Home care accreditation program goes national
Seeking to underscore uniqueness of hospice
The Accreditation Commission for Home Care (ACHC), an independent nonprofit organization based in Raleigh, NC, is now trying to extend its provider-designed, peer-reviewed accreditation standards for home health agencies, hospices, and other home care providers nationwide.
Although not as well-known as its much larger home care accreditation peers the Joint Commission on Accreditation of Healthcare Organizations and the Community Health Accreditation Project (CHAP) ACHC is trying to take its place as one of the "big three" standard-setting organizations in home care, and was scheduled to apply to the Health Care Financing Administration (HCFA) for deemed status by the end of May.
ACHC’s accreditation programs are discipline-specific, with designated standards for nursing, medical social services, in-home aides, respiratory therapy, and the rehabilitative therapies. Other standards apply to assistive technology, home medical equipment, home infusion, and home pharmacy services. Its active, 32-member working board includes providers, consumers, and government officials.
Recognizing hospice as unique care
Some hospice headers have complained that the Joint Commission and CHAP fail to recognize or underscore the subtleties that make hospice unique among home care providers. Hospices may thus be interested in knowing that Hospice for the Carolinas and its Standards and Ethics Committee played an active role in the development of ACHC’s current hospice standards, and hospice representatives sit on its board of commissioners.
ACHC’s hospice standards are based on the NHO’s movement-defining "Standards for a Hospice Program of Care." The hospice accreditation is separate from not an offshoot of, home care standards, says Cynthia Layton, BSN, MPH-HPA, vice president for NHO’s accreditation services.
ACHC has accredited 46 home care organizations with a total of 70 sites and has 32 applications in the pipeline, Layton says. North Carolina is home to two-thirds of the accredited organizations, but most of the new applications are from out of state. The commission has accredited five hospices that are departments of home health agencies, but the first four independent hospices are now waiting to be surveyed. It also hopes to submit an application for deemed status for hospice later this year.
[Editor’s note: The cost of ACHC accreditation for an independent hospice would range from $3,700 to $4,500, based on size and number of services. For more information, contact the commission at 3325 Executive Drive, Suite 150, Raleigh, NC 27609. Telephone: (919) 872-8609.]
HR 521, the Medicare Hospice Benefits Amendments Act of 1997, sponsored by Reps. Ben Cardin (D-MD) and Rob Portman (R-OH) has attracted more than 100 co-sponsors. A companion bill in the Senate, S734, was introduced by Sen. John Breaux (D-LA) in May.
Meanwhile, a set of proposals by the Clinton Administration to address fraud and abuse concerns in the Medicare program (see Hospice Management Advisor, May 1997, p. 53) has not yet been introduced in Congress, although it may be incorporated into a budget bill.
The administration’s plan, based in part on concerns identified through Operation Restore Trust (see story, p. 61), overlaps somewhat with HR 521, most notably in replacing the final fourth Medicare hospice benefit period, which is unlimited in length, with an unlimited series of 30-day (administration plan) or 60-day (HR 521) benefit periods.
National Hospice Organization President John J. Mahoney says his organization supports HR 521, but is not opposing the administration’s plan at least in its current form.
Meanwhile, President Clinton has signed into law the "Assisted Suicide Funding Restriction Act of 1997," which passed both houses by wide margins this spring. It prohibits using federal funds for causing or assisting in suicide or euthanasia but also authorizes the Public Health Service to fund demonstration proposals to reduce restrictions on access to hospice programs, among other features.
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