They started out from every corner of the state. Some rode on buses, others carpooled. But they shared a common destination—Madison. And they brought with them one message for their legislators—Wisconsin hospitals provide top quality care, provide a multitude of necessary community services and lead the nation in transparency.

Hundreds of hospital leaders and volunteers converged on the Monona Terrace for educational programming and then more than 300 participants met that afternoon with their elected representatives at the State Capitol.

WHA Executive Vice President Eric Borgerding encouraged the crowd to make their voices heard. "I meet with legislators very frequently on behalf of WHA, but frankly, legislators must also hear what their constituents think about important hospital issues. They represent you. Let them know you support your hospital and that you care deeply about your community’s health. In other words, tell your story," he said during his legislative briefing.

Borgerding emphasized that Wisconsin hospitals have a good story to tell. Wisconsin tops the nation in health care quality and safety. It also leads the nation in voluntarily publicly reporting on the quality, safety, and services provided in Wisconsin communities. In addition, hospitals are also addressing cost.

"Investments in quality and efficiency are slowing down the rate of growth of hospital operating costs. Data from 2002-2006 shows Wisconsin hospital operating costs have increased at a rate that is HALF the national average," Borgerding said. "That demonstrates that we are responding to employers and the public’s concern about rising hospital costs, and we are starting to see the results in the data," he added.

Hospital advocates were then able to take what they learned from the day and head to the State Capitol to meet with their legislators. While meeting with their legislators, hospital representatives emphasized the impact Wisconsin’s woeful Medicaid reimbursement rates are having on hospitals and health care costs.

During this, National Hospital Week, participants also shared with legislators how Wisconsin is a national leader on quality and patient safety, including being ranked number one in quality in 2007 and number two in 2008 by the federal Agency for Healthcare Research & Quality (AHRQ). Additionally, legislators heard how Wisconsin hospitals are on the forefront nationally in other areas of transparency, including a voluntary quality initiative, CheckPoint; a pricing initiative, PricePoint; and a voluntary community benefits report, ServePoint, among others.

"Legislative visits are the most important part of Advocacy Day," said WHA’s Jenny Boese on the record number of visits this year. "WHA thanks all the individuals who went on these visits. We cannot stress enough how valuable it is to promote the hospital message with legislators and their staffs during this annual event."

Governor’s Goal: Health Care Coverage for 98% of Wisconsin’s Citizens
"Build on strength of the current providers system"

Governor Jim Doyle was clear in his message to nearly 600 hospital supporters at Monona Terrace. His goal is to get 98 percent of Wisconsin’s population health care coverage. The Governor said he started with the fact that 90 percent of the people in Wisconsin already have insurance coverage.

"You build on that system and begin to make improvements. We know that people are concerned about the cost of insurance, but at least we have 90 percent of our population covered, so we start with that. We believe we have designed the best blue print in the country for getting people covered," Doyle said.

The Governor’s plan has three phases. The first, an expansion of BadgerCare Plus to get as many eligible children and families enrolled as possible, started January 1.

"We looked to get 100,000 people signed up the first year, and we expected about 25,000 would sign up the first month. In the first six weeks, 72,000 people signed up for BadgerCare Plus, including 45,000 children. That is something of which we should be proud. Others can talk about health care policy, talk about creating a system, but what really counts is what happened in this state. 72,000 people have insurance who didn’t have it before February 1," according to Doyle.

Doyle believes that BadgerCare Plus is the best program in the country in providing kids with health insurance. He credits simplifying the application process, along with hospitals’ efforts to identify eligible patients, with the enrollment success.

In the second phase of his drive to increase coverage in Wisconsin, the Governor said soon, with the help of Wisconsin hospitals, he expects approval from the federal government for a new program that will provide coverage to childless adults.

"It is basically unfair that two people can work at the same low-wage job, and one person has a minor child and can have BadgerCare Plus, while the other person has no access to coverage," he said.

"We hope that our efforts to help leads to adding 65,000 hard-working people to a new program," he said. "It is another major step forward in this state."

The third phase of the Governor’s plan is to make sure that the 800,000 people who work for small businesses have access to affordable health care. The Governor said only 44 percent of the employers who have 50 employees or less can afford to provide health insurance. The Governor said the idea is not to provide deluxe coverage, but just provide a "good, basic, bare-bones affordable plan so they at least are not hanging out there with nothing. "

The Governor believes that the key to affordability for this group is through community-rating small businesses.

"If we do those three things in Wisconsin—BadgerCare Plus for children, Childless Adults, and the small business initiative—we will be the national leader, and we will get to 98 percent coverage," according to Doyle.

"Let’s be honest about what we are doing. We will come as close as we can to full coverage. We can do it without 15 percent payroll tax and without blowing up the current system. We can build on the strength of our current provider system," Doyle said. "This is the direction that I want to go."

With a new budget sitting on his desk that does not include the hospital assessment, the Governor reminded the audience that Wisconsin faces a significant shortfall--$500 million. The Governor supports the hospital assessment because it would bring millions of dollars back to the state in such a way that raises the Medicaid reimbursement rate for hospitals. The Governor said he plans to include the hospital assessment in his 2008 budget.

"What concerns me about health care policy is it often loses sight of what this is all about. You know what ‘this’ is all about. You work in a way to provide health care services in this great state. This is what I always try to keep in mind. It is not about winning or losing. It is about whether a person in Wisconsin who has health care needs gets those needs met. We have wonderful hospitals; we have the best medical providers in the country. Ratings show we are at the top in quality. But we can’t rest on our laurels. We need to move forward, and with your help, we are moving in the right direction," Doyle said.

Following his speech, the Governor presented a Certificate of Commendation to WHA in recognition of National Hospital Week.

Legislative Leaders Share Views on Health Reform, Transparency
Same Goal…Different Play Books…

Legislative leaders had an opportunity to share their views on a number of health-related issues at Advocacy Day. Moderated by WHA’s Eric Borgerding, the panelists included: Sen. Mark Miller; Rep. Jeff Stone; Sen. Ted Kanavas; and Rep. Sheldon Wasserman, MD.

Borgerding asked each legislator to briefly explain what they feel are the most important issues in health care. Their comments centered on concerns about cost, access, utilization and insurance coverage. Borgerding then asked each panelist to provide their view on health reform.

Sen. Miller, a strong supporter of Healthy Wisconsin, a plan that would cover the entire population and is largely financed through an employer payroll tax, believes the cost to provide that plan would be $2 billion less than what is currently spent on health care. That savings, and the plan, were disputed by other legislators on the panel.

Rep. Stone said the challenge is that Healthy Wisconsin, if enacted, would attract thousands of people to Wisconsin just to access health care.

"We can’t support the nation’s health care needs. This is a national discussion. We all want health care for our residents, but we don’t want to do it in a way that ruins our economy," Rep. Stone said.

Sen. Kanavas agreed. "If something looks too good to be true….Healthy Wisconsin promises to cover everyone, save $2 billion and quality won’t go down. When we looked at it, small business would be taxed to the point where they could no long compete. We need to be more practical when it comes to health care and put our trust in the people who use the system. We need to be sensible and not radical," according to Kanavas.

Sen. Wasserman pointed out that no individual state has been successful in providing universal coverage. The number one reason? Cost.

"You’ve probably heard of medical tourism? We’d have medical tourism coming to Wisconsin!" Wasserman said. He said he favors the Governor’s incremental approach to health care reform.

On the issue of health care transparency, all candidates agreed consumers need information that they can use to make health care decisions.

Sen. Kanavas believes that people will make use of data to make good choices. Rep. Stone, who served on the Board of Directors at UW Hospitals and Clinics said he personally has a lot of faith in the people who "do the procedures and are involved in health care" providing the information. He added that Wisconsin has made a lot of progress in that direction.

Wasserman said WHA is one of the first organizations to "take it upon yourselves to provide data and discuss quality and cost. You are doing a great service to the citizens of the state."

Washington Pundit Says Wisconsin Will Play Key Role in Presidential Election

Fred Barnes, one of Fox News "Beltway Boys" and executive editor of "The Weekly Standard," knows Washington politics. So when he predicts that Wisconsin will play a bigger role than normal in the presidential race this fall, people listen.

"If you remember, Florida was the key in 2004. This year, the deciding states will be different. It will be the industrial belt states—Wisconsin, Michigan, Ohio and Pennsylvania. Those are the states up for grabs in 2008," according to Barnes. "Obama may well be the democratic nominee, but he may need to win all four of those states to take the presidency. Kerry won three of four in 2004, and he did not win the presidency."

The big question that is left for the Democrats is: Will Hillary Clinton become Barack Obama’s running mate? While Barnes said he doesn’t know the answer, he did identify three key considerations when choosing a running mate:

• Pick someone who is a plausible president. The American public wants to have faith that the vice president could run the country.
• Do no harm. Don’t drive away part of the party with the wrong pick.
• Chose someone who can bring something to the ticket. Barnes used as an example John F. Kennedy’s choice of Lyndon Johnson as his running mate. Johnson, a "titan of the U.S. Senate" was a proven leader, plus he brought the electoral support of Texas to the ticket.

It’s been a long campaign season, a fact that Barnes said he likes because now "voters are paying close attention."

"It’s not just political junkies and activists that are watching the campaign. During a long campaign we learn more about the candidates. Some of it good, some of it not," Barnes added.

Indications are that voters do not want to "stay the course," which usually fosters a huge turnout at the polls.

"The future in politics is never a straight line. Crazy things happen. Events intervene such as 911 and Hurricane Katrina. It’s never a straight line, even when it seems that way, but the media write about it like it is. We tend to fall into that trap in journalism," Barnes admitted.

This week the Wisconsin health care community is united in its grief over the loss of three individuals who dedicated their lives to caring for patients requiring emergency transport due to accident or life threatening illness. These heroic caregivers absolutely personify the definition of 24/7…the notion that health care availability is not limited by darkness of night, inclement weather or impossible travel conditions. Please join me in honoring Mark Coyne, RN, Dr. Darren Bean, and med flight pilot Steve Lipperer—the crew members who were lost this past weekend.   - Steve Brenton, WHA President

As we go to press, the Legislature narrowly passed a budget repair bill this week that seeks to address a projected $650 million shortfall in state finances before the end of the current biennium. The proposal now goes on to Governor Doyle who has already singled out several items in the bill that he opposes.

The final votes on passage were 17-16 in the Democratically-controlled Senate, and 51-46 in the Assembly where Republicans hold the majority.

Significant measures in the repair bill include: one-time refinancing of future payments from tobacco and cigarette manufacturers, which is expected to raise $209 million, and delaying $125 million in aid to public schools, a delay that would push the payment into the next state budget. Governor Doyle objects to both provisions.

The re-worked hospital assessment, under which hospitals would have been assessed $416 million over the 2008-09 biennium, was not included. When combined with the federal matching revenue those dollars would have captured, a potential total of $708 million would have been paid to hospitals in the form of much needed increases in Medicaid payments — $292 million more than the assessment.

The proposal now moves on to Governor Doyle where speculation is high that he will use a broad veto pen to quickly craft budget repair language significantly different than that passed by the Legislature.

Wisconsin is one of a few select states chosen to attend an elite Nursing Education Capacity Summit June 26-27 in Washington DC. The Summit is sponsored by the U.S. Department of Labor, Employment and Training Administration; the Robert Wood Johnson Foundation; the Center to Champion Nursing in America; and the U.S. Department of Health and Human Services, Health Resources and Services Administration. The sponsors chose only 15 states to participate from the 48 that applied.

The Nursing Education Capacity Summit will engage state teams in a solutions-based discussion to foster action, identify best practices and develop strategies to increase the number of nurses that are trained in the U.S. During the dynamic two-day meeting, state-based teams will work with facilitators, content experts, and peers to discuss best practices and develop action plans in four focus areas:

• Strategic Partnerships and Resource Alignment
• State Policy and Regulation
• Increasing Faculty Capacity
• Education Redesign

Participation in the summit is competitive. States were invited to submit applications with up to 10 members. The representatives from Wisconsin include:

• The Nursing Education System – Sally Lundeen, UW-M; Kathy Loppnow, Wisconsin Technical College System
• Employers of Nurses – Judy Warmuth, Wisconsin Hospital Association
• The Workforce Investment System – Rita Black-Radloff, Department of Workforce Development
• Regulatory Bodies – Marilyn Kaufman, Wisconsin Board of Nursing
• Nursing Leadership – Sue Schuler, Pam Maxson-Cooper, Barb Pinekenstein and Lea Acord, Wisconsin Center for Nursing
• Government Agencies, Policymakers, and Policy Advocates – State Senator Judy Robson

Judy Warmuth is looking forward to attending with the Wisconsin team. "The summit will strengthen and reinforce our team approach to the challenges of meeting the future demand for nurses in Wisconsin," said Warmuth.

In handing out grassroots advocacy awards this year, WHA highlighted the efforts of two individuals during WHA’s Advocacy Day – SSM’s Regional President/CEO Mary Starmann-Harrison and St. Clare Hospital CEO Sandy Anderson. Both were named earlier this year as outstanding advocates by the American Hospital Association (AHA), and WHA presented them with their AHA awards during Advocacy Day’s awards luncheon.

"Annually the AHA honors two individuals in each state with advocacy awards. This year both of Wisconsin’s honorees came from the same system, SSM Healthcare," said WHA Vice President of External Relations & Member Advocacy Jenny Boese. "We felt Advocacy Day was a perfect venue to honor their leadership on grassroots advocacy. WHA certainly values all that they do."

Both Starmann-Harrison and Anderson have served on various WHA committees and boards, including the Board of Directors, and both understand issues not only as they apply to their hospitals and communities but to the state as a whole. They have both carried out this commitment in various ways, such as engaging in grassroots advocacy efforts, mobilizing others on a variety of important issues and supporting WHA goals and initiatives.

"We depend greatly on champions like Mary and Sandy," said Steve Brenton, WHA president. "Wisconsin should be proud of all that these two have contributed to the delivery of health care throughout the state."

The previous year’s AHA honorees were Brad Neet, CEO, St. Michael’s Hospital-Ministry Healthcare in Stevens Point, and current AHA Chairman of the Board and President of Froedtert Hospital in Milwaukee, Bill Petasnick.

In presenting this year’s WHA Health Advocate Award to Kevin Hayden, WHA President Steve Brenton noted that this was the first time the prestigious award has ever been given to anyone other than an elected official. "A fact," Brenton said, "that says a lot about the many accomplishments Kevin made during his brief but extremely productive tenure as the leader of a state agency that is at the center of health policy development and service delivery for Wisconsin’s most fragile patients and families."

Brenton noted several of Hayden’s many accomplishments, including his efforts to modernize Wisconsin’s Medicaid program; work with the Governor to implement BadgerCare Plus, a program that has brought coverage to thousands of children and low-income families; help to remove barriers to electronic health information exchange; and his personal commitment to partner with Milwaukee County to find medical homes for thousands of Wisconsin’s most fragile patients.

"While accomplishing all of this, he set the stage for future progress. Kevin has always valued collaboration with the private sector, especially WHA. He has been a leader, a partner, and a good friend," Brenton added.

In accepting the award, Hayden said he was surprised and humbled by the fact he was the first non-elected official to receive it. "In my two years working with Governor Doyle, I simply tried to bring private sector discipline and rejuvenate the esprit d’ corps of the more than 7,000 employees in DHFS that in one way or another, intersect with Wisconsin’s hospitals in a number of ways."

"I have spent a lot of time with other hospital associations in my new position in California, and I can tell you, there is not another association like WHA. WHA brings vision and discipline to your issues, and seeks collaboration on difficult issues," Hayden said. "This award is a testament that this is the way WHA works with state government."

Later during his remarks, Governor Doyle also acknowledged Hayden’s contribution to "moving Wisconsin forward to the point where people have affordable health insurance."

"We were fortunate to get a person to come out of the private sector and become a first-rate Medicaid Director and then serve as Secretary of the Department of Health and Family Services. He deserves the honor that you gave him today," the Governor said.

Hearings have been scheduled at four Wisconsin locations on the proposed rule changes to HFS 129. This is the rule that regulates Certified Nursing Assistants. The amended rule would expand the number of hours of classroom time required for training to 120, and the number of clinical hours to 32. These changes will increase the cost and time necessary to prepare Certified Nursing Assistants. Lengthening the clinical time requirement is of additional concern because of the already intense competition for clinical time. The hearing notice and a plain language analysis of the rule can be found at:

https://apps.dhfs.state.wi.us/admrules/public/Rmo?nRmoId=988#initialRulesProposed

Dates and locations for the hearings are:

June 12, 2008, 9 - 11 a.m.
Wilson Street State Office Building, 1 West Wilson Street, Room 950 A, Madison, Wisconsin

June 13, 2008, 10 a.m. – Noon
Southeastern Regional Office, 819 North 6th Street, Room 40, Milwaukee, Wisconsin

June 16, 2008, 11 a.m. – 1 p.m.
Northcentral Technical College, Center for the Health Sciences Building – Auditorium, 1000 West Campus Drive, Wausau, Wisconsin

June 17, 2008, 11 a.m. – 1 p.m.
Wisconsin Indianhead Technical College, Room 174/176, 1900 College Drive, Rice Lake, Wisconsin

WHA has heard concerns from members regarding this increase in both cost and time. Please contact Judy Warmuth at WHA (jwarmuth@wha.org or 608-274-1820) with other concerns/issues that members have with this rule change.

The Osthoff Resort, Elkhart Lake *** June 18-20, 2008

The Osthoff Resort Room Reservation Cut-Off: May 28
Conference, Golf & Sailing Registrations: Due June 4 to WHA

More information and registration form can be found at www.wha.org

Diabetes is a serious, but controllable lifelong disease that affects more than 17 million Americans. It is up to individuals to take control of their diabetes before it takes over their lives and health. Knowing how important it is for those with diabetes to keep up-to-date on treatment options, Mile Bluff Medical Center in Mauston provides a number of educational and support services to the community through its nationally-recognized Diabetes Self-Management Education Program. Almost all of diabetes care is self-care, and Mile Bluff teaches individuals to better control their diabetes so they are able to live life to the fullest.

Participants in Mile Bluff Medical Center’s Diabetes Self-Management Education Program are taught self-care skills that promote optimal diabetes management. The program is provided on an individual basis and through group sessions at Hess Memorial Hospital. The combination of support from the health care team and the knowledge gained through the education program allows individuals to assume an active role in their diabetes management. Good control of diabetes can prevent and/or delay both short and long-term complications of diabetes.

The program is not only for those who have been recently diagnosed, but also those who have had diabetes for a while and have poorly controlled blood sugars, have had or need a change in medications, or those who have good control of their diabetes and want to learn to do all they can to keep it that way!

Mile Bluff’s education team consists of a certified diabetes educator, registered nurses, a registered dietitian, and a licensed clinical social worker. This group works together to ensure a comprehensive approach to diabetes self-management is taken with each individual that enters the program. Topics covered by the education team include:

• The disease process & treatment options
• Nutritional management
• The importance of physical activity
• The use of medications for therapeutic effectiveness
• Monitoring of blood glucose and use of the results to improve control
• Prevention, detection and treatment of acute and chronic complications, and risk reduction
• Goal setting to promote health and problem-solving for daily living
• Psychosocial adjustment
• Preconception care, management during pregnancy, and gestational diabetes management

Throughout the year Mile Bluff also offers a variety of other programs to help those with diabetes. Monthly support group presentations are offered free of charge, and even include a tour of the grocery store with a nutrition expert to help participants sift through those hard-to-understand food labels. Free foot, blood sugar and blood pressure screenings are held at a number of health fairs throughout the year, and at special National Diabetes Awareness Month events.

The American Diabetes Association believes that diabetes self-management education is an essential component of diabetes treatment, and has once again awarded Mile Bluff Medical Center the American Diabetes Association Education Recognition for the high-quality diabetes self-management education provided in Mauston.

Ensuring high-quality education for patient self-care is one of the primary goals of the Education Recognition program. Participants at Mile Bluff learn to assume a major part of the responsibility for their diabetes management, which can prevent the number of unnecessary hospital admissions and some of the acute and chronic complications of diabetes.

Mile Bluff Medical Center in Mauston continuously strives to serve the community with the perfect balance of big-city technology and personal, small-town care by providing benefits to the community through services such as the Diabetes Self-Management Education Program.

In 2006, a second patient transport van made it possible for Aurora Medical Center and Aurora clinics in Manitowoc County to complete 972 arrivals and 1,165 departures through its free transportation service. The free service is offered to patients who need transportation for appointments to and from Aurora Health Care facilities within Manitowoc County, yet have no other means of transportation and are able to exit and enter their dwelling independently or have made arrangements to have someone assist them. The van logged a total of 19,200 miles, with local volunteers making the drives.

In 2007, Aurora expects these numbers to increase. Funding for the van was made possible through proceeds from the sixth annual Golf Classic and donations through the Vince Lombardi Cancer Clinic Foundation Fund.

The transport van ensures that all patients needing assistance will make their appointments on time, rather than missing their appointments altogether.

St. Mary’s knows that "home is where the heart is," no matter how long a person lives elsewhere. That’s why it was important for the staff to help an elderly patient secure ongoing care near her son who lives two states away. After lengthy hospitalizations at St. Mary’s, it was determined that the woman would never be able to live on her own again. Her son, married with three children, was unable to uproot his family and needed help bringing his mother to Indiana. So St. Mary’s arranged for a nursing home bed and a primary physician there, in addition to ambulance transport. The Patient & Family Emergency Fund paid the amount for the ambulance that the woman’s family could not cover. In 2006, St. Mary’s dedicated more than $15,000 to this program.

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

Imagine getting into health care two years after the inauguration of Medicare. Loren Anderson, executive vice president of Aurora Health Care’s South Region, did just that, developing a 40-year career marked with professional accomplishments, significant honors and a reputation as a great mentor. Anderson, who has spent the last 20 years in Walworth County and the South Region, announced his retirement from Aurora, effective July 1, 2008.

Anderson began his career as chief executive officer of Five Counties Hospital and Nursing Home in Lemmon, South Dakota in 1968. He then joined the American Hospital Association in Kansas City, Missouri as associate regional director. He moved to Wisconsin in 1975 when he joined Community Memorial Hospital in Menomonee Falls as a vice president. He became administrator of Lakeland Medical Center in Elkhorn in 1988 and joined Aurora when Lakeland affiliated with Aurora in 1995. He became administrator for both Lakeland and Memorial Hospital of Burlington in 1996, and executive vice president for the South Region in 1997 when Aurora reorganized into its current regional structure. Anderson is a Fellow in the American College of Healthcare Executives (FACHE) and has long been active in Wisconsin Hospital Association leadership activities, serving on the WHA Board of Directors, the Medical and Professional Affairs Council, and on the WHA Financial Solutions Board of Directors.

Don Nestor, Aurora executive vice president and chief operating officer, described Anderson as an "inspirational leader who has an ability to recognize potential in individuals that they sometimes are unable to see in themselves."

The SynergyHealth Board of Directors has approved a definitive agreement to affiliate with Froedtert & Community Health to enhance the value of health care delivery in Washington County. The affiliation process is expected to be complete by July 1. Under the agreement, St. Joseph’s Hospital, the West Bend Clinic and the SynergyHealth Foundation will become part of Froedtert & Community Health. Froedtert & Community Health also includes Froedtert Hospital and Community Memorial Hospital in Menomonee Falls.

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