WiHPCA News

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.

The Republican-controlled state Assembly recently passed a redistricting reform plan to completely overhaul how legislative district maps are drawn in Wisconsin. Under the proposal, which is based on the model used in Iowa, a nonpartisan committee would draw the legislative maps. The maps drawn by committee would be subject to approval by the state Legislature. 

Gov. Tony Evers roundly criticized the proposal, saying it was essentially election interference by the GOP and strongly inferred he would veto the measure if it made it to his desk. Assembly Republicans praised the legislation as not only the fairest approach to redistricting for citizens, but also a plan that would avoid costly political and legal battles.

Recent polling has shown that a large majority of Wisconsin residents would prefer legislative district maps be drawn by a nonpartisan commission rather than elected officials.

The proposal, which passed the Assembly on a largely partisan vote with one Democrat voting for the measure, is awaiting further action in the Senate.

Earlier this month, the GOP-controlled state Assembly passed a nearly $3 billion state income tax cut proposal that would drop income tax rates from 5.3% to 4.4% for individual filers with incomes between $27,630 and $304,170 and deliver the same tax relief for married couples with incomes between $18,420 and $405,550. The legislation would also exclude the first $150,000 of a couple’s retirement income from state income taxes. The provision would apply to residents over the age of 67.

Gov. Tony Evers has promised to veto the legislation, saying it would jeopardize priorities such as public schools, child care, and public safety. On the flip side of the debate, Assembly Republicans said the measure, which passed on a partisan vote, will help fight inflation, encourage retires to stay in Wisconsin, and give a large portion of the state’s $4 billion surplus back to taxpayers.

The bill is currently under further consideration in the Senate.

Jenny Malak, Vice President of Homecare Operations for Agrace, has been appointed by Governor Tony Evers to serve on the Wisconsin State Board of Nursing, which resides at the state Department of Safety and Professional Services (DSPS). The Board is comprised of eight members who were appointed to four-year terms.

The State Board of Nursing oversees issues related to the protection of the public from illegal and unauthorized nursing practices. It also enforces standardized training and certifications for all nurse assistants, registered nurses, and advanced medical professionals in Wisconsin.

Malak, a registered nurse who is also certified in hospice and palliative nursing, currently oversees Agrace’s in-home hospice operations, its chronic specialty care program, and the Agrace Grief Support program. She also serves on several other local and national committees, including the National Partnership for Healthcare and Hospice Innovation’s (NPHI) chief clinical officer/chief operations officer forum, the National Hospice and Palliative Care Organization (NHPCO) quality and standards committee, the Wisconsin Organization of Nurse Leaders’ new membership committee, and the Wisconsin Nurses Association Workforce Advocacy Council.

*** Thursday, Oct 26th, 2023 ***

Don’t miss out on WiHPCA’s next quarterly meeting with the WI Department of Health Services’ Division of Quality Assurance (DQA), which is scheduled for Thursday, Oct 26, 2023, at 10:00 A.M. The meeting will be held virtually and is open to all WiHPCA members and hospice professionals across Wisconsin. 

The purpose of the DQA quarterly meetings is to create an opportunity for hospice and palliative care professionals to build and maintain a strong working relationship with a key state regulatory agency that oversees our industry. For members who have not had an opportunity to attend previous quarterly meetings, they provide members with valuable regulatory information and updates, as well as a unique chance to engage DQA staff, ask questions, and request guidance. If you would like to submit a question to DQA staff in advance, please CLICK HERE. 

DQA MEETING DETAILS:

• When:  Thursday, Oct 26, 2023 – 10:00 A.M. – 11:00 A.M.
• Where:  Virtual meeting
• CLICK HERE to register

By Hoven Consulting – WiHPCA’s lobbying firm

• WiHPCA Testifies at Assembly Health Committee on Death Reporting Legislation

On August 10, the state Assembly Committee on Health, Aging and Long-Term Care held a hearing on Assembly Bill 189 (AB189).  This bill 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 listed in state law.  This bill would impact hospices, as a significant number of expected deaths occur within 24 hours of admission to hospice care.

If AB189 becomes law as introduced, it would not only dramatically increase the workload of hospice nurses and staff during a time when surviving family members may need their support, it would also increase the workload of county medical examiners and coroners to unnecessarily review expected deaths. 

On behalf of WiHPCA, Jennifer Flugaur – who serves as the vice president of clinical excellence at Agrace – testified at the August 10 hearing to share these concerns on behalf of WiHPCA.  In particular, she discussed WiHPCA’s request for an amendment to exempt hospice from this legislation since a substantial number of expected deaths occur within 24 hours of admission to hospice care. 

• Governor Requests Special Legislative Session to Provide Funding for the Healthcare Workforce Shortage

On August 8, Governor Tony Evers announced that he was calling the Legislature into session on Wednesday, September 20, 2023, to provide funding for several of his major budget priorities that were not included in the FY2023-2025 state budget, including over $300 million for childcare programs, the creation of a paid family and medical leave program, and almost $60 million to help address the shortage of healthcare workers.  The funding to address the healthcare worker shortage includes:

However, very soon after this announcement, Republican legislative leaders stated that they opposed this special session.  As such, they will very likely call the Legislature into session on September 20 and then quickly adjourn the session, as they have done in the past when Governor Evers has called for a special session. 

• State Rep. Deb Andraca Appointed to Legislature's Joint Finance Committee

On August 16, state Assembly Minority Leader Greta Neubauer (D-Racine) appointed Rep. Deb Andraca (D-Whitefish Bay) to serve on the Legislature’s budget-writing Joint Committee on Finance for the rest of the 2023-2024 legislative session.  Rep. Andraca, who represents much of the north shore Milwaukee suburbs, will replace Rep. Evan Goyke (D-Milwaukee), who is departing the committee to focus on his campaign for the position of Milwaukee City Attorney.

• DHS Announces Free Online Program to Train 10,000 Caregivers

On August 8, the state Department of Health Services (DHS) announced an initiative to train 10,000 Wisconsinites as certified direct care professionals (CDCP).  These individuals provide personal/supportive home care to senior citizens and disabled people.

Wisconsinites interested in receiving the CDCP certification may sign up to receive free training and then will need to pass an online test in order to be certified.  Certified individuals who obtain employment with an eligible employer may earn up to $500 in combined hiring and retention bonuses. 

More information may be found on the DHS website.

• DHS Creates Webpage Detailing Statewide BadgerCare Plus & Medicaid Enrollment Data

During the COVID-19 pandemic, the federal government put in place a continuous coverage requirement for Medicaid enrollees.  Now that the pandemic-related federal public health emergency has ended, those Wisconsinites who benefit from BadgerCare Plus and Medicaid and want to continue to participate in these programs will need to renew their enrollment.  DHS has created a webpage that tracks this data, which will be updated on the third Thursday of each month. 

• DHS Launches "UpliftWI" Peer Support Phone Line

On July 31, the state Department of Health Services (DHS) unveiled “UpliftWI,” which is a new peer support phone line for individuals who are experiencing mental health and substance use challenges.  This phone line may be reached at 534-202-5438, seven days a week between the hours of noon and midnight.  There is no charge to use this service and those who call for assistance will not be required to disclose their name, address or other identifying information.  DHS intends to expand the phone line’s hours of operation to 24 hours a day by the end of 2024.  More information may be found at the UpliftWI website.