June 18, 2010
Volume 54, Issue 24


WHA’s Medicaid Advisory Group Reviews Fiscal Year 2011 Medicaid Base Rates
Chair Woodward thanks DHS staff for their transparency and hard work

The fourth meeting of the WHA Medicaid Advisory Group (MAG) with staff from the Wisconsin Department of Health Services (DHS) was held June 15 at WHA Headquarters. The major focus of the meeting was DHS’s presentation of the FY 2011 Medicaid rates for Wisconsin hospitals. DHS also provided a year to date update on the 2010 hospital assessment program and projections for the program in 2011.

Jason Helgerson and Jim Johnston from DHS, and Matt Sorrentino, a DHS consultant from Public Consulting Group, took the advisory group through a detailed, step-by-step explanation of the rate-setting process with the actual data used to create the hospital-specific 2011 Medicaid inpatient and outpatient rates. DHS explained the many factors that affect rate development including wage index, capital, medical education, rural and DSH adjustments, and outlier payments. DHS applied the factors and calculated the new rates using the most current claims and cost report data available to DHS. The DHS presentation resulted in a good discussion about the process.

WHA Vice President of Finance Brian Potter noted, "While this is clearly a very complex process, the MAG members appreciated the transparency. The amount of information included in the presentation spreadsheets helped everyone understand how DHS calculated the final rates within the confines of the state budget."

After the rate presentation, DHS staff provided an updated look at the preliminary results of the FY 2010 hospital assessment program. DHS also presented an initial projection for the FY 2011 hospital assessment program. DHS emphasized that the 2011 model will change when updated with the 2009 Fiscal Survey numbers. The initial numbers indicated that there should be significant payment improvements for most hospitals.

DHS also walked the MAG through an initial model of the CAH 2011 assessment. DHS again stressed that the model will change when updated for the 2009 Fiscal Survey numbers, but they believe it provides a good reference at this point in the process.

DHS staff also updated the group on their work to provide hospitals with more current cost reporting data through the ForwardHealth portal.

"This is an incredibly helpful development and a great outcome of the MAG. Hospitals appreciate DHS’s determination to do things in new and more efficient ways," said George Quinn, WHA senior vice president.

Finally, Helgerson updated the MAG on the latest developments with the new state office of health care reform and the southeast Wisconsin Medicaid HMO RFP.

At the conclusion of the meeting, MAG Chair Jim Woodward, CEO, Meriter Hospital, thanked Jason Helgerson and his team and WHA staff for their hard work throughout this process and for the level of detail and transparency that went into this year’s rate-setting process.

The next meeting of the Medicaid Advisory Group will be scheduled for October. Materials from this meeting, including the hospital-specific Medicaid rate sheets, hospital assessment models and projections, along with all presentation items from previous meetings and other information about the Medicaid Advisory Group can be found on the WHA Web site at: www.wha.org/financeAndData/MAG.aspx.

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Political Action Spotlight: Political Action Fundraising Campaign Reaches $90,000

Just over one month into the 2010 Campaign, contributions to the Wisconsin Hospitals PAC and Wisconsin Hospitals Conduit have topped $90,000. This puts the 2010 campaign at 42 percent of its $215,000 monetary goal.

As in previous years, individual contributors will be listed in The Valued Voice by name and affiliated organization on a regular basis. 2010 contributors to date are listed below. Contributors are listed alphabetically by contribution category.

For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

Contributions Ranging From $1 - $499

Ayers, Mandy         Wisconsin Hospital Association

Ballentine, Anne         Wheaton Franciscan Healthcare

Benz, Staci         Children’s Hospital and Health System

Biros, Marilyn         SSM Health Care-Wisconsin

Bosman-Clark, Jane         Children’s Hospital and Health System

Braddock, Jonathan         WHA Financial Solutions

Casey, Candy         Columbia Center

Conwell, Lisa         WHA Financial Solutions

Coon, Lawrence         Hall, Render, Killian, Heath & Lyman

Davis, Kathleen         Children’s Hospital and Health System

Eddy, Lee Anne         Children’s Hospital and Health System

Facey, Alice         St. Clare Hospital and Health Services

Govier, Mary         Holy Family Memorial, Inc.

Grohskopf, Kevin         St. Clare Hospital and Health Services

Gutekunst, Penny         Children’s Hospital and Health System

Hoege, Beverly         Reedsburg Area Medical Center

Jelle, Laura         St. Clare Hospital and Health Services

Jensen, Christopher         Children’s Hospital and Health System

Jentsch, Lisa         Children’s Hospital and Health System

Kerecman, Laura         Children’s Hospital and Health System

Kleaveland Kupczak, Sarah         Wheaton Franciscan Healthcare

Kluesner, Kevin         Aurora Health Care-South Region

Krueger, Mary         Ministry St. Clare’s Hospital

Margan, Rob         Wisconsin Hospital Association

Moraski, Kevin         Ministry Health Care

Nockerts, Steve         The Richland Hospital, Inc.

Olive, Willie         Children’s Hospital and Health System

Pedretti, Julie         Children’s Hospital and Health System

Pennebecker, Allen         Ministry Health Care

Pichotta, Naomi         Aurora Health Care

Piehl, Steven         Children’s Hospital and Health System

Podhora, Ida         Children’s Hospital and Health System

Priest, Geoffrey         Meriter Hospital

Ross, Forrest         WHA Financial Solutions

Sachse, Kelly         Children’s Hospital and Health System

Schaetzl, Ron         St. Clare Hospital and Health Services

Stout, Johni         WHA Financial Solutions

Swanson, Kerry         St. Mary’s Janesville Hospital

Swessel, Catherine         Children’s Hospital and Health System

Tapper, Joy         Milwaukee Health Care Partnership

Walker, Troy         St. Clare Hospital and Health Services

Weden, Mary         Children’s Hospital and Health System

Worrick, Gerald         Ministry Health Care’s Door County Memorial Hospital

Contributions Ranging From $500 - $999

Anderson, Sandy         St. Clare Hospital and Health Services

Bablitch, Steve         Aurora Health Care

Bonin, Christopher         Aurora Health Care

Borgerding, Dana

Brenton, Mary E.

Callies, Julie         WHA Information Center

Chess, Eva         Aurora Health Care

Clapp, Nicole         Grant Regional Health Center

Frank, Jennifer         Wisconsin Hospital Association

Geboy, Scott         Hall, Render, Killian, Heath & Lyman

Grundstrom, David         Flambeau Hospital

Just, Lisa         Aurora Medical Center in Hartford

Kerwin, George         Bellin Hospital

Korom, Nancy         Children’s Hospital and Health System

McDonald, Brian         Aurora Health Care

McDonald, Mary Beth         Aurora Health Care

Merline, Karen

Miller, Jim         Children’s Hospital and Health System

Moulthrop, David         Rogers Memorial Hospital

Normington, Jeremy         Moundview Memorial Hospital and Clinics

Potter, Brian         Wisconsin Hospital Association

Russell, John         Boscobel Area Health Care

Shabino, Charles         Wisconsin Hospital Association

Ship, Mark         Children’s Hospital and Health System

Size, Pat

Smith, Linda         Aurora Health Care

Stuart, Phil         Tomah Memorial Hospital

Topinka, Ralph         Mercy Health System Corporation

Westrick, Paul         Columbia St. Mary’s, Inc. - Milwaukee Campus

Contributions Ranging From $1,000 - $1,499

Bazan, Bill         Wisconsin Hospital Association

Birkenstock, Timothy         Children’s Hospital and Health System

Boese, Jennifer         Wisconsin Hospital Association

Britton, Gregory         Beloit Memorial Hospital

Brooks, Alenia         Aurora Health Care

Brophy, Michael         Aurora Health Care

Buser, Kenneth         Wheaton Franciscan Healthcare - All Saints

Chapin, Rocklon         St. Mary’s/Duluth Clinic Health System

Christensen, Cinthia         Children’s Hospital and Health System

Devermann, Robert         Aurora Medical Center in Oshkosh

Duncan, Larry         Children’s Hospital and Health System

Dunigan, Thomas         Children’s Hospital and Health System

Eichman, Cynthia         Ministry Our Lady of Victory Hospital

Fale, Robert         Agnesian HealthCare/St. Agnes Hospital

Friberg, Deb         Columbia St. Mary’s, Inc. - Milwaukee Campus

Greenberg, Beverly         Aurora Health Care

Hahn, Brad         Aurora Health Care

Hilt, Monica     Ministry Saint Mary’s Hospital

Kryda, Michael         Ministry Saint Joseph’s Children’s Hospital

Levin, Jeremy         Rural Wisconsin Health Cooperative

Loftus, Philip         Aurora Health Care

Martin, Jeff         Ministry Saint Michael’s Hospital

Nauman, Michael         Children’s Hospital and Health System

Niemer, Margaret         Children’s Hospital and Health System

Olson, David         Columbia St. Mary’s, Inc. - Ozaukee Campus

Petasnick, William         Froedtert Memorial Lutheran Hospital

Radoszewski, Pat         Children’s Hospital and Health System

Reynolds, Sheila     Children’s Hospital and Health System

Schafer, Michael         Spooner Health System

Stanford, Matthew         Wisconsin Hospital Association

Titus, Rexford         ProHealth Care

Troy, Peggy         Children’s Hospital and Health System

Warmuth, Judith         Wisconsin Hospital Association

Woodward, James         Meriter Hospital

Contributions Ranging From $1,500 - $1,999

Bailet, Jeffrey         Aurora Health Care

Banaszynski, Gregory         Aurora Health Care

Bloch, Jodi         Wisconsin Hospital Association

Brideau, Leo         Columbia St. Mary’s, Inc. - Columbia Campus

Erwin, Duane         Aspirus Wausau Hospital

Grasmick, Mary Kay         Wisconsin Hospital Association

Johnson, Peter         Aurora West Allis Medical Center

Kachelski, Joe         WHA Information Center

Kosanovich, John         UW Health Partners Watertown Regional Medical Center

Leitch, Laura         Wisconsin Hospital Association

Morgan, Dwight         Aurora Health Care

O’Brien, Mary         Aurora St. Luke’s Medical Center

Contributions Ranging From $2,000 - $2,499

Merline, Paul         Wisconsin Hospital Association

Oliverio, John         Wheaton Franciscan Healthcare

Starmann-Harrison, Mary         SSM Health Care-Wisconsin

Contributions Ranging From $2,500 - $2,999

Tyre, Scott         Capitol Navigators, Inc

Contributions Ranging From $3,000 - $3,999

Borgerding, Eric         Wisconsin Hospital Association

Size, Tim         Rural Wisconsin Health Cooperative

Contributions Ranging From $4,000 - $4,999

Contributions $5,000 and up

Brenton, Stephen         Wisconsin Hospital Association

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Health Reform, Medicaid Funding, State and Federal Advocacy Top WHA June Board Meeting

WHA President Steve Brenton told the WHA Board that the Association is actively engaged in advocacy efforts in Washington on Wisconsin-specific issues associated with the implementation of national health reform. Brenton shared a white paper he authored with input from WHA staff that identifies six themes that he believes are "at the center" of health reform. They include coverage, delivery system reform, payment reform, improved access, hospital reporting requirements, and hospital Medicare payment cuts.

Brenton identified one of the biggest short-term issues as an anticipated shortfall in Medicaid funding between now and 2014 when new money flows into the program. The second largest issue, according to Brenton, is the creation of the state-level health insurance exchanges that will serve subsidized individuals and small groups.

Later this month, WHA is sponsoring a one–day seminar focused on the implications of health reform on tax-exempt hospitals. The June 30 seminar in Madison (click here to register) will cover, among other issues, the new health reform law requiring hospitals to complete a community needs assessment every three years. Accelerated price and quality public reporting requirements included in the law will also take effect over the next few years.

Above all, Brenton said there is a growing concern about Medicare payment cuts that would be in addition to the $155 billion in hospital cuts already agreed upon by the hospital field. (See this week’s President’s Column on page 3.) "From where we stand, the cuts just keep getting deeper. This is a very serious concern, especially for leader states like Wisconsin," Brenton said. "We must call on Congress and the Obama Administration to be accountable for the deal that was made with the nation’s hospitals just months ago and stop these new cuts."

WHA is active on a number of groups and committees involved in health reform, including the national Healthcare Quality Coalition (HQC). The HQC was instrumental in gaining substantive, value-focused Medicare payment reforms as part of the health care reform legislation signed by President Obama. But those advances were hard won, and must still be implemented in the face of opposition from other parts of the country.

WHA will remain actively involved in health care reform implementation through continued involvement in the HQC and via Brenton’s recent appointment to an AHA Task Force on Health Reform. Closer to home, WHA’s Health Reform Task Force, chaired by Leo Brideau, will continue meeting with a focus on Wisconsin-specific health reform issues.

"It will be very important to be involved in the implementation of the value-focused payment reforms as they could be very positive for leader states like Wisconsin," Brenton said. "However, and quite frankly, these important gains are dwarfed by the massive cuts in Medicare payments that are on the horizon."

Brenton said WHA has vigorously advocated against the proposed Medicare cuts under the Fiscal Year 2011 IPPS rule and has filed comments on the rule with CMS. One of the more egregious provisions is a 2.9 percent coding "offset" that seeks to recoup half of the payments made in FYs 2008 and 2009 that the Centers for Medicare and Medicaid Services (CMS) claims is due to documentation and coding changes as the nation moved to the new MS-DRG coding system. For Wisconsin hospitals, the 2.9 percent cut amounts to over $51 million statewide next year. "The behavioral adjustment factored over 10 years has a far bigger impact than the other health reform cuts," Brenton said.

The WHA Medicaid Advisory Group is resource intensive, but Brenton said it is essential that WHA actively participate in the state’s Medicaid rate-setting process. "The skyrocketing Medicaid enrollment and the hospital assessment have created a situation where we needed to demand a more transparent approach from the Department of Health Services (DHS) that involves hospital input," Brenton explained. Overall, Brenton said that WHA has been successful in gaining DHS’s attention and the changes that have been made in the rate-setting process—including more money flowing into the base rate—would not have occurred without the joint meetings. He also noted DHS’s cooperation with the process.

WHA Senior Vice President George Quinn explained the fiscal year 2011fee-for-service rate-setting process to Board members, saying that there are two separate monetary allocations for hospitals in the Medicaid program—inpatient and outpatient. The 2010 allocations were adjusted to reflect projected volume and inflation changes for 2011. Because the allocations are fixed, each element of the payments allocated to hospitals has an impact on base rates.

Quinn said in the 2011 allocations, WHA insisted on maintaining the 2010 base rates. Quinn said if WHA had not intervened in the rate-setting process, there would have been a decrease in PPS hospital Medicaid payments from 2010. Many issues remain that require more discussion, but Brenton conceded that the Medicaid rate setting and budget process given the state’s fiscal condition will be an "annual struggle."

Quinn provided the status of the 2010 assessments and payments. The state has suspended the HMO access payments for May and June to allow for fee-for-service claims to be paid. However, Brenton reiterated that the State ultimately is required to pay out "every last dime" of the hospital assessment. Quinn also gave a summary of the state’s projected 2011 assessments and payments. The three-year totals for 2009 through 2011 will be $1.1 billion in assessments and $1.9 billion in payments, for a net gain to hospitals of $746 million.

HIT, HIE and Meaningful Use Rules: Wisconsin Advances HIE Plan

Wisconsin is currently developing a plan for a health information exchange (HIE) that will facilitate the exchange of health information. WHA staff and hospital members are actively engaged in the health information exchange planning through their participation on a number of committees that are working on a plan for a statewide HIE in Wisconsin that will receive some federal funding for implementation. The WIRED Board, of which Brenton is a member, is in place to oversee the creation of the HIE. Brenton said the WHA HIT Task Force early on developed a set of guiding principles that the Association is using to evaluate all aspects of the HIE planning process.

Above all, the HIE must bring value to consumers, providers and insurers or no one will be willing to pay for it. The initial funding only covers some implementation and planning costs; the HIE must be sustained by other sources of income, or it will fail.

The development of a statewide HIE is coincidental to and often confused with the push to have health care providers adopt electronic health record (EHR) technology. The EHR provider incentive payments are tied to meeting the largely unattainable "meaningful use" proposed rules for health information technology. Brenton said hospitals have requested rule changes, but if CMS doesn’t comply, no one will receive incentive payments. Brenton said Wisconsin’s HIE plan will be submitted to HHS later this summer, with an expectation that if it is approved, a state-designated entity (SDE) will be selected to implement the plan statewide later this year.

WHA Advocacy Efforts in High Gear on Every Front

The lazy days of summer may be finally here for some to enjoy, but not so for WHA’s advocacy team. WHA Executive Vice President Eric Borgerding said the Association is extremely busy not only in Madison, but health reform and unrelated, but additional, Medicare and Medicaid cuts have triggered a ramped-up presence for WHA in Washington as well.

In Wisconsin, the fall elections are on the horizon, and they will play out in the most "dynamic atmosphere witnessed in a long time," according to Borgerding. As they did in the 2008 election year, Borgerding and WHA Vice President of Government Affairs Paul Merline will hit the road and meet with the candidates in their districts. Borgerding said this year they plan to ask hospital CEOs and local business leaders to join them at a select number of meetings that will focus on the important economic impact hospitals have in their community.

Borgerding shared the results of a recent issue polling with the Board that will be used to develop both public and candidate education. Borgerding said the polling points advocacy messaging in certain directions. For example, the polling found that the public recognizes the significant role that the hospital plays in the local economy and drastic payment cuts could have an impact on local jobs.

State Budget Woes Will Welcome New Governor

Wisconsin’s new Governor will have a $2.6 billion deficit waiting for him as he takes office. This is a deficit that, according to Borgerding, will worsen if tax collections remain slow and the federal FMAP extension does not come through, or if plaintiffs prevail in the $200 million Injured Patients and Families Compensation Fund lawsuit. In addition to a new Governor, the Legislature will see an inordinate amount of turnover, with the announcement of 23 retirements to date.

Health Reform: Medicaid, Medicare Cuts Stack Up

The impact of health reform will be experienced differently by each state in the country. In Wisconsin, it translates to $2.6 billion in Medicare cuts over the next decade, and an addition of only 125,000 more insured. This is a modest amount when compared to other states that have not expanded their Medicaid programs as much as Wisconsin has over the past couple of years.

"Wisconsin will get about .04 percent of the coverage increases in exchange for 1.7 percent of all the cuts," Borgerding explained. "This has been a theme. We are a donor state to the health reform effort because we have been aggressive in getting people covered."

WHA Staff Act on Behavioral Health Task Force’s Recommendations

Earlier this year, the WHA Board approved 12 recommendations formulated by the WHA Behavioral Health Task Force chaired by George Kerwin, CEO, Bellin Health. WHA staff has actively begun to implement recommendations to further engage and collaborate with other organizations and agencies that have a stake in improving Wisconsin’s mental health delivery system.

Matthew Stanford, WHA associate counsel, said WHA has been meeting with various groups, including Department of Health Services work groups, a mental health task force created by Chief Justice Shirley Abrahamson, the Wisconsin Counties Association, and the Wisconsin County Human Services Association to share and receive perspectives on improving the delivery and funding of the public mental health system.

"There is common recognition among all stakeholders that Wisconsin’s county-based mental health system has some significant problems that need to be addressed," according to Stanford. "WHA’s goal is to find solutions that can be broadly supported and championed by multiple stakeholders in that system."

Stanford also reported on the recent announcement of the Joint Legislative Council to form a legislative study committee to review emergency detentions and admission of minors under chapter 51. The Committee will be co-chaired by Rep. Sandy Pasch (D-Milwaukee) and Senator David Hansen (D-Green Bay). WHA views this as a further positive development. At the request of the Joint Legislative Council, WHA has recommended that the Council consider George Kerwin, Phyllis Fritsch, Upland Hills Health - Dodgeville, David Moulthrop, Rogers Memorial Hospital – Oconomowoc, and Joy Mead-Meucci, Aurora Health Care, as potential public members of that study committee.

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Aspirus CEO Erwin Presented with AHA "Grassroots Champion" Award

During the WHA Board meeting on June 17, WHA presented Aspirus President & CEO Duane Erwin with an American Hospital Association (AHA) "Grassroots Champion" award. The award is given out each year by AHA to one individual in each state. Erwin received the award for Wisconsin due to his dedication and commitment to grassroots advocacy.

"WHA is pleased to present this AHA Grassroots Champion award to Duane Erwin for his advocacy efforts in support of hospitals," said Jenny Boese, WHA vice president, external relations & member advocacy, in presenting the award. "Duane is committed to the hospital mission and is a leader in promoting the value of hospitals to legislators, to opinion leaders, and to the community at large. For these reasons and more, WHA is proud to work with Duane on vital hospital issues."

The AHA Grassroots Champion Award was created to recognize those hospital leaders who most effectively educate elected officials on how major issues affect the hospital’s vital role in the community, who have done an exemplary job in broadening the base of community support for the hospital and who are tireless advocates for hospitals and their patients.

"We depend upon strong local voices to help tell the story of hospitals," said Steve Brenton, WHA president. "This award is recognition of all the hard work and dedication Duane Erwin brings to his community and his hospital."

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President’s Column: Important Payment Issues Before Congress…Right NOW!

There’s a lot going on in D.C. right now. And the active engagement of health care leaders with Members of Congress over the summer months is essential if we are to prevail on one Medicaid and several Medicare payment issues that are in play. The outcome of these individual battles will determine the financial viability of community hospitals and the services provided to patients and families for years to come. The outcome will also foreshadow whether or not lawmakers who cut a deal with the hospital field to help finance health reform were honest brokers. Here’s the current snapshot...

Medicaid

It is essential that the six-month extension of increased federal matching funding (January – July 2011) be passed by Congress soon. Without this funding, Medicaid programs in at least 30 states will face catastrophic budget problems—likely leading to across-the-board reductions in provider payments for services delivered to our most vulnerable patients and families.

Most Republicans and an increasing number of Democrats are expressing concern about where the $24 billion required to pay for the extension will come from. Like much of the electorate, they are reticent about further deficit spending and are asking supporters of the increased funding how to pay for it.

Here’s an answer: Take the desperately needed money from yet to be spent "stimulus" funds. Those dollars have already been approved by Congress so "new" deficit spending would not be an issue. There’s plenty of pork that can be trimmed to finance this desperately needed coverage priority.

Medicare

There are three Medicare issues in play right now. They are: IPPS rules that would whack PPS hospitals with a "behavioral offset" for alleged inappropriate DRG upcoding; IPPS rules that "clarify" that taxes on CAHs are not recoverable costs for Medicare payment; and a proposed $4 billion cut for outpatient therapy services that will pay for a temporary physician payment "fix." WHA is working with AHA and others to stop each of these ill-considered payment cuts.

The recent emergence of new Medicare cuts must be examined in the context that the hospital field had a "deal" with the Obama Administration and Democratic Leaders to contribute $155 billion in cuts over 10 years to help pay for coverage expansion. But these new reductions are additive to that "deal" and have the potential of piling on tens of billions of red ink for a program that pays hospitals less than 80 cents on the dollar for costs of care right now.

The hospital field can’t now go "weak-kneed" when it comes to demanding compliance with a "deal" that isn’t even three months old!

The implications of all of this for Wisconsin hospitals is even more important than it is for hospitals in "low coverage" states that can expect a big decrease in uncompensated care beginning in 2014. Only 125,000 uninsured are expected to find coverage in Wisconsin because of our already progressive Medicaid eligibility. That’s 125,000 out of 32 million…a stunning number providing some perspective of the proportionality of the impact of future coverage and the cuts that will pay for that coverage. Wisconsin hospitals are funding 1.7 percent of the Medicare cuts but will see only .04 percent of the coverage improvements.

Our overall position on new Medicare cuts should be a flat NO. The hospital field already anteed up $155 billion as part of health reform. No more.

Steve Brenton
President

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WHA Education: Health Care Reform & Tax-Exempt Hospitals: New Day, New Requirements
Wednesday, June 30
Sheraton Hotel, Madison

Focus on the new requirements and proactive measures to protect a hospital’s tax-exempt status.

Register today: www.wha.org/education/taxexempt6-30-10.aspx

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Rural Broadband Topic of Informational Hearing
PSC administrators discuss federal funding, future planning efforts

This week the Assembly Committee on Renewable Energy and Rural Affairs held an informational hearing on the issues and planning efforts surrounding rural broadband mapping and access in Wisconsin. Testimony was provided by Gary A. Everson, Administrator and Nick Linden, Assistant Administrator from the state’s Public Service Commission (PSC).

Included among the goals of the American Recovery and Reinvestment Act (ARRA) was the expansion of broadband access to un-served and underserved communities across the U.S. and billions of dollars were made available in the form of grants and loans to support the various infrastructure projects necessary to reach that goal.

Dave Fish, CEO at St. Joseph’s Hospital in Chippewa Falls, has been involved in this issue and continues to follow developments closely. "In today’s reality where Wisconsin is dealing with a very soft economy and a number of cities still in economic distress, there is nothing more important than being able to build community capacity," Fish said.

Significant community benefits can be expected from the implementation of ultra high-speed broadband, positively impacting cities and towns throughout Wisconsin. "By securing low-cost, high-speed broadband communications with its increased capacity and superior transmission interconnectivity, communities will be able to effectively link local hospitals, clinics, city and county governments, libraries, and schools. This will allow us to expand public private partnerships while creating community collaboration that improves public safety services, economic development efforts, transportation, and educational programming," Fish added.

Mapping where broadband access currently is and isn’t available and planning for where future coverage needs to be are among the most significant efforts underway. Overall, ARRA made $350 million available to states for these efforts. Wisconsin has received a grant of $1.7 million so far and efforts to develop a comprehensive statewide map of broadband availability, as well as regional broadband development plans, have begun. Supplemental grant applications are planned.

The statewide initiative, known as LinkWISCONSIN, describes its goals as threefold:

Among the next steps underway are to identify, consult and engage representatives from key Wisconsin stakeholders in the process. If you or members of your facility are interested in participating in efforts relating to improving broadband access across the state, please contact Gary Evenson directly at gary.evenson@wisconsin.gov. Periodic regional workshops and meetings are planned.

Ongoing mapping and planning updates are available at www.linkWISCONSIN.org.

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Wisconsin Technical Districts Receive Funding to Prepare HIT Workforce

Both the Milwaukee Area Technical College and the Madison College have received grant awards from the Office of the National Coordinator for Health Information Technology to rapidly create health information technology (HIT) education and training programs. These grants are part of a national commitment to fund the training and development of a workforce to meet short-term programmatic needs to meet the expectation for accelerated adoption of electronic medical records by hospitals and physician practices.

The Madison district received $759,000, while Milwaukee received $849,000 over a two-year period. They are charged with assessing the need for HIT workers statewide and implementing programs to address those needs. Training programs will be six months long and will result in certification.

Judy Warmuth, vice president, workforce, Wisconsin Hospital Association, serves on the Advisory Committee to both grants.

"Many of Wisconsin’s larger hospitals are well on the way to implementation, but smaller and less urban hospitals are at an earlier stage with their EMR, but are already anticipating great difficulty in recruiting experts and/or educating existing employees to direct and assist in selection, design, implementation and long-term support of the EHR. Carefully implemented, these grants can address those concerns and needs. I am pleased to be able to have input into grant planning and implementation," Warmuth said.

The grants run from April 2010 to April 2012, and curriculum development has already begun. For more information or to make suggestions to WHA’s advisory role, contact Judy Warmuth at jwarmuth@wha.org.

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Grassroots Spotlight: Sen. Holperin Visits Ministry-Eagle River Memorial Hospital Health Fair

Approximately 200 residents attended the annual health fair at Ministry Eagle River Memorial Hospital on Saturday, June 12. Sponsored by the Auxiliary–Partners of Ministry Eagle River Memorial Hospital, the health fair featured exhibits, demonstrations, health information, and free clinical testing. One hundred attendees had their cholesterol tested during the free screening.

Pictured is Senator Jim Holperin of the 12th Senate District, as he visits with some members of the Auxiliary–Partners of Ministry Eagle River Memorial Hospital.

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Wisconsin Hospitals Community Benefits: Adequate and Appropriate Nutrition

Nutrition counseling is an important aspect of the service that hospitals provide within their communities. Whether it is offering classes that focus on weight loss or promoting better health, or nutrition education for people who are diabetic, Wisconsin hospitals offer hundreds of free classes that stress the importance of diet on overall health. Hospital employees also help deliver Meals on Wheels and they organize and participate in food drives to benefit local food pantries.

Horizon Adult Day Care

A good meal is something many of us may take for granted. Studies have shown the effects of poor nutrition and the elderly. The Adult Day Care program provides not only a balanced nutritious hot meal, but also the important element of socialization to people that are often the most vulnerable to isolation. Each noon, participants of the program are served a meal planned by a registered dietitian and prepared by Langlade Hospital food service department. We know that when participants eat at the center they are receiving a balanced meal.

Horizon Adult Day Care has been providing services to frail elderly residents of Langlade County for the past 15 years. Horizon Adult Day Care provides the opportunity to get together during the day in a safe structured environment. The target population served is seniors with developmental disabilities, dementia, and individuals that are unsafe at home alone. The Adult Day Care is staffed by certified nursing assistants who plan and carry out activities with participants.

Participants planted a garden to grow vegetables and flowers. Activities they have involved themselves in range from trivia and bingo to outings to the zoo. Most of the participants in the program would otherwise not be able to participate in community events without the assistance of the Adult Day program.

Langlade Hospital, Antigo

500 Club helps people eat healthier

One of our biggest concerns…and challenges…is influencing healthier lifestyles in people in the communities we serve. Gundersen Lutheran’s nutrition therapy department, in an effort to combat the disturbing obesity trend, developed the innovative 500 Club® program, now celebrating its 25th anniversary.

The physician-endorsed 500 Club is a healthy eating program coordinated by Gundersen Lutheran registered dietitians. They work with area food retailers to help consumers make smarter, healthier food choices. The 500 Club partners include grocery stores, restaurants, quick-service counters, a take-and-bake business, delis, even convenience stores and a vending machine company.

To take the guesswork out of selecting healthier, great-tasting food, consumers only have to look for the green 500 Club logo on food products at dozens of area locations (a listing of 500 Club members is conveniently found on the Web at www.500-club.org). The green 500 Club stamp of approval means the selection contains approximately 500 calories or less and is controlled in fat.

Because of the importance of the mission of the 500 Club, the program is free for members and consumers alike. The only commitment is to enjoy a healthier lifestyle.

500 Club for Kids is also offered at select 500 Club member restaurants. This program helps children and parents make nutritious choices when dining out. 500 Club for Kids menu items don’t focus on calories but instead offer healthier side selections such as fruit and vegetables.

Snack healthier, too. In area vending machines, the 500 Club logo (or green "pushers") identifies snack items that are approximately 200 calories and 8 grams of fat per serving.

In 2009, Culver’s restaurants endorsed the 500 Club® options to their franchisees nationwide. According to the American Dietetic Association, 58 percent of Americans say they actively seek information about nutrition and healthful eating. The collaboration will make it easy for Culver’s diners to make smarter, healthier food choices.

Gundersen Lutheran Health System, La Crosse

Upland Hills Health educates second graders on the value of eating right

Getting children to eat healthy and eat vegetables is not an easy task for anyone. Upland Hills Health Registered Dietitian Jaime Austin and Dr. Jodi McGraw traveled to Ridgeway Elementary School with a few tricks up their sleeves to show Mrs. Venden’s second grade class that eating right can be fun and still include the foods they love.

The students enjoyed a meal of chicken nuggets, macaroni and cheese, fruit salad, and chocolate chip cookies. After lunch, the students were shown a variety of different vegetables, and learned about their nutritional value. Most of the class had never tried the vegetables and didn’t have the desire to.

The secret Austin and McGraw were holding was that the kid-friendly lunch prepared by Upland Hills Health Nutrition Services was full of hidden vegetables such as butternut squash, pureed broccoli, and chickpeas. After the revelation, the majority of students still agreed that the food was delicious and wanted a second helping.

By introducing healthy, kid- friendly foods at an early age, parents can show that eating healthy can be fun and delicious. Early education on the importance of eating right leads to healthy habits that can last a lifetime.

Upland Hills Health, Dodgeville


Boys & Girls Club nutrition program

Langlade Hospital provides annual support to the Boys & Girls Club of Langlade County to help in building healthier children through the snack and meal programs offered at the Boys and Girls Club.

Every day during the summer schedule, the Boys and Girls Club offers club members a balanced breakfast consisting of cold cereals or oatmeal with milk, in addition to yogurt, applesauce, cheese sticks, crackers and fruit that are available as a supplement at every meal. Also, every club member is provided a cold box lunch every day. The lunch consists of sandwiches, fruit, vegetables, chips or a pasta cup and milk with the option of adding yogurt, applesauce, cheese sticks, crackers and fruit. Club members are required to maintain healthy eating habits by being required to take the correct number of foods from each food group for every meal.

During the school year the club offers club members an after-school snack that consists of a sandwich, fruit/vegetable, cheese sticks, applesauce, yogurt, juice box, milk and crackers. Of course, the kids are allowed to choose snacks that they enjoy, but must pick from the five basic food groups to ensure they are receiving a balanced snack.

The Boys and Girls Club holds an Annual Thanksgiving Dinner for club members and their families. It is just one more step in making sure that club members have a happy and healthy Thanksgiving Dinner.

Langlade Hospital along is proud to support the Boys and Girls Club of Langlade County – A Positive Place for Kids.

Langlade Hospital – An Aspirus Partner, Antigo

Spooner Health System (SHS) makes a large donation to the Washburn County Food Pantry

SHS employees Jennie Klassa and Crystal Potter presented a check for $780 to the director of the Washburn County Food Pantry, Sue Adams. After being made aware of the increased number of people using the food pantry, Klassa organized a Jeans Day at SHS. Employees could wear jeans on that day with a donation of $5 to the food pantry. The amount raised by the employees was $390 and Spooner Health System matched it to total $780. A bag of grocery items was also donated by employees of SHS. In addition, Spooner Health System donated coloring books and boxes of crayons to be given out to kids by the food pantry.

Last summer, the food pantry served approximately 250 families per month. That number has increased dramatically and they are presently serving about 350 families. The Food Pantry is not a county-funded program, but rather serves the people of Washburn County.

Adams states, "We are very appreciative any time we receive a gift of money like this. This money will be used to purchase meat, eggs, margarine and milk, which are given to families along with the canned and shelf items they receive once a month."

Spooner Health System, Spooner

Aurora supports Oconomowoc Chamber of Commerce Farmer’s Market

Aurora Medical Center in Washington County is staffing an information booth at the weekly Farmer’s Market in Oconomowoc, presented by the Oconomowoc Chamber of Commerce. As a member of the Chamber, Aurora was asked to participate in the weekend markets to promote healthy eating and lifestyles. The nutrition component of the Fit Kids Fit Families program was promoted to correspond to the healthy food choices found at farmer’s markets.

Aurora Medical Center in Hartford

Meals on Wheels is more than a meal delivery

Three years ago, when the number of volunteer drivers for the Jackson County Aging Unit’s Meals on Wheels Service began to decrease, Black River Memorial Hospital stepped forward and made a commitment to help. The hospital’s Senior Leadership Team encouraged its managers to get involved, and nearly every manager quickly "volunteered," filling the Monday meal delivery sign-up sheet for the entire year. And, they are still involved. In 2009, the 30-plus managers and some of their staff delivered 600 meals to people in Black River Falls, and they have committed, once again, to all of the Mondays in 2010.

The meals are prepared by the hospital’s Food Service Department staff. In 2009 they served 8,303 meals to 72 clients. Food Service Manager Jennie Drangstveit, CDM explains the meals are delivered during lunch Mondays through Saturdays by both volunteers and drivers who are paid by the Aging Unit. "In reality, the hospital does not receive much revenue from the meals," says Drangstveit. "We do it more as a benefit to the community."

Drangstveit emphasizes that the Meals on Wheels Service does much more than provide meals. "It has also been a lifeline for some who receive the meals," she says. "Once a client was found wandering in her yard, unsure of where she was. A quick telephone call by the driver to the Aging Unit sent immediate help."

She also said the drivers are good about letting the food service staff know when clients don’t answer their door, do not look well, or if anything looks suspicious. "When the drivers drop off the food containers after deliveries they are very good about letting us know if something is just not right with a client," she says. "And with any of these reports, we immediately contact the Aging Unit and they send someone to check to make sure the client is safe or in need of medical assistance."

The hospital managers and staff who have been and continue delivering meals enjoy doing it. One recently commented that it’s an extension of our hospital’s core values of being a good community partner and providing excellent customer service with courtesy, respect and compassion.

Black River Memorial Hospital, Black River Falls

Teaching the community how to "dine with diabetes"

Edgerton Hospital and Health Services has partnered with the UW-Extension to offer a cooking school for people with diabetes and their families. This four-session class includes information on how to manage diabetes, food demonstrations and tasting healthy foods. Class participants learn to develop a clear understanding of the importance and interaction of a balanced diet, physical activity and diabetic medications to control blood glucose.

One participant made a special effort to let us know how beneficial these classes are. "I think these classes should be required when you learn you have diabetes. Doctors don’t always have the time to teach this, but patients need this information."

Edgerton Hospital and Health Services, Edgerton

BAMC gives up holiday party to support local food pantries instead

Bay Area Medical Center (BAMC), responding to employee suggestions and feedback, recently made donations to area food pantries of nearly $10,000. The donations were done instead of the holding the annual BAMC holiday party.

According to BAMC Assistant Administrator of Human Resources and Organizational Development Curt Oberholtzer, "As the holiday season approached, we received an employee suggestion that the organization consider a donation to the area’s food pantries in lieu of the annual party. Our People Council thought it was worth exploring, and so we asked employees what they thought of the idea."

The suggestion that a donation be made to the area’s food pantries received overwhelming support from BAMC employees, according to Oberholtzer. When contacted by the hospital, local agencies indicated that the pantries were facing unprecedented demand.

The donations were made to the Menominee Community Action Agency and Marinette St. Vincent DePaul the week before Thanksgiving, with total contributions of over $9,750.

"Our employees have a proud record of giving back to the local community," said BAMC President and CEO David Olson. "Our support is especially important during challenging economic times such as those we are going through today."

"Although we will miss the opportunity to spend an evening together during this year’s holiday season," Oberholtzer added, "others in our community will now be able to have a better holiday thanks to these donations."

Bay Area Medical Center, Marinette

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

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