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Events of Interest:
Finding Your Way: A Navigation Guide for Wisconsin Families Who Have Children and Youth with Special Health Care Needs and Disabilities has been published. Download a pdf version of the booklet here.
The National Youth Leadership Network announces their new curriculum: Reap What You Sow: Harvesting Support Systems Curriculum Training Packages. Reap What You Sow brings youth and adults together to build support systems. For more information, click here.
January 13-14, February 24-25, April 20-21. Youth in Partnership with Parents for Empowerment. 5 p.m. Fridays ending by 3 p.m. on Saturdays at the Tundra Lodge Resort & Conference Center, Green Bay, WI. Youth, parents and guardians must attend all five sessions. For more information, contact Martha DeYoung at 800-862-3725 or deyoungm@cesa5.k12.wi.us.
January 18. The Joint Committee on Audit will hold a public hearing on Audit Report 11-5: Family Care on Wednesday, January 18, 2012, at 9:00 a.m. The hearing will take place in 411 South in the State Capitol. The Committee will also consider a September 1, 2011, follow-up report prepared by the Department of Health Services in response to recommendations in report 11-5.
January 20-21, February 17-18, March 30-31. Parents in Partnership: A Leadership Development Opportunity for Parents of Children with Disabilities. 4:30 to 8:30 p.m. on Friday and 9 a.m. to 3:30 p.m. on Saturday at Paradise Shores Conference Center, 26364 County Hwy. M, Holcombe, WI. Parents and guardians must attend all five sessions. For more information, contact Ruth Adix at 715-864-3014 or raadix2@yahoo.com.
February 9-10. The Wisconsin Statewide Transition Initiative (WSTI) Conference will be held Feb. 9 - 10 at the Kalahari Resort, WI Dells. Registration information is available at: www.wsti.org/conf.register.php There are a limited number of scholarships still available to attend this conference! Go to www.wsti.org/conf.scholarship.php to complete the online form. You must be a parent/guardian of a youth with a current IEP age 14-21.
April 16. Parent to Parent of Wisconsin's Support Parent Trainings are held periodically throughout the State. Trainings are held in small group settings (8-15 participants). Registration is required for all trainings. The next training will be held on Saturday, April 16, 2012 from 9:00 am to 3:30 pm at the Children’s Hospital of Wisconsin Corporate Center (999 North 92nd, Milwaukee, WI). Call or email to register: 715-361-2934 or Get-Connected@p2pwi.org
April 26-27. Circles of Life Conference 2012: a statewide conference for the families of children and youth with disabilities and the professionals who support them. This year's conference will be at the Madison Marriott Hotel. Fore more information, click here.
Is there an event missing from our list? Let us know! Email us with events, directions and details other collaborators may like to attend.
A Training Announcement for All CYSHCN Collaborators: Thursday, January 19, 10:30-11:30am
Topic: "New Year's Resolutions: Preempting Problems, Planning for Change"
It's a new year, and already it's shaping up to be one of potentially dramatic political upheavals, heated policy debates and systemic changes. With so much going on, it is going to be all too easy to get frustrated or overwhelmed trying to help families access the coverage and services they need and deserve. Yes, there will likely be many changes in 2012, some sweeping and others subtle; but by using the lessons we learned from 2011, we can become even better advocates for the children and families that depend on us. This webcast will review some of those lessons and teach you how to apply them in the future situations. And, since last year taught us just how quickly things change, we'll be looking at some of the potential sources of change and resources to help keep you current.
Learning Objectives for this training, include:
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Understanding the take-aways from 2011 and what to watch in 2012
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Learning some of the proposed changes that could affect CYSHCN in Wisconsin
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Reviewing the resources and tools available to help you serve CYSHCN and their families
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Learning about the new county consortia in Wisconsin
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Taking a look at some of the big dates and events coming in 2012
CYSHCN Collaborators, click the "Referral Form" image at right to be directed to the printable version of the CYSHCN Client Referral Form! Use this handy tool in directing a family to ABC for Health for services.
Not able to join the live web cast? Don't worry, email Adam to get information on how to view the new webcast archive.
State & National News
HealthWatch Analysis and Comment
Long-Awaited Medicaid Audit is Released
The Joint Legislative Audit Committee, led by Republican lawmakers, requested that the Legislative Audit Bureau (LAB) conduct a comprehensive audit of Wisconsin’s Medical Assistance programs back in January 2011. Now, almost a year later, the LAB on December 20, 2011 released its comprehensive audit report. The full audit reveals a disproportionate, wasteful dependence on vendors to administer Wisconsin’s Medicaid programs and no evidence of the fraud and abuse that Medicaid opponents cited back when they called for the audit. While the audit report is not as thorough as some we have seen in the past, it still offers valuable insights into the status of Wisconsin’s health care system and spending – insights that could have been used to inform DHS officials and lawmakers before they developed and approved a waiver proposal that may irrevocably alter the face of Wisconsin’s public health landscape. Watch for a future edition of the HealthWatch Reporter devoted entirely to the Medicaid Audit.
Winnebago County Takes Over Well Woman Program
Planned Parenthood will no longer coordinate the Wisconsin Well Woman Program in Fond du Lac, Winnebago, Outagamie and Sheboygan Counties. The decision was made by Walker Administration officials who viewed "Planned Parenthood as too controversial," and therefore planned to move all Well Woman services to county public health departments, canceling contracts with Planned Parenthood. The final announcement that Winnebago County would take over the education and outreach piece of the Well Woman Program was made on December 23.
Planned Parenthood and the Well Woman Program are indispensable contributors to better health for many women in Wisconsin. The programs bridge many unique service gaps between low-income women and needed services. Cutting Planned Parenthood's funding will only result in long-term negative health outcomes for mothers, daughters and others in Wisconsin. This Program is essential to uninsured women who need access to early detection and treatment for cervical and breast cancers, and for many, Planned Parenthood is their trusted point of access to the Program.
For those of us who believe that we should have the healthiest Wisconsin that we can, regardless of politics, the decision to defund Planned Parenthood is a misguided, immoral blunder on the part of the Walker Administration.
Special Committee on Health Care Access Back in Session
Back when health reform implementation was the talk of the town, two Special Legislative Council Study Committees were formed. The Special Committee on Health Care Access and the Special Committee on Health Care Reform Implementation. The Committees typically work in between legislative sessions, to conduct background research, interview community members, experts and advocates, and take any other steps necessary to inform legislation and priorities for the coming session. In Wisconsin, however
which has not met since February of 2011, will reconvene on January 18, 2012, at 8:30a.m. They plan to pick up where they left off, but nowhere on their agenda is any mention of pressing current issues with Medicaid Cuts or Waiver Requests. View the committee's agenda here.
Headlines
GAO Report on Health Care Reform’s Medical Loss Ratio Rules Indicates That Many Insurers May Satisfy Applicable Standards
The GAO report uses preliminary data submitted to the National Association of Insurance Commissioners (NAIC) on insurer experience in 2010—before the MLR requirements were applicable. Based on the 2010 data, the report concludes that most insurers would have met MLR standards had they applied in 2010. In particular, the data indicates that 77% of large group market insurers (and 70% in the small group market) would have met the standards. The report also notes that MLRs varied widely among insurers and that even MLRs for the same insurer varied widely from state to state.
HHS deems insurance rate hikes 'unreasonable' in 5 states
The Hill, Jan. 12, 2012
Trustmark has raised its rates in Alabama, Arizona, Pennsylvania, Virginia and Wyoming by 13 percent, HHS said. In Alabama, the company has raised premiums by a total of 27 percent over the past year.
Study: Premiums could rise 25 percent without insurance mandate
The Hill, Jan. 12, 2012
Premiums would rise because young, healthy people would be less likely to buy insurance. The purpose of the mandate is, in large part, to force healthy people into the system, offsetting the cost of guaranteeing coverage to people with pre-existing conditions.
Medical Transport Lawsuit Gets Federal Injunction
California Healthline, Jan. 12, 2012
In addition to these four lawsuits over the 10% provider cuts, a federal judge also issued a preliminary injunction halting the 20% trigger cuts to In-Home Supportive Services. All of those lawsuits were filed before the governor released his current budget, which includes another series of health care reductions.
Health care in central city on brink of crisis
Journal Sentinel, Jan. 11, 2012
The health care crisis for some low-income Milwaukee neighborhoods is going to get worse than most people think, according to Perry Margoles. If Sinai Medical Center closed, it would create a gaping hole for thousands of low-income residents who live in or near that location. The hospital had 303,402 nonemergency visits and 68,196 emergency visits in 2010.
Wisconsin has more than 12,000 health care companies
The Business Journal, Jan. 11, 2012
Health care continues to be one of the fastest-growing industries in the nation’s economy with more than 12,140 private-sector companies in related fields of health care and social assistance alone.
U.S. Rep. Tammy Baldwin praises health care reform, derides partisan gridlock
Post Crescent, Jan. 11, 2012
"I wouldn't repeal the Affordable Care Act," Baldwin said. "I wouldn't throw the baby out with the bathwater. I would perfect it as we move forward." Baldwin, 49, praised a provision in the law that prohibits insurance companies from denying coverage to children who have so-called "pre-existing" health conditions, and touted a provision she authored that allows young adults to stay on their parents' insurance plans until age 26.
Nearly 500 state lawmakers to press Supreme Court to uphold healthcare mandate
The Hill, Jan. 11, 2012
The state lawmakers say requiring almost all Americans to buy insurance falls well within Congress's power under the Constitution's Commerce Clause. Echoing the Justice Department's arguments in support of the mandate, the state legislators said the Constitution gives Congress broad authority to regulate interstate commerce.
Slower growth in healthcare spending [Opinion]
New York Times, Jan. 11, 2012
That looks like good news after decades of soaring health care spending that outpaced economic growth. The hitch: the main factor was the recession that left millions of Americans unemployed, uninsured, short of income, and unable or unwilling to spend money on health care.
All Heat, No Light — The states' Medicaid claims before the Supreme Court
The New England Journal of Medicine, Jan. 11, 2012
Although the Constitution's 10th Amendment prohibits the federal government from forcing the states to carry out a federal program, it allows the federal government to require states to meet specific conditions if they accept federal money. The states, however, argue that they are being coerced into accepting the expansion, since Medicaid is their largest source of federal funding and since it offers the only basis for covering the poorest Americans under the ACA.
Medicaid: A year of excruciating decisions
Stateline, Jan. 11, 2012
2012 will likely be remembered less as an historic turning point than as a gradual continuation of states' longstanding struggles to get Medicaid costs under control.
Emergency Medical Assistance program ends (Minnesota)
Twin Cities, Jan. 11, 2012
Hundreds of people in Minnesota who aren't U.S. citizens will no longer receive most health care services from a program of last resort
States link health law's Medicaid expansion to individual mandate
The Hill, Jan. 10, 2012
The states say the law’s Medicaid expansion is coercive — that it goes beyond the program’s traditional federal-state partnership and essentially requires states to participate in Medicaid.
Kaiser Issue Brief Examines Medicaid’s Role For Women
Kaiser Family Foundation, Jan. 9, 2012
The Kaiser Family Foundation released a new issue brief that discusses the role of Medicaid for women and examines how changes under the health reform law will affect the program and women covered by Medicaid. The issue brief explores Medicaid’s role for women across their lifespans including reproductive health services, care for chronic conditions and disabilities, and long-term care services. It also provides new state-level data on enrollment and coverage policies on services of importance to women.
State wise to wait and see fate of health reform law [Opinion]
Journal Sentinel, Jan. 9, 2012
Sen. Lasee writes, "True free-market exchanges do exist, and the competition they generate yields positive results. A government-run Obamacare exchange is deceptive, ill-conceived and an expensive government expansion that our nation cannot afford at this time or in the near future."
Walker wrong to halt work on insurance exchanges [Opinion]
Journal Sentinel, Jan. 9, 2012
"Under federal health care reform, the state has to have its plan for implementation in place one year from now. Otherwise, the federal government will set up the exchange for Wisconsin. Even if the state is allowed to continue to work on its plan into 2013, which is possible through a conditional approval, that still gives the public far too little time for input."
Some mentally disabled lose service
AJC, Jan. 9, 2012
Mental health services in Georgia have long been underfunded, leaving programs such as SOURCE as safety valves, said Hunter Hurst, the founder of the program and director of the St. Joseph’s/Candler health system’s Georgia Infirmary in Savannah. Limited dollars along with strict Medicaid funding guidelines have presented challenges, Hurst said.
Editorial: Report has health insurance warnings
Post Crescent, Jan. 8, 2012
In 2000, health insurance costs in northeast Wisconsin were the lowest in the state. Since then, though, Green Bay has had the highest health insurance inflation in the state, at 309 percent. Appleton and Oshkosh are second at 206 percent. Fox Valley insurance costs are now higher than the state average.
When insurance fails
Wall Street Journal, Jan. 7, 2012
Many people assume insurance offered by their employer is a better deal than they can get on their own. But while the premiums can be lower, such policies have drawbacks
Justice Department, Lawmakers File SCOTUS Health Suit Briefs
Kaiser Health News, Jan. 6, 2012
The Obama Administration and the Department of Justice have submitted their briefs in the Supreme Court battle over health reform implementation. Kaiser gathered the briefs and relevant articles into a resourceful collection.
Legislators propose repeal of mandatory markup on prices of prescription drugs
Jan. 4, 2012
A bipartisan group of lawmakers introduced SB 360, legislation that would repeal provisions of the Unfair Sales Act that prohibit below-cost sale of prescription drugs.
Letter to Governor Walker regarding health insurance exchanges
Jan. 4, 2012
Senators Vinehout and Cullen argue Wisconsin should implement an exchange of its own accord, not hold off until the Supreme Court decision on whether or not it will be required.
Health exchanges remain a good idea [Editorial]
Journal Times, Jan. 4, 2012
Although the health care law includes provisions which are anathema to many people, such as the mandate that people buy health insurance, the Affordable Care Act has suffered little damage in court. Of the four federal courts of appeal that have considered the law, only the 11th Circuit found fault, and that court said the balance of the law can stand.
State scales back Medicaid shortfall by $300 million
Journal Sentinel, Jan. 3, 2012
In a letter to lawmakers Tuesday, the head of the Department of Health Services said that the shortfall through June 2013 is now expected to be $232 million in state and federal money, down from the $554 million that was projected in September. The change in the projections amounts to about 2% of the funding in the program.
State should plan for health care reform [Opinion]
Journal Sentinel, Jan. 3, 2012
Robert Kraig of Citizen Action of Wisconsin writes, "Given the oppressive burden of health care hyperinflation on the health security of Wisconsin workers and families, it is highly irresponsible for Walker to suspend planning of reforms that could increase access to affordable coverage, end discrimination against people with pre-existing conditions and create new tools for controlling costs."
State benefits from expansion of Family Care [Opinion]
Wausau Daily Herald, Jan. 3, 2012
Disabled people or those who are aging all will have different -- and changing -- needs. Putting them all into various institutions is not what they want and it's not what many need. For some, Family Care offers help just a few hours a week. It's a bridge to independence, in other words, and a way of providing needed care that treats individuals as individuals.
This Medicaid program also has real potential to save the state money in the long term precisely because for many it will delay the necessity of nursing home or institutional care.
Senator Vinehout: Show me the numbers
Jan. 3, 2012
"Last week the Governor announced he had the $80 million necessary to remove the cap
on Family Care. Today, in an amazing announcement, the Department of Health Services
Secretary tells us the Medicaid shortfall is scaled back by $300 million.
But the announcement came with little detail. In his letter the Secretary mentions several
factors but only details $18 million of the total $300 million. The lack of transparency
and accountability makes me very cautious about telling my constituents the hurt won’t
be as bad."
State's decision to halt health exchanges worries insurers
Journal Sentinel, Jan. 1, 2012
Under the health care reform law, the state must have a plan in place to set up an effective exchange by January 2013. If it doesn't, the federal government will set up the exchange. There's a risk in halting the work on the exchanges until the Supreme Court rules: If the law is upheld, the state would have only about six months to put together a plan.
Texas Consumer Health Assistance Program to close after losing federal funding
Washington Post, Jan. 1, 2012
Less than a year after it opened, the Texas Consumer Health Assistance Program is preparing to shut down, a victim of Congress’s inability to agree on a federal budget for next year.
Senator Vinehout’s Statement on Release of CMS letter regarding Family Care
Jan. 1, 2012
"The Governor must show us how he will fund removing the cap so families are confident their loved ones will get the care and services they need."
State needs public health consortium [Opinion]
Cap Times, Dec. 30, 2011
David 'Mac' Macmaster poses the question, "Why is it so difficult to get the funding and priority status for some of our pressing Wisconsin public health challenges?"
Chris Rickert: $23.5 million of misplaced prevention
Wisconsin State Journal, Dec. 29, 2011
Chris Rickert argues that "fixing the health insurance disease will do more to prevent actual diseases than spending millions on disease prevention."
Obama Administration awards nearly $300 million to states for enrolling eligible children in health coverage
HHS, Dec. 28, 2011
More than $296 million was awarded to states for ensuring more children have health coverage, HHS Secretary Kathleen Sebelius announced.
The performance bonus payments are funded under the Children’s Health Insurance Program Reauthorization Act, one of the first pieces of legislation signed into law by President Obama in 2009. To qualify for these bonus payments, states must surpass a specified Medicaid enrollment target. They also must adopt procedures that improve access to Medicaid and the Children’s Health Insurance Program (CHIP), making it easier for eligible children to enroll and retain coverage.
Wisconsin received $24,541,778 (third highest behind Maryland and Virginia).
For more information on CHIP awards, visit http://www.insurekidsnow.gov/professionals/eligibility/performance_bonuses.html
Capitol Report: Politics blamed for defunding a state program run by Planned Parenthood
The Capital Times, Dec. 28, 2011
The Wisconsin Well Woman Program, which serves uninsured low-income women ages 45 through 64, is administered by the state Department of Health Services. It is funded through a mix of state and federal dollars. Federal funds are used to pay for mammograms, Pap tests and other cancer screenings and tests for multiple sclerosis. State dollars are used for outreach, educational work or case management services. A spokesman with the governor's office declined to comment on whether the administration's actions were being driven by Planned Parenthood's connection to abortion services.
State Acknowledges They Have No Ready Cancer Coordination, Looks to Planned Parenthood for Continued Interim Care
Planned Parenthood of Wisconsin, Dec. 27, 2011
Department of Health Services (DHS) acknowledged the gap in cancer care
created by their sudden decision to end Planned Parenthood’s Well Woman contract by petitioning Planned Parenthood to continue the cancer care program for another 60 days. After repeated efforts by health department staff and patients from the four affected counties and their local governments to communicate serious concerns regarding the state’s abrupt removal of Planned Parenthood and the resulting disruption to the Well Woman Program, the state was forced to backtrack when service gaps became clear.
Planned Parenthood to oversee Wisconsin Well Women program for 60 days
Post Crescent, Dec. 27, 2011
The Wisconsin Department of Health Services has asked Planned Parenthood to continue its Wisconsin Well Woman program in the Fox Valley until the end of February, when the Winnebago County Health Department will take control of the program.
State releases details of budget cuts; UW system takes biggest hit
Wisconsin State Journal, Dec. 24, 2011
DHS is passing federal bonus money, received for simplifying enrollment and renewal of CHIP and Medicaid and increased child enrollment, to the state to help fill budget gap.
Citizen Action of Wisconsin: Walker abandons obligations under health care law
WisPolitics, Dec. 23, 2011
Governor Walker’s dramatic change in position comes on the heals of Citizen Action of Wisconsin annual Wisconsin Health Insurance Cost Ranking report, which shows that Wisconsin health insurance hyperinflation has been almost 20% worse than the national average over the last decade, and that every metro area with the exception of Madison has had above average health insurance inflation.
Looking Forward: Wisconsin in 2012 [Opinion]
Sen. Vinehout, Dec. 23, 2011
Sen. Vinehout sounds off on how Wisconsin should regroup and move forward mutually in 2012.
Chetek man brings Gov. Walker gift of petitions
WKOW, Dec. 22, 2011
Wisconsin resident John Hardin delivered nearly 15,000 signatures from his online petition to save BadgerCare.
Area legislators join in effort to extend SeniorCare program
The Chippewa Herald, Dec. 21, 2011
Republican and Democratic legislators from the Chippewa Valley are joining together to help the state extend its SeniorCare prescription waiver program. SeniorCare provides roughly 100,000 low-income elderly citizens with lower costs for prescription drugs. An estimate from the Wisconsin Department of Health Services states the cost of each SeniorCare user for the federal government is $509 per year, considerably less than the cost of its federal equivalent, Medicare Part D, at $1,484 a year per user. The SeniorCare waiver program is set to expire in December 2012.
CMS extends waiver in Massachusetts
The Hill, Dec. 20, 2011
The waiver will now run through 2014. It is focused primarily on efforts to improve the cost and quality of the Medicaid program and better coordinate care. The waiver provides incentives for hospitals to improve their efforts to integrate their services.
Feds face challenges in launching US health exchange
Kaiser Family Foundation/Washington Post, Dec. 19, 2011
With many states unwilling or unable to get insurance exchanges operational by the health law deadline of Jan. 1, 2014, pressure is growing on the federal government to do the job for them.
Low Medicare, Medicaid rates shift cost to insurers, study finds
Journal Sentinel, Dec. 17, 2011
An estimated $851 million is added to the cost of commercial health insurance to make up for the lower fees that Medicare and Medicaid pay hospitals in southeastern Wisconsin, according to a study released last week. The study, commissioned by the Greater Milwaukee Business Foundation on Health, supports the long-standing position of the hospital industry that the government health programs don't cover their share of costs and that the shortfall is passed on to employers and individuals through higher prices for commercial health plans.
Progress on infant mortality, but not enough [Opinion]
Journal Sentinel, Dec. 17, 2011
Milwaukee made progress in the past year in its fight to improve the city's infant mortality rate, but lasting change will not be achieved unless there is more buy-in from the community. Infant mortality is a complicated problem; it may take years before we see significant change. But we know that change can happen. All we have to do is look at Harlem in New York City to see how collaborative efforts have saved lives.
WALKER ADMINISTRATION ENDS CONTRACT FOR WELL WOMAN PROGRAM COORDINATORS WITHOUT INFORMING PATIENTS
Rep. Seidel, Dec. 16, 2011
The Department of Health Services (DHS) recently decided not to renew a contract with Planned
Parenthood that funds coordinators for the Wisconsin Well Woman Program in the Fox Valley. Since 1995 the state has contracted with Planned Parenthood to enroll women in the Well Woman Program, answer questions, notify and schedule appointments, coordinate follow-up care, and help women diagnosed with cervical or breast cancer to seek treatment.
HHS to give states more flexibility to implement health reform
HHS, Dec. 16, 2011
The Department of Health and Human Services released a bulletin outlining proposed policies that will give states more flexibility and freedom to implement the Affordable Care Act.
The bulletin released today describes an inclusive, affordable and flexible proposal and informs stakeholders about the approach that HHS intends to pursue in rulemaking to define essential health benefits. HHS is releasing this intended approach to give consumers, states, employers and issuers timely information as they work toward establishing Exchanges and making decisions for 2014. Read HHS's informational bulletin here.
Job Lock and the Potential Impact of the Patient Protection and Affordable Care Act
U.S. GAO, Dec. 15, 2011
In a recent study by U.S. GAO, researchers found that workers who rely on employer-provided health care coverage are much less likely to change or leave jobs even if they find their job frustrating. View the full details of the study here.
Once a pioneer, Wisconsin now sputters in securing jobs for disabled workers
Green Bay Press Gazette, Nov. 2, 2011
People supported by state Intellectual and Developmental Disabilities agencies who participated in integrated employment services peaked at 25 percent in 2001, according to the 2011 National Report on Employment Services and Outcomes compiled by the Institute for Community Inclusion at the University of Massachusetts Boston. That dipped to 20.3 percent in 2009, the most recent data available.
Seeking Legal Interns for Summer 2012
ABC for Health is seeking volunteer, work-study eligible, or students on public interest fellowships for this summer! The position requires admission to law school. Students will provide legal research and writing support for firm attorneys that may include client interviewing and follow-up, drafting letters and memos, assisting on court filings and briefs, and facilitating projects with other agencies and legislators. Other duties include interviewing clients at intake, client counseling, and investigation of health benefits denials. Legal research and writing experience are desired, as are proficiency in Microsoft Word for Windows and a background in health care. Ability to speak Spanish and/or Hmong is a plus. To apply, please email a cover letter and resume to Brynne McBride, Assistant Director.
Support Our Efforts!
2011 was a difficult year for many, including ABC for Health. Over $300,000 in funding and funding opportunities were eliminated from our budget. Consequently, our ability to serve Wisconsin families was greatly diminished. Please consider a tax-deductible donation to ABC for Health to keep advocacy, legal services, and projects like HealthWatch Wisconsin sustainable for years to come. Thank you!
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