Joint Finance Committee Approves 12% Increase to Personal Care

The Legislature’s Joint Finance Committee voted June 4 to approve a 12% increase to the Medicaid Personal Care Reimbursement Rate. The rate will increase by 9% on July 1, 2019 to about $18.23 per hour. It will increase by 3% in 2020 to about $18.77 per hour. This is the largest increase to personal care in nearly two decades.  Once the Joint Finance Committee has finished working on the budget, the full Assembly and full Senate will need to vote to approve it.

Other items contained in the Medicaid package passed by the Committee include:

 

Personal Care: Increased funding for the personal care rate by $91 million for the two-year budget period. This is roughly a 12% increase to the MAPC rate.

 

Family Care Direct Care Funding: Increased funding by $66 million for the two-year budget. I believe this puts total funding for that program at $126 million for the biennium. While personal care does not qualify for this money, supportive home care does.

 

Nursing Homes Rates: Increased funding by $73 million for the biennium. This works out to roughly a 7.4% increase to the nursing home rate for the biennium.

 

DHS Administrative Funding (EVV and other Contracts): Increased funding for the DHS Administrative budget by  $44 million. Part of this is being used to fund implementation costs for EVV implementation and other contracted services.

 

Dementia Initiatives: Provided funding to create eight new dementia care specialists and one tribal dementia care specialist.

 

Respite Care:  Increased funding by $125,000 per year.

 

Children’s Long Term Care: Approved the Governor’s recommendation to create a statewide intake, application and screening system for the Children’s Long Term Care System.  

 

Medicaid Cost-to-Continue: Approved cost-to-continue for Medicaid programming of $1.1 billion All Funds for the two-year budget.

Joint Finance Committee Authorizes Funding for Personal Care Training Grants!

The Joint Finance Committee voted 11-4 on May 16 to add language to the state budget that directs the Department of Workforce Development to award Fast Forward grants to personal care agencies this biennium for “a grant program that promotes the attraction and retention of personal care workers who provide home-based and community-based care, and that focuses on quality care.”

 This is a direct result of WPSA’s advocacy in the state capitol!

There are $4.5 million in available funds in the Fast Forward grant program during the biennium that could be accessed by personal care agencies and other employers.

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Gov. Evers Holding Oshkosh, Milwaukee Listening Sessions

Governor Evers is holding two more listening sessions on his proposed state budget. Governor Evers personally attends these listening sessions as well as his policy staff and members of his cabinet. These are great opportunities to meet the Governor to discuss personal care. Details below:

 

Oshkosh

WHEN:
Tuesday, April 23rd, 2019
5:30-7 p.m.
Doors open at 4:45 p.m.

WHERE:
Oshkosh Senior Center
234 N Campbell Road
Oshkosh, WI 54902

Register to attend: https://docs.google.com/forms/d/e/1FAIpQLSdrnafAKJJr-t5nmiD461Z9wxNzbS1X_hdxEcqY93Z5JZkXiA/viewform

 

Milwaukee

 WHEN:

Thursday, April 25th, 2019

5-7 p.m.

Doors open at 4:15 p.m.

 WHERE:

Journey House, Inc.

2110 W. Scott St.

Milwaukee, WI 53204

 Register to attend:https://docs.google.com/forms/d/e/1FAIpQLSc0b8cHqbO_rSZgluDWwUBBcUu1frZmumqC9o_r_QxmD2ZmWg/viewform

WPSA Board Member Amy Mlot Testifies Before Joint Finance Committee

WPSA Board Member Amy Mlot provided excellent testimony to the Joint Finance Committee about the critical need to address the direct care workforce crisis at the Oak Creek public hearing on the state budget bill.

Watch her testimony here.

There are two Joint Finance Public Hearings Left!

 

Monday, April 15, 2019 (10:00 a.m. to 5:00 p.m.)

University of Wisconsin – River Falls

University Center – Riverview Ballroom #260

500 Wild Rose Avenue

River Falls, WI 54022

Free Public Parking Accessible at: PAY 1 LOT, North Second Street, River Falls, WI 54022

 

Wednesday, April 24, 2019 (10:00 a.m. to 5:00 p.m.)

University of Wisconsin-Green Bay

University Union - Phoenix Rooms

2430 Campus Court

Green Bay, WI 54311

 

WPSA needs YOU to Testify at a Joint Finance Public Hearing on the State Budget!

Governor Evers’ proposed state budget increases the Medicaid personal care rate by 1.5% per year, but an 11% increase is needed to prevent the collapse of Wisconsin’s community-based direct care provider network.

WPSA needs your help to educate lawmakers about the critical need to address the workforce crisis. The Joint Finance Committee—the Legislature’s budget-writing committee—is holding public hearings on the budget during the month of April.  It is very important that they hear real stories from providers, workers and clients about how the crisis is impacting people in their everyday lives.

If you are interested in speaking at a public hearing, please contact the WPSA Board! WPSA’s budget talking points document and tips for testifying before the Joint Finance Committee can be found on the Legislative Resource page!

Here are the official dates and locations:

Friday, April 5, 2019 (10:00 a.m. to 5:00 p.m.)

Pontiac Convention Center

2809 North Pontiac Drive

Janesville, WI 53545

 

Wednesday, April 10, 2019 (10:00 a.m. to 5:00 p.m.)

Oak Creek Community Center

8580 South Howell Avenue

Oak Creek, WI 53154

 

Monday, April 15, 2019 (10:00 a.m. to 5:00 p.m.)

University of Wisconsin – River Falls

University Center – Riverview Ballroom #260

500 Wild Rose Avenue

River Falls, WI 54022

Free Public Parking Accessible at: PAY 1 LOT, North Second Street, River Falls, WI 54022

 

Wednesday, April 24, 2019 (10:00 a.m. to 5:00 p.m.)

University of Wisconsin-Green Bay

University Union - Phoenix Rooms

2430 Campus Court

Green Bay, WI 54311

Caregiver Tax Credit Bill Introduced

Caregiver Tax Credit

 Senator Patrick Testin (R-Stevens Point) has introduced Senate Bill 126, which creates a new $1,000 family caregiver tax credit. The proposal would allow individuals who provide care to their family members to get reimbursed for some caregiving expenses. Qualified expenses could include: employing a home care aide or personal care attendant ,making improvements or alternations to a residence to help with accessibility and mobility; purchasing or leasing equipment; adult day care, specialized transportation, legal or financial services, or assistive care technology.

DHS Holding April 10 Forum on EVV

DHS is holding a forum on electronic visit verification (EVV) implementation on April 10, 2019 starting at 10 a.m. in Milwaukee. You can attend in-person or online.

In Person
 Best Western Plus Milwaukee Airport Hotel & Conference Center
Mitchell Ballroom
5105 S Howell Ave, Milwaukee


Livestream

The forum will be livestreamed for anyone who cannot make it to the forum in person. Viewers can submit questions before and during the presentation via the EVV mailbox: DHSEVV@dhs.wisconsin.gov
 

Bookmark this webcast link: https://livestream.com/DHSWebcast/events/8424635 

Governor Evers' Proposed State Budget Includes 1.5% Increase to Personal Care

Governor Evers introduced his 2019-21 state budget on February 28. It includes several major investments in Medicaid, including a 1.5% per year increase to personal care rates and accepting federal funds to expand Medicaid.

 Highlights of the more than 1,100 page bill include:

 Personal Care Rates: Increases personal care rates by 1.5% per year. This would mean the MAPC rate would be approximately $16.98 in Fiscal Year ’20 and $17.23 in Fiscal Year ’21. Budget language says this rate increase should be used to “to support staff in those agencies who perform direct care.”

 Family Care Direct Care Funding: Provides an additional $14.7 million per year to increase the direct care and services portion of the capitation rates the department provides to managed care organizations in recognition of the direct caregiver workforce challenges facing the state. This increase would bring total funding for the program to approximately $90 million for the biennium.

 Nursing Homes Rates: Increases nursing homes and ICF-IIDs rates by 1.5% per year for direct care staff; and an additional 1% per year for acuity of patients.

Governor Evers Creates Task Force on Caregiving

Governor Evers has released an executive order to create a Governor’s Task Force on Caregiving.

 Membership of the task force has not been established yet, but the order says that the task force shall include: members of the Legislature, at least one provider agency, at least one organization providing respite services, at least one person who receives caregiving services, and  at least one individuals who provides caregiving services.  

 The task force is charged with:

·        Analyzing strategies to attract and retain a strong direct care workforce

·        Supporting families providing care to their loved ones through respite and other supports

·        Assessing compensation and fringe benefits for caregivers including ways to make health care affordable for the caregiving workforce through employer-sponsored plans, Medicaid buy-in plans, or other health insurance options

·        Establishing one or more registries of home care providers and developing a plan to provide referral and matching or matching services for individuals in need of home care.

·        Developing a plan to implement recruitment and retention programs to expand the pool of providers

·        Exploring and developing solutions, in collaboration with other relevant departments and agencies, to support and strengthen the direct care workforce, increase access, and improve the quality of caregiving in Wisconsin.

 

WPSA Legislative Chair Todd Costello and WPSA Government Relations Counselor Michael Blumenfeld attended the signing of the Executive Order creating the Governor’s Task Force on Caregiving.

WPSA Legislative Chair Todd Costello and WPSA Government Relations Counselor Michael Blumenfeld attended the signing of the Executive Order creating the Governor’s Task Force on Caregiving.

Governor Walker Signs Extraordinary Session Bills into Law, Including Medicaid Changes

Governor Walker signed the three extraordinary session bills passed by the legislature into law today. While Walker had previously said he was considering possible vetoes, he signed all of the bills into law as passed by the Legislature. The bills limit early voting to two weeks, create new legislative oversight of executive branch functions, place limits on the Attorney General’s ability to withdraw the state from lawsuits, create a process for the Legislature to intervene is certain lawsuits, and put the new work and cost-sharing requirements for childless adults on BadgerCare into law. 

 

There are several specific changes that may be of interest to WPSA.

 

  • Requires Joint Finance Committee (JFC) passive review of any Medicaid rate increases, supplemental provider payments or state plan amendments that have a fiscal impact of more than $7.5 million.

 

  • Creates a new waiver renewal and request process that includes strict legislative oversight. These changes will impact Family Care, IRIS, BadgerCare and other health and long-term care programs which are run using waivers. DHS may not submit a request to a federal agency for a waiver or a renewal, modification, withdrawal, suspension, or termination of a waiver unless legislation has been passed specifically directing the submission of the waiver.  At least 9 months before a waiver expires, DHS must submit a written notice to JFC of the expiration. If DHS intends to request substantive changes to the waiver, they must use the legislative oversight process created by the bill. This includes submitting a waiver implementation plan to the Joint Finance Committee,  submitting the proposed waiver request to JFC for approval before submitting it to the federal government, required bi-weekly contact with the federal agency negotiating the waiver request, progress reports to JFC on the negotiation process and JFC approval of the final negotiated waiver before it can take effect. If JFC determines that DHS has not made sufficient progress with a waiver request, they can reduce DHS’s administrative funding or staffing levels.

 

  • Creates new standards related to agency guidance documents, which the bill defines as “any formal or official document or communication issued by an agency, including a manual, handbook, directive, or informational bulletin” that explains the agency’s implementation of a statute or rule or offers guidance or advice on how the agency is likely to apply a statute or rule. It requires state agencies to cite the relevant state or federal statutory reference or administrative code in any guidance documents they release. Proposed guidance documents must be posted for public comment before they can be adopted. Once the guidance document is finalized, it must remain on the agency's website as long as it is in effect. It also prohibits agencies from seeking deference in a legal action based on their interpretation of any law.

 

  • Updates the current law process that allows the Joint Committee for Review of Administrative rules to suspend an administrative rule to clarify that the Committee can initiate the process to suspend a rule multiple times.

WPSA Needs Agencies, Workers and Consumers to Attend Listening Sessions with Gov.-elect Tony Evers  

Governor-elect Tony Evers is holding budget listening sessions over the next 7 days to hear from Wisconsinites about their top priorities. WPSA needs your help to make sure that Gov.-elect Evers addresses the direct care workforce crisis in his state budget.  Sign up to attend one of the listening sessions with Governor-elect Evers below and get your personal care workers and consumers to sign up too!  Big turnout is critical to having our voices heard. You can use the WPSA legislative priorities to help guide your talking points and turn in other written materials.

You must register to attend these listening sessions.

Dec. 17 in Superior: 4:30 p.m. to 6 p.m. at Superior Middle School, 3626 Hammond Ave. Register at http://bit.ly/WIBudgetSuperior

 Dec. 18 in La Crosse: Noon to 1:30 p.m. at American Legion Post 52, 711 6th St. South. Register at https://bit.ly/2EamsSE .

 Dec. 19 in Milwaukee: 4:30 to 6 p.m. at United Way of Greater Milwaukee, 200 West Pleasant St. Register at https://bit.ly/2B3PoJ6

Can’t make a listening session? Fill out this survey:https://docs.google.com/forms/d/e/1FAIpQLScHfkoflPcl76h5m8KKaIJ7oxYjdYpne2Dpt2YUikwfp21S2g/viewform

Here are some things you can say at the listening session:

 

  • Wisconsin is facing a critical shortage of personal care workers due to chronic underfunding of our long-term care system.

 

  • 1 out of 2 agencies surveyed by WPSA are considering no longer providing Medicaid personal care services. The Medicaid personal care reimbursement rate of $16.73 per hour is about $2.00 below the actual cost of providing care.  Rates must be increased by at least 11% to make agencies whole.

 

  • The direct care workforce crisis is threatening the health, safety and independence of people with disabilities and frail elders. Please convene a direct care workforce task force devoted to finding solutions to the worker shortage.

 

  • Share any stories you can about how the crisis is impacting your clients (for example, people sleeping in wheelchairs overnight, falls, hospitalizations, etc.).

Two Upcoming Opportunities to Provide Input on EVV

There are two upcoming opportunities to provide input into the implementation of Electronic Visit Verification (EVV) for personal care.  Policymakers need to hear from you about how EVV will impact agencies and consumers.  Please considering attending one of these upcoming forums to voice your concerns.

 

Federal Centers for Medicare and Medicaid Services Forum—November 7

 The Federal Centers for Medicare and Medicaid Services is holding a national conference call to get feedback on EVV on November 7 from 12 p.m.-2 p.m. CST (1 p.m. Eastern Time).

 Participant Dial-In Number: 1-(800)-837-1935

Conference ID: 33979177

State Department of Health Services Forum--November 27

 DHS is holding a forum to provide information and get feedback from stakeholders about Wisconsin’s plans to implement EVV on November 27 from 10 to 11:30 a.m. (CST) at the Stevens Point Holiday Inn Hotel and Conference Center, 1001 Amber Avenue, Stevens Point, WI. The forum will also be live-streamed for those who can’t make it to Stevens Point.

 You must register to attend this forum or to participate in the live-stream: EVV Registration Form

Questions can be submitted to DHS prior to the event at: dhsevv@dhs.wisconsin.gov

Frequently Asked Questions about the November 6th Election

DRW and the Wisconsin Disability Vote Coalition have developed an “FAQ” document with some of the most common questions we receive about the November 6th Election, and brief responses. We encourage you to review this document, which includes some of the basics about voting in Wisconsin, as well as information about disability related accommodations and voting rights.

Check out our November 6th Election FAQ for answers to common questions:
Frequently Asked Questions

Congress Provides Funding for National Family Caregiver Council

Congress has voted to provide $300,000 to help fund implementation of the RAISE Family Caregivers Act. This will help fund the creation of a national Family Caregiving Advisory Council charged with developing a family caregiving strategy.

The Strategy must recommend actions that Federal, State, and local governments, communities, health care providers, long-term services and supports providers, and others are taking, or may take, to recognize and support family caregivers in a manner that reflects their diverse needs. The Advisory Council would consist of the following appointed members:  Family caregivers, older adults with long-term services and supports needs; individuals with disabilities; health care and social service providers; long-term services and supports providers; employers; paraprofessional workers; state and local officials; accreditation bodies; veterans; other experts and advocacy organizations.  

Minneapolis Star Tribune: Congress funds first step for national caregiving strategy

Election Resources to Help You Follow the 2018 Campaign

Many federal and state offices are up for re-election in November 2018. This includes one U.S. Senate seat, all Congressional seats, Governor, Lt. Governor, Attorney General, every member of the State Assembly and State Senators from odd-numbered districts.

While the national and statewide races get the most media coverage, it is just as important to educate yourself on races for State Assembly and State Senate.

To see who is on your ballot this November, visit: https://myvote.wi.gov/en-US/PreviewMyBallot

Here are some helpful resources for news and candidate interviews:

Wisconsin Eye: http://www.wiseye.org/Campaign-2018

The Wheeler Report: http://www.thewheelerreport.com/

WisPolitics: https://www.wispolitics.com/

DHS Releases State Agency Budget Request

The Department of Health Services has released their agency budget request for 2019-21, which can be viewed here: https://doa.wi.gov/budget/SBO/2019-21%20435%20DHS%20Budget%20Request.pdf. These requests help the Governor prepare the state budget, which will be introduced in January or February of 2019.

 

DHS is requesting a cost-to-continue budget for Medicaid, which is an additional $496 million GPR for the biennium. Part of this is to reflect increased long-term care costs due to statewide expansion of Family Care.  DHS also requests an increase for administrative costs, which they say includes EVV for personal care in addition to increased administrative costs from FoodShare and Medicaid work requirements and other federal requirements.

 

Interestingly, DHS is projecting fee-for-service decreases in intensity/use for personal care, private duty nursing and home health (likely due to Family Care/managed care expansion) but increased fee-for-service costs for hospitalizations and prescription drugs. DHS also projects that nursing facility patient days will decline by 5.0% annually in Fiscal Year (FY)19, FY20 and FY21.

 

The major funding items they request for the biennium are:

 

·         Increased Medicaid and FoodShare administrative funding for FSET and implementing Medicaid work requirements/FoodShare work requirements passed by the Legislature in the Spring  as well as new federal administrative requirements, such as EVV for personal care ($22.5 million GPR)

·         Increased costs for the FoodShare Employment and Testing Program, which DHS also plans to use as a way for people to meet the Medicaid work requirement they proposed to CMS for childless adults on BadgerCare ($64.2 million GPR)

·         Cost-to-continue for Medicaid ($496 million GPR). DHS says the significant events that will impact Medicaid in the biennium are:

o   Statewide Family Care, individuals continue to enroll off the waitlist in Adams and Dane

o   Eliminating the waiting list for the Children’s Long Term Support Program, children continue to enroll. In addition, DHS must implement a statewide rate schedule.

o   Expansion of SSI-Managed Care resulted in approximately 20,000 new managed care enrollees, this provides significant opportunities for cost-savings

o   Phase-out of the enhanced federal matching for CHIP will begin in this biennium. However, standard FMAP is projected to increase while CHIP FMAP decreases.  

o   Strong growth of the Regional Comprehensive Community Services (CCS) program

o   Increased costs for FQHCs

o   Medicaid enrollment mix—growth of EBD population—managed care intensity

·         Resources to address childhood lead poisoning ($11 million GPR)

·         Funding for Income Maintenance Consortia to comply with new public assistance requirements, such as work requirements, health savings accounts and drug screenings ($1.8 million GPR)

·         Expansion of the Mendota Juvenile Treatment Center ($11.6 million PR)

·         Funding to sustain the Emergency Dispatcher CPR requirements from legislation passed this session ($233,400 GPR)

·         Additional funding for outpatient competency examinations, conditional and supervised release, and treatment to competency programs ($4.5 million GPR)

·         Increased funding for Mendota and Winnebago Mental Health Institutes to reflect changes in their patient populations ($4.3 million GPR)

·         Increased funding for overtime costs at the Mental Health Institutes, DD Centers and the secure treatment centers ($7.7 million GPR)

Take the DHS Provider Survey on EVV Implementation!

DHS has developed a survey to gather provider feedback about electronic visit verification (EVV) for personal care. Input from providers is essential to the planning process for the EVV requirement. Results from this survey will be used by DHS to help plan for the implementation of the EVV requirement.

Please complete the following survey by August 6, 2018 by clicking on the link below. The survey should take about 5–10 minutes to complete.

EVV Survey

If you have any questions or comments regarding EVV, please contact us at DHSEVV@dhs.wisconsin.gov.