Rick Klemme, dean and director of UW’s Cooperative Extension, summed up the reason why the Wisconsin Hospital Association commissioned a study with UW-Extension economists to determine the impact that Wisconsin’s 145 hospitals have on the state and local economy.

"Too often we only hear about the impact of industries when they leave, such as GM in Janesville," Klemme said at a news conference hosted at Meriter Hospital March 26. "What I like about this study is it is proactive and talks about a growth industry in terms of what it adds to the community."

The study found Wisconsin hospitals have a significant impact on the state’s economy, generating more than $22 billion annually in economic activity and employing more than 100,000 people in communities throughout the state.

"Not surprisingly, the study confirms that Wisconsin hospitals play an important role in the overall vitality of the state’s economy," Meriter Health Services President and CEO Jim Woodward told members of the press. "Importantly, hospitals also fund a large portion of their communities health care costs through free clinics, subsidized care, programs and services aimed at those with low incomes, as well as offering financial assistance and other support for patients," Woodward added.

In presenting the results of the study, Professor Andrew Lewis, community development specialist at the UW-Extension Center for Community and Economic Development, emphasized that the health sector is an economic mainstay that provides relative stability and growth. Equally important is the number of new jobs and the above average wages that hospitals provide in their communities.

"What a lot of people don’t realize is that in 2006, hospitals were among the top 10 employers in 44 of our 72 counties in Wisconsin and among the top five employers in 20 counties. Hospitals are an important economic driver in many of our communities," according to Lewis. In 2006, Wisconsin hospitals purchased more than $6.5 billion in goods and services.

According to the study, hospitals add to the attractiveness of a community. Expanding on that point at the news conference, St. Clare Hospital President Sandy Anderson said hospitals, particularly in rural areas, bring a higher quality of life to their communities.

"When people or businesses consider relocation, they are looking for four things: good jobs, good health care, good schools and good churches," Anderson said. And with her hospital’s proximity to Wisconsin Dells, a major tourist destination, Anderson said tourists account for 10 percent of the emergency department visits at St. Clare’s and 40 percent of the visits to the their Lake Delton urgent care center.

"We are appreciative of the study in pointing out to us the economic impact that we have on the area. Most people are not aware of the contributions that hospitals make to the economy," Anderson said.

Following the release of the report in Madison, Memorial Health Center, Medford, localized the study to the media in their area.

"Our business is, in part, successful because of Memorial Health Center," said Laurel Krebsbach, co-owner of In Stitches & Ink. "Their business and the personal business generated by their employees have a definite impact on our bottom line."

However, Memorial Health Center CEO Gregg Olson added a cautionary note, "Memorial Health Center is not immune to the challenged economy."

A WHA survey released late in 2008 showed that Wisconsin hospitals are treating an unprecedented number of patients who are either uninsured, receiving Medicaid benefits, or are unable to meet their deductibles. Elective procedures dropped and admissions slowed. Charity care and bad debt circumstances are rising by the double-digits. Operating margins dropped 25 percent in 2008; total margins are much worse.

According to Olson, Memorial Health Center’s clinic visits were down 11.4 percent in February. Charity care has increased 35 percent; bad debt has jumped 207 percent.

WHA President Steve Brenton said Olson’s situation is being seen in nearly all hospitals in the state. It is particularly concerning given that hospitals are not only tied to the health of our communities, but also to the health of our state’s economy.

"Wisconsin hospitals are, and will remain, major economic drivers in our state. This study shows that a healthy hospital is critically important to a healthy community as the ripple effect of the health care sector throughout Wisconsin’s economy is enormous," Brenton said.

As the Legislature’s Joint Committee on Finance continues holding budget hearings around the state, the WHA Public Policy Council examined several of the health care-related provisions proposed by Governor Doyle in his state budget when they met in Madison on March 26.

Council members also had a chance to discuss health care reform with Senator Kathleen Vinehout (D-Alma) who shared her ideas on achievable reform. WHA continues to participate in a health care reform discussion group convened by Vinehout and Representative Donna Seidel (D-Wausau).

"Everyone shares the same goals in health care reform," said Vinehout, a former university professor who holds both a health care-related master’s degree and PhD. "The question is how we get there."

Vinehout said understanding what is driving health care costs is key to addressing reform, including: an aging population, new technology, inflation, paperwork, uncoordinated care, misaligned payment incentives, and care of chronic conditions. Also important is having all stakeholders – including providers, insurers, employers, consumers and the government – working together by sharing the responsibilities for reform.

"Focusing only on providers and insurers is not productive," Vinehout said.

Among the issues Vinehout discussed as critical to moving health care reform forward were: electronic medical records, incentives for care coordination, moving to a new payment system for providers, and health care workforce data collection. Vinehout also singled out "hyper partisanship" as one of the key challenges standing in the way of significant health care reform.

Vinehout believes patterns of reform are emerging and that states will be critical for experimentation in reform efforts.

Prior to Vinehout’s presentation, WHA Executive Vice President Eric Borgerding provided Council members an in-depth look at many of the health care-related items included in Governor Doyle’s budget proposal.

Borgerding said among the most concerning are the approximately $100 million in proposed cuts to the Medicaid program and an additional nearly $40 million across the board reduction for the Department of Health Services (DHS). The cuts and reduction are not specified, but are proposed to come from overall savings in "operational efficiencies." The Doyle Administration has indicated that Medicaid provider payment cuts are a last resort, but may be necessary.

DHS has developed a process for gathering input from various groups, including WHA, on how to reduce spending in MA through greater efficiencies in the system. While DHS in encouraging groups to "think outside the box," reducing eligibility for MA and BadgerCare are off the table.

A bright spot in the budget mentioned by Borgerding is a proposal to increase staffing levels at the Department of Regulation and Licensing (DRL), where the Governor has proposed a new bureau with up to 24 additional FTEs that would help regulate those professions currently within the scope of the Medical Examining Board. Borgerding said the increased staff would help with expediting the physician licensure process and catching up on a large backlog of investigations. Also included is a small amount of funding to increase staff levels during peak times at the DRL who could assist with licensing non-physician health care professions, including nurses.

Among other state issues discussed, WHA Vice President of Workforce Development Judy Warmuth detailed Assembly Bill 152 relating to a ban on mandatory overtime for health care workers. Warmuth highlighted several WHA concerns with the proposal that would prohibit the use of mandatory overtime except in extremely rare circumstances.

Among the situations not addressed by the proposal are unexpected spikes in hospital admissions and unplanned absences from work. The bill, which Warmuth said also severely restricts the use of on-call hours, is scheduled for a hearing next Wednesday, April 1 in the Assembly Health and Healthcare Reform Committee.

Joe Kachelski, Vice President of the WHA Information Center, briefed Council members on the hospital economic impact report that was being released later that afternoon at a Madison press conference. (See related story.)

Kachelski also provided details on the far reaching and hard-hitting effects the recession is having on hospitals all across Wisconsin, where charity care and bad debt numbers continue to rise. Kachelski also indicated that overall for 2008, hospital margins were negative and that trends for 2009 continue to point lower.

WHA President Steve Brenton gave Council members an overview of how recent discussions in Washington were developing on the federal budget and health care reform. Brenton said that while health care reform remains a prominent issue in budget discussions at the national level, conversations thus far have been at a high level and lacking detail on what reform should include. Outstanding questions remain on how coverage for all might be implemented and uncertainty on what any public insurance program might look like.

Also on the federal front, Jenny Boese, WHA vice president of external relations and member advocacy, discussed the latest developments relating to the American Recovery and Reinvestment Act (ARRA), including a recent WHA meeting with DHS staff to discuss Health Information Technology (HIT) dollars included for Wisconsin. In addition, Boese discussed the Employee Free Choice Act (EFCA) indicating that co-sponsorships for this legislation are lower this year and encouraged Council members to engage their members of Congress and express opposition to this proposal.

The next meeting of the Public Policy Council is scheduled for July 14.

Cover the Uninsured Week (CTUW) is a national annual recognition week that calls attention to the health care needs and issues surrounding the uninsured. A key focus of the week is promoting access and coverage. Milwaukee County health care systems, the Milwaukee Health Care Partnership, WHA, and a variety of community organizations came together this week for the seventh consecutive year to celebrate progress in coverage expansions over the past year and promote a continued focus on coverage and access.

At the inaugural event for CTUW on March 23, WHA President Steve Brenton praised Governor Jim Doyle and Secretary Karen Timberlake for their respective leadership roles in promoting greater coverage for the uninsured and underinsured in Wisconsin through the creation and implementation of the BadgerCare Plus and the BadgerCare Plus for Childless Adults programs.

"Both Governor Doyle and Secretary Timberlake have been strong advocates for coverage for the uninsured and underinsured in Wisconsin," said Brenton. "A spirit of real partnership and collaboration has been the hallmark of their relationship with WHA and its members. WHA publicly recognizes and thanks them for their tremendous leadership in providing real coverage for some of the most vulnerable people in our communities."

Secretary Timberlake also acknowledged the close working relationship with WHA. "Without the leadership of WHA and its members, the BadgerCare Plus for Childless Adults program would not be a reality. If it were not for the Association’s tireless work with the Doyle administration on the hospital assessment bill, there would be no funding for this program," said Timberlake. "I am very grateful for the strong collaborative spirit of partnership that WHA has shown."

At the recognition event, Aurora, Children’s, and Wheaton health care systems were acknowledged by Secretary Timberlake as key organizations in promoting and enrolling people in the BadgerCare programs. In addition, the Secretary acknowledged Milwaukee Health Services and the 16th Street Community Health Center for their efforts in enrolling people in both programs.

"We need to replicate the successful Milwaukee County model in other parts of Wisconsin as we move forward with the Childless Adults initiative," Timberlake noted.

Remember, the deadline to submit your honored employee’s name and essay to WHA for the Wisconsin Health Care Employee Pride Program is TODAY (March 27), and the deadline for reserving a sleeping room at the Kalahari Resort is April 10 (or when the group block is full, whichever comes first). Access Pride Program submission materials on the Web site at www.wha.org/workforce/pride_2009.aspx.

The Wisconsin Health Care Employee Pride Program celebrates the pride and caring that health care employees bring to their work. We hope you and your hospital plan to be part of that celebration on May 7 at the Kalahari Resort in Wisconsin Dells. Pride honorees consistently tell WHA that the Pride Program recognition and award dinner are a career highlight.

For more information, contact Shannon Nelson at snelson@wha.org or Mary Kay Grasmick at mgrasmick@wha.org or call 608-274-1820.

This week, the University of Wisconsin Cooperative Extension and WHA released a report that documented what every hospital CEO in Wisconsin already knows: Hospitals have a significant impact on both their local and on the state’s economy. Wisconsin hospitals employ more than 100,000 people and generate more than $22 billion annually in economic activity. It is an aspect of our operations that does not receive a lot of attention.

The UW-Extension economists who wrote the report made special note of the economic impact of rural hospitals. Hospitals are among the top 10 employers in 44 of Wisconsin’s 72 counties. Spooner Health System, which includes a hospital and nursing home, is the 2nd largest employer in Washburn County and it generates more than $32 million in revenue within the community. In addition to directly employing 274 people, Spooner Health System supports an additional 115 jobs that are created indirectly through our purchases and 97 more jobs that are supported by employee purchases and economic activity. That’s a total of 486 jobs in an especially economically-challenged Wisconsin community.

The UW-Extension developed a tool that hospitals can use to create their own hospital-specific economic impact report (www.wha.org/financeandData/healthyhospitals.aspx). Using that tool and a template available on the WHA Web site, we created our own report. With Advocacy Day just around the corner, WHA is suggesting that hospitals run their individual report and bring copies to Madison to leave with legislators when they meet with them April 1.

The study demonstrates to community leaders and elected officials that the economic significance of Wisconsin hospitals reaches far beyond the perimeters of our campuses. That is not unlike our community benefit activities, which extend our medical services deep into our communities through health screenings, free clinics and wellness programs.

As we review our positive economic impacts, I would be remiss to not acknowledge the unprecedented economic challenges facing our hospitals. We are seeing dramatic increases in charity care and a growing number of uninsured patients. We’ve seen precipitous drops in our margins. But I don’t see hospitals backing away from their mission to serve. Instead I see hospitals more determined to help those who need it, 24 hours a day, seven days a week, 365 days a year.

What value does a hospital bring to a community? It is measured in far more than dollars and cents.

The Wisconsin Hospital Association sent a letter of support to Congresswoman Tammy Baldwin this week on her legislation, HR 1460, the Nurses Higher Education and Loan Repayment Act of 2009. The legislation seeks to address the nurse faculty shortage by establishing a loan repayment program for nurses who agree to teach full-time at an accredited school of nursing for at least four years in a six-year period.

In 2007, a report titled "Educating the Nursing Workforce: The Nurse Faculty Shortage in Wisconsin" was prepared by the Wisconsin Nurse Faculty Shortage Task Force, of which WHA is a member. The report expressed concerns regarding the future supply of nurse faculty in Wisconsin schools of nursing. It reflected a national trend that is emphasized in Wisconsin by the fact that both Wisconsin residents and Wisconsin registered nurses are older than national averages. The very first recommendation of the Task Force Report is to "provide financial support and other incentives for nurse graduate students," and HR 1460 speaks directly to this.

In this difficult economic period, it is critically important that nurses with an interest in teaching be encouraged to attain the graduate education necessary for faculty positions, and WHA supports HR 1460 to help in this regard.

The Centers for Medicare & Medicaid Services (CMS) recently announced that it will be hosting two Special Open Door Forums on the Medicare recovery audit contractor (RAC) program.

According to CMS, the purpose of the Special Open Door Forums is to introduce providers to the new RAC contractors and provide more information about the Medicare RAC program.

For Part A providers:
The Special Open Door Forum will take place from 2 - 3:30 p.m. (EST) on April 8, 2009. To participate in this Special Open Door Forum, call 1-800-837-1935 and reference conference ID 92490299. Beginning April 16, 2009, CMS will also post an audio recording and transcript of this Special Open Door Forum on the Special Open Door Forum page of the CMS website, which will be available for 30 days.

For Part B providers:
The Special Open Door Forum will take place from 2 - 3:30 p.m. (EST) on April 14, 2009. To participate in this Special Open Door Forum, call 1-800-837-1935 and reference conference ID 92489480. Beginning April 22, 2009, CMS will also post an audio recording of this Special Open Door Forum on the Special Open Door Forum page of the CMS Web site, which will be available for 30 days.

CMS suggests calling in early because capacity is limited for these Special Open Door Forums. CMS reports that one may begin calling into these forums as early as 1:45 p.m. (ET).

Recently Senate Majority Leader Russ Decker and State Rep. Donna Seidel met with more than a dozen nurses at one of the hospitals in their district, Aspirus Wausau Hospital. These nurse leaders and staff nurses wanted to discuss concerns with pending legislation that bans the use of mandatory nurse overtime. The companion bills are Senate Bill 108 and Assembly Bill 152.

During the meeting, Aspirus nurses detailed their concerns to Sen. Decker and Rep. Seidel, provided examples of problems under the bill and indicated they did not feel this ban was necessary. Additionally, the nurses provided insight into the underlying issue of fatigue and how a prescriptive ban on mandatory overtime would not address this issue.

After a productive dialogue, Chief Nursing Officer Tim Gengler said, "Overall, I believe we passionately covered all scenarios and the team relayed real life stories about the possible impact of this legislation."

Gov. Jim Doyle visited Children’s Research Institute in Milwaukee, a member of Children’s Hospital and Health System to learn about the cutting-edge, innovative research. After a tour of the laboratories, the Governor heard from investigators about their research and how the support of the state government and donors has impacted health care for Wisconsin children.

"We’re very proud of what we have here, and we know that you, Governor, and the people of Wisconsin have been instrumental in building this place," said Bill Abraham, board chair of Children’s Research Institute. "From environmental and community health to genomic sequencing, we’re driving discovery for pediatric health by collaborating with expertise across the state."

The Governor finished his visit by asking more questions about research and its impact on the health care of the state’s children. "It’s clear you’ve done great things here. It’s wonderful," said Doyle.

The WHA document "Hospital Assessment – Frequently Asked Questions" has been updated to include answers to questions generated by member inquiries and by the recent member conference call on the hospital assessment. The answers were provided by the state Department of Health Services staff. The updated document can be found at: www.wha.org/financeAndData/pdf/hospitalAssessmentFAQ.pdf

WHA expects to host additional conference calls on the assessment as the program is rolled out. WHA will also periodically update the FAQs.

Members with questions about the hospital assessment and payment system can contact either George Quinn or Brian Potter at WHA at 608-274-1820.

Reinforcing their commitment to their communities, eight more hospital and clinical laboratories around the state have qualified for the Certificate of Achievement for Laboratory Training in Emergency Preparedness from the Wisconsin Clinical Laboratory Network (WCLN – formerly known as the Wisconsin Laboratory Response Network). Since its inception in 2006, 53 laboratories have qualified for the honor.

The WCLN is a network of more than 130 clinical laboratories in Wisconsin, with the Wisconsin State Laboratory of Hygiene as the coordinating laboratory. The WCLN is a subset of the National Laboratory Response Network (LRN), a collaborative, voluntary system of laboratories that are equipped to respond quickly to acts of chemical or biological terrorism, emerging infectious diseases, and other public health threats and emergencies.

Laboratories in the WCLN have three primary roles in emergency response: 1) recognition of unusual organisms in patient specimens; 2) ruling out unusual organisms according to the laboratory’s testing capabilities and protocols; and 3) referral of unusual organisms to the Wisconsin State Laboratory of Hygiene in those cases where a bioterrorism agent or other unusual organism cannot be ruled out.

The WCLN developed a series of four laboratory examination modules (Biosafety, Emergency Laboratory Response, Packaging and Shipping Samples, and Laboratory Diagnostics for Bioterrorism) to document laboratory training achievements in emergency preparedness. To qualify for the award, at least two members of laboratory staff must successfully complete each module. There is no deadline for participation in the voluntary training program, so more laboratories are expected to qualify for the award in the future.

The eight additional laboratories that have qualified for the award are (alphabetical by city):

• ThedaCare Laboratories, Appleton
• Luther Hospital, Eau Claire
• Midelfort Clinic – Clairemont Campus, Eau Claire
• Sauk Prairie Memorial Hospital, Prairie du Sac
• Lakeview Medical Center-Laboratory, Rice Lake
• Shawano Medical Center, Shawano
• Spooner Health System, Spooner
• Aspirus Wausau Hospital/Aspirus Reference Lab, Wausau

Although the WCLN was created to facilitate the response to acts of terrorism, according to WCLN Coordinator Carol Kirk its impact extends beyond emergency preparedness.

"Wisconsin has one of the best response rates to food-borne illness outbreaks in the country," Kirk explains. "We believe that this is at least partly due to our network of actively engaged hospital and clinic laboratories that quickly send to the State Lab of Hygiene isolates of E. coli O157:H7, salmonella and other enteric pathogens from ill patients. This enables the WSLH to rapidly identify the matching ‘DNA fingerprints’ from multiple patients and help local, state and sometimes national public health agencies respond effectively."

The Wisconsin State Laboratory of Hygiene commends the staff and leadership of the laboratories that have qualified for the award, both for their commitment to emergency preparedness and their contributions to public health in Wisconsin.

Bellin Health provided life-saving skills to area residents through two free classes teaching cardiopulmonary resuscitation during its Super CPR Day event on April 19.

Individuals 12 and older were invited to participate in the free classes, and received instructions on both adult and child CPR. The non-certification classes were designed to give participants better knowledge of life-saving techniques and practical applications.

"Being trained in CPR can mean the difference between life and death for your loved ones or someone in need," said Debbie Leoni, community outreach coordinator for Bellin Health. "The American Heart Association says applying immediate, effective CPR following cardiac arrest can double a victim’s chances of survival."

CPR adds critical minutes to a victim’s life by pumping blood and oxygen to vital organs such as the heart, brain and lungs. It also lengthens the time that an electric shock from a defibrillator can be effective.

"CPR can be a vital, life-saving skill that everyone needs to know," Leoni said. "When your spouse, parent or child’s life is on the line, the training will allow you to overcome your fears and act quickly and confidently."

FACT: Falling is the leading cause of hospital admissions due to injury for those over 65. If you are over 65, you have a 1-in-3 chance of falling this year.

Lakeview Medical Center (LMC), the Barron County Office on Aging, and the Injury Research Center at the Medical College of Wisconsin recently partnered to create and implement a program aimed at preventing falls and fall-related injuries among older adults in Barron County. A secondary aim was to link older adults at risk for falls to existing health services.

Aligned with the state’s health plan to reduce fall-related injuries and deaths, the Barron County Fall Prevention Project involved risk assessments and screenings, education, physical therapy, exercise and home safety assessments and modifications.

While originally designed to be a year-long project, the success has caused elements to be incorporated into the daily operations of Lakeview Medical Center and the Office on Aging.

While it is a fact that falls pose a great threat to seniors, it’s also a fact that doing strengthening exercises can help.

With this in mind, Lakeview Medical Center’s Cardiac Rehabilitation department created its free-of-charge Fall Prevention Exercise Class. This class is designed to help seniors and others at risk for falls due to flexibility and balance issues.

As people age they lose muscle, which may cause loss of flexibility and balance. Fall Prevention Exercise Class is an 8-week program for anyone who wants to improve balance and reduce the risk of falls.

Participants are asked to bring small hand weights or soup cans to aid in the exercises. It is a safe class that allows participants to go at their own pace while working with LMC healthcare professionals—all set to fun, upbeat music. It can not only prevent falls, but relieve stiff joints and body pain, improve sleep, decrease depression, help those with arthritis and osteoporosis, and improve overall health.

Those who take part in the class not only benefit physically, but benefit through meeting new people and making friends, while establishing healthy habits.

LMC also plans to implement assessments to the hospital admission form that identify a patient’s risk for falls.

Providing youngsters with an awareness of strangers, good eating habits, and people’s differences is the goal behind the Healthy Kids Club program at Aurora Memorial Hospital of Burlington.

Using puppet shows, videos and other hands-on activities, volunteers and nurses teach area kindergarten students about healthy habits, personal safety around strangers, and appreciating other people’s differences. The goal of the program is to help keep children mentally and physically safe, introduce them to the hospital setting and guide them toward making positive choices later in life.

The Healthy Kids Club grew out of a kindergarten orientation program conducted by the hospital’s auxiliary many years ago. Since then, it’s been refined to include a video about understanding disabilities and differences among people and a puppet show highlighting personal safety issues.

The program also allows students an opportunity to try out pediatric wheelchairs, walkers and crutches to help develop an understanding of what it’s like to be disabled and that everybody is different. Nurses also discuss the importance of healthy eating, hand washing, immunizations, and the dangers of smoking.

A 22-year-old college student, who recently lost her health insurance coverage under her parents’ policy, came into the ER due to a viral infection. Since she was a full time student, she worked part time, which covered her basic living expenses. She contacted our Patient Financial Services Department with the immediate concern that she would need to quit school to pay for her medical bills. She applied for Community Care and qualified for 100 percent assistance. The student continued with her schooling and looks forward to graduation in 2009.

A 26-year-old uninsured construction worker was unexpectedly rushed to the ER due to intense abdominal pains. A severe intestinal obstruction was found which required immediate surgery. After a three day stay, the patient was discharged and returned home. The patient lost income due to several weeks of recovery and was considering filing for bankruptcy due to his unexpected medical expenses. He applied for Community Care and qualified for 100 percent assistance.

A 51-year-old recently came to us with income troubles. Her daughter and granddaughter had to move in with her due to the loss of their home from Hurricane Katrina. She did not qualify for medical assistance and needed some medical treatment for cardiac concerns. Thanks to Southwest Health Center’s Community Care program, the woman was able to get the tests done, receive the required medications, and therapy to help with her day-to-day living.

An unemployed 44-year-old having abdominal pains needed some expensive tests ran for proper diagnosis. He did not have insurance. After applying for Southwest Health Center’s Community Care program, the patient was able to get the proper testing and diagnosis. Since his diagnosis, Southwest Health Center helped him apply for other medical assistance programs, and now he receives regular treatment for his disorder.

At 7:30 in the morning, Sophie is smiling. She is number 17 in a line of over 30 people waiting to be seen at the Saturday Clinic for the Uninsured, and there’s a really good chance she’s going to be able to see a doctor today. She got here at 7 a.m. - but some people have been in line longer than that. Hopefully she can be seen soon, as she has to be at work in a couple of hours. Sophie, in her early 40s, works full-time as a personal care worker. It is ironic that she provides for the health care of others; but her job provides no health insurance. Since her first visit three years ago, she has come every two to three months to follow up for her diabetes and high blood pressure. Seeing the affect it had on her family, Sophie took charge of her health and has made great efforts to obtain much-needed health care.

When she first came to visit the doctors at the clinic, she had a hemoglobin A1C level of over 14 percent. Hemoglobin A1C is a blood test used to measure how well a person’s diabetes is controlled. Below six percent is normal, and anything over eight percent is usually cause for concern. Within a year of regular visits, medications, and lifestyle modifications, Sophie was able to reduce her level to about seven percent.

Sophie has spent her entire life living in Milwaukee, and thinks the Saturday Clinic for the Uninsured "is a great program." She likes talking with the students, and "enjoys helping the students learn." If it weren’t for the Saturday Clinic, she’s not sure where she would get health care.

The line is moving slow today so Sophie holds her spot while she runs to work to tell her boss she will be a little late. When she returns, she is able to quickly see a doctor, get refills of her medications, get her blood drawn, and go back to work within half an hour. As she walks out in to the warm July day, Sophie is still smiling.

Forever changed. That phrase describes the lives of so many when a high school student, simply out for a good time with his or her friends and often with alcohol, ends up in an automobile accident. The teenager’s life is forever changed—through death or serious injury—but so are the lives of the student’s parents and friends.

That’s the message that Froedtert & the Medical College of Wisconsin drives home in its new hard-hitting program on the dangers of drinking and driving. Froedtert & the Medical College, which created and sponsors the "Forever Changed" program, individualizes crash simulations for high schools with the help of local volunteers, police, fire and emergency personnel. Students from the high school are the actors in the lifelike event that’s followed with an in-depth discussion at a school assembly, led by Froedtert emergency medicine nurses and injury prevention educators.

With students as the actors, the impact is dramatic and far more lasting than a PowerPoint presentation. As one student put it, "I knew the kid that was on the hood of the car and you just remember it more. You think, ‘What if he really was dead?’"

It is estimated that each event represents a value of $10,000 to $15,000 with all the donated resources and volunteer time. The simulations are typically scheduled prior to major school events such as prom or homecoming. The Forever Changed program has been implemented at New Berlin Eisenhower and Hamilton High Schools in Milwaukee, with more school districts in the lineup for fall.

Submit hospital community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

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