1. health and fitness

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Notice of Public Meeting
Door County Government Center
Chambers Room, 1st floor
421 Nebraska Street, Sturgeon Bay, WI
LEGISLATIVE
COMMITTEE
Tuesday, March 31, 2015
2:00 P.M.
AGENDA
1. Call Meeting to Order
2. Establish a Quorum ~ Roll Call
3. Adopt Agenda / Properly Noticed
4. Approve Minutes: February 11, 2015 Legislative Committee Meeting
5. Communications
6. Public Comment
7. Supervisor Response
8. New Business
A. Room Tax Issue/Funding for Tourism Infrastructure
B. Levy Limit
C. 911 Funding
D. Budget Issues and Possible Action (Letter to Joint Finance and County Resolutions)
1.) Family Care/ADRC
2.) Wisconsin Fund
3.) Transfer of Assessor Work form Municipalities to County
4.) Wisconsin Harbor Association Program
5.) Property Insurance (LGPIF)
6.) Communicable Disease Funding
9. Adjourn
Deviation from the order shown may occur
Members of the Door County Board of Supervisors and/or its sub-units may be in attendance at this meeting to listen and gather information. Notice is hereby given that the above meeting
may constitute a meeting of the Door County Board of Supervisors or one of its sub-units. However no official action will be taken except by the Legislative Committee.
In compliance with the Americans with Disabilities Act, any person needing assistance to participate in this meeting, should contact the Office of the County Clerk at
(920)746 2200. Notification 72 hours prior to a meeting will enable the County to make reasonable arrangements to ensure accessibility to that meeting.
Posted _________, 2015
Initials: ___________
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MINUTES
Wednesday, February 11, 2015
LEGISLATIVE
COMMITTEE
Door County Government Center
Chambers Room, 1st floor
421 Nebraska Street, Sturgeon Bay, WI
Call Meeting to Order
Chair Susan Kohout called the February 11, 2015 meeting of the Legislative Committee to order at 4:02
p.m. at the Door County Government Center.
Establish a Quorum – Roll Call
Committee members present – John Bur, Kathy Schultz, Susan Kohout, David
Enigl and Ben Meyer.
Others present – CC Grant Thomas, County Clerk Jill Lau, League of Women
Voters Representative Barb Graul, and reporter Peter Devlin.
"These minutes
have not been
reviewed by the
oversight committee
and are subject to
approval at the next
regular committee
meeting."
Adopt Agenda/Properly Noticed
Motion by Schultz, seconded by Enigl to approve the agenda. Motion carried by unanimous voice vote.
Approve Minutes of January 14, 2015 Legislative Committee Meeting
Motion by Schultz, seconded by Enigl to approve the January 14, 2015 meeting minutes. Motion carried
by unanimous voice vote.
Communications
No communications presented.
Public Comment
No one from the public commented.
Supervisor Response
N/A.
Old Business
Prepare for Meeting with Representative Joel Kitchens – Monday, March 23rd – 6 PM
CC Thomas noted the agenda for the meeting can be noticed as a broad, general legislative issues
agenda and no action by the committee will be taken. Could specifically agenda items if action is
needed.
Specific topics to discuss with Representative Kitchens include County’s ability to bid on City roadwork;
Groundwater issues; 911 funding; and legal notice requirements.
Prepare for Meeting with Wisconsin Counties Association Director of Government Affairs Kyle
Christianson – Tuesday, March 31st – 2 PM
Specific topics to discuss with Kyle include Room Tax at a county level, the State’s Biennial Budget,
and levy limits.
WCA Ambassador Team Day – 2/3/15 – Report & Follow-Up
Information included in the meeting packet was reviewed. Chair Kohout represents Door County on
the WCA Ambassador Team. Items discussed at the meeting on the 3rd included State Transportation
Fund revenue; 911 funding; reimbursement for probation and parole holds; and, legal notice
requirements such as election advertising and Planning Department required notices.
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Legislative Exchange – February 3 & 4 – Report
Supervisor Schultz reported on the events and activities at the Legislative Exchange noting it was a
packed day and a half with many speakers.
Door/Kewaunee Legislative Days 2015 – April 15-16 – Update
Chair Kohout noted the Administrative Committee approved attendance for all County Board
Supervisors. Kohout encourages persons to attend. Groundwater issues is an expected topic, and
Highway Department roadwork for Cities.
New Business
2015-17 Biennial Budget – Prioritize
The budget summary was included in the meeting packet and was reviewed and discussed.
Chair Kohout will send a letter to Department Heads asking them to pass on any concerns they may
have with the state budget to the Legislative Committee for further review and discussion.
Matters to be Placed on a Future Agenda or Referred to a Committee, Official, or Employee
 Proposed legislation to eliminate county controlled Shoreland Zoning for Madeline Island and
Washington Island
Next Meeting Date
March 23, 2015 - 6:00 p.m. – Meeting with Representative Joel Kitchens
March 31, 2015 – 2:00 p.m. – Meeting with Wisconsin Counties Association Director of Government
Affairs Kyle Christianson
Adjourn
Motion by Enigl, seconded by Meyer to adjourn. Adjournment came at 5:03 p.m. Motion carried by
voice vote.
Respectfully Submitted by County Clerk Jill M. Lau
The Wisconsin Long-Term Care Coalition
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Keep Our Care at Home
RESOLUTION
Retain Wisconsin’s Current Long-Term Care System — Family Care, IRIS, Partnership, and Aging &
Disability Resource Centers — and make it available in all counties
WHEREAS Governor Walker’s 2015-2017 budget proposal
would dismantle Wisconsin’s nationally admired longterm care (LTC) system currently serving nearly 55,000
older adults and individuals with disabilities, and substantially reduce legislative oversight of the LTC system;
WHEREAS the governor’s budget would eliminate IRIS;
radically change Family Care and replace all 8 existing
regional, homegrown LTC managed care organizations
(MCOs) with statewide for-profit health insurance companies providing both health care and LTC services (using a
no-bid process); and give authority to the Department of
Health Services (DHS) to eliminate county-run Aging &
Disability Resource Centers (ADRCs) by contracting out
many of their functions;
WHEREAS this massive upheaval was initiated with no
input from people receiving LTC services or their families,
aging or disability advocates, local officials, MCOs, ADRCs,
provider agencies, the State Long Term Care Advisory
Council, or legislators;
WHEREAS the current LTC system was the outgrowth of
four years of intensive LTC reform planning involving LTC
consumers and families, aging and disability advocates,
providers, counties and state officials, resulting in strong
bi-partisan support for a LTC-only version of Family Care
which now enjoys very high customer satisfaction ratings;
WHEREAS the IRIS program was started in 2008 to provide
a non-managed care, free market alternative for people
who want to self direct all of their services and this popular, unique and flexible program has grown rapidly to its
current enrollment of 11,500 people;
WHEREAS ADRCs have become a nationally recognized
model and one of the most important roles of county
government to meet a variety of needs and reduce the
costs of a growing LTC population;
WHEREAS all of the projected $14 million in savings in
state and federal funds in the 2015-2017 budget are the
result of current expansion of the existing LTC system into
7 northeast counties and there are no projected additional savings resulting from the governor’s proposed
changes in LTC;
THEREFORE BE IT RESOLVED by the undersigned
organizations that Wisconsin should retain its
existing successful and cost-effective models of
Family Care, IRIS, Partnership and ADRCs, and the
WHEREAS the hoped-for reforms have actually been
produced by the current system: reducing nursing home
current level of legislative oversight; should make
utilization, “bending the curve” on Medicaid spending,
those models available in all counties to eliminate
reducing the portion of Medicaid spent on LTC, and
waiting lists, sustain quality, and achieve further
creating locally-based ADRCs to provide prevention and
savings; and should resume previous joint efforts
one-stop information on LTC for all citizens;
of all stakeholders to continually pursue new opWHEREAS the current system of Family Care, IRIS, Partner- portunities to improve the LTC system.
ship, and ADRCs has created huge savings for taxpayers
while maintaining quality: reducing the Medicaid portion
of the budget from 53% in 2002 to 43% in 2011, reducing
the nursing home population by 11,000 people, keeping
administrative costs for Family Care down to 4.2%, and
limiting MCO surpluses to 2%;
The Wisconsin Long-Term Care Coalition is made up of aging
and disability advocates, managed care organizations, Aging
& Disability Resource Centers, and county government, and
long-term care providers.
March 2015
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Overview of Wisconsin Communicable Disease Funding
Wisconsin’s Local Health Departments (LHDs) are as varied in size and composition as the populations of the
jurisdictions they serve. However, all these LHDs share a common mission of protecting and improving
community well-being. This is accomplished by preventing disease, illness, and injury and by impacting social,
economic, and environmental factors fundamental to excellent health.
Communicable disease control is one of the ten essential public health functions. Unfortunately the ability of local
public health departments to perform this core functions has been drastically limited by lack of funding. A
significant number of communicable diseases exist within communities, but health departments rarely have
sufficient staff time and expertise to support effective diseases prevention efforts.
Today’s system for financing public health in Wisconsin has several noteworthy aspects:
• No dedicated, stable state and federal funding for communicable disease control and prevention
• Inadequate Public Health and CDC funding per capita
• Declining local level funding due to budget levy limits
• Emerging and re-emerging health threats
• Reliance on categorical/silo funds
• Increasing reliance on fees
• Local funding disparities between agencies
State Public Health Funding Per Capita
$36
$33
$30
$27
$24
$21
$18
$15
$12
$9
$6
$3
$0
WI
FY 08
FY 09
$10.51 $10.23
FY 10
FY 11
FY 12
FY 13
$8.71
$9.29
$13.10 $13.10
Median $33.71 $28.92 $30.61 $30.09 $27.40 $27.49
CDC Funding Per Capita
Dollars per capita
Dollars per capita
In a comparison of state budgets and appropriations for the agency in charge of public health services, Trust for
America’s Health (TFAH) has consistently found that Wisconsin has ranked 46th – 49th out of 51 in state funding
for public health. Wisconsin ranked 43rd – 46th in CDC funding per capita. There has been some progress in
moving funding levels toward the median however we are still at the bottom of the rankings and need to continue
to make public health funding a priority.
$22
$20
$18
$16
$14
$12
$10
FY 08
FY 09
FY 10
FY 11
FY 12
FY 13
$14.97
$15.98
$15.80
$16.42
$15.83
$15.29
Median $17.60
$19.23
$20.25
$20.28
$19.54
$20.00
WI
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Rank for Combined Funding (State, CDC, HRSA) 2008 - 2014
Largest Changes in Health Rank Since 1990 Edition (25 Years)
In the April 2012 report For the Public's Health: Investing in a Healthier Future, the Institute of Medicine (IOM)
identified “essential ingredients” to renew the public health system:
• Adequate and sustainable funding for governmental public health;
•
Reform of governmental public health infrastructure and operations to align spending with need; and
•
Using public health knowledge to help improve delivery and quality of clinical care and integrate it with
public health’s population-based efforts.
Supporting a strong public health infrastructure is paramount with the continuing occurrences of natural disasters,
terrorist attacks, and infectious diseases like tuberculosis, Ebola, whooping cough and flu.
Problem Statement:
There is no dedicated, stable base state funding for communicable disease control and prevention.
Resources, staff and time, vary significantly from one agency to the next. Many agencies have limited resources
to respond to urgent and/or outbreak situations. As a result contact investigations may be delayed, disease
continues to spread and every communicable disease outbreak potentially becomes a crisis.
Performance Measures:
Outcome:
• Communicable disease rates fall over time
Interim:
• All cases and contacts will be investigated in timely manner; treatment and follow up is routine and
documented.
• Outbreaks are contained quickly; no secondary cases, or limited transmission documented
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•
•
•
Improved adherence of mandated reporting and treatment guidelines for communicable disease by
providers due to on-going educational outreach.
Increase in the percentage of individuals who successfully complete treatment and follow up testing.
Improved immunizations rates by raising community awareness and auditing of immunizations records
Rationale:
This is the highest-ranked priority for public health. The most basic public health intervention is to stop the spread
of disease by limiting exposure. This takes concerted effort wherever disease occurs, and is very time intensive.
Our “Ask”:
Currently Wisconsin’s public health funding allocation is $13.10 per capita. To reach the median level of state
public health funding per capita an additional $14.39 per capita increase is needed. (WI population = 5,742,713).
The estimated cost of just the increase would be an additional $82,637,640.07 each year. Realizing that this is not
feasible/realistic request, and being good stewards of dollars we receive, our request would be for a $5 million
budget line item, this biennium, specifically earmarked for local health departments. The purpose of would be to
provide a base funding amount to each local health department for the provision of mandated communicable
disease control and prevention activities, including staff training and development. This requested amount
equates to a less than one dollar per person increase in public health funding.
For additional information, please contact the Wisconsin Association of Local Health Departments and Boards
(WALHDAB) office ([email protected]) or the Wisconsin Public Health Association (WPHA) office
([email protected]).
Updated 2-16-15
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County of Door
PUBLIC HEALTH DEPARTMENT
County Government Center
421 Nebraska Street
Sturgeon Bay, WI 54235
Rhonda Kolberg
Director/Health Officer
(920) 746-2234
[email protected]
March 12, 2015
Dear Representative Kitchens:
As your constituent and a public health professional in Wisconsin, I would like to take this opportunity
to talk to you about the critical need to invest in Wisconsin's public health infrastructure and in efforts
to combat the spread of infectious disease in our communities.
I certainly understand Wisconsin's current budget situation and the need to make prudent spending
decisions that focus on essential services and programs. However, from my perspective, one of the
most important functions of government is to protect its citizens from outside threats – including the
threat posed by infectious disease.
Unfortunately, Wisconsin currently has no dedicated, stable funding source for infectious disease
control and prevention. As a result, local health departments rarely have sufficient resources, making
it extraordinarily difficult to carry out basic communicable disease functions required by the state.
Often times, basic follow-up and contact tracing investigations are not completed, allowing the
opportunity for disease to spread and become a crisis.
The highest priority for public health in Wisconsin and across the country is the control and
prevention of infectious disease – both familiar diseases such as influenza and tuberculous,
reemerging threats like measles, and new exotic threats, such as Ebola and Middle East Respiratory
Syndrome (MERS). Supporting a robust public health infrastructure is critical in a globalized world
that provides new opportunities for the emergence and spread of infectious diseases.
In an effort neutralize the threat faced by our communities, the Wisconsin Public Health Association
and the Wisconsin Association of Local Health Departments and Boards is asking the Legislature to
invest $5 million in new funding over the biennium to combat infectious disease. Under the proposal,
the state would allocate the funding to local health departments to strengthen prevention and
containment measures, such as disease surveillance, contact tracing, and public education.
While this would be a significant investment in Wisconsin's public health system during a time of
fiscal constraint, it is long overdue and a small price to pay to protect the state, our economy, and
ultimately the lives of our citizens from a disease epidemic and public health crisis.
Thank you for your time. As you and your legislative colleagues complete your work on the 2015-17
state budget bill, I would ask you to seriously consider supporting much-needed funding for
infectious disease control and prevention in Wisconsin. If you have any questions or would like
additional information, please do not hesitate to contact me at rkolberg.co.door.wi.us or (920) 7462234.
Sincerely,
Rhonda Kolberg
806 S. 12th Ave.
Sturgeon Bay, WI 54235
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*TEMPLATE* Resolution to Secure State Funding to
Support Communicable Disease Control for Population Health
1
WHEREAS,
communicable disease control and prevention efforts; and
2
3
WHEREAS,
WHEREAS,
Emerging and existing communicable diseases threaten health security,
economies, and quality of life for all; and
6
7
A strong public health infrastructure is paramount to the health of all
citizens; and
4
5
Wisconsin has no dedicated, stable federal and state funding sources for
WHEREAS,
Communicable diseases such as Ebola, H1N1, measles, HIV and AIDS,
8
tuberculosis, influenza, measles, syphilis, gonorrhea, rabies, hepatitis,
9
polio, and pertussis, can threaten the lives and well-being of Wisconsin
residents; and
10
11
WHEREAS,
Emerging and re-emerging threats such as Ebola, H1N1, SARS, and
12
measles threaten personal and community safety and require substantial
13
resources to contain;
14
WHEREAS,
Wisconsin local health department communicable disease programs
15
protect residents by investigating and controlling communicable diseases,
16
collecting data, educating the community about prevention and the
17
importance of immunizations, and caring for those affected by these
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diseases; and
19
WHEREAS,
Public health departments have been successful in controlling
20
communicable diseases through case reporting and involvement of public
21
health staff in referral of exposed persons for screening and prevention
22
services; and
23
WHEREAS,
Evidence in the scientific literature indicates that partner notification
24
services are not adequately assured in the absence of specific public
25
health staff involvement; and
26
27
WHEREAS,
Local health departments and the State of Wisconsin have demonstrated
commitment, competence and success in assuring the confidentiality of
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28
persons with reported communicable disease for decades, including
29
cases of AIDS; and
30
WHEREAS,
disease control; and
31
32
WHEREAS,
Communicable disease control is one of the ten essential functions of
public health; now, therefore, be it
33
34
Local health departments have placed a high priority on communicable
RESOLVED,
That the ___________ [Board of Health or County Board or appropriate
35
policy-making entity] urges the state legislature to develop and enact
36
bipartisan support for funding of comprehensive, sustainable, effective
37
and evidence based communicable disease control and prevention for
38
the public’s health.
Signed:
Date:
Final endorsed resolution should be sent to the Wisconsin Association of Local Health Departments and Boards (WALHDAB) at
[email protected], or 563 Carter Court, Suite B, Kimberly, WI 54136. Final endorsed resolution should also be sent to all
state legislators whose constituents are within the jurisdiction.