April 8, 2011
Volume 55, Issue 14

Governor Signs Budget Repair Bill
Measure fully funds Medicaid for remainder of FY11

Potentially delayed provider payments were averted this week when Governor Scott Walker signed a budget repair bill that fully funds the growing FY11 deficit in the state’s Medicaid program.

Without the fix, the program would have run out of money in May. WHA called for quick action on the measure, introduced last week.

A shortfall of $1.8 billion in Medicaid is a significant part of the $3.6 billion deficit the state faces in the next biennium. The bill, which received bipartisan support in both houses of the Legislature, included the fiscal items that were dropped from Governor Walker’s first budget adjustment bill.

As previously reported in The Valued Voice, (see www.wha.org/pubArchive/valued_voice/vv4-1-11.htm#1), the bill included $176.5 million to fund the Medicaid program in the current biennium, funded primarily from the refinancing of state debt that is expected to generate $165 million this fiscal year.

DHS had previously indicated the potential for delayed provider payments if the shortfall was not addressed.

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Joint Finance Committee Hears About Medicaid Budget
Cutting payments to providers "not a viable solution" says Co-Chair Vos

The Joint Finance Committee (JFC) concluded agency briefings this week in advance of a series of public hearings they are holding around the state on the 2011-13 Biennial Budget. Agency briefings provide committee members the opportunity to gather details on specific departmental areas of the budget and question department heads about the rationale of budget proposals.

Department of Health Services (DHS) Secretary Dennis Smith and Deputy Secretary Kitty Rhoades appeared before the JFC this week and provided committee members an overview of the Department’s plans to address a $1.8 billion shortfall in the Medicaid program over the next biennium. This shortfall is a significant part of the state’s $3.6 billion deficit over the next two years.

Governor Walker’s budget includes a proposed $1.3 billion in state funding for Medicaid, leaving $500 million in savings DHS will need to find and implement through the study and administrative rules process granted them in a recently-signed Budget Adjustment Bill (being challenged in the courts on an unrelated matter). (See article from March 11 Valued Voice at www.wha.org/pubArchive/valued_voice/vv3-11-11.htm#1).

In his remarks, Smith said DHS has already received dozens of ideas on ways to "bend the cost curve without jeopardizing access to services" in MA from conversations they have had with individual interest groups of those who deliver and those that receive services, and from listening sessions they are holding around the state.

Addressing costs is critical to the long-term sustainability of Medicaid. Among the programs Smith mentioned was Senior Care and the idea of requiring eligible individuals to apply for Medicare Part D as part of enrollment in the SeniorCare program. SeniorCare would become a wrap-around program for them, allowing individuals to take advantage of benefits in both programs. "If you have that benefit available, you should sign up for that benefit," Smith said. "Medicaid is supposed to be the payer of last resort," he added.

Smith said a big part of their focus will be on high-cost individuals in Medicaid, in particular the five percent of enrollees that spend 58 percent of program dollars, adding these are the individuals the Department wants to get into managed care.

‘Wisconsin has great, high-quality integrated health systems," Smith said. They provide an "oasis of excellence" that should be replicated around the state.

JFC Co-Chair, Senator Alberta Darling (R-River Falls), said oversight will be an important part of the process, and asked that DHS work closely with members of the JFC and the Legislature as important issues such as Senior Care and Medicaid reform are addressed.

Smith agreed, and said they welcome ideas and input on how to get where they need to be. Darling said Medicaid is one area where there could be a strong bi-partisan effort to get the best product possible because everybody on the Committee passionately cares about the issue.

Deputy Secretary Rhoades added, "This is the time to put forth our limited resources and find long-term sustainability. These are real people that come into our programs, and we need to assure them that we are going to be there."

The Committee also asked about other ideas the Department was exploring. Co-Chair Robin Vos (R-Burlington) wondered if Medicaid had been considered as a secondary insurance to benefits an individual may have access to through their employer.

"If you have insurance available, you should take advantage of that," Smith said. But he added, "I’m very interested in the premium assistance model. I think it makes a lot of sense and is an idea well worth exploring."

Vos reiterated the need to look at all areas for savings. "We have been trying for a long time to manage an increasing Medicaid population by basically doing it one way—cutting payments to providers. I think that is not a viable solution, any more than saying we’re going to kick people off (the program) because we can’t afford them."

During the briefing, Sen. Bob Jauch (D-Poplar) reminded the Department not to forget about the hearts and health of the people Committee members represent back home and what their needs are. He also raised concerns about the cost-saving efforts of the Department potentially jeopardizing federal Medicaid maintenance of effort (MOE) dollars for Wisconsin.

Smith said any proposed changes would first be presented to the public and the Legislature before they would seek required approval from the secretary of the federal Department Health and Human Services (HHS).

Smith said MOE takes a look at a snapshot in time and requires states to continue their eligibility standards in place at that time. Some of the areas DHS plans to review include ongoing eligibility determinations and retroactive eligibility. "We believe that especially as the economy improves, and individuals’ income goes up, then they should be moving back into the private sector and getting health care coverage through their employer."

While all areas will be reviewed for possible cost saving, Smith said each ultimately falls into three categories: eligibility, benefits and the service delivery system. He said eligibility reviews will also examine issues such as residency requirements. Benefit reviews will be limited to non-disabled enrollees, and how to deliver services to the five percent of enrollees that account for 58 percent of the cost will be emphasized.

Public hearings are scheduled to be completed by the middle of next week, after which the Committee will begin deliberation and voting on the budget. The entire process is expected to continue over the next few months.

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President’s Column

House Budget Committee Chair Paul Ryan (R-WI) has set the stage for a necessary and long overdue discussion about the future of the Medicare and Medicaid programs. While both programs are essential portals to health care services for vulnerable populations, their unsustainable financial trajectory over time is indisputable and contribute greatly to the deficit time bomb that all acknowledge but few want to seriously address.

Congressman Ryan’s initiative would institute a phased-in defined contribution approach for Medicare beginning in 2021, allowing seniors to choose their Medicare plan from a menu of health plan options through a vehicle that ironically resembles the health insurance exchanges created in the Affordable Care Act (ACA).

For Medicaid, the plan provides states with block grants that would increase two percent annually, regardless of economic or demographic circumstances. The trade off would be complete and total flexibility for states to manage their own programs absent "command and control" from Washington.

WHA has many questions regarding the yet to be determined "fine print" of the House GOP plan. For Medicaid we need to understand the adequacy of funding for such a breathtaking change in direction with a blue print clearly designed to reduce spending quickly and significantly. For Medicare we wonder whether the proposal will fix longstanding geographic Medicare spending inequities before the premium support plan kicks in. That’s a fairness issue for Medicare beneficiaries in Wisconsin, Iowa and Minnesota.

And we are disappointed that the proposal grabs $155 billion in Medicare hospital cuts that were offered up to pay for ACA coverage expansions that disappear under provisions of this proposal. GOP criticism of "Medicare cuts to fund ACA" during the most recent election cycle ring hollow given this specific provision.

On the other hand, the provider community should be excited about engaging in discussion of legitimate alternatives to the Medicare/Medicaid status quo, recognizing that federal and state efforts to fund Medicare and Medicaid have led to the current Medicare physician payment boondoggle and byzantine hospital price setting maneuvers like "behavioral adjustments" that will soon be replaced by "productivity adjustments" under ACA. And on the state level we witness and sometimes participate in Medicaid financing strategies that have failed to solve the largely enrollment-driven Medicaid funding crisis. There must be a better way than annually tinkering with the seriously flawed public program status quo.

So kudos to WI Congressman Paul Ryan for having the courage and unique leadership skills to get us all to begin thinking about the heavy lifting necessary to engage discussion about real change. Ryan’s demonstrated intelligence and telegenic presence have rightly propelled him to a singular position to influence much needed reform. But leadership also means flexibility to consider major adjustments to the legislation including moderating the magnitude of anticipated budget "savings" baked into the bill.

The larger issues of Medicare and Medicaid reform must be our primary focus going forward. The timing couldn’t be more appropriate. And for the cynics...If not now...when? And if not this approach...what’s the alternative, other than once again "kicking the can down the road," which will only worsen the growing debt bomb that future generations will some day face.

Steve Brenton

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A Legislator’s Perspective: The Value of WHA’s Advocacy Day
An interview with State Rep. Jennifer Shilling

Every year close to 700 individuals from hospitals across the state converge on Madison for the Wisconsin Hospital Association’s annual Advocacy Day. At Advocacy Day individuals learn about important issues and then meet with their legislators in the State Capitol. WHA wanted to hear directly from a legislator about Advocacy Day. In the following Q&A piece, you’ll hear from State Rep. Jennifer Shilling (D - La Crosse), on what she thinks is the value of annual Advocacy Day events.

Q: Every year many organizations like the Wisconsin Hospital Association (WHA) host days at the State Capitol for their members. Why do you think it’s important for individuals across the state to make it to events like WHA’s Advocacy Day?

Rep. Shilling: Meeting with constituents is always a great way for me to hear from the people who are the most knowledgeable about a particular issue or field. I look forward to lobby days in the Capitol because it allows me to hear direct feedback and have engaging discussions with the folks who live in my region. I think it’s also helpful for citizens to see how their state government functions so that they can become more involved in the political process.

Q: Every year WHA sees close to 700 hospital representatives from across the state at Advocacy Day. Some 400 of those individuals meet with their legislators. Why do you think it’s important for attendees to make these Capitol visits?

Rep. Shilling: Constituents can have a very powerful impact when they share specific stories and experiences on how legislation will affect them in their work or personal lives. When a bill comes before me in a committee or on the Assembly floor, I can look back at the meetings that I’ve had with local residents and use those conversations to help make informed and educated decisions. WHA members provide a unique insight into how our state laws directly impact health care providers and patients across the state. There are times when seemingly simple, uncontroversial legislation can have a big impact on how hospitals across the state do business and it’s important that experienced individuals make their voices heard.

Q: Hospital representatives love to meet personally with their legislators, but we know sometimes your schedule precludes that. Can you provide a little insight for our members on why meeting with your staff is also important?

Rep. Shilling: Many legislative days are scheduled when the Assembly or legislative committees are scheduled to be in session. While I always try to make myself available with constituent groups, there are times when I am unable to get out of certain meetings. However, my staff plays an important role in my office by helping to prepare information about various issues and legislative bills. If I am unable to meet with constituents or groups that come to Madison, my staff always takes the time to pass this information along to me and explain the issues that are raised. Since my staff is also directly involved in many of the legislative policy issues that are brought up, they also benefit from the opportunity to meet with individuals and gain a better understanding of important issues.

Q: What one key piece of advice would you provide to hospital constituents about their need to be involved in the legislative process (either through advocacy days or contacting you, etc.)?

Rep. Shilling: The legislative process is open to everyone who has something to say about an issue, a bill, or a problem that requires legislative action. Personal contact is always the best way to express your thoughts and opinions, although emails, phone calls and letters are a good substitute when you can’t make it to Madison. Face-to-face meetings are also the most effective method for ensuring that elected officials understand what is happening in their communities and what can be done to improve our state. Each legislative district in our state has its own unique story to tell and it’s important for local citizens to be able to highlight those specific issues and work to find solutions that will help to move our state forward.

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Wisconsin Rural Physician Residency Assistance Program Announces Funding Opportunities
Education sessions will be featured at Wisconsin Rural Health Conference in June

The Wisconsin Rural Physician Residency Assistance Program (WRPRAP) was created as a result of Wisconsin Act 190—the Critical Access Hospital assessment. Act 190 was passed and funded by the state Legislature to ensure access to care in rural areas and address the acute and growing shortage in the rural medical workforce. In addition to providing resources for health care provider loan repayment, the legislation allocated $750,000 in Budget Year 2010-11 to a new "rural physician residency assistance program" and designated the University of Wisconsin Department of Family Medicine (DFM) to administer these funds. The funds are to be specifically used to support graduate medical education rotations in rural areas.

While the UW-DFM is responsible for organizing this program, the dollars are available to any Wisconsin residency program in family medicine, general surgery, internal medicine, obstetrics, pediatrics or psychiatry. The central expectations are that one or more of a program’s residents will spend at least eight weeks of clinical time in a rural area and that existing funding will not be supplanted. In addition, the DFM is responsible for submitting an annual plan to the Legislature for enhancing resident experiences in rural areas.

First WRPRAP Funding Awards Announced

Proposals for WRPRAP funding in its initial year have resulted in three awards to enhance graduate medical education:

  1. Baraboo Rural Training Track: One-year support for a resident in family medicine
  2. Baraboo Rural Training Track: Subscription to an e-curriculum of clinical education and training courses for residents and faculty to enhance preparation for rural practice
  3. La Crosse-Mayo Family Medicine Residency: Support for an 8-week rural rotation in Tomah

The funding appropriated by the state Legislature creating WRPRAP initially covered one budget year (July 1, 2010 - June 30, 2011). While this year’s process is still in the early stages, the WRPRAP program has a line item in the governor’s proposed budget for the upcoming biennium.

WRPRAP Information Sessions Offered

The Wisconsin Hospital Association’s annual Rural Health Conference will feature two sessions on WRPRAP. The first session includes a discussion of the funding in place for this program, what the program hopes to do to address the rural physician shortage, and a review of the activities and pilot programs already in place to address the projected shortages. The second session will be a "nuts and bolts" discussion about what is involved with starting and maintaining a rural residency program as well as a rural rotation program.

For more information on the residency program go to: www.fammed.wisc.edu/wi-rural-physician-program or contact Clare Loxterkamp, program assistant, at clare.loxterkamp@fammed.wisc.edu.

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Guest Column: State Budget Brings Difficult Challenges
By Nick Turkal, MD, 2011 WHA Board Chair

As we’ve all seen, state and local government and elected officials are going to have to make some fairly dramatic changes in the nature and availability of public services in Wisconsin, including health care programs and services that receive government funding.

In the case of health care, the mix of government-funded and commercial insurance coverage and full versus partial reimbursement rates is a significant issue for us as providers. It creates the illusion that somehow one balances out the other and the actual cost of care is being covered. That’s not the case.

As with all businesses, health care providers have quantifiable expenses. Like other businesses, we also cannot spend more than we earn without eventually ceasing to exist. Consequently, when we provide care that is not fully reimbursed, we must address the loss of income by eliminating or reducing the cost of providing the service, shifting the un-reimbursed cost to other payers, or both.

Hospitals and health systems have had to make difficult decisions to reduce costs over the last several years to address the effects of the recession; we understand the direct correlation between revenues and expenditures and their impact on our expenses and our services.

Come July when the state budget effects become clearer and in the months that follow, we will need to make other difficult decisions. Here’s why:

Wisconsin’s health care providers face persistent financial challenges.

Yet we also need to acknowledge that the health care cluster is an economic driver for Wisconsin.

In spite of economic difficulties, Wisconsin’s health care providers are working to curb costs. In short, we’re doing our part.

So what’s next?

I know we all have a stake in this and that we need to search for common sense solutions. As WHA’s 2011 Board Chair, I look forward to continuing this important dialogue with my colleagues and policymakers across the state.

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Wisconsin’s Paul Ryan Unveils U. S. House Budget Proposal

This week House Budget Committee Chair Paul Ryan (R-WI) unveiled the House budget resolution for fiscal year 2012. The budget resolution, in essence, sets the framework for debate on this coming year’s budget.

Under the budget resolution, more than $6.2 trillion in government spending over the next 10 years is cut, including over $750 billion from the existing Medicaid program. Those Medicaid reductions come largely from moving the federal share of the Medicaid program into state block grants beginning in FY 2013. Block grants would then be increased annually by two percent. In addition, the budget resolution repeals the health care reform law, including the expanded coverage provisions, equaling a total reduction of $1.4 trillion.

On the Medicare side, the budget resolution proposes altering the program for those currently under age 55 to a premium support model as opposed to the current fee-for-service model. That premium support model would start in 2022. Under this model, new beneficiaries would choose a plan from a list of guaranteed coverage options. Medicare premium-support payments would then be paid, by Medicare, to the plan chosen by the beneficiary, subsidizing its cost. Medicare would remain the same for those at or near retirement.

Additional provisions of interest in the budget resolution include:

Access the budget resolution and related information online at: http://budget.house.gov/fy2012budget.

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Rep. Kind’s Quality Care Coalition Meets With Berwick

Recently Wisconsin Congressman Ron Kind and members of the U.S. House of Representative’s Quality Care Coalition (QCC) met with CMS Administrator Don Berwick to discuss the QCC’s priority issues. The Quality Care Coalition—which includes Representatives like Bruce Braley of Iowa, Jay Inslee of Washington and Betty McCollum of Minnesota—was formed during debate over health care reform and focused on addressing geographic disparities and updating Medicare formulas that adjust for regional differences in wages and other costs.

During their recent meeting, Dr. Berwick discussed several Institute of Medicine (IOM) studies for which the Quality Care Coalition advocated. Berwick indicated that the first IOM study reforming the physician fee schedule’s Geographic Price Cost Indices (GPCIs) and the hospital wage index to address the unfair geographic disparities that hurt Wisconsin and other high-value providers is on schedule to be completed by May 1. Berwick reiterated that he was committed to advancing these changes as quickly as possible.

With respect to the second IOM study looking at broader ways to move toward value-based payments and address geographic disparities, Rep. Kind stressed to Berwick that this IOM study needs to have an actionable plan, not just be an academic exercise. Berwick agreed.

Rep. Kind also indicated that $150 million in payments to hospitals in low-cost counties, including many in Wisconsin, will be made soon. These payments were secured by Kind and others in the health care reform law to begin to address current geographic inequities under Medicare.

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Hospitals Continue to Reduce Infection Rates

A progress report issued by the Agency for Healthcare Research and Quality this week showed that hospitals participating in the national On the CUSP: Stop BSI project reduced central line-associated bloodstream infections in adult intensive care units by an average of 35 percent in the first year of the program.

Infection rates dropped from an average 1.8 per 1,000 central line days to an average 1.17 for the more than 350 hospitals in 22 states that participated in the program in 2009, led by the AHA’s Health Research & Educational Trust affiliate. The 42 hospitals participating in the Stop BSI project in Wisconsin have expanded the improvement effort beyond just intensive care units. This combined effort has improved the Wisconsin rate from an infection rate of 2.24 per 1000 central line days to 0.71, well below the national rate.

"The philosophy of Wisconsin hospitals that even one infection is too many and the willingness to work together to eliminate these infections demonstrates the local commitment to excellent patient care in our state," said Kelly Court, WHA’s chief quality officer.

AHA President and CEO Rich Umbdenstock said the results demonstrate the commitment of America’s hospitals to providing safer care for their patients.

The report can be viewed at www.ahrq.gov/qual/onthecusprpt.

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Grants Enhance Educational and Health Care Services to Rural Communities

The USDA Rural Development is accepting applications for grants to support access and improve telemedicine and distance learning services in rural communities. The Distance Learning and Telemedicine (DLT) Program provides financial assistance for the purchase of eligible telecommunication equipment to advance educational and medical applications into rural areas.

"Investments in these state-of-the-art technologies allow rural residents access to quality health care and education opportunities across the rural landscape," said Stan Gruszynski, USDA Rural Development State Director. "The Distance Learning and Telemedicine Program supports rural hospitals, clinics, schools and libraries with the investments that will create sustainable rural communities."

For example, Gunderson Clinic in La Crosse is a past recipient of a DLT grant. Gunderson utilized DLT funding to purchase computed radiography equipment at five rural locations in Wisconsin, Minnesota, and Iowa. This advanced technology allows for the electronic transfer and viewing of images by radiologists located in La Crosse.

Ministry Health Care is also a past recipient of a DLT grant. Ministry’s DLT funding acquired technology that provided the ability to web cast, multicast, transcode and use two-way interactive video education over its network to six home health agencies and five home health work sites.

Distance Learning and Telemedicine grant applications are now being accepted and must be received by April 25, 2011. Applications must provide 15 percent matching funds, and awards range between $50,000 and $500,000. For additional eligibility information, visit www.rurdev.usda.gov/UTP_DLT.html. Funding is contingent upon the recipient meeting the conditions of the grant agreement.

The program is competitive. In 2010, USDA Rural Development provided grants for 106 projects in 38 states and one territory. Since inception of the DLT program, 1,269 projects in 49 states, four territories and the Commonwealth of Puerto Rico have been funded.

USDA Rural Development’s mission is to deliver programs in a way that will support increasing economic opportunity and improve the quality of life of rural residents. As the lead federal agency for rural development needs, USDA Rural Development returned over $936 million dollars this past year to rural Wisconsin communities. Funds are used to finance and foster growth in homeownership, business development, and critical community and technological infrastructures. Further information on USDA Rural Development programs is available at a local USDA Rural Development office or by visiting www.rurdev.usda.gov/wi.

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Free EHR Services Available to Rural Hospitals Through WHITEC
WHITEC Releases List of "Value Vendors"

The Wisconsin Health Information Technology Center (WHITEC) has partnered with the Rural Wisconsin Health Cooperative and the Wisconsin Hospital Association to provide meaningful use assistance, paid for by a federal grant. WHITEC’s aim is to help all 69 of Wisconsin’s qualifying rural hospitals (hospitals with 50 beds or less) to move toward achieving meaningful use of electronic health records.

More than 20 rural Wisconsin hospitals have already participated in WHITEC’s Rural Hospital Program. To date, the program has worked with hospitals using CPSI, Epic, Healthland, HMS, Meditech, among others.

By signing up for this program, hospitals with 50 beds or less can receive any or all of the following high-value services at NO COST:

By signing up for any of the above services, rural hospitals can receive valuable federally funded assistance at no cost. In the future, WHITEC will provide additional fee-based services (partially subsidized) such as detailed QI Measure Assessments and Security Risk Assessments. Participants in the free services are under no obligation to use these fee-based services. As a member of WHITEC’s steering committee, WHA encourages rural hospitals to contact Louis Wenzlow at lwenzlow@rwhc.com or 608-644-3237 to learn more about the rural hospital assistance program.

Value Vendors Selected

WHITEC continues to provide education, outreach, and technical assistance to Wisconsin practices, physicians, physician assistants, and nurse practitioners in selecting, implementing, and using health information technology. Toward that end, WHITEC recently released a list of six "Value Vendors." These vendors—athenahealth, Cerner, eClinicalWorks, e-MDs, Greenway Medical, and McKesson—were selected by a panel of community-based health professionals and WHITEC personnel and agreed to a number of criteria, including transparent pricing, streamlined processes, and joint development of EHR tools and resources.

Through the Value Vendor program, WHITEC aims to maintain ongoing, healthy competition among participating companies while at the same time establishing standards that will make the vendor process more efficient and effective. Although WHITEC is committed to working collaboratively with these selected vendors, it will assist and support all practitioners regardless of their final choice in EHR product. For more information regarding WHITEC, visit www.whitec.org.

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Wisconsin Hospitals Community Benefits: Physical Activity

The increasing rates of obesity among adults and children are raising concerns because of the dire implications on American’s health. In communities across Wisconsin, hospitals are dedicating resources and doing what they can to encourage people of all ages to lose weight and stay active.

Pouring on the pounds

Katie Klingbeil, 10, admits that she could exercise more and cut out sugary drinks. "I’m just unhealthy," she said as a matter of fact after the Chippewa Health Improvement Partnership’s presentation "Pouring on the Pounds" at Bloomer Middle School.

But Klingbeil, a Bloomer Middle School student, isn’t the only one. Sister Sarah Klingbeil, 9, said she also drinks pop and juice that contains lots of sugar. But she didn’t realize it until the program.

Family friend Barb Wall, who brought the girls to the program, said she is overweight and she wants to make a push to be more healthful. She brought the girls along so they too could learn about how energy drinks—although all the rage—are bad for your health. Chippewa Health Improvement Partnership (CHIP), a community endeavor hosted by St. Joseph’s Hospital in Chippewa Falls, is a community health coalition that has served as a catalyst for the enhancement of community health and quality of life through preventive and educational initiatives since 1994.

Judy Fedie, Chippewa County public health nutrition director and co-chair of Challenge Chippewa, the nutrition and physical activity action team of CHIP, spoke on behalf of the partnership about the current beverage trends and how they influence youth health, fitness and weight.

When asked why children drink too many sugar sweetened beverages, many of the 35 audience members shared their opinions. Some said it was peer pressure or because they’re more readily available. One father piped in and said, "It’s because we as parents don’t say no."

Fedie agreed with all assessments, and she detailed the consequences.

More children are obese today than ever before. Obesity in children causes adult conditions and diseases like high blood pressure, insulin resistance, sleep apnea, more mental health issues and isolation, she said.

The fiscal impact to the state is tremendous, Fedie said. Obesity cost the state $1.5 billion in 2010. If the trend continues, by 2018 half of residents will be overweight and the monetary impact will be about $6.7 billion.

Obesity in children isn’t a problem that’s going to fix itself, Fedie said.

"What’s the big deal, it’s just a little baby fat—they’ll grow out of it, right?" Fedie chided the audience. "Virtually none of them are going to outgrow it."

"The science is there. The evidence is there … but we don’t translate that into action."

Fedie said Challenge Chippewa is focusing on two main areas of behavior to turn this trend around in the Chippewa Valley. Parents and children should increase physical activity and reduce their consumption of sugar-sweetened beverages.

Of course people think of soda when they think of sugar-sweetened beverages, but energy drinks are the new rage. Fedie said the caffeine content isn’t regulated in those drinks because it’s considered a dietary supplement.

Fedie said parents need to be good role models, limit beverages on the go, and forgo buying sugary beverages to make water more appealing. "Create an environment where the healthy choice is the easy choice," Fedie said.

St. Joseph’s Hospital, Chippewa Falls

Community weight loss – one family at a time

It was all smiles at the Weigh to Win (W2W) commencement ceremony. The Ocampos—serving as the 2010 W2W spokes Family—had done it! They had successfully completed the 10-week weight loss challenge sponsored by UW-Health Partners Watertown Regional Medical Center. Over the 10 weeks, Javier and Ann Ocampo, along with their daughter Aaliyah lost a combined 23.3 pounds and lowered their body fat by 6.5 percent. "We gave 100 percent," Javier exclaimed, "I couldn’t believe how much weight I dropped."

Their success can be attributed to a combination of knowledge, determination, and hard work. "We gave them a lot of guidance," dietician Erica Hanson said, "but they had to do the work. They did a fantastic job."

Hanson, along with fitness specialist Shane Brown, met weekly with the Ocampos to discuss nutrition and track their daily exercise program. Brown said he used cardiovascular and strength training for Javier and Ann and other fun activities for Aaliyah based on each one’s needs.

"I had to make many small adjustments along the way," Brown noted. "We had to balance burning fat and building muscle."

Some of the challenges the Ocampos faced along the way was finding time and staying motivated.

"At some point we just had to turn off the TV and do what we were supposed to," Ann admitted. "Being part of W2W motivated us to keep going," Javier said. Hanson added, "Others were very excited when they saw the Ocampos at the fitness center. It encouraged everyone."

Not all of W2W was work. "I really liked helping my parents clean out the cupboards," eight-year-old Aaliyah gushed, "I also liked eating healthier." She also mentioned how much she enjoyed some of the exercise games Brown developed for her and her family. Her favorite was jump-roping and a card game that made the players perform various exercises as they played.

Although the program is officially over, the Ocampos are determined to continue their newly formed health habits. "Going back is not an option," Ann said emphatically, "this is not just a diet—it is a lifestyle change. We are asking ourselves ‘what kind of exercise do I want to do?’ not ‘should I exercise?’"

The Ocampos were thrilled they could participate in W2W as the spokes family. They said the program went above and beyond their expectations, and they would recommend it to anyone.

"We’re about educating others now," Javier concluded. "We really want to help others know more about health."

Weigh to Win is a free community weight loss challenge offered by WRMC in an effort to combat two of the region’s greatest health challenges—obesity and heart disease.

UW Health Partners Watertown Regional Medical Center, Watertown

Fort HealthCare’s Health365Events.com provides a wellness call to action

Fort HealthCare has developed a community Web site for posting, sharing and browsing local health and wellness events. The Health365Events.com Web site goes hand-in-hand with Fort HealthCare’s mission to improve the health and well-being of our community. Events must occur in the Fort HealthCare service area and must have a fitness or wellness theme.

The purpose of Health365Events.com is to make it easier for non-profit organizations to share details of their community fitness and wellness events and for users to find events they want to participate in. This Web site will foster a greater sense of community well-being and prove that being healthy and active can be fun. Event organizers responsible for fun runs, bike events or most any fitness-related activity can post an event online. Events are approved by Fort HealthCare staff before appearing online.

Event registration is not available through this site, but organizers can link to their own webpage or registration form. Interested community members can sign up for email notifications when an event that may be of interest is posted. Additionally, users can "Like" an event on Facebook and share it with friends.

It is Fort HealthCare’s goal that www.Health365Events.com becomes a central source for information on all area wellness activities. We encourage event organizers to use the new Web site and to help Fort HealthCare spread the word regarding fitness, exercise, nutrition and well-being.

Fort HealthCare, Fort Atkinson

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

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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