Earlier this summer, the U.S. Centers for Medicare & Medicaid Services (CMS) published their 2025 home health proposed payment rule, which immediately raised concerns for the home health care community in Wisconsin and across the country.

While the proposed rule includes a 2.5% increase, due to other proposed payment changes in the rule, including rebalancing of the Patient-Driven Groupings Model (PDGM), the update is estimated to be a 1.7% decrease, or $280 million less compared to calendar year 2024.

To express the concerns of our members that the rule as proposed will continue to significantly reduce access to essential home health services in Wisconsin and throughout the country, WiAHC signed on to a National Association for Home Care and Hospice (NAHC) state chapter letter proving key recommendations to CMS to improve the proposed rule. CLICK HERE to read a draft copy of the letter.

Report details recommendations to address challenges facing the state’s healthcare workforce

Gov. Tony Evers announced today the Governor’s Task Force on the Healthcare Workforce has released its final report and advisory action plan providing solutions to address the state’s longstanding healthcare workforce shortages that have plagued the state for years.

The Task Force was charged with studying the workforce challenges facing the state’s healthcare system, including recruitment and retention, identifying ways to improve patient care and alleviate the burdens on the healthcare workforce, exploring educational and training pathways to grow a sustainable healthcare workforce, and creating an action plan with solutions related to workforce development, industry innovation, education, and training for consideration in the governor’s 2025-27 executive budget.

The 25-member force met six times since March to hear from healthcare industry experts and leaders, analyze labor market data, and produce an advisory action plan for Gov. Evers’ review and consideration. As a result of those meetings, the Task Force adopted 10 recommendations with 26 action items representing a variety of policies and programs to address various industry issues, including education, training, recruitment, and retention of healthcare workers. The action plan represents a strategic set of policy and implementation approaches targeting the healthcare industry’s chronic challenges.

The plan:

·        Presents a comprehensive analysis of current and future workforce challenges impacting the healthcare sector;

·        Explores educational and training pathways to create a more diverse, equitable, and sustainable workforce;

·        Identifies strategies to improve patient care and alleviate the burden on our healthcare workforce; and

·        Recommends solutions, including new policies and programs, modifications to existing programs, and necessary changes to state statutes. 

Solutions address three broad categories, including education and training, recruitment and retention, and regulatory policy, including:

Education and training

·        Support faculty who teach healthcare professions through increased compensation and incentives;

·        Expand access to clinical training and hands-on experiences;

·        Break down barriers by funding wraparound services for students, including transportation and child care; and

·        Sustain and expand training programs for direct care professionals and certified nurse aides.

Recruitment and retention

·        Adopt Medicaid Expansion to support healthcare workers and fund workforce initiatives;

·        Increase rates for home and community-based services and behavioral health providers;

·        Continue and create grant funding for innovative programs and trainings to support employers; and

·        Ensure healthcare workers are able to navigate insurance benefits options.

Regulatory policy

·        Authorize Medicaid to pay for community-focused services, such as those provided by doulas and community health workers;

·        Support pathways to licensure for qualified internationally educated professionals;

·        Enter into multi-state licensing compacts, allowing professionals to practice in other participating states; and

·        Fund and grow healthcare workforce wellness programming to support retention.

Wisconsin held its partisan primaries yesterday (August 13) for state legislative and congressional races for the fall general election. Despite a significant number of primaries (primaries were held in roughly half of the 99 Assembly seats and 4 of the 16 Senate seats), there were very few surprises, with the only incumbents that lost their reelection bids were those who were paired against other incumbents due to redistricting.  There was also a statewide referendum on two proposed constitutional amendments. Please find below key election result highlights:

CONGRESSIONAL RACES OF NOTE:

• In the 8th Congressional District GOP primary, Trump-endorsed Tony Wied edged out state Senator Andre Jacque and former state Senator Roger Roth in this closely watched race. Wied will face Democrat Kristin Lyerly in November for the opportunity to fill the open seat vacated earlier this year by Congressman Mike Gallagher (R). Jacque will return to the State Senate, as his seat is not up in November.
• In the 3rd Congressional District, former WEDC Board member Rebecca Cooke beat state Rep. Katrina Shankland in the Democratic primary. She will face Congressman Derrick Van Orden (R) in the November general election. The 3^rdCD is considered a swing seat, and Democrats have targeted it in their attempt to win back the House this fall.

OVERVIEW OF STATE LEGISLATIVE RACES:

• Assembly Speaker Robin Vos easily won his primary challenge, which took place after two failed recall attempts against him earlier this year.
• Freshman Republican State Rep. Nate Gustafson defeated Rep. Mike Schraa in the 55^thAssembly District.  Schraa has served in the State Assembly for 12 years.
• Republican State Rep. John Spiros won his three-way primary for the 86^thAD, which also included two-term incumbent State Representative Donna Rozar.
• Freshman Republican State Rep. Elijah Behnke defeated freshman Rep. Peter Schmidt after moving into the 5^thAD to challenge him.
• Dave Armstrong defeated Jimmy Swenson in the GOP primary for the 67th Assembly District, capturing nearly 78% of the vote.
• Republican State Senator Dan Knodl defeated State Representative Janel Brandtjen in the Republican primary for the 24^thAssembly District.  Sitting senators don’t typically run for the State Assembly. However, Knodl was redistricted into another Senator’s seat and decided to return to the State Assembly rather than run for the Senate.  He served 15 years in the State Assembly prior to serving the last year in the State Senate.
• Dan Feyen (R-Fond du Lac) easily defeated Tim Ramthun in the GOP primary for the 20th Senate District, capturing nearly 65% of the vote.
• Democrat State Representative Melissa Ratcliffe won a three-way primary for the 16^thSenate District, defeating fellow State Representatives Jimmy Anderson and Samba Baldeh.  Both Anderson and Baldeh had to forgo running for their Assembly seat to run for Senate, so neither will be returning to the State Assembly in January.

PRPOSED CONSTITITIONAL AMENDMENTS:

• Wisconsin voters rejected both constitutional amendment questions on the ballot, which aimed to give the Legislature more control over spending federal funds.

CLICK HERE to review all election results.

On August 6, WiAHC unveiled a list of state legislators selected as “Champions of Home Health Care” and “Friends of Home Health Care” for the 2023-2024 state legislative session.  At the completion of each two-year legislative session, WiAHC identifies an exclusive group of lawmakers for their exceptional work to address the priorities of home health care agencies and staff throughout Wisconsin. 

The 2023-2024 “Champion of Home Health Care” recipients are:

--State Rep. Mark Born (R-Beaver Dam)                               

--State Sen. Howard Marklein (R-Spring Green)

The 2023-2024 “Friend of Home Health Care” recipients are:

--State Sen. Duey Stroebel (R-Saukville)                                

--Rep. Terry Katsma (R-Oostburg)

--Sen. Mary Felzkowski (R-Tomahawk)                                  

--Rep. Shannon Zimmerman (R-River Falls)

--Sen. Joan Ballweg (R-Markesan)                                           

--Rep. Jessie Rodriguez (R-Oak Creek)

--Sen. Patrick Testin (R-Stevens Point)                                   

--Rep. Tony Kurtz (R-Wonewoc)

--Sen. Eric Wimberger (R-Green Bay)                                    

--Rep. Alex Dallman (R-Green Lake)

--Sen. LaTonya Johnson (D-Milwaukee)                                 

--Rep. Tip McGuire (D-Kenosha)

--Sen. Kelda Roys (D-Madison)                                                 

--Rep. Deb Andraca (D-Whitefish Bay)

In the August 2024 edition of the Department of Health Services’ (DHS) ForwardHealth Update, it notes that the EVV “hard launch” for home health care services and nurse supervisory visit service code 99509 begins on October 1, 2024.  Claims submitted to DHS, HMOs and managed care organizations starting on this date that do not include the required EVV information will be denied.  This ForwardHealth Update may be viewed on the DHS website. 

If your home health agency has questions regarding EVV implementation, please contact Wisconsin EVV Customer Care at vdxc.contactevv@wisconsin.gov or at 1-833-931-2035, Monday – Friday, 7:00AM – 6:00PM (Central Time). 

In recent weeks, DHS asked Wisconsinites to complete a survey addressing maternal and child health needs. DHS conducts this comprehensive, statewide survey every five years due to the related federal funding the agency receives.  The survey addresses a variety of issues, such as prenatal care, access to health care, and maternal mental health.  The agency offers two separate surveys – one for individuals and one for organizations.  This survey will be available until September.  If you are interested in filling out this survey, please go to the DHS website. 

It is more important than ever for WiAHC members to strengthen their relationships with their state lawmakers to educate them on the value of skilled home health care, the regulatory challenges we face, and the legislative solutions we need to increase access to care for patients. Rember, decisions state legislators make in the Capitol can have a significant impact on the home health care industry, your organization, and your profession.

One of the best ways you as a WiAHC member can engage your local legislators is to invite them to tour your facilities to illustrate firsthand the many benefits of home health care. These visits provide a tremendous advocacy opportunity, which is why WiAHC members across the state have already hosted numerous successful legislative tours. But we need to maintain the enthusiasm for this critical grassroots advocacy program, and WiAHC is excited and ready to set-up additional tours today.  

If you would like to host a legislative tour at your site, please contact the WiAHC office at wiahc@badgerbay.co. We will work with you and your legislators to coordinate the meetings and will provide participating members with full support, including legislator bios, advocacy tips, issue briefings, and supporting documents.  

On June 6, the Governor’s Task Force on the Healthcare Workforce held a public meeting on the campus of Marquette University’s School of Dentistry.  The bulk of the livestreamed portion of the meeting was taken up by a panel discussion on education and training.  The following individuals participated in this discussion:

• Christina Patrin, Health Science Education Consultant, Wisconsin Department of Public Instruction (DPI)
• Danielle Cook, Education Director, Health Sciences, Wisconsin Technical College System (WTCS)
• • Note:  She is a task force member.
• Dr. Melissa Weege, Clinical Associate Professor, Radiation Therapy Program Director, UW-La Crosse
• Rebecca Larson, Executive Vice President for External Relations, Wisconsin Association of Independent Colleges and Universities

These panelists each gave some background information on their respective organizations, then discussed challenges, and possible solutions.  Patrin noted that while 60 percent of school districts in the state have a direct patient care training pathway (program) embedded in their schools, she noted that it is difficult to start such pathways at high schools.  Cook, Weege and Larson noted a number of similar challenges, including lack of classroom space, challenges in hiring faculty due to relatively low compensation levels, and continuing financial challenges for students. 

Next, the panelists proposed various solutions, including the following:

• Loan forgiveness for all health faculty, not just nursing faculty.
• Need incentives to help hire part-time health faculty.
• Need to do more to promote health care careers early on, even in elementary school.

The task force then moved on to the various breakout discussion groups and then adjournment, neither of which were covered in the livestream of this task force meeting. 

It is also worth noting that in preparation for the June meeting, a document listing draft task force recommendations was prepared.  The following is a high-level summary of these draft recommendations:

• Education and Training

• Recruitment and Retention

• Regulatory Policy

Help shape WiAHC’s Policy Agenda for the 2025-26 legislative session. The WiAHC Legislative Priorities Survey provides a tremendous opportunity to offer your input on what policy issues are most important to you and your organization. The purpose of surveying the full WiAHC membership is to help association leadership develop a policy agenda and determine what legislative and regulatory issues we should on focus during the 2025-2026 Wisconsin legislative session.

The survey takes only a few minutes to complete and will provide invaluable information used to help shape WiAHC’s advocacy priorities moving forward. The survey results will be presented to the WiAHC’s Legislative Committee and Board for further consideration. In addition to the member survey data, WiAHC leadership will consider the following criteria when finalizing the association’s policy agenda and issue priorities: 1.) The benefit to WiAHC members; 3.) The extent to which it will improve the delivery of home health care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

Once the WiAHC Board finalizes the policy agenda and legislative priorities for 2025-2026, it will be presented to the full membership and used by the WiAHC Government Affairs team to guide the association’s advocacy efforts over the next two years.

We value your input and encourage you to complete and submit the brief survey as soon as possible. Please CLICK HERE to take the survey.

After the state legislative session concludes in even-numbered years, the Legislative Council – the legislature's in-house, non-partisan group of attorney advisors – organizes study committees that perform in-depth reviews of various state policy matters facing Wisconsin.  Committees are comprised of both legislators and citizen members. 

Study committees hold hearings, during which they hear public testimony – including from subject-matter experts – on state policies that may need to be fixed or updated.  Once a committee has completed receiving public testimony, it generally drafts legislation for possible introduction and consideration by the legislature.  Recently, the scope of the Study Committee on the Regulation of Artificial Intelligence in Wisconsin was announced: 

“The Study Committee is directed to review current uses of artificial intelligence technology and make recommendations for legislation regarding the use and development of artificial intelligence technology. The committee may review the use of artificial intelligence in disinformation and artificial imagery and the feasibility of establishing a process to ensure continued state monitoring of high-risk use of artificial intelligence.”

State Senator Julian Bradley (R-Mukwonago), who will serve as chair, recently announced via press release the members of the committee.  Rep. David Armstrong (R-Rice Lake) will serve as vice chair.  Sen. Tim Carpenter (D-Milwaukee) and Rep. Clinton Anderson (D-Beloit) are the other legislator members.  Of the eight Wisconsin citizen members, there is one representative from the health care field – Jay Hill, who serves as vice president of advanced technologies for GE HealthCare.  The full committee membership list may be viewed on the Legislature’s website.

In his press release, Sen. Bradley also notes that this study committee “…will travel throughout the state to consider how the new technology will impact workforce, healthcare, law enforcement, government, and consumer protection.” 

The committee’s first meeting was held at the Waukesha County Technical College in Pewaukee on Wednesday, July 24.