2013 Annual Sauk County Health Department Community Health Improvement Plan (CHIPP) and Sauk County Comprehensive Plan Report

The 2011 Sauk County Need Assessments identified 4 top health priorities for the community, they are:

• Chronic Disease
• Physical Activity/or lack of
• Access to Dental Care
• Alcohol and Drugs

The Sauk County Comprehensive plan outlined three objectives in 2010. The health objectives are as follows:

1. Identify, prioritize and address health issues that affect the overall well being of County Residents.
2. Develop strategies to ensure an adequate supply of health care workers in Sauk County 
3. Promote healthier lifestyles

Objective 1 & 3 fall under the purview of the Sauk County Health and Wellness Collaboration (SCHWC). The members of the collaboration are:

• Reedsburg Area Medical Center
• St. Clare Hospital, Baraboo
• Sauk Prairie Hospital
• Sauk County Health Department
• Sauk County UW Extension

Through a CHIPP grant the group has had access to tools developed for community health improvement projects. The SCHWC meets quarterly to work on different projects related to the needs assessments completed by Sauk County Health Department and the three Sauk County hospitals.

Sauk County Health and Wellness Collaboration

Mission Statement:  The Sauk County Health and Wellness Collaboration works to raise awareness, provide education, and inspire action on health issues meant to improve the health of Sauk County citizens.

Objective One of the Comprehensive Plan

Partner Projects Reports/Updates

• Sauk Prairie Memorial Hospital (SPMH) has had a Wellness Movement meeting.  They will be distributing RFP’s to local vendors to establish the website.  They may donate their time.  The website is for local employers, encouraging them to establish a wellness program for their employees.  It will be a Splash Page to the Wellness Movement.  Hosting may be done by Merrimac.
• Reedsburg Area Medical Center has completed their needs assessment.  Their top three issues are: childhood obesity, community communication, and alcohol and drug abuse.
• RAMC has had challenges initiating a tooth brushing program in their local public schools.
• Ken Carlson of Sauk Prairie Memorial Hospital shared information on “Getting Better LLC.”  It uses a support group approach and costs $5,000.  It requires a doctor referral, accommodates up to ten people per group, and males and females are separate.  They are collecting evidence right now.
• Sauk County efforts to assist residents with the disposal of unused medications started with four medication/drug drop off sites that has now increased to six. Unused medications may be disposed in marked locked boxes located at the Lake Delton, Baraboo, Reedsburg, Sauk Prairie, and WI Dells Police Departments as well as the Baraboo Sauk County Sheriff Department. Over 400 informational flyers explaining the public health, and environmental rewards for appropriate drug disposal were handed out at the recent Sauk County funded Clean Sweep.   A drop off box location in the Spring Green area is currently under investigation. SPMH is willing to cost share.
   
• Anti-drug presentation speakers have been in local schools this past year and into spring 2014 as described below.

Sauk County has seen a significant rise in heroin use. Sauk County Health Department as a pilot site, is implementing strategies provided through the Infrastructure Improvement Project mini-grants for the presentations on drug abuse in the county. The first of the heroin presentations was held on April 26 at the Baraboo High School (BHS). The assembly was for all BHS students, and the parental presentation was inclusive of approximately 45 people. Some of the mothers and relatives of individuals who have lost someone to heroin, expressed interest in forming a support group for Sauk County. On October 30, 2013 the same presentation was provided to the Reedsburg community. The program had approximately 60 people in attendance, and the presentation the following day was to all Reedsburg High School students. Sauk Prairie was host to the presentation on February 18, 2014 for 800 High School students and the evening community event had 160 people in attendance. Spring Green School district has also expressed interest in the presentation to their youth and community.

Mental Health Professional Shortage Area

Sauk County is designated a mental health professional shortage area (HPSA). This designation indicates a significant shortage of providers in the service area and in the surrounding areas. It is measured by a population provider ratio. There are three types of HPSA’s:  primary care, dental care, and mental health.  In Sauk County, an additional 4.5 Full Time Equivalents (FTE’s) psychiatrists would be required to reduce the significant shortage.

The SCHWC on May 9^th 2013, invited Anne Dopp and Sheri Siemers of the Wisconsin Department of Health Services to present mental health issues to interested Sauk County residents.  The term “ shortage area designation” was explained to the group in attendance, along with information on what the designation means to us as far as federal funding and assistance.

On August 14^th the coalition met to determine its next steps. Bill Orth and Dan Brattset from Sauk County Human Services Department have joined the group. At this planning meeting it was determined to move forward with a focus on: developing the next steps for the coalition, creating public private partnerships, using tele-health, and having the human services department become a national service site and to address the transportation issues in the county. Additionally, the group will develop a roadmap by assessing current services, and work to address gaps using a collaborative approach.

The subcommittee working on Mental Health met October 30, 2013. A short survey is being created to determine what some of the needs of primary care physicians are regarding mental health. The human services department has applied to be a community clinic. The application was due October 31, 2013. Survey questions will be developed by Bill Orth and Dan Brattset to gather data for identification of service gaps.

Cindy Bodendein and Sue Nagelkirk attended the National Association of County 2013 Roadmaps to Health Forum Oct 31-to Nov.1, 2013. The County Health Rankings & Road Maps, along with related indicators were discussed. The importance of developing public/private partnerships, along with opportunities to sustain and enhance community engagement were identified.

Dental program

The Sauk County Seal-a-Smile program began in 2008, and continues with grant funding applied for yearly through the Children’s Health Alliance of Wisconsin. Since its inception, over 5000 dental sealants have been provided to area children at no cost to the recipients’ families.

In the first year the program visited 9 schools in 5 districts. Sealants and one-on-one education were provided to 200 children in grades 2-5. Each subsequent year the program has expanded and improved services, targeting those schools with a high rate of children receiving free and reduced lunches.

As of June 1, 2013 the 5th year of operations the program has served 17 Sauk County Schools in 6 districts. In the 2013 -2014 school year over 600 students were screened and one-on one education was provided. Sealants were placed on 448 of these children in grades 2-6.

A grant was written requesting funding through the Baraboo Area United Fund to pay for individuals in the Baraboo area needing emergent dental care. One local dentist is willing to participate in the program that will start January 1, 2014.

In 2013 24 dental vouchers were provided for individuals who had acute dental needs. Fluoride tablets were given to 12 families. At the Women Infants and Children’s clinic, 170 children received fluoride varnish applications.

The Sauk County Finance Committee recently approved allocating $2500.00 to the dental program for the purchase of a compressor for the Seal-a-Smile program.

Objective 3 of the Comprehensive Plan

Health Professional Development

Chapter 106.30 of the Wisconsin Statutes mandates that all registered nurses (RN) in the state complete a survey biannually with their license renewal.  The nursing workforce is directly related to the delivery of health care services and health outcomes in Sauk County. According to the Wisconsin Center of Nursing executive summary of the 2012 RN workforce survey a pending nursing workforce crisis is being projected.  Simultaneously the nursing workforce crisis is being driven by a growing elderly population, the rapidly aging nurse population, and the effects of healthcare reform.

The results of the 2012 survey indicate that over 20% of the nursing workforce intends to leave direct patient care in the next 5-9 years, and another 59% the following 10 years or more. This impending shortage will affect access to health care in Sauk County, across the state and nation. The Department is actively participating in efforts to aid in decreasing the impact of the shortage to the department and county.

The Deputy Director attended the annual Wisconsin Center for Nursing Convention. This conference presented the results of the 2012 nursing work force survey to a group of nursing leaders in Wisconsin.

Cultivating a Diverse Nursing Work force was the topic of the conference and aligns with recommendations from the Institutes of Medicine report, National Campaign for the Future of Nursing.

Nursing 419 students complete a rotation with a public health nurse to expand the student’s knowledge of public health.

Edgewood College brings senior nursing students and an instructor to the Sauk County Health Department (SCHD) for a rotation in public health.

The SCHD also has a contract with Viterbo University, UW Oshkosh, and  UW Green Bay returning RN students.

The Public Health Director is on the Madison College Nursing program advisory board.

The Public Health Director is on the South West Area Health Education Center Advisory Committee (SWAHEC). SWAHEC has a Youth Health Services Core, which holds a camp every year for individuals to learn about health careers. In addition, SWAHEC supports and has helped create local Health Occupation Classes.  AHEC also collaborates with Madison College to bring health educational opportunities to high school students. AHEC is currently working with the Reedsburg Area Medical Center on a youth program related to health occupations.