Wisconsin DHS

Based on data from the first two months of the COVID-19 vaccination program,(link is external) on a national and state level, most people who received their first dose also received their second dose and did so on time. Overall, this shows that our systems are working. However, there is room for improvement, and we need to work together to ensure the full series is completed. There are several reminder strategies to bolster the likelihood of patients returning for second visits, such as:

• Filling out and giving patients the CDC vaccination card. This card tells patients what COVID-19 vaccine they received, the date they received it, and where they received it. They are instructed to keep it as a reminder for their second appointment and for their records.
• Using the reminder/recall report in WIR.
• Utilizing VaxText.(link is external) This is a free text-messaging platform that providers can offer to their patients. Patients can opt in to conveniently receive text message reminders to get their second dose of COVID-19 vaccine. VaxText offers the added benefit of reminding patients to sign up for v-safe,(link is external) a tool that allows people to report adverse outcomes following vaccination.

Wisconsin’s home health care agencies provide high quality, cost effective skilled nursing care for individuals recently discharged from a hospital or skilled nursing facilities. Operating in rural and urban communities throughout the state, home health care agencies provide health care services including skilled nursing, physical therapy, occupational therapy, speech therapy and home health aide in a patient’s home. Home health care services address a variety of health issues, from pulmonary care and neurological rehabilitation to intravenous therapy, wound care, and chronic disease management.

This convenient quality healthcare is also cost effective and reduces the financial burden for patients, private insurance, and public payers. In fact, when home health is the first option utilized after discharge from a hospital, studies found a cost savings of $5,411 per person among the Medicare population. Additional data shows home health care services lead to 26% fewer acute care hospital admissions and 19-30% in total medical cost savings.

Unfortunately, the skilled home health care industry is facing a workforce shortage crisis, which is threatening patient access to care.

Wisconsin’s home health care agencies are reimbursed by private pay insurance, Medicare, and Medicaid. However, Wisconsin’s Medicaid reimbursement rate for home health services has been stagnant for over a decade, without a single increase. Yet over that same time, healthcare inflation has grown 32.3%, and the average Medicare reimbursement rates have increased by 26%. Medicare rates average $145.00 and Medicaid reimbursement for home health services remain at $85.54 per visit.

Such low Medicaid reimbursement levels create a critical workforce crisis for home health care agencies to retain essential skilled nursing staff and adequately serve Wisconsin’s home health care patients. Wisconsin home health agencies regularly lose highly skilled nurses to other sectors of the healthcare industry, mostly due to inequitable compensation potential.

According to the Wisconsin Center for Nursing, Wisconsin is well below the national average when it comes to RNs working in home health settings. RNs working in home health settings make up just 6% of the total nursing workforce in the state, while nationally that statistic is 13% of the total nursing workforce.

Wisconsin’s lagging Medicaid reimbursement rates not only create workforce challenges, they also negatively impact access to home health care services among the Medicaid population.

In short, Wisconsin’s home health care agencies have earned and deserve a Medicaid rate increase. Most importantly, Medicaid patients should be able to access home health services which increase quality of life and decrease medical costs.

By incentivizing home health care agencies to accept new Medicaid patients and increase capacity for home health care to attract new workforce, the state could reduce dependency on expensive institutional-care facilities for post-acute care. 

On behalf of the patients we serve, the Wisconsin Association for Home Health Care urges the Legislature to include a modest increase in the 2021-23 biennial budget. It is time to raise Medicaid reimbursement rates for home health care services. The downstream cost savings far exceed the investment and most importantly it will benefit all patients.

Lisa Kirker, RN, MSN, MBA
President
Wisconsin Association for Home Health Care

As was reported in previous editions of the WiAHC Advocacy Newsletter, the Association has launched a Legislative Key Contact Program, which can be a highly effective grassroots advocacy tool to help build and nurture strong on-going relationships between WiAHC members and lawmakers in Wisconsin. Ultimately, the program can help us help shape new policies important to our members.

We are happy to report the program is now live on the WiAHC website and members can easily and quickly sign-up as a Key Contact.

As a Key Contact, you can help influence the legislative process at both state and federal levels by cultivating relationships with elected officials. By taking advantage of existing relationships and making new contact with members of the Wisconsin Legislature and the Wisconsin Congressional  Delegation, you can help us educate lawmakers on industry issues and influence legislation.

But the program will not succeed without strong member participation, so please take a few moments to read more about it – and learn how simple it is to “enlist” and participate as a Key Contact. The time commitment is minimal and your responsibility as a key contact depends on your level of comfort and willingness to engage.

Remember, lawmakers are often eager to hear input from their constituents, and as an expert in your field, you can make a real difference in the policy process as a Key Contact. CLICK HERE to sign-up by filling out and submitting a brief online survey.

All too often, citizens believe they cannot influence the political and policymaking process. Fortunately, that perception is NOT ACCURATE, as lawmakers are eager to hear input from their constituents. In fact, they have a duty to listen to and address the concerns of their constituents, including those working in the home health care industry.

One of the most important steps WiAHC members can take to promote our industry and advance beneficial policies and legislation is to develop a relationship with their state legislators. With that in mind, the WiAHC Government Affairs Team is encouraging you to contact your state lawmakers TODAY, introduce yourself and educate them on the importance of the home health care industry in Wisconsin.

With the 2021-23 Wisconsin state budget bill currently under consideration, it is also an ideal time to remind your legislators the Medicaid reimbursement rate for Wisconsin home health care skilled nursing has not been increased in over a decade and their support for such increase is essential for the viability of home health care services in Wisconsin. 

Again, please contact your state lawmakers TODAY to introduce yourself and WiAHC, as well as to educate them on the home health care industry.

BACKGROUND:

Operating in communities through the state, home health care agencies offer a variety of health care services provided in the homes of patients and are integral to comprehensive post-acute medical care. In addition to offering quality, convenient care to patients in the comfort of their own homes, home health care agencies provide cost effective care that reduces the financial burden for patients as well as public and private payers.

However, home health care can mean different things to different people – including legislators. There is a great need to educate policymakers on what home health care means to WiAHC and our members. In short, skilled home health care includes a wide range of services to treat an illness or injury that are provided by skilled non-physician practitioners – including nurses and physical therapists – in a patient’s home.

It is also important for lawmakers to understand the benefits of home health care. Not only does it improve patient recovery time, convenience and quality of life, skilled home health care is typically less expensive then care a patient would receive in a hospital or other facility.

Unfortunately, current Medicaid reimbursement levels make it difficult to operate home health care agencies due to the problems it creates, including workforce retention and patient access challenges. Even a modest Medicaid rate increase would significantly improve home health care in Wisconsin.

WHAT YOU CAN DO TO HELP:

E-mail your state legislators today to introduce yourself and educate them about the importance of the home health care industry in Wisconsin. Please feel free to use WiAHC’s sample e-mail when contacting your lawmakers. All you need to do is cut-and-paste it into an e-mail, but please consider personalizing your e-mail to include examples of your personal experiences that capture the benefits of home health care. Also, please attach the WiAHC 101 document – which is linked below – to your e-mail to lawmakers.

If you don’t know who your state legislators are, or do not have their contact information, simply CLICK HERE and type your home address in the upper right corner text box. Remember to contact both your state senator and state representative.

If you have any questions on this WiAHC Advocacy Action Alert request or would like additional information on the issue, please contact WiAHC at erik@hovenconsulting.com or tim@hovenconsulting.com.

ACTION ALERT RESOURCES:

• Sample e-mail to legislators
• WiAHC 101 Document

Earlier this month, Congress passed, and President Joe Biden signed into law the American Rescue Plan Act of 2021. The sweeping $1.9 trillion legislative package includes a wide range of funding programs and policies to aid individuals, businesses, and communities across the county with additional COVID-19 relief. In addition to direct $1,400 stimulus payments to individuals, extended unemployment benefits, housing assistance and funding for states, large cities, and schools, the American Rescue Plan also includes funding for the COVID-19 public health response and numerous health care-related initiatives, including:

• $8.5 billion to track, administer and distribute COVID-19 vaccines.
• $47 billion for diagnosing and tracing COVID-19 infections.
• 10% increase to Federal Medicaid Assistance Percentage for home and community-based services (HCBS), which equates to a $12.67 billion payment increase for HCBS from April 1 of 2021 through March 31, 2022.
• $8.5 billion in payments for rural Medicare and Medicaid providers – including hospitals, clinics, home health, and hospice – for COVID-19-related expenses and lost revenue.
• $200 million for infection control and vaccination uptake in skilled nursing facilities.
• Requires COVID-19 vaccine coverage without cost-sharing for Medicaid beneficiaries.
• Increases health insurance premium assistance for individual coverage on the Affordable Care Act Marketplace for 2021 and 2022

For more information on the American Rescue Plan, please review a comprehensive overview of the new law provided by the National Conference of State Legislatures (see page five for health and human services provisions).

The Wisconsin Legislature's powerful budget-writing committee – the Joint Finance Committee – will  hold four public hearings next month on Governor Tony Evers' proposed $91 billion state budget bill. The committee has scheduled three in-person hearings and one virtual hearing for the following dates and locations: April 9 – University of Wisconsin-Whitewater April 21 – Rhinelander, WI (Hodag Dome) April 22 – University of Wisconsin-Stout (Menomonie, WI) April 28 – Virtual hearing The public hearings will begin at 10:00 AM and conclude at 5:00 PM. Due to COVID-19, capacity at each hearing site will be closely monitored. Individuals wishing to testify at the virtual hearing will be required to register in advance. The hearings will provide the public with an opportunity to comment on the state’s two-year spending plan and suggest modifications to the proposal before the Finance Committee votes to make what is anticipated to be extensive changes to Evers' budget bill. Once the committee finishes its work, the budget bill will be considered by the full Legislature. For individuals who cannot attend the public hearings, but wish to comment on the budget proposal, the following online portal is available for the public to provide input on the bill: www.legis.wisconsin.gov/topics/budgetcomments. If you have any questions on the state budget bill, would like more information, or need assistance on how to engage in the budget process, please contact WiAHC’s government affairs team at Hoven Consulting.

The Department of Health Services (DHS) announced today that individuals age 16 and older with certain medical conditions will be eligible for the COVID-19 vaccine beginning March 22, which is earlier than previously expected. This eligibility group includes individuals with medical conditions associated with an increased risk of severe illness from COVID-19.

The next eligibility group, which again will begin March 22, 2021, includes individuals age 16 and over with the following medical conditions:

• Asthma
• Cancer
• Cerebrovascular disease
• Chronic kidney disease
• COPD
• Cystic fibrosis
• Down syndrome
• Heart conditions
• Hypertension or high blood pressure
• Immunocompromised state
• Liver disease
• Neurologic conditions
• Obesity or overweight
• Pregnancy
• Pulmonary fibrosis
• Sickle cell disease
• Type 1 or 2 diabetes mellitus
• Thalassemia

Individuals with the outlined medical conditions can access vaccine through a variety of options, including community-based clinics, health care providers, Local and Tribal Health Departments, and pharmacies. Wisconsinites with a primary care provider may hear directly from their provider. Visit the Wisconsin COVID-19 vaccine options page or call the vaccine hotline at 1-844-684-1064 to learn more.

Additionally, DHS clarified current eligibility to include all clergy (as part of health care personnel who provide spiritual care to the sick), restaurant workers (as part of the food supply eligibility group) and further expanded public safety to include judges, prosecutors, and other essential criminal court personnel, in addition to public defenders.

Depending on vaccine supply, DHS still anticipates that Wisconsin will be able to expand eligibility May 1 to include all individuals age 16 and older. DHS will continue to monitor vaccination coverage statewide and partner with vaccine providers in order to provide an updated vaccination timeline for the general public.

For information, resources, and data related to Wisconsin’s COVID-19 vaccination program, visit the COVID-19 vaccine webpage.

First elected to the state Assembly in 2012, Representative Joe Sanfelippo (R-New Berlin) represents the 15^th Assembly District, which includes portions of Waukesha and Milwaukee counties. The district also includes the city of New Berlin and part of West Allis.

Before running for office, Rep Sanfelippo spent all his professional life in the private sector. He was the owner and operator of landscaping business for over 20 years, and he still operates a small Christmas tree farm. In addition to drawing on his experience as a small businessman to champion pro-business, pro-growth policies in the Legislature, as the long-time Chairman of the Assembly Health Committee, Rep. Sanfelippo has focused his policymaking efforts on health care issues and challenges facing the state.

Over the years, Sanfelippo has worked on numerous proposals to help improve the delivery of quality patient care, including legislation passed by the Legislature last session –but ultimately vetoed by Governor Tony Evers – to recognize and properly regulate direct primary care in Wisconsin. Under the direct primary care model, patients pay a monthly fee, with no further co-pays or deductibles, and in return receive unlimited access to their primary care doctor.

In the current legislative session, Sanfelippo has been a leading voice on COVID-19 vaccine distribution and authored legislation recently passed into law that authorizes pharmacy technicians with proper training and supervision to administer vaccines.

Rep. Sanfelippo took a few minutes to talk with us about a handful of topical health care-related issues and what his health care policy priorities are for the 2021-22 legislative session:

QUESTION:You are serving another session as Chairman of the Assembly Health Committee, which plays a vital role in shaping health care policy in Wisconsin. With that in mind, what do you believe are the most pressing health care-related challenges facing the state, and what policy solutions do you believe are needed to address those challenges?

Rep. Sanfelippo: The immediate issue at hand of course is to make sure we are getting vaccines to everyone who wants them as quickly as possible. The administration made such a mess by unnecessarily bogging down the initial rollout in bureaucratic red tape and only shaped up once the legislature began putting pressure on them. We need to eliminate their bureaucratic barriers to vaccination and continue our oversight to compel them to improve.

The other issue garnering much of my efforts will be to combat the Governor’s ridiculous idea to legalize marijuana. The potentially dangerous health implications are very serious according to every health care organization and official, especially for our kids which makes this politically motivated proposal even more reckless.

QUESTION:Outside of the state’s leading health care issues you mentioned above, what other health care-related proposals do you or your committee plan to pursue during the 2021-22 legislation? For example, last session you authored the direct primary care bill that would have exempted direct primary care agreements between a health care provider and a patient from Wisconsin’s insurance laws. Do you plan to reintroduce that bill or other legislation that would modify the traditional delivery of medical care in Wisconsin?

Rep. Senfelippo: We will continue focusing on innovative ideas that expand access and increase affordability while keeping the decision making between the doctor and patient where it belongs.

QUESTION: Prior to COVID-19, Wisconsin was facing a growing shortage of health care professionals, from physicians and nurses to CNAs and mental health care providers . The pandemic has only magnified the shortage and has put additional stress on the delivery of care in Wisconsin. Are there any potential programs or policies you are considering or willing to support that would help address the state’s health care workforce shortage?

Rep Sanfelippo: We can continue to work on education and tax incentives to encourage individuals to enter the health care fields with the most critical shortages. In addition, we must look at MA rates for certain sectors. Many of these services have not had any or only minimal increases in the past decade making hard for businesses to compete with the rest of the community for employees.

QUESTION: As part of his 2021-23 budget bill proposal, Gov. Evers once again recommended Wisconsin accept the federal Affordable Care Act's provision for Medicaid expansion, stating the expansion would provide healthcare coverage over 45,000 uninsured low-income families in Wisconsin and reduce state healthcare costs by $630 million over the two-year budget cycle. The Legislature removed the initiative form the Governor’s 2019-21 budget proposal, and it appears likely lawmakers will once again remove the provision. What is your position on the issue, and why?

Rep. Sanfelippo: MA expansion is DOA in my book. There is plenty of proof by looking at those states which did expand in the past to see the disaster it has caused for state budgets. Furthermore, adding another 45,000 individuals to a system that is already struggling to provide enough care for members is a recipe for disaster.

QUESTION:Last month, Gov. Evers recently vetoed Assembly Bill 1, the Legislature’s broad COVID-19 relief legislation. As a result, several of the bill’s provisions have been introduced as separate legislation. What steps, if any, do you believe the Legislature should take next to address the public health aspects of COVID-19, the continued roll out of vaccines, and any additional federal funding the state will receive to address the pandemic?

Rep. Sanfelippo:  The best thing the legislature can do is to continue our close oversight of the process. We know from experience that Governor Evers’ administration is severely challenged when it comes to carrying out day-to-day operational duties of an agency under demand. Just look at DWD and the unemployment mess. As soon as the legislature came back in last January, we made the vaccination rollout issue #1 and put the heat on the agency to shape up. Now that Secretary Palm has shipped out, we continue to be vigilant in our oversight and to address issues as they arise.

Register Today for Feb. 25 Event

The state of the Wisconsin Association for Home Health Care is strong, but we are only as strong as the members who make up our unique organization. And our continued success depends largely on passionate member engagement.

Thankfully, WiAHC’s upcoming membership wide Townhall Meeting provides you with a tremendous opportunity to stay connected with your association. The All-hands Meeting will allow you to stay updated on the latest WiAHC news, discuss ideas with your peers, help association leadership address challenges, and make collective decisions to move WiAHC forward and meet our major objectives.

In addition to general association updates and more specific regional breakouts, the Feb. 25 Townhall Meeting will feature a Legislative Update from WiAHC’s lobbying team at Hoven Consulting – Tim Hoven and Erik Kanter. Our lobbyists are committed to working with state lawmakers to promote programs and policies that improve home health care in Wisconsin. Their Legislative Update will include the latest on their efforts in the State Capitol to increase the Medical Assistance (MA) reimbursement rate for skilled nursing in a home health care setting.

Following the Legislative Update, Badger Bay Advocacy Director Michael Welsh will provide comments on the importance of grassroots advocacy and how WiAHC member engagement in the legislative process can augment our direct lobbying efforts and help meet the association’s legislative goals.

Meeting Details:

• WHAT: WiAHC Townhall Meeting
• WHEN: Thursday, February 25 – 11:30 AM to 1:00 PM
• WHERE: Virtual meeting – A Zoom invite link will be sent to registrants the day before the meeting.
• REGISTRATION: All WiAHC members are strongly encouraged to attend. CLICK HERE to register. Registration is free for members.
• AGENDA:
• • Keynote - Legislative Update featuring Timothy Hoven and Erik Kanter from Hoven Consulting. A grassroots advocacy report will follow the Legislative Update.
  • Association updates
  • Breakouts by region

We look forward to seeing you and hearing your thoughts on the future of WiAHC at the Townhall Meeting. Please do not miss out on this opportunity to participate in your association – and remember to register.

Coalition launches new ad campaign promoting continued use of face masks, social distancing and hand washing as key measures in the fight against COVID-19

Madison, WI -- The statewide coalition to combat the spread of COVID-19 launched a new ad campaign today calling on Wisconsinites to stay vigilant in the effort to curtail the spread of COVID-19. The ad campaign that will broadcast statewide on digital and broadcast media stresses the importance of wearing face masks, washing hands regularly, and continuing to practice social distancing as key, simple measures in the fight against the global pandemic.

“This past year, Wisconsin came together to take on COVID-19. Our frontline workers, businesses, and communities stepped up. And you are doing your part,” says the narrator in the ad. “We will stop the spread, but the fight’s not over yet. As many await vaccines, and our health care heroes battle new strains, we can’t let our guard down now.”

The launch of the Stop the Covid Spread! coalition’s public education announcement comes amidst a trend of falling COVID-19 cases, which could create a false sense of security. New strains of the virus that appear to be both more transmissible and potentially more deadly are spreading worldwide. Vaccine distribution in the state is also being hampered by a shortage of supply from the federal government, meaning much of the state’s vaccination capacity is being underutilized. By continuing to practice safe behaviors, including wearing masks, social distancing, and washing hands, we not only stop the spread, we save lives.

“Given the current pace of vaccination in Wisconsin, it will take some time for the vaccine to take hold in the state,” said Wisconsin Hospital Association President and CEO Eric Borgerding “And regardless of the political debates taking place in Madison, masks and other mitigation behaviors are critical factors in our COVID-19 fight. We’ve made great progress, and the health care community is very thankful for all that Wisconsin has done to slow COVID down, but we need to keep at it - mask up, maintain social distance, and wash hands.”

Since its launch in October, the “Stop the COVID Spread!” coalition has advanced an aggressive campaign encouraging the use of crucial safety measures to help reduce the spread of COVID-19. Coalition messaging has included public education announcements featuring a wide range of Wisconsin voices, including frontline health care workers from health systems throughout Wisconsin, members of the Green Bay Packers, Wisconsin Assembly Speaker Robin Vos, Congressman Mark Pocan, and UW System President Tommy Thompson, many of whom appear in the most recent ad.

“We are incredibly proud of the hard work and sacrifice that Wisconsinites have made over the past year, from the frontline workers in so many critical industries to the doctors, nurses and other healthcare personnel fighting this virus on a daily basis,” said Wisconsin Manufacturers & Commerce President & CEO Kurt Bauer. “It is time to double down on our efforts to stop the spread of COVID-19. We must continue to wear a mask, wash our hands and practice social distancing.”

The “Stop the COVID Spread!” coalition currently includes more than 135 of Wisconsin’s leading health care, business, and advocacy organizations. Notable coalition members include the Milwaukee Brewers, Milwaukee Bucks, Green Bay Packers, and representatives of local governments, chambers of commerce, and visitors bureaus from every corner of the state. The organizations have joined together with a shared goal of furthering public education about the seriousness of the COVID-19 pandemic in Wisconsin and the critical need for preventative measures. A full list of member organizations is below.

You can watch the new ad at: https://youtu.be/V3W0P0KY41g.