Rural hospital leaders, along with WHA President/CEO Eric Borgerding, testified before an Assembly Committee May 3 in support of a package of workforce, quality improvement and population health legislation known as the Rural Wisconsin Initiative. The legislative package provides matching grant funding for the training of advanced practice clinicians and allied health professionals in rural Wisconsin hospitals, state support for the expansion of quality improvement work provided by WHA and a one-time matching grant program to provide seed money for the development of medical wellness facilities and programs in rural Wisconsin.
Borgerding began his testimony by commending the work of Committee Chair Rep. Nancy VanderMeer in leading the effort to enact the Interstate Medical Licensure Compact in Wisconsin, a bipartisan piece of legislation that provides a voluntary, expedited path of licensure for physicians who are looking to practice in multiple states.
“The physician licensure compact is a great example of a bipartisan effort to identify, enact and now implement one strategy to address the health care workforce,” said Borgerding. “The bills you are hearing today will, hopefully, be the next example of that great work.”
Testifying along with Borgerding were 2018 WHA Board Chair Bob Van Meeteren, president/CEO, Reedsburg Area Medical Center and WHA 2017 chair of the Council on Rural Health; Charisse Oland, CEO, Rusk County Memorial Hospital, Ladysmith; and George Quinn, executive director, Wisconsin Council on Medical Education and Workforce.
In his testimony, Borgerding discussed the needs that exist in Wisconsin’s hospitals—but even more so in rural Wisconsin hospitals. Borgerding said one in ten advanced practice clinician positions in Wisconsin hospitals remain vacant, with allied health professional shortages climbing back to pre-recession levels. Borgerding also described the new and changing allied health professional positions that are becoming increasingly in demand with an enhanced focus on population health.
“Our members are increasingly using, and thus seeing greater demand, for professions that are taking on new and expanded roles as we focus not just on the care, but increasingly the overall health of patients outside the ‘walls’ of the hospital,” said Borgerding. “We regularly hear from members, who are looking to the future of value-based payment and population health, that there is an increasing demand for roles as patient care navigators, nurse case managers and social workers. These are allied health professionals that play important roles in health care delivery today and in the future.”
Borgerding described how the workforce legislation before the Committee for advanced practice clinicians and allied health professionals is modeled after a successful matching-grant initiative proposed by Gov. Scott Walker in the 2013-15 biennial budget to expand capacity for physician residency experiences in Wisconsin. Borgerding said the residency program created by Walker has spurred a nearly $22 million investment by the state and private sector partners in creating more residency capacity, especially in rural Wisconsin.
“Applying this same concept to training for advanced practice clinicians and allied health professionals will expose more individuals to rural communities and help address rural workforce shortages. This ‘grow our own’ strategy is another great example of bipartisan policymaking that is the blueprint for much of the legislation before you today,” said Borgerding.
Van Meeteren discussed the lengths Reedsburg Area Medical Center has gone to train, educate and successfully recruit surgical technician staff in his facility. At one time, Reedsburg Area Medical Center had three out of their five surgical technician positions vacant. At the same time, Madison Area Technical College had a two-year waiting period to get into the surgical technician program. Van Meeteren said Assembly Bill 224 would help create flexible, local training programs for allied health professionals, using hospitals as clinical rotation sites.
Several provider groups registered and testified in support of this package of legislation, including the Wisconsin Academy of Physician Assistants, Wisconsin Academy of Nutrition and Dietetics and the Wisconsin Association of Nurse Anesthetists. Beverley Speece, MTS, PA-C, on behalf of the Wisconsin Academy of Physician Assistants, provided testimony in support of the bill and said “Advanced practice clinicians (APCs), such as the over 2,000 PAs like me in Wisconsin, play a crucial role in rural hospitals and clinics because patients in rural areas rely on APCs as a primary care access point.”
In addition, Oland also testified on legislation, Assembly Bill 222, which would create a medical wellness grant program in rural communities. Oland discussed her area’s population health rankings, especially how their rankings are impacted by the community’s inability to access exercise opportunities. She was joined by Rusk County Memorial Hospital’s Director of Rehabilitation Tony Schotzko, DPT, who testified to the necessity of having access to wellness facilities for patients, especially when considering the future population health model communities across the country are trying to achieve.
Finally, WHA Chief Quality Officer Kelly Court was joined by two rural hospital quality improvement directors, Rob Pasbrig, Columbus Community Hospital and Shelly Egstad, Tomah Memorial Hospital, to testify in support of Assembly Bill 255, which provides state financial support to expand the services provided by WHA’s quality improvement program. Both Pasbrig and Egstad testified to the unique challenges they both face, needing to “wear many hats” in a rural hospital including quality improvement, risk management, compliance and others. They stated the tools provided to them by the Wisconsin Hospital Association’s quality improvement program have helped their organizations achieve substantial and measurable improvement in patient care.
“As in any small business or hospital, I wear many hats on a daily basis and am often faced with competing priorities. Typically in larger hospitals, one person would oversee each one of these areas. While the work is indeed challenging, I don’t do it alone. The quality staff at the Wisconsin Hospital Association has provided significant guidance and resources to aid in our success. Our organization would not be where it is today without the support that is offered,” said Egstad in her testimony supporting Assembly Bill 255. The Rural Wisconsin Initiative, which includes Assembly Bill 222
, Assembly Bill 224
, Assembly Bill 227
and Assembly Bill 255
, will now move forward to a vote in the Assembly Committee on Rural Development and Mining.