WiHPCA News

We’re pleased to report WiHPCA’s continues to maintain and strengthen our relationship with the Division of Quality Assurance (DQA) at the Wisconsin Department of Health Services. On Sept. 9, we held out third quarterly meeting with the regulatory agency.  As has been the case at past meetings, DQA provided participants with a review and discussion regarding survey deficiencies, complaint topics, and the continued infection control guidance at nursing homes and assisted living facilities.

Please see below a brief overview of what DQA reported on as it concerns surveys performed and survey topics:

• Number of surveys performed (June 1, 2021-August 31, 2021)
  • Number of complaint surveys – 8
  • Number of recertification surveys performed – 3

• Complaint surveys topics – Top 5 concern areas:
  • Patient Rights
  • Quality of Care and Treatment
  • Nursing Services
  • Patient Assessment
  • Admission/Transfer/Discharge Rights

The next quarterly meeting is tentatively scheduled for December but may be pushed back to January due to the holidays. Stay tuned for more details and the opportunity to register. We certainly encourage participation from all WiHPCA members, as the meeting provides invaluable information and regulatory guidance from DQA.

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 provides a tremendous opportunity for WiHPCA members to build or strengthen their relationships with local legislators and to educate them on issues important to hospice and palliative care professionals and their patients.

Please click here for more information on the program.

WiHPCA is committed to finding ways to strengthen the relationship between hospice and palliative care professionals and key government policymakers that impact our industry through regulation or legislation. Engaging with lawmakers and regulatory organizations and sharing your professional expertise with them can have a significant influence on the development of polices that impact hospice and palliative care in Wisconsin.

In addition to WiHPCA’s grassroots advocacy efforts in the State Capitol, at the beginning of 2021, we implemented a regulatory outreach program that provides members an exciting opportunity to consistently engage with the Division of Quality Assurance (DQA) at the Wisconsin Department of Health Services. 

The next virtual quarterly meeting is scheduled for Thursday, September 9 at 10:30 a.m. We would encourage you to REGISTER TODAY.

For members who have not had an opportunity to attend the first two quarterly meetings this year, the purpose of the meetings are to review and discuss survey deficiencies, examine avenues for improvement, and maintain a strong, ongoing dialogue between our members and DQA.

We hope to see you on Sept. 9!

Gov. Tony Evers and the Wisconsin Department of Health Services (DHS) announced today that six million doses of COVID-19 vaccine have been administered in the state of Wisconsin. Over half of all Wisconsinites have already completed their COVID-19 vaccine series.

“Wisconsin’s vaccine providers have worked tirelessly to get shots in arms,” said Gov. Evers. “This is a tremendous milestone, and we couldn’t have gotten here without the hard work and dedication of everyone involved. Whether you’re administering shots, scheduling appointments, answering phones, or sanitizing workstations, thank you. I encourage every eligible Wisconsinite who has not done so already to roll up their sleeves and get vaccinated to help protect themselves and their loved ones.”

Since Wisconsin began administering COVID-19 vaccine in mid-December of last year, over 3.1 million Wisconsinites have received at least one dose. The state continues to make deliberate choices to reduce barriers to accessing the COVID-19 vaccine and provide much-needed relief to communities that have withstood the worst of the pandemic. Since the start of the COVID-19 Vaccination Program in Wisconsin and thanks to countless partners, the state has launched a number of successful vaccine initiatives. Through the Vaccine Equity and Outreach grant program, DHS has helped support 100 organizations to serve as trusted vaccine messengers, increase vaccine confidence, and promote vaccine equity in racially and geographically diverse communities across Wisconsin.

Earlier this month, over 600 people got their COVID-19 vaccine at the Wisconsin State Fair, and in the process, a voucher for a free cream puff. Wisconsin also recently announced its $100 COVID-19 Vaccine Reward Program, which offers a $100 Visa gift card to anyone who receives their first dose of COVID-19 vaccine between August 20 and September 6.

Data continues to show that COVID-19 vaccines do their job by preventing severe illness, hospitalization, and death. In July, people who were not fully vaccinated were nearly three times more likely to test positive for COVID-19, and 3.7 times more likely to be hospitalized for COVID-19-related illnesses. The COVID-19 vaccines remain one of the best ways to protect yourself, your family, and your community from COVID-19 and the highly infectious Delta variant.

“It is important that we continue to vaccinate everyone who is eligible for the COVID-19 vaccine, especially as cases continue to rise, driven by the Delta variant,” said DHS Secretary-designee Karen Timberlake. “Layering protection by getting vaccinated and wearing masks in schools and in public, indoor settings is critical to stopping the spread of the Delta variant.”

The National Partnership for Healthcare and Hospice Innovation (NPHI) recently submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the hospice portions of the CY22 Home Health proposed rule. The proposed rule includes several provisions related to hospice accreditation organizations and enforcement remedies. Please find below a summary of NPHI's comments to CMS:

• NPHI is broadly supportive of the provisions laid out in the proposed rule and share many of CMS’s concerns regarding hospice quality of care. They believe that these new enforcement remedies, if appropriately targeted and effectively operationalized to focus on hospice bad actors, will result in an improved standard of hospice care across the industry and will allow for a more effective use of CMS’s limited resources.

• NPHI supports the use of a Technical Expert Panel (TEP) to determine the parameters for public reporting of survey data in a manner that is easily understood and of value to the public.

• NPHI supports the creation of a Special Focus Program (SFP) for those hospices found to be potentially placing patients at risk for poor care and encourage the use of a TEP to ensure that the SFP incorporates all the unique aspects of hospice care delivery in its creation and implementation.

• NPHI strongly supports efforts to ensure the consistency of survey results among State Agencies (SAs), and Accrediting Organizations (AOs), and encourage the use of surveyor staff with hospice industry experience and the requisite understanding of the core services to be delivered. 

For additional information on the proposed rule, please contact the WiHPCA office at wihpca@badgerbay.co.

First elected to the state Assembly in 2014, Representative Nancy VanderMeer (R-Tomah) represents the 70^th Assembly District, which includes portions of Monroe, Jackson, Wood, and Portage Counties. The district also includes the cities of Tomah and Sparta.

Before running for office, Rep VanderMeer owned an auto dealership, and her family continues to operate a dairy farm. In her many volunteer roles, Nancy has served on the Tomah Memorial Hospital board of directors and is a former president of the American Business Women’s Association. In addition to drawing on her experience as a small businessowner to champion pro-growth policies for rural Wisconsin, she has also focused on legislation to boost Wisconsin’s healthcare workforce.  

She currently chairs the Assembly Rural Development Committee and serves on the Assembly Health Committee.

Rep. VanderMeer took a few minutes to talk with us about a handful of topical health care-related issues and what the Legislature may focus on during the remainder of the 2021-22 legislative session:

Question:

As a member of the Assembly Health Committee and a legislator who has worked on numerous health care-related polices, including Interstate Medical Licensure Compacts, what do you believe are the biggest health care-related challenges currently facing the state? What policy solutions do you believe are needed to address those challenges? Are you currently working on any health care-related legislation?

Rep. VanderMeer:

I think that there are always things that can be improved, and the mark of any successful organization is constantly trying to identify areas of strength and weakness – and adjusting accordingly to better serve the individuals and stakeholders they work with.

One thing that can get overlooked in the minutia of things is that here in Wisconsin, we’re consistently ranked high and commended for the quality of care that providers deliver. There are a variety of metrics one can utilize in that regard. For example, toward the end of 2018, the federal Agency for Healthcare Research and Quality (AHRQ) issued a State Snapshots ranking naming Wisconsin fourth in the nation for highest overall health care quality among all 50 states and first in the Midwest. I believe that part of my role as a legislator on the health committee especially, is to do what I can to help ensure health care providers, both specialty and primary care, have the tools they need to provide quality care to patients, and that whenever possible, state government is working with providers and not standing in their way. Trying to limit bureaucratic hurdles is an example of that and deciding how to allocate limited taxpayer resources is another.

One of the reasons I’ve been so pleased with the work that went into both the initial Interstate Medical Licensure Compact in 2015 and the Enhanced Nurse Licensure Compact in 2019, is that I believe that those compacts are examples of the Legislature responding to defined needs brought forth by health care providers – and ultimately allowing our state to participate in those compacts that provide direct benefits to patients and providers. It will probably come as no surprise that I’m currently working with the Wisconsin Occupational Therapy Association on an Occupational Therapy Compact with Senator Ballweg of Markesan. I’m also looking at some licensing efficiency reforms for Speech Language Pathologists with Senator Kooyenga of Brookfield. I believe the compact model, if done correctly, has been proven successful in improving access to quality care. Another important benefit of the compacts is that they can be especially beneficial for military families and their spouses relocating to our state. That’s something that’s particularly important me in part because my district includes Fort McCoy and borders Volk Field in Monroe County. I was pleased to author and pass legislation last session that creates a licensure reciprocity process for military spouses.

Question:

Given your past policy work on workforce and rural development issues, you are certainly familiar with the growing health care workforce shortage in Wisconsin and the stress it is putting on the delivery of patient care. Aside from your extensive work on health care licensure compact legislation, are there any potential programs or policies you are considering or willing to support that you believe would help address our health care workforce shortage?

Rep. VanderMeer:

During the 2017-2018 Legislative Session, the Rural Development Committee was able to include a grant program in the state budget that allocated $500,000 annually for training and retaining allied health professionals and $500,000 annually for training and retaining advance practice clinicians. I think that’s a decent model to look at. I recently was able to participate in an update call on that program with a health care provider, and they were very pleased with what they’ve been able to do with the resources provided under the program. That said, I might think about the overarching issues a bit differently than some of my colleagues, in part because of what you shared above pertaining to my background, my close ties to the military community, and my experience as a board member of a rural, critical care access hospital.

Unfortunately, I don’t believe there is a silver bullet. However, I think we can make significant strides if stakeholders continue to think about things more comprehensively. For example, when the military makes decisions on whether to create, maintain, grow, shrink, or eliminate installations, they consider a variety of factors that affect their operations and personnel in a local community and geographic region, and how those factors support their overall mission. What are those factors? Those are things like the quality of workforce opportunities and educational opportunities for families - both at the K-12 and higher ed level. Additional considerations, for example, could include quality broadband access and housing available for the civilian workforce. Anyone who has followed the Assembly Committee on Rural Development since I took over as chairperson in the 2017-2018 session, knows that we’ve proactively tried to bring together stakeholders to look at some of these key issue areas. I’m always interested to learn about and would consider new ideas to address the workforce shortage, especially as it pertains to the health care workforce.

Question:

What key health care-related initiatives, if any do you believe the Assembly Republican majority will make a priority during the remainder of the current legislative session?

Rep. VanderMeer:

That is a great question, and if anyone has any specific ideas, I encourage them to contact my office. With that said, given the nature of the legislative process, I’ve learned not to over-speculate on what might move forward, or make it across the legislative “finish line” outside of what I’m directly working on. I can share that I’m cautiously optimistic about the prospects of some of the proposals I’ve authored and mentioned previously on the Assembly side of things this session. Outside of that, I can share that there’s generally broad agreement in both houses as it pertains to professional licensing reform. With that in mind, I think most of the significant policy items that we’ll see this session were already enacted via the state budget bill. There were numerous items in the budget that reflect the priorities of the Assembly Republican Caucus and aim to increase access to care, provide additional support for of our most vulnerable citizens, and limit bureaucratic hurdles for patients and providers. Things like adequately and continually funding Medicaid Disproportionate Share Hospital (DSH) Payments for rural, critical care providers was a significant achievement in this session’s budget.

Question:

Different approaches and new innovations in health care can lead to higher quality, greater convenience, and lower costs across the health care system. Examples include price transparency, increased use of telemedicine, and direct primary care. In addition, the delivery of certain health care services in non-hospital settings, such as ambulatory surgery centers, can be less expensive and more convenient for the patient. What type of innovative ideas and policies do you support or are you interested in exploring to expand health care access and increase affordability?

Rep. VanderMeer:

I agree that different approaches and new innovations in health care can lead to higher quality, greater convenience, and lower costs across the health care system. There is certainly a greater demand for the increased use of telemedicine. That’s something I hear about quite a bit from the health care providers in my district, and the constituents I represent. If you were to look at a map of my district, you would see that in some cases, a trip to a provider can take an hour or more each way. That is a challenge for most people, especially those in need of regular care. In short, I will continue to support policies that knock down barriers to expand use of telemedicine. I will also continue to listen to patients and providers on what is the most effective and efficient delivery of care.

One question I try to ask myself when evaluating these types of approaches and innovations is, how does this create access for patients? It is a very important consideration for me that the vast majority of those I represent reside in more sparsely populated areas of the state. Obviously, as a patient, one either goes to receive care, or care comes to them. I think some of the different models of care outside of telehealth, like ambulatory surgery centers and home health care, are examples of care coming to an individual or to their community. I commend the hospital at home model that some of the larger providers in and around my district have had success with. I also co-sponsored the direct primary care bill in the 2019 session (vetoed by the governor), and I think it’s a worthwhile concept to consider again in the future.

The views and opinions expressed in this interview are those of the individual interviewed and do not reflect the position of WiHPCA.

By Hoven Consulting – WiHPCA’s Government Affairs Firm

The Wisconsin State Legislature will be back in session in September. After passing the biennial state budget bill in late June, lawmakers did not hold floor sessions in July and August. Typically, legislators utilize the summer months to engage with constituents in their districts and prepare bills for the fall and winter sessions.

However, legislative committees have been quite active in the past eight weeks as they held public hearings on bills likely to come to the floor during the fall session days.

The Assembly Committee on Health held a marathon public hearing in late July lasting nearly 6 hours on eleven separate pieces of legislation. These bills touched on a number of topics from newborn screenings to Medicaid reimbursement for pharmacist services to scope of practice for advanced practice registered nurses. The Senate Health Committee also heard a public hearing in July on similar bills.

While there will surely be a fair share of health care legislation that makes its way to the floors of both the Assembly and Senate, the big story of the fall will be legislative redistricting.

Wisconsin received its final census data numbers in August, triggering the beginning of the redistricting process. The Republican legislature will look to pass a bill this fall defining legislative district boundaries for the next ten years. However, the bill will almost surely be vetoed by Democratic Governor Tony Evers, which will then put the bill in the in hands of the Courts.

Census data showed significant population growth in Democratic-stronghold Dane County with some analysts predicting the county could pick up an entirely new Assembly seat. Conversely, Milwaukee County, another solid stronghold for Democrats, lost population. This means longtime Democratic districts will need to grow in geographic size out into more conservative Milwaukee suburbs.

Stay tuned for more updates on relevant health care legislation and the redistricting fight throughout the fall. 

• Republican William Penterman won the July 14 special election to represent the 37^th Assembly District, which includes portions of Dodge and Dane Counties. Penterman, a former legislative aide, captured 54 percent of the vote in defeating Democrat Pete Adams, who finished with 44 percent of the vote. With Penterman’s victory, Republicans will hold a 61-38 seat majority in the state Assembly.

• Lt. Gov. Mandela Barnes has announced he is running for U.S. Senate in 2022, meaning he won’t be seeking a second term as Wisconsin’s Lt. Gov. Barnes is the eighth Democratic to announce plans to run against Republican incumbent Senator Ron Johnson (if he chooses to run). Other Democrats seeking the seat include state Treasurer Sarah Godlewski, state Senator Chris Larson (Milwaukee), Outagamie County Exec Tom Nelson, and Milwaukee Bucks executive Alex Lasry.

• Gov. Tony Evers recently signed a bill (AB 406) into law to prevent any increase in unemployment insurance (UI) contribution rates paid by employers through the end of calendar year 2023. Under the law, the “UI tax freeze” will be offset by transferring $60 million in general fund revenue to the UI trust fund in each of the next two fiscal years. 

• In a rare bipartisan effort, U.S. Representatives Scott Fitzgerald (R-Juneau) and Gwen Moore (D-Milwaukee) have sent a letter to the U.S. Treasury Department requesting more guidance on spending federal COVID-19 relief. More specifically, they asked for greater clarification on how state and local governments can spend the federal funds without violating restrictions. Click here to read a recently released Legislative Fiscal Bureau memo on Wisconsin’s State and Local Fiscal Recovery Funds Under the American Rescue Plan Act.

• It was announced this week that Wisconsin could receive up to $400 million as part of a tentative $26 billion national legal settlement stemming from the opioid crisis. The proposed agreement would resolve the lawsuit states (including Wisconsin) brought against pharmaceutical manufacturers and distributors for their role in creating the opioid epidemic.

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 provides a tremendous opportunity for WiHPCA members to build or strengthen their relationships with local legislators and to educate them on issues important to hospice and palliative care professionals and their patients.

Please click here for more information on the program.

As was reported in previous editions of the WiHPCA Advocacy Newsletter, WiHPCA has launched a 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.

As a Key Contact, you can help influence the legislative process at both state and federal levels by cultivating relationships with elected officials. By taking advantage of existing relationships and making new contact with members of the Wisconsin Legislature and 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 your 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.