Friday Update: June 25, 2004

Provider Organization Summit of Wisconsin Meets with Secretary Nelson
The Provider Organization Summit of Wisconsin met with Department of Health and Family Services Secretary Nelson and staff to discuss budget objectives for the 2005-07 biennial budget.  The coalition consists of the following organizations: Community Alliance of Providers of Wisconsin (CAPOW); Rehabilitation for Wisconsin (RFW); Residential Services Association of Wisconsin (RSA); Wisconsin Assisted Living Association (WALA); and, Wisconsin Personal Services Association (WPSA).  Representative from each association discussed the need for funding increases and staff wage increases provided through CIP, COP, Family Care, Medicaid, Brain Injury and Community Aids.  The meeting also entailed many other aspects including: DHFS’ push for increased managed care\case management of Wisconsin’s long-term care system; Streamlining regulatory paperwork and appeals; the Quality Home Care Initiative (state-wide unionization of all individuals providing independent home care); and Wisconsin’s state centers.  The meeting provided all participating associations insight and an opportunity to continue dialogue to achieve effective change.  As these meetings occur, the Association will continue to update members of progress.

Joint Committee Hearing on Assisted Living and Nursing Home Regulation Audit
The Joint Legislative Audit Committee held a public hearing on the audit report of Wisconsin’s assisted living and nursing home regulations.  This hearing was a follow-up to last year’s February 5, 2003 hearing where the Audit Bureau identified problems and provided suggestions for Wisconsin’s assisted living and nursing home regulation process.  DHFS was the only organization to testify before the committee.  Representing the department was: Sinikka Santala (Administrator, Division of Disability and Elder Services); Otis Woods (Deputy Director), and; Kevin Coughlin (BQA-Assisted Living Section).  The report on assisted living was a positive one.  (Testimony is Attached for your review)

The highlights included (Assisted Living):
- Currently 80% of facilities have had a survey in at least 2 years, up from 67% a year ago.  
- The violations cited have more of an emphasis on quality of life and quality of care, and less on paperwork or the more prescriptive requirements.
- Cites, or violations, per facility are down from 4.9 citations per survey in CY 2003 to 3.6 thus far in CY 2004.
- 63% surveys completed during the current calendar year with no citations compared to 44% CY 2003.
- Enforcement action has decreased slightly with a significant decrease in revocations.  One revocation so far in CY 2004 compared to 18 in CY 2003.

Nursing Home Highlights:
- DHFS is closing the gap of disparity of nursing home citations by region.
- The fact that citations increase when federal authorities are present during surveys occurs region and nationwide.  CMS does not appear to be concerned, but DHFS is closing the gap.
- The problem of nursing home forfeitures not being assessed in a timely manner: DHFS reports there are no past (before 2004) outstanding forfeitures at present and that all by 9 forfeitures from January 2004 fall within the 120 day timeline.
- The complaints of the informal dispute process has created much change within the department.  These changes have resulted in a more timely BQA review and decision-making.  Current data indicates that 70% of IDR reviews (versus the 32% a year ago) are completed with 21 days.
 

Legislative Hearing Notices

Assembly Health Committee
Tuesday, July 6, 2004  10:00 AM  State Capitol, Room 417-North
An informational hearing on health care costs, drug pricing and health care service investments in safety technologies.  The hearing will focus on issues raised by the following LRB's:
LRB-4538/1. Changes of healthcare providers, retail prices of prescription drugs, hospital estimates of charges, independent review of charges that exceed estimates.
LRB-4544/1. Requires hospitals and ambulatory surgery centers to disclose the manner and degree of implementation of patient safety practices.
LRB-4545/1. Requires hospitals to disclose readmission rates and the names of any other hospitals from which patients were discharged before readmission.

Senate Health, Children, Families, Aging and Long Term Care
Thursday, July 8, 2004   9:00 AM   State Capitol, Room 411-South
Public Hearing on SSI Managed Care.  Mandatory enrollment in managed care plans for MA recipients who receive SSI. (The 2003-05 budget directed DHFS to require adults who are eligible for SSI to enroll in managed care plans. Invited speakers include individuals from DHFS, HMOs, advocacy groups and the LFB.)


Important Dates to Remember

Wisconsin Council on Long-Term Care
July 9, 2004
August 13, 2004
September 10, 2004
October 8, 2004
November 12, 2004
December 10, 2004

Wisconsin Council on Long-Term Care
Residential Options Task Force
July 16, 2004
August 20, 2004
September 17, 2004
October 15, 2004
November 19, 2004
December TBA, 2004

2004 Wisconsin Elections
September 14, 2004: Partisan Primary (state elections)
November 2, 2004: Presidential and General Elections (federal and state-wide elections)


Long-Term Care in the News

Milwaukee Journal Sentinel (June 24, 2004)
Employers temper rise of health care costs
By increasing employee health insurance deductibles and co-payments, employers were able to slow the growth of their health care costs this year, according to an online survey of 100 employers in southeastern Wisconsin.  The preliminary result is from an ongoing survey by the Greater Milwaukee Annual Report on Health Care.
<http://www.jsonline.com/bym/news/jun04/239105.asp>

Sheboygan Press (June 23, 2004)
Letters: County Board, committee had to deal with health-care centers cost issues
I have followed with interest the numerous letters to the editor regarding the county health care center budget crisis. I am disappointed in many of the unfair comments about the County Board, staff, consultants and the committee. Personal attacks are not how issues get resolved.
<http://www.wisinfo.com/sheboyganpress/news/archive/opinion_16581235.shtml>

Sheboygan Press (June 22, 2004)
Letters: Governor needs to put honesty, integrity back in Medicaid system
At a recent gathering, I had a chance to talk to our governor, Jim Doyle. I raised the question as to the irresponsible handling of our Medicaid system in Wisconsin.  Earlier, he had indicated that we were doing an excellent job in our state regarding the Medicaid system. Now he admitted that the Medicaid system was a “mess” throughout the country, including Wisconsin.
<http://www.wisinfo.com/sheboyganpress/news/archive/opinion_16536858.shtml>

Oshkosh Northwestern (June 20, 2004)
Nursing home troubles not unique
At least five other counties have dealt with similar crisis
When it comes to the struggle of finding a way to pay for county-owned nursing homes, Winnebago County is not alone.  At least five other counties have dealt with nursing home crises – some more recent than others – in a variety of ways. Almost all said the steep loss of state and federal revenues has forced a re-examination of the size and future of county-owned nursing homes.
<http://www.wisinfo.com/northwestern/news/local/stories/local_16534862.shtml>

Department of Health and Family Services Testimony
Before the Joint Committee on Audit
Regarding the Legislative Audit Bureau Report on the
Regulation of Nursing Homes and Assisted Living
June 24, 2004