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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:
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.
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
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.
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.
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.
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.
All Health Plans to Cover Cost of At-Home COVID-19 TestsOn 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.
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
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.”
On November 3, Marquette Law School released a new poll that surveyed Wisconsin registered voters on their opinions of various national and statewide elected officials, as well as views related to the coronavirus pandemic.
In this poll, statewide elected officials had fairly low approval ratings. Among statewide elected officials, Governor Tony Evers has the highest favorable rating of 42%. However, he also had an unfavorable rating of 45%, while 13% didn’t know enough about him or don’t have an opinion. Notably, 53% approve of Governor Evers’ handling of the pandemic, while 40% disapprove.
U.S. Senator Tammy Baldwin (D) has the next-highest approval rating, with 38% of Wisconsin registered voters approving of her performance, 39% disapproving, and 22% did not have an opinion. Wisconsin’s other U.S. Senator – Republican Ron Johnson, had a 36% approval rating, a 42% disapproval rating, and 22% of surveyed voters didn’t know enough about him or didn’t not have an opinion.
The poll also asked several questions regarding the coronavirus pandemic. Here are the results:
DHS supports the FDA authorization, CDC recommendations
The Wisconsin Department of Health Services (DHS) supports the recommendation that anyone 18 and older receive a booster dose of COVID-19 vaccine at least six months after having received their second dose of the Pfizer-BioNTech (Pfizer) or Moderna vaccine. All adults are now eligible to receive booster doses, and booster doses are strongly recommended for everyone 50 and older, who are at the greatest risk for severe disease.
A recent decision by the CDC extends eligibility for a booster dose to everyone 18 and up at least 6 months after they received their second dose of Pfizer or Moderna. People who got the Johnson & Johnson COVID-19 vaccine are also eligible for a booster dose of any of the available COVID-19 vaccines. For the people who got the Johnson & Johnson COVID-19 vaccine, booster shots are recommended by the CDC for those who are 18 and older and who were vaccinated two or more months ago.
The CDC’s recommendations now also allow for mix-and-match dosing for booster doses. Some people may have a preference for the vaccine type that they originally received, and others may prefer to get a different booster.
“Getting everyone vaccinated continues to be our top priority for preventing serious illness and death from COVID-19,” said Dr. Ryan Westergaard, Chief Medical Officer and State Epidemiologist for DHS. “Too many of us remain unprotected going into the winter season. Getting a booster dose when it’s time to do so, and continuing to get our children 5 and older vaccinated will slow the spread of the virus and save lives.”
Getting vaccinated is about protection. Given that evidence suggests immunity is waning over time for some people who were initially well-protected by the vaccine, the booster dose can strengthen and extend their protection against infection, serious illness, hospitalization, and death from COVID-19.
With the high-level of disease transmission in Wisconsin, DHS continues to urge everyone who is not vaccinated to get the COVID-19 vaccine, and for all people to add additional layers of protection including masking up indoors, staying home when feeling sick, and avoiding large indoor gatherings.
DHS has also updated the COVID-19 vaccine administration dashboard on the COVID-19 vaccine data webpage. The expanded dashboard displays new data on additional and booster doses of COVID-19 vaccine. The administration tab now includes a section showing the cumulative number of additional and booster COVID-19 vaccine doses administered and reported to the Wisconsin Immunization Registry (WIR) by Wisconsin vaccine providers.
For up-to-date information about Wisconsin’s COVID-19 response, visit the DHS COVID-19 webpage.
The Wisconsin Department of Health Services (DHS) has released ForwardHealth Update 2021-40, “Electronic Visit Verification Soft Launch Has Been Extended.” This update communicates that DHS required hard launch consequences will not go into effect January 1, 2022.
ForwardHealth Update 2021-26, "Electronic Visit Verification Hard Launch Preparation" and ForwardHealth Update 2021-23, "Electronic Visit Verification Policy and Hard Launch Timeline" have been revised to reflect this extension.
With the soft launch extension:
DHS will continue to monitor the status of EVV and will be taking additional actions to further promote EVV usage and provider compliance during the extension.
Payers, provider agencies, and workers should use this extension to become more efficient with EVV, streamline processes, and take additional training as needed.
If you have questions or comments about EVV, please contact Wisconsin EVV Customer Care via phone at 833-931-2035. Customer Care hours are Monday–Friday, 7 a.m.–6 p.m. CT.
563 Carter Court, Suite BKimberly, WI 54136Phone: 920-560-5632 | Fax: email@example.com