March 23, 2020

 

The Honorable Tony Evers

Governor, State of Wisconsin

115 East, State Capitol

Madison, WI 53702

 

Secretary-Designee Andrea Palm
Wisconsin Department of Health Services
1 West Wilson St, Room 650
Madison, WI 53703

 

Dear Governor Evers and Secretary-designee Palm, 

First, thank you for the measures you have taken so far to address the COVID-19 pandemic. Your actions have pragmatically addressed this growing problem in the best interest of Wisconsin.  

As you prepare to issue tomorrow's Safer at Home order, the Wisconsin Association for Home Health Care, Inc. (WiAHC) urges you to allow home health care agencies to continue to provide our essential, life-sustaining services throughout the public health emergency. Home health care agencies and the RNs and LPNs who deliver home health care services must be considered essential services under the order. The home health patients who rely on our services simply cannot afford to be without care during this time and our skilled nursing staff needs to continue to provide that needed care. 

While we request home health care services be considered essential services, we also request you allow for following two changes to DHS 133 administrative code that will allow our skilled nursing staff to conduct certain home health visits telephonically:

·         DHS 133.18 Supervisory visits.

o    Current rule language: (1) If a patient receives skilled nursing care, a registered nurse shall make a supervisory visit to each patient's residence at least every 2 weeks. The visit may be made when the home health aide is present or when the home health aide is absent. If the patient is not receiving skilled nursing care, but is receiving another skilled service, the supervisory visit may be provided by the appropriate therapist providing a skilled service.

o    Current rule language: (2) If home health aide services are provided to a patient who is not receiving skilled nursing care, or physical, occupational or speech-language therapy, the registered nurse shall make a supervisory visit to the patient's residence, when the home health aide is present or when the home health aide is absent, at least every 60 days to observe or assist, to assess relationships, and to determine whether goals are being met and whether home health services continue to be required.

o    Our request is to allow for a grace period of an additional 14 days to conduct supervisory visits for both the 14-day requirement under sub. sec. 1 and the 60-day requirement under sub. sec. 2 while the state is under a public health emergency. Additionally, we request DHS allow agencies to conduct supervisory visits via telephone or videoconferencing while the state is under a public health emergency.

·         DHS 133.20 Plan of care.

o    Current rule language: (3) Review of plan. The total plan of care shall be reviewed by the attending physician, advanced practice nurse prescriber, or physician assistant, and appropriate agency personnel as often as required by the patient's condition, but no less often than every 60 days. The agency shall promptly notify the physician, the advanced practice nurse prescriber, or the physician assistant of any changes in the patient's condition that suggest a need to modify the plan of care.  

o    We request DHS allow home health care agencies to conduct any necessary visits from RNs associated with the 60-day review process to be done via telephone or videoconferencing while the state is under a public health emergency.

Thank you for your attention to these matters. If you have any questions, please contact Tim Hoven ( tim@hovenconsulting.com) and me (erik@hovenconsulting.com).

 

Thank you,

--

Erik Kanter
Hoven Consulting, Inc.