November 8, 2013
Volume 57, Issue 45


Hospitals Hail Assembly Final Passage of Legislation Addressing Jandre Decision

The Wisconsin Hospital Association (WHA) praised the State Assembly November 5 for concurring on AB 139 which addresses the Wisconsin Supreme Courtís Jandre decision.

"Left unaddressed, the provider community has been concerned that the Jandre decision would lead to increased health care costs related to the overutilization of tests and, because of those tests, unnecessary angst and increased potential risks for our patients. With this bill, Wisconsin hospitals and health systems can continue to provide high quality, efficient, outcome-focused care," said WHA Executive Vice President Eric Borgerding. "We want to thank members of the Assembly who supported this crucial legislation and stood for high quality health care in Wisconsin."

Assembly Bill 139 cleared the Assembly for the final time and will now be sent to the Governorís desk for his signature. WHA acknowledges the leadership of Rep. Jim Ott and Sen. Glenn Grothman for their support of this important policy initiative for Wisconsin hospitals.

The State Supreme Courtís Jandre decision created an unclear standard for physicians to meet when obtaining patientsí informed consent prior to providing treatment. Assembly Bill 139 addresses that by establishing a clear reasonable standard for physicians when providing patients with information about the risks and benefits of reasonable alternate treatment. The legislation also directly addresses the Jandre decision by making it clear that a negligent diagnosis claim is separate from an informed consent claim.

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Cong. Ribble Tells WHA Council "Hospitals Are Congressís Favorite Target"

Congressman Reid Ribble makes one thing clear: he is not interested in short-term fixes, and nothing in Washington has been kicked down the road more than the Medicare sustainable growth rate (SGR) issue. SGR is the method currently used by the Centers for Medicare and Medicaid Services (CMS) to control spending on physician services.

Ribble represents the 8th congressional district in northeast Wisconsin, which includes Green Bay and Appleton. Before he joined Congress, he ran the family roofing business for nearly 30 years. He is solutions oriented and brings that work ethic to Washington.

Speaking at the November 5 WHA Public Policy Council meeting in Madison, Ribble described himself as a Washington "outlier," a reference to his recent vote to end the government shutdown, the only Wisconsin Republican to do so. He is focused on finding long-term solutions to the nationís lingering fiscal problems. High on his list is finding a permanent fix for the SGR.

"Everyone from the President on down wants to fix SGR," Ribble said. "It is talked about in Congress more than almost anything else in the medical hemisphere. The original proposal was not a good fix, so we ended up replacing one SGR with a different SGR."

In spite of the lack of progress to date, Ribble said there are a few hopeful signs as of late with bipartisan, bicameral approaches to a fix being discussed, including the recent proposal released jointly by the U.S. Senate Finance Committee and the U.S. House Ways & Means Committee.

"We want it done. We want a long-term fix so we are not plagued with this uncertainty," Ribble said. "But the question of who pays for it remains, and it would seem that hospitals have been Congressís favorite target."

"You work in one of the most complex aspects of our economy," according to Ribble. "There is a lot of government intrusion and market manipulation. Government determines the channel you are reimbursed on. I am shocked at how great our health care is in Wisconsin given the playing field that has been laid out by our government."

Ribble is a strong supporter of rural health care and has been a vocal opponent of the devastating changes that have been proposed for the Critical Access Hospital program.

"I want to encourage you to continue to keep me current so that I can help make Wisconsinís health care system the best and most sustainable in the world," Ribble said.

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Exchange Dysfunction Fuels Medicaid Enrollment Concerns

Joanne Alig, WHA senior vice president of policy and research, detailed her experiences with the new insurance marketplace in a report to the WHA Public Policy Council November 4.

"There have been some significant errors in the application system," Alig said as she reviewed the exchange website with Council members. "Consumers are required to enter a lot of personal information, even before getting to a place on the site where they can compare health plans. And most people have not yet been able to complete the up-front process."

There are a number of reported functionality issues throughout the entire process, and it is difficult to determine the full extent of the problem. For consumers to get started and at a minimum find out if they are eligible for a premium tax credit, the stateís Regional Enrollment Networks are now encouraging use of the paper application. However, ultimately enrollment into a health plan cannot be completed offline.

That raises concerns among hospitals that the more than 70,000 people who are losing Medicaid eligibility January 1, 2014 will not connect to coverage on the exchange prior to that date. Alig said the Department of Health Services (DHS) is making changes to their ACCESS website so as of November 18 childless adults who will be newly-eligible for Medicaid will be able to enroll online through the DHS website.

In the meantime, WHA Executive Vice President Eric Borgerding said DHS, the hospitals and their partners in the community must continue to educate and assist people who are trying to enroll on the exchange.

"We are committed to doing everything we can to help Governor Walker accomplish his goal of cutting the uninsured rate in half in Wisconsin," Borgerding said.

It would be ideal, according to Borgerding, if DHS would delay transitioning people off the Medicaid program until the exchange is working. WHA staff continues to work with members and state officials to understand the issues and implications the exchange delay will have on Medicaid policy and the uninsured population.

WHA Advocates in Washington to "Protect Hospital Care"

In his remarks to the Council, Congressman Reid Ribble took the opportunity to thank WHA members for their continuing efforts to make their voices heard in Washington and at local town hall meetings. WHA recently led a group of 15 hospitals leaders to Washington, DC to meet with Cong. Ribble and the rest of Wisconsinís Congressional Delegation. Jenny Boese, vice president, WHA external relations & member advocacy, knows the value of educating members of Congress and was pleased to report that the number of WHA members participating in Washington DC fly-ins continues to increase, including close to 70 Wisconsin hospitals, system and physician leaders in 2013 alone.

That high level of engagement is critical as Congress faces tough decisions in the months ahead on how to solve the federal deficit. No one is safe in the current environment, according to Boese, but WHA has been tireless in its efforts to "protect hospital care."

"All hospitals, large and small, are targets in this type of fiscal environment. That is why we need hospitals to continue to be engaged with their legislators," said Boese. "With history as our guide, Congress will likely not come up with a Ďgrand bargainí but rather smaller deals and agreements."

Boese outlined several possible scenarios on how Congress could reach agreement on a SGR fix; however, she cautioned that a long-term solution remains elusive primarily due to the $140+ billion price tag and that other providers could sustain more Medicare cuts to pay for what would most likely once again be a short-term patch.

Boese said WHA continues to fight the federal cuts to hospital reimbursement with a multi-pronged campaign that emphasizes education and advocacy strategies. 2013 advocacy strategies have included five trips to Washington, DC, multiple WHA Hospital Listening Sessions with Members of Congress and more. WHA members who have not participated in a Washington trip or want to be involved in other ways to help "protect hospital care" are encouraged to contact Boese for more information.

WHA Marks Progress in Meeting 2013 Legislative Goals

WHA continues to make significant progress in meeting a number of its 2013 goals. On November 5, the State Assembly passed legislation that addressed the Supreme Courtís Jandre decision (See story above). That bill is now on its way to the Governorís desk. Borgerding acknowledged WHA staff members Laura Leitch, senior vice president and general counsel, and Kyle OíBrien, vice president, government relations, for their hard work to get the legislation passed.

Key elements in the WHA behavioral health legislative agenda are also being addressed by the Legislature, including mental health care coordination/HIPAA Harmonization, which has bipartisan support and 44 co-sponsors. Emergency detention policy reform, AB 488, creates a three-party petition process that allows family members and medical providers to petition a judge for an involuntary care order even when the county corporation counsel denies their request. A third bill, AB 456, requires DHS to create a way for counties to report what mental health services and programs they provide. (See related story in this edition)

Regulatory reform, including reforming Wisconsinís outdated and cumbersome hospital regulations, is a top priority for Wisconsin policymakers and WHA. The Council provided important input on needed improvements to the stateís certificate of approval and survey standards for hospitals. WHA told the Council that it is working with Rep. Howard Marklein (RĖSpring Green) in the Assembly on draft legislation that would enable the changes needed to update and streamline DHS 124.

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Guest Column: Commentary by Assembly Speaker Robin Vos: Moving Forward on Mental Health Reform

Mental illness affects families throughout Racine County and the State of Wisconsin. It takes a toll on personal relationships and if left untreated, experts estimate it costs the United States billions in lost productivity every year. There are no easy solutions, and there are huge barriers in getting treatment from finding a mental health professional to the stigma surrounding treatment itself. Fortunately, there is some good news to report. In recent weeks there has been an increased awareness of the problems surrounding mental health care in Wisconsin. I commend The Journal Times for doing a nine-day series called "Mental Illness: the power, the system and success." As the newspaper found, it truly "planted a seed" for those who never thought about getting help. What has become clear to me and many others is that our current system for treating those with mental illness is simply not getting the job done.

This past February, I created the Speakerís Task Force on Mental Health and charged its chair, Rep. Erik Severson, R-Osceola, and vice chair, Rep. Sandy Pasch, D-Shorewood, to find ways to increase access to care and improve the coordination of treatment. The task force held five public hearings and heard from more than 70 experts. In addition, I reached out to local mental health professionals in Racine County to get their input. After weeks of deliberation, the task force proposed meaningful reforms that legislators will soon vote on in the state Assembly.

There are more than a dozen bills that will make mental health treatment more accessible and hopefully, help reduce the stigma often associated with mental illness. One proposal creates a child psychiatry access line for pediatricians and other front line providers. This will give doctors a good resource for treatment since many Wisconsin counties lack even a single child psychiatrist. In fact, access to care was the largest concern brought forward at every public hearing of the task force. One way to address the problem is through legislation to create a grant program to encourage primary care physicians and psychiatrists to locate in underserved areas. No one wants a situation where a person finally decides to seek help and no one is there to answer the call.

Another need identified by the task force was better coordination between physicians and mental health professionals. Many people these days go to several doctors, and we want them to be on the same page regarding treatment. Too much is at stake with a personís health to have a condition or medication overlooked.

Iím proud of the work that was done by the members of the Speakerís Task Force on Mental Health, and I look forward to voting on their recommendations in the coming weeks. While these proposals wonít result in a solution overnight, weíre improving access to care and hopefully, that will result in others feeling more comfortable in approaching a mental health professional. This is a first step in addressing mental health concerns in Wisconsin. I hope we can continue to look at more ways to help individuals coping with mental illness to have fuller and more productive lives.

State Rep. Robin Vos, R-Rochester, is speaker of the Wisconsin Assembly.

Reprinted with permission from The Racine Journal Times, 11/2/2013

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Bipartisan Mental Health Task Force Bills Pass Assembly Committee

On November 5, the Assembly Health Committee approved with bipartisan support 11 bills recommended by the Speakerís Task Force on Mental Health. The bills included a key WHA legislative priority, AB 453 - the Mental Health Care Coordination Bill which passed on an 8-1 vote. The bills are now scheduled for a vote by the full Assembly on November 12.

"AB 453 removes statutory restrictions on psychiatrists and other mental health providers from coordinating a patientís care with the patientís other treating providers that has resulted in less coordinated, less integrated, and more costly care for individuals with mental illness," said WHAís Matthew Stanford in verbal testimony before the Health Committee in October. "AB 453 will improve the health outcomes for individuals with mental health needs by updating Wisconsin law to be consistent with modern integrated approaches to medicine."

Assembly Bill 488, a WHA-supported bill that reforms Wisconsinís three-party petition process for emergency detention, was also among the bills passed by the Committee on an 8-1 vote.

The bill addresses the difficult position that treating physicians are placed in when their assessment of a patientís need for involuntary care conflicts with an assessment by a county crisis agency or county corporation counsel that the patient does not meet the standards for involuntary care. Under current law, even if the treating physician recommends involuntary care, that patientís family cannot access a court to review the situation if county corporation counsel refuses to file a petition with a court to review the situation. This problem was identified in WHAís 2010 Mental Health Task Force White Paper.

"Assembly Bill 488 is the result of a collaborative effort of legislators and stakeholders," said Stanford in written testimony to the Committee. "It provides families with a pathway for a neutral partyóa judgeóto consider an order for involuntary care for a loved one while preserving the county corporation counselís role of representing the publicís interest in commitment proceedings."

Also passed by the Health Committee were WHA supported bills AB 456 regarding gathering information on county-provided mental health services, AB 452 which creates child psychiatry remote consultation programs, and AB 454 which provides new grant funding for newly-trained psychiatrists and primary care physicians that practice in underserved areas.

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New HHS Statement Raises Questions on Premium Support

On November 1, WHAís guest column reported on the "light at the end of the tunnel" on questions around premium support. One week later, the federal Department of Health and Human Services (HHS) seemingly reversed course saying it "discourages" hospitals, health care providers, and other commercial entities from supporting premium and cost-sharing payments for patients who have purchased qualified health plans in the exchange.

This latest development has created confusion, as HHS clarified in a recent letter to Congressman Jim McDermott that it does not consider qualified health plans (QHPs) purchased through the insurance exchange to be a "federal health care program." Prior to the HHS letter, it was unclear whether HHS would treat QHPs as federal health care programs and therefore subject to the federal Anti-Kickback Statute. The letter was viewed as a step in removing one of the legal barriers preventing premium support initiatives through a hospitalís charity care policies.

However, in the most direct statement from HHS on the topic through a Frequently Asked Questions (FAQ) document dated November 4, HHS indicated their concerns that premium support arrangements could "skew the insurance risk pool and create an unlevel playing field" in the exchange. HHS further encourages issuers to reject third party payments and indicates they will monitor and take action if necessary. The FAQ does not give details about how monitoring would occur or what action could be taken.

It will take some time to clarify the legal issues surrounding premium support payments. In the meantime, WHA will continue to track the developments on this important topic.

To see the latest HHS FAQ document, visit www.wha.org/EnrollmentResourcesólook under "Information About Premium Support." To see the letter from HHS to Congressman McDermott, go to: www.hlregulation.com/files/2013/10/The-Honorable-Jim-McDermott.pdf.

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Be Involved, Join a Council or Committee

WHA is currently soliciting appointment requests from WHA members to participate in WHA councils and subcommittees. Now is your opportunity to participate on the councils that are at the forefront of identifying key policy issues for the membership and making recommendations on positions to the WHA Board.

WHA is seeking member participation for five councils and one committee:

Additional information including council responsibilities and current member information is located at http://events.SignUp4.com/2014councilDescriptions. Direct questions to Sherry Collins at scollins@wha.org or 608-274-1820.

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WHA Launches HEAT "Roundtable Discussions" with State Legislators
Sen. Shilling, Reps. Nerison and Doyle meet with hospital constituents

Hospital constituents from across the 32nd State Senate District participated in the first WHA HEAT Roundtable Discussion hosted by Gundersen Health System in La Crosse. The discussion brought together roughly 20 hospital employees, trustees and volunteers from across the area for a discussion with Sen. Jennifer Shilling (D-La Crosse), Rep. Lee Nerison (R-Westby) and Rep. Steve Doyle (D-Onalaska). HEAT Roundtable Discussions are designed to bring hospitals and legislators together to share insights on legislative issues and their impact on hospitals/systems.

The first Roundtable included participants from Gundersen Health System, Mayo Clinic Health SystemóFranciscan Healthcare, Prairie du Chien Memorial Hospital, Vernon Memorial Hospital and Tomah Memorial Hospital.

During the discussion, Rep. Nerison provided insight into his leadership role in introducing legislation to create a psychiatry and primary care physician grant program. This legislation was developed as part of the Assembly Speakerís Task Force on Mental Health. The Task Force was created earlier this year by Assembly Speaker Robin Vos. WHA and hospitals have been integrally involved in providing insight and ideas to the Task Force. Nearly a dozen Task Force recommendations have already been introduced as legislation and are moving through the legislative process, with votes scheduled for the Assembly floor as soon as November 12.

Leading off the state legislative update, the group discussed the Mental Health Care Coordination bill, AB 453/SB 360, a bill that WHA proposed during a public hearing of the Speakerís Task Force on Mental Health. Sen. Shilling and Rep. Doyle, both co-sponsors of the legislation, discussed the need to update Wisconsinís mental health law. This legislation removes current barriers in sharing information between providers when a patient is receiving mental health services.

Another topic highlighted was the current compliance challenges hospitals face due to outdated regulations and unclear standards for hospital surveys. Hospitals indicated that they spend significant time trying to meet the requirements of federal law and the sometimes inconsistent or antiquated state standards. Participants told policymakers that they appreciated the efforts to clarify and modernize Wisconsin hospital regulations (DHS 124) through legislation that will be introduced later this session.

The group discussed a variety of other issues including medical homes, licensing, and accessibility for telemedicine particularly with physicians located in Iowa or Minnesota.

In closing remarks, Thompson highlighted three themes heard in the meeting:

Legislators let hospital constituents know that they were being well represented in Madison by WHA. WHA thanks these legislators and hospitals for participating.

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WHA Workforce Council Reviews Access to Clinical Education

The WHA Workforce Council reviewed how student clinical experiences are being accommodated in the hospital environment. An increasing number of requests for student experiences combined with a trend toward a decrease in inpatient days have led to new conversations about placement of learners in hospitalsí clinical units. At the November 7 Council meeting, chaired by John Zorbini, chief human resource officer, Aurora Health Care, presenters described strategies currently being used to address the issue.

Rebecca Radcliffe, health care strategist, described policy changes made by a large health care system to define which learners and which educational facilities would receive priority when requesting exposure to patients and patient units. Joanne Sandvick, project specialist at the La Crosse Medical Health Science Consortium, demonstrated the Student Link Database used by facilities in her region to manage the use of patient units for student learning experiences.

Several regional alliances have standardized the specific health requirements for student clinical placement. Judy Warmuth, WHA vice president, workforce development, demonstrated the website created by the South Central Healthcare Workforce Alliance and supported by the workforce investment board of south central Wisconsin.

Discussion by the group verified that the current regulatory environment, patient safety, patient satisfaction, the move toward shorter impatient stays and increased use of outpatient care are major factors that are directing many hospitals to discuss student learning placements.

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Annual WHA Physician Leadership Development Conference, March 14-15
Early bird discount available; register today

Registration is now open for the ninth annual "WHA Physician Leadership Development Conference." The 2014 event is scheduled Friday, March 14 and Saturday, March 15, and will be held at The American Club in Kohler. The full conference brochure, with agenda, registration and resort information, is included in this weekís packet. Online registration is available at http://events.SignUp4.com/14PLD.

This yearís conference will include a full-day Friday session focused on the role physician leaders play in supporting a culture in which quality improvement is an expectation, presented by David Nash, MD, internationally recognized for his work in quality outcomes management, medical staff development and quality-of-care improvement. The Saturday morning half-day session, presented by Tim Keogh, PhD, will focus on building the communication skills physician leaders need to gain influence, cooperation and colleague engagement.

Both Nash and Keogh are nationally-recognized faculty from the American College of Physician Executives (ACPE), and both will discuss important and practical leadership skills that help physician leaders move beyond their clinical training and take a new approach to managerial decision-making and problem solving.

A discounted "early bird" registration fee is available to those registering by January 15. Additionally, a "host" registration option is available for senior-level hospital representatives (non-physicians) who accompany one or more of their physicians to the conference but do not need CME credit.

ACPE is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. ACPE designates this live activity for a maximum of 12 AMA PRA Category 1 Credits.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Workplace Wellness Legislation Passes State Senate

During their floor session the week of November 4, the State Senate passed the "Wisconsin Healthy Jobs Act," Senate Bill 73, authored by Sen. Terry Moulton (R-Chippewa Falls) and Representative John Murtha (R-Baldwin). This bill, which has bipartisan support, would create a workplace wellness grant program housed in the Department of Health Services. The legislation would allow an employer to receive a grant for up to 30 percent of the costs of providing a workplace wellness program. The bill would appropriate a total of $3 million to distribute as grants. Only small businesses with 50 or fewer employees would be eligible to apply for grants.

The workplace wellness program must include health risk assessments and one or more of the following programs: chronic disease prevention, weight management, stress management, worker injury prevention programs, health screenings, nutrition education, health or fitness incentive programs, vaccinations or employee physical examinations.

In a statement earlier this spring, Sen. Moulton said that "A wellness program that offers assistance in making healthier lifestyle decisions would not only contribute to heading off these potential diseases but could increase productivity and general workplace satisfaction. Improved overall fitness, mental alertness, and morale are a mutual benefit to both employers and employees. A work environment that supports and encourages good health makes sense."

The Senate version of this bill passed the Senate with a 33-0 vote and will now be sent to the Assembly for concurrence. The Assembly version of the bill is still awaiting a committee vote in the Assembly Committee on Jobs, Economy and Mining.

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2014 Chargemaster Updates Focus of November 19 Seminar

WHA is offering "2014 Procedure Coding for Chargemasters," a one-day seminar November 19 focused on the 2014 reporting requirements, as well as CPT and HCPCS coding revisions and additions impacting the hospital Chargemaster. Discussions will focus on requirements with revisions required, as well as strategies for department staff education. Back by popular demand, the November 19 seminar will be led by coding expert Glenda Schuler.

Chargemaster/APC coordinators, chief financial officers, controllers, decision support managers, office managers, compliance auditors, coding staff, pharmacy directors, material managers/purchasing directors, and other directors and managers responsible for the charge generation process are encouraged to attend this event.

The seminar will be held at Glacier Canyon Lodge at the Wilderness Resort in Wisconsin Dells November 19. Access full information and online registration at http://events.SignUp4.com/13Chargemaster1119.

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BSN.WHA.org Offers Nurses Easy Access to BSN Completion Program Options in Wisconsin

As more Wisconsin hospitals encourage their nursing staff to consider taking the next step in their education, WHA learned some hospitals and health systems were making their own individual attempts to gather and maintain information on BSN completion programs, but were finding it to be complex and time-consuming. WHA began receiving requests for assistance from member hospitals.

In response to these requests, WHA discovered that although there is no shortage of BSN completion programs available to Wisconsin nurses, finding them and comparing what they have to offer was a bit more difficult than expected. The idea of developing a website that would include basic but important information for nurses looking to choose a BSN completion program in a user-friendly and standardized format came from WHAís Vice President of Workforce Development Judy Warmuth.

"Returning to school is a difficult choice for working nurses. Finding a program that meets date and time, cost and learning style requirements can take much effort even when you do find schools or programs, key information is likely not available without a call or sharing personal information. It was clear that nurses needed an inventory of programs that included key information on each one," said Warmuth.

The WHA Foundationís mission of supporting statewide health care workforce development initiatives helped turn this idea into a reality. With funding and support from the WHA Foundation, WHAís BSN completion program site, http://BSN.WHA.org, launched in April 2013. Since then, over 1,900 individuals have visited the site nearly 2,500 times, and average of more than 350 visitors each month.

This site provides Wisconsin nurses looking to move from an associateís degree to a bachelorís degree with a central online location to find information on BSN completion programs available in Wisconsin. Due to the ongoing funding support from the WHA Foundation, BSN.WHA.org is a neutral site with no advertising, and visitors are not required to reveal any personal data in order to search the site and learn information about each program.

As of November 7, the site contains information from 25 BSN completion programs that recruit RN students from Wisconsin. Those include BSN completion programs from all in-state public schools, all in-state not-for-profit private schools and any other schools approved by the Wisconsin Education Approval Board to solicit Wisconsin students. The site is updated in January and July with new programs or updated information on current programs.

WHA encourages member hospitals to link the http://BSN.WHA.org site directly from each hospitalís Intranet site, giving nurses ready access to the site. Consider passing information about the site along to nursing staff via employee newsletters, staff meetings or any other communication channels used in your hospital.

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Wisconsin Hospitals Community Benefits Ė Charity Care

Fear of a bill should never prevent a patient from seeking care at a Wisconsin hospital. Wisconsin hospital charity care programs provided $232 million to more than 700 patients each day last year. The stories that follow illustrate the deep commitment and continuing concern that hospitals have to their patients to ensure they receive the care they need regardless of their ability to pay.


A helping hand to make ends meet

A 47-year old mother of two living in Manitowoc County was downsized from a job she loved and turned to a staffing agency to find work. Bringing home a paycheck to feed and shelter her children was her number one priority. Unfortunately, the staffing agency does not provide medical insurance for part-time employees and with her pre-existing conditions, finding coverage was difficult.

One of her pre-existing conditions has caused her a great deal of physical pain in her knee and has affected her ability to move. This made it difficult to perform her work in an office setting where she performs clerical duties such as greeting clients, filing, and copying documents. The fewer hours she was able to work due to her physical pain made it more difficult to make ends meet, adding to her emotional and mental pain.

When she learned she needed arthroscopic knee surgery, she was worried that she would be unable to continue working all together and would be left with a large amount of financial debt for medical services. However, that worry ended as soon as she filled out the three-page application for Auroraís Helping Hand Patient Financial Assistance program and was approved for a 100 percent discount on her medical services. Not only did the program cover the cost of her knee surgery but it also allowed her to receive regular check-ups for her pre-existing conditions. She is able to focus on getting her health issues under control while bringing home a paycheck to take care of her children.

Aurora Medical Center-Manitowoc County, Two Rivers


Charity Care opens door for Wheaton Franciscan - St. Joseph patient

Elsie Jackson always had a job. Working since she was a teenager, Elsie enjoyed the independence of providing for herself and having an income. But in early 2012, Elsie suffered a string of injuries and illnesses that had her in and out of the hospital and unable to work.

"I was in the hospital needing stitches due to injuries from domestic violence," said Elsie. "A few months later, I was back with pneumonia." Her medical expenses continued to grow when she returned to the hospital with a broken ankle and later with a damaged disk in her neck.

"Social Security denied me. My insurance denied me. I was out of work and had no income," added Elsie. "With the bills piling, I had no idea what I was going to do."

Elsie was not used to being sick or without a job and she felt that all the doors around her were closing. Fortunately, Jennifer Mercado, a financial counselor with Wheaton Franciscan Healthcare, was able to open a door and lend a hand.

"Wheaton was a light at the end of the tunnel," shared Elsie. "They provided not only physical support, but also emotional support." With the help of Jennifer and the staff at Wheaton Franciscan Ė St. Joseph Campus, Elsie applied to Wheatonís Community Care program for those in financial need and as a result, Wheaton provided the services for free.

"I know I am going to get better," said Elsie. "This is the best thing that has happened to me all year."

Wheaton Franciscan - St. Joseph, Milwaukee


Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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