Wisconsin Healthcare Human Resources Association News

WHA Foundation Launches Statewide Workforce Campaign

Mon, 19 Feb 2024 18:35:45 GMT

New campaign targets youth and aims to boost the state's health care workforce.

MADISON, Wis. — The Wisconsin Hospital Association (WHA) Foundation is unveiling a new workforce campaign entitled So Many Options to attract new workers to Wisconsin’s health care workforce and foster a thriving and sustainable workforce for generations to come.

The statewide campaign features targeted digital advertising and the launch of a dedicated website to showcase the abundant health care career options – both clinical and non-clinical – available to current and prospective employees throughout Wisconsin. With a particular focus on middle and high school students, the campaign aims to inspire younger generations to pursue these career opportunities by highlighting appealing aspects such as competitive compensation, flexible schedules, and wide-ranging educational requirements.

“Whether young, prospective employees are looking for their first job or veteran health care workers are looking to transition careers, there are countless health care career options throughout Wisconsin’s hospitals, no matter a person’s background or vocational interest,” said Eric Borgerding, WHA President and CEO. “Careers in hospitals and health care are consistently in high demand, offering stability and enduring relevance. These professions are essential and will always be needed.”

The So Many Options campaign’s spokespeople are real clinical and non-clinical employees from hospitals across the state, including Reedsburg Area Medical Center, ThedaCare Regional Medical Center in Appleton, and Aurora St. Luke’s in Milwaukee. The So Many Options website guides users through descriptions of a variety of health care professions based on personal interests and educational background and connects users to a number of workforce-related resources, including WHA, Future Health Professionals (HOSA) and Wisconsin Area Health Education Centers (AHEC).

The campaign is made possible through generous sponsorship support from other organizations, including Presenting Sponsor, Rural Wisconsin Healthcare Cooperative (RWHC).

For more information, visit the So Many Options website.

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ABOUT THE WISCONSIN HOSPITAL ASSOCIATION FOUNDATION
The WHA Foundation, Inc. was formed in 1968 to support educational, research and charitable programs of the Wisconsin Hospital Association and its members. Today, as a 501(c)(3) organization, the Foundation focuses its grant making priorities on initiatives that have a statewide impact on health care in Wisconsin. To learn more, click here.

New Salary Survey Launches in January 2023 Workforce Resource for WHA and WisHHRA Members

Fri, 02 Dec 2022 14:43:58 GMT

WHA, in partnership with the Wisconsin Healthcare Human Resources Association (WisHHRA), will be launching a new salary survey in January 2023. The survey, and statewide and peer group results, will be available to member participants at no cost. The inaugural co-branded WHA-WisHHRA survey will collect salary information as of January 1, 2023, and results will be available to participants in late March or early April 2023.

There will be a virtual webinar held on Wednesday, December 14^th, 2022, from 11:30 am – 12:30 p.m. Join us for an opportunity to preview the salary survey site, online and bulk upload data submission, and options for participants to utilize standard peer groups or easily create your own. There will also be an opportunity for Q&A at the end of the webinar.

WHA and WisHHRA expect great participation and are committed to providing a survey and reporting that will be a meaningful resource for assisting hospitals and health systems as they work through the many workforce issues facing the industry.

For more information regarding this webinar, including registration, please click here. If you have any questions please contact Ann Zenk, azenk@wha.org or Jennifer Mueller, jumeller@wha.org.

Save the Date! WisHHRA Annual Conference April 28-29

Fri, 25 Mar 2022 18:11:12 GMT

Save the Date!

WiSHHRA Annual Conference
April 28-29, 2022
Osthoff Resort, Elkhart Lake

After a few years off and much deliberation, we have decided to resume our annual conference this spring. The annual conference will be April 28-29 in Elkhart Lake at the beautiful Osthoff Resort. This will be a great time to re-connect with colleagues from across the state. The conference schedule will feature a variety of sessions focused on recruitment and retention in today’s new market. Attendees will learn about how different strategies are being used to recruit and retain employees. This includes but is not limited to sessions on new technologies, compensation plans, rewards programs and organizational culture. Conference schedule and speaker details coming soon!

Schedule of Events

Wednesday, April 27 – Welcome Reception

Thursday, April 28 – general sessions, breakouts and networking groups meet from 8am to 5pm. Reception from 6pm to 8pm.

Friday, April 29 – general sessions and networking groups meet from 8:30am – 10:30am. And WiSHHRA business meeting to follow at 10:30am

Registration

WiSHHRA members can register for $225 for the full conference, or $175 for 1-day rate (Thursday only).

Non-members can register for $325 for the full conference, or $275 for 1-day rate (Thursday only).

Reserve your hotel today!

The Osthoff Resort has provided a great rate for our guests. Room rates start at $139 per night, and is available for 3 days before or after the event for those interested in extending their stay into the weekend. Make your reservations now by calling the Osthoff at 1-800-876-3399. Room rates are guaranteed until April 6.

WisHHRA Webinar Library

Tue, 23 Nov 2021 20:40:19 GMT

Access the On Demand Webinar Members Only Page!

2021

Legal Update - Presented by Sarah Coyne, Partner - Quarles & Brady
Legislative Update - Presented by Kyle O'Brien and Ann Zenk, Wisconsin Hospital Association
Compensating Providers Under the New Stark and Anti-Kickback Regulations - Presented by Heather Mogden & Wes Sylla, Hall Render
Keeping up with Comp in a HOT marketplace for talent! - Presented by Rena Somersan, Newport Group
Succession Planning - Presented by Michael Grubich, LAK Group & Andy Hilling, Andy Hillig Solutions, LLC
Vaccine Update - Presented by Ann Zenk, RN, BSN, MHA, Senior Vice President, Workforce and Clinical Practice & Lindsey W. Davis, Partner, Quarles & Brady LLP

2020

Physician Employment and Medical Staff Matters - Fun Times for HR Directors! - Presented by Sarah Coyne, Partner - Quarles & Brady

Vaccine Update Webinar | October 19, 9am

Tue, 12 Oct 2021 17:48:26 GMT

Topics

Waivers
New Biden rules
OSHA standards

Presenters

Ann Zenk, RN, BSN, MHA, Senior Vice President, Workforce and Clinical Practice
Lindsey W. Davis, Partner, Quarles & Brady LLP

Succession Planning Webinar | August 26, 12pm

Thu, 19 Aug 2021 13:36:29 GMT

In today’s highly competitive healthcare labor, nearly 9 out of 10 organizations are experiencing a leadership shortfall, and only one-third of organizations have formal systems in place to identify high-potential leaders and strategies to retain them. What gives? Market-leading healthcare organizations have one thing in common: succession planning.

Why bother with succession planning at all? “The clearest answer is that leadership really matters. Organizations either thrive or don’t because of the quality of their leadership,” writes Nancy Schlichting, former CEO of Henry Ford Health System. Effective succession planning protects organizations from severe disruption and underperformance in an era of value-based care and shrinking reimbursement; it also helps you keep employees engaged, retain top talent and groom them for leadership when succession plans broaden beyond C-suite.

Join Mike Grubich (President & Managing Partner of the LAK Group) and Andy Hillig (President of Andy Hillig Solutions, LLC) as they provide an overview of what succession planning is, the essential things to consider in your organization’s succession plan, and how individuals can take charge of their own careers and plan for their own career advancement.

Board of Directors: Election is Open until January 5!

(Past member) — Wed, 23 Dec 2020 23:18:01 GMT

Cast Your Vote for the 2021 Board of Directors Election!

It is time to elect your 2021 WisHHRA Board of Directors! Click the link below to view a list of the candidates, along with a ballot to complete.

You may accept all proposed candidates or write in candidates and their titles.

CAST YOUR VOTE!

Note: You must be logged into your WisHHRA member account to participate.

Voting Deadline: January 5th at Midnight CST

Board Nominations: Members Invited to Submit Names to Serve

Fri, 20 Nov 2020 01:30:08 GMT

Edit: Nominations closed December 4, 2020

The Wisconsin Healthcare Human Resources Association (WisHHRA) is now accepting nominations of any member in good standing interested in serving in leadership.

The Board is calling for nominations for the following positions:

President-Elect
Secretary
At-Large Director

Expectations of Officers and Board - All Officers and Directors of the Board shall attend in person, or telephonically, at least 60% of all Board meetings on an annual basis. Region Directors shall participate in all activities of the Board of Directors. Each shall recommend to the President, members of his/her district for appointment to various committees of the organization, act as a resource to members within their district, and assist with planning conferences on a rotating basis.

The President-elect shall, in the absence of, or because of the incapacity of the President, perform all duties and assume all responsibilities of the President. He/she shall have the responsibility of recognizing contributions of Board members. This position serves 1 year, proceeds to serve as President for 2 years and then proceeds to Past-president for 1 year. Nominees must have previously served at least 1-term on the board to be eligible as an officer.

The Secretary shall record the proceedings and prepare the minutes of the organization, which shall be available to the members for inspection. He/she shall maintain the supplies, minutes and official records of the organization and perform such other duties as may be necessary to coordinate and advance the organization's objectives as authorized by the Board of Directors. This position serves for two years.

At-Large Directors are elected to 2-year terms and may serve up to 2 consecutive terms.

All terms begin January 1, 2021.

Wisconsin Medicaid Telehealth Expansion Webinar: Stakeholder Input Session for Providers

Mon, 20 Jul 2020 15:08:27 GMT

The Wisconsin Department of Health Services (DHS) invites you to attend a Medicaid Telehealth Expansion interactive webinar.

Agenda

This webinar will seek your response to DHS’s proposed launch of Wisconsin Act 56: Telehealth Expansion, which will significantly expand Wisconsin Medicaid’s permanent telehealth policy. The presentation will include the following items:

1.       General overview of telehealth expansion
2.       General policy information
3.       Wave 1 priority acute and primary service areas:
4.       Proposed services included in telehealth
5.       Proposed services excluded from telehealth
6.       Input from attendees

Following the presentation, DHS will take questions from attendees via the DHS telehealth mailbox.

How to join

Thursday, July 30, 10:30 am – 12:00 pm

Click this URL to join; Password: 07302020

Join by phone: 646-558-8656; Webinar ID #933 1403 1869

Friday, July 31, 2:00-3:30 pm

Click this URL to join; Password: 07312020.

Join by phone: 646-558-8656; Webinar ID #999 9957 0817

Health Systems Seek to Make Temporary COVID-19 Flexibilities Permanent

Thu, 09 Jul 2020 15:39:38 GMT

Wisconsin Health News, July 9

Wisconsin hospitals are asking that the federal government consider making temporary COVID-19 regulatory flexibilities, especially those that helped expand telehealth, permanent.

Bellin Health CEO Chris Woleske said they asked Health and Human Services Secretary Alex Azar about making the waivers permanent during his visit to Green Bay last month.

Woleske said that keeping flexibility around licensing, emergency rooms and record keeping requirements beyond the pandemic would also be helpful. She said the waivers have played a vital role in meeting the needs of patients.

Eric Borgerding, Wisconsin Hospital Association CEO, said that they’ll advocate at both state and federal levels to make recent flexibilities permanent.

“The pandemic has shown that providers and patients have embraced the technology – utilization of telehealth has exploded since March,” he said in a statement. “Some healthcare systems have measured patient and provider satisfaction with telehealth visits and the reviews are consistently very positive.”

WHA supports permanent changes for other pandemic-related flexibilities, including allowing out-of-state healthcare providers to practice in Wisconsin.

Sen. Tammy Baldwin, D-Wis., was among a bipartisan group of 38 senators who sent a letter last week to Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma asking for a plan and timeline for making the telehealth flexibilities permanent.

Congress, through its COVID-19 relief packages, provided HHS with the authority to waive telehealth requirements for the length of the federal public health emergency. The senators said they’ve heard from patients concerned the rules will be rolled back.

“Telehealth has been a lifeline to patients and providers during the COVID-19 pandemic,” they wrote.

A CMS spokesperson said the agency is reviewing the flexibilities granted during the emergency and determining what it can do under its regulatory authority once the emergency finishes.

The spokesperson said telehealth has been a crucial tool in the fight against COVID-19.

The agency has in the past few months expanded telehealth aggressively, allowing for the use of virtual emergency room visits, letting doctors supervise clinical staff remotely and eliminating requirements that some visits be face to face. That’s led to a significant increase in visits, the spokesperson noted.

“CMS Administrator Verma believes it is crystal clear that we need to continue to harness the power of telehealth,” they wrote. “Factors such as reimbursement and how we determine which telehealth services work best are going to continue to evolve.”

A Message from WisHHRA President, Nicole Berlowski

Thu, 02 Jul 2020 14:11:35 GMT

Hello fellow WisHHRA members! I hope that this finds you all healthy and enjoying this warm Wisconsin weather. As I write this a few days before the long holiday weekend, I reflect how much has changed for all of us over these last few months. While I am sometimes sad about things that were cancelled and delayed, I am also grateful for the extra time that I got to spend with my family. From a professional perspective, and as Human Resources professionals a lot has changed for us as well. I don’t think that I learned as much in my career as I did over the last few months of enduring a pandemic. We have had to provide support to our employees in ways we never thought we would as well as trying to manage the changing market which has impacted all of our health care systems in different ways. In many ways, our leadership teams have looked to the HR professionals to help them navigate through these difficult times and from what I can see, everyone has stepped up to meet those challenges.

Now six months into my presidency, we have had to cancel our annual conference, which was saddening to me as I was really looking forward to connecting with many of you in-person. However, the Board is working through some alternative plans, which I hope will find new and exciting. More information will be coming in the next few months so please stayed tuned to your WisHHRA monthly messages. Please also take some time to respond to the survey that Badger Bay will be sending out shortly regarding what you would like to see as well as what topics you would like to spend some additional time talking about. In addition, I ask that you all please try to actively engage on our listserv. This is one of the many valuable things about being a WisHHRA member, the ability to share ideas and get feedback from your peers. There have been a lot of great questions posed as we all navigated through these new times together, and it always help to see what others are trying as well as what your organizations are doing as well.

Finally, I would like to take an opportunity to wish Bree Clarksen from Badger Bay good luck in her new adventure. For those of you who don’t know Bree, she is the Association Director from Badger Bay, who assists us with the management of WisHHRA. She has been instrumental in our conference planning as well as assisting me with the tasks related to being the President. She has kept me on task, and also provided some great ideas to myself and the Board. She has been very easy to work with and has made my transition to President very easy.

I hope that you all enjoy these next few summer months and all of the “excitement” that lies ahead. If there is ever anything that you would like to see in upcoming newsletters or activities that you would like us to consider or any thoughts related to WisHHRA, please do not hesitate to reach out to me at Nicole.berlowski@phci.org. I would love to hear from you!

Nicole

Battelle Critical Care Decontamination System Ready and Available for Use in Wisconsin

Sat, 09 May 2020 15:43:04 GMT

Governor Tony Evers today announced Wisconsin’s new Battelle Memorial Institute Critical Care Decontamination System™ is now ready and available for use by the state’s health care workers and first responders to decontaminate their N95 respirators so they can be reused up to 20 times. The Battelle system decontaminates N95 respirators by killing viruses and bacteria using hydrogen peroxide gas, and will greatly extend the life of a vital piece of Personal Protective Equipment (PPE).

The Battelle system will be able to decontaminate up to 80,000 N95 respirators on a daily basis. It can decontaminate respirators up to 20 times without degrading filtration performance. The usual decontamination turnaround time for users is a maximum of 72 hours, plus shipping time, as long as the site is not over its capacity for use. The Battelle system can only decontaminate respirators, and not other items of PPE. It is also not authorized for use with respirators containing cellulose-based materials.

Battelle decontamination services, including shipping, will be provided to Wisconsin healthcare organizations and professionals free of charge. Eligible healthcare providers include, but are not limited to, hospitals, nursing homes, public health professionals, human and child protective services offices, emergency managers, first responders, coroners, medical examiners, law enforcement and correctional institutions, home health organizations, pharmacists, rural health services and dental offices.

The new Battelle system highlights decontamination efforts ongoing throughout Wisconsin to try to ensure that health care workers and first responders can be as safe as possible when performing their duties.

With all of the decontamination efforts underway in Wisconsin, health care workers and first responders are being asked to save their used PPE supplies for decontamination. Throughout the past couple of weeks, outreach efforts were conducted to inform health care workers and first responders on how to sign up for the Battelle system decontamination service, and ensure their masks are safely returned to them.

Through a partnership with the Federal Emergency Management Agency (FEMA) and Defense Logistics Agency (DLA), the State of Wisconsin received the Battelle system this week. Battelle developed the system in 2015 to help decontaminate PPE to prevent further spread of Ebola. The Columbus, Ohio company is currently deploying the system to 60 different sites across the nation.

Beyond the Battelle system, other decontamination efforts in Wisconsin include UV decontamination sites. These sites service N95 respirators as well as other types of PPE, such as face shields, gowns, and aprons. UV decontamination facilities are currently operating in much of Wisconsin, highlighted by sites in Brown, Dane, Kenosha, and Sawyer counties.

In addition to statewide decontamination efforts, Wisconsin continues to work on building up its stockpile of PPE supplies. Last week Wisconsin received a delivery of 230,000 N95 respirators from FEMA. Gov. Evers continues to request more of these supplies to meet Wisconsin’s pressing need.

The full press release from the Governor is available online (link).

Governor Announces Badger Bounce Back Plan

Mon, 20 Apr 2020 15:59:15 GMT

Governor Evers today announced Wisconsin's "Badger Bounce Back" plan which outlines important criteria for Wisconsin to be able to reopen its economy in phases and includes steps to make sure workers and businesses are prepared to reopen as soon as it is safe to do so. In coordination with this announcement, at the direction of the governor, Wisconsin Department of Health Services Secretary-designee Andrea Palm issued Emergency Order #31 establishing the process and outlining the phases of the plan. The emergency order is available here.

The Badger Bounce Back plan is informed in part by the President's Guidelines for Opening Up America Again that was issued by the White House on April 16, 2020. Currently, Wisconsin does not meet the criteria the White House established to start reopening our state. The Badger Bounce Back plan takes important steps to get the state of Wisconsin there.

The goal of the Badger Bounce Back plan is to decrease cases and deaths to a low level, and increase capacity in our healthcare system so the phased reopening of businesses is possible. As part of that plan the state will be working to increase access to more testing and expand lab capacity. Under the Badger Bounce Back plan, everyone who needs a test should get a test. The state is setting a goal of 85,000 tests per week, averaging about 12,000 tests per day. More information on the state's testing efforts was released earlier today, and is available for review here.

Next, the state will be expanding contact tracing and more aggressively tracking the spread with the goal of every Wisconsinite who tests positive being interviewed within 24 hours of receiving their test results and their contacts being interviewed within 48 hours of test results.

Additionally, the state will continue to pursue every avenue to grow Wisconsin’s supply of personal protective equipment (PPE) for healthcare and public safety entities to conduct COVID-19 testing, patient care, and public safety work. Finally, the plan works to bolster healthcare system capacity where patients can be treated without crisis care and there are more robust testing programs in place for at-risk healthcare workers.

The state will be looking for a downward trajectory of influenza-like illnesses and COVID-19 symptoms reported within a 14-day period, and a downward trajectory of positive tests as a percent of total tests within a 14-day period. When the state has seen these efforts be successful, Wisconsin can begin to turn the dial, re-open the state, and get businesses and workers back on their feet.

The Badger Bounce Back plan is available here. The Wisconsin Economic Development Corporation’s portion of the Badger Bounce Back plan aimed at helping to ensure workers and businesses are prepared and ready to bounce back is available here. The Badger Bounce Back plan in brief is also available here.

Governor Extends Wisconsin's Safer at Home Order

Thu, 16 Apr 2020 15:21:44 GMT

Governor Evers today directed Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm to extend the Safer at Home order from April 24, 2020 to 8 a.m. Tuesday, May 26, 2020, or until a superseding order is issued. The order implements some new measures to ensure safety and support the progress we've made in containing COVID-19, but also allows certain activities to start up again.

The extension of the Safer at Home order includes a few changes. Some changes allow more businesses and activities to open back up, while other changes help make businesses safer for employees and customers.

The changes in this order go into effect on April 24, 2020. The order will remain in effect until 8 a.m. on May 26, 2020.

The order is available online (link). The Governor’s full press release is also available online (link).

Wisconsin Legislature Passes COVID-19 Response Legislation

Wed, 15 Apr 2020 15:19:17 GMT

The State Legislature passed, and the Governor has signed, the state's COVID-19 response package, which includes liability immunity provisions. A late amendment broadens the measure and ensures there is no ambiguity about protections applying to COVID and non-COVID patients alike.

The legislation also includes provisions that will help the state draw down additional federal dollars for Medicaid as well as a provision related to out of network billing.

Below is the liability immunity language as adopted.

SECTION 98. 895.4801 of the statutes is created to read:

895.4801 Immunity for health care providers during COVID-19 emergency.

(1) DEFINITIONS. In this section:

(a) “Health care professional” means an individual licensed, registered, or certified by the medical examining board under subch. II of ch. 448 or the board of nursing under ch. 441.

(b) “Health care provider” has the meaning given in s. 146.38 (1) (b) and includes an adult family home, as defined in s. 50.01 (1).

(2) IMMUNITY. Subject to sub. (3), any health care professional, health care provider, or employee, agent, or contractor of a health care professional or health care provider is immune from civil liability for the death of or injury to any individual or any damages caused by actions or omissions that satisfy all of the following:

(a) The action or omission is committed while the professional, provider, employee, agent, or contractor is providing services during the state of emergency declared under s. 323.10 on March 12, 2020, by executive order 72, or the 60 days following the date that the state of emergency terminates.

(b) The actions or omissions relate to health services provided or not provided in good faith or are substantially consistent with any of the following:

Any direction, guidance, recommendation, or other statement made by a federal, state, or local official to address or in response to the emergency or disaster declared as described under par. (a).
Any guidance published by the department of health services, the federal department of health and human services, or any divisions or agencies of the federal department of health and human services relied upon in good faith.

(3) APPLICABILITY. This section does not apply if s. 257.03, 257.04, 323.41, or 323.44 applies.

COVID-19 Volunteer Program Announced

Fri, 10 Apr 2020 14:36:36 GMT

Governor Evers announced that the state is seeking volunteers to support Wisconsin's healthcare system during the COVID-19 pandemic. Active and retired healthcare professionals and those who wish to help in non-clinical support positions are encouraged to sign up to volunteer through the Wisconsin Emergency Assistance Volunteer Registry (WEAVR).

The number of patients in Wisconsin who need to be treated for COVID-19 is expected to surge in the coming weeks. Building a network of available volunteers now will greatly reduce the hardships on hospitals and clinics that would not normally have the capacity to care for the increase in patients.

Both active and retired healthcare professionals can volunteer for critical clinical roles by entering their information into the WEAVR, a secure, password-protected, web-based volunteer registration system for healthcare and behavioral health professionals. Individuals who are not licensed professionals are also encouraged to sign up to volunteer for non-clinical support positions.

Volunteers will be assigned to locations across Wisconsin to support ongoing efforts related to the COVID-19 national emergency. Those who are willing to travel should note that when they sign up. All volunteers should also be aware that they will be required to complete a background check.

The full copy of the Governor’s press release is available online (link).

Wisconsin DHS Announces Resilient Wisconsin Initiative

Fri, 03 Apr 2020 15:23:45 GMT

The Department of Health Services announced the creation of the Resilient Wisconsin Initiative (website) on Friday, which provides Wisconsinites with resources to cope with stress and mental health challenges from COVID-19.

DHS recommends that Wisconsinites do the following:

· Get the three goods. That’s good-for-you foods, a good night’s sleep, and a good amount of exercise every day.

· Stay connected to your support system. Reach out to family and friends, colleagues, and community groups in whatever way you can—calls, texts, video chats, and more.

· Spend time away from focusing on COVID-19. Don’t let the pandemic take over what you read, watch, or talk about. And don’t be afraid to ask friends and family to talk about something else.

· Reduce anxiety by reducing your risk. Stay safer at home. Wash your hands for at least 20 seconds. Cover your nose and mouth when you cough or sneeze. Stay at least 6 feet apart while running essential errands at the store, pharmacy, or gas station. Knowing you’re doing everything you can to stay healthy can help you worry less.

· Check in with yourself. Everyone’s reaction to stress is different. Difficulty concentrating or sleeping, irritability, fatigue, and even stomachaches can be normal. But if you find you are overwhelmed or having thoughts of self-harm or suicide, reach out for help right away. Text HOPELINE to 741741 or call the National Suicide Prevention Lifeline at 1-800-273-8255.

New Marquette Law School Poll Finds Strong Support for Coronavirus Closings

Thu, 02 Apr 2020 20:00:27 GMT

A new Marquette Law School poll of Wisconsin registered voters finds strong support for government actions to control the coronavirus pandemic, even as the poll also shows these actions to be having a substantial financial impact on voters.

The survey found:

Eighty-six percent say that it was appropriate to close schools and businesses, and restrict public gatherings, while 10 percent say that this was an overreaction to the pandemic;

A large majority of voters approve of Gov. Tony Evers’ handling of the coronavirus issue, with 76 percent saying they approve and 17 percent saying they disapprove;

A majority, 51 percent, approve of President Donald Trump’s handling of the pandemic, while 46 percent disapprove;

Opinion is divided on holding the April 7 spring election as scheduled, with 51 percent saying the date should be moved and 44 percent saying it should be held as scheduled.

A full copy of the survey is available online (link).

Governor Evers Announces Second Package of Comprehensive Legislative Proposals Providing COVID-19 Relief and Support

Wed, 01 Apr 2020 19:58:41 GMT

Governor Evers today announced a second package of comprehensive legislative proposals that would provide critical investments in health services, support for essential workers, and assistance for Wisconsin families and businesses in response to the COVID-19 pandemic. The governor’s announcement today comes just days after Gov. Evers announced a first piece of legislation, which included additional funding and flexibility for public health professionals and healthcare professionals, a repeal of the one-week waiting period for unemployment insurance, expanding and improving access to telehealth services, among many other proposals.

As additional needs and issues arise from agencies and stakeholders, the governor is committed to working with legislators to find bipartisan solutions. The governor’s office welcomes the opportunity to hear and consider any proposals that legislators have to address the impacts of COVID-19 on the health and well-being of Wisconsin residents, businesses and communities.

This package, among many other proposals, includes:

Increasing funding for Medicaid providers via supplemental payments and rate increases to support the healthcare system’s response to the public health emergency;
Establishing a fund to reduce providers’ uncompensated care costs targeting reimbursement for treatment-related costs for uninsured individuals;
Establishing a COVID-19 reinsurance program to reduce health insurance premiums;
Providing grant funding to provide food assistance and meal delivery;
Prohibiting utility cooperatives from disconnecting customers and prohibiting land-lord directed disconnections from rental units during a public health emergency;
Ensuring workers receive back payment for any lost unemployment insurance benefits as a result of the delay in suspending the one-week waiting period;
Providing supplemental payments to child care providers, if that provider needed to shut down during the public health emergency;
Allowing households to apply for heating assistance under the low-income energy assistance program anytime during the 2020 calendar year;
Increasing the Earned Income Tax Credit for low-income families;
Providing municipalities the flexibility to implement multiple installments of three or more payments for 2020 property taxes;
Waiving interest and penalties on delinquent property taxes included in the 2019 payable 2020 tax roll, on and after April 1, 2020;
Creating a fund through the Wisconsin Housing and Economic Development Association to provide 6 months of support for prevention of single-family foreclosures and providing refinancing opportunities to current borrowers; and
Providing grant funding for small businesses and workers through the Wisconsin Economic Development Corporation.

The Governor’s first COVID-19-related legislation was introduced last week as LRB-5920 and is available here for review. A brief explanation of LRB-5920 is available here. A brief explanation of the governor’s second round of proposed legislation announced today is available online (link).

ForwardHealth Expands List of Drugs Available Through Expedited Emergency Supply

Wed, 01 Apr 2020 19:58:09 GMT

Effective for dates of service on and after April 1, 2020, ForwardHealth, which has an expedited emergency supply policy dispensing option available for certain drugs, has expanded the list of drugs available through expedited emergency supply and will allow most drugs to be dispensed in up to a 100-day expedited emergency supply.

A table with the expanded list of drugs available by expedited supply is included below and is also available on the Pharmacy Resources page of the ForwardHealth Portal. Pharmacy providers should continue to follow the current processes for requesting an expedited emergency supply of drugs detailed in the Emergency Medication Dispensing topic (#1399) of the ForwardHealth Online Handbook.

This Action Alert 10 and others are available on the ForwardHealth website (link).

Wisconsin LFB Published Report on State Funding in CARES Act

Wed, 01 Apr 2020 19:56:43 GMT

Wisconsin nonpartisan Legislative Fiscal Bureau (LFB) published an analysis of the approximately $2.2 billion Wisconsin is expected to receive from the from the Coronavirus Relief Fund created by the CARES Act. About $1.8 billion would go to the state government while the remaining funds would go to the City of Milwaukee, Milwaukee County and Dane County. The LFB has also provided Wisconsin-specific estimates for some of the programmatic increases provided by the stimulus package. That report is available online (link).

The report includes a summary on all programs funded in the Act, including:

Public Health Emergency Preparedness funding from CDC;
Administration for Community Living
Public Health and Social Services Emergency Fund
Direct Payments to State and Local Governments
Transportation, Housing and Unemployment Programs

Details on the full $2 trillion COVID-19 stimulus package are also available in the full bill available online (link). The following is a summary of some of the healthcare related provisions in the bill.

Health and Long-term Care

Grants to Hospitals and Health Care Providers: Provides $100 billion to reimburse, through grants or other mechanisms, eligible health care providers for health care related expenses or lost revenues that are attributable to coronavirus. Medicaid and Medicare providers are included in the definition of health care provider. To apply, providers must submit an application to the Secretary of Health and Human Services that includes a statement justifying their need.

Delay of Disproportionate Share Hospital Reductions. Delays scheduled reductions in Medicaid disproportionate share hospital payments through November 30, 2020.

Increasing Provider Funding through Immediate Medicare Sequester Relief. Temporarily lifts the Medicare sequester from May 1 through December 31, 2020, boosting payments for hospital, physician, nursing home, home health, and other care by 2%. The Medicare sequester would be extended by one-year beyond current law to provide immediate relief without worsening Medicare’s long-term financial outlook.

Medicare Add-on for Inpatient Hospital COVID-19 Patients. Increases the payment that would otherwise be made to a hospital for treating a patient admitted with COVID-19 by 20%. It would build on the Centers for Disease Control and Prevention (CDC) decision to expedite use of a COVID-19 diagnosis to enable better surveillance as well as trigger appropriate payment for these complex patients. This add-on payment would be available through the duration of the COVID-19 emergency period.

Grants to the V.A.: Provides $14.4 billion to the Veteran’s Administration for medical services.

CDC: Provides $4.3 billion to the CDC. Of these funds, $1.5 billion is set aside for grants to states, territories and tribes to help carry out surveillance, epidemiology, laboratory capacity, infection control, mitigation, communications, and other preparedness and response activities.

Strategic National Stockpile: Provides $16 billion in funding for the Strategic National Stockpile to procure personal protective equipment, ventilators and other supplies.

Hospital Preparedness: Provides $250 million for grants to improve the capacity of healthcare facilities to respond to medical events.

Rural Health: Provides $180 million to expand services and capacity for rural hospitals, telehealth, poison control centers.

Health Savings Accounts for Telehealth Services. Allows a high-deductible health plan (HDHP) with a health savings account (HSA) to cover telehealth services prior to a patient reaching the deductible.

Providing Hospitals Medicare Advance Payments. Expands, for the duration of the COVID-19 emergency period, an existing Medicare accelerated payment program. Specifically, qualified facilities would be able to request up to a six month advanced lump sum or periodic payment. This advanced payment would be based on net reimbursement represented by unbilled discharges or unpaid bills. Most hospital types could elect to receive up to 100% of the prior period payments, with Critical Access Hospitals able to receive up to 125%. Finally, a qualifying hospital would not be required to start paying down the loan for four months, and would also have at least 12 months to complete repayment without a requirement to pay interest.

Extension of Physician Work Geographic Index Floor. Extends payments for the work component of physician fees in areas where labor cost is determined to be lower than the national average through December 1, 2020.

National Academies Report on America’s Medical Product Supply Chain Security: Requires the Department of Health and Human Services to enter into an agreement with the National Academies to examine and report on the security of the United States medical product supply chain. Part of the report requires the examination of the United States’ dependence on critical drugs and devices that are sourced or manufactured outside of the U.S.

Requiring the Strategic National Stockpile to Include Certain Supplies: Requires the strategic national stockpile to include personal protective equipment, ancillary medical supplies, and other applicable supplies required for the administration of drugs, vaccines and other biological products, medical devices, and diagnostic tests.

Preventing Medical Device Shortages: Requires manufacturers of medical devices that are critical during public health emergencies to notify the federal government of any discontinuance or interruption to manufacturing of the device that could disrupt the supply of the device in the U.S. The information will be used to compile a list of devices that are determined to be in short supply.

Rapid Coverage of Preventive Services and Vaccines for Coronavirus: Requires insurers to cover without cost-sharing any qualifying coronavirus preventive service. Qualifying preventive services include any evidence-based item, service, or immunization that is intended to prevent or mitigate coronavirus disease.

Increased Funding for Health Centers: Provides $1.3 billion in additional funding to community health centers in fiscal year 2020.

Telehealth Network and Resource Center Grants: Provides $29 million per year through 2025 and reauthorizes Health Resources and Services Administration (HRSA) grant programs that promote the use of telehealth technologies for health care delivery, education, and health information services.

Rural health care services outreach, rural health network development, and small health care provider quality improvement grant programs. Provides $79.5 million per year through 2025 and reauthorizes HRSA grant programs to strengthen rural community health by focusing on quality improvement, increasing health care access, coordination of care, and integration of services.

Limitation on liability for volunteer health care professionals during COVID-19 emergency response. Makes clear that doctors who provide volunteer medical services during the public health emergency related to COVID-19 have liability protections. In order to have the liability protections provided by the bill, a volunteer provider must be acting within the scope of their license, registration or certification as defined by the state.

Health Care Workforce

Reauthorization of health professions workforce programs.

Provides $51.4 million per year between 2021 and 2025 for scholarships to health care students. The funding is given to eligible entities, which includes schools of medicine, nursing, dentistry, optometry, public health, etc.

Provides $48.9 million per year for the primary care training and enhancement program. Adds language prioritizing grant awards to programs that train physicians in rural areas.

Provides $41.2 million for eligible entities to establish health care workforce educational programs.

Provides $1.1 million per year for a loan repayment program for medical, dental and nursing students who agree to serve as faculty following graduation.

Provides $15 million per year to provide educational assistance to individuals from disadvantaged backgrounds to pursue health care education.

Extension of Demonstration Projects to Address Health Professions Workforce Needs: Extends the Health Professions Opportunity Grants (HPOG) program through November 30, 2020 at current funding levels. This program provides funding to help low-income individuals obtain education and training in high-demand, well-paid, health care jobs.

Education and training relating to geriatrics. Provides $40.7 million per year and reauthorizes and updates Title VII of the Public Health Service Act (PHSA), which pertains to programs to support clinician training and faculty development, including the training of practitioners in family medicine, general internal medicine, geriatrics, pediatrics, and other medical specialties. It emphasizes integration of geriatric care into existing service delivery locations and care across settings, including home- and community-based services. The Secretary may provide awardees with additional support for activities in areas of demonstrated need, which may include education and training for home health workers, family caregivers, and direct care workers on care for older adults. Eligible entities could receive awards of at least $75,000.

Economic Relief

Recovery Rebates for Americans: Provides a one-time payment of $1,200 to individuals with incomes below $75,000 or a one-time payment of $2,400 for joint filers with incomes below $150,000. Payments are increased by $500 per child. The bill requires the one-time payments to be made as soon as possible.

Relief Payments to States, Tribal Governments and Local Units of Government: Provides $150 billion in direct payments to states, tribal governments and local units of government with. To qualify, local governments must have populations of more than 500,000 people. Payments are required to be used to cover expenditures related to COVID-19 that occur between March 1, 2020 and December 30, 2020. Expenditures must not have been accounted for in the state or local government’s most recent budget. The bill requires the Treasury Secretary to make these payments within 30 days of enactment.

Loans for Small Businesses, Non-profits, Contractors and Self-Employed Individuals. Allows nonprofits and other businesses with less than 500 employees to get loans from the Small Business Administration if they were adversely impacted by COVID-19. Loans can be used to cover payroll costs, health care benefits, mortgage or rent payments, utilities or interest on debt. Borrowers will be eligible for loan forgiveness if they maintain employees and their salaries. The eligibility period runs from February 15, 2020 to June 30, 2020. Maximum loan amounts will be determined using the organization's average monthly payroll amounts over a one year period. The bill appropriates $349 billion for this loan program.

Employee retention credit for employers subject to closure due to COVID-19. Provides a refundable payroll tax credit for 50% of wages paid by employers to employees during the COVID-19 crisis. The credit is available to employers whose (1) operations were fully or partially suspended, due to a COVID-19-related shutdown order, or (2) gross receipts declined by more than 50 percent when compared to the same quarter in the prior year.

Small Business Administration Disaster Loans: Provides $562 million to the Disaster Loan Program.

Broadband and Telehealth

Rural Utilities Service--Distance Learning, Telemedicine and Broadband Program: Provides $25 million for telemedicine and distance learning services in rural areas.

Reconnect Pilot: Provides $100 million for grants for the costs of construction, improvement, or acquisition of facilities and equipment needed to provide broadband service in eligible rural areas.

Federal Communications Commission Telehealth: Provides $200 million to the FCC to respond to COVID-19. This includes supporting health care providers by providing telecommunications services, information services, and devices necessary to enable the provision of telehealth services.

Higher Education and Student Loans

Temporary Relief for Federal Student Loan Borrowers: Requires the Secretary to defer student loan payments, principal, and interest for 6 months, through September 30, 2020, without penalty to the borrower for all federally owned loans.

Adjustments of Subsidized Loan Limits. For students who dropped out of school as a result of COVID -19 excludes the term from counting toward lifetime subsidized loan eligibility.

Exclusion from Federal Pell Grant Duration Limit. For students who dropped out of school as a result of COVID -19 excludes the term from counting toward lifetime Pell eligibility.

Institutional Refund and Federal Student Loan Flexibility. For students who dropped out of school as a result of COVID -19, the student is not required to return Pell grants or federal student loans to the Secretary. Waives the requirement that institutions calculate the amount of grant or loan assistance that the institution must return to the Secretary in the case of students who dropped out of school as a result of COVID-19

Exclusion for certain employer payments of student loans: Allows employers to provide a student loan repayment benefit to employees on a tax-free basis. Under the provision, an employer may contribute up to $5,250 annually toward an employee’s student loans, and such payment would be excluded from the employee’s income. The $5,250 cap applies to both the new student loan repayment benefit as well as other educational assistance (e.g., tuition, fees, books) provided by the employer under current law. The provision applies to any student loan payments made by an employer on behalf of an employee after date of enactment and before January 1, 2021.

Wisconsin Partnership Program Releases RFP for $1.5 Million in COVID-19 Grant Funding

Tue, 31 Mar 2020 19:56:16 GMT

The Wisconsin Partnership Program released an RFP Tuesday for a new $1.5 million grant program to support projects that “aim to improve the health of the people of Wisconsin by lessening the impact of the COVID-19 pandemic.”

About $750,000 will be available for programs led by Wisconsin-based nonprofits, tax exempt, 501(c)(3) organizations or tribal/government entities. Special emphasis will be given to projects that target vulnerable populations.

Grant applications are due April 15, 2020.

Governor Evers Sets Up State COVID-19 Voluntary Isolation Facilities

Tue, 31 Mar 2020 19:55:20 GMT

Governor Evers today announced the State of Wisconsin Emergency Operations Center (SEOC) is opening two state-run voluntary isolation facilities in Madison and Milwaukee and is providing guidance to local communities throughout Wisconsin. The two sites are set to open April 1, 2020 are at Lowell Center in Madison and a Super 8 hotel in Milwaukee.

These facilities are for symptomatic individuals suspected to be infected with COVID-19 or who have a confirmed case of COVID-19. Individuals will not be permitted to register at the facility unless referred by a medical provider or public health official. Individuals register and stay at the isolation facility on a voluntary basis. The expected length of stay will be about 14 days, or 72 hours after symptoms dissipate. At any time, either the individual or the facility may terminate the individual’s presence at the site. Those staying at the facility will have wellness checks by phone every four hours during the day and if needed at night.

Additionally, the SEOC also issued guidance for communities seeking to open their own voluntary self-isolation centers. This guidance will aid local communities with the following:

How do we select, set up, and staff an isolation site?
How does a person get referred to and checked into the isolation site?
What happens while occupants are at the isolation site? Including details about medical monitoring/wellness check calls and other on-site services.
When do occupants leave the site? Including details about discharge and involuntary check out from the isolation site.

The full press release is available online (link).

Governor Evers Asks for Presidential Disaster Declaration

Tue, 31 Mar 2020 19:54:53 GMT

Governor Evers today sent a letter to the Federal Emergency Management Agency (FEMA) requesting that the president issue a major disaster declaration for the entire state of Wisconsin, as a result the COVID-19 pandemic. The request covers all 72 counties and the state’s federally recognized tribes.

Having determined that Wisconsin met all of the criteria required to receive a major disaster declaration, Gov. Evers in his letter requested that the federal government provide the following programs to support the state’s response: Public Assistance, Direct Assistance, Hazard Mitigation (statewide), and certain Individual Assistance programs; Crisis Counseling, Community Disaster Loans and the Disaster Supplemental Nutrition Program.

Gov. Evers declared a public health emergency on March 12 in response to the outbreak, which directed the Department of Health Services to take all necessary and appropriate actions to help combat the spread of the virus. On March 14, the governor directed Wisconsin Emergency Management to activate the State Emergency Operations Center (SEOC) to provide additional coordination in support of the state’s response.

A copy of the governor’s letter (link) and the full press release are available online (link).

Governor Evers Announces Additional Shipment of Personal Protective Equipment from the Strategic National Stockpile

Tue, 31 Mar 2020 19:54:17 GMT

Governor Evers today announced that Wisconsin has received its second phase of Personal Protective Equipment (PPE) from the Strategic National Stockpile (SNS) and is in the process of distribution. The second phase of supplies from the SNS are being delivered to healthcare workers, emergency medical services, and medical facilities including hospitals, nursing homes, assisted living facilities and clinics across Wisconsin.

The State Emergency Operations Center and Department of Health Services continue working to supply medical facilities with supplies requested from the Strategic National Stockpile. The second phase includes approximately 51,880 N95 respirators, 130,840 face/surgical masks, 23,400 face shields, 20,226 surgical gowns, 96 coveralls, and 79,000 pairs of gloves. Today’s shipment comes as Governor Evers announced Wisconsin’s first delivery of SNS supplies which included approximately 52,800N95 respirators, 130,000 face/surgical masks, 24,768 face shields, 20,286 surgical gowns, 96 coveralls, and 61,750 pairs of gloves. In total Wisconsin has received approximately 104,680 N95 respirators, 260,840 face/surgical masks, 48,186 face shields, 40,512 surgical gowns, 192 coveralls, and 140,750 pairs of gloves from the SNS.

The SNS supply shipments do not include supplies the governor has requested from FEMA for non-medical personnel or supplies being aggressively pursued through procurement, donations, or the governor’s buyback program.

ForwardHealth Announces New Policies for Telehealth Reimbursement

Mon, 30 Mar 2020 19:53:50 GMT

ForwardHealth will allow telehealth services utilizing interactive synchronous (real-time) technology, including audio-only phone communication, for currently covered services that can be delivered with functional equivalency to the face-to-face service. This applies to all service areas and all enrolled professional and paraprofessional providers allowable within current ForwardHealth coverage policy.

Please refer to the Forward Health Update 2020-15 (link) for a comprehensive explanation of the update.

Governor Announces New Public-Private Partnership to Increase COVID-19 Laboratory Testing Capacity

Mon, 30 Mar 2020 19:53:15 GMT

Governor Evers announced a new public-private partnership among Wisconsin industry leaders to increase Wisconsin's laboratory testing capacity for COVID-19. Prior to today's announcement, the Wisconsin State Lab of Hygiene and the Milwaukee Public Health Lab were leading the Wisconsin Clinical Lab Network labs to bring additional COVID-19 testing online.

The new partnership now includes laboratory support from Exact Sciences, Marshfield Clinic Health System, Promega, and UW Health. These organizations, along with the Wisconsin Clinical Lab Network, will now share knowledge, resources, and technology to bolster Wisconsin’s testing capacity.

The Wisconsin Clinical Lab Network labs have been averaging completion of 1,500-2,000 COVID-19 tests per day. The expanded capacity from the state’s new public-private partnership is expected to double that capacity initially and continue to expand as additional platforms and supplies become available.

Residents who are seeking a COVID-19 test are still required to receive an order from a doctor. These labs are not testing sites.

The full press release is available online (link).

Governor Issues Order to Expedite Expansion, Enhance Efficiency of Healthcare Workforce

Sat, 28 Mar 2020 12:14:31 GMT

Governor Evers and Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm today exercised their authority under Article V, Section 4 of the Wisconsin Constitution and Sections 323.12(4) and 252.02(6) of the Wisconsin Statutes to simplify healthcare license renewals during the COVID-19 public health emergency and to encourage recently retired professionals with expired licenses to re-enter practice. This full order is available online (link).

The order includes the following policy changes:

Interstate Reciprocity: allows any out-of-state health can provider licensed and in good standing to practice in Wisconsin without a Wisconsin credential. The order requires the out-of-state physician to apply for a temporary or permanent Wisconsin license within 10 days of first working at a Wisconsin health care facility; and the health care facility must notify DSPS within 5 days. The order temporarily suspends the visiting physician practice limitations in Med 3.04.

Temporary License: Any temporary licensed to an out-of-state provider during the emergency will be valid until 30 days after the conclusion of the emergency.

Telemedicine: Allows physicians licensed and in good standing in Wisconsin, another U.S. state or Canada to provide telemedicine services to Wisconsin residents.

Physician Assistants: Suspends several current rules regulating the practice of PAs in Wisconsin. This includes: the requirement of PAs to notify the MEB of changes to their supervising physician within 20 days (order changes it to 40 days); the requirement that PAs limit their scope of practice to that of their supervising physician (the order allows them to practice to the extent of their experience, education, training and abilities. It also allows them to delegate tasks to another health provider); the physician to PA ratio of 4:1 (the order allows a physician to oversee up to 8 on-duty PAs at a time, but there is no limit on how many PAs a physician may provide supervision to over time. It also allows a PA to be supervised by multiple physicians while on duty).

Nurse Training and Practice: The order suspends many rules related to nursing. This includes suspending a rule that prohibits simulations from being utilized for more than 50% of the time designated for meeting clinical learning requirements. It also suspends the requirement for nurses to submit an official transcript in order to get a temporary license and allows a temporary license to remain valid for up to 6 months. In addition, it suspends the rule requiring license renewal within 5 years.

Advanced Practice Nurse Prescribers: Temporarily suspends the requirement that Nurse Prescribers must facilitate collaboration with other health care professionals, at least 1 of whom shall be a physician or dentist.

Recently Expired Credentials: Requires the state to reach out to individuals with recently lapsed credentials about renewal options. The order also suspends many of the late renewal fees and continuing education requirements for most health professions. The order temporarily suspends MED 14.06(2)(a) to allow a physician whose license lapsed less than 5 years ago to renew without fulfilling the continuing education requirements. It also suspends RAD 5.01 (1) and (2) to allow radiographers or LXMO permit holders who have let their license lapse renew without completing continuing education.

Fees: The order also gives DHS the ability to suspend fees or assessments related to health care provider credentialing.

The order is effective immediately and will remain in effect through the duration of the public health emergency.

The full version of the Governor’s press release is available online (link).

Governor Suspends Evictions and Foreclosures During Public Health Emergency

Fri, 27 Mar 2020 19:51:02 GMT

Governor Evers directed the Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm to temporarily order the suspension of evictions and foreclosures amid the COVID-19 public health emergency. The full order is available online (link).

The order prohibits landlords from evicting tenants for any reason unless failure to proceed with the eviction will result in an imminent threat of serious physical harm to another person and mortgagees from commencing civil action to foreclose on real estate for 60 days. Wisconsinites who are able to continue to meet their financial obligations are urged to do so. This order does not in any way relieve a person's obligation to pay their rent or mortgages.

The full press release is available on the Governor’s website (link).

ForwardHealth Update on Urgent Prior Authorization Requests

Fri, 27 Mar 2020 19:50:24 GMT

For urgent prior authorization requests for fee‐for‐service members, contact ForwardHealth Provider Services at 800‐947‐9627 for assistance with expediting the prior authorization process. An urgent, medically necessary situation is one where a delay in authorization would result in undue hardship for the member or unnecessary costs for Wisconsin Medicaid as determined by the Division of Medicaid Services. In general, urgent requests will receive a response within five business days. Additional information regarding urgent services is available (link).

Note: Prior authorization is not required for emergency services, defined as services that are necessary to prevent the death or serious impairment of the health of the individual. Reimbursement is not guaranteed for services that normally require prior authorization that are provided in emergency situations; those services still must meet all ForwardHealth coverage requirements, including medical necessity.

This Action Alert 08 and others are available on the ForwardHealth website (link).

Temporary Change for Urgent Prior Authorization Requests

Fri, 27 Mar 2020 19:49:43 GMT

In response to the COVID‐19 pandemic, ForwardHealth is temporarily altering certain procedures in order to prevent further spread of the disease and effectively treat existing cases. These altered procedures will only be in effect during the public health emergency declared by Governor Tony Evers for the State of Wisconsin under Executive Order 72.

Temporary Phone Number Change for Urgent Prior Authorization Requests

Note: Prior authorization is not required for emergency services, defined as services that are necessary to prevent the death or serious impairment of the health of the individual. Reimbursement is not guaranteed for services that normally require prior authorization that are provided in emergency situations; those services still must meet all ForwardHealth coverage requirements, including medical necessity.

UW Health, UnityPoint Health-Meriter and Epic collaborate on child care center

Fri, 27 Mar 2020 16:45:27 GMT

Wisconsin Health News, March 27, 2020

UW Health, UnityPoint Health-Meriter and Epic are opening a temporary child care center for children of healthcare workers, according to a Thursday statement.

Epic is providing the use of its former headquarters in Madison for free as well as free meals by its culinary team. UW Health is providing furniture and other essential teams. The space will be designed with social distancing in mind.

Employees from the health systems will provide care for children ages six to 13. They're working with other front-line provider organizations in the community to join the effort.

“Right now, it's paramount that we remove barriers so that our healthcare teams can come to work if they're able," Meriter CEO Sue Erickson said. "This partnership has stepped up to help make that possible."

They expect to open the center as soon as updates to the space acre completed within the next few weeks.

Some health systems in the state have issued calls for community support to help with child care, while employees at others are looking at ways to support one another.

Governor Suspends Evictions and Foreclosures During Public Health Emergency

Fri, 27 Mar 2020 12:16:03 GMT

The full press release is available on the Governor’s website (link).

Hospitals face revenue fall as they pivot to fight COVID-19

Tue, 24 Mar 2020 16:00:04 GMT

Wisconsin Health News, March 24, 2020

Wisconsin hospitals and health systems have canceled elective procedures and delayed other non-essential care as they prepare for a surge of COVID-19 patients.

The actions, which health systems said are necessary, could strain their bottom lines as they work to address the pandemic.

"Canceling was the right decision for the health of the community," said Children's Wisconsin spokesman Andy Brodzeller.

He noted that the cancellation of non-time sensitive surgeries - as well as non-sensitive appointments in speciality and primary care - will have significant financial implications.

The Wisconsin Hospital Association estimates that the weekly impact of not performing elective procedures is around $150 million. The procedures make up around 25 percent of a hospital and health system’s revenue.

“We’re trying to establish lines of credit in the tens of millions of dollars to accommodate what we believe to be a long timeline that we are going to have to manage a surge of patients,” said Jim Dietsche, Bellin Health's chief operating officer. Dietsche said they haven’t finalized how much they think they need.

Dietsche said the challenge goes beyond elective surgeries and impacts Bellin’s other lines of business, like clinics, occupational health, specialty practices, therapy and testing, in part because of supply limitations and patients avoiding care out of fear of exposure. Bellin expects an over 60 percent reduction in their revenues on a monthly basis.

On Monday, Mercyhealth instituted a temporary furlough program for employees not providing direct patient care and providing services that can be delayed. They don't expect the furlough to last for more than a few weeks.

"These are unprecedented times," the statement noted. "In order to make sure we are positioned to meet our patients’ expected needs for critical care services and survive the economic challenges presented by this COVID-19 situation, Mercyhealth had to make difficult decisions."

Brian Potter, WHA's senior vice president of finance, noted that as revenues go down, hospitals are also increasing expenses as they redeploy staff for testing, screening and incident response.

They’re also working to protect the healthcare workforce, patients and community and spending limited resources to prepare for the surge expected in the next couple of weeks, he said.

“While everyone and every industry is hurting from the financial impact of COVID-19, healthcare is unique,” Potter said in a statement. “There are legislative efforts underway to help ease some of this burden on the healthcare system, but those efforts must be appropriate and done quickly to support this indispensable work on behalf of Wisconsin’s communities."

Tim Size, Rural Wisconsin Health Cooperative executive director, said that while margins for rural hospitals are thinner, Wisconsin hasn’t seen the number of closures that other states have seen.

“Without assistance from Washington and Madison, this will be a tipping point for a great many rural hospitals,” Size said.

He said that policymakers looking at financial support should look at it proportional to size and budgets, not overweighting it to places that see a lot of cases.

“I don’t think we can minimize the impact,” he said. “And it isn’t just for rural Wisconsin, but it’s around the country.”

Dennis Reilly, executive director of the Wisconsin Health and Educational Facilities Authority, said delaying the procedures is a concern for the future financial strength of the hospitals.

Reilly said they support requests from the American Hospital Association for additional resources for hospitals to fight the epidemic. The association wrote congressional leaders last week that supporting hospitals could also provide a stimulus to communities looking for financial stability.

The letter also calls for restoring the ability of hospitals and others to advance refunding of tax-exempt bonds, which Reilly said would give hospitals more flexibility to refinance with lower rates. And the association also called for allowing authorities like WHEFA to issue bonds with lower interest rates and higher borrowing limits. Both could help in the long term, he said.

Brodzeller said that Children's is trying to look past the immediate reaction and toward the long-term impact on families. That will require significant, long-term financial support at the state and federal levels.

"We know that kids’ health is dependent on the health of their families, neighborhood and community," he said. "We are engaged with our local, state and federal officials, as well as corporate leaders, on ways to address the impact this will have."

Evers issues "safer-at-home" order

Tue, 24 Mar 2020 15:56:27 GMT

Wisconsin Health News, March 24, 2020

Gov. Tony Evers’ administration issued an order on Tuesday that will require people to mostly stay at home except for essential travel like buying groceries, visiting the doctor, picking up medicine or caring for others.

The order, aimed at limiting the spread of COVID-19, will take effect 8 a.m. on Wednesday and remain in effect through 8 a.m. Friday, April 24 or until a superseding order is issued, according to Evers' statement.

Healthcare operations, banks, child care facilities, grocery stores and other essential businesses will be allowed to operate, the statement noted.

"Let’s all do our part and work together," Evers said.

There were 416 positive tests of COVID-19 across 30 counties in the state as of Monday afternoon, the Department of Health Services said. There have been five deaths, including a 54-year-old Milwaukee man who died Monday. So far, 7,050 have tested negative.

The City of Milwaukee issued its own nine-page, stay-at-home order late Monday night, with exemptions for essential business and operations. The city plans to modify its order to align with Evers' order when it's released.

Local law enforcement will enforce the governor's order, Ryan Nilsestuen, Evers’ chief legal counsel, told reporters Monday.

Evers said that he was acting on the advice of public health experts and that on a call Sunday night, business leaders "were insistent" he move forward with the order.

"Issuing a safer-at-home order isn't something I thought we'd have to do," he told reporters Monday. "It's not something that I wanted to do. And it's not something that I take lightly. We're all in this together and we need to help stop the spread of COVID-19 and flatten the curve to ensure that our doctors and nurses and healthcare workers have the opportunity to do their important work."

Evers said that as of Monday, they were still deciding what businesses will be considered essential.

“It’s not soup yet,” he told reporters on the call. “Otherwise, I would tell you it is soup. But it will be close to being soup tomorrow.”

Senate Majority Leader Scott Fitzgerald, R-Juneau, and Assembly Speaker Robin Vos, R-Rochester, said Evers’ Monday announcement “created mass amounts of confusion" and came as a "surprise" to the Legislature.

“The governor’s sudden change of course and lack of specific guidance have increased the level of uncertainty and anxiety in our state,” they said in a statement Monday afternoon. “It was a complete reversal from his repeated assurances. It should be noted that legislative leaders have asked on a daily basis whether or not this was the direction the governor was headed, and we were told it was not.”

Other updates on COVID-19:

The National Guard and the State Emergency Operations Center have been working on a personal protective equipment buyback program, said Major General Paul Knapp, Wisconsin's Adjutant General. He said they’d accept donations or will buy back the equipment from businesses that have closed as a result of the outbreak and no longer have use for the equipment. They’ll be able to get those out to first responders and medical workers that need it the most.
Evers credited private businesses for their help on Monday's press call, including Epic, which is providing project managers and data to help determine capacity in the state. He also singled out Exact Sciences for boosting lab testing capabilities and Promega for producing ingredients for the tests. He also said they’re asking experts from the University of Wisconsin and the Wisconsin Hospital Association to be part of the state’s emergency operations center.
Evers said they’ve created “strike teams” to focus on specimen collection and laboratory capacity; personal protective equipment and essential supplies; isolation facilities; surge capacity; healthcare worker child care; and contact tracing and surveillance. The task forces will ensure the healthcare workforce have the resources they need to serve across the state, he said.
A coalition of healthcare groups, including the Wisconsin Hospital Association, Wisconsin Primary Health Care Association, Rural Wisconsin Health Cooperative, Wisconsin Medical Society, LeadingAge Wisconsin, Wisconsin Health Care Association/Wisconsin Center for Assisted Living and the Wisconsin Nurses Association expressed support for the safer-at-home order. The Medical College of Wisconsin said Wednesday they back the order too.

Coronavirus Could 'Magnify' Heathcare Workforce Supply Shortages

Wed, 11 Mar 2020 15:54:18 GMT

Wisconsin Health News, March 11, 2020

An outbreak of coronavirus could worsen existing shortages of healthcare providers and supplies, panelists said Tuesday. The state also announced its third confirmed case of the illness in a Dane County resident.

Ann Zenk, vice president of workforce and clinical practice at the Wisconsin Hospital Association, said that the coronavirus is likely to “magnify shortages” that providers already know exist in the workforce and supplies.

“But this isn’t our first rodeo,” she said at a Wisconsin Health News event Tuesday. “We’re ready.”

Hospitals, nursing homes and clinics are important partners in county and local emergency preparedness efforts, she said. She noted they practice their communication, supply chain and transportation year-round.

Michael Pochowski, Wisconsin Assisted Living Association CEO, said his members’ biggest concern is obtaining personal protective equipment.

“They’re hearing from their medical suppliers that everything is being rationed right now,” he said.

Lisa Pugh, executive director of The Arc Wisconsin, said a concern is getting good information out to the public and preventing panic among vulnerable populations.

Department of Workforce Development Chief Economist Dennis Winters agreed that an outbreak could further increase workforce shortages. He added the economic effects aren’t known yet, although they’re projecting a turndown in economic activity.

Wisconsin received $1 million in immediate federal assistance last week for the coronavirus. It’s also slated to receive more than $10 million in emergency funding approved by Congress and President Donald Trump last week.

Sen. Patrick Testin, R-Stevens Point, credited the Department of Health Services with informing lawmakers and the public on the virus. Wisconsin is at low risk right now, he said, and it’s incumbent on the people to wash their hands and limit contact if they’re ill.

“As it stands right now, I think Wisconsin is well positioned to weather the storm,” he said. If that changes and there’s a need for lawmakers’ help, “the Legislature would answer the call,” he added.

State health officials announced the third confirmed case of coronavirus in Wisconsin on Tuesday morning. The Dane County resident caught the illness while traveling in the U.S and is in isolation at home. The second case, announced Monday, is in Pierce County.

Dane and Pierce counties are trying to determine who the patients had contact with and determine whether they should be tested and isolated to contain the illness.

“The news of new confirmed cases is not unexpected,” State Health Officer Jeanne Ayers told reporters on a press call. “We’ve been working with our laboratory partners over the past weeks to expand our ability to identify cases early. And we are expecting that as we expand our testing capacity, we will be able to identify any new cases as soon as they are present.”

Early identification of cases allows DHS and its partners to move quickly to isolate the patient and prevent the spread, she added.

She said Wisconsinites should use their best judgment when it comes to their spring travel plans. Those with pre-existing conditions like diabetes, lung disease and heart disease should be “very judicious in any non-essential travel.”

She said that they expect at some point Wisconsin will have broader spread.

Curtis Cunningham, assistant administrator of long-term care benefits and programs at the DHS Division of Medicaid Services, told members of the Long Term Care Advisory Council that they’ve formed work groups throughout the agency to focus on the virus.

He added that the department could pursue permission available in emergencies under Medicaid that would allow them to waive provider requirements and other Centers for Medicare and Medicaid Services requirements and still get a federal match.

A Message From Your New WisHHRA President, Nicole Berlowski!

Fri, 31 Jan 2020 21:45:00 GMT

Happy New Year as we go roaring into the new 20’s! I would like to introduce myself as your new WisHHRA Board president and I am so excited to begin my first year in this role. I have been a member of the WisHHRA board for a four years as a regional representative/Director-At-Large for the southeast region and I hope that you all feel the same way I do about the excellent value that your WisHHRA membership brings to you and your organizations. Before I go any further, I would like to thank our outgoing president, Robbi Bos on her contributions to WisHHRA over the past two years. Robbi took on her president role a little earlier than expected due to a job change of the former president so she did not have the benefit of a past-president to assist her, but she really didn’t need any assistance! Under Robbi’s tenure, we began to do a more formal strategic planning process to think of ways that we can continue to expand our service offering to our members and to make WisHHRA a successful organization for years to come. Robbi was also responsible for the transition of our board management activities to Badger Bay, which has brought about a lot of enhancements and administrative ease to our processes. In addition, we welcome two new members to our board this year and some role transitions for some of our Board members. Christopher Schmitz has transitioned from the treasurer role to the Membership Chair, and Jessica Fox has moved from the Membership Chair role to the treasurer role. Thank you to both Chris and Jessica for taking on these new responsibilities. In addition, Robert Stapel (Black River Falls Memorial) and John Konicek (Froedtert Health) have both joined the Board as Directors – At-Large.

I love the start of every new year because it brings with it a fresh slate, a new perspective and an excitement about what’s to come in the year ahead. As we all know, the human resources function is constantly changing as is our industry and sometimes I think that the ever evolving change is why we do what we do. The other exciting thing that will be happening this year is the 2020 WisHHRA Annual Conference at the beautiful Osthoff Resort in Elkhart Lake from April 22 – 24^th. Please watch your emails for the registration information. I would love to meet as many of you there as possible and hear your thoughts and ideas on how WisHHRA can best meet your needs. We have a great day and half of sessions and key- note speakers planned and I think that you will find the content of great value to you in these changing times. Please do not hesitate to connect with me regarding WisHHRA and I look forward to seeing you all in a few months.

Final President's Message from Robbi Bos

Thu, 26 Dec 2019 16:46:19 GMT

As I write my last newsletter as President, I am struck by the fact that we are mere days from a new decade. 2020 seemed a long, long way away when I took the presidency in late 2017 – I just can’t believe how the years have flown by. In the last two years, I’ve been privileged to serve on the WisHHRA Board with some of the finest healthcare HR professionals in the state and I’ve enjoyed working with them to focus on some key areas over the last two years. I was particularly excited to be part of the decision to contract with Badger Bay, who now handles much of the day-to-day administrative tasks of the Board. This has really freed us up to focus on the needs of the organization to a much greater degree. We’ve brought you webinars and conferences and I’m sure you’ll agree that our new website is a significant improvement. If you haven’t seen it lately, check it out at wishhra.org. We updated the bylaws to encourage greater participation on the Board. And the listserve continues to be a value added benefit to our members.

I look forward to stepping into my new role of past president and helping our new president, Nicole Berlowski and the rest of the Board as they take us into a new decade of change. If you’ve never served on the WisHHRA Board before, I encourage you to step outside your comfort zone and give it a try. Not only would you be sharing your knowledge with your peers, you’d be helping our newer HR professionals build that base body of knowledge they’ll need to succeed in healthcare human resources. But most of all, serving on the Board allows you to build amazing, enduring relationships. It’s the people that make an organization great. I can honestly say that I would do it all over again just to ensure I’d have that professional connection with all of you. Thank you for letting me serve.

I wish you the happiest of holidays and look forward to seeing you in the new, roaring twenties!

WHA Releases 2019 Wisconsin Health Care Workforce Report

Wed, 04 Dec 2019 19:46:34 GMT

Wisconsin Hospital Associaiton, December 2, 2019

Aging Population, Shrinking Workforce and Increased Regulations

WHA Health Care Workforce Report Reveals Current Challenges, Suggests Solutions

Facts and data detailed in WHA’s latest health care workforce report point to the continuation of concerning demographic, employment and regulatory trends in Wisconsin that could threaten access to care unless wise policy strategies are embraced.

The 2019 Wisconsin Health Care Workforce Report is the 16th annual report designed to assist health care entities and elected policymakers in helping to maintain Wisconsin as a source for nation-leading high-quality, high-value health care. The report draws from national and state data and studies, reports from other associations and findings in the field to offer recommendations for action.

Among the major challenges identified in this year’s report:

The escalating demands of an aging population – the population over age 75 will increase by 75% from 2017-2032, increasing the number of those requiring more intensive health care.
Increased competition over a shrinking workforce – the population under 18 will grow by only 3.5% from 2017-2032.
A rapidly changing environment – hospitals have moved from paper to electronic health records in just a decade, and 75% of hospitals now provide access through telemedicine. With rapid technology changes come challenges.
Increased regulatory demand – meeting regulatory demands requires 59 FTEs for an average-sized hospital; physicians and advanced practice clinicians devote more time to the electronic health record than they do face-to-face with patients.

WHA’s 2019 Health Care Workforce Report provides a snapshot and future projections for Wisconsin’s health care labor force while describing the current environment affecting this workforce. WHA analysis, along with the expertise and experience of WHA member hospitals, offers potential solutions for health care leaders, educators and policymakers to achieve a workforce of highly skilled professionals serving patients as coordinated teams working across the continuum of care to the top of their training and experience supported by effective technology.

Key among the recommendations: state and federal policymakers must weigh any proposed regulation against the expected benefit. Even regulations proposed for a seemingly-positive purpose can instead hinder hospital and health system efforts that reflect the unique needs of their communities. Wisconsin’s health care system has evolved throughout the state via different strategies – and usually in ways that are not the result of “one size fits all” regulations.

The report is available on WHA’s website.

Hospital Net Income Falls

Mon, 23 Sep 2019 14:46:25 GMT

Wisconsin hospitals earned $1.95 billion in net income in fiscal year 2018, around $280 million less than they did in 2017, according to a report published Friday by the Wisconsin Hospital Association.

The net-income percentage fell from 9.8 percent to 8.3 percent during the period.

Forty-one hospitals lost money in FY 2018, eight more than the prior year. Total hospital revenue was $23.4 billion, up about $1 billion from FY 2017.

“It’s a tougher environment,” said Brian Potter, WHA chief financial officer. “Healthcare is not inexpensive, and so there’s a lot of pressure from all payers to try to reduce the costs.”

Potter noted that net income has been trending down in the last couple of years. He cited Medicare cuts, which helped fund the Affordable Care Act's coverage expansion, as a big driver in the decline.

He noted that they’re also seeing a larger portion of a hospital’s business coming from Medicare, given an aging population.

Medicare accounted for 45.3 percent of patient revenue in FY 2018, up from 44.4 percent in the prior year. Meanwhile, commercial payments fell from 36.5 percent in FY2017 to 35.8 percent in FY2018.

“You’ve got Medicare, who’s paying worse than it has in the past, and you have more of your business now being in Medicare than in commercial, which commercial pays significantly better,” Potter said. “I think that payer mix component is really one of the big drivers.”

Potter said planned further Medicare payment cuts will put more pressure on hospitals to do more on expenses to maintain a margin that allows them to continue operating.

Operating margins are also declining at health systems, Potter said. The report noted that Wisconsin hospitals often provide the operating margin that allows health systems to support unprofitable services that are necessary for patients, like nursing homes, physician clinics and home healthcare.

WHA also surveyed 19 of the state’s largest healthcare systems, comprising 104 hospitals. While the average operating margin for hospitals within the systems was 8.8 percent, the systems as a whole had margins averaging 3.6 percent.

For FY 2017, WHA surveyed 18 of the state’s largest healthcare systems, representing 96 hospitals. The average operating margins for the hospitals and the health systems were 9.6 percent and 4.6 percent, respectively.

A rise in uncompensated care has also played a role in decreasing margins, Potter said. Uncompensated care charges went up 7.6 percent in FY 2018 to $1.2 billion, according to a separate report from WHA. Charity care amounted to $590.2 million, while bad debt was at $633.4 million.

Part of the reason for the change could be rate increases, according to Potter.

There was a $20.2 million increase in uncompensated care at cost, which was $436.8 million in FY 2018. That broke down to $209.1 million in charity care at cost and $227.7 million in bad debt at cost.

The main reason for the increase is plan design changes, with patients having to bear a higher portion of their healthcare costs through deductibles, coinsurance and copayments, Potter said.

ABC for Health Executive Director Bobby Peterson said “myopic policy decisions” by state and federal lawmakers have resulted in more people lacking medical coverage for needed care. He said expanding Medicaid and strong consumer protections could help.

“Bad debt and uncompensated care expenses hurt the bottom line for patients and hospitals, especially people affected by health disparities," he said in a statement.

WHA Workforce Council Previews Annual Workforce Report

Mon, 08 Oct 2018 13:52:11 GMT

Ann Zenk, WHA Vice President, Workforce and Clinical Practice, presented a preview of WHA’s 2018 Annual Health Care Workforce Report for WHA’s Council on Workforce Development at their October 4 meeting. The workforce challenges highlighted in this year’s report include physician shortages in primary care, rapid growth in advanced practice clinician employment, and increased difficulty in finding entry-level workers. The report also explores rapid adoption of telemedicine and technology, as well as electronic health records affecting and impacted by regulatory burden, trends.

“WHA created matching grant programs for graduate medical education, advanced practice clinicians, and allied health professionals to grow essential segments of Wisconsin’s health care workforce,” Zenk noted. “To meet the demands of a rapidly aging population and sustain the highquality health care our state expects and deserves, we also need to make sure all members of the health care team can work to the top of their skill, training, and experience, and we need to remove unnecessary regulatory burdens placed on health care providers.”

Read more here.

Nearly 1,000 Hospital Advocates Attend WHA’s Advocacy Day

Mon, 26 Mar 2018 14:50:16 GMT

Nearly 1,000 people filled an exhibit hall at Madison’s Monona Terrace March 21 to attend WHA’s 2018 Advocacy Day and hear keynote addresses from Lieutenant Governor Rebecca Kleefisch and Mara Liasson, correspondent for NPR and contributor to Fox News Channel. Over half of the attendees also ventured up to the state capitol in Madison to meet with their state senator and representative on issues impacting Wisconsin’s hospitals, including Medicaid reimbursement and a proposal to implement a government fee schedule in Wisconsin’s worker’s compensation program.

Bob Van Meeteren, WHA Board chair and president/CEO of Reedsburg Area Medical Center, welcomed attendees to Advocacy Day. “Every year that I’ve attended Advocacy Day, I am so impressed by the number of people who gather for this event and the passion you all have for your community hospitals, and this year is no different,” said Van Meeteren.

To kick off Advocacy Day, Van Meeteren introduced a video message from Gov. Scott Walker, recorded in advance at the Governor’s residence in Madison. In his remarks, Walker thanked everyone in attendance for contributing to Wisconsin’s achievement as the best state in the country for high-quality health care.

“On behalf of our citizens, I want to say thank you! We are so proud that our health care systems in Wisconsin are ranked number one in the nation for quality. That is so important to individuals and families all over the state, as our health is a top priority. It is also a great recruiting tool for top talent and new employers to the state,” said Walker.

The Governor told the crowd he is “proud to have such a great working relationship with WHA staff and members,” and highlighted several accomplishments achieved by working together.

“We’ve made major investments in Medicaid to keep our systems strong and to care for those in need. We even added more through the Disproportionate Share Hospital (DSH) program,” said Walker, referring to the last budget he signed into law, which increased Wisconsin’s DSH program by $25 million in state funds. The Governor went on to talk about additional investments in the state’s health care workforce, medical education campus expansion, eliminating the waiting period for children’s long-term care services and recent legislation—signed into law at Tomah Memorial Hospital—to create a reinsurance program in Wisconsin to help stabilize the individual health insurance market.

“Together, we will continue to reinforce Wisconsin’s reputation as a national leader in health care. Thank you for your service to your system, your community and to our state.”

WisHHRA Board Recommends Bylaws Change

Fri, 23 Mar 2018 13:48:13 GMT

The WisHHRA Board of Directors reviewed a set of proposed changes to the bylaws at their February 7th meeting. The primary change to the bylaws includes the elimination of regions within the governance structure, and replacing the regional directors on the board with at-large directors. The board discussed the importance of having statewide representation on the board, and would continue to encourage geographic diversity in recruiting candidates for the board.

At the same time, the change is intended to provide the board an opportunity to to also recruit for knowledge, skills, and abilities - in addition to geographic representation. A variety of other changes to the bylaws are also suggested, which are primarily editorial. A red-line version of the bylaws are posted here, and will be presented to the membership for approval at the annual meeting. Please let us know if you have any questions or comments on the proposed bylaws changes.