On Thursday, February 22, the Wisconsin State Assembly passed three bills aimed at addressing ongoing challenges of hospitals finding post-acute placement for complex and hard-to-place patients.

Assembly Bills 1086 and 1087 would establish new funding for addressing the complex patient issue:

1. The bill includes $10M in state funds (plus any federal matching funds) for enhanced rates to nursing homes who admit new residents with complex bariatric or wound care needs.
2. The bill also includes an additional $10M in state dollars for a complex patient pilot fund, which would allow health care partners (defined as a hospital system plus one or more post-acute settings, including SNF or AL). The complex patient pilot program was signed into law as part of the current biennial budget, and is aimed at allowing health care partnerships in Wisconsin to find innovative solutions to help facilitate hospital transfers to appropriate post-acute settings.
3. Lastly, the bill provides $20M for hospital supplemental payments when a hospital is unable to find post-acute placement for complex patients ready for discharge. Importantly, the legislation ensures that the state captures critical data from hospitals to continue to examine and address complex patient challenges into the future.

Assembly Bill 1088 includes several provisions, which:

• Creates a three-year pilot for a new “patient’s representative” decision-making process to help facilitate post-acute placement for incapacitated patients ready for discharge who do not have a guardian in place, while also balancing the future decision-making needs of the patient and allowing for important checks and balances to the process;
  • The bill was amended to include liability protections and to help empower both the patient’s representative and the post-acute facility to act in good faith on behalf of the incapacitated patient.
• Gives DHS discretion to allocate up to 250 total nursing home beds meant to be limited-use for purposes of placing complex patients when a hospital has been unable to find post-hospital placement; and
• Builds out the complex patient pilot which will allow acute- and post-acute health care partners to collaborate on finding provider-driven, patient-centered solutions to placing complex patients.

WHCA/WiCAL has been supportive of this package as a whole. Previously, on Wednesday, February 14, committees in the State Assembly and State Senate held hearings on the bills, and WHCA/WiCAL, along with other provider groups, testified in favor of the bills.

Now that the bills have passed the State Assembly, they are in the State Senate. Their fates in the Senate are unclear. WHCA/WiCAL continues to engage with legislators on these bills and will inform members of any new developments.