Representative Greg Underheim (R-Oshkosh), sponsor of legislation (AB 869) that would broaden the requirements for nurse faculty, this week asked key stakeholders to form a work group to address the issue. In announcing the decision before the Assembly Health Committee, Underheim made it clear that this decision reflects his "absolute commitment to moving forward on this issue."

Leading the group will be Rep. Leah Vukmir (R-Wauwatosa), vice-chair of the Assembly Health Committee. Vukmir thanked Underheim for the move, which will "allow for greater conversation about this issue" and reaffirmed her support for a solution.

This issue is not new for Rep. Vukmir, who appeared with Judy Warmuth, WHA’s vice president of workforce development, to discuss the issue at the January 26, 2006 meeting of the Board of Nursing. Vukmir petitioned the Board for a direct solution to the problem. It was WHA’s third such request.

Ensuring an adequate supply of knowledgeable faculty to teach in nursing programs has been a long standing priority for WHA. Healthier Choices, WHA’s 2004 health care reform package developed in partnership with the WI Manufacturers & Commerce and WI Association of Health Plans, includes a provision "call(ing) upon the Board of Nursing….to modify requirements for classroom and clinical instructors to increase the number of instructors available." Nurse faculty requirements continue to be a hot topic of discussion at WHA region meetings and councils.

"We are very pleased that Reps. Underheim and Vukmir have agreed to take on this challenge, said Warmuth. "Hopefully, this issue can be addressed in a serious way by all interested parties. This issue has been a priority for hospitals, the major employer of RNs in Wisconsin for a long time. Now it’s time to see some progress."

Administrative rules developed by the Board of Nursing currently require that to teach nursing courses in a professional nursing program, faculty must hold a master’s degree in nursing. Two types of exceptions are allowed, the standard exception for a student enrolled in a master’s program in nursing and the emergency exception – eight weeks in length – for unexpected, short-term situations. WHA has requested that these rules be expanded to include knowledgeable, skilled and experienced nurses without a master’s degree in nursing.

Register for this free event by visiting www.wha.org.
For more information, contact Sherry Rabuck at 608-274-1820 or srabuck@wha.org.
To schedule an appointment to meet with your legislator on the afternoon of April 5, contact Angela Miloszewicz directly at 608-268-1801.

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In addition to the welcome nursing home relief, the Legislature will transfer $76 million in funds to cover the projected Medicaid budget shortfall. Those dollars come from a small projected budget surplus.

"We applaud the Legislature’s leadership in fully funding the Medicaid budget and providing a small but desperately needed payment increase for Wisconsin nursing homes," said WHA President Steve Brenton. "The Legislature clearly recognizes the importance of funding Medicaid as a budget priority, a fact that must carry into 2007 when we work on our next biennial budget cycle."

Brenton also noted that a majority of Wisconsin hospitals and health systems own long term care facilities that provide a continuum of health care services to frail elderly patients. Financial losses associated with the facilities are often staggering due to inadequate Medicaid payments.

WHA staff specifically acknowledged the work of Joint Finance Committee co-chairs Senator Scott Fitzgerald (R-Juneau) and Representative Dean Kaufert (R-Neenah) for their leadership on the Medicaid issue. Senator Bob Jauch (D-Poplar) was instrumental in garnering Democratic support for the initiatives. The lead sponsors of the legislation were Senator Ron Brown (R-Eau Claire) and Representative Mark Pettis (R-Hertel).

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Marni Feldman, Medical Resident, Ophthalmology, University of Wisconsin – Madison, Native of New Richmond, Wisconsin

Josh Medow, Medical Resident, Neurosurgery, University of Wisconsin – Madison, Native of Chicago, Illinois

The Bush Administration’s proposed FY 2007 Medicare budget would cut payments to Wisconsin hospitals by more than $184 million over the next five years. The following chart shows the impact of key provisions on Wisconsin hospitals.

Source: American Hospital Association

In addition to those payment reductions, the Administration’s budget provides no payment updates for skilled nursing facilities and home health services for FY2007 and an update of market basket minus

0.4 percent in FY2008. Perhaps even more shocking is a proposed overall Medicare spending cap, which, if exceeded, would require automatic across-the-board cuts to all provider payments. In other words…a sum certain global budget!

WHA will join our federal partners—AHA—in vigorously opposing these provider payment cuts. Virtually all Wisconsin hospitals currently lose money from Medicare outpatient care, and most Wisconsin hospitals have negative margins from Medicare inpatients.

In closing, it’s noteworthy that during the first Bush term, the Administration’s budgets provided full market basket increases for hospital services. On the other hand, almost every budget proposed by President Clinton (7 of 8) sought market basket reductions. But this budget plan is what it is, and it is unacceptable.

Steve Brenton, President

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St. Mary’s Hospital and Ministry Medical Group Rhinelander hosted an in-depth meeting and tour for State Senator Roger Breske (D-Eland) and State Representative Dan Meyer (R-Eagle River) on Friday, February 10, 2006.

Dr. Dorothy Skye, Assistant Medical Director, was joined by other hospital leaders at this meeting.

During the meeting it was noted that in her years of practice as an OB/GYN, Skye had delivered approximately 3,000 of Breske’s and Meyer’s constituents. In addition, recent UW Medical School graduate Ted Shinners, MD, a radiologist in Rhinelander, provided particularly compelling comments regarding the realities young physicians face when looking for a job.

Shinners told the group, "If a state didn’t have a cap, it got checked off the list. You wouldn’t even go there for an interview." He also remarked that he was personally aware of a number of his medical school colleagues who sought out practicing in Indiana specifically because that state had a cap. Although Shinners remained in Wisconsin due to family considerations, he cautioned legislators that he is one of the few to do so.

Both legislators were also provided a brief overview of other issues, including community benefits information, before touring the James Beck Cancer Center. Truly a jewel for the Northwoods, the Rhinelander cancer center allows constituents of Breske and Meyer to access quality cancer care, including radiation therapy, without having to travel to Wausau or another distant community.

Upon conclusion of the tour, the legislators joined a larger group where they were greeted by the facility’s community volunteers, other facility employees, and physicians. Four of those physicians made passionate pleas with these elected officials to do everything they could to secure a cap at $750,000 for non-economic damages before the Legislature adjourns in spring.

WHA supports a clean $750,000 cap and is urging bipartisan support from both the Legislature and the Governor.

Has your hospital been involved in grassroots advocacy on restoring a cap on medical liability or other important issues? HEAT is always interested in hearing from you! Contact Jenny Boese at 608-268-1816 or jboese@wha.org  so WHA can showcase your efforts in The Valued Voice!

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"We have this incredible constellation of stars in Wisconsin health care…and to those who are cynical out there, we have people out there who are opening their books, creating transparency."
- Barbara Lawton, Wisconsin Lieutenant Governor

The night belonged to health care as Lieutenant Governor Barbara Lawton presided over the Forward Award ceremony held February 15 at the Overture Center in Madison. Of the 11 Forward Awards presented in 2006, nine went to health care organizations, seven specifically to hospitals.

In accepting their awards, Wisconsin health care executives said:

"We’re able to serve a much larger portion of our community in charity care and community benefits. When you embrace the Forward Award, things get better."
- Bob Fale, Agnesian HealthCare, Fond du Lac

"Each day we touch the lives of the people we serve. Each job is important. Every interaction has meaning." - Terri Potter, Meriter, Madison

"St. Marys Hospital and Medical Center was the first hospital to receive the Forward Award in 1999." (St. Marys Care Center is the first nursing home in Wisconsin to attain Mastery Recognition).
- Sr. Mary Ellen Lewis, Franciscan Sisters of Mary – Health Care

"We believe the application process is the best way to speed us along to providing exceptional health care." - Bill Bender, St. Marys Care Center, Madison

Award winners are listed below, along with the level of recognition that they received.

To see photos of the award winners, go to: http://www.wha.org/pubArchive/friday_packet/vv2-17-06.pdf    (page 5)

Mastery Recognition
Agnesian HealthCare, Fond du Lac

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Effective for dates of service on and after March 1, 2006, reimbursement rates and program requirements will change for Medicaid outpatient hospital physical therapy (PT), occupational therapy (OT), and speech and language pathology (SLP) services. The following changes will occur:

• Providers will be reimbursed up to an established maximum allowable fee rather than a hospital-specific outpatient rate-per-visit.
• Providers will be required to submit claims using the CMS 1500 claim form or the 837 Health Care Claim: Professional transaction. The UB-92 claim form and 837 Health Care Claim: Institutional transaction will not be accepted when submitting claims for these services.
• Providers will be required to follow prior authorization requirements and procedures for PT, OT, and SLP services.
• Providers will be required to use CPT and HCPCS procedure codes on claims submitted to Wisconsin Medicaid. Revenue codes will not be allowed when submitting claims for these services.

Because this is a payer-specific change, the requirements for submitting data to WHA Information Center will not change. WHA Information Center will continue to require hospitals to include revenue codes for Medicaid outpatient therapy services when submitting data under Chapter 153, Wisconsin Statutes.

Questions regarding WHA Information Center’s data submission requirements should be directed to Debbie Rickelman at 800-231-8340 or 608-274-1820.

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Hospital and clinic laboratory staffers are on the front lines during emergency response. At six regional meetings in March and April, these laboratorians will learn the latest about the Wisconsin Laboratory Response Network (WLRN) for preparedness and response to bioterrorism, chemical terrorism and other public health emergencies. A portion of the meeting will be focused on developing a  shared clinical laboratory response plan for pandemic influenza.

"Hospital and clinic laboratories are likely going to be one of the first to know if a terrorism event or public health emergency is happening as patients start presenting to the hospital or clinics for treatment," explains Dr. Peter Shult, Wisconsin State Laboratory of Hygiene Communicable Disease Division and Emergency Laboratory Response director.

Infection control practitioners and emergency department managers are also encouraged to attend. Local health department staff also attends the meetings.

Dates and locations for the meetings are:

• March 28 - Olympia Resort and Conference Center, Oconomowoc
• March 29 - Holiday Inn & Suites, Madison
• April 4 - Turtleback Golf and Conference Center, Rice Lake
• April 5 - Radisson Hotel, La Crosse
• April 11 - Hilton Garden Inn, Green Bay
• April 12 - Wausau Inn & Conference Center, Wausau

Please forward this information to appropriate personnel in your organization. More information and online registration can be found at the Wisconsin State Laboratory of Hygiene’s Web site at www.slh.wisc.edu/outreach/.

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At a recent summit of disaster preparedness stakeholders called together by Governor Doyle, recommendations for potential hospital evacuations were made by Denny Thomas, risk manager, Ministry Health Care, Saint Joseph’s Hospital in Marshfield; Bill Bazan, vice president Metro Milwaukee, WHA; and Dennis Tomczyk, director, Hospital Disaster Preparedness, Wisconsin Division of Public Health.

The following action steps were recommended to respond to specific issues that could and will arise.

• Step One: Formation of a State Expert Panel on the Evacuation of Hospitals

The object of this panel would be to develop a template policy for the evacuation or shelter-in-place of hospitals and to identify the critical operational components that should be consistent across all hospitals in the state. Membership on this panel would include hospital staff who have the operational responsibility for evacuation and shelter-in-place protocols. Completion of this objective would be June 2006.

• Step Two: Formation of a State Expert Panel on the Evacuation of all Health Care Facilities

• Step Three: Formation of a State Expert Panel on the Evacuation of Health Care Facilities by Emergency Medical Services and First Responders

The objective of this panel would be to develop various options for how other emergency responders may assist hospital and other health care facilities in both the decision and implementation of the decision to evacuate or shelter-in-place and what resources may or may not be available to these facilities to assist with this implementation. Membership on this panel would include hospital and other health care facility staff, fire departments, law enforcement and other emergency response partners who may be involved in assisting hospitals and other health care facilities in the decision to evacuate or shelter-in-place and in the actual implementation of that decision. Completion of this work is scheduled for September 2006.