MON AM News: WHA report highlights health care workforce challenges; Dairy groups appeal decision in suit targeting CAFO permit regulations

March 11, 2024

— The ratio of licensed nursing home beds to elderly, blind and disabled people on Medicaid in Wisconsin has worsened substantially over the past two decades, compounding existing challenges for the state health care industry.

The Wisconsin Hospital Association’s 2024 Health Care Workforce Report, being released today, highlights this trend and other issues facing hospitals in the state.

WHA Senior Vice President of Workforce and Clinical Practice Ann Zenk notes hospitals in the state are “working hard to grow, recruit, retain and support” the workforce that’s necessary to sustain high-quality health care in Wisconsin.

“But even with intense effort, it is unlikely that the health care workforce can grow fast enough to meet the rising health care demand of an aging population,” she said in a statement on the report.

The report calls for taking action on “root causes” to surmount health care workforce shortages. While the aging population is a demographic force that can’t be easily changed, WHA points to the nursing home bed issue as a key issue to address.

Drawing on Department of Health Services data, WHA notes more than 46,000 nursing home beds were licensed in Wisconsin in 2002 while about 143,000 elderly, blind and disabled people were enrolled in Medicaid. By 2024, the number of nursing home beds has dropped to 26,000 while the comparable Medicaid enrollee number has nearly doubled to 270,000, according to the report.

WHA warns nursing home bed closures have led to a “bottleneck” in post-acute care access, as bed shortages that spiked during the COVID-19 pandemic have continued into this year. This has led to hundreds of patients that no longer need hospital care being stuck there because no nursing home beds are available to take them.

This problem is adding to workforce demand and lengthening hospital stays “with no increase in reimbursement,” while backing up emergency departments, intensive care units and surgical care areas, according to WHA.

“The safety net hospitals provide must be adequately resourced while government leaders, public health, long-term care and other key stakeholders concurrently work to reduce over-reliance on hospitals, health systems and the health care workforce to meet post-acute care and other community needs,” report authors wrote.

Meanwhile, WHA President and CEO Eric Borgerding calls on health care organizations, educators, state regulators and elected officials to “continue partnering to minimize outdated barriers and implement innovations to encourage, support and advance health care workers in their pursuit of fulfilling attainable and meaningful careers.”

Across the spectrum of health care professionals, vacancy rates that shot up in 2021 and 2022 were “stabilizing, but still critical” in 2023. Still, vacancy rates for eight of 18 health care professions included in the report remained in the double digits near the end of 2022.

WHA points to nursing in particular as an area of concern, as growth in this profession is falling behind what’s needed to meet existing and future demand. The report calls for promoting interest in health professions while ensuring education access and offering more health career pathways.

See the full report.

— Dairy groups have appealed a decision by a Calumet County judge who found state law gives DNR “broad authority” over permit regulations for large farms and ruled the regulations don’t conflict with federal law.

The filing in Court of Appeals District II comes after Judge Carey Reed in late January rejected Wisconsin Manufacturers & Commerce’s argument on behalf of Venture Dairy Cooperative and Wisconsin Dairy Alliance that DNR can’t require CAFOs to obtain wastewater permits before they discharge a pollutant to navigable waters.

Kim Bremmer, executive director of Venture Dairy Cooperative, in a statement said the permit requirement assumes farmers who own CAFOs are “automatic polluters, and that is categorically false.”

“There is no question that bad actors should face penalties, and this lawsuit does absolutely nothing to change that,” Bremmer said. “It’s time that we look at meaningful solutions for environmental challenges rather than continually focusing on senseless regulations for a small group of farmers.”

Cindy Leitner, president of Wisconsin Dairy Alliance, said Wisconsin farmers want and need access to clean water just like everyone else.

“This lawsuit aims to reduce the cost and burden of obtaining an illegally required permit, while ensuring we can all continue to be proper stewards of the land,” Leitner said.

Meanwhile, Attorney General Josh Kaul in a statement to WisPolitics criticized the suit.

“Safe and clean drinking water is vital for our communities. We should be strengthening our protection of clean water, not weakening it as this case seeks to do,” Kaul said.

Clean Wisconsin attorney Evan Feinauer told WisPolitics Reed had made the right decision in affirming DNR’s authority to require CAFOs to obtain permits.

“I’m not surprised these special interest groups are appealing because they seem to have a strong financial interest in large CAFOs no longer having to meet the environmental standards in these permits,” Feinauer said. “No matter how much money is being put behind this effort we’re ready to defend Wisconsin’s clean water protections as long as it takes.”

Clean Wisconsin is an intervenor in the lawsuit.

Peg Sheaffer, spokesperson for Midwest Environmental Advocates, another intervenor in the suit, knocked WMC’s “reckless crusade to dismantle basic water quality protections,” but said the group is confident WMC won’t succeed.

“Environmental oversight of large livestock facilities is critical to protecting Wisconsin’s water resources. MEA is committed to ensuring that our environmental laws aren’t gutted by industry groups seeking to maximize profits at the expense of public health,” she said.

See WMC’s release.

See the notice of appeal and docketing statement.

See more from the WisPolitics Friday Report.

— SHINE Technologies has entered an agreement with a nuclear waste storage company to dispose of remaining materials from its spent fuel recycling service.

The Janesville company recently announced it has entered a memorandum of understanding with California-based Deep Isolation. Under the agreement, the companies have agreed to “collaborate and exchange critical information” on the use of Deep Isolation’s system for isolating and storing residue from SHINE’s technology for recycling used nuclear fuel.

The companies last year conducted a study exploring this application of storage system, which involves encasing the waste in canisters and placing it into deep “boreholes” to isolate it.

It found SHINE’s recycling process reduced the volume of “high-level” irradiated waste by more than 90% and Deep Isolation’s storage system is “technically and economically viable” for storing the leftover material, according to the companies.

Greg Piefer, founder and CEO of SHINE, says the 90,000 tons of civilian spent nuclear fuel in the United States “represent an untapped and arguably renewable resource that if recycled will reduce emissions” and hasten the deployment of fission energy.

“The result of this work will be a reduction in waste volumes and ultimately half-life that allows for simpler, safer disposal,” he said in a statement. “Deep Isolation has proven they have a realistic and reasonable solution for the disposal of these wastes, among others as needed.”

The company drills underground to place the waste hundreds of meters into stable geological formations, according to its website. Putting it that deep, well below drinking water aquifers, provides protection as radioactive particles decay long before they can reach the surface.

Deep Isolation CEO Liz Muller says the agreement sets out a “clear framework” for commercializing their related services in an integrated fashion.

“Clean nuclear power can only take off if the industry can show society that there are safe, practical, and permanent means of disposing the highly radioactive materials that result,” she said in the release.

The MOU comes just weeks after SHINE and a Maryland company called Orano announced an agreement to work together on developing a commercial-scale U.S. pilot plant for recycling used nuclear fuel from reactors.

See the release and listen to a recent podcast with Piefer.

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