On August 6, WiAHC unveiled a list of state legislators selected as “Champions of Home Health Care” and “Friends of Home Health Care” for the 2023-2024 state legislative session.  At the completion of each two-year legislative session, WiAHC identifies an exclusive group of lawmakers for their exceptional work to address the priorities of home health care agencies and staff throughout Wisconsin. 

The 2023-2024 “Champion of Home Health Care” recipients are:

--State Rep. Mark Born (R-Beaver Dam)                               

--State Sen. Howard Marklein (R-Spring Green)

The 2023-2024 “Friend of Home Health Care” recipients are:

--State Sen. Duey Stroebel (R-Saukville)                                

--Rep. Terry Katsma (R-Oostburg)

--Sen. Mary Felzkowski (R-Tomahawk)                                  

--Rep. Shannon Zimmerman (R-River Falls)

--Sen. Joan Ballweg (R-Markesan)                                           

--Rep. Jessie Rodriguez (R-Oak Creek)

--Sen. Patrick Testin (R-Stevens Point)                                   

--Rep. Tony Kurtz (R-Wonewoc)

--Sen. Eric Wimberger (R-Green Bay)                                    

--Rep. Alex Dallman (R-Green Lake)

--Sen. LaTonya Johnson (D-Milwaukee)                                 

--Rep. Tip McGuire (D-Kenosha)

--Sen. Kelda Roys (D-Madison)                                                 

--Rep. Deb Andraca (D-Whitefish Bay)

In the August 2024 edition of the Department of Health Services’ (DHS) ForwardHealth Update, it notes that the EVV “hard launch” for home health care services and nurse supervisory visit service code 99509 begins on October 1, 2024.  Claims submitted to DHS, HMOs and managed care organizations starting on this date that do not include the required EVV information will be denied.  This ForwardHealth Update may be viewed on the DHS website. 

If your home health agency has questions regarding EVV implementation, please contact Wisconsin EVV Customer Care at vdxc.contactevv@wisconsin.gov or at 1-833-931-2035, Monday – Friday, 7:00AM – 6:00PM (Central Time). 

In recent weeks, DHS asked Wisconsinites to complete a survey addressing maternal and child health needs. DHS conducts this comprehensive, statewide survey every five years due to the related federal funding the agency receives.  The survey addresses a variety of issues, such as prenatal care, access to health care, and maternal mental health.  The agency offers two separate surveys – one for individuals and one for organizations.  This survey will be available until September.  If you are interested in filling out this survey, please go to the DHS website. 

It is more important than ever for WiAHC members to strengthen their relationships with their state lawmakers to educate them on the value of skilled home health care, the regulatory challenges we face, and the legislative solutions we need to increase access to care for patients. Rember, decisions state legislators make in the Capitol can have a significant impact on the home health care industry, your organization, and your profession.

One of the best ways you as a WiAHC member can engage your local legislators is to invite them to tour your facilities to illustrate firsthand the many benefits of home health care. These visits provide a tremendous advocacy opportunity, which is why WiAHC members across the state have already hosted numerous successful legislative tours. But we need to maintain the enthusiasm for this critical grassroots advocacy program, and WiAHC is excited and ready to set-up additional tours today.  

If you would like to host a legislative tour at your site, please contact the WiAHC office at wiahc@badgerbay.co. We will work with you and your legislators to coordinate the meetings and will provide participating members with full support, including legislator bios, advocacy tips, issue briefings, and supporting documents.  

On June 6, the Governor’s Task Force on the Healthcare Workforce held a public meeting on the campus of Marquette University’s School of Dentistry.  The bulk of the livestreamed portion of the meeting was taken up by a panel discussion on education and training.  The following individuals participated in this discussion:

• Christina Patrin, Health Science Education Consultant, Wisconsin Department of Public Instruction (DPI)
• Danielle Cook, Education Director, Health Sciences, Wisconsin Technical College System (WTCS)
• • Note:  She is a task force member.
• Dr. Melissa Weege, Clinical Associate Professor, Radiation Therapy Program Director, UW-La Crosse
• Rebecca Larson, Executive Vice President for External Relations, Wisconsin Association of Independent Colleges and Universities

These panelists each gave some background information on their respective organizations, then discussed challenges, and possible solutions.  Patrin noted that while 60 percent of school districts in the state have a direct patient care training pathway (program) embedded in their schools, she noted that it is difficult to start such pathways at high schools.  Cook, Weege and Larson noted a number of similar challenges, including lack of classroom space, challenges in hiring faculty due to relatively low compensation levels, and continuing financial challenges for students. 

Next, the panelists proposed various solutions, including the following:

• Loan forgiveness for all health faculty, not just nursing faculty.
• Need incentives to help hire part-time health faculty.
• Need to do more to promote health care careers early on, even in elementary school.

The task force then moved on to the various breakout discussion groups and then adjournment, neither of which were covered in the livestream of this task force meeting. 

It is also worth noting that in preparation for the June meeting, a document listing draft task force recommendations was prepared.  The following is a high-level summary of these draft recommendations:

• Education and Training

• Recruitment and Retention

• Regulatory Policy

Help shape WiAHC’s Policy Agenda for the 2025-26 legislative session. The WiAHC Legislative Priorities Survey provides a tremendous opportunity to offer your input on what policy issues are most important to you and your organization. The purpose of surveying the full WiAHC membership is to help association leadership develop a policy agenda and determine what legislative and regulatory issues we should on focus during the 2025-2026 Wisconsin legislative session.

The survey takes only a few minutes to complete and will provide invaluable information used to help shape WiAHC’s advocacy priorities moving forward. The survey results will be presented to the WiAHC’s Legislative Committee and Board for further consideration. In addition to the member survey data, WiAHC leadership will consider the following criteria when finalizing the association’s policy agenda and issue priorities: 1.) The benefit to WiAHC members; 3.) The extent to which it will improve the delivery of home health care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

Once the WiAHC Board finalizes the policy agenda and legislative priorities for 2025-2026, it will be presented to the full membership and used by the WiAHC Government Affairs team to guide the association’s advocacy efforts over the next two years.

We value your input and encourage you to complete and submit the brief survey as soon as possible. Please CLICK HERE to take the survey.

After the state legislative session concludes in even-numbered years, the Legislative Council – the legislature's in-house, non-partisan group of attorney advisors – organizes study committees that perform in-depth reviews of various state policy matters facing Wisconsin.  Committees are comprised of both legislators and citizen members. 

Study committees hold hearings, during which they hear public testimony – including from subject-matter experts – on state policies that may need to be fixed or updated.  Once a committee has completed receiving public testimony, it generally drafts legislation for possible introduction and consideration by the legislature.  Recently, the scope of the Study Committee on the Regulation of Artificial Intelligence in Wisconsin was announced: 

“The Study Committee is directed to review current uses of artificial intelligence technology and make recommendations for legislation regarding the use and development of artificial intelligence technology. The committee may review the use of artificial intelligence in disinformation and artificial imagery and the feasibility of establishing a process to ensure continued state monitoring of high-risk use of artificial intelligence.”

State Senator Julian Bradley (R-Mukwonago), who will serve as chair, recently announced via press release the members of the committee.  Rep. David Armstrong (R-Rice Lake) will serve as vice chair.  Sen. Tim Carpenter (D-Milwaukee) and Rep. Clinton Anderson (D-Beloit) are the other legislator members.  Of the eight Wisconsin citizen members, there is one representative from the health care field – Jay Hill, who serves as vice president of advanced technologies for GE HealthCare.  The full committee membership list may be viewed on the Legislature’s website.

In his press release, Sen. Bradley also notes that this study committee “…will travel throughout the state to consider how the new technology will impact workforce, healthcare, law enforcement, government, and consumer protection.” 

The committee’s first meeting was held at the Waukesha County Technical College in Pewaukee on Wednesday, July 24. 

Each year on July 1, DHS is required by state law to adjust the maximum fees (factoring in the change in the consumer price index) that health care clinicians may charge for patient medical records.  The updated fee schedule may be viewed on the Legislature’s website. 

The 2023-24 legislative has come to an end, and legislators have shifted their focus to the upcoming election season and the need to connect with voters. With that in mind, it is more important than ever for WiAHC members to strengthen their relationships with their state lawmakers (and new legislative candidates) to educate them on the value of skilled home health care, the regulatory challenges we face, and the legislative solutions we need to increase access to care for patients. Rember, decisions state legislators make in the Capitol can have a significant impact on the home health care industry, your organization, and your profession.

One of the best ways you as a WiAHC member can engage your local legislators is to invite them to tour your facilities to illustrate firsthand the many benefits of home health care. These visits provide a tremendous advocacy opportunity, which is why WiAHC members across the state have already hosted numerous successful legislative tours. But we need to maintain the enthusiasm for this critical grassroots advocacy program, and WiAHC is excited and ready to set-up additional tours today.  

By Joyce Famakinwa | July 22, 2024

As home health providers continue to digest the proposed payment rule for 2025, National Association for Home Care & Hospice (NAHC) President William A. Dombi believes that the industry will ultimately see a comparatively toned down final rule.

“We believe we will not end up with this proposed rule as a final rule,” he said during the opening presentation at NAHC’s Financial Management Conference in Las Vegas on Sunday. “We will end up with something less draconian. The cuts will be reduced because, No. 1, that’s what they’ve done for the last several years, and, No. 2, it’s an election year.”

Even with a prediction of a “less draconian” final payment rule, NAHC is still gearing up to fight against home health cuts and the Centers for Medicare & Medicaid Services’ (CMS) payment-setting methodologies.

“Our focus more than anything else is remedy coming by way of Congress,” Dombi said. “If we run the clock back 365 days, we had a Congress that was telling us, very overtly, ‘We will not help you.’ They were telling us that because they believed [providers] were making too much profit in the Medicare program. They were not understanding how the business runs. They weren’t understanding how any margin [providers] got was subsidizing other government programs like Medicaid and Medicare Advantage. They now understand it.”

Dombi credits a meeting the organization had with Sen. Ron Wyden (D-Ore.), which took place in Portland, Oregon and included five home health agency representatives from the state.

“Senator Wyden asked the question: ‘MedPAC says your margins average 22%, are those numbers wrong or has something changed?’” Dombi said. “One agency representative immediately spoke up and said, ‘the numbers are wrong and things have changed for the worse.’ He started explaining what happened within his home health agency. Now Senator Wyden is working with us to help us bring about some positive legislative changes.”

Dombi noted that there is already pending legislation.

Still, working with Congress isn’t the only way NAHC plans to address the issue. The organization is still moving forward on its plan to sue the Department of Health and Human Services.

“The action plan continues with this litigation,” Dombi said. “This litigation does not give us quick remedies. My estimate is if we succeed in the first round, we will be facing an appeal by the government. If we lose, they’ll be facing an appeal. Then there’s still the step above that — the U.S. Supreme Court. This kind of litigation may take many years to get through.”

However, Dombi believes that last month’s Supreme Court decision, which struck down the Chevron doctrine, may help NAHC’s lawsuit.

The proposed payment rule wasn’t the only issue highlighted during Dombi’s rundown of legislative and regulatory updates, however.

80-20 silver lining

The “Ensuring Access to Medicaid Services” rule also came under fire, specifically its 80-20 provision, which is controversial among providers.

Dombi pointed out that caregivers should receive higher compensation for their work, but NAHC doesn’t believe that the 80-20 provision is the right method to achieve this.

“We’re in agreement that the direct care workforce is underpaid and underappreciated,” he said. “We don’t agree that the solution is to say, ‘You have to pay 80% of your payment rate as compensation to that workforce,’ when the states are paying you at such an abysmal level for the service. There’s nothing in this rule that increases payment rates for the providers of services.”

There is, however, a silver lining to the provision. It doesn’t require compliance for the first six years.

“In Washington circles, giving that much of a glide path for something to take effect is almost a death sentence, so we expect that there’ll be a number of changes or it will be abandoned along the way,” Dombi said.

Despite the 80-20 provision, Dombi explained that the rule had other aspects that would be beneficial to providers, including more accountability for the states regarding payment rates.

Dombi warned private-duty personal care providers not to fall into the trap of viewing the industry as being free of regulation.

“They may not be getting paid by federal or state governments, but they’re subject to a lot of rules and regulations, particularly under the Department of Labor,” he said.

Specifically, personal care is an industry that the department has its eye on when it comes to compliance with the Fair Labor Standards Act.

Aside from the DOL’s personal care focus, The Federal Trade Commission (FTC) also finalized a rule that effectively banned non-competes. Though this impacts all industries, Dombi noted that home care companies often rely on non-competes.

More recently, a federal court in Texas temporarily blocked the FTC’s non-compete ban. Dombi advised providers to follow these updates closely.