WISCONSIN LONG-TERM CARE UPDATE
By Forbes McIntosh, Lobbying Consultant

January 25, 2010

Momentum Grows for a Legislative Audit of Family Care
On Wednesday, January 13, 2010 a public hearing was held by the Joint Legislative Audit Committee to hear testimony on Senator Kathleen Vinehout's (D-Alma) request for a broad audit of Wisconsin's Medicaid system.  Along with other provider associations we testified to request a separate programmatic and financial audit of Family Care.

In addition, Rep. Peggy Krusick (D-Milwaukee) and Sen. Tim Carpenter (D-Milwaukee), who chair the respective Senate and Assembly long-term care committee have sent a letter signed by those committee members also requesting an audit of Family Care.  On behalf of RSA-Wisconsin, we appreciate Rep. Krusick's and Sen. Carpenter's leadership on this issue and those of the Senate and Assembly Committees on aging, long-term care and senior issues.

For long-term care providers - this would be good news, since it will shine a light on the program.  

At this time, the momentum is growing for support a programmatic and financing audit of the Family Care program.  But we have not won yet.

The Joint Legislative Audit Committee will be meeting this Wednesday, January 27, 2010.  The agenda for this meeting does not include the Family Care Audit, so it may not come up for discussion.  However, it will be important to have members that are located in (business or home) the district of the legislators on the Joint Audit Committee.

Please, if you are located in the districts of any of the members of the Joint Legislative Audit Committee - please call them or send an e-mail requesting an audit of the Family Care Program.  Look at the testimony attached as a resource in your message - but, if you are already in a Family Care County I expect you already have personal stories of why the Legislature should perform a programmatic and financial audit of Family Care.

PLEASE - ONLY CONTACT THOSE LEGISLATORS WHERE YOUR HOME OR FACILITY IS LOCATED.

Senate MembersAssembly Members

Kathleen Vinehout, Co-chairperson (D-Alma)

Peter Barca, Co-chairperson (D-Kenosha)

Robert Jauch (D-Poplar)

Andy Jorgensen (D-Ft. Atkinson)

Mark Miller (D-Monona)

Mark Pocan (D-Madison)

Robert Cowles (R-Green Bay)

Bill Kramer (R-Waukesha)

Mary Lazich (R-New Berlin)

Samantha Kerkman (R-Powers Lake)

AB-259 (Alzheimers) Update
This Thursday, January 28, 2010 the Assembly Committee on Aging and Long-Term Care will hold a committee vote on AB-259, relating to creating standards for Alzheimer's care and services.

During the public hearing in September, the provider community testified in opposition to the bill on various concerns with how the bill had been drafted.

In late October, Rep. Krusick acknowledged her intent to significantly amend the bill, taking into account the provider association concerns.  This substitute amendment Rep. Krusick provided  would make significant changes to the bill:

• Deletes the requirement for rule-making relating to the standards of care for services for persons with Alzheimer's disease and related dementia that facilities must satisfy in order to hold themselves as providing specialized services.
• Deletes the requirement that DHS include, in its currently required summary report, violations of these rules; and deletes the new requirement that a report on these rule violations be prepared and made available to AFHs and CBRFs.
• Required facilities that advertise, market or otherwise promote themselves as providing specialized servcies for persons with Alzheimer's disease and related dementia to produce written document (see the Leg Council Summary attached) that must be provide to the Secretary of Health Services upon request, the long-term care ombudsman, and each person seeking placement in the facility.

Last week, Forbes McIntosh, our lobbyist along with other long-term care provider associations met with Rep. Krusick's office to discuss continuing concerns with the proposed bill and amendments.

Based on that meeting, Rep. Krusick's office has also agreed to further amend the bill to include the following changes:

• Forfeiture: Stipulate that a violation of this provision would be considered a "Correction Order" instead of a "citation", to recognize that no harm to a resident actually occurred - therefore a provider would receive "correction order" on the first violation. If the violation continues to exist during the next survey, only then could a forfeiture not to exceed $500 be imposed.
• Stipulate that the disclosure statement is only to be used as a guide for consumers.  This is meant to mitigate provider fears that surveyors will use the document to cite facilities if a facility fails to strictly adhere to its disclosure statement).
• Remove the Independent "Cause of Action" provision from the bill.

We have also communicated that there is still considerable concern of how to interpret which providers would be impacted by this (what is specialized Alzheimer's\Dementia Care).  The response was that this language was taken from Minnesota, where it purports to be working without problems.  According to Rep. Krusick's office, this legislation is not meant to impact providers that have residents with Alzheimer's or dementia, but rather those providers that hold themselves out (market, advertise, promote) as providing "specialized services" for persons with Alzheimer's or dementia.  And, these changes no longer require any standards - but rather a disclosure of what those specialized services are.

At this time we are waiting to receive a copy of the new amendment to review before deciding on any action.

Wisconsin Mental Health Parity Legislation
The Senate and Assembly Bill will not be voted upon this month (January).  It is likely however that one or both bills will be voted on the floor of the Assembly or Senate in February.  The delay is due to an unintended consequence of the expected passage of the state bill and the federal legislation that has already passed  - Woodman's Grocery Store and the City of La Crosse announced that they have chosen to opt out of the Mental Health Parity and Addiction Act.  This has concerned some Legislative supporters of the bill and has delayed action on the Wisconsin bills until February.  The concern seems to be focused at how can this  legislation crafted in such a way as not to create an incentive for employers to take similar action and opt out of Mental Health before the state legislation passes?

If you support this legislation - I would recommend calling your state senator and assembly representative, tell them of your support and request the Wisconsin "Mental Health Parity Act" be passed as soon as possible - before this session ends on April 22nd.

LEGISLATIVE PUBLIC HEARING NOTICES

• 01-26-10: Executive Session: AB-608: Requiring carbon monoxide detectors in buildings containing one or two dwelling units.
• 01-27-10: Executive Session: AB-609: Vacating an award following arbitration pursuant to a collective bargaining agreement.
• 01-27-10: Public Hearing: SB-245: Collection of workforce data on registered nurse and licensed practical nurse license renewal forms.
• 01-27-10: Public Hearing: SB-96: Diversions under a community integration program of Medical Assistance - eligibilikty persons from imminent entry into nursing homes.
• 01-28-10: Executive Session: AB-259: Care and treatment of persons with Alzheimer's disease or related dementia in residential care facilities, reports on residential care facilities.
• 01-28-10: Executive Session: AB-389: Require nursing homes to notify residents of certain alleged violations and providing a penalty.
• 01-28-10: Public Hearing: AB-526: Require informed consent before administration of psychotropic medication to a nursing home resident who has a degenerative brain disorder.

OTHER MEETING NOTICES

• 01-26-10: DHS Forward Health Rate Reform Project (1:00 PM) DHS Building-Room 751, Madison, WI
• 03-02-10: Wisconsin Council on LTC (9:30 AM, Lussier Family Heritage Center, Madison)
• 03-09-10: Wisconsin (DHS) Assisted Living Forum  (10:00 AM - 2:00 PM) Madison Area Technical College, 211 N. Carroll St, Room 240, Madison, WI
• 03-10-10: Wisconsin LTC Workforce Alliance  (10:00 AM Board - 12:30 PM Membership) Community Living Alliance, 1414 MacArthur Road, Madison, WI

NEW STATE AGNECY MEMOS (DHS, DQA, DLTC, DMHSAS, etc.)

• N/A

NEW LEGISLATION - INTRODUCED PROPOSALS

• AB-684: (Krusick) Dementia Specialist - Dementia specialist training and certification program.

NEW STATE LEGISLATION - LRB CO-SPONSORSHIP MEMOS
Legislative Reference Bureau (LRB) Cosponsorship Memos are proposals not yet introduced as a bill, but will be at the identified times.  If you would like to receive a copy of the proposed legislation (LRB) and the corresponding co-sponsorship memo, please send an e-mail to forbes@wis-gps.com

• N/A

Contact Information: For substantive questions on rules contact: Pat Benesh, Quality Assurance Program Spec−Senior at 608−264−9896 or benespa@dhfs.state.wi.us.