February 6th, 2004 - WISCONSIN HEALTH CARE PROVIDER UPDATE

Sue Schroeder, Director of BQA, to Resign
Sue Schroeder, the Director of the Bureau of Quality Assurance (BQA), announced last Tuesday that she has decided to resign from BQA effective July 2004. Sue Schroeder has not announced what she will be doing after her departure from BQA.

Only Three More Weeks Until the Regular Legislative Session Ends
The Wisconsin Legislature adjourned last Thursday so that committees can finish public hearings and vote on selected bills. The legislature will reconvene on February 24 through March 11, for approximately 2 days per week. Basically this means there will only be 8-10 days of floor session left. On March 11, if a bill has not passed both houses – that bill is considered dead for the session and will have to be reintroduced during the next legislative session, which begins in January 2005. Therefore, if a bill has not been introduced or has not been voted out of committee as of today – the likelihood it will pass into law this year is very unlikely.

Lobbying to Offset the $400 Million Medicaid Deficit Continues – Not Much Progress
(Proposal Attached) As reported last week, the members of the Save Medicaid Coalition (a coalition started by Forbes McIntosh and other Broydrick associates) have been lobbying legislators to consider a proposal by Governor Doyle which would entail restructuring the State’s bonding debt to provide $175 million this year and another $150 million next year to offset the current $400 million deficit in Medicaid – this proposal must be passed by the legislature and signed into law by February 11, 2004 to work. The Wisconsin Medicaid Program is expected to literally run out of funding in April of 2005. However, politics between Democrat Governor Jim Doyle and the Republican controlled legislature seems to be a roadblock to this effort, which must be acted upon in the next 5 days. In another development, Sen. Mike Ellis (R-Neenah) and Sen. Robert Cowles (R-Green Bay) released a document criticizing the bond-restructuring proposal citing that the plan would “mean tens of millions in additional interest costs to the state.” “This credit card scheme should be a non-starter in the Legislature”.

Approximately 50 plus organizations and their lobbyists will continue to push for this bond restructuring effort. If this bond restructuring is not achieved – dealing with the $400 million Medicaid shortfall next January (2005) will be difficult and could jeopardize Medicaid provider reimbursement rates.

35% Reduced Forfeiture Option Extended to Assisted Living
Recently the Department of Health and Family Services - Bureau of Quality Assurance (BQA) announced and instituted the 35% Reduced Forfeiture Option to Assisted Living. One of the first notices\orders using this option was received last week by an assisted living facility. This option has traditionally been limited to Wisconsin nursing facilities. What is a Reduced Forfeiture Option? If you choose not to contest the Forfeiture, Statement of Deficiency, and any Orders contained in the notice and order, then the Department will reduce the total forfeiture by 35%. The reduced forfeiture amount is then due to the Department within ten (10) days of receipt of the notice and order. The “Orders” often include consultation and training from outside consultants or by the department itself and often include the development of written policies by the facility that address the action that was cited.

Division of Public Health (DHFS) to be “Restructured”
Last Tuesday DHFS Secretary Helene Nelson announced plans to reorganize the Public Health, a division of DHFS. The reorganization is expected to be finalized this summer and will merge many areas and completely eliminate others. The Division of Public Health does not directly impact most issues pertaining to nursing homes or assisted living. The following is a list of programs that could be affected by this restructuring plan: Communicable Disease Prevention; Chronic Disease Prevention and Health Promotion; Family and Community Health; Occupational Health; Environmental Health; Emergency Medical Services (EMS); Food Safety & Recreational Licenses; Health Hazard Evaluation; OSHA Consultation; Asbestos and Lead issues; Nutrition; Immunization; HIV and AIDS; and, Injury Prevention.
Restructuring Report Available: <http://dhfs.wisconsin.gov/aboutDHFS/dph/restructure/index.htm>