Today, WHA President Steve Brenton announced the creation of a fund designed to help victims of Hurricane Katrina who work in Louisiana and Mississippi hospitals. The "Wisconsin Hospitals Caring for Those Who Care" fund provides a vehicle for Wisconsin hospitals and hospital employees to help their counterparts in the badly battered Gulf States re-build their lives.

During a briefing with hospital associations on Thursday, September 1, Louisiana Hospital Association President John Matessino said describing the situation in New Orleans as bad "would be a huge understatement." Matessino said more than 3,000 patients still needed to be evacuated as of Thursday afternoon with hospitals operating on "generators that are overheating, breaking and running out of fuel."

Hospital employees’ families have taken shelter in several hospitals, as their homes and personal possessions were lost to ravaging floodwaters.

"We know that hospital employees in New Orleans and the gulf shores of Mississippi, in particular, are working in suboptimal, dangerous conditions to care for patients, while facing heartbreaking situations in their own lives," Brenton said. "With this fund, we want to help those employees who may have a difficult time financially as they try to reestablish stability in their lives."

WHA will work with the Louisiana and Mississippi hospital associations to ensure that the funds are distributed to hospital employees there who need assistance. WHA contributed $1,000 to the fund, and has extended an invitation to Association employees to participate as well. Every dollar given to the fund will go to organizations set up to aid hospital workers.

Contributions to the "Wisconsin Hospitals Caring for Those Who Care" fund can be sent to the WHA Foundation, PO Box 259038, Madison, WI 53725-9038. Please make checks payable to WHA Foundation and note that it is for Hurricane Katrina victims. For more information, contact Mary Kay Grasmick, mgrasmick@wha.org or 608-274-1820.

Speaker Gard’s Task Force on Medical Liability held its first meeting this week, entertaining testimony from invited speakers.

Richard Sweet, a senior attorney with the Wisconsin Legislative Council, briefed Task Force members on the Supreme Court’s Ferdon decision and walked through potential solutions hinted at in the ruling. Most solutions discussed so far include elements of a higher cap.

Testifying after Sweet for the Wisconsin Academy of Trial Lawyers (WATL) was Christine Bremer Muggli, a personal injury attorney from Wausau. After thanking Rep. Gielow for the opportunity to testify, Bremer Muggli blasted the Legislature and Task Force for "ignoring injured patients." She described the courts as the only place where plaintiffs "are on an equal footing with special interests," and described the legislative process as just another way to "take away their (injured patients) rights." — all in the first three minutes.

Using a 10-pound stack of studies, Bremer Muggli dismissed the positive impact damage caps have had in other states and in Wisconsin. She credited the Injured Patients and Families Compensation Fund (formerly Patients Compensation Fund) with much of Wisconsin’s success in controlling medical liability premiums.

"It’s interesting to see all the new friends the Fund has acquired since the Ferdon decision came out," said Eric Borgerding, "because they were nowhere to be found when the Fund was being tapped for hundreds of millions of dollars to balance the state budget in 2003 and again in 2005."

Bremer Muggli called the caps "immoral," and after being asked repeatedly, indicated that the Wisconsin Academy of Trial Lawyers would oppose reinstatement of any caps. She also called on the Task Force to examine other issues, including insurance regulation, strengthening physician discipline and patient safety concerns.

Absent from Bremer Muggli’s testimony was any mention of the fact that Wisconsin allows for unlimited economic damages.

Following Bremer Muggli was joint testimony from WHA’s Eric Borgerding and the Wisconsin Medical Society’s Mark Grapentine. Borgerding lead off the testimony by thanking the committee for the opportunity to testify and for their "extraordinarily rapid and high priority response to the loss of Wisconsin’s cap on non-economic damages."

Among other points, Borgerding quoted from a May 12, 2005 report issued by Wisconsin Insurance Commissioner Jorge Gomez, an appointee of Governor Jim Doyle. In the report, issued just six weeks before the Ferdon ruling, Commissioner Gomez discussed the impact of 1995 Act 10 ($350,000 cap on non-economic damages plus inflation), described a then favorable medical liability climate, and the impact it has had on access to health care.

To conclude … Wisconsin’s malpractice marketplace is stable. Insurance is available and affordable, and patients who are harmed by malpractice occurrences are fully compensated for unlimited economic losses. Tort reform of 1995, along with well regulated primary carriers and a well managed and fully funded Injured Patients & Families Compensation Fund has resulted in the stable medical malpractice environment, and the availability of health care in Wisconsin." (emphasis added)

Following Borgerding was Mark Grapentine, senior vice president with the Wisconsin Medical Society.

"It is important to note that five out of seven Wisconsin Supreme Court justices believe there can be a constitutional cap on non-economic damages," Grapentine said. "While the Court’s decision has been jarring, the wide bipartisan call in the Capitol and by the general public to restore the caps provides comfort. This cry for action shows that health care affordability and availability are nonpartisan issues."

Borgerding and Grapentine also reacted to the notion of expanding the committee’s review to include other related issues.

The legislation should be limited to restoring the cap, but "if we expand the scope to include other issues, such as insurance regulation and physician discipline as suggested by WATL, then we should also be looking at attorney’s fees," Borgerding said. "After all, this is about making sure the maximum amount of an award makes its way into the hands of a plaintiff and their family."

"… reinstating a reasonable and effective non-economic damage cap is clearly the top priority, as it has the largest impact on physician access and health care costs," Grapentine said. Adding too much to any one bill decreases the chances of the bill’s ultimate success."

The Task Force is scheduled to meet again on September 8, at which representatives from the Physician Insurance Corporation of Wisconsin and the Injured Patients and Families Compensation Fund have been invited to testify.

Community benefit, charity care, corporate campaigns, and billing issues are among the timely topics that headline this year’s Health Care Provider Legal Issues Program being offered concurrently with the WHA Annual Convention on September 22 at the Kalahari Resort in the Wisconsin Dells. Gardner, Carton, & Douglas, LLP, a law firm that has been at the forefront of these issues in Illinois as hospitals there navigate this new legal minefield, will outline these issues and provide practical steps that hospitals can take to minimize the risk of attacks by plaintiffs, unions, and government officials and maintain their place as vital community assets.

In addition, the Wisconsin Attorney General’s office will provide their perspective on the matters they are hearing about and watching that are important to hospital and health care providers, including their particular interest in billing and collection issues. In the afternoon, a panel of hospital counsel will discuss important issues they are currently facing, including executive compensation audits, property tax exemption challenges, the Scruggs litigation, current Supreme Court decisions, medical staff relations, and more. The agenda for the day’s program will include:

• A session addressing matters such as the outlook for the class action cases, the relationship between the charity care controversy and corporate campaigns, the role of state and federal authorities in the billing and uninsured patient setting, the potential for enforcement actions and denial of property tax exemptions, and the realistic prospects for federal legislative reform.
• A Department of Justice attorney presenting the perspective of the Wisconsin Attorney General’s Office on consumer protection issues important to hospitals.
• A session addressing practical steps that can be taken by non-profit hospitals to minimize the risk of legal attacks by plaintiffs, unions, government officials, the media, and advocacy groups. The discussion will cover matters such as enhanced governance processes, improvements in the compensation practices, community benefit and charity care measurement and reporting, financial assistance programs, outreach and advertising, dialogue and responsible consumer advocates and vulnerable assessments.
• A panel discussion of the latest issues hospital counsel are facing and tackling. The discussion will be led by the panel members, who will present their experiences and positions on the following topics: executive compensation audits; property tax exemption issues; HIPAA security; insurance and self-insurance issues; the Scruggs litigation; recent Wisconsin Supreme Court decisions; medical staff relations; peer review developments; and other breaking news.

A brochure with registration form, as well as the option for on-line registration, is available at www.wha.org. For registration questions, contact Sherry Rabuck at 608-274-1820 or srabuck@wha.org. WHA is applying for 6.0 CLE credits for this program.

The past ten days under the Marble Big Top (aka, the State Capitol) have included a flurry of circus-like activity and, frankly, just downright strange rhetoric and attacks surrounding Wisconsin’s new, self-created, medical liability problem.

Apparently, if you poll Wisconsin voters in a fair and straightforward way as WHA and the Wisconsin Medical Society recently did (see article in last issue of The Valued Voice), and the results don’t jive with the likings of certain subsidized, fringe "activist" groups, then you earn the now almost standard label of "front group for the malpractice insurance industry and the Republican party." Or worse yet, you are "being used as pawns" by the insurance industry and Republican party (in yet another evil scheme to take over the world, no doubt).

I guess the Democrat-controlled House and Senate in Illinois didn’t understand that they too were a front group for the insurance industry when they passed, and Illinois’s Democrat Governor signed into law, caps on non-economic damages last week. Just wait until the Democrats in Illinois learn the real truth – that they are just pawns of Darth Vader and the Republican party!

Here’s another fact, unveiled in Capitol testimony this week by a representative of personal injury lawyers, meant to expose the "fallacy" of damage caps: medical liability insurance premiums are relatively low and have not driven up the cost of health care in Wisconsin. Well, case closed. Lets all just go home and not worry about the FUTURE ramifications of the Supreme Court’s Ferdon decision.

Perhaps the strangest move by opponents of damage caps is the tremendous effort they are making to point out that Wisconsin does not have a medial liability crisis. Wow, another shocker.

I even suppose, if pressed hard, these opponents might acknowledge that Wisconsin did have a cap on non-economic damages during the past ten years. But then they’d quickly tell you the caps were "immoral" (as they did this week), and had nothing to do with keeping costs down or preventing a liability crisis.

They will be the first to tell you that medical liability premiums have not blown through the roof in Wisconsin, nor have they contributed to rising health care costs, (while dismissing, or simply ignoring, what has happened in states without caps). Since doctors have not fled Wisconsin in droves, hospitals have not closed emergency rooms, and trauma care has not been curtailed, there is nothing to worry about in the wake of Ferdon.

It is true that none of these things have happened in Wisconsin … DURING A TIME THAT WE HAD DAMAGE CAPS! So now we should get rid of them?

If you are confused by the rhetoric, well, that’s because it’s confusing. Does anyone really believe that the caps we have had for the past ten years were meaningless, or that the Wisconsin’s Patients Compensation Fund is the only reason doctor’s and hospital’s liability premiums have been kept in check? If that’s the case, then I suppose things will stay the same, or even get better, without the caps … and if you believe that, I have an oil well in Fredonia to sell you.

Wisconsin’s now overturned caps on non-economic damages are the single most significant reason we have avoided the litigation-driven dismantling of our health care system — a predicament many other states have been forced to stomach, and are now being forced to remedy.

Shall we just sit around and wait, ignoring the lessons from other states? I think not, and am quite certain that a majority of those in the Legislature don’t want to sit around and wait either.

WHA looks forward to working with the Governor and legislators from both parties in the coming weeks to craft legislation and/or a constitutional amendment that will prevent Wisconsin from joining the ranks of medical malpractice "crisis states."

Offers of assistance from Wisconsin hospitals arrived almost simultaneously with the news of the dire conditions faced by hospitals in Louisiana and Mississippi. WHA has received assistance offers from hospitals ranging from medical teams, supplies, and financial assistance. These contributions of personnel and supplies are being collected and communicated on a statewide basis by WHA to both the American Hospital Association and to the Wisconsin Department of Health and Family Services (DHFS).

Mary Kay Grasmick, vice president of communications at WHA, is coordinating the effort to team up nurses, physicians, therapists, and other medical personnel from a number of hospitals who have offered to help. Several medical teams have already been formed and are waiting to receive further instructions.

"We are working closely with DHFS to coordinate the requests for assistance with supplies and teams that we have in Wisconsin; at the same time, we’re monitoring the requests that come in for personnel to staff the field hospitals," Grasmick said. "The coordination is still rocky between the states and federal government, so I have logged our hospitals’ available resources with both AHA and with DHFS."

WHA posted all resources that have been volunteered onto the AHA Web site, www.hospitalreliefefforts.org. Individual hospitals are encouraged to NOT fill out the form on that page, as WHA has already completed this step for the entire state of Wisconsin.

As more information is available as to when teams are needed and what supplies are necessary, WHA will contact all hospitals through our regular listserves, and through our new Hurricane Katrina email list. If you are not on the CEO, PR or hospital lobby email list serve, and you are interested in volunteering either skills or supplies, send your name and email to mgrasmick@wha.org and we’ll add you to our listserve.

The hospital industry has a long history of commitment to their core product, patient care. Wisconsin hospitals are leading the charge to improve the quality and safety of the care they provide to their customers. A new white paper added to WHA’s popular Toolkit at www.wha.org was developed by Dana Richardson, WHA’s VP of quality, to highlight the commitment of Wisconsin hospitals over the past five years to this important initiative.

The white paper includes information on public reporting efforts on quality, safety and service, including WHA’s CheckPoint; quality and safety improvement efforts such as JCAHO accreditation and the Wisconsin Node; patient safety, such as the new voluntary organization, Safe Care Wisconsin; and other activities.

Find this useful publication and more online at www.wha.org/toolKit/default.aspx. The new quality information is under Quality Improvement Activities.

On August 25, Illinois Governor Rod Blagojevich signed medical malpractice legislation limiting recovery of non-economic damages to $500,000 from physicians and $1,000,000 for hospital judgments.

Senate Bill 475 allows the state, for the first time, to deny medical malpractice rate increases. If a company files a request for medical malpractice rate increases of more than 6 percent, mandatory public hearings on the proposed increase will be held, Blagojevich said.

The new law also requires the Department of Financial and Professional Regulation to collect and make available actuarial data relied upon for pricing by every medical malpractice insurer.

In addition, S.B. 475 increases the statute of limitations from five to ten years, an adjustment that will allow the Department to target "pattern of practice" cases and discipline doctors who have multiple negligence cases in which no single case rises to the level of gross negligence.

Under the law, a new Web site will be created, Blagojevich said, containing physician profiles that give background information about the physicians and data on the physician’s history for the previous five years, including criminal convictions, malpractice awards, and disciplinary actions taken by Illinois or reported by other states.

Dr. Rhea Seddon, assistant chief medical officer for Vanderbilt Medical Group of Nashville, TN, and former NASA astronaut, will present the concept of "Crew Resource Management" (CRM) at the 2005 Wisconsin Quality & Safety Forum, scheduled for October 17-18 in Appleton.

Seddon is currently co-leading the initiative to improve patient safety and quality of care by using the aviation-based model of CRM at Vanderbilt Medical Center. Seddon will discuss its origination in aviation, as well as her experience with CRM during her three space flights, and her experience in leading the implementation of CMR at Vanderbilt Medical Center.

Health care quality managers, risk managers, CEOs/administrators, clinician managers, physicians, nurses, pharmacists, patient care services staff, quality improvement team members, and others should plan to attend this year’s Quality & Safety Forum, scheduled for October 17-18 at the Radisson Paper Valley Hotel in Appleton. The full education agenda and registration materials for the 2005 Wisconsin Quality & Safety Forum are available on-line at www.wha.org.

Register today, and don’t forget to ask for the WHA Quality & Safety Forum room block at the Radisson Paper Valley Hotel when making your hotel reservation. Call 800-242-3499 to make your hotel reservation. The special room rate will be available only until September 18.

The new fiscal year for the HRSA Hospital Disaster Preparedness Program runs from September 1, 2005 through August 31, 2006. The focus for this new fiscal year will be on communication technologies. The overall purpose of the funding is to establish a secure and redundant communications system that insures connectivity during a terrorist incidence or other public health emergency between health care facilities and state and local health departments, emergency medical services, emergency management agencies, public safety agencies, neighboring jurisdictions and federal public health officials. To achieve a minimal level of readiness, all participating hospitals will need to have secure and redundant communications systems that allow connectivity to all other health care entities and emergency response agencies. The State of Wisconsin’s goal is that all hospitals have 4 levels of communication redundancy. The funds ($2M) from the 2005/06 HRSA Cooperative Agreements will be provided to hospitals to assist them to achieve this goal.

All hospitals in Wisconsin will be asked to sign on for a satellite telephone system which will be provided at no charge to all hospitals. This $2,000 telephone will also include installation and a phase-out process for payment of annual/monthly fees. There will be an important and informative teleconference call on Thursday, September 8, from 9-10 am that will address questions around the satellite telephone, its use, installation and funding. The call-in number is 866-371-3124 and the conference ID is 8466735.

A Communications Technology Seminar will be held in Madison on October 11 (Crowne Plaza Hotel) and in Wausau on October 12 (Plaza Hotel). The State Expert Panel on Communications has released its recommendations. (These recommendations have been shared with your local hospital coordinator.) At the seminar, topic experts will be available to address issues and concerns, as well as address questions about these recommendations. Your local hospital coordinator for disaster preparedness has received detailed information on this seminar including registration materials. Your coordinator has also received a PowerPoint presentation for the September 8 teleconference on the satellite telephone system.

The contract for testing graduates of nurse aide courses in Wisconsin changed recently and the American Red Cross of Pennsylvania is now doing the testing. WHA is interested in hearing how well the new system is working and what, if any, issues have arisen from hospitals that sponsor nurse aide courses.

Monica Hilt has been named president of Sacred Heart-Saint Mary’s Hospitals effective August 18. Hilt was vice president of human resources and has been at Sacred Heart-Saint Mary’s Hospitals for 14 years progressing through several management levels.

"Monica demonstrates the behavioral skill set of a Ministry Health Care leader and has a passion for her work," according to Nick Desien, president and CEO of Ministry Health Care. "She demonstrates the behavioral skill set of a Ministry Health Care leader."

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