Health Care Provider Advisory Committee Meeting Minutes

Aurora Medical Center

January 31, 2014

Present: Mary Jo Capodice DO,  Amanda Gilliland ,  Maja Jurisic MD , Peter Schubee DC, James O'Malley= Acting Chair, Jennifer Seidl , Sri Vasudevan MD

Excused: Barbara Janusiak RN, Mike Lischak MD, Jeff Lyne DC, Ron Stark MD,

Staff present: Joy Schmitt

Observers: None present at meeting.

  1. Call to Order: The Health Care Provider Advisory Council(HCPAC) meeting was called to order at approximately 10:10 AM in accordance with Wisconsin's open meeting law.  HCPAC members and staff introduced themselves.


  2. Approval of  Minutes: The Minutes of the October 29,2010, May 11,2012 and October 11,2013 meetings were discussed. A quorum of the HCPAC was not present and the minutes of the previous meetings were not formally approved. Formal Approval of the minutes for these meetings was deferred to the next meeting.


  3. Committee Membership: The members of the HCPAC discussed committee membership. The Wisconsin Medical Society provided the names of six (6) physicians to serve on the committee and in addition to another physician from northern Wisconsin. Maja Jurisic expressed her interest in continuing to serve as a member of the HCPAC. The Wisconsin Hospital Association provided the name of another individual to serve as a hospital representative. Jim O'Malley will contact Barbara Janusiak about her interest in continuing to serve on the committee.

    The following dates were set for future HCPAC meetings in 2014: May 2. July 25 and October 17. There was a consensus of the committee that the Department should send and e-mail message to all members of the committee of these meeting dates in the near future.

  4. Dispute Health Care Services Submitted to the WCD for Resolution: Jim O'Malley provided a three (3) page handout showing the top health care services submitted to the Department for resolution of reasonableness of fee disputes and a seven (7) page summary of a medical data call showing the top 25 treatment codes paid by WC insurance carriers from the Wisconsin Compensation Rating Bureau (WCRB). Sri Vasudevan also requested data from the Department showing the top health care services submitted for resolution of necessity of treatment disputes that the treatment guidelines in ch. DWD 81 of the Wisconsin Administrative Code are applicable.

  5. WCAC "Agreed Upon Bill": Jim O'Malley briefly summarized the statutory changes to ch. 102, Stats., included in the WCAC "Agreed Upon Bill" for 2014. The committee discussed some of the proposed statutory changes.

  6. Unfinished Business: Jennifer Seidl will continue to work on drafting language related to functional capacity assessments and evaluations in s. DWD 81.06 (1) (k) 4 of the Wisconsin Administrative Code. She will have draft language to present at the next meeting.

    There was a discussion about the adoption of treatment guidelines. There are currently treatment guidelines from Presley Reed and ACOEM. Colorado and Montana developed their own worker's compensation treatment guidelines. Defining good outcomes and the difficulties of getting an agreement on best practices was also discussed.

    A nine (9) page document entitled Chronic Opioid Clinical Management Guidelines by Dr. Scott Hardin from Aurora Health Care was discussed. Sri Vasudevan commented this is an excellent paper and recommended that the five (5) "A"s should be added to page two (2), Section 4, relating starting chronic opioids. The five (5) "A"s are as follows:
    Analgesia to reduce pain
    Activity to increase
    Adverse effect
    Aberrant behavior
    Attitude-effect on depression

    On page five (5) in the section related to addiction Sri Vasudevan also suggested that the four (4) "C"s should be added in Section 7, related to addiction. The four (4) "C"s are as follows:
    Compulsive use
    Control over Use
    Continued overuse despite harm
    Cravings

    The consensus of the committee was these were good suggestions and that the author of the paper should be contacted about adding the five (5) "A"s and four (4) "C"s.

  7. New Business: Maja Jurisic discussed the need for improved patient education. A pamphlet prepared by Dr. Jennifer Christian as part of the 60s Summit has very good information about Opioid use for patient education. Jim O'Malley indicated the Department will review the pamphlet and consider posting on its website.

  8. Next Meeting:  At the next meeting on May 2, 2014 the committee will plan to carefully review each section of the treatment guidelines contained in DWD 81 of the Wisconsin Administrative Code. An in-depth review of the treatment guidelines will be useful to the new members of the committee as well as the older members, because the treatment guidelines have been in effect since November 1, 2007. All members will be provided with the treatment guidelines before the next meeting and are requested to review them, especially the sections most closely related to their practice

  9. Adjournment: The meeting was adjourned at approximately 12:20pm