February 24, 2012
Volume 56, Issue 8

WICD-10, AHIMA Respond to ICD-10 Delay

Several health care organizations, including the Wisconsin ICD-10 Partnership (WICD-10), of which WHA is a founding member, responded February 17 to the February 16 decision by the Department of Health and Human Services (HHS) to indefinitely delay ICD-10 implementation.

The Wisconsin ICD-10 Partnership (WICD-10) members agreed that the HHS statement is a distraction to the focus necessary to promote a timely and successful implementation. WICD-10 represents providers, payers and vendors from Wisconsin in a collaborative approach toward ICD-10 resources and education.

"None of the 20 WICD-10 members present at the February 17 meeting (including payers and vendors) support the delay," according to WICD-10 member Debbie Rickelman, senior director of the WHA Information Center.

Sheila Goethel, who represents the Rural Wisconsin Health Cooperative on WICD-10, said, "The ICD-10 transition will be a financial hurdle for all providers, yet the cost of the transition is a reality regardless of when it occurs. We urge CMS to not consider the cost as the primary reason for delay. By not moving toward ICD-10, we ignore the increased medical knowledge and technology gained over the last 30 plus years."

On February 22, AHIMA voiced their concerns about the delay in a letter to Secretary Sebelius.

The main points raised by AHIMA were that ICD-9-CM does not accurately capture outcomes or support other important national health care initiatives such as Meaningful Use, pay-for-performance and electronic health records; a rule HHS published in 2009 adopting the ICD-10 system as the HIPAA transaction classification acknowledges that the ICD-9-CM system was broken and needed to be replaced as soon as possible; and, a large majority of the health care industry has made tremendous investments (some in the millions of dollars) in ICD-10. AHIMA further notes the health care industry needs to better understand what the delay means in terms of work that has already been done and how a delay is being considered and why.

AHIMA CEO Lynne Thomas Gordon also sent a "Ten for 10" list to the AHIMA membership encouraging members to use the messages to show real life examples of how an ICD-10 delay would greatly impact progress and resources that have already been invested in the transition.

"Already, surveys are being taken by employer associations like the American Hospital Association and other employers, both providers and health plans, to determine readiness," Gordon stated. "We need to be ready for ICD-10 and our individual organizations need to continue to work toward compliance on October 1, 2013."

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Accountable Care Can Take Multiple Forms – Wisconsin Providers Showcased at Capitol Briefing

Elliott S. Fisher, MD, MPH, director of the Center for Population Health at The Dartmouth Institute for Health Policy and Clinical Practice, made his annual visit to Madison to present at a Capitol Briefing sponsored by the Evidence-Based Health Policy Project. The title of this year’s panel discussion was "Accountable Care Innovators: Health System Transformation in Wisconsin."

Fisher was joined on the panel by George Kerwin, CEO of Bellin Health, Dr. Craig Samitt, CEO of Dean Health System and Dr. Jeff Thompson, CEO of Gundersen Lutheran Health System. Each of the three health systems described the transformation their system is undertaking to provide higher quality at lower cost. Thompson described reasons for backing away from applying to be a CMS Pioneer ACO, however noting that Gundersen is implementing many of the same requirements. Thompson described their "belief in integrated health care which requires heavy investment in primary care and disease management."

Kerwin provided an overview of the Bellin-ThedaCare Healthcare Partners, which is one of 32 Pioneer Accountable Care Organizations. Bellin and ThedaCare are partnering to redesign care delivery to achieve the same goals of improved quality, while trying to lower the increase in health care spending.

"Wisconsin is fortunate to have health care systems that have really advanced their understanding of how to redesign their systems and the need to take care of an entire population of people," according to Kerwin. The Bellin-ThedaCare Partners are focusing their redesign work on Medicare Fee-for-Service patients. The lessons learned from these patients will then be spread to other patient populations.

Sammit provided an overview of the system Dean Health System is implementing in partnership with SSM-St. Mary’s. After living in a world where it feels like "having a foot in two canoes—the fee-for-service canoe that rewards volume and the health plan canoe that rewards value"—Dean is focusing all of their redesign on systems that focus on value. "Accountable Care Organizations are a delivery system, not a payor relationship. This is about redesigning how we deliver care," Sammit said.

While each of the three Wisconsin systems described slightly different approaches to the structure of their accountable care work, all three described common core elements:

These core elements are perfectly aligned to the elements that Fisher described as being needed to transform the health care system. Fisher urged the attendees to be searching for redesigns, such as those described that are population-based with virtual budgets, include performance measurement, allow for patient choice and support many diverse approaches. He described health care as a local issue which will require new forms of partnerships between organizations that provide care, pay for care and other community organizations that can affect health.

"Wisconsin is blessed to be way ahead with supporting providers with measuring quality and improving performance and a long history of collaboration and focus on population health," Fisher said.

For more information on ACOs, go to: www.wha.org/data/sites/1/quality/ACOupdatedResourceList2-22-12.doc.

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Guest Column: Why I Attend Advocacy Day
By WHA Chair Sandy Anderson, President, St. Clare Hospital

Since moving to Wisconsin from Ohio in 2002, I have been a loyal attendee at Advocacy Day because I believe in this day and what it means for my hospital. St. Clare Hospital is a mid-size hospital, a "tweener" so to speak, not quite small enough to be critical access but not a large hospital either. We are the perfect size for Baraboo, a town of roughly 12,000, and provide our community with high quality care and hundreds of important jobs. St. Clare employees are proud to serve this community, and as hospital President, I feel a duty to speak up on issues that impact our economic and health care future. Advocacy Day is one important way I can do so.

As hospital leaders or employees, I know we all have precious little time to spend on much else than our immediate, day-to-day responsibilities, but over the past decade I have made attending Advocacy Day a priority. I encourage others to do likewise because of what it will mean if we don’t. . .

Each year the State Legislature introduces and debates dozens of policy changes that will positively or negatively impact each of our hospitals.

… Protecting hospitals in a budget with a $1.8 billion Medicaid shortfall

…Updating an outdated peer review statute

…Stopping a series of onerous hospital mandates

Those are just a few of the topics hospitals faced this past year where the hospital voice was successfully heard because we spoke up again and again, including at Advocacy Day. This event is a day to hear from national speakers and key elected officials. Sitting with 750 other hospital employees and volunteers who care passionately about their hospitals is powerful. What’s even more powerful is when we all go to the State Capitol to meet one-on-one with legislators and staff on key issues.

Last year I had the opportunity to be part of the celebration as Sen. Luther Olsen received the Legislator of the Year Award. I was not surprised to see Luther as our recipient, he has visited St. Clare many times and has always made himself available to listen and discuss health care or economic issues.

I firmly believe we each have a role to play in helping legislators understand what their decisions mean for us. When we don’t speak up, someone else speaks into that void. That’s why I am asking you to join with me in support of all of our hospitals at this year’s Advocacy Day event on April 24 in Madison.

We hope you agree about the value that Advocacy Day brings to your hospitals, your communities and your patients. A complete program and online registration for 2012 Advocacy Day on April 24 in Madison are available at http://events.SignUp4.com/AdvocacyDay12.

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WHA and WMS File Joint Amicus Brief with Supreme Court
Collateral source payments central issue

The Wisconsin Hospital Association and the Wisconsin Medical Society this week jointly filed an amicus brief with the Wisconsin Supreme Court in Weborg v. Jenny, a medical liability case.

After the jury found that the physicians were not negligent in their treatment of the patient, the plaintiffs appealed the case, arguing that collateral source evidence admitted during the trial—life insurance proceeds and social security payments—was so prejudicial that it tainted the jury’s analysis of the liability claim. The Court of Appeals disagreed, noting that courts should presume juries correctly follow the jury instructions and, even if the trial court should not have admitted the evidence, it was not prejudicial. The amici ask the Supreme Court to affirm the Court of Appeals decision.

In their brief, WHA and the Society note that there is a question left unanswered in the statute and existing case law: collateral source payments are admissible in medical malpractice cases, but how should the court instruct juries regarding this evidence?

Guy DuBeau, an attorney with Axley Brynelson who wrote the brief on behalf of WHA and the Society, explained, "The Legislature determined that the probative value of collateral source evidence outweighs any potential danger of unfair prejudice. The evidence is admissible; the important question is how the evidence is to be handled." DuBeau continued, "The answer is really quite simple. The collateral source evidence permitted by the statute should be received just as any other admissible evidence is received, its purpose being guided by the facts and nuances of each individual case." DuBeau noted that our system trusts juries to sift and winnow the evidence presented to them and arrive at justice in each individual case.

A copy of the joint amicus brief is available on the WHA website at www.wha.org/data/sites/1/legal/AmicusBriefWeborgvJenny.pdf.

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Senate Committee Holds Hearing on Workforce Survey Bill

On February 22, the Senate Committee on Workforce Development, Small Business, and Tourism held a hearing on Senate Bill (SB) 450. The bill would create a requirement that dentists, dental hygienists, physicians, psychologists, physical therapists, physician assistants, pharmacists, and clinical social workers provide workforce data as part of their license renewal process.

WHA testified in support of the proposal. A copy of a memo provided to committee members can be found here.

SB 450 is a Joint Legislative Council bill that was introduced as a work product of the 2010 Interim Legislative Council Study Committee on Health Care Access, chaired by Senator Luther Olsen (R-Ripon). Sandy Anderson, CEO at St. Clare Hospital in Baraboo, was also a member of the study committee, which unanimously approved the proposal.

A workforce survey requirement is already in place for nurses. The Joint Finance Committee included a provision in the 2009-2011 Biennial Budget adding the requirement. The provision has lead to 100 percent survey participation by the current nursing workforce. The results of last year’s survey of nurses have allowed health care employers and educators to improve their forecasting and their focus on meeting future nursing workforce needs.

A current and chronic shortage of physicians and other health care professionals is a problem that is projected to worsen in Wisconsin without immediate action. While a voluntary physician survey was conducted this year, it was completed by only approximately 30 percent of physicians. A return rate that small unfortunately does not allow for the same analysis, strength of conclusion, and workforce projections as the 100 percent response rate of the nursing survey.

"Information from the nursing workforce survey has proved to be extremely valuable. We believe the knowledge that would result from instituting additional health care workforce surveys at the time of license renewal will allow educational facilities to better predict what categories of workers they should be preparing," said Judy Warmuth, WHA vice president of workforce development, in testimony. "The information will also allow health care employers to better plan for their future needs, and ultimately improve overall access to health care by ensuring a strong future workforce," Warmuth added.

A committee vote could come the week of February 27.

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President’s Column: SGR Fire Drill Symptom of Broken Medicare FFS System

The annual (or more frequent) wrangling over the Medicare doc "fix" is Exhibit A as to just how broken the Medicare fee-for-service system has become.

Over the next ten years, the nation’s hospitals will pay up to $7 billion to finance a 10-month band-aid for the formula-driven physician payment system. This is just the latest "kick the can down the road" response to a staggering problem. And we get to look forward to doing this again when another faux crisis is upon us next December.

To add to this dark comedy, physician groups are criticizing the duration of the payment patch (not its funding source). This is ironic, perhaps even cynical as in March 2010, physician groups, led by the advocacy organizations accepted a "promise" that the SGR would be addressed. But the money needed to overhaul the SGR was instead used to pay for other priorities and gimmicks like the Louisiana Purchase, the Florida Gatorade and the Cornhusker Kickback. There was a $100 million earmark for a new medical school as well. Now we are out of money so temporary solutions resort to "robbing Peter to pay Paul."

The current Medicare payment system is a train wreck. The President’s budget worsens things by proposing mammoth provider payment cuts without fixing the SGR. And that spending initiative further tinkers with another flawed element of PPACA that is largely ignored—the IPAB Board. Beginning in 2015 a small group of experts will be empowered with "balancing" the Medicare budget annually by further tinkering with provider payments as the only available avenue to match Medicare revenues with expenses.

Steve Brenton

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Bill Would Earmark Funding for Dental Students from Loan Assistance Program

On February 23, the Senate Agriculture, Forestry, and Higher Education Committee held a hearing on Senate Bill (SB) 494, relating to establishing a separate grant and loan program for dental students.

The bill, authored by Senator Dave Hansen (D-Green Bay) and its companion, Assembly Bill (AB) 619 authored by Representative Sandy Pasch (D-Whitefish Bay) would reallocate funds from the current Health Professions Loan Assistance Program (HPLAP) and create a dental student only program under the Wisconsin Higher Educational Aids Board (HEAB).

Recipients of loans and grants from the new program would need to agree to practice in dental health shortage areas or provide services to Medicaid recipients.

The HPLAP is managed by the Wisconsin Office of Rural Health (WI-ORH), part of the School of Medicine and Public Health at the UW-Madison, and currently funds six professions—physicians, dentists, physician assistants, nurse practitioners, certified nurse midwives, and dental hygienists. Awards in the form of student loans are made to providers serving the neediest parts of the state.

Supporters of SB 494, including the Wisconsin Dental Association (WDA), believe the bill is necessary to address shortages of dentists in rural and underserved areas of the state. The WDA also believes the current HPLAP focuses more on the medical community and not dentists.

Several concerns were raised at the hearing by John Eich from the WI-ORH as the bill would take nearly half of the money from a fund designed for six professions and allocate it for just one profession. Loss of flexibility was another concern in that the WI-ORH now has the ability to make awards based on the providers that apply in any given year, and who will serve the areas with the greatest shortage. In some years applications may come from more dentists, in other years, from more physicians, etc.

Over the last three years, the WI-ORH has funded everyone who has applied.

Funding for the HPLAP includes dollars from the critical access hospital assessment, but WHA confirmed that those dollars are separate, designated to physician loan assistance only and not impacted by the bill.

WHA registered against SB 494 at the hearing and echoed many of the concerns of the WI-ORH in discussions with committee members and staff.

"The bills’ authors are well intended, as we do need to do something about the lack of access to dental care for Medicaid patients. Our members see the impact of this problem—when a Medicaid patient can’t get in to see a dentist, they often come to the hospital ER … for dental care," said WHA Executive Vice President Eric Borgerding. "But we also know that Wisconsin will need 100 new physicians per year for the next ten years just to keep pace with demand. We know that we will need more advanced practice nurses, physician assistants and dental hygienists, too. These are all important health care professions served by the HPLAP, and earmarking scarce dollars for one profession might not be the best approach right now."

As discussed in detail in WHA’s recent report, "100 Physicians a Year: An Imperative for Wisconsin," aggressive steps in the areas of medical education and training must be taken immediately to address the state’s looming physician shortage.

A fiscal estimate has not yet been completed for SB 494 and the authors have indicated they are working on the details of funding sources. The committee took no action on the bill.

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Wisconsin Hospitals in Washington, DC
Congress approves hospital cuts in extenders/SGR agreement

On February 15-16, Wisconsin hospital representatives joined with over 150 other hospitals advocates from across the country in Washington, DC to participate in the American Hospital Association’s Capitol Hill day. Attendees were in DC to continue the fight against proposed cuts to hospitals and met with Senators Kohl and Johnson and Representatives Baldwin, Duffy, Kind, Petri and Ribble.

The timing was precipitous as Congressional leadership released the day before a compromise proposal to address several issues, including physician reimbursement. In order to stave off physician cuts and extend other provisions, Congress had been looking at hospital cuts as pay-fors. During their meetings, hospital leaders pressed the issue of payment reductions, reminding legislators Wisconsin hospitals are already facing billions of dollars in cuts from health reform implementation, the sequester process and other policies, yet continue to be leaders nationally.

"Wisconsin will see the short end of the stick from Medicare cuts," said Mike Wallace, CEO of Fort HealthCare in Fort Atkinson. "We are already facing billions of dollars in cuts while doing great things in quality and efficiency."

Due to the strong, national grassroots efforts of hospitals contacting Congress—including over 1,200 contacts in the past month from WHA HEAT grassroots members—several proposed hospital cuts were not included in the final agreed upon package. Unfortunately hospitals did not go completely unscathed and will see the following reductions:

WHA continues to strongly oppose using hospital Medicare reductions as a means to fund other policies. When government health care programs like Medicare already under-reimburse hospitals for the cost of care, continued reductions force hospitals to make decisions on services, programs and/or employment.

On the final vote, Wisconsin Members of Congress split, but not along party-lines. Those voting against the package include: Senator Johnson, Representatives Kind, Petri, Ryan, Sensenbrenner. Voting in favor of the package include: Senator Kohl, Representatives Baldwin, Duffy, Moore, Ribble.

Wisconsin hospital leaders in DC included: Mike Wallace, Fort HealthCare; James O’Keefe, Mile Bluff Medical Center; Tim Eckels, HSHS (IL/WI); Scott McMeans, Holy Family Memorial (Manitowoc); Heidi Selberg, HSHS-Eastern (Green Bay); Juliet Nguyen, HSHS-Western (Eau Claire); Jon Sender, UW Hospitals & Clinics (Madison); and Jenny Boese, WHA.

WHA thanks these hospital leaders for taking the time to travel to DC for these important meetings.

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Walker: Provider Reimbursement Reductions Just a "Hidden Tax" on Employers

In a speech February 16 at Business Day in Madison, the annual lobby day for Wisconsin Manufacturers and Commerce (WMC), Governor Scott Walker singled out differences in Wisconsin’s approach to budgeting versus how other states, like Illinois, have dealt with their financial shortfalls.

Walker delivered his keynote address before roughly 1,000 business leaders in town for a day of networking, issue discussion and legislative visits.

The governor discussed the contrast between his efforts to address Wisconsin’s budget crisis and what’s being done in other states.

"We have seen other states go down paths that we have chosen not to take," Walker said. "We didn’t use higher taxes, massive layoffs or cuts to things like Medicaid," he said, specifically citing Illinois as a state talking about cutting $2 billion in the program. "That’s a system (Medicaid) where we actually added $1.2 billion…in Wisconsin."

"Cutting core services like Medicaid as other states have done was not an option," Walker explained. "I knew that would either affect needy families, children or seniors," he said. "… as has been done in the past, you saw cuts in Medicaid lead to reductions in reimbursement for health care providers, which is just a hidden tax on employers that pay for health insurance. That just gets passed on, and that’s not a good idea," Walker concluded.

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Grassroots Spotlight: Newly-Elected Senator King Visits Waupun Memorial

Waupun Memorial Hospital and Agnesian HealthCare (Fond du Lac) wasted no time in inviting newly-elected Wisconsin State Senator Jessica King for a visit.

"It is always a welcome opportunity when we can share firsthand our experiences in health care, as well as to provide specific education which can assist our legislators in key decisions they need to make on our behalf," said DeAnn Thurmer, Waupun Memorial Hospital chief operating officer, about the visit.

During her visit, Sen. King was able to hear directly from leaders at Waupun Memorial Hospital and Agnesian HealthCare about what is it to be a critical access hospital (CAH) and the importance of having a hospital in Waupun. The group spent time discussing topics, including issues facing CAHs, declining payer reimbursement, electronic medical records, telemedicine, certified registered nurse anesthetist role in rural hospitals, and provider recruitment.

Following the in-depth discussion, Sen. King toured the hospital, including its secured Department of Corrections unit, which provides inpatient and outpatient health care services for inmates at correctional facilities in Dodge, Fond du Lac, Sheboygan and Waushara counties. King also enjoyed an opportunity to meet other associates, physicians and volunteers.

Participating in the meetings with Sen. King were: Steven Little, Agnesian HealthCare president and chief executive officer; DeAnn Thurmer, Waupun Memorial Hospital (WMH) chief operating officer; Cheri Goddard, WMH inpatient services director; and Barb Karsten, WMH outpatient services.

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State of Wisconsin and Milicruit Team up to Help Veterans Find Jobs

The State of Wisconsin is partnering with Milicruit to deliver a virtual career fair for service members, guards/reservists, veterans, and military spouses on March 22 from 1-4 pm online at www.veteranscareerfair.com. This groundbreaking event is aimed at helping Wisconsin veterans find employment.

WHA encourages member hospitals to consider participating in the virtual fair. This will be a great way for employers to meet and interact with veterans in the state in real time, but without the cost or burden of travel. Milicruit will design your booth, train your recruiters and answer any questions you may have. Then simply log in and staff the virtual booth on March 22.

The cost for a virtual booth is $1,000 which is a 50 percent discount from the standard Milicruit pricing. To see a short video on how it works, click here: www.screencast.com/t/IcnWdSia.

For additional information on Milicruit or to purchase virtual career fair services, visit www.veteranscareerfair.com or contact Kevin O’Brien at kobrien@milicruit.com or 202-558-2899.

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CMS to Release Stage 2 Meaningful Use Proposal

Leaders from the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator of Health IT (ONC) announced on February 22 the proposed requirements for Stage 2 Meaningful Use and 2014 certification of electronic health records at the Healthcare Information and Management Systems Society’s (HIMSS) annual conference in Las Vegas. The leaders said to expect the notices of proposed rulemaking (NPRM) for the two sets of regulations to be published within the next few days in the Federal Register. (A link to a simple grid of the proposed MU Stage 2 requirements is posted on the WHA website at www.wha.org/Data/Sites/1/hit/Stage2GridfromProposedRule.pdf).

National Coordinator for Health IT, Farzad Mostashari, stated the Stage 2 Meaningful Use Rules and EHR certification standards largely reflect the recommendations made in 2011 by the Health IT Policy Committee and the Health IT Standards Committee. The proposed regulations, he said, emphasize the need for greater interoperability among systems and health information exchange. From a meaningful use perspective, this means that organizations will have to exchange data across organizational boundaries and disparate EHRs. According to Mostashari, other areas that receive additional attention in these NPRMs include patient engagement, patient safety and increased flexibility in the design of applications.

The proposed Stage 2 regulations will keep some Stage 1 criteria unchanged, revise others, and include new requirements. Some features include:

Some of the proposals for EHR certification include:

For more information contact Matthew Stanford at mstanford@wha.org or Debbie Rickelman at drickelman@wha.org. For information on WISHIN Direct, contact Jean Doeringsfeld, chief operating officer of WISHIN at jdoeringsfeld@wishin.org.

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Community Health Needs Assessment - Pilot Communities Grant Opportunity

WHA has been working closely with the University of Wisconsin Population Health Institute and the Wisconsin Association of Local Health Departments on a grant they received that focuses on strengthening the community health needs assessment process in Wisconsin. The goal of the grant is to encourage public health departments and hospitals to work together, include others into the process, and develop and implement a community health needs assessment using resources developed by the UW Population Health Institute. Many of you have heard Julie Willems Van Dijk, who has been featured on several WHA community benefit webinars. Julie is the principal investigator on the grant. The timing of this grant is perfect for hospitals as many are at some stage of the community health needs assessment process.

Below is the announcement that 10 communities will be chosen to pilot the new resources. Applications are being accepted between now and March 28 at 4:30 p.m. to be considered for one of the pilots. Up to $5,000 per site is available to pilot communities. The request for proposals is posted here. Notice that the applicant must show they are working with BOTH a hospital and the local public health department to be considered for the pilot project.

WHA and the UW Population Health Institute are sponsoring a conference March 23 in Wisconsin Dells that focuses on the community health needs assessment process. The information you receive at that conference should help inform you of the process that you will use if you decide to apply for a grant to be a pilot community. Julie Willems Van Dijk is one of the key presenters at the conference. To register for the WHA Community Benefit Conference, go to http://events.SignUp4.com/CommunityBenefit12.

WHA encourages you to participate in the informational conference call before you start the application process to be considered for pilot funding. The information/registration for on the call is below.

If you have any questions about the pilot programs, contact Mary Kay Grasmick mgrasmick@wha.org or Mandy Ayers, mayers@wha.org or call 608-274-1820 and ask for either Mary Kay or Mandy.

Grants Available to Support Community Health Assessment Process

Hospitals, local public health agencies, tribal health entities, and other local community agencies are invited to apply to participate in a pilot effort to strengthen local communities’ capacity to effectively conduct community health improvement processes. Applicant communities can be in any phase of their assessment-prioritizing-planning-implementing-evaluating cycle.

The pilot will be conducted from May 1, 2012 – December 31, 2013. Up to $5000 per site is available to conduct the pilot. Ten sites will be selected. Applications are due March 28 by 4:30 p.m.

An informational conference call will be held March 1 from 1-2:00. The call is not mandatory, however pre-registration is required. The call will be recorded for later listening. Additional details on the pilot opportunity, including the recorded informational call, can be found at www.walhdab.org/CHIPPpilot.htm.

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Successful Local Partnerships Showcased at WHA Community Benefit Seminar

The success of a community health improvement initiative is hinged on developing strong relationships with partner organizations. Several Wisconsin hospitals and health systems are working in partnership with their local health departments and other health-related organizations to develop their own community health needs assessment. Two successful local partnerships will be showcased at the WHA Community Benefit for Health Improvement Seminar March 23 at the Kalahari resort in Wisconsin Dells.

"Healthier Together – St .Croix County" will feature Karen Hansen, community relations manager at Hudson Hospital & Clinics along with Wendy Kramer, health officer, St. Croix County Public Health. This partnership has been featured as a national model on how to complete a community health needs assessment. Hansen and Kramer will share their experience, from inception to implementation.

The Milwaukee Healthcare Partnership, which is comprised of the five health care systems in Milwaukee, the federally-qualified health care centers, academic and government agencies, created the Greater Milwaukee Shared Community Needs Assessment initiative. Mark Huber, vice president of social responsibility for Aurora Health Care chairs the group. Huber, along with Clare Reardon, executive director, community affairs for Froedtert Health|Froedtert Hospital and Eric Gass, PhD, public health research and policy director for the City of Milwaukee Health Department, will explain how this partnership is bringing stakeholders together to develop a plan that will coordinate health activities across multiple sectors in Milwaukee.

One of the big questions that arises as communities start working on a health needs assessment is what data is available? What is the best data to use? Angela Kempf Rohan, PhD, Senior Maternal and Child Health Epidemiologist at the Wisconsin Division of Public Health, will help attendees understand what data sources are available, how they can be used, and how to determine that enough data has been collected.

Hospitals are encouraged to bring their community team to this conference, including the public health officer. To register, go to http://events.SignUp4.com/CommunityBenefit12.

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Licensure Rule Change Receives Board of Nursing Hearing
Enforcement Division reports much improved resolution rate for pending cases

A hearing on a rule change that would affect nurses’ ability to obtain a Wisconsin nursing license by endorsement was held February 23 at the Board of Nursing meeting in Madison.

The Wisconsin Board of Nursing is working to change the administrative rules around licensure by endorsement. Under the current rule, nurses are not eligible for Wisconsin licensure by endorsement if they have ever had action against their license in another state, even if it is for a very minor infraction. For example, a nurse who was late in paying his or her re-licensure fees in another state would have, in the past, been unable to obtain a Wisconsin license by endorsement. The Board is seeking a rule change that would allow cases to be considered individually. Staff at the Department of Safety and Professional Services (DSPS) estimates that 10 to 20 individuals per year are currently denied licensure under the current rule. Some of those may become eligible (depending on the circumstance of the action) under the rule change. The Board will review the testimony, consider changes to the rule, and forward to the Legislature. The rule change is CR 12-004 and can be read at: https://health.wisconsin.gov/admrules/public/Rmo?nRmoId=11663.

At the Board’s request, the Division of Enforcement reported on a number of cases that they were investigating as a result of complaints against nurses. The report included the following accomplishments by DOE:

The Division also reported that it has implemented production metrics and prosecutorial policies and procedures in 2012 to create better efficiencies, higher accountability, and to ensure the highest standards of production and service to the Board. The Nursing Team within the Division was recognized by the Secretary of DSPS for this impressive performance.

"The proposed licensure change and the much improved performance by DOE are good news for Wisconsin hospitals," said Judy Warmuth, WHA vice president of workforce. "WHA has requested that the DOE take actions that speed licensure and ensure quick resolution of complaints. Better measurement, combined with greater transparency, will be useful to employers and reassuring to the public."

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Governor Appoints Schubert to Wisconsin Interoperability Council

Lynn Schubert, manager of facilities and safety compliance at Aurora Health Care has been appointed by Governor Scott Walker to serve on the Wisconsin Interoperability Council. The Interoperability Council was established in March 2008 to develop strategies and recommend standards and guidelines for achieving statewide communications interoperability for Wisconsin’s public safety community. The Council advises the Office of Justice Assistance on the allocation of homeland security grants and other funding available for the Wisconsin Interoperability Initiative.

As the main statewide planning and governance body for communications interoperability in Wisconsin, the Council has chartered numerous other subcommittees and working groups to address particular communications issues. Members are appointed by the Governor and represent key state and local stakeholders.

Schubert has been a member of the Wisconsin Hospital Emergency Preparedness Program (WHEPP) leadership team and chair of Region 7 in Southeastern Wisconsin since their inception (2002).

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Volunteer Positions Open in Trauma Care System

The Department of Health Services (DHS) will be filling the final three Statewide Trauma Advisory Council (STAC) open positions that are appointed by the Secretary of the DHS. Term limits are at the discretion of the Secretary of DHS.

STAC and the DHS are requesting the following roles to fill these positions:

These are great opportunities to participate in statewide programming and decision making. If you have individuals at your hospital that have the necessary requirements and are interested in serving, contact Judy Warmuth, vice president, workforce at the Wisconsin Hospital Association at jwarmuth@wha.org or 608-274-1820.

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Member News: Olson Announces Retirement from ProHealth Care

Ed Olson will retire February 29 after 30 years of service with ProHealth Care. Over his tenure, Olson has served in several senior executive roles, most recently as chief external affairs officer and for eight years prior to that, he was president and chief executive officer of Waukesha Memorial Hospital. He has been with Waukesha Memorial and ProHealth Care since 1982.

Olson was instrumental in the development of the Rehabilitation Hospital of Wisconsin and led the formation of physician partnerships in the ProHealth-Moreland Ambulatory Surgery Center and the Orthopedic Surgery Center. He was part of the executive team that managed the transformation of Waukesha Memorial Hospital into a leading tertiary care center.

"Ed has made enormous contributions to our organization and the communities we serve," said Susan Edwards, ProHealth’s chief executive officer. "His commitment to excellent quality and service has set a high standard for health care delivery here."

Olson has been active in the Wisconsin Hospital Association serving on the WHA Board from 2008-2012, the Council on Public Policy from 2006-2012, the Advocacy Committee from 2007-2010, and the Task Force on Access & Coverage since 2006.

Olson will continue to work with ProHealth Care in a volunteer capacity as a senior adviser on community affairs, philanthropic activities and other matters. He is looking forward to having the freedom to pursue new professional, personal, volunteer and family interests.

"I am most proud of my 30-year association with the people of Waukesha Memorial Hospital and ProHealth Care who have lived our values of responding to the needs of the community and each other with excellent service, respect and compassion," Olson said. "I am grateful if I have played some small role in the success of our amazing organization."

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Member News: Julie Manas Named President/CEO of Sacred Heart Hospital

Julie Manas was named president/CEO of Sacred Heart Hospital in Eau Claire and will also serve as president/CEO of HSHS Division, Western Wisconsin. She will succeed Faye Deich, interim president/CEO, who will resume her role as senior vice president, division operations (Western Wisconsin) and chief operating officer for Sacred Heart Hospital. The HSHS Western Wisconsin Division includes Sacred Heart and St. Joseph’s Hospital in Chippewa Falls.

Manas most recently served as president of Genesis Medical Center and senior vice president of Genesis Health System in Davenport, Iowa. Prior to that, she was at Loyola University Health System in Chicago, Illinois, first as an executive director of their joint venture with the Rehabilitation Institute of Chicago and then as vice president responsible for system-level service lines. She has also held leadership positions with Resurrection Health Care and the Department of Veterans Affairs. She is a member of the American College of Healthcare Executives and has served on many local and regional boards.

"We’re delighted that Julie is joining HSHS and Sacred Heart Hospital. She brings extensive experience leading large complex health systems and elevating the quality of health care services provided at the organizations she’s served," said Mary Starmann-Harrison, HSHS President and Chief Executive Officer. "Her leadership abilities and success in implementing programs that have enhanced patient care will be a great asset as she guides Sacred Heart Hospital through a rapidly changing health care environment," she added.

Manas received her bachelor’s degree in family services from Iowa State University and a master’s degree in hospital and health administration from the University of Iowa. Manas will assume her new position in mid-March.

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Wisconsin Hospitals Community Benefits: Access to High Quality Health Services

Hospitals do what they can to move health care services out of the clinical setting into the heart of the community. Community health screenings and education classes help raise awareness of steps that individuals can take to improve their health. When people learn more about how their lifestyle decisions affect their health, they make changes that ultimately lead to better health, which raises the health status of the entire community.

Free Clinic of Pierce and St. Croix Counties

River Falls Area Hospital is proud to be a founding partner and ongoing supporter of the Free Clinic of Pierce and St. Croix Counties, which provides preventable health care, including prescription drugs, to individuals from throughout the two-county region with nowhere else to turn.

All services at the Free Clinic are provided free of charge. To qualify for services, patients must be at or below 185 percent of the federal poverty level and be uninsured with no other source of care. The clinic’s volunteer health care providers see an average of 25 patients each week on a first come, first serve basis. In 2010, the Free Clinic provided care through a total of 2,502 patient visits, dispensing 5,667 prescriptions with a total retail value of $554,478.

The River Falls Area Hospital supports the clinic by:

Acting as the employer-of-record for the three Free Clinic staff members, providing those employees with access to the same employment benefits as hospital staff and relieving the Free Clinic board of significant administrative responsibilities;

Through its foundation, providing a general operating grant of $10,000;

Providing laboratory and radiology services for Free Clinic patients;

Providing space for patient pre-screening on Tuesday evenings; and

Providing significant in-kind staff support for the Free Clinic.

"While we have not quantified the financial impact of the Free Clinic on our hospital, we know the Free Clinic is serving many individuals who would otherwise have ended up at an emergency room, either here in River Falls or at one of the other hospitals in our region, receiving care that would ultimately be uncompensated," said Heather Logelin, foundation and community engagement director at River Falls Area Hospital. "By providing access to primary care services the Free Clinic is helping to meet the health care needs of our region in a way that is better for the individual patient, the broader community and the health care system at large."

River Falls Area Hospital

African American Breast Health Initiative helps remove barriers to breast cancer screening

The African American Breast Health Initiative through Wheaton Franciscan – St. Joseph is making it easier for low-income African American women like Stacy Marsh to receive mammograms.

The Breast Health Initiative, funded in part by a $25,990 grant from the Southeast Wisconsin Affiliate of Susan G. Komen for the Cure, works to educate low-income African American women about breast cancer and the importance of consistent breast health care. It also helps remove barriers to mammograms and clinical breast exams and provides navigation services to African American women.

Stacy, 43 and uninsured, had never had a mammogram or given thought to having one until she attended Wheaton’s breast outreach program at Meta House, a drug and alcohol abuse treatment program for women. The education program provides women with breast health information and screening recommendations by a Wheaton Franciscan Healthcare oncology registered nurse navigator or a registered nurse breast coordinator. Women are encouraged to talk about their fears of getting screened, and myths about the causes of breast cancer are addressed. Each woman also receives a bead necklace to wear as a reminder of the different sizes of breast cancer tumors.

During the program Stacy met Janine Tucker, a Community Health Worker from St. Joseph. Janine assessed Stacy’s need for a mammogram. She also identified fear and a lack of financial resources as barriers to Stacy receiving a screening. With Janine’s help, Stacy obtained financial assistance through Kohl’s Southeast Wisconsin Breast Health Assistance Fund. She also accompanied Stacy to her mammogram to offer support and encouragement.

Much to Stacy’s relief, her mammogram came back negative, but she has a recommendation for a six month follow-up screening. Janine will be available to assist with follow-up scheduling and once again, accompany Stacy to her appointment if needed.

Stacy is grateful for the program, and in particular, the support she has received from Janine. "She has been very helpful. This has been a good experience," Stacy said.

Since April 2011, Wheaton Franciscan – St. Joseph has held 11 breast outreach programs, educated 190 women, and referred 79 women for mammograms. The program is on track to exceed all of its goals.

Wheaton Franciscan – St. Joseph, Milwaukee

Albrecht Free Clinic in Washington County

Since 2008, Lisa served as vice president and chief administrative officer at Aurora Medical Center in Hartford. She started her career as a physical therapist and has been part of the Aurora Health Care team for more than 20 years. Lisa serves on the board directors for the only local free clinic in Washington County, the James E. Albrecht Free Clinic.

The Albrecht Free Clinic was founded in 1996 and is led by a Board of Directors who oversees the clinic operations. Support for the clinic is through donations of time, money and services by individuals, corporations, foundations, clubs/organizations, churches, community groups, and health care providers. The clinic is independently operated and does not duplicate services of any other county agencies. The clinic’s volunteer family physicians, nurse practitioners, and internal medical providers primarily screen, diagnose, and often prescribe medication for health care problems.

Aside from Lisa’s board duties, she is involved with the eligibility and review committee and participates in fundraising events. In the past year, Lisa coordinated an annual rummage sale with all proceeds donated to the clinic. As part of this effort, several Aurora Health Care employees donated their time and vehicles to collect the donations for the annual rummage sale.

Each year, Aurora Medical Center in Hartford provides in-kind donations of laboratory tests and x-rays for patients who are referred by the clinic. Some patients may need specialists, many of whom provide pro bono services. As Lisa emphasized, "I believe in preventive care provided in community settings. Even people who receive assistance from the Aurora Helping Hand Patient Financial Assistance Program for inpatient medical care still need care outside the hospital for follow-up, medications, screenings and other preventative services. Providing care in community settings reduces expense and helps people live well."

Aurora Medical Center in Hartford

Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Read more about hospitals connecting with their communities at www.WiServePoint.org.

Top of page (2/24/12)