successfully navigate issues to address member concerns. Expertise on Policy Issues: In many policy areas, HCA staff is known nationally for its leadership and policy expertise. In several issue areas, HCA staff have been recognized by the National Association for Home Care and Hospice, the Forum of State Associations, the American Telehealth Association, the Institute of Medicine, the Federal Emergency Management Association, the Agency for Health Care Research and Quality and others as national home care policy and association experts on a variety of topics, including telehealth and technology, emergency and disaster preparedness, home care advocacy and public relations, Medicaid policies affecting home care, grant-writing, managed care reforms, and national health care reform as it impacts the home care community. 12

14 Communications, Media and Public Relations: Over the past two years, HCA has successfully built a proactive, aggressive and strategic communications operation that has maximized every media and public relations opportunity to bring positive attention to the quality services provided by New York s home care community. HCA s communications operation has helped to raise the profile of home care, and has garnered press coverage of many important HCA policy priorities and activities. Our media statements, policy stances and reports have been covered by the Associated Press (AP), the New York Times, the Albany Times Union, Newsday, the Buffalo News, Crain s New York Business, USA Today and other major newspapers statewide, as well as on television news and in the blogs. As part of our external and member communications efforts, HCA also disseminates advocacy alerts and tools to assist you in your advocacy efforts and to keep you informed, ramping up our member advocacy campaigns. For instance, in response to the Governor s proposed Deficit Reduction Plan (DRP) of 2009, HCA launched an advocacy campaign centered on the slogan Enough is Enough. This campaign includes a website at paid advertising, and other related marketing efforts. In fact, our marketing and public affairs efforts recently garnered HCA a Best in Show distinction at the Public Relations Society of America s (PRSA) Capital Region chapter for our work with Empire Public Affairs in developing successful outcomes on behalf of home care. Signature Reports on the State of the Home Care System in New York State: HCA frequently issues reports to highlight important home care issues including a report issued by HCA and the New York Association of Homes & Services for the Aging (NYAHSA) on the financial condition of the home care community in New York State. This report, begun last year, and issued annually, provides findings of a statewide analysis (using cost report data and survey results) on the fiscal condition of home care providers. This year s report is entitled Lethal Doses: How a perfect storm of a half-billion dollars in new home care cuts, mixed with unprecedented mandates and prior inadequate funding levels, would wipe out vital costeffective home care services. This is one of many reports published by HCA to highlight issues of concern to policymakers and the media, and to assist members in their advocacy. 13

15 The Power of Association Join HCA in 2010 HCA is proud of our member services, aggressive advocacy, expert policy development and policy analysis skills, progressive and plentiful education offerings, communications products, and media presence. We are also proud to take every opportunity to represent the voice of New York s home care community in every venue possible. HCA constantly strives to be diligent, proactive, polished and expert in our representation of New York s home care community and we deliver every single day for the membership of HCA. HCA s staff is among the most highly competent, knowledgeable, and committed team of individuals working at the association level to ensure the highest level of member service each and every day. As a member, you can rest assured that we use every dollar of our membership dues to provide services, programs and advocacy activities that directly benefit you and the patients you serve. We want to thank you for your commitment to being an active and engaged part of our membership by attending forums and education programs, reaching out to us by phone to lend your advice or highlight challenges that we need to know about, and especially for your passionate advocacy on behalf of the patients and communities you serve will likely be one of our most challenging years yet. With a worsening state fiscal and economic climate, an administration in Washington that is focusing on health care reform and deficit reduction, and an aggressive compliance and service integrity agenda among federal and state auditors and prosecutors, the home care community must remain poised as a strong force in our articulation of the benefits and value of home care services. We must also stand ready to effectively advocate for public policies that reinforce and strengthen our field while we urge rejection of public policies that weaken or dismantle our delivery system. Most important, we must remain unified. The power of our advocacy on behalf of home care will rest on the power of our association. For these reasons, I urge you to retain your membership in HCA. I know you have many choices in the number of associations to which you can belong. HCA, perhaps as never before, stands energized, active and engaged to provide to you the highest possible level of member service. To demonstrate your commitment to our efforts, and to remain a valued part of our association, please complete the enclosed application and return to HCA with your 2010 dues. For more information, contact Laura Constable, Senior Director of Membership and Operations, at or lconstable@hcanys.org. Thank you in advance for your renewed membership and your active engagement in our organization. HCA looks forward to continuing to provide you with value today and in

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