May 15, 2015
Volume 59, Issue 19


Finance Committee Makes Changes to Emergency Detention Procedures 
Adopts WHA modification preserving use of telephonic crisis assessments in ERs 


The Legislature’s budget-writing Joint Committee on Finance made several changes to proposals in the biennial budget bill impacting emergency detention procedures in Wisconsin. The Governor’s budget proposal would require that a county conduct a crisis assessment before the county may approve an emergency detention. The Department of Administration (DOA) submitted an errata letter that stated the Governor’s intention in the bill was to also prohibit these assessments from being conducted in a psychiatric hospital.

In a memo to the Committee, WHA raised concerns with the impact of adopting the crisis assessment requirement in state law since “crisis assessment” remains undefined in the statutes. WHA asked the Committee to make a clarification in the budget bill explicitly permitting that a telephonic assessment can be done by the county with or without video capability, since the lack of definition has resulted in ambiguity in the law and different interpretations by county agencies across the state. The Committee chose to accept this recommendation and incorporated the telephonic provision into the budget bill.

“Especially for hospital emergency departments in rural counties, it is important that crisis agencies have the option to conduct a crisis assessment telephonically,” said Matthew Stanford, WHA general counsel. “WHA was concerned that requiring ‘in-person’ crisis assessments by county crisis personnel would have resulted in longer delays for patients and law enforcement in the emergency department as they awaited the arrival of county crisis staff to the hospital.”

WHA also asked the Committee to not adopt the requested language change from DOA prohibiting an assessment from being conducted in a psychiatric hospital. In a memo to the Committee, WHA stated the policy could result in “such assessments occurring more often in general hospital ERs rather than in a specialized psychiatric setting,” especially in those communities that have invested in a psychiatric hospital. Under the errata language, WHA raised concerns that without adequate community-based crisis assessment services, the errata language would have likely resulted in assessments currently done at the Milwaukee County Psychiatric Crisis Services (PCS) facility being shifted to general hospital emergency departments. 

The Committee moved forward with WHA’s recommendation and chose not to adopt the errata language related to psychiatric hospitals. The budget bill as recommended by the Finance Committee, would maintain current law related to where a crisis assessment could be conducted. These provisions, if maintained in the budget bill, would take effect July 1, 2016.

The motion, authored by Rep. Dean Knudson (R-Hudson) and Sen. Leah Vukmir (R-Wauwatosa), would also allow the Department of Health Services (DHS) to determine which mental health professionals would be authorized to conduct a crisis assessment. In comments before the Committee about who would be authorized by the Department, Knudson stated he “hope[s] they (DHS) use discretion very carefully, in that they consult with stakeholder groups and ensure that it is done by qualified individuals who can perform an accurate assessment.”

The Joint Finance Committee also deleted the Governor’s recommendation to remove an emergency detention requirement applicable only to Milwaukee County that requires a special “treatment director supplement” procedure to occur within 24 hours of arrival at a “treatment facility,” extended a pilot program for emergency detention procedures in Milwaukee County until July 1, 2017, and approved 
$1.5 million in one-time grants to counties to improve existing crisis services.

See WHA’s memo to the Finance Committee here: www.wha.org/pdf/EmergencyDetention5-9-15.pdf


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Political Action Spotlight: Are You on the List?
Political Action Fundraising Campaign Update - 47% of Goal 


The Wisconsin Hospitals Conduit and State PAC annual fundraising campaign has raised more than $128,000 from 129 individuals since the beginning of the year. The Campaign will officially kick off the week of May 18 when leaders can expect to receive their packets in the mail. 

This puts the 2015 campaign at over 47 percent of the $270,000 goal—the highest goal ever set by the annual campaign. The 2015 Campaign’s progress is outpacing last year by more than $58,000. 

In fact, the average contribution ($992 v. $862), the number of participants (129 v. 80) and Platinum Club members, those who contribute at $1,500 or more, (42 v. 29) are all outpacing last year’s numbers at this same time, making for a very strong launch to this year’s campaign. If this trend continues, it will enable the campaign to meet the two percent increase over last year’s goal.

Individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. A special thanks to those individuals who are the first contributors in the 2015 campaign and who are listed below. Contributors are listed alphabetically by contribution amount category. The next publication of the contributor list will be in the May 29 edition of The Valued Voice. For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

Contributors Ranging from $1 - $499
Anderson, Phil Sacred Heart Hospital
Appleby, Jane Aurora Health Care
Ballentine, Anne Wheaton Franciscan Healthcare
Brenny, Terrence Stoughton Hospital
Cardinal, Lori Agnesian HealthCare
Carter, Shane Aurora Medical Center - Oshkosh
Clark, Renee Fort HealthCare
Collins, Sherry Wisconsin Hospital Association
Colman, Gerard Aurora Health Care
Cormier, Laura Bellin Hospital
Culotta, Jennifer St. Clare Hospital & Health Svcs
Dux, Larry Froedtert & MCW Community Mem. Hosp
Feeney, John Community Health Network, Inc.
Freitag, Vanessa                       Our Lady of Victory Hospital
Hafeman, Paul St. Vincent Hospital
Hamilton, Mark UW Hospitals and Clinics
Harrington, Kathleen Mayo Health System - Eau Claire
Jelle, Laura St. Clare Hospital & Health Services
Knutzen, Barbara Agnesian HealthCare
Leschke, John Mercy Medical Center
Lynch, Sue Mayo Health System - Franciscan HC
McArdle, PeggyAnn Agnesian HealthCare
McMeans, Scott Holy Family Memorial
O'Hara, Tiffanie Sundial Software
Peiffer, Susan Sacred Heart Hospital
Roundy, Ann Columbus Community Hospital
Schubring, Randy Mayo Health System - Eau Claire
Selle, Ginger St. Clare Hospital & Health Services
Statz, Darrell Rural Wisconsin Health Cooperative
Swanson, Kaitlin HSHS-Eastern WI Division
Tapper, Joy Milwaukee Health Care Partnership
Theiler, Brian Gundersen Tri-County Hospitals & Clinics 
Walker, Troy St. Clare Hospital & Health Services
Werkheiser, Cindy Monroe Clinic
Wheeler, Susan St. Nicholas Hospital
Whitinger, Margaret Agnesian HealthCare
Wold, Gwen Amery Regional Medical Center
Contributors Ranging from $500 - $999
Bagnall, Andrew St. Nicholas Hospital
Bailet, Jeffrey Aurora Health Care
Bard, Jeffrey Aurora Medical Center - Oshkosh
Dexter, Donn Mayo Health System - Eau Claire
Dicus-Johnson, Coreen Wheaton Franciscan Healthcarel
Dolohanty, Naomi Aurora Health Care
Golanowski, Marie Aurora St. Luke’s Medical Center
Graul, Mark Children’s Hospital of Wisconsin
Gustafson, Andy SSM Health Care-Wisconsin
Hanson, Gail Aurora Health Care
Heaney, Dwight Fort HealthCare 
Jacobson, Terry St. Mary’s Hospital of Superior
Kingston, Mary Beth Aurora Health Care
Kirsch, Jennifer Gundersen Health System
Lange, George Westgate Medical Group, CSMCP
Larson, Margaret Mercy Medical Center
Latta, Richard Godfrey & Kahn, SC 
Mohorek, Ronald Ministry Health Care
Nelson, James Fort HealthCare
O’Day, Thomas Godfrey & Kahn, SC
Oland, Charisse Rusk County Memorial Hospital
Ose, Peggy Riverview Hospital Association 
Quinn, George Wisconsin Hospital Association
Reardon, Brian Hospital Sisters Health System
Rozenfeld, Jon St. Mary’s Hospital - Madison
Rude, Nels The Kammer Group
Seitz, Verna ProHealth Care, Inc.
Selberg, Heidi HSHS-Eastern Wisconsin Division
Shabino, Charles Wisconsin Hospital Association
Shorter, Tom Godfrey & Kahn, SC
Simaras, Jim Wheaton Franciscan Healthcare
Teigen, Seth St. Mary’s Hospital 
Van Meeteren, Bob Reedsburg Area Medical Center
Yaron, Rachel Ministry St. Clare’s Hospital
Zenk, Ann Ministry St. Mary’s Hospital
Contributors Ranging from $1,000 - $1,499
Ashenhurst, Karla Ministry Health Care
Bloch, Jodi Wisconsin Hospital Association
Brenton, Andrew Wisconsin Hospital Association 
Connors, Larry St. Mary's & St. Vincent Hospital
Cullen-Schultz, Jeannie JP Cullen & Sons
Just, Lisa Aurora Health Care-South Region
Kerwin, George Bellin Hospital
Killoran, Carrie Aurora Health Care
Punzenberger, Lindsay Children’s Hospital of Wisconsin 
Rickelman, Debbie WHA Information Center
Roller, Rachel Aurora Health Care
Rush, Steven Wisconsin Hospital Association
Sato, Thomas Children’s Hospital of Wisconsin
Schafer, Michael Spooner Health System
Swanson, Kerry St. Mary’s Janesville Hospital
White-Jacobs, Mary Beth          Black River Memorial Hospital
Wolf, Edward Lakeview Medical Center
Contributors Ranging from $1,500 - $1,999
Boese, Jennifer Wisconsin Hospital Association 
Clapp, Nicole Grant Regional Health Center 
Court, Kelly Wisconsin Hospital Association 
Decker, Michael Divine Savior Healthcare 
Frank, Jennifer Wisconsin Hospital Association 
Grasmick, Mary Kay Wisconsin Hospital Association 
Harding, Edward Bay Area Medical Center
Kammer, Peter The Kammer Group
McKevett, Timothy Beloit Health System
Natzke, Ryan Marshfield Clinic 
Russell, John Columbus Community Hospital 
Schulze, Connie Ministry Health Care 
Sheehan, John UW Hospitals and Clinics
Wallace, Michael Fort HealthCare
Contributors Ranging from $2,000 - $2,999
Alig, Joanne Wisconsin Hospital Association
Anderson, Sandy St. Clare Hospital & Health Svcs
Duncan, Robert Children's Hospital & Health System
Herzog, Mark Holy Family Memorial
Jacobson, Catherine Froedtert & The MCW 
Kachelski, Joe WI Statewide Health Info Network 
Leitch, Laura Hall Render
Levin, Jeremy Rural Wisconsin Health Cooperative 
Lewis, Gordon Burnett Medical Center 
Mettner, Michelle Children’s Hospital of Wisconsin 
Pandl, Therese HSHS-Eastern Wisconsin Division
Meyer, Daniel Aurora BayCare Medical Ctr Green Bay
Potter, Brian Wisconsin Hospital Association
Potts, Dennis Aurora St. Luke’s Medical Center
Sanders, Michael Monroe Clinic 
Sliwinski, Ron UW Hospitals and Clinics
Stanford, Matthew Wisconsin Hospital Association
Troy, Peggy Children’s Hospital of Wisconsin
Contributors Ranging from $3,000 - $4,999
Boatwright, Damond SSM Health Care-Wisconsin
Brenton, Stephen Wisconsin Hospital Association
Hilt, Monica Ministry St. Mary’s Hospital
Little, Steve Agnesian Health Care
Neufelder, Dan Ministry Health Care
Normington, Jeremy Mercy Medical Center
O’Brien, Kyle Wisconsin Hospital Association
Size, Tim Rural Wisconsin Health Cooperative
Standridge, Deb Wheaton Franciscan Healthcare
Starmann-Harrison, Mary  Hospital Sisters Health System
Turkal, Nick Aurora Health Care
Contributors Ranging from $5,000+
Borgerding, Eric & Dana   Wisconsin Hospital Association
Tyre, Scott Capitol Navigators, Inc.


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New Legislator Profile: Rep. Mark Spreitzer, (D-Beloit)
Rep. Spreitzer Concerned with Impact of King v. Burwell Decision in Wisconsin


The Supreme Court’s ruling on King v. Burwell could have a dramatic and immediate impact on Wisconsin. Rep. Mark Spreitzer is among those who are deeply concerned about the ramifications that decision could have on tens of thousands of people here. He believes Wisconsin must create its own exchange and be ready with a Wisconsin solution if the Supreme Court strikes down subsidies. 

“We can’t expect Congress will fix this problem,” Spreitzer told WHA Valued Voice Editor Mary Kay Grasmick. 

Spreitzer has a goal of learning more about the hospitals and health care facilities in his district this summer. 
He personally met with his constituents at his State Capitol office during WHA’s Advocacy Day April 28, where he learned about the WHA-supported bill that would create an interstate physician licensure compact in Wisconsin. 

“I had a good conversation with hospital constituents during Advocacy Day about that issue, and it is certainly relevant to my district,” Spreitzer said. “It sounds like a reasonable approach, and I plan to support it.” 

Spreitzer understands the importance of supporting the Medicaid program, too, not just to ensure the most vulnerable citizens have access to care, but he also believes providers must receive adequate reimbursement. He supports reauthorizing the Disproportionate Share Hospital program (DSH). 

“We need to make sure we have a good Medicaid system and that we adequately reimburse hospitals,” while noting that he believes Wisconsin should “take the Medicaid expansion.” 

Representing a largely rural district, Spreitzer feels it is important to create an environment that attracts health care professionals.

“I have many small communities in my district where recruiting a physician to practice in those areas can be difficult,” he said. “We have to make sure we have nurses and physicians who are interested in practicing in rural areas that are underserved.” 

Spreitzer is familiar with the challenges associated with providing care to those with physical and mental health issues. His mother is a social worker in the Chicago area. 

“Mental health is on my radar. It needs to be part of the health conversation,” according to Spreitzer. “We can’t separate mental health from physical health if we are talking about treating the whole person.” 

Elected to the State Assembly in November 2014, Spreitzer represents parts of the City of Beloit and the surrounding rural communities in Green and Rock Counties. He served on the Beloit City Council from 2011 to 2015, serving as President of the Council during a portion of that term. Spreitzer is a 2009 graduate of Beloit College and worked as an assistant director of alumni & parent relations and annual support for the college before taking office. 

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WHA Sends Letter to Hill: No Medicare Cuts for TAA

The Wisconsin Hospital Association (WHA) continued to urge Wisconsin Members of Congress to strike language from pending trade legislation that would increase sequester cuts on Medicare providers.

“While WHA does not have a position on the underlying package of trade legislation, WHA and our hospitals and health systems strongly oppose using a health care offset on non-health care related legislation, such as the Trade Adjustment Assistance (TAA) bill,” said WHA President/CEO Eric Borgerding in the letter to Wisconsin’s entire Congressional delegation. “TAA legislation not only uses Medicare sequester cuts as an offset, but also increases the net impact of Medicare sequester beyond the original 2.0 percent per year statutorily set under the Budget Control Act.”

The letter follows on the heels of a series of face-to-face meetings WHA and hospital leaders had in Washington, D.C. with members of Wisconsin’s Delegation on this issue and others. In addition, WHA has previously communicated opposition to U.S. House Ways & Means Committee Chairman Paul Ryan. 

WHA continues to oppose use of health care cuts to fund other Congressional legislation or priorities, especially in light of Wisconsin’s continued ranking as a high-quality, high-value health care state. 

Read the letter at: www.wha.org/pdf/TAASequesterJohnson5-13-15.pdf.

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Finance Committee Pulls Long-Term Care Changes from Budget
Committee charges DHS with developing “limited reforms” with “strong legislative oversight”


Members of the state’s budget-writing Joint Finance Committee announced May 14 that the Committee will not be moving forward with changes in Gov. Scott Walker’s proposed budget to the state’s Medicaid long-term care programs, Family Care and IRIS. The co-chairs of the Committee, Sen. Alberta Darling (R-River Hills) and Rep. John Nygren (R-Marinette), and lead Republican health care policy members Sen. Leah Vukmir (R-Wauwatosa) and Rep. Dean Knudson (R- Hudson), released a statement to the press announcing their decision.

The announcement rejects the Governor’s proposal, which would have changed the Family Care program and moved toward a statewide model for providing long-term care services instead of the regional model that exists today. The Governor’s proposal also would have required the incorporation of primary care and acute care services into the Family Care benefit, instead of separately as a fee-for-service benefit to enrollees.

The announcement stated that the legislators would move forward with a plan that would pursue “limited reforms” with “strong legislative oversight” to protect self-directed care, preserve Aging and Disability Resource Center (ADRC) services and require the acceptance of “any willing provider” while transitioning to a new regional model with multiple Integrated Health Agencies (IHA) in every region. The Committee’s proposal would direct the state Department of Health Services to negotiate the proposed plan via a waiver with the federal government.

For a copy of the press release, click here: www.wha.org/pdf/LongTermCare5-14-15.pdf.

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WHA Convenes Group to Discuss Meaningful Use Proposed Rules

WHA convened a meeting May 13 to discuss three recently-proposed rules that would make significant changes to the reporting requirements of the Centers for Medicare & Medicaid Services (CMS) “Meaningful Use” Program. CMS, through the meaningful use program, levies Medicare penalties on hospitals and physicians that fail to adopt and meaningfully use EHR technology. 

An interdisciplinary group of WHA members that included hospital CEOs, CIOs, physician leaders and quality improvement leaders was at the meeting. The key proposals discussed were: 

While WHA supports several of the provisions in the proposed rules that give hospitals and physicians more flexibility, WHA is also concerned that many of the proposals raise the bar significantly on what hospitals and physicians are required to do to avoid Medicare penalties.

In addition to the May 13 meeting, WHA has been soliciting other input from members on various issues related to the proposed rules, including conducting a survey that asks specific questions related to some of the proposed changes. Collectively, this member input will help guide WHA’s comment letters to the federal Department of Health and Human Services on the proposed rules as well as other related advocacy efforts. Comments on two of the proposed rules are due May 29, and comments on the other proposed rule are due June 15.

For additional information, contact WHA’s Andrew Brenton at 608-274-1820 or abrenton@wha.org.

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Randall Joins WHA Quality Department

WHA is pleased to announce Katie Randall joined the WHA quality reporting and performance improvement department as a quality assistant. In her role, Randall will support the WHA Partners for Patients initiative as well as other WHA efforts including Transforming Care at the Bedside.

Randall received a bachelor’s degree from the University of Wisconsin-Eau Claire in health care administration. Prior to joining WHA, Randall worked in a similar role in a busy orthodontic clinic in the Twin Cities. A native of Tomah, she is happy to be back in Wisconsin.

“Katie’s enthusiasm for the work we are doing, her health care background and ‘members first’ approach will be a great asset for our hospital QI departments that are looking to us for information and resources,” said WHA Quality Manager Stephanie Sobczak. “She’s been a great contributor to our team since the day she began.”

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WI Rural Health Conference, June 17-19: Register Today
Hotel reservation deadline is May 27


Register today to join your colleagues at the 2015 Wisconsin Rural Health Conference. Scheduled June 17-19, this is the premier statewide forum for hospital executives, leadership staff and trustees to join together to examine issues that impact rural hospitals, while networking and collaborating with colleagues and each other. 

As a reminder, hotel reservations must be made by May 27 to ensure a reservation and to receive the special conference group rate. Remember, June is a very busy time in Wisconsin Dells, so it is very likely that hotel rooms will not be available to conference attendees after May 27. It is recommended that you make your hotel reservations immediately if you plan to attend.

This year’s conference will include an outstanding opening keynote session by Andrew Cohen; the ever-popular state of Wisconsin health care session presented by the leaders of the Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative; and an inspirational closing session by Ronan Tynan, one of the internationally-famous Irish Tenors.

A full brochure is included in today’s packet. In addition, online registration and full conference information are available at http://events.SignUp4.net/15Rural.

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May is National Stroke Awareness Month

According to the CDC, stroke is the fifth leading cause of death in the United States, killing nearly 130,000 Americans each year—that’s 1 of every 20 deaths. Someone in the U.S. has a stroke every 40 seconds. Every four minutes, someone dies of stroke. Every year, about 800,000 people in the U.S. have a stroke. About 610,000 of these are first or new strokes; 185,000 are recurrent strokes. Stroke is an important cause of disability and reduces mobility in more than half of stroke survivors age 65 and over. Stroke costs the nation $34 billion annually, including the cost of health care services, medications, and lost productivity. You cannot control some stroke risk factors, like heredity, age, gender, and ethnicity. Some medical conditions—including high blood pressure, high cholesterol, heart disease, diabetes, overweight or obesity, and previous stroke or transient ischemic attack (TIA)—can also raise your stroke risk. Avoiding smoking and drinking too much alcohol, eating a balanced diet, and getting exercise are all choices you can make to reduce your risk.

According to the WHA Information Center, In calendar year 2014 there were 6,779 inpatient admissions, 1,808 emergency room visits (treated and released), 646 observation care visits, and 9,959 hospital ancillary service visits where primary or secondary treatment was for stroke. 

Data provided by the WHAIC (www.whainfocenter.com)

The WHA Information Center is dedicated to collecting, analyzing and disseminating complete, accurate and timely data and reports about charges, utilization, quality and efficiency provided by Wisconsin hospitals, ambulatory surgery centers and other health care providers.

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2015 Hospital Week: WHA, AHA Promote Member Hospitals in Videos

Wisconsin hospitals care for more than 600,000 patients every year, providing some of the highest quality care in the nation. So far this year, Wisconsin has been recognized by two federal agencies. First, Wisconsin hospitals received some of the highest ratings for HCAHPS/patient experience scores in the country, as reported by the Centers for Medicare and Medicaid Services (CMS). And, Wisconsin was ranked as the second highest state in quality health care by the Agency for Healthcare Research and Quality (AHRQ). 

“There is a genuine commitment from our smallest rural hospitals to our largest urban hospitals to delivering better care, doing it more efficiently and more cost effectively. It is an asset for our state,” says WHA President/CEO Eric Borgerding in a video that premiered at WHA’s 2015 Advocacy Day to an audience of more than 1,000 hospital supporters. Watch the video here: http://youtu.be/cE5d-h-iyi8

Wisconsin’s reputation as a high-quality, high-value state was built on the hard work and the commitment to clinical excellence of the state’s health care professionals. 

“As we celebrate Hospital Week, we at WHA want to say ‘thanks’ to the men and women in our state working on the front lines or in support and administrative services who are putting the patient first, and by doing so, have built a sterling reputation for health care in Wisconsin,” Borgerding said. 

In recognition of National Hospital Week, the American Hospital Association also released a new video. Watch it here: https://www.youtube.com/watch?v=KTflFkcxdlg

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Member News: Edgerton Hospital Announces New CEO

Edgerton Hospital’s Board of Trustees announced Jim Schultz has been appointed the new chief executive officer (CEO). Schultz has been interim CEO for the hospital since July 2014, and has served as an active Board of Trustees member for the past 10 years, holding the position of Board Chair for five years and Foundation Board Chair for four years. 

“I am honored to be accepting the position of CEO for Edgerton Hospital,” said Schultz. “My goal has been, and will continue to be, to help ensure that this innovative, environmentally-friendly facility, as well as our patient-focused philosophy of high-quality home town care, will continue being offered to our area communities far into the future.”

Schultz has been active in Edgerton Hospital’s future in various capacities over the last 25 years, but his roots are also deep in education and business management. He has more than 45 years with the Edgerton School District, holding positions ranging from business education instructor to director of career/technical education to educational consultant. In 1990, Schultz implemented a nationally-recognized health services program between Edgerton High School, Blackhawk Technical College and Edgerton Hospital. 

Schultz received his BA degree from Wartburg College in Business Administration/Education and has done graduate studies at UW-Madison. He continues to contribute to the business community through the City Re-development Authority and the Economic Development Corporation. 

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Register Now for Healthy Hospitals and Clinics Forum, June 5

Registration is open for the “What Health Looks Like: Healthy Food and Beverages in Wisconsin Hospitals and Clinics” forum, scheduled Friday, June 5 at the Sheraton Hotel in Madison. 

The Forum serves as a kick-off event for an ongoing organized statewide learning community for hospitals and clinics to share and learn about healthy food and beverage practices. The Forum’s day-long agenda will feature a best practices panel with speakers from UW Health, Aurora Health Care, and Hudson Hospital and Clinics. Breakout sessions will highlight success stories from hospitals and clinics throughout the state, including: Agnesian HealthCare, Upland Hills Health, Sauk Prairie Healthcare, Watertown Regional Medical Center, and many others. 

The full agenda and online registration are available here: www.wicancer.org/healthyforum.cfm. Registration is $50. Hospitals and clinics are encouraged to bring a team to the forum. For more information, contact Emily Reynolds, eareynolds@uwcarbone.wisc.edu, 608-262-7285, or Nan Peterson, npeterson@uwhealth.org, 608-262-9993.

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