September 26, 2014
Volume 57, Issue 39


Court of Appeals Unanimously Upholds State Employee Damage Cap
WHAís advocacy efforts extend to the courtroom

A three-judge panel of Wisconsinís District IV Court of Appeals on September 25 unanimously upheld the constitutionality of Wisconsinís $250,000 cap on damages recoverable against state employees. The Courtís opinion in Fiez v. Keevil can be found at http://wicourts.gov/ca/opinion/DisplayDocument.pdf?content=pdf&seqNo=122448.

"We conclude that, in light of existing precedent, the Fiezes have not shown a basis to conclude that the $250,000 statutory cap on damages from state employees violates the state constitutionís equal protection, jury trial, or certain remedy clauses," wrote the Court in a per curiam opinion.

WHA and the Wisconsin Medical Society filed a joint amicus brief with the Court in May, and had asked the Court to consider the broader context in which the statutory cap on damages applicable to state employees operates. Attorney Guy DuBeau, Axley Brynelson, wrote and filed the brief on behalf of WHA and the Wisconsin Medical Society.

"It is for good reason that our Supreme Court cautions that the judiciary is not as well positioned as the Legislature to make the economic, social and political judgments involved in a matter like this," wrote DuBeau.

The plaintiffs will have an opportunity to appeal the Court of Appealsí decision to the Wisconsin Supreme Court.

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Survey of 20,000 U.S. Physicians: 80% of Docs Over-Extended or at Full Capacity
Wisconsin response mimics national findings

U.S. patients are likely to face growing challenges in access to care if shifting patterns in medical practice configurations and physician workforce trends continue. This is one of the key findings of a major new survey of 20,000 physicians conducted for The Physicians Foundation, a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of health care to patients.

According to the research, titled "2014 Survey of Americaís Physicians: Practice Patterns and Perspectives," 81 percent of physicians describe themselves as either over-extended or at full capacity, while only 19 percent indicate they have time to see more patients. Survey responses from physicians in Wisconsin indicate that 78 percent of physicians in the state are overextended or at full capacity.

"Expansion of our Wisconsin medical schools as well as state-based GME programs are important steps in efforts to increase capacity throughout the state," said WHA Chief Medical Officer Chuck Shabino, MD.

Forty-four percent of physicians surveyed plan to take steps that would reduce patient access to their services, including cutting back on patients seen, retiring, working part-time, closing their practice to new patients or seeking non-clinical jobs, leading to the potential loss of tens of thousands of full-time-equivalents (FTEs). In Wisconsin, 46 percent of physicians plan to take such steps.

"Americaís physician workforce is undergoing significant changes," said Walker Ray, MD, vice president of The Physicians Foundation and chair of its Research Committee. "Physicians are younger, more are working in employed practice settings and more are leaving private practice. This new guard of physicians report having less capacity to take on additional patients. These trends carry significant implications for patient access to care. With more physicians retiring and an increasing number of doctors, particularly younger physicians, planning to switch in whole or in part to concierge medicine, we could see a limiting effect on physician supply and, ultimately, on the ability of the U.S. health care system to properly care for millions of new patients."

The survey, conducted online from March 2014 through June 2014 by Merritt Hawkins for The Physicians Foundation, is based on responses from 20,088 physicians across the U.S. The overall margin of error (MOE) for the entire survey is less than two percent, indicating a very low sampling error for a survey designed to draw opinions and perspectives from a large population.

Responses to the survey are broken out by state. Wisconsin Hospital Association members who would like a copy of survey results for their state may call Kurt Mosley of Merritt Hawkins at 800-876-0500 or email Kurt.Mosley@amnhealthcare.com.

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RWHC to Establish Behavioral Telehealth Network

The Rural Wisconsin Health Cooperative (RWHC) has received a three-year Rural Health Network Development Grant to establish a Behavioral Telehealth Network. The $897,000 grant from the Health Resources and Services Administration will improve access to behavioral health in rural Wisconsin communities.

The RWHC Behavioral Telehealth Network will be designed to align behavioral health resources available in urban locations with the need for such services in rural communities. Access to behavioral health clinicians is a challenge statewide, but especially for those located in mental health professional shortage areas. Eight rural community hospitals in Wisconsin have committed to driving improvement in patient access to behavioral health services by participating in the development of the network.

"Access to behavior health services is one of the most difficult challenges for rural health. Using technology to connect rural patients to new or existing service locations has great promise," said Tim Size, RWHCís executive director.

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Health Law Manual Webinar: Medical Staff, Labor & Employment

WHA will continue its complimentary webinar series October 2 from 12-1:30 p.m. with a presentation of the "WHA Medical Staff, Labor & Employment Manual." This webinar will cover four broad issues faced by hospitals as employers: caregiver background checks and investigation of caregiver misconduct; family and medical leave and military leave issues; drug testing, including reasonable suspicion versus random drug testing policies; and the intersection of peer review privilege and employment law, including Wisconsinís peer review privilege, medical staff bylaws, hospital rights and immunities, and reporting requirements.

WHA members are encouraged to register for this webinar as well as any of the other webinars remaining in the series. Registration and additional information about each of the remaining webinars can be found at http://events.SignUp4.net/HealthLawManual. Attorneys in attendance may earn CLE credit.

This webinar will be presented by Ralph V. Topinka, Doris E. Brosnan, and Meghan C. OíConnor of the law firm of von Briesen & Roper.

The health law manuals are available for WHA members to view and download at www.wha.org/healthLawManual.aspx. WHA members who would like access to the manuals should contact webmaster@wha.org to request a username and password.

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Hospitals Host Senators for Roundtable Discussions

State Sen. Sheila Harsdorf and State Sen. Tom Tiffany were both hosted by their local hospitals for a roundtable discussion on important hospital and health care system issues. Burnett Medical Center (Grantsburg) hosted Sen. Harsdorf and more than 15 hospitals and physician leaders from across the district, while Ministry St. Maryís Hospital (Rhinelander) hosted Sen. Tiffany for a similar discussion.

Both groups discussed ongoing issues with inadequate Medicaid reimbursement for hospitals and how this underfunding creates a "hidden health care tax" on Wisconsin employers who provide private insurance coverage to their employees. This led to discussions about the experience hospitals are having with Medicaid and exchange enrollment. Hospital leaders expressed concern with the "take-up" rate so far, which is about 54 percent according to official Wisconsin Department of Health Services (DHS) numbers, far below the 90-93 percent that was projected by DHS. Group discussions also included workforce capacity and future needs, workers compensation and others.

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RTT Collaborative Annual Meeting: Moving Forward in the Face of Chaos
Call for presentations

The RTT Collaborative Annual Meeting (formerly known as the RTT Conclave) will be held in Madison and Baraboo May 27-29, 2015, and is now requesting presentations.

The Collaborative is particularly interested in presentations that highlight creative solutions to rural residency program challenges in the face of uncertainty. The submission deadline is October 20, 2014.

There is only one presentation format, a 50-minute lecture-discussion or workshop. More information and a submission form are available at www.rttcollaborative.net/news.html. If you have questions, contact Dawn Mollica at mollicd1@ohio.edu or 740-593-2253.

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