WiHPCA News

On November 2, the state Department of Health Services launched a free telehealth service to ensure rapid access to COVID-19 antiviral drugs.  With this service in place, any Wisconsinite 18 years of age or older who tests positive for COVID-19 is able to receive a telehealth consultation with a health care professional within 30 minutes, seven days a week during the hours of 8:00AM – 8:00PM.  If the patient is eligible for treatment, the patient will receive a prescription for a COVID-19 antiviral drug that may be filled at a pharmacy.  If the patient does not have access to a pharmacy, the prescription drug will be shipped overnight to the patient.  More information may be found on the DHS website.   

On October 20, the state Department of Health Services (DHS) unveiled a flu vaccine online “dashboard”.  In addition to providing data on a statewide basis, the dashboard breaks down data by county, age, race, gender and ethnicity.  Also, it shows seasonal trends over the last few years.  This dashboard may be accessed on the DHS website. 

By Hoven Consulting  – WiHPCA’s lobbying firm

·         November General Election Results – State Legislature

o   State Assembly: In the 2023-2024 legislative session, Republicans will have 64 members and the Democrats will have 35 members.  Republicans gained a net of four Assembly seats.  One of these Assembly seats is located in the western Milwaukee suburbs, two are located in far northwest Wisconsin, and the other is a district that is between Milwaukee and Madison and also includes the southcentral Wisconsin city of Milton.

o   State Senate: During the next legislative session, Republicans will have 22 members and the Democrats will have 11 members.  Senate Republicans gained one Senate seat that was held by Democrats.  This seat is located in far northwest Wisconsin and includes the community of Superior. 

·         Assembly and Senate Elect Leadership

On November 10, both the Senate and Assembly Republican caucuses met to elect their respective leadership teams for the 2023-2024 legislative session. 

Senate Republicans re-elected their current senior leadership team:

o   Senate President – Chris Kapenga (Delafield)

o   Senate President Pro-Tempore – Patrick Testin (Stevens Point)

o   Majority Leader – Devin LeMahieu (Oostburg)

o   Assistant Majority Leader – Dan Feyen (Fond du Lac)

The Assembly Republican caucus elected several members to new senior leadership roles.  The new senior leadership members are:

o   Assembly Speaker – Robin Vos (Rochester)

o   Assembly Speaker Pro Tempore – Kevin Petersen (Waupaca)

o   Majority Leader – Tyler August (Lake Geneva)

o   Assistant Majority Leader – Jon Plumer (Lodi)

During the week of November 14, both the Assembly and Senate Democratic caucuses elected their respective leadership teams for the 2023-2024 legislative session.  Senate Democrats also elected new members to their leadership team.  Their new senior leadership team is:

o   Minority Leader – Melissa Agard (Madison)

o   Assistant Minority Leader – Jeff Smith (Brunswick)

Assembly Democrats re-elected the following members to their current leadership roles:

o   Minority Leader – Greta Neubauer (Racine)

o   Assistant Minority Leader – Kalan Haywood (Milwaukee)

·         Occupational License Study Committee Update

On Tuesday, November 15, the Legislative Council Study Committee on Occupational Licenses held its November public meeting.  Included in the agenda for this hearing was testimony from a number of individuals, including representatives from the state Department of Safety and Professional Services (DSPS) – which processes most occupational credentials in the state – as well as discussion on several draft bills intended to improve the ongoing occupational credential processing backlog.  Most of the testimony from the DSPS representatives focused on this backlog. 

During the hearing, DSPS representatives repeatedly underscored their need for more staff – particularly call center staff and occupational credential processing staff.  They also discussed the need to offer higher salaries in order to attract and retain employees.  Committee chair/Senator Rob Stafsholt (R-New Richmond) indicated that he is open to possibly providing more funding in the 2023-2024 state budget to DSPS to hire more staff.  However, he underscored the committee’s prior request for more data on the processing backlog, which would help him justify that funding request.  DSPS representatives stated a few times during the hearing that they would need to re-task credential processing employees to gather that data, which would likely increase the backlog.  Chair Stafsholt stated that he realized that but obtaining that data would be critical to help to possibly secure additional staff funding for the agency.  Committee Vice Chair/Representative Shae Sortwell (R-Two Rivers) also appeared to be open to providing funding for additional agency staff but also agreed that DSPS needed to provide them with more data on the backlog first.

DSPS representatives appeared to be supportive of committee draft legislation increasing credential renewal periods from two years to four years, as well as legislation that removes the requirement for the agency to review certain types of minor criminal offenses.  However, they also noted that several of the committee’s other draft bills would require additional staffing to accomplish. 

After hearing all of the testimony, the committee was scheduled to have a discussion among themselves regarding their various draft bills addressing this processing backlog.  However, as the DSPS testimony and questioning ran much longer than anticipated, the committee agreed to adjourn and postpone discussion on these draft bills to their next public meeting, which is scheduled for December 13. 

NOTE:  If your hospice/palliative care agency has employees who are experiencing delays in receiving their occupational licenses, please contact WiHPCA’s government affairs professionals – either Nathan Butzlaff at (608) 310-8833 or nathan@hovenconsulting.com or Tim Hoven at (414) 305-2011 or tim@hovenconsulting.com. 

·         Uniform Death Reporting Standards Study Committee Update

The Legislative Council Study Committee on Uniform Death Reporting Standards held a meeting on October 17 in Madison.  Senator Joan Ballweg (R-Markesan) and Representative Jesse James (R-Altoona) serve as chair and vice chair, respectively, and heard various presentations, which are summarized below.   

Representatives from the state Department of Health Services (DHS) were the first to present at this hearing.  They discussed the National Violent Death Reporting System (NVDRS) and the State Unintentional Drug Overdose Reporting System (SUDORS).  In response to questions from committee members, DHS representatives noted:  (1) DHS requests NVDRS data from all counties, and most participate, though such participation is not required and (2) a significant majority of physicians continue to use a “fax attestation form” when certifying the cause and manner of natural deaths, rather than submitting that information as an electronic user of the State Vital Records Information System (SVRIS).

The second presentation featured representatives from the state Department of Justice.  Much of this presentation covered the types of death investigation training offered in Wisconsin.  In particular, they discussed: (1) the death investigation training provided at police academies, (2) an annual 80-hour course for death investigators organized by DOJ and (3) an annual four-day death investigation symposium organized by the Wisconsin Association of Homicide Investigators. 

Following the presentations, committee members discussed various issues.  Committee members expressed interest/support for the following:

o   Expanding the death record to include different data points, including noting whether substance abuse contributed to the death.

o   Requiring physicians to receive training on how to properly certify cause and manner of death, including training how to address the types of death that must be reported to coroners or medical examiners.

o   Requiring all those who certify deaths (e.g., physicians) to submit the medical certification electronically using the State Vital Records Information System (SVRIS).

o   Creating a state statute governing fatality review teams in a manner codifying current practice (allowing counties to decide which types of teams, if any, are created).

Last week, US Department of Health & Human Services (HHS) Secretary Xavier Becerra announced the renewal of the public health emergency (PHE) due to the ongoing COVID-19 pandemic. The PHE was originally declared on January 31, 2020 and has been renewed continuously since then. Renewal of the PHE keeps a number of important waivers and flexibilities active. The current PHE declaration will last 90 days from its effective date of October 13, 2022.

WiHPCA Legislative Key Contact Program

If you were not yet aware, we would like to remined you about WiHPCA’s Legislative Key Contact Program, which can be a highly effective grassroots advocacy tool to help build and nurture strong on-going relationships between WiHPCA members and lawmakers in Wisconsin. Ultimately, the program can help us help shape new policies important to our members.

The program is now live on the WiHPCA website and members can easily and quickly sign-up as a Key Contact. With the campaign season winding down, and the 2023-24 legislative session right around the corner, it’s more important than ever for WiHPCA to have a robust Key Contact Program. It is essential to raising our profile in the State Capitol and beyond.

As a Key Contact, you can help influence the legislative process by cultivating relationships with elected officials. By taking advantage of existing relationships and making new contact with members of the Wisconsin Legislature (as well as the Wisconsin Congressional  Delegation), you can help us educate lawmakers on industry issues and influence legislation.

But the program will not succeed without strong member participation, so please take a few moments to read more about it – and learn how simple it is to “enlist” and participate as a Key Contact. The time commitment is minimal and your responsibility as a key contact depends on your level of comfort and willingness to engage.

Remember, lawmakers are often eager to hear input from their constituents, and as an expert in the home health care field, you can make a real difference in the policy process as a Key Contact. CLICK HERE to sign-up by filling out and submitting a brief online survey.

WiHPCA Legislative Outreach Program

Grassroots advocacy is the most powerful tool WiHPCA 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 – WiHPCA 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 WiHPCA Government Affairs Team will set-up in-district meetings between WiHPCA 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 WiHPCA members to build or strengthen their relationships with local legislators and to educate them on hospice and palliative care and on policy issues important to hospice professionals and their patients.

WiHPCA encourages all members to participate in this critical grassroots advocacy program. Please click here for more information on the program. If you’re interested in participating in the program, contact the WiHPCA office at wihpca@badgerbay.co if you’re interested in participating.

Earlier this month, WiHPCA held its third quarter meeting with the WI Department of Health Services’ Division of Quality Assurance (DQA). We are pleased  to report there was record high turnout for the meeting, which was held virtually on Oct. 6.

The purpose of the DQA quarterly meetings are to create an opportunity for WiHPCA members and other hospice and palliative care professionals in Wisconsin to build and maintain a strong working relationship with a key state regulatory agency that can impact our industry. The meetings continue to provide our members with valuable regulatory information and updates, as well as a unique chance to engage DQA staff, asks questions, and request guidance.

For members who were not able to attend the oct. 6 meeting, please find below a high-level overview of the DQA’s quarterly report:

• Hospice Surveys
• Total Surveys:  9
• Recertification Surveys:  5
• Complaint Surveys:  4
• Complaints Overview: Six complaints received
• Four complaints investigated
• Seven unique allegations
• Four complaints substantiated related to:
•  Patient abuse
•  Nursing service
•  Quality Care
•  Misappropriation of property
•        Top Deficiencies
• Content of plan of care
• Fire protection
• Notice of rights and responsibilities
• Care planning coordination
• Executive responsibilities
• Prevention / infection control
• Governing body and administrator
• Professional management responsibility
• Physical environment of services
• Hospice plan of care

DQA also provided a link to a summary of recent changes to Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the COVID-19 Pandemic.

For more information, please CLICK HEREto visit the DHS Hospice Statistics webpage.

As a hospice professional and member of WiHPCA, your role in advocacy – both in the halls of Congress and at the State Capitol – is essential to our success in shaping public policies that affect hospice and palliative care. No one is better positioned than you and your colleagues to educate legislators and regulators on issues important to WiHPCA.

Thankfully, being an effective advocate can be quick and easy with the support of WiHPCA and our national partners. When it comes to advocating on federal issues, theNational Hospice and Palliative Care Organization’s Hospice Action Network (HAN) enables you to contact your Members of Congress on issues of importance to the hospice community. And it only takes a few moments of your time!

Please take advantage of the HAN Legislative Action Center to urge Congress to support the following key federal legislative proposals currently being considered in Washington:

·         The Palliative Care & Hospice Education and Training Act (PCHETA) – This proposal is the most important hospice and palliative care workforce investment legislation currently being considered in Congress. Among other things, PCHETA would increase the number of permanent faculty in palliative care at accredited medical, nursing, and social work schools, and other programs; promote education, research, and training in palliative care and hospice care delivery, and bolster the development of careers in academic palliative and hospice medicine.

If you haven’t already, please act on PCHETA today! Simply CLICK HERE to contact your Members of Congress and urge them to support this important legislation through the Hospice Action Network’s Legislative Action Center.

·         Expanding Access to Palliative Care Act – This bipartisan proposal would direct the Center for Medicare and Medicaid Innovation (CMMI) to create a Community-Based Palliative Care model demonstration, which would test the impact of offering palliative care concurrently with cure-focused treatment.

If you haven’t already, please act on the Expanding Access to Palliative Care Act today! Simply CLICK HERE to contact your Members of Congress and urge them to support this important legislation through the Hospice Action Network’s Legislative Action Center.

WiHPCA is happy to remind members about and provide links to the latest articles and information from Hospice News and other publications:

·         Focus Group Study: 30% Believe Hospice Intentionally Hastens Death

• By Holly Vossel | October 21, 2022

About 30% of participants in a recent study said they believe that “hospice intentionally hastens death and the dying process.” The data appeared in a recently developed evidence-based serious illness messaging toolkit from the MessageLab Serious Illness Messaging Project. The toolkit identifies new approaches for hospice and palliative care providers to break down barriers of public misperception and apprehension of their services. Read more…

·         Hospice Workers ‘Crave’ Safety, Connection, Efficiency

• By Jim Parker | October 3, 2022

As the hospice labor pool continues to dwindle, employers are seeking to understand what their workers need to continue on in the field. Researchers from Transcend Strategy Group have developed a stratified “hierarchy of needs” for hospice workers, based on data showing what those employees value most. Transcend found that the top priorities for hospice staff include financial security, safe working conditions, being empowered to focus on what matters, a sense of belonging, purpose and passion, and fulfillment in their work. Read more…

·         Palliative Care Needs a Defined Scope to Expand Access, Reimbursement

• By Holly Vossel | October 20, 2022

A primary barrier for patient and family access to palliative care is a lack of standardized definition and payment mechanism. Without an established palliative care benefit or universally recognized definition in place, care delivery models, patient experiences and reimbursement of palliative care services vary widely across the nation. Read more…

·         How the US Will Revamp Family Caregiver Support

• By Jim Parker | October 7, 2022

Without family caregivers, many hospice patients would be unable to receive care in their homes. To help keep patients at home — the lowest-cost setting of care — the federal government recently unveiled a National Strategy to Support Family Caregivers, which has more than two decade’s worth of advocacy behind it. Read more…

·         CMMI Working on Payment Models That Include Palliative Care

• By Jim Parker | October 3, 2022

The Center for Medicare & Medicaid Innovation (CMMI) is developing new reimbursement pathways for palliative care. As part of that process, CMMI is applying elements of its Medicare Care Choices Model (MCCM) demonstration, which ended Dec. 31, 2021, according to a new CMMI white paper. MCCM was designed to test the impact of concurrent hospice and curative care. Read more…

Hospice News, which is part of the Aging Media Network, is a leading source for news and information covering the hospice industry.

Earlier this year, you had an opportunity to respond to WiHPCA’s Legislative and Regulatory Priorities survey, allowing you to provide your input on what policy issues are most important to you, your organization, and the Wisconsin hospice and palliative care industry. The purpose of surveying the membership was to collect valuable data to help association leadership develop the WiHPCA policy agenda and determine what legislative and regulatory issues the organization should make a priority in 2023-2024.

Together, with your feedback as the foundation of the decision-making process, the WiHPCA Legislative Committee and Board considered the following criteria when finalizing the association’s policy agenda and issue priorities: 1.) The benefit to WiHPCA members; 3.) The extent to which it will improve hospice and palliative care in Wisconsin; and 3.) The likelihood of legislative/regulatory success.

With that in mind, WiHPCA is pleased to present members with our 2023-24 Policy Agenda, which will be used to guide the association’s advocacy efforts over the next two years.

The WiHPCA Policy Agenda provides a broad policy vision for advancing hospice and palliative care in Wisconsin and identifies the following specific legislative and regulatory goals for 2023-24:

 

• Educate the Wisconsin congressional delegation and state lawmakers on the potential negative impact the Center for Medicare and Medicaid Innovation VBID “Hospice Carve-In” pilot program could have on the long-term viability of hospice care in Wisconsin.

 

• Educate key state policymakers – including federal and state lawmakers and the WI Department of Health Services – on the inequity of the nursing home room and board Medicaid pass-through billing requirement imposed on hospice care. The ultimate goal is to eliminate or reduce the negative impact of the current policy.

 

• Promote public awareness and increase policy influence of palliative care, such as the creation of state palliative care advisory council.

Thank you to all WiHPCA members who reponed to the Legislative and Regulatory Priorities survey. Your feedback was invaluable to our policy agenda development process

By Hoven Consulting  – WiHPCA’s lobbying firm

• New Marquette Law School Poll Released on October 12

On October 12, Marquette Law School released a new statewide election poll, which was conducted between October 3-9.  The following poll findings may be of interest:

Gubernatorial Race

This poll asked likely Wisconsin voters about their preferred candidate for this year’s governor’s race.  The poll found the following:

·         Governor Tony Evers (Democrat): 47%

·         Tim Michels (Republicans): 46%

·         Joan Beglinger (Independent): 4%

o   NOTE:  Joan Beglinger ended her gubernatorial campaign in early September and endorsed Republican candidate Tim Michels.  However, her name will remain on the November general election ballot.

The October poll also asked respondents if they approved or disapproved of how Governor Evers is handling his job. The poll found the following:

Governor Tony Evers

·         Job Approval:  46%

·         Job Disapproval:  48%

·         No Opinion:  5%

U.S. Senate Race

This poll asked likely Wisconsin voters about their preferred candidate for this year’s U.S. Senate race.  The poll found the following:

·         Lt. Governor Mandela Barnes (Democrat): 46%

·         U.S. Senator Ron Johnson (Republican): 52%

The poll also asked respondents if they have a favorable or unfavorable opinion of Lt. Governor Mandela Barnes and U.S. Senator Ron Johnson.  The poll found the following:

Lt. Governor Mandela Barnes (Democrat)

·         Favorable: 39%

·         Unfavorable: 40%

·         Haven’t heard enough: 15%

·         Don’t know: 6%

U.S. Senator Ron Johnson (Republican)

·         Favorable: 41%

·         Unfavorable: 45%

·         Haven’t heard enough: 9%

·         Don’t know: 4%

• ·         WiHPCA Presents Legislative Awards

Under WiHPCA’s legislative awards program, state and/or federal legislators who demonstrate support for policies that advance hospice and palliative care in Wisconsin and are aligned with WiHPCA’s mission are eligible to receive one of WiHPCA’s legislative awards. WiHPCA has the following two award categories:  1) Champion of Hospice and Palliative Care and 2) Friend of Hospice and Palliative Care. The awards are given out every two years, following the end of each legislative session.

The selection process for WiHPCA’s legislative awards is based on several factors, including bills authored and co-sponsored, responsiveness to WiHPCA issues, voting record on legislation important to WiHPCA, and legislative leadership and key committee positions.

Award Selection Process

Lawmakers who display exceptional support of WiHPCA and hospice and palliative care in Wisconsin are eligible for recognition as a Champion of Hospice and Palliative Care.  Lawmakers who display general support of WiHPCA and hospice and palliative care in Wisconsin are eligible for recognition as a Friend of Hospice and Palliative Care.

WiHPCA has unveiled a list of lawmakers the organization is honoring for their work during 2021-2022. 

The following lawmaker has been recognized as a Champion of Hospice and Palliative Care:

·         U.S. Senator Tammy Baldwin (Wisconsin)

WiHPCA has recognized the following lawmakers as Friends of Hospice and Palliative Care:

·         State Rep. Rick Gundrum (Slinger)

·         State Rep. Donna Rozar (Marshfield)

• ·         Legislative Council Study Committee on Occupational Licenses - Update

This study committee’s most recent meeting occurred on Wednesday, October 12.  During the meeting, committee members expressed frustration with the state Department of Safety and Professional Services (DSPS) for their ongoing occupational license processing delays, as well as the limited amount of information the agency has provided to the study committee.  As such, there was discussion of potentially moving the responsibility of processing certain licenses to other state agencies (e.g., moving health care-related licenses to the state Department of Health Services). 

Other committee members stated their support to provide authority to DSPS to use more of their fee revenue to hire additional employees to assist with processing delays.  Interestingly, Committee Chair/Senator Rob Stafsholt noted that he does not oppose providing DSPS with the authority to hire more staff.  However, he would like the agency to provide the legislature with data to justify that.  Also, Chair Stafsholt and Vice Chair/Rep. Shae Sortwell noted their support for universal licensure recognition. 

A list of committee members, the full meeting agenda, as well as written presentations may be viewed on the legislature’s website.  This committee’s next public meeting will occur on Tuesday, November 15 in Madison.