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  • May 11, 2020 7:51 AM | Deleted user

    In the podcast, Taking Care of Yourself: Mental Health in the Time of COVID-19,  Dr. Ryan Stanton talks with Dr. Jack Rozel, Medical Director at Resolve Crisis Services and President of the American Association of Emergency Psychiatry.

  • May 04, 2020 2:21 PM | Deleted user

    May 4, Wisconsin Health News

    Gov. Tony Evers announced a plan Monday to make Wisconsin one of the top states for COVID-19 testing per capita. 

    Evers said the state is prepared to provide 85,000 tests per week.  

    “We want every Wisconsin resident who needs a test to get a test,” Department of Health Services Secretary-designee Andrea Palm told reporters. 

    As of Monday, the state has already provided more than 60,000 tests to hospitals, clinics, local public health departments, long-term care facilities and others.

    Fifty-seven of the state’s counties have requested and are getting supplies. 

    Other key components of the plan, according to a statement from the governor’s office, are: 

    • Providing free testing and diagnostics to Wisconsin’s 373 nursing homes to test all nursing home residents and staff. The goal is to test more than 10,000 residents and staff per week during the month of May. 
    • Working with the Wisconsin National Guard and local health groups to test all workers and families linked to outbreaks. 
    • Increasing the number of free drive-thru community testing sites throughout the state.
    • Mobilizing 15 more National Guard units to help local health departments set up testing sites and respond to outbreaks. That would bring the total number of National Guard units working on testing to 25. 
    • Providing free tests for state-sponsored test sites for those experiencing COVID-19 symptoms. No doctors’ visits will be required at sites sponsored by the National Guard.  
    • Providing test supplies to all Wisconsin healthcare systems. As of Monday, the state has provided 41,255 tests to healthcare systems. 
  • May 04, 2020 11:00 AM | Deleted user

    April 30, Medigram, Wisconsin Medical Society

    Settlers Bank is a Wisconsin business focused on serving the needs of physicians and clinics throughout the state. In order to best serve those needs during this time, they will assist physicians and clinics with questions regarding the SBA/PPP loan application process – even if they are not a current client.

    To use Settlers Bank for the SBA/PPP loan application process, a physician or clinic is simply required to open an operating account and have a conversation about their overall banking needs. Settlers Bank also works closely with the clinic’s CPA to help determine the qualified loan amount as well as financial modeling.

    Settlers Bank offers a one-call approach to the medical community, because they understand that now more than ever time is of the essence. 

    Anne Fink, CFP® is a private banker specializing in working with physicians. Contact Anne at afink@settlerswi.com or 608.842.5025. To learn more about Settlers Bank click here.

    Settlers Bank is MEMBER FDIC

  • April 23, 2020 10:16 AM | Deleted user

    April 23, Wisconsin Health News

    Wisconsin emergency rooms are seeing a decline in visits since the start of the COVID-19 pandemic, which providers attribute to a drop in injuries and respiratory illnesses due to social distancing, a boost in telehealth and fear of potential exposure to the new coronavirus. 

    “It’s a little amazing - what used to be an emergency or an urgent care visit isn’t there anymore,” Froedtert Health CEO Cathy Jacobson said during a Wisconsin Health News webinar last week. “It’s just not coming in.” 

    Health systems throughout the state say they’ve seen emergency department visits drop by around half during the pandemic. And the patients that emergency rooms are seeing tend to be sicker and more likely to need hospital care.

    Providers stress that they've taken measures to protect patients from possible COVID-19 infection. 

    Dr. Joshua Ross, executive vice chair of the BerbeeWalsh Department of Emergency Medicine at the University of Wisconsin School of Medicine and Public Health, said nationally emergency room visits are down around 50 percent. UW Health isn’t different. 

    Ross said they’ve spent a lot of time in preparation to make sure that emergency rooms can separate those with COVID-19 symptoms from those who don’t, as well as cleaning rooms and having appropriate personal protective equipment. He said the fact that visits are lower is good for preparation purposes.

    “But it’s also somewhat concerning because we know that there’s probably people out there with small heart attacks and strokes that aren’t seeking care," he said.

    Ross noted that volumes may be down because there aren’t influenza and other seasonal infections due to social distancing measures. They’re also not seeing traffic accidents or sports-related injuries. 

    He said they’re concerned about people not seeking care, adding that there are risks at home, including concerns around mental health and domestic violence.

    “We still have to be vigilant in terms of making sure our healthcare infrastructure and support systems are in place,” he said.  

    Ashley Lyman, Bellin Hospital's emergency department team leader, said visits are about half of their pre-pandemic normal, and hospital admission rates are up 5 to 10 percent. Part of that has to do with staying home, which is lowering the spread of contagious diseases. 

    Other factors could be expanded telehealth services that help triage patients to the appropriate level of care, patients being afraid to come to the department during the epidemic and suspension of elective care, which means fewer people coming in due to complications. 

    No school and limited daycare options could also be playing a role, as children with fevers aren’t able to go back to school or daycare the next day, she noted. 

    Dr. Michael Dolan, executive vice president at Gundersen Health System, said their emergency room volumes are down about 45 percent.

    He said they opened a respiratory clinic for people under investigation for COVID-19 where they’re sending patients who might otherwise head to an emergency room. 

    Dolan noted that their trauma cases are similar to what they normally see, while other hospitals have seen a decline due to fewer road accidents.

    “I think we’re making up for that in non-motor vehicle accident trauma,” he said. “We’re a rural area. Farmers are really trying to get out in the fields and get started with their crops. We see some farming-related trauma, some ATV-related trauma, things people can get into trouble with at home.” 

    Dolan said they also haven’t seen a decline in heart attacks as well as stroke numbers. But they’re seeing fewer patients with mild heart failure or mild infectious disease. 

    During the last six months, the emergency department at Children’s Wisconsin has seen a 60 percent decrease in the number of kids they’d expect this time of year. Spokesman Andy Brodzeller said part of that is expected, due to closed playgrounds and families driving less. 

    He added that families may be choosing other options, like online urgent care or reaching out to a primary care doctor.

    Dr. Brian Hoerneman, Marshfield Medical Center-Marshfield vice president of medical affairs, said part of their 40 percent drop in emergency department use could be a decline in illness due to social distancing.

    But he said that some of it appears to be people not seeking care when they need it. 

    “In conditions such as heart attacks and strokes, the window for treatment is narrow,” he said in an email. “Time is of the essence and outcomes worsen for every hour that treatment is delayed."

    Hoerneman stressed that the emergency department is safe for patients, and that telehealth is available to help people assess their medical situation. 

    Aspirus Wausau Hospital Emergency Department Director Robin Rudie echoed concerns that the decrease they're seeing in visits and the increase in severity could be due to fear of exposure of the virus.

    “We wouldn’t typically expect the pandemic to reduce our overall volumes,” she said in remarks to the media.

    Health systems stressed that emergency rooms are safe. LeeAnn Betz, a spokeswoman for Advocate Aurora Health, said that they’re taking all precautions to protect their health and safety, including separating COVID-19 patients from those with other symptoms or injuries. 

    “Staying home, ignoring the symptoms and suffering out of fear of COVID-19 is a risk people shouldn’t take with their health” Dr. Gregory Brusko, Ascension Wisconsin Chief Clinical Officer, said in a statement.

  • April 20, 2020 5:01 PM | Deleted user

    Governor Evers today announced Wisconsin's "Badger Bounce Back" plan which outlines important criteria for Wisconsin to be able to reopen its economy in phases and includes steps to make sure workers and businesses are prepared to reopen as soon as it is safe to do so. In coordination with this announcement, at the direction of the governor, Wisconsin Department of Health Services Secretary-designee Andrea Palm issued Emergency Order #31 establishing the process and outlining the phases of the plan. The emergency order is available here.

    The Badger Bounce Back plan is informed in part by the President's Guidelines for Opening Up America Again that was issued by the White House on April 16, 2020. Currently, Wisconsin does not meet the criteria the White House established to start reopening our state. The Badger Bounce Back plan takes important steps to get the state of Wisconsin there. 

    The goal of the Badger Bounce Back plan is to decrease cases and deaths to a low level, and increase capacity in our healthcare system so the phased reopening of businesses is possible. As part of that plan the state will be working to increase access to more testing and expand lab capacity. Under the Badger Bounce Back plan, everyone who needs a test should get a test. The state is setting a goal of 85,000 tests per week, averaging about 12,000 tests per day. More information on the state's testing efforts was released earlier today, and is available for review 
    here.

    Next, the state will be expanding contact tracing and more aggressively tracking the spread with the goal of every Wisconsinite who tests positive being interviewed within 24 hours of receiving their test results and their contacts being interviewed within 48 hours of test results.


    Additionally, the state will continue to pursue every avenue to grow Wisconsin’s supply of personal protective equipment (PPE) for healthcare and public safety entities to conduct COVID-19 testing, patient care, and public safety work. Finally, the plan works to bolster healthcare system capacity where patients can be treated without crisis care and there are more robust testing programs in place for at-risk healthcare workers. 

    The state will be looking for a downward trajectory of influenza-like illnesses and COVID-19 symptoms reported within a 14-day period, and a downward trajectory of positive tests as a percent of total tests within a 14-day period. When the state has seen these efforts be successful, Wisconsin can begin to turn the dial, re-open the state, and get businesses and workers back on their feet.

    The Badger Bounce Back plan is available here. The Wisconsin Economic Development Corporation’s portion of the Badger Bounce Back plan aimed at helping to ensure workers and businesses are prepared and ready to bounce back is available here. The Badger Bounce Back plan in brief is also available here.

  • April 16, 2020 1:56 PM | Deleted user

    Gov. Tony Evers today directed Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm to extend the Safer at Home order from April 24, 2020 to 8 a.m. Tuesday, May 26, 2020, or until a superseding order is issued. The order implements some new measures to ensure safety and support the progress we've made in containing COVID-19, but also allows certain activities to start up again. The order is available here

    “A few weeks ago, we had a pretty grim outlook for what COVID-19 could mean for our state, but because of the efforts of all of you, Safer at Home is working. That said, we aren't out of the woods just yet,” said Gov. Evers. “As I've said all along, we are going to rely on the science and public health experts to guide us through this challenge. So, as we extend Safer at Home, I need all of you to continue doing the good work you've been doing so we can keep our families, our neighbors, and our communities safe, and get through this storm together.”

    “Before we lift Safer at Home, the steps of testing and more robust public health measures must be in place,” explained Secretary-designee Palm. “These steps will help us reduce the risk of a second wave of the virus. If we open up too soon, we risk overwhelming our hospitals and requiring more drastic physical distancing measures again.”

    The extension of the Safer at Home order includes a few changes. Some changes allow more businesses and activities to open back up, while other changes help make businesses safer for employees and customers. The changes in this order include: 

    Businesses and activities ramping up service and operations:

    • Public libraries: Public libraries may now provide curb-side pick-up of books and other library materials. 
    • Golf Courses: Golf courses may open again, with restrictions including scheduling and paying for tee times online or by phone only. Clubhouses and pro shops must remain closed.
    • Non-essential Businesses: Non-essential businesses will now be able to do more things as Minimum Basic Operations, including deliveries, mailings, and curb-side pick-up. Non-essential businesses must notify workers of whether they are necessary for the Minimum Basic Operations.
    • Arts and Crafts Stores: Arts and craft stores may offer expanded curb-side pick-up of materials necessary to make face masks or other personal protective equipment (PPE). 
    • Aesthetic or Optional Exterior Work: Aesthetic or optional exterior law care or construction is now allowed under the extended order, so long as it can be done by one person.

    Safe Business Practices:

    • Safe Business Practices for Essential Businesses and Operations: Essential Businesses and Operations must increase cleaning and disinfection practices, ensure that only necessary workers are present, and adopt policies to prevent workers exposed to COVID-19 or symptomatic workers from coming to work.
    • Safe Business Practices for Retailers that Essential Businesses and Operations: Retail stores that remain open to the public as Essential Businesses and Operations must limit the number of people in the store at one time, must provide proper spacing for people waiting to enter, and large stores must offer at least two hours per week of dedicated shopping time for vulnerable populations.
    • Supply Chain: Essential Businesses and Operations that are essential because they supply, manufacture, or distribute goods and services to other Essential Businesses and Operations can only continue operations that are necessary to those businesses they supply. All other operations must continue as Minimum Basic Operations.

     Other changes include:

    • Schools: Public and private K-12 schools will remain closed for the remainder of the 2019-2020 school year.
    • Local parks and open space: Local health officials may close public parks and open spaces if it becomes too difficult to ensure social distancing or the areas are being mistreated. 
    • Travel: People are strongly encourage to stay close to home, not travel to second homes or cabins, and not to travel out-of-state if it is not necessary. 
    • Tribal Nations: Tribal Nations are sovereign over their territory and can impose their own restrictions. Non-tribal members should be respectful of and avoid non-essential travel to Tribal territory. Local government must coordinate, collaborate, and share information with Tribal Nations. 
    • Duration: The changes in this order go into effect on April 24, 2020. The order will remain in effect until 8 a.m. on May 26, 2020. 

    If you have questions, a Frequently Asked Questions (FAQ) document is available here for your review.

    The public should continue to follow simple steps to avoid exposure to the virus and prevent illness including:

    • Avoiding social gatherings with people of all ages (including playdates and sleepovers, parties, large family dinners, visitors in your home, non-essential workers in your house);
    • Frequent and thorough hand washing with soap and water; 
    • Covering coughs and sneezes;
    • Avoiding touching one's face; and 
    • Staying home.

    This is a rapidly evolving situation, and we encourage you and the public to frequently monitor the DHS website. We encourage you to follow @DHSWI on FacebookTwitter, or dhs.wi on Instagram. Additional information can be found on the CDC website.

  • April 15, 2020 1:41 PM | Deleted user

    The State Legislature passed, and the Governor has signed, the state's COVID-19 response package, which includes liability immunity provisions. A late amendment broadens the measure and ensures there is no ambiguity about protections applying to COVID and non-COVID patients alike.  

    The legislation also includes provisions that will help the state draw down additional federal dollars for Medicaid as well as a provision related to out of network billing.  

    Below is the liability immunity language as adopted.

    SECTION 98. 895.4801 of the statutes is created to read:

    895.4801 Immunity for health care providers during COVID-19 emergency.

    (1) DEFINITIONS. In this section:

    (a) “Health care professional” means an individual licensed, registered, or certified by the medical examining board under subch. II of ch. 448 or the board of nursing under ch. 441.

    (b) “Health care provider” has the meaning given in s. 146.38 (1) (b) and includes an adult family home, as defined in s. 50.01 (1).

    (2) IMMUNITY. Subject to sub. (3), any health care professional, health care provider, or employee, agent, or contractor of a health care professional or health care provider is immune from civil liability for the death of or injury to any individual or any damages caused by actions or omissions that satisfy all of the following:

    (a) The action or omission is committed while the professional, provider, employee, agent, or contractor is providing services during the state of emergency declared under s. 323.10 on March 12, 2020, by executive order 72, or the 60 days following the date that the state of emergency terminates.

    (b) The actions or omissions relate to health services provided or not provided in good faith or are substantially consistent with any of the following:

    1. Any direction, guidance, recommendation, or other statement made by a federal, state, or local official to address or in response to the emergency or disaster declared as described under par. (a). 
    2. Any guidance published by the department of health services, the federal department of health and human services, or any divisions or agencies of the federal department of health and human services relied upon in good faith.

    (c) The actions or omissions do not involve reckless or wanton conduct or intentional misconduct.

    (3) APPLICABILITY. This section does not apply if s. 257.03, 257.04, 323.41, or 323.44 applies. 

  • April 14, 2020 9:26 AM | Deleted user

    Brad Burmeister, MD, an emergency physician and President-Elect of Wisconsin ACEP, continues his COVID-19 discussion with Fox 11-Green Bay "Good Day Wisconsin" morning show.  View interview here


  • April 13, 2020 8:06 AM | Deleted user

    The Emergency Medicine Foundation is awarding funding of up to $100,000 in new research grants on emergency medicine areas related to COVID-19. 

    Topics may include, but are not limited to, the following:

    • Personal Protective Equipment (PPE), including Design, Cleaning, Re-use
    • Ventilator Scarcity
    • Telemedicine
    • Laboratory Testing
    • Rapid Screening, Triage and Testing
    • Clinical Diagnosis
    • Epidemiology of Disease
    • Therapeutics
    • Diagnostic Radiology, including Point of Care Ultrasound
    • Emergency Medicine Workforce, including Safety
    • Emergency Physician Wellness
    • Special Populations, such as High Risk, Homeless, Non-English Speaking, Transplantation Patients

    Proposals are due June 5, 2020.  Learn more and read the RFP.

  • April 10, 2020 8:54 PM | Deleted user

    Governor Evers announced that the state is seeking volunteers to support Wisconsin's healthcare system during the COVID-19 pandemic. Active and retired healthcare professionals and those who wish to help in non-clinical support positions are encouraged to sign up to volunteer through the Wisconsin Emergency Assistance Volunteer Registry (WEAVR)

    The number of patients in Wisconsin who need to be treated for COVID-19 is expected to surge in the coming weeks. Building a network of available volunteers now will greatly reduce the hardships on hospitals and clinics that would not normally have the capacity to care for the increase in patients. 

    Both active and retired healthcare professionals can volunteer for critical clinical roles by entering their information into the WEAVR, a secure, password-protected, web-based volunteer registration system for healthcare and behavioral health professionals. Individuals who are not licensed professionals are also encouraged to sign up to volunteer for non-clinical support positions.

    Volunteers will be assigned to locations across Wisconsin to support ongoing efforts related to the COVID-19 national emergency. Those who are willing to travel should note that when they sign up. All volunteers should also be aware that they will be required to complete a background check.

    The full copy of the Governor’s press release is available online (link).