A view from the inside of AAHomecare

Having completed a year as American Association for Homecare Board Chair, it is a good opportunity to share a view from the inside of the association. This is important because so often I hear opinions from members and non-members who have suggestions about how the association should operate and the strategies it should adopt. While those opinions are appreciated by every member of the staff and the board, I can tell you that they would be more productive if they were made while working from within the governance and committee structure than they are if made through the media or to some group that cannot change what is happening within AA-Homecare. The point is that if members want to influence the association and its direction, please get involved and make a commitment of both time and money. Beside that overriding message of involvement, I want the members to know that the AAHomecare staff, led by Kay Cox, is working very hard for the home care industry. During the MMA debate and beyond, the staff has worked unbelievable hours on members' behalf. The American Association for Home-care's status on Capitol Hill, and with CMS, has reached its highest level ever. That was the goal when we hired Kay Cox, a Capitol Hill insider, to put together a team of external lobbyists and internal staff members to focus on government relations and the protection/expansion of reimbursement so that the home care industry can thrive. Another observation that I would like to make is that the American Association for Homecare's role is not the same as a state association or a buying group. The American Association for Homecare, similar to state associations and buying groups, does provide networking opportunities for its members at Medtrade and the Washington Legislative Conference. It also provides excellent education through teleconferences and seminars. However, AAHomecare's main role is to protect and expand our reimbursement funding with Congress, CMS, and the other governmental agencies. When a company joins AA-Homecare, it is because that company's leader believes that the association is representing the industry's common good in Washington. Members who expect more than that need to understand that the American Association for Homecare has a budget of only $3 million and more than 60% of that is devoted to government relations. In order to reach its legislative and regulatory objectives, the association must maintain a laser focus on the government relations initiatives that sometimes make AAHomecare feel less member friendly than a state association or buying group. While I am touching on the American Association for Homecare's budget, I am proud that the associations budget operated in the black in 2003 (the first time in our three-year existence) and that membership revenue has continued to grow during the past year. The Executive Committee is constantly looking to increase revenue by partnering with companies like VNU/Medtrade and TracMedical (for ECMNs) to enhance the non-membership revenue. Do we have enough members? Not by a long shot. Over 10,000 homecare companies are not members of the American Association for Homecare because of a variety of reasons. While every company has to make their own decision, I cannot understand how companies could not make this important investment in the association that is representing us with our largest payer - Medicare. Buying groups and state associations have thousands of members, but none of them are devoting the resources to government relations that the American Association for Homecare does. Some of them have one or two people in a government relations area, while the American Association for Homecare invests approximately $2 million dollars towards this function. A membership in the American Association for Homecare today is an investment in your business. Some companies ask why invest in the association because they perceive that all the decisions are made by the national companies or that the American Association for Homecare is only focused on DME or home health issues. From the inside, I can tell you that perception could not be further from the truth. Because of the assoc-iation's council system of governance and because we try to balance board membership across all aspects of homecare, all of the American Association for Homecare's decisions are made with input from multiple parties. National companies realize they need the grassroots assistance of all home care providers. And frankly, smaller providers need the financial resources of national companies and manufacturers to fight the battle on Capitol Hill. In short, we need everyone to implement the American Association for Homecare strategies. Another thing I have learned during my time on the Executive Committee of AAHome-care is that in order to accomplish anything on Capitol Hill, it takes money. In order to cultivate congressional champions, the American Association for Homecare makes donations through its PAC to political campaigns and AAHomecare members often write personal checks directly to political campaigns and attend political fundraisers for these champions. Many of the personal checks written to our champions' campaigns may be for more than the $995 membership fee that is charged to the association's smallest members for dues. Therefore, it takes small, medium, and large members from all aspects of home care in order to make the American Association for Homecare effective in Washington. We need to build our clout, and this can only be done with a combined association (home health, DME and rehab) that attracts members from all sizes of companies. Lastly, I want to thank the members of the American Association for Homecare. You are the people who get it! There are more than 10,000 providers and manufacturers who are sitting on the sidelines, who do not get it. (Soon they may have to seek a new profession because of impending reimbursement cuts that we are fighting.) I look forward to continuing to fight for all of us with both my financial investment and my time. -  Joel C. Mills is president and CEO of Advance Home Care and Immediate Past Chair of the American Association for Homecare.