• Senate Committee Passes “Nursing Home Diversion” Legislation
• DHFS-BQA Will Issue Memo to LTC Providers on Transportation Safety
• Gov. Doyle Announces Nursing Home Relocation Initiative A Success
• Wisconsin Concealed Carry Legislation Moving Quickly Through Legislative Process
• Assembly Rep. Terri McCormick Will Not Seek Re-Election
• Update: LEGISLATIVE COMMITTEE PUBLIC HEARINGS
• Update: NEW LEGISALTIVE BILLS \ RECENTLY INTRODUCED

Senate Committee Passes “Nursing Home Diversion” Legislation
The Senate Health, Children, Families, Aging and Long-Term Care Committee voted 5-0 to pass an amended SB-312.  The bill would expand relocations from nursing homes under the community integration program (CIP) to include persons who are diverted from imminent entry into nursing homes.  The bill is now available for Senate Floor action.

The Substitute Amendment expands eligibility for the enhanced reimbursement rate for services under CIP II to up to 150 persons who meet MA level of care requirements for nursing home care and are diverted from imminent entry into nursing homes.  The bill requires DHFS to develop and utilize criteria for determining imminent entry into a nursing home.  The criteria are, under the substitute amendment, exempted from rule?making requirements.  If it is likely that the number of persons for which the enhanced MA reimbursement rate for services is provided for diversions from immanent entry into nursing homes will exceed 150, DHFS may submit a request to the Joint Committee on Finance of the legislature, under a passive review process, for approval to expand the number of that category of persons served.

DHFS-BQA to Issue Memo to LTC Providers on Transportation Safety
The Wisconsin Department of Health and Family Services – Bureau of Quality Assurance, the division that regulates and cites healthcare facilities will be issuing a memo that will require entities that transport clients, residents or patients outside the facility must develop and implement written policies by January 1, 2006.  The policies are subject to review by surveyors or licensing certification/specialists during on-site visits or upon request.  BQA states in the draft memo: that the purpose of the memo is to increase awareness of several serious situations that have arisen when clients, residents or patients have been transported outside the facility.  This includes being left in vehicles unattended during periods of heat and cold, and not being properly secured during transportation.

Written policies must include, but are not limited to: 

• A plan for in-service training of staff and volunteers who transport, or accompany clients, residents or patients during transit.  This training should inform staff and volunteers that leaving vulnerable persons unattended in a vehicle may be considered unlawful neglect under HFS Chapter 13 of the Wisconsin Administrative Code and can result in sanctions against the facility and/or individual caregivers.  Furthermore, individuals responsible for endangering clients, residents, or patients may be subject to criminal investigation.
• A plan for providing supervision to clients, residents, or patients during periods of transportation outside the facility.  This plan should include a statement that leaving vulnerable persons unattended in a vehicle may be considered unlawful neglect under HFS Chapter 13 of the Wisconsin Administrative Code and can result in sanctions against the facility and/or individual caregivers.
• A procedure to initially assess clients, residents, or patients for risks during periods of transportation outside the facility and to reassess as necessary when changes occur.
• A plan to address the safe and secure transport of clients, residents or patients. Issues to consider in this plan include the use of seat belts, security of wheel chairs, safety precautions when transporting oxygen or other potentially hazardous materials, and a schedule for the provision of vehicle maintenance.
• A plan to evaluate the effectiveness of established policies and procedures. 

Gov. Doyle Announces Nursing Home Relocation Initiative A Success
Earlier this week, Governor Doyle announced that the Department of Health and Family Services (DHFS) is on target to move 1,440 people out of nursing homes and into community-based settings over the next two years as called for in his Community Relocation Initiative.  Currently, 118 people in 35 counties are in various stages of the relocation process: 61 have either relocated or expect to shortly and 57 are arranging in-home services or locating appropriate assisted living settings and will likely relocate within the next two months. About 40 percent are relocating to a home or apartment and 60 percent are relocating to assisted living.  The goal of Governor Doyle's initiative is to move about 540 people in FY 05-06 and another 900 in FY 06-07.  Governor Doyle’s press release included stated that “Seniors and People with Disabilities Moving Out of Nursing Homes; Preference is for Home and Community Based Care.”

Whether the program is really providing the savings the Administration budgeted on should be known at the end of January, since the program officially began in October, analyzing the cost\financial data from October thru December will be a good measurement.  The real test will be determining if overall nursing home reimbursement based on Medicaid days is decreasing while patients are being relocated. 
Press Release: http://www.wisdems.org/ht/display/ReleaseDetails/i/701321

Wisconsin Concealed Carry Legislation Moving Quickly Through Legislative Process
Assembly Bill 763 and Senate Bill 403: The Concealed Carry debate is in full swing at the state Capitol, which would allow Wisconsin residents who pass firearms training and obtain permits to carry concealed handguns and other weapons in most public places, the few exceptions include schools, taverns, and police stations.  A private employer may prohibit an employee from carrying a concealed weapon in the course of the employee’s employment unless the employee is in his or her own vehicle.  Both bills are expected to pass the legislature in early December.  Governor Doyle is expected to veto the bills, which then a veto override in both houses will occur.  Last session the veto override failed by one vote – the next veto override is also expected to be close.

Both bills have been sent to the Joint Finance Committee, where the bills could be amended.  One of the amendments that is being considered would prohibit concealed carry of weapons in “healthcare facilities” as defined in Chapter 150.  This prohibition would include any hospital, nursing home, community-based residential facility, county home, county infirmary, county hospital, county mental health center or other place licensed or approved by the department.  We are working with legislators to also include Chapter 50, which would include Adult Family Homes and RCACs. Any amendment to the Concealed Carry legislation could prove to be difficult, since many legislators want to allow concealed carry anywhere.

Please contact your legislators and request that they amend the Concealed Carry Bills to “prohibit the carrying of concealed weapons in healthcare facilities.  And please include all healthcare facilities by stipulating both Chapter 150 and Chapter 50 Wisconsin Statutes”.  The safety of our patients and residents is our priority.  In addition, LTC facilities are already struggling financially and increased liability insurance increases would just be another unfunded mandate by the State.
Who Are My Legislators (Click Here)

Assembly Rep. Terri McCormick Will Not Seek Re-Election
Rep. Terri McCormick (R-Appleton) announced this week that she will not seek re-election to the Wisconsin Assembly, whether or not she runs for Congress.   Rep. McCormick is currently considering a bid for the open 8th Congressional seat in the Republican Primary.  Republican Assembly Speaker John Gard (R-Peshtigo) has already announced his bid for the same Congressional Race and is considered the leader in the primary.  Rep. McCormick cited her personal belief in “term limits” as her reason for not running for re-election.

LEGISLATIVE COMMITTEE PUBLIC HEARINGS

Assembly Committee on Health
Tuesday, November 22, 2005   10:00 AM   State Capitol, Room 417-N
Hearing on:
AB-828. Changes in the regulation of optometrists.
AB-683. Authorizes medically-related actions by advanced practice nurse prescribers and physician assistants.
AB-740. Medical use of marijuana.
Executive Session on:
AB-33. Exception to confidentiality requirements for treatment records.
AB-709. Licensing midwives.

Assembly Committee on Medicaid Reform
Wednesday, November 30, 2005   11:00 AM   State Capitol, Room 413-N
Informational and discussion session.
Wisconsin’s Medicaid Program. DHFS Sec. Nelson and Mark Moody of DHFS to present testimony regarding recent request for information/proposals relating to the long-term care system, as well as speaking on other topics related to Medicaid and Medicaid Reform issues.

Additionally, speakers from APS Healthcare, Inc. will present the results of the second Independent Assessment of Family Care, which was prepared and released in October.
Discussion Session. Following the testimony, the committee will continue to meet to discuss Medicaid reform ideas and proposals.

Assembly Committee on Aging and Long-Term Care
Wednesday, November 30, 2005   1:30 PM   State Capitol, Room 415-NW.
AB-791. Requires execution of a living will by Medical Assistance recipients.
AB-792. Requires a home care placement agency placing a home care worker in the residence of a home care consumer to provide notice to the consumer concerning rights, duties, responsibilities and liabilities of the consumer with respect to the worker and notice to the worker concerning the worker’s employment status.
SB-140. Eliminates penalty for certain early withdrawals from an IRA.

NEW LEGISALTIVE BILLS \ RECENTLY INTRODUCED

SB-416. Health Care Coverage (Robson) Requires legislature to meet certain deadlines regarding health care coverage. To Health, Children, Families, Aging and Long Term Care.

AB-791. Living Wills (Wasserman) Requires execution of a living will by MA recipients. To Aging and Long-Term Care.
AB-792. Home Care Workers (Van Roy) Requires home care placement agency placing a worker in a residence to provide notice to the consumer concerning the rights, duties, responsibilities of the consumer with respect to the workers and notice to the worker concerning worker’s employment status. To Aging and Long-Term Care.
AB-802. MA Payments (LeMahieu) Supplemental Medical Assistance payments to county and municipal nursing homes. To Finance.
AB-813. Medical Assistance (Black) Transfer of funds from Medical Assistance to the Long-Term Support Community Options Program under certain circumstances. To Finance.
AB-816. Health Care (Townsend) Tax-exempt accounts for health care expenditures for an individual's parents. To Insurance.