WiHPCA News

The Boards of Directors of the National Association for Home Care & Hospice (NAHC) and the National Hospice & Palliative Care Organization (NHPCO) signed a non-binding Letter of Intent earlier this week to jointly explore the formation of a new as-of-yet unnamed organization that combines the strengths of NAHC and NHPCO, creating a better and more powerful advocate for the entire home care, hospice, palliative care, and serious illness community.

The purpose of combining the two leading organizations serving providers of care to America’s elderly, disabled, and dying is simple: to better serve you. Both Boards voted for this course of action following the recommendations of a Steering Committee composed of member and staff leaders from both organizations. The Steering Committee’s recommendations were informed by consultation with members of both organizations. The Committee has been working, with the support of association consulting firm McKinley Advisors, since the March 8, 2023 joint announcement (NAHC website, NHPCO website) that NHPCO and NAHC would explore opportunities for deeper collaboration.

“The collaborative process of the NHPCO and NAHC Boards over the last five months has brought the two organizations closer together,” said Kenneth Albert, R.N., Esq., NAHC Board Chair, and President and CEO of Androscoggin Home Healthcare + Hospice. “In addition to the Board-level discussions, our organizations have been collaborating on multiple advocacy efforts, as well as projects such as the Value of Hospice research. Through these efforts, it has become crystal clear that we can do more on behalf of our members by working together. If the current discussions do not lead to a new, combined organization, the outcome will nevertheless be closer working relationships on behalf of community-based and home care providers.”

“The American healthcare system is shifting, and home and community-based care options are increasing in a multitude of forms across the country,” said Melinda Gruber, PhD, MBA, CNA, NHPCO Board Chair, and President of Caring Circle/Vice President, South Region, Medical Group and Continued Care of Corewell Health. “With decades of experience in hospice and home care, NHPCO and NAHC members are the long-standing experts, and they are evolving to meet patient needs in a shifting environment. As we look ahead, we see an opportunity for the organizations representing those providers to evolve. In this time of change, we are acting with intention and care to continue meeting the needs of providers, patients, families, and communities well into the future.”

To facilitate an effective process, both Boards have decided to suspend elections for new Directors this year.

We know our members may have many questions about this process and how a new combined organization will affect them. NAHC and NHPCO will be updating and consulting our members throughout this process to address your questions and concerns as quickly as possible.

Many details are still being determined and in the coming months, the NAHC and NHPCO Boards of Directors will work together, in consultation with member volunteers from both organizations, to determine how a consolidated organization could represent the best interests of the combined memberships. The organizations expect this process to take six to ten months, but getting it done right will be more important than getting it done quickly. McKinley will continue to support the process as an independent, third-party advisor.

In the meantime, you may be assured that staff of both organizations will continue to work as hard as possible to serve your needs, advocate for your interests, and strengthen the entire hospice, home care, and home health community.

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

·         How Emerging Hospice Regulations Could Impact Providers

• By Holly Vossel | Aug. 24, 2023

Increased hospice oversight aimed at curbing fraud in the industry could come with a mixed bag of financial and operational impacts for providers. The U.S. Centers for Medicare & Medicaid Services (CMS) has honed in on hospice program integrity, rolling out a swath of new measures to reduce fraud, waste and abuse in the space. During the past two years, CMS has introduced new regulations, updated survey process, increased auditing activity and enhanced reviews of providers’ claims, patient eligibility and quality data. Read more…

·         CMS: Nearly 400 Hospices Considered for ‘Administrative Action’ as Program Integrity Efforts Heat Up

• By Jim Parker | Aug. 22, 2023

The U.S. Centers for Medicare & Medicaid Services (CMS) is considering administrative action against 400 hospices, which could include revocation of their Medicare certification. The agency has been mobilizing against hospice fraud this year. In addition to new regulations and updated survey processes, CMS has been conducting unannounced onsite visits. To date, CMS personnel have appeared at 7,000 locations, with plans to visit every hospice site in the country. Read more…

·         Continuity of Palliative Care Often Disrupted at Hospital Discharge

• By Jim Parker | Aug. 22, 2023

Patients who receive palliative care in a hospital often have trouble finding a provider to continue those services after they return home. The number of hospitals that offer palliative care has grown exponentially during the past two decades. As of 2020, more than 83% of U.S. hospitals with 50 or more beds had a palliative program, up from 25% in 2000, according to the Center to Advance Palliative Care (CAPC). Read more…

·         Hospice Advocacy Groups Call on CMS to Delay, Revise Special Focus Program

• By Jim Parker | Aug. 21, 2023

A coalition of industry groups has spoken out about the design of the U.S. Centers for Medicare & Medicaid Services (CMS) forthcoming Special Focus Program (SFP) for hospices. CMS initially pitched the idea in 2022 but instead convened a Technical Expert Panel (TEP) to further guide development. The TEP completed its work late last year, and now, per the 2024 proposed home health rule, the agency wants to move ahead with it next year. Read more…

·         CMS Proposed 2024 Physician Fee Schedule Introduces New Supports for Family Caregivers, Social Determinants

• By Jim Parker | Aug. 18, 2023

The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed new pathways to support family caregivers for patients with serious illnesses. The agency’s 2024 physician fee schedule proposed rule contains a number of provisions related to caregiver assistance, health equity, interdisciplinary care and social determinants of health. Read more…

·         What Hospices Can Learn from Home Health Agencies on New Program Integrity Rules

• By Jim Parker | Aug. 8, 2023

Hospices seeking to gauge the potential impact of new regulatory actions in the space can look to their counterparts in the home health field. The steps that the U.S. Centers for Medicare & Medicaid Services (CMS) has put forth to strengthen hospice program integrity mirror rules implemented in years past for home health providers, including medical review processes and rules for when a provider can sell their business. Read more…

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

The WiHIPCA 2023 Annual Conference features a combination of dynamic keynote presentations and impactful breakout sessions of interest to all hospice and palliative care professionals. Invited speakers include leading subject experts from Wisconsin and across the country. The conference will be held Sept. 26 at the Glacier Canyon Lodge at the Wilderness Report in the Wisconsin Dells. REGISTER TODAY!

By Hoven Consulting – WiHPCA’s lobbying firm

• Fiscal Year 2023-2025 Finalized State Budget Highlights

The following are highlights of the finalized Fiscal Year 2023-2025 state budget, which was signed into law by Governor Tony Evers on July 5, 2023. 

Department of Health Services (DHS) – The approved DHS budget increased spending by $3.1 billion overall over the biennium. 

Department of Safety and Professional Services

• WiHPCA Requests Hospice or Palliative Care Provider to be Appointed to DHS Complex Patient Program Advisory Group

On July 17, WiHPCA leadership sent a letter to Wisconsin Department of Health Services (DHS) Secretary-designee Kirsten Johnson requesting that a hospice or palliative care provider be appointed to the advisory group for the new complex patient pilot program.  This pilot program, which was funded at $5 million in the recently enacted FY2023-2025 state budget, is focused on successfully transferring patients with complex medical needs from acute care facilities to post-acute care facilities.  WiHPCA made this request as hospice and palliative care providers have extensive experience providing post-acute care in community settings, are well acquainted with the nuances associated with caring for those with complex medical needs and are also well-versed in the financial and administrative elements of myriad government programs. 

• Improved Finances for State Medicaid Fund

DHS has projected that the state Medicaid fund ended state fiscal year 2023 with a $875.5 million surplus compared to the FY2021-2023 budgeted amount.  In addition, the surplus is $79.1 million more than what DHS projected this past spring.  This surplus was due to a number of factors, including lower costs for prescription drugs and long-term health care.  Once the surplus amount is finalized and confirmed at the end of July 2023, surplus funds will be transferred to the state’s general fund. 

• DHS Annual Adjustment to Patient Health Care Record Fees

Each year on July 1, DHS is required by state law to adjust the maximum fees (factoring in the change in the consumer price index) that health care providers may charge for patient medical records.  The updated fee schedule may be viewed on the Legislature’s website. 

On Aug. 10, the Assembly Health, Aging and Long-Term Care Committee will hold a public hearing on Assembly Bill 189, legislation that would create new requirements regarding the reporting of deaths to a medical examiner or coroner. More specifically, the bill would require a person that is currently obligated to report deaths and has knowledge of a death that occurred within 24 hours after an individual has been  admitted to a hospital or similar institution to contact the medical examiner or coroner to determine whether the death is reportable under current state law.

WiHPCA is seeking an amendment to the bill to exempt hospice agencies from the legislation’s  requirement to notify a medical examiner or coroner of deaths that occur within 24 hours. The bill as written would create additional stress and an administrative burden on hospice staff, as there are numerous (and expected) deaths that occur at hospice facilities within 24 hours of admittance. According to one mid-size agency located in southern Wisconsin, they have between 15 to 20 death a month that would require them to contact the coroner or medical examiner under the bill’s provisions.

The WiHPCA Government Affairs Team is currently working with lawmakers on the amendment described above. In addition, WiHPCA will be testifying at the hearing and will be asking select members to contact their legislators on the amendment.

Earlier this month, WiHPCA leaders met with the Wisconsin Department of Health Services’ Office of Inspector General (OIG) to discuss the growing – and highly concerning – trend of hospice fraud in other states and how Wisconsin can avoid similar fraud.

WiHPCA Board members Lynne Sexten (Chair) and Karen Carrig met with Inspector General Anthony Baize and his team to pass along critical information on new types of hospice fraud that has been seen across the country – starting in California a few years ago and spreading to Nevada, Texas, and Arizona, among a handful of other states. They also shared critical data and a sampling of national articles regarding hospice fraud that the OIG can use to help prevent similar fraud in Wisconsin.

The OIG appreciated the information and said they found the meeting highly valuable. They also expressed a desire to continue an open line of communication with WiHPCA and our members to help tackle potential hospice fraud.

Republican Paul Melotik (R-Grafton) defeated Democrat Bob Tatterson (D-Mequon) in a special election held on July 18 to fill the vacant 24th Assembly District –which includes portions of Ozaukee, Washington, and Waukesha Counties.

Melotik won the historically Republican-leaning district with 53.7% of the vote, compared to Tatterson’s 46.3% vote total. The Melotik victory gives the GOP a 64-35 majority in the 99-member Assembly.

Melotik, an accountant, small business owner, and former local official who has served on the Ozaukee County Board and Town of Grafton Board, will replace Dan Knodl (R-Germantown) in the Assembly. Knodl was elected to the state Senate (8th Senate District) in an April 4 special election.

From the Desk of the National Hospice and Palliative Care Organization(NHPCO)

The National Hospice and Palliative Care Organization (NHPCO) and its advocacy affiliate, the Hospice Action Network (HAN) are pleased to support the reintroduction of the Palliative Care and Hospice Education and Training Act (PCHETA) in the U.S. Senate. This bipartisan legislation (S. 2243) would meet the growing demand for serious-illness care by investing in training, education, and research for the palliative care and hospice workforce.

The bill has been introduced by Senator Tammy Baldwin (D-WI) and Senator Shelley Moore Capito (R-WV). This bill is also co-sponsored by Senators Kyrsten Sinema (I-AZ), Lisa Murkowski (R-AK), Jeff Merkley (D-OR), Mike Rounds (R-SD), Jack Reed (D-RI), Cindy Hyde-Smith (R-MS), Kirsten Gillibrand (D-NY), Marsha Blackburn (R-TN), John Boozman (R-AR), Roger Marshall (R-KS), Maria Cantwell (D-WA), and Angus King (I-ME).

“Having served as my grandmother’s primary caregiver, I know the difference quality palliative and hospice care can make for a loved one who is battling a serious illness,” said Senator Baldwin. “Our bipartisan Palliative Care and Hospice Education and Training Act will make an overdue investment in education and research to ensure doctors, nurses, and health care professionals have the tools they need as they work tirelessly to keep patients with serious or life-threatening illnesses comfortable and safe. This legislation will help more Americans get the training they need to provide palliative care, help strengthen our health care workforce, and also ensure those with serious illness get the care they deserve.”

“The need for high quality palliative and hospice care services—which are vital for patients and their families—continues to grow, making passage of our bill needed now more than ever,” said Senator Capito. “As a caregiver for parents that suffered from Alzheimer’s disease, I saw firsthand just how valuable these services can be. In order to preserve access to this care, our bill would strengthen training and education opportunities for individuals working in these fields. I look forward to working with Senator Baldwin and my colleagues in the Senate to pass this legislation.”

Palliative and hospice care focus on improving patients’ quality of life and relieving suffering from serious illnesses and pain management. Findings from a recent study on the Value of Hospice Care, by NORC at the University of Chicago, show that at any length of stay, palliative and hospice care benefits patients, family members, and caregivers, including enhanced quality of life, increased satisfaction, reduced physical and emotional distress, improved pain control.

“Every American facing a serious or life-limiting illness deserves access to quality hospice and palliative care. We desperately need to train more professionals in the field of palliative medicine. Without efforts to address the existing workforce shortage, there will be only one palliative physician for every 26,000 seriously ill patients by 2030,” said COO and interim CEO of National Hospice and Palliative Care Organization, Ben Marcantonio. “Thank you to Senators Baldwin and Capito for your leadership in reintroducing the Palliative Care and Hospice Education and Training Act.”

PCHETA is a critical next step in training and education to address the healthcare workforce crisis as the American population continues to age.

The Hospice Action Network, an affiliate of the National Hospice and Palliative Care Organization (NHPCO), is charged with implementing NHPCO’s public policy agenda through direct lobbying, grassroots advocacy, and by empowering Hospice Advocates to share their hospice story with Congress. The Hospice Action Network’s mission is to advocate, with one voice, for policies that ensure the best care for patientsand families facing serious illness and the end of life.

Please CLICK HERE to review federal legislation the Hospice Action Network is lobbying on during the 118^th Congress (2023-24).

Department of Health Services

The budget bill signed into law by the Governor increased DHS spending by $3.1 billion overall over Fiscal Year 2023-2025. 

Good news – The approved budget includes $2.5 million to expand allied health professional education and training grants.  It also expanded eligibility to registered nurses. 

• Medicaid/Medical Assistance

• o    Nursing Home Support Services:  Provide $73,200,000 in FY2023-24 and $73,200,000 in FY2024-25 to increase the support services portion of Medical Assistance program reimbursement for nursing homes. Require DHS to establish and implement a priced rate for nursing home support services based on median facility costs, plus 25 percent.
• o    Nursing Home Ventilator Dependent Rate:  Provide $5,000,000 in FY2023-24 and $5,000,000 in FY2024-25 to increase the all-encompassing ventilator-dependent resident reimbursement rate for nursing home care. Require DHS to increase the reimbursement rate under the Medical Assistance program for an authorized facility treating a resident of the facility who has received prior authorization for ventilator-dependent care reimbursed under the all-encompassing ventilator dependent resident reimbursement rate by $200 per patient day.

• Elder and Disability Services

• o    Aging and Disability Resource Centers (ADRCs):  Provide $2,513,700 in FY2023-24 and $5,027,400 in FY2024-25 in funding increases.
• o    Complex Patient Pilot Program:  Provide $5,000,000 in FY2023-24 on a one-time basis to help facilitate the transfer of complex patients from acute care settings, such as hospitals, to post-acute care facilities, such as nursing homes.

• Public Health

• o    Allied Health Professional Training:  Provide $2,500,000 annually to expand allied health professional education and training grants.  Expand eligibility for the program to include registered nurses.
• ·         Behavioral Health
• o    Telemedicine Crisis Response Pilot Program:  Provide $2,000,000 in FY2023-24 for a telemedicine crisis response pilot program.

Department of Safety and Professional Services

• Occupational Credentialing
• • Software:  $3.57 million for occupational credentialing software and related maintenance.
  • License Processing Staffing:  7 license processing contract workers (on a four-year employment contract).
  • Customer Service Call Center Staffing:  6 license processing-focused customer service call center contract workers (on a two-year employment contract).

• Prescription Drug Monitoring

• o    $1.1 million for software improvements, electronic health records integration, and licensing costs for the state’s electronic Prescription Drug Monitoring Program (ePDMP).