February 25, 2011
Volume 55, Issue 8

Assembly Advances Budget Adjustment Bill
DOA says MA funding set to run out by mid-May

After over 60 hours of contentious debate, the Assembly advanced the Budget Adjustment Bill (BAB) early this morning, despite objections and calls for procedural review of the vote from Assembly Democrats.

The bill, introduced earlier this month to address the state’s nearly $140 million deficit for the fiscal year ending June 30, now heads to the Senate, where as of press time, Democrats in that house remain out-of-state, thus preventing a vote in that house.

In the Assembly, Democrats offered dozens of amendments in efforts to extend debate on the bill in what was described as likely the longest legislative session in state history.

The scene and increasingly charged atmosphere surrounding the stalemate at Wisconsin’s capitol has become international news. People from around the country continue to pour into Madison to add their voices to the escalating debate over the role and impact of unions, set off by proposals Governor Walker included in the BAB to address Wisconsin’s looming $3.6 billion dollar deficit heading into the next biennium.

Among the provisions proposed by Walker are changes to state employee compensation that increase employees’ share of their pension and health insurance premium contributions. The bill would also limit collective bargaining for most public employees to wages.

But while the process has stalled, pressure continues to build on addressing Wisconsin’s immediate budget deficit which includes a Medicaid shortfall pegged at $153 million. In a memo this week (www.wha.org/MedicaidBudgetMemo2-24-11.pdf) to Department of Administration Secretary Mike Huebsch, State Budget Director Brian Hayes projects that in the absence of legislative action, the Medicaid program will run out of funding by mid-May.

"Some providers are heavily reliant on Medicaid payments, particularly nursing homes" said Hayes. "As such, plans may need to be made to respond to this situation by beginning to delay payments earlier than mid-May for certain providers and vendors."

As previously reported, Walker’s BAB fully funds the Medicaid deficit in FY2011 without cutting enrollment or provider reimbursement. The bill also includes a process whereby DHS will find savings over the coming year through studying key elements of the Medicaid program, developing a plan for changes and reforms, and implementing that plan via administrative rules, rather than legislation.

In addition, the bill authorizes restructuring of principal payments in fiscal year 2010-11 on the state’s general obligation bonds, allowing the principal payments to be made in future years, and reducing the state’s debt service costs by $165 million for this fiscal year. Administration officials have said the bill needs to be enacted by this weekend in order for savings from the debt restructuring to be realized.

Absent approval of the provisions in the BAB, Governor Walker has indicated layoff notices will need to be prepared for up to 1,500 state employees.

At this time, and while Governor Walker’s rescheduled budget address is still on for Tuesday, March 1, all eyes are on the Senate, where earlier today Republicans voted to engross the bill, moving it to an un-amendable form.

WHA will continue to provide updates from Madison as they become available.

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Reminder: Complete WHA Member Survey Today

As a reminder, one executive at each member hospital and health system has been invited to complete the WHA member survey. If you received that invitation, please complete this survey by March 9. It will only take 10-15 minutes of your time, but the feedback is essential to tee up the future priorities of the Association.

We currently have a 36 percent response rate. Please know that member participation in the survey is critical to the success of this effort. Significant participation, followed by incorporation of survey findings into WHA’s current and future programming, can only enhance member value. This is your opportunity to rate WHA’s effectiveness and value. Please take full advantage of it and provide your feedback.

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Guest Column: By Mary Kay Grasmick, Editor, The Valued Voice

If you had an opportunity to pitch the reasons why the President of the United States should visit your hospital, what would you say?

Holy Family Memorial (HFM) Medical Center in Manitowoc had that opportunity present itself in January when President Obama announced that he was planning a visit to their city. While the President wasn’t able to stop at the hospital, Obama noted while he was touring a local energy technology company there that he selected that site because he wanted to "glimpse the future."

I’m probably biased, and my bet is HFM’s CEO Mark Herzog is, too, but if the President wanted to "glimpse the future" he should have included a stop at a Wisconsin hospital. Wisconsin hospitals are not waiting for the future; they are shaping it by utilizing technology and innovation to drive down costs, improve quality and increase patient safety.

The brief two-page paper that HFM shared with local officials involved in planning the President’s visit made its way to our office in Madison and into the hands of WHA President Steve Brenton. As "Mikey" would say, "He likes it." It became the inspiration for WHA’s latest newsletter feature, "Wisconsin Hospitals: Connecting with Our Communities."

The first article of this new series appears here, and it features Holy Family Memorial Medical Center.

We hope you find inspiration in these articles too.

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WHA Raises Concerns About Stage 2 EHR Meaningful Use Proposal

WHA expressed concerns today about overly-ambitious, inflexible, and unclear Stage 2 electronic health record (EHR) meaningful use requirements being proposed by the Health Information Technology Policy Committee (HITPC, or the "Policy Committee") of the Office of the National Coordinator for Health IT (ONC).

The concerns were raised in a comment letter submitted to the HITPC on February 24. WHA’s comment letter was developed with substantial input from WHA’s HIT Task Force of hospital CEOs, CIOs, quality improvement experts and others.

"WHA is concerned that [the Policy Committee’s] initial recommendations are overly aggressive for Stage 2 meaningful use and are counter to Congress’ and the President’s goal of using HITECH stimulus funds to enable widespread adoption of EHRs," said WHA President Steve Brenton in the letter to the Policy Committee.

The Policy Committee is an advisory committee to the ONC, and its recommendations represent the first official step toward the development of Stage 2 meaningful use rules. Official proposed rules from Health and Human Services, and a second opportunity for comments, are not expected until later this year. Final rules are not currently anticipated before December 2011.

"Hospitals in Wisconsin are making significant investments in EHR technologies to improve patient care and meet the meaningful use standards," says Sandy Anderson, chair of the WHA HIT Task Force and chair-elect of the WHA Board. "It is critical to hospitals that the Stage 2 meaningful use rules be clearly spelled out and that the timeline for achieving meaningful use is reasonable."

In particular, WHA’s comment letter raises concerns about inflexible standards and a timeline that may jeopardize incentive payments to hospitals that are early participants in the Medicare EHR Incentive Program. The Policy Committee’s proposal for Stage 2 meaningful use reverts back to an "all or nothing" approach to meaningful use where hospitals would be required to meet at least ten new functionality requirements (a total of over 30 requirements) compared to Stage 1 meaningful use. Especially troubling is that if these recommendations were adopted in rule, hospitals that elect to receive Medicare EHR incentive payments in FFY 2011 could face a scenario where the Stage 2 rule is finalized in December 2011 and the hospital would have to implement a slew of new functionalities by October 2012 (only nine months) or risk losing a year’s payment under the Medicare EHR incentive program.

WHA’s comment letter can be found at www.wha.org/WHAhitpcMUcommentLetter.pdf. A copy of the Policy Committee’s Stage 2 meaningful use proposals can be found at http://healthit.hhs.gov/media/faca/MU_RFC%20_2011-01-12_final.pdf. Contact Matthew Stanford at mstanford@wha.org with questions.

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WHA Files Amicus Brief Supporting Hospital Property Tax Exemption

The Wisconsin Hospital Association this week filed with the Wisconsin Supreme Court its amicus brief in Covenant Healthcare System v. City of Wauwatosa, the case in which Covenant, now Wheaton Franciscan Healthcare, is appealing a decision by the Court of Appeals that denied the hospital property tax exemption for St. Joseph Hospital’s Outpatient Center. Following nine days of trial, the Circuit Court concluded that the SJOC was eligible for the property tax exemption as part of a nonprofit hospital.

The nonprofit hospital property tax exemption generally applies to property used for hospital purposes. The exemption, however, does not apply to property used as a doctor’s office. In its brief, WHA disagrees with the Court of Appeals decision, which focused on what doctor’s offices and hospitals have in common. Instead, WHA asks the Supreme Court to consider what distinguishes a doctor’s office from a hospital.

To determine the applicability of the property tax exemption to the SJOC, the Court of Appeals considered three factors: (1.) the absence of inpatient facilities; (2.) the fact that the facility provided the doctors with a space to do their work; and (3.) the fact that most patients were seen by appointment, during business hours. Attorney David Edquist, von Briesen & Roper, who wrote the amicus brief on behalf of WHA, said, "The Court of Appeals’ approach proves too much, since these criteria may be as applicable to nonprofit hospitals as they are to doctor’s offices." Edquist continued, "Each factor does no more to distinguish a doctor’s office from a hospital than other features the facilities may have in common, such as both are staffed by physicians and both maintain patient records."

The WHA brief recounts the legislative history of the nonprofit hospital property tax exemption. Importantly, as outlined in the brief, "the legislative and regulatory history makes it clear that outpatient hospital departments, including freestanding facilities, were considered to be part of a "hospital" both at the time that the nonprofit hospitals exemption was initially enacted and when the ‘doctor’s office’ language was added in 1977." In its brief, WHA proposes that the Supreme Court recognize, as a defining principle, that whether a facility is a "doctor’s office" for purposes of the nonprofit hospital exemption should be determined based on features that differentiate doctor’s offices from hospitals rather than on attributes common to the two. The brief provides criteria that indicate that a facility should not be considered a doctor’s office and criteria that may indicate that a facility is a doctor’s office for purposes of the nonprofit hospitals exemption.

A copy of the WHA brief and other documents related to the case are available on the WHA Web site at www.wha.org/legalAndRegulatory/default.aspx. The Supreme Court will hear the parties’ oral arguments on April 15, 2011, at 1:30 p.m.

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Connecting With Our Communities
Holy Family Memorial Medical Center, Manitowoc

This interview with Mark Herzog, President/CEO, Holy Family Memorial Medical Center, Manitowoc is the first of a series of articles that WHA is featuring in The Valued Voice that will demonstrate the important benefits that Wisconsin hospitals bring to their communities in the areas of economic development, community health and wellness and in ensuring access to high quality, affordable health care.

CEO Mark Herzog recently referred to Holy Family Memorial as the "poster child" of an integrated faith-based health system that is well-positioned for health care reform. That’s an impressive statement from a hospital CEO in an atmosphere where uncertainty and caution are usually the words that come to mind when health reform is mentioned. Herzog and his team didn’t wait for "reform" to come to them, embracing many of the key concepts embedded in health reform long before they became part of the massive new law. In fact, AHA Solutions featured HFM’s "Readiness for Reform" in a national webinar in 2009, and HFM has shared many of its practices on state and national platforms.

Examples of HFM’s "Readiness for Reform" include the fact that the organization’s physician integration and information systems models are among the most advanced in the nation, with over 90 percent of service provided through the employed physician model. HFM will be at HIMMS Level 7, which means it will have attained the highest operating electronic medical record possible by the end of 2011. Today, the hospital’s family medicine physicians work with specialists and allied health professionals in a medical home model to ensure care coordination. It’s just one way that Herzog said their health care team is working to hold down costs. Patients, especially those with chronic diseases, benefit most when health care professionals not only treat their specific illness, but also help them navigate the sometimes bewildering world of health care. To learn from the best, HFM is part of the AHA’s Healthcare System Reform Fellowship 2011 cohort, limited to only 20 organizations across the country.

At HFM’s medically-based community Wellness Center the focus is not just on "changing appearances" through weight loss and exercise, but on "changing lifestyles." Herzog said the Center’s class offerings and services are highly integrated with certified staff helping community members connect to the health care resources they need, whether the goal is helping a patient who is managing a chronic or acute disease or improving overall fitness and health. Organizations from as far away as Massachusetts and Arkansas have come to Manitowoc to study HFM’s Harbor Town health care village, the campus which is home to the Wellness Center and several other key programs.

Off campus, Holy Family Memorial works with employers to identify opportunities to improve the health of their employees by offering onsite nursing and case management combined with prevention and wellness programs. A service called "Easy Care" is available to employers that enables their employees to access walk-in care more quickly, replicating a work-site clinic process without the overhead, with high levels of user satisfaction.

Holy Family Memorial’s Local and Regional Role in Economic Development

Holy Family Memorial is an active contributor and leader in regional economic development. Among the largest tax payers and employers in Manitowoc County, the network estimates it brings $201 million dollars worth of economic activity to the area with its focus on buying from local vendors and contractors. In addition the 2,167 jobs that are created in the community as a result of these purchases, the local spending of its own 1,300 employees and 300 volunteers have a tremendous positive economic impact. HFM supports the Manitowoc County Economic Development Corporation, Main Street Manitowoc and network executives serve on a broad range of key community boards including chairing The Chamber – Manitowoc County, United Way – Manitowoc County, New North, Healthiest Manitowoc County 2020, Health Care Coalition, Rotary and Two Rivers Business Association. HFM was named "Business of the Year" in 2010 by The Chamber – Manitowoc County, based on its strategic focus, operational excellence, national recognitions, innovation and clearly-demonstrated commitment to bettering the Manitowoc community. HFM is vital to the community, its economy and its future.

Innovation and Improvement Help Lower Health Care Costs

To address the challenges of the future head on, Holy Family Memorial has adopted the "Innovators Prescription for HFM," which embraces Improvement (LEAN, Six Sigma), Innovation (Bright Ideas & Strategic Program/Unit Review) and Proactive Disruption (Blue Oceans & Strategic Partnering) as methods to intentionally shape HFM’s culture and business model for sustained excellence within its mission and values context. HFM’s initial "Blue Ocean" project was 2005’s Harbor Town campus which integrates family medicine, occupational services, walk-in/Easy Care, orthopedics, chiropractic, rehabilitation and wellness. Today’s focus is on the next strategic move to redefine the marketplace.

Over the past two years combined Improvement and Innovation processes have yielded over $8 million in improvements, and a three year ‘green dollar’ ROI of nearly 500 percent.

"We acknowledged eight years ago that physician integration, care coordination, cost reduction and information technology would be vital to patient care excellence, and our investments have been prescient," according to Herzog. "Not only have these processes improved quality and eliminated waste, they’ve taught us how to better anticipate, adapt and improve systems so patients can entrust their care to HFM."

In fact, HFM has received the premier national award for Excellence in Patient Safety (top two percent in the nation) four of the last six years largely due to its commitment to technology, standard work and organizational culture. Currently, HFM is using these processes to reduce fixed cost exposure by improving efficient use of facilities.

Looking to the Future

HFM’s board is uniquely composed of almost equal portions of community leaders, physicians and Franciscan ministry sponsors who embrace HFM’s approach to proactively address the challenges of the future. An updated mission statement focused on promoting health rather than only treating illness was adopted in 2008, setting the pace for today’s systematic review of operations and design. The SPUR process evaluates HFM’s 50+ programs through intense scrutiny from mission, best practice, essentiality, community need, quality and future relevance perspective. Over a three-year period, which began in 2010, every organizational program will undergo this review using teams of sponsors, physicians, leaders and ‘outside eyes.’ An ideal configuration for improving health long term is the objective, within the context of the mission. As Herzog summarized, "By demonstrating strong and courageous leadership to ask hard questions of ourselves, HFM’s board, physicians, leaders, staff and the Franciscan Sisters of Christian Charity are shaping the culture needed to do what is right both for our health care system and our community for today and for what will be a very challenging future. Regardless of the turns the health care reform debate will take, our actions today reinforce our commitment to sustained excellence for tomorrow."

What do you see as HFM’s greatest accomplishment in the community?

Herzog said HFM’s close relationship with the Catholic Health Association led the hospital to become an early adopter of community benefit reporting. Since 1989, HFM has produced—and publicly shared—their community benefit report.

"We receive very positive feedback about our report from our public leaders and local legislators because it provides the information they want to know about what we are doing for this community," according to Herzog. "We have a great deal of pride and ownership in our community benefit reporting efforts."

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Grassroots Spotlight: Rep. Kind Hears From Hospitals During Roundtable Discussion
Rural hospitals share concerns

Small, rural hospitals in Rep. Ron Kind’s district voiced concerns on various health care issues during a roundtable discussion held this week at Prairie du Chien Memorial Hospital.

Rep. Kind provided a brief overview on several issues that his office continues to work on, including the Critical Access Hospital (CAH) Flexibility Act. Kind has been a key leader on the legislation that allows CAHs more flexibility in how their 25-bed limit is determined.

Kind also said he continues to raise concerns with the Centers for Medicare & Medicaid Services (CMS) on the physician supervision rule and its impact on rural communities. Participants echoed their concern with this provision as well as an overarching concern that regulations coming down from CMS do not always reflect how health care is delivered in rural communities, thereby inhibiting effective and efficient delivery of that care. Others alerted Kind that cuts from CMS to hospice and home health will directly impact hospitals providing these services.

The group then spent time discussing physician-related issues, including the role of primary care in the delivery of health care as well as how to address physician shortages. During a brief discussion on the Health Information Technology (HIT) incentive payment program, the group alerted Kind that many hospitals are already making significant investments into HIT and that rolling back any of those program dollars, as some in Congress are proposing, would be detrimental.

Those participating in the roundtable included representatives from Prairie du Chien Memorial Hospital, Boscobel Area Health Care, Grant Regional Health Center, Tomah Memorial Hospital, The Richland Hospital, Rural Wisconsin Health Cooperative, Wisconsin Medical Society and Wisconsin Hospital Association.

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Sen. Leibham Shadows at Holy Family Memorial in Manitowoc

On February 7 Holy Family Memorial (HFM) hosted State Senator Joe Leibham during a shadow day opportunity. The shadow day initiative was launched by WHA in 2010 as a means for hospital leaders to demonstrate what it takes to run a hospital. Senator Leibham was able to see how HFM operates as he joined CEO Mark Herzog and others during their busy work day.

Through meetings, discussions and tours with staff, Sen. Leibham saw how HFM functions. This "hands on" approach exposed the Senator to the reality of delivering health care in Manitowoc County.

Throughout the day, Sen. Leibham asked detailed questions about the patient experience as well as hospital processes. At the same, HFM staff articulated both the successes and challenges in their efforts toward quality and process improvement, innovation, and customer service.

Leibham finished his day with dedicated time with Herzog and Patty Huettl, CFO & vice president of finance, discussing the financial environment within which the hospital operates. In closing, HFM offered to serve as a resource to the Senator as he deliberates health care issues in the Legislature, and the Senator said he would take them up on their offer.

"I would encourage every health care organization to think about hosting their legislators for a shadow day," said Scott McMeans, HFM administrative director for planning/process improvement, who was closely involved with Leibham’s shadow day. "Allowing legislators to share in hospital operations and the staff experience provides them valuable insight they can refer back to as they work on health care policy."

If your hospital has or would like to host a legislator shadow day, contact Jenny Boese at 608-268-1816 or jboese@wha.org.

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IRS Delays 2010 Form 990 Filing Date for Certain Hospitals

The Internal Revenue Service is delaying the start of the 2010 filing season for certain hospital organizations in order to complete changes to IRS forms and systems to reflect additional requirements enacted under the Patient Protection and Affordable Care Act. In an announcement this week, the IRS said hospital organizations may not file 2010 Forms 990 (with Schedule H attached) before July 1, 2011, regardless of whether the organization files an electronic return or a paper return.

The IRS has granted an automatic three-month extension of time to file the Form 990 to hospital organizations with original 2010 tax year filing due dates before August 15, 2011. The automatic extension applies only to hospital organizations that are required to file Schedule H with the 2010 Form 990. Hospital organizations affected by the delay are not required to file Form 8868 (Application for Extension of Time to File an Exempt Organization Return) in order to take advantage of the automatic three-month extension. However, recently formed hospital organizations that did not file Form 990, Schedule H for tax year 2009 and believe they are entitled to the automatic three-month extension are encouraged to file Form 8868 to reduce the risk that they may incorrectly receive a penalty notice, IRS said.

The revised Form 990 Schedule H can be found at: http://www.irs.gov/pub/irs-pdf/f990sh.pdf. A copy of the announcement is available at: http://www.irs.gov/pub/irs-drop/a-11-20.pdf.

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Reedsburg Hospital, Nursing Home Reach Nearly 90% Flu Vaccination Rate

Reedsburg Area Medical Center (RAMC) and the Reedsburg Area Senior Life Center (RASLC) together vaccinated 90 percent of their employees during the 2009-2010 flu season. Individually, RAMC attained an 89 percent employee flu vaccination rate, while the Reedsburg Area Senior Life Center (RASLC) vaccination rate was 94 percent.

Getting in the "80 percent club" for flu vaccinations is something RAMC and RASLC have become accustomed to, but the recognition still is a cause for celebration.

"We’ve been in the 80 percent club for years. I have records going back to 2007, and in 2008 we were at 88 percent, but this year we reached 90 percent!" Cherie Meyer, RN, employee health nurse of Reedsburg Hospital said.

Meyer attributes Reedsburg’s success with employee flu immunization rates to the support from the administration and the "pro-flu vaccination" attitude. In fact, 100 percent of the RAMC and RASLC administrative team was vaccinated this year, which sets an example for the success of Reedsburg’s flu immunization program. Directors of each department reached out to all health care workers, reminding employees who hadn’t received the vaccine and encouraging them to do so.

"We discussed the myths at staff meetings and provided the facts about the flu shot," Meyer said. "A lot of educational materials where distributed throughout the facilities—posters, time card messages, which helped us."

Accommodating employees is another key aspect in their strategic plan, as Reedsburg offered flu clinics around the clock for all shifts. Something that makes this 24/7 method work is the positive atmosphere Meyer and other nurses create, leading to a more personalized immunization experience for employees. In fact, Meyer attributes Reedsburg Area Senior Life Center high vaccination rates—94 percent this year—to a personalized atmosphere.

"The Senior Life Center rate is higher because Kathy Kinsman, RN, the resident care coordinator, administered the flu vaccinations to her own employees, which personalized the experience for them," Meyer said.

Giving incentives to employees to be immunized doesn’t hurt either. The health care workers who received a vaccination got an employee appreciation card valid for use at the cafeteria or gift shop, or a free candy bar.

All these accommodations and incentives aside, RAMC and RASLC still face its fair share of challenges. No matter how you present it, some employees still decline to be immunized. In fact, out of 470 employees, 48 declined to have the shot, seven of those declinations for allergic reasons. Nevertheless, Reedsburg Area Medical Center and Reedsburg Area Senior Life Center were still able to increase their vaccination rate from last year, a success that can be chalked up to education and persistence.

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WHA Work Group on the Physician Workforce Holds First Meeting

The WHA Work Group on the Physician Workforce held its first meeting February 24. The Work Group’s charge is to provide feedback on a WHA white paper that will analyze the projected physician supply in Wisconsin compared to the forecasted demand, assess whether a shortfall is likely, and make preliminary recommendations on how to mitigate or eliminate the projected shortfall.

Members of the Work Group include Dr. Michael Kryda, chief medical officer, Ministry Health Care; Dr. Bruce Van Cleave, chief medical officer, Aurora Health Care; Dr. Mark Kerberg, chief medical officer, Affinity Health System; Sandy Anderson, CEO, St. Clare Hospital and Health Services, Baraboo; and Tim Size, executive director, Rural Wisconsin Health Cooperative. The Work Group is staffed by Chuck Shabino, MD, WHA senior medical advisor, and George Quinn, WHA senior vice president.

At its first meeting, the Work Group reviewed a draft of the white paper and provided comments and suggestions. One of the more significant topics was the medical home model for care delivery, how it might affect future demand for services, as well as its affect on the health care workforce.

The Work Group will meet two more times to finalize the paper, which will be submitted to the WHA Board at its June meeting along with recommendations on achieving the goals outlined in the paper.

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On the CUSP: Stop BSI

The Wisconsin Hospital Association will received $22,500 in additional funding to expand aspects of the Stop BSI collaborative work already underway. Currently, WHA supports three cohorts of the collaborative and these funds will allow for expanded outreach and recruitment for small hospitals to participate in the national Stop BSI collaborative. Through strong participation by Wisconsin hospitals, the Healthcare Research and Education Trust (HRET) awarded WHA the additional monies to be applied in several key areas:

According to WHA’s Quality Coordinator, Jill Hanson, "We have a few rural hospitals participating in the current collaboratives, but we know the needs of small hospitals are different and the additional money from HRET will allow us to address these needs and support more rural hospitals participation in these nationwide improvement efforts."

For more information on these infection prevention improvement efforts, contact Jill Hanson at jhanson@wha.org.

Aligning Forces for Quality is supported by the Robert Wood Johnson Foundation, through a grant to the Wisconsin Collaborative for Healthcare Quality. In Wisconsin, Aligning forces for Quality is a joint project by the Wisconsin Collaborative for Healthcare Quality, Wisconsin Hospital Association, and other organizations.

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Expedited Inter-state Physician Licensure May be Close

Work continues to progress on the development of a process that would expedite licensure by endorsement of physicians within eight states. With assistance from an ARRA grant, the Wisconsin Department of Regulation and Licensing (DRL) has been working with representatives from Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Kansas, and South Dakota to find and agree upon criteria and processes that will work for all the states. The group is also working to improve information sharing among the states through an online system.

While the states have much in common, reconciling the differences among licensure requirements to build a program that allows for a rapid process, but is still acceptable to all, has been a challenge. The group of states has drafted eligibility requirements and an application process which is now being reviewed by an advisory board and by each state. Each state will need to consider if and how they will respond to the requirements. At their last meeting, the Wisconsin Medical Examining Board agreed to consider adding fingerprint criminal background checks for applicants, as most of the other states in the group currently do.

Judy Warmuth, WHA vice president of workforce, is a member of the advisory committee along with two others from Wisconsin (WMS and WAMSS) and an individual from each of the other states. All members of the advisory group have recently been asked to review the project work to date and offer advice and input.

"We are especially glad to have been able to share concerns from our members about physician licensing. It is great news that a faster, easier option may be available for physicians licensed in adjacent states to practice in Wisconsin by early next year," Warmuth said.

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Wisconsin Hospitals Community Benefits: Adequate and Appropriate Nutrition

Nutrition counseling is an important aspect of the service that hospitals provide within their communities. Whether it is offering classes that focus on weight loss or promoting better health, or nutrition education for people who are diabetic, Wisconsin hospitals offer hundreds of free classes that stress the importance of a nutritional, well-balanced diet on overall health. Hospital employees also help deliver Meals on Wheels and they organize and participate in food drives to benefit local food pantries.

County elderly meal program receives assistance from Luther Midelfort Northland

For more than 36 years, Luther Midelfort Northland - Mayo Health System has been assisting the Barron County Elderly Nutrition Program with meal service to homebound residents on special diets. While the county reimburses the medical center a portion of the costs, the 1,829 meals were an additional $8,231 expense to the organization in 2009 due to additional staff time and food costs to prepare meals for those with diet restrictions.

With Luther Midelfort Northland’s assistance, meals for those on special diets have remained affordable for the program participants. As a result, more seniors in the community are served -- individuals who might otherwise continue to struggle at home and eventually end up in a health crisis.

Luther Midelfort Northland, Barron

Tomah Memorial demonstrates proper portion size

Tomah fifth grade students have a better understanding on the amount of food they should have on their plate. As part of National Nutrition Month, Tomah Memorial Nutrition Services Director Donna Shuck and Registered Dietitian Joan Kortbein took their message on the road, talking nutrition and food portion size to elementary students in March. Students not only learned the proper portion of foods they should eat, but what kinds of foods make up a nutritious diet.

Tomah Memorial Hospital, Tomah

Heart healthy cooking

Heart disease is a health epidemic. It’s the No. 1 killer of men and women in the United States and throughout the world. Changes in a person’s cooking and eating habits can prevent or treat heart disease, as well as significantly improve overall health.

To help people better care for their hearts, Memorial Health Center regularly holds free Heart Healthy Cooking educational sessions for the public. At these sessions, Odessa Syryczuk, RD/CDE, Memorial Health Center registered dietitian, explains how to make smart food choices from every food group, read nutrition labels to identify heart healthy foods, and set achievable health goals. Proving that heart healthy meals don’t need to be boring or bland, a free heart healthy lunch is served to all attending.

Memorial Health Center – An Aspirus Partner, Medford

The Karen Yontz Center Wellness University

The Karen Yontz Women’s Cardiac Awareness Center, located at Aurora St. Luke’s Medical Center and in the Aurora Women’s Pavilion of Aurora West Allis Medical Center, is a nationally-recognized resource center dedicated to decreasing the incidence and impact of heart disease in women by raising awareness, promoting wellness and advocating for early diagnosis and intervention for women with cardiac disease.

The Women’s Health Education Series includes a year-long calendar of special educational series to support women and empower them in making healthy choices. Examples of topics, to name a few, include:

In West Allis, the hospital hosts the annual Reflections of Wellness for Women: Mind, Body & Spirit, featuring health-related exhibits, healthy foods and presentations. In 2010, more than 150 women of all ages attended. They paid a nominal fee, the proceeds of which were donated to the Greater Milwaukee Free Clinic in West Allis. In return, they were able to participate in Zumba lessons and get coaching from a personal trainer, learn about acupuncture, receive massages, sample deliciously nutritious appetizers and learn how to make them, and meet and network with other women while visiting numerous health and wellness-related exhibits. Capping off the day was a presentation entitled: Live Happy. Live Well. Live Now.

At Aurora St. Luke’s Medical Center, a sell-out crowd turned out for Women, Wine and Wellness, held ten days before St. Valentine’s Day.

Julie O’Neill, a community health educator at ASLMC, knew she had hit upon a successful formula to help women learn about the power of antioxidants.

Aurora’s Wellness Champion John Whitcomb, MD, explained how little indulgences in good things can protect our bodies’ cells and bring a healthy balance to life. He led an entertaining and enlightening discussion on the power of antioxidants in red wine, olive oil, dark chocolate and other heart-healthy foods – imbibed in just the right amounts.

To prove the point, samples were available to attendees for sipping, tasting and sampling.

"The benefits of red wine, dark chocolate and olive oil are touted in health and wellness websites constantly," Julie explains. "But there is a concern about how much is good and how much is too much, and that can get lost in the narrative on a Web page. Dr. Whitcomb was able to put it all in perspective in this face-to-face, interactive format that allowed our participants to ask questions and get answers."

The program was repeated to a sell-out crowd in West Allis.

Aurora St. Luke’s Medical Center, Milwaukee and Aurora West Allis Medical Center

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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