September 17, Wisconsin Health News

A new National Suicide Prevention Lifeline call center recently opened in Wisconsin. 

Family Services of Northeast Wisconsin will manage the new center, known as the Wisconsin Lifeline, under a $2 million grant from the Department of Health Services. It’s part of Wisconsin’s share of the federal Community Mental Health Services Block Grant. 

The center will accept calls originating from communities not covered by one of the four existing Wisconsin-based centers that are part of the national lifeline’s network.

“Adding capacity to handle Wisconsin calls to the National Suicide Prevention Lifeline is part of our ongoing effort to ensure the right supports are available at the right time for people in emotional distress,” DHS Secretary-designee Andrea Palm said in a Wednesday statement. “It’s about offering hope and promoting healing.” 

The new center began answering calls in August. During its first week, the percent of Wisconsin calls to the lifeline answered in-state increased to 85 percent, above the national benchmark of 70 percent. Before its launch, the in-state answer rate was at 30 percent due to the large volume of calls coming from areas outside of the four locally funded call centers’ responsibility. 

The new center will also position Wisconsin well to handle a predicted surge in calls when the 10-digit nationwide helpline number switches to 988 in July 2022, DHS noted.

Thursday, September 17, 2020, marks the 3rd annual National Physician Suicide Awareness Day. This year’s theme, One of Us, is meant to remind us that suicide can affect anyone... our families, our friends, our colleagues.

The Wisconsin Chapter, American College of Emergency Physicians, is proudly among numerous organizations across the country who support the event, which was created to honor the memory of physicians who have died by suicide and to continue to raise awareness and discussion on how to prevent it. 

Join us and Support National Physician Suicide Awareness Day at your work setting:

• Create a safe space by dedicating time to talk about mental health and suicide.  Setaside time at your morning report, morning huddle or faculty meeting to discuss physician mental health, depression and suicide. This allows your group to speak freely about it without a spotlight on them personally.
• Say the names of your colleagues who have died by suicide. Remember them, honor their memory, share stories and lessons learned. 
• Be vulnerable and a role-model for your colleagues and trainees. Physicians are notoriously constricted in sharing their own emotions and experiences which may contribute to the higher rates of burnout, depression and suicide rate. Start the conversation and break the ice. By role-modeling vulnerability, you are helping to change the culture in medicine.   
• Identify and promote access to mental health. Review and share how mental health care and resources are addressed and accessed locally.

Registration is now open for ACEP's upcoming summit, "Preparing for the Next Pandemic" with sessions taking place between August 31 and September 10, 2020.

ACEP's president, Dr. Bill Jaquis, will serve as moderator for eight, one-hour sessions focused on lessons learned during the COVID-19 crisis and strategies to better respond to the next pandemic. Session topics include: Communications, Data and Analysis, Deployment and Distribution of Physicians and Other Health Care Workers, Disparities and Vulnerable Populations, Information Flow, Research, Supply Chain, and Workforce Support and Sustainability.

View event information & register

Alternatively, you may register for each session directly using the session links below:

• Communications Session; Mon, Aug 31 01:00 PM CT - Link
• Disparities and Vulnerable Populations Session; Mon, Aug 31 02:30 PM CT - Link
• Supply Chain Session; Wed, Sep 2 01:00 PM CT – Link
• Research Session; Thu, Sep 3 03:00 PM CT - Link
• Information Flow Session; Fri, Sep 4 01:00 PM CT - Link
• Deployment and Distribution of Physicians and Other Health Care Workers Session; Wed, Sep 9 01:00 PM CT - Link
• Data and Analysis Session; Wed, Sep 9 03:00 PM CT - Link
• Workforce Support and Sustainability Session; Thu, Sep 10, 01:00 PM CT - Link

Ryan Thompson, MD, FACEP
WACEP President’s Message, August 2020

I recently started work on an addition for my house, and after digging a giant hole, my contractor discovered that the sandy dirt under my foundation had largely eroded away in the 90 years since the house had been built. This was an unwelcome (and expensive!) discovery, but even more concerning is that I suddenly had to worry about my house collapsing – a possibility I had never even considered in my 5 years of living there. How could something as seemingly small as sand have such a major impact on the stability of my home?!

Just like the sand under my home, Medicare reimbursement is probably something most emergency physicians rarely think about. However, since we see such a large number of Medicare patients, those payments do serve as the foundation for the financial solvency of many of our practices. And also like that sand, those payments are at threat of bringing down the whole house if they erode away.

ACEP had actually made great headway on increasing CMS payments for emergency E/M codes in this year’s CMS reimbursement fee schedule update. They were able to secure an increase of about 12.7% for level 3 charts, and an increase of about 5.25% for level 4 and 5 charts. This is good news! However, as always, the devil is in the details. In order to promote primary care, CMS increased payments for all outpatient office codes. However, CMS has a mandate to remain budget neutral, so they have proposed a rule slashing all other physician reimbursements by 9%. Factoring in the increase in ED codes, emergency physicians are facing a 6% decrease in reimbursement in 2021, taking a veritable firehose to the sand that supports many small practice groups.

However, we don’t have to stand idly by and watch this happen. If Congress waives the budget neutrality requirement, we will actually see an increase of about 3%. And in the midst of facing down a pandemic, now is not the time to start shortchanging the nation’s physicians. Reach out to your legislators and let them know that emergency physicians need relief right now, not belt tightening. A cut of this scale could force smaller groups out of business all around the nation, and Wisconsin has a high percentage of small independent groups.

If Congress fails to stop this erosion of the foundations of Emergency Medicine, the long-term damage will be far more expensive and difficult to fix than is apparent at first glance. Just ask my contractor!

Hear from the man who has been at the epicenter of this pandemic and get a first-hand account of the nation’s response to COVID-19. Dr. Anthony Fauci will offer his unique perspective on the virus and the care given to Americans in 2020.

He will kick off ACEP20 at 9 am CDT, Oct. 26, followed by a panel of international emergency physicians on “Lessons Learned: Global Response to COVID-19.”

Dr. Fauci was appointed Director of National Institute of Allergy and Infectious Diseases (NIAID) in 1984. He oversees an extensive research portfolio of basic and applied research to prevent, diagnose, and treat established infectious diseases such as HIV/AIDS, respiratory infections, diarrheal diseases, tuberculosis and malaria, as well as emerging diseases such as Ebola and Zika. NIAID also supports research on transplantation and immune-related illnesses, including autoimmune disorders, asthma and allergies.

Dr. Fauci has advised six Presidents on HIV/AIDS and many other domestic and global health issues. He was one of the principal architects of the President’s Emergency Plan for AIDS Relief (PEPFAR), a program that has saved millions of lives throughout the developing world.

Sign up for ACEP20 today.

Andrew Culp, a community ED physician based in Madison, is gathering physician feedback on epistaxis management for an upcoming Phase I NIH SBIR (Small Business Innovation Research) grant.  Please consider taking this 3-minute survey to share your perspective.

ACTION ALERT! Contact your member of Congress today and urge them to waive the budget neutrality requirement for calendar years 2021 and 2022 by signing on to a bipartisan “Dear Colleague” letter led by Rep. Bobby Rush.  It is essential that they hear directly from emergency physicians in their district just how devastating these cuts could be for access to emergency care for patients across the country.  Learn more and take action today.

The Wisconsin Department of Health Services (DHS) hosted all-inclusive webinars last week to engage providers, provider associations, members, and member advocates in telehealth expansion. These webinars provided an overview of the telehealth expansion project and gathered input on permanent telehealth policy. View Provider webinar here, and visit the DHS webpage for additional resources on telehealth expansion. 

Becker's Hospital Review 

A vast majority of emergency medicine physicians said increasing the availability of personal protective equipment would relieve their stress related to the COVID-19 pandemic, a new survey shows. The survey was emailed to all emergency medicine physicians at seven U.S. academic emergency departments. A total of 426 physicians responded. Survey results were published in the journal Academic Emergency Medicine.  READ MORE

On Thursday, the Secretary of the Department of Health and Human Services (HHS), Alex Azar, extended the COVID-19 public health emergency for another 90 days. This is the second time Secretary Azar has extended the public health emergency. It is now set to expire at the end of October.

The extension of the public health emergency means that the waivers and flexibilities that the Centers for Medicare & Medicaid Services (CMS) and other federal agencies have put into place to help health care practitioners and facilities respond to the pandemic (including those related to telehealth and EMTALA) will remain in place.

For more information about CMS’ emergency waivers click here, and for ACEP's summary of federal guidance related to COVID-19, click here.