January 21, 2014

Schofield received final approval from the New York State Department of Health last year to convert our Long Term Home Health Care Program to a Certified Home Health Agency (CHHA.) Schofield submitted an application through the State's certificate-of-need process in 2012 and was one of only two new CHHA's approved in the Western New York area. The name of our new CHHA will be Schofield Certified Home Care. Through the new CHHA, we will offer home health care services in both Erie and Niagara counties. The new agency will allow us to serve more individuals and expand Schofield's continuum of care. According to Edward J. Gray, President, sweeping changes in the delivery of home health care services in New York State are behind the change. "Changes brought on by restructuring of the Medicaid program in New York State are affecting how Medicaid home health care services are delivered," said Mr. Gray. "With all Medicaid patients set to be mandated to enroll in a Medicaid Managed Care (MMC) program or a Managed Long Term Care plan (MLTC), the role that the Long Term Home Health Care Program played in the health care system in the past will no longer be viable." One of these changes has already taken place. Previously, Schofield's LTHHCP could enroll patients who were Medicaid and Medicare/Medicaid eligible. Now LTHHCP's can only enroll those individuals who have both Medicare and Medicaid coverage. "The system is moving toward a managed care payment system which will emphasize the CHHA," said Mr. Gray. "Schofield is looking to adapt to these changes in a way that ensures we are able to continue our mission into the future." Both CHHA's and LTHHCP's offer similar services, however LTHHCP's currently coordinate and manage what are called Medicaid Waivered Services. These services include case management by Registered Nurses, home delivered or congregate meals, housing improvements and moving assistance, medical social services, nutrition and dietary services, respite care, social day care, and social transportation. Changes in the Medicaid system, calls for Managed Long Term Care plans to either provide, or arrange, and pay for, those services for Medicaid patients. "With Medicaid redesign, all of the patients currently in Schofield's LTHHC Program will eventually move into Managed Long Term Care plans ," said Mr. Gray. "These plans will be the case managers for the patient, or will contract with other agencies for case management services. At the time the patients are transitioned, they will have the opportunity to continue to be served by Schofield, if they request. They must choose a MLTC plan with which Schofield has a contract if they wish to continue receiving care from their current nurse, aides or therapists." When asked if adding the CHHA to Schofield's array of services would enhance the care offered to individuals, Mr. Gray replied with an emphatic "yes!" "Through Schofield Certified Home Care, we will also be able to provide more Medicare services to individuals who are discharged from hospitals or skilled nursing facilities and are in need of therapy services at home. This includes individuals discharged from the Schofield Residence Nursing Facility," said Mr. Gray. "Because of restrictions on our LTHHCP, we could only help if the patient had a need for nursing care as well as therapy services. With the CHHA, there is no such limitation." Schofield Certified Home Care will provide long-term nursing and home health aide services, can help patients determine the level of services they need, and can either provide or arrange for other services including physical, occupational, and speech therapy, medical supplies and equipment, and social worker and nutrition services. Schofield is also expanding geographically. "We can also offer care to residents in Niagara County, which our LTHHCP was not able to do," said Mr. Gray. "In addition, Schofield Certified Home Care will be able to provide clinical services to patients who are already receiving Traumatic Brain Injury (TBI) services through our TBI Case Management program and clinical services to patients in our AIDS Home Care Program." What will happen next? Several employees are currently working on developing policies/procedures and systems to submit for approval to New York State. Schofield Certified Home Care must begin providing care in Erie and Niagara Counties, and admit its first patient in each county by June 2014. Stay tuned for updates and progress regarding the establishment of Schofield Certified Home Care. Schofield's LTHHCP currently provides care to 215 Erie County residents. During the conversion process, Schofield will continue to admit and care for patients who are eligible for the program. For more information on Schofield's in-home care programs, call 716-874-2600.