SPOTLIGHT ON HEALTH CARE.

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1 SPOTLIGHT ON HEALTH CARE

2 Overview Achieving a stable, growing population in Wisconsin s rural communities is the best way to ensure that these areas remain prosperous in the future, but it will require the reversal of a multi-decade national demographic shift that has led people away from rural areas toward cities and suburbs. Employers seek to locate in areas with a well-trained, ready and healthy workforce. The presence of good jobs enables young people to settle in rural communities to raise their family. Funding that maintains our schools is tied to the number of pupils in attendance. To achieve a stable, growing population, we must work to ensure that people find equal opportunity in rural areas. With increases in technology, this should be easier than in the past. Site selectors often identify access to high quality, high value health care as an important factor in job creation and for a productive workforce. Access to quality health care services is important for young families deciding where they will make their home, and for senior citizens who are deciding where to spend their retirement. Wisconsin has done a great job in ensuring this access across the state, and is currently ranked 6 th in the country for health care access and ranked 3 rd in the country for health care quality. By anticipating potential barriers to access and addressing those needs now, we can ensure that Wisconsin s rural hospitals and clinics continue to provide the level of care that will attract and retain a vibrant population.

3 Investing in a Strong Health Care Workforce Cooperation is key in medicine and in education. 60% of the health care workforce is made up of allied health professionals - such as radiographers, physical therapists, nutritionists, respiratory therapists, surgical technicians and certified nursing assistants. These health care professionals provide us with important services and are an integral part of the health care team. Currently, demand for these positions is growing nearly twice as fast as the national economy. Rural Wisconsin can t afford workforce shortages in this sector. To address this need, we propose the creation of a $250,000 annual grant program that would be available to hospitals and educational entities that work together to form training consortia focused on this sector of the workforce. Advanced Practice Clinicians, such as Physician Assistants and Advanced Practice Nurses, are another important part of the front-line health care team that are facing shortages in rural areas including vacancy rates of over 10% in Wisconsin hospitals. To address this need, we want to encourage rural hospitals to partner with area educational institutions to form Advanced Practice Clinician training programs. To that end, we would create a $750,000 annual grant program to be used for the creation of clinical training infrastructure in rural communities. This investment would help to support clinical training preceptors, tuition assistance for students, required materials, and stipends for reasonable living expenses especially when a student relocates into a rural community for their training experience. Both programs would be supported through matching funds from the sponsoring organizations in a public/private partnership with the State of Wisconsin.

4 Investing in a Strong Health Care Workforce Rural Wisconsin is also in need of doctors. That is why we will be reintroducing legislation to better fund the Wisconsin Rural Physician Residency Assistance Program (WRPRAP). The legislature created the WRPRAP in 2010 in order to fund residency opportunities in rural Wisconsin communities, because it is documented that doctors are more likely to practice in the type of environment where they had their residency. In 2015, WRPRAP had a hand in funding 77 of Wisconsin s 83 rural residency programs that s 93%. With more funding now, we can curb the rural physician shortage, and continue to ensure that all Wisconsinites have access to the health care professionals they need. $250,000 annually over the biennium could secure serious investments in OB-GYN and mental health residencies in Northern Wisconsin. The 86% Equation According to data from the Wisconsin Council on Medical Education & Workforce, we know that a Wisconsin resident who attends medical school and trains in this state is 86% likely to stay and practice medicine in Wisconsin. Without that key Wisconsin residency training, this likelihood of growing our own physicians drops substantially.

5 Investing in a Healthy Rural Wisconsin Wellness programs are an important element in creating a healthy culture, and in rural Wisconsin, they can be hard to find. That is why we are proposing an incentive to create wellness facilities and programs in underserved areas of rural Wisconsin. Grants would be limited to $250,000, and a minimum of two would be awarded. These funds would be delivered only if the award recipient were to provide matching funds for the project, if the project was a partnership with a local hospital or health system and targets a community s health care needs. Wisconsin hospitals already offer high quality care, but there is more that we can do to encourage improvement. We are drafting legislation that would award an annual grant of $100,000 to the Wisconsin Hospital Association Foundation to increase participation by rural hospitals in quality improvement activities. By increasing the quality of care, we can cut down on return visits to the facility, thus providing further savings. As the state needs to become more involved in issues impacting our health care workforce, we will offer legislation that will identify future workforce gaps through better workforce data.

6 What Hospital Administrators Are Saying: Advanced practice nurses and physician assistants are playing a critical role as patient care leaders, alongside physicians, at Spooner Health. As northern Wisconsin continues to age, demand for health care will continue to grow and our need for advanced practice clinicians will increase. - Mike Schafer, Spooner Health Spooner, WI Our primary care providers have identified that patients lack access to wellness programs that can improve health behaviors in rural communities. In order to improve population health in all parts of Wisconsin, our state and community needs to make investments that will give our residents the tools to live a healthy lifestyle. - Charisse Oland, Rusk County Memorial Hospital Ladysmith, WI Health care s workforce challenges go beyond physicians and advanced practice clinicians. Our health system is in need of all levels of health care providers including certified nursing assistants and surgical technicians. By partnering with local educational institutions and offering incentives for people to enter these career fields, we can meet our workforce needs while also providing good paying jobs to citizens in rural communities. - Bob Van Meeteren, Reedsburg Area Medical Center Reedsburg, WI Graduate Medical Education is a critically important health care workforce investment in Wisconsin. Monroe Clinic has invested staff time and financial resources to establish rural training sites for Wisconsin-educated physicians. Our investment and partnership with the State of Wisconsin in Graduate Medical Education will result in physicians staying in Monroe to practice medicine. - Mike Sanders, Monroe Clinic Monroe, WI One could argue more than any other sector health care is a data driven industry. If Wisconsin is able to have more robust data on the supply of our health care workforce, it will help our state s policy makers and educational institutions make more precise decisions to support the labor needs of our state s hospitals, clinics and health systems. - David Hartberg, Gundersen Boscobel Area Hospital and Clinics Boscobel, WI

7 Get Involved! The Rural Wisconsin Initiative is meant to be more than just a package of legislation. This is an on-going movement that needs to include ideas from all over the state of Wisconsin. Get involved today on Facebook, Twitter, or on the website! #RuralWIForward Facebook.com/RuralWisconsinInitiative

8 Legislators Who are Leading the Rural WI Initiative Rep. Ed Brooks Reedsburg Rep. Travis Tranel Cuba City Rep. Kathy Bernier Chippewa Falls Rep. James W. Edming Glen Flora Rep. Scott Krug - Nekoosa Rep. Tom Larson - Colfax Rep. Jeff Mursau Crivitz Rep. Lee Nerison Westby Rep. Al Ott Forest Junction Rep. Keith Ripp Lodi Rep. Rob Swearingen Rhinelander Rep. Romaine Quinn Rice Lake Rep. Joan Ballweg Markesan Rep. Mary Czaja Irma Rep. Joel Kitchens Sturgeon Bay Rep. Bob Kulp Stratford Rep. John Macco De Pere Rep. John Murtha Baldwin Rep. Todd Novak - Dodgeville Rep. Warren Petryk - Eleva Rep. John Spiros Marshfield Rep. Gary Tauchen Bonduel Rep. Nancy VanderMeer Tomah

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