June 15, 2012
Volume 56, Issue 24

Medicaid Program Staff Focusing on Budget and Identifying Efficiencies
Wisconsin Medicaid Director Davis addresses hospital and health system government affairs leaders

While Wisconsin’s Medicaid program is in a far better situation than most states, it is not a boring ride for State Medicaid Director Brett Davis. Davis was a guest at a gathering of hospital and health system government affairs leaders called together and hosted by WHA on June 13 to discuss issues and strategies for the upcoming 2013-14 legislative session.

"Medicaid is similar to a rollercoaster," Davis said in a presentation at the WHA Government Relations meeting in Madison June 13. "There are so many variables coming at you it is impossible to lock in a number (related to the shortfall). When you get into the operations, (the budget) tends to ebb and flow."

At this time, the Medicaid shortfall stands at about $154 million, according to Davis, but the environment is so fluid that an "unknown variable will creep up" which will trigger the Department of Health Services (DHS) to reassess the situation and address the gap.

Davis said his staff is focused on the 2011-2013 budget and meeting the efficiency savings targets set by the Department. At the same time, planning has already started for the 2013-2015 budget cycle. Davis invited hospitals to participate in the process and encouraged them to submit their ideas for improving the efficiency of the program and saving costs.

The operations of the Medicaid program pose their own set of challenges, as well. Davis said the current fiscal agent contract ends toward the latter part of 2013, and staff has already begun contract planning activities. In addition, his staff is working on issues related to the implementation of ICD-10 and the Enhanced Ambulatory Patient Grouping (EAPG) system.

As speculation grows as to when the Supreme Court will issue its decision on the Patient Protection and Affordable Care Act (PPACA), Davis said changes in the law could have "huge implications" for the Medicaid program. When the decision is released, Davis said the Medicaid operations team, which already has familiarity with the issues embedded in the law, will evaluate the impact that any federal changes will have on Wisconsin’s program.

In response to a question about the maintenance of effort waivers, Davis said the Department submitted state plan amendments and waivers to the Centers for Medicare and Medicaid Services (CMS). While they are still negotiating with CMS around the medical home models, Davis said CMS’s "appetite" for other waiver requests is "not there" so the Department is weighing its options as they look at the state budget.

The medical home and managed care models fit in with Davis’s ideas for payment reform. So far, the Medicaid program has been looking to implement managed care programs for three groups: children in foster care; children with multiple complex conditions, and people with HIV/AIDS. Davis said he is also working on a managed care/medical home care model for those with behavioral health issues, but said it is "much more complicated, and every state is struggling with it."

WHA Executive Vice President Eric Borgerding mentioned the work that WHA has done related to "harmonizing" HIPAA and the privacy laws surrounding mental health—a move he said was integral to managing care and realizing cost savings for patients being served in both the private sector and through the Medicaid program.

Davis said he always appreciates it when hospitals contact his department, and in spite of their heavy workload, they try to respond as quickly as possible to concerns.

"We want to do an even better job of being responsive to the people we serve," Davis said.

While he is keenly aware of the issues that some hospitals have had with Logisticare, Davis said the cost savings that DHS realizes by implementing a uniform Medicaid patient transportation policy statewide add up to nearly $6.4 million. "We would rather go down this path than others to attain savings in the program," he added.

Priority Issues Discussed

In addition to Medicaid, the meeting agenda also included other priority issues for the upcoming 2013-14 legislative session, along with discussion of different strategy options. Among the issues addressed were the potential implementation of the Patient Protection and Affordable Care Act (PPACA); Wisconsin’s physician shortage; the Jandre court decision; collateral source; mental health care coordination/HIPAA; EMTALA conflicts with Chapter 51 and emergency detentions; regulatory streamlining, and efforts to address various aspects of employment law.

WHA Summer Candidate Education "Road Trips" Start Soon

With the recall elections now over, Paul Merline, WHA vice president, government relations, provided an environmental scan of the political landscape and a preview of the key up-coming elections. "With the newly-redistricted legislative districts in place for this fall’s election, and several open seats with new candidates from both parties, this summer promises to be one of the busiest campaign seasons of the last decade," Merline said. He and other members of the WHA government relations team will be meeting with candidates in the upcoming races both before and after Wisconsin’s primary election, which has been moved up to August 14.

Merline said WHA’s goal is to hold more than 70 targeted meetings with candidates over the next few months to educate them on the Association’s priority issues such as Medicaid, the value of health care in Wisconsin, the physician workforce shortage and the impact of federal Medicare cuts.

While state legislators have no control over the federal cuts to Medicare funding, Merline said they need to have an awareness of how these cuts will affect Wisconsin hospitals so legislators understand that if they propose changes in the state Medicaid program, hospitals are also dealing with major cuts at the federal level.

The Health Care Value Campaign

Borgerding said in the interim period before the Legislature resumes, WHA is developing an education campaign targeting the business community. In the past, WHA has developed tools to help member hospitals quantify the economic impact that they had on their communities. While that remains an important message, Borgerding said WHA is starting to focus on growing the non-health care economy because of the importance that family sustaining jobs with good benefits has on the overall health of the community and on individual’s ability to have the benefit of private health insurance.

It starts with a conversation around economic development and the role that high quality, accessible health care has in attracting and retaining business in Wisconsin.

"We want to inject health care quality and value into the economic development equation," Borgerding said. "Quality plays a huge role in producing better outcomes, keeping employees healthy, returning them to work sooner, and increasing productivity for employers here. We know that helps makes Wisconsin more competitive and attractive to employers."

"We want employers to think about the value of health care in Wisconsin," according to Borgerding. "Instead of being defensive about cost, we want to go on the offensive with value, because it is a far better term for describing where health care is moving in the future—which is toward better outcomes and a lower total cost of care."

Borgerding cited two recent examples where value was a key message, starting with Governor Walker’s keynote address at WHA’s Advocacy Day April 24. More recently, WHA was invited to provide testimony before the Assembly Health Committee on the importance that health care value has to Wisconsin’s future economic growth.

"It doesn’t matter how the Supreme Court rules on the PPACA, we know that Wisconsin health care leaders are already focused on a new future and are shaping, not waiting for, reform," Borgerding said. "We are moving in the right direction."

WHA Announces Federal Advocacy Effort

Working to protect hospitals from continued payment erosion at the federal level is one of the Wisconsin Hospital Association’s 2012 goals. Staff provided information on WHA’s "Protect Hospital Care" advocacy initiative. "With hospital payments the target under so many proposals, this comprehensive, multi-pronged strategy will help educate and mobilize our hospital leaders and advocates against Medicare and Medicaid cuts," said Borgerding.

The advocacy initiative seeks to engage hospitals, advocates and other key stakeholders in relaying the negative impact further cuts will have on hospitals and communities. The plan includes educating state legislators, local chambers and economic development boards, and working with important allies such as the Rural Wisconsin Health Cooperative, to educate Wisconsin’s congressional delegation. Developed resources include a white paper, grassroots toolkit, issue papers and much more that will soon be available on WHA’s newly-created Protect Hospital Care page on www.wha.org/advocacy.aspx. Multiple other opportunities to engage will be rolled out in the months to come. (See related President’s Column in this issue.)

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Guest Column: Access to Health Care
By William Petasnick, CEO, Froedtert Health and chairperson of the Milwaukee Health Care Partnership, and Joy Tapper, executive director of the Milwaukee Health Care Partnership

The following letter to the editor was recently published in the Milwaukee Journal Sentinel.

The May 7 Milwaukee Journal Sentinel article, "Access to Health Care Declines in Wisconsin, Nationwide," highlights the significant decline in insurance coverage in our state and across the country between 2000 and 2010. The University of Minnesota study illustrates the need for fundamental health care reform. It also presents a compelling case to immediately address access to care for the growing number of uninsured and underinsured individuals in our community.

The most recent Family Health Survey suggests that 15 percent of the Milwaukee County population is uninsured at any point in time. The majority of that group is poor, but contrary to popular belief, many of these uninsured individuals are employed and work in jobs that no longer provide affordable health care coverage, or any coverage for that matter. Even in a state with a progressive Medicaid program, we are experiencing a decrease in the number of people who have coverage, and those that do are burdened with higher co-pays and deductibles. As a result, people are not seeking prevention services and are delaying care, or only going to the doctor when their illness becomes disabling. Today in Milwaukee, more people will not get the care they need, more people will seek care in overburdened and under-resourced safety net clinics, and more people will use the emergency room to address basic health needs when they could have gotten care in a more appropriate and cost-effective setting. These practices have a negative impact on patients’ health and well-being, worker productivity, and ultimately, the total cost of care for all of us.

In the long term, we need to reform the health care system and ensure that there is adequate and affordable base-level coverage for everyone. In the short term, there are three things we can do: 1) find a way to ensure that people who are eligible for public or employer-based coverage get and stay enrolled; 2) strengthen and fully fund our community health centers that care for underserved populations; and 3) better coordinate care to make sure that patients get the right care, at the right time, in the right place. Coverage, access and care coordination—this is the Milwaukee Health Care Partnership agenda. We invite you to learn more about our plan at www.mkehcp.org.

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Legislator Profile: Rep. Elizabeth Coggs (D-Milwaukee)
A series of interviews with legislators, by Mary Kay Grasmick, editor

Rep. Elizabeth Coggs is passionate about her work as an elected official. Coggs has served on the Milwaukee County Board of Supervisors and was a member of many committees, including health and human needs, finance and audit, and housing. She has an extensive background in grassroots and community work. Now, as a member of the Wisconsin Legislature, Coggs said she is committed to working on issues related to health care, social services, safety net programs and behavioral health.

"My legislative priorities are health care, education, women’s issues, and ensuring that services are available to help our youth and our seniors," Coggs said. "And, of course, we need jobs, jobs, jobs."

The economic downturn and fiscal challenges that face Wisconsin and the nation have hit Milwaukee hard.

"If Milwaukee is hurting, the whole state is hurting," according to Coggs. We have to bring better economic prosperity to families in terms of living wages, jobs and benefits. At the same time, we need to encourage our families to live healthier and take care of their bodies and their minds so we can begin to reduce the high rate of hypertension and diabetes that we see among Latinos and Blacks."

Milwaukee area health systems, along with UW-Extension and UW-Milwaukee, have programs in place to help improve community health, efforts that Coggs said have helped; however, she continues to be concerned about access to health care in the inner city.

"We need to attract physicians," she said. "Years ago there were incentive programs to attract physicians and even teachers to the inner city. The physician loan assistance was tied to practicing medicine in underserved areas. These could work again."

Prevention is important, and the health systems and other entities that have worked with at-risk populations to help control obesity and connect the homeless and uninsured to medical homes all help, but the need is great in Milwaukee.

"Getting people healthier doesn’t happen overnight, but we have to start somewhere and do something," according to Coggs.

"Personally, as an elected official for the past 25 years, I have a passion for working for people who do not have a voice and who have nutritional, social services, and behavioral health concerns," she said. "It has been my life-long journey, and I take pride in trying to bring people together for the greater good of all."

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Political Action Fundraising Campaign Update - 33% of Goal

The Wisconsin hospitals state political action funds fundraising campaign has raised more than $84,400 in the last two months from 118 individuals. The individual average contribution is $715. Almost two months into the campaign, this puts the 2012 campaign at 34 percent of the $250,000 monetary goal.

Of the total contributors, 23 percent are members of the Platinum Club who have contributed $1,500 or more so far to the 2012 campaign. All individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. Thank you to the 2012 contributors to date who are listed below. Contributors are listed alphabetically by contribution category. The next publication of the contributor list will be in the July 6 edition 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

Ashenhurst, Karla Ministry Health Care

Bair, Barbara St. Clare Hospital & Health Services

Biros, Marilyn SSM Health Care-Wisconsin

Bowers, Laura SSM Health Care-Wisconsin

Brenton, Andrew Wisconsin Hospital Association

Coil, Joseph St. Clare Hospital & Health Services

Culotta, Jennifer St. Clare Hospital & Health Services

Dahl, James Fort HealthCare

Dalebroux, Steve St. Mary’s Hospital

Dufek, Nancy Memorial Medical Center - Ashland

Garibaldi, Isabelle Wheaton Franciscan Healthcare - All Saints

Hoege, Beverly Reedsburg Area Medical Center

Holub, Gregory Ministry Door County Medical Center

Hueller, Julie Wheaton Franciscan Healthcare

Jelle, Laura St. Clare Hospital & Health Services

Kepchar, Dennis Ministry Health Care

King, Steve St. Mary’s Hospital

Krause, Carolyn Meriter Hospital

Lampman, Sandra St. Mary’s Hospital

Lynch, Sue Mayo Health System - Franciscan Healthcare

Marcouiller, Don Memorial Medical Center - Ashland

Margan, Rob Wisconsin Hospital Association

Mason, Paul Wheaton Franciscan Healthcare - All Saints

Merline, Karen

Mettner, Michelle Children’s Hospital and Health System

Nguyen, Juliet Sacred Heart Hospital

O’Hara, Tiffanie Wisconsin Hospital Association

Olson, Bonnie Sacred Heart Hospital

Olson, Keri St. Clare Hospital & Health Services

Peiffer, Susan Sacred Heart Hospital

Penczykowski, James St. Mary’s Hospital

Pennebecker, Allen Ministry Saint Michael’s Hospital

Platt-Gibson, Melanie St. Clare Hospital & Health Services

Quinn, George Wisconsin Hospital Association

Reinke, Mary Aurora Health Care

Richbourg, Mary Sacred Heart Hospital

Roundy, Ann Columbus Community Hospital

Rudolph, Wade Sacred Heart Hospital

Sanicola, Suzanne Columbia St. Mary’s Columbia Hospital

Saunaitis, Tamara Meriter Hospital

Schaetzl, Ron St. Clare Hospital & Health Services

Sheehan, Heather Hayward Area Memorial Hospital and Nursing Home

Slomczewski, Constance Wheaton Franciscan Healthcare - All Saints

Statz, Darrell Rural Wisconsin Health Cooperative

Steevens, Alan St. Clare Hospital & Health Services

Swanson, Kerry St. Mary’s Janesville Hospital

Teigen, Seth St. Mary’s Hospital

Walker, Troy St. Clare Hospital & Health Services

Westrick, Paul Columbia St. Mary’s Hospital

Zeller, Brad Hayward Area Memorial Hospital and Nursing Home

Contributors ranging from $500 to $999

Anderson, Sandy St. Clare Hospital & Health Services

Borgerding, Dana

Byrne, Frank St. Mary’s Hospital

Canter, Richard Wheaton Franciscan Healthcare

Carlson, Dan Bay Area Medical Center

Heifetz, Michael SSM Health Care-Wisconsin

Hymans, Daniel Memorial Medical Center - Ashland

Johnson, Charles St. Mary’s Hospital

Just, Lisa Aurora Medical Center in Hartford

Larson, Margaret Mercy Medical Center

Lewis, Gordon Burnett Medical Center

Mantei, Mary Jo Bay Area Medical Center

Miller, Jim Children’s Hospital and Health System

Nelson, Dave SSM Health Care-Wisconsin

Richards, Theresa Ministry Saint Joseph’s Hospital

Rickelman, Debbie WHA Information Center

Roberts, Paula Children’s Hospital and Health System

Russell, John Columbus Community Hospital

Samitt, Craig Dean Health

Schafer, Michael Spooner Health System

Selberg, Heidi HSHS-Eastern Wisconsin Division

Shabino, Charles Wisconsin Hospital Association

Talley, Barbara St. Clare Hospital & Health Services

Taplin Statz, Linda SSM Health Care-Wisconsin

VanCourt, Bernie Bay Area Medical Center

Warmuth, Judith Wisconsin Hospital Association

Zenk, Ann Ministry Saint Mary’s Hospital

Contributors ranging from $1,000 to $1,499

Buck, Catherine Froedtert Health

Court, Kelly Wisconsin Hospital Association

Deich, Faye Sacred Heart Hospital

Frank, Jennifer Wisconsin Hospital Association

Herzog, Mark Holy Family Memorial

Hilt, Monica Ministry Saint Mary’s Hospital

Katen-Bahensky, Donna

Kelch, Elaine

Kosanovich, John UW Health Partners Watertown

Regional Medical Center

Mattes, Dan Wheaton Franciscan Healthcare

Roller, Rachel Aurora Health Care

Size, Pat

Tempelis, Eric Gundersen Lutheran Health System

Contributors ranging from $1,500 to $1,999

Alig, Joanne Wisconsin Hospital Association

Barney, Steven SSM Health Care-Wisconsin

Bloch, Jodi Wisconsin Hospital Association

Boese, Jennifer Wisconsin Hospital Association

Eichman, Cynthia Ministry Our Lady of Victory Hospital

Gorelick, Marc Children’s Hospital and Health System

Grasmick, Mary Kay Wisconsin Hospital Association

Levin, Jeremy Rural Wisconsin Health Cooperative

Potter, Brian Wisconsin Hospital Association

Stanford, Matthew Wisconsin Hospital Association

Wallace, Michael Fort HealthCare

Contributors ranging from $2,000 to $2,999

Brenton, Mary E.

Erwin, Duane Aspirus, Inc.

Kachelski, Joe Wisconsin Statewide Health Information Network

Leitch, Laura Wisconsin Hospital Association

Merline, Paul Wisconsin Hospital Association

Normington, Jeremy Moundview Memorial Hospital & Clinics

Pandl, Therese HSHS-Eastern Wisconsin Division

Sanders, Michael Monroe Clinic

Sexton, William Prairie du Chien Memorial Hospital

Size, Tim Rural Wisconsin Health Cooperative

Starmann-Harrison, Mary Hospital Sisters Health System

Woodward, James Meriter Hospital

Contributors ranging from $3,000 to $4,999

Borgerding, Eric Wisconsin Hospital Association

Fish, David Hospital Sisters Health System

Turkal, Nick Aurora Health Care

Contributors $5,000 and above

Brenton, Stephen Wisconsin Hospital Association

Tyre, Scott Capitol Navigators, Inc.

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President’s Column: "Protect Hospital Care" Advocacy Initiative

Protecting hospitals from continued payment erosion at the federal level is one of the Wisconsin Hospital Association’s 2012 goals. Shortly, hospital leaders will receive resources and details on WHA’s "Protect Hospital Care" advocacy initiative—a comprehensive, multi-pronged strategy to educate and mobilize against Medicare and Medicaid cuts.

For over a year, hospitals have been the target of numerous proposals cutting payments under the Medicare and Medicaid programs. Each of these proposals—ranging from cuts to Medicare bad debt and Graduate Medical Education to changes to Critical Access Hospital designation—will continue to be seen as future options for savings as Congress faces what some are calling a "fiscal cliff" later this year.

In late 2012 (and into early 2013), Congress needs to address the following:

The magnitude of this problem cannot be overestimated and, once again, hospital and health system payments will be major targets.

We know Wisconsin has a great story to tell about our ongoing commitment to health care value and quality, and we will continue to tell that story to our members of Congress and the public. However, we will also need to explain how cuts negatively impact hospitals and communities, and we’ll need your active involvement in order to do so.

To assist you, WHA will soon make available a white paper, resources, toolkits and more on our newly-created "Protect Hospital Care" webpage at www.wha.org/advocacy.aspx. Throughout the "Protect Hospital Care" campaign, WHA will use these resources and many other strategies to engage advocates to aggressively make the case against further cuts.

Watch for opportunities in the coming months for ways you can engage and help "Protect Hospital Care" in Wisconsin.

As always, please let WHA know how we can assist you in your efforts.

Steve Brenton,                  Sandy Anderson,
WHA President                 WHA Board Chair

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Last chance to register for the 2012 Wisconsin Rural Health Conference
The Osthoff Resort, Elkhart Lake *** June 27-29, 2012

Register today at: http://events.signUp4.com/12Rural

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Prairie du Chien TCAB Team Continues to Innovate

The closing round of site visits for Wisconsin’s first cohort of Transforming Care at the Bedside (TCAB) teams began this week at Prairie du Chien Memorial Hospital. Judy Warmuth, WHA vice president for workforce and clinical leader of the TCAB Project, will visit all of the teams as they near completion of the 18-month program.

The Prairie du Chien TCAB team presented a review of process and progress on an impressive list of patient-focused projects. The TCAB team shared their progress and demonstrated enthusiasm in improving patient care and increasing staff involvement, which is goal of Transforming Care at the Bedside. Participating in the site visit along with nurses were staff from nutrition services, social services and a family representative. The initiatives from the TCAB team are being incorporated into the planning of their new hospital to ensure that gains made will be sustained after the project ends in September.

Three new TCAB initiatives were highlighted by the team:

  1. Patient-focused room service dining (lead by nutrition services),
  2. An adaptation of Stoughton Hospital’s TCAB "All About Me" patient-focused project that alerts staff to patient preferences on the patient’s electronic medical record.
  3. Discharge bags that provide a way for discharge educational materials, equipment and medications to be safely and conveniently taken home and maintained by the patient. Patients and families are also encouraged to take the bags to their follow up physician visit.

A restful sleep menu is the next team project.

Site visits will be conducted for all TCAB teams this summer and a new cohort of hospitals will be invited to join the program this fall.

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DQA Encourages Hospitals to Sign up for Email Subscription Service

The Wisconsin Department of Health Services, Division of Quality Assurance (DQA) asked the Wisconsin Hospital Association to remind its members that DQA has an email subscription service for electronic notification of health care policy-related information. Because DQA no longer mails its notices and memos to hospitals, DQA stressed that it is important for hospitals to sign up for the email subscription service.

There are several DQA publications available through the subscription service, including DQA numbered memos, DQA Quarterly Information Updates, CMS program letters, provider training, the Pharmacy Newscapsule, physical plant memos, and more. Hospitals can sign up for the subscription service at www.dhs.wisconsin.gov/rl_DSL/Listserv/signup.HTM.

DQA encourages people who are unsure if they have signed up for the service to sign up again. The above link also includes an archive of DQA listserve messages.

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Member News: Rogers Behavioral Health System Names Patrick Hammer New President/CEO

Patrick (Pat) Hammer has accepted the position as president and CEO of Rogers Behavioral Health System. Hammer will officially take the helm when current president and CEO, David Mouthrop, PhD, retires at the end of August, 2012.

With over 20 years of experience in behavioral health operations, strategic planning and motivational leadership, Hammer says he is passionate about helping people to recover from mental illness and addiction.

Hammer’s executive experience includes directing the operations at freestanding behavioral health hospitals, residential treatment centers, partial hospitalization and intensive outpatient programs. He has served at several respected behavioral health facilities: Springstone Inc in Louisville, KY; Brentwood Meadows in Newburgh, IN; Wellstone Regional Hospital in Jeffersonville, IN; United Medical Corporation (behavioral health division, comprised of four freestanding psychiatric hospitals) in Louisville, KY; and Jefferson Hospital and Regional Treatment Center in Jeffersonville, IN.

A graduate of the University of Notre Dame in Indiana, Hammer holds a master’s degree in administration, as well as a bachelor’s degree in social work from Ball State University in Muncie, IN.

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Wisconsin Hospitals Community Benefits: Oral Health

Wisconsin hospitals share a common mission to improve their community’s health status, which includes oral health care, an area often neglected because people cannot afford dental work. Lack of proper dental care can lead to a myriad of other health problems. Those with severe tooth pain often end up in hospital emergency rooms for pain relief. By increasing access to dental services for those who cannot afford it, hospitals are not only improving the overall health of their communities, but also decreasing the burden on their emergency departments.

Joey’s Story: dental issues addressed = healthy boy!

Joey attends school at one of the more rural school districts in our service area. He had gone to the health room aide almost daily at school, complaining of pain in his mouth and ultimately vomiting. One of ProHealth Care’s community outreach nurses conducted a home visit and worked with his family to assess the situation and to provide education on oral hygiene.

Joey and his family had BadgerCare coverage, but they did not have a favorable relationship with their current dentist. The ProHealth Care nurse worked with the family to secure inexpensive transportation to the Waukesha County Community Dental Clinic, a community service co-founded and supported by ProHealth Care. There, Joey obtained compassionate, low-cost care and was found to have many cavities—so severe he required several extractions and spacers. In addition, Joey developed other medical issues, which have been resolved by linking Joey with a primary care provider at ProHealth.

As of today, Joey states, "All my problems are fixed!"

ProHealth Care, Waukesha

FCCHC offers dental services to underserved residents

Historically, access to oral health services has been a significant challenge for underserved residents in the Fox Valley, as few dental providers are able to cost-effectively treat Medicaid and uninsured patients. Wisconsin ranks in the bottom five states nationally for the amount of money allocated to its dental Medicaid program. In 2008, less than 20 percent of Medicaid/Badger Care recipients were able to receive dental services and the access issues for uninsured individuals are even more significant.

The statistics supporting the oral health needs in the Fox Valley communities are grim. Without action, the downward slide of dental services to the poor will accelerate. The Fox Cities Community Health Center (FCCHC), located in Menasha, Wis., added dental services in early 2009 after recognizing the decline in access to oral health in the area. The FCCHC dental department had over 4,200 visits in the first year.

In order to meet the growing needs of better access to dental services, in early 2011 the FCCHC moved its dental clinic to an office location allowing for more patients to access services. Since the new clinic location, it is up 80 visits per month, now averaging 1,000 visits per month.

The FCCHC, a community-initiated, non-profit organization, originally formed in 1997 with strong ties to local health systems, public health departments and the university system. This "free clinic" was created through a partnership of Affinity Health System and ThedaCare in response to the closure of state-funded county voucher programs for medical care. The FCCHC maximized local charity care programs and provided free care to uninsured patients.

In 2004, FCCHC was funded as a Community Health Center and Health Care for the Homeless program, the only combined program in the state of Wisconsin. Today, the in-kind and financial support of Affinity Health System and ThedaCare are an important partner in providing care. In the Fox Valley area, there continues to be a lack of coordinated, comprehensive primary and preventive care for individuals facing financial, cultural and linguistic barriers. FCCHC provides necessary primary and preventive services to more than 7,000 individuals that otherwise would not have access to care.

The mission of FCCHC is to create a vibrant community through health care access and quality service delivery to the underserved. FCCHC offers primary care, preventive dental care and mental health services at the main facility in Menasha, in the heart of the tri-county service area of Winnebago, Outagamie and Calumet County. Additional primary care, case management, and AODA services are provided through the center’s Healthcare for the Homeless Program at the regional emergency shelter in Appleton. All fees are based on a sliding scale ranging from $20-$80 depending on monthly income and family size; however, no one is turned away for inability to pay.

FCCHC has significant experience providing primary care services to the community’s most at-risk population. FCCHC has maximized collaborative relationships with local health systems, public health departments and other community service agencies, allowing FCCHC to concentrate on filling gaps in service and providing services to individuals with the greatest needs. FCCHC has grown considerably since its inception, resulting from the community’s investment in FCCHC and its ability to respond to the emerging health care needs of the community.

Affinity Health System

Free community dental care

Throughout small communities in Jefferson County, impoverished or underinsured families are cared for with the skilled hands of experienced physicians and dental professionals. The Community Dental Clinic in Fort Atkinson came to life by the generous contributions of many, including Delta Dental of Wisconsin, United Way of Jefferson and North Walworth Counties, Rock River Free Clinic, Fort Memorial Hospital, Wisconsin Dental Association, the Kohl Foundation, the State of Wisconsin grant program, Holt Dental Company and private donations.

The number of patients served by the free dental clinic has almost doubled since the program began in 2007. Numerous area dentists and hygienists donate their time to provide patients with standard evaluations and exams, x-rays, cleanings for adults and children three years and older, fluoride treatments, sealants, fillings, extractions, smoking cessation information, and oral health and dietary counseling.

Barbara Gudgeon, clinic coordinator, states, "We have a great working relationship with Fort HealthCare, and there are many people that made this service possible, including Paul Hable, director of safety and lab at Fort HealthCare, Gail Scott and Barb Dehnert from the Jefferson County Health Department, Debra Gatzke, Dan McCrea from United Way, dentists Juliet Slavens and Brian Turley and others were instrumental in turning the idea of the clinic into a reality. Fort HealthCare gives us technical support, lab services by testing our biopsies, and by promoting and supporting the dental clinic in any way they can. Fort HealthCare rents a 1,200 sq. ft. medical office suite to the clinic for one dollar per year."

"I am just very impressed with Fort HealthCare and their commitment to the area communities. The clinic has such wonderful volunteers and staff and everyone gives 150 percent of their time and energy without a second thought. I feel very honored to be a part of this incredible team," said Gudgeon.

Sixteen dentists volunteer for this service. Additionally, two assistants and four hygienists volunteer their time, and four patients have come back after their treatment was completed to volunteer.

Fort HealthCare, Fort Atkinson

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.

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