HCP Annual Report to Members

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® Home care. Health care. Your care . . . for life.

HCP 2009 Annual Report 

2009 HCP Year in Review HCP proudly celebrates 35 years representing the home care industry. Although the economic and political landscapes have changed over the years, the pressing need to increase awareness about the value of home care and the scope of services provided in the home remains the same. In 2009, HCP’s highly visibly public awareness campaign, “Home care. Health care. Your care . . . for life.®” which is now in its fourth year, continued to reach new audiences through public relations, increased communications, and member outreach initiatives targeted to elected and appointed government officials, consumers and potential new members.

Home Care Awareness HCP took its public awareness campaign to a new level in 2009, and a key aspect of HCP’s overall strategy was, and continues to be, moving the industry toward greater acceptance and use of technology, including increased use of the new HCP Web site. Launched in late October last year, the HCP Web site is increasingly being used as a central resource for consumers, government and elected officials and the medical community because of its relevant and timely information about home and community-based care. In conjunction with National Home Care and Hospice Month in November, HCP purchased a new url, www.homecareinfo.org which links directly to the “For Consumers” section of the new HCP Web site. This section of the HCP Web site, specifically designed for consumers, provides valuable information about types of agencies, how to find and pay for home care services, and numerous links to consumer resources on government and other Web sites. Consumers can also find a provider from among HCP member agencies using the “Find a Provider” search engine. HCP featured www.homecareinfo.org on marketing and promotional materials targeted to reach consumers throughout the year and encouraged its members to include this url in their grassroots marketing efforts. In March, HCP extended the reach of its public awareness campaign by leveraging components of the new National Association of Home Care (NAHC) awareness campaign, “Help Us Choose Home.” HCP posted NAHC’s 3-1/2 minute video, “Home” on the consumer section of the Web site, and promoted its availability to consumers. In April during the fight to save home care, HCP posted information about the devastating impact of the Governor’s restructuring proposals and budget cuts on the availability of home care services. A link was provided that allowed consumers to email their opposition to these proposals to Legislative leaders, and consumers voiced their support for home care during this period. Also as part of dozens of HCP public awareness initiatives, HCP Resources, Inc. purchased the rights for providers to use 1-800-HOMECARE and 1-800-HOSPICE in their marketing efforts. 1-800-HOMECARE is available to home care providers north of New York City. 1-800-HOSPICE is available to providers in all of New York State. Providers sign a contract to participate in the program and select the counties from which they want to receive calls. Research shows that the use of 800 numbers dramatically increases the number of incoming calls because the number is easy for consumers to remember. As HCP and participating providers promote these telephone numbers in the markets where the services are available, increasing numbers of consumers will be exposed to the message, and therefore learn about the availability of home care and hospice services.

HCP 2009 Annual Report 

HCP developed a relationship with the New York Post to create a Special Section about home and communitybased care in support of National Home Care and Hospice Month in November. The goal is to have a stand-alone section that will be saved and used by consumers as a valuable reference and resource about

home and community-based care. HCP is providing guidance on editorial aspects to the Post and also publicizing advertising opportunities with HCP members. The publication date is November 3, and it will reach over 8 million New York Post readers all across New York State.

HCP Celebrates 35 Years 2009

HCP establishes InPro™ (HCP WC Insurance Program, LLC)



HCP unveils state-of-the-art Web site

2008

2007

HCP introduces and trademarks home care positioning line, “Home care. Health care. Your care . . . for life.®”



2006

Home care awareness campaign launched



2004

Home Care Connect political education program introduced



2002

“Members Only” section added to HCP Web site



2003

HCP moves offices and opens training facility in East Greenbush



2001

HCP launches “Heroes in the Home™” statewide caregiver recognition program



1999

Edna A. Lauterbach Scholarship Fund established



1997

HCP launches first Web site



1995

HCP establishes Federal Political Action Committee (HCP FEDPAC)



1995

HCP retains first Federal lobbyist



1995

HCP Disability Benefits Trust established



1992

HCP Self-Insurance Trust (HCPSIT) established



1992

HCP Resources, Inc. established



1989

Community Health Care Services Foundation, Inc. (CHC) established



1988

Albany office opened



1986

Phyllis Wang elected HCP President



1984

Health Care Provider Political Action Committee (HCP PAC) established



1981

First Annual HCP Conference



1980

First State lobbyist retained



1980

First HCP Chapters formed



1974

HCP established

HCP 2009 Annual Report 

Public Relations Public relations (PR) in 2009 included support for National Home Care and Hospice Month, www.homecareinfo.org, 1-800-HOMECARE/HOSPICE, the Heroes in the Home caregivers program and the launch of HCP’s new Workers’ Compensation product, InPro™. PR efforts for the Edna A. Lauterbach Scholarship Fund resulted in coverage around the State and a record 43 scholarship applicants. Additionally, there have been consistent and aggressive policy efforts to prepare op-ed and letters to the editor, in support of home and community-based care in the face of proposed home care restructuring, drastic budget cuts and unfunded mandates affecting the industry. To date, HCP’s year-to-date media value, for the 2008/2008 fiscal year stands at almost $100,000. HCP will continue to use advantageous and timely media opportunities that will generate increased exposure for HCP, home and community-based providers and each of our members.

HCP’s Web Site HCP has realized significant benefits from its new Web site and has strived to make the new site an integral part of its overall business strategy. In addition to a valuable role in HCP’s public awareness initiatives, the Web site has also become a strategic resource for HCP members. Overall, Web site traffic has continued to grow significantly this past year due to enhanced content and improved navigation that enables visitors to find the information they need more quickly. There was a dramatic increase in site traffic during the Legislative Session as members and other providers turned to HCP’s Web site to get the latest information about proposed New York State budget cuts and the home care restructuring proposal. HCP staff used the Web site to provide ongoing updates, and members downloaded information for meetings with legislators and linked to the Legislative Action Center (LAC) to send critically important communications to Legislative leaders. It has also become a go-to resource for policymakers at all levels of government. The site was also a resource for members on a wide variety of important issues, including Live Scan Fingerprinting, the Home Care Registry, Office of Medicaid Inspector General (OMIG) audits, Third Party Liability (TPL), H1N1, flu vaccines, and National Health Care Reform. Enhancements and new content areas continue to be added. New features this year included “Legal Corner,” featuring legal articles of interest to providers from HCP Associate members; “Meet the Board,” with profiles of HCP Board members; and “Letter from the Chair,” a periodic communication from HCP’s Board Chair. Roster Management will be rolled out in November. This new functionality will allow HCP member main and branch contacts to update information about their agencies—information that is used as the basis of the “Find a Provider” search engine. They will also be able to update their personnel rosters for all their locations. Plans are currently underway for a redesign of the Community Health Care Services Foundation, Inc. (CHC) Web site. The new site will have a similar design to the HCP Web site, and the two sites will be fully integrated. The goal of the redesign will be to showcase CHC’s role as an education leader in the home care industry and to improve navigation to allow visitors to find CHC education programs, events and grants much more quickly and easily.

HCP 2009 Annual Report 

InPro™ InPro™ (HCP WC Insurance Program, LLC), HCP’s new member-owned Workers’ Compensation product, was launched on July 1, 2009 as a replacement product for the Health Care Provider Self-Insurance Trust (HCPSIT), which no longer provided coverage after June 30, 2009. InPro provides full Workers’ Compensation coverage at very competitive rates and is available to home and community-based providers nationwide. It is the only program of its kind nationally that is specifically designed to meet the unique needs of home and community-based providers, and it is the only program owned and managed by participating providers. The program name (InPro) and logo were developed by the HCP Marketing Division. The program was launched in July with a nationally distributed press release, articles in Tools for the Trade and The HCP Insider, promotional flyers and emails to HCP members, and informational Web pages on the HCP Web site. A new url was also purchased, www.inproworkerscomp.com, that will drive interested providers to the InPro Web pages on the HCP Web site. The national rollout of the program will begin in January 2010. To date there are about eighty participants in the program, and HCP expects this number to increase significantly as providers in New York and around the country realize the significant benefits and savings delivered by InPro.

Marketing, Membership & Communications Marketing The Marketing Division continues to drive a number of strategic initiatives and has developed marketing campaigns and sales support materials for programs, events, conferences, membership and grants for HCP and its affiliates. An important focus for the Marketing Division this year was the integration of key messages between Public Policy and Marketing to strengthen and broaden HCP’s message and reinforce HCP’s industry leadership position. Early in the year, HCP developed a strong strategic message as the umbrella for its advocacy efforts: “Real People. Real Families. Real Needs.” which focused on the realities and devastating impact of the proposed budget cuts and home care restructuring proposals. While HCP Public Policy staff worked round-the-clock on highly visibly advocacy efforts with HCP members, HCP’s retained lobbyists, Weingarten, Reid & McNally and the Legislature, HCP’s marketing team used the same theme to create a consumer campaign that included information on HCP’s Web site, press releases targeting mainstream media and consumers drawing attention to the issues. A letter campaign at the Empire State Plaza during Advocacy Days resulted in securing over 125 signed consumer letters supporting home care. This coordinated campaign raised awareness about the value of home care, and stopped devastating proposals from being enacted. Marketing worked to increase attendance at CHC educational programs with new materials designed to increase the effectiveness of the communications. Redesigned materials simplified the message, added the level of each program (beginner, intermediate, advanced/expert) to better segment the target audience, and improved the readability. HCP 2009 Annual Report 

These changes helped drive record attendance for several programs including the Home Care Management Institute, Surviving Surveys, and several Webinars that each drew a record number of sites. A number of educational programs were heavily promoted, including CHRC 101 and Live Scan Fingerprinting Training, Home Care Registry Implementation, as well as CHC Forums on topics including Chronic Kidney Disease, Working with the Developmentally Disabled, and Reporting and Recording for Paraprofessionals. The five Emergency Preparedness on site programs presented in July across the State through a grant from the New York State Department of Health saw record numbers of attendees in every location, supported by strong marketing efforts. Promotion for HCP’s 2009 Annual Management Conference & Exhibition in Albany began in May and June with distribution of the Exhibitor Prospectus, followed by the attendee brochure. HCP took full advantage of its new Web site, developing a dedicated area of the site devoted to the Conference. A special url, www.hcpconference.org, was purchased and heavily promoted to drive traffic to Conference Web pages, and registration was featured prominently to allow visitors to register instantly online. Conference marketing efforts included promotion of the newly approved contact hours for nurses, Private Pay track sessions, featured speakers, and Public Policy sessions.

Membership HCP continued aggressive membership recruitment efforts in 2009. A major provider membership campaign was launched in the Spring, and recruitment efforts were stepped up targeting the large numbers of non-members who attend onsite programs and events as well as reaching out to potential new Associate members. These efforts resulted in the addition of 37 new members this year—26 Provider and 11 Associate members. This year, as always, there was churn as agencies closed or experienced financial distress or other issues, which resulted in no change in absolute membership numbers. In August, HCP began distributing 2009/2010 membership renewals materials via email to all members. Several articles advising members about the electronic

renewals appeared in The HCP Insider along with a highly visible advertising campaign. In addition, HCP ran articles regarding the change in HCP dues and dues categories for the 2009/2010 membership year as recommended by a membership committee and approved by the Board of Directors in 2008.

Edna A. Lauterbach Scholarship Fund Edna A. Lauterbach was a nurse and respected leader in the home care community who believed that skilled nurses are essential to the delivery of quality care Edna A. Lauterbach in the home care industry. The scholarship in her name was created by the Health Care Providers Self-InsuranceTrust (HCPSIT) for New York registered and licensed practical nurses who want to further their education or training to enhance skills in the clinical or business area toward the goal of fulfilling an entrepreneurial dream in home or community-based care. Once again this year, HCP proactively solicited donations for the Scholarship from home and community-based providers, industry leaders and nursing schools. The Scholarship saw a 10% growth in monies available as a result of these efforts, which is a significant achievement given the difficult economy and tight budgets. The Scholarship was promoted in the media as well as across the State, resulting in a record number of applicants.

Heroes in the Home™ HCP’s Heroes in the Home™ Statewide Caregiver Recognition Program honors compassionate, dedicated caregivers who make extraordinary contributions on a daily basis to the delivery of high quality care in the home. This program also increases public awareness and understanding about the commitment and caring of home care workers. There were many outstanding candidates nominated for this year’s award, and one paraprofessional and one professional caregiver will receive their awards on October 29 at the Annual Awards Luncheon at HCP’s Annual Management Conference & Exhibition in Albany, New York. HCP 2009 Annual Report 

Publications HCP and its affiliates publish a number of high value publications throughout the year designed for HCP members, elected, appointed or those working in government, and others in home and communitybased care. These publications provide timely updates about important issues, information about home care education, grants, risk management, and insights, tools and resources to help providers run their businesses. This past year, HCP surveyed HCP members about the delivery method and content of The HCP Insider, and the results confirmed that this publication is an invaluable resource for members because of its in-depth news and insights about ongoing industry issues. While the content and delivery method will continue at the same level that members have come to expect, HCP is planning a fresh, new design for The HCP Insider, new graphic elements to draw attention to important information, and structural improvements that will make it easier to read and find articles within the publication. The new HCP Insider look will be rolled out with the first issue in November. Other HCP publications include Tools for the Trade, published bi-monthly, which features in-depth interviews with well-known industry figures along with practical public relations/marketing information and tips for providers on promoting their agencies and home care awareness. Home Care New York , which provides New York State Legislators and staff with important information and perspective supporting the home care industry. Focus, a quarterly publication published by HCP affiliate Community Health Care Services Foundation, Inc. (CHC), features information about home care education and grants.

HCP published HCP Member News, a periodic newsletter with important updates and membership benefits information for HCP members. This newsletter included an overview of HCP’s Public Awareness Campaign, an update on the HCP Web site and new features added to the site, information about the HCP membership dues restructuring, and notices about HCP’s electronic membership renewals.

Solutions, a safety and loss control publication, previously published by HCPSIT, is currently being revamped as an electronic publication for InPro™ that will feature information and perspectives on issues related to Workers’ Compensation, loss control, and safety in the workplace.

HCP In Detail and Legislative Retrospective

In-depth analysis of a particular subject is the hallmark of HCP In Details. In 2009, an analysis of the 2009 New York State budget was prepared as an In Detail. This year, HCP also developed The Legislative Retrospective that provided a comprehensive look at the entire 2009 New York State Legislative Session. In Details and The Legislative Retrospective are distributed to members with The HCP Insider and then are made available on Members Only pages of the HCP Web site.

HCP 2009 Annual Report 

Public Policy In 2009, with overwhelming support from HCP members and consumers, HCP defeated some of the most drastic and ill-conceived policy proposals affecting home and communitybased care. Communicating a strong advocacy message in a clear and unified way ensured that HCP was heard. Together, we saved home care! 2009 was a year like no other. Home care faced extraordinary policy and political challenges: hundreds of millions of dollars in proposed cuts; damaging restructuring proposals; a change in decades-long leadership in the New York State Senate along with a political coup at the end of Session; and an ongoing State fiscal crisis. During this time of turmoil, HCP helped home care providers gain critical access to decision-makers, keeping home care at the forefront of policy discussions. In addition to the major policy battles that ensued during budget negotiations, difficult regulatory challenges continued throughout the year. HCP advocated nonstop on behalf of members as various unfunded mandates were imposed on the home care industry—Office of Medicaid Inspector General (OMIG) audits, the Home Care Registry, the health care personnel flu mandate, Federal health care reform, and a number of other issues. All required HCP to use its considerable strength and influence, and that of our members, to advocate on behalf of home care.

HCP’s aggressive 2009 advocacy efforts resulted in: w Blocking proposals to prohibit contracting and mandate how providers use their revenue w Restoration of $243 million in State budget cuts w Major improvements in the Criminal History Record Check (CHRC) process, including supervision flexibilty and the transition to Live Scan w Advocacy for key reforms for the Home Health Aide Registry and the Mandatory Influenza Vaccination Requirement w Advocacy for providers on audit concerns to the Office of the Medicaid Inspector General w Strong and growing relationships with State government officials, including the new Senate Majority w Establishment of a strong, responsive and vocal grassroots network of advocates across New York State

HCP 2009 Annual Report 

Home Care Saved in 2009-10 State Budget The home care industry faced unprecedented challenges in 2009, all of which had the potential to change home care dramatically. An aggressive and comprehensive advocacy strategy, expertly executed by the combined efforts of HCP members, staff, and lobbyists Weingarten Reid & McNally (WRM), saved the industry from proposals that would have resulted in lost jobs, agency closures, disruption of home care services, and significantly altered home care reimbursement policies. This year’s budget victories are defined not by what was included in the final budget, but by what HCP’s concentrated efforts were able to eliminate from the budget. Prohibition on home care contracting • This defeated proposal would have forced the closure and downsizing of Licensed Home Care Services Agencies (LHCSAs) by not allowing them to service Medicaid home care patients through longstanding and effective contractual relationships. HCP’s immediate and aggressive response to this proposal saved more than 74,000 jobs that would have been lost, ensured the continuity of care for 350,000 patients, and prevented the potential closure and/or downsizing of more than 300 LHCSAs. This proposal also would have had a significant impact on how Certified Home Health Agencies (CHHAs) managed care for their patients. LHCSA revenue use mandate • HCP anticipated, and was prepared to block, the last minute attempt by adversaries to mandate how LHCSAs use their revenue. The proposal requiring that 77% of gross receipts from contracts with CHHAs/LTHHCPs be dedicated to wages and benefits for direct care workers was quickly extinguished by a well-prepared and informed HCP staff. CHHA reimbursement methodology restructuring • Constructive dialogue on reimbursement policy has always been encouraged by HCP, but a proposal to overhaul the CHHA Medicaid payment system with little input from the industry and an unrealistic timeline did not allow adequate time to address myriad concerns of HCP and the home care industry. HCP successfully advocated for the creation of, and has been active in, a Home Care Reimbursement Workgroup to establish a reimbursement methodology that would be studied and tested prior to its implementation. $243 million in cuts restored • $243 million worth of proposed cuts to home and personal care were defeated. These cuts included direct rate reductions, a reduced Administrative & General (A&G) cap and a reduced CHHA/LTHHCP rate ceiling. HCP was also successful at cutting the size of the home and personal care assessment tax in half.

HCP 2009 Annual Report 

A Year of Unparelled Advocacy on Behalf of the Home Care Industry The State’s fiscal situation will continue to present challenges for the home care industry. Budget cuts and reimbursement policy proposals are expected in the Governor’s 2010-11 Executive State budget, if not before, making participation in grassroots advocacy efforts essential for New York’s home care industry. HCP continues to build and maintain valuable relationships with key decision makers in the Executive and Legislative branches, and looks forward to continue working with HCP members to safeguard home care for New York’s elderly, disabled, and chronically ill.

Training and Certification Home health aide training and certification and the implementation of the New York State Home Health Aide Registry on September 25 were a high priority for HCP. HCP was on record with the Governor, Attorney General, Legislators and Department of Health (DOH) policymakers, identifying a number of critical issues with the Registry. Staff resources were devoted to addressing the stringent timeframes required of providers to enter information, the concern about worker privacy under the public access provision of the Registry, and the inability to complete in-home supervised practical training (SPT), worker privacy, and worker and patient safety. HCP offered recommendations for mitigating the overwhelming impact on the industry, including changing the timeframes for data entry, changing the SPT requirement, striking the public access provision, and extending the effective date of the Registry for one year. At the same time, HCP was highly active in providing education about the Home Care Registry, and worked in conjunction with Community Health Care Services Foundation, Inc. (CHC) and DOH to host two Registry training webinars on September 11. HCP will continue to work with the Governor, Legislature, Attorney General and DOH to create a stronger, workable Registry. HCP also remains in regular contact with DOH to secure up-to-date answers and clarification to the many questions providers have about the Registry.

Home Care Programs, and hospices must provide or arrange for influenza immunizations for their personnel, at no cost. HCP pressed hard for relief from this unfunded mandate. The mandate was brought to the attention of Legislators during statewide breakfasts and at a legislative hearing. Over 100 HCP members responded to HCP Action Alerts to contact the Governor, Legislators and Commissioner Daines to urge that the requirement be optional for 2009, as providers were not given adequate time or resources to prepare for this massive undertaking, employees were not allowed to decline the vaccine without losing their jobs, and financial resources were not made available to providers to fund the mandate.

CHRC Live Scan Progress Following years of relentless advocacy, HCP was successful this year in securing a change in the Criminal History Record Check (CHRC) regulation that now provides more supervision flexibility for providers, and allows direct on-site CHRC supervision visits to be completed by a licensed health care professional, senior aide or other paraprofessional who meets the one year requirement of employment in home care.

Mandatory Influenza Regulation

On June 15, the CHRC System was transitioned to Live Scan. HCP worked with DOH and Live Scan Vendor, L-1 Identity Solutions, to address many provider concerns about Live Scan implementation, including advocating for the vendor to travel to agencies with large groups of employees, expanding locations to provide more site options and provider flexibility, eliminating language barriers at the sites, and payment issues.

On August 13, DOH filed an emergency regulation with the Secretary of State to require influenza immunizations for health care workers. Under the regulations, LHCSAs, CHHAs, LTHHCPs, AIDS

For months, HCP worked to secure answers about Live Scan implementation, and through its affiliate CHC, provided educational programming that allowed providers to ask questions of L-1 Identity Solutions and experts from CHRC.

HCP 2009 Annual Report 10

OMIG Audits

Home Care Reimbursement Workgroup

In the wake of other regulatory mandates, providers were also subject to heavy audits by the Office of the Medicaid Inspector General (OMIG). HCP initiated a number of strategic initiatives to ensure home care providers are not subject to unfair and overly broad recoupment processes by OMIG.

HCP was successful in securing numerous positions on the Home Care Reimbursement Workgroup for prominent HCP members. The Workgroup, authorized by the 2009-10 State Budget, was charged with examining an episodic payment system for Certified Home Health Agencies (CHHAs) and subcontracting arrangements between CHHAs, Long Term Home Health Care Programs (LTHHCPs), AIDS Home Care Programs and Licensed Home Care Services Agencies (LHCSAs) for home health aide services.

HCP provided direct and open feedback about the overwhelming magnitude of recoupments being sought; concerns about the extrapolation methodology; problems with third parties involved in the authorization of the delivery of Medicaid services; why providers should not be held liable for the roles and responsibilities of others; and the concern that providers are being compelled to settle their audits or face higher penalties. HCP regularly met with Medicaid Inspector General James Sheehan and staff to address concerns about the Traditional Medicare Appeals Project (TMAP), which puts a massive burden on agencies in relation to how they bill for duallyeligible patients. HCP is working to reduce the burden of this project by terminating it altogether or cut the number of patient claims impacted by the project. HCP also continues to work with other provider groups to address issues raised as a result of OMIG audits. Going forward, strategies include all groups joining forces with both the Legislature and Governor’s office to seek legislative reprieve for unfair and overly broad recoupment processes by the OMIG. Through CHC, HCP is offering a three part webinar series, Preparing for OMIG Audits. which provides an overview of the New York State Provider Compliance Program, how to implement an effective compliance program, and a review of medical records and documentation required for the program. The first Webinar was offered in October, the second is scheduled for November 18, and the third for January 28, 2010.

Throughout the year, HCP worked strategically with Workgroup members and other key stakeholders to prepare materials, analysis, and recommendations. These recommendations will inform the Department of Health’s report to the Legislature, which is due December 1, 2009, and could alter the landscape for home and community-based care in New York State.

Emergency Preparedness HCP staff, along with staff from Community Health Care Services Foundation (CHC), provided free onsite emergency preparedness seminars across New York State to present this year’s work, funded through an emergency preparedness grant from the New York State Department of Health. Attendance continued to reach record-breaking numbers. CHRC staff and HCP public policy staff continue to work with Katharine Logan, Non-Acute Care Coordinator for the New York State Department of Health Emergency Preparedness Program on these seminars. Information was provided on medical surge plan template components, Health Provider Network (HPN) access, education on flood zones, definitions of Transportation Assistance Levels (TAL), an overview of the Incident Command System, and H1N1. HCP also provided emergency preparedness tools on the Web site for members (created by DOH and the Center for Disease Control) on infection control and emergency preparedness resources.

Home Care Quality Initiaves HCP remains an active member on the New York State Discharge Planning Committee. HCP secured three members to speak from the Certified Home Health Agency, Licensed Home Care Services Agency and Long Term Home Health Care perspectives, relating patient case stories about challenges and successes in Discharge Planning.

HCP 2009 Annual Report 11

HCP is also an active partner with other associations and DOH on a statewide pressure ulcer prevention initiative across all health care settings that includes education for providers that will help reduce pressure ulcers.

Grassroots Advocacy HCP member grassroots advocacy efforts are critical to the outcome of public policy campaigns. When combined with political action and formal advocacy by HCP and WRM in Albany, local grassroots advocacy is a powerful tool for delivering strong, consistent messages to policymakers about the issues facing the industry. In 2009, the home care industry faced unprecedented challenges, making grassroots advocacy more important than ever.

Targeted District Meetings In 2009, HCP amplified its grassroots advocacy efforts by implementing a statewide, district-level strategy. HCP staff recruited members to conduct meetings in key districts, provided direction, and created support materials. As a result of this strategic planning, HCP members met with over 50 legislators in their district offices to voice their concerns about the Governor’s Budget proposals. Coordinated messaging allowed HCP and WRM to leverage these district meetings during their daily visits with legislators in Albany. Member feedback from district meetings enabled HCP staff and WRM to refine messages as needed as the Budget process evolved.

Legislative Action Center HCP’s Legislative Action Center (LAC) is a powerful tool that allows members to contact their representatives quickly and easily. In 2009, HCP used the LAC to mobilize member efforts related to Medicaid cuts during the 2009-10 State budget negotiations, the proposed contracting prohibition, Medicare funding, Federal home care cuts, Federal health reform, and the health care personnel flu mandate. Using the LAC, nearly 400 unique users sent over 1,300 messages to State and Federal officials. For the first time, HCP successfully engaged the public through the LAC in 2009; 48 consumers sent over 100 messages to their legislators. The chart below shows the significant increase year-over-year in the use of the LAC by providers.

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HCP 2009 Annual Report 12

Home Care Connect HCP’s Home Care Connect program gives legislators and the media a first-hand look at home care. By inviting legislators on home visits, Home Care Connect gives policymakers a firsthand opportunity to learn about the vast array of services available in the State, the agencies that operate in their district, and the type of patients who receive home and community-based care. HCP staff provides assistance to members by coordinating visits and working with local media to encourage coverage. The result is increased public awareness about home care and the host agency. In 2009, seven State and one Federal policymaker participated in Home Care Connect. Since its inception in 2004, over forty elected officials have been on a home visit, including such prominent figures as U.S. Senator Charles Schumer, Senate Minority Leader Dean Skelos, and Assembly Majority Leader Ron Canestrari.

Federal Advocacy Efforts Federal health care reform has taken center stage in Washington, D.C. this year and could significantly impact home health care providers. Efforts to pay for reform have targeted Medicare, with a disproportionate percentage of cuts aimed at home care. HCP was one of the leading organizations supporting home care in the health care reform debate, utilizing relationships with key leaders in the U.S. Senate and House to raise awareness about destructive home care policies in various health reform bills. The HCP Board of Directors and HCP members began advocating for home care early in the year with personal office visits during the 12th Annual Congressional Advocacy Day in Washington, D.C. These meetings were just the beginning of a nearly constant flow of phone calls through HCP’s Health Care Reform Congressional Call-In, a virtual advocacy day, numerous letter-writing opportunities, and direct HCP contact with Legislative staff.

HCP also made New York State the national leader on a “Dear Colleague” letter in support of home care, garnering the support of thirteen New York House members (the most of any State) and both New York Senators. HCP used this momentum to garner support for amendments to health care proposals that significantly reduced the level of cuts to home care. Senator Charles Schumer (D) said it best when he told the Senate Finance Committee during debate on health care that home care was getting “clobbered” by proposed cuts. While the health care reform debate continues, HCP’s efforts have already paid dividends. The Senate has adopted several proposals offered by the home care industry and advocated for by HCP in place of more severe cuts, and awareness about home care cuts is increasing in the House. HCP will continue to fight for the interests of home care from a health care provider point of view and from the perspective of home care agencies as employers. Much progress has been made, but there is more to be done to preserve and enhance access to home care services. HCP also met regularly with members of the New York Congressional Delegation, requesting financial support of several priority programmatic initiatives for home care. HCP’s affiliate, CHC, submitted thirty earmark requests for fiscal year 2010 for a Telehealth and Diabetes Demonstration, Telehealth and Aging Demonstration, and a Home Care Jobs Campaign. As a result of HCP’s education efforts, Telehealth and Aging Demonstration earmarks were advanced by Senators Schumer and Gillibrand, and are pending inclusion in the final Agriculature bill.

Real People. Real Families. Real Needs. HCP published its third annual Legislative Gazette Special Issue, Real People. Real Families. Real Needs. This publication is a critical part of HCP’s home care advocacy efforts in the State Legislature and Executive Branch. Generous support from HCP members makes this key advocacy tool possible. The special issue helps the home care industry raise awareness about the benefits of home care while reporting on the impact that the State budget and other government policies have on the industry and those who rely on home care services to remain in their homes. HCP is preparing for the 2010 special issue, and will again seek sponsorship support from HCP members and other interested organizations. HCP 2009 Annual Report 13

HCP 2008-2009 Board of Directors Bader Reynolds Chairperson CareGivers Utica, NY

Deborah Glassey CHC Representative Always There Family Home Care Kingston, NY

Phyllis Raymond Northeastern New York Chapter President Accent Health Care Services, Inc. Troy, NY

Susan Bayerl Executive Vice Chair People Home Health Care Services Licensed & Certified, Inc. Buffalo, NY

Maria Sunukjian Health Related Organization Representative Family & Child Service of Schenectady Schenectady, NY

Linda Paasch Western New York Chapter President Health Association of Niagara County Niagara Falls, New York

Sue Ellen Stuart Vice Chairperson, CHHA Visiting Nurse Service of Ithaca & Tompkins County Ithaca, NY Jordan Shames Vice Chairperson, LHCSA Neighbors Home Care Bronx, NY Indi Shelby Vice Chairperson, LTHHCP Visiting Nurse Association of Central New York, Inc. Syracuse, NY Barbara Hiney Vice Chairperson, Hospice Metropolitan Jewish Health System Brooklyn, NY Annette Horvath Treasurer Bronxwood Licensed Home Care Bronx, NY Mary Winters Secretary RegionCare, Inc. Hempstead, NY

Paul Essner Associate/Allied Representative The Signature Group of Companies Garden City, NY

Robert Callaghan PAC Development Officer Robert L. Callaghan, Inc. Selden, NY

Lynn Holstein Central New York Chapter President Independent Health Care Services, Inc. Syracuse, NY

Paula Reichel Immediate Past Chairperson Community Health Center of St. Mary’s and Nathan Littauer Hospitals Johnstown, NY

Joseph Maloney Finger Lakes Chapter President Maxim Healthcare Services Rochester, NY

Phyllis Wang President HCP Albany, NY

Jennie Cortese Hudson Valley Chapter President WILLCARE Middletown, NY

Legal Counsel Joel Hodes, Esq. Whiteman Osterman & Hanna Albany, NY

Taryn Birkmire Long Island Chapter President Recco Home Care Service, Inc. Massapequa, NY Open Seat Mohawk Valley Chapter President

Retained Lobbyists Steve Weingarten, Esq. Bob Reid Shauneen McNally Weingarten Reid & McNally, LLC Albany, NY

Nina Polinsky New York City Chapter President Reliable Community Care, Inc. New York, NY

HCP 2009 Annual Report 14

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