Dear Seema Verma and Valued Public Health Officials:

My name is Lusine Ovsepian and I am the CEO of A to Z Home Health Care, Inc.--a home health care that has been making a difference within the Greater Los Angeles community for over ten years. As an individual who has been working in this field for over 15 years, I take pride in what our nation has been doing for those who are bed-bound and in need of assistance through JCAHO and Medicare certified home health agencies. 

However, despite this sense of confidence that I have had in our system throughout the years, I have felt hopeless and uncertain about the future throughout this COVID-19 pandemic. Uncertain because we are moving forth without policy--without any certainty that we will be compensated for 1) following up with patients via Telehealth; and 2) providing our nurses with proper PPE, so that we could be at the forefront of taking care of ill or potentially ill patients with COVID-19.

Much attention has been given to hospitals, outpatient facilities, skilled nursing facilities, but none for home care and hospice providers--which should be deemed as vital resources in America's response to this national crisis. While our company stocked up on supplies on time, in efforts to assist hospital patients with proper proper protective equipment (PPE), most agencies are struggling to maintain gloves, gowns, etc.

As we are ramping up training and preparing our healthcare professionals, we are asking for emergency waivers from Medicare for us to continue sustainable, quality-driven, and patient-centric healthcare. We can't do so without any direction and guidance on what to do without Telehealth. Patients are refusing our services more and more, in efforts to protect themselves. We worry that although we are respecting the valid concerns of these patients, they may be left in a position of greater risk. Without being afforded proper Billing Codes to ensure that we will be compensated for any Telehealth follow-up visits that we may have, we are unable to continue 1) screening patients at risk for or ill with COVID-19; 2) working with PCGs to ensure that the patients are improving (checking vital signs, engaging in medication management, etc.); and 3) joining hands with Social Workers able to check-in on patients via Telehealth to see if they are in need of meals or other centralized resources, such as rent forgiveness, eviction suspension, etc. 

Currently, we have staff prepared to screen and educate patients via phone, face-time, etc. but that isn't enough for us to dedicate our efforts--at the risk of us not being compensated. Keeping cash flow strong right now has been harder than ever, especially for agencies like mine where there is a large staff at hand. Not to mention, in-office employees are now beginning to work for home, in efforts to prevent further transmission, and new protocols have been are in place for nurses to pick up packages, drop off paper-work, etc.

Now should be where home health comes in; especially, when we may face a hospital capacity issue (like Italy, China, etc.). Again, now more than ever, we should be seen and utilized as a solution to this immense hurdle that our nation will inevitably face, should this situation not subside. 

I write this letter to you, public health officials, with the hopes that you and other governmental leaders will treat this uncertain situation with urgency and do everything you can in your power to support home health and hospice agencies at the forefront of this pandemic.

Thank you in advance for your time, help, and consideration.

Respectfully,

Lusine Ovsepian, CEO