Putting their mark on the budget process, the State Senate agreed with the Assembly this week and voted to remove the harmful tort provisions from the state budget.

The removal of the provisions by the Senate is another victory in the budget process for WHA, health care providers, patients, and the 70 organizations voicing opposition to the changes. Additional details on the provisions—which would drastically change Wisconsin’s litigation landscape—along with WHA’s position, can be found in last week’s Valued Voice (www.wha.org/pubArchive/valued_voice/vv6-12-09.pdf). WHA has made their removal from the budget a priority.

Troubling language remaining in the budget, and also supported by trial attorneys, related to medical record copy fees was improved by the Senate. The provision, initially slipped into the budget during

the final hours of Joint Finance Committee action, limited the amount that can be charged for copying medical records, included no provision for future price increases and included language that conflicts with state privacy laws and federal HIPAA regulations.

Working with other members of his Democratic caucus, Senator Dave Hansen

(D-Green Bay) was able to secure important changes to the language that indexes the price of copies to the Consumer Price Index (CPI) allowing for annual increases and preserves access to low-cost copies only for patients themselves or those designated to make health care (and not courtroom) decisions on their behalf. The improvements were not included in the version of the budget that passed the Assembly.

Because each house of the Legislature must pass identical versions of the budget before it can be forwarded to Governor Doyle for his consideration and potential vetoes, differences in the respective versions passed by the Assembly and Senate—including language relating to copy fees—must be reconciled.

Final details of the process were not available at press time, but it is believed a conference committee will be formed with members of each house to complete the process early next week. Legislative voting on the final budget will likely take place next week, with the Governor expected to sign the budget into law before the end of the month.

This past weekend the President announced his proposal to cut more than $200 billion to hospitals. The Wisconsin Hospital Association joins with the American Hospital Association in expressing serious concerns with the magnitude of these cuts and the harm they will cause to community hospitals.

The President’s proposal includes $110 billion in across-the-board "productivity adjustments" to Medicare payment increase and $106 billion in cuts to Disproportionate Share Hospitals (DSH), which serve a disproportionate number of poor and uninsured patients. The latter cut is defended based on claims of a declining uninsured population following health reform implementation.

"Even by the best estimates right now, people are saying that it looks like some of the [health reform] plans that are out there can cover maybe a third, maybe at the high end, two-thirds of the population," said American Hospital Association President Richard Umbdenstock. "That still leaves a lot of people uncovered. It still leaves a lot of people on the Medicaid program, and it still leaves a lot of people who are undocumented immigrants and so on. That need is not going to go away overnight."

The $220 billion in cuts are on top of proposed cuts under the FY 2010 Inpatient Prospective Payment System rule and massive cuts proposed earlier in President Obama’s FY 2010 Budget. After an initial review, WHA conservatively estimates the total cuts will equal at least $110 million in 2010 and over $2.5 billion over 10 years.

"Wisconsin is nationally recognized for providing high quality, low-cost care and we are committed to furthering appropriate health care reform options," said WHA President Steve Brenton. "However, cutting provider payments is not health care reform, and we urge our Members of Congress to work to stand with us against these cuts."

WHA has already conveyed its concerns to Wisconsin’s Congressional Delegation and will be relaying additional information to members in the coming days. If additional information is needed, contact Jenny Boese at jboese@wha.org or 608-268-1816.

At its meeting June 11, the Medical Examining Board (MEB) approved a WHA-backed proposal (www.wha.org/pubArchive/valued_voice/vv6-12-09.htm#5) to streamline Wisconsin licensure requests from physicians already licensed in Minnesota. WHA had requested the MEB to consider taking actions that would reduce the time to license these physicians and increase access to physicians for Wisconsin residents along the Wisconsin-Minnesota border.

The Board passed a motion stating: "For applicants who hold a full, unrestricted license as a Minnesota physician, exclusive of a telemedicine license, the board accepts the Minnesota license as proof of compliance for licensure requirements set out in Med 1.02 (2) (3) (4) and Med 1.06 (3), the effective date to be no later than August 1."

The Board agreed that those physicians would still need to complete an application (specific form to be created and available by August 1), and, if directed by the Board, based on information on the application, might still need to take an ethics exam and an oral exam.

This action by the MEB followed comparison of Wisconsin and Minnesota licensure requirements and WHA’s meeting with staff from the Office of the Commissioner of Insurance to affirm that the new streamlined process will have no impact on the Injured Patients and Family Compensation Fund.

Warmuth said that this was exciting news for WHA members, their patients and families.

"This will greatly reduce the amount of time required for physicians now licensed in Minnesota to obtain a Wisconsin license. It also reduces the amount of staff time required to process these requests in the Department of Regulation and Licensing," Warmuth said. "We commend the MEB for its action and look forward to working with the state to continue improving patients’ access to physicians in Wisconsin."

The proposal for streamlined licensure was developed with the assistance of the WHA Council on Workforce Development and should mean more timely access to physicians in Western and rural Wisconsin. It is the latest development in ongoing efforts by WHA to expedite licensure of health care professionals in Wisconsin.

WHA Workforce Council Chair Phil Stuart, CEO, Tomah Memorial Hospital, praised the MEB and the WHA staff for identifying an opportunity to have more physicians available to practice in Wisconsin.

"Workforce issues are now and I believe will continue to be a top priority for Wisconsin hospitals in the years ahead. Access to excellent health care hinges on having an adequate number of physicians. Simplifying the licensure process enables physicians to work across state borders. That is a move in the right direction," according to Stuart.

In other actions, the MEB learned that paper licenses will not be issued to individuals who renew their credentials electronically after July 1, 2009. Electronic documents will be available to those who need such, but the Department of Regulation and Licensing encourages use of the online ‘license look up’ feature to determine if an individual has a current license to practice.

In future meetings, the Board will consider several important issues: orders from out-of-state physicians for laboratory work, waivers to the limit on the number of physician assistants that can be supervised, and residency requirements for licensure.

Wisconsin’s Department of Health Services (DHS) will be holding five Health Information Exchange (HIE) Regional Summit Meetings in early July. The Summit meetings will be held in Appleton, Sauk City, Superior, Milwaukee and Marshfield, and they will be open to hospitals, physicians, payers, consumers and other stakeholders that would like to learn about and share their views about Wisconsin’s HIE initiative. Wisconsin’s HIE initiative is designed to assess, propose, plan and design a model and architecture for a state-level HIE governance entity and state-level business and technical services in Wisconsin.

Less than two months into the 2009 Campaign, the Wisconsin hospitals state political action funds fundraising campaign has topped $85,000. This puts the 2009 campaign at 40 percent of its $213,000 monetary goal.

Another goal of the 2009 campaign is to increase the number of individual contributors by 10 percent to approximately 660 individuals. To date 138 individuals have participated. Those 138 participants have contributed an average of $615.

As in previous years, individual contributors will be listed in The Valued Voice by name and affiliated organization on a regular basis. 2009 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 - $249

Arendt, Kathleen         Aspirus Wausau Hospital

Banaszynski, Gregory         Aurora Health Care

Beckler, Rick         Sacred Heart Hospital

Bernklau, Robert         Memorial Health Center

Bliven, David         Aspirus Wausau Hospital

Boson, Ann         Saint Joseph’s Hospital

Bowe, Cynthia         Sacred Heart Hospital

Brisch, Joe         Holy Family Memorial Medical Center

Burgener, Jean         Aspirus Wausau Hospital

Casey, Karen         Columbia Center

Censky, Bill         Holy Family Memorial Medical Center

Clapp, Nicole         Grant Regional Health Center

Collins, Sherry         Wisconsin Hospital Association

Culotta, Jennifer         St. Clare Hospital and Health Services

Davis, Kathleen         Children’s Hospital of Wisconsin

Dietsch, Teresa         St. Clare Hospital and Health Services

Grohskopf, Kevin         St. Clare Hospital and Health Services

Hinton, George         Aurora Sinai Medical Center

Hinz, Russ         Aurora Health Care

Hoege, Beverly         Reedsburg Area Medical Center

Jelle, Laura         St. Clare Hospital and Health Services

Jones, Tom         St. Joseph’s Community Health Services

Karow, Deborah         Aspirus Wausau Hospital

Kempen, Jacob         Aspirus Wausau Hospital

Krueger, Pamela         Aspirus Wausau Hospital

Logemann, Tim         Aspirus Wausau Hospital

McCoic, Kristie         St. Joseph’s Community Health Services

Miloszewicz, Angela         Wisconsin Hospital Association

Morauske, Michelle         WHA Financial Solutions, Inc.

Mourey, Gerald         Aspirus Wausau Hospital

Mulder, Doris         Beloit Memorial Hospital

Powell, Stacey         Sacred Heart Hospital

Prunty, Brian         Aspirus Wausau Hospital

Rasmussen, Sheri         WHA Financial Solutions, Inc.

Rocole, Theresa         Wheaton Franciscan Healthcare - All Saints

Roundy, Ann         Columbus Community Hospital

Schweitzer, Susan         Columbus Community Hospital

Selberg, Heidi         St. Mary’s Hospital Medical Center

Stanford, Matthew         Wisconsin Hospital Association

Swanson, Kerry         SSM Health Care-Wisconsin

Tryba, Jennifer         Aspirus Wausau Hospital

Walker, Troy         St. Clare Hospital and Health Services

Abitz, John         WHA Financial Solutions, Inc.

Allison Stonebraker, Pat         Children’s Hospital of Wisconsin

Ayers, Mandy         Wisconsin Hospital Association

Biros, Marilyn         SSM Health Care-Wisconsin

Clough, Sheila         Howard Young Medical Center

Conwell, Lisa         WHA Financial Solutions, Inc.

Deich, Faye         Sacred Heart Hospital

Dietrich, Dean         Aspirus Wausau Hospital

Geiss, Peter         ProHealth Care

Grundstrom, David         Flambeau Hospital

Gutsch, Mike         Southwest Health Center

Hattem, Marita         Aspirus Wausau Hospital

Johnson, Charles         St. Mary’s Hospital

Levin, Jeremy         Rural Wisconsin Health Cooperative

May, Carol         Sauk Prairie Memorial Hospital

Merline, Karen

Nelson, James         Fort HealthCare

Olkowski, Leland         Aspirus Wausau Hospital

Pinekenstein, Barbara         Oconomowoc Memorial Hospital

Ross, Forrest         WHA Financial Solutions, Inc.

Stout, Johni         WHA Financial Solutions, Inc.

Stuart, Phil         Tomah Memorial Hospital

Van Meeteren, Bob         Reedsburg Area Medical Center

Worrick, Gerald         Door County Memorial Hospital

Yunk, Dennis         Agnesian HealthCare

Andersen, Travis         St. Elizabeth Hospital

Anderson, Sandy         St. Clare Hospital and Health Services

Borgerding, Dana

Braddock, Michelle         WHA Financial Solutions, Inc.

Buerstatte, Gary         ProHealth Care

Bukowski, Cathy         Our Lady of Victory Hospital

Callies, Julie         WHA Information Center

Canter, Richard         Wheaton Franciscan Healthcare

Desien, Nicholas         Ministry Health Care

Eddy, Lee Anne         Children’s Hospital of Wisconsin

Frank, Jennifer         Wisconsin Hospital Association

Gutzeit, Michael         Children’s Hospital of Wisconsin

Harding, Ed         Columbus Community Hospital

Heifetz, Michael         SSM Health Care-Wisconsin

Huber, Mark         Aurora Health Care

Klawiter, Anne         Southwest Health Center

Korom, Nancy         Children’s Hospital of Wisconsin

Merline, Paul         Wisconsin Hospital Association

Miller, Jim         Children’s Hospital and Health System

Mlynarek, Robert         Waukesha Memorial Hospital

Potter, Brian         Wisconsin Hospital Association

Radoszewski, Pat        Children’s Hospital of Wisconsin

Schafer, Michael         Spooner Health System

Shabino, Charles, M.D.         Wisconsin Hospital Association

Ship, Mark         Children’s Hospital of Wisconsin

Wallace, Michael         Fort HealthCare

Woodward, Jim         Meriter Hospital

Bazan, Bill         Wisconsin Hospital Association

Birkenstock, Timothy         Children’s Hospital of Wisconsin

Bloch, Jodi         Wisconsin Hospital Association

Boese, Jennifer         Wisconsin Hospital Association

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

Christensen, Cinthia         Children’s Hospital of Wisconsin

Duncan, Larry         Children’s Hospital of Wisconsin

Dunigan, Thomas         Children’s Hospital of Wisconsin

Eichman, Cindy         Our Lady of Victory Hospital

Erwin, Duane         Aspirus Wausau Hospital

Gazzana, Thomas         Children’s Hospital of Wisconsin

Grasmick, Mary Kay         Wisconsin Hospital Association

Kachelski, Joe         WHA Information Center

Karuschak, Michael         Amery Regional Medical Center

Leitch, Laura         Wisconsin Hospital Association

Loftus, Philip         Aurora Health Care

Mettner, Michelle         Children’s Hospital of Wisconsin

Morgan, Dwight         Aurora Health Care

Munson, Kenneth         Children’s Hospital of Wisconsin

Niemer, Margaret         Children’s Hospital of Wisconsin

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

Olson, David         Bay Area Medical Center

Olson, Ed         Waukesha Memorial Hospital

Reynolds, Sheila         Children’s Hospital of Wisconsin

Richardson, Dana         Wisconsin Hospital Association

Robertstad, John         Oconomowoc Memorial Hospital

Roller, Rachel         Aurora Health Care

Stanford, Matthew         Wisconsin Hospital Association

Titus, Rexford         ProHealth Care

Troy, Peggy         Children’s Hospital and Health System

Turkal, Nick, M.D.         Aurora Health Care

Warmuth, Judith         Wisconsin Hospital Association

Welch, Kimberly         Aurora Health Care

Contributions Ranging from $2000 - $2999

Braddock, Jonathan         WHA Financial Solutions, Inc.

Brenton, Mary E.

Buser, Kenneth         Wheaton Franciscan Healthcare - All Saints

Katen-Bahensky, Donna

Quinn, George         Wisconsin Hospital Association

Starmann-Harrison, Mary         SSM Health Care-Wisconsin

Tyre, Scott         Capitol Navigators, Inc

Contributions $3000 and up

Borgerding, Eric         Wisconsin Hospital Association

Brenton, Stephen       Wisconsin Hospital Association

Size, Tim Rural         Wisconsin Health Cooperative

A unique collaborative of major Wisconsin health organizations has been awarded a $300,000 three-year Impact Award to address the state’s health care labor shortages and related data analysis needs, Wisconsin Department of Workforce Development (DWD) Secretary Roberta Gassman announced today.

The grant to DWD, the Wisconsin Department of Health Services (DHS) and two other health organizations is being provided by the Medical College of Wisconsin’s Healthier Partnership Program. The collaboration was spearheaded by DWD’s Select Committee on Health Care Workforce, which is comprised of more than 30 top regional and statewide educational, labor, employer and government organizations committed to growing Wisconsin’s skilled health care labor force.

The Wisconsin Hospital Association is a member of the collaborative, represented by Judy Warmuth. Warmuth has been a member of the Select Committee since its inception.

"As long as I have been in health care, there have been workforce shortages. Each shortage creates a call for increased educational capacity, but without data, these efforts are difficult to sustain. It is imperative in today’s very difficult economic environment that scarce dollars are wisely spent to ensure we are building the workforce needed for Wisconsin’s future," said Warmuth.

Effective health care workforce planning and policy development requires ongoing collection and analysis of labor force supply, demand and distribution data. State health care training programs work to determine numbers of prospective students to admit based on future workforce projections. Health care employers and students seek workforce data and labor market projections for business and career planning purposes.

The grant will provide:

• $108,000 to the Wisconsin Department of Workforce Development to expand data collection and analysis of Wisconsin’s registered nursing workforce and improve the Department’s forecasting tool for nursing shortage projections;
• $106,000 to the Wisconsin Department of Health Services to analyze the state’s public health workforce and ensure continued access to Wisconsin health care providers;
• $46,000 to the Wisconsin Center for Nursing to assist in expanded data collection and analysis of the state’s nursing workforce; and
• $40,000 to the Department of Population Health at the Medical College of Wisconsin to advise on the assessment of the current and projected public health workforce in Wisconsin.

The grant will be administered by the Wisconsin Medical Society in coordination with the Select Committee.

Leaders of the following organizations are included on the Select Committee’s health care workforce collaborative: Wisconsin Center for Nursing; UW-System; Wisconsin Department of Workforce Development; Wisconsin Nurses Association; Wisconsin Department of Health Services; Center on Wisconsin Strategies; Wisconsin Office of Rural Health and Center for Urban Population Health, School of Medicine and Public Health, UW-Madison; School of Pharmacy, UW-Madison; Wisconsin Primary Healthcare Association; Wisconsin Technical College System; UW-Milwaukee; Medical College of Wisconsin; Wisconsin Health Care Association; Wisconsin Medical Society; Rural Wisconsin Health Cooperative; Wisconsin Association of Homes & Services for the Aging; Workforce Development Board of South Central Wisconsin; Wisconsin Area Health Education Centers; Wisconsin Public Health Association; Wisconsin Hospital Association; and the Wisconsin Association of Independent Colleges & Universities.

This project is funded in part by the Healthier Wisconsin Partnership Program, a component of the Advancing a Healthier Wisconsin endowment at the Medical College of Wisconsin.

Bellin Health Family Medical Center-Wrightstown is offering a free health screening designed to ensure hunters are up to the demands of hiking through the woods in pursuit of wild game.

The free hunter’s health screenings include total cholesterol and glucose tests, a blood pressure check, body mass index, vision and hearing tests and risk factor evaluation by Dr. Brad Wozney.

Each year, more than 600,000 men and women take to the woods, fields and marshes during the fall hunting seasons. Of that number, many experience health issues while hunting that prove fatal.

Researchers in Royal Oaks, Mich., conducted a study on middle-aged, male hunters and reported their findings in the August 2007 edition of the American Journal of Cardiology.

In the study of 25 deer hunters, the research team found many of the activities related to hunting, such as walking through rough terrain, spotting and shooting an animal and dragging its body, sent the men’s hearts—monitored by portable heart rate equipment—to peak heart rates. In some instances, this led to potentially dangerous heart-rhythm disturbances.

"Findings like this are why we strongly encourage hunters to take advantage of our free screening," Wozney said. "It costs nothing and can help save hunters from potential life-threatening situations."

In these uncertain economic times, one thing’s for certain. The health services industry will continue to expand because of technological advances in medicine, a growing and aging population and the impending retirement of baby boomers. The demand for well-educated and well-trained health services professionals—in hospitals, home health care or in health practitioners’ offices—is projected to grow faster than many other occupations.

Two health care professionals from Southwest Health Center recently had the opportunity to share that positive outlook with participants from Wisconsin and Iowa high schools. Julie Tashner, a physical therapist and Debra Kieler, a laboratory technologist, both from Southwest Health Center, participated in a Medical Explorer’s Camp sponsored by and held at the University of Wisconsin-Platteville on November 8. Julie and Debra presented to groups of high school students who are interested in a health services career.

Choosing from eight different professions, the sessions gave insight into specific careers’ education requirements, skill sets, and compensation.