Governor Doyle continued his review of the 2003-2005 state budget this week and is expected to finalize line-item vetoes in a matter of days, but will not sign the bill into law by the Fourth of July as some expected.

Last week, an extensive grassroots effort to protect funding legislators restored for Graduate Medical Education (GME) and the rural hospital supplement was underway. Since that time, hundreds of hospital employees, volunteers and trustees have urged the Governor to sign this funding into law. Because a number of veto decisions had not been finalized as this week began, affected hospitals were asked to redouble their efforts and continue making contacts with the Governor’s office.

Still more contacts illustrating the importance of GME and rural hospital funding are needed. Each affected hospital is encouraged to generate ten more emails, phone calls or faxes to the Governor by early next week. Because the veto decisions will be made quickly, immediate action is needed.

"The Governor has taken notice of the huge outpouring of support for GME and rural hospitals, but we need him to take the next step and sign this funding into law," said Eric Borgerding, WHA senior vice president. "We can’t let up – we can’t leave any stone unturned as we fight to avoid a veto of these crucial programs."

For more information about contacting the Governor, contact Eric Borgerding, Jodi Jensen, or Ann Lucas at 608-274-1820 or eborgerding@wha.org, jjensen@wha.org , or alucas@wha.org.

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Included in this week’s packet is a nomination form for the 2003 Global Vision Community Partnership Award. This competitive grant award is presented to a community health initiative that successfully addresses a documented community health need. The Award, launched by the WHA Foundation in 1993, seeks to recognize and support ongoing projects that support community health.

Any WHA member can nominate a community health project. The project must have been in existence for a minimum of two years and must be a collaborative or partnership project that includes a WHA member hospital and an organization(s) within the community.

"Our members are participating in many collaborative programs within their communities. This award recognizes those programs, shares the wealth of knowledge gained from those programs and provides an unrestricted grant to support the program," said Ann Lucas, WHA foundation director.

The Award will be presented at the WHA annual meeting on September 25, 2003. Nominations are due August 25, 2003. Nomination forms can be located on the WHA Web site (www.wha.org). For more information about the award, contact Ann Lucas at alucas@wha.org or 608-274-1820.

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The FY 2003 Hospital Preparedness Grant was submitted to the Health Resources and Services Administration (HRSA) on July 1, 2003. This grant contains two specific awards for hospitals:
1) Negative pressure airborne isolation capacity enhancements ($3.375M); and
2) Decontamination capacity enhancement ($3M).

Each of the seven hospital bioterrorism teams in Wisconsin, acting through their respective project coordinators, will assess the isolation capacity of Wisconsin hospitals and determine which hospitals would like to take advantage of these funds to enhance isolation capacity. The project coordinators will contact the hospital infection control practitioner to complete the assessment. This assessment tool—Survey of Wisconsin Hospitals’ Negative Pressure Airborne Isolation Capacity is available for viewing at www.wha.org, under the disaster preparedness, bioterrorism section. The infection control practitioners are requested to contact their respective hospital administrator to determine future plans for enhancing isolation capacity and for completing this assessment. The results of the assessment process will allow the State Expert Panel on Isolation and the regional teams to establish criteria for awarding these funds. Significant dollars are expected to be available in 2004 for this same purpose.

Dennis Tomczyk, director of the Hospital Bioterrorism Preparedness Program, will present an information session at the WHA Convention at the Grand Geneva, September 24-26, 2003 on how these funds will be disbursed in Wisconsin. For information contact Dennis Tomczyk at 608-266-3128 or Bill Bazan at 414-431-0105.

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It is time again for the SHIP to set sail.  SHIP is the Small Hospital Improvement Program, which provides grant funding to small rural hospitals to: 1) pay for costs related to the implementation of the Prospective Payment System (PPS), 2) comply with provisions of HIPAA; and 3) reduce medical errors and support quality/performance improvement.  To be eligible for these grants, you must be a small rural hospital located in the United States or the Territories.  The definition of a small rural hospital is (1) small is defined as 49 available beds or less, as reported on the hospital’s most recently filed Medicare Cost Report, (2) rural is defined as located outside a Metropolitan Statistical Area (MSA); or located in a rural census tract of a MSA as determined under the Goldsmith Modification or the Rural Urban Commuting Areas; and (3) hospital is defined as a non-Federal, short-term, general acute care facility.

Approximately $15 million is available nationally for this grant program in FY 2003. It is anticipated that all eligible small rural hospitals (about 1,500) will apply, which means each hospital will get a grant award of about $10,000. It is expected that these grants will be used to purchase technical assistance, services, training and information technology. 

Hospitals that applied for, and received, SHIP funding last year must complete a very brief continuation application and return it to Barb Duerst at the Wisconsin Office of Rural Health as soon as possible.   If your hospital did not receive SHIP funding last year, and you believe your hospital is eligible, complete the new application and return it to Duerst soon.  Both applications are available in a word document on the WORH Web site (www.worh.org).

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Never before have both houses of Congress passed relatively similar versions of Medicare payment legislation that hold such promise for modestly addressing Medicare equity and adequacy issues for Wisconsin hospitals. Here’s a quick overview:

Equity—Both the Senate and House bills include provisions that permanently equalize the base inpatient payment rate. For non-Milwaukee and non-Critical Access Hospitals (CAH), this is a 1.6% payment hike worth close to $20 million annually.

The Senate and House bills also address long-standing, formula-driven wage index issues. Although not identical, legislation in play will reduce the impact of low wage indexes on Medicare inpatient payment. These changes mean $5-7 million dollars annually in higher Wisconsin hospital payments.

Adequacy—Importantly, the Senate-passed legislation provides a full market basket increase for inpatient payments for the upcoming year. The House bill reduces the market basket update by 0.4%. While the market basket used by Centers for Medicare and Medicaid Services (CMS) has never fully covered inflation associated with the major components of hospital inpatient costs, hospitals have not seen a full market basket increase for years.

CAH Improvements—The Senate and House bills include language that provides greater flexibility in "counting beds" as it relates to the 25-bed limit for CAH hospitals. At least a half dozen Wisconsin hospitals will likely benefit by this provision. [Special kudos to Paul Ryan (R-Janesville)]. A number of other favorable payment provisions are included in both bills…the House version, for example, would pay Critical Access Hospitals 102% of their costs.

Other Rural Provisions—A number of other rural payment improvements are embedded within the Senate and House bills. For example, the current, but expiring, hold harmless provisions for prospective outpatient payment are found in each of the initiatives.

Other Issues "In Play"—For Wisconsin, the House and Senate bills improve our state’s low Medicaid Disproportionate Share (DSH) cap and potentially free up millions of dollars in new payments for high volume indigent care hospitals. The House bill also provides some assistance (woefully inadequate) to address Indirect Medical Education payment issues for teaching hospitals. This latter issue, hopefully, will be in play during the conference process.

Over the next few weeks, House and Senate Medicare conferees will cobble together an initiative that reconciles differences between the Senate and House. While Medicare payment issues are relatively similar, Medicare "reform" issues are very much in disagreement, and the structure of the new Medicare prescription drug benefit remains a politically sensitive issue. Stay tuned.

The July 11 deadline for receiving all WHA and ACHE annual award nominations is fast approaching. It’s the last chance to nominate someone in your region, in your hospital or on your Board of Directors who deserves the honor of one of these prestigious awards:

• Distinguished Service Award is presented to a senior health care executive who has made an exemplary commitment to WHA and the community 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.

Details about the nomination process and nomination criteria can be found in the annual awards brochure on the WHA Web site at www.wha.org. For more information, contact WHA’s executive office at 608-274-1820.

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The educational seminar "Health Care Risk Management: The Basics" is scheduled July 25 in Madison. Hospital risk managers, chief financial officers, compliance officers, chief operating officers and anyone else involved in hospital risk management should plan to attend.

Whether you are an experienced risk manager, or just putting a program together, this program will outline what you need to know to determine your risk tolerance. The program focuses on how to implement an effective hospital risk management program and includes presentations on risk management from a defense attorney’s perspective, specifics on risk management in the clinical setting, and a peer panel of four hospital risk managers sharing personal experiences with both successful and not-so-successful risk management. The seminar is co-sponsored by Fitzgerald, Clayton, James and Kasten, a WHA Corporate Champion that offers risk transfer solutions through insurance and risk management services.

The seminar will be held July 25, 2003, from 8:30 am to 4 pm at the Clarion Hotel in Madison. The registration fee is $75. A brochure and registration form are included in this week’s packet and on the web site at www.wha.org. On-line registration is available.

For more information on the program content, contact Jennifer Frank at 608-274-1820 or email at jfrank@wha.org. For registration questions, contact Bridget Gifford at 608-274-1820 or email at bgifford@wha.org.

As the Oct. 16 deadline for implementing the electronic transactions standards under the Health Insurance Portability and Accountability Act approaches, the Centers for Medicare & Medicaid Services will present a program reviewing the transactions standards and other basics of the HIPAA administrative simplification provisions during a satellite broadcast on July 16 and 30. To find a broadcast site near you, or to register to host a broadcast in your community, go to www.cms.hhs.gov/medlearn. Click on "Satellite Broadcasts," then "HIPAA 101: The HIPAA Administrative Simplification."

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Spooner Health System Seeks Nursing Home Administrator
Spooner Health System, a 46-bed medical/surgical hospital, 90-bed nursing home and a home health agency seeks a nursing home administrator. The administrator will direct, supervise and coordinate the day-to-day functions and activities of the nursing home and associated departments. The administrator will consult with and advise the CFO of the overall organization issues related to the operation of the nursing home, and provide leadership and direction for the nursing home operations. Individual must be licensed as a nursing home administrator in the state of Wisconsin. Previous administration experience preferred. Competitive salary commensurate with qualifications and excellent benefit package offered. Please send resume and cover letter with salary requirements to Human Resources, Spooner Health System, 819 Ash Street, Spooner, WI 54801.

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Spooner Health System Seeks Nursing Home Director of Nursing
Spooner Health System, a 46-bed medical/surgical hospital, 90-bed nursing home and a home health agency seeks a nursing home director of nursing. The director of nursing will have authority, responsibility, and accountability for the functions and activities of the nursing staff. This includes developing standards of practice, policy and procedure manuals and job descriptions. Individual must be a registered nurse, licensed by the state of Wisconsin. Experience in nursing service administration, education and/or experience in such areas of rehabilitative, psychiatric and/or gerontological nursing. Competitive salary commensurate with qualifications and excellent benefit package offered. Please send resume and cover letter with salary requirements to Human Resources, Spooner Health System, 819 Ash Street, Spooner, WI 54801.

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