Please Consider a Donation to Support Our Efforts!

We could use your help; 2011 was a difficult year for many and ABC for Health was no exception. Over $300,000 in funding and funding opportunities were eliminated from our budget--some quite brutally. Consequently, our ability to serve families across Wisconsin was greatly diminished. But you can help. Please consider making an end of year, tax-deductible donation to ABC for Health to keep advocacy, legal services, and projects like HealthWatch Wisconsin sustainable for years to come. ABC for Health is a tax-exempt 501(c)(3) organization, and your contribution is deductible to the extent allowed by law. Thank you!

In this Issue...

HealthWatch Opens Registration for its 5th Annual Conference!

• Five years of providing members with a variety of comprehensive trainings and tools across various media.
• State of the art communication and training methods to help a range of health care service providers secure the knowledge and strategies required to increase access to health care and coverage.
• A group effort to help focus and amplify statewide efforts to connect more people to health care and coverage.

With Medicaid and BadgerCare being threatened, there's never been a more important time to continue the momentum.

Click or Call to Register for the 5th Annual HealthWatch Wisconsin Conference

Vol. 7, No. 22
December 1, 2011

In This Issue:

Conference Registration is Now Open!

Private Insurance "Emergency Rule" is in Effect

Waiver Sent to Feds

How to Comment on the Waiver

Share Your BadgerCare Story!

BadgerCare Plus Handbook Changes

HealthWatch News

HealthWatch Member Profile: Lisa Raethke

NEW! Core Plan Waiting List Counter!

Grapevine

Ops Memo

Coalition Roundup

3 C's for CYSHCN!

State & National News

On our Website:
HealthWatch Membership
Upcoming Coalition Meetings

Footage of Public Hearings: The Human Impact of BadgerCare Plus

Madison will be the place to be as we head towards spring! As a Presidential primary approaches and "recall fever" is in the air, we'll gather elected officials, candidates, experts and more to discuss our featured topic "Waive Goodbye to Medicaid? Not if We Can Help it!" and get perspectives on the future of health coverage in Wisconsin!

REGISTER ONLINE HERE
-OR-
CLICK TO PRINT A REGISTRATION FORM
-OR-
CALL TO REGISTER: (608) 261-6939 ext 204

Register Early for an Early Bird Discount! Save up to 15%!!

When: Monday and Tuesday, February 27-28, 2012
Where: Inn on the Park, Madison, WI
Cost: Discounts apply for HealthWatch Wisconsin members and subscribers. Additional discounts of up to 15% apply to those registering early, by 5:00pm on JANUARY 6, 2012. To view all cost options, see the registration page.

Join us in Madison this coming February as we strengthen relationships among interested members of the public health workforce.

Emergency Rule In Effect on Private Insurance Grievance and

Independent Review Processes

Wisconsin's Commissioner of Insurance, Ted Nickel, issued an "emergency rule" to implement changes to Wisconsin's independent review and grievance procedures, and grant exemptions for insurance companies. The "finding of emergency" was effective November 16. In an email dated November 22, Jim Guidry at the Office of the Commissioner of Insurance sent a limited distribution email (at the request of Ted Nickel) to inform insurers and select individuals that OCI was considering promulgating a permanent rule identical to this November 16 emergency rule. OCI included in its email that they were accepting comments "from businesses, governmental units, and individuals that may be affected by a permanent rule..." Unfortunately, comments were not solicited from consumers or even through the OCI website, even though consumers would be of course impacted by the permanent rule. Comments were due to Jim Guidry by November 29, 2011. The full impact of the emergency rule is still not clear. The purpose was to enact changes that failed when Assembly Bill 210 never made it out of the Senate. HealthWatch Wisconsin has sent an inquiry to the Commissioner of Insurance, seeking the date of a public hearing on this emergency rule. Watch a future edition of the Update for more developments on this topic.

Medicaid Waiver Sent to Feds

On Thursday, November 10, the Joint Finance Committee met to discuss and vote on the Wisconsin Department of Health Services proposal to drastically restructure and reduce enrollment in BadgerCare and Medicaid. Calling a vote, the proposal of the Department of Health Services to approve all items included in the Maintenance of Effort waiver request, and all items related to Benchmark Plans was approved along party lines, 11-4. That same day, November 10, the waiver request was submitted to the Centers for Medicare and Medicaid Services (CMS). CMS typically has 90 days to review a waiver request, unless more information is needed from the state making the request. In this instance, however, the State left CMS with fewer than 60 days to review the waiver request. Unfortunately over 53,000 childless adults in Wisconsin are, as Joint Finance Committee member Sen. Robert Jauch called them, "innocent hostages" caught in the middle of this DHS request and CMS review process and face BadgerCare program terminations if an approved waiver is not in place by Dec. 31, 2011.

 

State law, revised by the budget bill, suggests that if the waiver isn’t approved by Dec. 31, 2011, those parents on BadgerCare Plus and adults on the Core Plan above 133% FPL will be dropped. Remember that CMS normally asks for at least a 90 day review period. Stay tuned as trouble looms for over 53,000 adults in BadgerCare. .

Public Hearings:

In addition, two public hearings are scheduled for individuals to speak on the impact of BadgerCare and Medicaid cuts on their families. If you go:

Rhinelander - Thursday, December 8th
4:30-6:30pm
Nicolet College, LRC Theater
5364 College Drive, Rhinelander

Share your BadgerCare and Medicaid Story:

In Wisconsin, about 1.2 million people rely on BadgerCare and Medicaid programs to provide essential, affordable, and effective health care services. And the impact of these programs reaches thousands more--our friends, neighbors, grandparents,  colleagues, and health care providers large and small in every county of Wisconsin. Tell your BadgerCare or Medicaid Story! Why is BadgerCare or Medicaid important to you and your family? What would happen if BadgerCare or Medicaid ended? CLICK HERE to complete a story form!

Big Changes to the BadgerCare+ Handbook

On Tuesday, November 29, DHS released a new version of the BadgerCare+ Handbook. Included were several changes to procedures to prove citizenship, ways of requesting changes, Core Plan application methods and more. We outline a few of the changes below. Click here to read the memo on all the Handbook changes.

1. Deleted from the BadgerCare Plus Handbook: Proof of Citizenship: Reasonable Opportunity to Present Verification (Handbook Section 4.2.2) and Good Faith Effort: Extension of time to produce verifications if you are making a good faith effort, and let your worker know you are doing so or you ask your worker’s assistance in getting documentation (Handbook Section 4.2.3).

Rationale: The Ops memo says that these two important sections were removed based on changes made in Ops Memo 09-23, a memo circulated April 1, 2009 that was to modernize BadgerCare processes to be consistent with the signing of Public Law 111-3, the Children's Health Insurance Program Reauthorization Act of 2009. The major change included: "No Delay in Benefits for Applicants." It states: Applicants who are otherwise eligible and are only pending for verification of citizenship and identity must be certified for health care benefits, within the normal application processing time frame (30 days from the filing date), as long as the applicant has notified the worker that s/he is taking steps to obtain the necessary documentation or has asked for the worker's assistance to obtain it. The applicant will have 90 days after the request for verification to provide the requested documentation..."

Editor's Note: The change to the BadgerCare Plus Handbook was not necessary. In fact, the language of Ops Memo 09-23 was already adopted and appears in the BadgerCare Plus Handbook as an introduction to Section 4.2 "Documenting Citizenship and Identity." The Handbook was in full compliance of the Public Law. In fact, Wisconsin's process was more generous than the federal law in that it allowed additional "extensions" and "flexibility" in the production of verifications, perhaps understanding that in some instances, obtaining proof of citizenship or birth could take more than 90 days when dealing with various governments, agencies, and international entities. Yet, while the new Ops Memo deletes the "reasonable opportunity to present verification" and "good faith effort" requirements, it does not replace the language with any other procedures, in essence, removing any possibility of an extension or flexibility in the providing of documentation. It strictly adheres to the 90 day deadline to produce verifications of this sort or face Adverse Action and termination.

2. Changes in Addresses. If you are assisting a family with their BadgerCare Plus Applications and renewals, please note the following address changes:

 

a. Adding a Person to BadgerCare:

• Old: Mail, HP Enterprise Services, P.O. Box 7636, Madison, WI 53707
• New: Mail: ForwardHealth iChange, P.O. Box 7636, Madison, WI 53707-7636;
  Fax: (608) 221-8815
• Handbook Section: 19.10.2.1 Person adds

b. Good Faith Claims

• Old: HP Enterprise Services Good Faith Unit, P.O. Box 6215, Madison, WI 53784
• New: Mail: ForwardHealth iChange, P.O. Box 7636, Madison, WI 53707-7636;
  Fax: (608) 221-8815
• Handbook Section: 38.6.4 Process

c. Emergency Determination

• Old: The F-10110 may be submitted to the fiscal agent in the following ways: mail: HP Enterprise Services, P.O. Box 7636, Madison, WI 53707
• New: The F-10110 may be submitted to the fiscal agent in the following ways:  Mail: ForwardHealth iChange, P.O. Box 7636, Madison, WI 53707-7636
• Handbook Section: 38.6.4 Process

HealthWatch News

Do You Know the Advocate of the Year?? Help with the HealthWatch Annual Awards!

HealthWatch Wisconsin is currently accepting nominations for the Third Annual HealthWatch Awards to be presented at the HealthWatch Wisconsin annual conference luncheon on Tuesday, February 28, 2012. The Health Watch Wisconsin council seeks to recognize outstanding work in health care advocacy and service in four categories. Click on the category you wish to nominate someone for to download a nomination form!

• Advocate of the Year
• Elected Official of the Year
• Outstanding Outreach Effort Award
• Outstanding Media Coverage Award

To nominate someone for an award, complete the appropriate nomination form, found by clicking on the award names above. Return your form to HealthWatch Wisconsin by email, FAX: 608-261-6938 or US Mail: 32 N. Bassett St., Madison, WI 53703. To view last year’s winners, Click Here.

Join the Leadership of HealthWatch

Nominate a friend, colleague, public health hero of yours (or yourself) for the HealthWatch Wisconsin Council, the leadership committee of HealthWatch Wisconsin! We will compile nominations and prepare a ballot for the Annual HealthWatch Wisconsin conference February 27 & 28, 2012. To make your nomination, please email HealthWatch Wisconsin with your nominee's name, workplace, email and phone number.

HealthWatch Member Profile:

Lisa Raethke, Pierce County Health Department

by Adam VanSpankeren

Lisa Raethke has been working for the Pierce County Health Department for 20 years and has been a school nurse for even longer. Since HealthWatch Wisconsin began welcoming members five years ago, Pierce County has attended many trainings, but it was in 2011 that Lisa founded the Pierce County HealthWatch Coalition.

“Years ago, Mike Rust and Carole Crisler [of ABC for Health] used to come and present trainings on health benefits counseling, and I have always liked the idea.”  As a school nurse, Lisa has been doing informal health benefits counseling for families who use the school as a source of important health information.  She has also done health benefits counseling with maternal child health clients through the health department.   “The health department can’t fulfill that role alone, however,” said Lisa.  “With the Pierce County HealthWatch Coalition, I was hoping to bring together and educate more school nurses, clinic staff, and social service organizations to assist in that advocacy role.  I have always dreamed of having someone doing health benefits counseling between the health department and the clinics and hospitals.  The need for it is well stated.”

But the process of has not been without challenges.  “One thing I couldn’t plan for was the huge upheaval within the BadgerCare system,” Lisa laments, though she is far from alone in that statement.  HealthWatch Wisconsin has been trying to keep its members and subscribers informed of significant changes.  Lisa also stated that has been harder to get people engaged because everyone in the community is being asked to fulfill with their roles with less and less resources.

Despite that – or perhaps because of it – the Pierce County Health Department has recently become an express enrollment provider for kids. “We’ve always done it for pregnant women, but we can now say that we do express enrollment for children too.”

Thanks to Lisa’s efforts, the Pierce County Health Department also has a contract for federal overmatch starting in July, which should help conserve department resources while increasing the level and quality of outreach being done at clinics and schools.  “We need to fight the perception that ‘BadgerCare is going away,’” says Lisa.  “I see the system getting more complicated, not less.”

When asked what she likes about the statewide HealthWatch organization, Lisa responded: “I can’t tell you how important it is that we get legislative updates.  In western Wisconsin, we don’t hear much from Madison, and to have that information digested and clearly presented is absolutely invaluable.”The Pierce County HealthWatch Coalition will be turning two years old in 2012!  Stay tuned to the HealthWatch Wisconsin Update, or contact Lisa for information about their next meeting, on January 19.

Core Plan Waiting List "Counter"

One hundred fourteen thousand, three hundred and seventy eight people, and counting

This number represents the number of childless adults in Wisconsin sitting on the BadgerCare Plus Core Plan Waiting List as of the early afternoon on November 18, 2011. These individuals should be effectively screened by the Department of Health Services/Enrollment Services Center upon entering the abyss of the waiting list for different health coverage programs, including, but not limited to, Elderly, Blind and Disabled Medicaid, Medicaid Assistance Purchase Plan, HIRSP, or SSI/SSDI.

Grapevine

Wisconsin’s Birth Cost Recovery Policy Poses Barriers to Insurance Coverage for Low-Income Families

In Wisconsin, unmarried pregnant women are required to report the father of their baby on Medicaid applications. Women facing emotional or physical abuse situations can opt-out of reporting fathers though the “good cause exemption." ABC for Health Research the suggests the "Good Cause" process is rarely used and poorly understood by advocates ESS workers and Medicaid Beneficiaries. It’s illegal for Medicaid to charge women for costs related to the birth of their children but the state of Wisconsin can and does charge unmarried fathers for these costs. Last year the State collected over $18 million from unmarried fathers.  ABC staff is investigating reports of families being unfairly charged for birth costs. We are also looking into reports of women who were sanctioned for failure to cooperate with child support and then had difficulties accessing Medicaid. If you’ve been personally affected by birth cost recovery policy and would like to share your story, please contact HealthWatch staff.

The state is continuing to re-organize county economic support offices into local networks or consortia. These new consortia will operate much like the “change report centers” that are already in operation in counties such as Dane and Brown. The consortia will join together groups of counties for the purposes of client intake, changes, scheduling of appointments, etc. With an eye toward opening in early 2012, Consortia leaders are nervous individuals enrolled in BadgerCare Plus or Elderly, Blind and Disabled Medicaid programs and individuals eligible for (but not yet enrolled) will not be informed of these new changes and how to use the new system. In fact, the only outreach currently planned will fall the week between Christmas and New Year’s Day. Advocates and Consortia leaders would like this information out ASAP, so clients aren’t left in the dark.

We have heard that DHS will release a considerable number of Operations Memos (“Ops Memos”) right before the Christmas holiday. Please keep your eyes on the Ops Memo website for information on new changes with Consortia, appointments and interviews necessary for BadgerCare Plus, Fair Hearings, Medicaid Fraud investigations, and more.

Individuals who feel their Medicaid benefits were wrongly denied, terminated, or reduced by the state or county are entitled to a review process called a “fair hearing.” These hearings were normally conducted in the presence of an Administrative Law Judge, so that a family or individual could present their side of the story, their medical or financial evidence, and other materials to support their claim. We understand that the fair hearing process has recently changed, due to cost saving measures. The Department of Administration has issued a “moratorium on travel” for the Administrative Law Judges. As a result, most people can expect to get a fair hearing conducted by phone. However, we believe that an individual may still request a fair hearing in person. The Administrative Law Judge may still consider if they will accommodate such a request. It seems as though individuals who state they would be willing to travel to the Hearings and Appeals office in Madison (on a day when the Administrative Law Judge is at the office) may have a better chance of having their request granted. Please watch the “Update” for more specifics and tips as we investigate this change in procedure.

Ops Memos

Ops Memo 11-62: Online Query Internet Process (SOLQ-I) and Automatic Update of Social Security Information in CWW
[Delayed] Originally posted November 23, 2011
The purpose of this memo is to announce the implementation of a CARES Worker Web (CWW) automatic, real time update of information received through the State Online Query Internet (SOLQ-I) process with the Social Security Administration (SSA). The update will occur at application, renewal, person add, program add and Six Month Reporting. The information that will be updated includes Social Security Number (SSN) verification, Social Security Income (SS), Supplemental Security Income (SSI) and Medicare information. A subsequent message alerted us that: “Operations Memos 11-62; SOLQ-Implementation will be delayed until further notice.”

Ops Memo 11-63: Fair Hearing Process for Income Maintenance Programs
Attachment: Baseline Requirements for Managing DHA Fair Hearings
Released November 23, 2011
Purpose: The purpose of this memo is to outline the responsibilities of the Income Maintenance (IM) Consortia related to processing fair hearing requests for IM programs.

Background: As part of the 2011-2013 biennial budget, the Legislature directed the Department of Health Services (DHS) and the IM Consortia to share responsibilities related to IM program fair hearing requests. IM Consortia will be responsible for all fair hearing related activities for eligibility determinations and programs administered by the IM Consortia, and each Consortia will provide a single point of contact for Division of Hearings and Appeals (DHA) communication of fair hearing requests, schedules and decisions.

Process: Each IM Consortia will have a single point of contact for communicating fair hearing activities related to cases that belong to an agency within the Consortia. DHA has recommended that a group email address be created for each IM Consortia that is specifically used for DHA communications. Group email is preferred so that hearing activities can be monitored by more than one person in an IM Consortia to streamline the monitoring of fair hearing activities and timeliness. DHA also recommended that the IM Consortia consider adopting a process flow to track and monitor fair hearings.

Training: A PowerPoint presentation. In addition, DHA has training available for the IM Consortia related to their processes and expectations of agencies for responding to, acting on and attending fair hearings.

Ops Memo 11-64: New FoodShare Requirements for Reporting Income Changes on the Six Month Report Form
Attachment: FOODSHARE AND/OR CHILD CARE SIX MONTH REPORT
Attachment: FOODSHARE AND/OR CHILD CARE SIX MONTH REPORT INSTRUCTIONS
Released November 23, 2011
The purpose of this memo is to inform local agencies of changes to the Supplemental Nutrition Assistance Program (SNAP) Federal requirements for reporting changes on the Six-Month Report form (SMRF) for FoodShare as well as the changes to the SMRF to conform to the new requirements.

Ops Memo 11-65: 2012 Cost of Living Adjustment (COLA)
Released November 23, 2011
Cost of Living Adjustment (COLA) for 2012 is 3.6% for the Social Security Administration (SSA) Old Age Survivors and Disability Insurance (OASDI or Title II) and Supplemental Security Income (SSI or Title XVI) programs. The federal COLA increase will result in changes in CARES Worker Web (CWW) to the (MA) income levels, allowances and deductions as outlined in pages 5 - 10 of this memo.

Ops Memo 11-66: Request for Assistance (RFA) Telephonic Signature Policy and Process
Attachment: RFA Cover Letter, Balance of State
Attachment: RFA Cover Letter, MilES
Released November 29, 2011
CARES: To support the Consortia Call/Change Centers, CWW has been enhanced to allow collection of a telephonic signature during the Client Registration process for Income Maintenance program requests. Caretaker Supplement (CTS) is excluded from the telephonic signature process. PRINT APPLICATION REGISTRATION PAGE: The Print Application Registration page has been enhanced to support the gathering and recording of a telephonic signature. The following step by step instructions explain how to gather a telephonic signature. These instructions are broken out by the page headers and called out in the screen shot.

Coalition Roundup

Click here for a list of upcoming coalition meetings.

The Chippewa County HealthWatch Coalition met on Tuesday, November 8 at the Chippewa County Courthouse. Jaime Lawrence-Olson, Assistant Executive Director and Prevention Services Program Coordinator for Positive Alternatives, Inc., a multi-service nonprofit serving youth and families in Wisconsin presented on at risk children and related issues. The next coalition meeting isn't until January 10, 2012, but mark your calendars now! For more information about the Chippewa County HealthWatch Coalition, please contact Rose Marsh.

The Dane County HealthWatch Coalition will meet on Monday, December 5 at the Waisman Community Outreach Center in Madison. The coalition is going to be receiving an update on the income maintenance transition from Mike Wineke of Dane County Economic Services; and Erin McBride of ABC for Health will be leading a discussion of local and statewide trends to watch, which will include taking a look at the recent changes to fair hearings. Theresa Fosbinder will also be providing an update on Family Planning Only Services. Dane County HealthWatch will also be enjoying some treats as a reward for collecting 187 lb of food for its Thanksgiving food drive. For more information about Dane County HealthWatch, please contact Adam VanSpankeren.

The Eau Claire County HealthWatch Coalition met on November 3 at the Luther Hospital Cafeteria, welcoming Kari Francois, the Community Relations Coordinator for Heritage Senior Living as a speaker. She presented on the Chippewa Valley Assisted Living Association (CVALA), a collaborative group of area professionals committed to providing education, resources and tools to help folks simply the search for assisted living in Eau Claire, as a one stop shop for information on assisted living facilities. The next Eau Claire County HealthWatch meeting is on January 5, 2012. For more information on the Eau Claire County HealthWatch Coalition, please contact Lou Kelsey.

The Milwaukee HealthWatch Coalition will be meeting next on Wednesday, December 14 and will be joined by speakers from ABC for Health who will be presenting on the topic of Birth Cost Recovery based on the presentation from the HealthWatch Wisconsin "5 Things to Watch" workshop. The Milwaukee HealthWatch steering committee will be meeting before the full coalition meeting to discuss plans for 2012. If you would like more information on Milwaukee HealthWatch, please contact Julie Dixon-Seidl or (414) 773-4646.

The Pierce County HealthWatch Coalition next meets on January 19 at the Crossroads Community Church in Ellsworth, when a panel of service providers from the area will be presenting on a number of topics and initiatives, from homelessness to mental health to combating hunger. To RSVP for that meeting, please contact Lisa Raethke. Despite a short break between meetings, the Pierce County HealthWatch Coalition has been very productive, and the Pierce County Health Department has managed to secure a Medicaid overmatch contract, in addition to becoming an Express Enrollment Provider. Both of these developments came after nearly a year of arduous efforts by Lisa and others, and were well earned. Great job Pierce County! Stay tuned to the HealthWatch Wisconsin Update for more details. For more information about the Pierce County HealthWatch Coalition, please contact Lisa Raethke.

The Tri-County HealthWatch Coalition met on Tuesday, November 22 at the Goodwill Community Center in Menasha. The coalition brought together local stakeholders concerned about the threat to BadgerCare presented by the DHS waiver proposal hastily rushed through Joint Finance and sent to CMS. The Tri-County HealthWatch Coalition is also taking a look at charity care programs offered by hospitals in their area. The coalition has also reflected upon its activities in 2011 and is deciding a course for actions in 2012. For more information about the Tri-County HealthWatch Coalition, contact Susan Garcia Franz or Connie Raether.

3 C's for CYSHCN!

Ask a Good Question...

I recently received an eligibility denial from Katie Beckett Medicaid. I would like to appeal, but can’t get off work. Can I request a phone hearing?

...Get a Good Answer!

Yes. The Income Maintenance Manual Chapter 3.7 indicates that individuals may request a phone hearing, but it warns that there may be background noise concerns and an inability to get proper documentation to the hearing officer in time for such hearings. Please note that over the past few weeks, it has come to our attention that as part of “cost savings measures,” fair hearings will all take place over the phone, unless the individual requesting an appeal specifically asks for an “in person” hearing AT THE TIME they request the fair hearing. It is up to the discretion of the hearing officer to honor that request. Until more information becomes available, please assist individuals in getting their information and documentation organized in advance of any hearing, to facilitate submission of information to the hearing officer prior to any phone hearing.

Questions on this Answer?

Still not sure? Have another question? Send us an email! We may address emailed questions in the next edition of the Update Newsletter.

The WI Board for People with Developmental Disabilities is sponsoring a Partners in Policymaking six-part series to develop a grassroots network of parent/sibling/self-advocates who can be active in policy development, legislative advocacy, and systemic change. This incredible series is completely underwritten, so all participants’ expenses are covered. It begins in January, and applications are due TODAY, DECEMBER 1. If you know of family members or youth/young adults who would be interested in statewide systems change, please share this link with more info.

Events of Interest:

Is there an event missing from our list? Let us know! Email us with events, directions and details other collaborators may like to attend.

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.

December 2-3, 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.

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.

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, 2011 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

A Training Announcement for All CYSHCN Collaborators: The Next CYSHCN Live Web Cast is Thursday, December 15, 2011, 10:30am

Have you had this thought, "I've talked to this family two times already, and I'm not sure what resources are appropriate for them;" or "I wonder if ABC for Health would be able to pick up where I left off on this issue." If either is the case, this web cast will help you answer both of those questions. It will also provide a review of some of the common referrals we are seeing, and given the uncertain future of BadgerCare and Medicaid in Wisconsin, help sort out some possible approaches for conversations that we will have with families in early 2012. Learning Objectives for this training include, how to:

• Make a proper referral to ABC for Health
• Facilitate referrals to other agencies and resources
• The types of referrals we are seeing at ABC for Health
• "Things to Watch" in the next few months!

Click the "Referral Form" image at right to be directed to a printable version of the CYSHCN Client Referral Form! Use this handy tool with directing a family to ABC for Health for services.

This web cast training was selected by YOU! Thank you!

Watch your inbox for a confirmation of the date and time, future instructions, and login information! This is a live web cast, so you are able to participate, ask questions, and answer polls. Not able to join the live web cast? Don't worry, we'll share the archive link with you, and hope that you can join us again in the future.

State & National News

Analysis and Comment

State Legislature Wraps up Legislative Session with Bills on the Table

Wisconsin just came out of a very active legislative session (and "special session" on jobs!) Usually, at this time of year, we would expect the legislature to come back in the early months of January through March, to complete actions on outstanding bills. Yet, this year might be different. With recall actions potentially pending for legislative members and the governor and a campaign season generating strength, there is a large question mark on if we'll see the legislature back on the floor for anything other than just very limited business matters. For a wrap up of this legislative session and more on "what to watch in 2012," be sure to attend our HealthWatch Wisconsin Conference on February 27 & 28, 2012 for information and updates on this topic and more!

Update: Wisconsin Supreme Court to Weigh in on Civil Gideon

Recently, the Wisconsin Supreme Court held a public hearing on the issue of a civil right to an attorney, called a “Civil Gideon” petition. The name comes from the famed “Gideon vs. Wainwright” case in 1963 where the US Supreme Court ruled that state courts are required to provide attorneys in criminal cases for defendants unable to afford them. In this recent argument, attorneys from across Wisconsin encouraged the Wisconsin Supreme Court to require circuit courts to appoint lawyers at public expense for indigent defendants in civil cases in which the defendant’s basic needs (food, shelter, clothing, heat, medical care, safety, or child custody) were at stake.

Drafting a proposal on behalf of the Court was Chief Justice Shirley Abrahamson agreeing to the inherent need of indigent persons in civil cases to be represented. Yet, the Chief Justice refused to adopt the petition in front of her for two reasons. In her proposal, she states, “We hereby reaffirm that, as a matter of separation of powers and due process of law, circuit court judges have inherent authority to appoint counsel for indigent persons in civil cases when the court deems it necessary in the interests of the effective and efficient administration of justice….Because we conclude that the proposed language of the petition does not fit within SCR ll.02, and because this court has already established the inherent power of circuit courts to appoint counsel for indigent persons when the efficient administration of justice warrants it or when due process considerations in the individual case outweigh the presumption against such an appointment, we decline to adopt the petition.”

On Monday, December 5 at 9:45am, the Wisconsin Supreme Court will hold a discussion on this topic. The discussion is open to the public, but not a public hearing, meaning no testimony will be accepted at this time. The Justices are expected to vote on the petition, and there is no early sign of how they will vote. The Wisconsin Eye network typically covers these discussions.

The Lack of Meaningful Public Input

When preparing comments to the federal government on the Department of Health Services (DHS) Waiver Request, one of the hot button issues for us became the process for public input, as envisioned by the Affordable Care Act. We started reviewing the details: DHS only released copies of the full proposal on November 8th 2011 for public review. Although DHS accepted public comments on its website and provided an outline of their proposed changes prior to a hastily arranged daytime public hearing process, the public involvement was minimal and working families were largely excluded from testifying. Finally, the full breadth and reach of this dramatic proposal were only better understood after the non partisan Wisconsin Legislative Fiscal Bureau (LFB) submitted its comprehensive analysis of the MOE-related proposals to the Joint Finance Committee. This important analysis and detail was provided less than 48 hours prior to the committee’s public meeting to vote on the proposals and following all opportunities for public input.  DHS never held a briefing on the details of the proposal following the release of the LFB analysis. We believe this process is contrary to the Affordable Care Act’s requirement for a process when applying for demonstration waivers that involves “public notice and comment at the State level, including public hearings, sufficient to ensure a meaningful level of public input.” Until the release of the LFB analysis a typical parent or affected individual did not have a way to assess impact on his/her personal situation and therefore could not testify in a meaningful or sufficient manner.

Headlines

50 Wisconsin Organizations Unite to Call Upon Federal Government to Reject DHS Waiver
Save BadgerCare Coalition, Dec. 1, 2011
In an effort to prevent more than 64,000 Wisconsinites from losing their BadgerCare coverage, 50 organizations from throughout Wisconsin, call on U.S. Health and Human Services (HHS) Secretary Sebelius to deny the recent request from the Wisconsin Department of Health Services (DHS) for a waiver of federal maintenance of effort (MOE) requirements.

Wausau Health System May Start Medical School
Milwaukee Journal Sentinel, Dec. 1, 2011
Aspirus, a health system based in Wausau, said Wednesday that it was considering starting a medical school with other health care systems in north-central Wisconsin.

Toll Free Public Assistance Fraud and Abuse Hotline Announced
Governor Walker, Dec. 1, 2011
Governor Walker announced today that the Office of the Inspector General (OIG), an office within the Department of Health Services, was releasing a new public assistance fraud hotline.

Using Data to Drive State Improvement in State Enrollment and Retention Performance
Robert Wood Johnson Foundation, Nov. 2011
The Maximizing Enrollment program has worked intensively with eight states to help them increase their use of Medicaid and CHIP enrollment and retention data to monitor and improve performance in enrolling and retaining eligible individuals.

The Department of Labor has posted a New Consumer Assistance Web Page
Department of Labor Employee Benefits Security Administration, Nov. 2011
The Department of Labor has posted a new consumer assistance webpage.

FAQs About Affordable Care Act Implementation (Part VII) and Mental Health Parity Implementation
Department of Labor Employee Benefits Security Administration, Nov. 2011
The Department of Labor has posted some FAQs about the implementation of health care reform and mental health parity.

Employer Premiums as Percentage of Median Household Income for Under-65 Population, 2003 and 2010
The Commonwealth Fund, Nov. 2011
Premium increase map now available.

Federal FMAP percentages calculated for 2012

Federal Register Volume 76, Number 230, Nov. 30, 2011
The GPO has published a notice detailing the Federal Medical Assistance Percentages for October 1, 2012 to September 30, 2013.

Physician Shortage Threatens Patient Access, Quality
Wisconsin Hospital Association, Nov. 29, 2011
A new report released today by the Wisconsin Hospital Association entitled, “100 New Physicians a Year: An Imperative for Wisconsin,” raises concerns that a physician shortage is looming, unless aggressive action is taken now to avert a statewide crisis.

Obama administration rejects Republican states' health law waiver requests
The Hill, Nov. 28, 2011
The Department of Health and Human Services said Indiana and Louisiana do not need an adjustment from the health law's medical loss ratio, requiring insurers to spend at least 80 percent of premiums on medical care or offer rebates to their customers starting next year.

States squirm over health exchanges
Politico, Nov. 28, 2011
Even without the uncertainty surrounding the Supreme Court, states are already on a tight timeline to get exchanges in working condition. Though the exchanges open in January 2014, HHS must determine by Jan. 1, 2013, whether a state will be ready to run one. The last opportunity for states to receive federal financial assistance for building an exchange is the end of June 2012 — right around the time of the Supreme Court ruling.

Transition to electronic medical records gradually taking hold
Stateline, Nov. 28, 2011
There seems to be a broad consensus that increased use of electronic data will improve the quality of health care in the country and ultimately lower costs.

Study: Employers could dump sickest employees on public health care
MPR News, Nov. 28, 2011
A loophole in the federal health care overhaul would allow many employers to game the system by dumping their sicker employees onto public health insurance exchanges, according to two University of Minnesota law professors.
Related: Will employers undermine health care reform by dumping sick employees? (July 30, 2010)

Nominees to head Medicare viewed as pragmatist
Washington Post, Nov. 27, 2011
In interviews in the past week, former colleagues described Marilyn Tavenner as a patient-centered manager, a hands-on medical professional equally comfortable in the board room and the emergency room. And in contrast to Donald Berwick, she isn’t associated with a grand vision for health reform or a particular policy agenda for Medicare and Medicaid.

State pulls procurement for replacing flawed Medicaid payment system
TimesUnion, Nov. 27, 2011
The system, Thomas DiNapoli said, has been fraught with problems from the start. CSC got it online 33 months late and $166 million over budget. Since then, auditors found it was designed with obsolete computer programs and caused more than $500 million in losses to fraud, waste and abuse.

Consumer advocate Harvey Rosenfield takes on health insurers
LA Times, Nov. 26, 2011
Rosenfield, who used California's initiative process to regulate auto insurance rates more than two decades ago, is preparing a new initiative that would force health insurers to get state approval before they could raise premiums.

Arizona Medicaid cut approved by feds
AZcentral, Nov. 26, 2011
Federal health officials have approved an additional 5 percent reduction in the rates hospitals and other health-care providers are reimbursed for Medicaid patients, part of Gov. Jan Brewer's budget-balancing package.

Support builds for plan to rein in Medicare costs
New York Times, Nov. 24, 2011
Members of both parties told the panel that Medicare should offer a fixed amount of money to each beneficiary to buy coverage from competing private plans, whose costs and benefits would be tightly regulated by the government.

Renewing our heritage, restoring children's health
Rep. Chris Taylor, Rep. Chris Larson, Nov. 23, 2011
Reps. Taylor and Larson introduced the Wisconsin Children's Outdoor Bill of Rights, which seeks to reconnect children with nature to both improve their overall health and ensure we have a new generation of stewards to protect Wisconsin's valued natural environment.

Sen. Vinehout: Give people fair notice on loss of BadgerCare
Sen. Kathleen Vinehout, Nov. 22, 2011
Sen. Vinehout introduced a new bill, the “Fair Notice Act,” requiring a 60 day notice for families losing BadgerCare coverage.

Insurance commissioners back changes to healthcare law’s MLR standard
Healthwatch, Nov. 22, 2011
The healthcare law requires health plans to meet an 80 percent or 85 percent MLR, meaning they must spend 80 percent or 85 percent of their premiums on medical costs rather than profit and administrative expenses.

Language barriers keeping some from FoodShare help, advocates say
Milwaukee Journal Sentinel, Nov. 22, 2011
Immigrants with limited English skills are more likely to be denied or delayed FoodShare benefits because the state Department of Health Services has failed to provide adequate bilingual and translation services, even after complaints.

BadgerCare cuts will harm Wis. families [Opinion]
Wausau Daily Herald, Nov. 22, 2011
There is a particular part of the proposal advanced by the Walker administration that is over the line and should be changed. If a family misses a payment, they're kicked out of the program. They are automatically ineligible for at least a year and potentially much longer.

High Court should rule health-care reform law legal [Opinion]
Sheboygan Press, Nov. 22, 2011
“The Affordable Health Care Act is a step toward providing health insurance for everyone and even if the purchase mandate is tossed out, other elements of the law should be kept.”

Repealing and replacing Obamacare [Opinion]
Tommy Thompson, Nov. 22, 2011
Tommy Thompson voices disapproval for Obamacare on the grounds that it does not uphold a free market approach conducive to competition.

Wisconsin adopts federal income tax treatment providing tax-free health benefits to certain adult children
State Bar of Wisconsin, Nov. 16, 2011
As of Nov. 4, 2011, Wisconsin employers are no longer required to calculate and impute the fair market value of any employer-sponsored health benefits provided to adult children who will be under age 27 at the end of the tax year.

Study finds co-payments discourage drug treatments
New York Times, Nov. 14, 2011
A new study published on Monday shows patients are more likely to take their medicine when they do not have to help pay for the prescriptions.
 

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Update Staff:
Bobby Peterson, Executive Director
Brynne McBride, Assistant Director
Adam VanSpankeren, Education and Outreach Coordinator
Evan Benner, Publications Assistant