June 6, 2003
Volume 47, Issue 23
WHA Ranks High In Member Survey
In March and April, WHA members were independently surveyed by SatisfactionWorks, a California-based firm that conducts state hospital association surveys across the nation. The group had conducted a similar survey for WHA in 1996. As in 1996, SatisfactionWorks compared WHA results with those from 30 other hospital associations nationwide. The results: judged by its own membership, WHA significantly improved from its 1996 scores and today ranks among the top rated hospital associations in the country in virtually every measured category.
WHA members rank the Association high in the measured areas of: Understanding the Needs of Members, Responsiveness to Member Issues and Priorities, and Effectiveness in Assisting Members with those Issues and Priorities. Importantly, 96% of survey respondents indicated that WHA is delivering the members’ most expected benefit…advocacy…either well or extremely well. And 96% of responding members indicated that WHA’s overall performance is either excellent or good.
"I am particularly pleased that members feel good about the value they are receiving from their personal and economic commitment to our Association," said WHA Chair Jerry Worrick. "In fact, our members’ perception of Association value has skyrocketed since 1996 when only 57% of members indicated that WHA was an excellent or good value. We’re now above 90% and a top five association nationally."
And what services do members find of value? Practically all of them, according to the survey. From the timely and informative articles of Valued Voice, WHA’s weekly newsletter, to the varied and valuable WHA educational programs, and the evolving WHA Web site (www.wha.org), WHA members say they are getting their money’s worth.
"The combination of an outstanding staff as well as a committed and engaged membership are influencing member perceptions in a positive way," said WHA President Steve Brenton. "I’m particularly pleased that 99% of respondents rated the quality of WHA’s professional staff highly and that 96% of respondents believe that WHA is on the right track in working to influence the direction of health care delivery and policy in Wisconsin."
Both Worrick and Brenton noted that member survey results will be utilized to restructure the Association’s strategic plan this summer when board members, regional chairs and senior staff meet during the July planning session.
State Budget Clears Joint Finance
Earlier this week, the Joint Finance Committee (JFC) approved an amended state budget and sent it on to the Senate. Hospitals emerged in better shape than under the Governor’s original budget proposal (see May 30 Valued Voice), and got some additional good news.
Wisconsin Technical College System (WTCS) Funding: JFC restored a $14.8 million cut to two crucial WTCS workforce programs and provided WTCS some flexibility in complying with a three-year statewide property tax freeze. JFC fully funded the Governor’s proposed $9.8 million Health Care Training Grant Program, which is designed to expand course capacity and access to health care education. The committee also provided $6.5 million for the Incentive Grants Program which awards grants to districts for the expansion of basic skills programs and development of new and emerging occupation programs.
JFC also froze, with limited exceptions, property tax levies for municipalities, school districts and technical college districts, but allowed for up to a 2.6% annual increase in the technical college district levies. Districts could also exceed levy limits if approved by voters in a local referendum.
"While most would agree that property taxes in Wisconsin are too high, a one size fits all levy freeze, coupled with funding cuts, would have been a devastating double whammy for the technical colleges," said Eric Borgerding, WHA senior vice president. "We are pleased the joint efforts of WHA and WTCS paid off, and legislators realized the long-term devastating impacts of those proposals."
Patients Compensation Fund (PCF): JFC rejected the Governor’s proposal to use $200 million from the PCF to help fund Medical Assistance. Because this could have resulted in a $500 million hole in the MA budget ($200 million PCF + $300 million federal matching dollars), WHA’s consistent message was that a suitable alternative must be found. The committee agreed and replaced the
$200 million from the PCF with general purpose revenue (GPR). This move achieved three goals: assuring $300 million of federal matching dollars, utilizing an ongoing funding source (GPR) rather than "one-time" funding (PCF), and avoiding potential shortfalls in PCF reserves.
"The committee’s decision is, at least in the short-term, good news for all Medicaid providers since it reduces MA’s reliance on one-time funding," said Borgerding. "The one-time PCF money would not have been available in the next biennium, and the MA budget could have been $500 million short right out of the gate."
As the budget moves forward, one question that remains is the amount of federal dollars Wisconsin will receive to support the MA program. The budget approved by JFC anticipates about $210 million of federal revenues that have not yet been allocated to Wisconsin.
As previously reported in The Valued Voice, the Governor’s budget proposal relied on $434 million of new federal revenues. Two weeks ago, administration officials said they could secure this amount through a combination of sources: the federal Jobs and Growth Tax Relief Act, a federal waiver application to begin reforming long-term care, and related savings in the Medicaid budget (see
May 23 Valued Voice).With Wisconsin poised to receive $333 million under the Jobs and Growth Act, and with $70 million of MA savings having been identified, administration officials expressed confidence about receiving the approximately $30 million balance through the waiver. However, the committee committed only $151 million of the Jobs and Growth Act total to Medicaid, leaving about $210 million that must be secured through the waiver application. The remaining $182 million of Jobs and Growth Act revenue is being used to avoid the PCF transfer.
"No one is sure when the answer will come on the proposed waiver, but it’s likely to be within the next few months," said Jodi Jensen, WHA vice president of government affairs. "If this federal money doesn’t come through, the Governor and legislature could be forced to revisit the MA budget in its entirety and make some difficult and unpleasant decisions."
Whether the Senate or Assembly will make significant changes to the budget is uncertain, but WHA will continue its efforts to safeguard funding restored by JFC while fighting to restore additional dollars to GME.
"We have had a fair amount of success in this difficult budget--restoring full funding of the rural hospital adjustment, preserving targeted health care dollars for the technical colleges, securing IGT funding for the General Assistance Medical Program (GA-MP), and privatizing the Bureau of Health Information, are all very positive" said Borgerding. "Our number one priority right now is restoring more GME funding. While the Finance Committee fully restored $8 million for Direct Medical Education, we are still working with both houses to fund Indirect Medical Education as well."
The Senate expects to vote on the budget during the week of June 16, with Assembly action to follow shortly thereafter. Governor Doyle will then likely veto portions before signing it into law.
For more information about the state budget, contact Eric Borgerding or Jodi Jensen at 608-274-1820 or eborgerding@wha.org or
jjensen@wha.org.Health Care Loses a Shining Star
The health care community this week was deeply saddened by the news that one of its bright stars, Ann J. Haney, passed away after a long and courageous fight with breast cancer.
It is almost impossible to be involved in health care or Wisconsin politics and not have been touched in some way by Ann Haney. She traveled in many circles, moving easily from educator, to public servant, to Congressional candidate, to managed care executive, with dozens of other boards, commissions and task forces in between. She made life-long friends and admirers at every stop.
But Ann saved her best for last, serving as founder and president of the Breast Cancer Recovery Foundation (www.bcrf.org)--a long-lasting symbol of a proud woman, who fought her illness with dignity and courage. Through her work and through her life, Ann inspires countless others stricken with, or affected by, life threatening illness and other difficult life challenges.
Ann, 54, is survived by her husband Jim, and sons Eric and Peter. She will be sorely missed.
Archbishop Dolan Visits St. Francis Hospital
Archbishop Timothy Dolan greeted Representative Josh Zepnick and Senator Tim Carpenter in the chapel at St. Francis Hospital in Milwaukee on May 9, during a blessing of the newly renovated Family Birth Center and Intensive Care Unit. The hospital units were upgraded to accommodate recent patient volume growth. St. Francis, part of Covenant Healthcare, is the only Catholic hospital on Milwaukee’s South Side.
No member of Wisconsin’s Congressional Delegation is a more significant "player" on Medicare issues than is Janesville Republican Paul Ryan. Congressman Ryan is in the Majority on the powerful Ways and Means Committee, is a favorite of Committee Chairman Bill Thomas (R-Calif.) and is incredibly well versed on Medicare payment issues. That’s why Ryan’s thoughts about reforming Medicare are so important and why his comments in a recent interview in the Janesville Gazette are so significant.
In an article published Friday, May 30, Ryan said he has three priorities for Medicare reform:
Ryan noted that he is particularly "concerned that we will do the first two (priorities) and neglect the third," and that it would be unwise to "throw a $400 billion drug benefit on top of Medicare," which would merely "accelerate insolvency."
Ryan’s priorities, including his judgment that all three goals must be included as part of a package, are certainly on target. But another challenge awaits. There is growing speculation in Washington that House Ways and Means Committee Chairman, Bill Thomas, will likely push for new hospital cuts as part of his Medicare reform/prescription drug initiative.
Specifically, Thomas seems poised to reduce already woefully inadequate market basket updates over the next 10 years while extending the irrational transfer policy (lower payments for short lengths of stay for certain DRGs) to additional DRGs. The American Hospital Association estimates that the combination of these new hospital cuts could amount to as much as a half billion dollars for Wisconsin hospitals over the next decade!
One of WHA’s responsibilities, of course, is to remind members of the Wisconsin Congressional Delegation that "fair reimbursement rates" mean no new cuts! Fair reimbursement means adequate and equitable payment.
WHA Public Reporting Program: Sign Up Now
With the deadline for signing up for the WHA public reporting program fast approaching, member hospitals are sending in their participation forms to ensure that they are included in the first statewide voluntary reporting effort in Wisconsin. If assistance is required to determine how you will submit the data or to complete the forms, contact Dana Richardson, WHA’s vice president of quality. In addition, staff are available to provide on-site presentations or attend meetings. For more information, contact Dana Richardson at drichardson@wha.org or George Quinn at gquinn@wha.org or 608-274-1820.
Hospital and Tech College Officials Speak Out on Funding Cuts
A coalition of educators, health care workers, and hospital officials held a news conference at All Saints-St. Luke’s Hospital in Racine on June 3 to urge state lawmakers to restore a $14.8 million cut to technical colleges made by the Legislature’s Joint Finance Committee and reject a property tax levy freeze for the Wisconsin Technical College System (WTCS). Later that day, lawmakers responded to concerns raised by WTCS, WHA and others when the Finance Committee reversed the cuts in the WTCS budget and provided flexibility in complying with the levy freeze. (See related article on page 1)
WTCS President Richard Carpenter said cuts to the technical college budget would be devastating to the system’s health care education programs. The technical college system trains two-thirds of all skilled health care workers in the state.
"We can’t train health care workers fast enough to meet demand," said Gateway Technical College President Samuel E. Borden. "These positions are waiting vacant, while individuals who are trying to improve their lives and contribute to the quality of others lives, are not being served," Borden added.
"The shortage of nurses and other health care workers has reached a critical stage," said Ed Malindzak, vice-president-human relations at All Saints Health Care in Racine, which hosted the news conference. "While All Saints Health Care has remained in the forefront of minimizing worker vacancies, the health care workers shortage must be addressed now. We do not see the problem solving itself. It’s vital that Gateway Technical College does not lose any ground on this issue," Malindzak added.
Eric Borgerding, WHA senior vice president, said, "Hospitals and WTCS working in partnership on this issue went a long way toward focusing attention on the important role technical colleges play in training future health care professionals. This battle has definitely raised the profile of health care workforce issues in the legislature and there’s beginning to be consensus that tackling this issue is key to the state’s health and economic well being. But, health care providers will have to keep the issue front and center just as All Saints did this week."
The Wisconsin Technical College System has 16 technical college districts throughout Wisconsin, which offer more than 300 programs awarding two-year associate degrees, one- and two-year technical diplomas and short-term technical diplomas. One out of every nine adults in Wisconsin receives education from the state’s 16 technical colleges.
Assembly Approves Conscience Clause Bill
This week, the State Assembly gave final approval to the Health Care Providers’ Conscience Clause Bill. Assembly Bill 67 provides employment protection to health care workers who refuse, for moral or religious reasons, to participate in activities related to abortion, assisted suicide, euthanasia, and certain types of research including stem cell research and cloning. It also limits the liability of health care workers and hospitals if the refusal results in harm. AB 67 now moves to the Senate for further consideration. For more information about this bill, contact Bill Bazan at 414-431-0105 or bbazan@mailbag.com or Jodi Jensen at 608-274-1820 or
jjensen@wha.org.STAC Sunset Provision is Eliminated in the Senate
WHA testified in support of Senate Bill 115 which lifted the sunset provision for the State Trauma Advisory Council (STAC). On June 4, the Senate unanimously passed the bill by voice vote. The full Assembly will be taking up this bill soon. The Governor is expected to sign it into law. WHA extends appreciation to Sen. Ron Brown (R–Eau Claire) and Rep. DuWayne Johnsrud (R–Eastman) for their sponsorship and efforts in supporting STAC and its work of creating a statewide regional trauma plan for Wisconsin.
In another note concerning STAC, WHA will soon have a draft of the administrative rules governing STAC posted on our Web site. The association will be asking for your comments and review. As part of the State Trauma Plan, each hospital in Wisconsin will be asked to declare themselves as either a level I, II, III or IV trauma center. Levels I and II must be verified by the American College of Surgeons. Levels III and IV will self-declare. WHA will be sending out information and the criteria for this self declaration process to all hospitals later in the summer. For more information, contact Bill Bazan 414-431-0105 or by email at bbazan@mailbag.com .
Legislators Turn Attention to Workforce Issues
With state budget deliberations reaching their final stages, legislative leaders in both houses turned their attention to economic development late this week. Mixed in with proposals to streamline regulation and cut taxes are plans to study the Wisconsin Technical Colleges System (WTCS) and address the need for increased educational opportunities.
Assembly Speaker John Gard (R-Peshtigo) appointed Representatives Suzanne Jeskewitz (R-Menomonee Falls) and Gary Bies (R-Sister Bay) co-chairs of a task force charged with examining WTCS and making recommendations for improvements. Task force members will include legislators; WTCS officials; and representatives of local governments, taxpayer organizations, and Wisconsin businesses. Beginning this summer, the task force will study the overall efficiency of the system, effectiveness of the system for its students, staffing and capital costs, credit transfer issues, funding, and accountability to the taxpayers.
At the same time, Senate Majority Leader Mary Panzer (R-West Bend) announced the GROW (Growing and Reforming our Wisconsin) Initiative designed to stimulate the economy and expand employment opportunities. A newly created Select Committee on Job Creation, co-chaired by Senators Ted Kanavas (R-Brookfield) and Kathy Stepp (R-Racine), will develop legislative proposals to meet these goals.
Committee member Senator Joe Leibham (R-Sheboygan) is spearheading a comprehensive legislative package designed to increase educational opportunities in Wisconsin for existing and future workers. According to Sen. Leibham, the legislation will focus on retraining, skill enhancement and professional development. He hopes to forward the legislation for consideration during the fall session in October and November, but said he will wait until January if more time is needed to develop a meaningful package.
According to WHA Senior Vice President Eric Borgerding, "WHA staff will work closely with legislators on both initiatives to ensure that health care workforce issues are considered and addressed."
For more information about these proposals, contact Eric Borgerding or Jodi Jensen at 608-274-1820 or eborgerding@wha.org or jjensen@wha.org
Joint Commission Offers Web-based Videos on New Accreditation Process
The Joint Commission is producing a series of streaming videos about seven minutes in length available for viewing on its Web site to help accredited organizations and other key stakeholders learn more about its new accreditation process, Shared Visions--New Pathways. This series of five-to-seven minute videos will highlight the key components of the new accreditation process. The first video, "An Overview of Shared Visions--New Pathways," features Russell P. Massaro, M.D., executive vice president for accreditation operations, and Carol J. Gilhooley, director of accreditation process improvement.
Future topics include the Standards Review Project, On-site Survey Process, Tracer Methodology, Quality Reports, Surveyor Development and Physician Engagement, among others. To view the video go to: http://www.jcaho.org front page, under Shared Pathways video.
Wisconsin Healthcare Purchasers for Quality Survey Hospitals
WHA has received several calls from members who received a mailing from the Wisconsin Healthcare Purchasers for Quality, a statewide network of purchasers, asking that they complete the "Leapfrog Hospital Survey" by June 30, 2003. All hospitals located in Wisconsin’s urban metropolitan statistical areas (MSAs) have been chosen by The Leapfrog Group as one of its geographic areas of concentration along with 20 other regions across the United States.
Hospitals that choose to participate in this voluntary effort will complete a survey that includes questions about three patient safety practices. These practices, commonly referred to as leaps, include the use of computerized physician order entry, evidence-based hospital referrals, and ICU physician staffing.
The Leapfrog Group will make the results publicly available on its Web site in July. In addition, members of Wisconsin Healthcare Purchasers for Quality will promote this information through the media, employee newsletters, provider directories and other channels of communication to consumers. Those hospitals that choose not to respond will be listed as "Did Not Submit."
Wisconsin Healthcare Purchasers for Quality was formed due to a strong and shared commitment among purchasers statewide to the practice of value-based purchasing and to educate and engage consumers. Success is dependent on the availability of meaningful comparisons of both cost and quality.
Please contact Dana Richardson
drichardson@wha.org with comments or questions regarding this initiative.The Agency for Healthcare Research and Quality (AHRQ) announced the availability of funds for one to two year (maximum two years) research grants that will examine and promote the public health care system’s readiness for a bioterrorist event and other public health emergencies through the development of new evidence, tools and models. AHRQ seeks bioterrorism and other public health emergency preparedness projects that address these specific priority research areas:
Information on this new funding announcement is available on the AHRQ Web site: www.ahrq.gov/fund/grantix.htm and then click on PAR-03-130 Building the Evidence to Promote Bioterrorism and Other Public Health Emergency Preparedness in Health Care Systems). Or, go directly to the NIH Guide http://grants1.nih.gov/grants/guide/pa-files/PAR-03-130.html
Applications are being sought from eligible institutions, including hospitals.
Receipt and Review Schedule:
Technical Assistance Conference Call: July 2, 2003
Application Receipt Dates: July 17, 2003, January 14, 2004, January 14, 2005, January 17, 2006
(This Program Announcement expires on July 17, 2007 unless reissued.)
Peer Review Date: August 2003
Earliest Anticipated Start Date: September 2003
More information on application requirements and contact persons are described in the NIH Guide.
CMS Issues Proposed 2004 PPS Rules for Inpatient Rehab. and SNFs
The Centers for Medicare and Medicaid Services (CMS) has published the proposed Inpatient Rehab and SNF (Skilled Nursing Facility) PPS (Prospective Payment System) rules for fiscal year 2004.
For Inpatient Rehab. Facilities, the rate update in this proposed rule is effective for services beginning on October 1, 2003. CMS estimates the impact resulting from the provisions in the notice to be a 3.3% increase in payments across the nation. In the East North Central States, which include Wisconsin, CMS estimates urban provider payment rates would increase 2.7% while rural providers would see a 2.8% increase in payment rates. The differences are primarily due to wage indexes.
For SNFs, CMS estimates the financial impact resulting from the provisions in the notice to be an increase in payments of $400 million or 2.9% across the nation. This is solely attributable to the 2.9% market basket based update to the unadjusted federal rates from the prior year. Because of this, the impact is the same for every nursing home regardless of its region, ownership type, or urban/rural designation.
There are many other proposed changes to these prospective payment systems. For copies of the rules as well as a summary, go to the Finance and Data section of the WHA Web site at http://www.wha.org/financeAndData/ and click on the PPS area you are interested in.
Meriter Breaks Ground on New Child Psychiatric Hospital in Madison
Meriter Health Services began construction of the new 22-bed Child and Adolescent Psychiatric Hospital on Madison’s far west side. The freestanding not-for-profit facility, the only one of its kind in south-central Wisconsin, will cost $4.2 million to build, and is slated to open by the end of 2003.
Meriter has offered child and adolescent treatment at its West Washington Avenue campus in downtown Madison for the past 15 years; the adolescent program opened in 1988 and the child program in 1995. The capitol campus will no longer be used for clinical services.
Child and Adolescent Psychiatry Program Nurse Manager Sherry Casali, R.N., says Madison-area families need a facility such as this, especially in light of the fact that the closest alternate providers are located in Oconomowoc, Waukesha and Green Bay.
"Meriter has always been committed to providing an inpatient program as part of the full range of psychiatric care we provide children in this community," says Casali, "and without this program and facility, it would be difficult for local parents to participate. That’s important, because family involvement plays a crucial role in helping us successfully treat child and adolescent patients."
Black River Memorial Hospital’s Hospice Receives National Grant
Black River Memorial Hospital’s Hospice received one of 53 Federal Rural Health Outreach Grants from the Department of Health and Human Services, the only grant awarded in Wisconsin. In prepared remarks, HHS Secretary Tommy Thompson said, "The grants foster partnerships and creative strategies to help bring health care to rural Americans who might not receive it otherwise. They enable health care and social service providers, health centers, hospitals and universities to pool their resources and efforts to provide more and better services." The three-year grant totaling $357,625 will be used by the hospital’s hospice.
New Oconomowoc Memorial Hospital President Named
John R. Robertstad, current North Region President for ProMedica Health System, has been named president and CEO of Oconomowoc Memorial Hospital (OMH). Robertstad will replace Douglas Guy, who announced he was stepping into a new role with ProHealth Care last November.
The ProMedica Health System was ranked as the sixth most integrated health network in the country by Modern Healthcare Magazine. The ProMedica Physician Corporation has 125 employed primary care physicians and 550 physician partners. From 1976 until 1986, Robertstad worked for Madison General Hospital. He has also worked with Meriter Hospital, Riverside Medical Center in Kankakee, Illinois, and Bixby Medical Center in Adrian, Michigan.
Robertstad will assume his new duties on July 14.
Rogers Memorial Hospital Announces New Medical Director
Rogers Memorial Hospital has named Peter Lake, MD, the new medical director of the hospital’s Oconomowoc campus. Lake is a board-certified child, adolescent, and adult psychiatrist and also the medical director of the Child and Adolescent Services of Rogers Memorial Hospital in Oconomowoc. He received his medical degree from the University of Iowa. He completed his residency in adult psychiatry and fellowship in child and adolescent psychiatry at Vanderbilt University in Nashville, Tennessee.
Henckel Named CEO at Orthopaedic Hospital of Wisconsin
Susan M. Henckel has joined the Orthopaedic Hospital of Wisconsin as chief executive officer. Henckel has 16 years of experience in health care, most recently as executive vice president with Columbia St. Mary’s. Prior to her health care experience, Henckel, a certified public accountant (CPA) has eight years of diversified consulting experience. The Orthopaedic Hospital of Wisconsin, formed in 2001, is owned jointly by a group of Orthopaedic Surgeons and Columbia St. Mary’s.