August 23, 2013
Volume 57, Issue 34

WHA Engages State Legislature in Fight for Rural Health Care

This week the Wisconsin Hospital Association worked directly with state legislators on a bipartisan "Dear Colleague" letter to Wisconsin Members of Congress in support of their local critical access hospitals (CAHs). Leading efforts in the State Legislature on the letter are Sen. Sheila Harsdorf (R-River Falls) and Sen. Bob Jauch (D-Poplar) along with Reps. Kathy Bernier (R-Chippewa Falls) and Chris Danou (D-Trempealeau). The lead sponsors asked their colleagues in the Senate and Assembly to join them in signing the letter. In their message to the rest of the Legislature, the four lawmakers wrote that, "Critical access hospitals are foundational elements of Wisconsin’s rural health care infrastructure, important economic drivers and provide family-sustaining jobs. We strongly support the role of our CAHs in our communities and hope you do too by joining us on this letter." The bipartisan letter was released August 22 and more than 40 members of the State Legislature have already signed on.

"While this is a federal issue that will be deliberated in Washington, the impact will be severe and felt in state legislative districts across Wisconsin," said WHA Executive Vice President Eric Borgerding. "We are very pleased the State Legislature, in bipartisan fashion, is weighing in with our congressional delegation and taking action to help stop this misguided proposal in its tracks."

The "Dear Colleague" letter is in response to a recent recommendation from the federal Department of Health & Human Services’ Office of Inspector General (OIG), which recently proposed the essential elimination of CAH designation for roughly 850 of the nation’s 1,300 CAHs based on their distance from another hospital. The proposal would impact the vast majority of Wisconsin’s 58 CAHs.

Removing the CAH designation, which allows for an alternative Medicare reimbursement structure for low-volume hospitals in underserved areas, could have damaging effects to rural hospitals and could threaten the availability of core hospital services to Wisconsin citizens.

In addition to the importance of having access to health care available locally, the letter expresses support for the role of CAHs as economic engines in rural communities.

"Rural hospitals are often one of the largest local employers, providing family-supporting wages that ripple throughout rural communities and that generate tax revenue to support state and local services," the letter reads. "A 2009 study, updated in 2011, by the University of Wisconsin-Extension and the Wisconsin Hospital Association, revealed that hospitals across the state generate $28 billion in economic activity and employ over 100,000 people. The study found that hospitals were one of the top ten employers in 44 of Wisconsin’s 72 counties and one of the top five employers in 20 counties."

Unfortunately, this is not the first time CAHs have been targeted based on their distance from another hospital; however, this is one of the most aggressive proposals to date. Other proposals have focused on an arbitrary distance such as ten miles from the next nearest hospital. The recent OIG proposal is especially troubling as Congress faces significant fiscal decisions later this fall, including addressing the debt ceiling, the federal budget, and physician payments under Medicare.

In related news, the Wisconsin Hospital Association and Rural Wisconsin Health Cooperative sent a joint letter to the Congressional Delegation opposing the OIG recommendation.

Top of page (8/23/13)

Officials Tout Access, Cost Savings of Regionalizing Mental Health Services
Regionalization a key recommendation of WHA’s Mental Health Task Force

Public mental health services in La Crosse, Jackson, and Monroe Counties are being transformed into a regionalized service model pursuant to a pilot project formally announced August 16. A goal of the pilot project is to potentially identify a new way of organizing public mental health services in Wisconsin.

Transforming Wisconsin’s county-based public mental health system into a regionalized system has been a key reform recommendation of WHA’s Mental Health Task Force to make access to mental health services more consistently accessible across Wisconsin.

"My access to care shouldn’t be limited by the geography of where I live," DHS Secretary Kitty Rhodes said at a press conference announcing the project last week. She also noted the differing levels of access to mental health services between rural and urban counties, and that providing services on a regional basis will reorganize the delivery of mental health services, according to the LaCrosse Tribune.

"The regional pilot is a really good thing for patients in the La Crosse region," said Ann Stekel, administrative director of behavioral health services at Gundersen Health System. "Collaborating and sharing resources across county lines is a step in the right direction toward broader mental health access in the region."

"Mayo has been a supporter of collaborative efforts to increase availability, access and quality of mental health services for individuals in our region. As we have worked with the counties in the consortium on past efforts, they have demonstrated their strong administrative capacity, leadership and commitment to providing greater access to mental health services for patients in a more efficient and effective way," said Betty Jorgenson, RN, MSN, administrator, Mayo Clinic Health System-Franciscan Healthcare. Jorgenson also served as past chair of the La Crosse Medical Health Science Consortium’s Population Health Committee, which has focused on increased community awareness and improved care for mental health patients. "As others have said, this could become a potential model throughout Wisconsin. "

Officials at the press conference also touted the cost savings of consolidating county public mental health services across a region of counties and the ability to reinvest those savings into better access to services.

"We will capitalize on community resources, not replace them, and expand without the need for additional tax levels," Matt Streittmater, manager of the La Crosse County Human Service Department’s mental health recovery programs told the La Crosse Tribune.

"We are really headed for new heights, with the administrative savings we will have and avoid duplication of services," said Monroe County Human Services Director Linda Lazer, according to the La Crosse Tribune article.

In addition to the La Crosse area pilot, Barron, Buffalo, Chippewa, Dunn, Eau Claire, Pepin and Pierce counties are also participating in a similar regional pilot for mental health services.

WHA has identified Wisconsin’s reliance on a county-based public mental health system as a root cause of inefficiencies, differing levels of access to care, and an inefficient distribution of preventive and emergency mental health services throughout Wisconsin. WHA has recommended to the Speaker’s Mental Health Task Force that Wisconsin accelerate efforts to develop a regional system for public mental health services. Those recommendations mirror recommendations made in WHA’s 2010 Behavioral Health White Paper and recommendations to the Wisconsin Legislative Council’s Special Committee on Emergency Detentions in 2010. Those recommendations can be found at:

Top of page (8/23/13)

Political Action Campaign at 55% of Goal

Totals to the 2013 Wisconsin hospitals state political action funds fundraising campaign continue to climb. Surpassing the halfway mark raising an additional $15,000 from 38 more contributors including adding two more Platinum Club members in the last two weeks, the campaign has raised more than $143,000 from 207 individuals. This puts the 2013 campaign at 55 percent of the goal to raise $260,000 by year’s end.

Of the total contributors so far, 49 are members of the Platinum Club (PC) who have contributed $1,500 or more to the 2013 campaign, which is ahead of the 2011 and 2012 PC membership pace. The median contribution remains at $500, while the average contribution is $688.

While the 2013 campaign may be ahead of recent years in terms of PC membership, the campaign is behind 2012 in number of individual participants—down 54 contributors and $26,000 from last year’s record-breaking year.

All individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. Thank you to the 2013 contributors listed below. Contributors are listed alphabetically by contribution amount category. The next publication of the contributor list will be in the September 6 issue of The Valued Voice. For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

Contributors ranging from $1 to $499
Ambs, Kathleen St. Mary's Janesville Hospital
Ashenhurst, Karla Ministry Health Care
Bair, Barbara St. Clare Hospital & Health Services
Baltzer, David Memorial Medical Center - Neillsville
Bayer, Tom St. Vincent Hospital
Bergmann, Ann Spooner Health System
Bloom, Deborah Sacred Heart Hospital
Boson, Ann Ministry Saint Joseph's Hospital
Bowman, Andrew Sacred Heart Hospital
Breeser, Bryan Aurora Medical Center Summit
Brenholt, Craig St. Joseph's Hospital
Brennan, Karen St. Mary's Hospital
Brenny, Terrence Stoughton Hospital Association
Brenton, Andrew Wisconsin Hospital Association
Buss, Diane St. Mary's Hospital
Calhoun, William Mercy Medical Center
Capelli, A.J. Aurora Health Care
Cardinal, Lori Agnesian HealthCare
Casey, Candy Columbia Center
Censky, Bill Holy Family Memorial
Coniff, Barbara St. Mary's Hospital Medical Center
Connors, Lawrence St. Mary's Hospital Medical Center
Cormier, Laura Bellin Hospital
Culotta, Jennifer St. Clare Hospital & Health Services
Dahl, James Fort HealthCare
Dalebroux, Steve St. Mary's Hospital
Drengler, Kathryn Aspirus Wausau Hospital
Dux, Larry Froedtert Health - Community Memorial Hospital
Ferrigno, Sandra St. Mary's Hospital
Fielding, Laura Holy Family Memorial
Folstad, John Sacred Heart Hospital
Furlong, Marian Hudson Hospital & Clinics
Garvey, Gale St. Mary's Hospital
Gille, Larry St. Vincent Hospital
Granger, Lorna Aurora Health Care
Guffey, Kerra Meriter Hospital
Hafeman, Paula St. Vincent Hospital
Halida, Cheryl St. Joseph's Hospital
Hardy, Shawntera Hudson Hospital & Clinics
Hieb, Laura Bellin Hospital
Hockers, Sara Holy Family Memorial
Hofer, John Bay Area Medical Center
Jelle, Laura St. Clare Hospital & Health Services
Jensema, Christine HSHS-Eastern Wisconsin Division
Jensen, Russell St. Mary's Hospital
Johnson, Charles St. Mary's Hospital
Johnson, Kimberly Sacred Heart Hospital
Josue, Sherry St. Mary's Hospital
Karuschak, Michael Amery Regional Medical Center
King, Steve St. Mary's Hospital
Klay, Lois St. Joseph's Hospital
Klein, Tim Holy Family Memorial
Knutzen, Barbara Agnesian HealthCare
Lange, George Westgate Medical Group, CSMCP
Larson, William St. Joseph's Hospital
Leonard, Mary Kay St. Mary's Hospital
Lepien, Troy St. Mary's Hospital
LuCore, Patricia Sacred Heart Hospital
Maroney, Lisa
Martin, Nancy Ministry Saint Michael's Hospital
Maurer, Mary Holy Family Memorial
McManmon, Kristin St. Mary's Hospital
Meicher, John St. Mary's Hospital
Natzke, Kristin Marshfield Clinic
Nguyen, Juliet Sacred Heart Hospital
O'Brien, Laura
O'Hara, Tiffanie Wisconsin Hospital Association
O'Keefe, Robert
Oland, Charisse Rusk County Memorial Hospital and Nursing Home
Olson, Bonnie Sacred Heart Hospital
Ose, Peggy Riverview Hospital Association
Ostrander, Gail Hospital Sisters Health System
Ott, Virginia St. Joseph's Hospital
Palecek, Steve St. Joseph's Hospital
Pavelec-Marti, Cheryl Ministry Saint Michael's Hospital
Penczykowski, James St. Mary's Hospital
Pinske, Heather St. Mary's Hospital
Reinke, Mary Meriter Hospital
Rocheleau, John Bellin Hospital
Roundy, Ann Columbus Community Hospital
Schaetzl, Ron St. Clare Hospital & Health Services
Schubring, Randy Mayo Health System - Eau Claire
Sheehan, Heather Hayward Area Memorial Hospital and Nursing Home
Statz, Darrell Rural Wisconsin Health Cooperative
Stelzer, Jason St. Clare Hospital & Health Services
Swanson, Becky Sacred Heart Hospital
Tandberg, Ann St. Joseph's Hospital
Teigen, Seth St. Mary's Hospital
Thornton, Eric St. Mary's Janesville Hospital
Tuttle, Kathryn Memorial Medical Center - Ashland
Walker, Troy St. Clare Hospital & Health Services
Westrick, Paul Columbia St. Mary's Columbia Hospital
Whitinger, Margaret Agnesian HealthCare
Woleske, Chris Bellin Psychiatric Center
Wolf, Edward Lakeview Medical Center
Wymelenberg, Tracy Aurora Health Care
Wysocki, Scott St. Clare Hospital & Health Services
Yaron, Rachel Ministry Saint Clare's Hospital
Contributors ranging from $500 to $999
Bablitch, Steve Aurora Health Care
Borgerding, Dana
Bukowski, Cathy Ministry Health Care
Bultema, Janice
Carlson, Dan Bay Area Medical Center
Deich, Faye Sacred Heart Hospital
Dewitt, Jocelyn
Dietsche, James Bellin Hospital
Dolohanty, Naomi Aurora Health Care
Dube, Troy Chippewa Valley Hospital
Freimund, Rooney Bay Area Medical Center
Hinner, William Ministry Saint Clare's Hospital
Houlahan, Beth
Hyland, Carol Agnesian HealthCare
Jacobson, Terry St. Mary's Hospital of Superior
Johnson, Kenneth St. Mary's Hospital Medical Center
Joyner, Ken Bay Area Medical Center
Kellar, Richard Aurora West Allis Medical Center
Krueger, Mary Ministry Saint Clare's Hospital
Larson, Margaret Mercy Medical Center
Lewis, Gordon Burnett Medical Center
Mantei, Mary Jo Bay Area Medical Center
May, Carol Sauk Prairie Memorial Hospital
Mulder, Doris Beloit Health System
Nelson, James Fort HealthCare
Pollard, Dennis Froedtert Health
Quinn, George Wisconsin Hospital Association
Richards, Theresa Ministry Saint Joseph's Hospital
Rickelman, Debbie WHA Information Center
Rocole, Theresa Wheaton Franciscan Healthcare
Rohrbach, Dan Southwest Health Center
Russell, John Columbus Community Hospital
Schafer, Michael Spooner Health System
Selberg, Heidi HSHS-Eastern Wisconsin Division
Shabino, Charles Wisconsin Hospital Association
Simaras, James Wheaton Franciscan Healthcare
Sommers, Craig St. Mary's Hospital
Stuart, Philip Tomah Memorial Hospital
Swanson, Kerry St. Mary's Janesville Hospital
Thurmer, DeAnn Waupun Memorial Hospital
Van Meeteren, Bob Reedsburg Area Medical Center
Wolf, Edward Lakeview Medical Center
VanCourt, Bernie Bay Area Medical Center
Worrick, Gerald Ministry Door County Medical Center
Zenk, Ann Ministry Saint Mary's Hospital
Contributors ranging from $1,000 to $1,499
Britton, Gregory Beloit Health System
Dexter, Donn Mayo Health System - Eau Claire
Gullingsrud, Tim Hayward Area Memorial Hospital and Nursing Home
Heifetz, Michael SSM Health Care-Wisconsin
Huettl, Patricia Holy Family Memorial
Hymans, Daniel Memorial Medical Center - Ashland
Kerwin, George Bellin Hospital
Kosanovich, John Watertown Regional Medical Center
Lewis, Jonathan St. Mary's Hospital
Martin, Jeff Ministry Saint Michael's Hospital
McKevett, Timothy Beloit Health System
Mohorek, Ronald Ministry Health Care
Natzke, Ryan Marshfield Clinic
Roller, Rachel Aurora Health Care
Sanders, Robert Children's Hospital of Wisconsin
Turkal, Nick Aurora Health Care
Contributors ranging from $1,500 to $1,999
Alig, Joanne Wisconsin Hospital Association
Anderson, Sandy St. Clare Hospital & Health Services
Bloch, Jodi Wisconsin Hospital Association
Boese, Jennifer Wisconsin Hospital Association
Byrne, Frank St. Mary's Hospital
Clapp, Nicole Grant Regional Health Center
Coffman, Joan St. Joseph's Hospital
Court, Kelly Wisconsin Hospital Association
Eichman, Cynthia Ministry Our Lady of Victory Hospital
Francis, Jeff Ministry Health Care
Frank, Jennifer Wisconsin Hospital Association
Geboy, Scott Hall, Render, Killian, Heath & Lyman
Grasmick, Mary Kay Wisconsin Hospital Association
Harding, Edward Bay Area Medical Center
Hilt, Monica Ministry Saint Mary's Hospital
Lepore, Michael Wheaton Franciscan Healthcare
Levin, Jeremy Rural Wisconsin Health Cooperative
Meyer, Daniel Aurora BayCare Medical Center in Green Bay
Millermaier, Edward Bellin Hospital
Potter, Brian Wisconsin Hospital Association
Sanders, Michael Monroe Clinic
Sexton, William Prairie du Chien Memorial Hospital
Stanford, Matthew Wisconsin Hospital Association
Wallace, Michael Fort HealthCare
Warmuth, Judith Wisconsin Hospital Association
Contributors ranging from $2,000 to $2,999
Brenton, Mary E.
Desien, Nicholas Ministry Health Care
Duncan, Robert Children's Hospital of Wisconsin
Gage, Weldon Children's Hospital of Wisconsin
Herzog, Mark Holy Family Memorial
Jacobson, Catherine Froedtert Health
Kachelski, Joe Wisconsin Statewide Health Information Network
Kammer, Peter The Kammer Group
Katen-Bahensky, Donna
Kief, Brian Ministry Saint Joseph's Hospital
Leitch, Laura Wisconsin Hospital Association
Little, Steve Agnesian HealthCare
Mettner, Michelle Children's Hospital of Wisconsin
Neufelder, Daniel Affinity Health System
Normington, Jeremy Moundview Memorial Hospital & Clinics
O'Brien, Kyle Wisconsin Hospital Association
Oliverio, John Wheaton Franciscan Healthcare
Pandl, Therese HSHS-Eastern Wisconsin Division
Starmann-Harrison, Mary Hospital Sisters Health System
Woodward, James Meriter Hospital
Contributors ranging from $3,000 to $4,999
Borgerding, Eric Wisconsin Hospital Association
Size, Tim Rural Wisconsin Health Cooperative
Contributors $5,000 and above
Brenton, Stephen Wisconsin Hospital Association
Tyre, Scott Capitol Navigators, Inc

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HHS Releases Training Content for Certified Application Counselors

On August 21, the federal government made available the content of the training modules for certified application counselors. These documents provide insight into what is included in the required training for those who want to provide exchange enrollment assistance. The content has now been posted on the CMS website for the health insurance exchange/marketplace at This is a zip file with screen shots of each page of the required modules.

Top of page (8/23/13)

President’s Column: Joint Letter to the Wisconsin Congressional Delegation Opposing the OIG Recommendation Affecting CAHs

August 19, 2013

Honorable Members of the Wisconsin Congressional Delegation:

Sen. Ron Johnson
Sen. Tammy Baldwin
Rep. Paul Ryan
Rep. Mark Pocan
Rep. Ron Kind
Rep. Gwen Moore
Rep. James Sensenbrenner Jr.
Rep. Thomas "Tom" Petri
Rep. Sean Duffy
Rep. Reid Ribble

Most of rural Wisconsin has never heard of the Office of the Inspector General in the federal Department of Health and Human Services. But that’s about to change! This obscure agency is proposing to gut Medicare’s funding of their local hospitals–those funded under the Critical Access Hospital (CAH) program. If implemented, its recommendations would destroy health care stability and access to care for Medicare beneficiaries in rural communities across America.

We deeply appreciate the initial support we have received from Wisconsin’s Congressional Delegation. We hope for a united push back against misrepresenting the current federal law as a "loop hole." To help wage this fight, a bit of history is in order.

The current Medicare system for paying hospitals, the Prospective Payment System (PPS) started in 1983. It was only tested in a handful of large tertiary hospitals in New England; subsequently, following the implementation of PPS, hundreds of rural hospitals closed across the country, including several in Wisconsin.

Over the next 15 years, many of us worked hard to reform the PPS to make it work equitably for rural hospitals. Many ideas were tested and failed. Finally, with strong bipartisan support, Congress passed the Balanced Budget Act of 1997 and with it, the program for Critical Access Hospitals. The program built on existing demonstrations for remote rural hospitals and adapted it for small, rural hospitals across the country.

Individual states were given the right to designate, through the establishment of federally approved state health plans, "necessary providers" eligible to receive Critical Access Hospital funding. The purpose was deliberative, the process public--not a loophole, not a bonus, not charity. It was Congress’s response to addressing a growing rural health crisis.

In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act. This law removed state designation of "necessary providers" in exchange for allowing CAHs to have the flexibility to staff up to 25 beds (compared to the previous limit of 15) and to increase reimbursement from 100 percent to 101 percent of reasonable costs. This agreement has defined Critical Access Hospitals, as we have known them for the last ten years.

Rural health is already doing more with less. Critical Access Hospitals are facing sequester cuts, bad debt reductions and simultaneously working to provide high quality, cost-efficient care to a poorer and frailer population. Case in point, according to a report issued last December by the federal Department of Health & Human Services’ National Advisory Committee on Rural Health and Human Services:

"The people served by rural hospitals are more likely to report a fair to poor health status, suffer from chronic diseases, lack health insurance, and be heavier, older, and poorer than residents of urban areas. Yet overall, the average cost per Medicare beneficiary is 3.7 percent lower in rural areas than in urban areas, and rural hospitals perform better than urban hospitals on three out of the four cost and price efficiency measures on Medicare Cost Reports."

As important as Medicare is to rural health, it is also critical to the financial stability of rural America. Rural hospitals are often one of, if not the largest, local employers, providing family-supporting wages throughout rural communities. A 2011 study by University of Wisconsin-Extension and the Wisconsin Hospital Association revealed that hospitals across the state generate $22 billion in economic activity and employ over 100,000 people. The same study found that hospitals were the top ten employers in 44 of Wisconsin’s 72 counties and the top five employers in 20 counties. In addition, rural insurance premiums and taxes only come back to circulate in the community and create jobs if there are local health care providers there to attract those dollars. The rural economy is extremely dependent on WHERE its health care dollars are spent.

We ask Congress to push back against misguided proposals that strike at the heart of rural health and work with us to keep local care and jobs local.

Stephen F. Brenton                              Tim Size
President                                            Executive Director
Wisconsin Hospital Association            Rural Wisconsin Health Cooperative

Top of page (8/23/13)

Register for WHA’s GME Statewide Conference

Are you in the process of evaluating or implementing GME at your organization?

Then you should consider attending WHA’s event focused exclusively on GME:
Taking the Next Step: A Statewide Conference on Graduate Medical Education
October 24, 2013***Best Western Bridgewood Resort Hotel, Neenah

Get more information and register today at:

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WHA, Wisconsin Medical Society Collaborate on WHIO Public Reporting Info Webinars

The Wisconsin Health Information Organization (WHIO) has developed a detailed strategy to report provider performance to the general public in an effort to advance WHIO’s mission. The vehicle for this public reporting initiative is a web portal, which is in its final stages of development.

WHA and the Wisconsin Medical Society are jointly sponsoring webinar opportunities for hospital and health system staff and physicians to learn more about the WHIO site-level physician group reporting website. There are six dates available for this one-hour webinar, which will include a demonstration of the public reporting website and ample opportunity for questions and discussion.

Webinar Dates

Tuesday, August 27, 7:00-8:00 am
Wednesday, August 28, 5:00-6:00 pm
Thursday, September 12, 12:00-1:00 pm
Tuesday, September 17, 5:00-6:00 pm
Wednesday, September 18, 7:00-8:00 am
Thursday, September 19, 12:00-1:00 pm

Registration is required to participate. Register at WHA encourages participation as the final reporting system may change based on input from providers and other stakeholders during these webinars and at other meetings.

Top of page (8/23/13)

High Value Health Care—Wisconsin’s Competitive Advantage: Gundersen St. Joseph’s Hospital Finds Early Identification of Risk Helps Prevent Falls

Early identification of patients at risk of falling was one way that the patient care team at Gundersen St. Joseph’s Hospital and Clinics in Hillsboro helped lower their fall rate to a record low.

"Change begins at the bedside, and allowing the direct care staff to identify problems and take ownership for the solutions will result in a more sustainable change," according to Cheryl Vulstek, RN MSN, director of quality and education at Gundersen St. Joseph’s.

"The most effective way to drive rapid improvement and sustainability is to get the front line involved and engaged as early as possible, especially in such a patient-centered initiative as falls reduction," according to Tom Kaster, WHA quality improvement advisor. "Gundersen St. Joseph’s Hospital did just that, and as a result has sustained their excellent outcomes."

The team analyzed workflow, assessed equipment and studied processes that were in place to prevent falls. From there, they began to make "small tests of change" to support their goals. The data reports, displayed in a visual format when possible, helped illustrate and communicate with all staff the success of the falls prevention program.

The hospital also initiated an electronic incident reporting system that notifies managers and pertinent staff when there is a fall so the response is swift and automatic.

The hospital is raising public awareness of fall prevention in the community and will soon expand the program to include outpatient settings. In addition, the fall prevention activities were highlighted in the hospital’s annual report last spring.

The team at Gundersen St. Joseph’s focused on the following strategies and interventions as they worked to reduce falls:

"The toolkits supplied through the WHA Partners for Patients initiative have been instrumental in helping us stay organized and on-track with our efforts. Tools designed to track and organize small tests of change assisted us in moving forward without feeling overwhelmed by the workload," according to Vulstek. "We have learned more about the culture of safety and we have taken advantage of WHA’s ‘coaching calls’ and their ability to connect us with other hospitals so we can learn along with others who are also working on reducing falls."

Top of page (8/23/13)

Wisconsin Hospitals Community Benefits: Charity Care

Fear of a bill should never prevent a patient from seeking care at a Wisconsin hospital. Wisconsin hospital charity care programs provided $232 million to more than 700 patients each day last year. The stories that follow illustrate the deep commitment and continuing concern that hospitals have to their patients to ensure they receive the care they need regardless of their ability to pay.

Thankfully, she didn’t have to choose

Nikki, a single mom, was working as a certified nursing assistant and living without insurance. She wasn’t able to afford housing and health insurance, so she had to choose what was most important: providing for her son.

"Insurance through work was just too costly," said Nikki. Her son was covered by Badger Care.

Nikki unexpectedly became ill and was hospitalized at Mayo Clinic Health System - Red Cedar for a week. Following her hospitalization, she needed therapy through Behavioral Health at Mayo Clinic Health System in Menomonie.

She was struggling to make payments for her bills, so a staff member at Mayo Clinic Health System - Red Cedar called her to tell her about the Financial Assistance Program that the medical center offers. She submitted her application and qualified for a full discount.

"I was wondering how I was going to pay these bills. This way, it didn’t have to go through collections," she said with gratitude. "It was huge. It took a huge burden off of me. To pay the bills was to take money away from my son’s needs."

Nikki now has peace of mind as she is able to afford insurance coverage for her own medical needs.

Mayo Clinic Health System – Red Cedar, Menomonie

Financial assistance for Fort HealthCare patients

Concern over a medical bill should never prevent a patient from receiving good health care. Our goal is to arrange a manageable payment plan based on one’s ability to pay.

Fort HealthCare offers two financial aid options to patients who meet our income, asset and need criteria. They are the Self Pay Discount and the Community Care Program.

The Self Pay Discount is a discount of up to 20 percent on Fort Memorial Hospital’s inpatient and outpatient services. Potential Self Pay candidates are defined as those who have no health insurance and those receiving services that are not covered by health insurance or another state, government, liability or workers’ compensation program.

The Community Care program is a partial or complete write-off of all outstanding charges. The program serves patients requiring medically necessary treatment with no or limited ability to pay and whose income does not exceed current federal poverty guidelines. Also persons whose income exceeds current federal poverty guidelines, but whose expenses also exceed income are eligible. Community Care candidates are required to complete a financial questionnaire and provide proof of income.

Fort HealthCare, Fort Atkinson

Wheaton Franciscan Healthcare provides a home away from home

61-year-old Tahereh Samakar lived in Iran and occasionally traveled to visit her daughter in Wisconsin. On her trip in 2011, what Tahereh expected to be an ordinary visit took a serious turn when she was diagnosed with breast cancer. Not only was Tahereh sick while abroad, but she also did not speak English and needed an interpreter.

"I had no idea that I had cancer when I left Iran. I was so shocked and I had no idea what to do," shared Tahereh.

Although she was far from home, Tahereh knew she needed to move quickly and had a right breast ultrasound-guided needle core biopsy at Wheaton Franciscan - St. Francis.

When Tahereh needed more surgeries, she worried about how a visitor without health insurance would handle the costs. That is when her doctors introduced her to Donna Semons, a financial counselor with Wheaton Franciscan Healthcare. With Donna’s help, Tahereh applied to Wheaton’s Community Care program and was approved to receive free care.

"I was so surprised and happy," said Tahereh. "Everyone treated me like I was an ordinary person who had health insurance. I am really grateful."

While Tahereh received treatment at several Wheaton Franciscan campuses, she has daily radiation at the Elmbrook Memorial Campus. Tahereh will be extending her visa so she can finish her treatments before going home. Though Tahereh is eager to return to Iran, she said Wheaton has helped her more than ever in her time of need.

Wheaton Franciscan Healthcare St. Francis, Milwaukee/Elmbrook, Brookfield

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

Read more about hospitals connecting with their communities at

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