August 19, 2011
Volume 55, Issue 32


CMS’s Berwick, Rep. Kind Listen, Learn from Wisconsin Health Care Leaders
Berwick: We "have a diamond mine here in the Midwest"

After holding listening sessions with more than 300 hospital executives, nurses and physicians in attendance from three western Wisconsin communities, CMS Administrator Don Berwick, MD, was obviously impressed by what he heard.

"You have a diamond mine here in the Midwest," said Berwick. "People can learn a lot from Wisconsin."

Berwick confirmed what providers know as fact—the Wisconsin health care delivery system continues to be a model for the rest of the nation in terms of providing high quality, low cost patient care. Berwick was joined by Representative Ron Kind at listening sessions held August 18 in La Crosse, Eau Claire, and Black River Falls. Congressman Kind was equally impressed by what he heard.

"Our hospitals and clinics have long been providing the kind of high quality low cost care that the rest of the nation should be looking to as a model," said Rep. Kind. "Updating our delivery systems nationwide, to produce care focused on outcomes instead of volume, is the only way to get our health care costs under control in the long run. I am pleased that Dr. Berwick was able to tour and visit these high-performing facilities and meet with the committed providers that consistently deliver some of the best, most coordinated care in the country."

Stan Gaynor, president and CEO of Black River Memorial Hospital, hosted the rural health care roundtable held in Black River Falls, where Wisconsin Hospital Association Senior Vice President Brian Potter was in attendance, along with Tim Size, executive director of the Rural Wisconsin Health Cooperative (RWHC). They were joined by about 30 hospital CEOs and other administrative and physician leaders from several western and southern Wisconsin facilities, along with staff from the Wisconsin Medical Society, and Dean Robert Golden, MD, from the Wisconsin School of Medicine and Public Health.

Congressman Kind opened the Black River Falls listening session by discussing the challenges of health care reform. He stated the status quo is not sustainable, and delivery and payment reforms are necessary to improve the quality and access of health care in rural and urban areas across the country.

In his opening remarks to the group, Berwick mentioned since the day he started at CMS, rural health issues have been front and center for him. He told the group his father was a rural physician, and he is well aware of the many challenges rural providers face.

He went on to say the big challenge CMS has is to extend coverage with limited resources. That means the health care system needs to be reorganized to reward value instead of volume. Coordination, integration and community involvement are three key components to help facilitate this change.

During the roughly 60-minute session in Black River Falls, Berwick and Congressman Kind heard concerns, comments and questions on subjects ranging from issues surrounding the ACO rules and the potential impact on the future of rural independent providers, the role of CMS in providing better information to help providers facilitate change, liability reform, workforce shortage issues, administrative simplification, 340B drug program, and the challenges of providing long-term, home health, and end-of-life care.

Berwick ended the session by thanking the group for their input. He stressed CMS needs professional leadership from providers like those in the room to help facilitate the changes needed to improve the system. He encouraged the group to continue to come forward with ideas and committed to make CMS a better support system and resource for change.

"Wisconsin providers are at the leading edge of innovation and efficiency," Potter said. "Meetings like this provide a forum for showcasing Wisconsin’s leadership in providing high quality, accessible and affordable health care."

Prior to the rural health care roundtable meeting, RWHC compiled a comprehensive list of rural health issues that was shared with Berwick. The paper covered additional topics that due to time constraints were not discussed during the meeting. The list can be found online at www.rwhc.com/LinkClick.aspx?fileticket=uvpEYjeK2qw%3d&tabid=62.

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Register Today to Explore Tomorrow’s Health Care
WHA Annual Convention, September 14-16, Grand Geneva Resort

Each year, the WHA Annual Convention provides Wisconsin hospital leaders the opportunity to share conversation and ideas with colleagues from around the state, as well as with members of their leadership team and board of trustees. The 2011 Annual Convention is no exception, with opportunities this year to focus on and consider current and future physician supply issues, successful efforts toward community health improvement, and the patients’ experience and perspective.

Register today for the 2011 WHA Annual Convention online at http://events.SignUp4.com/Annual2011. Make hotel reservations as soon as possible at the Grand Geneva Resort to take advantage of special WHA group pricing and room availability. The WHA group rate and block of rooms expires on Wednesday, August 24.

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Wisconsin Hospitals Conduit & PAC Campaign Update

The Wisconsin Hospitals Conduit and PAC fundraising campaign raised $10,000 in just the last couple of weeks from 17 additional contributors putting the campaign at 55 percent of goal. The campaign goal is to raise $250,000. To date $137,299 has been raised from 232 individuals contributing an average of $592.

Individual contributors are 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 September 2.

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

Contributions ranging from $1 - 499

 

Adams, Daniel

Memorial Medical Center - Ashland

Alstad, Nancy

Fort HealthCare

Ashenhurst, Karla

Ministry Health Care

Ayers, Mandy

Wisconsin Hospital Association

Bablitch, Steve

Aurora Health Care

Banaszynski, Gregory

Aurora Health Care

Beall, Linda

Hudson Hospital

Biros, Marilyn

SSM Health Care-Wisconsin

Bloom, Deborah

Sacred Heart Hospital

Boson, Ann

Ministry Saint Joseph’s Children’s Hospital

Boudreau, Jenny

Wisconsin Hospital Association

Braunschweig, Jennifer

Gundersen Lutheran Medical Center

Brenny, Terrence

Stoughton Hospital Association

Byrne, Frank

St. Mary's Hospital

Calhoun, William

Mercy Medical Center

Campbell-Kelz, Nancy

Aspirus Wausau Hospital

Casey, Candy

Columbia Center

Caven, Michael

Memorial Medical Center - Ashland

Ceelen, John

Ministry Health Care

Censky, Bill

Holy Family Memorial, Inc.

Clapp, Nicole

Grant Regional Health Center

Clark, Renee

Fort HealthCare

Connor, Michael

Aurora Health Care

Cooksey, Patricia

Hudson Hospital

Dahl, James

Fort HealthCare

Dalebroux, Steve

St. Mary's Hospital

Decker, Michael

Divine Savior Healthcare

DeMars, Nancy

Sacred Heart Hospital

DeRosa, Jody

St. Mary's Janesville Hospital

Devermann, Robert

Aurora Medical Center in Oshkosh

Dolohanty, Naomi

Aurora Health Care

Donlon, Marcia

Holy Family Memorial, Inc.

Ela, Susan

Aurora Health Care

Elliott, Roger

St. Joseph's Hospital

Erickson, Susan

Meriter Hospital

Erickson, William

Ministry Saint Mary’s Hospital

Evans, Kim

Bellin Hospital

Facey, Alice

St. Clare Hospital and Health Services

Fielding, Laura

Holy Family Memorial, Inc.

From, Leland

Beloit Health System

Fuchs, Thomas

St. Joseph's Hospital

Furlong, Marian

Hudson Hospital

Giedd, Janice

St. Joseph's Hospital

Gjolberg, Skip

Prairie du Chien Memorial Hospital

Govier, Mary

Holy Family Memorial, Inc.

Grohskopf, Kevin

St. Clare Hospital and Health Services

Groskreutz, Kevin

St. Joseph's Hospital

Grunwald, Patricia

Meriter Hospital

Gullicksrud, Lynn

Sacred Heart Hospital

Gutsch, Mike

Southwest Health Center

Halida, Cheryl

St. Joseph's Hospital

Hattem, Marita

Aspirus Wausau Hospital

Hemes, Jim

 

Hieb, Laura

Bellin Hospital

Hill, Nick

St. Joseph's Hospital

Hockers, Sara

Holy Family Memorial, Inc.

Hoege, Beverly

Reedsburg Area Medical Center

Holub, Gregory

Ministry Door County Medical Center

Jelle, Laura

St. Clare Hospital and Health Services

Keene, Kaaron

Memorial Health Center - An Aspirus Partner

Klay, Lois

St. Joseph's Hospital

Klein, Rick

Aurora Health Care

Kuehni-Flanagan, Tracy

St. Joseph's Hospital

Lachecki, Therese

Memorial Medical Center - Ashland

Laird, Michael

Froedtert Health St. Joseph's Hospital

Lange, George

Westgate Medical Group, CSMCP

Marcouiller, Don

Memorial Medical Center - Ashland

Margan, Rob

Wisconsin Hospital Association

Maroney, Lisa

Marquardt, Amy

 

Mason, Paul

Wheaton Franciscan Healthcare - All Saints

Maurer, Mary

Holy Family Memorial, Inc.

McKevett, Timothy

Beloit Health System

McNally, Maureen

Froedtert Health

Meicher, John

St. Mary's Hospital

Merline, Karen

 

Meyer, Jeffrey

Osceola Medical Center

Muellerleile, Steven

Westfields Hospital

Mulder, Doris

Beloit Health System

Myers, Lynne

Meriter Hospital

Needham, Jean

Westfields Hospital

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

Page, Alison

Balwin Area Medical Center

Palecek, Steve

St. Joseph's Hospital

Peiffer, Susan

Sacred Heart Hospital

Penczykowski, James

St. Mary's Hospital

Peters, Kenneth

Bellin Hospital

Petonic, Mary Frances

Meriter Hospital

Piper, Barbara

Sacred Heart Hospital

Polenz, Scott

Memorial Medical Center - Neillsville

Potts, Dennis

Aurora Health Care

Powell, Stacey

Sacred Heart Hospital

Priest, Geoffrey

Meriter Hospital

Proehl, Sheila

Hudson Hospital

Radoszewski, Pat

Children's Hospital and Health System

Rambo, Kari

Hudson Hospital

Reinke, Mary

Aurora Health Care

Rickelman, Debbie

WHA Information Center

Roethle, Linda

Bellin Hospital

Roller, Rachel

Aurora Health Care

Rubenzer, Deanne

St. Joseph's Hospital

Rudolph, Wade

Sacred Heart Hospital

Rutkowski, Jennifer

Grant Regional Health Center

Samitt, Craig

Dean Health System

Saunaitis, Tamara

Meriter Hospital

Schaefer, Mark

Froedtert Health

Scieszinski, Robert

Ministry Door County Medical Center

Sheehan, Heather

Hayward Area Memorial Hospital and Water’s Edge

Smith, Greg

Wheaton Franciscan Healthcare

Stanford, Cynthia

 

Stelzer, Jason

St. Clare Hospital and Health Services

Stoffel, Julie

St. Joseph's Hospital

Sullivan, Anne

Memorial Medical Center - Ashland

Sullivan, Gail

St. Joseph's Hospital

Tapper, Joy

Milwaukee Health Care Partnership

Taylor, Steve

Beloit Health System

Tews, Carol

Memorial Medical Center - Neillsville

Tincher, Pat

Langlade Hospital - An Aspirus Partner

Turner, Sally

Aurora Health Care

Van Meeteren, Bob

Reedsburg Area Medical Center

VanDeVoort, John

Sacred Heart Hospital

Voecker, Ron

Wheaton Fransican Healthcare

Walker, Troy

St. Clare Hospital and Health Services

Worrick, Gerald

Ministry Door County Medical Center

Yaron, Rachel

Ministry St. Clare’s Hospital

Zeller, Brad

Hayward Area Memorial Hospital and Water’s Edge


Contributions ranging from $500 - 999

 

Andersen, Travis

St. Elizabeth Hospital

Anderson, Sandy

St. Clare Hospital and Health Services

Bailet, Jeffrey

Aurora Health Care

Bayer, Tom

St. Vincent Hospital

Bjork, Tanya

 

Bukowski, Cathy

Ministry Eagle River Memorial Hospital

Bultema, Janice

 

Canter, Richard

Wheaton Franciscan Healthcare

Cardamone, Dr. Steve

Wheaton Franciscan Healthcare

Carlson, Dan

Bay Area Medical Center

Clough, Sheila

Ministry Health Care’s Howard Young Medical Center

Court, Kelly

Wisconsin Hospital Association

Deich, Faye

Sacred Heart Hospital

Dietsche, James

Bellin Hospital

Eckels, Timothy

Hospital Sisters Health System

Frank, Jennifer

Wisconsin Hospital Association

Garcia, Dawn

St. Joseph's Hospital

Granger, Lorna

ProHealth Care

Grundstrom, David

Flambeau Hospital

Guirl, Nadine

ProHealth Care

Heifetz, Michael

SSM Health Care-Wisconsin

Hymans, Daniel

Memorial Medical Center - Ashland

Huettl, Patricia

Holy Family Memorial, Inc.

Johnson, Patricia

Hayward Area Memorial Hospital and Water’s Edge

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

Nelson, Nanine

ProHealth Care

Oberholtzer, Curt

Bay Area Medical Center

Postler-Slattery, Diane

Aspirus Wausau Hospital

Richards, Theresa

Ministry Saint Joseph’s Children’s Hospital

Rocole, Theresa

Wheaton Franciscan Healthcare

Russell, John

Columbus Community Hospital

Schafer, Michael

Spooner Health System

Selberg, Heidi

HSHS-Eastern Wisconsin Division

Shabino, Charles

Wisconsin Hospital Association

Stuart, Philip

Tomah Memorial Hospital

Swanson, Kerry

St. Mary's Janesville Hospital

VanCourt, Bernie

Bay Area Medical Center

Volpe, Joseph

Wheaton Franciscan Healthcare

Westrick, Paul

Columbia St. Mary's, Inc. - Milwaukee Campus

Zenk, Ann

Ministry Saint Mary's


Contributions ranging from $1,000 - 1,499

 

Alig, Joanne

Wisconsin Hospital Association

Boese, Jennifer

Wisconsin Hospital Association

Brenton, Mary E.

Britton, Gregory

Beloit Health System

Buser, Kenneth

Wheaton Franciscan Healthcare - All Saints

Duncan, Robert

Children's Hospital and Health System

Fale, Robert

Agnesian HealthCare/St. Agnes Hospital

Francis, Jeff

Ministry Health Care

Hahn, Brad

Aurora Health Care

Harding, Edward

Bay Area Medical Center

Hilt, Monica

Ministry Saint Mary’s Hospital

Karuschak, Michael

Amery Regional Medical Center

Kerschner, Joseph

Children's Hospital and Health System

Kosanovich, John

UW Health Partners Watertown Regional Medical Center

Loftus, Philip

Aurora Health Care

Martin, Jeff

Ministry Saint Michael’s Hospital

Mohorek, Ronald

Ministry Health Care

Morgan, Dwight

Aurora Health Care

Normington, Jeremy

Moundview Memorial Hospital and Clinics

Olson, David

 

Potter, Brian

Wisconsin Hospital Association

Robertstad, John

ProHealth Care - Oconomowoc Memorial Hospital

Sexton, William

Prairie du Chien Memorial Hospital

Size, Pat

Sohn, Jonathan

Wheaton Franciscan Healthcare

Standridge, Debra

Wheaton Franciscan Healthcare

Stanford, Matthew

Wisconsin Hospital Association

Troy, Peggy

Children's Hospital and Health System

Wallace, Michael

Fort HealthCare

Wolf, Edward

Lakeview Medical Center


Contributions ranging from $1,500 - 1,999

 

Bloch, Jodi

Wisconsin Hospital Association

Borgerding, Dana

Coffman, Joan

St. Joseph's Hospital

Eichman, Cynthia

Ministry Our Lady of Victory Hospital

Grasmick, Mary Kay

Wisconsin Hospital Association

Herzog, Mark

Holy Family Memorial, Inc.

Kammer, Peter

Essie Consulting Group

LePore, Michael

Wheaton Franciscan Healthcare

Mettner, Michelle

Children's Hospital and Health System

O'Brien, Mary

Aurora St. Luke's Medical Center

Olson, Edward

ProHealth Care

Starmann-Harrison, Mary

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

Katen-Bahensky, Donna

 

Kief, Brian

Ministry Saint Joseph’s

Leitch, Laura

Wisconsin Hospital Association

Levin, Jeremy

Rural Wisconsin Health Cooperative

Merline, Paul

Wisconsin Hospital Association

Neufelder, Daniel

Affinity Health System

Pandl, Therese

HSHS-Eastern Wisconsin Division

Sanders, Michael

Monroe Clinic


Contributions ranging from $2,500 - 2,999

 

Desien, Nicholas

Ministry Health Care

Taylor, Mark

Columbia St. Mary's, Inc.


Contributions ranging from $3,000 - 3,999

 

Borgerding, Eric

Wisconsin Hospital Association

Erwin, Duane

Aspirus Wausau Hospital

Size, Tim

Rural Wisconsin Health Cooperative

Turkal, Nick

Aurora Health Care


Contributions ranging from $4,000 - 4,999

 


Contributions $5,000 +

 

Brenton, Stephen

Wisconsin Hospital Association

Tyre, Scott

Capitol Navigators, Inc

 

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U.S. Rep. Ribble Meets with Hospital CEOs to Discuss Deficit Negotiations

This past week hospital executives met with U.S. House Representative Reid Ribble at St. Mary’s Hospital in Green Bay to discuss ongoing negotiations on the federal debt and how those could impact Medicare and Medicaid. The meeting was one of many coordinated by WHA as part of its grassroots campaign against further provider cuts to these government programs.

In describing his position on provider cuts, Rep. Ribble said, "The White House’s position is that providers, especially hospitals, can withstand another round of cuts. I disagree. I’m adamantly opposed to additional price fixing on the part of government. We need to reform Medicare and reward value."

Wisconsin hospitals have a strong record on proactively improving health care value through improved quality and increased efficiency. Riverside Medical Center CEO Craig Kantos provided an overview on the steps his organization has taken to reduce expenses in order to respond to concerns about rising health care costs. Ministry Health Care’s Sheila Clough described her organization’s commitment to care management, and St. Elizabeth Hospital President Travis Andersen discussed the use of medical homes.

Rep. Ribble responded by saying, "Hospitals all across my district are working hard to address the cost issue, but I’m not sure that you’ve told that story well enough to the public."

Rep. Ribble also described the environment in DC and indicated that he is committed to working with moderates on both sides of the aisle. "That’s the only way we’re going to solve our challenges, especially with the expensive entitlement programs."

This is the fifth in a series of hospital CEO meetings with Members of Congress coordinated by WHA during ongoing deficit reduction talks. To date, over three dozen hospital CEOs from across the state have met with Senator Ron Johnson and Representatives Sean Duffy, Ron Kind, Tom Petri and Reid Ribble. WHA thanks these individuals for their time and efforts.

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President’s Column: Three New Obstacles for Health Reform…

It hasn’t been a good couple of weeks for champions of the Affordable Care Act (ACA). And it’s been something of an "I told you so" moment for those who criticized former Speaker Pelosi’s comments about "we need to pass this bill (ACA) in order to find out what’s in it."

  1. The 11th Circuit Court of Appeals decision last week that the ACA "individual mandate" is unconstitutional was a very big deal. While some say that the court decision "only" targeted the mandate, as opposed to the larger law itself, the truth is that the individual mandate is the centerpiece of the entire 2,400-page law. Elimination of the mandate is a "poison pill" insomuch that a law prohibiting insurance underwriting only works if everyone has insurance. Absent a dual requirement that everyone be insured and that insurers take all comers, an environment will exist where only individuals facing significant medical expenses will demand coverage. This adverse selection will be a death spiral for health plans and doom the most important insurance reform provision found in the ACA. So now on to the Supreme Court.
  2. Another casualty of the recent Massachusetts hospital wage index "manipulation" (see last week’s President’s Column at www.wha.org/pubArchive/valued_voice/vv8-12-11.htm#5) is the undermining of a value-based purchasing (VBP) provision within ACA that had potential for helping Wisconsin providers. ACA requires CMS to adopt a VBP measure of Medicare spending per beneficiary that will reward efficient providers. The measure will benchmark 30-day episodes of care that include hospitalization expenses (Part A and B) and post hospital discharge spending. Low spending providers are to be "rewarded" beginning in late 2013.
  3. Unfortunately, among the factors that are to be removed from the spending episodes is the local wage index. That means that Massachusetts hospitals can exclude their artificially propped up wage index from their VBP benchmarks. So they will "have their cake and eat it too"—without the calories! This is another reason that the Massachusetts wage index manipulation must be repealed.

  4. As many as three million middle class "early retirees" will be able to qualify for Medicaid in 2014 under an obscure provision recently discovered in the ACA. The provision encourages Medicaid eligibility by excluding Social Security benefits from being counted as income. That means in 2014 a married couple, aged 62, with $64,000 in annual income will be Medicaid eligible. Medicare’s chief actuary Richard Foster says that the provision "doesn’t make sense" and that Congress "need(s) to do something about this."

Using scarce resources to expand Medicaid is breathtaking given the magnitude of deficit spending in Washington, and disconcerting to the nation’s governors as they try to balance state budgets. But some within the White House and Congress are taking credit for the new Medicaid loophole, claiming it was included in ACA "by design" to create a single national Medicaid eligibility standard. But former HHS Secretary Mike Leavitt notes that the provision "clearly begins to reveal that the nature of the law (ACA) was to put more and more people under eligibility for government insurance."

Unless repealed, this provision will lead to the further escalation of patients giving up commercial coverage in order to get coverage from Medicaid as the "low cost" option. For Wisconsin, that number could approach 60,000. And those are high users of health care services.

Steve Brenton,
President

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Recall Elections Completed, Democrats Retain Their Seats
Republicans maintain a 17-16 Senate majority

In the final recall elections of the summer held August 16, the remaining two Democratic Senators, targeted for their reaction to controversial proposals affecting state employee unions, held on to their seats.

The victories do not change the now current 17-16 Republican majority in the Senate.

Here’s a breakdown of this week’s results and the unofficial final margins:

District 12 — Senator Jim Holperin (D-Conover)
– Senator Holperin defeated Republican challenger and small business owner Kim Simac from Eagle River by a 55 percent to 45 percent margin.

District 22 — Senator Bob Wirch (D-Pleasant Prairie) – Senator Wirch defeated Republican challenger Jonathan Steitz, an attorney from Pleasant Prairie, by a 58 percent to 42 percent margin.

Details on the races of the six Republican Senators targeted for recall can be found in last week’s Valued Voice (www.wha.org/pubArchive/valued_voice/vv8-12-11.htm#1).

Overall, turnout in the recall elections was high, with over 40 percent of eligible voters in the nine recall districts going to the polls. This number is higher than the turnout in the recent Supreme Court election and approaching that of the 2012 Governor’s race.

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Reminder: Concealed Carry Implementation Resources Are on WHA’s Web Site

Hospitals can access WHA’s concealed carry resources within WHA’s legal and regulatory Web site at: www.wha.org/legalAndRegulatory/concealedcarry.aspx. Additional information including the Department of Justice’s Frequently Asked Questions and a 30-minute program from WisconsinEye discussing business implementation aspects of the new law have been newly added to the Web site resources. The new law goes into effect October 1.

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WHPRMS Annual Conference, October 12-14
Brochure and registration information included in this week’s packet

The Wisconsin Healthcare Public Relations and Marketing Society (WHPRMS) will hold its annual fall conference October 12-14 at Glacier Canyon Lodge at the Wilderness Resort in Wisconsin Dells. This year’s event will open with a keynote session presented by Jerry Hobbs and Phil Smith of Prairie Dog/TCG, both nationally known and respected voices in health care marketing and regular presenters at the national Society for Healthcare Strategy and Market Development.

Additional conference topics will include marketing to women, the new ethics guidelines in advertising, ways to apply creative thinking in health care organizations, increasing your return on creative, and satisfaction metrics and service recovery. The conference will conclude Friday morning with a session presented by Jennifer Armstrong Gay of the American Hospital Association and Steve Brenton, president of the Wisconsin Hospital Association. Both will focus on health reform, what those policies mean to Wisconsin hospitals, and how they can best be communicated to internal and external audiences.

The full conference brochure, with registration information, is included in this week’s packet and online at http://events.SignUp4.com/WHPRMS2011. For registration questions, contact Lisa Littel at 608-274-1820 or email llittel@wha.org.

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Understanding Community Needs
A Series of Articles on Community Health Improvement

By: Julie Hladky, CHIPP Research and Support Specialist
Wisconsin Association of Local Health Departments and Boards (WALHDAB) 

The first step in the community health improvement cycle is assessment. This includes locating existing (secondary) health data, gathering new (primary) health data, and assessing the existing community resources related to health. Many communities find it useful to form a data subcommittee to guide this stage of the community health needs assessment process.

A Community Health Data Framework

The challenge in conducting a community health needs assessment is knowing what data to use, when to gather additional local data, how to deal with data limitations, and how to present it in a meaningful way. A helpful way to organize the collected data is to select a framework that reflects not only health outcomes and health care utilization but also examines health behaviors and other underlying factors that influence health. These organizing frameworks can help structure the data for easier understanding. An example of such a framework is at: www.countyhealthrankings.org/our-approach.

Social Determinants and Health Disparities

The Affordable Care Act requires that hospitals examine primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups. A focus on these data helps to assure the resulting community health improvement plans are focused on the underlying causes of health problems and on the sub-populations most affected by them.

Data Sources

One of the challenges of conducting a community-level health assessment is finding community-level data. In addition community partners may have helpful local data such as immunization data from the health department or alcohol-related vehicle accident data from law enforcement. Other organizations that regularly conduct community assessments and therefore have local data include: Community Health Clinics/Federally Qualified Health Centers (FQHCs), United Ways, UW Cooperative Extension offices, and local health departments.

Data Challenges

Additional challenges that the data subcommittee will need to address may include:

Community Asset Assessment

At this stage of the community health needs improvement cycle, it is also helpful to examine resources (assets) that are available to address the community’s needs. This may include organizations, individuals/groups, buildings, landscape, and equipment that can be tapped to address community health needs. It can also include characteristics such as community pride or cohesion.

Next Step: Prioritization

Once the community health data is gathered and analyzed by the data subcommittee, it is presented to community partners and top priorities are selected for improvement. The next article in this series will focus on that process.

What is the deadline for the Community Health Needs Assessment?

The IRS Requirements states that the community health needs assessment must be completed and an implementation plan adopted by the last day of the "taxable year" that begins after 3/23/12. Hospitals with a December year end would need to have their community health needs assessment completed and an implementation plan adopted by December 31, 2013 and a June year end would have a June 30, 2013 deadline.

More resources are available at: www.wiservepoint.org/Resources.aspx

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Wisconsin Hospitals Community Benefits: Acute, Chronic and Communicable Disease Prevention and Control

Hospitals are well aware of the critical role they have in protecting public health. Whether it is working with public health agencies to develop protocols and responses to pandemic flu outbreaks, teaching children proper hand-washing techniques or educating people about how to live with chronic conditions, Wisconsin hospitals partner with key stakeholders to improve the health status of their communities.

Deadly illness made staff member a believer in flu vaccine

Julie Taylor has worked in environmental services at Froedtert Health St. Joseph’s Hospital for 36 years. A woman of determination, Julie is often seen flying through the halls wasting no time to get the next job done, whether it’s cleaning rooms or setting up for an event, and getting it right.

But when it came to getting a flu shot, Julie’s downright stubbornness nearly cost her her life.

St. Joseph’s Hospital has an active annual staff flu vaccine program, making sure each staff member is aware of the need for the vaccine and providing ample opportunities to get it – even taking the "flu cart" around to the floors on all shifts.

But Julie fought getting the flu shot for years, each year signing a declination form that any staff member must sign if they cannot or choose not to get the flu vaccine.

"My attitude was that I never got sick so why should I put something in my body that might make me sick –as some people believed. I just didn’t think I needed it," said Julie.

But in fall 2009 Julie became seriously ill, admitted to the hospital’s intensive care unit exhausted and with a fever of 105, her body under the full force of attack from a powerful flu virus. She didn’t remember anything until a week later. It took her a month of rehabilitation at home and with the help of therapists to learn to walk, and breathe, again.

In fall 2010, Julie got her flu shot and became an on-site advocate for the vaccine.

"I can’t believe what I went through….Even if you think you are hard as a rock or strong as an ox, it could happen to you," Julie said.

St. Joseph’s Hospital has an outstanding record for staff flu vaccine participation, and for the past several years has been at or above the state’s benchmark of 80 percent for the flu vaccine. In the 2009-2010 flu season, 100 percent of the staff were compliant, with 90 percent receiving the flu shot and 10 percent signing a declination form. In 2010-11, staff was 99 percent compliant, 80 percent receiving the vaccine and 19 percent formally declining.

"We’re working to raise the bar again this season," said occupational health nurse Mary Belger, RN.

Froedtert Health St. Joseph’s Hospital, West Bend


VascularAware

Peripheral Vascular Disease refers to diseases of the blood vessels outside the heart and brain. Left untreated, this disease can result in infection, skin ulcers, tissue damage, gangrene and ultimately, the need for amputation. According to the Wisconsin Department of Health Services, 50-75 percent of individuals who have Peripheral Vascular Disease are undiagnosed. However, vascular diseases are both modifiable and preventable. One of the ways Affinity Health System is targeting this important issue is by providing access to VascularAware, a free risk-assessment tool that identifies potential risks of vascular disease.

"This free assessment tool is an excellent resource for community members concerned about their risk for vascular disease due to family history or other risk factors," said Jody Andropolis, RN, clinic manager at St. Elizabeth Hospital Heart, Lung & Vascular Center. "Individuals who are identified as high risk can talk to a registered nurse who will help coordinate the next steps they can take to reduce their risk."

Daniel E. Neufelder, president and CEO of Affinity Health System, spearheaded the project in 2007, with the launch of HeartAware, the first health assessment test. HeartAware, which was funded by the St. Elizabeth Hospital Foundation, assessed the risk of heart disease.

"This tool is yet another way we provide our patients with personalized care," said Mike Drees, director of clinic operations at Mercy Oakwood Clinic. "Patients are able to take control of their health care and work proactively with their medical team to ensure they are taking the proper steps to prevent vascular disease."

The 10-minute online test quickly identifies an individual’s risk factors. If two or more risk factors are identified, the individual can opt in to be contacted by Affinity for follow up. In the first six weeks of its launch, 108 people completed the VascularAware assessment, with 32 identified as high-risk.

Affinity Health System, Appleton


Thomas

Two years ago, Thomas lived in south Florida and was coping with hypertension and substance abuse. Now a resident of Milwaukee and a regular client of the Community-based Chronic Disease Management (CCDM) Program, he is making progress on his health.

"I knew that I had high blood pressure," Thomas said. He was happy to receive care in Florida, but after a year, it was gone. "My insurance down there had expired, and I couldn’t get any medication. My top number [blood pressure] reading was 167. It was frightening."

So he moved to Milwaukee and joined Teen Challenge, a recovery program for adults and youths with more than 200 locations in the country. He works a full-time, non-paying job there.

"I’m the phone guy, the security guy. I keep an eye on the property, work the sound system if they need that. When you call Teen Challenge and somebody says ‘Hello,’ that’s me."

He described his care at CCDM as "unbelievable," and he has learned a lot about his hypertension. "I’ve learned a lot about things I can and cannot eat. I’m learning now how to control my diet. I have to monitor my sodium intake, and I read all the labels, even on bottled water. I pay attention more now and try to eat the right stuff."

Thomas works out regularly in the Teen Challenge gym. He lifts weights and uses the treadmill.

Thomas has kept his blood pressure under control for a year. "I’m eating more vegetables, and [I] try to get them fresh, not out of a can," he said.

"At the [CCDM] clinic, they draw your blood every six months, and then they go over the results with you. They explain what’s going on. They tell me, ‘You need to eat more of this; you need to do more of that.’’"

A busy man with a tight schedule, Thomas appreciates CCDM’s efficiency. "It’s a great place, and they have things under control," he said. "They get you in and out. No sitting around. When you get done, it’s ‘See you later.’"

The caring attitude of the clinic workers also makes a difference to Thomas. "I come here once a month. The people always take the time to listen. That’s important to me," he said.

"I neglected myself in the past, and now I’m trying to tighten up my life and my health. This is what I need."

Columbia St. Mary’s - Columbia Campus, Milwaukee


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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