Early this morning, the state Assembly narrowly passed first consideration of a constitutional limit on state spending. By a vote of 50 to 48 (legislation fails on a tie vote), AJR 77 — Taxpayer Protection Amendment (TPA) — cleared the Assembly and is now on its way to the Senate. A vote is expected in the Senate on May 3.

Want to know how your State Representative voted? See the roll call below.

"We are disappointed with the Assembly’s vote on TPA because state government doesn’t pay for its health care programs now – employers do," said WHA Senior Vice President Eric Borgerding. "Medicaid is not a hospital program, it’s a government health care program that pays hospitals .49 cents for every dollar it costs our members to treat a Medicaid recipient. Those unpaid costs are shifted to Wisconsin employers. If adopted, the TPA could very well exacerbate this shell game."

According to WHA, about $550 million in unreimbursed Medicaid hospital costs were shifted to employers and employees in 2005, and that is without a TPA. Dubbed the "Hidden Health Care Tax" by leading business groups, when unpaid physician and clinic costs are factored in, the number only gets worse.

The narrow margin of victory in the Assembly illustrates the uncertainty and unease many legislators have with amending the state’s constitution to control government spending. Many also understand the impact unpaid bills from state health care programs have on their constituent’s health insurance premiums.

AJR 77 now moves to the State Senate, where another close vote is expected.

"This was by no means a slam dunk, it was a very close vote and only after a major component of the proposal, limiting spending of local governments, was removed," said WHA lobbyist Jodi Bloch. "The focus now shifts to the State Senate where it will also be a very close vote. We will need hospitals from across the state to engage their Senators as soon as possible."

To amend the Wisconsin Constitution, a resolution (such as AJR 77) must pass both houses of the legislature in successive legislative sessions. Should AJR 77 pass the Senate next week, it will have to pass both houses again in the 2007-08 session and only then can it be put on the ballot for a statewide referendum vote, which could come as soon as April of 2007. Unlike regular legislation, the Governor plays no role in amending the Constitution, and can neither sign nor veto the proposal.

Contact Your State Senator Now!

The Taxpayer Protection Amendment (AJR 77) is expected to come before the State Senate in the very near future. Contact your senator and urge him/her to VOTE NO!

Tell your senator that Medicaid payments to hospitals dropped below 50 percent of cost in 2005 and a TPA will very likely make this situation even worse, further compounding the "hidden health care tax."

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The focus of the 2006 Wisconsin Rural Health Conference is health care consumerism, and you’ll have an opportunity to learn more about it from one of the nation’s leading experts on the subject, Ronald Bachman. Bachman helped draft the federal legislation and IRS language for two of today’s most important tools of health care consumerism – Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs). Learn more about what’s driving consumerism in health care, the tools such as HRAs and HSAs that are pushing it along, and the results to date.

This year’s conference also includes an education track devoted specifically to governance, with one of the country’s top governance speakers, a health care trustee himself for more than 15 years, Mac McCrary. He’ll focus on the board’s role in creating a culture of quality, what keeps a board performing at a high level, and review some of the best, and worst, governance practices in use today.

The conference will be held at the newly renovated Abbey Resort in Fontana, located on beautiful Lake Geneva. The Abbey Resort and the Fontana/Lake Geneva area offer a variety of activities for attendees and their guests, including The Fontana Spa and several activities designed especially for children. Leadership staff members from small or rural hospitals, as well as board of trustee members, are encouraged to attend this event. The full conference brochure with registration information is included in this week’s packet and is available online at www.wha.org.

A provision in the 2005 federal Deficit Reduction Act (DRA) that encourages states to enact more uniform Medicaid false claims statutes is generating discussion in various state legislatures. Particularly contentious has been a provision in the DRA that incentivizes states to allow private trial attorneys to bring state actions to enforce state Medicaid false claims statutes on behalf of the government (so called "qui tam lawsuits") and share in any recoveries.

Last month, the New York State Senate blocked such a provision from being enacted there. According to the New York Times, State Senate Republicans argued that the "proposal would lead to a flood of litigation brought by prospecting lawyers."

"They’re really just doing it for the trial lawyers," Senator Kemp Hannon told the New York Times. If the proposal were passed, Sen. Hannon told the Times, money that should go to the government would instead go to lawyers.

Unlike Medicare, which is a federal program governed exclusively by federal law, Medicaid is a joint federal-state program that is governed by the laws of individual states within the framework of federal mandates. Thus, across the country there are state-to-state differences in the regulation of false claims in the state share of the Medicaid program. Currently, the states and the federal government share the costs of state Medicaid programs, and as such share the damage awards for any Medicaid false claim recoveries. If a state adopts the uniform provisions encouraged by the Deficit Reduction Act, the state becomes eligible to receive an additional 10 percent share of a Medicaid false claim recovery.

Wisconsin law currently prohibits, among other Medicaid fraud related prohibitions, a health care provider from making a false statement or material representation in relation to Medicaid payments. Penalties can include fines, imprisonment, and civil damages of three times the amount of any excess Medicaid payments.

The Wisconsin Department of Justice’s Medicaid Fraud Control Unit enforces Wisconsin’s Medicaid fraud statute and is charged with investigating and prosecuting allegations of Medicaid fraud. The Medicaid Fraud Control Unit works cooperatively with other state regulatory agencies, including the Department of Health and Family Services, the Department of Regulation and Licensing, the Department of Revenue, and with district attorneys’ offices and law enforcement agencies around the state.

Last week, Attorney General Peg Lautenschlager issued a press release proposing that Wisconsin amend its laws to allow private trial attorneys to initiate their own suits in state court alleging false Medicaid claims and to share in the government’s recovery.

On April 18, the Governor signed 2005 Act 351 into law relating to caregiver background check forms. Prior to the act, Wisconsin’s caregiver background check law required hospitals to have their caregivers complete a background check form provided by DHFS. The act now allows a hospital to either use the DHFS background check form or their own background check form if the form requires the hospital’s caregivers to disclose to the hospital all information requested by the DHFS form and if the hospital also annually notifies the caregivers of the disclosure requirements.

The 2006 Wisconsin Hospitals Political Action Funds contribution campaign begins this week with a mailing to hospital CEOs and administrators that includes information about our campaign.

Over the past few years, our contribution campaigns have shown remarkable success. In fact, since 2001 contribution totals have grown almost 300 percent!

Just last year, our campaign generated $175,000 in contributions, signed up 12 new participating hospitals, saw 41 percent of our member hospitals exceeding their individual goals, and also featured a significant increase in individual giving in the "higher dollar" category. Notably, WHA staff raised over $20,000 for the 2005 campaign and has pledged to increase that total this year.

Over the years, the Wisconsin Hospitals Conduit and Wisconsin Hospitals PAC have played a critical role in achieving success for WHA’s government relations efforts at the state level. This year, WHA has added the Wisconsin Hospital Association Federal PAC to its family of political action funds to enhance federal political advocacy through greater involvement with members of the Wisconsin Congressional delegation. The Wisconsin Hospital Association Federal PAC will help Wisconsin meet its annual AHA PAC goal.

We look forward to a successful campaign once again this year. We know that we all can agree that supporting candidates and elected officials who understand the vital role our hospitals play in our communities is critical. Our measurable legislative successes this year, at least in part, are due to our demonstrated and increasing political clout.

Steve Brenton         Ned Wolf
President                Chair, Wisconsin Hospitals Political Action Funds

The final implementation phase of the Joint Commission on Accreditation of Healthcare Organizations’ (JCAHO) New Visions – New Pathways initiative started with the introduction of unannounced surveys, beginning in January 2006. All of the new challenges remain in place: Internet-posted quality reports, tracer-patient methodology, and the priority-focused processes, and now, add the unannounced survey. Organizations cannot "ramp up," but rather, they must develop strategies for continuous compliance.

The May 9 seminar "Surprise: It’s JCAHO! Adapting to an Unannounced Survey and 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. This seminar will be held from 8 am to 4 pm on May 9 at the Holiday Inn in Stevens Point.

While many organizations have sound processes in place for addressing the majority of the JCAHO standards, some struggle with how to address a few common but challenging issues. The May 10 seminar, entitled "JCAHO Continuous Standards Compliance: A Focus on Medication Management & Competency Assessment " will address two of those issues. This seminar will be held from 8 am to 4 pm on May 10 at the Holiday Inn in Stevens Point.

The May 10 seminar is a hands-on, working session to develop plans for complying with the most critical JCAHO compliance problems/issues. Participants will work with the instructor and their peers to develop methods of compliance similar to those that have been successful in other organizations. Through this approach, organizations should experience a reduction in the amount of time committees, task forces and teams expend in understanding new requirements, researching how others are approaching the requirements and initiating false starts at implementing new or revised processes. This program is not an overview of all standards or a basic primer for beginners. It is a focused working session to move organizations forward in resolving critical compliance problems.

Participants can choose to register for only the morning session focused on medication management, only the afternoon session focused on competency assessment, or the full-day seminar.

Facilitating patient-focused care during the last stage of life may be one of the most important gifts that a hospital can give to its patients. Over the past few years, several WHA members have indicated an interest in learning more about what can be done to improve existing services in this area.

WHA has developed a one-day conference, titled "Hopeful Responses to Meeting End-of-Life Care Challenges," to explore legal and ethical issues and to learn from other Wisconsin organizations about how they are approaching this important topic internally and from a community perspective.

The conference is scheduled May 16, 2006, at Stoney Creek Inn in Mosinee, from 9 am to 4 pm. A full brochure with registration information is available online at www.wha.org.

If you have questions about the content of this seminar, contact Jennifer Frank at jfrank@wha.org. If you have registration questions, contact Sherry Rabuck at srabuck@wha.org.

The Wisconsin Chapter of ACHE is presenting a workshop entitled "Developing High Performing Teams" on June 23, following the adjournment of WHA’s Wisconsin Rural Health Conference.

Today’s workplace calls for the development of high performance work teams to manage dynamic health care environments. The panelists will present strategies to design and implement collaborative work systems. Attendees will learn how to create a culture in their organizations that will embrace teamwork and collaboration; effective rewards for individual contributions to team efforts; how to identify characteristics of high and low functioning teams; and how to measure team success.

This program has been developed and is presented locally by the Wisconsin Chapter of ACHE. The American College of Healthcare Executives has awarded one (1) Category I (ACHE education) credit hour to this program.

The presenting panel will include Bob Morris, president of Organizational Skills Associations of Madison, who will act as moderator; Sandy Anderson, president of St. Clare Hospital and Health Services in Baraboo; Kristy Burger, director of quality and performance improvement for Moundview Memorial Hospital and Clinics in Friendship; and Jeffrey Meyer, chief executive officer for Osceola Medical Center in Osceola.

The conference will be held at the conclusion of the Wisconsin Rural Health Conference, on Friday, June 23, 2006, from 10:15 am to 11:30 am at The Abbey Resort in Fontana, located on Lake Geneva. There is no cost to register for this event, but pre-registration is requested. A brochure with registration form is included in this week’s packet and on the Web site at www.wha.org. Easy, online registration is available as well.

It’s a simple test of your circulation, but it can have powerful results.

By taking your ankle and arm blood pressure readings, a health care provider can identify if you are at risk for peripheral artery disease (PAD). Anyone with PAD is in increased danger of heart attack or stroke.

This screening is called the ankle-brachial index (ABI). Luther Midelfort, part of Mayo Health System, offered free circulation screening at its annual Healthy Heart Fair in February 2006. About 100 people received free ABI tests, a service worth about $40,000.

But even more amazing were the results. Thirty-three percent of those screened had abnormal tests and were encouraged to see a doctor. A nurse practitioner also made follow-up calls to those with abnormal results.

"This is the first year the Heart Fair offered ABI testing, and we were amazed at the number of people the screening identified with abnormal results," says Regis Fernandes, MD, a cardiologist at Luther Midelfort. "But this is just one more example of how a free event like the Heart Fair, which brings health care providers out in a community setting year after year, can have such a powerful impact."

Luther Midelfort’s annual Healthy Heart Fair has more than 20 informational booths and screening areas set up at Oakwood Mall in Eau Claire. More than 50 health care providers spend a Saturday and Sunday in February answering health questions from the public. They discuss smoking-cessation and weight-loss programs. They bring in an ambulance and demonstrate how to perform CPR and use an AED. They set up a surgical suite – complete with an operating table and all the instruments used – and show what happens during open-heart surgery.

Physicians present educational talks on heart health. A registered dietitian demonstrates how to cook heart-healthy food – and lets the audience taste the end product. Free blood pressure readings and cholesterol screenings also are offered. In 2006, about 120 free cholesterol screenings were done, a service worth $6,400.

And thinking about heart health isn’t just for grown-ups. At the 2006 Healthy Heart Fair, kids exercised to music with Shrek, SpongeBob SquarePants and other costumed characters. They colored pictures that show how the heart works. They looked at the differences between snack foods – and sampled some healthy ones.

The next Healthy Heart Fair is February 10 and 11, 2007.

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

Holy Family Hospital in New Richmond announced that it will change its name to Westfields Hospital on May 1.

The hospital became a part of the HealthPartners family of care in January, following a transfer of interest from the Sisters of St. Joseph of Carondelet, St. Paul, to HealthPartners. As part of the transfer the Sisters have asked that the name of the organization be changed.

"The name Holy Family Hospital has served us well for the past 56 years," said Jean Needham, CEO and president of the hospital. "Our name represents the mission and values ingrained within this organization. As we looked for a name that would grow with us into the future, we explored many ideas and talked with many residents of the community. Westfields Hospital rose to the top as a name that not only fits our geographic location in western Wisconsin, but also reflects the broad array of services and the welcoming and peaceful environment we offer to our patients and guests."

"This organization will continue to reflect the culture of this community and our staff will continue to live the mission each and every day, demonstrating the core values of the organization of respect, stewardship, care and quality. Our new name is consistent with keeping those values and our vision of the future," she added.

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