As many political spectators say, campaign season ramps up after Labor Day. Candidates are in a sprint to the finish just over six weeks to go until the November 3 general election. We issued an initial election outlook in June. After a summer of social unrest in cities across the country, an ongoing pandemic, and two national political conventions, one thing remains certain: voter preferences have not changed significantly since June.

Presidential Election Analysis

A Marquette University Law School poll from September 9 shows Democrat and former Vice President Joe Biden holds a four-point lead over Republican incumbent President Donald Trump in Wisconsin. A Washington Post poll from September 16 shows Biden holds a six-point lead in the state. Biden has held a four to six point in nearly every statewide poll since May. With neither candidate able to gain any ground, this could indicate a lack of a substantial set of swing voters in the state.

Discouraging to the Trump campaign, the President’s approval ratings in Wisconsin have consistently been below 50 percent while his disapproval ratings have consistently exceeded 50 percent in the Marquette University Law School polls this election season.

In a somewhat different take on gauging support for candidates, the September 9 poll asked participants if they believe each candidate cares about people like them. 41 percent said they believe Donald Trump cares about people like them, versus 56 percent who said he does not. Conversely, 48 percent said they believe Joe Biden cares about people like them, versus 45 percent who said he does not.

State Legislative Races

Meanwhile, in the state legislative races, it seems to be a tale of two houses. Assembly Republicans are playing more defense to protect current members while Senate Republicans are able to go on offense to try pick up some seats. While it is likely the Republicans will maintain majorities in both houses, insiders will be watching so see how many seats the Assembly Republicans may lose and how many the Senate Republicans may gain.

State Assembly Election Analysis

There are several somewhat vulnerable Republican Assembly seats in western Wisconsin. These include the 51^st District held by Todd Novak, the 96^th District held by Loren Oldenburg, and the 50^th District held by Tony Kurtz. However, these are seats Republicans traditionally expect to be contested and defend in campaign cycles.

This year, Assembly Republicans are also focusing their attention on defending seats in higher population areas in the Milwaukee suburbs and Green Bay area. Polling nationally has found that suburban women who have traditionally supported Republicans do not support Donald Trump. Should enough of that demographic abandon not just Trump but Republicans in general, that could spell problems for some suburban Republicans in relatively vulnerable seats. In particular, considerable efforts are being made to hold on to the 13^th District held by Rob Hutton, the 24^th District held by Dan Knodl, and 23^rd District held by Jim Ott.

Assembly Republicans currently hold a 27-seat majority, 63 to 36 seats. Even if they lose five to seven seats, they still maintain control of the Assembly. At this point, it seems likely they may lose a handful of seats. However, in 2018, many expected Assembly Democrats to flip several seats and they won just one in the Milwaukee suburbs, which was an open race.

State Senate Election Analysis

In contrast, Senate Republicans, who held 19 of the 33 Senate seats in the 2019-2020 legislative session are aiming to pick-up three seats. Doing so would provide them with 22 seats, enough to override any vetoes from Democratic Governor Tony Evers. A veto-proof majority in the State Senate would spell serious problems for the Evers Administration.

In the open 30^th Senate District in Green Bay, Democrat Jonathan Hansen is facing off against Republican Eric Wimberger. Both are political newcomers. The seat is being vacated by Democrat Senator Dave Hansen, who held the seat since 2000.

Looking at the performance of Republican presidential candidates in the last two elections, Romney lost the 30^th Senate District with 47.7% of the vote and Trump won it with 55.6%. If Trump performs well in Green Bay again, then it is conceivable Wimberger could win the district.

The open 32^nd Senate District is also a possible pick-up for Republicans. Former State Senator and Republican Dan Kapanke is running against former Secretary-designee of the Department of Agriculture, Tradem and Consumer Protection and Democrat Brad Pfaff.

The seat was left open following the resignation of Democratic Senator Jennifer Shilling, who narrowly defeated Kapanke in 2016. While the 32^nd Senate District in LaCrosse is typically a strong Democrat district, Trump did significantly better than Romney. Should Trump increase support in the LaCrosse area, Kapanke may have a chance.

Finally, political spectators are also keeping a close eye on the 10th Senate District in northwest Wisconsin, which is held by Democrat Patty Schachtner. Schachtner handily won the seat by 10-percentage points in special election in 2018. Schachtner is running against current area Republican State Representative Rob Stafsholt.

Republicans currently hold all three Assembly seats that comprise the Senate district, and Trump won the district with 55.6% of the vote in 2016. Again, Stasholt’s success may rely on the district’s support for Trump.

With the Office of the President being the only statewide race on the ballot, success for Democrats and Republicans in the state legislature could rely solely on attitudes in the presidential race.

However, while Wisconsin is considered one of the foremost battle ground states this year and Biden leads Trump in recent polling, the vast majority of Democratic voters reside in Milwaukee County and Dane County (Madison). Democrats already hold the legislative seats in these two areas. The reality of how voters are distributed in the state lends itself to the possibility that the Democratic nominee for president wins the state and legislative Republicans return with large majorities again.

Stay tuned for developments in what is sure to be an eventful fall.

On September 15, Wisconsin’s state agencies submitted 2021-23 budget requests to the state budget office at the Department of Administration. From these documents, Governor Tony Evers will begin framing his own 2021-23 biennial budget proposal, which he will send to the legislature in February 2021.

While these documents are helpful in gaining insight into what the Governor’s budget may look like in terms of general spending levels, they lack the policy and new big-ticket funding initiatives we typically see unveiled in the executive budgets.

In the letter Evers sent to state agencies in June, he directed agencies to devise their requests with the assumption there will be zero growth in appropriations. Essentially, he requested agencies to develop budgets based on current funding letters. This is typical of the agency budget request exercise.

One of the few exceptions to the direction is for the Department of Health Services, which can propose a budget based on forecasted cost-to-continue needs for Medicaid spending. To that end, DHS is requesting a 16.4% increase in total department funding. Much of that increase comes from future Medicaid expenditure projections. However, the increase also assumes and budgets for accepting federal Medicaid expansion dollars, which would provide over $1.5 billion in new revenue for state Medicaid programs.

While Medicaid expansion will likely be included in Evers’ February proposal, it is unknown what in Evers will draw from across all the agency budgets.

Once Evers introduces his proposal in February, the legislature’s Joint Committee on Finance will commence a series of hearings and debates that will likely take place March and May. Then the legislature will look to pass a final proposal in June 2021.

National Association for Home Care & Hospice You are invited to join a webinar this Friday September 25, 2020 from 12:00PM-1:30PM EST for Home Health and Hospice Facilities presented by the U.S. Department of Health and Human Services to discuss the Abbott BinaxNOW™ test. On August 27, 2020, the Trump Administration announced the purchase of 150 million rapid COVID-19 tests to be distributed across the country. You are receiving this email because your organization could receive Abbott BinaxNOW™ COVID-19 Ag Card Point of Care (POC) SARS-CoV-2 diagnostic tests from the U.S. Department of Health and Human Services (HHS), if you meet HHS criteria regarding testing prioritization. Training videos, modules, and frequently asked questions (FAQs) for the BinaxNOW™ test can be accessed here on Abbott's website. For questions regarding the BinaxNOW™ test, please call Abbott Technical Services at 1-800-257-9525 or email ts.scr@abbott.com. For shipment issues or questions, email ARDxUSGovernmentSupport@abbott.com. To assist states, home health agencies, and hospice facilities, HHS will host a webinar with Abbott on September 25, 2020 from 12:00PM-1:30PM EST to walk through the HHS BinaxNOW program, manufacturer's training and introduce the product. The webinar will have a training from Abbott to demonstrate the training tools available and answer questions and representatives from the U.S. Government to speak about the program. Use the following link to register for the training: click here to register If you are unable to attend the webinar the session will be recorded and available for review and shared soon. You can also access the Abbott BinaxNOW™ training portal using this link: click here to access training portal William A. Dombi, Esq. President National Association for Home Care & Hospice

The Wisconsin Department of Health Services has launched a newsletter to explain electronic visit verification in a clear and conversational way. The first issue contains information about the provider and worker identification processes and getting ready for Day 1 of EVV. Further issues of Your Key to EVV will be posted to the newsletter’s library page.

Nominate a yourself or a colleague to serve on the WiAHC Board of Directors today!

WiAHC is run by a volunteer Board of Directors. Board members are elected annually to staggered three-year terms. Board members develop and manage the affairs of the Association and are supported by Committee Chairs and staff. Positions include Chair, Vice-Chair, Secretary/Treasurer, and Regional and At-Large Representatives.

Positions serve a three-year term, starting January 2021. Those elected will also be invited to attend the final Board meeting of 2020.

To be eligible, a nominee's home health agency must be a current member of WiAHC.

How to Nominate

Nominating is easy, quick and simple!

Submit a nomination by completing the call for nominations form here.

The deadline to submit nominations is October 2, 2020.

WI Department of Health Services

Wisconsin Makes CARES Act funds available to home and community-based service providers, assisted living facilities, nursing homes, emergency medical services, and clinics

Starting Friday, September 4, the Department of Health Services (DHS) will once again be accepting applications for Wisconsin’s program to provide relief for specific types of health care service providers to offset losses or expenses they incurred due to the COVID-19 pandemic. The funding being used was allotted to the state under the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act.

The second round of the CARES Act Provider Payment (CAPP) Program will use the same application as the first round and will be open to the same provider types with one addition:

• Home and community-based service providers, including providers for 1-2 bed adult family homes, day services, home health, personal care, pre-vocational and supported employment, respite care, supportive home care, and daily living skills training for children
• Assisted living facilities, including community-based residential facilities, 3-4 bed adult family homes, and resident care apartment complexes
• Nursing homes, including skilled nursing facilities and intermediate care facilities
• Emergency medical services providers 
• (new) Emergency physician independent practice groups*

Read more here

Yesterday also marked the release of a new Marquette University Law School poll, which provides the latest insight on voter preferences on the presidential election as well as opinions on handling of the COVID-19 pandemic and popularity of masking.

Here are some topline results:

Preference in the Presidential Election

Biden: 49%

Trump: 44%

Trump Approval Rating

Approve: 44%

Disapprove: 54%

Trump Handling of COVID-19 Pandemic

Approve: 40%

Disapprove: 58%

Evers Approval Rating

Approve: 57%

Disapprove: 37%

Evers Handling of COVID-19 Pandemic

Approve: 61%

Disapprove: 35%

Masks Should Be Required in Public Places

Agree: 69%

Disagree: 29%

On August 11, Wisconsin held its partisan primaries for state legislative offices. These elections determined which two major party candidates will square off against each other in November. 

While most sitting legislators were either unchallenged or were expected to handily win their primaries, political spectators had their eyes on the following races: 

·  60th Assembly District GOP Primary - Ozaukee County: Rep. Brooks v Chris Reimer

·  82nd Assembly District GOP Primary - Franklin: Rep. Skowronski  v Theodore Kafkas

·  90th Assembly District Dem Primary - Green Bay: Rep. Staush Gruszynski v Kristina Shelton

·  6th Senate District Dem Primary - Milwaukee: Sen. LaTonya Johnson v Michelle Bryant

·  10th Senate District GOP Primary - Northwest Wisconsin: Rep. Stafsholt v Cherie Link

After votes were totaled, the only incumbent to lose was Democrat Representative Staush Gruszynski, who faced a tough reelection bid following sexual harassment allegations from a legislative staffer earlier this year.

Also of note, State Senator and Senate Majority Leader Scott Fitzgerald won the Republican Primary in the 5th Congressional District. Fitzgerald is seeking to replace longtime Congressman Jim Sensenbrenner, who is not seeking reelection. Fitzgerald's primary victory essentially guarantees his seat in Congress as the 5th District is overwhelmingly conservative. With Fitzgerald officially leaving the Senate, the Republican caucus are in search of a new Majority Leader, the most powerful position in the State Senate.

The state is now set for the November 3 general election. All 99 Assembly seats are up for election as well as 16 of the 33 Senate seats. For complete primary results, please see here.

Wisconsin Department of Health Services

What is Electronic Visit Verification?

The federal 21st Century Cures Act requires all states to put Electronic Visit Verification (EVV) into effect. This applies to all Medicaid-covered personal care and some supportive home care services.

EVV uses technology to make sure members and participants get their personal care or supportive home care services. EVV will not change your care. You will continue to receive the care you need.

Starting in November 2020, workers must use EVV for each visit. During each visit, six pieces of information will be recorded. 

Read more here

Electronic Visit Verification (EVV) training is being offered for personal care provider agencies, supportive home care agencies, and program payers. The intended audience for these trainings is provider agency and program payer administrative staff. The goal is for these staff to be trained on EVV so that they in turn can train other agency staff, including workers. DHS will provide an EVV system free of charge. However, provider agencies may choose to purchase an alternate system that meets DHS requirements. DHS will offer EVV-system trainings for administrative staff, specific to the EVV system being used:

• DHS EVV training (for the Sandata system provided by DHS) will include general EVV functionality, Sandata technology, and Wisconsin-specific information.
• Sandata Aggregator training (for EVV systems not provided by DHS) will cover Sandata’s aggregator, the technology that integrates information from alternate or third-party EVV systems with the DHS EVV solution.

The trainings are offered to assist with agency compliance before DHS’ scheduled implementation of the electronic visit verification (EVV) on November 2.  EVV will be required for Medicaid-covered personal care and supportive home care services that include personal care. EVV uses technology to verify that billed services were provided. Refer to the July 2020 ForwardHealth Update (2020-31), titled “Implementation of Electronic Visit Verification for Personal Care and Supportive Home Care Services,” for detailed information on EVV policy, technology, and validation. 

Additional information is available on the Wisconsin Department of Health Service’s website (link) for updates and information.  This site includes an informational video on the program, and summary of key policy decisions.