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University of Wisconsin–Madison

Assessing and Improving Community Health in Wisconsin

Waupaca County Health and Human Services

Implementation Approaches

Goal #1: Increase community awareness of scope of drug/alcohol issue

  • Implement policy regarding sponsorship of community events that negatively endorse alcohol use
  • "Community Campaign" Waupaca CHAT team members/community partners to increase awareness of alcohol issues in adults-may collaborate with Shawano County
  • Host "Party at the PAC" to educate teen drivers about risks of alcohol/substance use
  • Standardize curriculum for youth across school districts- easily implemented into curriculum

Goal #2: Reduce incidence of alcohol use and binge drinking

  • ThedaCare Initiative: Possible replication of Shawano are "Binge Drinking" social norms campaign
  • "Clinical Intervention" initiative in development by Waupaca CHAT team members/community partners develop coaches in clinics, hospitals, eventually schools, churches to assess for "risky drinking" and intervene
  • Easily accessible, affordable help
  • AODA Court options/interventions for those with an alcohol-related offense
  • Broad use of alcohol screening and brief interventions to identify persons with harmful alcohol consuption before health and social consequences occur
  • Increase cost of alcohol
  • Restrict drink specials that encourage over consumption

Goal #3: Reduce underage drinking

  • "Parenting Education" initiative in development by Waupaca CHAT team members/community partners to: identify "at-risk" parents/families, set up accessible education/information classes, contract with parents to not host a party, make public so other parents know
  • Provide financial support for "Chem-Free" graduation/prom parties
  • Maintain current minimum drinking age laws
  • Vigorous enforcement of existing underage drinking laws and minimum drinking age
  • Increase alcohol excise tax
  • Support responsible marketing and provision of alcohol
  • School-based social norming programs to reduce alcohol consumption
  • Responsible beverage server training

Goal #1: Mobilize community to action

  • Food pantry initiative under development by New London CHAT members and food pantry partners. Goal is to: get healthier foods onto food pantry shelves i.e. whole wheat products, fresh fruits and vegetables, increase food storage capacity of local pantries
  • Multi-component obesity prevention: combine educational environmental, behavioral activities such as: nutrition education, aerobic/strength training, exercise sessions, training in behavioral techniques and dietary prescriptions

Goal #2: Increase access to health foods

  • Waupaca Eating Smart (WES) Waupaca County DHHS initiative to engage area restaurants in providing healthier choices on their menus and highlighting these items for patrons
  • Waupace County's NuAct (Nutrition and Activity) Coalition continues to develop initiatives to engage area residents in healthier food choices and physical activities
  • Waupaca County DHHS "on-site Farmer's Market" initiative
  • ThedaCare ongoing initiative: provide funding and expertise for the startup/sustainability of local farm markets
  • Changes to School Nutrition Program being phased in including: whole wheat bread, pasta, fresh fruit and vegetable requirements, mandated additional fruits/vegetables placed on student trays by nutrition program staff if students do not choose enough on their own
  • Waupaca County Extension School Garden initiative to: increase consumption of fruits/vegetables by having available for snacks, lunch and after school provides physical activity when children work in gardens
  • Waupaca County's Community Gardens initiative. Provides healthy fresh foods to be distributed at various community venues including: WIC, Senior meal site, and food pantries
  • WIC vouchers for farmers markets purchase fresh fruits and vegetables
  • ACHIEVE grant initiative: Improve access to fresh fruits and vegetables by increasing number of businesses that adopt healthy eating strategies, i.e. cafeterias, vending machines, unsweetened beverage options
  • Corporate Wellness Initiative under development by New London CHAT members and community partners
  • Backpack Program provides a backpack worth of food for a child to take home for the weekend
  • Grocery stores in every community (now only convenience stores in some towns and neighborhoods)
  • Greater participation in NuAct from area growers, vendors, grocery store districts, businesses, political leaders, interested citizens
  • Expansion of "Farm 2 School" to all 7 school districts in Waupaca County
  • Nutrition/Physical activity interventions in preschool and childcare
  • Guidelines and policies governing food choices in preschool and childcare
  • Breastfeeding promotion programs- increase initiation, exclusive breastfeeding and duration of breastfeeding
  • Competitive pricing in schools- assign higher cost to non-nutritious foods and lower costs to nutritious foods

Goal #3: Increase participation in exercise and physical activity

  • Waupaca County DHHS NuAct Coalition continues to advocate for and plan community activities/events which promote physical activity through gardening
  • Waupaca County School and Community Garden initiatives promote physical activity through gardening
  • Waupaca County Park and Rec free "Bike Routes" and "Trail Maps" promote physical activity in the beautiful surroundings in Waupaca County
  • UW-Extension "Safe Routes to School" initiative encourages students to walk or bike to school providing safe routes of reasonable length
  • Corporate Wellness Initiative under development by New London CHAT members and community partners
  • Before/After School initiatives under development by New London CHAT members and community partners- goal to engage youth in physical activities before school starts and at the end of the school day to reduce "screen time" and encourage physically and emotionally healthier lifestyle habits and will hopefully be carried into adult life
  • ThedaCare initiatives: physical activity/health lifestyle classes, sponsor local events that encourage physical activity, have a ThedaCare presence in groups that advocate for environmental improvements that promote physical activity, partner with local school districts and Parks and Rec Departments to support physical activity efforts
  • Explore implementation of primary care provider "activity prescriptions"
  • Countywide: Structured recess- actively supervised games or activities
  • Physically active classrooms- physical activity break, classroom energizers, moving activities into lessons
  • School-based obesity prevention interventions- increase physical activity and nutrition before, during, and after school- includes family education and involvement
  • Breastfeeding Promotion Programs
  • Nutrition and physical activity interventions in preschools and child care- guidelines and policies governing food and choices, physical activity in all programs, emphasis on decreasing screen time

Goal #4: Increase resources in the community to feed the food insecure and others in need

  • Food pantries: cooking classes, increase storage capacity, expand supplies, help, hours, incorporate whole grains, fresh food
  • Community supper: provide in every community 1x1 week, provide in every community once each week alternate days around county, allow carry outs
  • Community Garden: expand to every community
  • WIC provides fresh food to participants in season, provides recipes to accompany fresh produce: "restaurant leftovers" program

Goal #1: Increase community awareness of scope of drug/alcohol issue

  • Implement policy regarding sponsorship of community events that negatively endorse alcohol use
  • "Community Campaign" Waupaca CHAT team members/community partners to increase awareness of alcohol issues in adults-may collaborate with Shawano County
  • Host "Party at the PAC" to educate teen drivers about risks of alcohol/substance use
  • Standardize curriculum for youth across school districts- easily implemented into curriculum

Goal #2: Reduce incidence of drug use

  • Prescription Drug Monitoring Database
  • Explore possibility of implementing Screening, Brief Intervention, and Referral for Treatment (SBIRT) clinical protocol to screen for substance abuse and refer for help
  • Explore establishment of system policy around prescription practices that impact heroin use
  • Community education campaign focusing on drug use separate from alcohol
  • Alert community through law enforcement, about broad scope of drug problem in Waupaca County communities
  • Comprehensive early childhood development programs

Goal: Reduce use of tobacco products

  • Expand use of "First Breath" strategies to general population
  • More accessible affordable smoking cessation programs in worksites and community venues 
  • Increase the number of Waupaca Parks covered by Young Lungs at Play smoke-free environment
  • Increase price of tobacco within individual communities or throughout the county
  • Increase number of cessation programs directed at youth
  • Mobile phone-based tobacco cessation interventions

Goal #1: Increase access to providers for needed care: mental health, primary care, dental

  • ThedaCare initiatives: support enrollment assistance in government-sponsored programs
  • Staff and fund "ThedaCare on call"- 24 hours/7 days a week access to medical advice over the phone
  • Provide financial and in-kind support to sustain Rural Health Initiative
  • Maintain funding for Seal-a-Smile initiative to help meet dental needs of Waupaca County children
  • Alternate models of care
  • "Medical homes" for all residents to ensure ease of referral and comprehensive care
  • Patient navigators-guide patients through system

Goal #2: Increase affordability of care

  • ThedaCare initiatives: Maintain system policy of financial assistance to those unable to pay
  • Provide financial and in-kind support to sustain Rural Health Initiative
  • Maintain funding for Seal-a-Smile initiative to meet dental needs of Waupaca County children
  • Assistance with Enrollment in Affordable Care Act "Marketplace"
  • Alternate models of care
  • Expand scope of practice for nurse practitioners
  • Telemedicine
  • Mental health benefits legislation regulates mental health insurance to increase access to services-no greater restrictions for mental health services than physical health services

Goal #3: Increase supply of medical professionals

  • ThedaCare initiatives: Provide venue and training for medical residents and nursing students to increase availability at the local level
  • Provide job shadowing and internship opportunities for high school youth interested in medical careers to increase likelihood of choosing health careers
  • Increase use of nurse practitioners
  • Increase number of Federally Qualified Health Centers

Goal #1: Decrease stigma associated with mental illness

  • Public acceptance of mental illness as life experience chemical imbalance
  • Trauma informed care as standard of practice
  • Group-based parenting programs geared toward families with children displaying aggressive, dispruptive behaviors and poor social skills. Benefits include reduced behavior problems, reduced stress, improved mental health

Goal #2: Earlier detection of mental health conditions

  • Incorporation of mental health-related questions into all healthcare visits as standard of practice
  • More emphasis from employers on EAP mental health services available
  • Expansion of referral resources
  • Educate healthcare providers on services available in county and cost
  • Collaborate with daycares, Head Start to identify "red flags" for mental health issues in children

Goal #3: Increase awareness of available resources

  • Greater education of public and providers of available resources, "hotlines"
  • More advertising by mental health providers of services available

Goal #4: Increase public awareness of strategies/resources to intervene when suicide is threatened

  • Suicide Prevention Coalition "They Save Lives, You Can Too" poster campaign, PSAs, with 'hotline' numbers
  • QPR training annually free to the public through Waupaca Suicide Prevention Coalition
  • Dissemination of information to county clinic managers to share with all providers

Goal #5: Increase clinical capacity for affordable mental health services

  • 50+ ThedaCare PCPs will have participated in 9-part CME education program to be able to treat basic mental health needs
  • Recruit mental health specialists into ThedaCare system
  • Reduce wait time for pediatric mental health services provided through Catalpa Health Pediatric Behavioral Health Services (Fox Cities)
  • Potential psychiatry residency through medical college in Northeast Wisconsin
  • Increase capacity, early entry into Waupaca County DHHS Mental Health screening and services
  • Greater education of public and providers of available resources, "hotlines"
  • More advertising by mental health providers of services available
  • Increase availability of Federally Qualified Health Centers-serve regardless of ability to pay

Goal #6: Increase affordable mental health care

  • Subsidize mental health services provided through ThedaCare
  • ThedaCare investigation of "No Wrong Door" initiative- software safety net- ensure people seeking mental health care treated at location best suited to meet their needs
  • Sliding fee scale mental health services 
  • Mental health benefits legislation to increase access to mental health services, including no greater restrictions on mental health services than on physical health services

Goal #7: Strengthen coping skills in youth

  • School districts to address issues of bullying and fighting
  • Standardized mental health/suicide prevention content in all school curricula
  • Standardized community, worksite, EAP education regarding stress reductions
  • Waupaca County Coordinated Services Teams- Provide assessment, goal setting and ongoing support for children/youth involved in multiple systems
  • Teach mental health coping skills using NAMI (standardized resource)
  • Develop aggressive penalites for bullying and fighting in schools
  • Teach coping skills in the workplace, faith-based community
  • Provide more community education on use of alcohol, drugs, and overeating as coping mechanisms and "comfort" measures for unresolved mental health issues
  • Make "time off" the norm- no work, no screen time, no weekend youth sports activities

Goal #1: Provide education focused on budgeting, borrowing (credit, loans), insurance, needs vs. wants, spending culture, and ethics

  • Free or affordable classes for families with limited resources and others interested
  • Transportation and childcare would be needed for families to be able to attend. A meal provided or a voucher for gas or food would be useful incentives
  • Repeating classes at different times of the day and days of the week would be helpful
  • A required "money management" class with every loan
  • A "Balancing Your Checkbook" class with each new account