WisMed calls for APRN bill changes

Speaking before the Senate Committee on Health Wednesday afternoon (May 24), the Wisconsin Medical Society (WisMed) called for important changes to proposed legislation (Senate Bill 145) that would allow certain Advanced Practice Registered Nurses (APRN) to practice independently – a change to current law which requires at least collaboration with physicians when providing care.

Speaking on behalf of WisMed and numerous physician specialty groups, WisMed Chief Policy and Advocacy Officer Mark Grapentine, JD, described how physicians are optimistic that a reasonable compromise can be achieved, allowing the state to take a responsible step into a health care environment allowing unsupervised practice for Nurse Practitioners (NP), certified nurse midwives and clinical nurse specialists. That compromise can be achieved, Grapentine said, by adopting important benchmarks included in Governor Tony Evers’s biennial budget proposal, such as:

• Requiring an APRN to have at least four years of real-world, team-based care experience before being allowed to practice independently. Two of those years must occur after receiving APRN certification.
• Adding statutory certainty that certain words and terms used to connote physicians and their specialties (including words such as “physician,” “anesthesiologist” etc.) may only be used by those who have earned a medical doctor (MD) or doctor of osteopathy (DO) degree. A separate bill to achieve this goal has been introduced as Senate Bill 143, which was also on the public hearing docket.
• Protecting patients seeking complex pain management services by requiring certified registered nurse anesthetists (CRNA) to work in collaboration with a physician specializing in pain medicine. Current law requires CRNAs to work in collaboration with a physician, with no requirements that the physician have any experience in pain medicine.

The Governor’s budget also shines a light on hospital emergency departments that do not have emergency medicine physicians on site at all times by requiring that kind of staffing.

“We believe a majority of legislative members on both sides of the aisle are prepared to move forward with this compromise language as outlined,” the physician coalition’s testimony reads. “Amending SB 145 to include the above provisions is a sensible and reasonable middle ground that would provide a much less controversial glidepath, ultimately resulting in passage of a bipartisan bill.”

Changes to SB 145 is also one of the main topics for this year’s Doctor Day, which will be held in Madison June 15 (see the below Medigram story for more). For more information, contact WisMed’s Mark Grapentine. 

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June 15 Doctor Day to focus on timely topics: independent nursing and post-partum coverage for new moms

Doctor Day is quickly approaching. If you haven’t registered for this day of advocacy, there’s still time. The line up for the day is full of fantastic speakers and there’s a spot for you! Thanks to our sponsors, the day is free for physicians and medical students.

Advanced Practice Registered Nurses (APRN) Legislation – Bills currently up for debate in the legislature would allow for most advanced practice registered nurses (CRNAs, NPs, certified nurse midwives and clinical nurse specialists) to practice independently in Wisconsin. Governor Tony Evers vetoed substantially similar legislation last session, stating in his veto message his dissatisfaction that the bill did not address “concerns raised by parties in the medical profession that went unremedied in the legislative process.” Gov. Evers then used his biennial budget proposal to lay out reasonable provisions that legislation would need to garner his signature. Physician groups agree that many of those provisions are vital if a bill is to be approved, especially:

• requiring four years of real-world experience in team-based care before being allowed to practice independently
• inclusion of important truth in advertising/titling protections that reserve terms such as “physician,” “anesthesiologist” etc. for those with a medical degree (MD or DO) and
• ensuring that any CRNA clinic offering pain management services work in collaboration with a physician specializing in pain medicine.

The legislation just received a hearing in the Senate Committee on Health on May 24 (see this story), so the timing is ideal for physician input. The companion bills (same language in each) are Senate Bill 145 and Assembly Bill 154.

Extending Medicaid Coverage for New Moms to One Year Post-Partum – Another issue that has widespread physician support: extending the time period that Medicaid will cover new moms who have delivered a baby to one year post-partum, matching the coverage newborns receive when the mother is Medicaid-eligible upon delivery. Medicaid eligibility levels are more generous for pregnant mothers, so sometimes a mother “incomes out” of the Medicaid program after giving birth. This disruption harms continuity of care and often makes it more difficult for moms to seek medical care for both themselves and/or their babies – which is usually when comprehensive care is needed the most.

The companion bills are Senate Bill 110 and Assembly Bill 114.

Register today. If you have any questions, contact Heidi Green or Mark Grapentine.

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The Opioid Epidemic and the Clinical Practitioner: Responses to Opioid Over-Prescribing webinar available on demand

The Opioid Epidemic and the Clinical Practitioner: Responses to Opioid Over-Prescribing takes a societal view of the opioid epidemic by addressing the policy and regulatory landscape to ensure adherence to safe prescribing practices and prescribers’ roles as promoters of public health with respect to opioids. Presented by Michael M. Miller, MD, DFASAM, DLFAPA, Associate Clinical Professor, Medical College of Wisconsin, who specializes in addiction medicine.

Upon completion of this course, learners should be able to:

• Describe the role of physicians and other prescribers in the evolution of the opioid epidemic
• Outline the role of licensure boards in influencing licensees’ clinical performance regarding opioids
• Embrace their role as promoters of public health with respect to opioids’ safe use

The Wisconsin Medical Examining Board (MEB) approved a rule requiring physicians with a DEA number to complete two CME credits on its Opioid Prescribing Guideline biennially. To help physicians comply with this rule, the Wisconsin Medical Society developed a series of on-demand webinars. This course meets the two-hour requirement. This course can also be combined with additional education to meet the Medication Access and Training Expansion (MATE) Act requirements for all DEA-registered practitioners who prescribe schedule II, III, IV or V drugs. For more information regarding the 2023 MATE Act, please reference the New DEA training requirement: What physicians need to know about the 2023 MATE Medigram article released on April 6, 2023.

Click here to register for The Opioid Epidemic and the Clinical Practitioner: Responses to Opioid Over-Prescribing or click here to learn about other courses that have been approved by the MEB. Wisconsin Medical Society Members get discounted registration on many of the courses.

Please contact education@wismed.org with any questions.

STATEMENT OF ACCREDITATION
The Wisconsin Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

MOC PART II CREDIT
This course has been approved for MOC Part II credit by American Board of Medical Specialties (ABMS) Member Boards, see course description for full details.

AMA CREDIT DESIGNATION STATEMENT
The Wisconsin Medical Society designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Increasing hope: Foundation grants support critical needs

Mary, a single mom with two daughters came to Hope House with very little but was grateful to shower and do laundry in a safe environment. “My daughters were so excited to have clean clothes.” Wisconsin Medical Society Foundation (Foundation) Program Coordinator, Jaime Craig, learned about Mary on a recent visit to 2022 Foundation Grant Recipient, Hope House, in Manitowoc.

The mission of Hope House is to help families and individuals experiencing houselessness achieve sustainable independence. Hope House is a 90-day shelter program serving families, couples and individuals who are unhoused throughout Manitowoc County. They provide guests with shelter, case management, referrals to community agencies and supportive listening. They help develop individualized plans to identify and address any barriers that may be getting in the way of living independently and link guests to community resources that assist them as they move toward self-sufficiency with safe and stable housing, suitable employment, schooling for children and more.

The grant provided by the Foundation allowed Hope House to remain open during evenings and weekends, a time when shelter is desperately needed. They have seven rooms, two kitchens, laundry facilities, a common area, dining room, outdoor play area and a beautiful indoor playroom. Upon arrival residents start with an intake with one of the onsite case managers to establish immediate needs, complete documentation, discuss shelter rules and prioritize where they need the most help. Prior to leaving Hope House paper keys are decorated to hang and represent finding new housing.

With the help received at Hope House, Mary and her daughters added their own paper key to the display and are now residing in their own place. “Hope House helped me find resources and meet my goals,” Mary said. Success stories such as Mary’s would not be possible without generous support.

Knowing that housing is health care, the Foundation was pleased to support this essential program during a time of critical need. Learn more about Hope House or support them directly by visiting hopehousemc.org. To learn more about the Foundation Grant program, please contact Jaime Craig at jaime.craig@wismed.org. Your gifts to the Foundation will go to support other important programs in Wisconsin providing direct support to people in need. Please give to the Foundation here.

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What's in a financial plan?

A financial plan is like a roadmap that helps you navigate through the twists and turns of life, whether you’re saving up for a new car or preparing for retirement. Think of it as your secret weapon to achieving your financial goals and living your best life.

Now, let’s break it down into the three scenarios we all share: a long healthy life, getting sick along the way or passing away early. We need to be prepared for all of them, and that’s where financial planning comes in handy.

Cash Flow

You might call it a budget, but we like to call it the “4 Fs.” It’s like a secret formula to financial success! You just need to know your:

• Fixed expenses (the boring stuff like housing and utilities)
• Future expenses (like saving for retirement or your next vacation)
• “F”ilanthropy expenses (how much you want to give back to your community)  
• Fun expenses (the things that make life worth living!)

Once you have these figures down, you can put your cash flow to work and watch your bank account grow.

Eliminating Debt

We all know it’s easy to fall into the trap of overspending. But a good financial plan will help you avoid that and pay off any debt you already have quickly.

Insurance

We might not like to think about it, but getting sick or passing away early is a possibility for all of us. That’s why having the right insurance and right amount is crucial. Health insurance, disability insurance and life insurance are all important components of a good financial plan.

Investing

A well-diversified portfolio with the right asset allocation and asset selection can help you achieve your financial goals. And don’t forget about asset location, putting the right investments in the right account, which can make a big difference in your after-tax returns. Bonus: check out the 7 proven ways to improve performance.

Retirement

Retirement is often the biggest topic that financial planning covers. How much do you need to save for retirement? When should you start withdrawing your money? Which account should you use first? And when should you start taking Social Security? These are all important questions that a good financial plan can help answer.

College

If you have children, college planning is often important. Saving for college is just the beginning – picking the right school that offers grants and scholarships can help cover the costs.

Tax

Taxes can be a huge expense for most people, which is why tax planning is a crucial part of a financial plan. By creating a strategy to manage your taxes, you can keep more money in your pocket.

Estate Plan

Finally, estate planning is something everyone should consider. Who will take care of your finances and health care if you become incapacitated? Who will take care of your children if something happens to you? A good financial plan should include a will, health care and financial power of attorney documents, beneficiary designations and possibly a trust.

Phew! That’s a lot to consider, but don’t worry – you don’t have to figure it all out on your own. A financial planner can help guide you through the process and create a personalized plan to help you achieve your financial goals. Are you ready to take control of your finances and start living the life you deserve?

For personalized help eliminating debt, investing smart and securing retirement, please contact Mark Ziety, CFP®, AIF® 608.442.3750.

Mark Ziety, CFP®, AIF®
WisMed Financial, Inc. part of the Wisconsin Medical Society. 

Originally posted May 23, 2023 in The Antidote.

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Last chance for discounted WisMed apparel

If you have been wanting to purchase Wisconsin Medical Society (WisMed) merchandise, we are pleased to now offer an online store to buy logoed apparel and accessories. Our introductory launch is now online, and to celebrate and thank our members for a successful WisMed Annual Event we are offering a ten percent discount for all orders placed by May 31.* Click here to visit the store. 

*Discount will automatically be applied in your cart. Please note that all orders placed between now and May 31 will ship in June.

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