This is your last chance to register for WHA’s 2008 Annual Convention September 17-19 at the KI Convention Center and the adjoining Hotel Sierra (formerly Regency Suites) in downtown Green Bay.

This year’s convention kicks off with a keynote by Ian Morrison, nationally-known health care futurist, followed by a CEO reactor panel that will share their thoughts on the keynote session, the upcoming election, health reform and other related topics. The reactor panel will be moderated by Leo Brideau of Columbia-St. Mary’s. Panelists include Ed Harding of Columbus Community Hospital, Brian Kief of Ministry Health Care, and David Olson of Bay Area Medical Center. Other notable activities include an address by AHA Chairman, and Wisconsin’s own, Bill Petasnick, as well as a closing session by Major General David Rubenstein, ACHE Chairman, deputy surgeon general for the U.S. Army, and former CEO of the largest American hospital outside of the U.S. and the only American tertiary hospital in Europe.

As a WHA member benefit, each WHA member hospital’s CEO and CFO will receive the Fiscal Year 2007 Annual Survey and Hospital Fiscal Survey data sets via email. The data sets contain all responses from all hospitals to the Annual and Fiscal Surveys.

These survey data sets are used to create the WHA Information Center’s Guide to Wisconsin Hospitals publication, as well as to populate financial information in WHA Information Center’s PricePoint system.

• The Hospital Fiscal Survey data set is an Excel spreadsheet that allows users to query facility-specific data related to: revenue and expense figures classified by gross patient revenue; deductions from public and commercial sources; unrestricted assets and liabilities; fund balances; charity care and bad debt figures; discharge counts; and gross and net revenue projections.

• The Annual Survey data set is an Excel spreadsheet that allows users to query facility-specific data related to staffing and utilization data about Wisconsin hospitals. This data set also includes information on accreditation and certification; managed care contracts; provision and location of selected inpatient, ancillary, and other services; number of beds set up and staffed; Medicare-certified swing bed utilization; and hospital staffing.

The data sets are also available to the public for purchase.

Questions about the data sets may be directed to Julie Callies, director, WHA Information Center, at jcallies@wha.org or 608-268-1805.

The WHA Nominating Committee will present its report and recommendations for board members to be voted on by the membership at the Annual House of Delegates meeting on Thursday, September 18 in Green Bay. The following individuals have been nominated to serve another term on the WHA Board of Directors. In addition, two people and one alternate have been nominated to serve as Wisconsin delegates to the American Hospital Association (AHA).

Sandra Anderson
(2nd Term)
President/CEO, St. Clare Hospital & Health Services, Baraboo

• WHA Board, 2004-2006
• Advocacy Committee, 2005-2008
• Nominating Committee, 2004, 2006
• Physician Task Force, 2003

Bill Bestor
(1st Term)
President/CEO, Community Memorial Hospital, Menomonee Falls

• Council on Finance and Payment, 2000-2005
• Medicaid Task Force, 2004-2005
• WHA Board, 2008
• WHA-FS Board, 1994-1999, 2004-2005
• WHA-IC Board, 2004-2006

David Grundstrom
(2nd Term)
President/CEO, Flambeau Hospital, Park Falls

• Council on Medical and Professional Affairs, 2003-2005
• Governance Council, 1992-1997
• WHA Board, 2005-2008

Nick Turkal
(2nd Term)
President/CEO, Aurora Health Care, Milwaukee

• Medical & Professional Affairs Committee, 2002-2003, chair 2004-2006
• Task Force on Access & Coverage, 2006-2008
• Task Force on Quality & Accountability, 2002
• WHA Board 2006-2008
• Executive Committee, 2004-2006

The new AHA Delegates are:

Mary Starmann-Harrison
Regional President/CEO, SSM Health Care - Wisconsin

• Council on Public Policy, 2001-2004-Chair, 2005-2006
• Task Force on Access & Coverage, 2006-2008
• WHA Board, 2000-2007, chair 2006
• Executive Committee, 2003-2005, 2006-Chair
• Nominating & Awards Committee, 2002
• PAC Committee, 2002
• Property Committee, 2003-2004
• Advocacy Committee, 2007 Chair

Gerald Worrick
President/CEO, Ministry Health Care - Door County Memorial Hospital, Sturgeon Bay

• Council on Rural Health, 1989-2003
• Council on Public Policy, 2001-2008
• WHA Board, 1996-2004, 2003-Chair
• Executive Committee, 2002-2004
• Advocacy Committee, 2004-Chair
• Nominating and Awards Committee, 1993-1995, 2002-2003, 2004-Chair, 2005-2006
• Property Committee, 2003-2004

Bob Fale - Alternate
President, Agnesian HealthCare, Fond du Lac

• Council on Finance & Payment, 1997-2002
• Council on Workforce Development, 1997-2002
• HFS124 Task Force, 2001-2003- Chair
• Task Force on Community Benefits, 2005-2006-Chair
• WHA Board 1999-2008, 2007-Chair
• Executive Committee, 2004-2008
• Advocacy Committee, 2008-Chair

Top of page

Regardless of the outcome of the November 4 elections, WHA’s top 2009 goal is to advance a legislative agenda that secures coverage for vulnerable populations and improves hospital Medicaid payments, especially for safety net hospitals that disproportionately serve fragile communities. Consistent with WHA’s Board-adopted health reform principles (www.wha.org/financeAndData/accessAndCoverage.aspx), Wisconsin hospitals will be proactive champions of initiatives that improve access and coverage regardless of partisan sponsorship.

Paying for coverage improvements like BadgerCare Plus-Childless Adults (which received strong bipartisan support in the last budget, but is not yet funded) and meaningful hospital payment increases will come with a cost—a high cost in what is certain to be a difficult state budget environment. Just two years ago, WHA supported a cigarette tax increase with dollars earmarked for Medicaid and other health care programs. Only a handful of lawmakers championed that position and at the end of the day every new dollar from the higher tobacco tax went to backfill other spending priorities.

It became increasingly apparent in 2007 that new spending on Medicaid, especially for hospital payment increases, would only come from an assessment on hospitals with dollars used to generate federal matching funding—a perfectly legal mechanism deployed in dozens of states across the country—including most of our neighbors. The proposal was blocked by Republicans in the Assembly, who viewed the hospital assessment as a "tax." This, coupled with the fact that there was no GPR available for payment increases (a fact harshly underscored by the bipartisan transfer of $200 million from the Injured Patients and Families Compensation Fund to balance the budget), meant a sixth straight biennium (12 years) with no real increase in hospital Medicaid payments.

The results of failing to address Medicaid in the last state budget?

• Hundreds of millions in federal health care dollars that rightfully belong in Wisconsin have been left on the table for other states to claim (more on that in next week’s Valued Voice).
• A lawsuit over the IPFCF transfer that could blow (another) massive hole in the next state budget.
• And, most troubling, health care costs that continue to escalate, fueled by the hundreds of millions in unpaid Medicaid costs that hospitals are increasingly forced to shift to families and employers through higher prices for hospital care.

As we meet with incumbent lawmakers and their challengers this year we need to ask….WHAT’S YOUR PLAN FOR MEDICAID? When the new Legislature is gaveled into order next January, it will have been more than a decade since most hospitals received a rate increase. In fact, due to longstanding Medicaid payment policy, most hospitals will see a decrease this year in order to maintain a cost-based payment commitment to Critical Access Hospitals. Robbing Peter to pay Paul in the current environment is not fair, equitable or sustainable.

The hospital assessment, as rewritten and approved by the WHA Board in late 2007, will again be the only realistic alternative to the unacceptable status quo. The notion that lawmakers will find new GPR in 2009 that they failed to identify in a far more robust 2007 is a fine notion, but hardly realistic or conducive to actually solving the long-ignored problem of cost-shifting.

So when discussing this matter with lawmakers and candidates who oppose the hospital assessment as "another new tax," ask them WHAT’S YOUR PLAN FOR MEDICAID?

Steve Brenton
President

Secretary Karen Timberlake, State of Wisconsin Department of Health Services, visited the Saint Mary’s Hospital campus on August 13, 2008. Secretary Timberlake’s visit was prompted by her interest in learning more about the Springer Health Access Program at Saint Mary’s Hospital and Ministry Medical Group in Rhinelander.

Secretary Timberlake and her executive assistant, Rea Holmes, toured the facility with Bill Erickson, vice president of operations. Joining Secretary Timberlake for lunch and discussion was Brian Kief, CEO, Northern Region Hospitals; Monica Hilt, president, Sacred Heart-Saint Mary’s Hospitals; Jill Spieckerman, vice president, Patient Care Services; Dr. Dorothy Skye, Ministry Medical Group; Kay Rawlsky, manager, Patient and Family Services; Sue Kirby, Community Link coordinator; Jodi Hanson, public and community relations manager and Bill Erickson.

Creditors holding consumer or other covered accounts must develop and implement an identity theft prevention program by November 1, 2008. This new requirement, which is part of the Federal Trade Commission’s (FTC) Red Flags Rule, likely affects hospitals in several ways.

According to the American Hospital Association’s outside counsel Hogan and Hartson, hospitals likely meet the rule’s broad definition of "creditor" and have patient accounts that would fall within the broad scope of "covered accounts." The definition of creditor includes anyone who defers payment for services rendered. The rule and FTC’s guidance specifically identify as a covered account a continuing relationship an individual establishes with the enterprise, such as billing for previous services rendered. Hogan and Hartson writes that any type of patient account or payment plan that involves multiple transactions or multiple payments likely falls within the definition of covered account in the rule.

Under the rule, hospitals, as creditors holding covered accounts, must develop an identity theft prevention program that includes reasonable policies and procedures for detecting or mitigating identity theft. Importantly, hospitals will need their governing boards (or appropriate committee thereof) to approve the initial written program by the November 1 compliance deadline. The programs should enable the hospital to:

• Identify relevant "red flags" (patterns, practices, and specific activities) that signal possible identity theft and incorporate those red flags into its identity theft program;
• Detect the red flags that have been incorporated into the program;
• Respond appropriately to the detected red flags to prevent and mitigate identity theft;
• Ensure the program is updated periodically to reflect changes in risk.

The U.S. Environmental Protection Agency (EPA) and Wisconsin Department of Natural Resources (DNR) will soon launch an education and regulatory compliance initiative on hazardous waste in hospitals and other health care facilities. Joanie Burns, section chief of the Hazardous Waste Prevention and Management Section at the Wisconsin Department of Natural Resources, discusses with WHA the initiative and what hospitals can expect from the DNR below.

WHA: U.S. EPA and DNR are planning an initiative focusing on hazardous waste in health care that will be launched this fall. What should hospitals know about this initiative?

Burns: In a joint initiative, the DNR and U.S. EPA, Region 5 have made compliance with hazardous waste regulations in health care settings a priority for the next two years. Hospitals are subject to federal and state hazardous waste regulations that have been the law since the 1970s. As a part of the initiative, DNR is preparing new information and guidance to hospitals to help them ensure compliance with hazardous waste regulations.

WHA: When will the initiative officially be launched?

Burns: DNR will officially announce the initiative and begin distributing new guidance and information to health care providers on hazardous waste compliance during the September 19 meeting of the Wisconsin Healthcare for a Healthy Environment in Green Bay at St. Mary’s Medical Center. You can contact Steve Brachman with UW-Extension for more information on this group and meeting. His email address is: steve.brachman@ces.uwex.edu.

WHA: Is the DNR planning on stepping up inspections of hospitals for compliance with hazardous waste regulations?

Burns: EPA and DNR want to make sure that health care facilities are a part of the universe of business and facilities that are inspected in 2009 to check for compliance with hazardous waste regulations. While EPA and DNR may conduct inspections at any facility or business at any time, Federal inspections aimed specifically at health care facilities are being planned for as early as late-2008. DNR is expecting to focus a portion of the hazardous waste inspections they do specifically on health care facilities sometime in 2009.

WHA: How will the initiative help hospitals prepare for hazardous waste compliance inspections?

Burns: DNR is preparing new information and guidance to hospitals to help them properly manage the waste they generate and ensure compliance with hazardous waste regulations. In particular, DNR will be posting on its Web site self audit forms based closely on DNR’s hazardous waste inspection forms, guidance documents that address basic hazardous waste compliance information that is geared specifically for the health care industry, and a table of common wastes in health care settings. This information will be in addition to information that is already available on the DNR’s Web site at http://dnr.wi.gov/org/aw/wm/.

WHA will cover the September 19 launch of the hazardous waste initiative in The Valued Voice and will provide more information, including new DNR materials, as it becomes available. For more information, contact Matthew Stanford at mstanford@wha.org or 608-274-1820.

Learn about and discuss some of the hottest topics in health care today—on-call compensation and how it relates to EMTALA; recent employment law developments; the new IRS Form 990 and Schedule H changes, and others—at the September 25 "Hot Topics in Health Care" seminar.

Application materials are now available for the Wisconsin state quality award program, Wisconsin Forward Award. The application process is open to all Wisconsin business, manufacturing and service organizations, as well public and private education (K-12 through post secondary), health care, non-profit and government entities. Organizations of any size are encouraged to apply. Preliminary intent-to-apply forms to verify eligibility are due October 31, 2008, with final applications due January 16, 2009. All application materials are posted at www.forwardaward.org or are available by calling 608-663-5300.

George Hinton has been appointed chief administrative officer for Aurora Sinai Medical Center. Hinton joined Aurora Health Care in 2000 and has served in a variety of roles during his tenure. Most recently he was the vice president of operations at Aurora Sinai and the vice president of academic affairs for Aurora Health Care. Prior to joining Aurora, Hinton worked as director of orthopedics, radiology and ambulatory services for Children’s Health System of Wisconsin and as the managing director of Inroads Wisconsin. Currently, he is a member of the national Institute for Diversity in Health Management and is a fellow of the American College of Healthcare Executives.

Hinton succeeds Len Wilk as chief administrative officer for Aurora Sinai. Wilk recently moved to Aurora Sheboygan Medical Center and the Aurora Surgery Center in Plymouth, as administrator.

One of the cornerstones of Bay Area Medical Center’s community programs is a series of free screenings to the public. In 2007, each screening saw a record number of people taking advantage of this important health service in the Marinette and Menominee area.

• Bay Area Medical Center’s annual cardiac screening was held in November and provided nearly 200 people with a low cost cholesterol/glucose screen as well as body composition and blood pressure screens.
• Bay Area Medical Center held its first annual Women’s Heart Health Day in February. Two hundred women from the community received a cardiac assessment and had the opportunity to talk with a variety of providers and Bay Area Medical Center staff about Women’s Health issues.
• 185 men took part in Bay Area Medical Center’s annual prostate screening in late September.
• In April, Bay Area Medical Center participated in the annual Mary Hendrickson-Johnson Skin Cancer Screening, with 197 people coming for valuable early detection and education offerings.
• During August, September and October, the Bay Area Oncology Fund provided 230 women in the community with free mammograms.
• Bay Area Medical Center also offered advance directives consulting as part of the Women’s Heart Health Day, cardiac screening and prostate screening.

Top of page

The health care team in surgical scrubs practices suturing wounds, casting broken bones, even performing gall bladder surgery—and they’re only in their teens.

Every semester a dozen seventh and eighth graders from Stoughton River Bluff Middle School get a hands-on introduction to health care careers through the Scrub Club, a program sponsored by the staff of Stoughton Hospital.

The idea came out of the Rural Wisconsin Health Cooperative, but Stoughton Hospital has made the Scrub Club its own, beginning with a survey asking students what types of activities would most interest them.

The students meet monthly in different departments. The program is chaired by three nurses (Director of Ambulatory Services Teresa DeNucci and Clinical Education Coordinators Mary Quisenberry and Mary Smith), but Smith notes that "the staff of every department handled the teaching, and they came up with some creative ways to introduce the students to all the different health care skills."

Scrub Club members learn how to administer an injection into the muscle, start an IV and use laparoscopic surgical equipment—to remove a "gall bladder" from a watermelon standing in for a human patient. They also practice physical therapy activities like transferring a patient via wheelchair.

The young participants are issued their own scrub shirts and name tags and sign the same confidentiality agreements that employees must complete.

"The kids have been really enthusiastic, and they never miss a class," Smith says. "One student was so excited he showed up a week early."

Stoughton Hospital also supports young people’s interest in health care careers by sponsoring several scholarships:

• The Stoughton Hospital Nursing Scholarship Fund is supported with contributions from the nursing staff, along with generous memorials from the family of a colleague who passed away recently. The fund supports scholarships for hospital staff who are continuing their nursing studies and a Stoughton High School senior who plans to study nursing.
• A $3,000 scholarship, sponsored by the Stoughton Hospital Foundation and Partners of Stoughton Hospital, is awarded to a Stoughton High School senior who plans a health care career.
• The Partners also sponsor the $1,500 Lois Roe-Kvamme Scholarship for a high school student planning to major in health care studies.
• The Carlton Pokrandt Scholarship, funded through the Foundation in memory of a long-time nurse anesthetist at Stoughton Hospital, also supports a student pursuing a nursing career.
• The Stoughton Hospital Medical Staff Scholarship Fund offers a $1,500 scholarship to a high school student in each of four area high schools (Stoughton, Edgerton, Evansville and Oregon) to enroll in a four-year accredited college with an emphasis on medicine or nursing.