The WHA Board has authorized the creation of a WHA Task Force on Access and Coverage. The action occurred at the June 15 Board meeting following discussion and consensus that the time is right to fine-tune the Association’s current position on the important public policy challenge.

"The continuing public policy focus on health care access, coverage and costs suggests that a number of increasingly specific initiatives will be the focal point of debate and discussion during the fall election cycle and into 2007 with the convening of the new Wisconsin Legislature," said WHA President Steve Brenton. "WHA’s strategic plan identifies the importance for the Association to constantly seek to improve coverage and access, and this new task force will do just that."

Board discussion centered on the fact that over the past several years, WHA has advanced the coverage and access agenda by supporting a variety of incremental Medicaid program improvements and by supporting the Healthier Choices agenda developed in partnership with Wisconsin Manufacturers & Commerce and the Wisconsin Association of Health Plans. The new task force will discuss the appropriateness and adequacy of this current advocacy agenda, and assess and inventory proposed state and national initiatives consistent with WHA’s strategic plan.

Leo Brideau, president/CEO, Columbia St. Mary’s, Inc., Milwaukee, will chair the new WHA Task Force. "I’m excited about this opportunity to focus on an issue that aligns so closely with the missions of our organizations," Brideau said. "This task force permits us to work on an issue whose solution is long overdue. WHA is showing great courage and leadership in tackling an issue that has been too long neglected by our elected leaders."

Membership on the Task Force on Access and Coverage will represent the diversity of WHA’s membership. The inaugural meeting of the Task Force is expected in August, with a report and recommendations likely to be presented to the WHA Board in December.

Nominations are now being accepted for WHA’s annual Distinguished Service Award and Trustee Award, as well as for the ACHE Young Healthcare Executive Award. These important awards recognize those who display leadership, dedication and professionalism to their community or the Association.

WHA will recognize the award winners at the 2006 Annual Convention in September. You may know someone in your region, in your hospital or on your Board of Directors who deserves such an honor. You now have an opportunity to nominate them for one of these annual awards:

Distinguished Service Award is presented to a senior health care executive who has made an exemplary commitment to WHA, his/her hospital, and the communities he/she serves.

Trustee Award honors a trustee of a WHA member organization who has made an exemplary commitment to his/her community and to the organization on whose board he/she serves.

ACHE Young Healthcare Executive Award is presented to a member of the American College of Healthcare Executives under the age of 40 who has shown exceptional professional development. Nominations for this award should be sent to Greg Banaszynski, president, Wisconsin Chapter of ACHE, Synergy Health, 551 South Silverbrook Drive, West Bend, WI 53095.

Administrators, trustees, senior managers, nurse leaders, volunteers and others are encouraged to review the criteria for the awards and consider nominating someone to receive one of these honors.

The deadline for submitting nominations is July 21. Details about the nomination process and criteria for nomination can be found in the annual awards brochure included in this week’s packet and on the WHA Web site at www.wha.org/about. For more information, contact Roberta Riddle or Steve Brenton at WHA, 608-274-1820.

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In the last two weeks, individuals have contributed in total nearly $25,000 to the 2006 fundraising campaign. Currently, more than 400 individuals have raised over $97,000 to date. This accounts for almost 53 percent of the fundraising campaign’s 2006 monetary goal to raise at least $185,000.

This year--2006--marks an election year in Wisconsin. It is a big election as the Governor’s seat is up for grabs, along with all 99 Assembly seats, 17 State Senate seats, all members of the Wisconsin’s Congressional delegation in the U.S. House of Representatives and one U.S. Senate seat.

An updated list of individual contributor’s names will be published in the July 14 edition of Valued Voice.

WHA Chair Mary Starmann-Harrison has asked the WHA Board to consider supporting a voluntary, statewide policy that calls on Wisconsin hospitals to prohibit smoking anywhere on a hospital’s campus. Discussion on the topic at WHA’s June board meeting centered on the potential for the initiative to serve as a catalyst for demonstrating leadership on what is arguably the most significant and manageable lifestyle-related public health issue.

WHA staff are currently researching local, regional and statewide initiatives already in place in other parts of the country. Staff will be seeking member feedback as to the pros and cons associated with such an initiative. We anticipate that a report on staff findings will be presented to the Board in October.

WHA’s recent member survey (more results to follow) found that close to one in five senior executives believe that physician workforce issues are their current most challenging issue. That finding is a big increase over survey results from our 2003 member survey and provides a strong signal that WHA needs to ramp up efforts to develop programming and help create an environment that will maximize the ability of hospitals, health systems and clinics to attract and retain tomorrow’s physician workforce.

WHA is a founding member of the Wisconsin Council on Medical Education and Workforce…a group that is the byproduct of a WHA task force that just three years ago predicted the now almost certain physician workforce shortages. Look for more information in a future Valued Voice guest column that will outline current and future program priorities of this multi-stakeholder council.

Over the past several years, WHA Board-created task forces have been the catalyst for the implementation and evolution of key WHA program priorities. CheckPoint, PricePoint, hospital community benefits reporting, WHA’s current Medicaid payment agenda, and the Wisconsin Council on Medical Education and Workforce have all been initiatives that resulted from board-level task force recommendations. That’s why the WHA Board’s appointment of a new Task Force on Access and Coverage is such an important and timely development that has the potential for evolving the Association’s current thinking and identifying program priorities on this sentinel public policy challenge.

Check out the recent Health Affairs lead article http://content.healthaffairs.org/cgi/reprint/hlthaff.25.w287v1 about the impact of non-profit hospitals on their communities. The gist of the story is that hospital community benefits should not be solely measured by indigent care services. In fact, the authors suggest that such a public policy approach is "misguided" in that it ignores a variety of other important programs and activities, some of which are difficult to measure in dollar terms.

Steve Brenton, President

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Harvard Business School Professor Michael E. Porter, Ph.D., co-author of the recently released book "Redefining Health Care: Creating Value-Based Competition on Results," is coming to Wisconsin in an effort to change the way health care is purchased. Sponsored by Fox-Valley-based ThedaCare and supported by some of the state’s largest employers, Porter will make appearances on July 12 in Appleton and Milwaukee. During these half-day seminars, he will challenge businesses to purchase health care only from providers that deliver the best outcomes at the lowest cost. According to Porter, this "value-based competition" will stem the tide of double-digit increases in costs.

"The current system is broken," said John Toussaint, MD, president and CEO of ThedaCare. "Many of the ‘solutions’ on the table treat the symptoms instead of the underlying reasons for skyrocketing costs and inconsistent quality. Porter will outline specific strategies for Wisconsin employers and providers to use to create value-based competition based on results."

Porter will speak at two half-day seminars:

• 9 a.m. to noon in Appleton at the Fox Cities Performing Arts Center, 400 W. College Ave.

• 2-5 p.m. in Milwaukee at the Italian Community Center, 631 E. Chicago St.

These will be his only Wisconsin appearances this year. Each seminar is $75 per person and is open to the public. Every attendee will receive a complimentary copy of "Redefining Health Care." For more information and to register, visit www.thedacare.org/porter.

In the book, Porter and his co-author, Elizabeth Olmstead Teisberg, argue that competition in health care takes place at the wrong levels, at the wrong times and focuses on the wrong things. Instead of working to create value for patients, Porter and Teisberg say players in the health care system, including employers, purchasers and providers, strive to capture more revenue, shift costs and restrict services.

The authors use ThedaCare as a local example of how innovative providers can help create competition based on value. They also outline how other Wisconsin initiatives can help create a new health care system that provides the best care at the lowest cost.

The seminars will include information on:

In Appleton, other speakers will include Eric Christianson, MD, of United Healthcare of Wisconsin; John Torinus of Serigraph, Inc.; Eric Stanchfield of the Wisconsin Department of Employee Trust Funds; and Patty Leiker of Miller Electric.

In Milwaukee, speakers will be Stuart Campbell of Anthem Blue Cross Blue Shield; Christopher Queram of the Wisconsin Collaborative for Healthcare Quality; Michael Brady from the City of Milwaukee; Constance Roethel of Roethel & Associates; and Dianne Kiehl of the Business Health Care Group of South East Wisconsin.

Major sponsors of the event are: Appleton, Boldt Construction, The Greater Milwaukee Business Group on Health, Simpler, and United Healthcare of Wisconsin.

Other sponsors are: Bemis Corporation, Anthem Blue Cross Blue Shield, HRH/Hilb Rogal & Hobbs Co., Humana, Kimberly Clark, Thrivent Financial, and UW Oshkosh College of Business.

Porter heads the Institute for Strategy and Competitiveness (ISC), a joint creation of Harvard University and Harvard Business School to further his extensive research. Among his other duties, he teaches a unique University-wide course on competitiveness and economic development that is also taught at 56 other universities around the world, using materials, video content and faculty training provided by Porter and his ISC colleagues. For more information about Professor Porter’s work, visit the Institute’s Web site at www.isc.hbs.edu.

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St. Joseph’s Community Health Services tried everything it could to keep the nursing home at its current 65-bed capacity; however, dismal government reimbursement rates are forcing St. Joseph’s into a fiscal corner. St. Joseph’s announced that in the near future it will reduce bed capacity from 65 to 21. The good news is that the hospital plans to counter the bed reduction with expanded services for seniors in the community. Expanded services are expected to be available within the next three to six months.

Throughout this difficult process, St. Joseph’s worked to engage the community and local elected officials about the impending changes. Their efforts are a great example of positive grassroots in the midst of a difficult situation.

One of the major ways St. Joseph’s engaged legislators and the community was by hosting a community forum. Community members were alerted to the forum and area legislators invited to participate. Both State Senator Dan Kapanke (R-La Crosse) and State Rep. Lee Nerison (R-Westby) joined CEO Bill Bruce to discuss the situation and answer questions from community members.

CEO Bill Bruce noted that St. Joseph’s could not continue to support the large community benefit of a nursing home in the coming year unless more donations come in to support operational shortfalls, which total nearly $1 million in the past two years. The large operating loss is a direct result of inadequate funding of nursing home care from the state’s Medicaid program.

As St. Joseph’s Community Health Services looks to the future, some of the new services approved by its Board of Directors include the following:

• A senior living center on the second floor of St. Joseph’s.

• Licensed home health care covered by Medicaid and Medicare as well as private insurance for care in a home-based setting.

• The implementation of the St. Joseph’s Senior Life Center which offers daily and overnight services for adults who live with a relative but cannot be at home alone for extended periods.

In 2006, Medicaid outpatient reimbursement rates to hospitals fell to just 49 cents on the dollar, equaling a hidden health care tax of $546 million in 2006 alone. The Wisconsin Hospital Association continues to advocate to policymakers that adequate reimbursement rates for Medicaid—especially to hospitals like St. Joseph’s which own nursing homes—are critical to the strong functioning of Wisconsin’s health care delivery system.

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Byron Crouse, MD, Associate Dean for Rural and Community Programs, UW School of Medicine and Public Health, is optimistic that at the next Wisconsin Rural Health Conference he will be able to report on the first five students admitted into the Wisconsin Academy for Rural Medicine (WARM). So far, Crouse reports, the plan to increase the size of the medical school by 25 students per year through WARM is moving forward. The goal is to attract and admit initially five medical students who have a strong affinity for practicing medicine in a rural area. Rural hospitals would eventually be asked to offer practice sites for these physicians.

In his remarks at the Rural Hospital/CAH Coalition meeting on June 24 at the Rural Health Conference, Crouse pointed out that while 33 percent of Wisconsin citizens live in rural areas, only 11 percent of physicians have rural practices. WARM is dedicated to improving the supply of physicians in rural Wisconsin and raising the health status of rural Wisconsin communities.

Rural Wisconsin Health Cooperative Executive Director Tim Size told the group that the Rural Health Development Council has chosen six local community projects located in Jackson, Langlade, Manitowoc, Sauk, Sawyer and Waupaca counties. The six projects use a variety of approaches that are intended to reduce the incidence of lifestyle-related chronic diseases. Size said the RHDC has successfully brought together six local community projects, two medical schools, and a statewide policy council with the potential to improve the health of 1.7 million rural Wisconsin residents.

Also at the Coalition meeting, the staff of the Wisconsin Office of Rural Health presented an overview of the services they provide, including the employment Web site, the Rural Hospital Flex program initiatives, and the physician and dentist placement services offered through their office.

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Longtime dental health access advocate Ray Myers, assistant administrator, St. Joseph’s Hospital, Chippewa Falls, received a "Hero" award at the 2006 Rural Health Conference on June 22 at the Abbey Resort in Fontana. In presenting the award, WHA President Steve Brenton said Myers has demonstrated exceptional commitment to his community’s health in a highly collaborative fashion.

Presented by WHA, the Rural Wisconsin Health Cooperative and Marshfield Clinic, the award recognized Myers and St. Joseph’s Hospital for their support in addressing the growing oral health disparities between those with financial resources and those without. Myers has worked tirelessly on the statewide oral health coalition, helping raise awareness and supporting policy options that address the crisis in dental health access in Wisconsin.

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According to a 2005 report by the National Highway Traffic Safety Administration, motor vehicle crashes are the leading cause of death for 15-20 year olds primarily because of "driver inattention."

Froedtert & the Medical College of Wisconsin, home to the only adult Level I Trauma Center in eastern Wisconsin, launched a new Just Drive! campaign to help eliminate distracted driving by educating both teens and parents about the importance of safe driving.

"Driving, like any other privilege, comes with certain responsibilities and driving dangerously can be met with serious consequences," said John Weigelt, MD, DVM, Chief of Trauma and Critical Care Medicine at Froedtert & the Medical College. "We hope by educating young drivers and their parents on safe driving habits, we can make a difference in decreasing the number of car-related injuries and deaths in Wisconsin."

Working with Froedtert, Milwaukee Mayor Tom Barrett declared the last week in March "Just Drive! Week" in the greater Milwaukee area. Throughout the week Froedtert & the Medical College representatives met with teens and parents at school assemblies and driving instruction classes to educate them on the importance of safe driving.

A key component of the educational campaign includes asking teens and their parents to sign the Just Drive! Contract to hold them accountable for their driving behavior. It serves as a reminder of what it means to drive safely and asks for a commitment from teens and parents to take that responsibility seriously.

Teens’ attention strays from the steering wheel by a variety of things including cell phones, friends, food, music and make-up. In Wisconsin, one teen driver is injured or killed in a car crash every 52 minutes, according to the Wisconsin Department of Transportation.

Parents have a significant impact on their teens’ driving habits. In fact, a recent online survey conducted by Froedtert & the Medical College revealed that parents are the biggest influence on teen drivers and that most parents are exhibiting the same distracted behaviors as teens such as talking on the phone, singing their hearts out to music, eating, speeding and following other vehicles too closely.

The campaign is continuing with ongoing presentations at schools throughout the area. In addition, Froedtert’s float in the Wauwatosa Fourth of July Parade will present the Just Drive! concept to even more drivers.

As the population continues to age, one of the greatest benefits that a hospital can offer to the community it serves is the ways and means to allow the elderly to live as full and productive lives as possible for as long as possible. Froedtert Hospital’s Senior Health Program is one such example.

During a period of tough economic times in health care when other programs contracted or disappeared, the Froedtert and Medical College of Wisconsin Senior Health Program has continued to flourish. Froedtert and its auxiliary and other stakeholders have maintained the commitment to care for vulnerable elders and ensure that competent physicians and other providers develop skills in providing care to this important and growing group of patients.

Founded in 1988, Froedtert’s Senior Health Program has served more than 2,000 new patients and their families in just last five years alone. It has preserved or, at least, slowed decline of physical function, reduced disability, improved social function in the community, decreased time spent in hospitals and nursing homes, and increased access to social support services as well as increased patient and family satisfaction for hundreds of elderly patients.

Not all seniors require the care of geriatrician. But those who do--vulnerable elders--are struggling to function. "They probably have deficits and are in jeopardy of losing more function to the point that they may require institutional care. They may also have quality of life issues that may not need institutional-ization, but are not always addressed in the traditional clinical approaches," Edmund Duthie, M.D., chief of Geriatrics and Gerontology, said. The main conditions include incontinence; mobility and falls; problems with medications; cognitive abilities and dementia; mental and emotional health; and lack of reserve.

The Senior Health Program approach to serving vulnerable elders doesn’t focus on a specific organ or disease. A thorough assessment of a patient’s needs is the first order of business. The goal of the evaluation is to help patients, their families, and caregivers, better understand health problems and care options and to help patients live as independently as possible. Based on the evaluation, recommendations for treatment, support services and ongoing care are made.

As a result of the evaluation, the patient may be referred to one of the clinics or services within the Senior Health Program. Some patients may require Professional Geriatric Care Management services. Care managers are certified and compassionate professionals with advanced degrees in nursing and social work that assist older adults by obtaining and supervising in-home services; offering guidance with decisions and supportive counseling, relocation information and assistance, ongoing communication with family members, no matter where they live, coordination of health care, telephone reassurance and 24-hour emergency assistance, and referrals to appropriate community providers.

In addition to the direct care the Senior Health Program provides is the ongoing education and preparation of future health care providers. Since 1988 thousands of fellows in geriatric medicine, internal medicine and psychiatry residents, medical students, advance practice nursing students and social work graduate students have rotated through the Senior Health Program.

The federally-qualified health center has two clinics – the Lisbon Health Center and Hillside Family Health Center. Westside provides primary care and dental services to an area of about 70,000 residents in Milwaukee’s central city. Froedtert and the Medical College are Westside partners, providing contracted physician services, health education and marketing support.

Among the services provided by Froedtert and the Medical College are: customer service training for staff; customized co-branded marketing materials; project management expertise and leveraged architectural consulting for clinic expansion; relevant health care research in the form of focus groups and community leader interviews; as well as assisting with its outreach activities including pastors’ breakfasts, establishing a community advisory group and staffing community health education events. Additionally, Froedtert created a full-time school nurse position for Milwaukee Public Schools’ Westside Academies to provide a tighter linkage to students’ families and a primary care home with Westside Healthcare Association.

The clinic serves approximately 6,400 patients; most live at or below the federal poverty level. The vast majority are African-American, while 7 percent are white; 4 percent Asian/Pacific Islander (primarily Hmong); 4 percent Hispanic, and about 1 percent are American Indian. Most rely on public assistance programs such as Medicaid and GAMP.

The organization wrestles with how best to serve its patients. Many have untreated mental health issues. They may not have transportation. They’re afraid of the healthcare system. They have all kinds of struggles and live life in chaos. Even navigating the public assistance requirements can be daunting for this population.

To increase its effectiveness Westside Healthcare strives to address patients’ mental health issues when possible, respect them and listen to their concerns, work within their cultural traditions and offer incentives to increase their well-being. As an example, the clinic has decreased its scheduled appointments and opted for a more open scheduling plan that allows patients to "drop in" for care at their convenience.