 Welcome to Sheboygan County Government, working for you. My name is Adam Payne, Sheboygan County Administrator and co-host of this program with Chairman Bill Gehring. And today we're pleased to highlight one of our departments that frankly is the largest department in Sheboygan County. With us today is Anne Wundergem, Director of the Health and Human Services Department. And she has a special guest with her, Milda Zingler. Milda is the new supervisor of the Aging and... Aging? Say it for me, Milda. Aging and Disability Resource Center. Thank you, Milda. That's why she's the supervisor. Anne's going to talk a little bit about the roles and responsibilities of the Health and Human Services Department. And then Milda's going to talk about this new area that is there to serve both aging individuals and folks with disabilities throughout Sheboygan County that really is a new initiative, an exciting initiative for Sheboygan County. Anne, why don't we start with you? Please tell us a little bit about some of the core services that the Health and Human Services Department provides. Well, I often say kind of in jest, we do it womb to tomb. In other words, we serve individuals while they're pregnant. And for people who financially need assistance, we assist with their burial and everything else in between. And that shows kind of the broad scope of what we do. But I think when I think about our primary areas, I look at public health where we provide vital services to the community and benefit everyone from hotel restaurant inspection to communicable disease control to nutrition programs. We also administer financial assistance programs for county residents so that we determine eligibility for medical assistance for food share. And we also operate the Wisconsin Works Program. And then of course, as you know, we provide services to children and families through protective services and juvenile justice. So we really look at that personal and public safety issue in terms of providing services. And we talked a little bit with the Aging and Disability Resource Center, our back end of that system, our long-term care system for our elders and people with disabilities who need services in their home to support them. And then last but not least, our behavioral health for individuals who are dealing with issues with mental health or substance abuse. So that kind of gives you a general overview of the breadth and scope of what we provide. And our services are many times based on eligibility and in other areas open to the general public, the residents of Sheboygan County. We could literally have you on probably every month of the year when I mentioned earlier that this is the largest department in Sheboygan County of our 23 departments. The Health and Human Services Department is the largest with over a $46 million budget. So a tremendous breadth and scope of program and services doing a lot of very important work in the community. And most recently, a new initiative came our way. And Milden now is the supervisor of the Aging and Disability Resource Center. You just had an open house. Yes, we did on Monday. And how'd that go? It went very well. We had approximately 80 people come through our doors and there was a nice variety of people. There was a nice representation by the boards, by board members. And we had providers from the community, people from different agencies that represent services to people. And then we had consumers, people who would be potential consumers also came through. And many county employees that know about us but hadn't been there to see the place. So they came through also. Now Milden, you've worked with the Health and Human Services Department for what, a little over eight years? Yes, eight years ago. And what's been your area of focus? I was an adult protective services specialist for eight years. And what I did is guardianship's protective placements, that court-related work. And then I also did abuse and neglect investigations. So during that time, I was able to interact with a lot of different populations of people, the elderly, developmentally disabled individuals, all adults. And also worked with lots of different consumers, service providers, and all the different units at Shboyton County Health and Human Services. So some good background to be the supervisor of the... What Milden did here, is that she also certified adult family homes. Very good. Well, now that you're a supervisor of the Aging and Disability Resource Center, I'm gonna try to say that 15 times during this program. And I know that this didn't just suddenly happen, that there's been a lot of discussion and planning that went into this. Please set the stage. How is it that this new approach came about, this little flavor for the planning? On a statewide basis, when there were pilot counties for family care, part of the family care process is an aging and disability resource center. So there were five pilot aging and disability resource centers located throughout the state. The state and federal government both agree that this is a good approach to delivering services. And Milden will talk a little bit more about how that delivery approach works. But the key point was, is the state wanted to expand this. And they looked at doing an additional nine to 10 pilots throughout the state. So we went through a competitive grant application process and applied for planning money about two years ago. And then we spent 12 months basically looking at our current system and how we could build on that and improve it to better integrate services to form the Aging and Disability Resource Center. Sheboyton County had a step up because we already were a Health and Human Services Department. So we could bring public health into the mix, which is a real key component. We already had aging as part of our department. So we had some of the necessary ingredients to really make this form and work. So then we were successful in writing the actual plan and submitted that to the state and got full funding for the new components in the system because there were three new components that we needed to bring in and then bring in our existing resources through our long-term care system, our aging unit and public health. So it's been a process that probably in Sheboyton County we were a few steps ahead and could build on the pluses that we had in our existing system. So folks have just joined us and now they've gotten a flavor for who you both are and the importance of the Health and Human Services Department. But they're hearing about this aging and disability resource center for the first time. Milda, what is it? What is it? We like to say it's a one-stop shopping. I mean, that's a little cliche that we use, but it's a central access point that people can come and obtain information about community resources, both public and private. It's for anyone, there's no eligibility requirement other than it's meant to be for people who are seniors and for adults with disabilities, particularly physical disabilities, developmental disabilities, mental health issues or substance abuse are the four that we address. And like I said, it's for the person themselves to call or their caregivers or their family members to call and get the information. Our emphasis is really on having it be a welcoming environment and I'm hoping that when people came to our open house they found that environment welcoming when you got off the elevator it was pleasant and the idea that you go in and you're going to speak with someone when you come or if you call us you're always going to speak with a person, you're not going to be given an answering machine unless you specifically ask for someone that has their machine on at that time. But besides giving out information, we also attempt to assist people to get hooked up with the resources. Many times when people, you can give them the information say you need to call here and here but they really don't know how to make that connection and how to call and that's part of our job is that if that's what they need at that point we will assist them with that. Obviously we can't have all the information at our little fingertips so another part of it is that we will always tell people that we will research it a little further and get back to them with some more information if that's what they need. And a big part of what we hope to be doing down the road is more preventative. We would like people to think about what their long-term care needs might be like or what are their options for that in the future so that they'll come to us and get the information and start planning for those long-term care needs. Because as we all know, everyone usually wants to stay in their own home as long as possible and if we can give them that upfront information on how they can possibly do that a little longer, use their resources a little more wisely, let them be the one making those decisions I think the county will be better off for it and the individuals will be too. Excellent, excellent. Now when Chairman Gehring and I attended the open house the other day, the elevator doors opened up and we stepped out and there were people that greeted us and handed us chocolate and there were cookies available. Is that going to continue? Well, the one thing that we will have is our little magnets that have our name and our phone number on. We have those at the front desk now so anyone who does come in can get those and unfortunately we've always got a basket of candy there so you're always welcome to get one. Well it certainly is a nice environment and you've been open actually since July. July 1st we opened our doors. Now since July, anytime you start something new generally you see opportunities for improvement or things you want to do a little differently. Since you've opened your doors what are some of the changes that you've made? I'm hoping that one of the biggest changes initially is that we will improve communication between the departments that we work with and that we emphasize the importance of sharing information, working together as a team so that one person isn't feeling like I have to answer all these questions for this person or try to help them with their issues that we understand that we don't have all the answers and that we have coworkers and resources in the community to approach and get that information. And so little by little I feel that that is a change that has taken place that people are understanding that we're going to call and we're going to ask for information, we're going to talk to them, we're going to share resources and put our heads together. I do believe that we have been well received by the community of the providers that I'm used to working with, the nursing homes, the home healthcare agencies, service organizations. When they hear about what our goal is, what our purpose is, they've been very excited and very willing to cooperate with us. And you mentioned you had the open house and I know there's been some really nice articles in the Sheboygan Press and editorial the other day. If a viewer is watching this and wants to learn more about this or has a family member that they think would benefit from phoning the office or going to the office, how did they access this information? Okay, obviously a person can stop in any time they'd like between eight and five o'clock on the workdays, Monday through Friday and there will be someone there to talk to them. I guess I would recommend that someone call our office though instead to start with because number one, most of our interactions do take place over the phone. We can access the information and get it to them, we can send it to them, we can email people. So a lot of it gets taken care of over the phone. Also, if they call them, they have a specific issue and they need to talk to a particular staff, we would like them to call so we can set up an appointment and they're not wasting their time coming in. The other nice thing about the Aging and Disability Resource Center is that we are free and expecting to go out to people's homes. So if there's an individual especially with serving the whole county that is not physically able to get into our center or it's not convenient for them, they do not have transportation, our staff will go out to see them and share those resources with them in their home. Very good, and finally before turning it over to Bill, I have two grandmothers that live in Sheboygan County, both very strong-willed, independent ladies, one over 91 in her late 80s and living at home, again trying to be as independent as possible but getting at a point where they're needing some assistance. And as I think about the one-stop-shop that you've just discussed and the opportunity to share more readily information and help them make decisions, help them make choices, in the short period that we've had this open since July, without breaching any confidentialities, is there any example or analogy you could provide that would give folks a better flavor for just how this can really help people? I did think of that in preparation and there are a lot of little things that we have done for people that I think have made a big difference to them, but they seem small. But I did want to highlight one person in particular, a gentleman that was in the hospital, was coming out of the hospital and as you know, many times they need extended, some nursing care yet. And so one of the nursing organizations was going to be coming in a couple of times a week. And when they did, they were very concerned about this person's living conditions. He was living, he's on a fixed income, has little family, little or no family. His home is in disarray and very poor furniture, those kinds of things. Plus, he was having difficulty getting around in his apartment because he needed to use a walker or wheelchair and it wasn't happening. So they called us to get involved and we do the assessment on someone and found out that he would be potentially someone that we could serve, but at the present time are not able to do that, as you know. So our worker or the social worker was able to do a variety of things that helped him even though we didn't have, couldn't put him on the program. They assisted with getting him into low income housing so that meant working with the housing authority. Getting him into a place then that was more wheelchair accessible. We worked with places like St. Vincent de Paul, Salvation Army, to get him some different furniture that would be better for him and by moving him was able to keep the place clean and less cluttered. We were able to assist him with getting what's called medical assistance personal cares. In other words, he needed help with showering and things like that and we were able to hook him up with that program so that his medical assistance would pay for that. And then we were able to find some emergency money to help him move. So that's kind of in a nutshell the kind of thing we like to do is when someone calls us, try to coordinate those things for them and find out what's out there for them that we can get that need met at that time. Very good. Thank you. And I think the EDRC is a very great initiative and I think it will really help the residents of Sheboygan County. Having been on the Human Services Board for a number of years, I know that the Human Services Department has many, many programs that they do administer. The state continually changes things. Can you talk just a little bit about some of the changes that your department has gone through because of state mandates in the last couple of years? Absolutely. As a former board member, you know that what I talk about today could also change tomorrow. So you always have to put it in that context. As Milda is well aware, one of the big initiatives that we had this past year was working with Rocky Knoll in specifically Woodland Village in terms of the relocation of the residents from what was called the ICFMR, the Intermediate Care Facility for people with mental retardation. And I can say as of today other than two residents, everybody has been relocated into a community-based setting. And everyone is doing well. We've had some feedback both from the vendors and from the family members. And I think as you and Adam are both aware, some of the family members were very concerned. They were happy with the living situation at Rocky Knoll and really didn't want to see that relocation occur. And it's proved to actually be a better move for some individuals. Instead of living in a larger facility, living in smaller homes with three or four other people has really been beneficial to them. So that was an excellent example of a state initiative that caused some concern for people but in the long run has worked off very well both for the county and for the individuals. And I can't say enough about the staff both in the healthcare centers and our department that worked on that particular initiative. I think one of the things when Milda just talked about assisting someone because we have weightless for our long-term care, our back end of our system after the Agent and Disability Resource Center, the state has instituted what's called a community relocation initiative. And that particular program allows someone who has gone into the nursing home and has medical assistance funding to move back into the community. And the money that's funding them in the nursing home follows them back into the community and has proved an excellent resource for individuals who had no other choice but to move into the nursing home because they're entitled to that Medicaid reimbursement now can move back into the community. And we've relocated 21 individuals since the start of that program. Some of them back into their own apartments and some of them into assisted living facilities. So that's been an excellent resource especially for our elderly population. And the kind of the last thing we're working on and I know it's on the long-term care area but that's where right now a lot of the state initiatives are is the expansion of family care statewide. As both you and Adam know and Milda is aware from her job we have well over 100 people waiting for long-term care services in the community unlike nursing home services which are an entitlement if you're functionally eligible health-wise and eligible financially. You can be eligible functionally and financially for our long-term care services but we don't have any money neither at the state level or the local level. So we have a wait list for those services under family care which we're now planning for it eliminates wait lists. It makes community-based care and entitlement just like nursing home care for someone who is financially and functionally eligible. So we're part of a 12-county consortium working with three private partnership not-for-profit entities and one other not-for-profit organization beginning to plan for how we can expand family care to the 12 counties in our region. So it's taking a lot of time but it's definitely going to be worth the effort in the long run as we can work much like our neighboring county to the West Vondelac which is a family care pilot county and has no wait lists for individuals wanting community-based services. So it's an exciting time. All of these initiatives basically come down both from the federal and state government. They will be impacting our nursing homes. Is that correct? Well when you think about it right now you can go into a nursing home and get funding. If you now have the choice to stay in the community more people will opt for that. I mean if you ask a room full of people do you plan on going to a nursing home? Most will say no I want to stay in my own home. So as these programs grow the need for nursing homes will change. It'll be rehabilitative short term or definitely end of life and I think you'll see less utilization of nursing home beds in the future. Okay we've talked quite a bit today about services for the elderly and disabled. What about children and families? What is your agency doing with children and families? Unfortunately we are seeing an increase in our child abuse and neglect referrals and we do investigate those and just one day last week we had 17 referrals in one day which is more than a number of staff we have available to do those investigations. So we're seeing an increase in that but on kind of the exciting front we were a recipient of a state grant that we applied for to begin to develop coordinated services teams. So we're really working with the community to begin a process where we can hopefully prevent and intervene earlier with families when they're identified outside of our system and work with them so that we can help strengthen families and make them more self-sufficient and in the future prevent abuse neglect. So that's kind of the exciting thing on that front along with the state is looking at reforming long-term care for children with disabilities. So we're in the process of working with the state on implementing what are called children's waivers and working on that long-term care reform effort for children also. Your department also has a responsibility for public health. The flu season is coming. Every flu season we hear about there might be a flu pandemic. Are we ready for that? As ready as we can be. I sat in on a tabletop a couple months ago in terms of really planning for a pandemic and what would that mean? And then also our healthy 2010 luncheon where we had a university professor talk about the previous flu pandemic and it's fascinating we could spend more than a half hour talking about it. But we have public health staff that have gone through the process of signage locating facilities how we would basically provide the vaccine to over 113 county residents including special needs populations. And I brought something along for you and Adam as part of our overall process. This is not only to help if we have a flu pandemic but we can use many of the same principles when we have a natural disaster and these are called survival kits and they're a nice little water bottle that you can fill and in that water bottle is a flashlight. It's got a little container that's waterproof that you can put around your neck. It's got a poncho some batteries. So I have one of these for each of you from public health. Thank you. So that's your gift this year from us. But it shows the need and I also brought some brochures along that I'll leave here at TV 8 that you can pick up in public health but we have two different brochures. One is preparing for actual disaster which would be more like Hurricane Katrina in our case it would be a tornado ice storm. And the other one is dealing with the flu and that's what we basically talked about the pandemic. Pandemic planning is very very different in some ways than natural disasters because when the flu hits out of the four of us sitting here three won't be here and one will be so be a pretty interesting interview back and forth. So you really have to think about your workforce from a business perspective. How are you going to provide vital services? Your special needs population that needs to be addressed. So public health has just done a tremendous job and I see the minutes from all their planning meetings. So I think we're better prepared or as prepared as we can be and it's not if it hits it's when it hits and to what degree it hits. So the last thing I have to say on the flu is wash your hands, wash your hands and it's the time of year you don't want to shake someone's hand. It's much better to do a little wave as a greeting. Certainly while you have a fairly large budget with the broad variety of programs you have we can understand why you have a large budget. So thank you. Thank you. So what's the story on this again? Those we received free and they are actual survival kits. It's some of the basic things that you need to think about keeping around your house and working with public health I should be more prepared because I have all the items in my house but I don't have them in one kit in terms of being able to easily access things you would need if all of a sudden your house is flooded out or you're going to the basement for a tornado things that you want to have with you and take with you so our brochures kind of outline that. You go to the website for Sheboygan County you'll find information on preparedness. And the department has these available for people who contact you? At this point, no. We just have those for you. We have a supply and they're working on the distribution mechanism. I just want to make sure that we don't have hundreds of stocking stuffers calling in the next couple of weeks thinking wow that's nice. This will come in handy deer hunting this weekend. So no, we don't have those available to the general public at this point in time but they're a sample of what we can take out to show people kind of ideas for how you want to think about preparing for an emergency. Parts of being prepared. Well speaking of preparations and we don't have a lot of time left here but the fat season will soon be here Thanksgiving's around the corner Christmas around the corner and I know it's every year where I put on two to three pounds looking forward to the holiday festivities and this time of year there are some folks who aren't as readily able to get some of the festivities and food that goes with this time with the holiday season and I know you have some important programs that the Health and Human Services Department provides for. Could you touch on some of those? We are really fortunate that community agencies are very supportive of our department. We participate in the Festival of Trees which is coming up December 1st, 2nd and 3rd at the Sheboygan Armory. We're a recipient of part of those funds so I'll be down there on Friday, December 1st in the evening at the bake shop just where I need to be around the holiday season is around those baked goods. So we really are supportive of that. The Sheboygan Press is working with us and share the spirit will again start where the press will feature a story about typically a person whose elderlier has a disability who would maybe like to have their hair permed and would like a certificate for that. In some cases, they want to go out for lunch at McDonald's. So we ask people to think about responding to that either in terms of actually providing what someone is requesting or making a monetary donation to allow us to provide for that. We work closely with our community groups and support the Salvation Army but we also have groups of individuals that provide toys and clothing articles to our department that then our staff can work with the families they're working with to help supplement the families to have a very nice Christmas. So those are some of the key things that are coming up at this time of the year that we can help support parents with their children or homebound elderly or people with disabilities. A lot of needs out there. Every time I talk to you about the number of people you're serving and the need out there just even being closer to it then generally most people in the community it always amazes me the need out there. And if folks want to get involved whether it's to donate food or gifts for the holiday season or just how they can help how do they contact you? How do they get more information? What they want to do is call our main number which is 459-6400-459-6400. That's our main receptionist and they can listen to the prompts or they can ask to speak to our volunteer coordinator in particular about the gifts in the Festival of Trees. In terms of Share the Spirit we're going to have them call the Aging and Disability Resource Center and I'm going to have Mil to give the number because it's been printed in a couple of places incorrectly. It's 459-3095. 459-3095. And it is the number that people have been calling for a long time so that's the nice part. It is the same number. So and that will access Share the Spirit and that particular program. It's just that time of year where people want to give and we want to make sure that we provide them the opportunity to do that and we support them in that. Well thank you both so much. The time just flew. Milda Zingler, Aging and Disability Resource Center Supervisor, we're so pleased that you were with us today and shared some very important information. Thank you. Thank you for the work that you're doing and Anne Wundergem of course our Director of Health and Human Services. Keep up the good work and we really appreciate what you and your staff do. Thank you. And thank you for joining us. Next month we're going to have a new face here. It's going to be Ellen Schleicher, our Register of Deeds who was just elected to the position so we'll look forward to learning more about the Register of Deeds roles and responsibilities and until next month have a safe and prosperous Thanksgiving and on behalf of Chairman Bill Gehring and myself Adam Payne. Thank you for joining us.