August 16, 2013
Volume 57, Issue 33

Misguided Medicare Recommendation Would Decimate Rural Health Care
53 of Wisconsinís 58 small, rural hospitals impacted

In a joint news release dated August 16, the Wisconsin Hospital Association and the Rural Wisconsin Health Cooperative cautioned that a proposal in an August 15 report would have staggering implications for rural health care across the country and negatively impact almost every rural hospital and community in Wisconsin.

"What a federal agency is proposing is nothing short of astounding," said Wisconsin Hospital Association President Steve Brenton, referring to a report released by the federal Department of Health & Human Servicesí Office of Inspector General (OIG). "These recommendations would decimate 20 years of health care stability and access to care for Medicare beneficiaries in rural communities across America."

In its report, the OIG recommends removing a Medicare payment status known as "critical access hospital" (CAH) for hospitals that do not meet certain distance requirements. The recommendation disregards the fact that each of the impacted hospitals was deemed a necessary provider by their respective states. Nationally, the OIG recommendation would rescind this status for roughly two-thirds of the nationís CAHs. In Wisconsin, the impact is even worse, resulting in 53 of 58 CAHs losing this status.

"Implementation of this recommendation in Wisconsin will cause great harm to keeping local care local," said Rural Wisconsin Health Cooperative Executive Director Tim Size. "Ending critical access hospital status for most rural hospitals in Wisconsin will eventually lead to the loss of many of these hospitals along with many jobs in already economically vulnerable rural communities."

Medicareís CAH status was enacted under the Balanced Budget Act of 1997 as Congress sought to address the closure of hundreds of rural hospitals across the country, which, due to their small size and care for disproportionately older, sicker and poorer patients, could not financially survive under Medicareís traditional payment system. The CAH designation provided an alternative reimbursement structure for these very small, rural hospitals in order to keep their doors open.

Since that time, the CAH program has operated efficiently, represents less than five percent of Medicareís total hospital budget, and has provided more than 60 million rural Medicare beneficiaries in the U.S. with access to health care that is close to home.

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WHA and WMS Demand Payment Rule Reconsideration to Avoid Bad Debt Spike

WHA President Steve Brenton and Wisconsin Medical Society (WMS) CEO Rick Abrams are calling on CMS Administrator Marilyn Tavenner to "reconsider a worrisome provision" in recent rules implementing the Affordable Care Act that could cause bad debt to skyrocket in 2014. (See the letter at

The rule provides a 90-day grace period during which coverage for individuals enrolled in insurance exchange/marketplace plans cannot be terminated for failure to pay premiums. Health plans are allowed to pend and then later deny claims after the initial 30 days of the grace period.

The regulatory direction is an "about face" for CMS, as the agency had initially proposed that health plans be required to pay all appropriate claims for care rendered during the grace period. Under that earlier provision, the health plans would have received the federal subsidy for the beneficiary during the grace period regardless of the individualís failure to pay their premium.

The CMS decision "places a heavy burden of uncertainty on the provider community," according to Brenton and Abrams, who call on Tavenner to reconsider the decision. They also note that provisions within the rule requiring health plans to notify providers about the status of a covered individualís premium status "as soon as practicable" is an inadequate protection open to "wide interpretation by health plans."

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New Legislator Profile: Rep. Robb Kahl (D-Monona)
A series of interviews with newly-elected legislators, by Mary Kay Grasmick, editor

As a four-term mayor of Monona, Rep. Robb Kahl knows what it takes to attract new business to a community. And high quality, accessible health care is very high on his list.

Now he is using those experiences to guide his decisions as a newly-elected member of the Wisconsin State Assembly.

"Employers look for this asset. Health care is one of the top five criteria that employers use when they are scouting a new location," according to Kahl. "You must have a quality education system and great health care. In Wisconsin, we have a first-rate university, a great network of private colleges, and we have top-rate health care. As an employer myself, I know they are looking at quality of life, and that includes access to high quality health care."

Monona is just across the lake from Madison, which is well-known for its hospitals and network of clinics. But during his tenure as Mayor, Kahl saw a need to have better access to medical clinics, and he was able to attract two ones to Monona.

"You donít have a community that can thrive and grow if you do not have a hospital, a clinic or a provider in it," he said.

From the perspective of a business coming to a new area, Kahl said one of their primary considerations is where employees will go for their health care and how their decisions will affect the cost of doing business.

"If you have off time for appointments, sick time and care, or if your employees have kids and they need to run them to the doctor, you have to factor in those costs, and you want care nearby," Kahl said. "If you look at the quality of our health care, it is an incentive for businesses to be in our communities, and it is also a strong economic development benefit."

Kahl said he has been impressed with the "phenomenal job" that Wisconsin hospitals have done in reducing readmissions. He went so far as to say that if there are things the state can do in the Medicaid program to provide incentives or reward hospitals for improving quality, it should do them.

"But most importantly, the benefit of high quality care is to the patient who can get back to work quicker, their children are healthier, and it reduces the stress in their lives," Kahl observed. "We have done a great job in this state Ďcatchingí patientsí issues before they end up back in the hospital. I just think that it should be recognized."

Kahl believes there is a role for the state in ensuring that Wisconsin has enough physicians to meet the future demand.

"We need to work with our medical colleges and get more students to attend medical school here, then continue their post-graduate training in the more rural areas of the state," said Kahl. "If we can provide some incentives while they are in training and if they can build a good base of potential patients, you make them feel like they are an essential part of the community and they are more likely to stay."

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DHS Announces Regional Enrollment Network Meeting Schedule

As reported in The Valued Voice August 2, the Department of Health Services (DHS) is forming Regional Enrollment Networks. These networks are intended to bring together at a local level those who are working on enrollment activities. DHS announced that they are planning kickoff meetings in each region. Each meeting will have a regional facilitator and host in partnership with DHS, Covering Kids and Families, and the Wisconsin Primary Health Care Association.

The meeting schedule and contact information for each region is below. All meetings will be from 8:00am Ė 3:00pm. Register at







Bay Lake

Brown, Door, Marinette, Menominee Oconto, Shawano

Tuesday, August 20

University Union, University of Wisconsin-Green Bay (Room Phoenix B)

Elizabeth Jungers


Crawford, Grant, Green, Iowa, Jefferson, Lafayette, Rock

Tuesday, August 20

Hilton Garden Inn Ė Middleton, WI

Julie Milleson

East Central

Calumet, Green Lake, Kewaunee, Manitowoc, Marquette, Outagamie, Sheboygan, Waupaca, Waushara, Winnebago

Wednesday, August 21

Winnebago County Expo Center, 500 E. County Road Y, Oshkosh, WI

Elizabeth Jungers


Great Rivers




Barron, Burnett, Chippewa, Douglas, Dunn, Eau Claire, Pierce, Polk, St. Croix, Washburn

Wednesday, August 21



Wisconsin Indianhead Technical College (WITC)  Rice Lake, WI



Michelle Larson




Adams, Columbia, Dane, Dodge, Juneau, Richland, Sauk

Thursday, August 22

Alliant Energy Center, Madison, WI (Mendota Rooms 2-4)

Amy Bell


Ashland, Bayfield, Florence, Forest, Iron, Lincoln, Price, Rusk, Sawyer, Taylor, Vilas, Wood

Friday, August 23


Monday, August 26


Wednesday, August 28

Flat Creek Inn, 10290 Highway 27 South Hayward, WI

Eagles Club, 1104 South Oak Avenue, Marshfield, WI

Forest County Potawatomi Auditorium, 5416 Everybodys Road, Crandon, WI

Melody Yeager


Langlade, Marathon, Oneida, Portage

Tuesday, August 27

Best Western Midway Hotel, Wausau, WI

Bill Hanna

Moraine Lakes

Fond du Lac, Ozaukee, Walworth, Washington, Waukesha

Tuesday, August 27

County Springs Hotel and Conference Center, Waukesha, WI

Angie Moran


Buffalo, Clark, Jackson, La Crosse, Monroe, Pepin, Trempealeau, Vernon

Monday, August 26

Lunda Center, Western Technical College, LaCrosse, WI

Jamie Fawcett


Kenosha, Racine

Wednesday, September 4  (*10:30am Ė 3:30pm)

Gateway Technical College Auditorium, Sturtevant, WI

Sarah Fraley


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Guest Column: Wisconsin Health Care on the Road to Reform
By Eric Borgerding, WHA Executive Vice President

Reprinted with permission from the WI Farm Bureau Federationís Rural Route magazine, Aug-Sept. issue.

Health reform has been in the headlines for months. From the local coffee shop to the hospital board roomóconversations are taking place about the impact the law will have in our state.

Quite honestly, Wisconsin health care providers were already well down the road to reforming health care long before it became the law of the land. Wisconsin is nationally recognized for providing some of the highest quality, safest and most accessible patient care in the country. Thatís not to say we canít improve, because we certainly can. With or without health reform, hospitals are focused on improving quality, moderating costs and raising the health status of our communities.

Thatís not to say health reform is without challenges or that it wonít bring changes to Wisconsin that we didnít ask for. But we think Wisconsin is well positioned to manage the coming changes. Thatís because Wisconsin has one of the most highly integrated, or coordinated, health care systems in the country. Meaning physicians, hospitals and other care providers work together to make sure that patients receive the right care, in the right place, at the right time. If health care is coordinated, it is less costly, more efficient and delivers better outcomes.

When care is coordinated it is less likely that a patient will be readmitted to the hospital. Last year, Wisconsin hospitals reduced their readmissions by more than 15 percent. In states where care is less integrated, or more "siloed" (pun intended), itís difficult to achieve those types of results. Our health care systems invest heavily in family physicians, nurse practitioners and other "primary care" providers because they are the first point of entry into this more coordinated systemóthey are the patientís navigator and partner.

Health reform introduced us to a new conceptóthe health insurance exchange. Under the new law, people earning up to $46,000/yr ($94,000/yr for a family of four) will be eligible for government-subsidized premiums if they purchase insurance through the exchange. In theory, exchanges are also a way for consumers to compare, select and purchase an insurance plan, similar to how we buy airline tickets on Travelocity. In reality, purchasing health insurance, even if heavily subsidized, is more complicated than buying a plane ticket. There are co-pays and deductibles to consider, as well as how accessible the physicians and hospitals are that are included in the plan you might select.

Will health insurance exchanges affect how you purchase insurance and will they result in more people having insurance? Itís hard to say since there is so little concrete information available about exchanges. Thatís a concern given that exchange enrollment is supposed to begin in less than three months. We do know that the Wisconsin state budget calls for moving some 90,000 low-income people who are now in Medicaid into the new exchange. Some are predicting large premium increases in Wisconsin, especially for those who are relatively healthy. Others speculate that many employers will drop coverage altogether, in favor of allowing people to connect on their own with coverage in the exchange.

The bottom line is this is an uncertain time in health care. We can agree that we cannot have more expensive insurance or fewer people with insurance and more people coming into hospital ERs for basic care. In spite of these challenges and uncertainties, Wisconsin hospitals, clinics and health systems will continue to put patients first and will not be deterred from their commitment to improve care and achieve better outcomes for their patients. That is the good news for everyone who lives in Wisconsin.

To see this article in Rural Route magazine, go to:

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State Legislators Host CMS, Senator Baldwin for ACA Roundtable
Exchange readiness and outreach key issues from stakeholder panel

State Senator Jon Erpenbach (D-Middleton) and Representative Jon Richards (D-Milwaukee) held a roundtable discussion August 14 with health care providers, insurers, consumers and policymakers from the state and federal government to discuss the operational readiness of the health insurance exchange in Wisconsin, and issues around enrollment in Medicaid and exchange coverage. Invited guests included U.S. Senator Tammy Baldwin (D) and Jackie Garner from the federal Department of Health and Human Services, who joined the roundtable from Chicago through a videoconference and presented to the group for nearly an hour. Included in the roundtable was WHAís Senior Vice President for Policy and Research Joanne Alig. Also attending were Wisconsin Department of Health Services (DHS) Deputy Secretary Kevin Moore, Medicaid Director Brett Davis, Office of the Commissioner of Insurance (OCI) Deputy Commissioner Dan Schwartzer and representatives from other stakeholder groups.

Garner began by discussing the operational readiness of the federal health insurance exchange. She stated that IT systems have already been established to communicate with health insurers offering qualified health plans (QHPs) in the exchange. Garner described the federal data services "hub" that connects the exchange to other databases to verify applicant information, indicating that it is complete but still in the final testing phases.

Garner also commented at length about outreach to organizations that will help individuals enroll in the exchange starting October 1, noting that hospitals and clinics are well established to do outreach to consumers, since those institutions have been working on Medicaid eligibility for years. In addition to the navigator and certified application counselor enrollment assister function, CMS has developed a new classification of partners called Champions for Coverage for those that want to provide outreach and connect people to enrollment resources. Speaking about the outreach efforts that will need to occur all over the nation, Garner said that, "right now we are in that time period where it is very important to begin that educational process." Garner commended the work of Brett Davis and his team, saying that "they have been fabulous partners, and weíre very grateful for the way that we have been able to work together."

From a state perspective, Moore and Davis told the group about the work that the Department is doing to accomplish Governor Walkerís goal of providing health care coverage to nearly 225,000 more people in Wisconsin. "We are working at 110 percent capacity to do what Wisconsin needs to do to fulfill the needs of the people of Wisconsin and to fulfill, ultimately, the overarching goal of trying to cut the uninsured rate in Wisconsin," said Moore in introductory remarks. The DHS officials said that they were concerned with "cross current" messaging causing confusion among consumers. The Department said it believes that consumers need to hear a consistent message from all those conducting outreach in order to maximize the potential of someone signing up for coverage.

WHAís Joanne Alig discussed the engagement of WHA members in getting individuals enrolled in the exchange. She also mentioned the need for education on items like insurance literacy that will need to take place so individuals begin to understand what products they are purchasing. The group discussed a host of other issues of concern to providers, insurers and consumers. Continuity of care for individuals who will be disenrolled from Medicaid, and affordability of coverage were identified as concerns, as were the premiums and rates charged by insurers in the exchange. Deputy Commissioner Dan Schwartzer informed the group that even though 13 plans have submitted their information to participate in the exchange, all 13 may not end up selling products on the exchange. Although Schwartzer indicated that it is still early to confirm who will participate and what premiums will look like in the exchange, OCI is conducting an analysis of the rates submitted by those insurers and will make their analysis public once complete.

Sen. Erpenbach and Rep. Richards are planning to host another roundtable meeting in November with Director Garner.

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Federal and State Officials Share Enrollment Information with WHA

In the third of WHAís members-only webinar series, held August 14, federal and state officials described in more detail how hospitals and health systems can engage in enrollment activities. The impressive speaker line-up included Cathy Leonis, a health insurance specialist with the Centers for Medicare and Medicaid Services (CMS), who is focused on outreach and enrollment efforts for the health insurance exchange specifically in Wisconsin; Brett Davis, Wisconsinís Medicaid director; and J.P. Wieske, legislative liaison and public information officer for the Wisconsin Office of the Commissioner of Insurance (OCI).

With just 48 days before open enrollment, Leonis said the federal government remains "on track and on schedule to ensure the marketplace is up and running and open for business in every state on

October 1." In addition to providing general information, Leonis provided more specifics about the certified application counselor (CAC) requirements. These requirements are of particular interest to hospitals, as this is the category of enrollment assisters that is most applicable to hospital staff. Leonis indicated that organizations employing CACs will first have to submit an application online to the federal Department of Health and Human Services (HHS). Those organizations will receive a "welcome packet" including templates for entering into a formal agreement with HHS and with their employed CACs: standard operating procedures for CACs; and how to connect to CAC training. CACs will be required to take five hours of federal training.

Davis provided information about Wisconsin Department of Health Servicesí (DHS) vision and commitment to reducing the uninsured in the state by half. Davis provided details about the DHS outreach plans, including sending letters and making phone calls to those who might be disenrolled from Medicaid beginning January 1, and contacting individuals on the Core Plan wait list. Davis also noted he wanted to work with WHA as they generate reports for providers about the members they have served in the past who might be disenrolled beginning January 1. Davis provided information about the regional enrollment networks (see related story). He also noted that DHS is currently working on developing rules and processes for hospitals to be able to implement presumptive eligibility determinations for adults beginning January 1. Davis ended with a note of caution that there is still some important system testing with HHS that needs to be completed to allow for an applicantís information to be electronically transferred between the federal insurance exchange and the Medicaid program. They believe this testing will be completed soon, but it is a "remaining risk," he noted.

Wieske provided an update on new requirements for enrollment assisters that was included in the recently-enacted biennial budget act (2013 Wisconsin Act 20). Wieske expressed concern that "sham operators" could come into the marketplace. OCI recognizes the need to protect consumers, but "balanced with the needs in the short term with the short time frames weíve got" for exchange enrollment. Wieske noted that entities employing CACs will have to register with OCI. The registration process is still under development, but they expect it to be a simple format. CACs will be required to complete 16 hours of training this year and take an exam. The exam fee is estimated at $75, and the exam will be offered at training sites throughout the state. Training is being offered via web, and could cost as much as $150 per person. OCI will also provide training in-person at no cost for the training itself. WHA is working with the Rural Wisconsin Health Cooperative and the Healthcare Financial Management Association to offer in-person trainings, and the Milwaukee HealthCare Partnership is sponsoring an in-person training as well. More information about these trainings will be available on WHAís website and in a future Valued Voice.

With all of the quickly moving parts, WHA has now expanded its website to include information about enrollment assistance and how and where to access the federal and state trainings. As information becomes available, the website will be updated. You can visit the website at:

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HHS Announces Wisconsin Navigator Grant Awardees
Funding falls short of what will be needed to fund a robust program

The Department of Health and Human Services (HHS) announced August 15 that six organizations will split a little more than $1 million in federal funding to serve as "navigators" for those who need assistance connecting with coverage in Wisconsinís exchange. While HHS originally anticipated $830,000 in grants would be available in Wisconsin, the small increase in actual funding still falls woefully short of what is necessary to fund a robust navigator program.

Navigator entities will be required to facilitate the selection of a health plan in the exchange, providing fair, accurate and impartial information. They will have to maintain expertise in the insurance exchange, provide information about the Medicaid program to consumers, and conduct public education as well. Navigator staff would be required to complete up to 30 hours of an HHS-developed training program, and pass an exam.

Grant recipients are listed below. Those marked with an asterisk (*) are operating in more than one state. The anticipated grant amount listed in each case only applies to the amount going to that organization for that stateís specific operations.

Partners for Community Development, Inc.
Anticipated grant amount: $315,720
Partners for Community Development will facilitate the enrollment of the uninsured with emphasis on reaching out to Hispanic and Hmong families and other hard-to-reach eligible consumers in Door, Kewaunee, Manitowoc, Ozaukee, and Sheboygan Counties in Wisconsin. It will focus outreach and enrollment efforts in its service area on hard-to-reach consumers and families with limited English proficiency.

Northwest Wisconsin Concentrated Employment Program, Inc.
Anticipated grant amount: $285,035
The Northwest Wisconsin Concentrated Employment Program will help lead a navigator project in their region to promote accessibility to the health insurance exchange and the health care system in Wisconsin. The cooperative agreement will be used to provide exchange navigator services at 21 Wisconsin Job Centers with outreach provided at libraries, senior centers and college campuses by existing staff that have experience working with diverse populations.

Legal Action of Wisconsin, Inc./SeniorLAW
Anticipated grant amount: $70,000
SeniorLAW is a community and consumer-focused nonprofit located in Milwaukee that provides a variety of services to individuals age 60 or over, mostly related to health insurance and public benefits. This group will conduct outreach to the 60-64 population in Wisconsin, using community education, client contacts and agency relationships that SeniorLAW has established throughout Southeastern Wisconsin.

National Council of Urban Indian Health*
Anticipated grant amount: $35,000
National Council of Urban Indian Health is the only national, membership-based organization dedicated to outreach and education on behalf of Urban Indian Health. It provides training, technical assistance, outreach, and education to Urban Indian Health Programs.

National Healthy Start Association
Anticipated grant amount: $191,667
The National Healthy Start Association is a non-profit organization that works to improve birth outcomes and health disparities across the country through the federal Healthy Start programs. They will reach out to the uninsured population and provide education and assistance services for exchange enrollment.

R&B Receivables Management Corporation DBA R&B Solutions
Anticipated grant amount: $104,520
R&B Receivables Management Corporation currently works to connect uninsured and underinsured individuals with coverage options to help them afford health care. They will expand their services to connect with a broader range of underserved populations, and leverage their experience screening people for eligibility for medical assistance programs to connect people with coverage.

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Grassroots Spotlight: HSHS St. Nicholas Hospital (Sheboygan) Hosts Legislators

Rep. Endsley participates in shadow day
State Rep. Steve Endsley (R-Sheboygan) visited St. Nicholas Hospital in Sheboygan for a shadow day August 14.

As part of this shadow day opportunity, Endsley observed a safety huddle and discussed its importance with St Nicholasí leaders. He was able to talk with the hospitalís LEAN coordinator about how LEAN techniques apply in health care.

Rep. Endsley spent time in the emergency department, learned about St Nicholasí outreach and community benefit efforts and saw firsthand the hospitalís use of its electronic medical records system. He was also able to tour the hospital campus.

U.S. Rep. Tom Petri Visits
U.S. Rep. Tom Petri took time during the August Congressional recess to also visit St. Nicholas Hospital.

While at the hospital, Petri was able to learn about and tour the emergency department as well as the hospitalís wound center and hyperbaric program. He was able to better understand how the use of an electronic medical record at the hospital has facilitated quality and productivity improvements and understand the importance of meaningful use dollars in assisting hospitals to implement this technology.

Hospital leaders also discussed the negative impact of the federal Recovery Audit Contractor program and how improvements to the program could be made, specifically, improvements as contained in the Medicare Audit Improvement Act, HR 1250.

Both of these visits are several of many hosted by hospitals connecting legislators to the hospitals in their districts. WHA greatly appreciates the willingness of hospitals like St. Nicholas in hosting their legislators.

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High Value Health CareóWisconsinís Competitive Advantage: Ministry Saint Michaelís Hospital Multidisciplinary Team Approach Reduces Fall Rate

Sometimes it is difficult to improve a process when you are part of it. That is why when Ministry Saint Michaelís set out to reduce the number of patient falls, they assembled a multidisciplinary team.

"When you bring staff in to help you improve a process that they may not be involved in as closely, they can provide a perspective that you may not have considered," said Margo Lamarche, manager, patient care services and leader of the falls project team at Ministry Saint Michaelís Hospital.

The team at Ministry Saint Michaelís employed a number of strategies and interventions that helped decrease their fall rate, including:

In addition, during the course of the project, they also had two significant capital purchases that were completed:

The staff for the WHA Partners for Patients initiative has helped Ministry Saint Michaelís Hospital by providing tools, facilitating best practice sharing and providing monthly webinars focusing on the IHI Model for Improvement.

"There is no magic care bundle that if used will eliminate falls in a hospital. Reducing the falls rate is hard work that takes a concerted multi-faceted effort," according Tom Kaster, WHA quality improvement advisor. "Ministry Saint Michaelís success is an example of how using the IHI Model for Improvement to incorporate evidence-based practices can result in rapid improvement. They have worked hard and their results show it."

Lamarche said the team will continue to collect and analyze data and share it throughout the hospital.

"Patience and persistence are two attributes that you want to look for when you select the members of your improvement team," according to Lamarche. "The data helps keep us focused on the work at hand and it helps to inform our quality improvement efforts. It helps us know how far we have come, and it directs us to what we need to do next."

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Conference Focuses on Graduate Medical Education, October 24

Hospital and health system leaders as well as other senior decision makers involved in the process of evaluating or implementing graduate medical education (GME) within their organization should consider attending the upcoming one-day event, "Taking the Next Step: A Statewide Conference on Graduate Medical Education."

Scheduled October 24 at the Best Western Bridgewood Resort Hotel & Conference Center in Neenah, this event is hosted by the Wisconsin Council on Medical Education and Workforce (WCMEW), in an effort to assist those organizations considering GME to move forward in the process.

Agenda topics will include how GME fits into an organizationís strategic plan, items to consider when starting a GME program and a review of the current GME funding environment. A variety of Wisconsin case studies will also be examined, with panelists sharing lessons learned on making consortiums work and gaining physician engagement.

A full agenda and online registration are available at:

For questions, contact Chuck Shabino, MD, WHA senior medical advisor, at or George Quinn, WHA senior policy advisor, at

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Register Today for the WHA 2013 Leadership Summit
September 19, 2013***Country Springs Hotel, Pewaukee

Full agenda and online registration available at

Need lodging? Make your hotel reservations before the August 28 deadline.

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DQA Announces Workshops on Investigating and Reporting Allegations of Misconduct

The University of Wisconsin Ė Oshkosh Center for Career Development (CCDET) is accepting registrations for an upcoming caregiver project workshop titled "Investigating and Reporting Allegations of Misconduct" to be held in several locations September through November. The Wisconsin Division of Quality Assurance (DQA) partners with CCDET to offer workshops at a cost partially subsidized by DQA.

According to CCDET, the four-hour class will help non-nursing home staff participants indentify the key components of conducting internal investigations into allegations of abuse, neglect, and misappropriation. The participants will develop an investigation protocol while learning about how to conduct investigations, interviewing skills, caregiver misconduct definitions, and reporting requirements for non-nursing homes.

The workshops will be held in Brookfield (September 13), Eau Claire (October 9). Oshkosh (October 25), and Tomah (November 6). To learn more about the program or to enroll, go to the following website:

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Wisconsin, Illinois to Sponsor Joint State Marketing/Public Relations Conference

For the first time, the Illinois Society of Healthcare Marketing & Public Relations (ISHMPR) and the Wisconsin Healthcare Public Relations & Marketing Society (WHPRMS) are joining forces to sponsor a joint conference October 23-25 at the Abbey in Fontana, WI.

The conference will feature presentations from national health care marketing experts who will offer suggestions and strategies applicable for organizations of every size. Meet colleagues from two states who are addressing similar challenges and network with industry leaders. The conference will feature a track specifically designed for small and rural hospital marketers.

Public relations and marketing professionals from hospitals, clinics and other health care provider organizations throughout Illinois and Wisconsin will want to attend. You do not need to be a member of ISHMPR or WHPRMS to attend the event.

The full agenda and registration information are at:

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Wisconsin Hospitals Community Benefits: Acute, Chronic and Communicable Disease Prevention and Control

Hospitals are well aware of the critical role they have in protecting public health. Whether it is working with public health agencies to develop protocols and responses to pandemic flu outbreaks, teaching children proper hand-washing techniques or educating people about how to live with chronic conditions, Wisconsin hospitals partner with key stakeholders to improve the health status of their communities.

Better Breatherís Club

Black River Memorial Hospitalís Respiratory Care Department has started a Better Breatherís Club. The Club is a program open and free to the public and designed to connect every other month with patients who have chronic pulmonary diseases, such as: COPD, asthma, fibrosis, etc.

Each meeting includes current events regarding pulmonary disease and some exercise tips for participants to try at home. Topics like traveling safely with oxygen, humidity, elevation, air quality checks have been covered. Several community members have been engaged with the program and have been recommending it to their friends who need help with breathing.

Black River Memorial Hospital, Black River Falls

The test that keeps on testing

On a seemingly ordinary day in September of 2008, Deanne F. of Medford went to wake her son for school. As she was preparing for the day, she noticed weakness on the right side of her body. Feeling tired, she sat down to take a break, watch the morning news and take a quick nap, or so her son thought. Little did she know this day would change her life forever.

Deanne woke up in the hospital 13 days later from an induced coma. What her son thought was a nap, was really a thalamic stroke. A thalamic stroke affects the thalamus, which is the area of the brain responsible for relaying sensation, for motor signals and spatial sense to the brain. A stroke occurs when the blood supply to the brain is suddenly interrupted. Unless the flow of blood can be quickly restored, brain cells begin to die, and various functions the brain controls begin to deteriorate. A thalamic stroke occurs in 15 percent of all stroke cases (more than 140,000 people die each year from stroke in the United States), with only a four percent survival rate. "I feel very blessed to be here," says Deanne.

After coming to the realization of her prognosis, Deanne now had to figure out how to manage life after a stroke. A positive, bubbly and forward thinker, she never let it get her down. "I refuse to let this stroke define me," says Deanne. "Iím going to have a sense of humor about it and live each day as I did in the past."

Deanne was searching for other people who were living life after a stroke, but found there werenít options in the area. After speaking with Sherry Meyer, marketing and sales for Memorial Nursing & Rehab Center, they started a stroke support group.

Today, a small group of stroke survivors meet monthly to discuss options to make life easier. "The group means so much to all of us. Itís the understanding of knowing what each other is going through. Itís not just emotional, itís the practical day-to-day things, and itís learning the new normal post-stroke," says Deanne. The group invites speakers, including occupation and physical therapy, yoga specialists and more. Each meeting brings hope and joy to each other through camaraderie and understanding.

"While a stroke wasnít in my plan, itís truly been a gift Ė a gift of faith that tests me every day," says Deanne.

Memorial Health Center, Medford

Submit community benefit stories to Mary Kay Grasmick, editor, at

Read more about hospitals connecting with their communities at

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