To ensure the voice of citizens is heard across state government, it is critical for Wisconsin residents to understand our electoral process, and even more important for them to cast their vote on election day. And a big election is right around the corner… Wisconsin’s 2023 Spring Election will take place on Tuesday, April 4, and voters will head to the polls to cast their ballots in the WI Supreme Court Race, which could decide the ideological direction of the court for years to come.

In the Feb. 21 Spring primary, Milwaukee County Circuit Judge Janet Protasiewicz and former Supreme Court Justice Daniel Kelly captured the most votes in the four-way race and will face-off in the April 4 general election. Protasiewicz took 46% of total votes cast, with Kelly coming in a distant second, capturing 24% of the votes. Again, the winner of the general election will decide the ideological direction of the 7-seat high court, which is currently controlled 4-3 by conservative-leaning justices.

In addition, for those of you who live in the 8th Senate District (in southeastern Wisconsin), there is a special election to replace Sen. Alberta Darling (R) who retired from the Wi Senate late last year.  Republican State Representative Dan Knodl is running against Democrat environmental attorney Jodi Habush Sinykin.

For more information about the April 4 Spring Election, including your polling place and which candidates and referendum questions will be on your ballot, simply CLICK HERE. 

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 grassroots advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has established 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 provide 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.

Again, WiAHC encourages all members to participate in this critical grassroots advocacy program. If you’re interested in participating, please contact the WiAHC office at wiahc@badgerbay.co.

By Hoven Consulting – WiAHC’s lobbying firm

• Governor Evers Submits FY2023-2025 Budget Request to Legislature

On Wednesday, February 15, Governor Tony Evers unveiled his budget bill proposal for the Fiscal Year 2023-2025 budget biennium. The budget bill outlines how the State of Wisconsin will administer tax dollars, program revenue, and federal aid dollars over the next two years. In total, the budget aims to spend $103.8 billion ($52.1 billion in FY2023-2024 and $51.7 billion in FY2024-2025) on state government programs.  For fiscal year 2023-2024, that's a $7.9 billion increase (17.9 percent) over the budget proposed by Evers in 2021. 

The most significant increase in state tax dollar spending is in the following state agencies/areas:

LARGEST BIENNIAL GPR (General Purpose Revenue) INCREASES OVER 2021-2023 FUNDING LEVELS

·        Department of Public Instruction:  $2.809 billion

·        Shared Revenue and Tax Relief:  $1.099 billion

·        Department of Administration:  $1.019 billion

·        Public Service Commission:  $755 million

·        Department of Health Services:  $716 million

·        Department of Children and Families:  $512 million

·        Department of Workforce Development:  $265 million

·        All Other Changes:  $1.656 billion

·        TOTAL:  $8.831 billion

The bill has now been sent to the Wisconsin legislature where it will be reviewed by the Joint Committee on Finance (JFC). The committee will review and amend the budget bill after having several public hearings across the state at which citizens may testify. After JFC has passed the bill, it will then be sent to the State Assembly and Senate for passage, likely in June.

It's important to note that Republican legislative leaders have stated publicly that they do not support the Governor's budget proposal. Republicans control both houses of the legislature and major changes to the proposal are expected.

• WiAHC Sends Legislative Priorities Letter to All Legislators

On January 27, WiAHC’s lobbyists sent an introductory letter to all Wisconsin state legislators.  In the letter, we provided background information on what exactly skilled home health care is and shared WiAHC’s state legislative agenda for the 2023-2024 legislative session.  WiAHC provided legislators with a “legislative leave-behind” document that includes this information. 

• WiAHC Requests DHS to Remove Professional Advisory Bodies from State Regulations

On January 26, WiAHC Board Chair Jayne Thill sent a letter to DHS Deputy Secretary Deb Standridge – the most senior DHS official on that date – requesting that the department update an outdated administrative rule relating to professional advisory bodies for home health agencies.  In particular, WiAHC requested that they bring state regulations in line with federal regulations by eliminating professional advisory bodies but maintaining governing bodies along with regulatory oversight for ensuring the quality of care and patient safety.  We requested that they make this change in their biannual comprehensive list of regulatory updates. 

• DHS Releases State Health Improvement Plan

On February 2, DHS released its 2023-2027 State Health Improvement Plan.  Under state law, DHS is required to craft a public health agenda for the state at least once per decade – this plan meets that requirement.  Further, this plan helps maintain DHS as an accredited state health department, per the requirements of the Public Health Accreditation Board. 

In summary, the report recommends the following three “foundational shifts” in how Wisconsin addresses public health:

·        Institutional and systemic fairness

·        Representation and access to decision-making

·        Community-centered resources and services

Also, it highlights the following priority areas – areas that are critical to ensuring the wellness of Wisconsinites:

·        Social and community conditions

·        Physical, mental, and systemic safety

·        Person and community centered health care

·        Social connectedness and belonging

·        Mental and emotional health and well-being

The full report may be viewed on the DHS website. 

• Home Health Care Services Electronic Visit Verification Public Forum on March 2

DHS will hold an online public forum on Thursday, March 2, 2023, from 1:00 – 3:00PM addressing the electronic visit verification (EVV) requirement for home health care services.  During this forum, DHS representatives will discuss the federal requirement to implement EVV for Medicaid-covered personal care and applicable home care services and answer any questions that attendees may have.  Attendees may submit questions in advance to DHS by emailing:  dhsevv@dhs.wisconsin.gov. 

For more information on this public forum, including the Zoom meeting link and call-in number, please go to the DHS EVV Forum page.

As mentioned above, Gov. Evers recently introduced his 2023-25 budget proposal – the state’s two-year spending plan – before a Joint Session of the Wisconsin Legislature. Although the Republican-controlled Legislature is expected to scrap most of the Evers budget and craft their own version by working off current spending levels, it is likely the Legislature will adopt some of the governor’s proposals.

According to Evers, his budget includes proposals that would increase access to affordable healthcare coverage, improve the quality of healthcare services in the state, and expand the scope of benefits available through Medicaid. Please find below a brief overview of items included in governor’s budget proposal that may be of interest to WiAHC members:

• Expand Medicaid eligibility for parents and adults from 100% of the federal poverty line ($27,750 annually in 2022 for a family of four) to 138% of the federal poverty line ($38,300 annually in 2022 for a family of four). According to the Evers Administration, this expansion would result in 89,700 low-income individuals becoming eligible for Medicaid, of which approximately 30,300 are uninsured. Under this proposal, the state would realize a savings of over $1.6 billion and draw down an additional $2.2 billion in federal funding over the two-year budget cycle. Republicans who control the Legislature are firmly opposed to this proposal.

• Provide $200 million in additional funding for Wisconsin Innovation Grants, a current program previously funded with federal dollars to design and implement plans to address workforce challenges. This proposal includes a $100 million allocation to specifically focus on fortifying the state’s healthcare workforce by providing grants to healthcare employers and related organizations.

• Provide $22.5 million to establish an ongoing Innovation Grant program for healthcare employers to engage in improved recruitment and retention of long-term care providers.

• Provide $10 million to expand the state’s nurse educators program.

• Provide $5 million GPR in additional funding for the Worker Advancement Initiative to support efforts by technical colleges and nursing schools to reduce barriers to graduation and assist students in becoming career ready.

• Provide $8 million for continuation of the WisCaregiver Careers program, which aims to address the shortage of certified nursing assistants in the state by supporting recruitment, training and retention of individuals to care for nursing home residents across Wisconsin.

• Provide over $900,000 to the Department of Workforce Development to support healthcare profession apprenticeship curriculum development and to advance new collaborations related to healthcare workforce.

• Provide nearly $4 million and increased staffing to the Department of Safety and Professional Services to streamline the state’s credentialling process for licensed professionals and provide more efficient processing of license applications.

The WiAHC Government Affairs Team will continue to analyze the recently introduced budget bill and keep the membership updated throughout the budget process.

Earlier this month, Gov. Tony Evers announced his appointment of Kirsten Johnson as the next secretary of the Wisconsin Department of Health Services (DHS). Johnson, who begins her new role on Feb. 27, will replace former Secretary Karen Timberlake’s who left the state agency at the end of 2022. 

According to a press release issued by the governor’s office, Johnson has over 20 years of experience as a public health leader in local, state, national, and international organizations. Most recently, she served as the health commissioner for the city of Milwaukee following her appointment in January 2021. Prior to serving the city of Milwaukee, Johnson led the Washington-Ozaukee Public Health Department for more than a decade as the director and health officer. Johnson also served as a health policy fellow and advisor for U.S. Congressman Ron Kind and helped develop policy for the House Committee on Ways and Means.

“Over the past 20 years of my career in public health, I have worked to address the challenges and health disparities facing Wisconsin’s rural, urban, and suburban communities alike—disparities that were laid bare by the pandemic,” said Johnson. “I am excited and honored to join Gov. Evers’ administration to lead DHS, where I look forward to using my expertise and knowledge to continue this important work.” 

Johnson has her master’s degree in public health from Tulane University of Public Health and Tropical Medicine and holds certifications as a public health professional and certified education specialist.

In the closely watched Feb. 21 primary for the Wisconsin Supreme Court – which centered on the issue of abortion after the U.S. Supreme Court overturned Roe v. Wade in 2022 – liberal-leaning Milwaukee County Judge Janet Protasiewicz and conservative former Supreme Court Justice Daniel Kelly captured the most votes in the four-way race and will face-off in the April 4 general election. Protasiewicz took 46% of total votes cast, with Kelly coming in a distant second, capturing 24% of the votes. The winner of the general election will decide the ideological direction of the 7-seat high court, which is currently controlled 4-3 by conservative-leaning justices.

The other high-profile primary race saw Republican state Rep. Dan Knodl (R-Germantown) defeat fellow state Rep. Janel Brandtjen in the GOP primary for the 8th WI Senate District. Knodl will face Democrat Jodi Habush Sinykin in the April 4 spring election for the chance to replace former Republican Sen. Alberta Darling, who left office in Dec. 2022 after holding the senate seat for three decades. If Knodl ultimately wins the seat, Republicans will hold a veto-proof majority in the senate.

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 grassroots advocacy. In effort to capitalize on our greatest advocacy resource – our membership – WiAHC has established 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 provide 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.

Again, WiAHC encourages all members to participate in this critical grassroots advocacy program. If you’re interested in participating, please contact the WiAHC office at wiahc@badgerbay.co.

Please bring your questions about electronic visit verification (EVV) and the Sandata EVV system to our monthly Q&A session, Key Conversations. There, you will join experts from the Wisconsin Department of Health Services (DHS), Wisconsin EVV Customer Care, and Sandata. Next session: February 20, 2023, 1-2pm CT Online Zoom link:  https://dhswi.zoomgov.com/j/1601125213 Call in: 1-669-254-5252, Webinar ID* 160 112 5213  Key Conversations are informal, monthly drop-in sessions for anyone who has questions about EVV. No new policy or technical processes will be announced in these sessions. If you have any questions, please reach out to Wisconsin EVV Customer Care at 833-931-2035 or vdxc.contactevv@wisconsin.gov.   Thank you, Wisconsin DHS EVV Team Reminder Electronic visit verification (EVV) has been required in Wisconsin for Medicaid-covered personal care and supportive home care services since November 2, 2020. In order for Wisconsin Medicaid to continue to receive its full federal funding, the Wisconsin Department of Health Services (DHS) is required to begin imposing consequences for failure to capture required EVV information. For dates of service on and after May 1, 2023, DHS will begin imposing financial and programmatic consequences when EVV information is not captured for required personal care and supportive home care services (service codes T1019, T1020, S5125, and S5126). Consequences include claim denial, exclusion from future capitation rate setting development, and possible IRIS (Include, Respect, I Self-Direct) participant disenrollment. The beginning of these consequences is known as hard launch. For more information, review ForwardHealth Update No, 2022-48.

Wisconsin EVV Customer Care: 833-931-2035 Monday–Friday, 7 a.m.–6 p.m. CT vdxc.contactevv@wisconsin.gov

Application Period to Open Soon for $15 Million in Grants Supporting Quality and Innovation in Wisconsin Medicaid Home and Community-Based Services Join informational webinars February 14 and 16 The Wisconsin Department of Health Services (DHS) is launching the second round of Home and Community-Based Services (HCBS) Grants Supporting Quality and Innovation, funded through the American Rescue Plan Act (ARPA). These grants offer an exciting opportunity for entities active in the state’s Medicaid HCBS system to apply for $25,000 to $1 million to enact innovative changes that will benefit participants, families, and the long-term care workforce in Wisconsin. The initiative aims to positively impact people receiving HCBS from providers regionally, locally, and in urban and rural communities throughout the state. A total of $15 million is available. Applications will open on February 21 and close on March 21, 2023. Visit the DHS website for details about the grant opportunity. Refer to the grants webpage for more information as we get closer to the release date. Applications will open on February 21 and close on March 21, 2023. Visit the DHS website for details about the grant opportunity. Refer to the grants webpage for more information as we get closer to the release date. Upcoming webinar info sessions DHS is hosting informational webinars to provide detailed information on the grant opportunity and application process. Use the links below to register for an upcoming session. Round 2 Overview Tuesday, February 14, 2023 9-10 a.m. Central Time Register on Microsoft Teams Improve Your Grant Application Thursday, February 16, 2023 3-4:30 p.m. Central Time Register on Microsoft Teams Accessibility If you need American Sign Language, live captioning, or other language assistance during the presentation, please email us by February 10, 2023, at DHSDMSWIARPAHCBS@dhs.wisconsin.gov. The presentation will be posted to the DHS website before the webinar, and a recording will also be posted afterward for those who cannot attend. Support resources Help desk If you need assistance with your application, you may contact our help desk Monday through Friday from 8 a.m.-4:30 p.m. Central Time at the email and phone number below. Email GrantsWIARPAHCBS@pcgus.com Call 833-660-2499 Virtual office hours From February 22 through March 15, 2023, we will hold virtual office hours on Wednesdays from 2-3 p.m. Central Time to answer questions about the grant process. Join virtual office hours on Microsoft Teams when office hours are open. For questions, email the DHS ARPA HCBS team. For more information about ARPA funding for HCBS, visit the Wisconsin Department of Health Services website.

On January 2, 2023, Wisconsin Department of Health Services (DHS) Secretary-designee Karen Timberlake resigned her position.  She was appointed to this position after the 2021 resignation of then-DHS Secretary-designee Andrea Palm, who resigned her position to join the Biden Administration in Washington, DC.  Karen Timberlake also served as the DHS Deputy Secretary and Secretary under former Wisconsin Governor Jim Doyle’s (D) administration in the mid-to-late 2000s. 

Governor Evers has publicly stated that he will announce a new DHS Secretary-designee in the coming weeks.  As such, DHS Deputy Secretary Deb Standridge is the most senior official at this state agency at this time.  Once the Governor announces a new DHS Secretary-designee, we will share that in a future newsletter.