Nearly 600 people, some in red, white and blue, from cities and towns across Wisconsin converged on Madison April 1 for WHA’s Advocacy Day. It was an impressive view from the podium for WHA Chair Mike Schafer, president and CEO of Spooner Health System, who presided over the event, as he surveyed the crowd gathered at Monona Terrace. Even more impressive was the fact that 350 of the attendees journeyed to the capitol in the afternoon to meet with their legislators.

"The sheer number of people in attendance here today demonstrates the power that this group can have in shaping the future of health care in Wisconsin," Schafer observed. "WHA’s success in advocating for hospitals is certainly bolstered by your grassroots efforts. Our voices matter, and we will be heard. Days like this help us in our efforts."

WHA Executive Vice President Eric Borgerding noted that Advocacy Day attendance has nearly tripled in the past few years. This year set a new record for the number of legislative visits scheduled at the capitol.

"Your participation in the legislative process, including writing and meeting with your legislators, is important in ensuring that legislators understand the enormous impact that hospitals have on both the physical and economic health of the communities they serve," Borgerding said.

American Hospital Association Executive Vice President Rick Pollack provided an insider’s view on the political scene in the nation’s capitol. But first, he took a few minutes to give the audience an outsider’s view of Wisconsin’s reputation as a national health care leader.

"Wisconsin is a national leader in both quality and price transparency. The fact that you are part of the Robert Wood Johnson Aligning Forces grant is evidence that Wisconsin carries a significant piece of leadership in this country," according to Pollack. "You are on the cutting edge of technology to reduce blood stream infections, and you’ve been aggressive in telling your story whether it is describing what you contribute in community benefit or the role hospitals play as economic engines in this state."

Pollack saluted "hospital people" whether they are trustees or volunteers or caregivers.

"You provide service day in and day out. You are challenged to manage effectively and efficiently as a business, but also to compassionately care for the sick and dying, and that is not easy," Pollack said. "You have dedicated your lives to make hospitals very special places that care and cure. They give life, sustain life, and save lives. It is an honor and privilege to represent you on Capitol Hill."

Pollack said health reform "will happen" under the Obama administration. He said AHA has been working with the state hospital associations to develop a vision and direction on how best to proceed with national health reform. The five pillars of health reform developed by AHA include wellness, affordable and high quality care, providing good information to the public, and coverage for all. Those elements are AHA’s guideposts as they evaluate health reform proposals, according to Pollack.

AHA has surveyed their membership twice in the last six months to give Congress data that supports that "hospitals are hurting." The AHA message, according to Pollack, reinforces the work that WHA has completed on the impact that the economy is having on hospitals.

Following Pollack’s presentation, WHA President Steve Brenton shared his concern that there will not be enough physicians to care for patients. Pollack said AHA believes that nationally, an investment must be made in getting more physicians into medical school, increase the number of residency slots for physicians, and consideration should be given to having nurses assume duties that are appropriate to their training that are now being performed by primary care physicians.

Hospital nurses, volunteers, managers and administrators united this week when the Assembly Health and Healthcare Reform Committee held a hearing on Assembly Bill (AB) 152. The proposal seeks to ban mandatory overtime—an avoided and seldom used, but unfortunately sometimes necessary, approach to hospital staffing necessary to ensure the safety of hospital patients.

More than a dozen hospital leaders signed up to testify and close to 100 registered their opposition to the bill. They were unanimous in their concerns that AB 152 as presently drafted would severely restrict the ability of Wisconsin hospitals to provide safe and responsive care in the frequently unpredictable environment of 24/7/365 health care.

"This bill limits the options hospitals have to respond to unexpected patient care needs and does not address the more frequent and larger issues of fatigue and extended hours of work," WHA Vice President of Workforce Judy Warmuth said in her testimony. "Hospitals continuously work on improving patient care and safety through evidence-based strategies for addressing fatigue."

Warmuth highlighted the commitment of Wisconsin hospitals to patient safety, citing public reporting measures found on WHA’s CheckPoint website and the leading role hospitals play in community and statewide initiatives on error reduction. "WHA believes the discussion on fatigue should focus not on mandated hours, but on total hours worked, recovery time and the effects of fatigue on patient safety," Warmuth said. "This bill ignores that much broader issue while potentially creating another – leaving hospitals short-staffed at their most critical times and emergencies."

In her testimony, Paula Hafeman, chief nursing officer at St. Vincent’s Hospital in Green Bay, cited the unplanned and unpredictable nature of hospital admissions as a particular concern. She described a recent example of a bus accident with 20 children all needing care that, according to AB 152, would not be defined as a disaster requiring additional nursing staff to stay and care for the incoming patients if necessary. "This bill limits options available to health care facilities to staff for unpredictable patient care demands," Hafeman said.

Beyond restrictions on the extremely rare circumstances under which mandatory overtime could be used, AB 152 places new limits on the use of on-call time which would limit hospitals’ ability to avoid the use of mandatory overtime. The on-call provisions have not been included in previous versions of the bill.

"Mandatory overtime is never a good solution or strategy for staffing," said Jan Bauman, chief nursing executive for Divine Savior Healthcare in Portage. "We use proactive strategies to ensure we have staff for above our daily census. Some of these strategies include having casual and per-diem staff available and when an unexpected rise occurs, we initiate calls to our part-time staff for unpredictable surges in census," Bauman said. "Limiting the tools available to hospitals impairs their ability to ensure the correct number of staff is available whenever there is the need."

Also testifying was Roger Lucas, vice president of human resources at Aspirus Wausau Hospital. "The quality of health care in Wisconsin consistently ranks among the best in the nation," said Lucas. "While Aspirus as a policy does not employ mandatory overtime, if it was having the impact proponents say it is around the state, that quality simply would not be there."

An issue consistently raised by committee members was the comparison of mandatory and voluntary overtime. "Patient safety is everyone’s goal," said Representative Kitty Rhoades (R-Hudson). "But if fatigue from mandatory overtime is an issue, voluntary overtime fatigue raises the same concerns. A worker who chooses to stay on duty for 16 hours experiences the same fatigue as one who is required to stay 16 hours. You can’t discuss one without talking about the other."

The committee did not act on the proposal.

The City of Wauwatosa’s denial of a property tax exemption for the Wheaton Franciscan Healthcare’s outpatient facility has been widely followed as a test case for the exempt status of off-campus hospital outpatient facilities. Just a few days ago, a Milwaukee County judge rebuffed the City’s challenge and upheld the property tax exemption for the St. Joseph Hospital outpatient facility in Wauwatosa.

In this column, we discuss a few of the many challenges raised by Wauwatosa, and the Court’s rationale in rejecting these challenges.

Doctor’s Office. The hospital exemption does not apply to property used for doctor’s offices. About two floors of the outpatient facility were used by physicians for their practices and no exemption was sought for this area. Wheaton Franciscan Healthcare sought an exemption for the balance of the facility that was dedicated to providing outpatient services in the same manner as outpatient services that are provided within any hospital. For example, services were provided by physicians with hospital privileges, services were subject to hospital-based reimbursement and both the outpatient facility and main hospital campus used the same billing and medical records systems.

Wauwatosa argued that an outpatient facility, regardless of the manner in which the services are provided, is a doctor’s office and, therefore, is not exempt from the property tax. The Court rejected the City’s argument, noting all of the ways in which the outpatient facility operated in the same manner as a hospital.

Commercial Purposes. The outpatient facility was designed to expand and improve the services provided by St. Joseph Hospital, including women’s health services, emergency care and wound care. While acknowledging the expansion of services, the outpatient facility’s business plan focused on economic considerations. Wauwatosa argued that the focus on economic considerations in planning for the facility indicated that it was built for a commercial purpose, and therefore was not exempt.

The Court rejected this argument. The Court acknowledged that nonprofit hospitals operate in a competitive environment and that attention to these pressures does not mean the facility was designed for commercial purposes.

Private Benefit. Most of the City’s challenges concentrated on the outpatient facility itself. Here, the City challenged the manner in which Wheaton Franciscan Healthcare operated, essentially challenging the exempt status of all hospital property owned by the system.

The exemption statute provides that the net earnings of a nonprofit hospital may not inure to the benefit of a shareholder, director, officer or member. The parent corporation of St. Joseph Hospital, which is technically a "member" of St. Joseph Hospital, provided all manner of services to St. Joseph Hospital. St. Joseph Hospital paid for a disproportionate share of these services so as to subsidize other facilities in the system (e.g., nursing homes) that could not cover their costs.

The City argued that these payments constituted impermissible inurement to a member. The Court rejected this argument, concluding that the statute was not intended to apply to payments to a member that is a nonprofit corporation.

Postscript. Wauwatosa may appeal and so this decision may not be the final word on these issues for a few years. Yet, no matter how this case ultimately plays out, it is clear that the statute governing property tax exemptions for hospitals contains a number of hurdles, each of which must be met by a hospital seeking the exemption. As hospitals develop more off-campus facilities and enter into more joint ventures with for-profits, hospitals must take great care to meet all of these hurdles so as to maintain their property tax exempt status.

About the Authors: Don Millis and Kristina Somers represented Wheaton Franciscan Healthcare against Wauwatosa’s challenge to the property tax exemption for the St. Joseph Hospital outpatient facility. Millis is a shareholder in the Madison office of Reinhart Boerner Van Deuren, s.c.; Somers is a shareholder in the firm’s Milwaukee office.

Aurora HealthCare received the Wisconsin Hospital Association’s 2009 All-Star Grassroots Advocate Award for doing what they do best—advocating for the communities they serve.

In accepting the award at WHA’s Advocacy Day April 1, Aurora President and CEO Nick Turkal, MD, said he feels strongly that people should stay informed and participate in local and state government.

"We have an opportunity to positively advocate for our patients, their families and the communities we serve every single day. Whether people pick up the phone and call their legislator or visit them in person—participating in the process does make a difference," Turkal said. "As health care providers, we care for a lot of people in this state. We need to always ask ourselves what we can do to make a difference in our state, and help make it a better place for people to receive health care."

Jenny Boese, WHA vice president of external relations & member advocacy, commended Aurora Health Care.

"WHA depends on individuals at hospitals and health systems like Aurora because there is no substitute for grassroots involvement," said Jenny Boese, "They know the issues, they work with WHA, they engage their elected officials, and they mobilize others to be involved—it’s this year-round commitment to advocacy that is the heart of grassroots!"

Two top officials at the Wisconsin Department of Health Services received WHA’s 2009 Health Care Advocate of the Year Award April 1 at WHA’s Advocacy Day in Madison. The WHA annually presents the award to an individual who demonstrates outstanding efforts on behalf of Wisconsin hospitals and a strong commitment to health care policy.

This year, DHS Secretary Karen Timberlake and Jason Helgerson, administrator of DHS’s Division of Health Financing, shared the honor. According to WHA President Steve Brenton, Timberlake and Helgerson were tireless in their efforts to expand coverage and improve access to care for vulnerable populations

Brenton noted, "You really cannot fully advance reform without addressing both of those issues. In other words, coverage without necessary infrastructure fails to adequately achieve meaningful health reform."

Timberlake and Helgerson successfully expanded coverage in Wisconsin by making improvements in the Medicaid BadgerCare Plus program, which enrolled over 70,000 new beneficiaries in 2008. They were also instrumental in gaining the Centers for Medicare and Medicaid Services (CMS) approval for a waiver that over the next year or two, will provide coverage to as many as 80,000 childless adults who have been without health insurance for at least one year.

"These two dedicated public officials understand the essential need for appropriate access to health care services, especially primary care services," Brenton added. "All across Wisconsin, inadequate access threatens to undermine our successes on the coverage side of the ledger."

Timberlake and Helgerson have actively participated in the Milwaukee Health Care Partnership, a unique collaboration of hospital systems and community clinics with a common mission of growing primary care infrastructure in southeastern Wisconsin. They also have been strong advocates for Wisconsin’s network of primary care community clinics--organizations that are at the front lines of serving the most vulnerable patient populations.

The largest road block to "big ticket" health reform, including full universal coverage, may not be Republican push back…or….vigorous opposition from PHARMA and from multi-state health insurers. What could end up dialing back the expectation that Congress will enact a once in a lifetime initiative this year may be the vision of a growing mountain of national debt. That’s a growing concern for some Congressional Democrats who have qualms about seeking re-election in swing districts with the issue hanging over their heads.

The Congressional Budget Office (CBO) released eye-popping numbers last week. The results were greeted with disbelief by many members of Congress. While Obama Administration officials had claimed that their ten-year budget blueprint will result in a $6 TRILLION increase in the federal deficit, the CBO says that the real deficit will climb to $9.3 TRILLION. And although the Obama budget plan includes a $634 billion "placeholder" in new funding for universal health care, there’s consensus that that’s not nearly enough to provide coverage for all….a bottom line objective for many health reformers.

Most supporters of universal health care coverage agree that the ten-year price tag will surpass $1.2 trillion dollars. Champions of "coverage for all" point out there are 47 million people currently without coverage. Even if one subtracts undocumented immigrants (who will continue to require emergent care) and the population currently eligible for public programs but not "signed up"….the number to be covered by some new program will probably approach $25 million or so.

In addition to financing a universal coverage program, the Administration will also need to pay for new infrastructure necessary to address access for the soon to be fully-covered population. Whether or not the Obama plan will account for that massive expense in their next set of financial projections will be learned soon. And what about the increasingly expensive Medicare physician payment "fix" that keeps being pushed back each year to the next? That’s another huge hole to be filled.

These reality checks mean that the soon-to-emerge reform plan will require hundreds of billions of new monies that aren’t in the budget blueprint that is already being nervously eyed by many in Congress. Or it will otherwise require actuarially sound "savings" that can be extracted from the current delivery and payment systems. The eventual details as to where these billions will come from will be additive to growing political concerns over future deficits. This dynamic may end up resulting in a more incremental approach to the next rendition of health reform when reality sinks in later this summer.

Steve Brenton
President

One of the most popular features of Advocacy Day—the legislative panel—gives legislators an opportunity to share their views on health care directly with a large gathering of hospital supporters. Moderated by WHA Executive Vice President Eric Borgerding, the panel had an opportunity to provide the audience a brief overview of their priority issues.

For Rep. Jon Richards (D-Milwaukee) health reform and passage of a statewide smoking ban headed his list of priorities. Richards said after spending time with hospital leaders in his area, he learned that the largest source of bad debt in hospitals is people with health insurance unable to pay large deductibles. Citing the fact that chronic disease is responsible for 40 percent of hospital admissions and 75 percent of health care costs, Richards said as the state and nation move forward on health reform, it is imperative to reduce health care costs, adopt a more "rational" style of care, and "end up with better health care and better outcomes."

Richards is a strong supporter of a statewide smoking ban, terming it a "health issue, not a personal preference."

Sen. Dale Schultz (R-Richland Center) is a believer in people taking responsibility for their personal health. Schultz actively participated in a broad-based community health project in Juneau County. The project was aimed at encouraging and promoting healthier lifestyles and managing chronic disease. The project got a major boost from the Robert Wood Johnson Foundation, which is looking at it as a model for a national health initiative.

"In Fennimore right now they are having a contest to see who the biggest loser is. They are taking tons of weight off in that community," according to Schultz. "Each and every person in this room understands the problems with obesity that we see in our communities."

Schultz invited audience members to be involved in these discussions.

"And I know you will because you are integral to our communities…you provide leadership and an economic boost to our communities," he added.

Responding to health care issues is top on Rep. Donna Seidel’s (D-Wausau) list. She referenced a Public Television documentary that spotlighted the plight of those who lose employer-sponsored health insurance and find themselves ill and uninsurable.

"We are grappling with a problematic health care system. We hear about it daily," Seidel said. "Each and every one of us is just one or two life events away from disaster."

Seidel said she believes that legislators in Madison have an opportunity to take positive, proactive actions to move health reform forward.

Rep. Jeff Stone (R-Greenfield) sees dramatic change on the horizon for health care because of its importance to those who to access it and to the nation’s economy. He is, however, upbeat about the delivery system in Wisconsin.

"I would like to put it out there that I do not think we have a health care crisis. There is no place on earth that I’d rather be than right here in Madison or Milwaukee," Stone stated. "What we have is a wellness crisis that drives utilization, disrupts the delivery system, and drives up cost."

Stone pointed out that the USA spends more than other countries, and receives good health care in return; however, he is concerned about access.

"It gets down to how we finance health care in this country. Should business and health insurance divorce? It is a tradition on how we deliver health care, but is it the right way to finance it?" he asked.

Is a Ban on Mandatory Overtime Necessary?

All questions for the panel were from audience members and more than 50 were submitted. Borgerding issued a good-natured warning to the panelists that, by far, he received the most audience requests to ask about legislation banning the use of mandatory overtime (MOT). He noted that a legislative hearing on MOT, along with several other issues, was scheduled to begin in a few hours at the State Capitol. Many in attendance planned to stop in and register or testify against the bill.

"The question is, ‘how does restricting a hospital’s ability to staff with AB 152 (MOT) improve the quality of hospital care? Doesn’t this legislation seem broad and sweeping for a problem that rarely occurs and hospitals are diligent in avoiding all overtime? Isn’t this a solution looking for a problem?’," Borgerding asked.

"Do you want to treat the symptoms or do you want to treat the problem?," Rep. Stone asked. "The problem is we don’t have a proper supply of nurses and other health care professionals," he added, as spontaneous applause thundered in the room.

Schultz stated his position simply: "I think this law is a bad idea. I have never supported it. It sets up an ideal situation for litigation, and that is a bad idea for lowering health care costs. It removes your ability to assess the situation."

Schultz echoed Rep. Stone’s concern that the problem is a workforce shortage and the answer is to develop a plan to train more workers and ensure that they are distributed throughout the state.

Hearings are a good forum for airing issues and a great example of how the Legislature works, according to Seidel. "I am willing to say that I plan to learn from you and others this afternoon. I expect to hear a great deal of testimony on this issue so we can formulate the best decision," she added.

Richards, a supporter of the bill, agreed that most hospitals don’t use it, but, "That is another reason that says to me, if it is not used very often, set the law straight so it is the law. Mandatory overtime is not allowed, but there are exceptions….I do think it is a good law."

Health Care Reform Wisconsin-Style: Views May Differ, but Goal is the Same

When Borgerding asked the panel for their views on health care reform, the legislators said Wisconsin will wait for Washington to take the lead, but they are prepared to take action if reform stalls in the nation’s capitol. Richards said national health reform would be best for the country and his hope is that it will be successful this time around.

"If the Washington plan falls apart, we need a Wisconsin plan to address the issues here quickly," according to Richards. "It requires bipartisan support and must be specific to our state."

Schultz is skeptical of Congress taking the lead in health reform.

"The opposite of progress is Congress. So far, we have the government running the banks, running the auto industry, now they would run the health care system?" Schultz asked. "I for one have been around long enough to have seen and heard a lot from Washington and nothing translated into real health care reform."

That lack of action on a prescription drug program is what led Wisconsin to develop the Senior Care Program.

"We have a problem paying for health care, we have access issues, we need to have a larger conversation on what we can do collectively so we can point to something that really made a difference," Schultz said.

In sharp contrast, Seidel is optimistic about what the Obama Administration could accomplish.

"Many of us are optimistic that action will take place in the federal government. The question is—do we do it in leaps and bounds or in incremental steps?" Seidel asked.

Wisconsin does need a plan if the wheels fall off the wagon in Washington. Acknowledging the complexity of a "fix," Stone did offer that he believes there needs to be some kind of efficiency between the insurance company and the purchaser. He said market forces should be at work, forces that fail if health care is just "available."

In response to the last question posed by Borgerding on what the role of government is in the current economic turmoil, perhaps Rep. Stone summed it up best: "In this environment the best we can do is to do no harm. Not reduce reimbursement and think we are solving a problem, when really we are just shifting it. We need to do things that get people working again and back on employer-sponsored insurance plans."

"All the results of what we have done together is evident today, particularly for the 100,000 people who a year ago did not have health insurance. I want to thank the WHA and you for the incredible work you have done to move us forward to my goal of getting almost everybody in Wisconsin good health insurance," Governor Doyle said. "I spoke to someone who has a child with chronic illness that now has health insurance. It is the difference for them being able to move on and have a future," he added.

The Governor emphasized that even in the current economic downturn, he remains steadfast in protecting his top priorities: education, health care and positioning Wisconsin’s economy to be "in a better place than we came in" to the recession.

"These are tough times for all of us. During this time, we need to do two things: protect our priorities and be careful to not move back so far that we can’t move forward when the economy picks up," according to Doyle.

While other states are cutting eligibility for state medical assistance programs, the Governor vows that that he is not going to do that here.

"We’ve made huge progress. We can’t say to some child who didn’t have health care, ‘that was a nice thing you had for a year, but now it’s gone.’ That is what other states are doing…I am not going to do that. We’ve worked too hard to get where we are now to restart this fight in five years," Doyle said. "We set ourselves on a course on how we are going to move; we have taken care of that step by step. We might slow down, but we won’t stop and won’t reverse," he added.

The Governor said when he hears people complain about the percent of gross domestic product spent on health care, he asks, "What would you rather spend our money on? I would put health care and education at the top of my list. You create good jobs and provide top quality health services. That is an economy that will do well for the state of Wisconsin in the coming years. It fits our values, and I thank you for creating jobs."

The Governor believes that within the next two to four years there will be an opportunity for every single citizen in Wisconsin to have health insurance. He acknowledged and commended Wisconsin’s health care system.

"People see good doctors, great nurses, wonderful hospitals that deliver high quality care," Doyle said. "I know you go through a lot of battles, government regulations and competition, but in the big picture, we are doing it right. And we want to make sure we do it right for every single citizen of this state."

After waiting more than a decade, Wisconsin hospitals will see their first increase in Medicaid reimbursement this spring. As WHA Executive Vice President Eric Borgerding prepared the attendees for the legislative meetings at the State Capitol that would follow his briefing, he shared his concern about one of WHA’s priority issues, the State Budget.

"It took two years for the hospital assessment to pass, which will provide hospitals with much-needed Medicaid payment increases and they come at the right time," Borgerding said. "The economy has had an impact on hospitals as the number of uninsured has climbed and people are not able to pay for the care they need."

Cuts in the state’s Medicaid budget could mean more cost shifting and higher health care costs, a situation that WHA hopes to avoid. The Department of Health Services is working with many organizations, including WHA, to find ways to improve efficiencies in the Medicaid budget. Concern centers on protecting the dollars that flow from the federal government to Wisconsin through the hospital assessment from being raided to fill holes in the State Budget. Borgerding warned that any changes in how the assessment is calculated or raids on the funding will lead to more cost shifting and will give credence to opponents of the hospital assessment who have labeled it a "sick tax."

Borgerding said legislation to ban mandatory overtime in hospitals has been introduced in each of the past four legislative sessions.

"We have serious concerns with this bill as drafted. We need to be able to care for patients every minute of every day during unanticipated circumstances. This bill ties our hands and makes it difficult to care for patients in unpredictable circumstances," he said. He added that statements made by supporters that hospitals are regularly using mandatory overtime are absolutely not accurate. The real issue is fatigue, which must be addressed in a comprehensive way involving employers and employees, not through narrow legislation.

Economic Impact of Hospitals: Healthy Hospitals. Healthy Communities.

"This is a message that our legislators really need to understand. Hospitals play a critical role in their communities, not just delivering health care but they have a tremendous economic impact as some of the largest employers in the state," according to Borgerding. "Go to the Legislature this afternoon and tell your story."

In addition, hospitals generate public benefit and services that would not exist if the hospital was not in the community. Services like no cost health screenings, free clinics and support for community wellness initiatives would vanish.

Health Care Reform

Borgerding said increasing access to coverage is a fundamental aspect of health reform. With that comes a discussion of health care costs, an examination of how health care is delivered and an analysis of how it is being used.

"WHA has supported expanding coverage to targeted, low-income, uninsured populations. Our hope is that employers will continue to provide health insurance to their employees so only those who are truly uninsured must access their health insurance through the state medical assistance programs," he said.

Access to care hinges on the ability of health care organizations to grow their workforce and avert shortages in key occupations. The workforce issue continues to be a top priority at WHA. Expanding coverage will have little impact if patients cannot find doctors or other health care providers.

"Above all else, any health care reform must preserve the strengths of our current system. We have the highest quality health care in the nation delivered by hospitals that believe in clinical excellence," according to Borgerding. "We want to preserve what is good about our system and continue to meet the high expectations of our patients and our communities."

The shortage of physician therapists (PT) and PT assistants in hospitals is currently one of the issues that the Wisconsin Physical Therapy Association (WPTA) is seeking to address. Speaking at the WHA Workforce Council meeting March 31, William Boissonnault, faculty at the UW Physical Therapy Program and chair of the WPTA Task Force voiced concern about challenges hospitals face in both the recruitment and retention of physical therapists. Boissonnault reported that the Task Force has begun collecting information from therapists. The Task Force will develop recommendations based on their findings and they have requested WHA’s assistance in implementing the recommendations.

One of the Task Force’s first initiatives was to plan a ‘first ever’ meeting of the directors of all the Wisconsin Physical Therapy Programs to be held in April. WHA’s Judy Warmuth has been invited to participate at this meeting to present the hospital perspective at this meeting. Boissonnault also provided information to the Council on the state school programs that prepare physical therapists. He strongly encouraged hospitals to consider initiating or expanding clinical sites for physical therapy students. Any future expansion of educational programs will require an increase in the number of options available for clinical experiences. He also explained that many therapists are interested in seeing patients outside of the physician referral model. He suggested hospitals that are open to this model may find it easier to attract and retain physical therapists.

The Council also discussed a wide variety of workforce issues and offered advice and suggestions on current workforce initiatives. Members expressed concerns and discussed strategies about the proposed ban on mandatory overtime, the employee free choice act and other legislative issues. Council Chair Phil Stuart, president and CEO, Tomah Memorial Hospital, described his own contact with legislators and encouraged Council members to communicate with their lawmakers as well.

The impact of the current economic environment on workforce was also discussed. Concern centers on current issues that may dissuade or discourage interest in health care careers, which could create more serious issues in the future.

Drinking and drug abuse affects all-too-many people—not only the abuser, but his or her family and friends, too. To address this serious problem, Gundersen Lutheran’s Behavioral Health department runs an ongoing four-week program, free for families struggling with substance abuse.

Addiction is often referred to as "the family disease" because it affects everyone. That’s why this program was geared to families. Participants learn about:

• Addiction as a disease.
• The biological and psychological impact of addition.
• How living with a person who is addicted can make the behavior of the family feel crazy or out of control, too.

The four classes—Alcohol/Addiction 101, Family Roles/Rules, Communication, and Resources and Support—repeat every four weeks throughout the year to reach as many people as possible.

Two Holy Family Memorial employees organized a Bowling Tournament in February 2007 to help promote the need for organ donation. The funds raised are used by the National Kidney Foundation to promote health awareness and the transplant games. Every two years transplant recipients are able to compete in Olympic style events against other transplant recipients nationwide. Two HFM employees are donor parents and have seen the good that comes from organ transplants. The money raised supports a family who has never been able to attend such an event and help the National Kidney Foundation promote kidney research.

Rebuilding together

A group of Holy Family Memorial employees from the Support Services Department met in Two Rivers on April 28, 2007, as a part of the Manitowoc County Rebuilding Together Group started by a Holy Family Memorial support worker. The day stared at 8 a.m. with the distribution of t-shirts, ice, soda, coffee thermoses, sweet rolls, bagels, and tools. The project engineer gave directions on the work for the day—the need for a handicap ramp. After a photo was taken, the grid was laid out and the work began. Holes were dug, anchor posts cemented, and the project progressed like a well-oiled machine. Everyone knew what to do. The sponsoring group provided lunch at noon and the work picked up again with vigor with the ramp completed and the clean-up finished by early afternoon. A good job accomplished by all!

Relay for life

Holy Family Memorial Teams for Relay for Life raised a large amount of money as reported by the Director of Cancer Services for 2007! In addition to their tremendous activities, effort and hard work to raise funds, additional bake sales were held at different HFM sites for the Relay for Life project. All were willing to help stamp out cancer!

Students sometimes think they would never be interested in a certain field until they find out more about it. That’s the idea behind Medical Explorers, a partnership between Wheaton Franciscan Healthcare - Elmbrook Memorial, located in Brookfield, Wisconsin and the Exploring Learning for Life Division of the Potawatomi Area Council Boy Scouts of America in Waukesha County. The goal is to attract as many promising young people as possible to medical professions as well as give them an idea of what jobs are available as they move toward college.

During the school year, high school students are invited to hear doctors and nurses speak about their profession. Students have the opportunity to ask candid questions about the health care professional’s specific interest and concerns, which provides them with information to make educated and experienced decisions about a health career. Students are offered a behind-the-scenes look at hospital departments, hands-on experience with equipment and tools of the trade, shadowing opportunities, and a chance to learn about the many jobs available in health care.

Discovering what really goes on behind closed doors can help students know that they would love working in health care, or just as important, that it is not the path for them.

Welcoming a new baby is an exciting time for any new parent. Once the baby is born, it is important for parents to realize that they are not only parents but teachers to their newborn child. Studies have shown that a child’s first five years is a vital period for brain development. A child’s brain grows to 80 percent of the adult size by age three and to 90 percent by age five, according to the National Institute of Child Health and Human Development.

Recognizing this important statistic, the River Falls Area Hospital has started a program to raise awareness on this issue and to help guide new parents. Through a partnership with the Success by 6® program through United Way, River Falls Area Hospital provides families of newborns the opportunity to meet with a parent educator during their hospital stay. An extension of this service that is also offered, are the free "Baby and Me" classes that are held weekly and focus on play and cognitive development. Other topics that are covered are sleep, reading and understanding baby cues, baby sign language, nutrition, separation anxiety, music and family traditions. The classes are a great way for parents to learn how to interact with their infants and are also an opportunity to get to know others in the community who they can discuss concerns and share ideas with.

This program ensures that new parents have the resources and connections they need to foster the development of their newborn babies. Any parent in the St. Croix and Pierce County areas can attend.