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Wisconsin State Profile and Policy Report

Wisconsin State Profile and Policy Report

Heart Disease and Stroke Burden

Table of Contents

Wisconsin - State Deaths for Heart Disease and Stroke

  • More than 1 out of 4 deaths in Wisconsin are due to heart disease.

  • 11,451 Wisconsinites died from heart disease in 2006 (24.8 percent of total deaths in Wisconsin).

  • 2,829 Wisconsinites from stroke in 2006 (6.1 percent of total deaths in Wisconsin).
    Source: National Vital Statistics Report, 2009.

Wisconsin - 2007 State Risk Factors for Heart Disease and Stroke

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Wisconsin - 2003 State Costs for Cardiovascular Disease

In October 2007, the Milken Institute, an independent research group, released a study, An Unhealthy America: The Economic Impact of Chronic Disease. The study details the economic effects of treatment costs resulting from chronic disease in the United States. Below is a breakdown of Wisconsin’s estimated medical costs to treat heart disease, hypertension and stroke based on 2003 Medical Expenditure Panel Survey data.

Wisconsin Annual Cost of Hypertension, Heart Disease and Stroke 

Treatment Expenditures (Direct Costs) - Total annual medical cost.

Hypertension 

$.60 billion

Heart Disease          

$1.47 billion

Stroke                     

$.28 billion

Source: Milken Institute, An Unhealthy America: The Economic Impact of Chronic Disease, October 2007. 

Wisconsin - Estimated 2007 Medicaid Treatment Costs for Cardiovascular Diseases
 

Based on Wisconsin's Medicaid population, economic estimates for 2007 were projected using Medical Expenditure Panel Survey data.  Medicaid spending has grown rapidly in recent years, placing a significant burden on state budgets.  To help states estimate the financial impact of cardiovascular diseases among their Medicaid beneficiaries, the Centers for Disease Control and Prevention (CDC) and RTI International developed the Chronic Disease Cost Calculator, which was used to estimate the Medicaid costs below. 

 Heart Disease

 $107 million

 Hypertension

 $408 million

 Stroke

 $245 million

 Congestive Heart Failure

 $47.5 million

 

Funded CDC Heart Disease and Stroke Prevention Grantees in Wisconsin

The Centers for Disease Control and Prevention (CDC) funds Wisconsin's Heart Disease and Stroke Prevention program to increase control of high blood pressure and cholesterol; increase awareness of the signs and symptoms of heart attack and stroke and the importance of promptly calling 911; improve emergency response; improve quality of care; and eliminate related health disparities.  These efforts are informed by monitoring heart disease, stroke and related risk factors statewide.

Wisconsin State Highlights - Heart Disease and Stroke Prevention Program

  • The Wisconsin Heart Disease and Stroke Prevention (HDSP) program completed an inventory and analysis of statewide and organizational policies. The inventory enumerated policies on heart disease risk factors (tobacco use, high cholesterol, high blood pressure, physical inactivity and poor nutrition). The process of developing the policy inventory was the catalyst for program interactions and integration between chronic disease programs. The inventory logically led to a "gap analysis" of state and organizational level policies to focus the Wisconsin Heart Disease and Stroke Alliance's policy development activities.

  • The Wisconsin HDSP program in partnership with the Wisconsin Society for Cardiovascular and Pulmonary Health and Rehabilitation developed the Wisconsin Cardiac Rehabilitation Outcomes Registry (WICORE).  It was the first large-scale, fully automated, outpatient cardiac rehab registry in the country.  The registry supports epidemiological analysis, case management, quality improvement, and tracking health disparities.   

WISEWOMAN - The CDC also funds the WISEWOMAN program, which provides low-income, underinsured and uninsured women ages 40 to 64 with access to preventive health services by screening for high blood pressure, high cholesterol and diabetes.  The program also provides lifestyle interventions that are tailored to each woman's heart disease and stroke risk factor screening results and links participants to free and low-cost community-based nutrition, physical activity, and quit smoking resources. 

Wisconsin is planning to provide WISEWOMAN services to 3,000 women, ages 35 to 64 over the five years of the project. Wisconsin will implement WISEWOMAN in the Southeastern Region first. Approximately 41 percent of Wisconsin’s potential WISEWOMAN participants reside in this region.

  • Wisconsin works with a variety of low-cost and no-cost community resources to provide the necessary lifestyle intervention services, including community weight-loss programs, dietitians, mall walking clubs, technical college cooking classes, university outreach and extension programs, and certified diabetes health educators.

State Laws and Policies

Public Awareness of Heart Disease and Stroke

WI AJR 7/SJR 6 (2011, pending) - Proclaims February 2011, as “American Heart Month” and February 4, 2011 as “Wear Red Day.” Encourages all citizens to show their support for women and the fight against heart disease by wearing red and recognizing the importance of learning to use an automated external defibrillator to help increase survival rates from cardiac arrest.

WI AJR 103 (2010, adopted) - Recognizes February 2010 as “American Heart Month.”

WI AJR 106 (2010, adopted) - Recognizes February 5, 2010 as “Go Red for Women Day.”

WI SJR 4 (2009) - The Senate resolves with the assembly concurring, that in recognition of the importance of the ongoing fight against heart disease and stroke, the members of the Wisconsin Legislature do hereby proclaim February 2009 to be American Heart Month and February 6, 2009, to be Wear Red For Women Day and urge all citizens to show their support for women and the fight against heart disease by commemorating this day by the wearing of the color red.

SJR48 (2007) - The members of the Wisconsin Legislature hereby express their support for the American Stroke Association’s “Power to End Stroke” campaign and do hereby recognize May as Stroke Awareness Month.

AJR97/SJR84 (2008) - In recognition of the importance of the ongoing fight against heart disease and stroke, the members of the Wisconsin Legislature do hereby proclaim February 2008 to be American Heart Month and February 1, 2008, to be Wear Red For Women Day and urge all citizens to show their support for women and the fight against heart disease by commemorating this day by the wearing of the color red.

AR7/SR5 (2007) - The members of the Wisconsin Assembly declare April 25, 2007, “Start! Walking At Work Day” and urge all citizens to show their support for walking and the fight against heart disease and to commemorate this day by walking at work. By increasing awareness of the importance of physical activity to reduce the risk of cardiovascular disease, we can save thousands of lives each year.

Prevention of Risk Factors (Nutrition, Physical Activity, Tobacco)

Tobacco Control

Wisconsin's state employee tobacco cessation program meets two of the three CDC guidelines that include:

1) Coverage for at least four counseling sessions of at least 30 minutes; YES 
2) Access to smoking cessation agents, including prescriptions and nicotine replacement; YES 
3) Counseling and medication coverage for at least two quit attempts annually; NO 

  • Wisconsin also has a cigarette excise tax and quit line.  The cigarette excise tax in Wisconsin is $1.77.

  • Wisconsin's state Medicaid tobacco cessation program covers over-the-counter and prescription products, therapy, counseling and social support. A statewide public program is also available; coverage may vary from other programs. 

WI AJR 42 (2009, adopted) - The assembly resolves with the senate concurring, that the members of the Wisconsin Legislature declare Wednesday April 8, 2009, as "Wellness Day" in Wisconsin.


Increase Early Detection and Treatment of Heart Disease and Stroke

Wisconsin Statutes and Annotations 255 (2007) - The state epidemiologist for chronic disease shall do all of the following: (1) develop and maintain a system for detecting and monitoring chronic diseases within this state; (2) investigate and determine the epidemiology of those conditions that contribute to preventable or premature illness, disability and death. The department shall conduct programs to prevent, delay and detect the onset of chronic diseases, including cancer, diabetes, cardiovascular and pulmonary disease, cerebrovascular disease and genetic disease, and other chronic diseases that the department determines are important to prevent, delay and detect in order to promote, protect and maintain the public’s health.

State Employee Health and Wellness

  • The Wisconsin Department of Employee Trust Funds (DETF) uses the 3-Tiered approach to health insurance purchasing.  The 3-Tier model was designed in 2004 to address cost escalation problems "while maintaining high-quality, low-cost health care coverage. While still maintaining a uniform medical insurance benefits package, each plan has now been assigned to one of three tiers based on the relative efficiency with which a plan is able to provide the benefits and the quality of care required by the Board. Plans were given extra credit in the tier assignment process if they scored well on measures of quality, such as clinical measures and member experience. This approach has created significant incentives for health plans to hold down the costs they charge the state while guaranteeing that all employees in the state have access to a Tier 1 plan in their area. In addition, monthly premium contributions for the Standard Plan have been capped."   For January 2009 through December 2009, the least expensive, Tier 1 (with 21 plan choices among geographic areas)  individuals contribute $31/month; families contribute $78.  Tier 2 (with one plan choice, BCBC Northwest) individuals contribute $69; families contribute $173.  Tier 3 (with one plan, "Standard Plan") individuals contribute $164; families contribute  $412. [2009 Benefits description]

  • In 2004, Wisconsin announced that required employee contribution rates for health coverage will increase for all employee groups beginning January 2005.  Rates for both the general/teacher (from 9.8 percent to 10.2 percent) and executive/elected (from 10.8 percent to 11.2 percent) categories of employees increased by .4 percent. Wisconsin also authorized the Department of Employee Trust Funds to contract with a Pharmacy Benefits Manager (PBM) to provide pharmacy benefits services to all State of Wisconsin group health insurance participants.  Effective January 1, 2004, all participants receive their pharmacy benefits from the PBM, Navitus Health Solutions.

Improve Quality of Care and Access to Care

No policy listed at this time

 

Address and Eliminate Disparities 

 No policy listed at this time

 

Emergency Medical System (EMS) and Automated External Defibrillators (AED)

Wisconsin Statutes and Annotations 46/SB142 (2007) - The Department shall approve individuals, organizations, or institutions of higher education to provide instruction in the use of an automated external defibrillator, as defined in s. 146.50 (1) (cr) [s. 256.15 (1) (cr)], for persons who are required as a condition of licensure, certification, or registration to have current proficiency in the use of an automatic external defibrillator.

Wisconsin Statutes and Annotations 48/SB142 (2007) - The department shall promulgate rules establishing minimum requirements for the issuance of licenses to, and establishing standards for the operation of, child welfare agencies, day care centers, foster homes, treatment foster homes, group homes, shelter care facilities, and county departments. All day care center licensees, and all employees of a day care center, who provide care and supervision for children have current proficiency in the use of an automated external defibrillator.

Wisconsin Statutes and Annotations 50/SB142 (2007) - The department shall promulgate, adopt, amend and enforce such rules and standards for hospitals for the construction, maintenance and operation of the hospitals deemed necessary to provide safe and adequate care and treatment of the patients in the hospitals. Before providing emergency services in a hospital, medical and nursing personnel shall have proficiency in the use of an automated external defibrillator, as defined in s. 146.50 (1) (cr) [s. 256.15 (1) (cr)], achieved through instruction provided by an individual, organization, or institution of higher education that is approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 100/SB142 (2007) - A fitness facility shall ensure that each of its employees, within 90 days after hire, satisfactorily completes at least one course in basic first aid and basic cardiopulmonary resuscitation taught by an individual, organization, or institution of higher education approved by the department and has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education that is approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 254/SB142 (2007) - Before serving as a lifeguard at a public swimming pool or a recreational and educational camp or as an on−site health services staff member at a recreational and educational camp, an individual shall have proficiency in the use of an automated external defibrillator, as defined in s. 146.50 (1) (cr) [s. 256.15 (1) (cr)], achieved through instruction provided by an individual, organization, or institution of higher education achieved through instruction approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 256 (2007) - A certified first responder is authorized to use an automated external defibrillator, as prescribed for first responders in rules promulgated by the department. The rules shall specify the content of the training, qualifications for providers of the training, and the frequency with which emergency medical technicians, first responders, and individuals who provide instruction to emergency medical technicians or first responders must complete the training.

Wisconsin Statutes and Annotations 440/SB142 (2005) - A licensed midwife shall, at the time that he or she applies for renewal of a license under sub. (1), submit proof satisfactory to the department that he or she has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 446/SB142 (2007) - Except as provided in sub. (9), no person may engage in the practice of chiropractic or attempt to do so or hold himself or herself out as authorized to do so, unless such person meets the requirements of continuing education for license renewal as the examining board may require, which requirements shall include current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 447/SB142 (2007) - The examining board shall grant a license to practice dentistry to an individual who does all of the following: Submits evidence satisfactory to the examining board that he or she has current proficiency in cardiopulmonary resuscitation, including the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 448/SB142 (1999) - "Affiliated credentialing board” means the athletic trainers affiliated credentialing board. The affiliated credentialing board shall do all of the following: Promulgate rules requiring each applicant for a license under this subchapter to submit evidence satisfactory to the affiliated credentialing board that the applicant has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 460/SB142 (2007) - The department shall grant a certificate as a massage therapist or bodyworker to a person who satisfies all of the following: The person submits evidence satisfactory to the department that he or she has current proficiency in the use of an automated external defibrillator achieved through instruction provided by an individual, organization, or institution of higher education approved under s. 46.03 (38) to provide such instruction.

Wisconsin Statutes and Annotations 49/SB142 (1997) - A person who is certified to provide transportation by specialized medical vehicle under sub. (2) (a) 11. shall ensure that every person who drives or serves as an attendant to passengers on a specialized medical vehicle, before driving or serving as an attendant, has current proficiency in the use of an automated external defibrillator, as defined in s. 146.50 (1) (cr) [s. 256.15 (1) (cr)], achieved through instruction provided by an individual, organization, or institution of higher education that is approved under s.46.03 (38) to provide such instruction.

Stroke Systems of Care 

 No policy listed at this time

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