Wisconsin Health News May 15, 2025

Nursing independence bill receives support, but concerns raised over ER care

A compromise bill that would allow some nurses to practice independently of physicians received support at a public hearing Wednesday. But a doctors’ group raised concerns about emergency rooms operating without emergency physicians. 

Advanced practice nurses have pushed for more than a decade for independence. They’ve faced opposition from doctors and Gov. Tony Evers, who vetoed their last two proposals. 

The latest plan would allow advanced practice nurses to work independently of doctors after four years, with restrictions around practicing pain management and title protections for physicians. 

“We're confident the bipartisan bill before you — a compromise reached between our offices, so many stakeholders and the governor's office — will make it across the finish line,” bill author Rep. Tony Kurtz, R-Wonewoc, told the Assembly Committee on Health, Aging and Long-Term Care. 

“This legislation is long overdue,” said Terri Vandenhouten, a nurse practitioner in New Franken in northeast Wisconsin. “I look forward to my colleagues providing the best care possible to those in need of care.” 

Dr. Aurora Lybeck, an executive board member for the Wisconsin Chapter of the American College of Emergency Physicians, testified for information only. She said the bill has a “major deficiency” by not having physician staffing requirements for emergency rooms. 

Lybeck said emergency physicians are trained to handle complex medical cases and provide life-saving treatment based on minimal medical information. They’re seeing trends like for-profit microhospitals with minimal staffing as well as emergency departments without emergency physicians, particularly in rural areas. 

“I'd argue that an emergency department without an emergency physician is really just an urgent care,” she said. 

Lybeck acknowledged the Legislature may be concluding the discussion on advanced practice nursing independence, but said that conversation — and potentially legislation — on emergency department staffing may follow. 

Regional centers will serve those with mental health and substance use needs

Wisconsin has taken another step forward to help people with mental health and substance use emergencies with the opening of five crisis stabilization centers for adults. Crisis stabilization facilities support people who can't stay in their community safely, but don't need to be hospitalized. Funded by the Department of Health Services (DHS), the centers provide a dedicated location for this level of care for most counties.

"Whether it's been declaring 2023 the Year of Mental Health, securing new investments for school-based mental health and other initiatives, or supporting the launch of the state's 988 Suicide & Crisis Lifeline contact center, we've been working to find solutions to the burgeoning mental health crisis facing our state since 2019," said Gov. Tony Evers. "This includes bolstering our state's crisis care infrastructure so that folks can access the care and support they need when and where they need it—especially in an emergency. While the opening of these new facilities is a tremendous step forward, we know there's far more to do, and we're committed to building on these efforts to ensure every Wisconsinite has access to mental and behavioral health care regardless of their ZIP code."

"The need for services for people experiencing mental health and substance use emergencies has been rising steadily over the past several years," said DHS Secretary-designee Kirsten Johnson. "Our investment in these five crisis stabilization facilities for adults is a commitment to ensuring the right care is available at the right time in the right place for all state residents who need help."

DHS set aside $10 million in 2021 to support the development of five crisis stabilization facilities for adults, with each location serving multiple counties. The funding is part of Wisconsin's share of American Rescue Plan Act (ARPA) funds reserved for mental health and substance use services. Today's announcement represents the work of four providers who each received a share of the funding in 2022 to establish these home-like centers. The services areas are based on partnerships the providers have set up with county agencies providing mental health and substance use services.

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Wisconsin Senate Bill 145 – the “APRN bill” - has again passed both houses of the legislature. Far beyond licensure, this bill expands scope of practice and eliminates current law physician collaboration requirements for nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists.

Last legislative session, Governor Tony Evers vetoed this legislation. Despite his previous veto, the bill was not improved significantly and still lacks provisions and guardrails that WACEP and other physician groups consider vital. So again, our last hope to protect patient safety in Wisconsin is another veto by Governor Evers.

Far beyond creating an APRN license, this bill takes physicians out of patient care and jeopardizes patient safety. From independent practice without any physician involvement to prescribing privileges that are regulated solely by the state’s Board of Nursing, this bill disrupts the cooperative and collaborative team-based model of health care that makes Wisconsin a leader in patient care. WACEP believes that emergency care is best led by an emergency physician and that the best solutions to increase access to care in rural areas does not include complete advanced practice nurse independence. Passage of this bill will translate into nurse practitioners working independently in your local urgent care or an emergency department with no physician involvement or backup.

Urge Governor Evers to veto this ill-advised legislation.

Your advocacy is needed now!

Contact the Governor Now

Dear Member,

I am writing to request your preferred contact information for a study led by Dr. Angie Ingraham at the University of Wisconsin-Madison. Dr. Ingraham is conducting the Support Interhospital Transfer Decisions (SITe) study. Through this study, Dr. Ingraham seeks to understand providers’ experiences communicating during calls about interhospital transfers for older adults with emergency general surgery (EGS) diagnoses.

Emergency medicine physicians play a critical role in the transfer of EGS patients. Dr. Ingraham seeks to gather contact information for emergency medicine physicians now, so that you can be reached quickly if you participate in a transfer call that meets study criteria. If you call the UW Health-Meriter Access Center regarding an older EGS patient, you may be contacted about this study. Your contact information will be kept confidential and only used to invite you to complete a 3-minute survey each time you make an eligible call. Participation in the study will not affect transfer requests.

Please take one minute to share your contact information here: https://go.wisc.edu/egs

This study has been funded by the National Institute on Aging and approved by the University of Wisconsin Institutional Review Board.

Thank you for taking the time to support this important effort.

Please email egstransferstudy@surgery.wisc.edu with any questions. 

Best regards,
Dr. Kerry Ahrens

Dear Wisconsin ACEP Member,

You are invited to take part in this research project entitled “Effects of Legislation on Workplace Violence in Emergency Departments Across Wisconsin.”

You will be asked to complete a survey to evaluate your experiences surrounding workplace violence. The survey will take about 10-15 minutes to complete.

More information is provided at the link to the survey below.

Link: bit.ly/45xFQT0

You may forward the survey to any colleagues (MD/DO, NP, PA, or RN) who practice in an emergency department in Wisconsin who did not receive the survey.

Sincerely,

Corey Sell, MD and Matthew Chinn, MD

Principal Investigators

Department of Emergency Medicine

Medical College of Wisconsin

Department Phone: 414-955-6450

E-mail: csell@mcw.edu; mchinn@mcw.edu

The WACEP Spring Symposium Planning Committee is opening a call for presentations for the 2024 Spring Symposium! We are looking for topics you are interested in presenting and you think others will enjoy learning more about! This could include clinical topics, hot topics, interesting cases and more.

Submit your Presentation Here

Time slots will range from 15-min to 1-hour sessions. The Spring Symposium will take place March 6-7, 2024 at the Brookfield Conference Center in Brookfield, WI. You must be available to present in-person.

Presenters will be selected based on topic of interest and brief description of the presentation. Please submit your presentation proposal no later than September 30, 2023 for consideration. If you have questions contact the WACEP office at WACEP@badgerbay.co.

Interested in serving as leader of your professional membership organization?

The Wisconsin Chapter, ACEP Nominating Committee is now accepting nominations of any member in good standing interested in serving in WACEP leadership through the WACEP Board of Directors, Councillors to ACEP or on the WEMPAC Board.

Nominate yourself or someone here!

Nominations are being accepted for the positions listed below (terms begin January 1, 2024):

WACEP Board of Directors Positions

• (3) Directors-at-Large on the Board of Directors (4-year term)
• President-Elect (1-year term followed by 2-year President term and 1-year Past-President term)
• Secretary/Treasurer (2-year term)
• (1) Alternate Councillor Position

WEM-PAC Board Positions

• Director

WACEP's Board of Directors meets quarterly and provides ongoing strategic oversight as the organization works to advance the effectiveness, sustainability and mission of the Chapter. Board members are expected to participate in all Board meetings, the annual Spring Symposium, and to volunteer for other activities that will help advance the organization's strategic priorities.

A councillor/alternate councillor is a key participant in the leadership and development of ACEP policy. The councillors represent WACEP and have the responsibility to voice the concerns of their constituents on the floor of the council meeting and in reference committees. Councillors can also express the will of their constituents by the execution of their votes for or against resolutions and electing the president-elect, Board members and Council officers at the annual meeting.

WEM-PAC Board of Directors meets 2-3 times per year and makes decisions on PAC contributions. The board is also responsible for promoting the PAC and encouraging donations throughout the year.

If you or any of your colleagues are committed to serving in a leadership capacity and being a resource for information, education, networking and advocacy, we encourage you to get involved!

Nominate yourself or a colleague today! Nominations are due by September 15, 2023.

NOW ACCEPTING NOMINATIONS FOR THE
2023 DISTINGUISHED SERVICE AWARD

SUBMIT NOMINATIONS HERE

About the Award:

The WACEP Distinguished Service Award program began in 2018 to annually recognize a WACEP member who has made extraordinary contributions to the advancement of the emergency medicine specialty, and who has demonstrated the ideals of the organization through their ongoing activities and accomplishments. The recipient is recognized annual during the during the annual WACEP Spring Symposium.

Criteria:

• Nominee must be a WACEP member in good standing.
• Nominations should detail the unique or extraordinary impact the nominee has made within emergency medicine.
• Nominee's contributions may be at the local, state, or national level.

Past Distinguished Service Award recipients include:

• 2023 - Julianna Doniere, MD, MPH
• 2022 - Jeffrey Pothof, MD, FACEP
• 2021 - Michael Pulia, MD, MS, FACEP
• 2020 - Michael Repplinger, MD, PhD, FACEP
• 2019 - Howard J. Croft, MD, FACEP
• 2018 - Azita Hamedani, MD, MBA, MPH, FACEP

WHN; June 28, 2023

A Senate committee voted unanimously Tuesday to advance a plan that would extend Medicaid postpartum coverage to a year. 

Currently, the program offers 60-day postpartum coverage to those making a little more than three times the federal poverty level. Federal officials are considering a request by the state to bump that to 90 days. 

All five members of the Committee on Insurance and Small Business voted by paper ballot to recommend passage of the yearlong extension. The bill has the support of 72 legislators and a number of healthcare organizations. It received a public hearing in March.  

“Postpartum care, including recovery from childbirth, follow-up on pregnancy complications, management of chronic health conditions and addressing mental health concerns, is essential to increasing positive health outcomes for mothers and babies, and often requires follow-up beyond the current 60-day period,” bill author Sen. Joan Ballweg, R-Markesan, wrote in testimony submitted at the public hearing. “This is especially true for pregnant women of color, who experience large disparities in maternal mortality before and after childbirth.” 

Assembly Speaker Robin Vos, R-Rochester, said at a Wisconsin Health News event in mid-June that he opposes the extension, in part because he wants to encourage people to leave Medicaid as soon as possible and enter the private insurance market.

The Legislature’s budget-writing committee voted along party lines around two weeks ago to block an attempt by Democratic members to add the proposal to the 2023-25 budget

Last week the Joint Committee on Finance voted to increase funding for MA reimbursement rates for ED physician services to 40% of Medicare rates. This is another needed increase to get Wisconsin in line with the rest of the United States! The budget will be approved in the next couple of weeks by the legislature and then go to the Governor. We expect the legislature to sign off and the Governor to ultimately approve (as he proposed an increase in his executive budget). So unless there is a full veto of the entire budget, we expect this increase to be implemented as of January 1, 2024 (still need to confirm after budget process) and the new rate will continue going forward.

This is another huge win for Emergency Medicine! Thank you to the WACEP Legislative Committee, Chaired by Dr. Lisa Maurer and WACEP’s Lobbying team Greg Hubbard, AJ Wilson and Dan Romportl at HWZ for their continued advocacy on this important issue.