 The oldest child turned 25 this year and I started with the county before her birth. So it's been quite a while and a number of different positions within the county, including starting out at the Comprehensive Health Care Center back in the late 70s. So I've been director of the Health and Human Services Department since June of 2004. I'm sorry, June of 2001, so it'll be four years next year. So it's been a real pleasure serving in that capacity and working with the management team and the staff at the Health and Human Services Department. And as you said, a number of years with the department starting at the Comprehensive Health Care Center and prior to becoming director, you were actually division manager of social services. That's correct. I did that for a number of years and prior to that I was actually a social work supervisor with responsibility for a number of special projects. And as I look back at that time, I wrote the first county community youth and family aids plan, the first community options program plan. So really had the experience in a number of different areas within the department. And I think as director as I look back, even though some of that knowledge is a bit outdated, it gives me a good perspective on how we can integrate services not only within the department but within the county structure as a whole. We could take this entire program and talk about Ann's experience because not only is she a tremendous asset to Sheboygan County, but the state is also drawn on her as well to participate in some state committees and the governor's appointed her to the Munga Refugee Resettlement Task Force. Thank you, Ann. So she definitely is a tremendous asset to all of us. Ann, why don't you start by sharing with our viewers not only the little bit you did about yourself but those who aren't aware of the mission of the Health and Human Services Department. What is that core mission? In actual terms, it's just to improve the quality of life and self-sufficiency for all Sheboygan County residents. I sometimes say this, but it is true. We serve people pre-birth all the way through death. So we kind of say a little bit, it's womb to tomb. When you look at the services we provide in the division of public health, we're very concerned about the unborn child and healthy pregnancies, good nutrition. And for some people in our community, based on their economic situation, through our economic support division, we actually assist people with the burial process and everything in between. So it is a wide range of services that we do provide. We are located in three locations right now too with our economic support W-2 agency at the Job Center on Wilgus Avenue, our main building for those lifelong Sheboygan residents being in the old Sheboygan Clinic on North A Street, and then our annex location on North A Street a little bit further to the south in the former Baxter building. So we're located in three locations at this point in time in providing those services. And you're organized by five different divisions. Maybe that'd be a good way to share with folks the primary organizational structure. Sounds good. And I do have five division managers for each of those divisions. I'll start with the Job Center, which we talked about being the location for economic support W-2. That is the division that provides eligibility determination for financial assistance. And for many people, they're familiar with the food stamp program. That program is now called food share. It's no longer food stamps. And individuals who are eligible can obtain a quest card, and that is much like a debit card, that the food share allocation is put on that card and they use it just like a debit card in the grocery store. For some of our elderly individuals who are receiving food share, it might be $10 or $15 a month. And that doesn't sound like a lot. But if you think of an older person who might want to save that up from the first of the year through Thanksgiving and provide a Thanksgiving meal for the family or be able to participate in that, it can mount up over a 12-month period that $10 or $15. For our lower income households, food share, which is now the program, definitely comes in handy in terms of stretching limited budgets. They also determine eligibility for medical assistance. And we also operate the W-2 or Wisconsin Works program out of the Job Center. We have the Division of Community Programs. And that is a very expansive division, including all the behavioral health, which is your substance abuse and mental health. In addition, that is the area of service primarily responsible for long-term support services to people with disabilities. It could be a developmental disability, a physical disability, or infirmities of aging. And what we do there is work to keep people in the community versus going into a nursing home, or at least hitting that continuum of care at the appropriate time in their life. We also have, as you mentioned before, the Division of Social Services, and Marty Bonk is a division manager, that area of our program basically has responsibility for all child protective services. That's all the abuse neglect for children and also for juvenile justice. And those are young people who tend to get themselves into some trouble in the community. Anything from truancy all the way through armed robbery, burglary, those types of things. And I forgot to mention Joan Ketterman is our division manager for community programs. And Liz Malick is our manager for economic support. The fourth division is our division on aging. And Jim McCabe is that division manager, formerly and oftentimes still called the office on aging. Primary responsibility for the elderly. And when you ask about who's elderly and who's not, it varies depending upon the program. So there's no magic time that you become elderly. It's based on certain program criteria. Primarily, they're known for their nutrition sites. They're senior dining sites throughout the county. And we have nine of those. And individuals can partake not only in the congregate meal activity, but other activities that might be counseling on nutrition. We bring in people to help prepare taxes, apply for energy assistance right at those senior dining sites, and also the handy care transportation program for the elderly and people with disabilities. And this year, we got two new buses through a state grant. So that's been very, very helpful in that area. And then our final division, which I'm drawing a blank on at this point in time. And I'm on that floor. And it's public health. And it's Dale Hiffner-Steel as a division manager. Public health ranges from our hotel restaurant inspection program to prenatal care that I talked about earlier, the Women, Infant, and Children, or WIC program, school health. And as we'll probably talk about a little bit later, some of the activities that always occur during the winter with flu and other things like that, but definitely more in the area of prevention with immunizations, making sure children are immunized, lead abatement, and healthier lifestyles for all of us. So economic support, social services, public health, office on aging, and community programs. Very good. If I could draw a blank in a short period of time, as you just did a minute ago, we'd all be in better shape. Very good. A great overview. Now, these division managers and yourself, obviously, a tremendous amount of responsibility you provide important leadership. How many employees are working at the Health and Human Services Department? Well, when I started, we had just over 200. And with downsizing and some of the budget reductions and changes that we were able to make, we're at 189 employees. A few of those are part-time, but I'd say that's down to about four different individuals that are part-time at this point in time. The rest are full-time. And for the benefit of our viewers who have perhaps heard some of this information for the first time or are interested in learning more about how a program or service might be able to help them or a friend or a loved one, how would they go about getting that type of information? OK. I'm going to give two general numbers out, and I'll do it twice just so everybody knows. 459-6400 is our main number for our main building. With that process, you would access actually the voicemail system that would give you prompts in terms of if you're seeking a certain type of area. If you don't want to listen to those prompts, you can hit 0, and an actual person will answer the phone and be able to direct your phone call. Also for our job center, it would be 208-5800. And that would take you directly to a main number at the job center in terms of W-2 or any of the financial assistance programs. So again, 459-6400 and 208-5800. I think it's important to note that some of the people that we actually work with and provide services to are not voluntary clients. So for people that wish to refer a case to us, let's say, for child abuse, neglect, or suspected elder abuse, they can look in the phone book and actually find an extension that would get them to report that. But if they do call the main number at 459-6400, that would be able to direct them to the correct place. But we provide information and referral and assistance more in terms of prevention. But there are other ways that we do provide services, and that would be through an involuntary process. And final question before I turn it over to Bill. All of these programs and services that are available, obviously, providing such an important niche in the community, but how many people do you think the department serves on an annual basis? When we talk about this every year, I keep saying one of these years I'm going to have an information system with an unduplicated count. But since the state of Wisconsin can't reach that point, I'm not sure Sheboygan County can either. In going through the various systems that we have in terms of data collection, on an average we serve between 30 to 35,000 distinct individuals. Now some of those would be part of a family unit. But that's a significant part of the population, and that's as close as we can get to an unduplicated count. Some people may be receiving services from economic support and also public health. So they may be receiving more than one service also. Well, the population of Sheboygan County is about 112, 115,000. So that department is touching the lives of 25% or better of our friends and neighbors in the community. Absolutely. Thank you, Ann. Thank you. As you know, I worked in the human services field for most of my career and also served on the Human Services Board. And I would just like to tell you how much I appreciate the job that's being done by Sheboygan County Human Services Department and especially with you as director. Thank you, Bill. Now that said, most of the funding for our programs comes from the state and federal government, although there is a fair amount of county dollars that go into it. Most of those funding streams have stayed fairly steady or decreased. But are there any areas where the state has helped to expand programs that were actually going further than we did before? Absolutely. And as you said, our budget is significant. It's about $39 million. And out of that, 11 million approximately is tax levy in the balance of state and federal funding. Most recently, as you know, with the state budget crisis, the state is looking for new ways to provide funding to counties in terms of service delivery. Bioterrorism has been a big push at the federal level with the Homeland Security and our public health unit and division has been very, very involved in bioterrorism planning, along with Steve from our emergency government. Just about a month ago, I participated in the tabletop in Ozaki County, which is one of our partners. In terms of bioterrorism planning and the actual exercise they go through is just an excellent learning tool if we'd ever have to face some actual crisis. So bioterrorism has been one of the areas. In addition, the state has really expanded some funding in terms of medical assistance waivers. And that would be our comprehensive community services grant, which will allow us to provide services to existing clients with mental health needs, but expand that population and allow us to access federal dollars at the 60% level. So that's been very, very helpful to us also. As you're aware with the refugee resettlement and as Adam referred to with the governor's task force, the state has made additional Wisconsin Works W-2 revenue available not only to meet the refugee resettlement needs, but also the growing needs in the W-2 population. As we talked about, little federal mandates continue to change over time and there is currently a change going on with the ICFMR. How will that and other changes impact your operation? The ICFMR being the intermediate care facility for mental retardation is a unit within many county nursing homes that provides long-term care institutional services to people with developmental disabilities. The legislation will prohibit long-term placements being made in those ICFMR facilities effective January 1st of 2005, so it will limit new admissions to ICFMRs. In addition, we'll have to begin doing assessments of current residents and determine what might be a more appropriate setting and in the state and federal terms, that's called most integrated setting. For some individuals, they'll be able to continue to remain in the facility, but at a nursing skill level versus an ICFMR level. In some cases, the court will actually order a community placement. Over a period of time, based on this legislation, we will see ICFMRs basically downsizing, and in some cases, county nursing homes eliminating that as part of their program and service delivery system. The community services budget really has been difficult throughout the years and we've had a waiting list which has grown and grown and grown, but could you tell us about at least a little bit of good news that came from the county board recently? Absolutely, and we were really pleased with the support of the county board supervisors and the community. Individuals in the community have been on, with developmental disabilities, I should put a parameter around that, have been on a wait list waiting for community-based services, and as of today, we have 118 individuals on that wait list, and I need to always clarify, that wait list can increase or decrease depending upon what happens, but as of today, it's 118. The county board added an additional approximately $200,000 of tax levy into our budget, which will allow us to draw down additional federal dollars, in fact, 60% federal dollars, to address people on the wait list. Based on our estimation of how the money can be used, we anticipate beginning in January that we'll be able to reduce the wait list by 30 individuals, although I'm sure most people would like to see the wait list totally eliminated. 30 is just a really nice start in terms of serving people. Some of those people have been on that wait list since 1999, so they've been waiting a long time for services, so the consumers are pleased, the advocates are pleased, and definitely for us, we're looking forward to being able to provide services to approximately 30 additional people. Now on Tuesday night, next week, Tuesday, we will be voting, or I should say the county board, will be voting on adding a staff position to the table or actually amending it so that we can have a staff person that will actually do the assessment and provide those case management services to those 30 individuals. So I guess I want to say thank you, Bill, and to the county board supervisors for their support of that. Have you any idea where we are percentage wise as far as having a wait list and compared to other counties, if we're kind of in the middle, higher or lower, is it difficult to tell? The state doesn't track that because it's not one of those data elements that's in any system. What I do know is those counties that are family care counties have no wait list. It's just part of the family care, managed care process. Unfortunately, the state doesn't have the money to expand family care statewide. There are some counties such as Calumet County, just a little bit to the north of us that does not have anybody on a wait list. And then there's other counties that have more significant wait lists. So just my best guess without official data is we're probably at the middle, but the top end of the middle. If you don't count those family care counties at this point in time. Then finally, I know our county partners with a lot of other community agencies. Can you talk maybe about how we partner regarding elder abuse or some other program? Right, and I know that we've talked about elder abuse before because it is a fairly new program. We have a M team process, kind of a multidisciplinary team process, both internally and externally with the elder abuse program. And just to help the public understand, elder abuse would be financial abuse of an elderly person. It could be physical abuse of an elderly person, emotional abuse, or it could be self-neglect, where I'm self-neglecting myself as an elderly person and there's nobody to intervene or step in. The state looks at about one third of the elderly population at some point in time suffers from some type of abuse. So it's a fairly significant number. What we've been able to do is partner, not only with the Sheriff's Department and the District Attorney's Office, but we've partnered with financial institutions and community organizations and they form our M team and give us advice. Currently that M team is targeting financial institutions for education and outreach. Financial abuse is really a significant area of use for the elderly and if you have a teller or someone at the bank that typically is working with an elderly person and can see any unusual activity in their savings account or their trust accounts or whatever it might be, we fear that's gonna be one good way to be able to eliminate some of the financial abuse that leads to serious stresses for an elderly person. So it's been a really good partnership with the financial institutions and they're looking at having a conference in mid-spring and we're still looking for a location in terms of then providing some additional outreach to the community on elder abuse. Okay, thank you Anne. Thanks Bill. Well Anne, it's that time of year where the temperatures are dropping and certainly our viewers are aware that teens change, the teen temperatures change how you're gonna dress and get out and about in the community and that can impact both young and the aging. And one of the reasons we have you on this time of the year is the Health and Human Services Department provides some very important programs that help people, especially when the temperatures are dropping as well as just the holiday season. Why don't you touch on some of the programs that your department's involved in? Well I'm gonna start with the Energy Assistance Program and it's called Wisconsin Housing and Energy Assistance Program. It seems every year they change the title just a little bit. But that does provide some financial assistance to low income families and individuals, especially the elderly again, in meeting their heating bills and their electric bills based on eligibility criteria and we continue to take applications at this point in time through our job center and we've done outreach at the meal sites and in a variety of other locations throughout the community that's limited assistance but it does help people at least a little bit with their heating bills and also provides an assessment if they could use some modifications to the home in terms of energy conservation. This past year we also worked with one of the steam fitter local organizations and they came in one Saturday in October and we had about 12 elderly low income individuals where they actually went in into a furnace check and went through the house and checked for smoke alarms and that type of thing and they hope to expand that next year in terms of being able to do more homes. At this time of the year, we talked about a little bit earlier but the flu vaccine shortage really had an impact in terms of public health and now that's been expanded a little bit so people will be hearing more that if you haven't been able to get a flu shot the population that now can get that has been expanded so that might help a little bit. I brought something along. It's nothing major but it's some key things that we wanna talk about at this time of the year and I did share copies with the cameraman but washing our hands at this time of the year is just vitally important and I won't go in how we do it but if nothing else prevents the spread of illness and colds it's definitely washing your hands and we can't stress that enough for both children and adults and then we have cover your cough and I have to laugh at this one and Adam we were at a human resources committee meeting where I kept reminding and Bill was there also. We always tend to cough in our hands. Well that's one good way now I shake your hand Adam and I've spread it so even though our mothers would always say we shouldn't do this they recommend that you cough into your sleeve and that way you're not gonna be transmitting so those are some things that we're really focusing on at this time of the year in terms of disease prevention and control. Good tips and simple ones for people to follow if they just take the time to change their behavior a little bit. That coughing the sleeve though might upset a few mothers this time of the year. Not only that but I keep reminding myself too because it's so ingrained in us to put our hand in front of our face. And often when you're with friends or family over the holidays and someone extends their hand to shake it you're gonna shake that hand but washing your hands frequently is gonna help keep people healthy. So you talked about a very important program when it comes to keeping people's homes warm if especially low income would have you. What about some of the other programs such as the share of the spirit and the food donation program? Christmas and this community has always been generous and yesterday I had the opportunity to go upstairs to our gift room and help take some contributions up. We have groups and individuals that have provided clothing, toys, food products specifically for the clients that we serve from the children in foster care to children with their families to the elderly and that gift room I can't even begin to describe the extent of the goods that have been donated so it's been fantastic that way. What our staff can do then is go into that gift room and pick out a toy item and a clothing item for every child in the family and also something for each adult in the family. That then is given to the parents or the foster parents to provide to their child so it's not like oh my social worker gave me these Christmas presents but it's a way to really support our families. Share the Spirit has been an ongoing project with the Sheboygan Press and primarily our division on aging and long-term support units. And if you'll notice in the Sheboygan Press there's a column called Share the Spirit and in there it might highlight someone by the initials AW, age 62 who is residing in a community-based residential facility. We'd really like to get out to the beauty shop and get a permanent. And what happens is we have individuals that may agree not only to provide that payment for the permanent but actually provide the transportation for that person. And some people are just more than willing to write out a check or do a financial donation. We were so fortunate last year with a fairly sizable donation that we had needs that came up over the summer months for people needing things that were elderly or had a disability and were able to actually you share the Spirit to meet those needs also. So it's something as you look through the paper and you see what the needs are, you can be matched with a particular individual or more than definitely send some money and we'll see that those needs are met. Wonderful, wonderful. How about with food donations? We do a limited amount with food and I wanna stress that because we aren't equipped to handle perishable food and that's always a key thing. Last not this Thanksgiving but the previous Thanksgiving what occurred was we had some people drop off actual frozen turkeys and milk products and that type of thing and we had to get to families rather quickly for that. We do maintain though some canned goods and we have the JCs and a few other groups that do prepare food baskets and then we match them with an actual family or a person where we can do that type of food donation. And of course we work closely with the food pantries and the Salvation Army. So we wanna make sure that we're not duplicating a service but definitely supporting what is out there in the community. Well you said it earlier, Ann. We have such a generous community and people often are looking to help and sometimes don't know where they can go to make a contribution. And for people who are watching this and interested in reaching out to someone or providing some assistance, what's the best way for them to contact your department? Okay, we do have a person that does volunteer coordination on a very part-time basis and that's Pat Prigge. And again, by calling that 459-6400 number, that call can be directed to Pat. She's always looking for volunteers and she is the one that coordinates the holiday donations for us also. Judy Linesy, by calling that 6400 number, phone calls can be directed to her for Share the Spirit in terms of questions. And she coordinates that. And also our volunteer driver program for the elderly in terms of medical transportation. Judy would be able to link you with that. We always need foster families, families that are willing to open their doors and their hearts to children who need placement outside of the home. And Jackie Erdmeyer, again, through our main number, all you have to do is ask to talk about foster care and that phone call would be directed there. We have a similar need for adults with disabilities in terms of adult family care. And that would be instead of taking in a young child, a family takes in an adult who may have a developmental disability or some other type of disability. And again, provide that support in the home to that person with a disability to keep them in the community. We do a lot during the course of the year in terms of special functions with school supplies. And again, that would be through the 6400 number. Well, I am just a great overview of all the programs and services. And I know you couldn't touch on them but in that short period of time, a wonderful overview. And for our viewers who have the opportunity to take this in, please, if you have any questions or if you wanna help or if you wanna just get involved, don't hesitate to contact Ann or a member of her staff because as you can quickly appreciate, there's a lot of good things happening in Sheboygan County by our Health and Human Services Department. So Ann, thank you for joining us today. Thank you. Next month, our guest will be Chuck Mayer, the airport director doing a lot of good things out at the Sheboygan County Memorial Airport. And until then, on behalf of County Board Chairman Bill Gearing and myself, Adam Payne and the Sheboygan County Board of Supervisors, happy holidays.