WiHPCA News

Over the last few weeks, Governor Evers has taken action on numerous bills, including the following bills of interest to WiHPCA:

• Signed - Senate Bill 178 – Creates a requirement, in certain circumstances, for physicians, authorities of various medical institutions, or other persons required to report deaths under current law to contact a medical examiner or coroner within 24 hours after an individual either has presented at or is admitted to a hospital or similar institution, whichever is earlier, to determine whether the medical examiner or coroner is required to investigate a death. Thanks to WiHPCA advocacy efforts, via an amendment we lobbied for, hospices were made exempt from the requirements of the new law.  The Governor signed an amended bill on March 22.

• Vetoed - Senate Bill 158 – Proposed creating a preliminary health care credential that is available to individuals who have completed the requirements for the corresponding permanent or training health care credential while they await a decision from the Department of Safety and Professional Services (DSPS) regarding their application for the permanent or training credential. The Governor vetoed this bill on March 29, issuing the following statement in his veto message:

On April 4, the Governor’s Task Force on the Health Care Workforce held a public meeting in Madison.  Lt. Governor Sara Rodriguez, a registered nurse, chairs this task force.  The intent behind this task force is to craft health care workforce recommendations that may be included in the Governor’s FY2025-2027 budget request to the Legislature.

The meeting started out with a discussion of the results of a survey that was sent to all 24 task force members, all of whom completed the survey.  The intent of this survey was to help determine the potential areas of focus for the task force. 

With respect to specific profession areas, the survey found that the task force should focus on the following (in order of priority):

1. Behavioral Health
2. Nurses
3. Direct Care
4. Allied Health
5. Physicians
6. Oral Health
7. Emergency Medical Services
8. Other

With respect to health care sectors, the survey found that the focus should be on the following (in order of priority):

1. Behavioral Health
2. Long term care
3. Primary care
4. Emergency Medical Services
5. Oral Health
6. Other

With respect to health care workforce improvement strategies, the survey found that the focus should be on the following areas (while they are in order of importance, these were all ranked quite close to each other – therefore, the task force views these as effectively equal):

1. Recruitment and Retention
2. Education and Training
3. Regulatory Policy

Following this conversation, David Polk, who serves as the director of the Bureau of Apprenticeship Standards at the state Department of Workforce Development, discussed the various health care apprenticeships that are currently offered in the state.  These apprenticeships include medical assistants, pharmacy technicians, and registered nurses.  Immediately following that presentation, Bridgett Willey, the director of Allied Health Education and Career Pathways at UW Health, described their health care apprenticeship offerings.

Next, Jessica Smith, who serves as the director of the Center for Inclusive Transition, Education, and Employment at UW Whitewater (UWW), presented on the Qualified Treatment Trainee (QTT) grant program at UWW.  A QTT is someone with a master’s degree in social work, counseling or marriage and family therapy, who wants to get a professional license for such counseling work.  These individuals perform counseling work under the guidance of a clinical supervisor.  This grant program is funded by the state Department of Health Services (DHS) and is administered by DHS, along with UWW.  Right after this presentation, Jill Baures, Psy.D., who serves as the Clinical Training Director for Pauquette Center for Psychological Services in the Madison area, discussed her agency’s experience with the QTT program.

At the end of the meeting, the upcoming task force meeting schedule was discussed:

• May 9 – UW La Crosse
• • During this meeting, the task force will identify additional strategies and opportunities.
• June 6 – UW Milwaukee
• • During this meeting, they will start prioritizing all strategies and opportunities.
• July 11 – UW Green Bay
• • During this meeting, they will review a draft set of recommendations.
• August 8 – Madison (Hill Farms State Office Building)

For further details about the task force’s April 4 meeting, you are welcome to review a more detailed summary.

In early April, the state Department of Health Services (DHS) submitted a proposal to the Legislature’s budget-writing Joint Finance Committee requesting their approval for DHS’s plan for spending $36 million in settlement funds received from opioid litigation.  In summary, DHS proposes to spend these funds for the following purposes:

• Tribal Nations:  $6 million
• Community, Education, After-School Prevention:  $5 million
• Family Support/Resource Centers: $5 million
• Peer Support in Opioid Treatment Programs: $5 million
• Narcan:  $3.5 million
• Fentanyl Test Strips:  $1 million
• Capital Projects:  $3 million
• Room and Board: $2.5 million
• EMS “Leave Behind” Programs:  $1.5 million
• Public Health Vending Machines: $1 million
• Law Enforcement Grants:  $1 million
• Data Collection and Surveillance System Enhancements:  $1.5 million

On April 11, Wisconsin Supreme Court Justice Ann Walsh Bradley announced that she would not run for re-election in 2025.  She is currently a member of the liberal majority of the court.  When she completes her term on July 31, 2025, she will have served 30 years as a justice on the Wisconsin Supreme Court.  Prior to her service on this court, she served 10 years as a circuit court judge in Marathon County. 

The primary election to fill her seat on the court will be held on February 18, 2025, and the general election will occur on April 1, 2025.  As this is written, former Republican Attorney General Brad Schimel – who currently serves as a judge in Waukesha County – is the only candidate who has announced a run for Justice Walsh Bradley’s seat on the State Supreme Court.

On February 20, the state Assembly approved Assembly Bill 736 – a bill creating a state Palliative Care Council – by voice vote.  Prior to that, the Assembly Committee on Health, Aging and Long-Term Care voted unanimously (16-0) to recommend approval of this legislation.  WiHPCA worked closely with the authors of this legislation, state Rep. Patrick Snyder (R-Wausau) and state Sen. Jesse James (R-Eau Claire Area), in the drafting of this bill.  WiHPCA is grateful to Rep. Snyder and Sen. James for their tireless efforts on this legislation.  In fact, you may watch a brief video (3 minutes, 40 seconds) of Rep. Snyder discussing this bill on the floor of the state Assembly. 

The state Palliative Care Council created by this bill would advise the state Department of Health Services (DHS) and provide recurring reports to the Legislature.  More specifically, the proposed palliative care council would work 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.  This council would not only improve awareness of palliative care – a type of care that is often misunderstood – but will ultimately help with increasing access to this specialized type of care.

Once AB736 passed the Assembly, it was referred to the Senate.  Specifically, it was referred to the Senate Committee on Government Operations.  This committee held a hearing on the Senate companion version of this bill – Senate Bill 703 – on February 1.  Unfortunately, however, this bill faced some political obstacles.  Committee Chairman/Senator Duey Stroebel (R-Saukville) indicated after the February 1 hearing that he did not plan on voting this legislation out of his committee. 

In response to this obstacle, WiHPCA’s government relations representatives aggressively lobbied Senate leadership to attempt to bring this bill to a vote before the full Senate.  In support of that effort, WiHPCA sent out an Action Alert to all WiHPCA member agencies, as well as a separate Action Alert to all WiHPCA member agency volunteers, requesting individuals to contact their respective state senators to ask them to contact Senator Stroebel to vote the bill out of his committee.  We greatly appreciate the efforts of WiHPCA member agency staff, as well as volunteers, in advocating for the Senate passage of this legislation!  Unfortunately, however, this bill ultimately did not pass the state Senate before it adjourned for the 2023-2024 legislative session in mid-March. 

 In addition, we would like to share that Wisconsin Public Radio interviewed WiHPCA board chair Lynne Sexten – the President and CEO of Agrace Hospice and Palliative Care – regarding the palliative care council bill during the March 4 edition of WPR’s Morning Show.  The audio of this interview may be heard here (you will need to scroll down the page slightly to find the “Listen” button for this topic).  

On March 7, representatives from WiHPCA and the Wisconsin Association for Home Health Care (WiAHC) participated in a joint virtual meeting with Lieutenant Governor Sara Rodriguez to discuss health care workforce issues.  Lt. Gov. Rodriguez, a registered nurse, chairs the newly formed Governor’s Task Force on the Healthcare Workforce.  Various issues were discussed, including reimbursement from insurers and public sector payers, medical personnel wage levels, and the potential to expand an existing effort to concurrently train high school students to be licensed practical nurses (LPNs), which would enable them to graduate from high school and immediately enter the workforce. 

Future task force meetings will be held each month from April through August.  The following is the schedule that is currently available:

• Thursday, April 4th, 1-4pm, Madison (Hill Farms State Office Building – Room TBD)
• Thursday, May 9th, 1-4pm, La Crosse (Location TBD)
• Thursday, June 6th, 1-4pm, Milwaukee (Location TBD)
• Thursday, July 11th, 1-4pm, Green Bay (Location TBD)
• Thursday, August 8th, 1-4pm, Madison (Hill Farms State Office Building – Room TBD)

In addition, the task force will launch a website in the future.  Once that occurs, that will be shared in a future edition of this newsletter. 

On December 22, 2023, the State Supreme Court issued a ruling that Wisconsin’s state legislative district maps are unconstitutional and the maps for each such district must be redrawn before the 2024 elections.  State Supreme Court justices voted 4-3 in favor of this ruling.  The decision focused on specific state legislative districts that include non-contiguous portions of land, which the court found violated the state constitution.

Specifically, the court ruled that the legislature must redraw the boundaries for each state Assembly and state Senate district in advance of the August 2024 primary election.  If the Legislature and Governor Evers were not able to agree on legislation creating new district boundaries, the court noted that it would decide on the new boundaries.  As a practical matter, the state Elections Commission noted that new district boundaries needed to be finalized by March 15, 2024. 

In January, the parties to the case submitted various proposed state legislative district maps to the court and the court-appointed consultants reviewed these maps and provided their analysis to the court on February 1.  However, in mid-February, the Legislature passed a bill with the version of state legislative district maps that Governor Evers previously submitted to the court.  This legislation passed both chambers of the Legislature with mostly Republican votes and was sent to the Governor.  On February 19, Governor Evers signed this legislation.  As such, these new legislative district maps will take effect for legislative candidates who are elected in November 2024. 

The new 2024 state Assembly and state Senate district maps may now be viewed on the Legislature’s interactive district map page. 

In addition, the following related articles/links may be of interest:

• “Here are the 10 most competitive districts under Wisconsin’s new legislative maps” – Wisconsin State Journal
• Listing of which incumbent legislators are now paired in the same legislative district – WisPolitics.com

In February, the state Department of Safety and Professional Services (DSPS) announced that it added additional information to its online credential processing dashboard.  This updated website includes additional data points, including the median amount of time to receive an occupational credential in the health or business industries, or in the trades. 

In early March, the state Department of Health Services (DHS) opened registration for their annual Opioids, Stimulants, and Trauma Summit.  According to DHS, this summit “highlights prevention, harm reduction, treatment, and recovery strategies related to opioids, stimulants, and trauma.”  This event will be an in-person event (with a virtual option) held on May 7-9, 2024, at the Kalahari Resort in Wisconsin Dells. 

For more information, please visit the DHS website. 

From the Desk of the NHPCO – March 2024

The National Hospice and Palliative Care Organization (NHPCO) responded to today’s announcement from the Centers for Medicare & Medicaid Services (CMS) that as of December 31, 2024, the hospice benefit component of the Value-Based Insurance Design (VBID) Model will conclude. This model allowed participating Medicare Advantage Organizations (MAOs) to include the Medicare hospice benefit in their Medicare Advantage benefits package.

CMS cited feedback from providers, beneficiaries, and MAOs about their experience with VBID as the reason for discontinuing the hospice component of the model. CMS will no longer be accepting applications for the calendar year (CY) 2025 Request for Applications. This means hospice will no longer be a part of the VBID model beginning January 1, 2025. Hospice providers currently contracted with MAOs will continue with their contracts for CY 2024.

This outcome is a direct response which follows over five years of advocacy and engagement by NHPCO, including meetings and official filings with CMS’ VBID team in February 2024, August 2022, August 2021, and Spring 2020.

“This is a huge victory for patients’ access to quality care and for hospice providers who have continually identified challenges with this demonstration including concerns about VBID giving MAOs the ability to limit patient choices. NHPCO has advocated for years to end the VBID hospice carve-in and appreciate CMS making this important change,” said Ben Marcantonio, COO and Interim CEO of NHPCO. “We saw great success with concurrent care tested through the Medicare Care Choices Model (MCCM) and would encourage CMMI to consider these learnings as a potential path forward.”

CMS will continue the VBID model in 2025 without the hospice component with the goal of delivering equitable, quality, person-centered care to Medicare beneficiaries. NHPCO will continue to work closely with Congress and CMS to reduce barriers for Americans seeking access to hospice and ensuring quality end-of-life care.