The WACEP 2020 Spring Symposium, scheduled for April 15-16 in Madison,  has been CANCELLED due to the COVID-19 pandemic. 

Guests who made hotel reservations at the Madison Marriott West are requested to cancel their reservations individually via the hotel's central call line at 888-745-2032. Your patience is appreciated as wait times may be longer than usual. 

WACEP is exploring the option of offering sessions from the Symposium as online, on-demand courses. Details and registration information will be shared as available. 

The ACEP committee application process is now open to any member interested in joining a committee. The deadline to apply is May 1, 2020.

ACEP has more than 35 committees and task forces working on issues such as ethics, emergency medicine practice, pediatric emergency care, disaster medicine and more. Please consider volunteering—ACEP and emergency medicine need your experience and expertise. Committees provide important leadership to ACEP members, its Board and Council.

EMRA members who are interested in serving as that organization's representative on an ACEP committee should also apply. The process is the same for resident and active members and you can expedite the process by using the online application. Residents and candidate applicants may provide a letter from their program directors and/or mentors as well.

The majority of committee work is accomplished through e-mail and conference calls. Committee members are expected to attend the organizational meetings at the annual meeting in Dallas, TX, October 26-29, 2020.  

Those not currently serving on a national ACEP committee will be required to submit a current CV to volunteer for a committee. Please attach your CV to the online form or mail it to ACEP headquarters. You may also want to submit a letter of support from the Wisconsin Chapter, ACEP.  

Review the online application for details and to begin the process.  After completion of the form, you should receive an acknowledgement that your committee interest form has been submitted. Mark S. Rosenberg, DO, MBA, FACEP, ACEP's President-Elect, will finalize committee appointments in late June. If appointed to an ACEP national committee, your appointment will not be considered final unless a completed Conflict of Interest form is submitted by the deadline. 

Each Committee is appointed by the President to assist with activities for the year. Committee members serve for a specific period of time and are accountable to the President for achievement of assigned objectives. Task forces operate much like committees, but once their work is complete they are deactivated. 

Questions may be directed to Mary Ellen Fletcher, CPC, CEDC, at 800-798-1822, ext. 3145, or mfletcher@acep.org. 

March 4, Wisconsin Health  News

Gov. Tony Evers signed into law four bills on Tuesday that target substance use disorder and opioid use in Wisconsin.

Evers said more needs to be done to expand access to healthcare across the state and bolster treatment and recovery services.

“Folks have seen firsthand how substance use disorder—especially opioid use—has torn apart families and communities across our state, and we need to get serious about tackling this issue in Wisconsin," Evers said in a statement. "I am proud to sign these bipartisan bills into law today that are a step in the right direction, but we know that there is more work we have yet to do."

The bills are part of Marinette Republican Rep. John Nygren's Heroin, Opioid Prevention and Education Agenda. The four bills bring the total number of HOPE Agenda laws to 34.

“While there is always more work to be done, more lives to save, and more avenues to recovery that need opening, today’s actions are another arrow in the state’s quiver to combat substance abuse," Nygren said in a statement.

Nygren also called on the Senate to act on two more bills that passed the state Assembly.

One bill would repeal a sunset for a law that provides some legal immunity for aiders who help a person experiencing an overdose as well as overdose victims. 

The other would create a Medicaid benefit for acupuncture and increase rates for chiropractors and physical therapists.

The bills signed by Evers will:

• Allow county jails to enter into agreements to obtain naloxone and training and require the Department of Health Services to study the availability of medication-assisted treatment for opioid use disorder in county jails and prisons.
• Prevent state employees from being disciplined for using or possessing a controlled substance if they're using it as part of their treatment, require DHS to maintain a registry of recovery residencies and mandate that the residencies allow residents to participate in medication-assisted treatment.
• Extend a sunset date on a mandate that prescribers check the prescription drug monitoring program before issuing a prescription order through April 1, 2025.
• Create a Medicaid benefit for peer recovery coach services and mandate that DHS establish a program to coordinate and continue care following an overdose. 

Evers also signed into law additional healthcare-related bills that will:

• Allow medication or treatment records administered at a recreational camp to be maintained electronically.
• Allow for changes in the supervision of physical therapy and physical therapy assistant students.
• Increase the amount of funding for an award grant program for retired volunteer firefighters, first responders and emergency medical technicians.
• Allow physician assistants, registered nurses and nurse anesthetists to perform official duties of the armed services or federal health services in Wisconsin without being licensed by the state.
• Clarify that reimbursement of patient-incurred expenses in cancer clinical trials aren't considered undue inducement to participate.
• Require the DHS to implement a diabetes care and prevention plan.
• Update state law for respiratory therapists.
• Create a Lyme disease awareness campaign.
• Allow municipalities to increase levy limits to pay for charges assessed by a joint emergency medical services district.

Novel Coronavirus (COVID-19) Policy Priorities

As anticipation grows for more widespread community transmission of COVID-19 in the United States, emergency physicians will be on the frontlines of caring for those affected. In order to help ensure our health care system is prepared, a number of policy changes will need to be implemented to address the unique needs of this growing public health emergency.

Ensuring access to care for those infected or suspected infected

• Consider implementing alternative testing sites for faster, more cost-effective testing while freeing up hospital capacity for those who need it most and allowing those infected to self-quarantine, should they test positive.
• Alternative sites of care for respiratory patients to reduce contamination of other patients, and to reduce the need for PPE
• Public education on when and where to seek testing (including alternative testing sites mentioned above), when and where to seek care, self-quarantine procedures, home care if infected (including supplies to have on hand, etc), etc.
• Ensure production of medications relevant to treatment of Covid-19 is prioritized and their distribution directly to relevant sites of care is emphasized.

Securing an adequate workforce

• Prioritize availability of personal protective equipment (PPE) for emergency workers and other frontline personnel responding to the epidemic (including EMS, clerical staff, nurses, emergency physicians, etc.).
• Temporarily loosen restrictions on hospital privileging and removing barriers that impede workforce movement across state lines, such as licensure and liability protection.
• Ensure health care workers who become infected receive treatment quickly and readily.

Ensuring adequate resource allocation

• Ensure full coverage of testing and diagnosis by payers without patient cost-sharing.
• Temporarily remove the originating site limitation under CMS telemedicine rules, and add emergency telehealth services to the list of approved Medicare telehealth services.
• Ensure federal and state emergency funding is targeted and distributed beyond hospitals, such as for EMS and emergency and other relevant hospital-based specialty physicians who are not hospital employed.

March 3, Wisconsin Health News

The Wisconsin State Laboratory State Lab and City of Milwaukee Health Department are now able to test for the new coronavirus, health officials said Monday.

Positive test results will be presumed positive and forwarded to the Centers for Disease Control and Prevention for confirmation, according to a statement from the Department of Health Services.

Jeanne Ayers, state health officer and administrator of the DHS Division of Public Health, said the ability to test in the state will allow for faster results to let people with symptoms of the disease know if they have it. 

“Faster test results will also help our epidemiologists and local health departments monitor people suspected of having the virus and other people who may have been exposed to it,” she said in a statement.

She added that the risk remains low.

So far, there’s only been one confirmed case in the state. They were released from isolation last Friday after testing negative for the virus twice.

The agency has investigated 21 state residents for the virus. Eighteen tested negative, and two test results were pending as of Monday afternoon.

Tom Haupt, respiratory disease epidemiologist and influenza surveillance coordinator, told reporters that the flu season is also peaking in Wisconsin, with more than 500 hospitalizations in the last week. He called that “amazing for this time of year.”

“We want people to be aware not only of the COVID-19, but also the influenza virus that’s currently circulating,” he said on a conference call.

The first few minutes after a major medical emergency are critical for survival, and emergency personnel aren’t always the first ones on the scene.  To educate the general public on basic life-saving skills, the American College of Emergency Physicians (ACEP) created Until Help Arrives, a one-hour training course taught by emergency physicians in their local communities.  More than 470 certified instructors are now participating across the country. 

Visit ACEP's Until Help Arrives website at untilhelparrives.org, which is being developed as a helpful tool for instructors as they prepare to plan for and host trainings.  Instructor resources are currently being distributed by Simulab through an instructor portal. 

Sam Shahid, MBBS, MPH
Practice Management Manager, ACEP

ACEP would like to provide you with very brief synopses of the latest articles and articles coming soon to Annals of Emergency Medicine. Some of these have not appeared in print. These synopses are not meant to be thorough analyses of the articles, simply brief introductions. Before incorporating into your practice, you should read the entire articles and interpret them for your specific patient population. View synopses here.

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

Multiple WACEP members represented our specialty at this year’s Doctor Day, meeting with their legislators to discuss issues relevant to the house of medicine. We were also able to collaborate with physicians of all stripes from around the state. It’s such a pleasure to meet with other docs and discover that we are facing many of the same issues across the full spectrum of medicine and come together to advocate for the health of our state.  This year, over 315 Wisconsin physicians met with their local legislators, covering 31 of 50 State Senators, and 57 out of 99 Assembly members.

One of the most popular breakout sessions at Doctor Day was a legislative update, and one of the most-talked-about topics was the CARES act. For those who are not aware, the CARES act was put forth by the Wisconsin Academy of Physician Assistants (WAPA) with the goal to improve parity with nurse practitioners in the state, who currently enjoy significantly more autonomy than PAs. The Wisconsin Hospital Association strongly supports the bill, as it makes it easier for hospitals to employee PAs. The bill removes the currently mandated ratios of physicians to PAs, changes the PA-physician relationship to one of “collaboration” rather than “supervision”, and allows PAs to work remotely from their collaborating physician. At the time of Doctor Day, several provisions in the bill were causing concern amongst physicians, including a titling change which would allow PAs to call themselves “Associate Physicians”, and the creation of an independent PA licensing board separate from the medical licensing board (NPs are licensed through the Nursing Board). Also controversial was the language surrounding the collaboration agreement between a PA and a physician. 

The Wisconsin Medical Society (WMS) has been negotiating with WAPA and the bill sponsors to alter some of the more problematic portions of the bill. An updated version of the bill stripped out the title changes, and supports the creation of an associate PA board, underneath the state Medical Board – similar to how Podiatry currently has an associate board in the state. The associate board would not be permitted to expand the scope of practice of PAs without the approval of the Medical Board. The language around the collaboration agreement also was changed to ensure that a physician can provide collaborative care for a patient cared for by a PA within a medically reasonable amount of time. With these changes in place, WMS supported the bill, and it quickly passed both the Assembly and Senate, and awaits signature by Governor Evers.

In other legislative news, the US House of Representatives seems highly motivated to pass an Out-of-Network Bill this year. For some background, if this legislation ends up being unfavorable for EM physicians, it could cause the biggest disruption in Emergency Medicine since EMTALA went into place in the 80s! National ACEP has been working hard to push for fair compromise and promote negotiation between physician groups and insurers and avoid price-fixing. The insurance industry has been swinging their considerable political weight and lobbying coffers into this, so it is vital that EM physicians take a strong stand in response. If insurers get their way, we can expect EM compensation to drop considerably nation-wide, and the patient safety-net of Emergency Departments to disintegrate.

Several House committees have developed bills with various levels of favorability. First, the bad: The Education and Labor Committee has put forth a bill that sets the lower limit to allow arbitration between physicians and insurance companies at $750, far above most ED bills, essentially locking out emergency care from this solution. ACEP is understandably opposed to this bill. There is, however, a more promising bill coming from the Ways and Means Committee, known as “Consumer Protections Against Surprise Medical Bills Act of 2020”. This bill has no threshold, and is the most fair bill to EM physicians because it encourages robust insurance networks to help protect patients. ACEP supports this bill, and it moved out of committee on February 12th. Now the full House must reconcile these bills and amend them before going forward with a full House vote.

It is vital that our Wisconsin legislators hear from Emergency Physicians on these bills! Please write, call, meet with, or email your house legislator today, and let them know that you support the protections offered to patients in the Ways and Means Bill. In particular, ACEP is still pushing for some amendments to that bill, so it essential that Wisconsin representatives Ron Kind (WI 3 – Western WI) and Gwen Moore (WI 4 -Milwaukee) hear from their EM physician constituents. The only Wisconsin representative on the Education and Labor Committee is Glenn Grothman (WI 6 -Eastern WI) so if you are in his district, be sure to let him know the reasons you oppose the bill coming from his committee.

It has been a surprisingly busy winter in terms of legislation both at the state and federal level, but you can count on WACEP to keep you up-to-date on the issues that matter to you and your patients!

Wisconsin ACEP is planning a second Rural Outreach Program on Friday, June 19, 2020 as part of an initiative to engage emergency physicians in more rural and remote practice settings for education, networking and fun.

Save the date and plan to join us on Friday, June 19th at Marshfield Medical Center, Rice Lake.

The program will have a pediatric focus with updates on Peds ICU, Peds Trauma, Best Practices in Burn Care, and much more! Whether you practice in that part of the state or elsewhere, join us and learn the unique challenges and opportunities in more rural settings. You'll likely discover that despite differences in transfer times and resources, many more similarities actually do exist across practices, regardless of location.

Save the date of Friday, June 19 and plan to make a weekend of all that is offered in beautiful Northwest Wisconsin! Program registration will be open soon, and will include optional social and/or family excursions. 

March 1st is the deadline to submit nominations for ACEP Leadership and Excellence Awards. Learn more and submit a nomination.

Nominations are also being accepted through March 1st by ACEP's Council Awards Committee for the following Awards:

• Council Teamwork Award 
• Council Horizon Award
• Council Curmudgeon Award
• Council Champion Award in Diversity & Inclusion 

Descriptions of the Council awards can be found online. and nominations may be submitted here.