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Capitol Update: Rural health care matters in the 17th Senate district
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The vast majority of the 17th Senate District is rural. The senate district I represent is one of the largest in the state of Wisconsin, with all or parts of nine counties. The residents of these nine counties face special challenges when it comes to seeking and receiving the health care they need. Larger cities naturally draw medical talent, resources and investment, but there are crucial needs in our rural communities. As your state senator, I am seeking ways to improve the environment for medical professionals in our rural communities and finding opportunities to make our laws better meet our real-world needs.

One such need is a bill that makes Wisconsin a member of the Interstate Medical Licensure Compact. This compact creates a voluntary licensing option with an expedited licensing process for physicians to practice in multiple states. The licensing process moves faster and accounts for "static qualifications" such as medical education, graduate medical education, and results of medical or licensing examinations, that are the same in most states.

By becoming part of this compact, Wisconsin will be able to better recruit and retain physicians in our rural communities. This licensing option is particularly important to the 17th Senate District because our borders touch Iowa and Illinois; we are also close enough to Minnesota to realize an impact from our neighbors to the west. All of our neighboring states are already participants in the compact and in Wisconsin, the compact has received broad support from the medical community, including hospitals, physicians, and clinics.

Enacting the compact will allow doctors to grow their practices and serve a larger number of patients in our rural communities. It will also allow Wisconsin hospitals and clinics to recruit medical professionals from neighboring states by streamlining the licensing process. I was proud to co-sponsor this legislation.

Licensing is also an issue when it comes to emergency medicine. In response to concerns from southern townships in Lafayette County, I co-authored Senate Bill (SB) 210 last spring to allow an Illinois-based Emergency Medical System service, just over the border in Illinois, to respond to an emergency call in Wisconsin when they are the closest response team.

In Lafayette County, there are several townships that are closer to Illinois-based EMS than they are to Wisconsin-based EMS. Complications in licensing prevented an Illinois provider from serving Lafayette County even though it is simply faster to have an EMS service over the border in Illinois respond to the call.

When it is a matter of life and death, a state border should not get in the way of saving a person's life. My main concern, when reviewing this situation, is not who responds; it is that someone responds. Gov. Scott Walker signed this bi-partisan bill earlier this year to exempt limited EMS services in certain situations. I was proud to make this common sense change to the law so that our rural residents are better covered for emergency medical situations.

But this isn't our only challenge when it comes to EMS services in rural Wisconsin. Recruiting local people to serve as Emergency Medical Technicians is becoming more and more difficult. Several local groups have told me that the training requirements for EMT licensing have made it difficult to recruit new people because of the time it takes to become licensed. As the training requirements increase, the number of volunteers in rural communities decreases.

In our rural communities, the majority of EMS personnel are volunteers. They give their time and talent to protect their families, friends, neighbors and visitors. They want to help.

However, the amount of time it takes to become licensed as an EMT has steadily increased over the last 30 years. The state has added a lot of training and information that goes well beyond the realistic needs of our rural EMTs. I am working with our communities and my legislative colleagues to find ways to improve the training program to make it easier for rural EMS to recruit members and train responders so that our communities are covered for emergencies.

I have also worked with my colleagues to insure that our rural communities are served by hospitals. Last year, hospitals employed about 107,000 people in Wisconsin. The average salary for those individuals working in health care is higher than the average wage for all occupations. In 2013, a typical worker in Wisconsin earned $44,690 and the average employee in the health care industry in Wisconsin earned $58,300. In many areas of the state, the hospital is the largest employer in many communities. In our area of the state, hospital employment represents 3.9 percent to 4.7 percent of total employment.

In the state budget, I supported two important provisions that help rural hospitals. The first was an additional $33 million in payments from the state for hospitals that saw a disproportionate share of Medicaid patients. They currently do not receive full reimbursement for these patients. There is one of these hospitals in almost every county I represent.

The second provision was the retention of the Rural Physician Residency Assistance grant program through the University of Wisconsin-School of Public Health for medical students that spent their residency working in a rural or underserved area in Wisconsin. Grant recipients have gone on to serve in our communities at Monroe Clinic, Grant Regional Health Center, Dean Clinic-Dodgeville and Richland Medical Center.

Through the support for initiatives such as the Interstate Medical Licensure Compact, the Rural Physician Residency Assistance Program, and additional funding for disproportionate share hospitals, the state is able to facilitate an environment that helps foster one of its strongest industries. I will continue to work on new ways to ensure that the people in our communities receive the access they need to quality health care.

For more information and to connect with me, visit my website and subscribe to my weekly E-Update by sending an email to Do not hesitate to call 800-978-8008 if you have input, ideas or need assistance with any state-related matters.

- Sen. Howard Marklein represents Wisconsin's 17th Senate District. His column is published Mondays in the Times.