WiAHC is happy to remind members about and provide links to the latest articles and information from Home Health Care News and the National Association for Home Care and Hospice:

$1.5 Trillion Omnibus Spending Bill Leaves Out Home Health Telehealth Reimbursement

Home Health Care News - By Joyce Famakinwa | March 10, 2022

The U.S. House of Representatives passed a comprehensive $1.5 trillion omnibus spending package on Wednesday. The legislation, among other things, extends the temporary virtual care flexibilities that were put in place during the public health emergency. Read more…

New Legislation Would Extend the Hospital at Home Program

National Association for Home Care and Hospice | March 22, 2022

The bipartisan Hospital Inpatient Services Modernization Act is new legislation introduced in both the Senate and House of Representatives that would extend the acute care hospital at home waiver program. Initially introduced in November of 2020, during the height of the COVID-19 public health emergency (PHE), the program provides an alternative setting of care for certain conditions, such as asthma, pneumonia, and COPD. Read more…

How the PE Nursing Home Crackdown Could Affect the Home Health Industry

Home Health Care News - By Patrick Filbin | March 13, 2022

Pushed by the White House, federal watchdogs have a new directive – cracking down on private equity in health care. While they’ll largely be targeting nursing homes and PE investment as part of a recently unveiled senior care initiative from the Biden administration, there will likely be ripple effects in the home-based care space. Read more…

NAHC Shares Tech Recommendations with Congress

National Association for Home Care and Hospice | March 21, 2022

The National Association for Home Care & Hospice and a coalition of long-term & post-acute care (LTPAC) and health information technology (HIT) groups have submitted comments to an important congressional task force exploring ways to accelerate innovation in the health care system. 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. National Association for Home Care and Hospice is the largest professional association representing the interests of chronically ill, disabled, and dying Americans of all ages and the caregivers who provide them with in-home health and hospice services.

Help WiAHC Develop a Legislative & Regulatory Agenda for 2023-24

The 2021-22 legislative session, which came to an end earlier this month, gave WiAHC plenty of opportunities to engage in the legislative process, build relationships with lawmakers, and ultimately pass legislation important to our members.

While the Legislature has adjourned for the year and lawmakers have returned to their districts to run for reelection, there is plenty of advocacy work to do behind the scenes. In fact, it is a perfect time for WiAHC to begin planning for the 2023-24 legislative session, which includes the development of a legislative agenda.

Crafting a legislative agenda serves two specific purposes:

1.)    Inform WiAHC membership on the foremost state legislative and regulatory issues that impact home health care in Wisconsin and provide direction on which issues to actively advocate for before the legislature and executive branch.

2.)    Provide state lawmakers, the governor’s office, and state agency officials with WiAHC’s position on key legislative and regulatory topics that will be relevant during the two-year session.

Identifying and prioritizing issues critical to home health care is the initial – and the most important – step in developing a legislative agenda. By deciding what the most important issues are before the start of 2023-24 legislative session, WiAHC can determine what resources will be necessary to meet the legislative and regulatory goals of our members.

To best determine WiAHC’s legislative and regulatory priorities, the WiAHC Government Affairs Team will be sending out a legislative priorities survey within the next month to give all our members an opportunity to provide their input on what issues are most important to them. The information gathered via the survey will be presented to the WiAHC Legislative Committee and Board and used to identify the association’s top priorities that will make-up association’s 2023-24 legislative agenda.

In addition to the member survey data, WiAHC leadership will consider the following criteria when finalizing legislative and regulatory priorities: 1.) The benefit to WiAHC members; 3.) The extent to which it improves home health care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

WiAHC values its members’ input and encourages everyone to participate in the legislative priorities survey when they receive it in their email inbox.

The WiAHC Legislative Bill Tracker lists and allows members to follow and learn more about the bills WiAHC lobbied on and monitored during the 2021-22 legislative session, which came to an end earlier this month. The Bill Tracker, which you can find below, includes the bill number, a brief description of the bill, its status, and WiAHC’s position on the proposal.

• Bill: Assembly Bill 215 / Senate Bill 230
• Description: Relating to visitation of a long-term care facility resident or hospital patient by an essential visitor or member of the clergy.
• Status: AB 215 was introduced and referred to the Assembly Aging and Long-Term Care Committee. SB 230 was introduced and referred to the Senate Human Services, Children, and Families Committee. Failed to pass this session.
• WiAHC Position: Support

• Bill: Assembly Bill 679 / Senate Bill 687
• Description: Relating to hospital services provided in a home setting.
• Status: AB 679 was passed by the full Assembly and Senate. The governor has signed the bill into law as 2021 WI Act 208.
• WiAHC Position: Currently Neutral/Actively Monitoring
• Bill: Assembly Bill 718 / Senate Bill 753
• Description: Relating to prohibiting certain practices relating to insurance coverage of clinician-administered drugs (“white bagging” legislation).
• Status: AB 718 was referred to the Assembly Health Committee and received a public hearing on 02/16/22. SB 753 was referred to the Senate Insurance, Licensing and Forestry and received a public hearing on 01/20/22. Failed to pass this session.
• WiAHC Position: Support
  
• 

• Bill: Assembly Bill 729 / Senate Bill 700
• Description: Relating to modifying administrative rules related to home health agencies.
• Status: AB 729 was passed by the full Assembly on 02/23/22. SB 700 was referred to the Senate Labor and Regulatory Reform Committee and received a public hearing on 01/13/22. Failed to pass this session.
• WiAHC Position: Support

• Bill: Assembly Bill 960/ Senate Bill 970
• Description: Increases criminal penalties for battery or threat to a health care provider or staff member of a health care facility.
• Status: AB 960 was passed by the full Assembly and Senate. The governor has signed the bill into law as 2021 WI Act 209.
• WiAHC Position: Support

• Bill: Assembly Bill 1030/ Senate Bill 999
• Description: Medical Assistance program coverage of home health services or products provided outside the home.
• Status: AB 1030 was passed by the full Assembly and Senate. The bill will now be sent to the governor for his signature or veto.
• WiAHC Position: Support

By Hoven Consulting – WiAHC’s lobbying firm

In late February and early March, the legislature passed several bills of interest to WiAHC as it looked to likely wrap up the 2021-2022 legislative session.  The following is a list of these bills:

• Assembly Bill 960 – This bill makes it a felony to threaten or physically attack a health care provider, a staff member of a health care facility or a family member of either, if the threat or attack is related to an official act of the provider or is related to an occurrence at the health care facility.  Both the Assembly and Senate passed this bill.  It will now go to the Governor for his consideration.  WiAHC supports this bill.  In addition, WiAHC signed on to a joint memo to the Legislature supporting this bill, along with numerous other statewide health care organizations. 

• Assembly Bill 1030 – This bill eliminates the requirement that home health services and products be provided in a patient’s home to be reimbursable under the Medical Assistance program.  This legislation was introduced at the request of the Department of Health Services.  Both the Assembly and Senate approved this bill, and it now goes to the Governor.  WiAHC supports this bill. 

• Assembly Bill 729/Senate Bill 700 – This legislation, which was introduced by Rep. Donna Rozar (R-Marshfield) and Sen. Joan Ballweg (R-Markesan) at the request of WiAHC, brings Wisconsin’s home health regulations in line with federal regulations by eliminating home health care professional advisory bodies but maintaining governing bodies.  This bill passed the Assembly in late February.  The Senate Labor and Regulatory Reform Committee held a hearing on the bill in January.  However, it is disappointing to note that this legislation was not voted on in the full Senate since Senator Steve Nass (R-Whitewater), who chairs the Senate Labor and Regulatory Reform Committee, refused to vote this bill out of this committee.  Senator Nass does not have a problem with the policy in this legislation but objects to bills that change administrative rules through legislative action, rather than via the administrative rules process.  WiAHC tried several different tactics but, unfortunately, we were not able to remove his objection.  The WiAHC Legislative Committee will regroup and look at alternative options to make the change included in this bill. 

DHS Payment Increase Delays - Update

In February, WiAHC Board Chair Lisa Kirker sent a letter to State Medicaid Director Lisa Olson at the Department of Health Services (DHS) requesting a status update on the processing of two separate payment streams to home health care providers.  One such payment stream was nearly an eight percent increase for select nursing care services in home health agencies, which was included in the 2021-2023 state budget.  The other payment stream was an additional five percent Medicaid reimbursement rate for home and community-based services, which was funded by the federal American Rescue Plan Act (ARPA).  WiAHC has heard from members who have not yet received these increased payments. 

DHS responded that they have run into delays in modifying their system to incorporate these increased payments.  Once DHS completes those modifications, they will process the payments retroactive to January 1, 2022.  The agency did not provide any details as to when these payments will likely be processed. 

Recent Marquette University Poll

On March 2, Marquette Law School released a new poll that surveyed Wisconsin voters on their opinions of various national and statewide elected officials, as well as candidates for statewide office. 

U.S. Senate Election 

With respect to those voters who intend to vote in the Democratic primary for U.S. Senator Ron Johnson’s seat, Lieutenant Governor Mandela Barnes was the leading candidate with 23 percent, and Alex Lasry followed with 13 percent.  The other candidates only received support in the single digits, while 48 percent of Democratic primary voters have not decided whom they will support. 

Gubernatorial Election

In this poll, Republican gubernatorial candidate Rebecca Kleefisch led her primary rivals with 30 percent of Republicans and Republican-leaning voters selecting her, eight percent selecting former U.S. Senate candidate Kevin Nicholson and five percent selecting State Representative Tim Ramthun.  However, 54 percent of these voters responded that they did not know whom they will support in the Republican primary. 

At this time, Governor Tony Evers leads in popularity among elected statewide officials with 50 percent approving and 41 disapproving.  President Biden has a 43 percent approval rating and a 52 percent disapproval rating.  With respect to Wisconsin’s two U.S. Senators, Senator Tammy Baldwin has a 42 percent approval rating and a 36 percent disapproval rating, while Senator Ron Johnson has a 33 percent approval rating and a 45 percent disapproval rating. 

State Supreme Court Ruling on Redistricting

At the beginning of each decade, each state redraws state legislative and congressional district lines based on data from the most recent federal census.  After the Governor vetoed the legislature’s proposed legislative and congressional district maps last year, this dispute ended up in the courts.  On March 3, 2022, the Wisconsin Supreme Court decided that Governor Evers’ updated state legislative and congressional maps will be used as they make fewer changes to district boundaries than the Legislature’s proposed maps. 

On Monday, March 7, the Legislature appealed this ruling directly to the U.S. Supreme Court.  And just this week, the nation’s highest court threw out the state legislative maps drawn Governor Evers and adopted by the Wisconsin Supreme Court. The U.S. Supreme Court said the state court’s approval of Evers’ maps was flawed, as it did not adequately consider whether certain newly crafted Assembly Districts in Milwaukee complied with the federal Voting Rights Act. The maps were sent back to the Wisconsin Supreme Court for further consideration.

Politicians on the Move - Update

• On February 24, State Rep. Mike Kuglitsch (R-New Berlin) announced that he will not run for re-election in 2022.  He was first elected to the Assembly in 2010.  He serves as the Chair of the Assembly Energy and Utilities Committee and also serves on the following Assembly committees:  Environment; Government Accountability and Oversight; and State Affairs. 

• On March 3, State Rep. Gordon Hintz announced that he will not run for re-election this year.  He used to serve as Assembly Minority Leader and was first elected to the Assembly in 2006. 

• State Sen. Roger Roth (R-Appleton) has announced that he is running for lieutenant governor.  He has served in the Senate since 2015 and also served in the Assembly in 2007-2008.  He chairs the Senate Committee on Universities and Technical Colleges and is vice chair of the Committee on Utilities, Technology and Telecommunications. 

• State Rep. Rachael Cabral-Guevara (R-Appleton) announced on March 17 that she is running for Senator Roth’s seat.  She is a nurse and was elected to the Assembly in 2020.  She is the vice chair of the Assembly Mental Health Committee and is a member of the following Assembly committees:  Health, Colleges and Universities, Public Benefit Reform, and Regulatory Licensing Reform. 

• State Sen. Dale Kooyenga (R-Brookfield) announced on March 8 that he will not run for State Senate this year since this year’s redistricting process relocated his home from his current district to a different Senate district that is not up for election until 2024.  [Note:  The redistricting is based on a March Wisconsin Supreme Court ruling.  However, it is worth noting that this ruling is being appealed to the U.S. Supreme Court, which has not yet decided whether to take this case.]  He was first elected to the Senate in 2018 and served in the Assembly from 2011 through 2018.  He is currently the chair of the Senate Committee on Financial Institutions and Revenue. 

• State Sen. Janis Ringhand (D-Evansville) announced on March 9 that she will not run for re-election this year.  She was first elected to the Senate in 2014 and served in the Assembly in 2011 through 2012.  She serves as the Assistant Minority Leader and serves on the following Senate committees:  Economic and Workforce Development; Financial Institutions and Revenue; and Insurance, Licensing and Forestry.

• State Rep. Mark Spreitzer (D-Beloit) subsequently announced that he will run for Sen. Ringhand’s seat.  He has served in the Assembly since 2015.  He currently serves as the Assembly Minority Caucus Chair and is a member of the following Assembly committees:  Agriculture, Campaigns and Elections, Local Government, and Sporting Heritage. 

• State Rep. Timothy Ramthun (R-Campbellsport) has announced that he will run for Governor this year.  He has served in the Assembly since 2019.  He is the Vice Chair of the Children and Families Committee and is a member of the following Assembly committees:  Constitution and Ethics, Education, Judiciary, Transportation, and Ways and Means. 

• State Sen. Jerry Petrowski (R-Marathon) has announced that he will not run for re-election in 2022.  He was first elected to the Senate in 2012 and served in the Assembly from 1999 to 2012.  He serves as the chair of the Senate Committee on Transportation and Local Government, is vice chair of the Committee on Sporting Heritage, Small Business and Rural Issues and is a member of the Committee on Agriculture and Tourism. 

• State Sen. Brad Pfaff (D-Onalaska) has announced that he is running for Congressman Ron Kind’s (D) seat in 2022.  He was first elected to the Senate in 2020 and currently serves on the following Senate committees:  Utilities, Technology and Telecommunications; Universities and Technical Colleges; Transportation and Local Government; Economic and Workforce Development; and Agriculture and Tourism.  [Note:  If he does not win his congressional race, he will still remain a member of the State Senate as his current term does not run out until 2024.] 

• State Sen. Patrick Testin (R-Stevens Point) has announced that he is running for Lieutenant Governor.  He currently serves in Senate leadership as the President Pro Tempore.  He was first elected to the Senate in 2016 and was re-elected in 2020.  He currently is chair of the Senate Health Committee, is vice chair of the Economic and Workforce Development Committee and is also a member of the Senate Agriculture and Tourism Committee.  [Note:  If he does not win his race for lieutenant governor, he will still remain a member of the State Senate as his current Senate term does not run out until 2024.]

Help Advocate for Home Health Care: Sign-up for WiAHC’s Coffee Conversations with Legislators Program

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 advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has unveiled 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 provides 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.

Obviously, the surge in COVID-19 cases currently makes it difficult for some in-person meetings, but as cases subside and depending on your comfort level with meeting face-to-face, WiAHC would encourage you to participate in this critical grassroots advocacy program.

Please click here for more information on the program.

Wisconsin DHS Announces Rate Increase to Help Support Healthcare Workforce During COVID-19 Case Surge
 
Gov. Tony Evers and the Department of Health Services (DHS) earlier this month announced that Wisconsin has increased reimbursement rates by five percent for several types of home and community-based services (HCBS) provided to members of Wisconsin's Medicaid programs. The announcement from Gov. Evers and DHS today comes as the state continues to face healthcare workforce challenges in the midst of surging COVID-19 cases across Wisconsin. Last week, the Evers Administration announced the state has worked to recruit nearly 600 temporary staff to support the state's healthcare workforce.

HCBS providers serve Wisconsin's older adults, as well as adults and children with disabilities, enabling them to live independently in the community. The rates were increased by using funds provided through the American Rescue Plan Act (ARPA). The increases took effect as of Jan. 1, 2022, and will run through March 31, 2024.

“As our state continues to face some of the worst case increases we've seen during this pandemic, we're working to ensure our state's hospitals and long-term care facilities have the resources and support to retain and recruit workers and continue providing care to folks across our state,” said Gov. Evers. “The pandemic has put a significant strain on our healthcare workforce, and we're making critical investments so providers can better keep pace with rising costs and maintain access to care for Wisconsinites.”

“It is essential that we invest in our long-term care infrastructure so Wisconsinites who are elderly or who have a disability are able to access the services and support they need to live as independently as possible in their community,” said DHS Secretary-designee Karen Timberlake. “These rate increases are needed now more than ever as providers of care and services for our elders and adults and children living with disabilities are also being affected by the current surge in COVID-19 cases.”

Increasing Rates for Nursing Homes and Hospitals
Gov. Evers and DHS have increased rates and provided additional support to Wisconsin's nursing homes and hospitals, so they have the resources and support to continue providing high-quality care. Wisconsin hospitals and nursing homes provide care that is essential to the well-being of people across the state. COVID-19 has added more financial pressure due to supply and equipment costs, testing, and disruptions in admissions and discharges. Increasing funding for nursing homes and hospitals is a key part of supporting our most vulnerable residents.

Over the period from July 1, 2019 through June 30, 2023, Wisconsin will invest more than $500 million in payments and incentives to nursing homes, and more than $275 million in payments and incentives to hospitals. These payments are summarized below. They reflect increased reimbursement rates for nursing homes, increased payments made to hospitals that provide a higher amount of care to Medicaid members and people who are uninsured or underinsured, increased payments to rural hospitals, and additional funding provided to hospitals and nursing homes to offset the losses and expenditures providers have experienced due to the COVID-19 pandemic.

Nursing Homes
The rate increases for nursing homes were provided through the 2019-21 and 2021-23 biennial budgets. Payments to offset losses and expenditures experienced due to the COVID-19 pandemic were provided through one-time federal Coronavirus Aid, Relief, and Economic Stability (CARES) Act funding.

• Rate increases in the 2019-21 biennial budget: $148,157,800 (Reflects budgeted amounts for fiscal year 2020 through fiscal year 2023, The rate increase is ongoing.)
• Rate increases in the 2021-23 biennial budget: $252,409,700 (Reflects budgeted amounts for fiscal year 2022 through fiscal year 2023. The rate increase is ongoing.)
• CARES Act Direct Provider Payments to Nursing Homes: $75,640,729
• CARES Act Admissions Incentive Program: $30,000,000

Hospitals
Increased payments for hospitals were provided through the 2019-21 and 2021-23 biennial budgets. Payments to offset losses and expenditures experienced due to the COVID-19 pandemic were provided through one-time federal CARES Act funding.

• Increased disproportionate share hospital payments in the 2019-21 and 2021-23 biennial budgets: $215,587,514
• Increased rural critical care supplement for rural hospitals in the 2019-21 and 2021-23 biennial budgets: $19,748,200
• CARES Act Direct Provider Payments to Hospitals: $40,000,000

Increasing Rates for HCBS
Wisconsin projects that the demand for long-term care services will rise faster than the workforce will grow in the coming years. According to the Governor's Taskforce on Caregiving, the state's population aged 65 and older is expected to grow by 72 percent between 2015 and 2040. The rate is six times higher than the overall Wisconsin population growth project of 12 percent for the same period.

HCBS are essential to meeting the daily needs of the members of Wisconsin's long-term care programs, allowing them to avoid unnecessary institutionalization. Examples of HCBS include care received at an assisted living facility, personal care, home health, residential substance use disorder treatment, respiratory care, and in-home nursing, physical therapy, and occupational therapy. These services have been shown to be a cost-effective alternative to higher-cost institutional services, such as nursing home placements or hospital services. Higher rates help providers recruit staff and maintain the important system that delivers such critical care. The rate increase is part of DHS' broader plan to reinvest resources provided through ARPA into home and community-based services.

The ARPA rate increase for HCBS is being made in addition to the investments in support of the Medicaid HCBS workforce provided through the 2021-23 biennial budget. This included funding to increase the hourly rate for personal care services, increases for behavioral treatment services for individuals with autism and other disorders, increases for home health, therapeutic services, and Family Care providers, as well as funding increases for the direct care workforce funding program for Family Care. These investments will be significant to support individuals in their homes. As one example, when the workforce investments in the 2021-23 biennial budget are combined with this five percent rate increase, the hourly reimbursement rate for personal care services will be increased by 14 percent from $19.16 per hour and $21.84 per hour.

WiAHC Legislative Tracker

The 2021-22 WiAHC Legislative Bill Tracker lists and allows members to follow and learn more about the bills WiAHC is lobbying on and monitoring as they work through the legislative process. The Bill Tracker, which you can find below, includes the bill number, a brief description of the bill, its status, and WiAHC’s position on the proposal.

• Bill: Assembly Bill 215 / Senate Bill 230
• Description: Relating to visitation of a long-term care facility resident or hospital patient by an essential visitor or member of the clergy.
• Status: AB 215 was introduced and referred to the Assembly Aging and Long-Term Care Committee. SB 230 was introduced and referred to the Senate Human Services, Children, and Families Committee.
• WiAHC Position: Support

• Bill: Assembly Bill 679 / Senate Bill 687
• Description: Relating to hospital services provided in a home setting.
• Status: AB 679 was referred to and passed by the Assembly Health Committee on 11/10/21. SB 687 was referred to the Senate Health Committee and received a public hearing on 1/12/22.
• WiAHC Position: Currently Neutral/Actively Monitoring

• Bill: Assembly Bill 718 / Senate Bill 753
• Description: Relating to prohibiting certain practices relating to insurance coverage of clinician-administered drugs (“white bagging” legislation).
• Status: AB 718 was introduced and referred to the Assembly Health Committee. SB 753 was introduced and referred to the Senate Insurance, Licensing and Forestry
• WiAHC Position: Support

• Bill: Assembly Bill 729 / Senate Bill 700
• Description: Relating to modifying administrative rules related to home health agencies.
• Status: AB 729 was referred to the Assembly Aging and Long-Term Care Committee and received a public hearing on 01/12/22. SB 230 was referred to the Senate Human Services, Children, and Families Committee and received a public hearing on 01/13/22.
• WiAHC Position: Support

• All Health Plans to Cover Cost of At-Home COVID-19 Tests
  On January 13, Governor Evers and Insurance Commissioner Nathan Houdek announced that all health insurance plans will be required to cover the cost of at-home rapid, diagnostic COVID-19 tests, starting on January 15, 2022.  This is required by the federal government.  These tests may be free or reimbursable to patients, depending upon arrangements health plans and insurance companies make with retailers/pharmacies.  Health plans and insurance companies will be required to cover up to eight such diagnostic tests per person, per month. 

• State Improves Prescription Drug Monitoring Program 
  In December, the state Department of Safety and Professional Services (DSPS) announced that the U.S. Department of Justice awarded $1,648,000 to the Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP).  These dollars will be used to help connect the ePDMP with existing electronic medical records systems in Wisconsin. DSPS intends to focus these efforts on medical providers in rural and underserved regions in our state. 
• Medicaid Program Surplus Projected
  On December 30, 2021, the Department of Health Services informed the legislature that it projects that the state will have a $184.9 million surplus in the Medicaid program by the end of the 2021-2023 state budget.  The state budget expires at the end of state fiscal year 2023, which ends on June 30, 2023.  This increase is largely due to the extension of the federal COVID-19 public health emergency and the additional 6.2 percent Medicaid match rate, which is provided by the federal government while the emergency declaration is in place. 
• Gov. Evers Announces Wisconsin National Guard to Support Hospital and Nursing Home Capacity
  Wisconsin Gov. Tony Evers recently announced new efforts with the Wisconsin National Guard to bring needed staffing support to Wisconsin's hospitals and nursing homes by training Wisconsin National Guard members as certified nursing assistants. In an effort to free up capacity at hospitals, staffing relief will allow skilled nursing facilities to open up 200 or more beds by the end of February to receive post-acute care patients. This week, approximately 50 Wisconsin National Guard members were deployed to six nursing homes across the state. A group of about 80 members who started training this week will deploy at the end of January. Another group of about 80 members will start training in early February to deploy by the end of February.
• Protecting Medicare and American Farmers from Sequester Cuts Actz
  On December 10, President Biden signed the Protecting Medicare and American Farmers from Sequester Cuts Act (S. 610) into law, addressing multiple policies expected to drastically cut  physician Medicare reimbursement in 2022. More specifically, the act does the following:
• • Provides a 3 percent increase to the Medicare Physician Fee Schedule (MPFS) conversion factor in 2022, which provides relief from the scheduled expiration of a 3.75 percent increase passed as part of the Consolidated Appropriations Act, 2021.
  • Extends the suspension of the automatic 2 percent cut to Medicare reimbursement, known as the sequester, until March 31, 2022.
  • Delays an additional 4 percent cut stemming from the Statutory Pay-As-You-Go Act of 2010 (PAYGO) until at least 2023.

• Supreme Court Blocks Biden’s COVID Vaccine Mandate Rule for Large Businesses; Upholds Health Worker Requirement
  As has been widely reported, the U.S. Supreme Court recently handed down a split decision on two Biden administration COVID-19 vaccine requirement workplace rules: 1.) An OSHA rule requiring businesses with at least 100 employees to compel their workers to get vaccinated or wear masks and test negative at least once per week; and 2.) The CMS rule mandating most health care workers to be vaccinated against COVID-19. The High Court struck down the OSHA Rule on a 6-3 decision, but it upheld the CMS mandate on a 5-4 decision.

WiAHC Government Affairs Report | By Hoven Consulting – WiAHC’s Lobbying Firm

Assembly and Senate Committees Hold Hearing on Home Health Rules Update Bill

During the week of January 10, the Assembly Aging & Long-Term Care Committee and the Senate Labor and Regulatory Reform Committee held hearings on Assembly Bill 729 and Senate Bill 700, respectively.  This legislation, which was introduced by Rep. Donna Rozar (R-Marshfield) and Sen. Joan Ballweg (R-Markesan) at the request of WiAHC, brings Wisconsin’s regulations in line with federal regulations by eliminating home health care professional advisory bodies but maintaining governing bodies.  WiAHC state lobbyist Tim Hoven testified at both hearings on behalf of WiAHC and received a positive reception from members of both committees. 

Current state administrative rules require each home health agency to establish a professional advisory body, which is required to review and submit recommendations to the governing body regarding various operational matters each year.  However, in 2017, federal regulations eliminated professional advisory committees and instead created an ongoing quality assessment and performance improvement (QAPI) program.

A home health agency’s governing body is ultimately responsible for ensuring that the QAPI program is operated properly. An additional professional advisory body is no longer needed in state administrative rules now that the federal government has eliminated professional advisory committees and required home health agencies to implement QAPI programs, which prioritizes quality of care and patient safety.  CLICK HERE to read the one-page issue summary that WiAHC provided to legislators.

Politicians on the Move

• On January 10, State Representative Gordon Hintz (D-Oshkosh) stepped down as Assembly Minority Leader.  He was first elected to the Assembly in 2006 and was elected as Assembly Minority Leader in 2017.  On January 10, State Representative Greta Neubauer (D-Racine) assumed the role of Assembly Minority Leader.  Rep. Kalan Haywood (D-Milwaukee) was elected to serve as the next Assistant Minority Leader and will take over from State Rep. Dianne Hesselbein (D-Middleton), who will run for the seat of State Senator Jon Erpenbach (D-West Point), who is retiring this year.
• State Representative Beth Meyers (D-Bayfield) recently announced that she will not run for re-election in 2022.  She was first elected in 2014.  She is a member of the Assembly Democratic leadership team as the Minority Caucus Secretary and is also a member of the Aging and Long-Term Care Committee.  On January 10, new Assembly Minority Leader Greta Neubauer appointed Rep. Meyers to a seat on the Joint Finance Committee for the rest of the 2021-2022 legislative session.
• State Representative Jim Steineke (R-Kaukauna), the current Assembly Majority Leader, recently announced he will not seek re-election in 2022. Steinke was first elected in 2010, and quickly rose through the ranks of the Assembly GOP leadership. He has served as Majority Leader since 2015.
• State Senator Kathy Bernier (R-Chippewa Falls) announced on January 7 that she will not run for re-election this year.  She was elected to the Senate in 2018 and previously served in the Assembly from 2011-2018.  She currently chairs the Senate Committee on Elections, Election Process Reform and Ethics and serves on the Joint Finance Committee.

Home Health Care News

By Andrew Donlan | November 19, 2021

The Biden administration’s Build Back Better plan – which includes an array of support for home-based care and senior services – took a significant step Friday.

A $1.9 trillion bill got the necessary number of votes to make it through the U.S. House of Representatives. The next stop will be the Senate.

“Today’s historic vote of support for home care comes at a time when the country needs it more than ever,” National Association for Home Care & Hospice (NAHC) President William A. Dombi said in a statement shared with Home Health Care News. “Health care at home is widely recognized as high value, high quality and highly preferred.”

Most notably, $150 billion will be dedicated to reducing waiting lists for in-home care services and improving pay for low-wage in-home care professionals.

But the Build Back Better plan will also include $150 billion to increase the supply of affordable housing, $130 billion to provide tax credits for uninsured people in states that have not expanded Medicaid benefits, $1 billion for direct care workforce competitive grants, and $20 million for hospice and palliative nursing programs.

“From pediatric nursing care to home care aide services for those with multiple chronic illnesses as they age, this legislation will provide improved access to home care,” Dombi said. “We now look to the Senate to complete the work to protect our families and friends who need this essential care.”

Originally, the plan included $400 billion for home- and community-based services (HCBS), but it was eventually trimmed as Democrats and Republicans bargained for their respective side’s wishes.

Even the lesser version won’t be a shoo-in to get through the Senate, though advocates are arguing relentlessly on its behalf. The Senate is expected to consider the bill in the coming weeks, with the hope that a decision will be made before Christmas.

“Today’s vote is a major step forward for millions of older Americans … stuck on waiting lists to rent a place they can afford, and unable to get the home health and other help they and their families need,” Katie Smith Sloan, the president and CEO of LeadingAge, said in a statement. “It’s also an overdue step toward alleviating workforce shortages that are denying critical services and support to millions of older adults.”

While the funding would help on the recruiting and retention front by improving wages, it would also likely give hundreds of thousands more Americans access to home-based care.

“Support for home- and community-based services and affordable senior housing programs in the Build Back Better legislation can fundamentally transform how people grow old in this country,” Sloan continued. “These are critically needed resources – especially the investments in the workforce – that will immediately help alleviate current shortages and scarcity across aging services.”

The investment in workers, particularly, has drawn praise from organizations across the country that represent caregivers and other home-based care professionals.

Ai-jen Poo, the executive director of the National Domestic Workers Alliance (NDWA) and Caring Across Generations, remarked that this was a step toward “the care and infrastructure our families and economy need.”

“Today’s vote brings us one step closer to realizing a future where America’s home care workers … receive a family-sustaining wage,” Poo said in a statement. “And those who need care … will be able to receive quality, affordable care services at home. The Senate’s quick passage of this historic legislation with all three pillars of the care economy – including home- and community-based services, child care and paid family medical leave – will enable us to start building the care infrastructure our families and economy need.”

The plan would be building on other legislative moves made to support in-home care since the onset of the COVID-19 pandemic. The passage of another $1.9 trillion stimulus bill, the American Rescue Plan set the stage for Build Back Better after it made a 10 percentage point increase to HCBS funding through the Federal Medicaid Assistance Percentage (FMAP) match.

An example of how those funds were used surfaced earlier this week in Florida, as the state used that hike to invest $1.1 billion to support HCBS for Floridians. Of that $1.1 billion, more than $669 million will go toward directly addressing HCBS providers’ ongoing workforce challenges and more than $128 million will go toward enhancing services for older adults.

As of Oct. 21, two dozen states had received approval to use increased FMAP funds to increase HCBS provider payment rates. Another 20 or so used it to offer special bonus payments to workers.

“Florida will invest the enhanced funding to allow Florida health care providers to recruit and retain staff to care for the most vulnerable and bolster the ability of Floridians to receive care in a community-based setting,” a statement from the state’s Agency Health Care Administration (AHCA) read. “HCBS programs serve the state’s aging population, as well as individuals with physical, intellectual and developmental disabilities.”