WiHPCA News

The COVID-19 pandemic has had an unprecedented impact on the nation's healthcare system, requiring providers to embrace innovation and rely heavily on technology and telehealth to deliver quality care to patients. 

Moreover, the pandemic highlighted the need to update telehealth coverage rules, leading Congress to provide emergency (and temporary) telehealth waivers designed to ensure safe access to care for seniors and other vulnerable populations. The recently introduced Telehealth Modernization Act would ensure the emergency expansions of telehealth coverage for Medicare beneficiaries are made permanent.

One critical provision of this bill would extend existing flexibilities that allow Medicare to cover more telehealth services used for hospice care.

Fortunately, you can play an important role in helping to move the bipartisan Telehealth Modernization Act through the legislative process by urging your Members of Congress to support this important legislation and ensure telehealth flexibilities are made permanent beyond the COVID-19 Public Health Emergency.

It only takes a few minutes to contact your federal lawmakers through the National Hospice and Palliative Care Organization’s Hospice Action Network. Simply CLICK HERE to be an advocate for the hospice care and help advance the Telehealth Modernization Act.

As was reported in last month’s WiHPCA Advocacy Newsletter, the Association 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 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.

All too often, citizens believe they cannot influence the political and policymaking process. Fortunately, that perception is NOT ACCURATE, as lawmakers are eager to hear input from their constituents. In fact, they have a duty to listen to and address the concerns of their constituents, including those working in the hospice and palliative care industry.

One of the most important steps WiHPCA members can take to protect our industry from harmful policies and position us for beneficial legislation in the future is to develop a relationship with their state legislators.

Please contact your state lawmakers TODAY, introduce yourself and educate them on the importance of the hospice and palliative care industry in Wisconsin.

BACKGROUND:

Hospice and palliative care professional across Wisconsin provide quality care for patients facing a terminal or life-limiting illness. WiHPCA members play a pivotal role in the lives of these patients and their families, and the services they provide are an essential component to the state’s health care infrastructure.

However, in many cases policymakers inadvertently overlook the importance of hospice and palliative care and the positive impact it has on many on their constituents. With that in mind, it is increasingly important for WiHPCA members to remind their state lawmakers about the need to address the regulatory challenges facing the industry and to encourage their support for innovative, effective approaches to enhance hospice and palliative care in Wisconsin. 

WHAT YOU CAN DO TO HELP:

E-mail your state legislators today and educate them on the important role hospice and palliative care plays in the Wisconsin Health Care system. Please feel free to use WiHPCA’s sample e-mail when contacting your lawmakers. All you need to do is cut-and-paste it into an e-mail. Also, please attach the WiHPCA 101 document linked below to your e-mail to legislators.

If you don’t know who your state legislators are, or do not have their contact information, simply CLICK HERE and type your home address in the upper right corner text box. Remember to contact both your state senator and state representative.

If you have any questions on this WiHPCA Advocacy Action Alert request or would like additional information, please contact WiHPCA at erik@hovenconsulting.com or tim@hovenconsulting.com.

ACTION ALERT RESOURCES:

·     Sample e-mail to legislators

·     WiHPCA 101 document

Earlier this month, Congress passed, and President Joe Biden signed into law the American Rescue Plan Act of 2021. The sweeping $1.9 trillion legislative package includes a wide range of funding programs and policies to aid individuals, businesses, and communities across the county with additional COVID-19 relief. In addition to direct $1,400 stimulus payments to individuals, extended unemployment benefits, housing assistance and funding for states, large cities, and schools, the American Rescue Plan also includes funding for the COVID-19 public health response and numerous health care-related initiatives, including:

·     $8.5 billion to track, administer and distribute COVID-19 vaccines.

·     $47 billion for diagnosing and tracing COVID-19 infections.

·     10% increase to Federal Medicaid Assistance Percentage for home and community-based services (HCBS), which equates to a $12.67 billion payment increase for HCBS from April 1 of 2021 through March 31, 2022.

·     $8.5 billion in payments for rural Medicare and Medicaid providers – including hospitals, clinics, home health, and hospice – for COVID-19-related expenses and lost revenue.

·     $200 million for infection control and vaccination uptake in skilled nursing facilities.

·     Requires COVID-19 vaccine coverage without cost-sharing for Medicaid beneficiaries.

·     Increases health insurance premium assistance for individual coverage on the Affordable Care Act Marketplace for 2021 and 2022

For more information on the American Rescue Plan, please review a comprehensive overview of the new law provided by the National Conference of State Legislatures (see page five for health and human services provisions).

The Wisconsin Legislature's powerful budget-writing committee – the Joint Finance Committee – will hold four public hearings next month on Governor Tony Evers' proposed $91 billion state budget bill. The committee has scheduled three in-person hearings and one virtual hearing for the following dates and locations:

·     April 9 – University of Wisconsin-Whitewater

·     April 21 – Rhinelander, WI (Hodag Dome)

·     April 22 – University of Wisconsin-Stout (Menomonie, WI)

·     April 28 – Virtual hearing

The public hearings will begin at 10:00 AM and conclude at 5:00 PM. Due to COVID-19, capacity at each hearing site will be closely monitored. Individuals wishing to testify at the virtual hearing will be required to register in advance.

The hearings will provide the public with an opportunity to comment on the state’s two-year spending plan and suggest modifications to the proposal before the Finance Committee votes to make what is anticipated to be extensive changes to Evers' budget bill. Once the committee finishes its work, the budget bill will be considered by the full Legislature.

For individuals who cannot attend the public hearings, but wish to comment on the budget proposal, the following online portal is available for the public to provide input on the bill: www.legis.wisconsin.gov/topics/budgetcomments.

If you have any questions on the state budget bill, would like more information, or need assistance on how to engage in the budget process, please contact WiHPCA’s government affairs team at Hoven Consulting.

The Department of Health Services (DHS) announced today that individuals age 16 and older with certain medical conditions will be eligible for the COVID-19 vaccine beginning March 22, which is earlier than previously expected. This eligibility group includes individuals with medical conditions associated with an increased risk of severe illness from COVID-19.

The next eligibility group, which again will begin March 22, 2021, includes individuals age 16 and over with the following medical conditions:

·     Asthma

·     Cancer

·     Cerebrovascular disease

·     Chronic kidney disease

·     COPD

·     Cystic fibrosis

·     Down syndrome

·     Heart conditions

·     Hypertension or high blood pressure

·     Immunocompromised state

·     Liver disease

·     Neurologic conditions

·     Obesity or overweight

·     Pregnancy

·     Pulmonary fibrosis

·     Sickle cell disease

·     Type 1 or 2 diabetes mellitus

·     Thalassemia

Individuals with the outlined medical conditions can access vaccine through a variety of options, including community-based clinics, health care providers, Local and Tribal Health Departments, and pharmacies. Wisconsinites with a primary care provider may hear directly from their provider. Visit the Wisconsin COVID-19 vaccine options page or call the vaccine hotline at 1-844-684-1064 to learn more.

Additionally, DHS clarified current eligibility to include all clergy (as part of health care personnel who provide spiritual care to the sick), restaurant workers (as part of the food supply eligibility group) and further expanded public safety to include judges, prosecutors, and other essential criminal court personnel, in addition to public defenders.

Depending on vaccine supply, DHS still anticipates that Wisconsin will be able to expand eligibility May 1 to include all individuals age 16 and older. DHS will continue to monitor vaccination coverage statewide and partner with vaccine providers in order to provide an updated vaccination timeline for the general public.

For information, resources, and data related to Wisconsin’s COVID-19 vaccination program, visit the COVID-19 vaccine webpage.

As our members know, 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. As part of that effort, WiHPCA has established quarterly meetings with the Division of Quality Assurance (DQA) at the Wisconsin Department of Health Services. The purpose of the quarterly meetings is to review and discuss survey deficiencies, examine avenues for improvement, and maintain a strong, ongoing dialogue between our members and DQA. The first meeting, which was held virtually on March 11, was a great success and well attended by both WiHPCA members and DQA employees. Following an opening statement by WiHPCA Legislative Committee Chair Rita Hagen and the introduction of DQA officials, the meeting started with a presentation – per our request – on the required organizational background checks due in 2021. DQA also directed attendees to the following memo (DQA Memo 21-02) regarding four-year renewals of organizational background checks. In addition, DQA officials answered the following questions that WiHPCA sent to the agency prior to the meeting: Please update WiHPCA on the status of COVID-19 testing efforts in long-term care and assisted living facilities and any expected changes to testing plans moving forward – both in the short and long-term. DQA reported there are no anticipated changes to testing plans. Nursing Homes – See Memo QSO-20-38-NH Assisted Living – See GovDelivery Message HERE What is the status of COVID-19 Focused Infection Control Surveys and what plans, if any are there for future audits? In addition, can DQA share the current findings of the surveys? QSO Memo – With Focused Infection Control Tool – See QSO-21-08-NLTC Disease Reporting Requirements at DHS 145.04(1)(c) Bureau of Communicable Diseases Memo 2020-17 DQA provided an overview of recent complaint investigations and outcomes, as well as trends regarding the types of recently filed complaints.  Please share the Division’s thoughts on the potential need and benefits of convening a small taskforce to review and update the Hospice and Facility Interface document, which the state and HOPE last updated in 2012.  P-00252 – Hospice-Nursing Home Interface According to DQA, this effort would require the involvement of several bureaus within the agency, making a review and update of the Interface document difficult. However, they are open to the possibility in the future. Our next quarterly DQA meeting is scheduled for June. If you have any questions about the March 11 DQA meeting or upcoming meetings, please contact the WiHPCA office.

First elected to the state Assembly in 2012, Representative Joe Sanfelippo (R-New Berlin) represents the 15^th Assembly District, which includes portions of Waukesha and Milwaukee counties. The district also includes the city of New Berlin and part of West Allis. 

Before running for office, Rep Sanfelippo spent all his professional life in the private sector. He was the owner and operator of landscaping business for over 20 years, and he still operates a small Christmas tree farm. In addition to drawing on his experience as a small businessman to champion pro-business, pro-growth policies in the Legislature, as the long-time Chairman of the Assembly Health Committee, Rep. Sanfelippo has focused his policymaking efforts on health care issues and challenges facing the state.

Over the years, Sanfelippo has worked on numerous proposals to help improve the delivery of quality patient care, including legislation passed by the Legislature last session –but ultimately vetoed by Governor Tony Evers – to recognize and properly regulate direct primary care in Wisconsin. Under the direct primary care model, patients pay a monthly fee, with no further co-pays or deductibles, and in return receive unlimited access to their primary care doctor.

In the current legislative session, Sanfelippo has been a leading voice on COVID-19 vaccine distribution and authored legislation recently passed into law that authorizes pharmacy technicians with proper training and supervision to administer vaccines.

Rep. Sanfelippo took a few minutes to talk with us about a handful of topical health care-related issues and what his health care policy priorities are for the 2021-22 legislative session:

QUESTION: You are serving another session as Chairman of the Assembly Health Committee, which plays a vital role in shaping health care policy in Wisconsin. With that in mind, what do you believe are the most pressing health care-related challenges facing the state, and what policy solutions do you believe are needed to address those challenges?

Rep. Sanfelippo: The immediate issue at hand of course is to make sure we are getting vaccines to everyone who wants them as quickly as possible. The administration made such a mess by unnecessarily bogging down the initial rollout in bureaucratic red tape and only shaped up once the legislature began putting pressure on them. We need to eliminate their bureaucratic barriers to vaccination and continue our oversight to compel them to improve.

The other issue garnering much of my efforts will be to combat the Governor’s ridiculous idea to legalize marijuana. The potentially dangerous health implications are very serious according to every health care organization and official, especially for our kids which makes this politically motivated proposal even more reckless.  

QUESTION: Outside of the state’s leading health care issues you mentioned above, what other health care-related proposals do you or your committee plan to pursue during the 2021-22 legislation? For example, last session you authored the direct primary care bill that would have exempted direct primary care agreements between a health care provider and a patient from Wisconsin’s insurance laws. Do you plan to reintroduce that bill or other legislation that would modify the traditional delivery of medical care in Wisconsin?

Rep. Senfelippo: We will continue focusing on innovative ideas that expand access and increase affordability while keeping the decision making between the doctor and patient where it belongs.

QUESTION: Prior to COVID-19, Wisconsin was facing a growing shortage of health care professionals, from physicians and nurses to CNAs and mental health care providers . The pandemic has only magnified the shortage and has put additional stress on the delivery of care in Wisconsin. Are there any potential programs or policies you are considering or willing to support that would help address the state’s health care workforce shortage?

Rep Sanfelippo: We can continue to work on education and tax incentives to encourage individuals to enter the health care fields with the most critical shortages. In addition, we must look at MA rates for certain sectors. Many of these services have not had any or only minimal increases in the past decade making hard for businesses to compete with the rest of the community for employees.  

QUESTION: As part of his 2021-23 budget bill proposal, Gov. Evers once again recommended Wisconsin accept the federal Affordable Care Act's provision for Medicaid expansion, stating the expansion would provide healthcare coverage over 45,000 uninsured low-income families in Wisconsin and reduce state healthcare costs by $630 million over the two-year budget cycle. The Legislature removed the initiative form the Governor’s 2019-21 budget proposal, and it appears likely lawmakers will once again remove the provision. What is your position on the issue, and why?

Rep. Sanfelippo: MA expansion is DOA in my book. There is plenty of proof by looking at those states which did expand in the past to see the disaster it has caused for state budgets. Furthermore, adding another 45,000 individuals to a system that is already struggling to provide enough care for members is a recipe for disaster. 

QUESTION: Last month, Gov. Evers recently vetoed Assembly Bill 1, the Legislature’s broad COVID-19 relief legislation. As a result, several of the bill’s provisions have been introduced as separate legislation. What steps, if any, do you believe the Legislature should take next to address the public health aspects of COVID-19, the continued roll out of vaccines, and any additional federal funding the state will receive to address the pandemic?

Rep. Sanfelippo: The best thing the legislature can do is to continue our close oversight of the process. We know from experience that Governor Evers’ administration is severely challenged when it comes to carrying out day-to-day operational duties of an agency under demand. Just look at DWD and the unemployment mess. As soon as the legislature came back in last January, we made the vaccination rollout issue #1 and put the heat on the agency to shape up. Now that Secretary Palm has shipped out, we continue to be vigilant in our oversight and to address issues as they arise. 

State residents can sign up for weekly emails containing updates, news, and resources

The Department of Health Services (DHS) announced today a newsletter the public can sign up for to get direct information about the COVID-19 response and vaccine rollout. Every Friday, a COVID-19 update newsletter will be sent via email to people who sign up to receive it. Registration is now open, and archived copies of the weekly newsletter will also be available.

“Throughout this pandemic, we have remained committed to keeping the residents of Wisconsin as informed as possible,” said Secretary-designee Andrea Palm. “The more quality information we have, the more effective we can be in making healthy and safe choices. That is why we have regularly updated data dashboards and science-based guidance on our website, and it is also why we want to add a weekly newsletter to our communications toolbox.”

View the entire news release.

Reminders and updates for members:

• The state holds weekly updates for vaccinators and stakeholders.  These webinars are Fridays at 9am.  Past webinars are also available on line.
• The state has updated its information on the vaccinate enrollment process.  This and past information are available on the state’s website for COVID-19 vaccinators.  Check here to learn more about enrolling as a vaccine provider and related resources.
• The state also launched a new vaccine page for the public.  This includes a summary of vaccine allocated, shipped and administered.