By Forbes McIntosh Concealed Carry to Pass Legislature This Week by alicejenny


									Wisconsin LTC Update (Monday, June 13 , 2011)
By Forbes McIntosh

Concealed Carry to Pass Legislature This Week - Amendment to Protect LTC Facilities Included
The Wisconsin Legislature is poised to pass Senate Bill 93 this week that will legalize the "concealed
carry" of a weapon. The Joint Finance Committee modified the
concealed carry bill to allow a person with a valid license or an out-of-state license to carry a concealed
weapon. Obtaining a license would consist a person passing a background check; be over 21 years of
age and meet certain state\national certified training or hunter training requirements. A person cannot
obtain a license if they have every been convicted of a felony; determined to be incompetent; found not
guilty of any crime by reason of mental disease or defect; has been involuntarily committed under s.
51.20 or 51.45; subject to an injunction; or if the individual is on release under s. 969.01.

Although long-term care facilities are able to place orange signs at entrances prohibiting concealed carry
by employees and visitors, the original would have allowed long-term care facility residents rights to
carry a concealed weapon.
An amendment was included at the request of our lobbyists Forbes McIntosh and Jeff Schonefeldt
(Government Policy Solutions) that defines certain long-term care facilities as "non-residential
buildings." The intent of the Legislature is to clarify and allow facilities to prohibit concealed carry of
weapons by residents, employees and visitors.

Amendment Language (Senate Substitute Amendment 2)
SECTION 76. 943.13 (1e) (cm) of the statutes is created to read:
943.13 (1e) (cm) “Nonresidential building” includes a nursing home as defined in s. 50.01 (3), a community−based residential facility as
defined in s. 50.01 (1g), residential care apartment complex as defined in s. 50.01 (1d), an adult family home as defined in s. 50.01 (1), and
a hospice as defined in s. 50.90 (1).

DHS Releases RFP for Managed Care Organizations to Serve Residents of Kenosha & Racine
On June 2, 2011 DHS released a Request for Proposals (RFP) for Managed Care Organizations
interested in providing the Family Care or Family Care Partnership Programs (managed long-term care
options) in the counties of Kenosha and Racine. According to the announcement, entities interested in
providing notice of participation in proposers' conference call is June 9, 2011 and the due date for
proposals is July 14, 2011 at 2:00 PM. To view a copy of the RFP # 1720-DLTC-JB, please send an e-
mail to

Wisconsin Biennial State Budget Could Pass Assembly & Senate This Week
The Joint Finance Committee concluded deliberations and actions on the state budget nearly one week
ago. The State Assembly is scheduled to begin debate on the 2-year budget bill tomorrow, Tuesday,
June 14th. The State Senate is tentatively scheduled to take up the budget on Thursday.
Many provisions of the budget do impact long-term care providers (see below). The independent and
Wisconsin Legislative Fiscal Bureau last Friday made available its comparative summary of the budget
(Governor's recommendations versus Joint Finance Committee proposal).
Although there will be some further amendments to the budget bill on the floor of the assembly and
senate this week, the vast majority of the changes made by the Joint Finance Committee will for the
most part remain intact.

One major item that could be included in the budget are the provisions in the budget repair bill that
passed earlier this year, but has run into problems with the courts due to government notice meeting
requirements of at least 24-hours notice. The inclusion of these provisions will depend on whether the
State Supreme Court will take action on the lower court's decisions within the next two weeks.
The Budget Repair Bill contained many changes, but it is recognized for the controversial
state employee collective bargaining changes and authority for the Department of Health Services to
reshape Medicaid programs by administrative rule.

If the Budget Repair Bill language is indeed amended into the 2-year Biennial Budget Bill, protests in
and around the capitol are expected to increase significantly this week.

Please note that we were successful with including Residential Care Apartment Complexes (RCACs) in
the definition of health care provider for the purposes of being included in the "Peer Review" or
"Confidentiality of Healthcare Service Reviews" statutes. RCACs were not included in the original
definition that was passed in the tort reform bill earlier this year.

Budget Provisions Impacting Long-Term Care

   •   Approves Governor's $466.6 million (all funds-approx.) unspecified cuts to Medicaid programs.
   •   Approves Governor's proposal to cap enrollment for Family Care, PACE, Partnership and IRIS
       for 2-years.
   •   Approves Governor's proposal to halt expansion of Family Care into new counties for 2-years.
   •   Approves Governor's proposal to transfer state regulation of Adult Family Homes to counties
       and MCOs.

   •   Provides for certain institutional facility relocations in Family Care counties.
   •   Requires a DHS Study and Report on cost-effectiveness of Family Care, PACE, Partnership and
   •   Prohibits MCOs from requiring return funding in excess of the cost of service to the CMO for
       certain services.
   •   Creates an $5 million annual Family Care Waiting List Crisis Fund.
   •   Deletes the Governor's Senior Care recommendations and fully funds the program.
   •   Requires a DHS study on competitive bidding process for purchase of generic drugs.
   •   Seeks CMS approval of family contributions for irrevocable burial trusts.
   •   Prohibits prior-authorization for certain wheelchair repairs.
   •   Provides a 14-Day Legislative Committee Passive Review of DHS Federal Medicaid Waivers
       (reshaping Medicaid)
   •   Modifies Nursing Home Labor Regions for Dunn and Dodge Counties Effective 2013.
   •   Provides 1 position ($85,000 CMP funding) at BOALTC to serve as a relocation
       ombudsman specialist position.
   •   Provides that all criminal history background check search fees be $7 per request.
   •   Includes RCACs in confidentiality of Peer Review \ Health Service Review statutory
   •   Deletes funding for Wisconsin Quality Home Care Authority.

   •   Increases funding by $21.8 million to recognize a 1% acuity increase for nursing homes in each
       year of the biennium.

   •   Exempts Veteran Nursing Homes from bed assessment.
   •   Allows for private entity to operate Veterans Home in Chippewa Falls.
   •   Provide for a Legislative Audit of Chippewa Falls Nursing Home run by a private entity.
   •   Require cost-benefit analysis on allowing private entity to run Chippewa Falls Nursing Home.
   •   Require private entity operating Chippewa Falls to maintain at least 4-star in the federal rating
   •   Permit (instead of require) DHS to incorporate acuity measurements under most recent RUGs.

University of Wisconsin Receives Federal Grant to Keep Older Adults in their Homes
The University of Wisconsin - Madison's "Center for the Health Enhancement System Studies"
announced in a press release last week that it has been awarded a $9.5 million collaborative research
grant by the federal Agency for Healthcare Research & Quality (AHRQ) to "develop innovations that
help older adults remain in their homes as long as possible." Three Wisconsin counties will help develop
and test the technology over five years.

According to the press release, the grant will "bring the Center's research team together with engineers
from two other research centers based in the UW-Madison Department of Industrial & Systems
Engineering: the Driving Simulation Laboratory and the RFID Laboratory. Experts from UW-
Madison's Mass Communication Research Center, geriatricians, specialists from Wisconsin's State
Bureau of Aging & Disability Resources and community advocates from around the state will also
participate in the collaborative."
The study will also use process improvement methods developed by the center to help service providers
operate more efficiently and effectively.

Non-Emergency Medicaid Transportation Manager (LogistiCare)
Effective July 1, 2011, the Wisconsin Department of Health Services will implement the new statewide
non-emergency transportation management (NEMT) system for Medicaid and BadgerCare Plus
members. Members enrolled in Family Care will continue to receive NEMT services from the Family
Care - care management organizations. Nursing homes are also exempt from this new system. The
company that DHS awarded the contract to is "LogistiCare Solutions, LLC." For additional
information, please go to:

Voter ID Legislation Published on June 9th
Governor Walker signed Act 23, the "Voter ID Bill" on May 25th - but was published as law last week
on June 9th. The bill allows absentee voters in long-term care facilities in lieu of providing a photo ID
to submit the absentee ballot with a statement signed by the special voting deputies. At the request of
our lobbyists, when special voting deputies are not sent to the facility, the bill allows "an authorized
representative" of the facility to submit with the absentee ballot a statement verifying the voter's name
and address.


Wisconsin State Journal (June 12, 2011)
Assessing Impact of Walkerville (Protest Tent City)

WISN-TV Door County (June 13, 2011)
Madison Police Brace for Protest Crowds

Milwaukee Journal Sentinel (June 10, 2011)
State Official Defends Freeze on Family Care

Green Bay Press Gazette (June 9, 2011)
Wisconsin Family Care Cap Raises Concerns


   •   06-14-11: AB-40: Wisconsin Biennial Budget 2011-13.


   •   06-14-11: SB-93: Concealed Carry of Weapons.
   •   06-14-11: SB-107: Prohibit ordinances that place certain limits on landlords.
   •   06-14-11: AB-148: Fiscal Year 2011 Budget Repair Bill.
   •   06-14-11: AB-40: Wisconsin Biennial Budget 2011-13 (Tentative)

Only proposals that are a direct impact to long-term care are listed.
To view the complete list of public hearings, click on: "Legislative Public Hearings."

   •   N/A

   •   07-05-11: 9:00 AM: WI Council on Long-Term Care (Care Wisconsin, 2917 International Lane,
       3rd Floor Conf. Room)
   •   07-12-11: 10:00 AM: DHS Assisted Living Forum (Madison Area Technical College, 211 N.
       Carroll St, Madison, WI)
   •   07-13-11: 12:30 PM: WI Long-Term Care Workforce Alliance (Community Living Alliance,
       1414 MacArthur Rd, Madison, WI)


   •   06-06-11: DQA Memo 11-017: Electronic Signatures on Health Care Documents.
   •   05-31-11: DQA Memo 11-016: Guidelines for Use of Sign-Language Interpreter in Nurse Aid
   •   05-25-11: DQA Memo 11-013: {Pre-admission Consultation Requirements (CBRFs).
   •   05-24-11: DQA Memo 11-015: Life Safety Code Waiver Requests.
   •   05-16-11: DQA Memo 11-014: Summary of DQA Provider Post-Survey Questionnaire.

   •   06-08-11: DMHSAS Memo 2011-01: Use of Out-of-Home Care for Mental Health Crisis
   •   06-02-11: DMHSAS Memo 2011-04: 2010 Substance Abuse Prevention & Treatment Block
       Grant Report.
   •   06-01-11: DMHSAS Memo 2011-03: Mental Health Block Grant Community AIDS Formula


   •   N/A

To view the entire Administrative Register click here: "Administrative Register."

   •   CR-10-145: Revise DHS Ch. 88, resource center referrals by adult family homes (Published -
       Effective June 1, 2011).

Legislative Reference Bureau (LRB) co-sponsorship memos are proposals that are not yet introduced as
a bill, but will be soon.
If you would like a copy of the memo and legislative bill draft, please send an e-mail to: Forbes

   •   LRB-1628 (Wanggaard\Bernier) Income Tax Checkoff. Contributions to elementary and
       secondary education, shared revenue, and Medicaid.

To obtain additional information on these events, please feel free to reply to this e-mail.

   •   06-14-11: 5:30 PM: Attorney General J.B. Van Hollen (Trocadero, 1758 N. Water St,
   •   06-15-11: 6:30 PM: Sen. Randy Hopper (Home of Ben Ganther, 6030 County A, Oshkosh)
   •   06-27-11: 5:30 PM: Attorney General J.B. Van Hollen (Southern WI Regional Airport, 4004 S.
       Oakhill Ave, Janesville)
   •   06-29-11: 5:00 PM: U.S. Rep. Sean Duffy (Iron Horse Hotel, 500 W. Florida Ave, Milwaukee)

To request additional information or to be removed from this list, please contact
Forbes McIntosh, Lobbying Consultant
(608) 255-0029

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