The Wisconsin Association for Home Health Care joined a coalition of medical societies in Wisconsin that created an open letter to the people of Wisconsin on the importance of wearing masks and social distancing to help curb further spread of COVID-19. 

Read letter.

The Wisconsin Department of Health Services (DHS) invites you to attend a Medicaid Telehealth Expansion interactive webinar.

Agenda

This webinar will seek your response to DHS’s proposed launch of Wisconsin Act 56: Telehealth Expansion, which will significantly expand Wisconsin Medicaid’s permanent telehealth policy. The presentation will include the following items:

1.       General overview of telehealth expansion

2.       General policy information

3.       Wave 1 priority acute and primary service areas:

4.       Proposed services included in telehealth

5.       Proposed services excluded from telehealth

6.       Input from attendees

Following the presentation, DHS will take questions from attendees via the DHS telehealth mailbox.

How to join

Thursday, July 30, 10:30 am – 12:00 pm

Click this URL to join; Password: 07302020

Join by phone: 646-558-8656; Webinar ID #933 1403 1869

Friday, July 31, 2:00-3:30 pm

Click this URL to join; Password: 07312020.

Join by phone: 646-558-8656; Webinar ID #999 9957 0817

Wisconsin Association for Home Health Care Announces

2019-2020 “Friend of Home Health Care” Recipients

Designation bestowed on select group of legislators

(Madison, WI) – Today, the Wisconsin Association for Home Health Care (WiAHC) announced its 2019-2020 “Friend of Home Health Care” recipients. The designation is meant to publicly identify Wisconsin State Legislators that supported the expanded utilization of home health care as an effective, affordable option for post-acute care.

The 2019-20 “Friend of Home Health Care” recipients include the following legislators:

Rep. Jimmy Anderson	Sen. Dale Kooyenga	Rep. Chris Sinicki
Rep. David Bowen	Rep. Scott Krug	Rep. Ken Skowronski
Rep. Rob Brooks	Sen. Chris Larson	Rep. John Spiros
Rep. Jonathan Brostoff	Rep. Amy Loudenbeck	Rep. Mark Spreitzer
Sen. Tim Carpenter	Rep. Nick Milroy	Rep. Lisa Subeck
Rep. Dave Considine	Rep. Jeff Mursau	Rep. Rob Summerfield
Rep. Barbara Dittrich	Rep. Beth Myers	Sen. Lena Taylor
Rep. Steve Doyle	Sen. Steve Nass	Sen. Patrick Testin
Rep. James Edming	Rep. Warren Petryk	Rep. Jeremy Thiesfeldt
Rep. Jodi Emerson	Rep. Sondy Pope	Rep. Ron Tusler
Rep. Mary Felzkowski	Rep. Melissa Sargent	Rep. Don Vruwink
Sen. Dan Feyen	Sen. Patty Schachtner	Rep. Chuck Wichger
Rep. Cody Horlacher	Rep. Katrina Shankland

“These legislators were critical to our legislative success and championed our most important priorities,” said Lisa Kirker, Chair of the WiAHC Board of Directors. “Home health care agencies across Wisconsin are grateful for the support and partnership of these individuals.”

WiAHC was very active during the 2019-2020 legislative session in educating legislators on the workforce issues facing home health care agencies and how increasing MA reimbursement rates can alleviate financial burden as well as attract new staff. WiAHC was successful in advocating for the introduction of Assembly Bill 447/Senate Bill 416, which aimed to increase MA reimbursement rates by 10% for home health visits. The bill received a public hearing in the Senate Health Committee, and WiAHC is hopeful there will be continued interest in the legislation next session. WiAHC also successfully advocated for legislation that allowed all MA reimbursable services to be conducted via telehealth.

WiAHC is a membership-based association that represents home health care agencies and their staff. WiAHC helps to support the common interests of its members to promote home health care as a quality, cost-effective health care option in our state. Home health care services are not the same as personal care services. Home health care services are medical, skilled nursing services as opposed to personal care services administered by non-health care professionals.

Do you know a colleague who would be a great fit for the Board? Submit a nomination 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 affairs of the Association and are supported by Committee Chairs and staff. Positions include Chair, Vice-Chair, Secretary/Treasurer, 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 using the form below. 

The deadline to submit nominations is August 20, 2020.

Click here

In a 6-0 decision, the Wisconsin Supreme Court reinstated a 2016 circuit court order prohibiting the Wisconsin Department of Health Services (DHS) from recouping Medicaid payments made to Medicaid providers “if the provider’s records verify that the services were provided and the provider was paid an appropriate amount for such services, notwithstanding that an audit identified other errors or noncompliance with [DHS] policies or rules.”

The Supreme Court labeled DHS’ recoupment policy for such services provided a “perfection policy” and held that such a policy was not consistent with Wisconsin’s Medicaid recoupment statute or administrative rules.

The case, Papa vs. Wisconsin Department of Health Services, involved the extent of DHS’ authority to require repayment from providers for previously paid claims based on failure to follow all documentation and other technical requirements contained in a confusing series of administrative rules in the Forward Wisconsin Provider Handbook, technical bulletins and other sources. In 2016, a Waukesha County Court found that DHS’ position that compliance with all technical and documentation requirements by providers as a prerequisite for payment amounted to a “Perfection Rule” that exceeded its authority to recoup payments otherwise properly made. However, the Wisconsin Court of Appeals overturned that decision in July 2019.

In today’s 6-0 decision, the Supreme Court reversed the Court of Appeals and restored the county court’s 2016 order limiting DHS’ authority to recoup payments, concluding that “so long as DHS can verify that a covered service was actually provided, the claim was appropriate, and the claim was accurate, DHS cannot recoup payments based on a record imperfection. A record imperfection alone is not an independent basis for recouping payments.” The decision provides clarity and greater certainty for physicians, who could otherwise face demands for repayment of thousands of dollars months or years after the fact based entirely on unintentional documentation errors.

Thursday, August 6, 2020
10:30 a.m. – 12:00 p.m. CST

Program Description:

Post-acute care is key for accelerating hospital throughput to ensure beds are available during potential Covid-19 surges and for providing critical rehabilitation services for patients with and without a Covid-19 diagnosis. But the epidemic has upended the role post-acute should play, particularly the transition patterns between acute and post-acute providers.

Learn how each post-acute setting fits into a hospital’s updated discharge strategy and find opportunities to optimize relationships and support post-discharge care.

Learning Objectives:

At the conclusion of the webinar, attendees will be able to:

• Describe how the COVID-19 pandemic has altered the role post-acute should play
• Describe how each post-acute setting fits into a hospital’s discharge strategy
• Identify the opportunities to optimize relationships and support post-discharge care

Intended Audience:

CMOs, CNOs, Quality Leaders, Skilled Nursing, and Home Health

Featured Presenters:

Jared Landis is the Executive Director over the Advisory Board’s post-acute research practice and a national spokesperson for the company—regularly presenting at industry conferences such as the American Health Care Association, National Association for Home Health and Hospice, and Leading Age. In 2010, he helped launch and continues to lead the Post-Acute Care Collaborative, which provides original research and dedicated resources to assist post-acute and long-term care providers, as well as hospital systems. Jared is a subject matter expert (SME) in post-acute market trends, post-discharge care management initiatives, and acute/post-acute alignment strategies. Jared is a 2005 graduate of Duke University with a Bachelor of Arts in Economics.

Questions:

For registration questions, contact Allison Taylor at ataylor@wha.org.

Fee:

There is no cost for this webinar.

Register Here!

On Monday, June 29, the Governor’s Task Force on Caregiving held a public listening session to gain input from stakeholders on the task force’s draft proposals. WiAHC members Leah Perras, , Executive Director of Transitions at Home, and Greg Von Arx, CEO of Recover Health testified at the listening session. Perras’ and Von Arx’s testimony was aimed at the task force’s failure to propose a Medicaid reimbursement rate increase for home health services despite previous testimony to the task force requesting such an increase.

“Wisconsin is lagging behind the nation in ensuring home health can adequately compete for staffing against other sectors of the healthcare industry despite growing demand for home health care services,” Perras said. “Due to Medicaid rates in Wisconsin, home health agencies pay below the state average for the same position across other sectors of the medical industry. As growth in the utilization of home health care services continue, today’s workforce challenges will only get worse.”

Perras explained that Wisconsin is well below the national average when it comes to RNs working in home health settings. RNs working in home health settings make up just 6% of the total nursing workforce in the state, according to the Wisconsin Center for Nursing. Nationally, RNs working in home health settings make up nearly 13% of the total nursing workforce, according to the Bureau of Labor Statistics. Unfortunately, home health agencies regularly lose highly skilled nurses to other sectors, mostly due to compensation potential.

According to CMS, patients’ homes are considered the ideal care setting, which is causing rapid growth in the industry, faster than most other health care categories since 2013. Increased utilization will also be necessary for the aging Baby Boomer generation.

“While healthcare inflation has grown 32.3% and Low Utilization Payment Adjustment (LUPA) rates, which are federally averaged Medicare rates, have increased by 26%, Wisconsin’s Medicaid reimbursement rate for home health services has increased 0% over the last ten years,” Von Arx told the task force.

During the 2019-20 legislative session, WiAHC worked with a large bipartisan group of lawmakers on legislation to increase the Medicaid home health visit rate by 10 percent. The bill, Senate Bill 416/Assembly Bill 447, received a public hearing in the Senate Health Committee and had considerable support in both the Senate and Assembly. WiAHC is hopeful a recommendation from the task force would assist in increasing awareness on the urgency of the issue facing Wisconsin’s home health agencies.

WiAHC lobbyists are also submitting a memo to the task force and will continue to advocate for including a rate increase in the task force’s final proposal.

June 1 marked the official start of state legislative campaign season in Wisconsin. Candidates for state office turned their nomination papers into the Wisconsin Elections Commission and will now campaign ahead of the August 11 partisan primary. Candidates who win in August will square off in the general election on November 3.

The 2020 election will produce both change and consistency in the state legislature. With 7 open Senate Seats and 13 open Assembly seats, there will be plenty of new faces. At the same time, it is likely that Republicans will maintain control of both houses, extending their ten-year majority another two years.

The following seats are open due to retirements whether leaving to pursue higher office or leaving public service:

•         SD-12: Tom Tiffany (R-Elected to Congress)
•         SD-14: Luther Olsen (R)
•         SD-16: Mark Miller (D)
•         SD-26: Fred Risser (D)
•         SD-28: Dave Craig (R)
•         SD-30: Dave Hansen (D)
•         SD-32: Jennifer Shilling (D)
•         AD-8: JoCasta Zamarripa (D)
•         AD-11: Jason Fields (D)
•         AD-17: David Crowley (D-Milwaukee County Exec)
•         AD-29: Rob Stafsholt (R-running for SD-10)
•         AD-35: Mary Felzkowski (R-running for SD-12)
•         AD-41: Joan Ballweg (R-running for SD-14)
•         AD-44: Deb Kolste (D)
•         AD-48: Melissa Sargent (D-running for SD-16)
•         AD-55: Mike Rohrkaste (R)
•         AD-57: Amanda Stuck (D-running for CD-8)
•         AD-69: Bob Kulp (R)
•         AD-75: Romaine Quinn (R)
•         AD-76: Chris Taylor (D)

The current political wisdom is that Assembly Republicans are in position to maintain control following the 2020 election due to their large majority. They currently have a 63-36 seat majority. Should the election be favorable for Democrats, there is a chance they could win nine competitive seats currently held by Democrats. However, they would still be short of obtaining the majority. The nine competitive seats currently held by Republicans include:

•         AD-21: Jessie Rodriguez
•         AD-49: Travis Tranel
•         AD-50: Tony Kurtz
•         AD-51: Todd Novak
•         AD-68: Jesse James
•         AD-85: Patrick Snyder
•         AD-88: John Macco
•         AD-92: Treig Pronschinske
•         AD-96: Loren Oldenburg

Likewise, it is expected Senate Republicans will also maintain control of that body. Until recently, Republicans had a 19-14 majority. However, following the resignations of Republican Tom Tiffany (elected to Congress in May) and Democrat Jennifer Shilling (resigned to take a job in the private sector), Republicans currently have an 18-13 majority.

Of the open seats, it is likely, Republicans will maintain control of the 12^th (Tiffany – Northern WI), 14^th (Olsen – Central WI) and 28^th (Craig – Southeast WI) Senate Districts. Likewise, it is certain Democrats will maintain control of the Madison-based 16^th and 26^th Senate Districts, which have both garnered large Democratic primaries.

Conversely, the open seats in the 30^th (Hansen – Green Bay) and 32^nd (Shilling – LaCrosse) Senate Districts could potentially go either way. Looking at the performance of Republican presidential candidates in the last two elections, Romney lost the Green Bay-based 30^th Senate District with 47.7% of the vote and Trump won it with 55.6%. If Trump performs well again, then it is conceivable a Republican State Senate candidate could win the district.

While the 32^nd Senate District in LaCrosse is typically a strong Democrat district, Trump did significantly better than Romney. Additionally, former 32^nd District Democratic Senator Jennifer Shilling narrowly defeated her opponent, Republican Dan Kapanke in 2016. Kapanke, a former Senator from the area, is running again this year. Should Trump increase support in the LaCrosse area, Kapanke may have a chance.

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

If Senate Democrats have the opportunity to flip a seat, it could be the 24th Senate District held by Republican Patrick Testin (Stevens Point). The central Wisconsin district, which includes the city of Stevens Point and surrounding areas, was once considered a Democratic district. Romney lost the district in 2012 and Trump won it with 53% in 2016. In 2018, Republicans running for statewide office lost the district. If the district continues its swing left and support for Trump decreases, Democrats could flip the seat.

The 2020 election in Wisconsin will be somewhat unique because there is no race for statewide office (Governor, U.S. Senate) for the first time in several cycles, which should mean that success for Democrats and Republicans in the state legislature will 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.

Starting June 5, the Wisconsin Department of Health Services (DHS) will be accepting applications from specific types of health care providers (listed below) for $110 million of funding provided to the state under the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act. These funds will be used to make payments to offset lost revenues and expenditures facilities and services incurred during March, April, and May 2020, related to the COVID-19 pandemic.

Providers eligible to apply are:

Home and community-based service providers* that provide:

• 1-2 bed Adult Family Homes
• Day services
• Home health
• Personal care
• Pre-vocational and supported employment
• Respite care
• Supportive home care
• Daily living skills training for children

Assisted Living Facilities, including:

• 3-4 Bed Adult Family Homes
• Community-Based Resident Facilities (CBRFs)
• Resident Care Apartment Complexes (RCACs)

Nursing Homes, including:

• Skilled Nursing Facilities
• Intermediate Care Facilities

Emergency Medical Service Agencies

Clinics/Health Centers, including:

• Rural Health Clinics
• Federally Qualified Health Centers
• Tribal Health Clinics
• Free and Low Cost Clinics

* Only entities/organizations may apply for funding. Individuals such as those who are participant-hired workers or paid through a fiscal agent are not eligible.

The application for these funds will be available from June 5 to June 30. For more information on eligibility, the application, and the payment process, please visit the CARES Act Provider Payments page on the DHS website.

On May 13, the Wisconsin State Supreme Court struck down the Safer at Home extension ordered by Department of Health Services Secretary-designee Andrea Palm. While the Court did not rule on the legality of the Safer at Home policy, it did rule the process by which the policy was implemented was illegal.

The Court ruled that Secretary-designee Palm did not have the singular authority to extend the Safer at Home order to May 26 and stipulated the action required emergency rulemaking procedure, which was not executed by the Department.

At the heart of the issue was whether or not DHS can extend the Safer at Home order beyond May 11. Governor Tony Evers declared a public health emergency in March. By law, such declarations expire after 60 days. In this specific instance, the expiration date was May 11. 

Emergency Order #28, issued by Palm, extended the Safer at Home order two weeks beyond the expiration date. Palm and DHS cited statute 252.02 as providing the department the authority to take actions to combat outbreaks of communicable disease outside the confines of a 60 day public health emergency declaration. Republican legislative leaders disagreed with the interpretation of that statute and filed the challenge in the State Supreme Court.

The ruling was decided on a 4 to 3 vote. One conservative member, Justice Brian Hagedorn, disagreed with his conservative colleagues, stating in his dissent, “The legislature may have buyer's remorse for the breadth of discretion it gave to DHS in Wis. Stat. § 252.02. But those are the laws it drafted; we must read them faithfully whether we like them or not.”

In the wake of the ruling, Wisconsin is now without a statewide strategy to combat COVID-19. While the Department of Health Services took direction from the ruling and submitted proposed emergency rules to the legislature for approval, it rescinded that proposal on May 18, after comments from Republican legislative leaders who want to leave ongoing strategies to local public health departments.

Dane County, for instance, issued its own Safer at Home order shortly after the Court’s ruling on May 13. Other counties followed suit, but some later rescinded after confusion over their legal authority to do so became unclear. This confusion caused Attorney General Josh Kaul to issue an opinion that nothing in the Supreme Court’s ruling affects the authority of local public health officials to issue Safer at Home orders for their jurisdictions.

There is, however, some public opposition to local orders. On Wednesday, May 20, a group of Wisconsin citizens filed a challenge against local orders on Constitutional grounds in federal court in Milwaukee. The challenge states that safer at home orders infringe upon rights to freely assembly and freely practice religion. There has yet to be any developments in the challenge beyond the initial filing.

WiAHC’s lobbyists continue to closely monitor the situation and will provide updates as they’re available.