WISCONSIN LONG-TERM CARE UPDATE
July 30, 2007
Budget Update: First Meeting of Conference Committee on the Budget Held
The Wisconsin Legislature’s recently created “Budget Conference Committee” met for their first time last Wednesday for 2.5 hours. The 4 Democrat – 4 Republican Conference Committee did not agree on any pending budget issues. This first meeting was more about providing statements establishing party positions on key budget issues and discussion options for future negotiations.
The Senate Democrats on the conference committee focused their comments on the need to include in the final budget “Healthy Wisconsin”, a universal health insurance proposal. Due to the overall cost and complexity of this proposal, is not expected to pass this session. However, this issue is becoming one of the key issues Senate Democrats will focus on in the 2008 state elections.
The Republicans focused on the unreasonableness of including the $15 billion “Healthy Wisconsin” proposal in the budget and their goal to fight tax increases. In addition, the Republicans on the conference committee stated that they did not want to agree to any program spending in the budget at this time, until both sides first identify and agree to a level of overall spending in the state budget.
The Conference Committee adjourned without taking any action or agreeing on any budget provisions. The Conference Committee members will meet again on Wednesday, August 1st at 11:00 AM.
You should have received an e-mail requesting that you and your organizations contact your state senator and state assembly representative. Please follow through with these requests and follow up with your staff to make sure these calls are being made.
The Budget Conference Committee process could take 4-weeks, or it could take much longer – but we cannot let down with contacting our legislators and making sure they understand the need for including
Go to the following website to “Who are My Legislators?”
http://www.legis.state.wi.us/waml/
SUPPORT: Family Care Provider Contracts: “Consumer Freedom of Choice” Budget Provision
This provision was introduced by Senator Hansen and approved by the Joint Finance Committee 16-0. Both the Assembly and Senate have approved this provision as well. Long-term care providers and consumer advocates such as AARP support passage. This provision would maximize consumer choice and protect their right to access CMO-approved care and services through adoption of an “enrollee freedom of choice” provision.
This provision would require DHFS to specify, as a provision of any contract DHFS enters into or renews after the effective date of the bill with a care management organization (CMO) to provide the Family Care benefit, that the CMO must allow any community-based residential facility (CBRF), residential care apartment complex (RCAC), community rehabilitation program, home health agency, day service provider, personal care provider, or nursing facility to serve as a contracted Family Care provider if: (a) the provider agrees to be reimbursed at the CMO's contract rate negotiated with similar providers for the same care, services, and supplies; and (b) the facility or organization meets all guidelines established by the CMO related to quality of care, utilization, and other criteria applicable to facilities or organizations under contract for the same care, services, and supplies.
SUPPORT: Family Care “Time Limits for Paying MA, BadgerCare, SeniorCare and Family Care”
This provision was included in the Assembly version of the budget. There is great concern by many in the long-term care profession that as Family Care expands statewide, Care Management Organizations (CMOs) could extend or delay payments to providers. Long-Term care providers already face financial challenges due to inadequate reimbursement – please do not let our financial situation grow worse or allow patient care to be jeopardized by delayed MA and Family Care payments.
Require Family Care - Care Management Organizations (CMOs) that pay health care providers for services they provide to Family Care enrollees to issue payment for 95% of proper claims for reimbursement for Family Care benefit services within 30 days of receipt of the claims and pay 100% of such claims within 45 days of receipt of the claims.
PUBLIC HEARING \ MEETING NOTICES
Legislature’s Budget Conference Committee
Wednesday, August 1, 2007 11:00 AM 412 East, State Capitol
- SB-40: State finances and appropriations, constituting the executive budget act of the 2007 legislature, introduced by Joint Committee on Finance, by request of Governor James E. Doyle.
STATE AGENCY MEMOS (DHFS, OQA, DDES, etc.)
State Expert Panel on Healthcare Facilities (July 27, 2007)
Funding Available for Demonstration Projects and County Networking Meetings
(See Attached: Cover Memo_2.doc)
From: Information from the Division of Public Health distributed via the DQA ListServ.
To: All Nursing Homes, Assisted Living Facilities, Group Homes and Other Congregate Living Facilities You will find attached to this Memo information about funding of $20,000 for one nursing home, $10,000 for one assisted living facility and $3,000 for one small group home to complete a Demonstration Project on Emergency Preparedness. There is also funding of $1,500 per county (a total of $108,000) for a long term care facility to help facilitate County Networking Meetings to assist Nursing Homes, Assisted Living Facilities, Group Homes and other Congregate Living Facilities in their emergency preparedness initiatives through networking with their emergency response partners. The deadline for applications for both of these projects is August 31, 2007.
DDES Memo 2007-10 (06-28-2007)
New Federal Standards for Human Services Reporting System (HSRS) Alcohol and Other Drug Abuse Reporting
New federal requirements for substance abuse data reporting through the Human Services Reporting System are described including timeliness, completeness, and accuracy.
DQA Memo 07- 011 (July 16, 2007)
Serious and Persistent Mental Illness and Dementia Resources
This memo provides information on resources and educational opportunities available for people who work with individuals experiencing serious and persistent mental illness or dementia. (Adult Family Homes, CBRFs, Facilities for the Developmentally Disabled, Nursing Homes and RCACs)
DQA Memo 07-010 (June 26, 2007)
Office of Caregiver Quality is Moving
The purpose of this memo is to inform providers that the Division of Quality Assurance's Office of Caregiver Quality (OCQ) will be moving from 2917 International Lane Suite 300 to 1 W. Wilson Street, Madison WI on July 24, 2007. (Impacts: Adult Family Homes, Mental Health and AODA Programs, CBRFs, Facilities for the Developmentally Disabled, Home Health Agencies, Hospices, Hospitals, Nurse Aid Training Programs, Nursing Homes, RCACs)
DQA Memo 07-008 (May 29, 2007)
Medication Return, Donation, and Disposal
This memo provides guidance with medication removal in assisted living facilities, including Community Based Residential Facilities (CBRFs), Adult Family Homes (AFHs), and Residential Care Apartment Complexes (RCACs). In addition, this memo waives a portion of section HFS 83.33(3)(j), Wis. Admin. Code, related to medication destruction. (Impacts: CBRFs, Adult Family Homes, RCACs)
DDES Memo 2007-09 (May 29, 2007)
Mental Health Block Grant Community AIDS Formula Allocation
This memo outlines the reporting requirements for the Mental Health Block Grant for CY 2006 and expenditure requirements for the use of CY 2008 MHBG funds. Counties are required to comply with the HSRS reporting requirements including the Consumer Status Data Set. A DHFS priority is to serve persons with a serious mental illness whom are homeless. For CY 2008 a new category, Comprehensive Community Serves (CCS) has been added to the list. Comprehensive Community Services (CCS) certified counties may utilize block grants funds under the CCS category. Return the County Reporting Form no later than August 1, 2007. Reports are form fillable. You should disregard any previous DDES memos relating to the Mental Health Block Grant reporting requirements.
MISCELLANEOUS LTC MEETING NOTICES
Wisconsin Council on LTC Reform – Comprehensive System Change Committee
Friday, August 3, 2007 9:00 AM Coalition of WI Aging Groups (CWAG)
2850 Dairy Drive - Madison
DHFS - DQA Provider Training: OASIS Automation
Home Health Outcome and Assessment Information Set (OASIS Automation)
Wednesday, August 29, 2007 9:00 AM Howard Johnson Plaza Hotel
3841 E. Washington Ave.
Madison, WI 53704
DHFS Focus 2007 Conference: Coming Together: Mapping the Journey to Excellence
August 7-8, 2007 All Day Event Stevens Point, Wisconsin
Wisconsin Council on LTC Reform
Friday, September 14, 2007 10:00 AM Coalition of WI Aging Groups (CWAG)
2850 Dairy Drive - Madison
- Agenda (not available at this time)
Wisconsin Council on LTC Reform – Committee on State and Local Stakeholder Participation
Monday, September 17, 2007 10:00 AM Coalition of WI Aging Groups (CWAG)
2850 Dairy Drive - Madison
- Agenda (not available at this time)
1st Annual Wisconsin Self-Determination Conference - “Organizing for Self-Directed Supports”
November 5-7, 2007 Wisconsin Council on Developmental Disabilities
Kalahari Resort, Wisconsin Dells
“Increasing the presence and participation of people with disabilities in our neighborhoods.”
LEGISLATIVE BILL WATCH (Bills, Resolutions & New Legislation)
Senate Bills:
- SB 32: (Nursing Home Diversions) Diversions under a community integration program of Medical Assistance-eligible persons from imminent entry into nursing homes. (S-Public Health, Senior Issues, Long Term Care and Privacy Committee)
- SB 40: (State Budget) Wisconsin 2007-09 Biennial State Budget: finances and appropriations. (Joint Finance Committee)
- SB 60: (Tort Reform) Evidence of lay and expert witnesses (S-Judiciary and Corrections).
- SB 71: (Pharmacy) Prohibit certain substitutions by pharmacists dispensing epilepsy drugs (S-Health and Human Services).
- SB 76: (Prescription Drugs) Eligibility for and deductible amounts under the prescription drug assistance program for the elderly, providing an exemption from emergency rule procedures, and requiring the exercise of rule-making authority (S-Public Health, Senior Issues, Long Term Care and Privacy).
- SB 85: (Tort Reform) Damages for frivolous claims (S-Judiciary and Corrections).
- SB 114 (MA Estate Recovery and LTC Insurance) Long-Term Care Partnership Program (S-Public Health, Senior Issues, Long Term Care and Privacy)
- SB 144: Changes relating to assets and divestment for Medical Assistance eligibility. (S-Health and Human Services)
Senate Bills Continued:
- SB 147: Requiring a disease management program and health risk assessments. (S-Health and Human Services)
- SB 153: (Protective Placements) Protective placements and protective services; involuntary administration of psychotropic medication; guardianships, conservatorships, and wards; and services for adults at risk and elder adults at risk. (S-Judiciary and Corrections)
Assembly Bills:
- AB 94: (Publicly Financed Healthcare System) Establishing a publicly financed health care system for residents of this state, creating the Department of Health Planning and Finance, Health Policy Board, and regional consumer health councils, granting rule-making authority, and making appropriations (A-Health and Healthcare Reform).
- AB 121: (Tort Reform) Evidence of lay and expert witnesses (A-Corrections and Courts).
- AB 137: (Prescription Drugs) Eligibility for and deductible amounts under the prescription drug assistance program for the elderly, providing an exemption from emergency rule procedures, and requiring the exercise of rule-making authority (A-Health and Healthcare Reform).
- AB 150: (Pharmacy) Prohibit certain substitutions by pharmacists dispensing epilepsy drugs (A-Health and Healthcare Reform).
- AB 213: (MA Estate Recovery and LTC Insurance) Long-Term Care Partnership Program (A-Aging and Long Term Care).
- AB 224: (Liability) Immunity from liability for a health care provider, health care facility, or employee of a health care provider or health care facility that, in good faith, reports a violation of the law or of a clinical or ethical standard by another health care provider, health care facility, or employee of a health care provider or health care facility.
- AB 247: Notification of the state regarding a medical malpractice claim. (A-Judiciary and Ethics)
- AB 274: A state minimum wage and granting rule-making authority. (A-Jobs and The Economy)
- AB 279: Protective placements and protective services; involuntary administration of psychotropic medication; guardianships, conservatorships, and wards; and services for adults at risk and elder adults at risk. (A-Aging and Long Term Care)
- AB 385: Deadlines for payment of provider claims under the Medical Assistance and Badger Care programs and the prescription drug assistance program for elderly persons. A-Health and Healthcare Reform
- AB 413: Temporary certificates to practice respiratory care. A-Public Health
LRB Co-sponsorship Memos: (Legislative Drafts Not Yet Introduced as a Bill)
-None at this time-
Administrative Rules
HFS 06-053 Nursing Homes HFS 83 Rewrite
Nursing homes and affecting small businesses.
- Effective August 1, 2007.
- Rule orders filed with the Revisor of Statutes Bureau.
Through this rulemaking order the Department proposes to repeal or revise outdated or overly prescriptive rule provisions, and to repeal provisions that are duplicative of the requirements that are already stated in and monitored under ch. 50, Stats., 42 CFR 483, or chs. Comm 61 to 65 (The two nursing home associations agreed to these changes).
In addition, the Department also proposes to create rule provisions requiring applicants for nursing home licensure to disclose the qualifications of any person with authority to manage the nursing home; any occurrences that required closure of a residential or health care facility or that required moving its residents; and any financial difficulties that a person or business entity connected with the nursing home has had in operating a residential or health care facility. The Department further proposes to create a quality assurance and improvement committee to distribute funds as allowed under ss. 49.499 (2m), Stats., to nursing homes for innovative projects that improve the efficiency and cost effectiveness of operating a nursing home and that improve the quality of life of residents.
HFS 07-042: Involuntary Administration of Psychotropic Drugs
Relating to facility reporting of involuntary administration of psychotropic medication under s. 55.14, stats. and affecting small businesses.
- Referred to committee on Health and Human Services (07-12-2007)
- Referred to committee on Aging and Long Term Care (07-20-2007)
HFS 07-060: Home Health Care Agencies
Relating to home health care agencies and affecting small businesses.
- Received by Legislative Council (06-12-2007)
- Report sent to Agency (07-09-2007)
- Public comment period to the Agency ended on 07-27-2007
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2004 Residential Services Association of Wisconsin