July 13, 2007
Volume 51, Issue 27
Assembly Passes Its Version of State Budget
Hospital tax removed, hospital rates increased, stalled patient safety initiatives advance
On July 10, the Republican-led Assembly passed its version of the state budget on a 51-44 vote. The Assembly’s $56.3 billion proposal spends nearly $10 billion less than the $66.1 billion approved by the Senate, but is still a five percent increase, all funds, over the 2005-07 state budget. Healthy Wisconsin, the Senate Democrats’ $15 billion plan to completely overhaul Wisconsin’s health care system, was not included in the Assembly budget.
As expected, Assembly Republicans removed a 1 percent tax on hospital gross revenues, proposed by Governor Doyle and approved by Democrats in the Senate. Unfortunately, a $1.25 increase in the cigarette tax was also deleted. However, the Assembly addressed many other WHA Medical Assistance (MA) and health care policy priorities.
In addition to removing the hospital tax, the Assembly voted to increase MA reimbursements to hospitals that receive a disproportionate share of Medicaid patients by $19 million for inpatient and $7 million for outpatient services for all hospitals; delete the increase in the nursing home bed tax and increase nursing home payment rates by five percent; remove the "Raid on Medicaid" and instead fund MA with General Purpose Revenue (GPR) dollars; and delete the raid on the Injured Patients and Families Compensation Fund (IPFCF).
The Assembly also included several proposals to promote health care quality and patient safety. The Assembly budget includes the Quality Improvement Act, legislation strongly backed by WHA that passed overwhelmingly last session but was vetoed by Governor Doyle. The proposal fosters quality and safety improvement by expanding current law protections of the records and information created during quality and safety reviews, evaluations and improvement actions. Other provisions included in the Assembly budget would improve patient safety by making sure health care providers know about reported patient abuse and neglect by potential employees, and providing immunity for health care providers that report clinical or ethical violations.
Additionally, provisions were included making contributions to Health Savings Accounts (HSAs) and health insurance premiums tax deductible; requiring the Wisconsin Health and Educational Facilities Authority (WHEFA) to issue bonds for a project if it determines that revenues associated with the project would be sufficient to pay all debt services costs related to the bonds; providing an exemption from individual and corporate taxes for interest paid on WHEFA bonds used by a health facility to fund the acquisition of information technology hardware or software; and increasing the allowable copying charges for medical records to up to $1 per page to help cover the cost of making the copies and bring Wisconsin’s allowable charges more in line with other states.
Commenting on the Assembly budget, Speaker Mike Huebsch (R-West Salem) said, "Assembly Republicans balanced the budget while protecting seniors and low-income families served by Medicaid and BadgerCare. Our budget also addresses the hidden health care tax by providing rate increases for Wisconsin’s hospitals and nursing homes."
In contrast, Assembly Minority Leader Jim Kreuser (D-Kenosha) criticized the Assembly Republicans’ budget for limiting vital services, but said in the end, "We want to work together with you. Most of the people of this state want us to work together."
As previously mentioned, because of the drastic differences in the Assembly and Senate versions of the budget, a conference committee will now be formed to hammer out the differences between the two proposals.
Conference committee members from the Assembly will include Speaker Mike Huebsch, Joint Finance Committee Co-Chair Kitty Rhoades (R-Hudson), Majority Leader Jeff Fitzgerald (R-Horicon) and Minority Leader Jim Kreuser. Senate committee members will include Majority Leader Judy Robson (D-Beloit), Joint Finance Committee Co-Chair Russ Decker (D-Weston), Senator Bob Jauch (D-Poplar), and Minority Leader Scott Fitzgerald (R-Juneau).
Eventually, identical budget language will need to be approved by each house of the Legislature before being forwarded on to Governor Doyle for his line-item veto and ultimate signature. The Senate is expected to pass a Joint Resolution on the conference committee on July 17, with the Assembly to follow. Discussions could begin as early as the end of next week as legislators try to bridge the vast divide in budget priorities.
Know Your Legislators...Rep. Kevin Petersen (R-Waupaca)My priorities remain the same as when I was campaigning—lowering taxes, improving family core values, education, health care, and protecting veterans.
No. Hospitals would potentially lose millions of dollars. The Governor is trying to change the repayment plan, but the tax that is in the budget is still the same. I won’t support any tax on hospitals, even if there is some sort of "deal," I won’t support a hospital tax.
I do not support raids on segregated funds. I was one of 11 Republicans to vote against the budget repair bill because it raided the transportation, recycling, and forestry funds. I ran on a platform against these raids and I do not support legislation that proposes using funds that were collected for one purpose to use for another.
The most important issue facing seniors is the cost of health care. Over the next 20 years we’re going to see the number of seniors living in our state double. We need to plan now for the future to ensure that we can take care of our senior citizens. One of the proposals I support, along with Rep. Pat Strachota (R-West Bend) and Sen. Carol Roessler (R-Oshkosh) is a Long Term Care Partnership Program. This would allow a person who has purchased qualified long-term care insurance and who has exhausted the benefits of that policy the ability to access Medicaid benefits without the standard means test that currently applies to Medicaid applicants. The idea here is to encourage individuals to make an effort to provide for their own long-term care.
I am from Waupaca and consider myself as living in a rural area, and the health care in my area is excellent. I don’t see access as being an issue. I think keeping physicians in the state as a whole hinges on making sure that there is a cap on non-economic damages associated with medical malpractice, and ensuring that the Injured Patients and Family Compensation Fund remains intact.
A reform proposal must include these three points:
Political Action Spotlight: 262 Individuals Raise Over $110,000 for Political Action Funds
In the first two months of the 2007 fundraising campaign for the Wisconsin Hospitals Political Action Funds, which include the Wisconsin Hospitals PAC, Wisconsin Hospitals Conduit and WHA Federal PAC, 262 individuals affiliated with 68 hospitals have raised $110,102 to date. The average individual contribution is just over $400, up from $265 this same time last year.
This year-to-date progress accounts for almost 57 percent of the 2007 fundraising campaign’s $195,000 monetary goal. In working toward the goal, the Campaign mailed additional fundraising packets this week to those individuals who have yet to contribute.
Persons who have contributed this year are listed below by name and affiliated organization. If you are a contributor, check to see if your name appears on the list. Contributors are listed by amount and in the order the contribution was received. The next publication of contributors will be in the August 10 edition of The Valued Voice.
For more information, contact Jenny Boese, jboese@wha.org, 608-274-1820 or Jodi Bloch, jbloch@wha.org, 608-217-9508.
2007 Fundraising Campaign Contributors:
Contributions ranging from $1 - $249
Rickelman, Debbie WHA Information Center
Ayers, Mandy Wisconsin Hospital Association
Reichert, Kevin Froedtert Memorial Lutheran Hospital
Gerke, Mary Lu Gundersen Lutheran Medical Center
Hiatt, Emily Gundersen Lutheran Medical Center
Kruse, Joe Franciscan Skemp Healthcare-
La Crosse Campus
Klauck, James Froedtert Memorial Lutheran Hospital
Schneider, David Langlade Memorial Hospital
Harm, Sandy Lakeview Medical Center
Callies, Julie WHA Information Center
Sanders, Michael The Monroe Clinic
Coller, James St. Mary’s Hospital Medical Center
Policello, Louise Bay Area Medical Center
Baker, David Saint Michael’s Hospital
Bonnett, Joseph Beaver Dam Community Hospitals
Buss, Diane St. Mary’s Hospital Medical Center
Iding, Laura Froedtert Memorial Lutheran Hospital
Jelle, Laura St. Clare Hospital and Health Services
Schamberg, MD, Jay Aurora Health Care
Reinke, Kathy Shawano Medical Center
Anderson, Mary Hayward Area Memorial Hospital
and Nursing Home
Marcouiller, Don Memorial Medical Center-Ashland
Marsch, Jean St. Vincent Hospital
Quade, Steve Door County Memorial Hospital
Myers, Robert Vernon Memorial Healthcare
Prince, Nancy Aspirus Wausau Hospital
Walker, Troy St. Clare Hospital and Health Services
Tierney, Mary Alice Aurora Health Care
Korff, Sally St. Nicholas Hospital
Grady, Glen Memorial Medical Center-Neillsville
Werner, Andrea Bellin Memorial Hospital
Adams, Daniel Memorial Medical Center-Ashland
Dettman, Amy Bellin Memorial Hospital
Hinz, Russ Aurora Health Care
Mickelson, Ronald St. Clare Hospital and Health Services
Tandberg, Christine Sacred Heart Hospital
Olson, Keri St. Clare Hospital and Health Services
Skifton, Russell Saint Michael’s Hospital
Casey, Candy Columbia Center
Klinge, Ann Memorial Medical Center-Ashland
Santini, Kathy Memorial Medical Center-Ashland
Watts, Susan St. Vincent Hospital
Elsen, Mary Pat St. Clare Hospital and Health Services
Heider, Lisa Community Memorial Hospital
McCloskey, Lynne Saint Michael’s Hospital
Stelzer, Jason St. Clare Hospital and Health Services
Lindquist, Keith Cumberland Memorial Hospital
Thompson, James Aurora Health Care
Bell, Kristine Aspirus Wausau Hospital
Bosio, David Aspirus Wausau Hospital
Burtch, Sue Aspirus Wausau Hospital
Sullivan, Anne Memorial Medical Center-Ashland
Bjork, Ted Westfields Hospital
Hinker, Jennifer Aspirus Wausau Hospital
Rodriguez, Debra St. Clare Hospital and Health Services
Thorpe, Marya Aspirus Wausau Hospital
Bliven, David Aspirus Wausau Hospital
Cohen, Joan Aspirus Wausau Hospital
Kopplin, Jean Aspirus Wausau Hospital
Murphy, Michael Aspirus Wausau Hospital
Rothfuss, James Meriter Hospital
Tate, Marceline Aspirus Wausau Hospital
Arendt, Kathleen Aspirus Wausau Hospital
Bouvat, Dale Aspirus Wausau Hospital
Burgener, Jean Aspirus Wausau Hospital
Danner, Forrest Aspirus Wausau Hospital
Lucas, Roger Aspirus Wausau Hospital
Mohr, Carol Sacred Heart Hospital
Brenny, Terrence Stoughton Hospital Association
Burgett, Lyle Aspirus Wausau Hospital
Drengler, Kathryn Aspirus Wausau Hospital
Scinto, Jeanne Aspirus Wausau Hospital
Sczygelski, Sidney Aspirus Wausau Hospital
Cox, Tamarah Aspirus Wausau Hospital
Misiewicz, Barbara St. Mary’s Hospital of Superior
Schraufnagel, Patricia Memorial Medical Center-Ashland
Bessen, Paulette Saint Michael’s Hospital
Campbell-Kelz, Nancy Aspirus Wausau Hospital
Dorpat, Denice Aspirus Wausau Hospital
Roundy, Ann Columbus Community Hospital
Todd, Jeffrey Aspirus Wausau Hospital
Borgstrom, Jim Memorial Health Center
Carrier-Diemer, Peggy Aspirus Wausau Hospital
Pinekenstein, Barbara Meriter Hospital
Waldoch, Timothy Froedtert Memorial Lutheran Hospital
Fochs, Mary Aspirus Wausau Hospital
Lakey, Sandy Aspirus Wausau Hospital
Maas, Pamela Aspirus Wausau Hospital
Roraff, Greg Memorial Health Center
Ellis, Nancy Aspirus Wausau Hospital
Gengler, Tim Aspirus Wausau Hospital
Reider, Rodney Aurora Health Care
Bush, Nan Bellin Memorial Hospital
Peters, Kenneth Bellin Memorial Hospital
Watson, Christopher Bellin Memorial Hospital
DeWitt, Pamela St. Joseph’s Community Health Services
Fry, Robert Bellin Memorial Hospital
Rocheleau, John Bellin Memorial Hospital
Roethle, Linda Bellin Psychiatric Center
Trachte, Kathryn Saint Michael’s Hospital
VanStraten, Randy Bellin Memorial Hospital
Coblentz, Kathy Jo St. Joseph’s Community Health Services
McCoic, Kristie St. Joseph’s Community Health Services
Lorenz, Bruce Aspirus Wausau Hospital
Pengra, Mary Sacred Heart Hospital
Pfaff, Stephanie Tri-County Memorial Hospital
Bergeron, Brant Saint Michael’s Hospital
Cotone, Candace Cumberland Memorial Hospital
Gantner, Sue Aspirus Wausau Hospital
Jensema, Christine St. Nicholas Hospital
Erickson, Robert Aspirus Wausau Hospital
Maurer, Mary Holy Family Memorial Hospital
Greene, Roxanne Ministry Healthcare
Facey, Alice St. Clare Hospital and Health Services
Jacobsen, Joan Meriter Hospital
Bundner, Mark Meriter Hospital
Yunk, Dennis Agnesian Health Care
Fulwiler, Terry Bellin Memorial Hospital
Dwyer, Maxine St. Mary’s Hospital
Contributions ranging from $250 - $499
Braddock, Michelle WHA Financial Solutions, Inc.
Rozenfeld, Jonathan St. Mary’s Hospital Medical Center
Cryns, Janice Children’s Hospital of Wisconsin
Hammer, Michael Good Samaritan Health Center of Merrill
Canter, Richard Wheaton Franciscan Healthcare
Kinsella, Connie
Standridge, Debra St. Francis Hospital
Groepper, Ron St. Joseph’s Regional Medical Center
Curran, Joan Gundersen Lutheran Medical Center
Bayer, Tom St. Vincent Hospital
Miller, Kimberly Beaver Dam Community Hospitals
Brandel, Patrick Holy Family Memorial Medical Center
Schafer, Michael Spooner Health System
Baer, James Shawano Medical Center
Johnson, Charles St. Mary’s Hospital Medical Center
Roller, Rachel Aurora Health Care
Meyer, Miles Meriter Hospital
Biros, Marilyn SSM Health Care-Wisconsin
Klein, Jacqueline Lakeview Medical Center
Carlson, Dan Bay Area Medical Center
Shapiro, David Columbia St. Mary’s
Grundstrom, David Flambeau Hospital
Mantei, Mary Jo Bay Area Medical Center
VanCourt, Bernie Bay Area Medical Center
Wilk, Leonard Aurora Sinai Medical Center
Fields, Mary Aurora Health Care
Harding, Edward Columbus Community Hospital
Neet, Bradley Saint Michael’s Hospital
Schroeder, Patricia Wheaton Franciscan - Milwaukee
Abels, Maya Aurora Health Care
Capstran, Barbara Aurora Health Care
Baker, Scott Aurora Health Care
Hessert, Peter Aspirus Wausau Hospital
Nevers, Rick Aspirus Wausau Hospital
Olkowski, Leland Aspirus Wausau Hospital
Rocole, Theresa All Saints Healthcare
Ulery, David Aurora Health Care
Arnett, E. Stuart Aurora Health Care-South Region
Banzhaf, Elaine Waukesha Memorial Hospital
Schmidt, Kari Aurora Health Care
Svetlik, Joe Reedsburg Area Medical Center
Bezucha, Gary Boscobel Area Health Care
Lockhart, MD, Jack Gundersen Lutheran Medical Center
Dietsche, James Bellin Memorial Hospital
Heifetz, Michael SSM Health Care-Wisconsin
Jones, Tom St. Joseph’s Community Health Services
Peterson, Kimberly Bellin Memorial Hospital
Woleske, Chris Bellin Psychiatric Center
Hiltunen, Mary Bellin Memorial Hospital
Stuart, Philip Tomah Memorial Hospital
Johnson, Curtis Tri-County Memorial Hospital
Kolb, Marvin Aurora Health Care
Clough, Sheila Ministry Health Care
Keene, Kaaron Memorial Health Center - Medford
Lange, MD, George M. Westgate Medical Group
Contributions ranging from $500 - $999
Bloch, Jodi Wisconsin Hospital Association
Miloszewicz, Angela Wisconsin Hospital Association
Potter, Brian Wisconsin Hospital Association
Frank, Jennifer Wisconsin Hospital Association
Shabino, Charles Wisconsin Hospital Association
Grasmick, Mary Kay Wisconsin Hospital Association
Richardson, Dana Wisconsin Hospital Association
Borgerding, Dana Wisconsin Hospital Association
Cutler, Dave WHA Financial Solutions, Inc.
Stanford, Matthew Wisconsin Hospital Association
Milakovich, Paul Aurora Health Care
Bonk, Daniel Aurora Sheboygan Memorial Medical Ctr.
Brannon, James Aurora Health Care
Mlynarek, Robert Waukesha Memorial Hospital
Teigen, Bobbe Aurora Medical Center - Manitowoc
Morgan, Dwight Aurora Health Care
Brophy, Michael Aurora Health Care
Buerstatte, Gary ProHealth Care
Kellar, Richard West Allis Memorial Hospital
Brasseaux, Mary St. Nicholas Hospital
Anderson, Sandy St. Clare Hospital and Health Services
Capelli, A.J. Aurora Health Care
Duncan, Larry Children’s Hospital of Wisconsin
Eddy, Lee Anne Children’s Hospital of Wisconsin
Gutzeit, Michael Children’s Hospital of Wisconsin
Jones, Michael Children’s Hospital of Wisconsin
Neufelder, Daniel Affinity Health System
Niemer, Margaret Children’s Hospital of Wisconsin
Radoszewski, Pat Children’s Hospital of Wisconsin
Reynolds, Sheila Children’s Hospital of Wisconsin
Ship, Mark Children’s Hospital of Wisconsin
Woodward, James Meriter Hospital
Falvey, Patrick Aurora Health Care
Allison Stonebraker, Pat Children’s Hospital of Wisconsin
Postler-Slattery, Diane Aspirus Wausau Hospital
Smith, Linda Aurora BayCare Medical Center
Kerwin, George Bellin Memorial Hospital
Klawiter, Anne Southwest Health Center
Korom, Nancy Children’s Hospital of Wisconsin
Tyre, Scott Wisconsin Hospital Association
McGee, Fred Meriter Hospital
Contributions ranging from $1000 - $1999
Leitch, Laura Wisconsin Hospital Association
Merline, Paul Wisconsin Hospital Association
Boese, Jennifer Wisconsin Hospital Association
Braddock, Jonathan WHA Financial Solutions, Inc.
Bazan, Bill Wisconsin Hospital Association
Kachelski, Joe WHA Information Center
Vice, Jon Children’s Hospital of Wisconsin
Gazzana, Thomas Children’s Hospital of Wisconsin
Nannis, Paul Aurora Health Care
Olson, David Bay Area Medical Center
Devermann, Robert Aurora Medical Center of Oshkosh
Loftus, Philip Aurora Health Care
Nestor, Donald Aurora Health Care
Buettner, Susan Aurora Health Care
O’Brien, Mary Aurora St. Luke’s Medical Center
Starmann-Harrison, Mary SSM Health Care-Wisconsin
Kaufman, Nancy Aurora Health Care
Van Cleave, Bruce Aurora Health Care
Erickson, Lief Aurora Health Care-South Region
Wick, Timothy Burnett Medical Center
Britton, Gregory Beloit Memorial Hospital
Johnson, George Reedsburg Area Medical Center
Koehler, Thomas Aurora BayCare Medical Center
Robertstad, John Oconomowoc Memorial Hospital
Erwin, Duane Aspirus Wausau Hospital
Birkenstock, Timothy Children’s Hospital of Wisconsin
Dunigan, Thomas Children’s Hospital of Wisconsin
Anderson, Loren Aurora Health Care-South Region
Karuschak, Michael Amery Regional Medical Center
Munson, Kenneth Children’s Hospital of Wisconsin
Derrig, MD, Thomas Aurora Health Care
Olson, Edward Waukesha Memorial Hospital
Westrick, Paul Columbia St. Mary’s-Milwaukee Campus
Fale, Robert Agnesian HealthCare
Bruce, Bill St. Joseph’s Community Health Services
Contributions $2000 -$2999
Brenton, Mary Wisconsin Hospital Association
Warmuth, Judith Wisconsin Hospital Association
Quinn, George Wisconsin Hospital Association
Buser, Kenneth All Saints Healthcare
Mahoney, Lorelle Aurora Health Care
Titus, Rexford ProHealth Care
Ela, Susan Aurora Health Care
Brideau, Leo Columbia St. Mary’s-Columbia Campus
Size, Tim Rural Wisconsin Health Cooperative
Johnson, Peter Aurora Health Care
Contributions $3000 and up
Brenton, Stephen Wisconsin Hospital Association
Borgerding, Eric Wisconsin Hospital Association
Turkal, Nick Aurora St. Luke’s Medical Center
Supreme Court Issues Decision in Lornson CaseThe Wisconsin Supreme Court issued its decision in Lornson v. Siddiqui on July 10, holding that "in wrongful death actions, an eligible claimant’s cause of action does not survive the death of a claimant." As advocated by the amicus curiae brief filed by WHA and the Wisconsin Medical Society, the Court in a 4-3 decision affirmed the trial court’s ruling to dismiss the case on the grounds that the personal representatives to an estate of a claimant lack standing under the medical negligence statutes to maintain medical malpractice wrongful death claims.
The Court’s decision, written by Justice David Prosser, focused largely on statutory interpretation and an analysis of the legislative history of the survival provisions of the wrongful death statute. After completing that analysis, the Court concluded that Wisconsin’s wrongful death statute since 1933 has provided that a wrongful death claim survives the death of a wrongdoer, but does not provide that such a claim survives the claimant’s death.
The Court also held that its interpretation of the medical malpractice statutes in conjunction with the survival provisions of the wrongful death statute does not deprive the claimant or his estate of a vested property right without due process or violate equal protection of the law.
Justice Patrick Crooks, concurring in part and dissenting in part, and joined by Chief Justice Shirley Abrahamson and Justice Ann Walsh Bradley, agreed with the plaintiffs that an amendment to the survival provision of the wrongful death statute made in a 1999 Revisor’s Correction Bill unambiguously provided that a wrongful death claim survives both the wrongdoer and the claimant. Justice Crooks argued that because the statute is unambiguous, no analysis of legislative history should have been undertaken by the Court to interpret the statute.
The defendants conceded that the survival claim by the special administrators on behalf of the estate of the injured party was unaffected by the claimant’s death. Thus, the Court remanded the case back to the trial court for further proceedings on the separate claim of the estate of the injured party.
The text of the Supreme Court’s decision can be found at
www.wicourts.gov/sc/opinion/DisplayDocument.pdf?content=pdf&seqNo=29654.Top of page
President’s Column: Assembly Republican budget bill
There are a "baker’s dozen" reasons to like the Assembly Republican budget bill. That’s right, there are several positive initiatives for health care in the Assembly Republican budget bill, starting with the fact that the legislation provides Medicaid payment increases to hospitals and nursing homes without resorting to new or higher provider taxes to finance the much needed payment relief. Additionally, the initiative removes the Doyle Administration’s third proposed raid of the Injured Patients and Families Compensation Fund (IPFCF)—a $175 million money snatch that if allowed to stand would lead to huge premium increases for physicians and hospitals. The budget proposal also restores almost a billion dollars in existing funds that were siphoned out of Medicaid for other state spending.
In addition to protecting the IPFCF, the GOP budget proposes other WHA-backed, patient-centered initiatives including new peer review protections that will serve as a catalyst to accelerate Wisconsin’s current leadership role in the public reporting of patient quality and safety measures. A similar freestanding bill, the Quality Improvement Act, was vetoed in 2006 despite receiving 129 of 132 votes in the Wisconsin Legislature. Other GOP amendments relating to medical record copy costs, a much needed statutory provision that prevents the WI Health and Education Facilities Authority from becoming a de facto CON Board, and state income tax deductibility for HSA contributions are described elsewhere in this week’s Valued Voice.
There are also a couple of disappointments that can be remedied by adding the biggest missing ingredient in the GOP initiative—hiking the tobacco tax. Not only would this prevent kids from smoking, but the revenues generated can be used to fund coverage expansions included in the Doyle Administration budget and provide more significant hospital Medicaid payment increases.
The Senate version of the budget did include the $1.25 tobacco tax increase, but used every penny of the $500+ million it generates to fill a manufactured hole in the Medicaid budget. With the budget bill now in conference committee, a compromise can be reached that not only results in a higher tobacco tax, but equally important, assures that the revenue is used to make progress in health care—not simply fill budget holes.
Steve Brenton
President
WHA and the Wisconsin Medical Society Foundation will be working together to provide the inaugural class of the Wisconsin Academy for Rural Medicine (WARM) with an opportunity to gain experience in a rural hospital setting through the Foundation’s 2008 Summer Fellowship in Government and Community Service.
The primary goal of these fellowships is:
To provide medical students accepted in WARM with hands-on experiences working in Wisconsin rural communities to address a health concern, integrating their knowledge of resources available through local, state, and/or federal agencies
One of the key obstacles for students interested in the Foundation’s fellowships is the lack of a local physician "mentor" who can help them determine community health priorities and then direct them to individuals who can help develop and oversee their projects. WHA is partnering with the Foundation and WARM to remove this obstacle by securing physicians in hospital settings who can work with interested students. The role of the physician, or an appropriate designee, will be to:
Each medical student is responsible for submitting the fellowship application to the Foundation. A typical fellowship lasts 6 – 8 weeks. Approved fellows receive a $3,500 stipend from the Foundation. Preference is given to applications that include a letter of support from a Wisconsin Medical Society member.
The Wisconsin Council on Medical Education and Workforce (WCMEW), which includes the Wisconsin Medical Society and WHA as members, strongly endorsed the WARM fellowships, and will be monitoring the progress of this initiative.
WARM is dedicated to improving the supply of physicians in rural Wisconsin and improving the health of rural Wisconsin communities by increasing the size of the medical school class by 25 students over the next few years, and training and directing those students towards practicing in rural Wisconsin. Five students have been accepted in the program for the 2007/2008 academic year. All five students have roots in Wisconsin’s rural communities.
WHA will be contacting members in the next several months to identify interest in acting as facilitators for the fellowships. In the meantime, if you have questions about the WMS/WHA WARM fellowship, please contact either Chuck Shabino or George Quinn at WHA at 608-274-1820.
HHS Offers Online Health Care Language Services GuideThe Office of Minority Health at the U.S. Department of Health and Human Services (HHS) recently released the Health Care Language Services Implementation Guide. The Guide offers step-by-step practical advice on planning, implementing, and evaluating language access services in health care organizations. The Guide is an interactive Web-based learning tool that is available at no cost at www.thinkculturalhealth.org.
For hospital staff, the Guide offers an interactive content presentation, multimedia-based case studies to underscore the importance of language access services, and interactive worksheets. The Guide includes a collection of resources, implementation tips, and examples of forms and documents. Physicians and nurses can also access an accredited continuing education program on the provision of culturally competent care.
Therapist Positions Top Vacancy List in National SurveyWhile hospitals across the country have focused a lot of attention on nurse recruitment, new shortages are beginning to erupt that are also of great concern to health care providers. In a national survey of hospital leaders sponsored by the American Hospital Association, therapists topped the vacancy list. When asked which occupation was most difficult to recruit, 58 percent of the hospitals reported that recruitment of therapists was more difficult in 2006 than in 2005, and 44 percent indicated that pharmacist positions were more difficult to fill. Additionally, the vacancy rate for pharmacist positions now equals those in nursing. The emerging vacancy issue for therapists is driven by the increased demands of an aging population (hip and knee replacement surgery, for example), and for pharmacists by the growing number of prescription medications per person.
Demand is not the only factor driving the shortage. On the supply side consider that Wisconsin has only one School of Pharmacy and five physical therapy programs. A change in educational preparation of these occupations has also impacted the situation as both occupations have moved to clinical doctorate as the entry level of preparation. This means that health care professionals are prepared in university settings, not by local technical colleges who respond to local needs and requests. It also means that it takes more time in school and costs more to enter these occupations—serious considerations for students thinking about health care careers.
WHA’s 2006 publication, Building A Healthcare Workforce in Wisconsin, outlines the issues and concerns with these specific occupations and proposes actions necessary to ensure future access to care. It can be viewed at www.wha.org/workforce/pdf/2006workforce_october.pdf. WHA is working to create interest in these careers and increase the number of professionals prepared to work in Wisconsin’s hospitals by encouraging programs that educate these professionals to increase capacity, educating policy makers about new shortages, and talking with potential learners about the value of a health career.
WHA Financial Solutions: Limited Medical: Deciding on the Right PlanThe limited medical market continues to grow as more and more employers address the need to provide basic medical benefits for employees as they wait to become eligible for a major medical program. These products offer the dual benefit of controlling group medical costs and providing first dollar benefits to entice employees to stay on.
While there is often little question as to whether these plans can help round out an employer’s benefit offering, finding the right plan design isn’t always as simple. Limited medical products come in two basic forms: co-pay and indemnity. Each design has subjective advantages and disadvantages. Learn more by reading Solutions Spotlight, included in this week’s packet.
Community Benefits: Stories From Our Hospitals – River Falls Area Hospital, River FallsThe idea to start a free clinic in River Falls was an outcome of conversations between River Falls Area Hospital ("Hospital"), the Kinnickinnic Valley Health & Education Foundation ("Foundation") and the River Falls Medical Clinic ("Clinic").
In November of 2005, during a strategic planning retreat with foundation board members, "access to health care for the uninsured" was identified as a priority issue for the foundation. A few weeks later, a physician from the Clinic happened to cross paths with a former colleague who had helped start a free clinic in Menomonie, Wisconsin. A few short weeks after that, an employee of the hospital came across a recent study indicating that Pierce and St. Croix Counties were among the worst in the state when it comes to the percentage of residents who were going without needed health care. It didn’t take long before the idea of a new free clinic emerged, and representatives of the Hospital, the Foundation and the Clinic were soon on their way to Menomonie to visit with the staff and volunteers of the free clinic that had been operating there for just under one year.
The visit to Menomonie convinced the representatives of these three organizations to move forward with the project, and they immediately started work to establish a steering committee to assume responsibility for planning the clinic. The steering committee included representation not only from the hospital (five hospital staff, including the hospital president, served on the steering committee), the Foundation, and the Clinic, but also from the public health departments, human services, the legal profession, the business community, the clergy, and the community at-large.
Monthly meetings of the steering committee began in April of 2006. A name (Free Clinic of Pierce and St. Croix Counties) and a mission statement for the clinic were approved at the May meeting; the mission approved was "to provide primary health care and preventative health education for the people of Pierce and St. Croix Counties who have no health care alternative." Bylaws were approved in July and incorporation papers were filed in August.
In October of 2006, the Foundation designated the proceeds of its fall fundraiser – the Harvest Moon Barn Dance – to support the Free Clinic. Hundreds of people turned out for the event, which netted more than $50,000. The Foundation also agreed to act as fiscal agent for the Free Clinic while it awaited a 501(c)3 determination from the IRS. In November of 2006, the Foundation was awarded a $50,000 grant through the Wisconsin Office of Rural Health to support the Free Clinic. (It is of note that the Foundation’s contributions to this effort are also indirect contributions of the hospital, which covers all of the Foundation’s administrative expenses.)
In January of 2007, the Steering Committee disbanded and a permanent Board of Directors was elected. All five of the hospital staff who served on the steering committee were elected to remain on the permanent Board, filling three of the four seats on the executive committee. The first paid staff members were also hired, including a part-time clinic manager and a part-time volunteer coordinator. These staff are actually employed by the hospital and leased back by the Free Clinic; this provides the staff with access to health care and retirement benefits, and relieves the Free Clinic of the burden of maintaining a human resources function.
The Free Clinic was granted 501(c)3 status in March of 2007. The Free Clinic opened its doors on April 24, 2007. Volunteers at the weekly clinic are providing primary health care, including lab and x-ray services donated by the hospital, and prescription drugs to an average of 20 patients each week.
Submit hospital community benefit stories to Mary Kay Grasmick, editor, at
mgrasmick@wha.org.