WiHPCA News

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.

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.