• Wisconsin Legislature Expected to Return Next Week for Veto Override
• Wisconsin State Medicaid Director to Leave DHFS Effective June 30th
• DHFS Releases Report on Community Options Program Waiver
• DHFS to Hold Web cast to Assist Entities on Creating Managed LTC
• DHFS to hold Healthcare Provider and BQA Staff “FOCUS 2006 Conference”
• DHFS-BQA\BQC Memos
• Public Hearing Notices
• Legislative Bills

Wisconsin Legislature Expected to Return Next Week for Veto Override
Governor Jim Doyle will veto legislation today that would have mandated legislative oversight of off-reservation casinos.  Since this is such a polarized and contentious issue, the Legislature is expected to return next week to attempt an override of the Governor’s veto.

Wisconsin State Medicaid Director to Leave DHFS Effective June 30th
Mark Moody, the DHFS Division Administrator of Health Care Financing (i.e. State Medicaid Director), announced this week that he would leave the DHFS effective June 30, 2006 to accept a position in a senior executive capacity with WEA Trust.  WEA Trust is the organization that provides insurance products to Wisconsin public school employees and their families.  No information is yet available on whom Mr. Moody’s replacement might be.  We wish Mr. Moody well in his new position.

DHFS Releases Report on 2004 Home and Community-Based COP\CIP Programs
DHFS Executive Summary: As required by state law, the Department of Health and Family Services released a report to the Wisconsin Legislature on the Community Options Program (COP), which also includes information on the Community Integration Program (CIP).  COP and CIP are home and community-based funding programs that serve the elderly and people with disabilities. COP–Regular serves people who are elderly or who have a physical, developmental or mental disability.  The COP Medicaid waiver serves only people who are elderly or have a physical disability.  This includes the Community Options Program-Waiver (COP-W) and the Community Integration Program II (CIP II).  Different waivers serve people with developmental disabilities.

The average daily cost of care for participants in CIP II and COP-W in Calendar Year (CY) 2004 was $89.07.  The average daily cost of care for people in nursing homes, at the same combination of levels of care, was $108.01 of Medicaid funds.  Almost three-fourths of COP and all waiver participants received care in their own homes or apartments; only 14 percent were living in community-based residential facilities (CBRF). 

In 2004, COP and all home and community-based waiver programs served a total of 26,923 people, of which 9,322 or 35 percent were elderly, 12,204 or 46 percent were persons with developmental disabilities, 4,436 or 16 percent were persons with physical disabilities, 852 or 3 percent were persons with mental illness, and 9 were persons with alcohol and/or drug abuse (AODA).  In 2004, $58 million of state COP served five client populations.  In addition, $143 million of state and federal funding was spent on elders and people with physical disabilities under the COP Waiver and CIP II programs.  Long term care waivers for children and those with developmental disabilities spent $325 million.

If you would like a copy of the 28-page report, please send your request to mcintosh@broydrick.com.

DHFS to Hold Web cast to Assist Entities on Creating Managed LTC
The Wisconsin Department of Health and Family Services (DHFS) will be hosting a web cast on critical components of managed long-term care.  These are the third and forth in a series of briefings to assist long-term care planning grantees and others interested in expanding managed long-term care in Wisconsin.  The format will include a 50-60 minute presentation followed by 30-40 minutes for questions from the audience.

Tuesday, June 6th   1:30 – 3:00 PM:
Critical Components of Managed Long-Term Care:  Quality Management Systems
A robust quality management system is a critical component of managed care.  Quality management systems are procedures and practices that determine the degree to which programs are operating as intended and achieving intended results, ensure remediation of identified problems, and maintain continuous system improvement.  This briefing will describe the Department's approach to quality management of managed long-term care and how this differs from quality management of fee-for-service long-term care.  The speaker will also highlight the expectations for Managed Care Organizations’ (MCO) quality management systems and the role of a federally mandated External Quality Review Organization (EQRO).

Visit this address http://dhfs.wisconsin.gov/LTCare/rfi/webcasts/index.htm for more information.

DHFS to hold Healthcare Provider and BQA Staff “FOCUS 2006 Conference”
From DHFS May Newsletter: The Wisconsin Department of Health and Family Services DHFS will be holding its 6th Annual Conference for health care providers and the Bureau of Quality Assurance Staff on August 29-30, 2006 at the Radisson Paper Valley Hotel in Appleton, Wisconsin.

August 29th: The pre-conference is titled “Sexual Abuse of Vulnerable Adults in Long Term Care: Research Findings and Implications.”  The session will feature presentations by Pamela Teaster and Holly Ramsey-Klawsnik, nationally recognized researchers in the area of sexual abuse.  They will identify approaches to prevent victimization, how to effectively investigate cases of alleged resident sexual abuse, and how to support victims of sexual abuse.

August 30th: The “FOCUS 2006: Collaborating for Quality-Ideas to Action Conference”.   The goal of the conference is to provide ideas, information, and strategies on person-directed care and culture change useful to conference participants.  Opening remarks will be provided by the Wisconsin Department of Health and Family Services’ Secretary, Helene Nelson, and the federal Center for Medicare and Medicaid Services Director, Thomas Hamilton.  A keynote address by Steve Shields, President/CEO of Meadowlark Hills Retirement Community, will include valuable information on his facility’s experience with the implementation of person-directed care.  The conference also offers a variety of educational breakout sessions and informational exhibits, as well as opportunities to network with colleagues.

This conference is for staff from adult day services, assisted living facilities, facilities Serving People with Developmental Disabilities, nursing homes, and the Bureau of Quality Assurance.    The costs are $45.00 for the pre conference and $99.00 for the conference, for a total of $144.00.

Additional information will be provided on the BQA Internet Training Information site at http://dhfs.wisconsin.gov/rl_DSL/Training/index.htm.

PUBLIC HEARING NOTICES:

DHFS Nursing Home Level of Care Briefing
Monday, June 5, 2006    10:00 AM    DHFS, 1 W. Wilson St., Room 751 Madison, Wisconsin
Dr. Ann Pooler will demonstrate the MDS based nursing home level of care computer program that she developed for DHFS.  This computer program will determine eligibility for Medicaid funded nursing home care and will be the standard used by BQA surveyors to validate staffing ratios.

DHFS Announces Public Hearing on Ch. 132 Administrative Rule Changes
The Department of Health and Family Services (DHFS) published public hearings on the proposal to repeal, renumber, renumber and amend, amend, and create rules relating to chapter 132, which regulates nursing homes.  The changes include:

• Repeal or revise outdated or overly prescriptive rule provisions
• Repeal provisions that are  duplicative of the requirements that are already stated in and monitored under Wisconsin ch. 50, Stats., 42 CFR  483, or chs. Comm 61 to 65.
• Creates 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.

• 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.

If you are interested in this administrative rule, please go to the following website to view the administrative rule and the notice, which provides a summary of the changes.
https://apps4.dhfs.state.wi.us/admrules/public/Rmo?nRmoId=387

To view the rule changes: https://apps4.dhfs.state.wi.us/admrules/public/Rmo?nRmoId=387

Hearing Dates, Times and Locations:

• July 24, 2006          9:00 AM – 3:00 PM:

(Milwaukee) Southeastern Regional Office, 819 N. 6th St., Room 40

• July 25, 2006          9:00 AM – 3:00 PM:

(Madison) DHFS Building, 1 W. Wilson St., Room 751

• July 26, 2006          9:00 AM – 3:00 PM:

(Green Bay) Northeastern Regional Office, 200 N. Jefferson St., Room 152-A

• July 28, 2006          9:00 AM – 3:00 PM:

(Rhinelander) Northern Regional Office, 2187 North Stevens St., Large Conference Room

• July 31, 2006          9:00 AM – 3:00 PM:

(Eau Claire) Western Regional Office, 610 Gibson St., Room 123

DHFS-BQA\BQC Memos

Memo 06-008: DHFS 24-Hour Emergency Telephone Hotline
for Reporting Public Health and Human Services Emergencies (May 15, 2006)
Notify providers of the Department of Health and Family  Services' (DHFS) 24-hour emergency telephone hotline, (608) 258-0099
http://dhfs.wisconsin.gov/rl_DSL/Publications/06-008.htm

Memo 06-007: DHFS New Procedure for Disseminating BQA Information (May 15, 2006)
Effective January 1, 2006, the Bureau of Quality Assurance (BQA) will implement a new process for disseminating information and updates to providers.  The BQA Quarterly Information Update will be posted to the Internet once it is final and a postcard or similar notification will be mailed to providers announcing the posting and giving the website location.   BQA will no longer be routinely mailing hard copies of the BQA Quarterly Information Update.
http://dhfs.wisconsin.gov/rl_DSL/Publications/05-013.htm

Legislative Bills

Signed into Law
AB-426 (Act 438) Changes to the Specialized Transportation Assistance Program.
SB-226 (Act 444) Informed consent for minors for inpatient and outpatient treatment for mental illness and developmental disability, informed consent for the administration to minors of psychotropic medication, and access to records.
SB-650 (Act 449) Registration and treatment records for services for mental illness, developmental disability, alcoholism, or drug dependence, exceptions to confidentiality for treatment records, and a good faith exception to liability for release of records by a record custodian.