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Emergency Order 16 FAQ and Telehealth Guidance Wisconsin Department of Safety and Professional Services
The Department of Safety and Professional Services (Department) has received numerous inquiries regarding Emergency Order 16 and also the status of telemedicine/telehealth practice as a result of the COVID-19 public health emergency.
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.
Sincerely,
Dawn B. Crim
Secretary-designee
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The Wisconsin Partnership Program released an RFP Tuesday for a new $1.5 million grant program to support projects that “aim to improve the health of the people of Wisconsin by lessening the impact of the COVID-19 pandemic.”
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.
Governor Evers today announced the State of Wisconsin Emergency Operations Center (SEOC) is opening two state-run voluntary isolation facilities in Madison and Milwaukee and is providing guidance to local communities throughout Wisconsin. The two sites are set to open April 1, 2020 are at Lowell Center in Madison and a Super 8 hotel in Milwaukee.
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:
The full press release is available online (link).
Governor Evers today sent a letter to the Federal Emergency Management Agency (FEMA) requesting that the president issue a major disaster declaration for the entire state of Wisconsin, as a result the COVID-19 pandemic. The request covers all 72 counties and the state’s federally recognized tribes.
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).
Governor Evers today announced that Wisconsin has received its second phase of Personal Protective Equipment (PPE) from the Strategic National Stockpile (SNS) and is in the process of distribution. The second phase of supplies from the SNS are being delivered to healthcare workers, emergency medical services, and medical facilities including hospitals, nursing homes, assisted living facilities and clinics across Wisconsin.
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.
Governor Evers announced a new public-private partnership among Wisconsin industry leaders to increase Wisconsin's laboratory testing capacity for COVID-19. Prior to today's announcement, the Wisconsin State Lab of Hygiene and the Milwaukee Public Health Lab were leading the Wisconsin Clinical Lab Network labs to bring additional COVID-19 testing online.
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.
ForwardHealth will allow telehealth services utilizing interactive synchronous (real-time) technology, including audio-only phone communication, for currently covered services that can be delivered with functional equivalency to the face-to-face service. This applies to all service areas and all enrolled professional and paraprofessional providers allowable within current ForwardHealth coverage policy.
Please refer to the Forward Health Update 2020-15 (link) for a comprehensive explanation of the update.
ForwardHealth has published Alert 009, titled "Temporary Changes for Durable Medical Equipment and Disposable Medical Supplies Face-to-Face Requirements," to the ForwardHealth COVID-19 Portal Page (link). Beginning March 12, 2020, ForwardHealth will not require a face-to-face visit with a physician or authorized non-physician practitioner for an initial prescription of any durable medical equipment or disposable medical supplies. A prescription will continue to be required for durable medical equipment and disposable medical supplies.
Governor Evers released a 65-page draft piece of legislation and a draft joint resolution on Saturday night aimed at addressing COVID-19. The Governor also released a chart outlining the proposal. The Legislative Fiscal Bureau also provided a Summary of provisions of Governor Evers’ proposed legislation and Joint Resolution indefinitely extending public health emergency to state legislators.
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
Emergency Preparedness
Health
Health Care Workforce
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:
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:
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).
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