WACEP is pleased to share these updates from our partners at the WI Medical Society

As Governor extends statewide mask order, the Society urges proactive public behaviors

As Governor Tony Evers declared a new public health emergency and issued a new face covering mandate on September 22 due to increases in the state’s COVID-19 case rate, the Wisconsin Medical Society (Society) took the opportunity to remind the public how they can take proactive measures to help reduce the spread of the virus, regardless of any government action related to the pandemic.

In a media statement sent statewide the afternoon of the Governor’s announcement, Society CEO Bud Chumbley, MD, MBA, emphasized how mask wearing, physical distancing and regular hand washing are proven effective strategies to reduce the spread of COVID-19. “If we all agree to take simple steps, we can reduce the spread of the pandemic and protect our state’s physical and economic health,” Dr. Chumbley said in the statement. “We strongly urge everyone to wear masks, maintain social distancing and continue to wash hands often and thoroughly,” Dr. Chumbley said. The statement also emphasized that with seasonal influenza season looming, getting a flu vaccination is another action individuals can take that helps protect themselves and the public.

The statement is the latest in a series of actions the Society has taken to help remind the public of their important role in helping stem community spread, including three public service announcements that have been aired on statewide television and on the Society’s various social media channels.

Contact Mark Grapentine, JD for more information.

Medical Examining Board concerned over possible proposal to change nursing collaboration requirement

Many physician members of the state’s Medical Examining Board (MEB) raised concerns at its monthly meeting on September 16 over a potential Board of Nursing (BON) proposal that would repeal a requirement that Advanced Practice Nurse Prescribers (APNP) work in collaboration with at least one physician or dentist. While the MEB does not have jurisdiction over how nurses are regulated, numerous MEB members were concerned that such a proposal would have negative impacts on Wisconsin’s high-quality health care system.

The MEB’s concerns rose from a BON meeting on Sept. 10, which included initialization of the process used to change the administrative code: preparing a proposed “Scope Statement” laying out the desired change. The specific scope statement proposal, which requires approval from the Governor before it can be developed further, was included in yesterday’s MEB agenda for discussion.

State MEB administrative staff indicated that the BON may be withdrawing or further modify the scope statement and said a BON subcommittee will be discussing the issue Sept. 18. The Society will attend that subcommittee meeting and has already been in contact with other physician-centric advocacy organizations to ensure all are aware of the possible attempt to alter the collaboration requirement.

In other action, the MEB unanimously approved its own scope statement for a regulatory update that would extend the current requirement for physicians holding a U.S. Drug Enforcement Administration number to complete controlled substance education as part of the 30 hour biennial license requirement.

That statement will now be sent to the Governor for review; the Board will further develop the rule following the Governor’s likely approval.

Contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.

Society's COVID-19 Task Force asks physicians to review DHS alert on antigen testing

The Wisconsin Medical Society’s (Society) COVID-19 Task Force recommends that Wisconsin physicians review a COVID-19 Health Alert on antigen testing issued today, September 24, by the state’s Department of Health Services’ (DHS) Bureau of Communicable Diseases.

Calling this testing an “important and evolving topic,” DHS Chief Medical Officer and State Epidemiologist for Communicable Diseases Ryan Westergaard, MD, PhD, MPH, provides important information regarding various aspects of this type of testing, including considerations for using antigen tests in symptomatic vs. asymptomatic patients, the characteristics of the antigen tests for SARS-CoV-2 currently available and a list of antigen tests currently authorized for use in the U.S.

The Society’s COVID-19 Task Force continues to meet biweekly as Wisconsin battles the pandemic, and regularly updates relevant information on the Society’s COVID-19 Resources webpage.

Contact Society CEO Bud Chumbley, MD, MBA with any questions for the COVID-19 Task Force.

Virtual trivia – October 8

Join your fellow Wisconsin Medical Society members for a virtual WisMed Meet Up! Trivia nights provide an opportunity to connect with your peers across the state from the comfort of your home.

The Society will create trivia teams, or you are welcome to invite colleagues to create a team of your own by emailing Jess. (Maximum of 4 people per team).

Date: Thursday, October 8, 2020
Time: 6:00-7:00 p.m.
Register here!

Gift cards will be awarded to the winning team! Please contact our Membership Specialist at jessica.schreiter@wismed.org with any questions.

Thanks to Exact Sciences for sponsoring this member exclusive event!

Lisa Maurer, MD, FACEP
WACEP Legislative Chair

Wisconsin ACEP continues to advocate for the practicing emergency physician and your patients with the state’s legislators and regulators.  In the last year, we supported EM physicians as COVID-19 hit, and we’ve also continued important work in our ongoing priorities of Medicaid reimbursement and psychiatric care. 

Even though March seems lightyears away, I’ll never forget that overwhelming feeling of the unknown as we started to see patients with COVID.  There was little to no research to support best practices, and even our patients without COVID feared hospitalization for concern of having an exposure.  In times of such uncertainty, WACEP fought to bring medical liability protection to the physicians on the front line.  Wisconsin now provides civil liability immunity for care provided during the Public Health Emergency pending “actions or omissions do not involve reckless or wanton conduct or intentional misconduct.” 

We also heard from our members that independent EM physician practice groups should be eligible for state distributions of CARES Act financial support, just as hospitals were, for lost revenue and increased expenses due to COVID.  In September, DHS announced that emergency physician practice groups could apply for those funds, and they will be distributed before the month is over. 

WACEP will continue its focus on improving Medicaid reimbursement rates, especially as we expect post-pandemic Medicaid enrollment to rise and our state budget to be squeezed.  We absolutely must improve our worst-in-the-nation Medicaid fee schedule for emergency services.  Our state values the expertise of emergency physicians standing by to save lives, and this is not accurately reflected currently as Medicaid reimbursement does not even pay for half of the cost of providing emergency care to its enrollees.  We are honored to have Wisconsin Medical Society also name this as a priority issue as we craft the next state budget.  Of note, our state passed a bill last November that would ensure all services covered under Medicaid would be equally valued if provided via telehealth, including consultations and home monitoring.

WACEP also recognizes that we continue to have room to improve our care for patients with psychiatric emergencies, and oftentimes that necessitates progress in legislation.  We continue to actively participate in the Wisconsin Emergency Psychiatric Task Force, partnering with our colleague psychiatrists as well as other stakeholders such as law enforcement, the Attorney General, WI Counties Association, and others.  We have agreed and published a SMART protocol for risk-based medical evaluation of patients with emergent psychiatric conditions, and look forward to upcoming projects and bipartisan legislation regarding increased transparency in bed availability, regional approaches to stabilization, and pilot projects for novel admissions procedures.  We supported legislation that was already passed in March 2020 whereby law enforcement agencies may contract a DHS-approved third-party vendor to transport an individual for emergency detention.

Thank you to all WACEP members for your support and engagement in grassroots advocacy over the last year.  Without you, none of this would happen.  Please continue to stand together as we anticipate a busy legislative session in the upcoming year, including bills on physician assistant scope of practice, balanced billing for out-of-network care, and much more. 

The Wisconsin Elections Commission encourages every eligible citizen to vote and to become involved in the election process. One way to get involved is to become an Election Day poll worker, also known as an election inspector).  

Citizen involvement is essential to conduct open, accurate and fair elections in Wisconsin. And, Emergency Physicians as well as other healthcare providers are uniquely positioned given the comfort level with PPE.

There are several different jobs at polling places in Wisconsin, all of which are appointed by municipal clerks. Learn more at elections.wi.gov.

In response to the increasing COVID-19 cases, Governor Evers announced a new Emergency Order—EO-2.  Included in this new order are new provisions applicable to health care providers including interstate reciprocity, credentialing, and Telemedicine.  

In addition, the provisions from previously released EO-16 related to physician assistants and nurses are included by reference.  The new order is effective immediately and unless suspended by the legislature or the courts, will remain in effect for the duration of the federal declared public health emergency.  

View the Governor's press release. 

The ACEP20 countdown is on. This year's conference is October 26-29 and has much to offer!  Watch this short video that will surely get you pumped up to attend and take part in the innovative features and creative programming of this year's virtual experience.  Everyone has their reasons: The education, the community, the career advancement opportunities. Maybe it's the chance to break from the daily grind and treat yourself to some “me time.” Whatever your reason, register today!

2020 WACEP President’s Report
Ryan Thompson, MD, FACEP 
(Excerpted from the 2020 WACEP Business Meeting, September 15, 2020)

This has been an unprecedented year, with a myriad of challenges. COVID-19 has upended our state and our world in ways we couldn’t have dreamed of a year ago. So first I would like to thank each and every one of you for what you have done this year. Emergency physicians in our state stepped up in every conceivable way to face this challenge. Your ability to continue to provide incredible care to Wisconsinites despite the challenges of PPE shortages, despite the risks to your own health, and that of your families, even while facing budget shortfalls, constantly shifting guidelines, and a mountain of uncertainty, has been absolutely incredible. So thank you all!

This year of my presidency has certainly not been what I expected. My background is as an educator, and I was excited to bring that energy to this year’s Spring Symposium and continue to expand our Rural Outreach educational program. However, events conspired to cancel both of those events, and our focus by necessity shifted to advocating for our members and patients during a pandemic. I will be forever in the debt of my fellow physicians on the WACEP Executive Board and Board of Directors. Without their expertise and hard work, none of what we have accomplished this year would be possible. If you know any of these folks, please reach out to them with a hearty thank you!

I am happy to report that we have been able to have a big impact during COVID. We advocated for liability protections during the Emergency order, and were also able to convince the state to include emergency groups in eligibility for CARES funds. WACEP joined other medical societies in supporting common-sense masking and social distancing, and collaborated with the Wisconsin Hospital Association to produce a PSA reassuring Wisconsinites about the safety of our Emergency Departments despite the pandemic. 

Beyond COVID, we’ve had great success in other areas as well, including state level advocacy, membership retention, and collaborative efforts to improve mental health care in Wisconsin. Despite the challenges of the year, I feel good about what WACEP has achieved, and I look forward to what we will continue to accomplish in the year to come.  

Advocating for EM physicians and our patients requires us to have the means to get our ideas and advocates in front of Wisconsin politicians. Each of our board members has committed to donating to our PAC, and I would encourage all of our members to make a contribution as well—our PAC is what allows  us to advocate for substantive change in the state. There are great things on the horizon in our state, but also significant challenges. A strong PAC will allow us to face those challenges head-on. If you feel that WACEP has improved your practice environment, please consider making a contribution today!

The Wisconsin Chapter, ACEP Nominating Committee is now accepting nominations of any member in good standing interested in serving in WACEP leadership.

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.

Nominations are being accepted for the positions listed below (terms begin January 1, 2021):

• (3) Directors-at-Large on the Board of Directors (4-year term)  
• President-Elect (this is a 3-year commitment, one year each as President-Elect, President and Immediate Past President)  
• Secretary/Treasurer (1-year term) 

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 November 20, 2020. Submit nominations here.

WACEP congratulates Michael Repplinger, MD, PhD, FACEP as the recipient of this year's WACEP Distinguished Service Award. The award was presented during the virtual Annual Membership Meeting on September 15, 2020 by WACEP President Ryan Thompson, MD, FACEP. 

Over the last 10 years, Dr. Michael Repplinger has demonstrated a commitment to improving patient care and promoting the profession of emergency medicine. He was UW’s first resident delegate to the WACEP Board and has continued to serve in various roles in WACEP including President in 2013 and Councilor for the past 3 years. During his tenure on the Board, Dr. Repplinger has substantially contributed to numerous WACEP initiatives, resulting in important changes to Wisconsin’s statutes. Examples include changing the statutory definition of informed consent for medical care, reinstating medical malpractice caps for noneconomic damages, and providing statutory liability protection when conducting body cavity searches. 

Outside of political lobbying, Dr. Repplinger has advocated for emergency physicians at the Wisconsin Medical Society and in teaching medical students and residents. He has personally penned and successfully promoted the adoption of resolutions favorable to emergency medicine including a policy supporting the increase of Medicaid reimbursement for EMTALA-related services. Current initiatives led or substantially bolstered by Dr. Repplinger include streamlining and standardizing the medical assessment of patients being admitted with mental health crises, improving the current version of a web-based statewide psychiatric bed locator, and reversing the current Medicaid policy that bars reimbursement for inpatient psychiatric care at freestanding psychiatric hospitals. 

Beyond his patient and profession-centered advocacy efforts, Dr. Repplinger is a stellar emergency care researcher, focused on the use of radiation-free imaging in the ED. He has been awarded several federal, foundation, and institutional grants, published nearly 40 peer-reviewed articles, and received numerous research awards. His unique line of research is innovative and practice changing. 

For all these reasons and more, WACEP is delighted to announce that Dr. Repplinger is this year’s recipient of the Distinguished Service 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. 

It's National Suicide Prevention Week. ACEP will be sharing relevant patient care tools and resources for members on social media while also conducting an awareness campaign for the public.

Next week, ACEP will share advocacy updates and wellness tools to mark Physician Suicide Awareness Day on Sept. 17. Join the conversation as we work together to raise awareness about this important issue during an especially challenging season for EM physicians and society as a whole.

WACEP Immediate Past President and UW Health's Chief Quality Officer, Dr. Jeff Pothof was interviewed on PBS Wisconsin’s Here and Now. Dr. Pothof was the first among an expected 1,600 volunteers to take an experimental COVID-19 vaccine at a study run jointly by UW Health and the UW School of Medicine. He joins the program from Madison. View interview.