Hubbard, Wilson, Zelenkova
November 2022

Despite an Election Night that was in many ways shocking; generally speaking, the status quo was maintained in Wisconsin.   While a few legislators who worked well with WACEP did not run again, the political dynamics and the players who were key allies in supporting our policy positions and successful efforts to increase MA reimbursement in the last budget will be returning. 

Governor Evers’ victory, by over three percentage points, marked the first time in thirty-two years that a Wisconsin governor won reelection during a midterm in which the President of the United States was of the same political party.  Attorney General Josh Kaul, won reelection in an even tighter race.  Democrats – comprising the majority parties in Congress - generally faced strong headwinds:  lagging presidential approval ratings, historic trends of voters turning against the party in power at the midterm elections, and of course kitchen table issues like inflation and rising costs.  Despite these factors, voter turnout, especially among young voters, was immense and helped level the tide. 

In other statewide races, incumbent US Senator Ron Johnson narrowly defeated Lt. Gov. Mandela Barnes.  Democrat Doug LaFollette was reelected as Secretary of State by only seven thousand votes.  And republican Jon Lieber was elected as State Treasurer by 1.5% points.  These very close results again proved that Wisconsin, for statewide races, is a very purple state. That’s not the case however in the state legislature.

Election results in the State Assembly and State Sente were very much what we expected to see.  The major question going into the election cycle was whether Tony Evers, if re-elected, would still have enough democrats in at least one house to uphold his vetoes.   While republicans expanded their legislative majorities, democrats did manage to protect the democratic governor’s veto power.  

In the State Assembly, Republicans expanded their majority to 64-35, two less than what they needed to become “veto proof”.   Assembly Democrats lost a net three seats, two open seats in the northern part of the state held by retiring democrats and one incumbent, Rep. Don Vruwink of Milton, who was forced to run in a mostly new area due to redistricting. 

In the State Senate, Republicans gained one seat where former state representative Romaine Quinn defeated Kelly Westlund.  This victory expanded republican numbers to a 22-11 super majority.  Democrats were unable to answer in the open 5^th Senate district (Brookfield area) or the open 19^th Senate district (Appleton area).  Both of those seats were held by republicans and will stay that way.  

Overall, there are 24 new members of the state assembly and 4 new members of the state senate (three of whom were previously representatives in the state assembly).  

In addition to the US Senate race on the federal level, all congressional republicans were re-elected as were democrats who were running again.   Republicans picked up the one open congressional seat where Derick Van Orden defeated Brad Pfaff to replace retiring democrat Ron Kind.  The WI congressional delegation is now comprised of six republicans and two democrats in the House of Representatives.

Inauguration and the start of the 2023-2024 Wisconsin legislative session will be in early January.  If you are not sure who your state legislators are, please follow this link https://legis.wisconsin.gov and enter your address at “Who are my Legislators?”

Voting is a cornerstone of American democracy and gives citizens a voice in choosing the elected officials whose decisions impact us, not only personally, but often professionally for those who work in highly regulated industries. With that in mind, take a few minutes to educate yourself on what you need to know to cast your vote on Election Day – Tuesday, November 8^th.

• Wisconsin allows both traditional absentee voting, as well as early in-person voting, which starts today, Tuesday, October 25th. 
• Anyone can request an absentee ballot in Wisconsin. Click here to make the request electronically.
• Click here to find out additional information on how to cast an absentee ballot in-person between now and the Sunday before election day.
• Your election day polling place can be found here. 
• If you still need to register to vote, it’s not too late, you can register to vote in-person on election day.  Click here to find out what is required to register.
• Enter your home address here to find out which candidates will be on your ballot

Dear WACEP Members,

I hope that October is bringing you more treats than tricks thus far, although this early respiratory season sure feels like a nasty trick.  I wanted to start this month’s message with an update of the ACAEP Scientific Assembly that occurred the last week of September in San Francisco.  Thank you all who made it out for the WACEP reception—what a great night.  There was also some very important business conducted at a successful two-day ACEP Council Meeting.  The selection of college leadership and the discussion and voting on 65 resolutions by the representatives of each chapter and section helps to direct the future of the college in order to best represent each ACEP member.  This year, that included:

• 45 Resolutions adopted with 4 others referred to the Board of Directors. This includes several resolutions addressing the reproductive rights. If you are interested in reviewing these resolutions, they can be found here. 
• The selection of Aisha Terry, MD as the ACEP President Elect. For those of you who remember, Dr. Terry was a speaker at our WACEP Spring Symposium in 2021.
• The inauguration of Christopher Kang, MD as the WACEP President.
• The election of four ACEP Board of Directors members: Jeffrey M. Goodloe, MD, FACEP (incumbent), Gabe Kelen, MD, FRCP(C), FACEP (incumbent), Kristin McCabe-Kline, MD, FACEP, and Ryan Stanton, MD, FACEP, (incumbent).

The last thing that I want to emphasize is that voting for the midterm elections is rapidly upon us with in-person voting taking place on November 8th. WACEP has a very active PAC (political action committee) that works hard to create relationships with government representatives in order to represent our chapter’s interests and this has paid huge dividends in recent years with some big wins for WACEP. Please consider donating to the PAC, but also please make sure that if you get out to vote on November 8th to represent your individual interests (if you have not already done so by absentee ballot). There are several high-profile races and this is one of the best ways to make sure your voice is heard while our state addresses some critical issues in the years to come.

Thanks as always for everything you all do and of course Trick or Treat!!

Best,

Brian

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With many questions surrounding the status of Wisconsin’s abortion-related law following the U.S. Supreme Court’s Dobbs decision in June 2022, the Wisconsin Medical Society (WisMed) is offering members a special webinar with legal experts to describe the current legal landscape. Attorneys from the Madison law firm Pines Bach will present “Providing Patient Care Post-Dobbs: A Look at Wisconsin Abortion Law” live at noon on Tuesday, September 20, including time for Q&A. The presentation will also be recorded and available on-demand for a limited time.

Register for this members-only event here. There is no cost for this WisMed member benefit. If you have questions about the current status of Wisconsin law you think should be covered in the program, please contact WisMed Chief Policy and Advocacy Officer Mark Grapentine, JD.

About the legal experts, Pines Bach attorneys Diane M. Welsh and Leslie A. Freehill:

Attorneys Diane Welsh and Leslie Freehill of Pines Bach LLP

Attorney Diane Welsh is a partner at Pines Bach LLP, where she advises clients on a variety of matters, including government and health law, and represents clients in all levels of litigation. Prior to joining Pines Bach, Diane served as Chief Legal Counsel for the Wisconsin Department of Health Services and as assistant attorney general at the Wisconsin Department of Justice. Attorney Leslie Freehill is an associate at Pines Bach, where she practices in the areas of civil litigation, administrative law and appeals. Prior to joining Pines Bach, she served as a staff attorney for the Dane County Circuit Court

Wisconsin Meetup @ ACEP22
Sunday, October 2, 2022
7:00-10:00 pm
Black Hammer Brewing
544 Bryant Street | San Francisco, CA

Join your Wisconsin colleagues for drinks and light snacks at this annual WACEP reception during ACEP's Annual Meeting.

This year's event will take place at Black Hammer Brewing, about a half mile from the Moscone Convention Center. The event is complimentary, but please RSVP if you plan to attend.

RSVP Here

Wisconsin Medical Society
August 18, 2022

The state of Wisconsin Medical Examining Board (MEB) put the final touches on its revamped chaperone rule for sensitive physical exams at its monthly meeting August 17, significantly scaling down the proposal’s scope following individual physician and Wisconsin Medical Society (WisMed) advocacy ever since the potential rule was first discussed in April 2021. The current version of the rule would require physicians to post their clinic/office’s chaperone policy “in at least one location reasonably likely to be seen by all affected patients.” If a self-employed physician does not have a chaperone policy, the rule requires the physician to create one and follow the posting requirements. The rule does not specify any parameters for what a chaperone policy must include – those decisions are left to the physician or their employer.

The MEB grappled with a thorny issue inherent in a state where so many physicians are employed by large health care systems: what if the physician has little or no control over their employer’s practice of posting a chaperone policy?

“My specific question on this new language is that it does put some of the onus on the physician to make and post the copy of these rules – which is effective in a small practice or a clinic where a physician has more control over those things,” said MEB member Emily Yu, MD. “But many people practice in an environment where that's more of a hospital responsibility of posting procedures – and so how would an individual physician be affected if their hospital corporation didn't comply with some of this language?”

Wisconsin Department of Safety and Professional Services legal staff acknowledged that the MEB’s authority does not extend to hospitals or non-physician employers – prompting MEB public member Rachel Sattler to ask, “Wouldn't this compel the hospitals to actually do that as well?”

”One would hope,” replied the MEB’s Sumeet Goel, DO.

“Sometimes it's difficult for an individual physician in a big corporation to make sure those things happen,” Dr. Yu said, “and I don't think it's fair to ask a physician to be responsible for that – not that it shouldn't stay in this language, but I think it's a consideration as far as who is actually responsible for that part of the process if a complaint is filed against a physician in that situation,” Dr. Yu said.

“If there is a complaint directed at a specific doctor for not having this posted in the hospital, we have the discretion to handle that,” Sattler said. “And if their position is ‘I don't control what the hospital does,’ that seems legitimate.”

Following discussion, the MEB unanimously approved moving forward with the new rule language, triggering another public comment process. The first step will be an Economic Impact Assessment period where physicians and other entities can comment on the projected fiscal effects of complying with the new rule. Following that feedback, the MEB can decide whether to continue moving forward with the proposal. If it decides to do so, the MEB would schedule a public hearing as part of a future MEB monthly meeting. Stay tuned to future editions of Medigram for news of when these comment periods are officially scheduled.

Elected officials are heading back to their districts for the month check out ACEP's Advocacy At Home: August Recess Toolkit can help you set and prepare for local meetings with federal legislators or staff. This is a great time to share your stories that personalize our calls for policy changes. 

Your PAC has had a busy summer prior to the mid-term elections. We are just short of our goal of $20,000 for this election cycle having raised about 75% of our goal. Your PAC board has been busy visiting multiple campaign events the last few months to discuss issues important to emergency physicians.

  

Photo captions:
Wisconsin Emergency PAC board member attends a fundraiser for Tammy Baldwin which was sponsored by NEMPAC 

Wisconsin Emergency PAC members attend a fundraiser for Tony Evers.

Wisconsin Emergency PAC board member attends a fundraiser for Andrew Thomsen a republican candidate for state senate in the Fox Valley area.

Contribute to the PAC Today!

Wisconsin Medical Society
July 21, 2022

The 988 Suicide & Crisis Lifeline (Lifeline), a free, confidential behavioral health and support line is now available. Anyone can utilize the Lifeline at any time by calling 988 (multiple languages available), texting a message to 988 (English only), or using the chat feature at 988lifeline.org (English only). People can connect with a trained crisis counselor to get help for themselves or a loved one experiencing a crisis, such as is thoughts of suicide, a mental health concern, substance use issue or any kind of emotional distress.

Additional details about the Lifeline:

• Wisconsin Lifeline counselors are trained to reduce stress, provide emotional support and connect people with local resources.
• The 988 Suicide & Crisis Lifeline is available to use at no cost to Wisconsin residents. Additional care or intervention may come with a cost.
• Wisconsin Lifeline is not able to send an in-person response directly. An in-person response requires a transfer to another service and could involve law enforcement.
• Calls, texts and chats with Wisconsin Lifeline are confidential between the person and counselor, unless there is imminent danger for the person or others.

Jerry Halverson, MD, DFAPA, WisMed Board Chair and Rogers Behavioral Health Chief Medical Officer, told Fox6, "The purpose of 988 is to help you get over that crisis point, and get you someone that can help you more definitively. This is going to open up access to a lot of people who wouldn’t have taken advantage in the past. It can be a game-changer."

The 988 Suicide & Crisis Lifeline is a network of more than 200 support centers around the country. Contacts not answered by in-state partners roll over to a national backup system. The Wisconsin Lifeline has helped ensure that as many contacts as possible are answered by Wisconsin-based counselors who have the best understanding of local communities, cultures and resources. 

Learn more about Lifeline here.