Joint Finance Committee to Hold Public Budget Hearings Across Wisconsin

Let Your Voice Be Heard!

The Legislature's Joint Finance Committee has scheduled four public hearings on Gov. Walker's Biennial Budget Bill. These hearings give you an opportunity to tell the Committee your thoughts about the bill's effects on BadgerCare and Medicaid. 

The hearing schedule is as follows:

• Thursday, April 7 (10 am – 6 pm). UW-Stevens Point, Lee Dreyfus University Center, Melvin Laird Room, Stevens Point
• Friday, April 8 (10 am – 5 pm). Northwood School Richard’s Auditorium, Highway 53, Minong.
• Monday, April 11 (10 am – 6 pm). State Fair Park, Expo Center Hall A, West Allis.
• Wednesday, April 13. (10 am – 6 pm). Arcadia High School Auditorium, Arcadia.

The Joint Finance Committee's public hearings are not to be confused with the DHS town hall meetings (see below).
For more information on the budget bill, see this page on the HealthWatch website, and for an even more comprehensive breakdown, check out this matrix produced by the Wisconsin Council for Children and Families.

Typically, Joint Finance Committee meetings are held up at the Capitol and allow for public input.  However, the Committee meetings scheduled between March 31 and April 6, indicate they are open for "briefings" only, with no opportunity for public comment, so if you're headed up to the Capitol then, you won't get to share your inpuy. A briefing by the Department of Health Services is scheduled for April 6.

Write a Letter!

If you cannot attend a hearing, email your written comments to the committee at: budgetcomments@legis.wisconsin.gov  or send by US mail to: Joe Malkasian, Room 305 East, State Capitol, Madison, WI 53703.

Madison's Mayor Dave Holds Hearing

Because none of the Joint Finance Committee's four public hearings are scheduled to be in Madison, the Mayor of Wisconsin's capitol city took matters into his own hands. On Wednesday, March 30, Madison's Mayor Dave Cieslewicz held his own public hearing on the budget bill drew about 100 people with questions and concerns about how Walker's budget bill will affect them, especially concerns about health care, from treatment to cuts to Wisconsin's BadgerCare and Medicaid programs.

"'I'm tired because I saw two women with very similar conditions, but [I] was forced to treat them differently because one had insurance, allowing me to place her on appropriate, efficient medication and the other did not, meaning we had to make do with what we could,' said Dr. Dipesh Naysaria, a pediatrician."

Madison Residents Share Thoughts About Walker's Budget Proposal (Channel 3000, 31 Mar. 2011)
Madison snubbed on state budget hearing, so Cieslewicz calls his own (Bill Novak, Capital Times, 28 Mar. 2011)

Now Available On-Demand! Dennis Smith & Brett Davis Speak at HWW Conference

You can click here or on the picture at right to watch the video and hear the questions that members of HealthWatch Wisconsin had for Smith and Davis.

Smith and Davis spoke immediately before a HealthWatch Wisconsin-sponsored public hearing on BadgerCare and Medicaid cuts (see below).  Davis stated, "I appreciate you holding these listening sessions.” Smith and Davis, however, did not stay for the testimony. “We will send Secretary Smith and Administrator Davis a complete copy of this testimony," said Bobby Peterson. "We hope they listen to it, as it tells an important story of Medicaid and BadgerCare in Wisconsin. Secretary Smith indicated that he would listen to what the people of Wisconsin have to say. We also intend to send information on ways the programs can run more efficiently."

To view more of the HealthWatch conference, click here to buy a conference CD complete with video recordings of key sessions.

HealthWatch News

HealthWatch Public Hearing Footage Now Online

HealthWatch Wisconsin has posted to its website the first round of video footage of public testimony about the impact of proposed BadgerCare and Medicaid cuts that will affect 1.2 million Wisconsinites covered by these programs. Earlier this month, HealthWatch Wisconsin sponsored two days of public hearings during the HealthWatch Wisconsin Annual Conference, drawing hundreds of people to listen, learn, and for some, to share their stories and the stories of loved ones. HealthWatch Wisconsin staff was on hand to record participants' testimony. “Our participants shared stories about what coverage programs like BadgerCare Plus mean to them, to their grandchildren, nephews, patients, neighbors, and friends. People were fearful and angry with the dramatic changes proposed to health coverage programs in the Administration’s budget and budget repair bill,” said Public Interest Attorney Bobby Peterson. “Many views were quite frank, many were emotional, and most left those of us in the audience with a sense of urgency to help policymakers understand how important and life preserving Medicaid and BadgerCare are to people in Wisconsin.”

Please see www.safetyweb.org/healthwatchwi/publicHearing.html to view these HealthWatch Wisconsin public hearings.  Stay tuned, as more will be posted continually throughout the coming weeks!

Welcome New Members of the HealthWatch Wisconsin Council!

The results of the 2011 election for the HealthWatch Wisconsin Council members are in!

Congratulations to:

• Sara Finger, Wisconsin Alliance for Women’s Health
• Georgia Fischer, Bridge Community Health Clinic
• Jon Peacock, Wisconsin Council on Children and Families
• Kris Peterka, Riverwest Health Initiative
• Josh Salazar, UW Hospital and Clinic

The HealthWatch Wisconsin Council serves as the advisory committee for the HealthWatch Wisconsin organization and helps guide the project’s activities. The Council provides leadership and advice to HealthWatch Wisconsin as we work to transform the public health landscape and increase access to care and coverage for people in Wisconsin through training, education, and collaborative partnerships.

HealthWatch members voted for the new Council members in person at the Annual HealthWatch Conference in early March. Those not in attendance responded to an emailed ballot. Upon the closing of the voting period, the winners were formally adopted by the HealthWatch Executive Committee. The three-year term for each new Council member will officially begin on July 1, 2011, to coincide with the new membership year of HealthWatch Wisconsin. The next meeting of the full Council will be in October 2011. Help us welcome these new members to the Council!

Grapevine

Obama Phone?

The Safelink Wireless program helps connect low-income people to cellular phones. The phones have mistakenly been called “Obama Phones,” though the program is not funded by the government. Applicants must fulfill certain eligibility requirements to receive the free service, which vaires from state to state. In Wisconsin, an applicant must be already enrolled and receiving benefits from BadgerCare, FoodShare, Low Income Home Energy Assistance Program (LIHEAP), MA, SSI, WI Homestead Tax Credit (Schedule H), or Wisconsin Works (W2). Applicants may also qualify if they are not enrolled in any of the aforementioned programs but have a household income of 135% FPL or less. Verification of enrollment in a public assistance program or income verification must be approved for the program. Once approved for the Safelink program, enrollees must complete a yearly review to demonstrate continued eligibility.

The program includes a free cell phone with free airtime minutes each month for one year. There are three different plans available in Wisconsin, with different options for minutes, international calling, rollover options, etc. The enrollee chooses a plan and can change plans at any time. If an enrollee becomes ineligible, it is their responsibility to report that to Safelink. They can keep the phone free of charge, but will have to purchase airtime minutes from anywhere that sells TracFone telephone cards, like Walgreens, Target and Wal-Mart. For more information, click here.

ABC for Health, Inc., also produced a training last year on Lifeline and Linkup Services, which also provide communication assistance for eligible low-income individuals.  Click here to view that free training.

For the last 25 years, Frank has worked at Children’s Hospital as a financial counselor. He counsels the families of uninsured children and helps families determine if their child qualifies for benefits programs such as BadgerCare Plus, Federal HIRSP, Katie Beckett, and SSI. If they qualify, Frank will help try to complete express enrollment. In some cases, the hospital also provides charity programs based on household size and adjusted gross income.

Frank and two other counselors constantly help answer financial questions asked by parents and hospital staff. Each day, these three counselors field an average of 30 to 40 phone calls from people looking for assistance. This is in addition to the 40 notifications they receive daily alerting them to patients that are being seen at the hospital and are self-paying.

“Most times, we have dealt with clients at the hardest times of their lives, and it’s hard to advise them of all available programs,” he said. “There are only so many hours in the day.”

But despite the challenges of keeping up with this high demand, Frank uses his own time to advocate on behalf of the children he serves. He said one of the reasons why he became an advocate is because when he started working at the hospital, the number one cause of infant mortality was child abuse.

“We would get the child in our ER, and there was nothing we could do as far as preventative things that could stave off what was happening to the kids who were getting abused,” he said.

In addition to this tragic issue, Frank also wanted to help patients’ families understand health coverage. “Before HealthyStart started…to navigate that system and to get coverage was horrible at best,” he said.

Frank has been a Milwaukee HealthWatch Coalition member since 1998, advocating for children in these issues and many more. He is currently serving as Co-Chair of the Enrollment Process Improvement Committee (EPIC). The committee brings up possible enrollment issues and has different representatives—from the state, HMOs and hospital providers—get together to find a solution. He also used to serve as Co-Chair of HealthWatch Milwaukee.

With the current state of the budget, Frank is worried about cuts and alterations to BadgerCare programs. “Our fear is that they’ll change not the way they qualify in terms of the eligibility rules, but they’ll change dollar amounts and institute more co-pays, even to someone that might be on the Standard program and not the Benchmark program,” he said. He is also worried that recipients will be forced to reapply for services every six months instead of every year, which might deter them from trying to get coverage.

Overall, Frank hopes that HealthWatch Coalitions throughout the state of Wisconsin will continue to band together as a force of health care advocates. “Because of everything that’s happening right now, it’s a great time to be an advocate,” he said.  “You can get more involved because of all the issues that are happening, and help more people.”

Coalition Roundup

Click here for a list of upcoming coalition meetings.

Dane County HealthWatch has its next meeting Monday, April 4 at the usual location of 122 E. Olin Ave in Madison. Theresa Fosbinder and Margaret LaBorde of Planned Parenthood of Wisconsin and Kari Sievert of the Wisconsin Well Woman Program are coming to speak to the group about some of their budget concerns and recent happenings within each organization. For more information about the Dane County HealthWatch Coalition, please contact Adam VanSpankeren.

The Dunn County HealthWatch Coalition’s next luncheon meeting is Thursday, April 7, at the Red Cedar Medical Center. Chris Kruse, an EMT and Chief Medical Examiner for Dunn County, will be coming to speak to the group about causes of death in Dunn County. For more information about the Dunn County HealthWatch Coalition, please contact Wendy MacDougall or Sandy Nevin.

The Milwaukee HealthWatch Coalition will meet Wednesday, April 13, to welcome Virginia Zerpa-Uriona, who will give an overview of the Milwaukee Latino Health Coalition. For more information about the Milwaukee HealthWatch Coalition, please contact Nora Foshager.

The Pierce County HealthWatch Coalition steering committee has been busy! The steering committee has another planning meeting on April 14, but the Pierce County HealthWatch Coalition’s kickoff meeting has been scheduled for May 12 at Crossroad Community Church in Ellsworth, Wisconsin. Mike Rust, of ABC for Rural Health and the Polk and Barron County HealthWatch Coalitions, will be the group’s first speaker and will be discussing changes to the BadgerCare programs. For more information about the Pierce County HealthWatch Coalition, please contact Lisa Raethke.

The Tri-County HealthWatch Coalition had a successful strategic planning meeting on Tuesday, March 29. They mapped out their mission and vision and planned some of their activities for the next year. The group is eager to start working and will be asking some of the other HealthWatch coalitions for input as they move forward.  The next Tri-County HealthWatch meeting is scheduled for Tuesday, April 26, from 9-11 a.m. at the Goodwill Community Center in Menasha. For more information about the Tri-County HealthWatch Coalition, contact Susan Garcia Franz or Connie Raether.

CKSN Corner

Covering Kids with Special Needs

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.

April 6. Disability Advocacy Day. State Capitol, Madison. Gather at the Capitol on April 6 and help policymakers understand how people with disabilities can have REAL Work, REAL Lives and a REAL Smart Wisconsin! For more information, call Fil Clissa at 608-698-0333.

April 12-13. 4th Biennial Wisconsin Health Literacy Summit. Health Literacy Wisconsin, a division of Wisconsin Literacy, Inc.  For more information click here.

April 28-29. Circles of Life 2011. Hyatt Regency, Milwaukee. State's largest conference for families of children with disabilities and special health care needs. For more information, click here.

May 14.  Workshop on employment for youth with special health care needs, 8:30 a.m. to 12 p.m., Children’s Hospital of Wisconsin Corporate Center, Suite 220. Sponsored by the Southeast Regional Center for Children & Youth with Special Health Care Needs and Children’s Hospital of Wisconsin Social Work Program. Call 414-266-3188 to RSVP and for more information. Space is limited.

Ops Memos

On March 28, the DHS released a new BadgerCare Plus Handbook. The new handbook is available here.  For a PDF version with highlighted changes, click here.

Ops Memo 11-11: BadgerCare Plus Basic Plan Enrollment Changes
Released March 19
New Policy: New requests for enrollment in the Basic Plan are no longer accepted. The Basic Plan premium will increase to $200 per month with the premium due May 5, 2011, for June coverage. The option to pay premiums in advance at a discounted rate is no longer available.

State & National News

Analysis and Comment

DHS Town Hall Meeting in Eau Claire Draws Many

The Department of Health Services (DHS) Town Hall Meeting in Eau Claire on March 30 was well attended, with a packed auditorium and continuous testimonies from 1 to 5 p.m.  Many groups were represented, from the Center for Independent Living to the Farmer’s Union to the Public Health Departments.  DHS Secretary Dennis Smith and Deputy Secretary Kitty Rhoades listened to testimonies that ranged from the practical, as speakers illuminated the inefficiencies of the application process or the costs of teen pregnancy, to the heart-wrenching, as people shared the importance of state health programs in their lives and the dire straits they would be facing without them. As the northernmost public hearing that DHS has announced, people flocked from all over northern Wisconsin, including  Ashland, Bayfield, Superior, and Washburn counties, to attend and share their concerns.

In a press release, DHS confirmed their next Town Hall meeting for Fennimore, Wisconsin.

The Defunding of Civil Legal Services in Wisconsin

Governor Walker's budget bill elminates all indigent civil legal service funding, currently a Department of Administration budget item. (In comparison, indigent civil legal services were in the 2009-2011 biennial budget at a $1,958,600 appropriation in FY 10 and a base-year appropriation of $2,546,100 in FY 11.)  ABC for Health is one of the dedicated non-profit public interest law firms that will feel the impact of this cut. ABC’s attorneys and health benefits counselors help individuals and families determine the best health coverage choices; apply for health coverage programs; negotiate with insurance companies; and challenge insurance claim denials. Many of our clients are overwhelmed with the changes ahead in Medicaid and private insurance. Consumers are confused by the political conversation about which programs are actually in effect, how to enroll or challenge denials, and what appeals and other legal rights are available. Cutting civil legal services, in addition to blocking health reform’s implementation and reducing enrollment and expenditures in BadgerCare and Medicaid programs will harm thousands of Wisconsin families. Consider the following:

ABC for Health's direct legal service work benefits our client and impacts the community as a whole.  ABC documents the economic return from the disability benefits, Medicaid, health insurance coverage, and other benefits our clients obtain. In fact, in 2010, our partnership with one hospital points to an impact of over $3,793 in third-party reimbursements from state or private insurance from only the first encounter for each client we served. This figure, when extrapolated each potential client, and potential multiple encounters, demonstrates a savings to the client and contributes to economic stimulus.

This year has proven to incredibly overwhelming for many families and individual seeking basic health care coverage information. The lack of information can lead to medical debt, judgments and poor credit scores that contribute to a spiral into the cycle of poverty. Consumers are often confused about appeal rights and slowed down or stymied by bureaucratic red tape. Elements of health reform mean new options for dependent coverage, independent review, elimination of pre-existing exclusions, insurance exchanges, and increased access to Medicaid and Medicare programs. Despite past enrollment success, thousands of Wisconsin eligible children are not enrolled in health coverage programs, with over 65,000 children being completely uninsured.

As advocates, we know that even discussion of enrollment cutbacks chills enrollment. Families are nervous of the potential new benefits landscape, and if there is a place for them in the coverage options of the future. No matter the future political environment in Wisconsin, many things will not change: the needs of the people of Wisconsin to be informed and educated on their legal options and rights to health care coverage and services.

Federal Budget Threatens Medicaid

Next week, House Republicans will likely announce their budget proposal for 2012. The proposed budget will almost surely include deep cuts to Medicaid. The National Health Law Program expects that the Republicans’ budget may propose federal block grants to state Medicaid programs.  Currently, states receive federal matching funds based on the number of eligible Medicaid recipients in each state. A switch to block grants would mean that states get a fixed amount of money from the federal government each year. The block grant amount would be less than the federal government now pays in matching funds. With inadequate federal funding, states would have to contribute more of their own money to Medicaid or cut eligibility and programs.

For more information:
NHeLP Breaks Down the Federal Budget Threats to Medicaid (National Health Law Program, 30 Mar. 2011)
Medicaid Block Grant Would Shift Financial Risks and Costs to States (Center on Budget and Policy Priorities, 23 Feb. 2011)

Headlines

Federal funds for "free market" health care
Matt Hrodey, Milwaukee News Buzz, 31Mar. 2011
“Wisconsin, along with a handful of other states, will serve as a national model for implementing the federal health care reform law. The state will receive $37.7 million in federal funding to begin designing the state’s health insurance exchange as required by the law. But it remains unclear how the funding will be used under the administration of Gov. Scott Walker, an avowed opponent of the law.”

High-Deductible Plans: When Spending Less On Health Care Isn't Always Good News
Jonathan Cohn, Kaiser Health News, 30 Mar. 2011
“Conservatives think traditional health insurance provides too much financial protection from medical expenses. They also think that the Affordable Care Act will make this situation worse. That's one reason they want to repeal it.”

Editorial: High Price of Rigidity
New York Times, 29 Mar. 2011
“House Republicans have already won so much in this year’s federal budget standoff that they could easily declare victory and put an end to the maddening and dysfunctional cycle.”

The Tea Party's Latest Scheme to Kill Health Reform
Stephanie Mencimer, Mother Jones, 29 Mar. 2011
“Egged on by tea partiers, at least a dozen states are now contemplating legislation that supporters believe would allow them to seize control of and administer virtually all federal health care programs operating in their states and exempt them from the requirements of the health care law.”

Low Health Literacy Linked to Higher Risk of Death and More Emergency Room Visits and Hospitalizations
Press Release, Agency for HealthCare Research and Quality, 28 Mar. 2011
“Low health literacy in older Americans is linked to poorer health status and a higher risk of death, according to a new evidence report by HHS' Agency for Healthcare Research and Quality. More than 75 million English-speaking adults in the United States have limited health literacy, making it difficult for them to understand and use basic health information.”

DHS secretary says proposed MA cut has to be put in perspective
Wispolitics.com, 28 Mar. 2011
“The state of Wisconsin expects an increase of $472.9 million in GPR during the first year of the budget. Directing all of that money to [the DHS] is still not enough to cover the program’s expenses.”

Wisconsin Farmers Union raising more hell than corn
Bill Berry, Capital Times, 28 Mar. 2011
“WFU may not be as big as some mainstream farm groups, but it's making up for it with pluck and grass-roots organizing that has put it at the forefront on crucial rural issues at just the right moment.”

Health law safety net gets little attention
Guy Boulton, Milwaukee Journal Sentinel, 27 Mar. 2011
“The primary goal of the 1-year-old health care law - a goal that has gotten scant mention by supporters and opponents alike - is to offer a financial safety net to tens of millions of Americans by providing or subsidizing their health insurance coverage.”

Vital Signs: State GOP health bills mirror model ALEC legislation
Shawn Doherty, Capital Times, 27 Mar. 2011
“All the fuss this week over ALEC, a right-wing organization said to be the mastermind behind a nationwide wave of conservative proposals and laws, inspired me to look into whether the group has anything to do with a spate of recent health legislation from Gov. Scott Walker and Republican lawmakers.”

Walker's health chief taking on shortfall
Guy Boulton, Milwaukee Journal Sentinel, 26 Mar. 2011
“Dennis Smith's first task as secretary of the Department of Health Services is to eliminate a roughly $500 million shortfall in the state budget for the BadgerCare Plus and Medicaid programs. But his ultimate goal is to make the programs more efficient.”

Vital Signs: ABC for Health files legal claim against Walker officials for terminating contract
Shawn Doherty, Capital Times, 25 Mar. 2011
“ABC for Health filed a notice of claim with the state attorney general's office Thursday against top Walker administration officials, the first step in a potential lawsuit over the administration's decision to terminate a contract that would have given the public interest law firm $238,000 to help consumers navigate health care reform.”

Vital Signs: Secretary Smith vs. researcher Jon Peacock: why health plan for poor is failing
Shawn Doherty, Capital Times, 24 Mar. 2011
“It took less than a year for a no-frills public health plan for poor Wisconsin adults that was supposed to pay for itself to fail.”

Increase in black infant deaths stumps health officials
David Wahlberg, Wisconsin State Journal, 24 Mar. 2011
“Dane County's black infant mortality rate, which dropped for several years and became a national success story, shot up again to four times the rate for whites over the past three years, leaving health officials stumped.”

Scott Walker and DHS head Dennis Smith pay back health industry donors
Emily Mills, Isthmus, 24 Mar. 2011
“Walker appointed a vocal critic of Medicaid and health reform in general to head up the state's Department of Health Services.”

Vital Signs: Will Health Secretary Dennis Smith save SeniorCare from the chopping block?
Shawn Doherty, Capital Times, 23 Mar. 2011
“Secretary of Health Dennis Smith may be backpedaling on a controversial budget proposal to force the 91,000 members of the state's SeniorCare program to switch into a Medicare drug program.”

State Health head outlines possible changes to Medicaid programs
David Wahlberg, Wisconsin State Journal, 23 Mar. 2011
“The state should curb the cost of the most expensive people on Medicaid by paying flat fees for more elderly and disabled patients and those with diabetes and mental illness, the head of the health department said.”

$134 million Medicaid budget gap remains unplugged
David Wahlberg and Mary Spicuzza, Wisconsin State Journal, 23 Mar. 2011
“Wisconsin's $134 million budget gap in Medicaid for this year, which Gov. Scott Walker's original budget repair bill would have plugged, remains under the version of the bill Walker signed.”

Editorial: Jury still out on Obamacare
Wisconsin State Journal, 23 Mar. 2011
“We’ll continue to root for positive outcomes and improvements while keeping a skeptical eye on costs.”

U.S. Rep. Kind: One year later, Wisconsin benefits from Affordable Care Act
Press Release, 22 Mar. 2011
“Wisconsinites are already seeing the benefits of the Affordable Care Act”

Vital Signs: Amid proposed budget cuts, funerals for the poor get funding boost
Shawn Doherty, Capital Times, 16 Mar. 2011
“The governor's budget steps up payments for funerals for people on Medicaid even as it cuts nearly $500 million from the health programs that serve 1.2 million statewide.”

Medicaid debate, by the numbers
Dennis Smith, Milwaukee Journal Sentinel, 15 Mar. 2011
“To reach the necessary decisions about critical programs like Medicaid, it is vital to understand how our funding requests fit into the state's budget.”

Don't cut Medicaid, fund it better
Aaron Carroll, CCN, 15 Mar. 2011
“As states try to tackle their shortfalls, Medicaid has become a target. All over the country, governors are attempting to reduce coverage, benefits and spending. This is a pity, because Medicaid is already underfunded. That's right -- we don't spend too much --we spend too little.”