Following a lengthy teleconference, the WHA Board of Directors on October 3 lifted the Association’s opposition to the hospital tax. The Board agreed to remove its opposition only after hearing that several statutory changes have been offered to the plan that, if enacted, will address the key concerns WHA has raised about the tax over the past eight months. Concerns with the hospital tax have focused largely on four areas:

1. Ensuring that the $284.2 million (net) in increased Medicaid payments promised from the hospital tax will actually flow to hospitals

2. Preventing the tax from being levied prior to the state receiving necessary approvals from the federal government to implement the payment plan and deliver promised levels of payment increases

3. Safeguarding the hospital tax and resulting revenues from reductions or diversions for unrelated purposes

4. Exempting Critical Access Hospitals (CAHs) from the tax given the fact that they would otherwise be net losers under the plan

"It’s been about 12 years since hospitals received a rate increase for Medicaid, and our primary concern is making sure Wisconsin’s safety net hospitals are helped—that’s our motivation," said WHA Executive Vice President Eric Borgerding. "We don’t think this is necessarily the ideal approach, but it is workable if enacted and maintained with these amendments."

The Wisconsin Hospital Association has expressed strong concerns with the hospital tax included in Governor Doyle’s version of the state budget. At the same time, WHA has continued to advocate for much needed hospital Medicaid payment increases in order to relieve the financial burden on Wisconsin’s "safety net" hospitals and begin reducing the "hidden tax" that results from cost shifting Medicaid losses.

WHA President Steve Brenton said the hospital tax proposal on the table today is significantly different than the proposal put forth in February, which warranted strong opposition.

In June, WHA sent a letter to the Joint Finance Committee outlining specific concerns with the hospital tax, many of which revolved around ensuring that the hospital tax revenues and the federal matching dollars they capture are actually returned to hospitals. Statutory amendments recently agreed to by the Doyle Administration address those concerns.

"If enacted and sustained with amendments now being offered, we believe the proposal will result in substantial and much needed Medicaid payment improvements for safety net hospitals while reducing the statewide impact from cost shifting unpaid Medicaid costs," according to Brenton.

Among other protections agreed to, the hospital tax would sunset after two years, ensuring it will be revisited if not functioning as intended.

WHA staff will be scheduling member conference calls next week. Details will be communicated directly with member hospitals early next week.

Where do you go when you need medical attention, and you don’t have insurance? More and more hospitals in Wisconsin are helping establish free clinics in their community to treat patients who do not have a "medical home." Often in partnership with other hospitals, public health agencies and medical clinics, hospitals support or operate more than 70 free clinics in Wisconsin, serving patients with chronic illness, dental, or primary health care concerns.

Charles Shabino, MD, senior medical advisor with the Wisconsin Hospital Association, said free clinics provide a barrier-free access point to health care services for people who do not have a primary care physician, or are unable to pay for the care they are sometimes afraid they will need.

"Free clinics fulfill a vital role in many of our communities. A visit to a free clinic can provide not only care for an immediate health issue, but it also helps establish a relationship with a group of medical professionals who can connect the patient to a physician that can provide follow-up care," Shabino said.

Hospitals Create "Safety Nets"

Without warning, Mary Horne’s life was turned upside down. A stroke paralyzed her right side, affecting her ability to write, drive and even hold a phone. As a retired teacher who relocated to Wisconsin, her insurance wouldn’t cover the treatments, which totaled thousands of dollars. She asked for help from St. Mary’s Hospital in Madison and found that she qualified for discounts, charity care, and some much-needed emotional support.

Mary Horne was one of the thousands of patients who needed help with a medical bill and found that they qualified for charity care in Wisconsin last year. In 2006, Wisconsin hospitals provided $202 million in charity care to an average of 685 people every day of the year. Larry Wagner in Eau Claire was among them.

Larry’s wife Agnes was worried about Larry’s health as they rushed to Luther Midelfort Hospital in Eau Claire following his heart attack, but she also worried how they were going to pay his bill.

"I told the staff right away that we didn’t have insurance, but they said ‘Don’t worry about that right now. We’ll talk about that when Larry is stable.’ There was never any pressure," she says. The couple later learned that they qualified for the hospital’s charity care program.

Linda Ward, patient financial specialist at Sauk Prairie Memorial Hospital in Prairie du Sac, connects patients with the resources they need in her community. "Community Care, or charity care, represents the hospital’s commitment to improving the health of our community," according to Ward. "One of the most tangible ways we can do this is to recognize people who may be struggling to pay medical bills. We can help determine if a patient can get financial help from local, state and federal health care programs, and we can help them with the application process," she added.

WHA President Steve Brenton said community service and the desire to improve the health status of the entire community is fundamental to the mission of every Wisconsin hospital.

"Whether it is providing financial assistance to patients with limited resources through charity care programs, or improving access to essential or primary health care services by sponsoring free clinics or health screenings, Wisconsin hospitals provide a ‘safety net’ of care in the communities they serve," Brenton said. "Without that care in place, state and local government would have a much greater burden in trying to deliver these essential services to a vulnerable population," he added.

WHA surveyed its 132 member hospitals and asked them to describe and quantify the programs, services, and activities that they provide at or below cost, solely because those programs fulfill a health need in the community. Wisconsin is the first state in the nation to voluntarily report on quality, safety and price of care that they provide. Consumers can learn more about the valuable educational classes, free clinics and bill assistance programs as well as other services hospitals offer at www.wiServePoint.org.

Fast Facts From the WHA 2007 Hospital Community Benefits Report

• Wisconsin hospitals reported spending $134 million on medical education. Hospitals donated space for clinical training, provided instructors to teach classes, and trained new physicians and nurses on site with experienced medical staff.

• Nearly 70,000 people in Wisconsin participated in a hospital-sponsored support group.

• Hospitals reached more than five million people through their community education and outreach efforts.

• The 33 hospitals that own nursing homes lost nearly $17 million on those operations in 2006. In many of these communities, if the hospital did not operate a nursing home, those residents would be forced to leave their community to receive this specialized care.

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Wisconsin health care consumers now can access even more information on the quality and safety of hospital care by accessing CheckPoint version 2.0 on the World Wide Web (www.wicheckpoint.org). The redesigned version of CheckPoint includes additional measures on heart attack, pneumonia and surgical infection prevention. These measures add depth to the information currently available on CheckPoint, which enables consumers to be more active partners in their own health care. The new information also assists Wisconsin hospitals as they continue their efforts to lead the country in providing high quality health care.

Other improvements to CheckPoint include a redesigned front page that allows consumers, purchasers, providers, and public policy makers to more readily identify information relevant to their interests. For example, the report selection screen now allows Web site users to select information by clinical topic (i.e., heart attack, pneumonia) or measure type (i.e., error prevention, surgical infection prevention). In addition, trend graphs have been added that show each hospital’s progress on each measure over time.

Wisconsin hospitals have maintained a leadership role in publicly reporting quality and safety information to support their commitment to be accountable for the care they provide in their communities. Over the past four years, the CheckPoint program has continued to expand the scope of the information reported by adding measures and creating new ways to display the information.

"Wisconsin hospitals place a high priority on increasing the amount of health care quality data published to ensure consumers have the data they need to make informed decisions," said Charles Shabino, MD, WHA senior medical advisor and chair of the Wisconsin Quality Steering Committee.

For more information about CheckPoint, contact Dana Richardson at 608-274-1820 or email drichardson@wha.org.

Every day, we all cross paths with people who have been healed, touched, or whose lives have been saved in our hospitals. We are privileged in health care to care for people in our communities when they experience their greatest joy, or when they have experienced their deepest sorrow.

In 2006, more than 40,000 patients received care in a Wisconsin hospital every day of the week, every hour of the day and night. People like Jane Galligan in my community who depends on our free van service to get to her doctor’s appointments. Couples like Ty and Judy Spencer of Balsam Lake who found help with their prescription drug expenses at St. Croix Regional Medical Center. And kids like Jason who received care at and essential medications from Aurora’s Psychiatric Hospital after all others had abandoned him. Wisconsin hospitals also operate or help support more than 70 free clinics scattered from Spooner to Milwaukee, Marinette to La Crosse. Clinics that make care more accessible to the chronically ill, homeless, the poor and those who are just temporarily down on their luck.

As hospital leaders, we hear the stories of healing, touching, and caring on a daily basis, oftentimes directly from the patients and their families. I know more than once I have wished that I could broadly share these stories because they more accurately portray our services and our workforce than any balance sheet ever could.

The WHA community benefit reporting process provides us with opportunity to account for our service and tell our stories. All WHA’s members—132 hospitals—completed the 2007 Community Benefit Survey. In addition, WHA received more than 160 stories from its member hospitals over the past 12 months. More than 100 of those stories are in the 2007 WHA Annual Community Benefit Report.

It is important to tell our story, for as they say, if we don’t, someone will do it for us. I chaired the Community Benefits Task Force that recommended that WHA ask its members to voluntarily collect and report hospital community benefits far in advance of any government-mandated public reporting requirement. Thanks to your support, we are the only state in the nation to voluntarily report not only community benefits, but also quality, safety and price information.

Wisconsin hospitals provided over one billion dollars in community benefits, reaching over six million people. The numbers are impressive, but we all know it is not about the dollars spent. It is about the profound influence that we have on the health of our communities and the fact that this service is a fundamental element in every mission of every hospital in Wisconsin.

Bob Fale, Chair
Wisconsin Hospital Association

WHA Information Center’s (WHAIC’s) PricePoint system has become the nation’s leading hospital pricing transparency system, now operating in 11 states, with several others scheduled to launch in the coming months. Recognizing that the needs of clients and users are likely to change over time, WHAIC hosted a PricePoint user group meeting at WHA on September 27 and 28 to discuss the future of PricePoint with representatives of eight other hospital associations.

Key points of discussion included:

• Demand for health care pricing information is growing. A major driver of that demand is the growth of consumer-directed health plans ("CDHPs" such as health savings accounts and health reimbursement accounts), which provide incentives for patients to shop for health care services in a way that traditional insurance plans have not. While CDHPs remain a small portion of the overall private insurance market, CDHP enrollment is growing rapidly, having doubled between 2005 and 2006.

• Insurers have for the most part failed to respond effectively thus far to consumer demand for comparative (out-of-pocket) pricing information across providers, even though they are best positioned to do so when traditional insurance coverage is involved. Invited speaker Mona Lori, who developed the Web site "OutOfPocket.com," told the group she was inspired to create the site because of her frustration in seeking pricing information. At one point in Ms. Lori’s search, her insurer even told her that it would be "a HIPAA violation" to give her pricing information.

• Though some health care providers, primarily hospitals and health care systems, are responding to demands for pricing information and even working with insurers to provide patient-specific out-of-pocket estimates, for obvious reasons they are not typically providing comparative information regarding other providers.

• Hospital associations are not currently well positioned to provide local, regional or statewide out-of-pocket cost comparisons across multiple providers and insurers unless the out-of-pocket cost can be calculated directly from the billed charge.

• Demand for pricing information is likely to be greatest for services that are more elective than urgent in nature, that are relatively low-cost (i.e., within the patient’s deductible threshold) and that can be delivered by multiple providers near the patient’s home. This means that PricePoint will have to increasingly accommodate and display information about outpatient pricing. But challenges remain, not the least of which is how to best aggregate, label, and display prices for outpatient services in a way that allows valid comparisons and is understandable to consumers.

• Quality and safety are other dimensions of value for consumers, and they need to be integrated into pricing transparency initiatives. Dana Richardson, WHA’s vice president, quality initiatives, briefed the group on the features of WHA’s CheckPoint system. She noted that WHA has built CheckPoint systems for hospital associations in Utah and New Mexico, with others in progress.

Representatives of hospital associations in Connecticut, Kansas, Nebraska, Nevada, Oklahoma, South Carolina, Texas, and Virginia attended the PricePoint user group meeting.

The Internal Revenue Service (IRS) recently mailed a questionnaire to more than 200 tax-exempt organizations concerning post-issuance bond compliance and record retention practices. The questionnaire comes as part of the IRS’ ongoing effort to increase voluntary compliance by tax-exempt organizations. It has been sent to selected organizations, including hospitals, that have reported an outstanding balance of tax-exempt financing on their 2005 Form 990.

This initiative is intended by the IRS to measure post-issuance compliance knowledge and practices including requirements for:

• Record retention
• Qualified use of bond-financed property
• Arbitrage yield restriction and rebate
• Debt management policies and procedures

This questionnaire is a tool designed to help educate tax-exempt organizations about their reporting requirements under existing rules and law, and to increase voluntary compliance. It is not an examination, and the IRS indicates it will not ask questions regarding tax liabilities. Answering the questionnaire is voluntary; however, the IRS has the option to open a formal examination, regardless of whether the organization agrees to participate. The IRS intends to issue a report publicizing its findings and describing recommendations for follow-up outreach or compliance initiatives.

The American Hospital Association (AHA) suggests hospitals receiving the questionnaire consult with bond counsel on the proper way to respond. AHA also recommends that hospitals not receiving a questionnaire consider completing it for their own purposes to learn what areas the IRS might consider in the event of a future audit or examination.

The compliance check questionnaire is posted at www.irs.gov/pub/irstege/form_13907_teb_financing_questionnaire.pdf.

As hospitals are aware, changes under the Inpatient Prospective Payment System (IPPS) took effect October 1. WHA released a summary in August of the reimbursement changes and other provisions contained in the final rule. The summary is located online at www.wha.org/financeAndData/pdf/2008IPPSsummary.pdf. (Note: Since this summary was released, cuts under the behavioral offset provision were reduced by half.)

Additionally, WHA has received questions regarding a disclosure provision for hospitals without a physician on site at all times. Under the provision, hospitals, including critical access hospitals, are required to disclose to patients at the time of inpatient admission or registration for outpatient service whether a physician is available on the premises 24 hours per day, 7 days per week. This disclosure notice must also describe how the hospital will meet the medical needs of any patient who develops an emergency medical condition, at a time when a physician is not present in the hospital.

Contact Brian Potter at 608-274-1820, bpotter@wha.org or Jenny Boese at jboese@wha.org with questions.

With just about a month left to reach the goal, nearly 90 percent of the hospitals in Wisconsin report they are now tobacco-free campus wide. The WHA Board of Directors set a goal about a year ago for all Wisconsin hospitals to become tobacco free campus wide by the Great American Smokeout, which is November 15, 2007. A tobacco-free campus may include exceptions for patients receiving nursing home, psychiatric or AODA care, and other unique groups in accordance with federal and state requirements, and in the best interest of the patients overall health status.

"The WHA Board set this goal so hospitals can improve not only the health of our patients and employees, but also be a positive influence in our communities by setting an example for other businesses to create a healthy workplace," said Mary Starmann-Harrison who chaired the WHA Board and was a strong supporter of the recommendation when it passed in June 2006.

The Center for Tobacco Research Institute (CTRI) located within the University of Wisconsin-Madison, provides numerous resources for hospitals that are either considering going tobacco free, or who need support and information during implementation. They can be reached at: www.ctri.wisc.edu.

Below is a list of hospitals that currently have tobacco free campuses. WHA will publish another list to coincide with the Smokeout.

Agnesian HealthCare/St. Agnes Hospital, Fond du Lac

Amery Regional Medical Center, Amery

Appleton Medical Center, Appleton

Aspirus Wausau Hospital, Wausau

Aurora BayCare Medical Center, Green Bay

Aurora Memorial Hospital of Burlington, Burlington

Aurora Lakeland Medical Center, Elkhorn

Aurora Med. Ctr. of Manitowoc Co., Inc., Two Rivers

Aurora Med. Ctr. of Washington Co., Inc., Hartford

Aurora Medical Center, Oshkosh

Aurora Medical Center-Kenosha, Kenosha

Aurora Psychiatric Hospital, Inc., Wauwatosa

Aurora Sheboygan Memorial Medical Center, Sheboygan

Aurora Sinai Medical Center, Inc., Milwaukee

Baldwin Area Medical Center, Baldwin

Beaver Dam Community Hospitals, Inc., Beaver Dam

Bellin Hospital, Green Bay

Berlin Memorial Hospital, Berlin

Black River Memorial Hospital, Black River Falls

Bond Health Center, Oconto

Boscobel Area Health Care, Boscobel

Children’s Hospital of Wisconsin-Fox Valley, Neenah

Children’s Hospital of Wisconsin-Kenosha, Kenosha

Columbia Center, Milwaukee

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

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

Columbia St. Mary’s, Inc. - Ozaukee Campus, Mequon

Columbia St. Mary’s, Inc. - Sacred Heart Rehab. Inst., Milwaukee

Community Memorial Hospital, Menomonee Falls

Community Memorial Hospital, Oconto Falls

Cumberland Memorial Hospital, Inc., Cumberland

Divine Savior Healthcare, Portage

Door County Memorial Hospital, Sturgeon Bay

Eagle River Memorial Hospital, Eagle River

Edgerton Hospital and Health Services, Edgerton

Flambeau Hospital, Park Falls

Fort HealthCare, Fort Atkinson

Franciscan Skemp Healthcare-Mayo Health System, Arcadia

Franciscan Skemp Healthcare-Mayo Health System, La Crosse

Franciscan Skemp Healthcare-Mayo Health System, Sparta

Good Samaritan Health Center, Merrill

Grant Regional Health Center, Lancaster

Gundersen Lutheran Health System, La Crosse

Hayward Area Memorial Hospital, Hayward

Holy Family Memorial, Inc., Manitowoc

Howard Young Medical Center, Woodruff

Hudson Hospital, Hudson

Kindred Hospital Milwaukee, Greenfield

Ladd Memorial Hospital, Osceola

Lakeview Medical Center, Rice Lake

Langlade Memorial Hospital, Antigo

Luther Hospital, Eau Claire

Luther Midelfort Chippewa Valley, Bloomer

Luther Midelfort Northland, Barron

Luther Midelfort Oakridge, Osseo

Memorial Health Center, Medford

Memorial Medical Center, Ashland

Mercy Health System Corporation, Janesville

Mercy Medical Center, Oshkosh

Mercy Walworth Hospital and Medical Center, Lake Geneva

Mile Bluff Medical Center, Mauston

Moundview Memorial Hospital & Clinics, Inc., Friendship

New London Family Medical Center, New London

Oconomowoc Memorial Hospital, Oconomowoc

Orthopaedic Hospital of Wisconsin, Glendale

Our Lady of Victory Hospital, Stanley

Prairie du Chien Memorial Hospital, Prairie du Chien

Red Cedar Medical Center - Mayo Health System, Menomonie

Reedsburg Area Medical Center, Reedsburg

River Falls Area Hospital, River Falls

Riverside Medical Center, Waupaca

Riverview Hospital Association, Wisconsin Rapids

Sacred Heart Hospital, Eau Claire

Sacred Heart-St. Mary’s Hosps., Rhinelander

Sacred Heart-St. Mary’s Hosps., Tomahawk

Saint Clare’s Hospital, Weston

Saint Joseph’s Hospital, Marshfield

Saint Michael’s Hospital, Stevens Point

Sauk Prairie Memorial Hospital, Prairie du Sac

Southwest Health Center, Platteville

Spooner Health System, Spooner

St. Clare Hospital & Health Services, Baraboo

St. Croix Regional Medical Center, St. Croix Falls

St. Elizabeth Hospital, Appleton

St. Joseph’s Hospital, Chippewa Falls

St. Mary’s Hospital, Madison

St. Mary’s Hospital Medical Center, Green Bay

St. Mary’s Hospital of Superior, Superior

St. Nicholas Hospital, Sheboygan

St. Vincent Hospital, Green Bay

Stoughton Hospital Association, Stoughton

SynergyHealth St. Joseph’s Hospital, West Bend

The Monroe Clinic, Monroe

Theda Clark Medical Center, Neenah

Tomah Memorial Hospital, Tomah

Tri-County Memorial Hospital, Whitehall

Vernon Memorial Healthcare, Viroqua

Watertown Memorial Hospital, Watertown

Waukesha Memorial Hospital, Waukesha

Waupun Memorial Hospital, Waupun

West Allis Memorial Hospital, West Allis

Westfields Hospital, New Richmond

Wheaton Franciscan Healthcare-All Saints, Racine

Wheaton Franciscan Healthcare-Elmbrook Memorial, Brookfield

Wheaton Franciscan Healthcare-St. Francis Hospital, Milwaukee

Wheaton Franciscan Healthcare-St. Joseph, Milwaukee

Wheaton Franciscan Healthcare-The Wisconsin Heart Hospital, Wauwatosa

Many hospital clinical staff, billers and HIM coders are now intimately involved in the facility’s chargemaster. Staff is being asked to assume the role of "chargemaster coordinator" with little or no background in billing, coding, or reimbursement. Trying to learn it all at once is often overwhelming and can be costly to the facility. This half-day seminar provides attendees with the "basics" to the chargemaster and tools needed to keep this vital document up-to-date. It is scheduled 8 a.m. - 12 p.m. on November 14 in Wisconsin Dells.

This half-day session goes beyond the basics. The OPPS Final Rule for 2008 will be reviewed in depth, along with review of the latest CMS program memorandums. Financial analysis by ancillary departments will be explored with operational recommendations to ensure hospital departments are able to adapt and remain viable in the ever-changing outpatient health care arena. This half-day seminar is scheduled November 14 from 1-5 p.m.

The educational seminar "2008 Updated Procedure Coding for Chargemasters" is scheduled November 15, from 9 am to 4 pm in the Wisconsin Dells. This full-day program will focus on updating your chargemaster for the 2008 reporting requirements and new chargemaster opportunities to keep you "in the know" for CPT and HCPCS coding revisions, concentrating on those new codes impacting the chargemaster.

Chargemaster/APC coordinators, coding staff, office managers, CFOs, and others who are responsible for charge generation processes are encouraged to attend these events. The three workshops will be held November 14-15 at the Kalahari Resort in Wisconsin Dells. A brochure with registration information is included in this week’s packet, and is available online at www.wha.org, as well as easy, online registration. Discounts are available for those who register for more than one of the three sessions. For registration information, contact Lisa Geishirt at lgeishirt@wha.org or at 608-274-1820.

More than 360 Partners of WHA volunteer members from 67 hospitals across Wisconsin attended the annual Partners of WHA state convention on October 2-4 in Eau Claire. The theme of this year’s convention was "An Apple a Day for a Healthier Way."

The convention included a panel discussion on the impact of health care and rising health care costs. WHA member CEOs Dave Fish of St. Joseph’s Hospital in Chippewa Falls and Ned Wolf of Lakeview Medical Center in Rice Lake participated, along with Bob McCoy, Eau Claire Chamber of Commerce director and Mike Jordan, Chippewa Falls Chamber of Commerce director.

Founded in 1951 as Wisconsin Hospital Association Auxiliaries, Partners of WHA emphasizes volunteer service and participation in grassroots advocacy, public policy and community health education, and health career programs for Wisconsin hospitals. Additionally, Partners promotes leadership development offering resources and educational seminars to local hospital volunteer and auxiliary groups, and shares information on successful community health education initiatives, advocacy and fundraising activities and trends on volunteerism through a variety of channels, including its quarterly newsletter, Reaching Out.

A free program called "Family Food and Fitness Fun" was offered at local schools to encourage healthy lifestyles for families. Sponsored by Marshfield Clinic’s Healthy Lifestyles program in partnership with Flambeau Hospital and the Price County Nutrition Coalition and Physical Activity Group, these programs highlighted fun ways to lead more active, healthier lifestyles.

"Our families, especially our children, need to learn healthy activities and healthy lifestyles to prevent obesity, diabetes, heart disease and other chronic diseases," said Linda Daubner, Registered Dietitian, Flambeau Hospital. "These evening programs were designed to help busy parents create supportive food and activity environments for their kids. We provided free, supervised children’s activities as well as informational presentations about easy, positive steps for leading a healthy lifestyle."

Presentations included:

• Healthy snack ideas
• Fast and healthy meals on the go
• Move it or lose it – helping kids to get and stay active
• Breakfast on the run
• Mom was right about eating those fruits and vegetables—fun ways to keep them interesting
• An ounce of prevention is worth a pound of cure! Preventing and/or treating weight problems in youth

"The programs were fun, supervised children’s activities were provided, and it was free, " Daubner stated.

It was scheduled to start at 9 a.m. That didn’t make any difference to the dozens milling around the lobby at Spooner Health System on Saturday morning, August 4, 2007. Today was Spooner Health System’s Health Fair and they were lining up for health screenings. Over 350 Burnett and Washburn County residents took advantage of the free screenings offered during the morning; free blood pressure checks, cholesterol screening, blood sugar testing, pulmonary function testing and more…continuous education offered from professionals: nurses, physical and respiratory therapists, dietician, social workers and others.

The need to know about their health is prominent in the minds of many as we saw what took place that Saturday morning. The crowd was great and varied, from Medicare-age recipients to the honest hard-working families that may fall into the growing group…."the working poor" who have no health insurance.

It was a good day. No, it was a great day to be in health care. Giving feels good.

The Hermes Monato, Jr. Prize of $1,000 is awarded annually for the best rural health paper. It is open to all students of the University of Wisconsin (any campus). Students are encouraged to write on a rural health topic for a regular class and then submit a copy to the Rural Wisconsin Health Cooperative as an entry by April 15. Previous award winners as well as judging criteria and submission information are available at www.rwhc.com/Awards/MonatoPrize.aspx.

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