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Health Care Provider Advisory Committee
Meeting Minutes for October 29, 2010
Crowne Plaza
Madison WI
DRAFT 

Present:  Frances Huntley-Cooper, Barbara Janusiak, Maja Jurisic MD, Steven Kirkhorn MD, Jeff Lyne DC, Peter Schubbe DC, Jennifer Seidl, Ron Stark MD

Excused:  David Bryce MD, Gina Buono MD, Mary Jo Capodice DO, Amanda Gilliland, Mike Lischak MD, Karen Pease,  Sri Vasudevan MD.

Staff present:  Joy Schmitt and Jim O'Malley

Observers:  None present at meeting.

1. Call to Order:  The Health Care Providers Advisory Committee (HCPAC) meeting was called to order by Frances Huntley-Cooper at approximately 10:20 AM in accordance with Wisconsin’s open meeting law. 
   
   Members of the HCPAC and the Department staff introduced themselves.
   
   
2. Approval of Minutes: The minutes of the February 19, 2010 meeting were unanimously approved without correction.
   
   
3. Unfinished business:  The members of the HCPAC had no unfinished business to discuss. Jennifer Seidl recommended patient access and service delivery as a new topic for future discussion. 
   
   Jim O’Malley discussed the requirements for incorporating standards established by technical societies and organizations of recognized standing by reference into administrative rules. When an agency wishes to incorporate standards by reference in an administrative rule, the agency is required to submit a written request for authorization to the Wisconsin Attorney General.  The factors considered are whether the rule is of limited public interest, the extent of unwarranted expense if permission is not granted, if the standards were established by a society or organization of nationally recognized standing, and if the standards are readily available in published form or are available on optical disk or other electronic format.  Jim O’Malley contacted the Attorney General’s Office and was given an informal opinion that the paper Imaging Guidelines for Low Back Pain Secondary to Work Injury would not be approved for incorporation by reference because of its relative short length and there is a concern about whether it is readily available to the public. 
   
   
4. New business:  Review DWD forms & Publications Related to Physicians.  The committee reviewed the publication Guide for Wisconsin Doctors (WKC-7280) that included instructions for completing the WKC-16-B.  Steve Kirkhorn stated that sometimes physicians do not have enough information to respond to Questions 11, 12 and 13 on the WKC-16-B. Ron Stark suggested adding a third answer block for these questions for the practitioner to respond “Not Know”.  
   
   There was a discussion about the degree of certainty that is required for physicians to express opinions on the Department’s medical report forms. The requirement is for opinions to be expressed to a reasonable degree of medical probability. It is not necessary for opinions to be expressed to a reasonable degree of medical certainty. Opinions expressed on the basis of possibility are not sufficient to support an award of compensation.
   
   Steve Kirkhorn suggested that the publication Guide for Wisconsin Doctors (WKC-7760) should include examples on how to correctly fill out the answers to Questions 11, 12 and 13 on the WKC-16-B. 
   
   The committee reviewed How to Evaluate Permanent Disability (WKC-7761).  In many states the AMA Guidelines are used to assess permanent disability resulting from work-related injuries. Ron Stark advised that figure 26 on page 18 showing radial (abduction) and ulnar (adduction) flexion of the wrist were reversed.
   
   The committee reviewed the information available under the heading Medical on the Worker’s Compensation Division’s webpage. There was a discussion about employees being strongly encouraged to see the employer’s doctor and how this impacts care.  Tie-breaker examinations and return to work at modified duties were discussed.
    
5. Future Meeting:  There were no major issues to cover at this time. Future meetings will be held as issues come up. The consensus of the committee was that it was not necessary to schedule another meeting until there were enough items to fill the agenda. The chairperson may have a teleconference with the committee members to discuss scheduling future meetings.   
   
   
6. Adjournment:  The meeting was adjourned approximately at 2:30 PM.