(a) Quality is that characteristic which
reflects professionally appropriate and technically adequate patient
services.
(b) The state home health
industry, through development of ethical standards and a peer review process,
can foster provision of quality home health care services. Each provider must
establish mechanisms for quality assurance, including procedures for resolving
concerns identified by patients, physicians, families or others involved in
patient referral or patient care.
(c) Planning Policies
1. Planning Policy. The county is the
geographic unit for need determination, based upon population.
2. Planning Policy - (New Providers). When a
new provider is approved for a county, that provider will have eighteen (18)
months from the date the Certificate of Need is issued to meet the identified
need in the county before a new provider may apply for a Certificate of Need to
serve a county.
3. Planning Policy
- Favorable Consideration. Home health agencies that achieve or agree to
achieve Charity Care plus Self Pay at the statewide average percent for all
home health providers shall be given favorable CON consideration over home
health applicants that do not achieve the statewide average for Charity Care
plus Self Pay, but not less than one percent (1%). The latest published SHPDA
data report HH-11 shall be used to determine the assets to governmental and
non-profit organizations at the individual county level to be considered. See
section
410-2-2-.06
for the definition of charity care.
4. Planning Policy - CON
Intervention/Opposition.
(i) Any CON
application filed by a health care facility shall not be deemed complete until,
and unless:
(I) The applicant has submitted
all survey information requested by SHPDA prior to the application date;
and
(II) The SHPDA Executive
Director determines that the survey information is substantially
complete.
(ii) No Home
Health Agency or Hospice Agency filing an intervention notice or statement in
opposition in any CON proceeding may cite or otherwise seek consideration by
SHPDA of such facility's utilization data until, and unless:
(I) the intervenor or opponent has submitted
all survey information requested by SHPDA prior to the application date;
and
(II) the SHPDA Executive
Director determines that the survey information is substantially
complete.
5.
Home Health Need Methodology
(i) Purpose. The
purpose of this home health need methodology is to identify, by county, the
number of home health agencies needed to assure the continued availability,
accessibility, and affordability of quality home health care for residents of
Alabama.
(ii) Basic Methodology. In
order to perform the calculations for this methodology, population data from
the Center for Business and Economic Research (CBER) is utilized. All time
frames are based on the year of the latest reported data.
Step 1:
1. Data required to perform the calculations
in this methodology are population data for the current reporting year, the two
reporting years immediately prior to the current reporting year, and the
projected data for three years immediately following the current reporting
year.
2. Persons served data for
the current reporting year, and the two reporting years immediately prior to
the current reporting year, are required to perform the calculations in this
methodology. This information can be gathered from the HH-2 report as generated
by SHPDA.
3. The ratio for the
change in population for two age cohorts, Population under 65 and Population
age 65 and over, is determined per county. The ratio for the change is a
three-year period. The current reporting year is compared to the year three
years following the current reporting year. The year immediately prior to the
current reporting year is compared to the year two years following the current
reporting year. The year-two year prior to the current reporting year is
compared to the year immediately following the current reporting year. To show
this another way:
Current Reporting Year -- Current Reporting Year + 3
years
Current Reporting Year -- Current Reporting Year + 2
years
Current Reporting Year -- Current Reporting Year + 1
year
4. Projected patients
served under the age of 65 for future reporting years are calculated on a
county basis by multiplying the year's total persons served by 25% (0.25) to
determine the approximate number of persons served under the age of 65. This
number is divided by the county population under the age of 65 to determine a
utilization rate. To determine the projected patients served under the age of
65, this total is then multiplied by the total projected population for the
target year for each county.
5.
Projected patients served age 65 and older for future reporting years are
calculated on a county basis by multiplying the year's total persons served by
75% (0.75) to determine the approximate number of persons served age 65 and
older. This number is divided by the county population 65 and older to
determine a utilization rate. To determine the projected patients served age 65
and older, this total is then multiplied by the total projected population for
the target year for each county.
6.
To determine the total number of projected persons served per county, add the
totals from steps 4 and 5.
7. Add
the total number of projected persons served, by county, to determine the
statewide projected total persons served.
8. Multiply the target year's projected total
persons served for the target year by 25% (0.25) to reflect the projected
statewide total persons served under the age of 65.
9. Divide the total statewide population
under the age of 65 for the target year by 1000.
10. Divide the numeric result from step 8 by
the numeric result in step 9.
11.
Multiply the target year's projected total persons served by 75% (0.75) to
reflect the projected statewide total persons served ages 65 and
over.
12. Divide the total
statewide population age 65 and over for the target year by 1000.
13. Divide the numeric result from step 11 by
the numeric result in step 12.
14.
Add the results from steps 10 and 13. This is the projected average statewide
persons served per 1000 population, by county, for the target year.
15. Repeat steps 4 through 14 for the second
target year.
16. Repeat steps 4
through 14 for the third target year.
17. To determine the projected weighted
statewide average persons served multiply the projected statewide average
persons served per 1000 population for 3 years after the current reporting year
by 3; multiply the projected statewide average persons served per 1000
population for 2 years after the current reporting year by 2; and multiply the
projected statewide average persons served per 1000 population for 1 year after
the current reporting year by 1.
18. Add the three results determined in step
17 and divide the total by 6 for the projected statewide average persons served
per 1000 population.
19. To
determine the Current Home Health Comparative Value, multiply the number
derived in step 18 by 85% (0.85). This value will be utilized in the
comparisons in step 2.
Step 2:
1. Using the data created above for the
target year (the year three years after the current reporting year), follow the
steps below to determine the future projected need for Home Health Services by
county.
2. Multiply the target
year's total persons served by 25% (0.25) to reflect the county wide total
persons served under the age of 65.
3. Divide the total county wide population
under the age of 65 by 1000.
4.
Divide the numeric result from step 2 by the numeric result in step
3.
5. Multiply the current year's
total persons served by 75% (0.75) to reflect the county wide total persons
served ages 65 and over.
6. Divide
the total county wide population age 65 and over by 1000.
7. Divide the numeric result from step 5 by
the numeric result in step 6.
8.
Add the results from steps 4 and 7. This is the projected total persons served
per 1000 population used to determine need for Home Health Services in a
county.
9. Subtract the result from
step 8 from the Current Home Health Comparative Value for each county. If this
number is negative, there is no need for a new Home Health provider in a
county. If the number is positive, continue to step 10.
10. This number is then divided by the SUM of
0.75 (75%) times 1000 divided by the county population aged 65 and over AND
0.25 (25%) times 1000 divided by the county population under the age of 65.
This number is the number of new persons required to be served in a county to
bring the county persons served per 1000 value up to the statewide comparative
value.
11. A threshold level of 100
new patients needed to be served is required for a determination of need in a
county. If the number of new patients needed to be served is less than 100,
there is no need for a new Home Health provider in a county. If the number is
equal to or greater than 100, there is a need for a new Home Health Care
provider in a county.
Step 1:
For each target year by county:
* (reported year persons served * 0.25) / (reported year
population under 65) = utilization rate population under 65
* Utilization rate * target year population under 65 =
projected persons served under 65
* (reported year persons served * 0.75) / (reported year
population age 65 and over) =utilization rate population age 65 and over
* Utilization rate * target year population age 65 and over =
projected persons served age 65 and over
* Projected persons served under 65 + projected persons served
age 65 and over = Target year projected persons served by county
For each target year:
* Sum of all Target year projected persons served by county =
Target year projected total persons served
* (Target year projected total persons served * 0.25)/
(Projected population under 65/1000) + (Target year projected total persons
served * 0.75) / (Projected population age 65 and over/1000)
=Projected Statewide Average Persons Served per 1000
Population
To Determine Current Home Health Comparative Value for
Step 2:
* (3 years after Current Reporting Year Projected Average
Persons Served * 3) + (2 years after Current Reporting Year Projected Average
Persons Served * 2) + (1 year after Current Reporting Year Projected Average
Persons Served * 1) / 6
=Projected Weighted Average Persons Serviced per 1000
Population
* Projected Weighted Average Persons Served per 1000 Population
* 0.85 =Current Home Health Comparative Value
Step 2:(Using population
and persons served for 3 years after current reporting year)
* (countywide total persons served * 0.25) /(county population
under 65/1000)
+
* (countywide total persons served * 0.75)/ (county population
65 and over/1000)
= County Persons Served per 1000 Population
* Current Home Health Comparative Value - County Persons Served
per 1000 Population
= County Projected Persons Per 1000 Population in Need of Home
Health Services.
* County Projected Persons Per 1000 Population in need of Home
Health Services/ (0.75*1000/Population age 65 and over) + (0.25*1000/Population
under 65)
= New persons required to be served in county to equal Current
Home Health Comparative Value
If number is less than 100, there is no need in a
county.
If number is 100 or more, there is a need for a new Home Health
provider in a county.
For a listing of Home Health Agencies or the most current
statistical need projections in Alabama please contact the Data Division as
follows:
MAILING ADDRESS
(U. S. Postal Service) |
STREET ADDRESS
(Commercial Carrier) |
PO BOX 303025
MONTGOMERY, AL 36130-3025 |
100 NORTH UNION STREET, SUITE 870
MONTGOMERY, AL 36104 |
TELEPHONE:
(334) 242-4103 |
FAX:
(334) 242-4113 |
EMAIL:
data.submit@ shpda.alabama.gov
WEBSITE:
http://www.shpda.alabama.gov