First elected to the state Assembly in 2014, Representative Nancy VanderMeer (R-Tomah) represents the 70th Assembly District, which includes portions of Monroe, Jackson, Wood, and Portage Counties. The district also includes the cities of Tomah and Sparta.

Before running for office, Rep VanderMeer owned an auto dealership, and her family continues to operate a dairy farm. In her many volunteer roles, Nancy has served on the Tomah Memorial Hospital board of directors and is a former president of the American Business Women’s Association. In addition to drawing on her experience as a small businessowner to champion pro-growth policies for rural Wisconsin, she has also focused on legislation to boost Wisconsin’s healthcare workforce.

She currently chairs the Assembly Rural Development Committee and serves on the Assembly Health Committee.

Rep. VanderMeer took a few minutes to talk with us about a handful of topical health care-related issues and what the Legislature may focus on during the remainder of the 2021-22 legislative session:

Question:

As a member of the Assembly Health Committee and a legislator who has worked on numerous health care-related polices, including Interstate Medical Licensure Compacts, what do you believe are the biggest health care-related challenges currently facing the state? What policy solutions do you believe are needed to address those challenges? Are you currently working on any health care-related legislation?

Rep. VanderMeer:

I think that there are always things that can be improved, and the mark of any successful organization is constantly trying to identify areas of strength and weakness – and adjusting accordingly to better serve the individuals and stakeholders they work with.

One thing that can get overlooked in the minutia of things is that here in Wisconsin, we’re consistently ranked high and commended for the quality of care that providers deliver. There are a variety of metrics one can utilize in that regard. For example, toward the end of 2018, the federal Agency for Healthcare Research and Quality (AHRQ) issued a State Snapshots ranking naming Wisconsin fourth in the nation for highest overall health care quality among all 50 states and first in the Midwest. I believe that part of my role as a legislator on the health committee especially, is to do what I can to help ensure health care providers, both specialty and primary care, have the tools they need to provide quality care to patients, and that whenever possible, state government is working with providers and not standing in their way. Trying to limit bureaucratic hurdles is an example of that and deciding how to allocate limited taxpayer resources is another.

One of the reasons I’ve been so pleased with the work that went into both the initial Interstate Medical Licensure Compact in 2015 and the Enhanced Nurse Licensure Compact in 2019, is that I believe that those compacts are examples of the Legislature responding to defined needs brought forth by health care providers – and ultimately allowing our state to participate in those compacts that provide direct benefits to patients and providers. It will probably come as no surprise that I’m currently working with the Wisconsin Occupational Therapy Association on an Occupational Therapy Compact with Senator Ballweg of Markesan. I’m also looking at some licensing efficiency reforms for Speech Language Pathologists with Senator Kooyenga of Brookfield. I believe the compact model, if done correctly, has been proven successful in improving access to quality care. Another important benefit of the compacts is that they can be especially beneficial for military families and their spouses relocating to our state. That’s something that’s particularly important me in part because my district includes Fort McCoy and borders Volk Field in Monroe County. I was pleased to author and pass legislation last session that creates a licensure reciprocity process for military spouses.

Question:

Given your past policy work on workforce and rural development issues, you are certainly familiar with the growing health care workforce shortage in Wisconsin and the stress it is putting on the delivery of patient care. Aside from your extensive work on health care licensure compact legislation, are there any potential programs or policies you are considering or willing to support that you believe would help address our health care workforce shortage?

Rep. VanderMeer:

During the 2017-2018 Legislative Session, the Rural Development Committee was able to include a grant program in the state budget that allocated $500,000 annually for training and retaining allied health professionals and $500,000 annually for training and retaining advance practice clinicians. I think that’s a decent model to look at. I recently was able to participate in an update call on that program with a health care provider, and they were very pleased with what they’ve been able to do with the resources provided under the program. That said, I might think about the overarching issues a bit differently than some of my colleagues, in part because of what you shared above pertaining to my background, my close ties to the military community, and my experience as a board member of a rural, critical care access hospital.

Unfortunately, I don’t believe there is a silver bullet. However, I think we can make significant strides if stakeholders continue to think about things more comprehensively. For example, when the military makes decisions on whether to create, maintain, grow, shrink, or eliminate installations, they consider a variety of factors that affect their operations and personnel in a local community and geographic region, and how those factors support their overall mission. What are those factors? Those are things like the quality of workforce opportunities and educational opportunities for families - both at the K-12 and higher ed level. Additional considerations, for example, could include quality broadband access and housing available for the civilian workforce. Anyone who has followed the Assembly Committee on Rural Development since I took over as chairperson in the 2017-2018 session, knows that we’ve proactively tried to bring together stakeholders to look at some of these key issue areas. I’m always interested to learn about and would consider new ideas to address the workforce shortage, especially as it pertains to the health care workforce.

Question:

What key health care-related initiatives, if any do you believe the Assembly Republican majority will make a priority during the remainder of the current legislative session?

Rep. VanderMeer:

That is a great question, and if anyone has any specific ideas, I encourage them to contact my office. With that said, given the nature of the legislative process, I’ve learned not to over-speculate on what might move forward, or make it across the legislative “finish line” outside of what I’m directly working on. I can share that I’m cautiously optimistic about the prospects of some of the proposals I’ve authored and mentioned previously on the Assembly side of things this session. Outside of that, I can share that there’s generally broad agreement in both houses as it pertains to professional licensing reform. With that in mind, I think most of the significant policy items that we’ll see this session were already enacted via the state budget bill. There were numerous items in the budget that reflect the priorities of the Assembly Republican Caucus and aim to increase access to care, provide additional support for of our most vulnerable citizens, and limit bureaucratic hurdles for patients and providers. Things like adequately and continually funding Medicaid Disproportionate Share Hospital (DSH) Payments for rural, critical care providers was a significant achievement in this session’s budget.

Question:

Different approaches and new innovations in health care can lead to higher quality, greater convenience, and lower costs across the health care system. Examples include price transparency, increased use of telemedicine, and direct primary care. In addition, the delivery of certain health care services in non-hospital settings, such as ambulatory surgery centers, can be less expensive and more convenient for the patient. What type of innovative ideas and policies do you support or are you interested in exploring to expand health care access and increase affordability?

Rep. VanderMeer:

I agree that different approaches and new innovations in health care can lead to higher quality, greater convenience, and lower costs across the health care system. There is certainly a greater demand for the increased use of telemedicine. That’s something I hear about quite a bit from the health care providers in my district, and the constituents I represent. If you were to look at a map of my district, you would see that in some cases, a trip to a provider can take an hour or more each way. That is a challenge for most people, especially those in need of regular care. In short, I will continue to support policies that knock down barriers to expand use of telemedicine. I will also continue to listen to patients and providers on what is the most effective and efficient delivery of care.

One question I try to ask myself when evaluating these types of approaches and innovations is, how does this create access for patients? It is a very important consideration for me that the vast majority of those I represent reside in more sparsely populated areas of the state. Obviously, as a patient, one either goes to receive care, or care comes to them. I think some of the different models of care outside of telehealth, like ambulatory surgery centers and home health care, are examples of care coming to an individual or to their community. I commend the hospital at home model that some of the larger providers in and around my district have had success with. I also co-sponsored the direct primary care bill in the 2019 session (vetoed by the governor), and I think it’s a worthwhile concept to consider again in the future.

The views and opinions expressed in this interview are those of the individual interviewed and do not reflect the position of WiAHC.