May 1, 2015
Volume 59, Issue 17


WHA Advocacy Day Attendance Tops 1,000, Shatters Old Record

There is only one word that could describe the size of the WHA 2015 Advocacy Day crowd gathered April 28 at Monona Terrace in Madison. And WHA Chair Therese Pandl found it. 

“WOW! This room is spectacular!” Pandl, who is president/CEO of HSHS Eastern Wisconsin Division, said as she stood at the lectern before a record-setting crowd of hospital supporters. “This turnout is absolutely inspiring…to look out and see all of you out there supporting our hospitals every day.” 

Pandl introduced a new video that highlights the important role that WHA and its member hospitals have in improving health care quality and the value of care in Wisconsin’s communities. Watch it here: 
https://youtu.be/cE5d-h-iyi8.

WHA President/CEO Eric Borgerding presented a brief history of Advocacy Day, which dates back to the 1970s. Borgerding said total attendance at Advocacy Day in 1985 didn’t quite reach 200, compared to this year when HSHS alone brought more than 140 supporters. Borgerding noted the steady climb in interest among legislators, evident by the fact that in the early years of Advocacy Day, then called “Day at the Capitol,” a handful of legislators joined their constituents during lunch. Contrast that to this year when 650 hospital supporters arrived at the Capitol by buses to meet with their legislators. 

“If attendance keeps climbing, which we hope it does, we may need to get a bigger State Capitol!” Borgerding quipped. 

Keynote speaker Tucker Carlson, a journalist with Fox News and several other media outlets, was equally as impressed as Pandl, but what really bowled him over was the number of attendees who were heading to the State Capitol in the afternoon to meet with their legislators. 

“I understand more than 600 of you are going to the State Capitol. That is great!” Carlson added. “You have the best and most straight forward message, and your work benefits America. You are doing a great thing—you are saving lives. They will pay attention to you.” 

As a Washington-based political insider, Carlson said he is often asked about insights into the 2016 presidential race. One thing he does see in a sea of uncertainty is an America that is in the middle of what he called a “profound transition” at every level. 

“Demographic. Economic. America is changing really fast. All societies go through this at regular intervals. In the United States it happens about every 40 years. Last time it occurred was in the fabled ‘60s,” according to Carlson. “Uncertainty cuts against human nature. When you are in the middle of one of these great pivot points, people try to forecast the future and fail miserably. Something happens that changes the course of history, such as 911 or Pearl Harbor. The truth is change brings about anxiety. We embrace change, we even vote for change, but the truth is, we don’t yearn for wholesale change.” 

Polling on basic assumptions in American life has shown, according to Carlson, that people under 30 have a dramatically different view than those over 30 years old. And it’s not just in music. The under 30 group is now questioning the most basic premises in American life related to democracy, capitalism and science. Carlson noted that the impact of immigration has also had a profound effect on Americans’ views. He noted that the United States has had more legal immigration in the last 50 years than there has been in any country, ever. 

“You are looking at a very different country attitude-wise than the one you grew up in,” he said.

What does this mean to the political system? 

“If you are looking at this presidential election in the conventional way, and you assume that the 2016 election will be like the last one and the one in 2012, you would have a clear set of expectations related to the presidential nominees,” Carlson said. However, the presidential election, according to Carlson, is a pure contest among opposing world views, and on Election Day, anything can happen because Americans “hire the person who matches up with our beliefs,” he said.

 

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Walker Promotes Wisconsin Health Care Globally
Governor: “We have access to some of the most remarkably high-quality health care in the world”


When it comes to promoting Wisconsin health care, it would be difficult to find a more committed spokesperson than Wisconsin Governor Scott Walker. Speaking before a crowd that topped 1,000 at WHA’s Advocacy Day April 28, Walker touted Wisconsin’s high-quality, high-value health care as an economic development asset that deserves global recognition. 

“All across the state of Wisconsin, there’s access to really remarkably high-quality health care, some of the best not just in the country, but in the world, and you can’t put a premium on that,” according to Walker. “Sometimes we take it for granted because we don’t have to travel to another state or another region. Thank you for your leadership and the long-standing tradition of WHA and the health care systems in the state for providing that kind of health care. It is a key element in the quality of life that we have in the state of Wisconsin.”

While he was on a recent trade mission to Europe, the Governor said he included Wisconsin’s high quality health care on his list of important assets to the state’s infrastructure. He called it a “core strength,” as vital as good transportation, the regulatory environment and the tax climate to attracting business to the state, which he believes is increasingly overlooked in some parts of the country.

“I was in Europe a week and half ago…making our sales pitch to employers and investors to come and bring jobs to Wisconsin…You know what we include in our packet or on our lists? Quality rankings of health care in the state of Wisconsin,” Walker said. “When people look not just around the region, or in the Midwest or around the world when they make a decision on where to locate their business or their headquarters…access to quality health care is a big part of it, so we appreciate what you do.”

The Governor said quality health care is fundamental to attracting and keeping top talent in the state’s workforce. He added that quality health care is available everywhere in Wisconsin, and it adds value not just to the quality of life, but it is also a key factor in any community’s ability to attract and keep employees. Watch a clip of the Governor’s comments related to health care as an economic development asset: https://youtu.be/pFyFeeZvXoY.

In his introductory comments, WHA President Eric Borgerding noted this was the fourth time the Governor has presented at Advocacy Day, and with 1,100 people in attendance, it was also the biggest crowd WHA has gathered for the event since its inception. The Governor clearly enjoys it, too.

“I love to come here and see all of you, because so many of you are volunteers. Your role in the community keeps your community strong because of the presence you provide for your health care systems,” Walker said. “There is buzz…an excitement at this event. People enjoy being here with others who share their commitment to quality health care and to their communities.”

Walker also voiced his appreciation to hospitals and health systems that are reaching out to hire veterans and for their support of Project Search, which helps persons with disabilities connect with appropriate employment. (See related Guest Column by Therese Pandl at www.wha.org/Data/Sites/1/pubarchive/valued_voice/WHA-Newsletter-3-6-2015.htm#4.)

“We are looking at ways to partner with WHA and with hospitals and health care systems across the state,” Walker said. “We are going to continue to find ways to partner with health care providers because you are at the front lines.” 

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Legislators Share Thoughts, Positions on Worker’s Comp, DSH, Medicaid Costs

A popular feature of the WHA Advocacy Day event is the legislator panel. Here is Part 1 of a two-part article featuring the four legislators’ responses to a number of questions related to WHA’s key legislative priorities.

While dissent among legislators draws more press than agreement, much of the work on health care-related issues in the Legislature is accomplished in a bi-partisan manner. In fact, in introducing the popular Legislative Panel at WHA’s Advocacy Day April 28, WHA President/CEO Eric Borgerding noted the majority of WHA’s priority legislative proposals over the past few years have passed both houses of the Legislature with bi-partisan support. 

Legislators participating on the panel were: Sen. Sheila Harsdorf (R-River Falls), Sen. Jen Shilling (D-La Crosse), Rep. Joe Sanfelippo (R-West Allis) and Rep. Peter Barca (D-Kenosha). Borgerding moderated the panel. 

A perennial issue is Wisconsin’s Medicaid reimbursement rate, which is the second worse in the nation. The state budget includes a proposal to reauthorize the Disproportionate Share Hospital (DSH) Program, which is heavily supported by WHA. Borgerding asked the legislators if they support reauthorizing, strengthening and making DSH permanent. 

Shilling: While her first choice would be to expand Medicaid, Shilling says DSH is “critical to the hospitals I represent in Western Wisconsin” and she supports it. 

Sanfelippo: “The problem is we are not properly funding Medicare and Medicaid. DSH is the temporary fix. We really need to start looking at those rates and about bringing them up. I would like to see us address the real problem and get us above that 65 cents on the dollar that is being paid right now because those costs are being shifted to employers and other payers.”

Barca: “We should keep the band-aid on (DSH program) to address the hemorrhaging, but we should address the reimbursement rates. We have universal health care in this country—it’s called the emergency room. We have to get away from that.”

Harsdorf: “I am pleased the Governor maintained DSH at the level it is. I am hoping there is support for making it permanent.” 

Borgerding: Close to 80,000 (net) people living at the FPL and lower gained coverage in the last state budget. That positive outcome also comes at an increased cost. The costs of the Medicaid program are “crowding out” funding for other budget priorities. How sustainable will the Medicaid program be if expansion is not an option in the near future?

Sanfelippo: “I think it will continue to be a priority. As the economy grows, so will the revenue coming in the state. We need to look at other areas for efficiencies in government and in programs we run… I don’t think anyone will backtrack on the commitment to Medicaid.” 

Barca: “I largely agree with Joe; we have a moral and ethical obligation to take care of people. We expanded Medicaid on our own dime in Wisconsin. It is crowding parts of the budget out…you have to have a sustainable budget and it needs to start now.” 

Shilling: “We have an aging demographic in our state. We really are on the cusp that we need to make sure we are looking through the lens to see what will be needed in our future budgets to make sure we are protecting our most vulnerable citizens.” 

Harsdorf: “One in five people in Wisconsin are on medical assistance. To ensure sustainability we need to look at how we can provide more effective programs and avoid duplication. The most effective is preventive care. We won’t solve the problem of health care if we only focus on acute care.”

Borgerding: For the first time since World War II, the Legislature did not pass an “agreed-upon” Worker’s Compensation bill. What are your thoughts on the Wisconsin’s Worker’s Compensation program and do you see a price-setting proposal gaining any traction this legislative session? 

Harsdorf: “We have a model program. Compared to other states, it is efficient, saves costs and gets people back to work. No one made the case for change.”

Shilling: “I would have serious concerns with a fee schedule—our system now costs less. It is important to be a citizen lobbyist today, to be that squeaky wheel and talk to your legislator about the worker’s comp program. Talk about why this is the wrong direction. Ask them for the data to demonstrate why (the changes) are necessary. It is a solution looking for a problem—I would like to stay on the path we are on. Don’t take your foot off the gas.”

Sanfelippo: My experience as an employer is we have a good program, I am not in favor of fee setting. There is some room for administrative reform on the paperwork—it is tedious for a small employer…but a fee schedule is not something I would support.”

Barca: “We have the best, by far, (Worker’s Compensation) program in the entire nation. I headed up an operation on the border with Illinois….and another that had employees in eight different states, and Wisconsin was by far the best program. One reason it was the best program is because, frankly, politicians stayed out of it … Any changes that need to take place in worker’s comp where you are an incredibly important piece of it must take place in consultation with your group and your association. That is the part we can all agree to that we would like to see in changes to the program.” 

Borgerding: Many people in Wisconsin now receive subsidies in the health insurance exchange to enable them to have coverage. Sometime this summer, a Supreme Court decision could impact those subsidies. In Wisconsin, about 185,000 people are receiving a subsidy—one of the highest rates of subsidized coverage in the country—which could lead to a massive loss of insurance coverage. If the Supreme Court rules in favor of King, and if the federal government fails to act or fails to act in a timely manner—what do you envision could be a Wisconsin solution?

Shilling: “It will be incredibly disruptive. It is imperative that Gov. Walker and the Legislature work together with all stakeholders to find a solution as quickly as we can.”

Sanfelippo: “We would need to look at options to allow states to work together and form a coop, or have a private provider run an exchange, or maybe the feds will change and go into a contractual agreement with the state on an exchange. I’d like to see more power in the hands of citizens to give them access to plans that are more tailored to their needs.” 

Barca: “I would hope they do not strike it down. That would be massively destructive. Those people need a solution and it needs to be well thought out in consultation with health care professionals.” 

Watch for more coverage of the legislative panel in the May 8 issue of The Valued Voice.

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650 Hospital Supporters Meet with Legislators Seeking Support for DSH and to “Keep Worker’s Compensation as it is”

The only statistic from WHA’s 2015 Advocacy Day that was as impressive as the total attendance, which topped 1,000 people, was the number of hospital supporters who met with their legislators in the State Capitol in the afternoon. Arriving at the capitol in buses and trolleys, 650 hospital supporters found their way to offices, conference rooms and even to the cafeteria to meet and share their views with legislators and their staff on important legislative proposals now being considered by legislators. 

In his briefing with attendees just prior to the meetings at the State Capitol, Kyle O’Brien, WHA senior vice president, government relations, encouraged hospital supporters to share their local stories with legislators to let them know the impact proposals developed in Madison have on their local hospital and in their community. 

“Legislators want to hear from you, their constituents, about the impact of Medicaid reimbursement on your hospital, your local employers and your community,” said O’Brien. “Wisconsin’s Medicaid reimbursement rates result in $960 million worth of costs that are shifted to Wisconsin’s employers and families each year. We need to increase Medicaid reimbursement for Wisconsin hospitals and physicians to offset this hidden health care tax.”

The “citizen lobbyists,” as they were described by WHA President/CEO Eric Borgerding during the legislative panel, were armed with information on WHA’s key legislative priorities, which included:

In addition, supporters were reminded to tell their legislators that Wisconsin’s high-quality health care is an economic development asset that makes our state, and their communities, more competitive in a global economy.

Several legislators responded positively to afternoon meetings with hospital advocates, including legislators who offered to co-sponsor the Interstate Physician Licensure Compact bill. Other feedback included support for making DSH a permanent appropriation and concerns from legislators with any proposal that would implement a government-imposed fee schedule in Wisconsin’s Worker’s Compensation program. 

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VanderMeer, Harsdorf to Introduce Physician Compact Legislation
Bill has 39 co-sponsors just days after being highlighted at WHA’s Advocacy Day


Rep. Nancy VanderMeer (R-Tomah) and Sen. Sheila Harsdorf (R-River Falls) circulated legislation April 27 that would implement a Physician Licensure Compact in Wisconsin and allow for a more streamlined process for physicians who want to be licensed in multiple states. This concept was developed by the Federation of State Medical Boards and has received critical support from key health care stakeholders in Wisconsin including WHA, several hospitals and health care systems, the Wisconsin Medical Society and the Medical Examining Board. 

The Interstate Physician Licensure Compact bill (LRB 1138/1) was an issue discussed by over 600 “citizen lobbyists” and hospital advocates who met with their local legislators during WHA’s Advocacy Day on April 28. The Compact will streamline the licensure process for physicians, cut regulatory red tape for hospitals and ultimately improve access to care in Wisconsin communities.

“The more co-sponsors this legislation receives, the better chance the bill has of becoming law,” said Kyle O’Brien, WHA senior vice president, government relations, during the afternoon’s legislative issues briefing. “You will have the opportunity to ask your legislator to take action, today, by signing onto this bill. Your work this afternoon will help make the Compact a reality in Wisconsin.”

Several legislators committed immediately to signing onto the legislation during WHA Advocacy Day meetings at the Capitol. Legislators acknowledged that this seemed to be a “common sense” reform to the licensure process in Wisconsin, especially with the evolution of health care delivery through telemedicine. So far, nearly 40 legislators have sponsored the bill with more expected to sign on before the bill is introduced in mid-May. The bill has already received bipartisan support from Republicans and Democrats in both chambers of the Legislature. 

Harsdorf also participated in the legislative panel during WHA’s Advocacy Day, where she touched on why she authored the Compact. Harsdorf mentioned that one of her constituents, Gordy Lewis of Burnett Medical Center, approached her about authoring this legislation. After reviewing it, she decided to author the bill and felt like it should be done “this session to streamline the process for licensing physicians in our state and make it easier to practice in several states.” 

Currently, the licensure process in Wisconsin for physicians already licensed in another state can last months due to wait times on verification and eligibility information. The goal of the Compact is to create an ability to easily share that information between Compact states to create an expedited licensure process for those physicians that currently hold an unrestricted license in good standing in another Compact state. 

Other key elements of the Interstate Physician Licensure Compact bill include:

So far, six states have adopted the Compact, and another 11 states have introduced the legislation. Wisconsin will be the eighteenth state to have introduced and/or enacted legislation adopting the Compact, with more states expected to join.

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Private Ambulance Tax Refund Intercept Bill Passes Committees 

Legislation allowing certain private ambulances to utilize the state tax refund intercept program has cleared two committees of the Legislature, opening up the likelihood that the proposal will reach the Senate and Assembly floor for consideration by the full Legislature. 

On April 29, the Senate Committee on Revenue, Financial Institutions, and Rural Issues voted to recommend the legislation with a bipartisan, unanimous 5-0 vote. A week earlier, the Assembly Committee on Ways and Means voted the bill out of Committee with a 10-2, bipartisan vote. Both Committees were in favor of an amendment that would require the ambulance provider to be on a contract with a municipality or a county in order to utilize the state tax refund intercept program.

WHA registered its support for this proposal with both the Senate and Assembly Committees.

The bill (SB 40 and AB 31) would allow private ambulance services on contract with a county or municipality to utilize the state Tax Refund Intercept Program (TRIP) for debt owed by an individual from a government-operated 911 service call. Counties and municipalities with public ambulance services can already utilize the TRIP program to recover debt owed by an individual who utilizes emergency 911 services, but private ambulance services operating on behalf of the county for these services cannot.

The TRIP program allows a county or municipality to certify certain debt to the State Department of Revenue (DOR), resulting in DOR reducing the size of an individual’s income tax refund to collect on this debt. Under current law, private ambulance services are unable to use the TRIP process even though they are providing emergency services on behalf of a local unit of government.

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2015 Health Care Advocate Nygren Confirms Support for WHA Key Priorities
Nygren says he has DSH support; does not favor worker’s comp fee schedule


In accepting the WHA 2015 Health Care Advocate of the Year Award at the Advocacy Day event April 28, Rep. John Nygren (R-Marinette) voiced his support for several of WHA’s key legislative priorities, including making the Disproportionate Share Hospital (DSH) program permanent and keeping government imposed fee schedules out of Wisconsin’s Worker’s Compensation system. 

“It is a desire and one of the goals of WHA in this legislative session and in this budget to make the DSH program permanent,” Nygren said. “I think we have the support so we will try to move forward to make it permanent.” 

On another important WHA priority, Nygren said he supports a process that will bring all parties together to resolve differences over changes that have been proposed in the worker’s compensation program.

“It is my goal not to have another government-driven program relying on fee schedules, much like Medicaid, in our worker’s compensation program,” Nygren told the more than 1,000 hospital supporters in attendance. “It is my desire to bring both sides together so all parties can reach agreement because there is something special here the way we have built the worker’s compensation program, and the way we continue to provide a dialogue for all parties to have their concerns addressed.” 

WHA Immediate Past Board Chair Ed Harding, president/CEO of Bay Area Medical Center in Marinette, presented the award to Nygren in recognition of his collaborative efforts with hospitals and health care systems on several key issues.

Harding commended Nygren on his work to curb opiate and heroin abuse in Wisconsin by authoring and championing the bipartisan Heroin and Opiate Prevention and Education (HOPE) agenda. Harding noted that this legislative package has propelled a necessary statewide conversation about the impact opiate and heroin addiction have on Wisconsin families and communities. 

Harding noted that Nygren has also been very supportive of WHA’s physician workforce agenda, demonstrated by his efforts to strengthen a provision in the last budget that expanded opportunities for physicians to complete post-graduate training in Wisconsin. This initiative has resulted in the creation of 60 new residency slots in more than 20 Wisconsin counties. 

Read the news release: www.wha.org/nr4-29-15nygren.aspx. See Nygren’s acceptance speech: http://youtu.be/bRdW8jOP5oY.

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Wheaton Franciscan - St. Joseph Campus Receives WHA 2015 Advocacy All-Star Award

Wheaton Franciscan - St. Joseph Campus, Milwaukee, received the Wisconsin Hospital Association (WHA) 2015 Advocacy All-Star Award at the Association’s annual Advocacy Day in Madison April 28. 

Debra Standridge, President of Wheaton’s North Market, accepted the award before 1,100 hospital supporters participating in the day’s activities. The award is presented to one hospital each year that exemplifies dedication to grassroots advocacy. 

Standridge said she was honored to accept the award on behalf of the hospital’s Board of Directors and the physicians, nurses, associates and volunteers, but she recognized all Wisconsin hospitals for their advocacy efforts. 

“We know we have a strong collective voice that is being heard and it is gaining traction in the State Capitol. We are more than ready to continue those vital conversations with our legislators,” Standridge said in accepting the award. “We are anxious to be supporting the priorities that are essential to Wisconsin’s hospitals as we continue to deliver the care we know makes a difference every day in our patients’ lives.” 

Over the past year, the hospital’s advocates have regularly contacted, hosted and met with their elected officials to discuss important health care issues, including advocating for improvements in Wisconsin’s Medicaid program. They have traveled to Washington, DC with WHA multiple times to make certain legislators are aware of how federal issues impact the hospital and local community. 

“Wheaton Franciscan Healthcare, with Deb’s great leadership, has been a dedicated partner to advancing positive health care policy in Madison and Washington, D.C.,” said Jenny Boese, WHA vice president, federal affairs & advocacy. “WHA has the pleasure of working alongside their entire team, and they are well-deserving of this honor.”

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Registration Open for 2015 Wisconsin Rural Health Conference, June 17-19

Register today and join your colleagues at the 2015 Wisconsin Rural Health Conference, scheduled June 17-19 at Glacier Canyon Lodge at The Wilderness Resort in Wisconsin Dells. This annual event is the forum for examining the issues that impact small and rural hospitals most, networking with colleagues and collaborating with your team of senior staff and trustees.

Each year, WHA’s Council on Rural Health acts as the planning committee for this conference, and once again in 2015, they have crafted an interesting and diverse education agenda. Attendees of the annual Wisconsin Rural Health Conference will discuss public policy issues affecting rural health care, identify how the delivery of and access to rural health care are changing, and identify ways data and technology are improving health care for rural populations. The conference will again include the popular education track focused on governance and trustee issues.

This year’s opening keynote speaker is Andrew Cohen of Kaufman Hall, who will examine business model changes from hospital-centric sick care to community-centric health care, will define the impact of the business model disruption on providers, and will provide practical information to prepare for the payer and purchaser expectations of the future.

The annual Wisconsin Rural Health Conference is a great way for hospital executives, leadership staff and trustees to take advantage of quality education, right in your backyard. Make attendance at this year’s conference a priority. Online registration is available at http://events.SignUp4.net/15Rural.

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Partners of WHA Donates $2.27 Million, 1.45 Million Volunteer Hours in 2014

Partners of WHA, Inc., the non-profit, volunteer service organization affiliated with WHA, raised and donated over $2.27 million to hospitals throughout the state for needed equipment and other capital projects in 2014. This was accomplished through over 500 separate fundraising activities conducted by local Partners groups in 2014.

In addition, Partners members volunteered 1.45 million hours of service to Wisconsin hospitals in 2014, as reported by Bonnie Olson, current president of Partners of WHA. The financial value of a volunteer’s time has been estimated nationally at $22.55 per hour, based on a 2013 report from Independent Sector in Washington, D.C. At that rate, the Partners volunteers donated a total value of $32.8 million in time and services to Wisconsin hospitals and health systems during 2014. 

Partners of WHA awarded nearly $490,000 through 433 scholarships to both traditional and non-traditional students seeking health care-related degrees in 2014. Over 400 community health education projects were also planned and implemented by local Partners of WHA groups in 2014.

Partners of WHA is comprised of over 10,000 volunteers and auxilians at 71 Wisconsin hospitals. 

Founded in 1951 as Wisconsin Hospital Association Auxiliaries, Partners emphasizes volunteer service and participation in grassroots advocacy, public policy and community health education, and health career programs for Wisconsin hospitals. Additionally, Partners promotes leadership development by offering resources and educational seminars to local hospital volunteer and auxiliary groups, and shares information on successful community health education initiatives, advocacy and fundraising activities and trends on volunteerism through a variety of channels, including its annual fall convention and quarterly newsletter, Reaching Out.

If you are interested in your hospital’s volunteer and/or auxilian group becoming part of the statewide Partners of WHA organization, visit www.partnersofwha.org or contact Jennifer Frank, WHA’s liaison to Partners, at 608-274-1820 or jfrank@wha.org.

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