WiHPCA News

As you know, the 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.

We are happy to report the program is 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 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.

There is no question that members of WiHPCA are experts and leaders in Wisconsin’s hospice and palliative care industry. With that in mind, it is rewarding when our members are acknowledged in the media or other public forums for their relentless work and dedication to caring for patients with terminal and life-limiting illness. Not only does it recognize the hard work of our members, but it also helps educate the public on the importance of hospice and palliative care.

We are pleased to report that Rita Hagen, WiHPCA Board member and Executive Director of Hospice Alliance, penned an article – “COMMUNITY: Understanding Hospice Alliance's palliative care” – that was recently printed in the Kenosha News. Please CLICK HERE to read Rita’s article, which provides a tremendous overview of palliative care/Supportive Care Management and how it benefits individuals living with serious illness.

The U.S. Treasury last week issued guidelines for state and local governments on how they can access their share of the $350 billion in COVID-19 aid for state, local, tribal, and territorial governments included in the American Rescue Plan Act (ARPA).

It was also announced the state of Wisconsin will receive $700 million less in ARPA funding than originally anticipated – from and an anticipated $3.2 billion to an actual $2.5 billion. In addition, the direct federal funding to the state will be split into two payments a year apart. The reduction in funding is due to improvements in the state’s unemployment rate, which has returned close to pre-pandemic levels.

Governor Tony Evers (D) who has full control over the allocation of the federal aid had planned to put $700 million toward the state’s ongoing response to the pandemic and $2.5 billion toward economic recovery. That will now need to be revisited with less funding coming into Wisconsin.

Evers, along with Wisconsin U.S. Senator Tammy Baldwin (D) has sent a letter to the Biden Administration asking Treasury to reconsider the split payment approach.

The newly released rules provide guidance on allowable uses of the federal relief funding. The federal government’s funding objectives for the relief aid includes:

• Support urgent COVID-19 response efforts to continue to decrease spread of the virus and bring the pandemic under control.
• Replace lost revenue for eligible state, local, territorial, and Tribal governments to strengthen support for vital public services and help retain jobs.
• Support immediate economic stabilization for households and businesses.
• Address systemic public health and economic challenges that have contributed to the inequal impact of the pandemic.

State and local governments may use these funds to:

• Support public health expenditures, by, for example, funding COVID-19 mitigation efforts, medical expenses, behavioral healthcare, and certain public health and safety staff.
• Address negative economic impacts caused by the public health emergency, including economic harms to workers, households, small businesses, impacted industries, and the public sector.
• Replace lost public sector revenue, using this funding to provide government services to the extent of the reduction in revenue experienced due to the pandemic.
• Provide premium pay for essential workers, offering additional support to those who have and will bear the greatest health risks because of their service in critical infrastructure sectors.
• Invest in water, sewer, and broadband infrastructure, making necessary investments to improve access to clean drinking water, support vital wastewater and stormwater infrastructure, and to expand access to broadband internet.

Within these overall categories, recipients have broad flexibility to decide how best to use the funding to meet the needs of their communities.

For more information, please visit the U.S. Treasury website.

The Joint Finance Committee, the state Legislature’s budget writing committee, has begun voting to reshape Governor Tony Evers’ $91 billion state budget bill proposal. The most significant action the GOP-controlled committee took was the approval (along party lines) of a motion to pull more than 380 items from Evers’ two-year spending plan for the state. The items removed from the legislation were either non-fiscal policy items or provisions included by the governor that are opposed by the Republican majority in the Legislature.

More specifically, the motion removed the following health care-related items from the 2021-23 budget bill:

• Full federal Medicaid expansion
• Creation of a state-based Health Insurance Exchange
• Legalization of medical marijuana
• Raising to 21 the minimum age to purchase tobacco products

By removing the provision to expand Medicaid, Wisconsin is declining $1.6 billion in additional federal aid over the next two years, including $1 billion in American Rescue Plan Act (ARPA) funding for each state that approves Medicaid expansion. Proponents of the measure say expanding Medicaid eligibility would not only save the state money, but also provide health coverage to over 90,00 additional people.

Republicans who control the Legislature oppose Medicaid expansion, pointing to the lack of a coverage gaps between BadgerCare eligibility and eligibility for subsidies to purchase private coverage in the health insurance marketplace. They also believe expansion could put Wisconsin is a tough fiscal position in the future if the federal  government decides to reduce Medicaid contributions made to states. 

The Joint Finance Committee will continue to meet during the month of May to take further action on the budget bill. However, they are not expected to address major spending items, including Medicaid issues until next month.

Although much of the focus in the State Capitol is on development of the 2021-23 state budget bill – the $91 billion two-year spending plan for the state – lawmakers are also acting on stand-alone, non-budget legislation, including many that impact the delivery of health care in Wisconsin. Legislation of interest to health care professionals across the state that have been introduced and are currently being considered by the Legislature’s Health Committees include the following:

• Assembly Bill 66 - Relating to community health center grants and making an appropriation.
• Assembly Bill 86 - Relating to providing complementary and alternative health care practitioners with exemptions from practice protection laws, requirements and prohibitions for individuals who provide complementary and alternative health care services.
• Assembly Bill 184 - Relating to application of prescription drug payments to health insurance cost-sharing requirements.
• Assembly Bill 281 - Relating to registration of pharmacy technicians.
• Assembly Bill 290 - Relating to reimbursement of pharmacist services under the Medical Assistance program.
• Assembly Bill 295 / Senate Bill 308 - Relating to licensing and regulation of pharmacies and remote dispensing sites under the pharmacy practice law and the practice of pharmacy.
• Assembly Bill 296 - Relating to funding for free and charitable clinics and defining telehealth.
• Senate Bill 337 - Relating to prohibiting businesses from discriminating against customers due to vaccination record.
• Senate Bill 340 - Relating to reimbursement rates for behavioral treatment services under the Medical Assistance program.
• Senate Bill 342 - Relating to prohibiting the state or other governmental entities from discrimination based on whether the person has received a COVID-19 vaccine.

For a full list of bills currently being considered by the Assembly and Senate Health Committees, CLICK HERE to view Assembly bills and HERE to view Senate bills. You bill be able to read the bills in full and track their status as they move through the legislative process.

WiHPCA is committed to strengthening the relationship between hospice and palliative care professionals and key government policymakers that impact our industry through regulation and 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, we have created an exciting opportunity for members to regularly engage with the Division of Quality Assurance (DQA) at the Wisconsin Department of Health Services. 

In fact, on Thursday, June 10, WiHPCA is holding its second quarterly meeting with DQA. Please REGISTER TODAY for this unique opportunity. This webinar will not be recorded. Please plan to participate in the webinar and take advantage of live Q&A.

The purpose of the quarterly meetings – which are tentatively scheduled to be held every three months during the second week of the month – is to review and discuss survey deficiencies, examine avenues for improvement, and maintain a strong, ongoing dialogue between our members and DQA.

A more detailed agenda, a summary of questions, and other related materials will be sent to registrants prior to the meeting.

If you are interested in submitting a question for the June 10 meeting, please do so no later than close of business on Wednesday, May 26.

By Hoven Consulting

In February, Governor Tony Evers introduced his 2021-23 biennial budget proposal. The 1,000+ page document lays out the Governor’s preferred spending levels for all agencies and programs administered by state government for the next two fiscal years.

The challenge for Democratic Governor Evers is getting the Republican legislature to pass his spending bill. Many of the major tenants of the proposal, including marijuana legalization and accepting federal Medicaid expansion dollars, have already been rejected by legislative leaders.

The bill is now in the hands of the legislature’s budget-writing Joint Committee on Finance, a committee compromised of 6 Republicans and 2 Democrats from the Senate and 6 Republicans and 2 Democrats from the Assembly.

There are three core stages of the committee’s process. The first occurred earlier this month when the committee invited select administrative agency heads to testify and further explain the Governor’s spending proposals as it affects their agencies. This year, the committee spent two days hearing from the leaders of the Department of Public Instruction, the Department of Workforce Development, the Department of Natural Resources, and the Public Service Commission. These four agencies compromise a significant portion of overall spending, along with the Department of Health Services and Department of Administration, which were not asked to testify.

These hearings are largely fact-finding missions, with some political barbs thrown in from time to time. They provide an early glimpse on how the legislature’s priorities differ from the Governor’s.

As of this writing, the committee is now in its second stage of holding hearings around the state to gain input from the public on how to prioritize spending. The first hearing was held in Whitewater on April 9, the second in Rhinelander on April 21, Menomonie on April 22, and finishing with a virtual hearing on April 28.

The public hearings are typically long days with hundreds of individuals testifying on a wide variety of issues. They provide the committee with general trends on what is important to the public and informs the committee’s third and final stage.

In May, the committee will begin voting agency by agency on its own spending proposals. They will typically meet two to three times a week each week in May spending many hours each day debating and voting on each proposal. This is the most important stage of the committee’s process as it’s basically the final chance to fight to put a priority in the budget or keep a bad proposal out of the budget.

This year, we expect significant departures from the committee’s (legislature’s) final budget proposal compared to the Governor’s. While proposals are beginning to solidify, much remains to be seen on major spending initiatives.

Complicating the matter is the $3.2 billion the state is receiving from the federal American Rescue Plan Act. Governor Evers has complete discretion on how to spend these dollars without any legislative approval. It seems the legislature wants to know the details of the Governor’s plan to inform their budgeting initiatives.

Once the committee finishes its voting in May, the bill will go to the full legislature for a vote in both houses. The goal is for that to occur in June as the fiscal year ends July 1. In Wisconsin, the governor has the ability to line-item veto spending bills. In other words, he or she can veto portions of the budget bill without vetoing the bill in total. In 2019, Governor Evers vetoed many items in the bill that eventual passed the legislature. That is expected to occur again.

In short, the budget process is a long, somewhat messy undertaking with priorities and ideas that seem to shift daily. It’s not really until the dust settles after the Joint Committee on Finance finishes voting in May that the public gets a good idea of a final proposal. Stay tuned for updates as the process continues.

Last week President Biden signed into law the Medicare Sequester Relief Act that pauses through the end of the year an automatic 2% cut for all Medicare payments to health care providers. The bill enjoyed strong bipartisan support in Congress, passing 384-38 in the U.S. House of Representatives and 90-2 in the Senate.

Congress initially paused the cuts last year as the COVID-19 pandemic unfolded and have made several extensions since. Although the moratorium on the 2% reduction ended on March 31, the Centers for Medicare & Medicaid Services has not been enforcing the cuts in anticipation of the Sequester Relief Act passing to ensure providers were not negatively impacted.

The moratorium extension gives health care providers much-needed financial relief as they continue to grapple with the pandemic that has stretched resources and created unprecedented challenges in the delivery of quality care.

The April 6 spring election had two special legislative races on the ballot to fill vacancies in Wisconsin’s 13th Senate District and 89th Assembly District.

Current State Representative John Jagler (R-Watertown) won his bid for the 13th Senate District seat to replace former Senator Scott Fitzgerald who was elected to Congress last fall. Jagler captured 51 percent of the vote, while his Democrat challenger, Melissa Winker received 44% of the vote.

Once Jagler is sworn into office in his new role as state senator, Republicans will hold a 21-12 majority in the Senate.

In the 89th Assembly District special election, Republican Elijah Behnke easily defeated Democrat Karl Jaeger, capturing 63 percent of the vote. Behnke will fill the seat vacated by Republican John Nygren, who resigned from office in December 2020.  

With Behnke’s victory, Republicans will hold a 61-38 seat majority in the Assembly.

Representative Rozar (R-Marshfield) is a freshmen lawmaker who was elected to the state Assembly in November 2020. She represents the 69th Assembly District, which includes portions of Clark, Marathon, and Wood counties. It also includes most of the City of Marshfield.

Prior to running for office, Rep. Rozar worked as an emergency room and medical-surgical registered nurse. She was also a nurse educator at UW Eau Claire College of Nursing before retiring from that position in May 2020. She continues to be employed by the Marshfield Clinic as a casual cardiac medical-surgical clinical RN.

She also continues to serve as a Wood County Board Supervisor, and currently chairs the Health and Human Services Committee.

In the Assembly, Rep. Rozar serves on the Assembly Health Committee and has been involved in the development of several health care-related legislative proposals.

Please CLICK HERE to read Rep. Rozar’s guest article written specifically for our Advocacy Newsletter. It is part of our effort to introduce members to the thoughts and opinions of state elected officials and policymakers.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of WiHPCA.