 Welcome to Sheboygan County government working for you my name is Adam Payne Sheboygan County administrator and co-host of this program with chairman Mike Van der Steen and today we're very pleased to have two of the most powerful men from the health and human services department with us our health and human services director Tom Eggebrecht and our public health manager Dale Hippenstiel welcome gentlemen thank you madam good to have you both here as you know every month we try to bring a different department program to you to learn more about the roles and responsibilities of county government and next month we're going to have Sheboygan County government's work works week which really follows a national program where we're trying to raise greater awareness about the important roles and responsibilities of county government and these two gentlemen are going to be taking a lead role with that for Sheboygan County this year because we want to focus on the the very critical programs and services in our health and human services department particularly promotion prevention opportunities so Tom I'd like to start with you please talk a little bit about the health promotion and prevention programs that you have in the health and human services department sure again thanks for allowing us the opportunity Adam we've talked on the show previously about a lot of the safety net services that our department is involved in a lot of times prevention and promotion flies under the radar so indeed we've got a thirty one million dollar budget for operating divisions and hundred eighty excellent staff and they are involved in a variety of early intervention prevention and health promotion activities and those really reach over the lifespan so on the front end we offer prenatal care coordination assistance in the area of maternal and child health a birth to three early intervention program we've talked a little bit about the aging and disability resource center previously and those programs are pretty well known and in the middle are a variety of activities including access to health insurance we've got community health promotion by way of our immunization clinics environmental health that looks at food and water source safety and I'm happy to have Dale with me today because we're actually involved in a variety of community coalitions and planning in the area of health promotion as well as one of the things that's really impressed me about the health and human services department in particular is such a broad degree of programs and services as you said critical safety net services but we also have these prevention programs and outreach programs that the participation from the public has been fantastic a lot of support lots of volunteers Dale talk about some of these coalitions a little bit what's in play well I appreciate that I think people need to understand that the public health has evolved health and human services has evolved from that place you would stop and get your immunization or that place you might stop to get a some kind of counseling service and then you go about your business you may have some maternal child health visits those kinds of things certainly some some old-fashioned public health interventions take place every day but what we've evolved into is a group of folks through lots of training lots of changing of paradigms to try to bring the community together to solve problems we as a division as a department as a county have a very difficult time doing that when we we've sort of lived in these silos and I'll just mention a handful of coalitions that we're involved with sometimes we take a lead role sometimes we share lead roles our healthy Sheboygan County group 2020 is a wonderful group of folks that some people I work with co-chair we have representatives from both the hospital St. Nicholas and Aurora we have people from different nonprofit organizations and more importantly we try to have people at large people on the community that can give us feedback and say no we're not sure why you're doing that that's really not working for us so that's a really good coalition to to respond to because they have very specific responsibilities that are looking at community health improvement plans one of the things that were that we're really excited about is a very aggressive immunization coalition that Diane Leibenthal one of my supervisors is working with again hospitals the clinics the schools trying to keep immunization rates in children and in some adult populations as high as we possibly can because we know that's a scientifically based way to prevent diseases Tom mentioned prevention is really important to us there's also a coalition that was driven by activities from United Way and I know Adam you've been involved with the United Way recently call our community health center coalition and this is a group of folks again from many of the same partners but also the community from the private sector that are looking at access to healthcare particularly dental healthcare for underserved folks we actually have a small clinic that we just started in cooperation with Manitowoc County as a grant that we received with our friends in Manitowoc County and we're very excited about those activities because they really provide access for people with no insurance or or Medicaid different Medicaid models to access a higher level of service so we're excited about that and these are great partners had a had a meeting this morning with some folks out of Milwaukee and they were just quite surprised that we are able to sit with our hospital partners on a daily basis in the same room and everyone's civil you know because they are so competitive but so yeah a lot of activities like that we're excited about a lot of activities and again I don't think most people recognize that it isn't a few county staff rubbing their hands together at an office deciding what we're going to focus on or where the needs are you're truly working with the community as partners engaging them getting their ideas determining priorities so if someone's watching this program and they're thinking geez I there's a lot going on at the Health and Human Services Department I'd like to get involved or I'd like to help how do they reach out and become a member of this coalition how do they offer that assistance Tom me whoever go ahead well we're always looking for members in fact a sign of a good coalition is that there's always change in membership that you're finding people with different skill sets people with different interests willing to sit on these boards and these and these committees and I would suggest that people have an interest in any of these these kind of issues and would like to know more about different coalitions they should they should call our office stop in of course now everything's email send an email through the the accounting website and we'd be happy to talk to them and let them know what we're up to excellent and the last question before I turn it over to Mike need the needs out there are so great and it's my impression that demands for services are only going up not down but what are some of the trends with these particular planning coalitions that you mentioned here what are some of the greatest needs that you're seeing in the community well from a pure health perspective a primary health care perspective both are healthy 2020 group and St. Nicholas Hospital and the in the Aurora system who does a very extensive survey in our community which they do in all the communities they serve the the one the number one issue is access to dental care just basic primary dental care and prevention for folks in the Medicaid population and people who have no insurance that is floated at the top you know and we all sort of have our biases but I think Tom we've we've seen that through our through our groups you know you can have a lot of things wrong but if you have bad dental health it has such a negative effect on your overall mental and physical health that this is risen at the top and we're getting wonderful cooperation from many of our our dental community folks so outstanding outstanding thank you Mike Tom earlier you mentioned the birth to three program and other early venture intervention programs you tell us a little bit about how that birth to three program really benefits the families in Sheboygan County sure one thing that science has told us Mike is that development in those first three years of life is critical in the first 12 months for example a baby's brain doubles in size in the first three years of life brain activities about double that of what it will be in later life so that first three years offers critical opportunities to promote development and those windows of opportunity close after the first three years and we also know that the role of families and caregivers and promoting development during that early stage is critically important so we offer a program called birth to three I'm pleased to say that it's open to all county families it's not an income-based program it takes a look at the development of children those who may be experiencing developmental challenges who may have diagnosed conditions that could result in some form of delay or have atypical development or just questions in general about how a child is developing can request screening through the birth to three program so once children are found eligible I'm pleased to say and it's in alignment with a little bit of what Dale was talking about historically our approach to serving children in that circumstance may have been what I'll call a traditional medical model we would have focused service in the interest of that child we would have held the child as the center point of our efforts but this birth to three program engages families it's a home-based program and it understands that if we're going to best promote children's development long-term then we should focus our efforts on educating families on how to promote that development so once children are enrolled in the program it's a home-based delivery system families may be called upon to cost share if their income is high enough we'll ask for access to health insurance if health insurance is available and once that's all in place we work with a number of community partners we work with the rehabilitation center of shabuigan and they provide us with educators and service coordination assistance we work with an agency called rehab resources that provides therapists speech therapists occupational therapists physical therapists in all of those professionals will do home-based instruction and intervention again engaging with families to teach them how to best support those children last year we serve just over 300 children and families in that program sounds like that's a big help deal what about maternal child health and wick programs how are those similar and what areas do they really help out well the the women's infants and children's program returned to commonly as wick that is a nationwide program that deals with with nutrition activities health activities or health assessments of folks that are eligible for the program and people certainly could call the office we'd encourage them to see if they're if they are eligible and our staff could certainly give them detail on that but it's pretty integrated the maternal child health staff which do which also do a variety of things but they do prenatal care coordination to make sure that mom's pregnant ladies younger women particularly have access to good prenatal care have access to these prevention programs be sure that during their pregnancies that they understand good nutrition we're we're doing a we're working with folks now on a thing called first breath which are gee believe it or not there are young people that smoke unfortunately and there are young women that are pregnant that smoke and we're trying to intervene and at least get them through their pregnancies without without the smoking habit which is so deadly to those those children before they're born so it you know in again in the old days as I would call it in my in my career there were things were categorized things were in silos and I was a person or a I would have a person do wick I'd have a person do prenatal care I'd have a person do lead now when a child walks into a the wick clinic as an example they will have a health screening they will have a lead poisoning blood test they may be referred to immunizations they'll catch them up on their immunizations you know we we kind of capture them for a few minutes and we try to to do everything we can in the preventive world preventive health world to keep those moms and keep those children moving forward in a good healthy manner thanks for explaining those similarities Tom I know that your department's also involved in helping people find access to health care and what's that situation like today what kind of assistance can you provide and how are the demands for that coming along is that something we're seeing more need for you bet Mike that access to to health insurance benefit is made available through our economic support division and I guess it follows that in order to make use of health care most persons need a payment source when people don't have a payment source they will defer health care and what that does is it leads to major illness and poorer health outcomes so our department through our economic support division in particular provides access to a program called Medicaid or medical assistance which many people are familiar with and there's a couple of tracks that will allow people to gain access to that health insurance the traditional track is related to social security determination on behalf of persons who are elderly disabled or blind but in recent years the state of Wisconsin also opened that Medicaid program up to working families who are either underemployed or whose cost of health insurance access is not able to be met with wages alone that program's called badger care and what we know is that our experience in Sheboygan County that program has grown by 300 percent the enrollment in that program has grown by 300 percent in the last 10 years we saw a spike in 2004 when the program was opened up to working families and that spike was about 40 percent growth at that time I'm sorry 50 percent growth at that time and then in 2009 once we started to realize the full downturn of the economy and people became unemployed program enrollment grew by another 40 percent so you can see you know the the environmental conditions that have led to the growth of that program currently as of last year we're serving about 16,000 persons per month through the medical assistance program and benefits totaling about a hundred million dollars per year are made available and that pays for health care prescriptions things of that nature within Sheboygan County that's great now our aging population is a concern more than just Sheboygan County but how are you dealing with the people from the baby boomer generation who are trying to access health care programs in Sheboygan County yeah you're right Mike the the aging population and I'm glad I'm not there yet by the way so the aging population is becoming a huge driver if you will for many of the programs that we offer and for health care in general I mentioned our aging and disability resource center earlier that's a program that was established through our department's efforts about five or six years ago if I recall correctly and the demand for that service has grown exponentially during that period of time last year alone requests for assistance through the ADRC grew by 20 percent we're currently receiving about 11,000 requests for help each year and those requests range from information and assistance benefits counseling futures planning and health promotion activities one of the things we did this year Dale and I in collaboration and in partnership with our staff as we've now assigned one of our public health nurses to a halftime position at the ADRC in the interest of health promotion so why health promotion for older people well one of the major public health concerns for folks who are older is falls and what we know is that for persons aged 65 and over about one out of three is going to experience a fall each year by the time you reach age 85 your likelihood of sustaining a fall grows by about four times that amount and falls lead to major injuries lead to hospitalizations and in some cases lead to death so preventing falls is a major public health concern we offer falls prevention programming through the ADRC we offer living well with chronic conditions classes through the ADRC right here on TV eight there's a monthly independent lifestyles program we have a senior newsletter that's actually available online for persons who may not be able to access it or not accessing it through direct mailing currently and we offer five senior meal sites throughout the county and that's in Adele Plymouth Howard's Grove Sheboygan Falls Sheboygan and so we promote nutrition but also socialization for that population all of which lead to better health outcomes that's great appreciate you expanding your programs to keep up with that growing generation that'll turn it back over to Adam thanks Mike Tom you and I had a chance to attend a meal site a number of months ago but it was for an individual I think celebrating our hundredth birthday that's correct yeah and it was pretty neat it was real neat and it was nice to interact with the individuals that took advantage of that service and and just it was just a good day Bernita I think her name I think I think you're right yeah we had a big celebration that day a lot of music some laughs some fun and you're absolutely right I mean just sitting over lunch and hearing some of those life stories and comparing notes it incredibly enjoyable for me and I can appreciate for the folks that have come to rely upon those meal sites that's a vital piece of their their daily life we had public hearings we have public hearings every year related to our budget and I would have to say that the number one you know hope that was expressed to us through our public hearings is please keep the meal programs going because people appreciate them so much well speaking of meals I know Dale you comment commonly are in the paper referring to some public health matter dealing with our restaurants or food safety water quality to the season pretty soon folks are going to be heading back out to Lake Michigan and taking advantage of the spring and summer conditions share a little bit about your role there what why do we see you periodically commenting in the paper about water quality or food handling sure sure that's one of my favorite subjects that happened to be my my original public health background when I got out of college we have a small unit called environmental health services within public health and health and human services and in the old days our people would have been referred to inspectors we try to refer to them as environmental health specialists and environmental health educators the focus has changed we we have about 700 establishments ranging from every kind of restaurant in the county to lodging units to swimming pools to spas there are about 20 different kinds of licenses that we that we issue with an agreement with the state to act as their agent so it gets really it's just a lot of fun we provide serve courses for the restaurant managers and their owners so they understand what they're supposed to be doing to protect the public and in this day and age when every time we open the paper up we're looking at tourism we're looking at trying to bring people to our community not only to for economic growth but because we were proud of it that the last thing you want to have is any significant kind of outbreak because of poor environmental health programming you talk about people soon be going to the the lake I was I have we have a good fortune of living a block or about a half a block off Lake Michigan and last weekend you could hardly get down Lake Shore Drive because everybody was waiting around and all the the kite flyers on their boards were were on the south off the south pier at Blue Harbor so you know we sample all the beaches through a DNR program periodically through the summer we post those they are on a website and we mentioned Tom mentioned the website earlier for folks that are interested in the quality of those beaches they they can go on the website and see what's going on whether the beach is open or there's any warnings those kinds of things we also do a lot of work in in the city of Sheboygan on childhood lead poisoning because of construction because we have a lots and lots of pre 1970 housing units in the county and we have a very active program so good stuff excellent work a lot of very important work and I know we had a few more questions we want to hit here yet today but we've already gone through our 30-minute program and again I can impress upon you enough the important role and responsibilities of our health and human services department and today was just a thimble of the very important work that they do and if you have more questions or would like to get a better understanding of other programs and services don't hesitate to contact either of these gentlemen or anyone at the health and human services department we have outstanding staff highly dedicated and they're there to help you so don't hesitate to follow up again as I mentioned at the onset next month Sheboygan County government works week health and human services will be our fundamental focus there's going to be some special programming and opportunities to learn more and again get involved be part of this outstanding community and certainly we support your work and thank you Tom and Dale for being here today giving a nice overview thank you both so on behalf of the Sheboygan County board and chairman Mike van der steen again thank you for joining us next month our child support director Jim Graff will be here to talk about the important work of the child support department and again until then thanks for joining us