Assessing and Improving Community Health in Wisconsin

Green Lake County Department of Health & Human Services

571 County Road A
PO Box 588
Green Lake, WI 54941-9719
Green Lake County
Local Health Department Website
Community Health Needs Assessment
Community Health Implementation Plan
Time Frame: 2014-2018

Implementation Approaches

Primary Goals: 

  • Decrease the use of alcohol, energy drinks and other drugs by Green Lake County citizens.
  • Decrease social acceptance of tobacco, alcohol and drug use.

Objectives: 

-By 2018, we aim to reduce unhealthy use of alcohol and other drugs by implementing a county-wide prevention campaign.

   Suggested Evidence-Based or Promising Practices:

  • Promote interagency awareness of current alcohol and drugs in our community through bi-monthly meetings.
  • Alter attitudes by educating county residents on the negative consequences of unhealthy use of alcohol and other drugs. 
  • Encourage county school districts to implement evidence-based curriculum that promotes awareness and prevention of alcohol and drug abuse.
  • Meet with legislators to discuss current alcohol, tobacco and drug legislation.
  • Seek funding for alcohol and drug education.
  • Promote organizations that offer treatment options for alcohol and drug abusers.
  • Increase access to services by distributing County Health Department’s ATODA and Mental Health Resource Directory.
  • Increase community awareness regarding the signs of alcohol and drug abuse, and the dangers of binge drinking.
  • Work with community organizations to eliminate availability of alcohol at community events.
  • Conduct alcohol compliance checks to monitor sales of alcohol to underage youth.
  • Support state laws that limit days and hours of sale of liquor.
  • Support laws that increase alcohol taxes.
  • Promote use of SBIRT Tool (screening, brief intervention, referral to treatment) within healthcare settings in Green Lake County.
  • Support current regulation of alcohol outlet density, informing governing entities, elected officials and/or the public of potential public health impacts, intended and unintended, from current and or proposed policies.
  • Consider health literacy when designing written materials and presentations utilizing the “Simply Put Guide” from the CDC.

-By 2016 the Drug Endangered Children Group will host two table top reviews per year, including all stakeholders, to discuss process improvement and implement recommended changes to the process.

   Suggested Evidence-Based or Promising Practices:

  • Active participation by stakeholders in process improvement.

-By 2018, decrease the number of Green Lake County residents arrested for operating while intoxicated and driving while under the influence to fewer than 378 per 100,000

   Suggested Evidence-Based or Promising Practices:

  • Identify, implement and promote programs designed for parents about the consequences of underage drinking and operating while intoxicated.
  • Identify and develop designated driver programs, “Safe-Ride-Home” options, and encourage businesses to support designated drivers.
  • Increase awareness of costs of DUI and use of drugs by writing an article for the local papers.
  • Provide responsible beverage service training to promote safe distribution of alcohol and to educate owners, managers, servers, and sellers at alcohol establishments about strategies to avoid illegally selling alcohol to underage youth or intoxicated patrons. Practices include offering customers food with drinks, delaying service to rapid drinkers, refusing service to intoxicated or underage consumers, and discouraging intoxicated customers from driving.
  • Require keg registration to decrease binge drinking, underage drinking, and driving traffic fatalities due to excessive drinking. Registration to include: recording of the purchaser’s name and address, date of birth, and intended use of the keg, as well as date of sale, keg registration number, information regarding penalties for careless or illegal use and signature recognizing penalties for illegal use.
  • Restrict drink specials that encourage over-consumption, such as “all-you-can-drink” happy hours.
  • Restrict alcohol sales at public events such as concerts, street fairs, and sporting events, as well as in public spaces such as parks and beaches. Such restrictions can be implemented voluntarily by event organizers or through local legislation, to reduce underage drinking, decreased impaired driving, and decreased public disturbance calls.
  • Restrict advertisement placement to reduce youth exposure.
  • Provide school based instructional programs to reduce alcohol-impaired driving.
  • Utilize local community leaders to change perception of the severity of the issue.
  • Promote Dram shop liability laws that allow owners or servers at retail establishments where a customer recently consumed alcoholic beverages to be held legally responsible for harms inflicted by that customer.

-By 2018, the percentage of inmates with mental health and ATODA issues who participate in the Reduction and Recidivism Program in the County Jail will increase

   Suggested Evidence-Based or Promising Practices:

  • Develop statistical analysis of current Reduction and Recidivism program to document current participation and to support program sustainability.
  • Seek grant funds for sustainability of current Reduction and Recidivism Program.
  • Continue to offer ATODA, therapy, support groups, 1:1 counseling, and other Reduction & Recidivism opportunities to develop positive coping skills and decrease reoffending rates in county jails.

Primary Goals: 

  • Increase physical activity for all through changes in facilities, community design, and policies
  • Provide safe, affordable and culturally appropriate environments to promote increased physical activity
  • Encourage physical activity or limit sedentary activity among children and youth
  • Work with county school personnel to promote healthy nutritional attitudes, knowledge, and behavior regarding food policy, environmental factors and nutrition education
  • Work with local employers to promote healthy nutritional attitudes, knowledge and behavior regarding food policy, environmental factors and nutrition education
  • Promote and support exclusive and sustained breastfeeding as the norm in infant feeding
  • Encourage improved nutrition for all community members regardless of age

Objectives: 

-By 2018, we will decrease the percentage of Green Lake County adults who are physically inactive as measured by the County Health rankings

   Suggested Evidence-Based or Promising Practices:

  • Increase distribution of information regarding parks and other local recreational activities.
  • Encourage employers to adopt wellness programs that include evidence based ways to increase employee physical activity.
  • Use social media and web-based ways to promote physical activity, including the community’s use of accessible resources (e.g., hiking trails, open gym times, etc.).
  • Partner with existing community organizations such as senior centers and schools to assure that physical activity is integrated in all programming.
  • Consider health literacy when designing written materials and presentations utilizing the “Simply Put Guide” from the CDC
  • Physical Activity Action Group will meet at least quarterly to implement strategies to promote healthy and safe activity for all ages in Green Lake County.

-By 2018, we will make presentations to each of the 4 major City Councils and County Board about how changes in the built environment and overall environment of Green Lake County can support safe physical activity for a healthier community.

   Suggested Evidence-Based or Promising Practices:

  • Increase access to fitness/community centers, athletic facilities, green space and parks within the county.
  • Identify and develop strategies to implement active transportation initiatives (“Walk and Bike to Work/School” programs) in all county schools and offer support to businesses to do the same.
  • Promote the development of additional bike, cross-country ski, snowshoe, and walking trails in Green Lake County.
  • Attend City Council and County Board meetings to be a resource to policy makers about healthy community considerations to promote activity.
  • Promote awareness at the planning level of complete streets initiatives and their importance to health.
  • Encourage communities to participate in Safe Routes to school.
  • Enact community zoning regulations that require all new subdivisions to include pedestrian/bicycle friendly facilities

-By 2018, the Green Lake County Wellness Coalition will conduct an assessment of all four Green Lake County school districts, and develop a plan for how to best support them in the promotion of physical activity among their students.

   Suggested Evidence-Based or Promising Practices:

  • Establish, increase or assess physical activity benchmarks and activity requirements in schools.
  • Increase time of physical activity in preschool or daycare settings; decrease screen time in these locations to less than two hours daily.
  • Expand existing Safe Routes to School and Walking School Bus programs.
  • Encourage schools to conduct a community-wide campaign to promote physical activity for families, such as “Read, Run, Reach”, a comprehensive wellness campaign promoting literacy, physical activity and being kind in actions.
  • Provide comprehensive, center-based early childhood development programs (Head Start).
  • Provide extracurricular sports/after-school activities for schoolchildren.
  • Offer more physical activities at the Boys & Girls Club and 4-H.
  • Establish structured recess activities.
  • Implement activity breaks in the classroom.
  • Share information with children and their families about the benefits of physical activity for wellness and risks of inactivity, obesity and preventable illness.
  • Coordinate health education messages between the health department, community partners and schools.
  • Ask local school districts to consider opening their facilities for families and individuals to walk and exercise.
  • Educate families and individuals about the benefits of being active, and how to make exercise part of their daily schedules.
  • Encourage parents to set positive examples with exercise for their children.

-By 2018, Green Lake County Wellness Coalition will implement a multimedia campaign to increase awareness of ways to access nutritious, high quality and affordable foods and beverages, weight-loss resources, and nutrition support groups for chronic conditions.

   Suggested Evidence-Based or Promising Practices:

  • Develop nutrition resource guide to include ways to access nutritious, high quality and affordable foods & beverages, weight-loss resources, nutrition support groups for chronic conditions, and healthy nutrition guidelines.
  • Distribute nutrition resource guide to clinics, schools, local businesses and libraries.
  • Post resource guide on Green Lake County Wellness Coalition website and encourage community partners to share with those they serve.
  • Review and update the brochure annually.
  • Post information about county classes that support healthy nutrition, such as “Healthy Eating for Successful Living in the Older Adults” 30, and “Strong Women-Strong Bones”
  • Maintain or increase the number of farmers markets that accept Senior vouchers and WIC checks, maintaining at least one certified farmer in each of the three farmer’s markets in the area.
  • Maintain the “no sugary drinks” policy that prevents distribution of sugary drinks in lunch lines and vending machines at high schools and middle schools.
  • Identify existing programs and resources via the GLCWC website that can help increase community awareness of local resources to improve or maintain good nutritional habits.
  • Continue to support legislation to reform the FoodShare program in WI, limiting the ability to purchase junk food and sugared beverages.
  • Support legislation that will improve food security for households in Green Lake County.
  • Nutrition Activity Action Group will meet at least quarterly to implement strategies to promote healthy and safe nutrition for all ages in Green Lake County.
  • Work with local food pantries to develop a recommended donation list of nutritious items.
  • Work with local food pantries to provide recipes and education for how to use products donated.
  • Offer healthy choices in school and work vending machines.
  • Encourage families to eat together at least once a day.
  • Educate residents on how to use FoodShare to purchase nutritious foods.
  • Encourage school districts to continue to offer F.A.C.E. classes to help students to learn proper food handling and preparation.
  • Encourage individuals to talk with their physicians about healthy weight.
  • Encourage parents to set positive examples of healthy eating for their children.

-By 2018, GLCWC members will provide two nutrition education programs each year to Green Lake County residents.

   Suggested Evidence-Based or Promising Practices:

  • Identify existing programs and resources that can help increase community awareness of the importance of good nutritional habits and post on the GLCWC website.
  • Work with community groups such as senior centers, day care providers, Boys and Girls Club, and schools to increase the awareness of the importance of good nutritional habits and healthy choices.
  • Identify community groups willing to work with schools and community groups to provide nutrition education and /or activities.
  • Identify areas where consistent information can be distributed, such as the GLCWC website, health fairs, and coalition sponsored events.
  • Monitor the number of nutrition presentations and activities per month in the community.
  • Consider health literacy when designing written materials and presentations utilizing the “Simply Put Guide” from the CDC.

-By 2018, all first time moms in the county will receive information about the benefits of breastfeeding and available support services.

   Suggested Evidence-Based or Promising Practices: 

  • Increase public awareness about the benefits of breastfeeding via a community education campaign in collaboration with BFAN. (The Breastfeeding Alliance of Northeast Wisconsin.)
  • Encourage breast feeding mothers and mother’s-to-be by educating them on the benefits of breast feeding.
  • Develop a program to follow-up with new moms to support them with breast feeding during the first 6 months.
  • Continue to support a peer counselor for breastfeeding moms through WIC.

Primary Goals: 

  • Decrease the use of alcohol, energy drinks and other drugs by Green Lake County citizens.
  • Decrease social acceptance of tobacco, alcohol and drug use.
  • Decrease the number of injuries and deaths to Green Lake County residents caused by substance abuse.
  • Implement and encourage appropriate methods for disposal of prescription drugs.

Objectives:

-By 2018, we aim to reduce unhealthy use of alcohol and other drugs by implementing a county-wide prevention campaign.

   Suggested Evidence-Based or Promising Practices:

  • Promote interagency awareness of current alcohol and drugs in our community through bi-monthly meetings.
  • Alter attitudes by educating county residents on the negative consequences of unhealthy use of alcohol and other drugs.
  • Invite legislators to interagency meetings to discuss heroin and opiate use in our county.
  • Consider grant opportunities to fund a prescription drug drop in Green Lake County.
  • Develop flyer to describe appropriate methods for disposal of prescription drugs.
  • Post information about appropriate methods for disposal of prescription drugs on Coalition website.
  • Encourage county residents to watch online videos from the “Fly Effect Heroin Prevention Campaign”
  • Encourage county school districts to implement evidence-based curriculum that promotes awareness and prevention of alcohol and drug abuse.
  • Meet with legislators to discuss current alcohol, tobacco and drug legislation.
  • Seek funding for alcohol and drug education.
  • Promote organizations that offer treatment options for alcohol and drug abusers.
  • Increase access to services by distributing County Health Department’s ATODA and Mental Health Resource Directory.
  • Distribute, implement and promote programs to help parents and caregivers identify drugs their children use.
  • Implement and promote programs on the proper use, and the hazards of abuse of prescription drugs for the elderly population.
  • Increase community awareness regarding the signs of alcohol and drug abuse, and the dangers of binge drinking.
  • Promote County Hazardous Waste Clean Sweep for safe disposal of expired or unwanted prescription drugs.
  • Promote use of SBIRT Tool (screening, brief intervention, referral to treatment) within healthcare settings in Green Lake County.
  • Consider health literacy when designing written materials and presentations utilizing the “Simply Put Guide” from the CDC. 

-By 2016 the Drug Endangered Children Group will host two table top reviews per year, including all stakeholders, to discuss process improvement and implement recommended changes to the process.

   Suggested Evidence-Based or Promising Practices:

  • Active participation by stakeholders in process improvement.

-By 2018, the percentage of inmates with mental health and ATODA issues who participate in the Reduction and Recidivism Program in the County Jail will increase

   Suggested Evidence-Based or Promising Practices:

  • Develop statistical analysis of current Reduction and Recidivism program to document current participation and to support program sustainability.
  • Seek grant funds for sustainability of current Reduction and Recidivism Program.
  • Continue to offer ATODA, therapy, support groups, 1:1 counseling, and other Reduction & Recidivism opportunities to develop positive coping skills and decrease reoffending rates in county jails.

Primary Goals: 

  • Decrease social acceptance of tobacco, alcohol and drug use.
  • Reduce use of all types of tobacco products among adolescents and adults in Green Lake County.
  • Increase tobacco use quit rates.

Objectives:

-By 2018, fewer than 19.4% of high school students will use a tobacco product as reported by the Health Risks Survey

  Suggested Evidence-Based or Promising Practices:

  • Promote and continue to support state tobacco programs like First Breath, QuitLine, and WI Wins*, by providing information to the public about the programs and protecting their health in relation to tobacco products.
  • Increase data collection of risk taking behavior in schools.
  • Educate youth and parents about the risks of smoking and using smokeless tobacco products.
  • Educate children and adults about the risks of second hand smoke.
  • Encourage student run organizations such as FACT (Fighting Against Corporate Tobacco).
  • Restrict advertisement placement to reduce youth exposure.
  • Utilize local community leaders to change perception of the severity of the issue.
  • Educate on the tactics of product placement by tobacco companies in relation to other tobacco products.
  • Continue to do and track tobacco compliance checks (will have a sales rate to minors of 5% or less.)9
  • Increase the awareness of the health risks associated with electronic cigarettes.
  • Promote the use of mobile phone-based tobacco cessation interventions which utilize interactive features such as text messages to deliver evidence-based information, strategies, and behavioral support directly to tobacco users interested in quitting such as: smokefreetext and QuitNowTXT.
  • Enforce smoke-free policies.
  • Consider increasing the unit price of tobacco products.
  • Inform governing entities, elected officials and or the public of potential public health impacts, both intended and unintended from current and or proposed policies.

-By 2018, reduce the percent of low birth weight (5.5 pounds) babies to less than 5.2%

   Suggested Evidence-Based or Promising Practices: 

  • Increase the percent of Green Lake County children and infants in smoke-free homes.
  • Advocate for tobacco cessation programs through WIC, Birth to 3, and First Breath.
  • Survey adults about tobacco products used in the family.
  • Promote the use of the Wisconsin Tobacco Quitline through health care providers, employers, insurers, media, and community-based organizations.
  • Offer all pregnant women in the WIC program the opportunity to participate in the First Breath Program.
  • Educate primary care providers of women of childbearing age, about the First Breath Program, and the benefits for patients and their families.
  • Increase percentage of mothers who abstain from smoking during pregnancy.

-By 2018, reduce the percent of low birth weight (5.5 pounds) babies to less than 5.2% (Promoting Healthy Growth and Development)

   Suggested Evidence-Based or Promising Practices: 

  • Promote early prenatal care to women of childbearing age and to those who are newly pregnant to increase the percentage of pregnant women receiving prenatal care in the 1st trimester from 74 to 77.9%.4
  • Offer all pregnant women in the WIC program the opportunity to participate in the First Breath Program.
  • Educate primary care providers of women of childbearing age, about the First Breath Program, and the benefits for patients and their families.

-By 2018, continue to participate in the Healthy Babies Coalition with Marquette and Waushara Counties. (Promoting Healthy Growth and Development)

   Suggested Evidence-Based or Promising Practices:

  • Actively participate in Healthy Babies Coalition meetings.
  • Gather information to help support healthy children and families in Green Lake County.
  • Distribute helpful information via the Green Lake Wellness Coalition website.
  • Present quarterly updates to the Mental Health/ATODA Action Group.
  • Present yearly updates to the Green Lake County Wellness Coalition.

Primary Goal: 

  • Green Lake County will strive to improve the health and well-being of its residents by increasing their protective factors and use evidence-based strategies that address mental health needs of children, adults, and families in our community.
  • We will work to create healthy environments to build resiliency in people to help them cope better during life’s challenges while reducing disparities for disproportionate populations.

Objectives: 

-By 2018, all four Green Lake County School Districts will implement the Youth Risk Behavior Survey.

   Suggested Evidence-Based or Promising Practices:

  • Survey all Green Lake County school districts about their participation in the Youth Risk Behavior Survey.
  • Encourage schools that are not participating in the Survey to consider implementing it to gather data to recognize needs within their schools.
  • Encourage schools to adopt evidenced-based curriculum based on identified needs.
  • Support schools as they implement new curriculum based on their identified needs from the survey.
  • Facilitate conversations between schools and community partners to address identified needs from the survey with presentations and community resources.
  • Implement prevention strategies through classroom curricula that focus on increasing youth assets and developing resiliency such as creative problem solving, coping skills and conflict resolution skills.
  • Provide educational environments that are both physically and psychologically safe from bullying and violence.
  • Promote use of evidence-based screening tools for depression and suicidal ideation and acts.
  • Educate mental health and substance abuse providers to recognize signs and symptoms of depression and to assess suicide risk.
  • Implement community wide “gatekeeper trainings” to train persons (gatekeepers) who have regular contact with potentially vulnerable populations to more readily identify populations at risk for suicide and refer them to appropriate services, such as QPR (Question-Persuade-Refer).
  • Utilize media guidelines to encourage members of the media to follow procedures for reporting suicide so as not to encourage at-risk persons to attempt suicide.
  • Promote and implement means restriction to reduce access or availability to the means and methods of deliberate self-harm in an attempt to reduce the odds that an attempt will use a highly lethal means.
  • Coordinate efforts with law enforcement, crisis responders, social services, mental health, and substance abuse professionals, and service organizations.
  • Develop community-wide coalition to provide suicide prevention education.
  • Consider health literacy when designing written materials and presentations utilizing the “Simply Put Guide” from the CDC.

-By 2016, assess mental health risk and wellness education in local schools, by conducting a survey of the curriculum used in K-12 to promote mental health and wellness, suicide prevention, drug, tobacco and alcohol education, and the prevention of bullying, child abuse, sexual assault and violence.

   Suggested Evidence-Based or Promising Practices:

  • Develop survey and distribute to local school districts to determine community needs.
  • Engage community partners to make presentations in local schools related to topics of prevention, protection, resilience, coping skills and healthy relationships.

-By 2016, expand recovery services by regionalizing Comprehensive Community Services (CCS) for mental health with Marquette, Juneau, Adams, Waushara, Waupaca and Green Lake counties.

   Suggested Evidence-Based or Promising Practices:

  • Submit a plan for regionalization to provide CCS.
  • Educate county decision makers about benefits of regionalization of services.
  • Implement Comprehensive Community Service (CCS) 101 Training to Green Lake County consumers, employees, health providers, community partners, families and individuals.
  • Culturally tailor messages and implement comprehensive multi-component interventions to reduce suicides across all ages, racial/ethnic, deaf and hard of hearing, veteran, and sexual orientation populations.
  • Require training for mental healthcare providers in cultural competency.
  • Encourage hospitals to offer mental health practitioners in or near the primary care facilities for expert consultation for adults and children.
  • Work with legislators to promote mental health legislation that will improve access and affordability of mental health treatment, increased diagnosis of mental health conditions, reduced prevalence of poor mental health and reduced suicide rates.
  • Collaborate to develop and implement mechanisms to assist the public to increase access to healthcare services for depressive disorders

-By 2015, increase awareness of mental health resources in our county by distributing pamphlets to local care providers, schools and faith communities.

   Suggested Evidence-Based or Promising Practices: 

  • Inform governing entities, elected officials and/or the public of potential public health impacts, both intended and unintended from current and/or proposed policies.
  • Collaborate to develop and implement mechanisms to assist the public to increase access to healthcare services for home-based depression among older adults.
  • Promote county-wide use of “Telehealth” for mental health services by primary care physicians, which increases access of mental health information and treatment for adults and children, and allows physicians to provide mental health consultation if needed.
  • Encourage care providers to use the “Patient Shared Decision Making process” in which patients are educated on their treatment options and are involved in selecting treatment.
  • Encourage active screening for depression in primary care offices.
  • Support ongoing case management for mental health.
  • Increase number of regular activities provided by senior centers; increase participation in these programs or include programs that require continued participation.
  • Increase mental health services to the aging population with depression, dementia and related conditions.
  • Implement a “Families and Schools Together” (FAST) program to promote educational development, foster familial support, and prevent substance abuse in children.1
  • Create assessment guidelines for existing mental health services and work on quality improvement of these services.
  • Increase engagement from faith-based groups and worksite support.
  • Increase training of law enforcement.
  • Reduce stigma surrounding mental health in our county.
  • Distribute “ATODA and Mental Health Resources” brochure in clinics, schools, local businesses.
  • Review and update “ATODA and Mental Health Resource” brochure annually.
  • Post “ATODA and Mental Health Resources” on Green Lake County Wellness Coalition website.
  • Increase social connectedness through wellness and recovery support groups.
  • Mental Health/ATODA Activity Action Group will meet at least quarterly to implement strategies to promote mental health, responsible alcohol use, cessation of tobacco and drug abuse prevention.
  • Consider health literacy when designing written materials and presentations utilizing the “Simply Put Guide” from the CDC.
  • Promote programs and classes that support group participation, healthy management of chronic conditions and combat isolation such as: “Stepping On”32 and “Living Well With Chronic Conditions”.