January 16, 2004
Volume 48, Issue 3
Governor Holds Town Hall Meetings in Chippewa Falls, Superior, and La Crosse
Governor Jim Doyle held town hall meetings in Chippewa Falls, Superior and La Crosse earlier this week. At each stop, Wisconsin hospital leaders were there to share their perspective on the state of health care in Wisconsin. In Chippewa Falls, members of the St. Joseph’s Hospital Health Care Advisory Committee expressed their support for Healthier Choices and encouraged the Governor to give serious considerations to the important priorities spelled out in this proposal.
In Superior, Terry Jacobsen, CEO, St. Mary’s Hospital of Superior, had the opportunity to meet Governor Doyle and express his appreciation for the support the Governor’s team lent to assisting St Mary’s being designated as a critical access hospital, thereby preserving local access to hospital care in the area.
In La Crosse, Joan Mueller, administrator, business development, Franciscan Skemp Healthcare – Mayo Health System attended the listening session. Afterward, Mueller and Rob Nesse, MD, CEO and president, Franciscan Skemp, met briefly with the Governor to discuss health care priorities.
"The importance of our members attending these listening sessions and offering the local perspective on health care is an important piece of our overall advocacy efforts for hospitals. Elected officials know that the hometown perspective is important, and these members bring that point home at every opportunity, said Ann Lucas, VP, member advocacy. The Governor has scheduled listening sessions preceding his State of the State in the following communities: Green Bay on January 16; Milwaukee on January 17, and Monona on January 20.
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Business Day in Madison a Huge Success
Wisconsin hospital leaders joined over 1,000 other business leaders from across the state for the second annual Business Day in Madison. WHA was a gold sponsor of the event, which included a special briefing for WHA members on the Healthier Choices for Affordable Health Care proposal released earlier this month. Steve Brenton presented the proposal and emphasized the collaborative efforts of the associations and their members who prepared the proposal: Wisconsin Manufacturers and Commerce, the Wisconsin Association of Health Plans, and WHA.
"This is an important annual event for all business leaders across the state. Many of our hospitals are the largest employers in their communities, and a vital part of the economic engine driving Wisconsin. It is truly appropriate for us to join our business colleagues to press for economic growth for Wisconsin," said Steve Brenton, WHA president.
The program included a legislative leadership panel on regulatory reform, keynote speaker Oliver North, a panel on tax reform, and a presentation by Governor Jim Doyle.
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Hudson Hospital Hosts Senator Sheila Harsdorf
Marian Furlong, president and CEO, Hudson Hospital, invited Senator Sheila Harsdorf for a tour and to meet employees on Friday, January 9, 2004. "We were pleased to share with Senator Harsdorf our new facility and have the opportunity to discuss our local health care issues with her. As a border facility, we have issues from both Wisconsin and Minnesota, and it’s important for our elected officials to understand the impacts and differences of being a border facility on our patients and employees," said Marian.
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Wisconsin’s Technical Colleges See 24% Increase in Grads from 1998-2003
Report Increase of 2,700 nursing and nursing assistants over two years
This week, the Wisconsin Technical College System (WTCS) reported a 24% jump in technical college graduates entering the workforce over the past five years. Last year alone, the number of graduates increased more than 1,500, or nearly 9%. Many of the new grads are in health care programs, where WTCS reported an increase of 2,700 nursing and nursing assistant graduates over the past two years. According to WTS, the increase in health care occupation graduates is the result of aggressive efforts by the colleges to address shortages in this area.
Judy Warmuth, WHA VP, workforce development, applauded the efforts made to increase the number of graduates prepared to enter the health care workforce. She attributed the increase in interest by students to enter health occupations to a unified push by WTCS, WHA, and member hospitals.
"Many of our member hospitals have worked cooperatively with the technical districts to offer clinical sites, faculty, grants and even classroom space," Warmuth said. "There are some wonderful examples of joint efforts between community hospitals and their technical college that led to the increase in grads."
Warmuth cautioned that the modest increase in the number of graduates in health occupations doesn’t necessarily translate to long-term solutions to the workforce shortage. In their report, WTCS said the overall number of students in technical colleges has not increased, meaning students are taking more credits and completing programs at a higher pace than past years.
"We still see students on waiting lists, which is distressing. We need to increase the number of students in the pipeline by getting them into their coursework as soon as possible. As long as there are waiting lists at the technical college, and position vacancies in hospitals, we must continue to push for more slots for health care training programs," according to Warmuth.
Recent improvements at WTCS, specifically the new nursing curriculum, are impressive in the fact that all technical college districts will have the same courses, same course numbers, and same admission standards. This provides students and potential students more flexibility and options in obtaining their education. It also simplifies the transfer for credit to four-year campuses of the University of Wisconsin, enabling students to complete their baccalaureate degree.
WHA President Steve Brenton acknowledged efforts by WTCS President Richard Carpenter and other college leaders to make health care their top priority. "Health careers provide family sustaining incomes with solid benefits to current and future Wisconsin workers," Brenton said. "This report clearly demonstrates that our technical colleges are stepping up to the workforce challenge and producing real results."
Steve Brenton
President
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WHA Sponsored Legislation (AB-727) to Amend Chapter 146 Passes Assembly
WHA has been working with leadership in the Assembly and the Senate to amend Wisconsin law making it more consistent with the HIPAA Privacy Rule related to the sharing of patient information. The HIPAA Privacy Rule permits providers to release medical records without specific patient consent for purposes of payment, treatment, and health care operations. The problem with Wisconsin law is that it does not include an exception for health care operations, which include activities like quality assessment and improvement, auditing functions, and legal services, including fraud and abuse detection and compliance programs; and competency review to name a few. Wisconsin law was written over 25 years ago, prior to the time when many of these operational issues that help contain costs and improve the quality of health care became a focus, and needs to be updated.
AB-727 passed the Assembly January 13 on a vote of 58-33 and now heads to the Senate. The Senate Special Select Committee on Job Creation held a hearing on the bill on January 15 and Laura Leitch, WHA’s general counsel, testified on behalf of Wisconsin hospitals in support of the bill. Laura explained to the Committee that, "The federal government itself estimates that the cost of implementing HIPAA for the health care community will exceed $17 billion over ten years. Unfortunately, the cost for Wisconsin health care providers will be higher than estimated because of the inconsistency between state and federal law." Leitch continued by providing examples of how this change is important for purposes of patient care. Also testifying in support of AB-727 was Nevin Olson, quality improvement director for Dean Health Plan, Inc.
You can help WHA move this important legislation forward by contacting your state senators and the Governor’s office and urging them to support AB-727. For additional talking points, WHA’s position paper on this issue can be found on our website at www.wha.org. For more information contact Jodi Bloch at 608-274-1820 or email jbloch@wha.org.
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WHA CheckPointSM Launch Preparation Regional Meetings Set
WHA is holding meetings in all WHA regions to prepare members for the launch of the public reporting program, CheckPointSM. Member participation in the promotion activities, along with a good understanding of the CheckPointSM program, are necessary to both the launch and long-term success of CheckPointSM. Dana Richardson, vice president, quality initiatives, will answer questions related to the program and Mary Kay Grasmick, vice president, communications, will present the draft statewide communications plan. CEOs, quality managers and public relations professionals are urged to attend. RSVP to Grasmick at mgrasmick@wha.org or 608-274-1820.
January 28: Western—Shared Health Services, La Crosse, 12 p.m.
January 29: Packerland—St. Mary’s Hospital Med. Center, Conf. Rm C, Green Bay, 12 p.m.
February 4: North Central—Wausau Hospital, Boardroom, 9 a.m.
February 11: West Central—Myrtle Werth Hospital, Menomonie, 10 a.m.
February 13: Southern—Divine Savior Hospital, Portage, 11:30 a.m.
February 25: Southeast/Milwaukee—University Club, Milwaukee, 10 a.m.
March 5: Vikingland—Hayward Area Memorial Hospital, 10 a.m.
The CheckPointSM program will be publicly announced at news conferences around the state on March 30.
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2004 WHA Leadership Announced
WHA’s effectiveness depends on health care leaders committed to working with the Association, analyzing issues and forming overall policy. WHA Chair Chuck Shabino, MD, has announced a slate of committed individuals who have volunteered their time and leadership in helping to advance WHA’s mission in 2004.
Membership lists of the boards of WHA and its subsidiaries, as well as the councils and committees, can be found at www.wha.org/about/councils_boards_regions.aspx.
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CMS Survey on Occupational Mix for the Hospital Wage Index Due Feb. 16
CMS has developed a survey that collects data on paid employee hours for 20 different occupation categories of hospital employees. Data from the survey will be used to adjust the hospital wage index to account for differences in the types of caregivers employed by hospitals. Instructions for completing the survey and submitting the data were sent to all prospective payment system hospitals by fiscal intermediaries and are also available at www.cms.gov/providers/hipps/ippswage.asp. The survey must be completed and returned to fiscal intermediaries by February 16. WHA is concerned about the time frame provided to hospitals and the ability of hospitals, CMS, and fiscal intermediaries to ensure the validity and accuracy of the newly collected occupational mix data to be used for inpatient payments beginning October 1.
WHA will be conducting an educational session on the occupational mix survey on January 20. Hospital CFOs have been invited to either attend the session in Madison or to join in via conference call.
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CMS Publishes OPPS Interim Final Regulation
CMS has published in the Federal Register its outpatient prospective payment system (OPPS) interim final regulation for 2004. The rule, prompted by last year’s Medicare prescription drug bill, supercedes a previous final rule issued by CMS and has a 60-day comment period ending March 8. CMS estimates these changes will cost $150 million. The rule extends the hold-harmless payments for small rural hospitals with 100 or fewer beds through December 31, 2005. In addition, these hold-harmless payments are extended by the prescription drug bill to cover sole community hospitals in rural areas. The rule defines a class of separately payable drugs called "specified covered outpatient drugs" that in 2004 and 2005 is subject to payment floors and ceilings that vary by type of drug (sole source, innovator multiple source and non-innovator multiple source). And the rule changes payment rates for pass-through drugs and biologicals for 2004 and future years. The regulation can be found on the WHA website at www.wha.org/financeAndData/pps_outpatient.aspx.
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CMS Details Criteria for Special, One-time Wage Index Reclassification
CMS recently published in the Federal Register a notice providing instructions for hospitals to appeal for re-classification for their hospital wage index, as required by the Medicare prescription drug bill. The notice outlines criteria for hospitals to reclassify for a higher wage index and information the hospitals must submit to apply for this one-time appeal. Hospitals appeal requests must be received by the Medicare geographic classification review board by Feb. 15. Reclassification of the hospitals wage index will be effective for a three-year period for discharges beginning on or after April 1. The Medicare prescription drug bill allows CMS to spend no more than $900 million over the three-year period for this one-time wage index reclassification process. For more information, see the WHA website at www.wha.org/financeAndData/wage_index.aspx.
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Wisconsin Ag Health and Safety Forum
The Rural Wisconsin Health Cooperative and the Wisconsin Office of Rural Health are jointly sponsoring an Ag Health and Safety Forum on Wednesday, February 18, 2004 from 10–12 noon in Sauk City.
Dr. Steven R. Krikhorn, MD, MPH, medical director for the National Farm Medicine Center and Occupational Medicine at Marshfield Clinic will discuss cardiovascular risks and the farm population. The purpose of the forum is to facilitate informal networking and best practices among health practitioners and administrative staff at organizations working with farmers and agricultural workers. This is not intended as a policy forum. For more information and a form for free registration, call 608-643-2343 or download http://rwhc.com/AgForum.pdf.