Legislative Agenda | Legislative Archive

WISCONSIN LONG-TERM CARE UPDATE
March 27, 2006

• Call to Action: TABOR-II: Why Amending the Constitution will Hurt Healthcare
• Governor Signs Medical Malpractice Caps for Hospitals and Physicians
• Joint Finance Committee Meets Next Week to Pass Expansion of Family Care
• Scott Walker Drops Out of Republican Primary for Governor
• Governor to Sign Nursing Home Rate Increases on Monday
• New Legislative Bills – Recently Introduced
• Legislative Committee Public Hearings

Call to Action: “TABOR-II” \ “TPA”: Why Amending the Constitution Will Hurt Healthcare
Please Contact Your State Legislator and Ask them to Oppose TABOR-II
The proposed “Taxpayer Protection Amendment” (TPA), commonly referred to as “TABOR-II”, caps state and local government revenue and spending through a 2,500-word amendment to the state Constitution, which includes a mathematical formula based on “rate of inflation + population”.  TABOR-II was recently introduced as Assembly Joint Resolution 77\Senate Joint Resolution 63.Unfortunately, the legislation being offered in Wisconsin today is based on a similar TABOR Constitutional Amendment that Colorado passed in 1992, which has had an adverse impact on Colorado’s economy and ability to provide government services.

TABOR-II will basically lock in the current government financing system, which already significantly under-funds vital health care programs such as Medicaid.  Best estimates indicate that the MA program under pays Wisconsin’s hospitals, nursing homes, doctors, dentists and home health care providers by nearly  $1 billion.  Since medical and healthcare costs traditionally increase higher than what the TABOR-II Constitutional Amendment will allow, not only will TABOR-II “cap” or “lock” this under funding problem in place forever – It will likely make the under funding of Medicaid even worse.

The Wisconsin Legislature will reconvene on April 25th.  Legislative leadership has stated that the Senate and Assembly will likely vote on TABOR-II at that time.  Two more public hearings will be held on TABOR-II.  The March 30th public hearing will be held by “invitation only”.  The Second hearing in early April will be open to the general public.

It is essential that the healthcare and long-term care providers communicate with their legislators between now and April 25 and urge them to oppose the TABOR-II \ TPA Constitutional Amendment. It is particularly important that the following seven Republican Senators who have not signed on as co-sponsors of the TABOR-II Constitutional Amendment hear from local officials:

Ron Brown (Eau Claire)                                    sen.brown@legis.state.wi.us
Rob Cowles (Green Bay)                       sen.cowles@legis.state.wi.us
Mike Ellis (Neenah)                               sen.ellis@legis.state.wi.us
Sheila Harsdorf (River Falls)                  sen.harsdorf@legis.state.wi.us
Dan Kapanke (La Crosse)                     sen.kapanke@legis.state.wi.us
Luther Olsen (Ripon)                             sen.olsen@legis.state.wi.us
Carol Roessler (Oshkosh)                      sen.roessler@legis.state.wi.us

To find out who your state senator and assembly representative are, click on: Who Are My Legislators?

To view a 13-minute informational video on TABOR-II, please go to:
“The Truth About TABOR”: http://www.cbpp.org/taborvideo.htm
Governor Signs Medical Malpractice Caps for Hospitals and Physicians
Governor Doyle signed Assembly 1073 into law last week, which places limits or caps on non-economic damage awards of $750,000 on lawsuits affecting physicians and hospitals.  Now that this legislation has become law, next January our lobbyist in coordination with other organizations will seek to expand this law to long-term care providers.  January 2007 is when the next Legislative Session will begin.  Legislation will not be introduced this year, since the Legislature has finished most of its work already and will have only a short floor period in April and May.  It is imperative that long-term care providers continue to educate their local legislators of the high liability insurance premiums; the difficulty of obtaining\maintaining liability insurance; and the fact that many liability insurance companies will no longer offer liability insurance to long-term care providers – due to the fact that their risk cannot be defined.

Joint Finance Committee Meets Next Week to Pass Expansion of Family Care
The Wisconsin Legislature’s Joint Finance Committee will meet on Thursday, March 30, 2006 at 9:00 AM at the State Capitol to vote on several pieces of legislation, including SB-653.   If passed, Governor Doyle has stated he will sign the bill into law.  SB-653 will in essence remove current restrictions on expanding Family Care “Care Management Organizations” (CMOs) and “resource centers” into additional counties.  Family Care is a county government-run managed care pilot program established to expand eligibility of care for elderly and disabled individuals to home and community-based care alternatives, while not increasing state funding of long-term care programs.  This cost neutrality is achieved by limiting or “case-managing” provider reimbursement rates from  the county-run CMO.  Although no long-term care provider associations are opposing the expansion of Family Care, there is considerable concern that Wisconsin’s long-term care system is being under funded.  Many organizations believe the under funding of long-term care could threaten quality care.

Scott Walker Drops Out of Republican Primary for Governor
Milwaukee County Executive Scott Walker announced last Friday that he is pulling out of the Republican primary for Governor.  This means that Congressman Mark Green (R-Green Bay) will face Democrat incumbent Jim Doyle for the November 2006 Governor’s race.  Walker’s dropping out of the race will have many implications on the race for Governor.  To view remarks and political analysis in Wisconsin Newspapers, click on the following:
Milwaukee Journal Sentinel: http://www.jsonline.com/story/index.aspx?id=410867
Wisconsin State Journal: http://www.madison.com/wsj/mad/top/index.php?ntid=77648&ntpid=1
Capital Times: http://www.madison.com/tct/news/index.php?ntid=77669&ntpid=1

Governor to Sign Nursing Home Rate Increases Today (Monday)
Governor Doyle will sign Assembly Bill 981 into law today at 11:00 AM in the Governor’s Office at the State Capitol.  AB-981, authored by Rep. Dean Kaufert (R-Neenah) and Sen. Scott Fitzgerald (R-Juneau) was amended earlier this month with the Senator Brown\Rep. Pettis Nursing Home Funding Bills SB-532\AB-972.

Although the bill now becomes law, the rate increases will likely not be realized by nursing home facilities until sometime later this summer or early fall – since the state is still working with CMS to approve the current Medicaid state plan amendment from last yar, and these new rate increases will require another plan amendment.  In addition, please note that the new MDS\RUGs acuity-based reimbursement system will be implemented on July 1, 2006.  What the payments will look like for each facility under the new system has not yet been released by DHFS.

Nursing homes will receive $26.8 million in new funding this biennium: 1.4% rate increase ($3 million: $1.2 million GPR\$1.8 million Fed) in the last quarter of FY2005-06 (April - June).  And then a 2.8% rate increase ($23.8 million: $10.1 million GPR\13.7 million FED) for fiscal year 2006-07.  State fiscal years begin on July 1st and end on June 30th.

Governor Expected to Sign Sauk County Labor Region Bill into Law
Governor Doyle is expected to also sign Senate Bill 547 into law, which would move Sauk County nursing homes into the Dane, Iowa and Columbia County nursing home labor region.  Senate Majority Leader Dale Schultz (R-Richland Center) is the author of the Bill.  Sauk County is located in his Senate District. The financial impact on nursing homes in the new labor region composed of the Counties of Dane, Columbia, Iowa, and Sauk would vary by county.  Nursing homes in Dane, Iowa and Columbia Counties will likely experience a decrease in their nursing homes' direct care maximums by approximately 1% (approx. $1 per MA day decrease).  Nursing homes in Sauk County would see an increase of approximately 13.3% in their direct care maximums, with a potential increase in direct care payments of 13.3% (approx. $10 per MA day increase). Direct care costs comprise approximately 67% of total costs to nursing homes.

Following the lead of SB-547, Senate Minority Leader Judy Robson (D-Janesville) recently introduced Senate Bill 662, which would move Rock County into the Dane, Iowa and Columbia County nursing home labor region.  This bill will likely not pass this session, but if it ever does pass into law – the reduction of nursing home reimbursement rates in Dane, Iowa and Columbia Counties would be much more severe.  Both Bills modify the agreement that the Department of Health and Family Services would use the Federal Government’s Medicare Nursing Home Labor Regions for reimbursement purposes.

NEW LEGISALTIVE BILLS \ RECENTLY INTRODUCED

Senate Bill Introductions
SB-662. MA Labor Region (Robson) Requires DHFS to treat Dane, Iowa, Columbia and Rock counties as one labor region for purposes of MA nursing home reimbursement. To Health, Children, Families, Aging and Long Term Care.
SB-666. Birth Certificates (Miller) Increases birth certificate fees. To Veterans, Homeland Security, Military Affairs, Small Business and Government.

Assembly Bill Introductions
AB-1121. MA – Hospitals (Wasserman) Requires MA incentive payments to hospitals establishing a physician order entry record system. To Medicaid Reform.
AB-1127. Health Care Whistleblowers (Pridemore) Immunity from liability for a health care provider, facility or employee that, in good faith, reports a violation of the law or a clinical or ethical standards by another health care provider, facility or employee. To Health.
AB-1128. MA – Nursing Homes (Shilling) Increases MA supplementary rate reimbursement for nursing homes. To Finance.

New LRB Co-Sponsorship Memos (Bills Not Yet Introduced)

- None -

LEGISLATIVE COMMITTEE PUBLIC HEARINGS

Senate Committee Health, Children, Families, Aging and Long Term Care
Wednesday, March 29, 2006   10:00 AM   State Capitol, Room 411-S.
Hearing on:
AB-33. Exception to confidentiality requirements for treatment records.
AB-1021. Inadmissibility of a statement of apology or condolence by a health care provider.
LRB-4804/1. Certification of substance abuse counselors, clinical supervisors and prevention specialists.
The committee may hold an executive session on any of the bills currently in committee.

Joint Finance Committee
Thursday, March 30, 2006   9:00 AM   State Capitol, Room 412-East
Executive Session (Vote):
AB-431. Special license plates – emergency responder personnel.
AB-591. GPS tracking of certain sex offenders.
AB-625. Sale of tangible personal property delivered in this state.
AB-892. Income/franchise tax credit for sales/use taxes paid on purchase of Internet equipment used in broadband.
AB-942. Child porn.
AB-1087. Individual income tax checkoff for prostate cancer research; research board; prostate cancer research.
SB-658. Individual income tax checkoff for prostate cancer research; research board; prostate cancer research.
AB-1110. Contracts with entities to operate resource centers and care management organizations under the Family Care Program.
SB-653. Contracts with entities to operate resource centers and care management organizations under the Family Care Program.
SB-563. Income/franchise tax credits for expenses related to film production services and for capital investments made by a film production company.