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University of Wisconsin–Madison

Assessing and Improving Community Health in Wisconsin

Community Memorial Hospital-Menomonee Falls

Implementation Approaches

Goal: To provide knowledge our community needs and the access necessary for early intervention and continued treatment of mental illness and/or substance abuse

Objective: Increase community awareness of mental health and alcohol and other drug abuse problems and collaborate for better case management and navigation of treatment

  • Actively participate in Waukesha and Washington County steering committees and project teams
  • In-kind support of Froedtert Health leaders, staff and physicians with knowledge and expertise in behavioral health
  • Provide support groups and programs for individuals/family members impacted by mental illness and AODA issues
  • Provide behavioral health and AODA screenings in the Community Outreach Health Clinic and connect patients and family members with community resources

Goal: To provide knowledge our community needs and the access necessary for early intervention and continued treatment of mental illness and/or substance abuse

Objective: Increase community awareness of mental health and alcohol and other drug abuse problems and collaborate for better case management and navigation of treatment

  • Actively participate in Waukesha and Washington County steering committees and project teams
  • In-kind support of Froedtert Health leaders, staff and physicians with knowledge and expertise in behavioral health
  • Provide support groups and programs for individuals/family members impacted by mental illness and AODA issues
  • Provide behavioral health and AODA screenings in the Community Outreach Health Clinic and connect patients and family members with community resources

Goal: Expand assistance and support of the Community Outreach Health Clinic to improve access to healthcare for uninsured and underinsured populations.

Objective: Continue the support of Community Outreach Health Clinic and community stakeholders to increase access to preventative and primary care, improve quality and reduce costs

  • Continue referral process for uninsured/underinsured populations from CMH to Community Outreach Health Clinic
  • Provide ancillary/specialty care services for COHC patients
  • Screen uninsured patients for financial assistance programs (Marketplace, BadgerCare etc) including Froedtert Health’s Financial Assistance Program
  • Provide financial support for clinic operations and functions
  • Screen patients for underlying AODA/Mental Health Conditions
  • Provide behavioral health coaching and referral to community services

Goal: 
- Improve primary care access to Waukesha and Washington County Residents
- Train physicians who will provide advocacy, representation and leadership for the specialty of Family Medicine

Objective: 
- Expand access to care and healthcare services to vulnerable populations in Waukesha and Washington County
- Develop skills in new physicians around team development, continuity of care, collaboration, and leadership needed for effective team-based care

  • Provide access to care with family practice residents
  • Provide paths to improve access to underserved populations in Waukesha and Washington County

Goal: Improve access to basic and preventative dental care for uninsured and underinsured children and adults residing in Community Memorial Hospital’s service area

Objective: Support WCCDC’s Menomonee Falls Dental Clinic to increase access to preventative and general dentistry and reduce unnecessary emergency room utilization for oral health needs

  • Education and awareness of dental clinic with community partners and agencies
  • Develop referral process with Community Outreach Health Clinic, Emergency Department and Family Medicine Residency Program
  • Promote Froedtert Health Classes and Screenings with WCCDC patients – especially those with chronic conditions

Goal: Reduce readmission rates and increase timely access to care for individuals living with Chronic Conditions (Pneumonia, Congestive Heart Failure, AMI, Diabetes and Stroke).

Objective: Provide wellness checks within 48 – 72 hours of discharge for high risk populations for 65% of patients that qualify for program.

  • Identify patients at risk for readmission and refer/follow care plans/outcomes in partnership with Menomonee Falls and Lisbon Fire Departments
  • Provide ongoing consultation with medical professionals throughout the organization to improve continuum of care
  • Provide continuing medical education and training for contracted fire departments

Goal: Reduce readmission rates and increase timely access to care for individuals living with Chronic Conditions (Pneumonia, Congestive Heart Failure, AMI, Diabetes and Stroke).

Objective: Provide wellness checks within 48 – 72 hours of discharge for high risk populations for 65% of patients that qualify for program.

  • Identify patients at risk for readmission and refer/follow care plans/outcomes in partnership with Menomonee Falls and Lisbon Fire Departments
  • Provide ongoing consultation with medical professionals throughout the organization to improve continuum of care
  • Provide continuing medical education and training for contracted fire departments

Goal: Decrease the cancer mortality rate in Washington and Waukesha Counties

Objective: Implement programs to increase cancer awareness, screening and early detection at CMH and organizations across the hospital’s service area

  • Dedicated navigator working with patients receiving care in the CMH Cancer Center and provide assessment and referrals for health system and community resources
  • Screen all uninsured patients for financial assistance programs through the Marketplace or government sponsored programs
  • Execute a minimum of two community cancer screening programs per year
  • Execute quarterly cancer awareness and education events (classes, health fairs, events etc.)

Goal: Reduce morbidity and mortality from chronic conditions

Objective: Increase self-management for individuals living with chronic conditions and reinforce healthy lifestyles to encourage behavior change

  • Facilitate a minimum of three Living Well with Chronic Conditions/Diabetes programs each year
  • Deliver evidence-based health screenings and education programs at CMH and in the community at community partner locations and strategic access points
  • Explore opportunities for enhancing and expanding clinical support groups and community health education programs in community based settings

Goal: To provide knowledge our community needs and the access necessary for early intervention and continued treatment of mental illness and/or substance abuse

Objective: Increase community awareness of mental health and alcohol and other drug abuse problems and collaborate for better case management and navigation of treatment

  • Actively participate in Waukesha and Washington County steering committees and project teams
  • In-kind support of Froedtert Health leaders, staff and physicians with knowledge and expertise in behavioral health
  • Provide support groups and programs for individuals/family members impacted by mental illness and AODA issues
  • Provide behavioral health and AODA screenings in the Community Outreach Health Clinic and connect patients and family members with community resources

Oral Health

Goal: Improve access to basic and preventative dental care for uninsured and underinsured children and adults residing in Community Memorial Hospital’s service area

Objective: Support WCCDC’s Menomonee Falls Dental Clinic to increase access to preventative and general dentistry and reduce unnecessary emergency room utilization for oral health needs

  • Education and awareness of dental clinic with community partners and agencies
  • Develop referral process with Community Outreach Health Clinic, Emergency Department and Family Medicine Residency Program
  • Promote Froedtert Health Classes and Screenings with WCCDC patients – especially those with chronic conditions