It was a full house for the first WHA Council on Public Policy meeting in 2005, which was held Tuesday, March 8 at the WHA headquarters. The meeting was called by David Olson, President/CEO at Bay Area Medical Center, the Council’s new chairperson for 2005.

The meeting was highlighted by the appearance of State Representative Kitty Rhoades (R-Hudson). Beginning her fourth term in the State Assembly, Rhoades is a member of the budget-writing Joint Finance Committee where she spends a great deal of her time focusing on the state’s Medicaid program.

Rhoades wasted no time and minced no words in assessing Governor Doyle’s budget proposal. "This budget tops the last one. It is balanced with one-time funding and more borrowing," Rhoades said "It’s like the Titanic; instead of fixing the hole, the Governor is selling more tickets for a sinking ship."

On WHA’s top priority, Medicaid, Rhoades called for program reforms. "We have to find a better way to do what we do with the resources we have," Rhoades said. "We have to build sustainable programs and there is no one single fix, we need to take baby steps."

Along those lines, Rhoades outlined for the first time a new voucher-based approach for delivering autism care and dental services within Medicaid. According to Rhoades, a voucher-based system will give people and parents more choices while reducing paperwork and payment headaches for health care providers.

Rhoades urged WHA members to attend the budget hearings being held across the state (for more information, contact Jenny Boese at 608-274-1820).

On the issue of hospital construction, Rhoades noted that in her community of Hudson, a new replacement hospital was built with a great deal of local support. Rhoades, who also backed the project, said the new hospital was built even though there was another hospital 20 miles away in Minnesota.

"What we don’t need are 20 and 30-year old kids in Madison in charge of health care," Rhoades said. "Rural parts of Wisconsin need to be equal to, as accessible and as affordable as health care in metropolitan areas."

Following Rep. Rhoades’ comments, Eric Borgerding gave an update on Governor Doyle’s budget proposal from the WHA perspective. He noted that it was better than the last budget, where hospitals were singled-out for $95 million in all funds cuts.

"The Governor proposes increases in important areas, including restoring some of the cuts to Graduate Medical Education (GME), a program that was almost eliminated in the last budget. But he wants to pay for all of GME and all of the rural hospital supplement by using a one-time transfer from the patients compensation fund," Borgerding said. "He is replacing ongoing GPR funding with a one-time transfer – not only does that threaten these programs, it assures more structural budget trouble down the road."

To make matters worse, the one-time-funded increases are wiped out by another cut. The Governor proposes reducing reimbursement for outpatient therapy services by almost $10 million dollars.

"We have hospitals in this state actually being paid $93 for an outpatient heart catheterizations, $94 dollars for a tonsillectomy, and $93 for a hernia repair by Medicaid, and now we are going to cut outpatient by another $10 million?" Borgerding asked. "Is it any wonder why Wisconsin businesses are getting slammed with $450 million in higher health care costs due to Medicaid cost shifting – the ‘hidden tax’ WMC is talking about?"

"We wholeheartedly agree with WMC," said WHA President Steve Brenton. "We also think the first reform to the Medicaid program should be paying for it, not forcing providers to pass on the true costs of these programs through higher prices and higher insurance premiums for employers."

In other business, the Council endorsed proposals from the Governor’s Task Force on Dental Access that will give Medicaid patients greater access to dental care from dentists and dental hygienists — not in hospital emergency rooms. The Council also endorsed enhanced Medicaid reimbursement for behavioral health care services. The Council will move to three meetings per year, with the next meeting scheduled for Tuesday, July 12.

Make plans now to attend WHA’s Advocacy Day on May 11 in Madison. An interesting line-up of speakers will kick off with an inside scoop presentation from Washington correspondent Mark Shields, who has spent 30 years covering American politics. With the unique ability to make audiences laugh and think, Shields will share personal perspectives and stories about Washington DC and the importance of grassroots advocacy at all levels of government.

Shields is a nationally known columnist and commentator with unmatched credentials as an analyst of the U.S. political system. He can be seen every Saturday night as the moderator of CNN’s The Capital Gang, alongside Robert Novak, Al Hunt, Kate O’Beirne, and Margaret Carlson. Since 1979, Shields has been writing his column on national politics for The Washington Post, which is now distributed nationally. And since 1987, he has been the principal political analyst for The NewsHour with Jim Lehrer on PBS, seen every Friday and during primaries, national conventions and elections.

Christopher Kush, author of The One-Hour Activist and president of Soapbox Consulting in Washington DC, has trained thousands of federal, state and local advocates to effectively advocate for their issues. During his interactive presentation, Kush will teach attendees tried-and-true tips for discussing your most important health care issues with your state and federal legislators.

Governor Jim Doyle has been invited to speak during the luncheon, and WHA’s government relations team will update you on current legislative issues that attendees should discuss with their legislators.

Advocacy Day is a key event for Wisconsin hospitals. It is an opportunity to improve our grassroots effectiveness, while learning about the issues that will shape the future of health care delivery in Wisconsin. Again this year, WHA will present an Advocacy Award to a group or individual that has demonstrated a keen understanding of and dedication to grassroots advocacy.

The deadline to submit the name of one employee to be honored at the Wisconsin Hospital Employee Pride Program 2005 is just around the corner. Each hospital’s honored employee’s name and his/her story is due to WHA by April 1.

Please note that each hospital may choose and submit the name of one employee to be honored at the 2005 Pride Program. A reception and dinner will be held on Thursday, April 28, at the Kalahari Resort in Wisconsin Dells to honor these employees from around the state.

The formal submission form, reception/dinner registration form, and information about making hotel reservations at the Kalahari Resort can be found on the WHA Web site at www.wha.org. Click on the Pride Program logo on the home page to be linked to all the appropriate information.

Pride Program Timeline

March 15, 2005
Suggested deadline for employees to submit their Pride Program story to their hospital representative

April 1, 2005
Deadline for hospital representative to submit the following to WHA:

    1) ONE employee’s essay, poem, or story (via email to mgrasmick@wha.org);
    2) That employee’s signed Application; and
    3) A completed Submission Form

April 7, 2005
Deadline for reserving a sleeping room at the Kalahari Resort (WHA group rate of $99 for standard room expires after this date)

April 14, 2005
Deadline for hospital representative to submit the registration form for the reception and dinner to WHA (honored employee, hospital representative attending, and all guests must be registered with WHA by this date)

April 28, 2005
Pride Program Reception and Dinner at Kalahari Resort in Wisconsin Dells

Don’t miss this opportunity to honor one of your employees through the 2005 Pride Program. For more information contact Mary Kay Grasmick at mgrasmick@wha.org, or Shannon Nelson at snelson@wha.org, or call 608-274-1820.

AHA members should soon receive materials for AHA’s Annual Meeting to be held May 1-4 in Washington DC. Time has been set aside on Wednesday, May 4, for Hill visits.

The Annual Meeting provides Wisconsin hospital leaders the opportunity to network with peers from across the country, hear from key policymakers and, most importantly, meet with Wisconsin Congressional members on issues of importance to your hospital and the public you serve.

To facilitate Hill visits, WHA staff will make appointments with members of the Wisconsin delegation on your behalf. Please contact Jenny Boese, VP, external relations & member advocacy, at jboese@wha.org or 608-268-1816 if you are attending the Annual Meeting or if you need additional information.

A few weeks ago, WHA Information Center (WHAIC) marked a major milestone, having completed an entire year’s worth of data collection and dissemination after assuming the responsibility from the state Bureau of Health Information (BHI).

So now is an appropriate time to look back on what has been accomplished, and what lies ahead in the near future.

The Lessons of our First Year

In a word, privatized data collection WORKS. Although there was some hand wringing about the dangers of moving away from BHI, the supposed gold standard of data collection, we’ve done the job better, faster and cheaper than BHI did, just as we promised.

• Better: We have made numerous improvements in the data collection process that have resulted in the production of more complete and more accurate hospital data. In our August 2004 survey, data submitters and data consumers gave WHAIC very high marks on customer service. They also rated WHAIC much higher than BHI along multiple dimensions of performance. We are certainly proud of those results.
  
• Faster: Our on-line data collection system greatly simplified the submission and edit-correction process for Wisconsin hospitals. As a result, we are able to produce quarterly data sets about 85 days faster than BHI’s average in its last two years of operation. Thus our quarterly data sets are released almost a full quarter sooner.
  
• Cheaper: Hospital assessments – of more than $1.4 million a year – to fund BHI operations were eliminated as a result of privatization. The Information Center employs five full-time equivalents, versus BHI’s 18. WHAIC’s total operational costs in 2004 were nearly $1 million less than BHI’s costs in 2003.

In the bigger picture, WHAIC’s success has helped position Wisconsin hospitals as leaders on health care transparency issues, and, in turn, has shined a spotlight on the relative lack of transparency that exists in other segments of the health care marketplace. The unveiling of our PricePoint Web site (www.wipricepoint.org) three weeks ago is the most recent example. There simply is no analog to PricePoint for non-hospital services.

The Year Ahead

Phase II of data privatization still lies ahead. As required by law, WHAIC will begin collecting hospital outpatient data this year. This has required the installation of a new data collection system and some reprogramming for hospitals. We will work with hospitals and other data consumers over the coming months to plan for an orderly and meaningful release of new outpatient data.

The process of transitioning to the new system reminds us that our achievements would not have been possible without the active cooperation of Wisconsin hospitals. WHA members have enthusiastically embraced WHA’s transparency agenda and are partners in its success. Far from being the "fox guarding the henhouse," as some critics feared, WHA is widely perceived as a trusted and accessible source for hospital information. As such, WHA occupies the high ground in the ongoing quest for health care transparency and is well positioned for the future.

The most important part of the 2005 Advocacy Day agenda is the visit with your legislator. WHA encourages you to make this a part of your trip to Madison on May 11.

This year’s Advocacy Day event is in the midst of the legislative effort to balance the 2005-2007 state budget, and a variety of health care related issues are in play. Now is the time to talk to legislators about those issues that affect your hospital. During Advocacy Day, you’ll learn more about those issues and how to most effectively deliver your message to your legislator. Then, put what you’ve learned into action and share your thoughts at the Capitol.

Time has been set aside at the conclusion of the Advocacy Day agenda for legislative visits. You are welcome to make legislative appointments, and can find your legislator’s contact information in the SpeakUp section of WHA’s web site at www.wha.org/speakUp.

WHA staff is available to schedule your legislative visit. If you want WHA to schedule an appointment for you, call Angela Miloszewicz at 608-268-1801, by Monday, May 2.

The WHA Toolkit, accessible on WHA’s web site at www.wha.org, is the latest way to access the resources available from the Wisconsin Hospital Association.

Executives who are preparing presentations to their hospital board, employees and senior managers, or community groups will find information and resources on the issues affecting hospitals and health care, as well as state and federal policy issues tracked by WHA.

For 15 different key issues affecting WHA members today, you’ll find a concise Issue Summary Paper outlining the background of the issue, WHA’s position, a WHA expert staff contact, and links to many related resources.

The Toolkit will be maintained to always include the latest and most pertinent information and resources, and new topics are already being developed for inclusion. Check it out on the home page of the WHA Web site. If you have an idea for a subject, or a resource you would like added, contact Jennifer Frank, jfrank@wha.org, or 608-274-1820. Your feedback is always welcome, as these are your tools.

Wisconsin Forward Award (WFA) is looking for volunteers to serve on their Board of Examiners. The Board of Examiners, both individually and as part of a team, review a written application based on the WFA/Baldrige Criteria for Performance Excellence. Some Examiners also participate in an on-site visit with an applicant. At the end of the review process, the Examination Team develops a feedback report for the applicant. The feedback report details an applicant’s strengths and opportunities for improvement, which assists them with reaching their performance excellence goals. During the entire review process, Examiners are supported by mentors, team leaders, and the WFA staff.

The deadline for Examiner applications is April 22, 2005. The 2005 Call for Examiner form, outlining many of the benefits of serving as an Examiner, is available at www.forwardaward.org/materials/05CallExam.doc, and application materials can be found at www.forwardaward.org/materials/2005ExaminerApp.doc. Continuing education credits are available.

The Board of Nursing approved a white paper on March 10 that outlined the process hospitals should follow in supervising nurses who return to employment in a capacity that does not require nursing licensure. The Board had previously developed the white paper regarding nurses who wished to work in jobs requiring less than nursing licensure. A common example in hospitals is a nurse who has been out of the practice arena for a period of time, and wishes to work as a Health Unit Coordinator.

The white paper, "Position of the Board of Nursing Regarding Nurses Practicing at a Level Below that of their Licensure," reflects a very different position than the one taken historically by the Board. Hospitals should review the new paper, which will be available very shortly on the Department of Regulation and Licensing Web site http://drl.wi.gov/boards/nur/pap/index.htm. The new position sets expectations that employers will be explicit with nurse employees (both RN and LPN) who choose to work in a job below their level of licensure about the job description, the job expectations and the protocol to follow when a situation requires referral to another professional.

There was much discussion about why nurses choose to maintain a current license when they do not choose to work in a position that requires a license. In response to the interest, the Board plans to produce another position paper on Licensure Status, which will outline the options available such as non-renewal and voluntary surrender.

WHA Financial Solutions, Inc., the wholly owned, for-profit subsidiary of the Wisconsin Hospital Association, Inc. and leader in providing employee benefit, retirement and corporate insurance solutions to health care facilities statewide, has announced a strategic partnership with MHA Insurance Company.

MHA Insurance Company was formed in 1976 in response to the decision of many commercial insurance companies to no longer provide liability insurance coverage. They currently provide competitively priced professional medical liability insurance coverage to health care providers throughout the Midwest, building partnerships that renew at a rate of 95 percent per year.

Jon Braddock, WHA Financial Solutions’ senior vice president states, "MHA Insurance Company has been significantly responsive to the needs of Wisconsin hospitals. They are a conservative carrier, price their coverage responsibly, and have a stellar foundation of risk management."

This new alliance offers Wisconsin hospitals unparalleled expertise in professional liability insurance. MHA Insurance Company is able to respond quickly to client concerns with customized products and services, while controlling claims costs and stabilizing policy premium.

Overviews and analysis of the current hot topics in health care law are the focus of the May 11 "WHA/HAW Health Care Provider Legal Issues Program," presented by the top health attorneys in Wisconsin.

Recent developments in the laws and regulations that affect hospitals, health systems, clinics, and other entities serving the health care community will be discussed during the program, in addition to the opportunity to discuss these important topics with others who are working to guide their employers through the increasingly complex regulatory environment for health care providers.

As part of the agenda, registered attendees will participate in the luncheon and address by Governor Jim Doyle (invited) at WHA’s 2005 Advocacy Day, being held at the Monona Terrace that same day. Additionally, the program will be submitted for 6.0 hours of continuing legal education.

The seminar will be held on May 11, from 9 am to 4 pm at the Madison Club in Madison. A brochure with registration form is included in this week’s packet, and is available online at www.wha.org. Easy, online registration is also available on WHA’s Web site.

Health care organizations are experiencing revolutionary and significantly different Joint Commission on Accreditation of Healthcare Organizations (JCAHO) processes. Survey preparation activities that have worked in the past for hospitals will no longer ensure full accreditation status. These traditional methods must be supplemented with new strategies and techniques for assessing standards compliance, developing improvement plans, and evaluating success.

The April 13 seminar "JCAHO: Maintaining Continuous Survey Readiness" will teach you how to meet the new requirements and maintain JCAHO standards for overall quality improvement and for a successful survey outcome at any time. Survey prep team members, compliance officers, quality managers, performance improvement coordinators, medical staff leaders, nursing executives and directors, department managers, and CEOs/administrators should attending this important seminar.

The seminar will be held on April 13, from 9 am to 4 pm at the Chula Vista Resort, Wisconsin Dells. A brochure and a registration form are available online at www.wha.org. Easy, online registration is also available on WHA’s Web site.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified miscommunication, or lack of communication, as one of the top five reasons that wrong things happen to patients. In the medical, legal and regulatory driven environment in which health care professionals work, it is essential that written communication, specifically medical record documentation, is done properly.

The April 14 seminar "Improving Medical Record Review and Documentation" will take an intensive look at medical record review/documentation and address how hospitals can build an organizational framework to support this process. Medical records directors, nurse executives and managers, compliance officers, quality managers and medical staff directors should consider attending this important event.

The seminar will be held on April 14, 2005, from 9 am to 4 pm at Chula Vista Resort in Wisconsin Dells. A brochure and a registration form are available on the Web site at www.wha.org. Easy, on-line registration is available as well.

For more information on the program content, contact Jennifer Frank at 608-274-1820 or jfrank@wha.org. For registration questions, contact Sherry Rabuck at 608-274-1820 or srabuck@wha.org.

If you register for both seminars, you can receive a $75 discount on the registration fee:

"JCAHO: Maintaining Continuous Survey Readiness" Wednesday, April 13
"Improving Medical Record Review and Documentation" Thursday, April 14

"The Support Staff Professional Who Makes a Difference" is the theme for this year’s Administrative Professionals conference. Support staff will explore the evolving roles, functions and expectations of the support staff professional, specifically in a health care organization. Attendees will learn to identify key fundamental skills and characteristics that will help define a truly valued support staff professional, capable of making a significant positive difference in fulfilling your organization’s goals and objectives. This program is designed for executive assistants, administrative assistants, business office managers, secretaries and other support staff professionals.

The conference will be held April 22 at the Blue Harbor Resort & Conference Center in Sheboygan. It opens with an optional networking reception and dinner on the evening of April 21 and continues with a full day of education on April 22. A brochure and a registration form are available on the Web site at www.wha.org. Easy, online registration is available as well.

For more information on program content, contact Jennifer Frank at 608-274-1820 or email jfrank@wha.org. For registration questions, contact Sherry Rabuck at 608-274-1820 or email srabuck@wha.org.

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