September 8, 2017
Volume 61, Issue 36
JFC Wraps Up Budget Work, Sends Amended Bill to Full Legislature
After a nearly three-month break, the State’s Joint Finance Committee (JFC) quickly resumed work on the state budget in late August and finalized their full amendment to the budget bill September 6. The budget bill, as amended by the Committee, will now move to the Assembly and Senate—with action by the Assembly already scheduled September 13 and action in the Senate as soon as late next week.
Gov. Scott Walker will receive the amended budget bill immediately following action by the Senate. If the Senate and Assembly act next week on the bill, the Governor could have the final budget bill and veto message signed before the end of the month.
The budget’s substitute amendment supported by the Committee includes several key WHA priorities:
- A $25 million increase in state support of the Medicaid Disproportionate Share Hospital (DSH) program, resulting in over $60 million All Funds (state and federal dollars) increase in the program;
- A $1.2 million All Funds payment to support rural hospitals who meet the Medicaid payer mix threshold for DSH but do not provide obstetric services;
- Rural health care workforce investments of $1 million annually for training advanced practice clinicians and allied health professionals;
- A $1.5 million increase for the state’s Graduate Medical Education matching grant program; and,
- A $2.25 million pilot program for intensive provider care coordination services for Medicaid patients who are high-utilizers of hospital emergency departments.
In addition to finishing the JFC’s nearly eight-month deliberation of the state budget, the JFC also recommended passage of legislation creating a new electronics and information technology manufacturing zone intended to incent an investment upwards of $10 billion into southeast Wisconsin for electronics manufacturer Foxconn. The Assembly and Senate both need to take action on this legislation before the September 30 deadline established in a memorandum of understanding between Walker and Foxconn CEO Terry Gou. The Senate is planning to take up the final, amended bill September 12 and the Assembly is planning to take up the bill September 14.
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Six Lawmakers Circulate WHA-Supported Legislation to Keep Wisconsin in Nurse Licensure Compact
WHA’s efforts to join the enhanced Nurse Licensure Compact (eNLC) reached an important milestone when Sens. Howard Marklein, Rob Cowles and Luther Olsen, and Reps. Nancy VanderMeer, Travis Tranel and Keith Ripp circulated legislation September 5. The legislation maintains Wisconsin’s membership in the nurse licensure compact through the eNLC, now adopted by 26 other states. In a memo asking their colleagues to cosponsor the legislation, these six policymakers noted, “If Wisconsin does not adopt the new enhanced Compact before the end of 2017, Wisconsin’s nurses who currently enjoy the benefits of a compact license will be forced to apply for a single-state license in Wisconsin and all other states in which they want to practice, including those that have joined the eNLC.”
Nearly all of the current compact states will move to the new compact January 19, 2019. As the sponsoring senators and representatives point out, “Inaction by the state Legislature will create unnecessary red tape and licensure barriers for nurses interested in serving patients in any of the 26 compact states.” WHA member action is needed for this bill that is supported by WHA, the Wisconsin Organization of Nurse Executives, the Wisconsin Nurses Association, and 98 percent of individual nurses who responded to a Board of Nursing request for feedback and comment on the eNLC. On September 8, WHA and a coalition of health care organizations sent a memo to the Wisconsin State Assembly urging legislators to support our state’s adoption of the eNLC. The memo noted the importance of the compact to our Wisconsin-Iowa border, where compact licensure “is essential to places like Southwest Health in Platteville where nearly one in five nurses commute from Iowa.” The memo also noted the compact’s reach “extends beyond the Wisconsin-Iowa border; multi-state licensure facilitates nurses providing services through telemedicine, online education, agency nursing, and disaster relief.” The memo shares examples from the past two weeks where the value of multi-state licensure is clearly demonstrated:
“As a compact state, Texas is grateful to the many compact state nurses able to provide essential hurricane disaster relief with no additional action necessary by the Texas Board of Nursing. In the almost two weeks since Harvey hit, Texas had to issue over 600 emergency licenses to non-compact state nurses, an unnecessary regulatory burden during an unprecedented disaster which could have been avoided by compact membership. And over 100 Wisconsin hospitals reported deploying telemedicine in the recently completed WHA Information Center Annual Survey of Wisconsin Hospitals, creating access to Wisconsin’s #1 health care for patients in Wisconsin and other states.”
Ann Zenk, WHA vice president, workforce and clinical practice, encourages hospital advocates to contact their legislator, noting, “This is a perfect opportunity to engage with state lawmakers in support of legislation that helps ensure an adequately staffed health care workforce, and I encourage WHA members to contact their state legislators to ask them to cosponsor the bill enacting the eNLC in Wisconsin.” Over 650 HEAT members have already contacted their legislators in support of the eNLC. For additional information on the details of the eNLC, contact Zenk at 608-274-1820 or firstname.lastname@example.org.
Individuals who want to stay up to date on this and other important legislation as well as take action on those issues should contact Jenny Boese, WHA vice president, federal affairs & advocacy, at email@example.com or join WHA’s grassroots advocacy program, HEAT, at www.wha.org/heat-grassroots-advocacy.aspx.
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DHS Discontinues Outpatient Behavioral Health Prior Authorization Requirements
WHA work group recommended reforms to behavioral health prior authorization process
The Department of Health Services (DHS) has discontinued the prior authorization requirement in the fee-for-service Medicaid program for outpatient mental health and outpatient substance abuse treatment in excess of 15 hours or $825 per year and for outpatient mental health and outpatient substance abuse assessments in excess of eight hours per year. This change was published in the September 2017 ForwardHealth Update (2017-27) “New Prior Authorization Policy for Outpatient Behavioral Health Services” and is effective October 1, 2017.
“WHA has long supported reducing regulatory burdens on health care providers in a number of areas, including Medicaid,” said Joanne Alig, WHA senior vice president, policy and research. “WHA’s Medicaid Policy Work Group has focused on the area of mental health and substance abuse in particular, and reforming the prior authorization requirements was one of the recommendations coming out of that work group over the past year. WHA is pleased DHS is taking this step.”
In addition to the change in prior authorization requirements, the ForwardHealth Update provides several “reminders” regarding covered services, claims submission, medical necessity and documentation for outpatient mental health and substance abuse services. It also notes the Update contains fee-for-service policy and “applies to services members receive on a fee-for service basis only,” but that “[Managed Care Organizations] are required to provide at least the same benefits as those provided under fee-for-service arrangements.”
DHS also published changes to covered services and prior authorization requirements for adaptive behavior assessment and treatment for Medicaid members with autism or other diagnoses or conditions associated with deficient adaptive or maladaptive behaviors. Those changes were contained in a second September 2017 ForwardHealth Update (2017-28), “Changes to Coverage Policy and Prior Authorization Requirements for Behavioral Treatment”. Among the changes in this Update, “behavioral treatment technicians” are now permitted to deliver “focused behavioral treatment” under certain conditions. These changes are also effective for dates of services on or after October 1, 2017.
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WHA Quality Forum: Patient Safety Tools & Concepts, Oct. 17
On October 17, WHA is offering a one-day session focused on patient safety tools and concepts, including an emphasis on the deviation management process, and discussion on a variety of practical tools including FMEA, RCA2, ACA and risk-based decision making and data management. Faculty includes Kelly Court, WHA chief quality officer, and Alex Hunt, quality assurance manager, Community Blood Center, Appleton. Hunt is well-known in Wisconsin quality leadership circles and has served as director of patient safety for Hospital Sisters Health System (HSHS) and was the quality director for the ThedaCare system.
“Patient Safety Tools and Concepts” will launch WHA’s new Quality Forum, a series of day-long education events that will address high priority topics for hospital quality leaders and others involved in quality improvement in Wisconsin hospitals and health systems. The series includes topics such as medical staff quality, survey readiness, meeting external reporting requirements and more, and presenters for each will share topic expertise and best practice applications.
Online registration and information on all six sessions of the WHA Quality Forum can be found at www.cvent.com/d/f5qhb9. Registration at each session will be limited, so those interested should register as soon as possible. For registration questions, contact Kayla Chatterton at firstname.lastname@example.org. Contact Beth Dibbert at email@example.com, for questions about the content of these sessions.
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Active Shooter, Cyber Threats, Infectious Disease Outbreaks: Be Ready to Respond
Act now - registration closes September 13
Wisconsin hospitals must be prepared to respond to a number of challenges, including infectious diseases, active shooters and cyber threats, to name a few. These very real situations can happen anywhere at any time.
On September 20, WHA is sponsoring the “WHA Emergency Preparedness Conference: Ready to Respond.” This one-day conference will feature Vincent Covello, PhD, a nationally and internationally recognized trainer, researcher, consultant and expert in crisis, conflict, change and risk communications. Covello will keynote the conference and offer a deep-dive session in the afternoon specifically for public information officers and health care public relations professionals. Peter Shult, PhD, associate director of the Wisconsin State Laboratory of Hygiene, will brief the audience on infectious disease outbreaks in the past, present and those that are anticipated in the future. Shult will also share best practices and describe ways hospitals can be better prepared for these events.
Chris Sonne and William Castellano, both of HSS EM Solutions, will share best practices and lessons learned from live active shooter scenarios, as well as direct tabletop exercises and a practical, scenario-based training exercise, during a special afternoon session focused on preparing for an active shooter.
The role of state government during an emergency involves a series of steps that are not always well understood by outsiders. Stephanie Smiley, director of the bureau of communicable diseases at the Wisconsin Department of Health Services, will explain the process the State follows to officially declare an emergency and what triggers the declaration that would impact hospitals.
Hospitals are encouraged to take advantage of this in-state training opportunity designed for hospital emergency preparedness directors, emergency department directors and physicians, infection prevention staff, department directors, public relations professionals and public information officers.
This conference is September 20 at the Sheraton Hotel in Madison. The registration fee is $225 per person. The agenda and registration are available at www.cvent.com/d/b5qw08.
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Register Now: Midwest Forum on Hospitals, Health Systems, Population Health
Nov. 29 – Dec. 1, 2017, Chicago
The Midwest Forum on Hospitals, Health Systems and Population Health: Partnerships to Build a Culture of Health November 29 – December 1 in Chicago will bring together organizations and key stakeholders dedicated to improving the health of all Americans. The forum will assemble nearly 300 Midwestern leaders from health care, public health, social services and other sectors to engage in a broad dialogue around integrating clinical, community health and prevention strategies to solve complex health issues.
This is a major conference that is rarely held in a location this close to Wisconsin. For those managing community benefits, population health or integrated care delivery, this is a not-to-be-missed opportunity to network with peers from communities and organizations of all sizes.
Top-notch national speakers will share innovative working models that will inspire the audience to take action to help transform the existing system of care in the United States to a system that strategically plans for and supports the health of its population, building on health equity as the core forum theme.
- John Auerbach, President and CEO, Trust for America’s Health: Auerbach oversees TFAH’s work to promote sound public health policy and make disease prevention a national priority.
- Mona Hanna-Attisha, MD, Director of the Pediatric Public Health Initiative & Pediatric Residency Program at Hurley Children’s Hospital at Hurley Medical Center at Michigan State University: Hanna-Attisha was heralded internationally for her study that exposed elevated lead blood levels in Flint children. Today, Hanna-Attisha directs the Michigan State University and Hurley Children’s Hospital Pediatric Public Health Initiative, an innovative and model public health program to research, monitor and mitigate the impact of the Flint Water Crisis and help all Flint children grow up healthy and strong.
- John R. Lumpkin, MD, MPH, Senior Vice President-Program at the Robert Wood Johnson Foundation: Lumpkin is responsible for the Robert Wood Johnson Foundation’s efforts aimed at transforming health and health care systems, ensuring everyone has access to stable and affordable health care coverage, building leadership, and engaging business toward building a culture of health in the United States.
- Anand Parekh, MD, MPH, Chief Medical Advisor, Bipartisan Policy Center: Parekh’s areas of expertise include translating research into policy, quality and safety of health care, health and health care disparities, childhood obesity and child health services.
- Lisa Simpson, MB, BCh, MPH, FAAP, President and Chief Executive Officer, AcademyHealth: Simpson has been the president and chief executive officer of AcademyHealth since 2011. A nationally recognized health policy researcher and pediatrician, she is a passionate advocate for the translation of research into policy and practice. Simpson’s areas of expertise include translating research into policy, quality and safety of health care, health and health care disparities, childhood obesity and child health services.
- Kimberlydawn Wisdom, MD, MS, Senior Vice President of Community Health & Equity, Chief Wellness & Diversity Officer, Henry Ford Health System: Michigan’s first surgeon general
- Steven Woolf, MD, MPH, Professor, Director, Virginia Commonwealth University (VCU) Center on Society and Health: Woolf has conducted studies demonstrating that addressing poverty, education, and the causes of racial and ethnic disparities could accomplish far more to improve the health of Americans than investing predominately in medical technological advances. In addition to scientific publications, he has tried to bring this message to policymakers and to the public through testimony in Congress, editorials in major newspapers, web-based tools and speeches.
Agenda and registration information are here: http://iphionline.org/midwestforum.
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Next Wisconsin Hospitals State PAC/Conduit Contributor List Runs Sept. 15
Make your contribution today
The Wisconsin Hospitals State PAC & Conduit fundraising campaign’s full contributor list will be published in the September 15 issue of The Valued Voice.
So far in 2017, 235 individuals who have contributed $215,000 will be on the list. Will you? To make sure your name appears on the list, contribute by September 14.
Log onto www.whconduit.com to contribute online or call WHA’s Jenny Boese at 608-268-1816 or Nora Statsick at 608-239-4535.
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Fast Facts from the WHA Information Center: September is Prostate Cancer Awareness Month
Prostate cancer is one of the most common cancers in men, after skin cancer. According to the American Cancer Society, there are more than 2.9 million men in the U.S. who count themselves as prostate cancer survivors.
Data from the WHA Information Center collected in 2016 showed there were 1,536 inpatient stays for prostate cancer in Wisconsin and 40,838 outpatient visits, which included outpatient surgery, emergency room, observation and ancillary services over the same time period.
For more information on prostate cancer, visit: www.cancer.org/cancer/prostatecancer/index.
Data provided by the WHA Information Center (WHAIC). WHAIC is dedicated to collecting, analyzing and disseminating complete, accurate and timely data and reports about charges, utilization, quality and efficiency provided by Wisconsin hospitals, ambulatory surgery centers and other health care providers.
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