Wisconsin’s response to COVID-19 has strained supplies of personal protective equipment (PPE) across the state, leading to some shortages of critical supplies including N95 respirator masks. In addition to sourcing additional N95 masks, the State of Wisconsin is exploring processes to decontaminate masks so they can be reused.

In partnership with the Federal Emergency Management Agency (FEMA) and Defense Logistics Agency (DLA), the State of Wisconsin will be receiving a Battelle CCDS Critical Care Decontamination System™, which can decontaminate tens of thousands of N95 masks daily. The Battelle CCDS Critical Care Decontamination System™ decontaminates masks by killing viruses and bacteria using hydrogen peroxide gas. Battelle advises masks can be decontaminated up to twenty times without degrading filtration performance.

In Wisconsin, it is our goal to have the Battelle Decontamination System in operation by mid-May. A process is currently being developed to collect, decontaminate, and swiftly return N95 masks for users throughout the state. In the meantime, we are asking Wisconsin health care providers interested in using the Battelle CCDS, to retain and not discard used N95 masks for future decontamination.

Please note:

• The Battelle Decontamination System is not authorized for use with respirators containing cellulose-based materials.
• All compatible N95 respirators must be free of any visual soiling or contamination (e.g., blood, bodily fluids, makeup).
• Compatible N95 respirators that are visually soiled or damaged should not be collected for decontamination and will be disposed of and not returned after decontamination.
• Masks should be marked with the name of the healthcare professional to whom the mask was issued.

Learn more about the Battelle CCDS Critical Care Decontamination System™

Final questions relative to the Battelle CCDS Critical Care Decontamination System™ installation will be answered in the coming weeks. More details will be provided in the coming days.

ForwardHealth recognizes that increased demand on the direct care services provided by physicians during the COVID-19 public health emergency could cause a delay in the availability of physicians to prescribe, refer, or order home health services in the normal timeframe. Therefore, during the COVID-19 public health emergency, ForwardHealth will allow Medicaid-enrolled nurse practitioners and physician assistants to prescribe, refer, or order the following:

• Home health nursing and aide services
• Medical supplies and equipment
• Physical therapy, occupational therapy, or speech pathology and audiology services

Billing policy and other requirements for these service areas as described in the Claims for Services Prescribed, Referred, or Ordered topic (#15737) of the ForwardHealth Online Handbook have not changed. Prescribers should note that they cannot have any affiliation, such as personal or financial affiliations, with the member or agency they are prescribing services for.

Governor Evers today announced Wisconsin's "Badger Bounce Back" plan which outlines important criteria for Wisconsin to be able to reopen its economy in phases and includes steps to make sure workers and businesses are prepared to reopen as soon as it is safe to do so. In coordination with this announcement, at the direction of the governor, Wisconsin Department of Health Services Secretary-designee Andrea Palm issued Emergency Order #31 establishing the process and outlining the phases of the plan. The emergency order is available here.

The Badger Bounce Back plan is informed in part by the President's Guidelines for Opening Up America Again that was issued by the White House on April 16, 2020. Currently, Wisconsin does not meet the criteria the White House established to start reopening our state. The Badger Bounce Back plan takes important steps to get the state of Wisconsin there. 

The goal of the Badger Bounce Back plan is to decrease cases and deaths to a low level, and increase capacity in our healthcare system so the phased reopening of businesses is possible. As part of that plan the state will be working to increase access to more testing and expand lab capacity. Under the Badger Bounce Back plan, everyone who needs a test should get a test. The state is setting a goal of 85,000 tests per week, averaging about 12,000 tests per day. More information on the state's testing efforts was released earlier today, and is available for review here.

Next, the state will be expanding contact tracing and more aggressively tracking the spread with the goal of every Wisconsinite who tests positive being interviewed within 24 hours of receiving their test results and their contacts being interviewed within 48 hours of test results.

Additionally, the state will continue to pursue every avenue to grow Wisconsin’s supply of personal protective equipment (PPE) for healthcare and public safety entities to conduct COVID-19 testing, patient care, and public safety work. Finally, the plan works to bolster healthcare system capacity where patients can be treated without crisis care and there are more robust testing programs in place for at-risk healthcare workers. 

The state will be looking for a downward trajectory of influenza-like illnesses and COVID-19 symptoms reported within a 14-day period, and a downward trajectory of positive tests as a percent of total tests within a 14-day period. When the state has seen these efforts be successful, Wisconsin can begin to turn the dial, re-open the state, and get businesses and workers back on their feet.

The Badger Bounce Back plan is available here. The Wisconsin Economic Development Corporation’s portion of the Badger Bounce Back plan aimed at helping to ensure workers and businesses are prepared and ready to bounce back is available here. The Badger Bounce Back plan in brief is also available here.

Governor Evers today directed Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm to extend the Safer at Home order from April 24, 2020 to 8 a.m. Tuesday, May 26, 2020, or until a superseding order is issued. The order implements some new measures to ensure safety and support the progress we've made in containing COVID-19, but also allows certain activities to start up again.

The extension of the Safer at Home order includes a few changes. Some changes allow more businesses and activities to open back up, while other changes help make businesses safer for employees and customers.

The changes in this order go into effect on April 24, 2020. The order will remain in effect until 8 a.m. on May 26, 2020.

The order is available online (link).  The Governor’s full press release is also available online (link).

Governor Evers announced that the state is seeking volunteers to support Wisconsin's healthcare system during the COVID-19 pandemic. Active and retired healthcare professionals and those who wish to help in non-clinical support positions are encouraged to sign up to volunteer through the Wisconsin Emergency Assistance Volunteer Registry (WEAVR). 

The number of patients in Wisconsin who need to be treated for COVID-19 is expected to surge in the coming weeks. Building a network of available volunteers now will greatly reduce the hardships on hospitals and clinics that would not normally have the capacity to care for the increase in patients. 

Both active and retired healthcare professionals can volunteer for critical clinical roles by entering their information into the WEAVR, a secure, password-protected, web-based volunteer registration system for healthcare and behavioral health professionals. Individuals who are not licensed professionals are also encouraged to sign up to volunteer for non-clinical support positions.

Volunteers will be assigned to locations across Wisconsin to support ongoing efforts related to the COVID-19 national emergency. Those who are willing to travel should note that when they sign up. All volunteers should also be aware that they will be required to complete a background check.

The full copy of the Governor’s press release is available online (link).

The National Association for Home Care & Hospice will be co-hosting a weekly webinar series with Littler Mendelson and the Home Care Association of America on legal and regulatory changes caused by the COVID-19 pandemic. The goal of the webinar series is to provide the industry with substantive updates and shed light on advocacy efforts.

This weekly webinar series will kick off this Thursday, April 9th at Noon EST and we will continue with additional webinars each Thursday at the same time for at least the next 6 weeks. These webinars will be cumulative, substantive and free for all home care providers to attend.

This week, hosts Angelo Spinola of Littler, Bill Dombi of NAHC, and Vicki Hoak of the HCAOA, will provide an update and analysis of the status of the health care provider exemption to the FFCRA,  the unemployment dilemma under CARES Act, the industry coalition efforts associated with the fourth stimulus package and the work being done to develop industry best practices.  The registration page includes an opportunity to submit a question or topic you would like the hosts to address in this weekly series. The webinar will also feature a live Q&A session at the end to address as many questions as possible. REGISTER NOW

Governor Evers announced that Wisconsin has been granted a major disaster declaration for the entire state of Wisconsin, as a result of the COVID-19 pandemic. The declaration provides access to Public Assistance programs for all 72 Wisconsin counties and the state’s federally recognized tribes.

Gov. Evers earlier this week requested that the federal government provide the following programs to support the state’s response: Public Assistance, Direct Assistance, Hazard Mitigation (statewide), and certain Individual Assistance programs; Crisis Counseling, Community Disaster Loans and the Disaster Supplemental Nutrition Program.

The Federal Emergency Management Agency (FEMA) notified the state today that it is granting the request for Public Assistance to help provide reimbursement for emergency protective measures taken by state and local governments in their response to the COVID-19 outbreak. The declaration also authorizes direct Federal Assistance which means when the State and local governments lack the capability to perform or to contract for eligible emergency work and/or debris removal, the State may request that the work be accomplished by a federal agency. The governor’s additional requests for assistance remain under review.

The major disaster declaration covers assistance to public entities, and will cover eligible projects submitted by counties, cities, townships, tribes, and certain private, not-for-profit organizations. Local governments in the declared counties are now eligible for federal assistance and should contact county emergency management directors for further information. Under the program, FEMA provides 75 percent of eligible costs, while the remaining 25 percent is the responsibility of state and local agencies.

The Governor’s full press release is available online (link).

Governor Evers signed Executive Order 21 on April 3.  The Order suspends a number of rules related to home healthcare agencies.  The order specifically:

• Suspends DHS 133.18 (Supervisory Visits) in its entirety during the public health emergency;
• Allows any necessary visits from RNs associated with the 60-day review process as required by DHS 133.20(3) may be completed via telephone or videoconferencing during the public health emergency; and
• Suspends home health agencies' training and orientation requirements in DHS 133.06(4)(a) and 133.17(4) and orders that "every employee shall be oriented to the agency and the job for which he or she is hired."

The order also makes similar changes for Hospice Agencies in the state, including:

• Suspends DHS 131.15 (inspections, investigations and enforcement) except for cases of immediate jeopardy as defined in Wisconsin Statute 50.01(1ng);
• Suspends DHS 131.22 (quality assessment and performance improvement activities), with continued general requirement for staff to be oriented to their responsibilities according to DHS 131.31(2); and
• Suspends DHS 131.31(3) (training and orientation program contents) with continued general requirement for staff to be oriented to their responsibilities as required in DHS 131.31(2).

The Governor’s action is consistent with the requests WiAHC has made of the Department and Governor since the start of the Safer at Home Order.  The full executive order is available online (link).

A new Marquette Law School poll of Wisconsin registered voters finds strong support for government actions to control the coronavirus pandemic, even as the poll also shows these actions to be having a substantial financial impact on voters.

The survey found:

• Eighty-six percent say that it was appropriate to close schools and businesses, and restrict public gatherings, while 10 percent say that this was an overreaction to the pandemic;
• A large majority of voters approve of Gov. Tony Evers’ handling of the coronavirus issue, with 76 percent saying they approve and 17 percent saying they disapprove;
• A majority, 51 percent, approve of President Donald Trump’s handling of the pandemic, while 46 percent disapprove;
• Opinion is divided on holding the April 7 spring election as scheduled, with 51 percent saying the date should be moved and 44 percent saying it should be held as scheduled.

A full copy of the survey is available online (link).

Governor Evers today announced a second package of comprehensive legislative proposals that would provide critical investments in health services, support for essential workers, and assistance for Wisconsin families and businesses in response to the COVID-19 pandemic. The governor’s announcement today comes just days after Gov. Evers announced a first piece of legislation, which included additional funding and flexibility for public health professionals and healthcare professionals, a repeal of the one-week waiting period for unemployment insurance, expanding and improving access to telehealth services, among many other proposals.  

As additional needs and issues arise from agencies and stakeholders, the governor is committed to working with legislators to find bipartisan solutions. The governor’s office welcomes the opportunity to hear and consider any proposals that legislators have to address the impacts of COVID-19 on the health and well-being of Wisconsin residents, businesses and communities. 

This package, among many other proposals, includes:  

• Increasing funding for Medicaid providers via supplemental payments and rate increases to support the healthcare system’s response to the public health emergency;  
• Establishing a fund to reduce providers’ uncompensated care costs targeting reimbursement for treatment-related costs for uninsured individuals;
• Establishing a COVID-19 reinsurance program to reduce health insurance premiums; 
• Providing grant funding to provide food assistance and meal delivery;  
• Prohibiting utility cooperatives from disconnecting customers and prohibiting land-lord directed disconnections from rental units during a public health emergency; 
• Ensuring workers receive back payment for any lost unemployment insurance benefits as a result of the delay in suspending the one-week waiting period; 
• Providing supplemental payments to child care providers, if that provider needed to shut down during the public health emergency;  
• Allowing households to apply for heating assistance under the low-income energy assistance program anytime during the 2020 calendar year; 
• Increasing the Earned Income Tax Credit for low-income families;  
• Providing municipalities the flexibility to implement multiple installments of three or more payments for 2020 property taxes;  
• Waiving interest and penalties on delinquent property taxes included in the 2019 payable 2020 tax roll, on and after April 1, 2020;  
• Creating a fund through the Wisconsin Housing and Economic Development Association to provide 6 months of support for prevention of single-family foreclosures and providing refinancing opportunities to current borrowers; and  
• Providing grant funding for small businesses and workers through the Wisconsin Economic Development Corporation. 

The Governor’s first COVID-19-related legislation was introduced last week as LRB-5920 and is available here for review. A brief explanation of LRB-5920 is available here. A brief explanation of the governor’s second round of proposed legislation announced today is available online (link).