March 22, 2013
Volume 57, Issue 12


DHS Testifies on Medicaid at Joint Committee on Finance

DHS Secretary-elect Kitty Rhoades testified this week before the Joint Committee on Finance regarding Governor Walker’s proposed Medicaid budget. Rhoades began by reviewing the state’s fiscal situation, reminding members of the Committee that Governor Walker invested $1.2 billion into Medicaid in the previous budget and is proposing to provide an additional $650 million in state funds for Medicaid in this upcoming budget. The most attention, however, was focused on the budget provision that would reduce eligibility for Medicaid in Wisconsin to 100 percent of the federal poverty level ($11,500/yr), a move that could impact approximately 100,000 current Medicaid enrollees while increasing reliance on the federal health insurance exchange for low-income coverage.

Currently in Wisconsin, parents, caretakers and childless adults with incomes up to 200 percent FPL are eligible for Medicaid, but enrollment for childless adults is frozen. Rhoades outlined the Governor’s proposal to lower the Medicaid eligibility for these groups to 100 percent of the federal poverty level while lifting the enrollment freeze for childless adults below 100 percent FPL. This move requires all individuals above the poverty line, including those currently eligible for Medicaid, to access coverage through a still being constructed federal health insurance exchange.

“Governor Walker saw a conflict under the current Medicaid rules – people in poverty (those at or below 100 percent FPL) not being eligible for Medicaid because their eligibility was tied to their household structure, not their income,” Rhoades said in describing the plan.

Joint Finance Committee member Senator Luther Olsen (R-Ripon) said that he has heard from hospitals and other providers who have concerns with the current proposal, especially related to the potential levels of uncompensated care incurred by health care providers, if previous Medicaid enrollees do not connect with and retain coverage in the exchange.

“Even hospital folks are saying that we think 133 percent (federal poverty level) is better than 100 percent,”said Olsen “(They) are very concerned that between 100 percent and 133 percent there will be a lot of uncompensated care.”

Medicaid Director Brett Davis, who testified with Rhoades, responded by indicating he has been in regular communication with the Wisconsin Hospital Association.” (They are) concerned with the uncertainty,” Davis said, referring to provider reimbursement rates and consumer behavior in the exchange, and “nobody really knows and there is uncertainty across the board.”

Sen. Olsen also raised questions about the funding involved with the budget plan, noting that Wisconsin could save millions by maintaining its eligibility levels at 133 percent FPL. “We’re going from $14 million in cost, to $91 million in savings,” said Olsen, drawing from an analysis by the Legislative Fiscal Bureau. “I always, in my life, never leave any money on the table and it seems to me we are leaving some money on the table here, grab it while we can and if it goes away later…then we have to make some serious changes.”

Representative Jon Richards (D – Milwaukee) and Representative Cory Mason (D – Racine) both spoke of requirements in the exchange for maximum out-of-pocket costs of $2,000 for individuals making between $11,500 and $15,300 a year. In response, Rhoades noted that there are subsidies for premiums in the exchange that bring the premium (not co-pays or deductibles) cost down to 2 percent of an individual’s income.

“You (Secretary-elect Rhoades) mentioned several times in your testimony that we need to get people out of the Medicaid reimbursement rate and into the commercial reimbursement rate,” said Representative Mason. “If those were the only two options, I would understand why that makes sense. But in reality …we are going to continue to have people that are uninsured who go into the emergency room to get their care. In my community, the hospital…the number I heard was $19 million in uncompensated care that then just gets cost shifted to everybody else that has that private coverage.”

The Joint Finance Committee is expected to begin entertaining amendments to the budget bill later in April before sending it to the Assembly and Senate for further consideration.

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"Match Day" Demonstrates Need for Gov. Walker’s Medical Education Agenda

"Match Day" results revealed that Wisconsin medical students are showing slightly more interest in primary care careers, but only 35 percent of Wisconsin medical school graduates will stay in-state to complete their first year residency. "Match Day" is when graduating medical school seniors across the country learn where they will be going for their first-year residency training.

The good news is that interest in primary care residency programs increased modestly. Of the University of Wisconsin School of Medicine and Public Health (UWSMPH) graduates, 46 percent chose primary care, while at the Medical College of Wisconsin (MCW) 38 percent of this year’s class chose to pursue a career in primary care.

UW School of Medicine and Public Health

Medical College of Wisconsin

2012

2013

2012

2013

Medical school graduates who chose primary care (%)

45%

46%

32%

38%

Medical school graduates who will begin first-year residency in WI (%)

32%

38%

34%

31%

On the downside, however, only 31 percent of MCW medical school graduates will stay in Wisconsin to complete their residency and 38 percent of the UWSMPH medical school grads will stay in state for their post-graduate training. The Wisconsin Academy of Rural Medicine (WARM) reported that of their 20 graduates, half will stay here to complete their residency.

According to a recent Wisconsin Hospital Association report, "100 New Physicians a Year: An Imperative for Wisconsin," almost half of the physicians who complete a residency in Wisconsin stay here. That percentage jumps to 80 percent if the student is a Wisconsin native and attended both medical school and completed an in-state residency here, according to the WHA report. Where a physician does his or her residency is a leading indicator of where they will practice medicine.

"We know we must increase the percentage of graduates that enter a Wisconsin residency program, especially primary care, so we can count on those physicians to establish a practice in Wisconsin in the future," according to Chuck Shabino, MD, WHA senior medical advisor. Along with that, Shabino said Wisconsin must increase the number of in-state residency positions.

U.S. medical school graduates increased by 1,000, a reflection on the increase in the size of existing medical schools as well as the creation of new schools. This growth in U.S. graduates will continue as new medical school programs are created and existing programs expand. MCW recently announced plans to locate two new campuses in Green Bay and Wausau. WHA has been enthusiastic about the plan to increase the medical school class size in Wisconsin, but is concerned about having an adequate number of residencies available for the new graduates.

"We have been supportive of increasing the class size in Wisconsin’s medical schools, however, we must keep these new physicians here to complete their residency by creating more in-state opportunities for them to complete their training," said Shabino. "If we don’t, we will lose them to programs in other states."

The WHA report, as well as other national organizations, warned that within the next five years there may well be more U.S. medical school graduates than available residency positions. Residency training is a pre-requisite to licensure and thus inadequate availability of residency positions will potentially prevent graduating medical students from progressing to practicing physicians.

Governor Scott Walker included several initiatives in the state budget that are aimed at increasing capacity in Wisconsin’s medical schools and expanding opportunities for medical school graduates to complete their residency training here.

The Governor’s 2013-15 state budget contains funding for several key initiatives to address residency and education capacity in Wisconsin, including:

"The Match Day results really illustrate the value that can be realized if the funding the Governor has included in his budget to expand medical education and residency positions in Wisconsin is approved," said WHA executive vice president Eric Borgerding. "This funding, along with the Governor Walker’s strong commitment to this issue, will go a long way in building the infrastructure to ensure that we will have the physician workforce that we need to meet the demand for medical care in the future."

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Deputy Secretary Moore at Public Policy Council Meeting

Newly-appointed Deputy Secretary at the Wisconsin Department of Health Services (DHS) Kevin Moore was the featured speaker at WHA’s Public Policy Council meeting March 19. Deputy Secretary Moore shared his thoughts on the major issues that DHS is facing including implementation of the Affordable Care Act, expanding mental health services and properly managing the state’s FamilyCare program.

Moore said Medicaid eligibility is one of the biggest issues facing DHS. In his budget, Governor Scott Walker proposed lowering eligibility for non-elderly, non-disabled adult Medicaid coverage down to those making less than $11,500 per year. All current Medicaid enrollees, between 100 percent and 200 percent of the FPL would then transition to the health insurance exchange, according to Moore, to purchase coverage.

"Regardless of your family status, if you live in poverty, Medicaid will be there for you. We believe this is a pretty significant shift," according to Moore. "As we look at this population (up to 100 percent FPL), we expect this will be an expensive group to keep in Medicaid. Regardless of whether they have kids, we wanted them to have coverage, including mental health."

For people who now have Medicaid coverage, Moore said the objective is to ensure a smooth transition from government coverage to private insurance. Moore said they have had initial conversations with Deputy Commissioner Dan Schwartzer at the Office of the Commissioner of Insurance (OCI) and with Brett Davis, Medicaid director, about shifting people who are now on Medicaid to the health insurance exchange (see "CMS Discusses Contingency Planning and Outlines Exchange Planning Timeline" below).

However, Moore said if there is a delay, the Governor has been "prudent" and provided some latitude in the state budget to "weather mechanical challenges that we could have with the exchange."

"We want to make sure we get enough information early on because the operational side (of the exchange) will be a difficult lift," Moore said. "That is why the Governor invested in administration and staffing to ensure we have the state staff on hand because (the exchange) is a long-term project, not only in the Department but for your (county) income maintenance consortium."

There have been some initial discussions at DHS about the role of the navigators in the exchange and questions about how DHS would "plug in" to the health insurance exchange if it is an OCI function. Moore acknowledged that it is also difficult to determine policy when there is uncertainty about what insurers will participate in the exchange. But, Moore said, "The Governor said we will have an exchange, and we will need to be ready to go with it when it goes live."

In response to a question from one of the Council members about transitioning people from Medicaid to the exchange, Moore said there will have to be an education process with the Legislature. If people now on it are not eligible, you can’t just "dump" them.

"We need a next step, and this is so new we don’t have a template," Moore said. "The margins—those who are at the edge of eligibility—are always difficult."

WHA Executive Vice President Eric Borgerding explained to the Council how the exchange and Medicaid are interwoven.

"Hospitals and health systems have always played a vital role in helping connect our low-income and uninsured patients with coverage. This will be even more important in the future because it won’t just be Medicaid, it will also be enrolling people in the exchanges," according to Borgerding. "There need to be as few impediments to this connection process as possible. We can’t reduce eligibility for Medicaid and rely on exchanges to pick up that coverage, but then have regulatory bottlenecks in connecting these same people with coverage in the exchange. We have to be very cautious."

Health Care Providers Praise Governor’s Mental Health Initiative

Moore said the Governor’s initiative to enhance and expand mental health services for children and adults living with mental illness is an unprecedented investment that will provide significant results in the future. In particular, Moore touted the Governor’s plan to "buy out" with state funds current county funding of services under the Comprehensive Community Services program, expand that program statewide, and move toward providing those services on a regional rather than county level. Moore said that the proposals in the budget will have a large, and positive, impact on the lives of people who are most in need of these services.

"These are very positive initiatives that could take behavioral health care in much needed new directions," Borgerding said. "We commend the Governor for moving in this direction and are anxious to work with DHS on these and other important behavioral health care reforms."

WHA’s Behavioral Health Task Force has identified moving from county-based public mental health services to regionally organized services and having the state reassume county funding obligations for public mental health services as important systemic reforms needed to enable more consistent access to mental health services across Wisconsin. Matthew Stanford, WHA vice president, policy and regulatory affairs and associate counsel, staffs the WHA Task Force. Stanford commended Moore on the Governor’s proposal to buyout and expand the Comprehensive Community Services Program on a regional basis as an important step toward those broader goals.

Medicaid Coverage and Exchange Concerns Persist

Joanne Alig, WHA senior vice president, policy & research, updated the Council on the issues surrounding Medicaid coverage and health insurance exchanges. Alig described WHA’s position on Medicaid coverage. She indicated that recent decisions by the federal government around exchanges are causing continued concern about the level of exchange functionality when the exchange is intended to be operational this fall. She also recapped information from the Office of the Commissioner of Insurance and noted recent federal guidance and rules on exchanges. (See March 15, 2013 Valued Voice and related story in this issue.)

WHA is actively involved in advocacy efforts at the federal level on several fronts. Jenny Boese, WHA vice president, external relations and member advocacy, provided information to the Council on issues pending at the federal level, including debate over the federal budget, implementation of the sequester process and what faces hospitals for the remainder of 2013. Boese also provided an update on WHA’s "Protect Hospital Care" advocacy campaign, which continues to engage hospital advocates in fighting back against additional Medicare/Medicaid cuts to hospitals and health systems.

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CMS Discusses Contingency Planning and Outlines Exchange Planning Timeline

On Monday, March 18, CMS held a nationwide stakeholder conference on health insurance exchanges. CMS’ Gary Cohen, deputy administrator and director for the center for consumer information and insurance oversight (CCIIO) indicated the agency is actively building the federally-facilitated exchange.

The stakeholder call, however, comes several days after Cohen indicated his agency is conducting contingency planning for the open enrollment period to begin on October 1, as reported in several news outlets. Details about the contingencies were not available and apparently have not been finalized yet by the agency. As reported, it is the first time the administration appears to indicate that all aspects of the exchanges may not be fully functional and back-up plans may be necessary.

In addition to the release of a grant application for the navigator function, current plans by CMS for implementation of the application, consumer assistance and web portal are as follows:

CMS also announced they will host state-by-state calls beginning the last week in April. A schedule of calls will be available. A call for Wisconsin is currently scheduled Wednesday, May 1, 2013 at 1:00 pm.

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New Wisconsin Health Services Head Kitty Rhoades to Keynote Advocacy Day Luncheon
Pre-event webinars available for attendees participating in legislative visits

Wisconsin Health Services (DHS) Secretary Kitty Rhoades is confirmed as the luncheon keynote speaker for the Wisconsin Hospital Association’s Advocacy Day coming up on April 23 in Madison. Hundreds have already registered for this premier event, so make sure you are assembling your hospital contingent today.

Rhoades was appointed in February 2013 as DHS Secretary, which is the top position at the state’s Department of Health Services, which handles programs like Medicaid. She moved into the role after serving as DHS Deputy Secretary since January 2011. Previously Rhoades served in the Wisconsin State Assembly from 1999 until her retirement in 2010. While in the Legislature she served as the co-chair of the powerful budget-writing committee and the Joint Legislative Committee on Finance. She also served on the State Assembly’s Health and the Aging and Long-Term Care standing committees. In addition to Secretary Rhoades’ address at the luncheon, WHA will present its prestigious Advocacy All-Star Award to one outstanding hospital and its Healthcare Advocate award to one outstanding legislator.

More than 750 hospital staff, trustees and volunteers converge on Madison for WHA Advocacy Day to hear from national and state speakers and then put this knowledge into action. This year with the state budget process unfolding concurrently with Advocacy Day, the ever-popular state legislative panel will provide insight into budget deliberations and other pending health care issues of importance. In the afternoon, attendees will be able to go to the State Capitol, only two blocks away, to meet personally with their legislators or staff on these important health care issues. Individuals must register for legislative appointments, after which WHA will specifically schedule appointments for them with their legislator’s offices.

To help prepare individuals for legislative appointments, WHA is providing two optional webinars prior to Advocacy Day. Choose from either of the following dates to learn about your legislative appointments, topics to be covered and tips on being an effective advocate. Please register online at: http://events.SignUp4.com/13PreAdvoacy041216 for either Friday, April 12, 12-1pm or Tuesday, April 16, 12-1pm.

Again, don’t miss out on Advocacy Day 2013 to make sure the voice of hospitals is heard in Madison. Advocacy Day is a free event, but pre-registration is required. A program and online registration are available at: http://events.SignUp4.com/13AdvocacyDay0423.

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WHA Testifies at MEB Hearing on Proposed Unprofessional Conduct Rule

The public had the opportunity this week to comment on the Wisconsin Medical Examining Board’s proposed revisions to Med 10, the administrative rule defining unprofessional conduct for physicians. The Wisconsin Hospital Association and the Wisconsin Medical Society testified at the public hearing and provided written comments.

In its testimony, WHA expressed its appreciation for the MEB’s integral role in ensuring that Wisconsin’s excellent health care system continues to be one of the best in the country. WHA also thanked the Board for a number of the decisions it made throughout the more than yearlong process. Those decisions included protecting local peer review, recognizing that physicians and other practitioners can provide outpatient services ordered by a physician licensed in another state in certain circumstances, and referencing the informed consent statute in rule.

WHA also asked the MEB to reconsider several of its decisions. WHA asked the MEB to replace its proposed language related to patient abandonment with the Society’s recommended language. WHA also suggested changes to provisions related to wrong site surgery, supervision, and state agency decisions being conclusive evidence of findings of fact and conclusions of law.

You can click to download the following documents:

WHA and the Society will continue to work with the MEB as it completes its revisions to Med 10. Before the proposed Med 10 can become effective, the MEB must approve it in its final form and it must clear a legislative review process.

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WHA Physician Leadership Conference Draws 190 Physicians, Administrators

A growing number of new physician leaders attend WHA’s annual Physician Leadership Development Conference because they find that it helps them to bridge the gap between traditional clinical training and their new leadership roles. Many of their hospital administrators join them to take advantage of the rare one-on-one opportunities with their physician leaders. This year’s event, held March 8-9, was the largest to-date, drawing nearly 150 physicians and 46 hospital leaders, representing 62 different hospitals and health systems.

According to WHA Senior Medical Advisor Chuck Shabino, physicians find great value in participating in the conference. "Physicians attending this year’s conference once again pointed out that in addition to the information learned from the presenters, the opportunity to network with and learn from other colleagues attending the meeting was of great benefit."

Joan Coffman, president and CEO of St. Joseph’s Hospital in Chippewa Falls, attended this year’s event with two of her physician leaders.

"Health care and the delivery of health care are rapidly evolving, and physician leaders are being invited to serve in positions that require a combination of business, interpersonal and clinical skills and competencies," Coffman said. "WHA’s Physician Leadership Conference is an exceptional venue for current and future medical staff leaders to become better prepared and engaged in the development of these critical skills while networking with others to listen, learn and share."

Coffman believes the conference facilitates valuable dialogue between physicians and administration.

"Top performing organizations are best served by building trusting relationships with physicians, as our physicians are much better positioned to gain the consensus of their peers in support of high quality care and service. Attendance together (at the conference) affords us the opportunity to get to know one another in a much more meaningful way, further appreciating the gifts and talents each member brings to the organization."

The 2014 event is scheduled March 14-15 at The American Club in Kohler. Mark your calendar, share this date with your medical staff, and encourage your new and potential physician leaders to consider attending as part of your team.

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RWJF Recognizes MHCP ED Care Coordination Initiative

The Milwaukee Health Care Partnership’s (MHCP) Emergency Department Care Coordination (EDCC) initiative was recently featured in the Robert Wood Johnson Foundation (RWJF) Aligning Forces for Quality best practices publication.

The EDCC initiative has also been featured in other periodicals, and leadership has participated in several local and national conferences and webinars showcasing these efforts and accomplishments.

Since the article was published, the MHCP completed a phase 1 evaluation of its ED to Medical Home initiative in collaboration with the Center for Urban Population Health. The preliminary findings revealed that emergency department (ED) patients who were referred to and kept their initial appointment with a federally qualified health center had a 43 percent decrease in ED visits in the subsequent six months.

"The Milwaukee hospitals’ efforts to connect patients to a medical home who have not had access to primary care in the past took creativity, collaboration and commitment," according to WHA President Steve Brenton. "The results speak for themselves in terms of decreased emergency room utilization, reduced costs and better care coordination."

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Grassroots Spotlight: Columbus Community Hospital Hosts Members of Congress

Recently Columbus Community Hospital (CCH) hosted U.S. Rep. Tom Petri and staff to U.S. Senator Ron Johnson at the hospital.

"Columbus Community Hospital greatly appreciates the willingness of our Members of Congress to visit our hospital and learn more about the importance of access to care in rural communities," said John Russell, president & CEO of CCH.

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AHA to Host Webinar on Accessing the Healthcare Connect Fund

The American Hospital Association (AHA) Constituency Sections are hosting a webinar with the Federal Communications Commission (FCC) emphasizing the new opportunity for rural/metro consortia as part of the FCC’s Healthcare Connect Fund (HCF), which provides discounts for broadband connectivity to eligible health care providers. The webinar will review funding available through the HCF, which was established to help rural providers improve broadband capacity and leverage the full potential of telemedicine, electronic health records, and other health information technology through consortia with metro partners.

The 60-minute webinar will be April 4 at 12 pm, and it will be repeated April 5 at 1 pm.

The initiative is part of the annual FCC Rural Health Care Program, and it builds upon the experiences of an FCC pilot program that facilitated the creation of 50 statewide and regional broadband networks dedicated to health care, connecting public and private non-profit health care providers in rural and urban locations. The FCC expects to begin the competitive bidding process for new applicants this summer.

Chantal Worzala, PhD, director, AHA policy will be joined by Linda Oliver, deputy chief, FCC Wireline Competition Bureau, Washington, D.C. Case examples from Colorado and Iowa pilot programs and their experiences expanding broadband and improving communication and quality of care with metro consortia will be featured.

Click to register for the April 4 webinar or register for the April 5 webinar.

If you have questions, email jpalencia@aha.org or call 312-422-3345. A reminder with login and dial-in instructions will be sent to you a day prior to the call.

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Wisconsin Hospitals Community Benefits: Injuries and Violence

A teen arrives in the emergency department by ambulance following a terrible car accident. A child receives head injuries while bicycling without a helmet. A woman walks into the emergency department with injuries inflicted by an abusive spouse. These are stories of pain and tragedy that hospital personnel see all too often. Injury is the most under recognized major public health problem facing the country and it is the leading cause of death in people ages 1 to 44 in Wisconsin. Wisconsin hospitals devote significant resources to reduce the number of intentional and unintentional injuries that occur in the communities they serve.


SANE program launches partnership between Fort HealthCare and PADA

The Sexual Assault Nurse Examiner (SANE) Program at Fort HealthCare began providing confidential services to sexual assault victims in February. Prior to that date, Jefferson County had no facility offering these services. Victims were referred to other hospitals, in more urban communities.

SANE is provided in partnership with People Against Domestic and Sexual Abuse (PADA), Jefferson County’s program for domestic and sexual abuse victims. PADA staff and volunteers will be on-call to respond to the hospital and provide supportive counseling to victims of sexual assault during the SANE exam process. They will also offer ongoing support and advocacy to victims, such as legal advocacy, counseling and community resource advocacy.

Amy O’Neil, executive director of PADA says, "We are very pleased to partner with Fort HealthCare to offer this vital service to victims of sexual assault in our community. Having a SANE program sends a clear message to victims and survivors that our community cares about them."

To operate the program, there are training and equipment expenses. The Fort HealthCare Partners organization chose the SANE program as the recipient of the 2012 Love Lights campaign funds. Through the donation, SANE program and clinical coordinator for emergency services, Sarah Chesmore, RN, was able to obtain the materials needed to perform sexual assault exams.

"Once an exam begins, the nurse is not to leave the room, because it holds evidence of a potential crime," remarks Chesmore. "For that reason, our exam cart is mobile and can be taken to the patient anywhere in the hospital, thanks to the Fort HealthCare Partners donation." The cart is secured with a keypad lock and holds all necessary equipment including: an alternate light source, speculum, swab dryer, high-definition camera, combs, cotton swabs, and all other items needed for the comprehensive exam, so the nurse never needs to leave the patient.

The SANE program is staffed by registered nurses who have received advanced education and instruction in medical-forensic examination of sexual assault victims. They are also equipped to respond to the psychological and emotional trauma that may be present after an assault. Services provided by SANE nurses include: assistance with reporting the crime to police, a comprehensive, sensitive examination of injuries, collection of medical-forensic evidence that may be useful in court, and assistance with the many concerns that follow sexual assault, such as the threat of sexually transmitted diseases and pregnancy.

Training requires over 44 hours of classroom education and additional practical experience. Nurses who complete training gain experience with law enforcement personnel, criminal justice procedures, victim advocacy, medical examinations and social services. Through training, nursing staff deliver coordinated, expert forensic and medical care that not only provides comfort and reassurance to the victim, but also safeguards evidence that aids in the successful prosecution of offenders.

Fort HealthCare, Fort Atkinson


P.A.R.T.Y. time for area schools

In October of 2012, Monroe Clinic and Hospital Foundation presented the Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y.) Program to 10 different high schools in the area. The 60-minute presentation at the Monroe High School Performing Arts Center (PAC) featured a dramatization, and a number of guest speakers depicting the tragic results that can occur from drinking and driving.

More than 700 students from Albany, Argyle, Belleville, Blackhawk, Darlington, Juda, Lena-Winslow, Monroe, Monticello and New Glarus High school were in attendance.

"It’s an important message, and one we hope sticks with students as they grow and become more and more independent," said Sherrie Volbrecht, Monroe Clinic’s coordinator of emergency services and P.A.R.T.Y. Program coordinator. "Often times, young adults don’t consider the sweeping impact that one bad decision can have. This program showed them the whole process, which can start at a party and end with a trip through the emergency room, rehabilitation center, judicial system and even the coroner’s office," said Volbrecht. "In our continuing support for this program, our hope is that students will make smart, safe choices."

Monroe Clinic, Monroe


Car Control Clinic offers teenagers real-life driving experience

Staff of Gundersen Lutheran’s Division of Trauma, sadly, sees too many young people who are victims of traffic accidents. Motor vehicle crashes (MVC) are the leading cause of fatality for teenagers, accounting for more than one in three deaths. MVC are disproportionately more severe when they occur on rural roads. Deadly crashes on rural roadways account for more than half of all traffic fatalities. Among the population Gundersen Lutheran served from 2001-2011, 67 percent of crashes were due to loss of control; 90 percent occurred in a rural setting.

Young people are at greater risk for traffic accidents due to one major reason—lack of experience. Committed to keeping teens safe, Gundersen Lutheran has offered its free Teen Car Control Clinic for several years. The clinic is offered to teen drivers ages 15 to 19 with a license or learner’s permit. A parent or guardian attends the course with the teen.

The daylong clinic teaches drivers the fundamentals of vehicle control during the classroom session and also provides practical behind-the-wheel exercises. During the in-car portion of the clinic, instructors familiarize students with proper breaking concepts, vehicle weight transfer and cornering, and unexpected lane changes. The session is designed to heighten students’ awareness and responsiveness to real-world situations and boost their own confidence in their driving skills.

Recently, there was a review of data from our Teen Car Control Clinics. Data were collected through written surveys completed pre- and post-clinic and phone surveys six months post-clinic to assess driving confidence, changes in driving patterns, application of techniques learned, motor vehicle crashes and injury rates.

More than 280 teens have participated in the clinic at Gundersen Lutheran. There was a significant improvement in ‘Perceived Confidence’ from pre- to post-course and continued improvement at the six-month followup. Most of the participants who responded (89 percent) reported changes in driving patterns based on topics covered at the clinic, and 58 percent encountered situations that required application of a technique taught. Overall MVC rates were 8 percent with only minor injuries reported.

Participation in the Gundersen Lutheran Teen Car Control Clinic resulted in an overall improvement in driving confidence, application of practiced techniques and a low incidence of motor vehicle crashes.

Gundersen Lutheran Health System, La Crosse


Bicycle helmet program

Wearing a bicycle helmet is the most important thing you can do to protect yourself from head injuries in a bicycle accident. Teaching children the importance of helmets at an early age helps to build good habits that will last a lifetime.

St. Nicholas Hospital in Sheboygan offers a bicycle helmet program through which staff not only sells helmets at cost, but also fits them to the individual. Helmets are available to all ages, but the hospital works closely with groups to fit and educate children.

One such event is the annual Safety Town where young children learn to safely cross streets, ride bicycles, and the like. Over a two-day period last summer, St. Nicholas colleagues fit helmets for 160 five- and six-year-olds in Sheboygan attending Safety Town. Each child also received instruction on the importance of wearing a bicycle helmet.

St. Nicholas Hospital, Sheboygan


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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