OAHC Position Paper

The delivery of home health care has demonstrated significant cost savings in the healthcare sector, enhances patient outcomes, grants access to cutting-edge therapies and medical technologies, and emerged as the preferred medical care setting, particularly highlighted during the pandemic. It is imperative for the Oregon Legislature and Congress to safeguard and enhance access to home health care by removing obstacles to its provision. Furthermore, concerted efforts should be made to broaden its utilization as a viable solution to escalating healthcare expenses and an efficient means of managing patient well-being during this crisis.

In our commitment to preserving access and ensuring the quality of care in home care delivery, the Oregon Association for Home Care (OAHC) has outlined the following State and Federal priorities for 2024 and beyond.

State Priorities

• Protect Medicaid funding to ensure Oregonians have access to home health care to stay out of hospitals and nursing homes. Ensure biennial rates are established as previously set by the legislature.
• Support legislation that would ensure access to palliative care in the continuum of care.
• Support legislation that will reduce administrative burden
• Support legislation that will make for a more friendly tax structure
• Support legislation that will increase access to home health care and address hospital discharge challenges
• Advocate for fair and reasonable employment standards that do not open providers up to liability exposure, particularly the Private Attorneys General Act, which would have permitted individuals to sue businesses on behalf of the state under any statute that includes a civil penalty.
• Advocate for responsible state regulations that do not add barriers to access to care commensurate with issued federal guidelines and limit additional state requirements for home health providers. Monitor and engage on burdensome employment requirements and proposals that increase costs for agencies.
• Support legislation and regulations that make in-home care, home health and hospice accessible and streamlined for patients and their families, particularly those in rural communities with less access to traditional health care service models.
• Monitored legislation that would have limited a provider’s ability to provide appropriate care based on patient demographics.

Federal Priorities

• Workforce
• Require medical residents and other professional licensed staff to have home care and hospice experience as part of their education
• Provide sufficient home care and hospice payments so that agencies can provide appropriate wages and benefits to caregiving staff
• Ensure availability of home care and hospice personnel to meet the growing needs of the baby boom generation, particularly in rural, inner city, and other underserved areas
• Support efforts to meet the growing need for trained palliative care professionals
• Home Health
• Ensure fair and accurate payment rate adjustments for home health agencies
• Ensure adequate reimbursement from Medicare Advantage plans for home health services
• Ensure a fair and equitable Home Health Value Based Purchasing (HHVBP) system
• Provide reimbursement recognition for telehealth
• Hospice
• Permanently allow the use of telehealth to perform hospice Face-to-face (F2F) encounter
• Advance hospice program integrity measures that more accurately and timely identify egregious fraudulent or abusive providers
• Protect the integrity of the Medicare Hospice Benefit by averting any major payment cuts or structural changes that could reduce access to care
• Hospice Special Focus Program (SFP) modifications to ensure the program identifies the appropriate hospices in need of additional scrutiny and supports SFP candidates’ ability to improve quality-of-care
• Demo respite care in the home
• Medicaid
• Moratorium on finalizing 80-20
• Enact legislation that requires that states continually assess Medicaid home care rates of payment and the methodology utilized for establishing rates
• Congress should enact requirements to ensure that home care reimbursement allows for appropriate living wage and benefit levels (including health care and paid sick leave), and annual pay increase for all caregiving staff
• Reconsider the requirements for the use of EVV in home care services
• Establish HCBS as a mandatory program