January 27, 2012
Volume 56, Issue 4


Gov. Walker Focuses on Jobs, Small Businesses in State of the State Address

As the only sitting Governor to deliver a State of the State Address while facing the potential of a recall election, Governor Scott Walker used his opportunity to address this past yearís challenges and announce some new initiatives focused on jobs, small business, and a program aimed at improving the stateís reading scores. Speaking to a crowded Assembly Chamber, filled with cheers and jeers, Walker focused on the task at hand: describing the past yearís environment and laying out the year ahead.

"We are turning things around," the Governor said. "We are headed in the right direction." He reminded his audience that a year ago, the stateólike other states across the nationówas facing a significant budget deficit that was largely the result of past budget practices such as the use of one-time funds to pay for ongoing costs. "Some states cut core services like Medicaid. But in Wisconsin, we added some $1.2 billion to MedicaidÖ," he noted.

His priorities for the coming year include the creation of a Small Business Regulatory Review Board, charged with reviewing state agency rules and removing regulations that impede job creation. He also is forming a new task force charged with implementing the savings items identified in the recent report from the Waste, Fraud and Abuse Task Force. This report contained suggestions for combating fraud in a variety of state programs, including a focus on recipient fraud and errors in the stateís Medicaid program.

Walker didnít shy away from the controversial collective bargaining changes and reforms made last year. He says such changes have made a difference in the health care costs paid for by school districts and in their ability to hire and keep top performing teachers. He also announced the "Read to Lead" program to focus on raising support for reading programs and improving Wisconsinís national ranking in the 4th grade reading assessment.

Walker made only brief mention of the Medicaid program as noted above, and did not mention health care reform or his recent announcements around the insurance exchange. He stayed focused on his jobs, business creation and education messages.

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WHA Seminar Offers Guidance on Health Needs Assessment, Schedule H
In partnership with UW Population Health Institute and Healthy Wisconsin Leadership Institute

While hospitals are familiar with the requirements for filing Schedule H and know that the Affordable Care Act (ACA) requires that they complete a community health needs assessment, the process of "doing" has raised many questions as hospitals work through the process.

WHA, in partnership with the University of Wisconsin Population Health Institute and the Healthy Wisconsin Leadership Institute, are offering a one-day seminar, "Community Benefit for Health Improvement: Hospital, Public Health and Community Partnerships," March 23 at the Kalahari Resort in Wisconsin Dells.

The seminar will cover the basics of the ACA and IRS requirements, and acquaint participants with tools, strategies and resources that will be helpful as community health assessments are developed and implemented.

The day will start with a presentation by David Edquist, an attorney with the law firm von Briesen & Roper. Edquist will lay out the groundwork for community health needs assessments and discuss recent IRS guidance on common questions such as those involving community input, prioritization, implementation, and reporting. This session then goes beyond the basics to explore how to balance legal requirements and community expectations with the practical limitations facing member hospitals.

A successful community health improvement project starts by building strong partnerships. Julie Willems Van Dijk, deputy director for the County Health Roadmaps project at the University of Wisconsin Population Health Institute, will share tools and resources that support building a partnership between hospitals and public health.

Two successful local partnerships will be featured: St. Croix Countyís "Healthier Together" and the Milwaukee Healthcare Partnership. Four breakout sessions will be held in the afternoon, which will include:

Hospital community benefit managers, public relations staff, chief financial officers, and public health officers will benefit from the information and discussion at this day-long event. WHA members and public health officers registering by February 24 will receive an early bird discount rate of $50; after February 24 the registration fee is $65. The non-WHA member registration fee is $100.

A copy of the brochure is available in this weekís Friday packet. Complete information and online registration are available at http://events.SignUp4.com/CommunityBenefit12.

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Presidentís Column: Hospital Associationsí Letter to President Obama to "fix" Wage Index Manipulation

Twenty-one state hospital associations have asked President Obama to "fix" the Wage Index Manipulation (aka - Bay State Boondoggle) as part of his future budget proposal.

Our Coalition is seeking administrative address as opposed to aggressively lobbying Congress at this time given the importance of concentrating on stopping pending Medicare cuts. The field must concentrate on one issue at a time right now and the magnitude of another round of hospital cuts demands our full attention.

Nevertheless, "fixing" this outrage is a serious long-term objective. We want our money back!



Steve Brenton, 
President

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WHA Urges Congressional Delegation to Oppose Continued Assaults on Medicare Payments
Will lead DC Capitol Hill trip February 15

On behalf of Wisconsin hospitals, WHA President Steve Brenton wrote Wisconsinís Congressional Delegation this week in strong opposition to Medicare cuts that have reemerged as Congress wrestles with how to fund physician payments under the sustainable growth rate (SGR) among other provisions.

"On behalf of the members of the Wisconsin Hospital Association (WHA), I would like to express our continued opposition to hospital cuts as a means to funding physician payments or other proposals Congress may be discussing," Brentonís letter began. "Wisconsin hospitals strongly support correcting the sustainable growth rate formula (SGR), but cutting hospital payments is not an appropriate answer."

In late 2011, Congress faced cutting physician payments 27.4 percent under the SGR unless sufficient funding was found. Congress considered cuts to hospitals in order to find the money. Hospitals successfully fought those cuts last year, but another SGR deadline is looming, and some in Congress are again looking at hospital Medicare payments as a means to finding the necessary dollars.

"Two provisions of concern that arose in 2011 during debate on the SGR/extenders legislation were: cuts to hospital Medicare bad debt payments and cuts to Medicare payment rates for evaluation and management (E/M) services in hospital outpatient departments," said Brenton. "As one of our stateís strongest industries, several Medicare provisions currently being discussed in Congress would reduce hospital payments approximately $450 million and, when combined with other impending reductions, force Wisconsin hospitals to reassess programs, services or even future employment needs. WHA asks you to oppose these efforts to cut Medicare payments."

WHA estimates that the proposed cuts to E/M services would total $354 million over 10 years (and potentially upwards of $400 million) and that the cuts to Medicare bad debt would total $88 million over 10 years. (See table below for estimated impacts by Congressional District.)

Estimated Ten-Year Impact

OPPS Payments for E/M

Services

Estimated Ten-Year Impact

Bad Debt Payment Reduction

(All Settings)

Wisconsin Total

($353,434,358)

($87,798,940)

Paul Ryan

($38,178,254)

($6,874,419)

Tammy Baldwin

($122,689,880)

($9,110,575)

Ron Kind

($4,312,848)

($19,179,104)

Gwen Moore

($58,980,280)

($7,863,095)

James F. Sensenbrenner

($58,597,250)

($5,336,902)

Thomas Petri

($21,962,669)

($9,534,255)

Sean P. Duffy

($41,808,122)

($19,309,104)

Reid J. Ribble

($7,905,053)

($9,861,540)

To relay to Congress our continued opposition to these cuts, WHA will lead a trip to Washington, DC on February 15 in conjunction with the American Hospital Associationís Capitol Hill fly-in. WHA will coordinate, schedule and staff Hill visits on February 15 with Wisconsin Members of Congress. If you are planning to travel to DC for this event, please let WHAís Jenny Boese know at 608-268-1816 or jboese@wha.org.

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Grassroots Spotlight: Grant Regional Hosts State Officials

Secretary Dave Ross and Deputy Secretary Bill Wendle of the Wisconsin Department of Safety & Professional Services (DSPS) visited Grant Regional Health Center on January 19. The officials spoke with Nicole Clapp, president/CEO, and Betty Ingersoll, medical staff coordinator during their time in Lancaster. Ross and Wendleís visit was one of several made across the state to share information and gather feedback in an effort to improve the Departmentís services.

The DSPS was formerly known as the Department of Regulation & Licensing and is responsible for licensing and regulating 132 different types of credentials in more than 58 professional fields, including various health care professionals.

The DSPS administers education, experience, and examination requirements, sets professional practice standards, and ensures compliance by enforcing occupational licensing laws. The Department is organized into four divisions and the Office of the Secretary. The divisions are Board Services, Enforcement, Management Services, and Professional Credential Processing (including the Office of Education and Examination).

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Participate in the 2012 Wisconsin Health Care Employee Pride Program
Donít miss an opportunity to recognize your health care workforce

The Wisconsin Hospital Associationís commitment to publicly recognize the dedication of Wisconsinís health care workforce now spans a decade. Since 2002, the WHA Health Care Employee Pride Program has received hundreds of essays, poems and stories written by health care employees that passionately describe why they chose a career serving others.

The program encourages WHA member hospitals to invite their employees to express themselves in an essay and tell others why they chose a health occupation. The Pride Program gives employees the opportunity to share why they love their career of service to others, while giving the Association an opportunity to honor their contributions to their hospital, community and profession.

A designated leader from administration, human resources, public relations or patient care from WHA member hospitals is asked to coordinate the program. Employees are encouraged to submit to the hospital a 300-word essay, poem or story that explains why they chose to work in health care. From those essays, a committee at the hospital will pick one employee to represent their hospital and forward that personís essay to WHA. WHA will send the hospital representative a certificate and pin to present to their honoree in May, and will also post the essays on the WHA website at that time.

Pride Program materials are available on WHAís website at www.wha.org/pride-program.aspx. Donít miss this opportunity to participate in the 2012 Pride Program. For more information contact Shannon Nelson at snelson@wha.org or Mary Kay Grasmick at mgrasmick@wha.org, or call 608-274-1820.

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Reminder: Business Day 2012 on February 16

The Wisconsin Hospital Association joins other organizations every year, including host organization Wisconsin Manufacturers & Commerce, in co-sponsoring the "Annual Business Day in Madison," set for February 16, 2012 at Madisonís Monona Terrace.

This yearís program will focus on energy, the economy and the elections. Speakers on those topics are:

Governor Scott Walker will also be a guest speaker. WHA encourages you to consider attending this event as well as sharing the invitation with board members and senior leadership teams.

Learn more or register for Business Day in Madison online at: www.businessdayinmadison.com.

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Wisconsin Hospitals Community Benefits: Charity Care

Fear of a bill should never prevent a patient from seeking care at a Wisconsin hospital. Wisconsin hospital charity care programs provided $232 million to more than 700 patients each day in 2010. The stories that follow illustrate the deep commitment and continuing concern that hospitals have to their patients to ensure they receive the care they need regardless of their ability to pay.

Vision restored for homeless man

J.F.I. is a homeless middle-aged adult male living in an emergency shelter in western Wisconsin that provides transitional housing for men and women. Heís been hospitalized several times because of pancreatitis due to excessive alcohol use, and he recently lost a job at a manufacturing company due to his poor eyesight.

J.F.I. qualified for Community Care at St. Croix Regional Medical Center, where an exam revealed severe cataracts in both his eyes. He was quickly scheduled for surgery with St. Croix Regional Medical Center ophthalmologist Dr. Jeff Sanderson to remove the cataracts.

"Without this surgery, J.F.I. would have been completely blind within 12 months," said Dr. Sanderson.

"The Salvation Army and Serenity House provided amazing support by giving me rides to my clinic appointments," J.F.I. said. "Dr. James Sotis and surgery scheduling staff, and everyone really took good care of me and made me feel comfortable. I couldnít have asked for better care at the clinic. I had no idea what the surgery would cost [approximately $7,000/eye], but they told me not to worry. This is a godsend to me, and the best Christmas gift ever!"

St. Croix Regional Medical Center, St. Croix Falls


Charity care

John, an adult resident of Oshkosh, came to Bellin Health in July of 2011 in dire straits. The cancer he was fighting had wrecked havoc on his financial health as well as his physical well-being.

He was in a serious bind, but Bellin was able to help.

"He came in to see if there was anything we could do to assist him. You could really tell just by looking at him that he was sick," said Cathy Barbeaux, a financial assistance specialist at Bellin. "I encouraged him to apply for our Community Care program. We were able to write off all of the expenses he incurred here at 100 percent."

Community Care or charity care is offered to low-income patients that have little or no ability to pay for much needed medical services.

The charity care provided to John was a relief, not just for him, but for his sister, Susan. She stood with him through his bout with cancer.

"She was so appreciative of our charity care," Barbeaux said. "She appreciated how everyone was so nice and treated them with dignity and respect."

Many times potential recipients of charity care are reluctant to accept it, Barbeaux said.

"Some are embarrassed by their financial status, some are distrustful of the fact that we need certain financial documents such as tax papers and bank statements to determine their financial situation," she said. "Generally, we are able to ease their concerns and erase their fears and get them the care they need."

Successfully aiding people at one of the most vulnerable points in their lives is a fulfilling accomplishment for Barbeaux.

"Most of the time, the people we assist with charity care are taken care of over the phone or through written correspondence," she said. "So when weíre able to assist someone like John in person and you can see the relief on his face and see how truly appreciative he is, it really warms the heart."

Note: The patientís and family memberís names in this story have been changed to protect patient confidentiality.

Bellin Health, Green Bay


Charity Care program

When a woman in her mid-40s survived a life-altering heart event, but didnít have the means to pay for the rehabilitation and care she needed, Prairie du Chien Memorial Hospitalís Charity Care program was a second chance at life. Having no insurance and enduring what seemed be a long chain of hardships, the possibility of obtaining free care almost seemed too good to be true for this woman.

Prairie du Chien Memorial Hospital provided health care services, dietary counseling and 20 cardiac rehabilitation sessions totaling more than $20,000, at no cost to this patient. The woman desperately wanted to get back to a healthy lifestyle and return to her job to get back on her feet financially. Charity Care allowed her to recover without the stress of the medical bills, which would have compounded the strain on her finances. The woman was able to return to work and was so grateful for the assistance she was given. She was especially appreciative to the providers at Prairie du Chien Memorial Hospital whose foremost concern was her health and encouraged her to apply for the program.

This is one of many stories of free and reduced care and education provided each year to the communities served by Prairie du Chien Memorial Hospital. In 2010, more than $3,100,000 worth of Charity Care and other community benefits was provided to improve the health of our communities in Southwest Wisconsin and Northeast Iowa.

Prairie du Chien Memorial Hospital


Community Care story

For a homeless person, obstacles abound and help may seem nearly impossible to find especially when it comes to accessing health care. Often, even the most basic medical care is very difficult to get. Homelessness and health care are tightly interwoven and is often the result of a downward spiral that begins with a health problem. Unfortunately, many homeless people who are sick and need treatment do not ever receive medical care.

This was not the case for a young homeless man that happened to be passing through Antigo during the summer of 2010. A bicycle accident sent the young man to the emergency room at Langlade Hospital and subsequently to the Intensive Care Unit for several days. The young man was traveling with nothing more than the clothes on his back and his bicycle. While he was in the hospital, the staff reached out to him and cared for him beyond his medical needs. His clothes were taken home by the med/surg nurse supervisor to be washed and mended. The inpatient nurse manager brought clothing and other items from home for him as he had so few personal belongings.

When the young man was well enough to be discharged from the hospital, concern grew among staff as to where he would recuperate. He was well enough to be discharged from the hospital but certainly not strong enough to travel or be out in the elements. Times like this are when the hospitalís mission and the commitment of staff to live out that mission become crystal clear.

Langlade Hospital Social Services sprung into action making arrangements to assist the patient after he was discharged. Langlade Hospital owns and operates an assisted living facility which happened to have a vacant apartment. The manager of adult services was contacted and agreed that the vacant apartment would be the best place for him to recuperate. Since the apartment was unfurnished, the hospital maintenance staff pulled together and moved furniture and a bed into the apartment. Comfortable bedding and other amenities were brought in to make sure that he was comfortable. He moved into the apartment, and the manager of the complex went to the pharmacy and purchased recommended over-the-counter pain medication for him. Hot meals were provided by the hospitalís nutritional services department as well. He was truly being cared for.

Within days, a nurse from Langlade Hospital Social Services visited the man in the apartment and after talking with him, she had concerns that he may be experiencing some complications. She talked with him and transported him back to the hospital where he was readmitted for pain management.

When he was well enough to be discharged, he needed accommodations for one night. He decided to stay in a hotel until his mother arrived the next morning. Again, Langlade Hospital Social Services made a pre-paid reservation, arranged transportation for him, provided gift cards and money to cover food and delivered prescription medications to him to ensure that he would heal and be well until his mother could travel from another state to Antigo to pick him up.

The compassion that was extended to this young man was incredible and a shining example of living out the Langlade Hospital mission.

In conclusion, the manís hospital bills totaled well over $60,000 and were covered 100 percent through the Langlade Hospital Community Care Program.

Langlade Hospital Ė An Aspirus Partner, Antigo


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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