State Issues Public Health Order to Limit Flu Shots to High Risk Individuals
Gives providers authority to ensure vaccine goes to priority patients

Today, the State of Wisconsin issued a Public Health Emergency Order governing the distribution of influenza vaccine.  The emergency order uses the force of law to limit influenza vaccinations to those who are in high priority categories. Failure to comply with the emergency order will result in additional enforcement, including immediate court proceedings.

At a news conference on Friday afternoon, Governor Jim Doyle said, “Our nation is facing an unprecedented shortage of the flu vaccine this year.  This Public Health Order will ensure that those who are at the greatest risk will receive the care they need.  The Order effectively gives providers the authority to ensure priority patients can receive the flu vaccine in Wisconsin. “

Wisconsin hospitals are reporting growing concern in their communities as the demand for the influenza vaccine is far exceeding the supply.  In many areas, employer-sponsored flu clinics and many that were scheduled by hospitals and health clinics have been cancelled, or scaled back to include only those identified in the high risk categories.

Yesterday, the Wisconsin Department of Health and Family Services held an emergency meeting to discuss the current situation and develop strategies for addressing the issue. 

DHFS Secretary Helene Nelson said the shortage of flu vaccine is an “important public health issue and we need to work smartly and quickly to make sure that people who need the vaccine get it.”

Secretary Nelson encouraged health care providers to work cooperatively with public health departments to ensure that the shortage is treated in a way that ensures the health of the public is the first priority. 

Dana Richardson, WHA’s representative at the DHFS meeting, said all hospitals should contact their local public health department regardless of their supply.  The Public Health Department is gathering information about the supply and demand for vaccines within each community, region, and in the state.   

DHFS said they are holding weekly conference calls with public health officials and hospital infection control specialists.  All hospitals should ensure that they have designated staff to participate in these calls to assure that they communicate the needs of their community to the state and keep abreast of changes in the state’s action plan over the flu season.  Hospital staff can also access information and monitor changes in the action plan at the DHFS Web site, http://www.dhfs.state.wi.us

DHFS has opened a priority email contact system to assist health care providers who have special concerns. The address is:  dphemergency@dhfs.state.wi.us 

Last year, only 44 percent of the people who were identified to be at high risk for the disease actually received the vaccination.  This year, more of those in the high risk categories are expected to ask for the vaccination because of the increased awareness and education that is being promoted in the media.

It is imperative that hospitals, physician offices, and other providers follow the DHFS guidelines as stated in the emergency order for vaccine distribution so that many of those most vulnerable receive the vaccine. These guidelines take precedent over earlier CDC recommendations and are as follows:

• All children age 6-23 months

• Adults age 65 and over

• Persons age 2-64 years with underlying chronic medical conditions

• All women who will be pregnant during the influenza season

• Residents of nursing homes and long-term care facilities

• Children age 6 months to 18 years on chronic aspirin therapy

• Healthcare workers involved in direct hands-on patient care

• Out-of-home caregivers and household contacts of children under 6 months of age

The State has further refined these guidelines for Wisconsin, including specific recommendations for vaccinating hospital workers and who qualifies as high risk within the guidelines.  This specific information is posted on the DHFS Web site,  http://www.dhfs.state.wi.us

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Campaign Spotlight                      Senate District 22                                      Fall 2004

The incumbent Democratic Senator Bob Wirch is facing Republican challenger Reince Priebus.

District Description:

The 22nd Senate District covers all of Kenosha County as well as the town and city of Burlington in  Racine County.

District Hospitals: Kenosha Hospital and Medical Center, Children’s Hospital, Aurora Medical Center – Kenosha and Memorial Hospital of Burlington.

Candidate Profiles:

A member of the Democratic Party, Bob Wirch was first elected to the Senate in 1996.  Prior to being elected to the State Senate he served in the Wisconsin Assembly since 1992.  Before statewide elected office, Sen. Wirch served on the Kenosha County Board.

Reince Priebus is a member of the Republican Party.  He resides in Kenosha where he is an attorney who has experience working on behalf of hospitals and other health care providers.

Candidate Survey Results:

Candidates’ answers to selected abbreviated questions from WHA’s 2004 candidate survey appear below.  Incumbent Bob Wirch did not return the survey.  To view the entire survey for this or any other race, contact Eric Borgerding or Jodi Bloch at 608-274-1820.

WHA has identified a serious and growing shortage of physicians in Wisconsin including specialists and primary care physicians.  The last budget slashed $45 million in funding for graduate medical education.  Would you support restoring this funding?  Priebus: YES

Do you think the property tax exemption for non-profit hospitals should continue?  Priebus: YES

Wisconsin’s Medicaid and BadgerCare programs pay only 59 cents for every $1 it costs hospitals to care for these patients.  The remaining unpaid costs must be recouped through cost shifting to the private sector also known as the “Medicaid Hidden Tax.”  Would you support proposals aimed at having the  state pay more of actual hospital costs for the Medicaid and BadgerCare programs?  Priebus: YES

Hospitals are experiencing a growing shortage of health care workers from nurses to pharmacy technicians, and this shortage is projected to worsen as the demands for health care increase even more as the baby boom generation approaches their senior years.  Would you support efforts to target new or existing dollars within the technical college system and UW System to alleviate waiting lists and get  more people into health care professions?  Priebus: YES

Should state government approve hospital decisions about the purchase of new equipment and construction of new facilities?  Priebus: NO

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WHA , WHAIC, WHAFS Employees Exceed United Way Financial Goal by 20%

The employees of the Wisconsin Hospital Association, WHA Information Center and WHA Financial Solutions turned out for the United Way Campaign in a big way-- exceeding the financial goal by       20 percent and meeting the 100 percent participation goal.  Campaign coordinators Roberta Riddle, Pam Aud, Julie Callies, Angela Miloszewicz, Bridget Gifford and Ann Lucas reported that the signed pledge forms came in within 48 hours after the initial kick-off, and employees were eager to meet the campaign goals.  “We are proud of the terrific response from our staff. It’s particularly impressive that employees of an organization that advocates for hospitals, which are community based organizations, are so committed to supporting their own community organizations represented by the United Way,” WHA President Steve Brenton added.  

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President’s Column

Last week in Wausau, several hundred Wisconsin “Partners of WHA” (hospital volunteers) gathered for their annual meeting and convention.  A program highlight was a hospital leadership panel moderated by WHA Chair Chuck Shabino, MD, that included Mike Hammer, CEO, Good Samaritan Health Center, Merrill; Dan Hymans, president, Memorial Medical Center, Ashland; and Paul Spaude,   CAO, Aspirus Wausau Hospital.

These leaders provided attendees with a thoughtful overview of why hospital auxilians, volunteers and trustees play such a vital role in the success of their community hospitals.  Kudos to Chuck, Paul, Dan and Mike for sharing their meaningful comments and encouraging viewpoints.

Competitive Wisconsin, the statewide bipartisan organization of business, labor, agriculture, education and health leaders, last week endorsed a series of resolutions relating to their health care agenda.  In addition to endorsing the six Institute of Medicine (IOM) Aims for a 21st century health care system, the group recognized that encouraging healthy lifestyles through the workplace, schools and government is essential to driving down health care cost inflation.

Competitive Wisconsin leaders also endorsed transparency of health care information as a health reform strategy.  That resolution “encourages all health care providers to publicly report quality and price information so that consumers can make value choices.”  The resolution also commends the Wisconsin Hospital Association for CheckPointSM and the Wisconsin Collaborative for Healthcare Quality for their public reporting initiative.

Did anyone else catch this? 

In responding to a question about Medicare at the October 8 presidential debate in St. Louis, Senator Kerry said, “Actually, Mr. President, in 1997, we fixed Medicare, and I was one of the people involved in it.”

For those with short memories, in 1997, then-President Bill Clinton and most members of Congress enthusiastically embraced the Balanced Budget Act of 1997.  The nation’s physicians, hospitals and other Medicare providers were slapped with across-the-board reimbursement reductions amounting to billions of dollars.  In “fixing Medicare,” the bipartisan initiative created oceans of red tape and cost shifting to the private sector.  Congress then spent the next three years undoing financial damage caused by a variety of BBA ‘97 “fixes.”

The BBA of 1997 also repealed the Boren Amendment, which required Medicaid provider rates to reflect some semblance of “reasonableness” in paying provider costs.  Seven years later, Wisconsin hospitals are paid 59 cents on the dollar.

Wisconsin hospital and health system friends have contributed to making the 2004 Healthy Wisconsin campaign a record success!  We recently blew through our $125,000 campaign goal and have totaled contributions surpassing $153,000!  What a terrific effort!

Steve Brenton, President  

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Speaker Gard’s Task Force on Wisconsin Technical College System meets

In addition to the issues of credit transfer and ease of movement into baccalaureate programs, other issues COBE will address include funding, access, student support, incentives and more. This group has 13 recommendations that will be presented to the respective system boards in November. Seven of those recommendations are ready to advance, while the rest will take more time or resources. Following action by the Boards, COBE will report back to the Speaker’s Task Force with final recommendations in January.  Philip Stuart, CEO at Tomah Memorial represents WHA on this group. WHA will continue to monitor the recommendations of the Task Force and work with committee members to streamline credit transfer to move more students into health care careers to meet the increased demands in the future.

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Office of the Inspector General  Releases Work Plan for 2005

The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has issued its Work Plan for fiscal year 2005.  The OIG describes its Work Plan as encompassing those project areas the OIG views as critical to the mission of the OIG and to HHS.  According to the OIG, it attempts to target its resources on those areas that best identify the vulnerabilities in HHS’s programs and activities and that promote the economy, efficiency, and effectiveness of those programs.

There are a number of projects in the OIG Work Plan that are of interest to hospitals.  Some of those projects are the following:  

• Determine whether rehabilitation services provided by hospital outpatient departments met the Medicare coverage requirements.

• Examine DRGs that have a history of aberrant coding to determine whether some acute care hospitals exhibit aberrant coding patterns.

• Review hospital cost reports to examine the administrative and other costs incurred by Critical Access Hospitals for inpatient and outpatient services for time periods both prior and subsequent to their conversion to Critical Access Hospital status.

• Determine whether claims for inpatient outlier payments were submitted in accordance with Medicare laws and regulations.

• Review payments to inpatient rehabilitation facilities under the prospective payment system to determine the extent to which they were made in accordance with Medicare laws and regulations.

• Study the appropriateness of alternative payment methodologies for GME involving the costs of training residents in nonhospital settings.

A copy of the OIG Work Plan is available on the WHA Web site under Legal and Regulatory. 

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WHA Job Bulletin Update: Submit Job Positions Online Now
New service makes posting a job vacancy easy

Since July, the Wisconsin Hospital Association has offered a new member service, The WHA Job Bulletin.  Published monthly, The WHA Job Bulletin provides WHA member hospitals another venue where they can post job vacancies.  The Job Bulletin is distributed along with The Valued Voice, and it is also posted to the WHA Web site in the workforce section.  Each job position will be printed in one monthly issue of the Job Bulletin, but will remain posted to the Web site for one month.  If the vacancy is open for more than one month, it will need to be resubmitted to the Job Bulletin.

Job positions can now be posted by members on-line by using a Web based tool that can be found at www.wha.org/workForce/job_submit.aspx or click “Submit a Job Online” from the home page of the website. Job openings can be posted directly to the bulletin by using this online tool. 

For your reference, postings in the WHA Job Bulletin are:

• Available to WHA members only, for positions that are directly employed by the member’s hospital or health system

• Updated daily on the web – positions are posted for one month only, unless they are resubmitted

• Positions announcements are printed for inclusion in the Friday Packet once a month. The next Bulletin will be printed on October 29.

• Free

The benefits of posting a position in the WHA Job Bulletin:

• Offered as a no-cost benefit of membership

• It is another strategy for addressing workforce issues

• Position announcements are publicized in both the Friday Packet and on the WHA Web site. These familiar tools are widely accessed by large numbers of people interested in health care issues in Wisconsin.

If you have questions about the web-based submission tool, contact Tammy Hribar at thribar@wha.org .  For more information on this or other issues related to workforce, contact Judy Warmuth at jwarmuth@wha.org  or call 608-274-1820.

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WHA Comments on Proposed Outpatient Services Rule

In written comments submitted Friday, October 8 to the Centers for Medicare & Medicaid Services (CMS), WHA expressed support for several proposed revisions to Medicare’s hospital outpatient prospective payment system. Specifically, WHA commended CMS for establishing a fixed-dollar threshold designed to better target outlier payments to truly high-cost services, for simplifying the requirements for observation services and for improving the coding for drug administration.

WHA also commented on the overall payment inadequacy of the OPPS, noting that the system pays only 87 cents for every dollar of hospital outpatient care provided to Medicare beneficiaries. Further, WHA expressed a need to address the more than 60 “broken” ambulatory payment classification rates that resulted in hospital losses of more than $1.4 billion in Medicare payments in 2003. 

WHA’s comments are online at www.wha.org/financeAndData/pps_outpatient.aspx.

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