Earlier this month, on Oct. 6, the Wisconsin Supreme Court issued a 4-3 decision – split down ideological lines – agreeing to hear a legal challenge to the state’s current legislative maps, which were drawn following the 2020 U.S. Census and after a series of rulings by the Wisconsin Supreme Court and the U.S. Supreme Court. The lawsuit, filed on behalf of Wisconsin voters, claims Wisconsin Assembly and Senate legislative districts were gerrymandered in violation of the state constitution.

Depending on a final ruling by the liberal-leaning court, new legislative maps could be in place by next year and could shift the balance of power in the Legislature. Republicans have held large majorities in both houses since 2011. The state’s high court will hear oral arguments in the case on November 21, but has not provided a timeline for when it will issue a decision.

Earlier this month, the Wisconsin Department of Administration (DOA) announced the state closed the 2023 fiscal year, which ended June 30, with a surplus of slightly more than $7 billion. That is roughly 65% more than last year’s $4.3 billion balance. In addition, the state Budget Stabilization Fund, or “rainy day” fund continues to have a balance of $1.8 billion.

The home health community is seeking support for legislation to curb dire cuts to Medicare home healthcare services. The Preserving Access to Home Health Act of 2023 (S.2137/H.R. 5159), introduced by Senators Debbie Stabenow (D-MI) and Susan Collins (R-ME) and Representatives Terri Sewell (AL-7) and Adrian Smith (NE-3), would safeguard access to essential home-based, clinically advanced healthcare services for America’s older adults and people living with disabilities by preventing the Centers for Medicare & Medicaid Services (CMS) from implementing devastating cuts. Passage of this legislation is imperative to ensure the continued functioning of the Medicare Home Health Program.

This critical legislation would:

• Stop CMS from imposing certain permanent and temporary payment cuts. More specifically, the bill would repeal CMS’s authority to make these permanent and temporary payment cuts based on its misguided budget neutrality methodology.

• Instructs MedPAC to analyze the Medicare Home Health Program. Under current law, the Medicare Payment Advisory Commission (MedPAC) is allowed to review the effect of Medicare payment policies on the delivery of healthcare services outside of Medicare. The bill would require MedPAC to report on aggregate trends under Medicare Advantage, Medicaid, and other payers, and consider the impact of all payers on access to care for the Medicare population. It also updates the Commission’s Medicare home health cost reports to include data on visit utilization and total payments by program.

Of course, when advocating for home health with your Members of Congress, it is important to ensure your message is both compelling and clearly presented. Thankfully, our national partner, the National Association for Home Care and Hospice (NAHC), has made connecting with your elected representatives as easy as a few clicks on your computer or mobile device.

Simply CLICK HERE to contact your federal lawmakers on the Preserving Access to Home Health Act of 2023. All you need to do is fill in your name and contact information and hit SEND.

WiAHC is happy to remind members about and provide links to the latest articles and information on the home health care industry from Home Health Care News and other publications:

·        The Last-Ditch Efforts Home Health Providers, Advocates Are Making To Nix Payment Cuts

Home Health Care News – By Joyce Famakinwa | Oct. 24, 2023

Any day now, the Centers for Medicare & Medicaid Services (CMS) will release the 2024 home health final payment rule. In anticipation, home health providers and advocates have been appealing to Congress, educating, calling to action on social media and more. Read more…

·        New Legislation Offers Hope For Expanding HCBS Across More States

Home Health Care News – By Patrick Filbin | Oct. 24, 2023

Over the past several years, many states have strengthened their home- and community-based services (HCBS) programs by covering more services and increasing rates. Now, over a dozen members of Congress are trying to give states additional funding to help expand those HCBS programs further.

Read More…

·       Medicare Advantage Plans Pulling Back On In-Home Care Supplemental Benefits

Home Health Care News – By Robert Holly | Oct. 23, 2023

Insurance companies selling Medicare Advantage (MA) plans have been facing increased scrutiny from members of Congress and regulators, with critics of the private version of Medicare claiming carriers are profiting far too much. Read More…

·       Intrepid USA CEO John Kunysz: We Can’t Keep Approaching Home Health ‘Like It’s 1965’

Home Health Care News – By Andrew Dolan | Oct., 2023

In home health care, there’s value in fighting for things to be a certain way. At the same time, there’s also value in accepting things for how they are right now. John Kunysz, the president and CEO of Intrepid USA, is looking for proactive strategies to address how things are right now. He’s found some of those already. Read more…

Home Health Care News, which is part of the Aging Media Network, is a leading source for news and information covering the home health industry.

By Hoven Consulting – WiAHC’s lobbying firm

• WiAHC Requests DHS to Appoint Home Health Provider to Possible Complex Patient Pilot Program Advisory Group

In the FY2023-2025 state budget bill that Governor Evers signed into law, the Legislature appropriated $5 million for a complex patient pilot program focused on successfully transferring patients with complex medical needs from acute care facilities to post-acute care facilities.  These are funds that are directed toward the state Department of Health Services (DHS). 

Governor Evers’ original FY2023-2025 budget request included a provision giving DHS authority to administer these funds, including the creation of an advisory group that would assist the department with developing and creating a complex patient pilot program.  Furthermore, members of such an advisory group would need to have “clinical, financial, or administrative expertise in government programs, acute care, or post-acute care.”  However, the final enacted version of the budget did not provide this authority. Despite that, the Evers Administration is working towards obtaining legislation that provides this authority. 

With this in mind, WiAHC sent a letter to state Department of Health Services Secretary-designee Kirsten Johnson in August requesting that DHS consider appointing a home health care provider to a complex patient pilot program advisory group, should separate legislation be enacted that authorizes this program, including the creation of an advisory group. 

• Governor Evers/DSPS Unveils New Occupational License Processing Dashboard

On August 31, Governor Tony Evers and the state Department of Safety and Professional Services (DSPS) unveiled a new online dashboard that provides high-level data on occupational license processing.  In addition to showing the average number of days to process all new applications, all health applications, and all business applications, users may also look up application review times by profession. 

• Governor Evers Creates Task Force on Workforce and Artificial Intelligence

On August 23, Governor Tony Evers signed an executive order creating the Governor’s Task Force on Workforce and Artificial Intelligence.  This task force will “produce an advisory action plan to identify the current state of generative artificial intelligence’s impact on Wisconsin’s labor market and develop informed predictions regarding its implication for the near term and future.”  In addition, it will “recommend solutions related to workforce development and educational systems.” 

This task force will be chaired by the state Department of Workforce Development Secretary Amy Pechacek and will include the Secretary of the state Department of Administration, the head of the Wisconsin Economic Development Corporation, representatives from the University of Wisconsin System, the Wisconsin Technical College System, as well as other public and private sector representatives. 

The Governor’s executive order did not include a timeline for the work of this task force.

• Assembly Speaker Robin Vos Creates Artificial Intelligence Task Force

On August 31, Assembly Speaker Robin Vos announced the creation of several speaker’s task forces, including one focused on artificial intelligence.  This task force, comprised entirely of Republican and Democratic state representatives, will hold public hearings at various locations across Wisconsin, starting in September.  The task force aims to complete its work by the end of 2023 and recommend legislation for introduction during the 2024-2025 legislative session.  This task force will be chaired by state Rep. Nate Gustafson (R-Neenah).

• State Rep. Deb Andraca Appointed to Legislature's Joint Finance Committee

On August 16, state Assembly Minority Leader Greta Neubauer (D-Racine) appointed Rep. Deb Andraca (D-Whitefish Bay) to serve on the Legislature’s budget-writing Joint Committee on Finance for the rest of the 2023-2024 legislative session.  Rep. Andraca, who represents portions of the north shore Milwaukee suburbs, will replace Rep. Evan Goyke (D-Milwaukee), who is departing the committee to focus on his campaign for the position of Milwaukee City Attorney.

On August 8, Governor Tony Evers called a special session of the Legislature, urging lawmakers to consider a $1 billion workforce development package the Governor said was needed to address the state’s workforce shortage crisis.

Republicans, who control both houses of the Legislature, convened the session as required by law, but quickly adjourned without acting. They called the special session a “political stunt” that was fiscally irresponsible and did not provide real solutions to Wisconsin’s workforce challenges.

The Governor’s proposed legislative package included $365 million to support childcare programs; the creation of a paid family and medical leave program that would cost $243 million; $66 million for the UW; $40 million for the state’s technical colleges; and nearly $60 million to help address the shortage of healthcare workers across the state. The funding to address the healthcare worker shortage included:

o   $10 million for the state’s nurse educators program, which incentivizes nursing professors to remain in Wisconsin.

o   $6 million for the WisCaregiver Careers program, which is intended to increase the number of certified nursing assistants employed at nursing homes.

o   $17 million for healthcare opportunity grants, which will go to local workforce development boards to help individuals obtain employment in the healthcare field.

o   $936,600 for the state Department of Workforce Development to work on healthcare apprenticeships.

o   $22.5 million for healthcare innovation grants, which will help the healthcare industry recruit and retain employees.

o   Over $1.2 million for graduate medical training support grants.

The Republican-controlled state Assembly recently passed a redistricting reform plan to completely overhaul how legislative district maps are drawn in Wisconsin. Under the proposal, which is based on the model used in Iowa, a nonpartisan committee would draw the legislative maps. The maps drawn by committee would be subject to approval by the state Legislature. 

Gov. Tony Evers roundly criticized the proposal, saying it was essentially election interference by the GOP and strongly inferred he would veto the measure if it made it to his desk. Assembly Republicans praised the legislation as not only the fairest approach to redistricting for citizens, but also a plan that would avoid costly political and legal battles.

Recent polling has shown that a large majority of Wisconsin residents would prefer legislative district maps be drawn by a nonpartisan commission rather than elected officials.

The proposal, which passed the Assembly on a largely partisan vote with one Democrat voting for the measure, is awaiting further action in the Senate.

Earlier this month, the GOP-controlled state Assembly passed a nearly $3 billion state income tax cut proposal that would drop income tax rates from 5.3% to 4.4% for individual filers with incomes between $27,630 and $304,170 and deliver the same tax relief for married couples with incomes between $18,420 and $405,550. The legislation would also exclude the first $150,000 of a couple’s retirement income from state income taxes. The provision would apply to residents over the age of 67.

Gov. Tony Evers has promised to veto the legislation, saying it would jeopardize priorities such as public schools, child care, and public safety. On the flip side of the debate, Assembly Republicans said the measure, which passed on a partisan vote, will help fight inflation, encourage retires to stay in Wisconsin, and give a large portion of the state’s $4 billion surplus back to taxpayers.

The bill is currently under further consideration in the Senate.

Jenny Malak, Vice President of Homecare Operations for Agrace, has been appointed by Governor Tony Evers to serve on the Wisconsin State Board of Nursing, which resides at the state Department of Safety and Professional Services (DSPS). The Board is comprised of eight members who were appointed to four-year terms.

The State Board of Nursing oversees issues related to the protection of the public from illegal and unauthorized nursing practices. It also enforces standardized training and certifications for all nurse assistants, registered nurses, and advanced medical professionals in Wisconsin.

Malak, a registered nurse who is also certified in hospice and palliative nursing, currently oversees Agrace’s in-home hospice operations, its chronic specialty care program, and the Agrace Grief Support program. She also serves on several other local and national committees, including the National Partnership for Healthcare and Hospice Innovation’s (NPHI) chief clinical officer/chief operations officer forum, the National Hospice and Palliative Care Organization (NHPCO) quality and standards committee, the Wisconsin Organization of Nurse Leaders’ new membership committee, and the Wisconsin Nurses Association Workforce Advocacy Council.

By Hoven Consulting – WiAHC’s lobbying firm

• DHS Announces Sept. 7 Electronic Visit Verification Public Hearing for Home Health Care Services

The Wisconsin Department of Health Services will hold a public hearing regarding Medical Assistance electronic visit verification (EVV) requirements on Thursday, September 7 at 11:00AM. This hearing will be held virtually (via Zoom).  The following is a link to a page with the Zoom meeting link:  https://docs.legis.wisconsin.gov/code/register/2023/812a3/register/rule_notices/cr_23_045_hearing_information/cr_23_045_hearing_information

Please note that this EVV hearing will address an administrative EVV rule for Medical Assistance personal care and home health care services.  To view the rule text (it is fairly short), please go to the following page (you will need to scroll to the bottom of the page to review the rule text):

https://docs.legis.wisconsin.gov/code/register/2023/812a3/register/rule_notices/cr_23_045_hearing_information/cr_23_045_rule_text

• Governor Requests Special Legislative Session to Provide Funding for the Healthcare Workforce Shortage

On August 8, Governor Tony Evers announced that he was calling the Legislature into session on Wednesday, September 20, 2023, to provide funding for several of his major budget priorities that were not included in the FY2023-2025 state budget, including over $300 million for childcare programs, the creation of a paid family and medical leave program, and almost $60 million to help address the shortage of healthcare workers.  The funding to address the healthcare worker shortage includes:

• o   $10 million for the nurse educators program, which incentivizes nursing professors to remain in Wisconsin.
• o   $6 million for the WisCaregiver Careers program, which is intended to increase the number of certified nursing assistants employed at nursing homes.
• o   $17 million for healthcare opportunity grants, which will go to local workforce development boards to assist individuals obtain employment in the healthcare field.
• o   $936,600 for the state Department of Workforce Development to work on healthcare apprenticeships.
• o   $22.5 million for healthcare innovation grants, which will help the healthcare industry recruit and retain employees.
• o   Over $1.2 million for graduate medical training support grants.

However, very soon after this announcement, Republican legislative leaders stated that they opposed this special session.  As such, they will very likely call the Legislature into session on September 20 and then quickly adjourn the session, as they have done in the past when Governor Evers has called for special sessions. 

• DHS Announces Free Online Program to Train 10,000 Caregivers

On August 8, the state Department of Health Services (DHS) announced an initiative to train 10,000 Wisconsinites as certified direct care professionals (CDCP).  These individuals provide personal/supportive home care to senior citizens and disabled people.

Wisconsinites interested in receiving the CDCP certification may sign up to receive free training and then will need to pass an online test in order to be certified.  Certified individuals who obtain employment with an eligible employer may earn up to $500 in combined hiring and retention bonuses. 

More information may be found on the DHS website.

• DHS Creates Webpage Detailing Statewide BadgerCare Plus & Medicaid Enrollment Data

During the COVID-19 pandemic, the federal government put in place a continuous coverage requirement for Medicaid enrollees.  Now that the pandemic-related federal public health emergency has ended, those Wisconsinites who benefit from BadgerCare Plus and Medicaid and want to continue to participate in these programs will need to renew their enrollment.  DHS has created a webpage that tracks this data, which will be updated on the third Thursday of each month. 

• DHS Launches "UpliftWI" Peer Support Phone Line

On July 31, the state Department of Health Services (DHS) unveiled “UpliftWI,” which is a new peer support phone line for individuals who are experiencing mental health and substance use challenges.  This phone line may be reached at 534-202-5438, seven days a week between the hours of noon and midnight.  There is no charge to use this service and those who call for assistance will not be required to disclose their name, address or other identifying information.  DHS intends to expand the phone line’s hours of operation to 24 hours a day by the end of 2024.  More information may be found at the UpliftWI website.