The Wisconsin Hospital Association Task Force on Behavioral Health discussed a survey of emergency department behavioral health issues, Milwaukee County’s mental health care system, and the Governor’s proposed budget at its second meeting April 8. The WHA Board charged the group with "identifying the barriers to accessing behavioral health services in Wisconsin and developing a set of recommended goals and actions for improvement."

WHA Senior Vice President George Quinn and Associate Counsel Matthew Stanford presented an overview of the results of an online survey of hospital emergency department managers regarding mental health care in their emergency departments and communities. The survey, developed by WHA staff, focused on the accessibility of mental health care and the role counties play in providing these services, including emergency detentions.

"The results of the survey often showed variation among the counties that did not necessarily follow urban/rural or regional patterns," said Stanford. "However, the survey showed that throughout the state, more patients are coming to emergency departments seeking treatment for mental health problems."

Rob Henken from the Public Policy Forum and WHA Vice President Bill Bazan discussed efforts underway in Milwaukee County to improve its mental health care delivery and financing system. Henken explained a new planning approach funded in part by the Milwaukee Health Care Partnership (which includes the five Milwaukee hospital systems and others) that will be designed to address the mental health care system as a whole and include definitions of responsibilities of all relevant entities. Henken emphasized the importance of collaboration among all entities involved in providing mental health care, including hospitals, clinics, the county, law enforcement, the state and others.

George Kerwin, president, Bellin Hospital in Green Bay and Task Force chair, led the group in a discussion of next steps for the Task Force, which will include an examination of best practices, outcome and financing data, and workforce issues. The Task Force will continue their work and meet again this summer.

Among the many important agenda items before the WHA Board at their April 16 meeting in Madison, perhaps none drew more dialogue than the topic of health care reform.

WHA President Steve Brenton, WHA Chair Mike Schafer and Health Reform Task Force Chair Leo Brideau all attended the White House Regional Health Care Forum in Dearborn, Michigan held in late March. Brenton noted that when the new administration was ushered in to Washington in January, the stars seemed to align around "getting something done on health care reform" and that the Forum was designed to create energy for advancing the reform discussion.

Brenton said consensus could soon explode into "the usual partisan acrimony and debate" over three major issues related to health reform: the public plan alternative, a National Health Board, and the employer/individual insurance mandate.

The public plan alternative as detailed in President Obama’s plan relates to whether there should be a government program or plan alternative to commercial insurance plans that would be available to people through either a network or a national insurance connector.

The National Health Board would be structured similar to the Federal Reserve Board and be comprised of an independent group of experts that would serve to shield tough decisions from the political process in a similar manner to that of the independent board appointed to make recommendations on which military bases to close a few years ago. Brenton suggested that a board of this nature might be the only way to tackle the long-term issues associated with significant health reform.

Would national health reform include an employer or individual mandate to obtain coverage, as is true in Massachusetts? Brenton said a mandate would clearly be required to attain the goal of universal coverage. The question is, at what cost and who pays?

In response to a question about when health reform might reach Congress, Brenton and Brideau both said if reform is not passed by year end, given that the election cycle restarts in 2010, nothing major would happen for years.

Brenton noted that one of the hallmarks of Wisconsin’s strong health care delivery system is its high degree of integration. This is possible in part because of the large number of provider-owned health plans in Wisconsin. If health reform leads to a government-sponsored plan or program, most likely it could lead to the eventual demise of private insurance. Currently, Wisconsin has several provider-owned health plans that would be directly affected by a public plan available in their marketplace.

Hospitals and the Economy

Brenton said over the past month, WHA staff has developed and released two new reports related to the economy. Working with the UW-Extension, WHA developed a report on the significant impact that hospitals have on the local and state economy. He noted that many hospitals used the set of tools developed by UW-Extension and WHA to "tell their story" in the community (www.wha.org/financeAndData/healthyHospitals.aspx).

The second report (www.wha.org/pubArchive/special_reports/WisHospitalsandEconomyUpdate4-2009.pdf) was an update to the Special Report on the Economy issued in February that confirms that Wisconsin hospitals are feeling the pain of a down economy. More than 60 percent of the hospitals in the state reported a decrease in patient volume and mounting levels of charity care and bad debt.

Advocacy Report: The Wisconsin State Budget – With a Medicaid Twist

WHA Executive Vice President Eric Borgerding told Board members that the State Budget is at the top of the Association’s advocacy agenda. Governor Jim Doyle faces a $5.7 billion budget deficit in the upcoming biennium, and has said that he is intent on addressing the deficit by improving efficiency without cutting into his stated priorities, health care and education.

Borgerding said the Governor’s proposed budget includes $140 million in needed Medicaid savings and the Administration is taking an unprecedented approach to identify those savings. The Department of Health Services created eight individual work groups, each covering specific service areas such as long-term care, managed care, and physician services, and tasked each with identifying savings and efficiencies in the Medicaid budget. WHA is participating in the hospital workgroup to develop ideas that will create savings by reducing inappropriate utilization and better managing care. The final package of proposals from the hospital work group is due June 1.

The Governor’s proposed budget bill is now in the hands of the Legislature. Borgerding said that the bill includes the hospital assessment as negotiated. WHA staff is working with the state to determine the best process for monitoring payments received by hospitals. Borgerding also said that WHA is pleased that the budget includes significant improvements in the Department of Regulation and Licensing. The DRL improvements include:

• A new bureau within DRL, including funding for 15 new FTEs, responsible for enforcement and licensing of all Medical Examining Board regulated professions; and,
• Funding for LTEs during peak licensing periods. This is a positive development for hospitals as it improves medical access by reducing the waiting period for licenses to be processed.

Borgerding said there is cause for concern in the Governor’s budget because it includes measures that would dismantle key aspects of tort reform. He said significant progress was made in 1995 to reform joint and several liability and contributory negligence. While there is a cap on non-economic damages in medical liability cases, if the new proposals are enacted, it will jeopardize Wisconsin’s favorable liability environment. (See related story on page 4.)

The budget also calls for counties to pay what is now the state’s share of providing services to individuals under the age of 22 and over the age of 65 for care received in the state’s mental health institutions. Counties also would have the new authority to approve or deny the transportation of mental health patients to and detention in the facilities. Given their increased financial exposure, WHA is concerned that the counties will not approve necessary detentions, shifting the costs to local hospitals. WHA opposes this proposal.

Advocacy Day Attendees Weigh in at Mandatory Overtime Ban Hearing

The Assembly Health and Health Care Reform Committee held a hearing April 1 on a bill that would ban mandatory overtime, the same day as WHA’s Advocacy Day. Advocacy Day drew more than 600 people. Borgerding said Advocacy Day participants left Monona Terrace "fired up about the bill," with close to 100 of them registering in opposition to the bill and many providing powerful testimony against the bill. Borgerding said WHA’s lobby and grassroots activities are having an impact on legislators.

Bill Bazan, WHA vice president, Metro Milwaukee, told Board members that WHA is working with Rep. Jon Richards (D-Milwaukee) and Rep. Jeff Stone (R-Greenfield) to draft legislation that would create the Physician Order for Life Sustaining Treatment (POLST) document in state statutes and give health care providers immunity when implementing a POLST. A POLST is a physician order that allows a patient’s wishes concerning their treatment to be honored in a number of health care settings. Bazan believes this legislation will move with bi-partisan support through the legislative process.

Health Care Reform – Wisconsin Style

If Washington fails to act on health reform, there is no doubt in Borgerding’s mind that the Wisconsin Legislature will pick up the baton. Sen. Kathleen Vinehout (D-Alma), who recently spoke at the WHA Public Policy Council meeting, has taken a proactive approach on reform. WHA is participating in a group Vinehout formed to advise her on the matter. Borgerding said she is emerging as a strong advocate for integrated delivery systems and provider-driven HMOs or health plans. WHA will continue to participate in any reform discussions within the state capitol which, for now, is watching Washington and taking a "wait and see" approach.

Worker’s Compensation Advisory Council Negotiations Continue

WHA Senior Vice President Laura Leitch provided the Board with an update on the Workers Compensation Advisory Council’s biennial negotiations on changes to the Workers Compensation system. The Council plans to complete its negotiations by June in order to allow the Legislature to complete its work on the resulting bill before the end of the calendar year.

Council, Committee and Task Force Reports

Nominating and Bylaws Committee: WHA Chair Mike Schafer received approval to accept the roster of nominees for the 2009 Nominating and Bylaws Committee.

Task Force on Access and Coverage: Chair Leo Brideau said Rep. Jon Richards (D-Milwaukee), who chairs the Assembly Committee on Health and Health Care Reform, described his perspectives and priorities on health care reform at the Task Force’s last meeting. Richards indicated that his four goals for reform include: reducing costs, achieving universal coverage, advancing wellness and prevention, and improving Wisconsin’s already high quality of care.

Brideau said the Task Force continues to review the WHA principles developed to guide the Association in evaluating health care reform proposals.

Behavioral Health Task Force: Chair George Kerwin and George Quinn, WHA senior vice president, shared the results of a WHA survey of emergency department directors. The survey asked questions related to how accessible and available mental health services are in both the inpatient and outpatient settings, and trends related to how individual counties are meeting the demand for these services. Results varied widely by county and were influenced by whether the patient had insurance. (See related story on page 1.)

Finance Council: Chair Tom Bayer said WHA staff continues to monitor developments related to and plan for RAC implementation. The Council also discussed the hospital assessment implementation, issues related to Medicaid crossover claims, specific payer issues, and experiences with the current tight credit market.

Council on Rural Health: Presenting the report on behalf of Chair Ed Harding, Quinn said the Council’s activities focused on developing the agenda for the Rural Health Conference, which is set June 17-19, in Wisconsin Dells. Registration materials are now available at www.wha.org, and will be mailed shortly.

Public Policy Council: Delivering the report on behalf of new PPC Chair Diane Postler-Slattery, Borgerding noted that the meeting coincided with the release of the hospital economic impact report developed by UW-Extension. He said there was good discussion on both federal and state level issues. Jenny Boese, WHA vice president for External Relations and Member Advocacy reported on the considerable amount of grassroots activity being generated in Wisconsin hospitals, and presented the results of a recent survey of WHA HEAT program members, which were positive and provide direction for the future.

Workforce Council: Chair Phil Stuart said the lack of clinical sites for potential hospital employees to receive training necessary to complete their education continues to be an issue. He also cited a recent newspaper article that said some education systems are capping enrollments in health occupation training programs. He said WHA is monitoring this development and others related to ensuring Wisconsin hospitals are able to maintain an adequate workforce in the future.

Audit and Investment Committee: Chair Greg Britton provided recent audit results and asked the Board to approve the Committee’s report and recommendations. Both received Board approval.

Massive Medicaid cuts are being proposed in Massachusetts just three years after a comprehensive health reform law committed to align physician and hospital payments with the cost of care. A new report released by the Massachusetts Hospital Association (MHA) said while progress was made initially to ensure that MassHealth (Medicaid) reimbursement addressed the gap in reimbursement between the cost of providing care to Medicaid patients and what hospitals were paid, the new cuts head "in the opposite direction." The provider cuts to the MassHealth (Medicaid) program are especially concerning to hospitals because 72,000 people have been added to MassHealth since April 2006.

"Difficult decisions must clearly be made to resolve the state’s current fiscal emergency. But the MassHealth cuts are of such magnitude that hospitals and other providers cannot absorb them without affecting their mission, employment, current patient needs, and investments in tomorrow’s patients," according to MHA. MHA warns that if the newly-proposed cuts are enacted, it will create an underpayment gap of approximately $500 million relative to the cost of care provided to Medicaid patients. MHA forcasts that the underpayment gap for hospitals will be larger in 2010 than before the reform law was enacted.

The funding gap, according to MHA, is a grave concern because coverage expansion under reform cannot be sustained unless there is adequate funding to pay for care. Adequate funding helps avoid the need to shift government payment responsibility onto the private sector. The report goes on to say that reducing state payments to hospitals "is not equivalent to reducing health care costs; it simply shifts the state’s costs to hospitals that will be forced to reduce employment and services and shift some of the state’s costs to the private payers."

In a report issued one year after Massachusetts enacted its health care reform legislation, the Kaiser Commission on Medicaid and the Uninsured observed that the Massachusetts plan "builds on a broad base of public coverage for the poor and near poor, and relies very heavily on federal Medicaid funds to finance the plan." As Massachusetts hospitals face huge Medicaid cuts, concern deepens that following an "historic expansion of access to health care coverage," the state’s economy and health care coverage will both suffer because of underfunding.

According to the MHA report, "The health care sector has always been a stabilizing force in the state’s economic down turns, the recent instability of hospitals is especially troubling. The damage being done to hospitals through budget cuts and underfunding is making it more difficult for Massachusetts to rebound economically."

MHA notes that the federal stimulus package increases the federal matching percentage to about 60 percent. MHA recommends that the state use the significant new federal Medicaid revenue to restore and prevent Medicaid and health care budget cuts.

"Doing so will preserve the excellent provider access that is so important to Massachusetts patients and communities, and leverage federal matching revenues as a more effective stimulus to the state’s economy, consistent with the purpose of the federal stimulus funds.

"We want to show that supporting hospitals—at a time when we’re undertaking important cost-cutting strategies—is wise economic and health care policy," said MHA President and CEO Lynn Nicholas. "Right now, with the federal recovery package, we have the opportunity to resolve the issue now and for the future."

"Massachusetts Hospitals: Critical to the Commonwealth and Threatened in the Economic Downturn" is available on MHA’s Web site at www.mhalink.org.

It is increasingly likely that the Obama Administration’s health reform plan will include a public health insurance "option" that, if enacted without amendment, will have a profound impact on the nation’s providers and private insurers.

Despite specific details, Administration officials and Congressional allies have signaled that their reform plan will: 1) include a public plan "alternative" to private insurance; 2) be available, minimally, to individuals and small groups (and perhaps early retirees?); and 3) look a lot like the current Medicare program without Medicare Advantage.

The LEWIN GROUP, a Washington D.C. based consulting group that’s often referred to as the "gold standard" when it comes to modeling health care policy proposals, weighed in recently with its findings about just how the public plan will affect private insurance, hospitals and physicians. Here’s what they had to say:

• Because the public plan will likely mimic Medicare’s regulated provider fee schedules and administrative costs (why would it pay more?), the public plan premiums will be at least 30 percent less than private premiums.
• At least 32 million people will quickly flee their current commercial coverage (this assumes that only individuals and small businesses would be eligible for the plan) to participate in the less costly public plan.
• As many as 119 million people would leave private insurance (that’s a 2/3 reduction) if the public insurance option is available to everyone—consistent with the position of most Democratic leaders in Congress.
• All hospitals and most physicians will participate in the public program due to the sheer magnitude of covered lives.
• Even with a reduction in uncompensated care due to increased coverage (not as significant of an issue in low uninsured states like Wis. and Minn.), there will still be a major net reduction in hospital and physician income due to the reduced payments from the public program.

What isn’t known yet is whether or not current state-by-state Medicaid programs will be rolled into the new national public program. For poor-paying Medicaid states like Wisconsin, that dynamic would likely be positive for providers due to the fact that Medicare provider payment is better than Medicaid.

Another unknown is whether or not the Medicare-like public program will replicate payment inequities and inefficiencies baked into the current program. That assumption is a huge unanswered detail for cost effective upper Midwestern states.

The LEWIN GROUP findings provide much fodder for analyzing the Obama Plan in advance of the "details." Those details will likely be available soon.

Steve Brenton
President

Three changes to Wisconsin’s tort system intended to increase recoveries for plaintiffs remain in the proposed budget bill although the Legislative Fiscal Bureau identified the changes as non-fiscal policy items.

Unlike 45 other identified non-fiscal items in the budget bill effectively removed from the Governor’s proposed budget bill by the co-chairs of the Joint Finance Committee, changes to contributory negligence, joint and several liability, and jury instructions remain in the budget bill. An overview of the changes is below.

To allow for a more thorough consideration of possible unintended consequences for the medical liability system, Wisconsin health care providers, and patient care in Wisconsin, WHA has asked members of the Joint Finance Committee to remove the tort changes from consideration in the budget bill.

WHA has raised several questions about the effect of the tort changes on Wisconsin’s carefully-balanced medical malpractice system that includes mandatory, unlimited malpractice coverage for many Wisconsin health care providers through the Injured Patients and Families Compensation Fund (IPFCF). For example:

• Will Wisconsin providers become reluctant to accept cases from physicians who are employed by the state, counties or municipalities and have special liability limits?
• Will damages caused by out-of-state health care providers be shifted on to Wisconsin health care providers that are minimally at fault?
• Will the changes affect the delivery of care to patients?
• Will the changes or the uncertainty associated with the changes increase insurance rates?
• Will the changes make Wisconsin a more hostile place for physicians and discourage physicians from practicing here?

The budget bill is currently before the Joint Finance Committee. Following consideration by the Joint Finance Committee, each house of the Legislature will need to pass identical versions of the budget before it is returned to Governor Doyle for his review and signature.

Overview of Tort Changes in the Budget Bill

Joint and Several Liability
If multiple defendants are liable to a plaintiff, but one or more of the defendants is unable pay their share of damages to the plaintiff for reasons such as insolvency, lack of insurance, or governmental immunity, a solvent defendant may be forced to pay the other defendants’ share of damages to the plaintiff due to joint and several liability.

Under current joint and several liability law, a defendant can be liable for 100 percent of all damages to the plaintiff but only if the defendant was 51 percent or more at fault. Under the budget proposal, a defendant can be liable for 100 percent of damages to the plaintiff if the defendant is simply more at fault than the plaintiff. Defendants in states with such expansive joint and several liability laws often settle out of court for fear of being saddled with paying the entire judgment even though they are only partially liable.

Contributory Negligence
If a plaintiff is partially at fault for their own injuries, contributory negligence law may limit the plaintiff from recovering against a defendant that is also partially at fault for the plaintiff’s injuries.

Under current law, a plaintiff may recover from a defendant only if the defendant was more at fault that the plaintiff. Under the budget proposal, unless the plaintiff is more than 50 percent at fault, the plaintiff could recover from a defendant even if the plaintiff is more at fault than the particular defendant. On a macro level, more defendants will be paying damages as a result of this change.

Jury Instructions
Current law limits a jury’s duty to fact finding, including determining which parties are at fault and their percentage of fault. The budget proposal requires the court to inform the jury how the jury’s findings on fault affect responsibility for damages. This proposal would allow the jury to adjust fault determinations in order to maximize awards to plaintiffs.

Earlier this week, Senate Minority Leader Scott Fitzgerald (R-Juneau) held a district listening session at Columbus Community Hospital. Over 20 local citizens turned out, including hospital CEO Ed Harding and other staff members. Sen. Fitzgerald answered questions from participants and discussed various topics including the state budget, health care, insurance, local economic development and how federal stimulus dollars could impact Wisconsin.

Does your hospital have a grassroots story to share? Send it to HEAT at jboese@wha.org or 608-268-1816.

Fifty-four percent of hospitals had negative total margins during the first quarter of fiscal year 2009, including 80 percent of hospitals with 500 or more beds, according to a nationally-representative survey by the Healthcare Financial Management Association (HFMA). Eight in 10 hospitals report declines in non-operating revenue since the economic recession began last summer, and seven in 10 report fewer days cash on hand. Four in 10 hospitals report a decline in net patient revenue and investment losses of 25 percent or more. Patient revenue declined in almost half of the hospitals that responded to the survey. The HFMA findings are consistent with data recently collected by the American Hospital Association. The survey results are available at: www.hfma.org/NR/rdonlyres/B5FE7CAD-6BC4-449C-BA21-08D170F5B28C/0/Pulse.pdf.

The Wisconsin Hospital Association released the results of its second survey that indicated hospitals here continue to see margins drop while charity care and bad debt escalate. The WHA Special Report is available at www.wha.org/pubArchive/special_reports/WisHospitalsandEconomyUpdate4-2009.pdf.

AHA members are invited to participate in one of two identical upcoming AHA RAC Education Series calls during which experts will review the contents of a March 27, 2009 Regulatory Advisory (www.aha.org/aha/advisory/2009/090327-regulatory-adv.pdf) on the Medicare appeals process. The call will review key distinctions for RAC appeals.

AHA members can register for one of two identical calls on Wednesday, April 22, or Tuesday, May 12, at 1:00 p.m. EDT by visiting www.aha.org/rac. The call-in number and materials for each call will be sent the day before the call to registered AHA members. For questions, call Member Relations at (800) 424-4301.

Online registration is now open for the 2009 Wisconsin Rural Health Conference, scheduled June 17-19 at The Kalahari Resort in Wisconsin Dells. This annual event is the statewide forum for examining issues that impact small and rural hospitals. It’s a great way for hospital executives, leadership staff and trustees to take advantage of great education with nationally-known speakers, right in your backyard, at a fraction of the travel and registration costs of out-of-state events.

This year’s conference is once again offered in collaboration with MetaStar, Rural Wisconsin Health Cooperative, Wisconsin Office of Rural Health, and the Wisconsin Primary Health Care Association.

The Federal Trade Commission (FTC) will begin enforcing the "Red Flags" rule May 1 after a six-month delay in enforcement announced in November. Hospitals are likely to meet the rule’s broad definition of "creditor," requiring them to develop a written identity theft prevention program.

The FTC recently published a guide to help businesses and other creditors comply with the rule. The FTC guide is available at http://www2.ftc.gov/redflagsrule. Under the rule, financial institutions and creditors with covered accounts must have identity theft prevention programs to identify, detect, and respond to patterns, practices, and activities that could indicate identity theft. The rule applies to financial institutions and creditors, including non-profit and government entities, that defer payment for goods and services.

Wisconsin hospitals are being hit hard by the recession, documented by two recent WHA member surveys. Hospitals report patient volume and margins are down, while they see an unprecedented increase in the number of patients who are either uninsured, receiving Medicaid, or are unable to meet their deductibles. WHA produced two Special Reports, one in February and another in April, that illustrate the impact the economy is having on Wisconsin hospitals, based on the surveys. A new briefing paper in the WHA Toolkit provides quick access to the reports and to PowerPoint slides of the charts that are used in each.

WHA’s successful initiative to standardize patient color code alerts in Wisconsin’s hospitals will be featured in the May 1 issue of the American Journal of Health-System Pharmacy. As of March 1, more than 80 percent of the hospitals had adopted the standards recommended by WHA. According to Dana Richardson, WHA vice president, quality initiatives, the remaining 20 percent are currently working on making the switch.

Richardson points out in the article that pharmacists will most likely find the allergy standard to be the most important in their practice. David Grinder, director of pharmacy at Monroe Clinic, and Tom Lausten, director of pharmacy and distribution at Children’s Hospital of Wisconsin in Milwaukee, were also interviewed for the story.

"It’s not just putting on a band; it is a little bit more," Lausten said.

Because Children’s patients range in size from tiny neonates to full-grown adults, finding colored bands to fit all patients took longer than expected.

And, as at Monroe, a major concern for pharmacy was that the patient-identification bands accommodate the bar codes used with Children’s bedside bar-coding system for medication administration.

A quarterback cannot lead his team down the field from the sidelines. A soccer team is nearly defenseless if their goalie is sitting in the stands. And dozens of high school athletes may not be allowed to step onto the field and play on their teams because they haven’t had their required physical.

Each year, 85,000 high school students participate in interscholastic athletics in Wisconsin. Wisconsin Interscholastic Athletic Association rules state that an athlete needs a physical to be eligible—but many families do not have health insurance or income to pay for that physical.

In Dane County, it’s estimated that two to five percent of high school athletes are without health insurance.

To help these student athletes get into uniform and back in the huddle, the Dane County Sports Medicine Council teams up with UW Health Sports Medicine Center, UW Department of Physical Therapy, and MEDIC students from UW School of Medicine and Public Health to offer a free athletic physical clinic each August. UW Health physicians, athletic trainers, residents, medical students and Spanish interpreters provide athletic physicals and immunizations.

"This is a nice opportunity to take care of a large group of student athletes who have no health insurance or very limited financial resources," said Joe Greene, supervisor of athletic training services at the UW Health Sports Medicine Center. "Getting these physicals done in a timely manner helps to keep these young people participating and active at what they like to do."

The staff at UW Health Sports Medicine Center has been working with the Madison Metropolitan School District and other entities to offer free athletic physicals for several years. Each year, more than 40 student athletes in the Madison area attend the clinic.

"This is a great collaborative effort between the hospital staff, medical students and the schools," Greene said, "and the families and athletes are always very appreciative."

Sacred Heart Hospital knows that at the heart of every hospital’s mission is a desire to help and heal. Although it is expected that a health care facility would address patients’ physical needs, sometimes providing patients a full recovery means assisting them financially as well.

Father Lawrence Dunklee, director of Sacred Heart Hospital’s Center for Spiritual Care, says, "The Sisters who founded our hospital did so not for economic opportunity, but to address the community’s health needs. People have a fundamental human right to health care. Nobody who comes to our door is ever going to be turned away or denied necessary health care services and medical treatment."

Laura Gautsch of Eau Claire didn’t have health insurance when she was admitted to Sacred Heart Hospital with uncontrollable high blood pressure. Her two-week hospitalization left her with a bill of more than $30,000. Laura, a 32-year-old college student who had already taken out a loan to pursue her studies, didn’t know how she was going to pay the charges. Fortunately, she qualified for Sacred Heart Hospital’s Community Care program, which provides full or partial financial assistance to those who qualify. Financial counselors evaluated her situation and forgave 100 percent of her bill.

Laura says, "They let me know that my bill was waived pretty quickly, so I didn’t have that much time after I got out of the hospital to think ‘Oh my gosh, what am I going to do?’" She adds, "Without the hospital’s generosity, I wouldn’t be where I am now."

Laura holds a four-year degree from UW-Madison and was taking general courses at UW-Eau Claire at the time of her hospitalization. However, her experience at Sacred Heart Hospital moved her so much that she decided to pursue a nursing degree. She is now set to begin an accelerated nursing program at Johns Hopkins University in Baltimore. Laura comments, "[Without the financial assistance from Sacred Heart], I probably would’ve had to drop out and work, look for some other financial help somewhere else or declare bankruptcy. I don’t know what you do in those kinds of situations."

After graduation, Laura intends to work with low-income patients in the Baltimore area and do her part to give back. "If more people could just have a chance to not be in debt because of an exorbitant hospital bill, look what so many people would have the chance to make of themselves," she says.

Sacred Heart Hospital cares for all patients, regardless of their ability to pay. Community Care is a hospital-based program to provide full or partial financial assistance for Sacred Heart Hospital services to patients. The hospital processes Community Care applications for about 900 families each year. Approximately 71 percent are granted full assistance. Those who are accepted are "extremely grateful" for the help, Father Dunklee says, "not only for the assistance that’s been given, but the way in which we give it."

The Baby Safe Sleep Bilingual program at Wheaton Franciscan Healthcare – St. Francis provides new mothers with safe-sleep education and, if needed, a translator when Spanish is the mother’s first language. A social worker is also provided to seek information regarding home care and other critical needs.

Two years ago, a young woman delivered a baby at St. Francis. Sadly, the baby died of SIDS six weeks later. Last July, the same woman was in labor and delivery and the unit nurse/director recognized her name. After she gave birth to a beautiful baby boy, the nurse contacted the social worker, interpreter and nurse educator to assist with education and any questions related to home health for the newborn. The nurses were very sensitive to the mother’s needs and asked if she would like to talk to a chaplain. The chaplain gave the mother the opportunity to talk. The team approach that was administered to the young mother was given with great sensitivity, empathy and compassion. The young mother left two days later with a new understanding of care for her newborn, and she was filled with relief and appreciation. The social worker also kept in contact with the family during the year.

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

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