Wisconsin health care is bleeding. Tony Evers' vetoes only worsen trauma. | Opinion
While it's not something we look back on fondly, there are things we adopted during the COVID-19 pandemic that just made sense to keep doing: Zoom meetings, giving everyone a little more personal space waiting in line and washing your hands after going to the bathroom.
All kidding aside, there were two things in particular we did in Wisconsin for health care during the pandemic that seem to have worked: Allowing out-of-state mental health providers to treat patients using telehealth services and letting advanced practice nurses operate without physician collaboration agreements.
The temporary rules were part of emergency orders Gov. Tony Evers signed in 2020. The first allowed any mental health care provider outside Wisconsin to work with patients in the state so long as they registered a temporary or permanent license with the Department of Safety and Professional Services within 10 days of working with the patient. The second allowed Advanced Practice Nurses to practice nursing care management without a collaborative agreement. The provisions expired when the state public health emergency ended in May 2023.
They were designed to provide care in a system under incredible strain. Both seemed to have helped a lot of people access care they needed, especially those in rural parts of Wisconsin. While the crisis has passed, the health care system is still stressed.
So it is not surprising extending the provisions won bipartisan support in the last legislative session.
The telehealth bill would have allowed a mental health care provider credentialed in another state to provide telehealth services to patients in Wisconsin. The ARPN Modernization bill would have lifted the requirement to have documented oversight agreements with physicians when treating patients and allowed some APRNs to open independent clinics. The bills passed ? and both were recently vetoed by the governor.
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Gov. Tony Evers vetoed bipartisan bills extending health care provisions
Evers said allowing out-of-state mental health professionals to practice could leave residents with fewer protections if they receive poor quality or unethical treatment. Similarly, he said that the APRN modernization act doesn’t provide enough safeguards to patients.
Both veto statements come across as the governor wanting to protect Wisconsinites, but actually seem to deny the reality that Wisconsin health care is bleeding out. Metaphorically, it's kind of like Evers is turning down a belt to wait for a hospital grade tourniquet in order to fix the problem.
The state does not have enough mental health professionals to meet demand, forcing people to wait months on waitlists before they can see anyone. A 2021 report from Evers’ own Office of Children’s Mental Health found that this was the case even before the pandemic. As of 2021, nearly 70,000 people in Wisconsin have received mental health services. But treatment gaps far exceed this number, with nearly 340,000 Wisconsin adults in need of mental health support not being treated and another nearly 75,000 Wisconsin youths experiencing similar service gaps.
This shortage is exacerbated in rural areas. Buffalo County has 13,300 people for the single mental health provider serving the county. Florence County has a single mental health provider to serve its population of 4,590 people. Allowing Wisconsinites access to telehealth providers from out of state would have shortened wait times for people who need to see someone today, not three months from today.
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Providers closing rural hospitals and clinics across Wisconsin
Similarly, Wisconsin health care systems are closing hospitals and halting services exacerbating the access people in rural areas have to providers. Earlier this year, Prevea Health and Hospital Sisters Health System closed hospitals and clinics in Eau Claire and across the Chippewa Valley. Marshfield Clinic Health System halted services. Across the country, more than 600 rural hospitals are at risk of closing in the near future, according to the Center for Healthcare Quality & Payment Reform.
The ARPN Modernization Act could have licensed over 8,000 Advanced Practice Registered Nurses, many who are the sole point of care in rural and underserved communities. This bill would have improved rural Wisconsinites access to healthcare that is otherwise a further and further drive for many to get to.
It’s understandable that protections and safeguards should be in place before allowing folks to practice haphazardly. But when you split hairs over details in bills that would have immediately alleviated some of Wisconsin’s biggest health care obstacles, you’re getting in the way of improving the access to timely care.
These were both readily available solutions that succeeded during COVID, and just like washing your hands for a full 20 seconds, it makes sense to keep doing them.
Kristin Brey is the "My Take" columnist for the Milwaukee Journal Sentinel.
This article originally appeared on Milwaukee Journal Sentinel: Wisconsin needs access to care. Evers vetoed bills that would help