This member benefit is released quarterly into your email inbox "as the seasons turn." Members check your emails to access the link. If you are not a member of the Academy, and therefore a member of WAND, you can still subscribe to receive Season(ing)s each quester for only $25/year. Click here for more details or to sign up.

Thank you for your support of WAND and we hope you enjoy Season(ing)s!

Dietitian nutritionists are uniquely positioned to improve nutrition security in our state! If you work with patients or clients, work in the community with community members or are a part of a food/nutrition security project, consider participating in 2024.

This opportunity is open exclusively to WAND members. Included along with approximately 6 virtual sessions, Leadership Academy participants will attend at least 3 in-person meetings at:

• WAND’s Annual Conference in Oshkosh, April 18-19
• Food & Nutrition Conference & Expo (FNCE) in Minneapolis, October 4-7
• WAND’s Leadership & Career Day in Stevens Point, November 1

All training and registration fees and materials are FREE of charge. Project participants would be required to cover their own travel costs to attend required in-person sessions.

For all the details on WAND’s Leadership Academy and to express your interest in participating in the 2024 project cohort, fill out and submit the form online no later than Monday, January 8, 2024. WAND is looking for 16-20 participants in this inaugural year of the Leadership Academy. Notice of selection will be emailed to members in mid-January.

Download (and share) the informational flyer here.

The public and healthcare professionals both benefit from having a complete accurate picture of the nature of the risk caused by unqualified and unlicensed providers. At the same time, increasing awareness of the value of quality RDN-provided services advances the profession and enables recognition of effective, superior practice. Whether you are using this Incident Reporting Tool as a consumer or as a health care provider, efforts are critical in ensuring the public is provided excellent care and that service delivery is documented to ensure high standard of professional practice in the future. Likewise reporting excellence in care is essential in assuring the services delivered are documented for future standards of professional practice.

Do not include patients' protected health information. The Wisconsin Academy of Nutrition and Dietetics will securely maintain these incident reports, follow-up as needed, and provided compiled de-identified data. Use of the Incident Reporting Tool will enhance efforts to prevent further harm and recognize success to better promote enhanced nutrition care and protect public safety.

The primary goal of the Academy of Nutrition and Dietetics' (Academy) and its credentialing agency the Commission on Dietetic Registration's (CDR) Code of Ethics for the Nutrition and Dietetics Profession (Code) "is the protection of the individuals, groups, organizations, communities, or populations with whom the practitioner work and interacts." According to the Code:

• "The nutrition and dietetics practitioner supports and promotes high standard of professional practice, accepting the obligations to protect clients, the public and the profession; upholds the [Code]; and shall report perceived violations of the Code through established processes."
• "Nutrition and dietetics practitioners shall report inappropriate behavior or treatment of a patient or client by another nutrition and dietetics practitioner or other professionals."

The Incident Reporting Tool provides a mechanism for facilitating Registered Dietitian Nutritionist (RDN) and Nutrition and Dietetics Technician, Registered (NDTR) compliance with ethical obligations. Note that some questions are optional. Simply complete the information to the best of your knowledge.

To report an incident of actual or potential harm or violation of state licensure laws or a success story showing the value of effective dietetics practice, click here to be redirected to the Academy's website to report.

*All above information is from the Academy of Nutrition and Dietetics.

Incident Reporting Tool Overview

• Review the webinar
• Download the PowerPoint Slides

Gov. Evers Goes All In for Agriculture with $50 Million in Relief for Wisconsin Farmers, $15 Million Food Security Initiative

MADISON — Gov. Tony Evers today announced the Wisconsin Farm Support Program, a $50-million investment to provide direct payments to Wisconsin farmers in support of the agricultural sector during the COVID-19 pandemic, and a $15-million Food Security Initiative to combat hunger in Wisconsin.

Wisconsin is a national agriculture leader, but COVID-19 has created unprecedented challenges for our farmers, food processors, and all those in the food supply chain. Federal aid so far has attempted to support agriculture nationwide, but Wisconsin farmers have been left out.

Eligible farmers will be asked to apply for the aid through the Wisconsin Department of Revenue, which is working in collaboration with the Wisconsin Department of Agriculture, Trade, and Consumer Protection (DATCP). Farm support payments could begin arriving as early as June.

“Farmers have asked for help, and this direct aid is meant to aid the farmers who are the foundation of our food system. Farmers also serve as the backbone of many of Wisconsin’s local rural economies, and these direct payments will help revitalize local economies and jump-start Wisconsin’s food supply chain, which has been significantly disrupted by the COVID-19 pandemic,” Gov. Evers said. “DATCP and I have engaged in productive meetings with agriculture stakeholders to ensure a fair, accessible distribution system for these aid payments, and I look forward to getting this relief into the hands of farmers around the state.”

To complement the Wisconsin Farm Support Program and combat food insecurity, the governor has also committed $15 million to the Food Security Initiative. A portion of the funding will go toward helping food banks, pantries, and other nonprofit organizations fighting food insecurity adapt to challenges posed by the COVID-19 public health crisis. This may include adjustments to public health and social distancing guidelines, such as curb-side pick up or delivery services, purchasing prepared meals from local restaurants for distribution, as well as other expenses that are being incurred by these organizations as they continue to provide services to families in need. The initiative will emphasize the importance of prioritizing the use of Wisconsin products wherever possible in feeding citizens who find themselves in need of support. Applicants are strongly encouraged to partner with local food experts to aid in connecting with farmers in their area.

Additionally, the Food Security Initiative will help food banks, pantries, and other nonprofit organizations purchase, process, and/or store Wisconsin agricultural products for distribution to local consumers in need. Furthermore, these grants will bolster Wisconsin’s food supply chain by strengthening bridges, from producers and processors to food banks and consumers. This section of the Food Security Initiative will help ensure that the funding provided in the federal CARES Act goes to help Wisconsin organizations distribute nutritious Wisconsin food products to Wisconsin consumers who need them most. This initiative is a win-win for Wisconsin as it fights food insecurity while also investing in the agriculture industry, supporting Wisconsin’s food supply chain from farm to family. Successful applicants are encouraged to partner with organizations that work directly with Wisconsin’s agricultural producers and food processors to maximize the use of Wisconsin products.

“During this difficult time, people across our state don’t have enough to eat in a state that helps feed the entire country,” said Gov. Evers. “Connecting the dots between struggling food producers with organizations that are working to address food insecurity requires a coordinated effort—one that draws upon the ingenuity of our residents and their devotion to their neighbors and communities. Our farmers and agribusinesses have never wavered in their commitment to providing nutritious, high-quality food for folks here in Wisconsin and around the world. Now, we’re going all in together to support both Wisconsin’s agriculture industry and people in need throughout the state.”

###

The changes in this order go into effect on April 24, 2020. The order will remain in effect until 8 a.m. on May 26, 2020.

The order is available online (link). The Governor’s full press release is also available online (link).

The full copy of the Governor’s press release is available online (link).

The Career Starter Dues Program offers reduced dues rates for members in their first five years of Active category membership eligibility. Dues increase incrementally each year for up to five years to help you get established in the profession. The Career Starter Dues Program allows you to renew your Academy membership at a significantly reduced rate, giving you the financial flexibility and time to learn how to take advantage of the various services the Academy offers.

The graduated dues are offered in a tiered structure based on your RD/RDN or DTR/NDTR eligibility date on file with the Commission on Dietetics Registration. Graduation date can be used in lieu of eligibility date for those who do not pursue a CDR credential. Student members who recently established eligibility for a CDR credential will automatically be moved into this program and Active category membership during the next membership renewal cycle.

Please contact the Academy's Member Service Center at 800/877-1600, ext. 5000 or email membership@eatright.org. Representatives are available weekdays 8 a.m. - 5 p.m. (Central time).

The Governor’s full press release is available online (link).

DHS recommends that Wisconsinites do the following:

• Get the three goods. That’s good-for-you foods, a good night’s sleep, and a good amount of exercise every day.
•  Stay connected to your support system. Reach out to family and friends, colleagues, and community groups in whatever way you can—calls, texts, video chats, and more.
•  Spend time away from focusing on COVID-19. Don’t let the pandemic take over what you read, watch, or talk about. And don’t be afraid to ask friends and family to talk about something else.
•  Reduce anxiety by reducing your risk. Stay safer at home. Wash your hands for at least 20 seconds. Cover your nose and mouth when you cough or sneeze. Stay at least 6 feet apart while running essential errands at the store, pharmacy, or gas station. Knowing you’re doing everything you can to stay healthy can help you worry less.
•  Check in with yourself. Everyone’s reaction to stress is different. Difficulty concentrating or sleeping, irritability, fatigue, and even stomachaches can be normal. But if you find you are overwhelmed or having thoughts of self-harm or suicide, reach out for help right away. Text HOPELINE to 741741 or call the National Suicide Prevention Lifeline at 1-800-273-8255.

The emergency covers a wide range of issues across many health care professions. The order took action that will make it easier to quickly expand the health care workforce by readmitted those with expired licenses and by welcoming providers from other states. It will also enhance flexibility so providers can more effectively respond to areas of greatest need. Please read the order, linked above, and also reference this  Frequently Asked Questions document for clarifications. Both address individuals who have expired licenses and wish to return to practice.

Also, the order addresses telemedicine specifically, but we have also received questions about telehealth practice for other providers. The practice of telehealth is generally allowed under existing Wisconsin law unless there is some profession-specific requirement or restriction. Credential holders must use their professional judgment to determine if telehealth is appropriate for the patient or client being treated, to abide by all other applicable rules of practice and professional conduct, and to be properly credentialed or authorized to practice in the state of Wisconsin. If someone can practice in Wisconsin via an Emergency Order, a compact, or a temporary or permanent license, that individual can practice telehealth in Wisconsin and provide services to Wisconsin residents to the same extent as similarly licensed Wisconsin practitioners.       

The Wisconsin Medical Examining Board has the only telemedicine rule currently in effect in Wisconsin. This rule may be found at Wis. Admin. Code Med chapter 24. While this rule applies only to the Medical Examining Board, many of the concepts in this rule may be informative to credential holders in other professions. Here is a link to this rule. Note that portions of this rule were suspended when Governor Evers issued  Emergency Order 16. Please review both Med chapter 24 as well as the statutory and rule provisions governing your profession when evaluating telemedicine/telehealth practice options during the COVID-10 public health emergency.

The Department is not able to answer legal questions regarding what the standard of care requires for any specific profession or any specific situation a credential holder may encounter. If practice-related questions arise, the Department encourages credential holders to consult with a supervisor, with their own private or institutional legal counsel, with their colleagues within the profession, or other sources familiar with their profession’s standards of practice. Profession-related statutes and rules can be found by clicking on a profession under the Rule/Statutes column  here.

Also, there have been recent changes to Medicaid reimbursement of telehealth services. The Wisconsin Department of Health Services issued  guidance on telehealth reimbursement changes and status during the COVID-19 public health emergency. The guidance is available  here. The Office of the Commissioner of Insurance has also sent this letter regarding related insurance (malpractice) issues to insurers.

This information will be posted to our website. Please visit often, as we are updating it daily as decisions are made and new information is available.

Interstate Reciprocity Temporary License Application

Emergency Order #16 Renewal Form

Health Care Facility Notification of Temporary Provider Practice

Sincerely,

Dawn B. Crim

Secretary-designee

The survey found:

•  Eighty-six percent say that it was appropriate to close schools and businesses, and restrict public gatherings, while 10 percent say that this was an overreaction to the pandemic;
•  A large majority of voters approve of Gov. Tony Evers’ handling of the coronavirus issue, with 76 percent saying they approve and 17 percent saying they disapprove;
•  A majority, 51 percent, approve of President Donald Trump’s handling of the pandemic, while 46 percent disapprove;
•  Opinion is divided on holding the April 7 spring election as scheduled, with 51 percent saying the date should be moved and 44 percent saying it should be held as scheduled.

As additional needs and issues arise from agencies and stakeholders, the governor is committed to working with legislators to find bipartisan solutions. The governor’s office welcomes the opportunity to hear and consider any proposals that legislators have to address the impacts of COVID-19 on the health and well-being of Wisconsin residents, businesses and communities. 

This package, among many other proposals, includes:  

• Increasing funding for Medicaid providers via supplemental payments and rate increases to support the healthcare system’s response to the public health emergency; 
• Establishing a fund to reduce providers’ uncompensated care costs targeting reimbursement for treatment-related costs for uninsured individuals;
• Establishing a COVID-19 reinsurance program to reduce health insurance premiums;
• Providing grant funding to provide food assistance and meal delivery; 
• Prohibiting utility cooperatives from disconnecting customers and prohibiting land-lord directed disconnections from rental units during a public health emergency;
• Ensuring workers receive back payment for any lost unemployment insurance benefits as a result of the delay in suspending the one-week waiting period;
• Providing supplemental payments to child care providers, if that provider needed to shut down during the public health emergency; 
• Allowing households to apply for heating assistance under the low-income energy assistance program anytime during the 2020 calendar year;
• Increasing the Earned Income Tax Credit for low-income families; 
• Providing municipalities the flexibility to implement multiple installments of three or more payments for 2020 property taxes; 
• Waiving interest and penalties on delinquent property taxes included in the 2019 payable 2020 tax roll, on and after April 1, 2020; 
• Creating a fund through the Wisconsin Housing and Economic Development Association to provide 6 months of support for prevention of single-family foreclosures and providing refinancing opportunities to current borrowers; and 
• Providing grant funding for small businesses and workers through the Wisconsin Economic Development Corporation. 

The Governor’s first COVID-19-related legislation was introduced last week as LRB-5920 and is available here for review. A brief explanation of LRB-5920 is available here. A brief explanation of the governor’s second round of proposed legislation announced today is available online (link).

The report includes a summary on all programs funded in the Act, including:

• Public Health Emergency Preparedness funding from CDC;
• Administration for Community Living
• Public Health and Social Services Emergency Fund
• Direct Payments to State and Local Governments
• Transportation, Housing and Unemployment Programs

Details on the full $2 trillion COVID-19 stimulus package are also available in the full bill available online (link). The following is a summary of some of the healthcare related provisions in the bill. 

Health and Long-term Care 

Grants to Hospitals and Health Care Providers: Provides $100 billion to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus. Medicaid and Medicare providers are included in the definition of health care provider. To apply, providers must submit an application to the Secretary of Health and Human Services that includes a statement justifying their need.

Delay of Disproportionate Share Hospital Reductions. Delays scheduled reductions in Medicaid disproportionate share hospital payments through November 30, 2020.

Increasing Provider Funding through Immediate Medicare Sequester Relief. Temporarily lifts the Medicare sequester from May 1 through December 31, 2020, boosting payments for hospital, physician, nursing home, home health, and other care by 2%. The Medicare sequester would be extended by one-year beyond current law to provide immediate relief without worsening Medicare’s long-term financial outlook.

Medicare Add-on for Inpatient Hospital COVID-19 Patients. Increases the payment that would otherwise be made to a hospital for treating a patient admitted with COVID-19 by 20%. It would build on the Centers for Disease Control and Prevention (CDC) decision to expedite use of a COVID-19 diagnosis to enable better surveillance as well as trigger appropriate payment for these complex patients. This add-on payment would be available through the duration of the COVID-19 emergency period.

Grants to the V.A.: Provides $14.4 billion to the Veteran’s Administration for medical services. 

CDC: Provides $4.3 billion to the CDC. Of these funds, $1.5 billion is set aside for grants to states, territories and tribes to help carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities. 

Strategic National Stockpile: Provides $16 billion in funding for the Strategic National Stockpile to procure personal protective equipment, ventilators and other supplies. 

Hospital Preparedness: Provides $250 million for grants to improve the capacity of healthcare facilities to respond to medical events.

Rural Health: Provides $180 million to expand services and capacity for rural hospitals, telehealth, poison control centers.

Health Savings Accounts for Telehealth Services. Allows a high-deductible health plan (HDHP) with a health savings account (HSA) to cover telehealth services prior to a patient reaching the deductible. 

Providing Hospitals Medicare Advance Payments. Expands, for the duration of the COVID-19 emergency period, an existing Medicare accelerated payment program. Specifically, qualified facilities would be able to request up to a six month advanced lump sum or periodic payment. This advanced payment would be based on net reimbursement represented by unbilled discharges or unpaid bills. Most hospital types could elect to receive up to 100% of the prior period payments, with Critical Access Hospitals able to receive up to 125%. Finally, a qualifying hospital would not be required to start paying down the loan for four months, and would also have at least 12 months to complete repayment without a requirement to pay interest.

Extension of Physician Work Geographic Index Floor. Extends payments for the work component of physician fees in areas where labor cost is determined to be lower than the national average through December 1, 2020.

National Academies Report on America’s Medical Product Supply Chain Security: Requires the Department of Health and Human Services to enter into an agreement with the National Academies to examine and report on the security of the United States medical product supply chain. Part of the report requires the examination of the United States’ dependence on critical drugs and devices that are sourced or manufactured outside of the U.S. 

Requiring the Strategic National Stockpile to Include Certain Supplies: Requires the strategic national stockpile to include personal protective equipment, ancillary medical supplies, and other applicable supplies required for the administration of drugs, vaccines and other biological products, medical devices, and diagnostic tests. 

Preventing Medical Device Shortages: Requires manufacturers of medical devices that are critical during public health emergencies to notify the federal government of any discontinuance or interruption to manufacturing of the device that could disrupt the supply of the device in the U.S. The information will be used to compile a list of devices that are determined to be in short supply. 

Rapid Coverage of Preventive Services and Vaccines for Coronavirus: Requires insurers to cover without cost-sharing any qualifying coronavirus preventive service. Qualifying preventive services include any evidence-based item, service, or immunization that is intended to prevent or mitigate coronavirus disease. 

Increased Funding for Health Centers: Provides $1.3 billion in additional funding to community health centers in fiscal year 2020.

Telehealth Network and Resource Center Grants: Provides $29 million per year through 2025 and reauthorizes Health Resources and Services Administration (HRSA) grant programs that promote the use of telehealth technologies for health care delivery, education, and health information services. 

Rural health care services outreach, rural health network development, and small health care provider quality improvement grant programs. Provides $79.5 million per year through 2025 and reauthorizes HRSA grant programs to strengthen rural community health by focusing on quality improvement, increasing health care access, coordination of care, and integration of services.

Limitation on liability for volunteer health care professionals during COVID-19 emergency response. Makes clear that doctors who provide volunteer medical services during the public health emergency related to COVID-19 have liability protections. In order to have the liability protections provided by the bill, a volunteer provider must be acting within the scope of their license, registration or certification as defined by the state. 

Health Care Workforce 

Reauthorization of health professions workforce programs.

Provides $51.4 million per year between 2021 and 2025 for scholarships to health care students. The funding is given to eligible entities, which includes schools of medicine, nursing, dentistry, optometry, public health, etc.

Provides $48.9 million per year for the primary care training and enhancement program. Adds language prioritizing grant awards to programs that train physicians in rural areas.

Provides $41.2 million for eligible entities to establish health care workforce educational programs.

Provides $1.1 million per year for a loan repayment program for medical, dental and nursing students who agree to serve as faculty following graduation.

Provides $15 million per year to provide educational assistance to individuals from disadvantaged backgrounds to pursue health care education. 

Extension of Demonstration Projects to Address Health Professions Workforce Needs: Extends the Health Professions Opportunity Grants (HPOG) program through November 30, 2020 at current funding levels. This program provides funding to help low-income individuals obtain education and training in high-demand, well-paid, health care jobs.

Education and training relating to geriatrics. Provides $40.7 million per year and reauthorizes and updates Title VII of the Public Health Service Act (PHSA), which pertains to programs to support clinician training and faculty development, including the training of practitioners in family medicine, general internal medicine, geriatrics, pediatrics, and other medical specialties. It emphasizes integration of geriatric care into existing service delivery locations and care across settings, including home- and community-based services. The Secretary may provide  awardees with additional support for activities in areas of demonstrated need, which may include education and training for home health workers, family caregivers, and direct care workers on care for older adults. Eligible entities could receive awards of at least $75,000. 

Economic Relief 

Recovery Rebates for Americans: Provides a one-time payment of $1,200 to individuals with incomes below $75,000 or a one-time payment of  $2,400 for joint filers with incomes below $150,000. Payments are increased by $500 per child. The bill requires the one-time payments to be made as soon as possible. 

Relief Payments to States, Tribal Governments and Local Units of Government: Provides $150 billion in direct payments to states, tribal governments and local units of government with. To qualify, local governments must have populations of more than 500,000 people. Payments are required to be used to cover expenditures related to COVID-19 that occur between March 1, 2020 and December 30, 2020. Expenditures must not have been accounted for in the state or local government’s most recent budget. The bill requires the Treasury Secretary  to make these payments within 30 days of enactment. 

Loans for Small Businesses, Non-profits, Contractors and Self-Employed Individuals. Allows nonprofits and other businesses with less than 500 employees to get loans from the Small Business Administration if they were adversely impacted by COVID-19. Loans can be used to cover payroll costs, health care benefits, mortgage or rent payments, utilities or interest on debt. Borrowers will be eligible for loan forgiveness if they maintain employees and their salaries. The eligibility period runs from February 15, 2020 to June 30, 2020. Maximum loan amounts will be determined using the organization's average monthly payroll amounts over a one year period. The bill appropriates $349 billion for this loan program. 

Employee retention credit for employers subject to closure due to COVID-19. Provides a refundable payroll tax credit for 50% of wages paid by employers to employees during the COVID-19 crisis. The credit is available to employers whose (1) operations were fully or partially suspended, due to a COVID-19-related shutdown order, or (2) gross receipts declined by more than 50 percent when compared to the same quarter in the prior year.

Small Business Administration Disaster Loans: Provides $562 million to the Disaster Loan Program. 

Broadband and Telehealth 

Rural Utilities Service--Distance Learning, Telemedicine and Broadband Program: Provides $25 million for telemedicine and distance learning services in rural areas. 

Reconnect Pilot: Provides $100 million for grants for the costs of construction, improvement, or acquisition of facilities and equipment needed to provide broadband service in eligible rural areas.

Federal Communications Commission Telehealth: Provides $200 million to the FCC to respond to COVID-19. This includes supporting health care providers by providing telecommunications services, information services, and devices necessary to enable the provision of telehealth services. 

Higher Education and Student Loans 

Temporary Relief for Federal Student Loan Borrowers: Requires the Secretary to defer student loan payments, principal, and interest for 6 months, through September 30, 2020, without penalty to the borrower for all federally owned loans.

Adjustments of Subsidized Loan Limits. For students who dropped out of school as a result of COVID -19 excludes the term from counting toward lifetime subsidized loan eligibility. 

Exclusion from Federal Pell Grant Duration Limit. For students who dropped out of school as a result of COVID -19 excludes the term from counting toward lifetime Pell eligibility.

Institutional Refund and Federal Student Loan Flexibility. For students who dropped out of school as a result of COVID -19, the student is not required to return Pell grants or federal student loans to the Secretary. Waives the requirement that institutions calculate the amount of grant or loan assistance that the institution must return to the Secretary in the case of students who dropped out of school as a result of COVID-19

Exclusion for certain employer payments of student loans: Allows employers to provide a student loan repayment benefit to employees on a tax-free basis. Under the provision, an employer may contribute up to $5,250 annually toward an employee’s student loans, and such payment would be excluded from the employee’s income. The $5,250 cap applies to both the new student loan repayment benefit as well as other educational assistance (e.g., tuition, fees, books) provided by the employer under current law. The provision applies to any student loan payments made by an employer on behalf of an employee after date of enactment and before January 1, 2021.

 About $750,000 will be available for programs led by Wisconsin-based nonprofits, tax exempt, 501(c)(3) organizations or tribal/government entities. Special emphasis will be given to projects that target vulnerable populations.

Grant applications are due April 15, 2020.

These facilities are for symptomatic individuals suspected to be infected with COVID-19 or who have a confirmed case of COVID-19. Individuals will not be permitted to register at the facility unless referred by a medical provider or public health official. Individuals register and stay at the isolation facility on a voluntary basis. The expected length of stay will be about 14 days, or 72 hours after symptoms dissipate. At any time, either the individual or the facility may terminate the individual’s presence at the site. Those staying at the facility will have wellness checks by phone every four hours during the day and if needed at night.

Additionally, the SEOC also issued guidance for communities seeking to open their own voluntary self-isolation centers. This guidance will aid local communities with the following:

• How do we select, set up, and staff an isolation site?
• How does a person get referred to and checked into the isolation site?

• What happens while occupants are at the isolation site? Including details about medical monitoring/wellness check calls and other on-site services.

• When do occupants leave the site? Including details about discharge and involuntary check out from the isolation site.

The full press release is available online (link).

Having determined that Wisconsin met all of the criteria required to receive a major disaster declaration, Gov. Evers in his letter requested that the federal government provide the following programs to support the state’s response: Public Assistance, Direct Assistance, Hazard Mitigation (statewide), and certain Individual Assistance programs; Crisis Counseling, Community Disaster Loans and the Disaster Supplemental Nutrition Program.

Gov. Evers declared a public health emergency on March 12 in response to the outbreak, which directed the Department of Health Services to take all necessary and appropriate actions to help combat the spread of the virus. On March 14, the governor directed Wisconsin Emergency Management to activate the State Emergency Operations Center (SEOC) to provide additional coordination in support of the state’s response.

A copy of the governor’s letter (link) and the full press release are available online (link).

The State Emergency Operations Center and Department of Health Services continue working to supply medical facilities with supplies requested from the Strategic National Stockpile. The second phase includes approximately 51,880 N95 respirators, 130,840 face/surgical masks, 23,400 face shields, 20,226 surgical gowns, 96 coveralls, and 79,000 pairs of gloves. Today’s shipment comes as Governor Evers announced Wisconsin’s first delivery of SNS supplies which included approximately 52,800N95 respirators, 130,000 face/surgical masks, 24,768 face shields, 20,286 surgical gowns, 96 coveralls, and 61,750 pairs of gloves. In total Wisconsin has received approximately 104,680 N95 respirators, 260,840 face/surgical masks, 48,186 face shields, 40,512 surgical gowns, 192 coveralls, and 140,750 pairs of gloves from the SNS.

The SNS supply shipments do not include supplies the governor has requested from FEMA for non-medical personnel or supplies being aggressively pursued through procurement, donations, or the governor’s buyback program.

• Prior authorization (PA) for enteral nutrition formula will be approved in real time when submitted on the ForwardHealth Portal for members who receive all nutrition administered through a gastric or jejunostomy tube.
• For all PA submission types, the Healthcare Common Procedure Coding System (HCPCS) code for enteral nutrition formula will be approved, not the specific enteral nutrition formula brand name.
• Coverage for enteral nutrition formula consumed orally has been expanded for members with diagnoses of failure to thrive, malnutrition, and/or inborn errors of metabolism.
• Coverage for enteral nutrition formula consumed orally and for members transitioning from tube feeding to an oral diet has been expanded. Requests will be reviewed on an individual basis and will not be subject to predetermined quantity or time limitations.
• Coverage of syringe-fed enteral feeding supply kits will be added.

The full update is available online (link).

The new partnership now includes laboratory support from Exact Sciences, Marshfield Clinic Health System, Promega, and UW Health. These organizations, along with the Wisconsin Clinical Lab Network, will now share knowledge, resources, and technology to bolster Wisconsin’s testing capacity.

The Wisconsin Clinical Lab Network labs have been averaging completion of 1,500-2,000 COVID-19 tests per day. The expanded capacity from the state’s new public-private partnership is expected to double that capacity initially and continue to expand as additional platforms and supplies become available.

Residents who are seeking a COVID-19 test are still required to receive an order from a doctor. These labs are not testing sites. 

The bill includes several healthcare provisions, including language related to out-of-network bills that occur during the public health emergency. The language caps physician payment rates at 250% of the Medicare rate.

Insurance 

• Prohibits health plans from charging patients more for out-of-network services related to the diagnosis and treatment of the condition for which a public health emergency has been declared than they do for in-network services (if an in-network physician is not available).
• The bill requires the plan to reimburse the out-of-network provider at 250% of the Medicare rate. Providers and facilities are prohibited from charging patients more than what they are reimburse by the plan.
• Creates a process for out-of-state physicians to have liability coverage in Wisconsin during a public health emergency. They would need to provide OCI with a certificate of insurance for a policy of health care liability insurance issued by an insurer that is authorized in a jurisdiction accredited by the National Association of Insurance Commissioners.
• Requires health plans to cover without cost-sharing any testing, treatment or vaccines related to COVID-19.
• Requires health plans to cover any services provided via telehealth if they cover that service when it is provided in-person.
• Prohibits health plans from canceling policies due to non-payment during the COVID-19 emergency
• Prohibits health plans and pharmacy benefit managers from requiring prior authorization for any early refills of prescriptions or restricting the period of time in which a drug may be refilled.
• Creates a process for pharmacists to extend prescription orders by up to 30 days during public health emergencies. 

Emergency Preparedness 

• Provides $300 million to the Department of Military Affairs to respond to the public health emergency.
• Provides $200 million to the Department of Administration to respond to the public health emergency. 

Health 

• Creates a public health emergency fund for the Department of Health Services.
• Provides $100 million for a new health care provider grant program specific to planning, preparing for and responding to COVID-19.
• Provides $17.4 million to local health departments.
• Creates 64 positions within the Department of Health Services’ Division of Public Health.
• Allows DHS to suspend any premium or cost-sharing requirements for childless adults on BadgerCare in order to qualify for enhanced federal Medicaid matching funds related to COVID-19.
• Exempts the Department of Health Services, during a public health emergency, from the current law legislative review requirements for submitting waiver requests to the federal government, amending the state Medicaid plan or raising Medicaid reimbursement rates.
• Expands the definition of public health emergency to include toxins or other threats to health. 

Health Care Workforce 

• Allows former health care providers to receive a temporary license to provide services during a public health emergency. This would apply to physicians, nurses, PAs, dentists, pharmacists, phycologists, social workers and other health providers who have practiced within the last 5 years but do not currently have a license. The temporary license would be valid until 90 days following the conclusion of the health emergency.
• Allows out-of-state health care providers to receive a temporary license to practice in Wisconsin. The temporary license would be valid until 90 days following the conclusion of the health emergency.
• Allows the state to waive licensure fees for physicians, physician assistants, nurses, dentists, pharmacists, psychologists, and certain behavioral health providers.
• Exempts certain health care provider credentials issued by credentialing boards in DSPS from having to be renewed during the public health emergency. 

Unemployment Insurance

• Eliminates the one-week waiting period for Unemployment Insurance

Voting

The bill contains several provisions related to voting during public health emergencies. Specifically, for elections held during a declared public health emergency, it would: 

• Require elections held during public health emergencies to be held by mail.
• Waive the state’s Photo ID requirement.
• Waive the requirement that mail-in absentee ballots need a witness signature.
• Allow mail-in ballots to be counted as long as they are postmarked by Election Day.
• Allow voters to register electronically until 5 days before the election.

Please refer to the Forward Health Update 2020-15 (link) for a comprehensive explanation of the update.

Governor Issues Order to Expedite Expansion, Enhance Efficiency of Healthcare Workforce 

March 28, 2020

Governor Evers and Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm today exercised their authority under Article V, Section 4 of the Wisconsin Constitution and Sections 323.12(4) and 252.02(6) of the Wisconsin Statutes to simplify healthcare license renewals during the COVID-19 public health emergency and to encourage recently retired professionals with expired licenses to re-enter practice. This full order is available online (link).

The order includes the following policy changes:

• Interstate Reciprocity: allows any out-of-state health can provider licensed and in good standing to practice in Wisconsin without a Wisconsin credential. The order requires the out-of-state physician to apply for a temporary or permanent Wisconsin license within 10 days of first working at a Wisconsin health care facility; and the health care facility must notify DSPS within 5 days. The order temporarily suspends the visiting physician practice limitations in Med 3.04.
• Temporary License: Any temporary licensed to an out-of-state provider during the emergency will be valid until 30 days after the conclusion of the emergency.
• Telemedicine: Allows physicians licensed and in good standing in Wisconsin, another U.S. state or Canada to provide telemedicine services to Wisconsin residents.
• Physician Assistants: Suspends several current rules regulating the practice of PAs in Wisconsin. This includes: the requirement of PAs to notify the MEB of changes to their supervising physician within 20 days (order changes it to 40 days); the requirement that PAs limit their scope of practice to that of their supervising physician (the order allows them to practice to the extent of their experience, education, training and abilities. It also allows them to delegate tasks to another health provider); the physician to PA ratio of 4:1 (the order allows a physician to oversee up to 8 on-duty PAs at a time, but there is no limit on how many PAs a physician may provide supervision to over time. It also allows a PA to be supervised by multiple physicians while on duty). 
• Nurse Training and Practice: The order suspends many rules related to nursing. This includes suspending a rule that prohibits simulations from being utilized for more than 50% of the time designated for meeting clinical learning requirements. It also suspends the requirement for nurses to submit an official transcript in order to get a temporary license and allows a temporary license to remain valid for up to 6 months. In addition, it suspends the rule requiring license renewal within 5 years.
• Advanced Practice Nurse Prescribers: Temporarily suspends the requirement that Nurse Prescribers must facilitate collaboration with other health care professionals, at least 1 of whom shall be a physician or dentist.
• Recently Expired Credentials: Requires the state to reach out to individuals with recently lapsed credentials about renewal options. The order also suspends many of the late renewal fees and continuing education requirements for most health professions. The order temporarily suspends MED 14.06(2)(a) to allow a physician whose license lapsed less than 5 years ago to renew without fulfilling the continuing education requirements. It also suspends RAD 5.01 (1) and (2) to allow radiographers or LXMO permit holders who have let their license lapse renew without completing continuing education.
• Fees: The order also gives DHS the ability to suspend fees or assessments related to health care provider credentialing. 

The order is effective immediately and will remain in effect through the duration of the public health emergency.

The full version of the Governor’s press release is available online (link).

March 27, 2020

Governor Evers directed the Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm to temporarily order the suspension of evictions and foreclosures amid the COVID-19 public health emergency. The full order is available online (link).

The order prohibits landlords from evicting tenants for any reason unless failure to proceed with the eviction will result in an imminent threat of serious physical harm to another person and mortgagees from commencing civil action to foreclose on real estate for 60 days. Wisconsinites who are able to continue to meet their financial obligations are urged to do so. This order does not in any way relieve a person's obligation to pay their rent or mortgages.

The full press release is available on the Governor’s website (link).