By Hoven Consulting – WiAHC’s lobbying firm

• Electronic Visit Verification (EVV) Will Be Implemented on May 1, 2023

As of May 1, 2023, the state Department of Health Services (DHS) will begin imposing penalties when personal care and home health agencies do not collect the required electronic visit verification for Medicaid-covered personal care and supportive home care services.  This is otherwise known as the “EVV hard launch.”  The included service codes are:  T1019, T1020, S5125 and S5126. 

DHS is imposing these penalties to ensure that the state receives its full allocation of federal Medicaid funding. 

If you would like additional information, please review the April 2023 ForwardHealth Update.  If you have any questions, please feel free to contact DHS EVV Customer Care at 1-833-931-2035 between 7:00AM – 6:00PM (Central Time), Monday through Friday or via email at vdxc.contactevv@wisconsin.gov.

• Temporary Health Care “Act 10” Occupational Licenses Will Continue to Be Available

During the COVID-19 pandemic, Governor Tony Evers signed into law legislation that became 2021 Wisconsin Act 10.  This legislation allowed health care professionals who are licensed in good standing in other states to work in Wisconsin immediately, without obtaining a permanent occupational credential.  This was to ensure that Wisconsin had enough health care professionals to treat Wisconsinites during the pandemic.  These temporary licenses are known as “Act 10 licenses.”

This state law was tied to the end of the pandemic-related Presidential Emergency Declaration.  On April 10, 2023, President Biden signed federal legislation that ended this emergency declaration.  According to state law, the “Act 10 licenses” expire 30 days after the Presidential Emergency Declaration ends – which is May 10, 2023 – unless the license holder applies for a permanent license by that date.  If a license holder applies for a permanent license by that date, that individual will still be allowed to practice in Wisconsin.

In addition, there is a provision in 2021 Wisconsin Act 10 that could benefit out-of-state health care professionals who seek Wisconsin licensure after May 10, 2023, and wish to practice immediately in the state.  If an individual’s out-of-state license is in good standing, that professional could apply simultaneously in Wisconsin for an “Act 10 license” and a permanent license and would be able to practice immediately in Wisconsin. 

For more information on “Act 10 licenses,” please go to the state Department of Safety and Professional Services’ FAQ page. 

The WiAHC Legislative Committee is charged with developing the association’s legislative priorities and providing direction and support on public policy that impacts Wisconsin’s home health care industry. The committee, which meets once a month, also evaluates legislative and regulatory issues of importance as they arise and leads WiAHC’s lobbying and grassroots advocacy efforts. The committee recently acted on the following items:

·         State Funding for Nurse Educators

WiAHC’s 2023-24 Legislative Agenda includes a priority to strengthen Wisconsin’s home health care workforce. More specifically, WiAHC is working to secure additional state funding to increase the supply of nurse educators in Wisconsin. As such, the WiAHC Legislative Committee recently approved a member-driven grassroots advocacy campaign to encourage the WI Legislature to provide $10 million in additional funding to boost the state’s Nurse Educators program.

The Nurse Educators program was established two years ago to support nursing education and increase the number of nurses in Wisconsin by providing grants to nurses enrolled full-time in doctor of nursing or mater of nursing programs. Grant recipients must commit to teaching at an approved Wisconsin nursing school for at least three years post-graduation. Providing additional funding for this program is more important than ever, as nursing education programs across the state are struggling to turn out enough graduates to meet the growing demand for nurses in Wisconsin.

Please be on the lookout for a WiAHC Advocacy Action Alert asking you to contact your state lawmakers and urge them to support $10 million in funding for the Wisconsin Nurse Educators program as part of the state budget bill.

• Legislation to Expedites Health Care Occupational Licensing in Wisconsin
• Speaking of workforce challenges in the home health care industry, many of our members have had trouble and experienced delays securing occupational licenses from the Wisconsin Department of Safety and Professional Services (DSPS). The licensing backlog at DSPS is exacerbating the state’s health care workforce shortage crisis, and WiAHC has been encouraging policymakers to address the problem. In fact, the WiAHC Legislative Committee recently voted to support Assembly Bill 144, legislation to expedite occupational licensing in Wisconsin.

This bill requires the state to grant preliminary occupational credentials to health care professionals. More specifically, the bill requires DSPS to grant a preliminary credential to an individual who has met all the requirements for a permanent credential, including having completed all education, training, supervised experience requirements. In addition, an applicant for a preliminary license must also: 1.) Attest that they do not have a disqualifying arrest or conviction record; 2.) Verify that the position they have been hired for is within the scope of their practice; and 3.) Confirm that they have applied for a permanent credential. Finally, the health care employer that hired the applicant must verify that the individual has – to the best of the health care employer's knowledge – completed the required education, training, and supervised experience necessary for a permanent credential. 

WiAHC is happy to remind members about and provide links to the latest articles and information on the home health care industry from Home Health Care News and other publications:

·         CMS To Publicly Release All Ownership Info of Home Health, Hospice Agencies

Home Health Care News – By Andrew Dolan | April 20, 2023

The U.S. Department of Health and Human Services (HHS) is making ownership data for all Medicare-certified home health and hospice agencies publicly available. The Centers for Medicare & Medicaid Services (CMS) announced the news early Thursday. Read more…

·         Providers On Biden’s Executive Order, Home-Based Care ‘Drumbeat That Won’t Be Ignored’

Home Health Care News – By Andrew Dolan | April 19, 2023

The Biden administration has made mention of home-based care regularly and intentionally during its tenure in the White House. It did so again Wednesday, this time through 50-plus directives for government agencies, many of which were home care-related. Though still just directives, the sitting president making this sweeping of an executive order focused on senior care – in part – is worth plenty of weight. Read More…

·         As States Negotiate Budgets, Biden’s Executive Order Puts Home-Based Care at The Forefront

Home Health Care News – By Andrew Dolan | April 18, 2023

In tandem with an executive order, the White House announced a bevy of directives for government agencies on Tuesday, many of which were centered around bettering home-based care. Perhaps most notable is the timing, however. As states work through their budgets and potential Medicaid spending, the Biden administration has put home care at the forefront of their minds. Read More…

·         Nearly 800,000 More Nurses Are Expected to Leave Field Within 5 Years

Home Health Care News – By Andrew Dolan | April 17, 2023

Nearly 100,000 registered nurses left the field during the COVID-19 pandemic, according to an analysis conducted by the National Council of State Boards of Nursing (NCSBN). Worse yet, the analysis suggested that nearly 800,000 more nurses could leave the field by 2027. For home health providers already short on staffing, that could mean significant headwinds over the next five to ten years. Read more…

Home Health Care News, which is part of the Aging Media Network, is a leading source for news and information covering the home health industry.

WiAHC’s grassroots advocacy program is critical to the success of the association’s overall government affairs program. It allows our members to have a voice and influence in shaping public policy that impacts home health care in Wisconsin.

With that in mind, we are pleased to report about WiAHC’s latest legislative advocacy outreach effort.  WiAHC Board member Nicole Naidl recently hosted state lawmaker Rep. Paul Tittl (R-Manitowoc) at Holy Family Memorial Home Care (Manitowoc Medical Center) to discuss WiAHC and home health care in the Badger State.

The meeting, which also included WiAHC Advocacy Director Micheal Welsh, provided a tremendous opportunity to have a conversation about the importance of home health care for Wisconsin patients. Nicole did a great job briefing Rep. Tittl on the value of home health care and WiAHC’s legislative priorities, which focused primarily on the industry’s workforce challenges.  WiAHC would like to thank Nicole for making time to host the meeting. She did a wonderful job leading the discussion and was a fantastic representative of WiAHC. Her passion for home health care was evident and appeared to have a big impact on Rep. Tittl.

As mentioned above, grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy – and building relationships with lawmakers is the most important aspect of grassroots advocacy. The meeting with Rep. Tittl was just the latest endeavor in WiAHC’s goal to connect members with their local legislators. WiAHC encourages all members to participate in this critical grassroots advocacy program. If you or your organization is interested in hosting a state lawmaker, please contact the WiAHC office at wiahc@badgerbay.co.

By Hoven Consulting – WiAHC’s lobbying firm

• WiAHC Advocacy on State Budget Bill

One of WiAHC’s top legislative priorities for the 2023-24 legislative session is to strengthen Wisconsin’s home health care workforce. More specifically, WiAHC will be working to secure additional state funding to support efforts to increase the supply of nurse educators in Wisconsin.

Fortunately, Gov. Tony Evers has included a provision in his state budget bill proposal to allocate an additional $5,000,000 annually for the state’s nurse educators program. The program provides the following to boost the state’s nursing workforce:

While WiAHC will be implementing numerous advocacy tactics to support the proposal and win legislative approval – including direct lobbying and member grassroots advocacy engagement – one of the first steps we can take is to “enlist” members to testify on the initiative before the Joint Finance Committee’s public hearings on the budget bill.

In fact, the Co-Chairs of the GOP-controlled Joint Finance Committee – the Legislature’s powerful budget-writing committee – recently announced they will hold the following four public hearings across the state to give Wisconsin residents the opportunity to testify on issues related to the Fiscal Year 2023-2025 State Budget bill, which lays out the state’s spending plan for the next two years:

If you are interested in attending one of the public hearings and testifying in favor of the nurse educators funding proposal on behalf of WiAHC, please contact WiAHC Advocacy Director Michael Welsh for coordination purposes.  You may reach Mike at mwelsh@weda.org. 

Please keep in mind the public hearings on the budget bill are very well attended and generally take all day. Individuals who testify typically have two minutes to speak and could wait several hours for their brief appearance before the committee. With that said, there is still significant value in testifying before the committee and signaling to lawmakers that the nurse educators funding proposal is important to home health care and the overall health care workforce in Wisconsin.

• State Legislative Committee Suspends Certain DHS Immunization Requirements for Children

Earlier this year, the state Department of Health Services (DHS) announced updates to the required immunizations for children attending school, as well as those placed in child-care facilities. The changes to chapter DHS 144 of state administrative rules include requiring:  (1) children to receive the Tdap (tetanus, diphtheria, and acellular pertussis) vaccine at the start of the seventh grade (instead of the sixth grade), (2) students starting seventh grade to receive a meningococcal vaccine (MenACWY-containing vaccine), (3) high school seniors to also receive a booster of the meningococcal vaccine, (4), parents/guardians to obtain proof from a medical clinician that their child in child care or school has had chickenpox if they want their child to be exempted from the chickenpox vaccine, and (5) updating the definitions of “substantial outbreak” for both child care centers and schools so that they are aligned with Centers for Disease Control and Prevention (CDC) definitions and to add chickenpox and meningococcal disease to the definitions.

As originally released, these requirements took effect at child-care centers on February 1, 2023, and were to take effect for school-age children at the start of the 2023-2024 school year. 

On Tuesday, March 7, the Legislature’s Joint Committee for Review of Administrative Rules (JCRAR) held a public hearing in Madison to consider suspending these updated state administrative rules.  Two days later, JCRAR voted 6-4 to suspend portions of chapter DHS 144 of state administrative rules addressing student immunizations.  The following items were suspended: 

As a result of this March 9 vote in JCRAR, this will likely suspend implementation/enforcement of the three portions of chapter DHS 144 referenced immediately above until at least spring 2024. 

• WiAHC Supports Occupational Licensing Legislation

At its March meeting, the WiAHC Legislative Committee agreed to support the following legislation:

• Governor Evers Appoints New Secretary of State

Effective on Friday, March 17, longtime Wisconsin Secretary of State Doug La Follette resigned his position.  He had held that position for more than 40 years and was re-elected to a four-year term in November 2022.  Also, on Friday, March 17, Governor Evers appointed former State Treasurer Sarah Godlewski as the new Secretary of State.  Godlewski will serve out the remainder of La Follette’s term, which will end in January 2027. 

Earlier this month, the WiAHC had the opportunity to ask State Representative Clint Moses (R-Menomonie), Chair of the Assembly Health, Aging and Long-Term Care Committee, what his health care-related policy goals are for the 2023-24 legislative session. Here is what he had to say:

“My health priorities this session is to address the healthcare workforce shortage and to help make healthcare more affordable and accessible for Wisconsin citizens. Throughout Wisconsin, the health care workforce shortage has reduced accessibility to quality care. We have seen reduced service options and closures of clinics. In many cases, people are driving over an hour plus for a routine checkup. This creates a challenging situation for patients, especially for our aging population who face increasingly difficult decisions when it comes to their healthcare. I have been spending time learning about regulations surrounding Senior Care, IRIS, Nursing Homes, and Hospitals services across the state. I have also been on numerous tours in health care facilities and have met with many health care providers. I look forward to working with all the stakeholders to make Wisconsin a healthy state for all ages.”

Representative Clint Moses (R-Menomonie) represents the 29^th Assembly District in northwestern Wisconsin, which includes portions of Dunn and St. Croix Counties. He was first elected to the Assembly in 2020 and was reelected in 2022. He currently serves at the Chair of the Assembly Health, Aging and Long-Term Care Committee. Rep. Moses, who resides in Menomonie with his wife and four daughters, is a chiropractor by trade. He operates Red Cedar Chiropractic with his wife, Dr. Nora Moses, and has been caring for residents of Dunn County for 20 years. He is a member of the Chiropractic Society of Wisconsin, Community Foundation of Dunn County, lifetime alumni member of Northwestern Health Sciences University, and has served on the Colfax Health & Rehabilitation Board.

WiAHC is happy to remind members about and provide links to the latest articles and information on the home health care industry from Home Health Care News and other publications:

·       In Win For Home-Based Care Providers, Health Care Workforce Bill Passes

Home Health Care News - By Patrick Filbin | March 22, 2023

A bill that passed Wednesday on the state level is being touted as a potential blueprint to mitigating home-based care workforce shortages nationwide. In Frankfort, Kentucky on Wednesday, Gov. Andy Beshear passed the Kentucky Healthcare Workforce Development Act, legislation that aims to combat workforce shortages by building a public-private partnership that is designed to increase workforce training and education initiatives. Read More…

·       Home-Based Care Stakeholders See Public-Private Partnerships As Way To Address Workforce Shortage

Home Health Care News - By Joyce Famakinwa | March 20, 2023

Following the U.S. Senate’s request for information (RFI) regarding solutions to the national health care workforce crisis, the Partnership for Quality Home Healthcare (PQHH) submitted a comment letter on Saturday. The letter detailed the challenges the home-based care sector has been facing, and also included possible solutions. Among the potential solutions is recent state legislation that PQHH and others believe could work on a national level. Read more…

·       Biden Administration Calls For $150 Billion For Home- And Community-Based Services

Home Health Care News - By Patrick Filbin | March 9, 2023

The Biden Administration, as part of its 2024 proposed budget, plans to allocate $150 billion for home- and community-based services over the next 10 years. That, and a plan to keep Medicare from becoming insolvent in the near-term future, were the most relevant home-based care takeaways. Read more…

·       Lawmakers Introduce Bill To Expand Home-Based Care Coverage Under Medicaid

Home Health Care News - By Joyce Famakinwa | March 9, 2023

A number of lawmakers – including Sen. Bob Casey (D-Pa.) and Rep. Debbie Dingell (D-Mich.) – introduced a bill Thursday that would expand coverage of home- and community-based services under Medicaid. The HCBS Access Act was introduced by Casey, as a companion bill to the Better Care Better Jobs Act, which was originally unveiled in 2021 and reintroduced in January. Read more…

Home Health Care News, which is part of the Aging Media Network, is a leading source for news and information covering the home health industry.

To ensure the voice of citizens is heard across state government, it is critical for Wisconsin residents to understand our electoral process, and even more important for them to cast their vote on election day. And a big election is right around the corner… Wisconsin’s 2023 Spring Election will take place on Tuesday, April 4, and voters will head to the polls to cast their ballots in the WI Supreme Court Race, which could decide the ideological direction of the court for years to come.

In the Feb. 21 Spring primary, Milwaukee County Circuit Judge Janet Protasiewicz and former Supreme Court Justice Daniel Kelly captured the most votes in the four-way race and will face-off in the April 4 general election. Protasiewicz took 46% of total votes cast, with Kelly coming in a distant second, capturing 24% of the votes. Again, the winner of the general election will decide the ideological direction of the 7-seat high court, which is currently controlled 4-3 by conservative-leaning justices.

In addition, for those of you who live in the 8th Senate District (in southeastern Wisconsin), there is a special election to replace Sen. Alberta Darling (R) who retired from the Wi Senate late last year.  Republican State Representative Dan Knodl is running against Democrat environmental attorney Jodi Habush Sinykin.

For more information about the April 4 Spring Election, including your polling place and which candidates and referendum questions will be on your ballot, simply CLICK HERE. 

Grassroots advocacy is the most powerful tool WiAHC has at its disposal to shape public policy – and building relationships with lawmakers is the most important aspect of grassroots advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has established our Coffee Conversations with Legislators advocacy program.

The initiative is designed  to help connect members with their local legislators. Under the program, the WiAHC Government Affairs Team will set-up in-district meetings between WiAHC members and state lawmakers who represent them in the Legislature. These meetings, which can be located at your facility, or a local coffee shop provide a tremendous opportunity for WiAHC members to build or strengthen their relationships with local legislators and to educate them on home health care and on policy issues important to home health care professionals and their patients.

Again, WiAHC encourages all members to participate in this critical grassroots advocacy program. If you’re interested in participating, please contact the WiAHC office at wiahc@badgerbay.co.

By Hoven Consulting – WiAHC’s lobbying firm

• Governor Evers Submits FY2023-2025 Budget Request to Legislature

On Wednesday, February 15, Governor Tony Evers unveiled his budget bill proposal for the Fiscal Year 2023-2025 budget biennium. The budget bill outlines how the State of Wisconsin will administer tax dollars, program revenue, and federal aid dollars over the next two years. In total, the budget aims to spend $103.8 billion ($52.1 billion in FY2023-2024 and $51.7 billion in FY2024-2025) on state government programs.  For fiscal year 2023-2024, that's a $7.9 billion increase (17.9 percent) over the budget proposed by Evers in 2021. 

The most significant increase in state tax dollar spending is in the following state agencies/areas:

LARGEST BIENNIAL GPR (General Purpose Revenue) INCREASES OVER 2021-2023 FUNDING LEVELS

·        Department of Public Instruction:  $2.809 billion

·        Shared Revenue and Tax Relief:  $1.099 billion

·        Department of Administration:  $1.019 billion

·        Public Service Commission:  $755 million

·        Department of Health Services:  $716 million

·        Department of Children and Families:  $512 million

·        Department of Workforce Development:  $265 million

·        All Other Changes:  $1.656 billion

·        TOTAL:  $8.831 billion

The bill has now been sent to the Wisconsin legislature where it will be reviewed by the Joint Committee on Finance (JFC). The committee will review and amend the budget bill after having several public hearings across the state at which citizens may testify. After JFC has passed the bill, it will then be sent to the State Assembly and Senate for passage, likely in June.

It's important to note that Republican legislative leaders have stated publicly that they do not support the Governor's budget proposal. Republicans control both houses of the legislature and major changes to the proposal are expected.

• WiAHC Sends Legislative Priorities Letter to All Legislators

On January 27, WiAHC’s lobbyists sent an introductory letter to all Wisconsin state legislators.  In the letter, we provided background information on what exactly skilled home health care is and shared WiAHC’s state legislative agenda for the 2023-2024 legislative session.  WiAHC provided legislators with a “legislative leave-behind” document that includes this information. 

• WiAHC Requests DHS to Remove Professional Advisory Bodies from State Regulations

On January 26, WiAHC Board Chair Jayne Thill sent a letter to DHS Deputy Secretary Deb Standridge – the most senior DHS official on that date – requesting that the department update an outdated administrative rule relating to professional advisory bodies for home health agencies.  In particular, WiAHC requested that they bring state regulations in line with federal regulations by eliminating professional advisory bodies but maintaining governing bodies along with regulatory oversight for ensuring the quality of care and patient safety.  We requested that they make this change in their biannual comprehensive list of regulatory updates. 

• DHS Releases State Health Improvement Plan

On February 2, DHS released its 2023-2027 State Health Improvement Plan.  Under state law, DHS is required to craft a public health agenda for the state at least once per decade – this plan meets that requirement.  Further, this plan helps maintain DHS as an accredited state health department, per the requirements of the Public Health Accreditation Board. 

In summary, the report recommends the following three “foundational shifts” in how Wisconsin addresses public health:

·        Institutional and systemic fairness

·        Representation and access to decision-making

·        Community-centered resources and services

Also, it highlights the following priority areas – areas that are critical to ensuring the wellness of Wisconsinites:

·        Social and community conditions

·        Physical, mental, and systemic safety

·        Person and community centered health care

·        Social connectedness and belonging

·        Mental and emotional health and well-being

The full report may be viewed on the DHS website. 

• Home Health Care Services Electronic Visit Verification Public Forum on March 2

DHS will hold an online public forum on Thursday, March 2, 2023, from 1:00 – 3:00PM addressing the electronic visit verification (EVV) requirement for home health care services.  During this forum, DHS representatives will discuss the federal requirement to implement EVV for Medicaid-covered personal care and applicable home care services and answer any questions that attendees may have.  Attendees may submit questions in advance to DHS by emailing:  dhsevv@dhs.wisconsin.gov. 

For more information on this public forum, including the Zoom meeting link and call-in number, please go to the DHS EVV Forum page.