New Assembly Speaker Mike Huebsch, (R- West Salem) didn’t mince words when he spoke to the WHA Board at their regular meeting December 14 in Madison.

"The biggest problem in health care today is government. The ‘hidden’ health care tax and the underpayment of the Medicare and Medicaid programs paying pennies on the dollar has helped create the crisis," according to Huebsch. "The third party payer system has been around for a long time and that has caused some problems of its own — but what caused the crisis is government over-promising and under-delivering," he added.

"Accessible and affordable health care in Wisconsin are the number one issues that we must tackle in the coming legislative session," Huebsch said. He told the Board that the Wisconsin Legislature recognizes that health care is a huge priority. While both political parties agree that it is important to ensure that all people have health care coverage, how each party intends to arrive at that goal differs.

"The AFL-CIO has a plan, as does David Reimer. I have expressed my concerns with those plans many times," Huebsch explained. "We intend to move forward, but we must also push for a consumer-based free market. We took steps in that direction in the last session. We can’t have meaningful health care reform unless we address what is driving those costs, and that’s largely utilization."

Huebsch said he believes in the power of the market. "In a normal marketplace, a consumer has knowledge, knows the cost, and has the power to individually make decisions about the purchase. When you have knowledge and a Health Savings Account (HSA), you begin to reform the system," according to Huebsch.

"People need some skin in the game. These (health care) dollars are not a work benefit that you should use because you have it. People have to make better decisions about the health care they need and we need to provide an incentive for them to stay healthy," Huebsch said. "The answer to the health care crisis won’t come from the AFL-CIO or David Reimer. It will come from individuals like you who understand the issue and do not think parochially," he added.

Impact of 2006 Fall Elections on WHA Priorities

During his report, WHA Senior Vice President Eric Borgerding told the Board that in line with Rep. Huebsch’s comments, the WHA advocacy staff expected that most of their efforts in 2007 would focus on being actively involved with the Legislature as they debate health care reform in 2007. WHA and its members have built a fair amount of bipartisan credibility in the State Capitol and will be counted on to provide input and be involved in shaping health care policy.

Borgerding said Medicaid would continue to be a priority issue for WHA in 2007, with an emphasis on promoting the "hidden tax" message that has been extremely effective in relating why Medicaid underpayment is a health insurance cost driver for employers.

Borgerding is hopeful that the Governor, who previously did not support an increase in the tobacco tax, is now reconsidering his position "since the elections are behind us and the notion of being labeled a politician who supports tax increases is not as big of a concern" as it was before the elections. "Our polling has consistently shown that the tobacco tax is overwhelmingly supported by voters, and even more so when the dollars are used for health care programs like Medicaid," Borgerding told the Board.

WHA Chair Starmann-Harrison Delivers Final Report

In her last report to the Board as chair, Mary Starmann-Harrison reviewed WHA’s 2006 activities. Leading the list of major accomplishments was the restoration of a cap on medical liability, a top priority for the Association in 2006. WHA continued to advance the transparency agenda with the addition of new measures to the CheckPoint program and improvements made to the PricePoint Web site. WHA developed a new health care cost toolkit that members can use when they receive questions from community leaders and local employers about health care costs. WHA is also partnering with other organizations to develop meaningful solutions to increases in health care costs. A Board recommendation on an issue that is of special importance to Starmann-Harrison—the move to make hospitals tobacco-free campuswide—earned the Association an award of excellence recently from the American Cancer Society (ACS).

"WHA was one of several organizations, including hospitals, that were recognized by the ACS for their efforts to reduce tobacco use. The award was a direct outcome of your (the Board) proactive action at the last Board meeting to recommend all hospitals become tobacco free campuswide by November, 2007," she said.

WHA Board Members Receive Service Awards

Several members were recognized for their leadership in the Association and to the health care industry as they leave the WHA Board. They included: Mike Schafer, CEO, Spooner Health System; Richard Range, CEO, Baldwin Area Medical Center, who is retiring; and former WHA Chair Ned Wolf, Lakeview Medical Center, Rice Lake. WHA Board member Nick Turkal, president/CEO of Aurora Health Care, was recognized for his contributions as chair of the WHA Medical and Professional Affairs Council, which will now be chaired by Brad Manning, MD, president, Wisconsin Medical Society. Turkal will continue to serve on the WHA Board.

WHA President Steve Brenton thanked WHA Chair Starmann-Harrison for her service to the Association over the past year.

"Mary’s leadership this year was a key factor in WHA’s success in moving an ambitious program agenda," according to Brenton.

WHA President’s Report

In his report, Brenton described WHA’s annual process for setting goals. Individual goals developed by the WHA staff are divided into several themes including advocacy, membership services and operational issues. "We provide an assessment on the outcome of every one of the goals to the WHA Board at year end," Brenton said.

Brenton said the WHA staff is in the process of setting individual goals, which will form the basis for the overall 2007 Association goals. Brenton said this document would go out for comment to the Board before the Board is asked to finalize the 2007 goals at the February meeting.

In other action, Brenton presented the 2007 WHA council and committee rosters for 2007, which were approved by the Board.

The Wisconsin Council on Medical Education and Workforce

WHA Senior Medical Advisory Chuck Shabino presented an update on the Wisconsin Council on Medical Education and Workforce. Shabino said the goal of WCMEW is to increase the number of physicians practicing in Wisconsin, in line with the recommendations made in the 2004 report, "Who Will Care for Our Patients," authored by WHA Senior Vice President George Quinn.

The five goals of WCMEW are:

1. Recruit, enroll and train in Wisconsin, individuals likely to practice in Wisconsin. The UW School of Medicine and Public Health has created a "school within a school" to admit into medical school students most likely to practice in a rural setting. The first medical student was recently admitted to the Wisconsin Academy of Rural Medicine.
2. Encourage physicians to relocate to Wisconsin. Currently, Wisconsin is able to keep about 35 percent of the physicians who graduate from a medical school here. A Web portal will be developed to reach out to physicians who have left the state, designed to encourage them to consider Wisconsin.
3. Develop care delivery models that leverage physician resources. WCMEW has surveyed health systems on their use of Advanced Practice Providers (APPs), and is using the results of the survey to develop provider education programs. In addition, WCMEW will be encouraging the medical schools to develop team based medical education models.
4. Provide adequate and targeted funding for Graduate Medical Education. WCMEW has been involved in collective advocacy for increased GME funding. Viable Residency programs help keep physicians in Wisconsin.
5. Develop an infrastructure to guide medical education policy. The Wisconsin Medical Society will be gathering physician supply data that will be used in a 2007 updated physician workforce report.

WHA Information Center Board Chair Ford Titus provided an update on WHAIC activities. Titus complimented the WHAIC staff for what he termed, "a fine job in 2006." He explained the new pricing structure and asked for the Board’s approval for the 2007 WHAIC Budget, which was approved.

Task Force on Pricing and Billing

WHA Task Force on Pricing and Billing Chair, Tom Bayer, complimented the WHA staff on the solid team that was selected to serve on the task force. Bayer said he is currently reviewing the 2004 WHA Billing and Collection Guidelines and will compare them to the AHA guidelines. The Task Force will also consider the type of information that hospitals need to provide to patients related to billing, along with developing "consumer friendly pricing." The Task Force will present a set of recommendations to the WHA Board in February.

Several Wisconsin Members of Congress will serve on key committees when the new Congress convenes in January.

With Democrats ascending into all leadership positions in the Congress, Cong. David Obey (D-Wausau) is set to assume the chairmanship of the powerful House Appropriations Committee. This House Committee shares jurisdiction with its Senate counterpart over the 11 or so appropriations bills that move through Congress each year. Obey previously served as Chair of this committee.

Cong. Ron Kind (D-La Crosse) will become a member of the House Ways & Means Committee. The Ways and Means Committee possesses jurisdiction over all taxation, tariffs, and other revenue-raising measures, as well as a number of other programs, including Medicare. Among the issues Kind said he hopes to tackle on the Committee is promoting rural health.

On the Republican side, Cong. Paul Ryan (R-Janesville) hop-scotched over a dozen other more senior Republicans on his way to becoming the Ranking Member of the House Budget Committee. As Ranking Member, Ryan will serve as the leader for the Committee’s minority Republicans. This Committee works on drafting the budget blueprint for Congress and then monitors budget progress.

Cong. Tammy Baldwin (D-Madison) begins her second term on the House Energy & Commerce Committee, which holds jurisdiction over issues including Medicaid, and Senator Herb Kohl will chair the Senate Appropriations’ Subcommittee on Agriculture, Rural Development and Related Agencies and the Special Committee on Aging.

On December 12, Governor Jim Doyle announced the launch of a new Web site to help provide information and resources to people across the state about pandemic flu. The site was designed to help individuals, families, businesses, schools, and communities prepare for and make plans to deal with a possible pandemic.

"Wisconsin is recognized as a national leader in preparing for an influenza pandemic," Governor Doyle said. "We are doing everything possible to be prepared and to keep our residents as safe and healthy as possible during a pandemic. This Web site is just one more step to help our communities, businesses, schools, organizations, and government agencies to connect."

Last year, Governor Doyle instructed the Department of Health and Family Services to convene and lead the Avian Flu Coordination Team in the development of clear, concise, and consistent communication for the public regarding pandemic flu.

In addition to information about pandemic flu and avian (bird) flu, the site has planning checklists and links to other related Web sites and resources. The site also provides details about the three types of flu – seasonal, bird, and pandemic – and information about Wisconsin’s efforts to prepare for a potential pandemic.

Pandemic.wisconsin.gov was created with input by the Wisconsin Departments of Administration, Agriculture, Trade, and Consumer Protection, Health and Family Services, Natural Resources, Public Instruction, Wisconsin Emergency Management, the State Laboratory of Hygiene, the University of Wisconsin-Madison, and the Wisconsin Hospital Association.

Visit http://pandemic.wisconsin.gov to learn more.

WHA 2007 dues invoices will be mailed to members next week. Included in the mailing will be an eight page 2006 Results newsletter. For the past few years, our Results publications have served as a de facto, year-end annual report. That’s the plan again for 2006.

As pointed out in her guest column two weeks ago, WHA Chair Mary Starmann-Harrison noted that WHA "batted 1,000… a perfect five for five… when it came to achieving our 2006 program priorities." A quick review of the 2006 Results newsletter will underscore WHA’s noteworthy achievements this past year… achievements made possible because of a connected and engaged membership and a talented staff fully committed to advancing the Association’s ambitious agenda.

The 2006 program priorities included: a focus on medical liability; sweeping and proactive transparency initiatives, including community benefit reporting; access, coverage and cost initiatives; Medicaid improvements, including dental access; and a variety of workforce issues. It must be emphasized that member involvement in PAC and HEAT activities has become a key catalyst for achieving our goals. Earlier this year, results of WHA’s member survey found members rating the Association at 100 percent for "clout" as a political advocate on statewide issues and 98 percent on ability to "mobilize" grassroots support and coalition building. No state hospital association surveyed by our vendor has ever ranked higher in either specific category – a testament to strong staff support and member buy-in to grassroots and PAC participation.

WHA staff is currently identifying 2007 goals and objectives. WHA’s Board will have substantial input with this effort but we’d also like to hear from you about the priorities that you would like to see us tackle in the coming year. Please feel free to call me directly or email me at sbrenton@wha.org.

Steve Brenton,
President

A new Hospital Citation Report is now available on the WHA Web site. The Report is for the period July 1, 2006 – September 30, 2006 and provides the number of and describes the most common citations issued by OQA surveyors during that period.

The Report was provided to WHA during the most recent Hospital Forum meeting, a quarterly meeting in which WHA and the Rural Wisconsin Health Cooperative meet with Otis Woods, director, Office of Quality Assurance, and his staff to discuss current and emerging issues for Wisconsin hospitals. During the meeting, OQA asked WHA to remind its members that DHFS is asking hospitals to complete a survey that will: (1) Help determine how public health can best allocate funds and resources to assist hospitals in emergency preparedness efforts; and (2) Establish a base-line measure of health care facility preparedness.

In a letter to state Medicaid directors, the Centers for Medicare and Medicaid Services (CMS) provided guidance on the implementation of section 6032 of the Deficit Reduction Act of 2005, "Employee Education About False Claims Recovery." CMS also provided the state Medicaid agencies with a "preprint" of an amendment for their State Plans. The preprint provides further details concerning the definitions and implementation of section 6032.

Section 6032 mandates that state Medicaid programs amend their State Plans to require any entity that receives annual payments of at least $5 million under a state Medicaid program to establish written policies for its employees, contractors, and agents. The policy must include detailed information about:

• Federal False Claims Act
• Program Fraud Civil Remedies Act
• State laws pertaining to civil or criminal penalties for false claims and statements
• Whistleblower protections provided under such federal and state laws
• The entity’s policies and procedures for detecting and preventing fraud, waste and abuse and the entity’s whistleblower protections.

Section 6032 also requires that if the entity has an employee handbook, the handbook must include similar information. The effective date for section 6032 is January 1, 2007.

Does this new graduate nurse have a license to practice? Is all the paper work in for the physician candidate’s license request? Are there restrictions on a pharmacist’s license? Questions about license status, application status and discipline of licensed professionals are common and frustrating for human resource professionals working in Wisconsin hospitals. Telephone contact with the Department of Regulation and Licensing (DRL) is difficult and time consuming, but this critical information must be gathered before a licensed health care professional can be recruited or work in a hospital.

The Wisconsin Hospital Association has heard those concerns from our hospital members and has been working to address them with DRL. The Department has responded by upgrading their Web site in an effort to provide faster service. Found at http://drl.wi.gov/index.htm, the site has a new look and is easier to use. Disciplinary actions taken against licensed professionals can now be accessed from the front page along with a copy of the actual order, including restrictions and sanctions. The status of applications is also accessible from the front page and lists exactly what documentation necessary in the application process has been received and which is still missing. This page is very helpful when employees are waiting for licenses before beginning work. It is most helpful for applicants to follow the progress and follow up with DRL, if for example, a school of nursing has not yet submitted evidence of graduation.

Judy Warmuth, WHA’s vice president of workforce, said the new Web site should help ease some of the issues that have slowed down the process in the past. "We appreciate that DRL has listened to our member’s concerns by providing this new resource," said Warmuth. She encourages members to provide feedback to WHA and directly to DRL if they continue to experience problems.

A DRL handout on how to use the new Web site is included in this week’s packet.

Lakeview Medical Center in Rice Lake has taken building relationships with their legislators to heart, inviting both of their legislators to visit during the month of December.

On December 4, Lakeview Medical Center welcomed Senator Bob Jauch (D-Poplar) for a visit. Sen. Jauch spent a considerable amount of time at the hospital discussing important issues, touring the facility and joining with staff and volunteers at the 2006 Love Light Ceremony.

During his meeting with hospital staff, Sen. Jauch was very sympathetic to issues impacting Lakeview Medical, particularly inadequate state reimbursement for Medicaid patients. Discussion also focused on the rising cost of health care and the lack of federal responsibility for fair compensation of Medicaid patients.

Lakeview Medical Center will welcome State Representative Mary Hubler (D-Rice Lake) on December 18 for a similar visit.

If your hospital will be hosting your legislator, please let the HEAT program know by contacting Jenny Boese at 608-268-1816 or jboese@wha.org.

The Wisconsin Hospital Association (WHA) is pleased to announce that Lisa Geishirt joined their staff as education coordinator on December 5, 2006.

Geishirt’s main responsibility will be to handle all WHA event registrations, although she will also work closely with WHA’s education department to assist with seminar and convention preparations and on-site implementation. She will assist a variety of other WHA departments with support services as well. Geishirt comes to WHA from Covance Clinical Research in Madison, where as the Six Sigma administrative assistant, she had similar responsibilities.

"Lisa is a great addition to our education team and will be a wonderful representative of WHA as we further expand education programming in 2007," said Jennifer Frank, vice president of education and marketing. Please join WHA in welcoming her when you see her on-site at the next WHA education event.

Saunders Creek, which runs through the center of Boscobel, was notorious for overflowing its banks in the spring. But now, thanks to a flood mitigation project, area residents can enjoy a walking path instead.

Boscobel Area Health Care (BAHC) christened the new paved sidewalk that runs along the creek bed with their first annual "Wellness Walk" this August. The event was flooded with more than 200 walkers. "It was great to see so many people from the community participating – all ages, including the little ones in strollers, families and seniors," said Gary Bezucha, BAHC administrator.

The 2.5-mile walk featured six wellness stops, all designed to teach safe habits and reinforce the importance of regular exercise. The bicycle safety stop was especially popular with kids. Other stops highlighted proper hydration, the correct way to monitor pulse rate, the benefits of exercise to cardiac health, good nutrition and stress reduction. Blood pressure checks were also offered at the registration station.

"The Wellness Walk was a huge success," reports James Schneider, BAHC community relations coordinator. "It was a fun day and we hope that community members will use this event to kick-start an ongoing walking program."

After completing the route, each walker received a pedometer and water bottle, compliments of BAHC and other sponsors. The effort was a collaboration of the BAHC, Boscobel Clinic, Bluff Street Clinic, Boscobel Counseling Services and Wisconsin Heart with volunteers playing a key role in the event’s success. Coverage of the event was provided by the Boscobel Dial.

Fifty-three hot and enthusiastic young church campers hiked to Upland Hills Health last July for a quick and tasty presentation by the hospital’s nutrition services staff.

Campers munched on apple & dip snacks and milk while Director Liz Berkey, RD presented the importance and components of good nutrition.

Patricia Lawson, director of marketing & community relations explained, "If we teach children healthy habits while they’re young, we can help our community to stay healthier. We were happy to have the opportunity to reach out to these children."

The church campers were part of the Grace Lutheran Church Vacation Bible School program. Each child went home with a bag of goodies that included a sport water bottle and packets of sunscreen.

Upland Hills Health & Southwest Wisconsin Area Health Education Center team up to improve care of Hispanic patients

In a focused effort to better serve the Hispanic residents in our community, Upland Hills Health and Southwest WI AHEC (Area Health Education Center) co-sponsored an initiative to train and increase awareness with area caregivers.

Efforts included developing Spanish resources; training nursing, social services, clinic and emergency personnel in basic Spanish language skills to overcome initial barriers; and providing admission documents that are translated into Spanish.

A survey was conducted of Upland Hills Health departments and area agencies to determine the Spanish resources currently available and what is needed. The results are available to all agencies to promote the sharing of resources.

Several years ago, Watertown Area Health Services’ board of directors formed a community endowment fund to provide monies for activities that further the organization’s mission to create healthier communities and meet identified community development needs. The fund’s priority activities meet the needs of special populations, such as minorities, frail elderly, people with disabilities and children.

This year, the community endowment fund has identified the presence of automatic external defibrillators (AEDs) in community schools as a priority need.

Over the last several years, the presence of automatic external defibrillators (AEDs) in community settings has saved thousands of cardiac arrest victims. When there is no AED present, cardiac arrest survival rates hover around five percent; with an AED on-site, survival rates have soared to as high as 74 percent.

Currently, the endowment fund is providing assistance to schools in the city of Watertown so that one AED may be available at each school. In this project, the community endowment fund will assist each school by providing financial assistance for 50 percent of the cost of one AED (up to $1,000) for each school; if a school has already purchased an AED, the fund will reimburse the school for 50 percent of the cost of one AED (again up to $1,000). In addition, Watertown Area Health Services will provide the school with a list of training opportunities so schools can identify and train responders in the use of AEDs. Watertown Area Health Services will also provide the required medical director oversight for schools.

Other priority programs identified by Watertown Area Health Services’ community endowment fund include community health services and clinics, community health education, disease prevention and education, support programs, self-help programs, community-building activities, youth fitness, wellness and leadership development.

Submit hospital community benefit stories to Mary Kay Grasmick, editor, mgrasmick@wha.org or call 608-274-1820.

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