WiHPCA News

By Hoven Consulting – WiHPCA’s lobbying firm

• ·       Palliative Care Council Legislation to be Consider Under the Capitol Dome

State Representative Patrick Snyder (R-Schofield) and State Senator Jesse James (R-Altoona) have teamed up to introduce legislation (Senate Bill 703) that would create a state Palliative Care Council, which will help increase awareness of and need for palliative care in Wisconsin. WiHPCA worked closely with both legislators to craft this legislation, which our organization wholeheartedly supports. 

Unfortunately, there are currently barriers in place with respect to palliative care in Wisconsin.  For starters, there are simply not enough health care providers in our state who specialize in palliative care.  Also, there is a shortage of information on palliative care for practicing health care providers, patients, and their loved ones.   

Legislation to create a palliative care council would help improve these shortcomings. Under the bill, the council is charged with working with DHS on analyzing existing palliative care programs, as well as identifying ways in which health care providers could improve the quality of life for patients throughout our state.  The council would be comprised of 22 members representing diverse perspectives, including physicians, nurses, a spiritual care professional, palliative care patients or family members of such patients, a health insurance company representative with expertise in palliative care, and a bipartisan group of legislators.  The council would meet at least twice per year in various locations across the state.

Many other states have already taken the step of creating a palliative care advisory council or advisory group to increase awareness of access to this specialized type of care.  In fact, 25 other states from coast to coast have formed such entities. Wisconsin would be well-served in joining these other states to help improve access to palliative care for those Wisconsinites who could benefit from it. 

The WiHPCA Government Affairs Team will provide members with the latest development as the bill moves through the legislative process.

• ·       State Senate Approves Bill Requiring Death Reporting Within 24 Hours of Presentment or Admittance – Including WiHPCA-Requested Exemption for Hospice

On November 7, the state Senate voted unanimously to approve Senate Bill 178, which would require all individuals or organizations that are currently required to report certain deaths to medical examiners or coroners to also notify these officials of all persons who have died within 24 hours of admittance or presentment to a hospital or other facility (including a hospice) – even deaths not currently included under existing reportable circumstances under existing state law. 

WiHPCA members already report deaths under certain circumstances – typically following a significant fall – to the appropriate county coroners or medical examiners as is required by existing state law.  However, WiHPCA is concerned that a requirement to notify the coroner or medical examiner regarding all deaths that occur within 24 hours of admittance or presentment would significantly increase the number of death notifications that would need to be submitted. 

As such, WiHPCA’s Madison lobbyists successfully advocated for an amendment exempting hospice from the death reporting requirements in Senate Bill 178, as well as the Assembly companion bill – Assembly Bill 189. 

The next step is for the full Assembly to vote on this amended legislation, now that the full Senate has approved it.  WiHPCA’s Madison lobbyists will continue to advocate for the approval of this legislation. 

Governor Tony Evers recently declared November 2023 as Hospice and Palliative Care Month in Wisconsin.  Check out the Proclamation HERE.

By Hoven Consulting – WiHPCA’s lobbying firm

·       Assembly and Senate Health Committees Approve 24 Hour Death Reporting Bill with WiHPCA Hospice Exemption Amendment

Over the last few weeks, both the Assembly and Senate Health Committees voted to recommend approval of legislation (Assembly Bill 189 and Senate Bill 178) that would require all individuals or organizations that are currently required to report certain deaths to medical examiners or coroners to also notify these officials of all persons who have died within 24 hours of admittance or presentment to a hospital or other facility (including a hospice) – even deaths not currently included under existing reportable circumstances under existing state law. 

WiHPCA members already report deaths under certain circumstances – typically following a significant fall – to the appropriate county coroners or medical examiners as is required by existing state law.  However, WiHPCA is concerned that a requirement to notify the coroner or medical examiner regarding all deaths that occur within 24 hours of admittance or presentment would significantly increase the number of death notifications that would need to be submitted. 

As such, WiHPCA’s Madison lobbyists advocated the Assembly and Senate Health Committees to amend both bills to exempt hospice.  On October 10, the Assembly Health Committee voted unanimously to recommend approval of an amendment exempting hospice from the requirements of Assembly Bill 189, as well as the amended bill itself.  On October 13, the Senate Health Committee also voted unanimously to recommend approval of an amendment to exempt hospice from Senate Bill 178, as well as the amended bill itself. 

The next step is for the full Assembly and Senate to vote on this legislation.  WiHPCA’s Madison lobbyists will continue to advocate for the approval of this legislation.

·       DSPS Upgrades Prescription Drug Monitoring Program

On October 15, the state Department of Safety and Professional Services (DSPS) unveiled an updated Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP) website.  In its recent announcement, DSPS noted that the updated website incorporated feedback from stakeholders, including prescribers, health care systems, law enforcement and pharmacies.  Specifically, DSPS highlighted the following improvements:

o   Dispensing records will be processed as soon as they are submitted, and patient reports will be updated accordingly as close to real time as possible.

o   Instances of patient records being falsely merged or separated will be significantly reduced. Falsely matched records will be addressed in a timely manner should they occur.

o   Healthcare professional account users will be able to reconfigure their own patient report layout to prioritize information most useful to their clinical practices and treatment decisions. 

·       Legislative Committee Rejects Request for More DSPS Occupational Credential Staff

On September 26, the Legislature’s Joint Finance Committee – the budget writing committee – rejected Governor Evers’ request to provide more funding for additional staff members at the state Department of Safety and Professional Services (DSPS) to assist in processing occupational credential applications.   The vote was along party lines – 10 against and 4 in support.  In its request, DSPS noted that they needed more staff members to maintain or reduce processing time for occupational credentials. 

During the Fiscal Year 2023-2025 budget process, the Legislature approved over 17 new positions for DSPS, as well as approximately $3.5 million for credentialing software.

·       Senate Health Committee Recommends Approval of DHS Secretary Nominee

On September 27, the Senate Health Committee held a hearing on the nomination of Kirsten Johnson to be the Secretary of the state Department of Health Services (DHS).  Prior to her nomination, Kirsten served as the head of the City of Milwaukee Health Department, as well as the Washington-Ozaukee Health Department.  She also served as the president of the Wisconsin Public Health Association.  On October 6, the Senate Health Committee voted 5-1 to recommend her confirmation to the full Senate.  Senator Andre Jacque (R-DePere) voted no.  The next and final step is for the full Senate to vote on her confirmation.  This full Senate vote could occur by mid-November. 

The Wisconsin Hospice and Palliative Care Association (WiHPCA) continues to strengthen its grassroots advocacy outreach program. We are pleased to report that Wisconsin Sen. Van Wanggaard (R-Racine) recently visited the Hospice Alliance Hospice House in Pleasant Prairie, WI.

Wanggaard’s visit was part of WiHPCA’s Captiol Connection program aimed at connecting our members with their local state legislators to discuss the benefits of hospice and palliative care for patients and their families.

“I am grateful to Senator Wanggaard for taking the time to meet with us to learn more about hospice and palliative care and to tour our beautiful hospice house,” said Rita Hagen, Hospice Alliance Executive Director. “I also appreciated the opportunity to share with him the great work that we are doing to provide quality care to patients with serious illness in our community.”

While the tour of the Hospice House was limited to common spaces and did not interfere with patient privacy or safety, Wanggaard visited a vacant private hospice suite and met with Hospice Alliance staff to better understand how they provide compassionate end-of-life-care.

“I really enjoyed meeting with the Hospice Alliance to learn more about hospice and palliative care, which is frequently misunderstood by the public,” said Sen. Wanggaard. “There is immense value to these services, and I was happy to learn about the successes and challenges hospice and palliative care providers have in Wisconsin.”

Wanggaard, who was first elected to the Wisconsin Senate in 2010, represents the 21^st Senate District, which includes large portions of Racine and Kenosha Counties. He currently serves as the Senate Majority Caucus Chair and Chair of the Senate Judiciary and Public Safety Committee.  

Hospice Alliance is a non-profit, community-based provider of hospice and supportive care management, which was founded over 40 years ago by a group of hospice-care advocates determined to ensure that quality, end-of-life care and family support were available to residents of southeastern Wisconsin. Hospice Alliance is committed to supporting patients in living each day with dignity, comfort, and hope.

Governor Tony Evers recently unveiled a proclamation declaring November 2023 as Hospice and Palliative Care Month in Wisconsin. The proclamation, which was requested by WiHPCA, outlines the value of hospice and palliative care in Wisconsin for patients in need of life-ending and life-limiting care. It also applauds the tremendous contributions of hospice and palliative care professionals across the state and the importance of the quality care and services they provide to patients and their families. CLICK HERE to read the full proclamation.

Next month, WiHPCA will be issuing an Advocacy Action Alert membership-wide urging members to contact their local state lawmakers to introduce them to WiHPCA, educate them on the importance of hospice and palliative care, and to help celebrate Hospice and Palliative Care Month. Please watch your inbox for the Alert and take a few minutes to help advance WiHPCA’s advocacy efforts. 

Earlier this month, the Wisconsin Department of Administration (DOA) announced the state closed the 2023 fiscal year, which ended June 30, with a surplus of slightly more than $7 billion. That is roughly 65% more than last year’s $4.3 billion balance. In addition, the state Budget Stabilization Fund, or “rainy day” fund continues to have a balance of $1.8 billion. CLICK HERE to review the full DOA Annual Fiscal Report.

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

·        2 Under-the-Radar Reasons for Hospice Claims Denials 

Hospice News – By Jim Parker | Oct. 19, 2023

A Medicare Administrative Contractor (MAC) can deny a hospice claim for a wide range of reasons, but two types of errors stand out that can lead to a rejection. A few causes of denials are widely known. They stem almost entirely from documentation errors or omissions such as a physician’s signature on the certification form or other indications that a patient may not be eligible for hospice or for a particular level of care, such as General Inpatient Care. Read More…

·        New Hospice Executives Focused on Technology, Workforce Development

Hospice News – By Holly Vassel | Oct. 17, 2023                         

New hospice leaders have indicated that workforce development, efficient technologies and growth in home-based services represent key focus areas for providers during the next few years. Meanwhile, their biggest challenges include regulatory and reimbursement shifts. Hospice News recently sat down with two new hospice executives to discuss some of the biggest opportunities and concerns on the horizon in end-of-life and serious illness care. Read More…

·        The First Year of Hospice VBID Is the Hardest for Payers and Providers

Hospice News – By Jim Parker | Oct. 13, 2023

Implementation of the Medicare Advantage hospice carve-in has been challenging for both payers and providers, though a recent analysis indicates that it may get easier over time. The U.S Centers for Medicare & Medicaid Services (CMS) commissioned the RAND Corp. to conduct the analysis of the program, formally called the hospice component of the value-based insurance design model (VBID). CMS launched the carve-in in 2021. The RAND analysis released this week covers the calendar year 2022. Read More…

·        Hospice Leaders: Change Must Come to the Medicare Benefit

Hospice News – By Holly Vassel | Oct. 9, 2023

Calls have grown louder for an overhauled design of the Medicare Hospice Benefit, but the path towards change is riddled with contrasting views over regulation, policy and payment structures. Hospice providers are hitting financial and regulatory walls when it comes to sufficiently covering the spectrum of services necessary to care for patients and families, according to Marian Grant, senior regulatory advisor at the Coalition to Transform Advanced Care (C-TAC). Read More…

·        Congress Members Call on CMS to Revise Proposed Hospice Special Focus Program

Hospice News – By Jim Parker | Oct. 4, 2023

Four members of Congress led by Reps. Beth Van Duyne (R-Texas) and Earl Blumenauer (D-Oregon) have called for changes to the forthcoming Special Focus Program (SFP) from the U.S. Centers for Medicare & Medicaid Services (CMS). Jimmy Panetta (D-CA) and Brad Wenstrup (R-OH) were also signatories on the letter to CMS Administrator Chiquita Brooks-LaSure and White House Office of Management and Budget Director Shalanda Young. The four lawmakers contend that the SFP, as currently designed, would not adequately identify poor performing hospices in need of the program. Read More…

·        Understanding CMS’ Civil Monetary Penalties for Hospices

Hospice News – By Jim Parker | Oct. 2, 2023

The U.S. Centers for Medicare & Medicaid Services (CMS) has been gradually implementing changes to the hospice survey process and enforcement remedies, including civil monetary penalties in some instances. Congress approved the survey changes and enforcement actions through the Consolidated Appropriations Act of 2021, which incorporated language from the Helping Our Senior Population in Comfort Environments (HOSPICE) Act. CMS in 2022 began working the legislation’s provisions into its rulemaking. Read More…

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

October 2, 2023

Hospice Alliance hosted State Senator Van Wanggaard at their facility.

Thank you to Rita Hagen, Executive  Director and her team for hosting the tour and the discussion and providing an overview of hospice care in Wisconsin with the Senator.  The discussion focused on the value and quality of hospice care in Wisconsin and shared feedback on regulatory challenges.  If you would like to host a legislative visit, contact the WiHPCA office at wihpca@badgerbay.co.

By Hoven Consulting – WiHPCA’s lobbying firm

• Governor Evers/DSPS Unveils New Occupational License Processing Dashboard

On August 31, Governor Tony Evers and the state Department of Safety and Professional Services (DSPS) unveiled a new online dashboard that provides high-level data on occupational license processing.  In addition to showing the average number of days to process all new applications, all health applications, and all business applications, users may also look up application review times by profession. 

• DSPS Signs Data Sharing Agreement with Michigan to Expedite Occupational License Processing

On August 17, leadership from the Wisconsin Department of Safety and Professional Services (DSPS) and the Michigan Department of Licensing and Regulatory Affairs announced an agreement to "speed up professional license approvals in both states."  In particular, this agreement will allow for the automated, secure exchange of occupational license applicant data between both states, which will expedite processing for applicants.

• Governor Evers Creates Task Force on Workforce and Artificial Intelligence

On August 23, Governor Tony Evers signed an executive order creating the Governor’s Task Force on Workforce and Artificial Intelligence.  This task force will “produce an advisory action plan to identify the current state of generative artificial intelligence’s impact on Wisconsin’s labor market and develop informed predictions regarding its implication for the near term and future.”  In addition, it will “recommend solutions related to workforce development and educational systems.” 

This task force will be chaired by the state Department of Workforce Development Secretary Amy Pechacek and will include the Secretary of the state Department of Administration, the head of the Wisconsin Economic Development Corporation, representatives from the University of Wisconsin System, the Wisconsin Technical College System, as well as other public and private sector representatives.  The Governor’s executive order did not include a timeline for the work of this task force.

• Assembly Speaker Robin Vos Creates Artificial Intelligence Task Force

On August 31, Assembly Speaker Robin Vos announced the creation of several speaker’s task forces, including one focused on artificial intelligence.  This task force, comprised entirely of Republican and Democratic state representatives, will hold public hearings at various locations across Wisconsin, starting in September.  The task force aims to complete its work by the end of 2023 and recommend legislation for introduction during the 2024-2025 legislative session.  This task force will be chaired by state Rep. Nate Gustafson (R-Neenah).

On August 8, Governor Tony Evers called a special session of the Legislature, urging lawmakers to consider a $1 billion workforce development package the Governor said was needed to address the state’s workforce shortage crisis.

Republicans, who control both houses of the Legislature, convened the session as required by law, but quickly adjourned without acting. They called the special session a “political stunt” that was fiscally irresponsible and did not provide real solutions to Wisconsin’s workforce challenges.

The Governor’s proposed legislative package included $365 million to support childcare programs; the creation of a paid family and medical leave program that would cost $243 million; $66 million for the UW; $40 million for the state’s technical colleges; and nearly $60 million to help address the shortage of healthcare workers across the state. The funding to address the healthcare worker shortage included:

o   $10 million for the state’s nurse educators program, which incentivizes nursing professors to remain in Wisconsin.

o   $6 million for the WisCaregiver Careers program, which is intended to increase the number of certified nursing assistants employed at nursing homes.

o   $17 million for healthcare opportunity grants, which will go to local workforce development boards to help individuals obtain employment in the healthcare field.

o   $936,600 for the state Department of Workforce Development to work on healthcare apprenticeships.

o   $22.5 million for healthcare innovation grants, which will help the healthcare industry recruit and retain employees.

o   Over $1.2 million for graduate medical training support grants.