Home Health & Hospice Week

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Hurricane Katrina may take its toll on home care providers for a long time to come, depending on how lawmakers approach the budget for disaster relief.

The hurricane has blown some legislation in the U.S. Congress off course. Katrina-related activities have bumped imminent legislation addressing health care information technology and physician reimbursement, congressional observers say.

Congress will also rethink its mission to cut $10 billion from mandated programs such as Medicaid and Medicare, lawmakers indicate.

Observers expect no reconciliation bill this year, which may mean no Medicare or Medicaid cuts that are usually included in such bills, notes Kathy Thompson with the Visiting Nurse Associations of America.

Beware: But home care providers shouldn't get too comfortable. Lawmakers are searching far and wide for funding required for Katrina relief, and mandated programs like Medicare are juicy targets. Home health agencies could face the usual proposals for a copayment for home health services and reductions to the market basket index inflation update, warns William Dombi with the National Association for Home Care & Hospice. "Those are the dollar trigger points for home care," Dombi tells Eli.

HHAs will fight such attempts in part by showing the increased cost of transportation for home care workers, considering record-high gas prices, Dombi says. And the transport problem is especially hard on rural agencies that have lost their rural add-on, he adds.

Medicaid Coverage Assured

Federal officials are working out agreements to pave the way for providers to get paid for treating the waves of Katrina evacuees. Under a newly agreed-upon waiver, Texas will provide temporary eligibility for five months of Medicaid coverage to a variety of evacuees including individuals with disabilities, low-income Medicare recipients, and low-income individuals in need of long-term care, the Centers for Medicare & Medicaid Services says in a release.

The federal government will pick up the full cost of these evacuees, as opposed to the usual cost-sharing arrangement for Medicaid.

A bill proposed Sept. 14 in the Senate wants to take Medicaid coverage even further. The legislation proposed by Senate Finance Chair Charles Grassley (R-IA) and Ranking Member Max Baucus (D-MT) would extend Medicaid coverage to hurricane survivors for five months. And the bill would establish federal add-on payments for providers serving increased Medi-caid populations due to Katrina or for providers who lost their population base due to the hurricane.

In a question-and-answer on its Katrina Web site, CMS says it won't do anything different to address an increased demand for home care services in certain areas. "CMS does not limit the number of patients that can be cared for by a home health agency," it says.

Providers in Louisiana and Mississippi can expect survey changes due to the disaster. The Louisiana Department of Health and Hospitals has suspended surveys for at least a few weeks because surveyors are staffing shelters throughout the state, CMS says in another Q&A. Mississippi also put surveys on hold for a time and cancelled revisits, the agency adds.

Providers Offer Assistance

Many home care providers have offered help to those affected by the hurricane. Johns Hopkins Home Care Group, together with other area hospitals, flew three doctors and nine nurses to Louisiana to provide relief to the staff of the West Jefferson Medical Center in Marrero, LA, according to the Associated Press.

Medline Industries Inc. initiated and helped fund a first response helicopter team that delivered medical supplies and evacuated hundreds from hospitals, nursing homes and other New Orleans rooftops, the Mundelein, IL-based medical supply company says in a release. Medline also donated $100,000 to the American Red Cross, set up a $100,000 relief fund for aid to its employees, and is providing other relief supply services from its Covington, LA and other area locations.

Invacare Corp. shipped a truckload of wheelchairs, nebulizers and oxygen equipment to the Red Cross in Lafayette, LA. The Elyria, OH-based manufacturer's other Katrina efforts include establishing a hotline, 1-888-966-6468, for suppliers' urgent equipment needs. "Consumers calling the hotline will receive information about open home medical equipment locations in the Gulf Coast region, or be directed to the locations near them for home oxygen and home medical equipment products and services," the company says in a release.

The HomeCare Association of Louisiana has collected stories of heroic home care nurses riding out the storm with patients, keeping them alive and shepherding them to safety.

The Hurricane Katrina Home Care Recovery Center is operating in 2,000 feet of donated office space in New Iberia, LA with donated office equipment and furniture, HCLA reports. The Center will support agencies' operations and serve as a communications hub.

The Hurricane Katrina Homecare Recovery Fund, a 501-C3 corporation that allows tax deductible donations set up by the state associations of Louisiana, Mississippi and Alabama, is giving 100 percent of its proceeds to individuals affected by the storm and flood. Up to 3,900 home care employees in Louisiana alone have been affected, the Fund says in a release. The Fund is accepting credit card donations at www.hclanet.org.