May 13, 2011
Volume 55, Issue 19


WHA Announces New Quality Committee Structure at MPA Council Meeting
Goal is to align state quality activities with the national agenda

At the May 5 meeting of the WHA Council on Medical and Professional Affairs in Madison, Kelly Court, WHA chief quality officer, announced that WHA has moved to a new structure to address issues related to patient safety and quality. The activities of the Quality Steering Committee, which originally guided the development and selection of measures for the CheckPoint program, will be assumed by the WHA Quality Measures Team. The Team will forward to the WHA Board any decisions that require Board action.

Court said a new group, the Wisconsin Healthcare Improvement Coordinating Committee, is currently being formed in partnership with the Wisconsin Collaborative for Healthcare Quality (WCHQ). The new Committee will be comprised of multiple stakeholders that play a role in health care improvement in the state. This new group will be a coordinating body that identifies synergies, reduces redundancies, and encourages collaboration among providers.

"The changes in how we structured our quality activities at WHA and WCHQ are designed to keep hospitals aligned to existing national measurement strategies and to achieve more statewide collaboration on improvement projects," according to Court. "One of our primary aims is to recognize that hospitals are being asked to collect data for and report to a multitude of entities. By aligning state activities with the national agenda, we can hopefully help our hospitals respond to these requests and requirements while being mindful that resources are limited."

Clinical leaders play key role in ICD-10 transition

Debbie Rickelman, senior director of the WHA Information Center, summarized the process involved in the mandatory transition from ICD-9 to ICD-10 diagnosis and procedure coding that takes effect October 1, 2013.

"This will be a key change that will affect all health care providers," Rickelman said. "The new system will add more specificity to medical coding and put the United States on the same system as the rest of the industrial nations."

Rickelman said the new system will improve clinical, financial and performance measures, expand the capability to prevent and detect health care fraud and abuse, and improve capabilities related to tracking public health risks. The new codes are supported by the 5010 electronic claim form that will be effective January 1, 2012. Rickelman said clinical leaders play a key role in preparing hospitals for a successful transition. These tasks include review of clinical documentation processes and tools, and creating awareness of the move to ICD-10 among physicians.

WHA is partnering with the Wisconsin Medical Society, the Rural Wisconsin Health Cooperative and the Wisconsin Health Information Management Association to create and disseminate tools and resources to assist health care providers with this transition.

New project aimed at improving health care equity in Wisconsin

A new project of the Aligning Forces for Quality grant that is designed to increase health equity in Wisconsin hospitals was presented to the Council by Stephanie Sobczak, WHA quality manager. The three goals for the project include:

  1. Standardized collection of patient-identified race, ethnicity and primary language (R/E/L) for all patients receiving health care
  2. Stratification and analysis of quality performance measures using the R/E/L data
  3. Use of the stratified data to identify and develop quality improvement interventions targeted to specific patient populations.

Sobczak said nationally the top barriers identified to completing the first goal include reluctance of hospital staff to directly ask patients for the R/E/L data, confusion about standardized data elements and the difficulty in extracting data from data systems that may not be linked. Initial data analysis by WHA quality staff demonstrates that the R/E/L data is not being consistently collected in many Wisconsin hospitals. Sobczak described the Aligning Forces resources WHA will make available to members, including a toolkit, to train registration staff. Over the summer, hospitals will have an opportunity to learn best practices related to race, ethnicity and language data collection through several webinar opportunities.

"Hospital leaders play a key role in supporting the work needed to collect and use this data so that everyone is assured all patients receive the best care possible," according to Sobczak.

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Register Today for the 2011 Wisconsin Rural Health Conference
The Osthoff Resort, Elkhart Lake *** June 15-17, 2011

Reminder… Osthoff Resort Room Reservation Cut-Off: Monday, May 23

Due to other large events in the area, it is very likely there will be no hotel rooms available after the May 23 cut-off date, so make your reservations ASAP.

More information and online registration is available at http://events.signUp4.com/Rural

This year’s conference is a great way for hospital executives, leadership staff and trustees to take advantage of quality education presented by nationally-recognized faculty, at a fraction of the travel and registration costs for out-of-state events.

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Political Action Spotlight: Political Action Fundraising Campaign Raises $68,000 in First Month

One month into the 2011 Campaign, the Wisconsin hospitals state political action funds fundraising campaign has raised $68,374 from 103 individuals. This puts the 2011 campaign at 27 percent of the $250,000 monetary goal.

As in previous years, individual contributors will be listed in The Valued Voice by name and affiliated organization on a regular basis. 2011 contributors to date are listed below. Contributors are listed alphabetically by contribution category. The next publication of the contributor list will be in the May 27 edition of The Valued Voice.

For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

Contributions ranging from $0 - 499

Alstad, Nancy         Fort HealthCare

Ashenhurst, Karla         Ministry Health Care

Ayers, Mandy         Wisconsin Hospital Association

Bablitch, Steve         Aurora Health Care

Bailet, Jeffrey         Aurora Health Care

Byrne, Frank         St. Mary's Hospital

Clark, Renee         Fort HealthCare

Connor, Michael         Aurora Health Care

Dahl, James         Fort HealthCare

Decker, Michael         Divine Savior Healthcare

Devermann, Robert         Aurora Medical Center in Oshkosh

Evans, Kim         Bellin Hospital

From, Leland         Beloit Health System

Furlong, Marian         Hudson Hospital

Hieb, Laura         Bellin Hospital

Holub, Gregory         Ministry Door County Medical Center

Keene, Kaaron         Memorial Health Center - An Aspirus Partner

Klein, Rick         Aurora Health Care

Laird, Michael         Froedtert Health St. Joseph's Hospital

Lange, George         Westgate Medical Group, CSMCP

Margan, Rob         Wisconsin Hospital Association

Marquardt, Amy         Columbia St. Mary's, Inc. - Columbia

McNally, Maureen         Froedtert Health

Merline, Karen

Niemer, Margaret         Children's Hospital and Health System

O'Keefe, James         Mile Bluff Medical Center    

Olson, Bonnie         Sacred Heart Hospital

Ose, Peggy         Riverview Hospital Association

Penczykowski, James         St. Mary's Hospital

Peters, Kenneth         Bellin Hospital

Petonic, Mary Frances         Meriter Hospital

Potts, Dennis         Aurora Health Care

Priest, Geoffrey         Meriter Hospital

Radoszewski, Pat         Children's Hospital and Health System

Reinke, Mary         Aurora Health Care

Rickelman, Debbie         WHA Information Center

Roller, Rachel         Aurora Health Care

Samitt, Craig         Dean Health System

Schaefer, Mark         Froedtert Health

Scieszinski, Robert         Ministry Door County Medical Center

Stanford, Cynthia

Tews, Carol         Memorial Medical Center - Neillsville

Worrick, Gerald         Ministry Door County Medical Center

Yaron, Rachel         Ministry St. Clare’s Hospital


Contributions ranging from $500 - 999

Anderson, Sandy         St. Clare Hospital and Health Services

Carlson, Dan         Bay Area Medical Center

Clough, Sheila         Ministry Health Care’s Howard Young Medical Center

Court, Kelly         Wisconsin Hospital Association

Dietsche, James         Bellin Hospital

Eckels, Timothy         Hospital Sisters Health System

Frank, Jennifer         Wisconsin Hospital Association

Grundstrom, David         Flambeau Hospital

Heifetz, Michael         SSM Health Care-Wisconsin

Kerwin, George         Bellin Hospital

Lewis, Gordon         Burnett Medical Center

Mantei, Mary Jo         Bay Area Medical Center

Mohorek, Ronald         Ministry Health Care

Nelson, James         Fort HealthCare

Schoof, Susie         Essie Kammer Consulting Group

Selberg, Heidi         HSHS-Eastern Wisconsin Division

Shabino, Charles         Wisconsin Hospital Association

VanCourt, Bernie         Bay Area Medical Center

Westrick, Paul         Columbia St. Mary's, Inc. - Milwaukee

Contributions ranging from $1,000 - 1,499

Alig, Joanne         Wisconsin Hospital Association

Bloch, Jodi         Wisconsin Hospital Association

Boese, Jennifer         Wisconsin Hospital Association

Borgerding, Dana

Brenton, Mary E.

Britton, Gregory         Beloit Health System

Duncan, Robert         Children's Hospital and Health System

Hahn, Brad         Aurora Health Care

Harding, Edward         Bay Area Medical Center

Hilt, Monica         Ministry Saint Mary’s Hospital

Kerschner, Joseph         Children's Hospital and Health System

Kosanovich, John         UW Health Partners Watertown Regional Medical Center

Levin, Jeremy         Rural Wisconsin Health Cooperative

Loftus, Philip         Aurora Health Care

Mettner, Michelle         Children's Hospital and Health System

Morgan, Dwight         Aurora Health Care

Normington, Jeremy         Moundview Memorial Hospital and Clinics

Olson, David         Columbia St. Mary's, Inc. - Ozaukee

Potter, Brian         Wisconsin Hospital Association

Size, Tim Rural         Wisconsin Health Cooperative

Stanford, Matthew         Wisconsin Hospital Association

Troy, Peggy         Children's Hospital and Health System

Wallace, Michael         Fort HealthCare

Contributions ranging from $1,500 - 1,999

Eichman, Cynthia         Ministry Our Lady of Victory Hospital

Grasmick, Mary Kay         Wisconsin Hospital Association

Herzog, Mark         Holy Family Memorial, Inc.

Starmann-Harrison, Mary         SSM Health Care-Wisconsin

Turkal, Nick         Aurora Health Care

Warmuth, Judith         Wisconsin Hospital Association

Woodward, James         Meriter Hospital

Contributions ranging from $2,000 - 2,499

Fish, David         Hospital Sisters Health System

Kachelski, Joe         Wisconsin Statewide Health Information Network

Leitch, Laura         Wisconsin Hospital Association

Merline, Paul         Wisconsin Hospital Association

Neufelder, Daniel         Affinity Health System

Pandl, Therese         HSHS-Eastern Wisconsin Division

Contributions ranging from $2,500 - 2,999

Borgerding, Eric         Wisconsin Hospital Association

Contributions ranging from $3,000 - 3,999

Erwin, Duane         Aspirus Wausau Hospital

Contributions ranging from $4,000 - 4,999

Tyre, Scott         Capitol Navigators, Inc

Contributions $5,000 +

Brenton, Stephen         Wisconsin Hospital Association

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Legislature Considers Concealed Carry Bills
WHA testifies at Assembly hearing in Madison

Proposals that would allow Wisconsin citizens to carry concealed weapons were heard in both the Assembly and Senate this week.

In Madison, the Assembly Criminal Justice and Corrections Committee, chaired by Rep. Garey Bies (R-Sister Bay) listened to testimony on Assembly Bill (AB) 126 that would allow eligible individuals to carry a concealed weapon after obtaining a license. The proposal is authored by Rep. Jeff Mursau (R-Crivitz) and Sen. Pam Galloway (R-Wausau).

On the same day, the Senate Judiciary, Utilities, Commerce, and Government Operations Committee, chaired by Sen. Rich Zipperer (R-Pewaukee) traveled to Wausau for a hearing on the Senate companion version of the proposal, SB 90. The Senate committee also listened to testimony on a separate measure from Sen. Galloway, SB 93 that would allow for the carrying of concealed weapons without a licensing system, also known as constitutional carry.

Language included in the proposals allows private businesses, including hospitals and clinics, to "post" their facilities and prohibit the carrying of concealed weapons. Similarly, employers could prohibit their employees from carrying a concealed weapon in the course of their employment. The prohibitions would not extend to parking facilities.

In testimony at the Assembly hearing, WHA’s Vice President of Government Affairs Paul Merline said the ability for hospitals to prohibit the carrying of concealed weapons is especially important because of the unique nature of their facilities. (The testimony can be viewed at www.wha.org/AB126AssemblyCriminalJustice.pdf.)

"Oxygen and other dangerous combustibles are routinely present and in use in hospitals," Merline said. "An accident with a concealed weapon could lead to tragic results on its own, but an accident that ignites highly combustible material could lead to an explosive catastrophe affecting the lives of every man, woman and child in the hospital."

Merline also pointed out that hospitals strive to maintain a non-threatening health care environment. This is especially important as patients and families often face traumatic or emotionally devastating situations while at hospitals. Hospital patients may also be struggling with behavioral health issues or under the influence of narcotics. Allowing guns in hospitals would only compound these difficult situations.

While a specific hospital and health care facility exemption is not currently included in the bills, WHA would seek such an exemption if other specific exemptions are added. The provision allowing private property and business owners to prohibit concealed firearms is a good step, and supported by WHA.

Also testifying this week was Dr. Stew Watson, CEO Ministry Medical Group and a physician of emergency medicine at Ministry St. Clare’s Hospital. In his comments, Dr. Watson also supported the ability of a hospital to post their facilities and prohibit the carrying of concealed weapons and the ability of an employer to restrict concealed carry and asked that the legislation retain both provisions.

WHA raised a concern about the bills lacking any language related to training requirements and the ability to obtain a license for carrying a concealed weapon. In his comments, Merline agreed with others who testified that extensive training is employed for law enforcement use of weapons for those who use and grow accustomed to their weapons as everyday occupational tools.

"The ability to become licensed to carry a concealed weapon capable of deadly force brings with it the expectation and the responsibility of the licensee to have a basic knowledge of safety and the capabilities of that weapon," Merline said. "As such, some level of mandatory training should be required for potential concealed weapon licensees who will very likely not achieve the same level of familiarity as someone professionally accustomed to their weapon."

The licensing versions of the concealed carry proposals, AB 126 and SB 90, have strong legislative support. Committee votes are expected in the next few weeks.

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Grassroots Spotlight: Ron Kind Visits Memorial Medical Center-Neillsville

Congressman Ron Kind (D-La Crosse) visited Memorial Medical Center-Neillsville on Thursday, April 28, 2011, for a facility tour and an opportunity to meet with staff and community members. Kind discussed the future of rural health care and how changes to insurance and Medicare will affect it. He also talked about Advanced Directives and his support for a change from "fee for service" to "fee for value" system. Members of the community also asked about his stance on SeniorCare and the recruitment and retention of rural providers.

During his time at Memorial Medical Center, Kind and two representatives from the Rural Development branch of the U.S. Department of Agriculture presented the medical facility with a $50,000 grant check to assist with the facility’s $1.2 million electronic health record implementation. The USDA has also awarded Memorial a low-rate loan to help cash flow for the remainder of the project.

"The USDA and Congressman Ron Kind’s office were extremely helpful during our application process for this grant, and we are honored to be selected as a recipient," said Scott Polenz, CEO of Memorial Medical Center. "The Congressman’s visit was a great opportunity for us to share our successes and challenges with him one-on-one. In the ever-changing health care climate, it’s important that our government representatives have the opportunity to discuss issues with the businesses and community members they represent."

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Hospice Use in Wisconsin on the Rise

Fewer chronically-ill patients are dying in hospitals and instead, are choosing to spend their last days in hospice care. A recent study by the Dartmouth Atlas showed, on average, a 13 percent decrease in the number of chronically-ill patients who are dying in hospitals.

When medical treatment can no longer slow or cure an illness, patients often want to spend their last days with loved ones at home or in a residential hospice setting, a wish that Wisconsin hospitals are striving to fulfill.

A study by the Dartmouth Atlas, (www.dartmouthatlas.org), included several Wisconsin communities: Milwaukee, Madison, Green Bay, Appleton, and La Crosse. All these communities showed a decrease between 2003 and 2007 in the number of chronically ill patients who died in a hospital.

Melanie Ramey, executive director/CEO of the Hospice Organizations and Palliative Experts of Wisconsin (HOPE), said there are now 18 hospice residencies in Wisconsin. She said the fact that Wisconsin is not a certificate of need (CON) state—meaning hospice facilities do not have to go through a lengthy process to obtain a license—has made hospice care more accessible, especially in rural areas. While CON is not a barrier to promoting the use of hospice, reimbursement is a major challenge.

"We are very concerned about the survival of the more rural hospices because the reimbursement they receive will be cut by 14 percent over the next four years," says Ramey. "Hospices are unique in that they are reimbursed on a per diem, not fee-for-service basis, which raises an issue because patients in less populated areas are more expensive to serve due to the cost of gasoline and the amount of time it may take to care for them at home."

Struggles aside, hospice care is beneficial both for communities and patients. "Palliative care and hospice are both very economical for a provider and the government," says Ramey. "When patients utilize these care centers, there is no need to go to the emergency room when a change in their condition or complications occur, which cuts costs."

While hospice and palliative care centers can be a prudent choice, it ultimately comes down to what the patient desires.

"Every resident of Wisconsin can now have access to hospice care if they choose, and we want that to continue to be the case," says Ramey. "The whole person’s need should be considered—not just their medical ones."

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Hayward Area Memorial Hospital CEO Barbara Peickert Announces Retirement

Barbara Peickert, CEO of Hayward Area Memorial Hospital and Water’s Edge will retire on July 22, 2011 after a long and rewarding career in health care.

Peickert graduated from the University of Minnesota in 1968 with a BSN. She worked at the U of M as a staff nurse in the transplant and dialysis units, as clinical director of the Masonic Cancer Hospital at the University and as associate director for inpatient services during her 14 years there.

In1980 the family moved to Ashland, Wisconsin when Barbara accepted the director of nursing position at Memorial Medical Center. She continued to work in Ashland until 1986 when Hayward Area Memorial Hospital was purchased by Regional Enterprises, Inc, the parent company of the Ashland facility. At that time, she accepted the opportunity to serve as CEO of the Hayward facility. She continued in that role for 25 years.

Peickert served two terms on WHA’s Board of Directors as well as fulfilling leadership roles in many other civic organizations including the Hayward Development Corporation and Hayward Rotary Club.

Throughout her career, the dignity and care of patients and residents has been the focus of her leadership. A long held dream to change the culture of hospitals and nursing homes to a healing environment has now been realized. The construction of a new surgical center and an inpatient unit with private rooms plus the renovation of several other departments was completed in 2004. A new assisted living complex was opened on February 1, 2011 of this year and a care center with private rooms and a culture change philosophy will open on May 17 bringing her dream to reality.

When asked what she was most proud of, Peickert responded, "The growth of health care services needed in our area and the establishment of collaborative working relationships with facility staff and medical staff. It has been a wonderful opportunity to work with so many talented people."

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Wisconsin Hospitals Community Benefits: Mental Health and Mental Disorders

Mental disorders vary in severity and in their impact on people’s lives. The symptoms can be severe and extremely destructive, causing immeasurable suffering for the patient and their families. Hospitals see an ever-increasing number of patients seeking treatment for mental disorders in their emergency departments. Hospitals that can offer inpatient treatment generally operate this service at a loss. With a disturbing shortage of mental health professionals, hospitals will continue to partner with each other and their communities to meet the growing demand for these services.

"Walk for Angels" was a walk to remember

The Community Memorial Hospital Share Pregnancy and Infant Loss Support Group serves people whose lives have been touched by the tragic death of a baby through pregnancy loss, stillbirth, or in the first few months of life. The group’s 2nd Annual Share "Walk for Angels" sent 85 balloons sailing over the Oconto River. The balloons were memorials, each with a personal inscription attached.

The Share "Walk for Angels" hosted by Community Memorial Hospital (CMH) brings families and friends together in a special way. Participants carry balloons down Main Street to the East Side Beach in Oconto Falls. On a Sunday afternoon, as the group gathered at the beach for a reflection and the climactic balloon release, an unlikely rainbow appeared in a clear blue sky.

"Suddenly a rainbow just appeared over the river," said Nikki Stapleton, RN, of CMH Center for Women’s Care, who organized the event. "It gave me chills."

The event concludes with a reception at Community Memorial Hospital for coffee, cider, refreshments, and fellowship.

Nikki is the Share coordinator and leader of the CMH Share Support Group which meets monthly at Community Memorial Hospital. "It’s an inspiring group," says Nikki. This year’s "Walk for Angels" raised $720 to benefit the CMH Share Support Group and the National Share Pregnancy and Infant Loss Support, Inc. Share is a national organization with nearly 100 groups across the country that has supported initiatives such as a $3 million allocation in 2003 for stillbirth research to the National Institute for Health. Founded in 1977, the group offers mutual support for bereaved parents and families, professionals, clergy, and funeral directors. It provides a monitored interactive Web site containing chat rooms and message boards. Its web site is www.nationalshare.org.

Community Memorial Hospital, Oconto Falls

Help through the grieving process

A Grief Support Group for people who are grieving the loss of a loved one was held Tuesday evenings for six consecutive weeks October 6 through November 10 at the United Methodist Church in Black River Falls. The support group, sponsored by Black River Memorial Hospital, was open to the public at no cost. Facilitated by hospital social worker Denise Gearing, the group provided the opportunity to meet with others who are experiencing the loss of a loved one and to provide the tools to help people go through the grieving process. Material and information on the grieving process was shared with the participants.

Black River Memorial Hospital, Black River Falls

Support Group provides access to information for preventing exhaustion

"People don’t know what they don’t know," says Aurora RN Susanne Malestic, a senior resource nurse coordinator in Western Racine County.

She’s referring to knowledge about dementia, as well as the toll it eventually takes on family and friends who serve as caregivers to persons with dementia.

"The more they know about dementia, the better able they will be to prevent their own emotional and physical exhaustion and redirect their frustration when the dementia episodes are most distressing," Susanne explains.

"Caregivers themselves need to be healthy. Without the proper resources and support, caregiving can be challenging and draining,’’ she said. "One outlet that helps them maintain their wellness and resilience is getting out and socializing with others in our support group and being able to look forward to that on a monthly basis."

In addition to being an RN who specializes in geriatric care through the Aurora Senior Care Resource Nurse program, Susanne is a caregiver to her father who was diagnosed with dementia. She leads the group with empathy and compassion, while also imparting the knowledge she has accumulated through her years of clinical practice.

The group meets the fourth Wednesday of every month at the Aurora Wellness Center in Burlington.

Aurora Memorial Hospital of Burlington

Breaking down barriers

Offering a lifeline for mental health access

When mental health problems occur, they can drastically and negatively impact a person’s career, relationships and overall health. Such was the case for Jason*, a young man who suffered so badly from attention deficit disorder (ADD), he was unemployable. Unfortunately, no job meant no insurance, and no insurance meant no access to the medical care he so badly needed.

While state-sponsored health plans help many individuals and families pay for needed healthcare services, there are gaps. Jason fell into those gaps and soon found himself in a seemingly inescapable nightmare. From the sidelines, his mother watched helplessly as her grown son lost control over his life’s direction.

However, Jason found a lifeline in Monroe Clinic’s community care—a program that provides reduced or free medical services to lower-income, uninsured patients, within their service region, who do not qualify for government assistance. Monroe Clinic’s community care connected Jason with their behavioral health experts and even paid for his prescription medication. Jason’s mother says he is a new person because of it.

Addressing mental health needs as a community

Still, Jason’s story is one of many, which is why Monroe Clinic is continually searching for new ways to eliminate the literal and invisible barriers that keep people from receiving help for mental health concerns.

In 2009 and 2010, Monroe Clinic partnered with the UW Extension Office, Green County United Prevention Professionals for Youth (GUPPY), Community Suicide Intervention (CSI) and Green County Law Enforcement to host a Mental Health Summit at Monroe United Methodist Church. The half-day event brought together mental health experts, advocates, and other professionals to offer support for caregivers, family members and individuals impacted by mental health issues.

Both years, the Mental Health Summit addressed a diverse and highly specialized range of concerns by following a keynote presentation with a large selection of breakout sessions. Approximately 70 people attended the most recent Mental Health Summit on April 30, 2010. Plans are already underway to offer the event every other year, with the next being in spring 2012.

Keeping mental health services accessible

It may surprise many people to know behavioral health is among Monroe Clinic’s subsidized services, which means the organization provides the service to patients at a financial loss. Other subsidized services include dialysis, emergency services and palliative care.

"Behavioral health services are as crucial to our communities’ quality of life as oncology or cardiovascular medicine," said Mark Thompson, MD, chief medical officer at Monroe Clinic. "Due to some old misconceptions—along with the complex and sensitive nature of this care—people who depend on behavioral health access don’t always discuss it with their friends and neighbors like they might an angioplasty, but that doesn’t detract from the relevancy and need surrounding this service."

Behavioral health continues to be a well-utilized service, and with 12 providers, it is one of the largest departments within Monroe Clinic. Most significantly, not only does the service exist—it is accessible to all. And because of this, Jason can pursue a better tomorrow.

*patient name has been changed to protect his privacy.

Monroe Clinic, Monroe


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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