WPHCA POLICY & ADVOCACY updates & resources

November 12, 2020

State Updates

Leadership Elections- Legislature

Note new leadership among Republicans and Democrats and we expect to see appointment to the powerful Joint Committee on Finance soon

Republican Leadership Democratic Leadership

Assembly Republicans Assembly Democrats Speaker – Minority Leader – Speaker Pro Tempore – Tyler Assistant Minority Leader – Dianne August Hesselbein Majority Leader – Caucus Chair – Assistant Majority Leader – Kevin Assistant Caucus Chair – Lisa Petersen Subeck Caucus Chair – Caucus Secretary – Beth Meyers Assistant Caucus Chair – Cindi Caucus Sergeant at Arms – Kaylan Duchow Haywood Caucus Secretary – Caucus Sergeant at Arms – Sam Kerkman

Senate Republicans ​Senate Democrats Majority Leader – Devin LeMahieu Minority Leader – Janet Bewley Assistant Majority Leader – Dan Assistant Minority Leader – Janis Feyen Ringhand President – Chris Kapenga Caucus Chair – Jeff Smith President Pro Tempore – Pat Testin Assistant Caucus Chair – Melissa Caucus Chair – Van Waggaard Sargent Caucus Vice-Chair – Kathy Bernier

Governor's Listening Sessions for the 2021-2023 State Biennial Budget

The Governor and Lieutenant Governor are hosting a series of issue-based virtual budget listening sessions. These virtual budget listening sessions will provide the Governor and Lieutenant Governor with an opportunity to hear directly from you and other Wisconsin residents on the issues impacting you and your communities.

The first virtual budget listening session will take place next week Tuesday, November 17, 2020 at 6:00PM and will focus on Healthcare and Public Health.

The virtual budget listening sessions will begin with all participants in a large group meeting for introductions. All participants will then be transferred to small group breakout rooms where they can have a more in-depth discussion on various budget topics related to the issue.

Please consider this email as a personal invitation to you, your networks, your members and your advocates to attend. Please share widely.

Register to attend here.

If you would like to submit a written public comment, please do so here .

Each virtual budget listening session requires registration, which will close promptly on the day of the listening session at 6:00pm.

For more information click the link, to access the Governor and Lieutenant Governor’s 2020 Budget Listening Session website.

State Budget Process Update

WPHCA is actively involved in advocacy for Health Centers throughout the biennial budget process. At this point, agencies have provided their baseline budget requests and we eagerly await a November 20th fiscal update which will let us know more about the fiscal “state of the state.” We are virtually engaging with policymakers and leadership in the Governor’s office to advance Health Center priorities. The Governor’s budget proposal is anticipated in February.

DHS releases summary of COVID-19 vaccination plan

Steps for Health Centers:​ 1. Enroll in the COVID-19 Vaccine Provider Enrollment Tool : The COVID-19 Vaccine will not be available for private purchase and will only be available for delivery through the Wisconsin COVID-19 Vaccine program. All organizations who plan to deliver the vaccine must enroll. ​ 2. Connect with HERC coordinators: They are sending info to their regions on the vaccination plan, along with Executive plan and info on the COVID-19.​ 3. Begin working with a broad coalition in your area: to identify the number of doses that needed to vaccinate staff in Phase 1a and identify ways to collaborate on creating larger, single orders.​

Tuesday, 11/10 meeting, State Disaster Medical Advisory Committee (SDMAC), Subcommittee on Vaccine Distribution Narrowed the definition of Phase 1a health care providers: Individual who provide direct patient service (compensated or uncompensated) or engage in healthcare services that place them in direct contact with 1. Patients who are able to transmit SARS-CoV-2, and or 2. infectious material containing SARS-CoV-2 virus. Will be recommending this definition to the SDMAC leadership team. DHS estimated that this would be about 400,000 people throughout the state. Phase 1a is targeted at preventing a collapse of the healthcare system. Systems will need to work together to provide vaccine locations where health care providers will be able to receive the vaccine as the state will not be able to distribute small amounts of vaccines to hundreds of organizations. There are 72 organizations approved to give vaccines to children; expecting the number of vaccine approved organizations to grow for the adult population with the COVId-19 vaccine. Pfizer is estimated to have about 50M vaccines ready globally. Reminder that this vaccine vial once thawed last for 5 days. Each vial contains 5 doses, which must be used within the same day. Are moving up their timeline slightly due to the Pfizer update, are now assuming a vaccine may be available late Dec or early next year.

DHS FAQ’s​ includes: General enrollment​ Filling out the forms​ Resubmitting forms​ Vaccine delivery and redistribution COVID-19 Vaccine Resource Library

From Wisconsin Health News: Evers urges Wisconsinites to stay home as state sets new COVID-19 records

Gov. on Tuesday signed an executive order recommending that Wisconsinites stay home as much as possible to fight the spread of COVID-19.

"Wisconsin, this is serious," Evers said during a prime-time address. "The crisis is urgent."

Evers' speech came the same day that state health officials reported a record number of new daily COVID-19 cases and deaths. The state set a new high for COVID-19 hospitalizations too.

The Department of Health Services reported 7,073 new COVID-19 cases, for a total of 278,843. The state’s death toll is at 2,395 after 66 more deaths.

There were 2,070 COVID-19 patients in Wisconsin hospitals, a single-day increase of 67 and up 356 from last week, per the Wisconsin Hospital Association.

A record 418 COVID-19 patients were in intensive care units, a single-day increase of 22 and up 71 from the prior week.

Evers' order recommends Wisconsinites avoid gatherings of any size with people outside their household, maintain a physical distance of at least six feet from others and wear a face covering.

“We must get back to the basics of fighting this virus just like we did last spring, and it starts at home," Evers said. "It’s not safe to go out. It’s not safe to have others over. It’s just not safe.”

The order also encourages businesses to limit staff and customers and follow recommended guidelines when remote work isn’t possible, like requiring masks and complying with social distancing practices.

Evers said he’ll be releasing legislation in the coming days aiming to tackle the COVID-19 pandemic. He didn't provide details.

“We must start fighting this virus together and we must start tonight,” he said.

The Stop the COVID Spread! Coalition released a new ad Tuesday warning that Wisconsin “is losing” its fight against COVID-19.

“Our front-line workers are doing all they can, but they can’t do it alone,” the ad’s narrator says. “More people are getting sick and dying. Unless we make changes, there will be more deaths we could have prevented. You can change this.”

Lunch Time Policy Update Call

LOCATION Zoom

DATE AND TIME 11/19/20 12:00pm-11/19/20 12:30pm

Zoom Link: https://zoom.us/j/99392568340?pwd=emtFVDRNN3F1dnJkcnY1OHRrQ2xudz09 Meeting ID: 993 9256 8340 Passcode: 504069 Ph: 1 312 626 6726

Planning to Join

FEDERAL UPDATES

Senate Releases FY21 Appropriations Bills

In the late morning on November 10, the Senate Appropriations Committee released its drafts of all twelve spending bills for the FY21 federal budget. The text for the Labor, Health, and Human Services spending bill is available here. A summary of the bill is available here. The Senate Appropriations Committee Vice Chair Senator Patrick Leahy (D-VT) described the bills as a bipartisan starting point for negotiations to develop a finalized federal budget based on what the Senate has released and the budget passed by the House of Representatives over the summer.

Crystal Ball: Biden Administration Impacts on Health Center Funding

NACHC is closely engaged on advocacy for Health Centers with the Biden transition team. The incoming administration has committed their support for long-term Health Center funding. WPHCA and NACHC will continue to engage with the President-elect’s team to address federal funding priorities. Federal funding priorities include: 1. Immediate long-term reauthorization of the Community Health Center Fund is needed to stabilize a critical system of care for vulnerable communities, especially during the COVID-19 pandemic. 2. Infrastructure investment of $20 billion over five years to the Community Health Center Fund would enable health center expansion, addressing the unmet needs of underserved communities in both rural and urban areas. 3. $7.8 billion investment in workforce expansion efforts to address current and projected workforce shortages is needed. 4. $7.6 billion infusion of COVID-19 Emergency Funding would position Health Centers to effectively and proactively address the pandemic.

CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment

CMS announced that starting November 10, Medicare beneficiaries can receive coverage of monoclonal antibodies to treat COVID-19 with no cost-sharing during the Public Health Emergency (PHE). CMS’ coverage of monoclonal antibody infusions applies to bamlanivimab, which received an Emergency Use Authorization (EUA) from the FDA on November 9.

View the Monoclonal Antibody COVID-19 Infusion Program Instruction.

CMS Releases Vaccine Administration Interim Final Rule

On October 28, 2020, CMS issued an Interim Final Rule establishing vaccine-related coverage provisions for Medicare, Medicaid, CHIP, and private insurance. The rule has not been published in the Federal Register but will have a 30-day comment period starting the day it is published. The rule states that as a condition of receiving free COVID-19 vaccines from the federal government, providers will be prohibited from charging consumers to administer the vaccine. NACHC is reviewing and will follow up with more information. CMS issued toolkits aimed at State Medicaid Agencies, providers who will administer the vaccine, and health insurance plans. Some important highlights include: States that receive the temporary FMAP increase must cover COVID-19 testing services and treatments for all Medicaid enrollees without cost-sharing during the public health emergency (PHE). After the PHE, Medicaid programs must still be required to cover COVID-19 vaccines for several populations. Beneficiaries with Medicare will have no cost-sharing for COVID-19 vaccines. Providers can be reimbursed for administering the COVID-19 vaccine to individuals without insurance through the PRF.

340B Advocacy NACHC Lawsuit Filed On October 21, 2020, NACHC filed a lawsuit against HHS to defend the 340B Discount Drug Program. NACHC is preparing the motion for a preliminary injunction. Thank you to all those Health Centers in Wisconsin that submitted declarations to support the suit! Federal Comments WPHCA submitted comments on two 340B-related items – one to the HELP Committee regarding an inquiry on “how to improve” the program, and a second on a proposed Executive Order regarding epi pens and insulin through the 340B program. WPHCA will also reach out to our Members of Congress to share these comments.

Media Effort In collaboration with Health Center Communications staff, WPHCA developed an op-ed style article highlighting the threats to the 340B program and impacts on patients. This letter has been pitched to Wisconsin Health News and includes a call to action for our Congressional Delegation from 8 Health Center Leaders.

Sign-on Letter Deadline today for Rep. Spanberger and Rep. McKinley Letter to HHS – Sign-On Letter deadline is today. Wisconsin Congressional member who have signed on are: Glen Grothman, Gwen Moore, Mark Pocan, Ron Kind, and Tom Tiffany. Click to see a current list of co-signers. WPHCA has reached out to all members of WI’s congressional delegation to ask for sign-ons.

340B Resource Library

Advocacy Center of Excellence (ACE) Program Renewals ​ Health Centers that have achieved ACE certifications need to renew their certification every two years. CHCs that were due to renew at any point in 2020 must submit a renewal application by December 16 to maintain or upgrade their current status. You can email us at [email protected] to determine which CHCs in your states are due for renewal this year. Changes to the program will be coming in 2021 – stay tuned for updates!

From Axios: Trump's Extreme Endgame

With President Trump making little headway in courts, Republicans are hinting at an extreme last-chance way for him to cling to power using the Electoral College, Margaret Talev and Glen Johnson write.

In this long-shot scenario, Trump and his team could try to block secretaries of state in contested states from certifying results. That could allow legislatures in those states to try to appoint new electors who favor Trump over Joe Biden. If Trump were to pursue this course, it likely would become apparent the week before Thanksgiving, as states face deadlines to finalize election results. Trump hasn't said he'll pursue this strategy. But Senate Majority Leader Mitch McConnell and Secretary of State Mike Pompeo each noted yesterday that the election results don't become official until electors cast votes next month. Election totals don't become official until states certify them.

"At some point," McConnell said, "we’ll find out, finally, who was certified in each of these states, and the Electoral College will determine the winner and that person will be sworn in on January 20th. No reason for alarm." A Senate leadership aide said McConnell wasn't signaling an elector strategy, and was simply noting that litigation isn't uncommon.

Pompeo, who said there'll "be a smooth transition to a second Trump administration," independently raised the Electoral College during a State Department news conference. "When the process is complete, there’s going to be electors selected," he said. "There’s a process; the Constitution lays it out pretty clearly."

How it works: If a lawsuit successfully stops certification of results in a state, legislators could step into the void and pick a pro-Trump slate of electors. Among key swing states, Arizona and Georgia have GOP governors and legislatures. Michigan, Pennsylvania and Wisconsin have Democratic governors but GOP legislatures. The next step could be to try to get federal or state courts to enjoin secretaries of state from certifying results. Any move to provide an alternative slate of electors could force the first real test of the Electoral Count Act of 1887, and could land before the Supreme Court.

Additional Readings and Resources:

The Fern. Food system workers may get early access to a Covid-19 vaccine, but how should states prepare? WISC. Department of Public Instruction wants $1.6 billion more in budget, finance committee chair calls it ‘unrealistic’ Fox 6. 1st Muslim elected to Wisconsin State Legislature U.S. News & World Report. Republicans Searching for Problems With Wisconsin Election Gov. Evers. Gov. Evers Calls for Unity, Working Together, Signs Executive Order Advising Wisconsinites to Stay Home. Executive Order #94 CBS 58. Wisconsin hospitals prepare for potential staff shortages as ICU beds fill, COVID-19 hospitalizations increase Reuters. U.S. Supreme Court justices appear unlikely to throw out Obamacare Wisconsin Elections Commision. Correcting Misinformation about Wisconsin’s Election Milwaukee Journal Sentinel. Top Republican says an investigation of Wisconsin's election is unlikely to take away Biden's win in the state Health Affairs. Adopting PCMH elements among US physician practices nationwide, and suggestions on how to achieve PCMH transformation acr

POLICY & ADVOCACY resources

WPHCA Policy & Advocacy Website 340B Resource Library

Business Continuity Resource Library Policy & Advocacy Resource Library NACHC Advocacy Page Policy Communications Library

​ ​