Two weeks ago, The Valued Voice reported that joint committees in the Senate and Assembly co-chaired by Sen. Dave Zien (R-Eau Claire) and Rep. Scott Suder (R-Abbotsford) heard more than ten hours of testimony on AB 763 and SB 403, the concealed carry bills. Last week the committees passed the bills without any additional exemptions being added. The legislation is now headed to the Joint Finance Committee for a hearing at the end of this month.

The bills allow the lawful carrying of concealed weapons in Wisconsin with few exceptions. The bills do allow businesses to decide if they want to allow concealed carry on their premises, but they must post a notice at entrances stating this and approach violators warning them before contacting authorities. Proponents argue that people should have the right to carry a concealed weapon for personal protection with little exception.

Without an exemption for health care facilities, WHA remains opposed to the legislation. WHA believes that when patients come to the hospital, they expect the hospital to be safe. AB 763 and SB 403 jeopardize the ability of Wisconsin hospitals to provide that safe patient care environment if people can bring weapons into a hospital where many highly combustible materials are present.

Similar legislation introduced last session did include an exemption for hospitals and other health care facilities that was backed by WHA.

WHA is looking to work with Joint Finance Committee members to amend the bill to once again include an exemption to prohibit the carrying of concealed weapons in a health care facility. WHA urges you to contact your representatives and tell them to support an exemption for health care facilities. For more information about this legislation, contact WHA’s Jodi Bloch at 608-274-1820.

Seven area legislators were welcomed to the Marshfield tertiary-care rural teaching hospital by President Michael Schmidt and CEO Michael Kryda, MD on November 7. While at the hospital, the legislators - Sen. Russ Decker (D-Weston), Rep. Amy Sue Vruwink (D-Milladore), Rep. Scott Suder (R-Abbotsford), Rep. Donna Seidel (D-Wausau), Rep. Jerry Petrowski (R-Stettin), Rep. Marlin Schneider (D-Wisconsin Rapids) and Rep. Rob Kreibich (R-Eau Claire) – attended a meeting to discuss legislative issues with staff and were able to tour the facility. In addition to employees of Saint Joseph’s Hospital, other Ministry Health Care employees attending the event included individuals from Saint Michael’s Hospital in Stevens Point, Ministry Medical Group in Rhinelander and Howard Young Medical Center in Woodruff. Mary James coordinated the on-site details for the legislative meeting.

Schmidt and Dr. Kryda brought a number of critical public policy issues to the attention of the legislators, including outpatient Medicaid reimbursement, Graduate Medical Education, quality and safety (with special focus on health care information technology) and medical liability legislation (Assembly Bill 766) which is currently awaiting action by the Governor.

Over the past months many Ministry Health Care employees have been involved in grassroots contacts to their legislators in support of AB 766. The November 7 hospital meeting and tour provided them a perfect opportunity to personally thank the legislators who voted in support of AB 766. For those who did not support the legislation, the hospital employees spent time explaining the impact a veto of AB 766 could have on Ministry Health Care and Saint Joseph’s Hospital.

While discussing the impact of AB 766, employees made sure to reiterate points made by Ministry Physician Recruiter Claudine Taub during her appearance at a legislative hearing of the Senate Insurance Committee in October on AB 766. In her testimony, Taub provided examples of how two family practice physician recruits from Illinois withdrew their interest from Ministry Health Care in the Stevens Point area, citing the Supreme Court decision as their reason for withdrawal.

Following the lively discussion on issues, the group visited a heart catheterization lab and learned details of the impressive technology being utilized to save lives.

November 17, 2005

Attorney General Peggy A. Lautenschlager

Wisconsin Department of Justice
P.O. Box 7857
Madison, WI 53707-7857

Dear Attorney General Lautenschlager:

It would be an understatement to describe our reaction to your Milwaukee press conference last week to be one of disappointment. Your decision to hold a press conference singling out two Milwaukee hospitals for "price gouging" uninsured patients will accomplish nothing to advance what I suspect is our common desire to improve access to necessary care for a growing number of uninsured patients, a crisis that is especially acute in the City of Milwaukee.

Your enforcement actions of last week mimic lawsuits filed by trial lawyers against hospitals nationwide, cookie-cutter lawsuits that have been actively promoted by Mississippi trial lawyer Dickey Scruggs, whose colleague joined you at the podium in Milwaukee last Monday. You should be aware of the fact that those same lawsuits have been consistently dismissed as baseless by trial court judges in state, after state, after state…in several cases following harsh scolding by the trial judge.

As you read this letter today, Wisconsin hospitals will care for close to 2,500 patients who have no insurance. They’ll do it again tomorrow, and again the day after that. Ultimately, payment for that care will amount to something less than 20 cents on the dollar of costs. No matter how you cut it, that reality rebuts any notion of "price gouging." And no number of press events will alter those very real facts.

Despite our severe disappointment with your action to date, I’d like to renew the offer made in my September 26, 2005 communication to you (never acknowledged or responded to) to continue to work with your office by creating a workgroup to help publicize hospital billing and collection guidelines. This envisioned effort would serve as an education tool to help hospitals continuously improve the billing and collection process and provide an opportunity for your office to be a partner in educating and communicating our current billing and collection guidelines to the public. We feel that such a collaborative approach will benefit uninsured patients and their families.

I look forward to hearing from your office regarding a potential meeting to initiate such an initiative.

Kindest regards,

Stephen F. Brenton

President

c: Wisconsin Hospitals and Health Systems

The WHA Foundation’s 2005 Annual Fundraising Campaign, its first fundraising effort since 2001, continues on, raising more than $33,000 within the first month of the campaign. The WHA Foundation’s Board of Directors has set a goal to raise $500,000 by the end of 2008.

The campaign contributions will be used to fund the WHA Foundation Scholarship Program at the state’s 16 technical colleges, the Nurse Leadership Succession Project, the Global Vision Community Partnership Award, and other statewide initiatives that support hospitals throughout Wisconsin.

Thank you to the organizations and individuals who have shown support for the Foundation and contributed early in the campaign. Additionally, the Foundation would like to recognize Aspirus – Wausau Hospital, UW Hospital & Clinics and WHA Financial Solutions, Inc., for their support as Champion Donors.

Aspirus – Wausau Hospital, Wausau
UW Hospital & Clinics, Madison
WHA Financial Solutions, Inc., Madison

Contributions from Organizations

Black River Hospital, Black River Falls
Flambeau Hospital, Park Falls
Holy Family Hospital, New Richmond
Lakeview Medical Center, Rice Lake
Memorial Medical Center, Ashland
Mercy Health System, Janesville
Saint Joseph’s Hospital, Marshfield
SSM Health Care of Wisconsin, Madison
St. Vincent Hospital, Green Bay

Contributions from Individuals

Steve Brenton, Wisconsin Hospital Association
Daniel Fischer, in honor of Mrs. Lillian Fischer’s 85^th Birthday
Jennifer Frank, Wisconsin Hospital Association
Dan Hymans, Memorial Medical Center
John Landdeck, Beaver Dam Community Hospital
John Marnell, Hudson Hospital
Tom Plantenberg, Friends of Froedtert

On November 8, the Green Bay Press Gazette ran a joint opinion editorial from the CEOs of Prevea Clinic, St. Vincent Hospital and St Mary’s Hospital, all of Green Bay, on medical liability caps. The three leaders – Richard Rolston, M.D. of Prevea Clinic, Joseph Neidenbach of St. Vincent Hospital and Jim Coller of St. Mary’s Hospital - urged passage of medical liability legislation.

"We urge state lawmakers and the Governor to restore caps on pain and suffering…Until now, Wisconsin’s cap on non-economic damages, in conjunction with the Injured Patients and Families Compensation Fund, has made our state the envy of the nation," their editorial began.

The opinion piece further discussed problems Wisconsin will encounter without caps, including the ability to recruit and retain physicians. Physicians are already in short supply across the country, and the situation is expected to worsen with an aging population who will require more health-care related services. When liability insurance costs get too high, doctors are forced to evaluate whether to continue to practice or to retire.

The editorial highlighted a survey done by Northern Illinois University’s Center for Governmental Studies, which found 44 percent of those living in southern Illinois reported having lost access to their doctors because she or he left a practice or moved out of state to escape high liability costs.

"Until now, Wisconsin has been a "go-to" state for some of these physicians," the opinion piece read. "Northeastern Wisconsin residents must understand that caps mean our health care organizations are better able to attract and retain physicians, especially in higher risk specialties."

In closing, the three leaders urged citizens, patients and community leaders across Wisconsin to tell legislators and the Governor to support restoring the cap so Wisconsin can return to its once-envied medical liability environment.

The State Assembly and the State Senate approved Assembly Bill 766, which restores the cap. AB 766 now awaits action by Governor Doyle. Contact Governor Doyle and urge him to sign AB 766 into law.

Log on to www.wha.org/speakUp/emailLegislator.aspx for more information.

WHA’s Judy Warmuth testified in support of AB 830 before the Assembly Health Committee. The legislation is coauthored by Rep. Steve Wieckert (R-Appleton) and Sen. Alan Lasee (R-Ledgeview). Warmuth stated that WHA supports the bill because it will provide clarity to Wisconsin hospitals regarding tissue donation at a time when issues over the process of tissue donation have been raised.

Some Wisconsin hospitals have made WHA aware of concerns in certain counties of the state where the local coroner has stepped in when a death occurs in a hospital. In these instances, the coroners have told hospital personnel they will be contacting the tissue bank that they have contracted with for tissue removal. This has posed problems for the hospital putting them in possible violation of federal law, while also creating a confusing situation for the donor family who have signed off on consent for donation with one tissue bank, only to be approached later with request for consent from another tissue bank.

Federal law and the Center for Medicare and Medicaid Services’ (CMS) regulations require hospitals to contract with at least one tissue bank. When the coroner steps in when a death occurs in a hospital claiming they have control, and will be contacting a tissue bank they have a contract with, the coroner places the hospital in a situation where if the hospital complies with the coroner’s demand, the hospital is at risk of violating federal law and regulation.

AB 830 attempts to remedy this situation by clarifying that when a death occurs in a hospital, that any release of the descendent for potential tissue donation be to the tissue bank that the hospital has a contract with as required under federal law.

In summing up the need for the legislation, Warmuth described how "Wisconsin has a long proud tradition of being at the forefront of anatomical donation, and this bill preserves the future of organ donation in Wisconsin by making it clear in the statutes that in most circumstances the patient’s wishes and/or those of the patient’s family for organ donation should be carried out unless a coroner or medical examiner can provide justification for not doing so."

For more information, contact WHA’s Judy Warmuth at jwarmuth@wha.org or Jodi Bloch at jbloch@wha.org or 608-274-1820.

The week after Thanksgiving, registered nurses in Wisconsin will receive license renewal information. With that letter will also come a request to complete the 2005 RN workforce survey. WHA requests that member hospitals encourage all RNs to take the time to complete the survey. Why?

Wisconsin is more fortunate that other states. Today, most of our nursing positions are filled. While certain types of positions are difficult to fill and classified ads and Web sites reveal lots of opportunity for the RN looking for work, Wisconsin is not in a nursing shortage crisis.

The future is probably very different. The age distribution of RNs licensed in Wisconsin reveals an aging workforce. Retirements, the aging of Wisconsin’s resident population and increasing demand will make the future a very different scenario. Wisconsin is staring down a RN workforce shortage that requires data, information and planning.

The first step to planning the workforce of tomorrow in nursing is to characterize and understand the workforce of today.

How many nurses are employed in Wisconsin? DWD data shows many full time equivalents of RN are employed, but not how many nurses are within those jobs. It is also unknown how many of the positions reported by DWD are occupied by any one nurse.

How many nurses work in multiple jobs? It is clear that some nurses hold more than one position --faculty at a school and PRN staff at a nursing home is an easy example. Weekender at a hospital and part-time school nurse during the week is another. How many nurses hold two or more jobs?

Could the existing RN workforce expand to meet future needs? Are nurses working in jobs outside of nursing that could be recruited back? What would it take to accomplish that? Are nurses working outside of Wisconsin that might return here to work? What would lure them back?

When will the shortage become reality? When nurses plan to retire, if they don’t plan to retire soon, do they plan to reduce their hours? Quit one of their jobs? Who plans to increase hours and when?

The survey can be completed on the Internet at http://worknet.wisconsin.gov/RN. Nurses who do not have Internet access can complete the survey by phone at 1-800-966-0152, Monday-Friday, 7:45 a.m. to 4:30 p.m. To fill out the survey, a nurse will need to supply his or her license number and date of birth.

WHA and staff received a "Best Practices" award from the United Way of Dane County for their efforts in the 2005 fundraising campaign. In total, WHA and 41 of its 42 staff contributed over $12,000 to the 2005 campaign.

"The generosity of WHA employees in support of the United Way has been tremendous," said Jenny Boese, WHA VP of external relations & member advocacy and this year’s United Way campaign coordinator. "This award recognizes their commitment to providing for those in need."

The Best Practices award recognizes organizations that go above and beyond the call of duty. Those receiving the award were nominated because of their giving and because they fulfilled all of the best practices (a list of 14 things) that the United Way uses to recognize successful campaigns. Very few organizations in Dane County receive the award.

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