Community Health Improvement Plan 2011-2015 - West Allis-West Milwaukee

 
West Allis-West Milwaukee
Community Health
Improvement Plan
   2011-2015

                            V: 09192011
Introduction

This document marks the third comprehensive Community Health Improvement Plan (CHIP) for
the West Allis and West Milwaukee communities providing a blueprint for community action
through the year 2015. The process framework used for the development of the West Allis-
West Milwaukee Community Health Improvement Plan 2015 was MAPP (Mobilizing Action
through Planning and Partnerships), available through NACCHO (National Association of County
and City Health Officials). MAPP is a community driven strategic planning process designed to
improve community health. This interactive process, facilitated by public health leaders, helped
the community prioritize public health issues and identify resources to address them. For more
information regarding the MAPP process, see the MAPP website:
http://www.naccho.org/topics/infrastructure/MAPP/index.cfm.

The West Allis-West Milwaukee Community Health Assessment was completed in 2010. This
document was a thorough report of community health, assets, challenges, barriers, and
resources. Each of the four assessments: Local Public Health System Assessment, Community
Themes and Strengths Assessment, Forces of Change Assessment, and Community Health
Status Assessment gathered data to thoroughly analyze the community’s health.

A Community Health Improvement Planning Team was convened in 2011 to provide oversight
for the development of the 2015 West Allis-West Milwaukee Community Health Improvement
Plan. Team members consisted of:
        Terry Brandenburg, MPH, CPH – West Allis Health Department
        Melissa Hanson, RN – West Allis Health Department
        Shawne Johnson, RN, MPH – West Allis Health Department
        Sally Nusslock, RN – West Allis Health Department
        Mary Sue Oppermann, RN, MPH – West Allis Health Department
        Geyla Savic – West Allis Health Department

The process of developing the West Allis-West Milwaukee Community Health Improvement
Plan 2015 began with the formation of a Steering Committee consisting of a broad array of
community stakeholders. This committee met to review and analyze the findings of the
Community Health Assessment 2010, review the accomplishments of the Community Health
Improvement Plan 2010, receive an overview of the Public Health Preparedness Program for
the Milwaukee/Waukesha County Consortium, design the structure of CHIP 2015, develop a list
of top health priorities for the community, and set in motion a process for workgroups to create
achievable, measurable objectives for the community to complete by the year 2015.
The Steering Committee recommended nine health priorities critical to improving the
community’s health:

   •   Access to Care
   •   Alcohol and Other Drug Use
   •   Emotional Well Being
   •   Health Communications
   •   Healthy Homes
   •   Healthy Lifestyle
   •   Obesity
   •   Safety and Injury
   •   Unhealthy Aggressive Behaviors

Workgroups were formed around each of the nine priorities determined by the Steering
Committee. Facilitators guided each workgroup to develop SMART (specific, measurable,
achievable, relevant, and time-framed) objectives and determine appropriate agencies willing
to take responsibility for measuring progress and achieving completion. In addition, each
workgroup was provided with current state and/or federal objectives related to their assigned
priority. The workgroups were asked to consider these and incorporate them when formulating
new objectives for the community. The Steering Committee subsequently finalized and
approved the 2015 West Allis-West Milwaukee Community Health Improvement Plan.
Acknowledgements

Steering Committee

Steve Bane ................................................................ Assistant Fire Chief, City of West Allis
Jeannette Bell................................................................... President, West Allis Rotary Club
Terry Brandenburg................................................ Health Commissioner, City of West Allis
Dan Devine.....................................................................................Mayor, City of West Allis
Kim Eagan ..........................................................Administrator, Village of West Milwaukee
MaryCay Freiberg ....................................................... Member, West Allis Board of Health
Mickey Gabbert .....................Manager Chemical Dependency, Rogers Memorial Hospital
Ron Hayward ............................................................President, Village of West Milwaukee
Mike Jungbluth ..................................................................... Police Chief, City of West Allis
Rick Kellar ............................................................... CEO, Aurora West Allis Medical Center
Joe Kempen ............................Member Hospital Board, Aurora West Allis Medical Center
Susan Lockman................................................................. Pastor, United Methodist Church
Lydia Lopez ..........................................................................................................Promotora
Joanie Luedke ................................................President, West Allis Chamber of Commerce
Kathy Schneider .................................................................. Greater Milwaukee Free Clinic
Mary Steinbrenner..............................Marketing Director, Meadowmere, Mitchell Manor
John Stibal ............................................................. Dept of Development, City of West Allis
Kurt Wachholtz ..................... Superintendent, West Allis-West Milwaukee School District
Marty Weigel ........................................................................... Alderman, City of West Allis

Access to Care

Yvonne Duemke ................................................................... West Allis Health Department
Kitty Dufek-Maier ................................................................. West Allis Health Department
Melissa Hanson* ................................................................... West Allis Health Department
Shawne Johnson* ................................................................. West Allis Health Department
Lydia Lopez ..........................................................................................................Promotora
Kim Melcher.....................................................................Aurora West Allis Medical Center
Kathy Schneider .................................................................. Greater Milwaukee Free Clinic

Alcohol and Other Drug Use

Steve Bane .................................................................................West Allis Fire Department
Steve Beyer ............................................................................ West Allis Police Department
Mickey Gabbert .......................................................................... Rogers Memorial Hospital
Shawne Johnson ................................................................... West Allis Health Department
Tammy Molter* .................................................................................. Community Coalition
Duncan Shrout ..........................................................................................................IMPACT

Emotional Well Being

Steve Bane .................................................................................West Allis Fire Department
Janet Gatlin ................................................................................ Rogers Memorial Hospital
Beth Heflin* ......................................................West Allis-West Milwaukee School District
David Henderson......................................................................................................InHealth
Shawne Johnson ................................................................... West Allis Health Department
Rod Nelson ............................................................................ West Allis Police Department
Mary Sue Oppermann........................................................... West Allis Health Department
Jodi Pahlavan .............................................................................. Rogers Memorial Hospital
Marsha Wojciechowski ........................................................ West Allis Health Department

Health Communications

Terry Brandenburg*.............................................................. West Allis Health Department
Melissa Hanson ..................................................................... West Allis Health Department
Sally Nusslock........................................................................ West Allis Health Department

Healthy Homes and Neighborhoods

Mary Ann Curtis .................................................................... West Allis Health Department
Dan Devine.....................................................................................Mayor, City of West Allis
Chad Evenson......................................................................... West Allis Police Department
Mary Koller*.......................................................................... West Allis Health Department
John Stibal ..............................................................West Allis Department of Development
Laura Temke.......................................................................... West Allis Health Department
Marty Weigel ........................................................................... Alderman, City of West Allis

Healthy Lifestyles

Terese Beauchamp*.........................................................Aurora West Allis Medical Center
Diane Brandt ...................................................................West Allis Chamber of Commerce
Mike Jungbluth ..................................................................... Police Chief, City of West Allis
Joe Kempen ............................Member Hospital Board, Aurora West Allis Medical Center
Dan Ledvorowski........................................................................West Allis Fire Department
Shelly Zajdel .......................................................................... West Allis Health Department
Obesity

Jeanne Clark .....................................................................Aurora West Allis Medical Center
Cheryl Davies*....................................................................... West Allis Health Department
Mary Koller............................................................................ West Allis Health Department
Dan Koralewski...................................................................... West Allis Health Department
Steve Kosnar ..............................................................................................................Sodexo
Shelly Strasser ...................................West Allis-West Milwaukee Recreation Department
Jennifer Vaclav* .................................................................... West Allis Health Department

Safety and Injury

MaryCay Freiberg *..................................................................... West Allis Board of Health
Linda Huske ......................................................................... Public Works, City of West Allis
Dan Machowski..........................................................................West Allis Fire Department
Marilyn Matter...................................................................... West Allis Health Department
Mary Sue Oppermann........................................................... West Allis Health Department
Brian Saftig ............................................................................. West Allis Police Department
Mary Steinbrenner.............................................................. Meadowmere, Mitchell Manor

Unhealthy Aggressive Behaviors

Robert Fletcher* .................................................................... West Allis Police Department
Beth Heflin ........................................................West Allis-West Milwaukee School District
Karen Fuerstenau-Zigman.................................West Allis-West Milwaukee School District

* Denotes facilitator
Table of Contents

                                                                                               PAGE
                                                                                               NUMBER

Access to Care................................................................................. 1

Alcohol and Other Drug Use............................................................ 4

Emotional Well Being...................................................................... 9

Health Communications................................................................ 14

Healthy Homes and Neighborhoods.............................................. 16

Healthy Lifestyles.......................................................................... 25

Obesity ......................................................................................... 32

Safety and Injury........................................................................... 39

Unhealthy Aggressive Behaviors ................................................... 43
ACCESS TO CARE

Access to Care

Background

Access to health services means the timely use of personal health services to achieve the best
health outcomes. This requires three distinct steps:
   •    Gaining entry into the health care system
   •    Accessing a health care location where needed services are provided
   •    Finding a health care provider with whom the patient can communicate and trust1

Currently, access to health care services in the United States is regarded as unreliable; many
people do not receive the appropriate and timely care they need. Furthermore, it is anticipated
there will be an added burden placed on the already strained U.S. health care system when a
projected influx of patients in 2014, will lead to approximately 32 million Americans having
health insurance for the first time.1

Access to health care services can be better understood when broken down into four
components: Coverage, Services, Timeliness and Workforce.
   1. Coverage – Adequate coverage helps people to get the health care they need and avoid
       the burden of large medical bills.
   2. Services – Improving health care services depends in part on ensuring that people have
       a usual and ongoing source of care. People with a usual source of care have better
       health outcomes and fewer disparities and costs
   3. Timeliness – Timeliness is the health care system's ability to provide health care quickly
       after a need is recognized. Actual and perceived difficulties or delays in getting care
       when patients are ill or injured reflect significant barriers to care.
   4. Workforce – The number of practicing primary care physicians can dramatically affect
       the general public’s health status.2

In order to access cost effective, quality health care in a timely manner from the appropriate
medical provider, it is extremely important for health care consumers to learn to advocate for
their own health care needs.1 One primary way for a health care consumer to get high-quality
health care is to be an engaged, responsible member of his own health care team and to find,
use, and share information wisely on decisions made regarding his health care.2 A person’s
ability to access adequate and safe healthcare services impacts his overall physical, social and
mental health status, his quality of life and life expectancy.

Resources
   1) Access to Health Services. Healthy People 2020. U.S. Department of health and Human
      Services. http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1

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ACCESS TO CARE

    2) Agency for Healthcare Research and Quality. Quick Tips When Talking with Your Doctor.
       U.S. Department of Health and Human Services.
       http://www.ahrq.gov/consumer/quicktips/doctalk.htm

Assessment Data and Objectives

Objective 1: By December 31, 2012, build a network of community partners to designate a
frontline information and referral source for medical, dental and mental health needs in order
to provide up-to-date, appropriate options for accessing health care services.
Baseline: No network in place
Goal: Network in place

This objective will be tracked by the creation of a network of community partners brought
together to develop culturally competent media outreach strategies to increase consumer
awareness of a frontline information and referral source for access to health care services
options.

Strategies/Activities                           Responsibility        How is progress evaluated?
Participate in a collaborative process to      Access                 Meeting notes
identify a frontline information and           Workgroup, Area
referral source                                hospital/clinic(s)
Develop protocol among participating           Access                 Protocol, meeting notes
community partners to redirect consumers       Workgroup, Area
to this community resource                     hospital / clinic(s)
Establish a “no wrong door” policy among       Access                 “No wrong door” policy,
participating community partners               Workgroup, Area        meeting notes
                                               hospital/clinic(s)
Utilize culturally competent media             Access to Health       Documentation of media
outreach strategies to increase consumer       Care Workgroup         outreach strategies or tools
awareness regarding a frontline                                       utilized, educational
information and referral source. Example                              materials
strategies would include fact sheets,
display boards, and a link on City of West
Allis website providing regularly updated
health care services information

Objective 2: By December 31, 2012, survey 75% of the large medical clinics and dental clinics in
West Allis and West Milwaukee to identify clinic policies regarding reduced fees and payment
plans for self pay patients.
Baseline: No survey completed
Goal: 75% of large medical clinics and 75% of dental clinics will be surveyed

This objective will be tracked by a log of the clinics surveyed.

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ACCESS TO CARE

Strategies/Activities                           Responsibility   How is progress evaluated?
Survey clinics regarding their existing        WAHD              Percent of clinics surveyed
policies
Develop a spreadsheet to record the            WAHD              Spreadsheet
payment options for each clinic
Review and distribute payment options          WAHD              Meeting notes documenting
spreadsheet to the Access to Health Care                         review and distribution
Workgroup

Objective 3: By December 31, 2014, launch a community education campaign on how to
become a responsible health care consumer.
Baseline: No community health care consumer education campaign currently in place
Goal: Community health care consumer education campaign in place

This objective will be tracked through the implementation of a community education campaign
on how to become a responsible health care consumer.

Strategies/Activities                           Responsibility    How is progress evaluated?
Develop a culturally competent teaching        Access            Development of a teaching
tool for health care providers to use to       Workgroup         tool on “How to become a
educate the public on their responsibilities                     responsible health care
as health care consumers                                         consumer”
Identify underserved or at-risk populations    Access            List of target populations
to offer this teaching tool                    Workgroup
Provide training to WAHD, Aurora West          Access            Record of trainings (include
Allis Medical Center and Greater               Workgroup         date and number of
Milwaukee Free Clinic staff on how to                            participants), training
coach clients or patients on their health                        materials
care responsibilities
Explore meeting with WAWM high school          Subgroup of       Meeting notes
health teachers to discuss the benefit of      Access
adding a component on becoming a               Workgroup
responsible health care consumer into
their curriculum

                                                                                            Page 3
ALCOHOL AND OTHER DRUG USE

Alcohol and Other Drug Use

Background

Alcohol and other drug abuse is defined as any use of a substance that results in negative
consequences. This abuse refers to a set of related conditions associated with the consumption
of mind and behavior altering substances that have a negative behavioral and health outcome
including, but is not limited to, alcohol, prescription substances, and illegal mood-altering
substances.1 Social attitudes and political and legal responses to the consumption of alcohol
and illicit drugs make substance abuse a very complex public health issue. Studies have shown
that substance abuse is a disorder that develops in adolescence and, for some individuals, will
develop into a chronic illness that will require lifelong monitoring and care.2 Substance abuse
has a major impact on individuals, families, and communities. The effects of substance abuse
are cumulative, significantly contributing to costly social, physical, mental, and public health
problems such as teenage pregnancy, domestic violence, motor vehicle accidents, physical
fights, crime, homicide, and suicide.2

Alcohol
Alcohol-related deaths are the fourth leading cause of death in Wisconsin behind heart disease,
cancer, and stroke. Although Wisconsin’s drinking culture is not intentionally harmful, rather,
most residents drink responsibly, safely, and legally, this culture is, in many ways, tolerant of
excessive, dangerous, unhealthy, and illegal drinking. Alcohol-related societal problems include
homelessness, child abuse, crime, unemployment, injury, health problems, hospitalization,
suicide, fetal abnormalities, and even early death.1 Youth who drink alcohol are at a greater risk
to experience difficulties in school, social problems, legal repercussions, physical problems, and
alcohol related unintentional injuries. Youth may also place themselves in high-risk social
situations leading to unplanned and unprotected sexual activity, physical and sexual assault,
homicide, suicide, abuse of other drugs, and/or death from alcohol poisoning due to their
altered judgment related to drinking.3

Marijuana
Youth marijuana use is associated with a number of risky behaviors. Teens, 12-17 years of age,
who smoke marijuana are more than twice as likely to cut class, steal, fight, and destroy
property than those who do not smoke marijuana. Marijuana use can also lead to decreased
lung functions and impaired memory.4

Prescription Drug Abuse
An emerging area of concern is adolescent abuse of prescription drugs. Prescription drug abuse
means taking a prescription medication that is not prescribed for you, or taking it for reasons or
in dosages other than as prescribed. This abuse has continued to rise over the past five years in
the United States. One factor leading to this increase in abuse is the availability of prescription

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ALCOHOL AND OTHER DRUG USE

drugs from many sources including the family medicine cabinet, the Internet, and doctors. In
addition, many adolescents believe that prescription drugs are safer to take than street drugs.2

Resources:
   1) Alcohol and Other Drug Use. Wisconsin State Health Plan: Healthiest Wisconsin 2020.
      Wisconsin Department of Health Services.
      http://www.dhs.wisconsin.gov/hw2020/pdf/alcohol.pdf
   2) Substance Abuse. Healthy People 2020.U.S. Department of Health and Human Services.
      http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=40
   3) Underage Drinking. Centers for Disease Control and Prevention. U.S. Department of
      Health and Human Services. http://www.cdc.gov/alcohol/fact-sheets/underage-
      drinking.htm
   4) Other Drug Consumption. (2008). Wisconsin Epidemiological profile on Alcohol and
      Other Drug Abuse. http://www.dhs.wisconsin.gov/stats/pdf/otherdrug2008/pdf

Assessment Data and Objectives

Objective 1: By April 31, 2012, launch a community education campaign for Alcohol Awareness
Month
Baseline: No community education campaign for Alcohol Awareness Month currently in place.
Goal: Community education campaign for Alcohol Awareness Month in place

This objective will be tracked through the development of a community education campaign.

Strategies/Activities                        Responsibility        How is progress evaluated?
Distribute an alcohol screening and          IMPACT,               Availability of alcohol
education tool from IMPACT through a         WAHD,                 screening and education tool
variety of venues – Wellness programs,       Community
Chamber of Commerce, etc.                    Coalition,
                                             City of West Allis,
                                             Chamber of
                                             Commerce,
                                             WAWM Schools
Facilitate Mayoral proclamation for          WAHD,                 Mayoral proclamation
Alcohol Awareness Month                      Community
                                             Coalition
Develop a display board for display in       WAHD,                 Display board
public settings during Alcohol Awareness     Community
Month                                        Coalition
Promote the use of the domino strategy to    WAHD,                 Educational materials
educate the community on drinking            Community             include domino strategy
responsibly                                  Coalition

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ALCOHOL AND OTHER DRUG USE

Objective 2: By September 30, 2012, maintain or increase current levels of compliance with,
and enforcement of, ordinances and laws related to youth substance abuse as measured by
WAPD and WMPD reports in West Allis and West Milwaukee.
Baseline: In West Allis, from 10-1-09 through 9-30-10, there were 47 tobacco compliance
checks and 139 alcohol compliance checks. In West Milwaukee, from 10-1-09 through 9-30-10,
there were no tobacco or alcohol compliance checks.
In West Allis, from 10-1-09 through 9-30-10, there were 78 tobacco citations issued and 16
alcohol citations issued. In West Milwaukee, from 10-1-09 through 9-30-10, there were no
tobacco citations issued and 16 alcohol citations issued.
Goal: Maintain or increase compliance

This objective will be tracked using alcohol and tobacco compliance checks conducted by the
WAPD and WMPD.

Strategies/Activities                        Responsibility      How is progress evaluated?
Enforce compliance of ordinances and         WAPD, WMPD          Number of compliance
laws related to youth substance abuse                            checks completed, number
                                                                 of citations issued
Review reports of compliance with, and       Community           Review of enforcement
enforcement of, ordinances and laws          Coalition           reports
related to youth substance abuse

Objective 3: By December 31, 2013, there will be a 3% reduction in age of onset of using
alcohol prior to age 13 years.
Baseline: 26% in 2009
Goal: 23% in 2013

Objective 4: By December 31, 2013 there will be a 3% reduction of use of alcohol in the past 30
days.
Baseline: 44% in 2009
Goal: 41% in 2013

Objective 5: By December 31, 2013, there will be a 3% increase in students’ perception of risk
or harm from using alcohol.
Baseline: 26% in 2009
Goal: 29% in 2013

Objective 6: By December 31, 2013, there will be a 3% increase in students’ perception of
parents’ disapproval of students’ use of alcohol.
Baseline: 41% in 2009
Goal: 44% in 2013

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ALCOHOL AND OTHER DRUG USE

Objective 7: By December 31, 2013, there will be a 3% reduction in age of onset in using
prescription drugs and non prescription pain killers prior to age 13 years.
Baseline: 5% in 2009
Goal: 2% in 2013

Objective 8: By December 31, 2013, there will be a 3% reduction of use of marijuana in the past
30 days.
Baseline: 5% in 2009
Goal: 2% in 2013

These objectives will be tracked using the Youth Risk Behavior Survey (YRBS) to survey 8th-12th
grade WAWM students.

Strategies/Activities                        Responsibility       How is progress evaluated?
Administer the YRBS to 8th-12th grade        WAHD                 Administration of survey
students every two years in the WAWM
School District
Provide information and enhance skills of    Community            Report of program delivery
youth grades 6-12 via delivery of            Coalition,
comprehensive K-12 ATODA prevention          WAWM Schools
program
Provide support for youth to make healthy    Community            Offering of alcohol and drug
choices through alcohol and drug free        Coalition,           free events
events                                       Community
                                             Alliance Against
                                             Drugs (CAAD)
Provide information to parents,              Community            Educational materials
community members and youth about            Coalition,
underage alcohol, marijuana, and             CAAD
prescription drug and non prescription
pain killers abuse

Objective 9: By December 31, 2013, survey and provide education to 100% of the large medical
clinics in West Allis and West Milwaukee regarding prescription drug use and abuse.
Baseline: No survey has been administered
Goal: Survey completed

Objective 10: By December 31, 2013, survey and provide education to 75% of area dental
clinics in West Allis and West Milwaukee regarding prescription drug use and abuse.
Baseline: No survey has been administered
Goal: Survey completed

These objectives will be tracked through the administration and analysis of the survey and the
provision of educational materials.
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ALCOHOL AND OTHER DRUG USE

Strategies/Activities                         Responsibility     How is progress evaluated?
Survey and provide education to large         Rogers Hospital,   Distribution of survey,
medical clinics regarding prescription drug   WAHD,              percent of clinics surveyed,
use and abuse                                 Community          educational materials
                                              Coalition
Survey and provide education to area          Rogers Hospital,   Distribution of survey,
dental clinics regarding prescription drug    WAHD,              percent of clinics surveyed,
use and abuse                                 Community          educational materials
                                              Coalition

Objective 11: By December 31, 2015, annually assess and update alcohol and drug abuse
resources available in West Allis and West Milwaukee listed through IMPACT.
Baseline: Resources not updated regularly
Goal: Updated alcohol and drug abuse resources listed through IMPACT

This objective will be tracked through an annual review and update of area alcohol and drug
abuse resources from IMPACT.

Strategies/Activities                         Responsibility     How is progress evaluated?
Request listing of area alcohol and drug      WAHD,              Annual list of resources
abuse resources from IMPACT                   Community
                                              Coalition,
                                              IMPACT
Review and update listing of area alcohol     WAHD,              Memo detailing review and
and drug abuse resources from IMPACT          Community          updates if any
                                              Coalition,
                                              IMPACT

Page 8
EMOTIONAL WELL BEING

Emotional Well Being

Background

Emotional well-being is not the absence of emotions, but rather, it is the ability to understand
the value of emotions and use them to move forward in life in a positive direction. Everyday
emotional well-being also involves identifying, building upon, and operating from strengths
rather than focusing on fixing problems or weaknesses. The better one is able to master
emotions, the greater the capacity to enjoy life, cope with stress, and focus on important
personal priorities.1

The emotionally well person maintains satisfying relationships with others, feels positive and
enthusiastic about oneself and life, manages one’s feelings and related behaviors, realistically
assesses one's limitations, develops autonomy, and has the ability to cope effectively with
stress.1

Parenting
Improving parenting skills is one way to improve emotional wellbeing. Family functioning and
positive parenting can have positive outcomes on the mental health of children. Parents play a
critical role in their child's development. Providing a safe and loving home and spending time
together – playing, singing, reading, and even just talking – can make a big difference in the life
of a child by providing the foundation for emotional wellbeing.2

Infant mental health
Infant mental health (IMH) is synonymous with social and emotional development in young
children. Social and emotional development involves skills such as self-confidence, curiosity,
motivation, persistence, self-control, and trust – all of which affect future learning, growth, and
success. The development of these traits begins in infancy and within the context of
relationships. Emotional and social milestones include a child's ability to experience, regulate
and express emotions, and form close and secure interpersonal relationships. A child's
capacities to identify their own feelings, experience empathy for another and constructively
manage strong emotions are skills that begin in early childhood and support later learning.3

Mental health screenings
Mental health is fundamental to overall health and productivity. Mental health disorders are
real and disabling conditions. Left untreated, mental illness can result in disability and despair
for families, schools, communities and the workplace. Teenage depression is a common cause
of reduced academic achievements, poor attendance, tense or non-existent social
relationships, and substance abuse. Early recognition and treatment, if needed, can help
prevent mental illness from worsening and improve an individual’s chances for recovery.4

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EMOTIONAL WELL BEING

Screening is a safe, effective way of detecting the earliest stages of mental illnesses. The U.S.
Preventive Service Task Force recommends routine screenings for all adults as well as
adolescents between the ages 12-18 years and recommends having systems in place for follow-
up. Asking two simple questions about mood, "Over the past 2 weeks, have you felt down,
depressed, or hopeless?" and "Over the past 2 weeks, have you felt little interest or pleasure in
doing things?" may be as effective as using more formal instruments.5

Trauma exposure
Research shows that trauma can undermine children’s ability to learn, form relationships, and
function appropriately in the classroom. When there is family violence, home is not the safe
haven it is for most children. Adults who should be relied upon for nurturance may actually be a
source of terror, or they may be victims themselves and unable to provide protection. When
the perpetrator of violence is a caregiver – the person in whom a child has placed great trust,
and upon who the child’s very life depends – the betrayal a child experiences can be
devastating. These adverse childhood experiences (ACE) such as physical abuse and neglect,
exposure to domestic violence, parental substance abuse, mental illness, and parental
incarceration, may lead to future injury, violence, substance abuse, and even chronic disease.6

The Wisconsin Department of Public Instruction recommends schools become more sensitive to
the needs of children who have been traumatized by directly, or vicariously, experiencing
violence, homelessness, or loss (or fear of loss) of loved ones.7 Given that law enforcement is
often the first and primary system involved in intervening at these events, it is uniquely
positioned to collaborate with schools to develop innovative approaches to reduce the impacts
of adverse childhood experiences on children’s short and long term health and well being.
Rapid intervention with students and families may prevent the development of stress related
symptoms which can interfere with optimal functioning.6

Resource:
   1) The Six Dimensions of Wellness Model. National Wellness Institute, Inc.
      www.nationalwellness.org
   2) Learn Some Positive Parenting Tips. Centers for Disease Control and Prevention. U.S.
      Department of Health and Human Services. http://www.cdc.gov/Features/Parenting/
   3) Early Relationships Matter. Wisconsin Alliance for Infant Mental Health. www.wiimh.org
   4) Mental Health. Wisconsin State Health Plan: Healthiest Wisconsin 2020. Wisconsin
      Department of Health Services.
      http://www.dhs.wisconsin.gov/hw2020/pdf/mentalhealth.pdf
   5) Mental Health and Mental Disorders. Healthy People 2020. U.S. Department of Health
      and Human Services.
      http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=28
   6) The Effects of Childhood Stress on Health Across the Lifespan. Centers for Disease
      Control and Prevention. U.S. Department of Health and Human Services.
      http://www.cdc.gov/ncipc/pub-res/pdf/childhood_stress.pdf

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EMOTIONAL WELL BEING

   7) Creating Trauma-Sensitive Schools to Improve Learning: A Response to Intervention
      Model. Mental Health. Wisconsin Department of Public Instruction.
      http://www.dpi.wi.gov/sspw/mhtrauma.html

Assessment Data and Objectives

Objective 1: By December 31, 2012, create a network of community maternal child health
(MCH) providers offering parenting support and education, identify populations experiencing
barriers to parenting support and education, and promote strategies to improve access.
Baseline: No network of community MCH providers currently in place
Goal: Network of community MCH providers in place

This objective will be tracked by the creation of a network of community providers offering
parenting support and education.

Strategies/Activities                          Responsibility    How is progress evaluated?
Convene a group of community MCH              WAHD               Meeting notes
providers to participate in a collaborative
process to assess the availability, cost,
location, and time commitment of
parenting support and parenting
education
Identify underserved and at-risk parents      Network of         Meeting notes
who need parenting education and/or           community MCH
other supportive services                     providers
Survey underserved and at-risk parents to     Network of         Survey
determine what barriers exist that prevent    community MCH
them from accessing parenting education       providers
and other supportive services
Develop strategies to promote access to       Network of         Meeting notes
parenting education and other supportive      community MCH
services                                      providers

Objective 2: By December 31, 2013, launch a community infant mental health education
campaign.
Baseline: No community infant mental health education campaign currently in place
Goal: Community infant mental health education campaign in place

This objective will be tracked through the implementation of a community mental health
campaign.

                                                                                           Page 11
EMOTIONAL WELL BEING

Strategies/Activities                         Responsibility       How is progress evaluated?
Send a minimum of two public health           WAHD                 Training materials
providers to trainings at the Infant Mental
Health Institute in Madison, WI
Trained public health providers will train    WAHD                 List of trainings including
child care providers, SAPP staff and early                         date, number of
education staff on the topic of infant                             participants, and target
mental health                                                      audience

Objective 3: By December 31, 2012, develop and implement mental health screenings for K-12
students in the West Allis-West Milwaukee School District.
Baseline: Document any tools currently available and/or in use
Goal: Review and pilot chosen screening tools selected for use

This objective will be tracked through the use of mental health screenings in the West Allis-
West Milwaukee School District.

Strategies/Activities                         Responsibility       How is progress evaluated?
Review mental health and substance            WAWM Schools         Email or memo listing tools
abuse screening tools in use in the WAWM                           in use
Schools
Research mental health and substance          WAWM Schools,        Mental Health Workgroup
abuse screening tools appropriate for         Mental Health        notes
school-age children and adolescents           Workgroup
Pilot a new mental health screening tool in   WAWM Schools         Copy of screening tool
one elementary, intermediate and high
school in the WAWM School District

Objective 4: By December 31, 2015, a shared data system to monitor student attendance,
grades and behavior of students exposed to adverse childhood events to mitigate the harmful
effects of such events will be developed and piloted.
Baseline: No formal shared data system in place
Goal: Formal shared data system in place

This objective will be tracked through a shared data system between the WAPD and the
WAWM School District.

Strategies/Activities                         Responsibility       How is progress evaluated?
Develop data-sharing policies and             WAWM Schools         Policies and procedures
procedures for students exposed to            (Mental Health
trauma                                        Specialist), WAPD
Develop child and adolescent intervention     WAWM Schools         Protocols
protocols for students exposed to trauma      (Mental Health
                                              Specialist)

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EMOTIONAL WELL BEING

Develop parent and family intervention      WAWM Schools        Protocols
protocols, considering both diversion and   (Mental Health
restorative practices                       Specialist)
Educate local civic, educational, and       WAWM Schools        Promotional materials
parent organizations about adverse          (Mental Health
childhood events and garner support for     Specialist)
the initiative
Review and refine the Trauma Card that is   WAWM Schools        Revised Trauma Card
currently distributed on all police calls   (Mental Health
responding to family violence               Specialist), WAPD

                                                                                         Page 13
HEALTH COMMUNICATIONS

Health Communications

Background

Health communications is the study and use of communication strategies to inform and
influence individual and community decisions that affect health. It links the fields of
communication and health and is recognized as having a vital impact on personal and public
health.1

With the increasing complexity of health information and health care settings, most people
need additional information, skills, and supportive relationships to meet their health needs.
Disparities in access to health information, services, and technology can result in lower usage
rates of preventive services, less knowledge of chronic disease management, higher rates of
hospitalization, and poorer reported health status.2

Health literacy refers to the capacity of individuals to obtain, process, understand and share
basic health information and the services that are necessary to make appropriate decisions
about one’s health. Research shows that increasing health literacy can have a positive impact
on an individual’s overall health.3 Improved health literacy is a shared responsibility between
consumers, families, providers and organizations, with increasing responsibility on the health
care system to present health information in formats that are conducive to optimal learning
and that promote better consumer understanding and participation in their health care and
health decisions.3

Both public and private institutions are increasingly using the Internet and other technologies
to streamline the delivery of health information and services. However, for non-Web users,
other communication venues, besides Internet access, are critical to ensure that all health care
consumers are able to access and understand pertinent health information in a timely manner.
These methods include printed materials, media campaigns, community outreach, and
interpersonal communication.2 Understandably, it is helpful to develop and employ a myriad of
communication tactics in order to better accommodate the general public’s varying capabilities,
preferences, and styles of learning.

Resources
   1) Health Communication. U.S. Department of Health and Human Services.
      http://www.health.gov/communication/resources/Default.asp#overview
   2) Health Communication and Health Information Technology. Healthy People 2020. U.S.
      Department of Health and Human Services.
      http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx ?topicid=18
   3) Health Literacy. Wisconsin State Health Plan: Healthiest Wisconsin 2010. Wisconsin
      Department of Health Services.
      http://www.dhs.wisconsin.gov/hw2020/pdf/healthliteracy.pdf

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HEALTH COMMUNICATIONS

Assessment Data and Objectives

Objective 1: By December 31, 2013 form a community health communications network to
strategize the timely, accurate, and appropriate dissemination of health information to health
professionals, policy makers, and the general public throughout the community.
Baseline: No community health communications network currently in place
Goal: Community health communications network in place
This objective will be tracked through the development of a health communications network.

Strategies/Activities                          Responsibility    How is progress evaluated?
Invite select community partners, both        WAHD               Attendance log, meeting
traditional and non-traditional, to form a                       notes
health communications network (HCN)
Research evidenced-based health               Health             Notes re: research findings
communications interventions that have        Communications
been associated with positive health          Network (HCN)
outcomes
Identify the populations at greater risk of   HCN                Meeting notes
low literacy in order to customize health
literacy interventions
Develop/locate and distribute a fact sheet    HCN                Fact sheet, distribution list
that highlights the association between
low health literacy and poor health
outcomes to members of the local public
health system to expand awareness of the
impact of health literacy on health
outcomes
Design a health communications plan that      HCN                Completed plan
recommends specific communication
methods, technologies and social
marketing and media strategies for use
with specific target groups.
Distribute the health communications plan     HCN                Distribution list
to community partners for community-
wide use

                                                                                            Page 15
HEALTHY HOMES AND NEIGHBORHOODS

Healthy Homes and Neighborhoods

Background

Healthy neighborhoods begin with a healthy home. A healthy home is designed, built, and
maintained to promote health by providing a clean, safe, supportive environment for residents
of all ages. Neighborhoods are the places where the everyday practice of life occurs.

Essentially, neighborhoods create and form communities. Residents share the same
experiences. They suffer or revel in the availability and quality of local housing, schools, jobs,
businesses, health care, and human services. They experience the effects of crime that occurs
within neighborhood boundaries. Neighborhoods create the background for people’s life
stories. They leave lasting impressions on residents about what life is like and what social
problems do or do not exist in the community.1

Carbon Monoxide Detectors
Carbon monoxide (CO) is an odorless, colorless gas that can cause sudden illness and death.
Carbon monoxide detectors trigger an alarm based on an accumulation of carbon monoxide
over time. The most common symptoms of CO poisoning are headache, dizziness, chest pain,
and confusion.2 A new Wisconsin law went into effect in February 2011 requiring carbon
monoxide detectors to be installed in one-story and two-story homes in addition to multi-family
dwellings and any public building that is used for sleeping or lodging purposes.3

Childhood Lead Poisoning
Elevated lead levels can have serious health effects, especially for children under six years old.
The main source of childhood lead poisoning is lead based paint chips and dust from
deteriorated paint that is found in older housing units. Although lead based paint was taken off
the market for residential use in 1978, any house built prior to 1978 may still have lead paint.
However, it is the deterioration of paint that causes a problem. Other sources of lead exposure
may include water pipes, toys, imported candies, pottery, and even traditional folk remedies.

Lead poisoning is entirely preventable. The key is stopping children from coming into contact
with lead and treating children who have been poisoned by lead. Eliminating the source of lead
exposure, and therefore preventing lead exposure to children before they are harmed,
significantly lowers the number of lead poisoned children. Lead hazards in a child’s
environment must be identified and controlled or removed safely.4

Asthma
Asthma is a chronic inflammatory disorder of the airways characterized by episodes of
reversible breathing problems due to airway narrowing and obstruction. These episodes can
range in severity from mild to life threatening. Symptoms of asthma include wheezing,
coughing, chest tightness, and shortness of breath.5

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HEALTHY HOMES AND NEIGHBORHOODS

Asthma is the most common chronic disorder in childhood. It is the third leading cause of
hospitalization among children under 15 years of age and the leading cause of school
absenteeism attributed to chronic conditions.6

Exhaust fumes contain significant levels of small particles, known as fine particulate matter.
These fine particles pose a significant health risk because they can pass through the nose and
throat and lodge themselves in the lungs causing lung damage and premature death. They can
also aggravate conditions such as asthma and bronchitis and are responsible for thousands of
premature deaths every year.

People with existing heart or lung disease, asthma or other respiratory problems are most
sensitive to the health effects of fine particles. Children are more susceptible to this type of air
pollution than healthy adults because their respiratory systems are still developing and they
breathe faster than adults, inhaling more air per pound of body weight. Reducing the exhaust
emissions of buses and cars around areas where children congregate is an important step in
reducing respiratory threats to health.7

Emergency Preparedness
Emergency preparedness is a social responsibility. It is important for individuals and families to
be knowledgeable and ready in order to create a culture of preparedness and be able to
respond efficiently to emergency situations. The more ready individuals and families are, the
better their community will respond and recover.

Households should have an emergency kit with enough supplies (food, water, pet supplies, and
medicines as well as at least one battery-operated radio) to last three days following a natural
disaster, health or man-made emergency, and an emergency plan that has been discussed with
family, friends, and neighbors. Families should be sure vaccinations are up-to-date, including
vaccinations against pneumonia for older family members. Neighbors should be aware of other
neighbors, friends, or relatives who may need help during an emergency and know whom to
notify to assist them.8

Built Environment
The built environment encompasses all buildings, spaces and products that are created, or
modified, by people. It includes homes, schools, workplaces, parks and recreation areas,
greenways, business areas and transportation systems. It extends overhead in the form of
electric transmission lines, underground in the form of waste disposal sites, and across
communities in the form of roads and highways. The built environment also includes land-use
planning and policies that impact the community in which we live.9

Well-planned neighborhoods can encourage people to engage in physical activities that are
healthful. For example, bike paths make it safer for children to bike to school, communities that
are walkable encourage community members to walk rather than drive which not only
increases physical activity but reduces transportation-related pollution. Developing an
infrastructure that increases opportunities for physical activity, healthy eating, and breathing

                                                                                                Page 17
HEALTHY HOMES AND NEIGHBORHOODS

clean air, goes a long way in reducing the rates of chronic disease such as obesity, diabetes, and
asthma. To this end, public health and planning strategies focusing on environmental and policy
changes (e.g., active community environment initiatives, urban planning, safety enforcement,
trails and sidewalks) are needed to reach large sections of the community.10

Neighborhoods
Based on the core concept of neighbors helping neighbors, the Neighborhood Watch Program
brings together law enforcement, city officials and residents and ask them to work together to
provide protection for their homes and communities. It utilizes citizen involvement by tapping
in their awareness and familiarity with their own neighborhoods. Residents not only take care
of their own homes and businesses, but also those of their neighbors. By taking an active role in
the protection of their families and possessions, residents are better able to discourage criminal
activity and keep their neighborhoods safe. As a result, they are able to assist police officers
with the protection of their neighborhood by calling the station at the first sign of suspicious
activity.

Community Gardens
With more awareness of the benefits of local foods and organic foods, urban gardens have
become more popular in many cities across the nation. Numerous cities have established
programs to promote urban gardens and have taken steps to establish urban gardens in
communities through community gardens, garden mentors, providing funds and resources, as
well as other methods.

Community gardens are collaborative projects on shared open spaces where participants share
in the maintenance and products of the garden, including healthful and affordable fresh fruits
and vegetables.

Gardens may improve quality of life for people, offering physical and mental health benefits by
providing opportunities to:
   • Stimulate social interaction and improve social well-being through strengthening social
       connections
   • Foster opportunities for intergenerational and cross-cultural connections
   • Eat healthy fresh fruits and vegetables.
   • Engage in physical activity and skill building
   • Beautify vacant lots, public parks, schools and neighborhoods
   • Serve as a catalyst for neighborhood and community development
   • Preserve green space
                                    12
   • Decrease violence and crime

Resources
   1) Geography and Public Safety. U.S. Department of Justice.
      http://www.nij.gov/maps/gps-bulletin-v2i2.pdf
   2) CDC Injury Fact Book. Centers for Disease Control and Prevention. National Center for
      Injury Prevention and Control. www.cdc.gov/injury/publications/factbook

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HEALTHY HOMES AND NEIGHBORHOODS

   3) Journal Sentinel Online. Law requiring carbon monoxide detectors goes into effect
       February 1. http://www.jsonline.com/news/wisconsin/114912554.html
   4) Centers for Disease Control and Prevention. U.S. Department of Health and Human
       Services. Lead Prevention Tips. http://www.cdc.gov/nceh/lead/tips.htm
   5) Respiratory Disease. Healthy People 2020. U.S. Department of Health and Human
       Services.
       http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=36
   6) Asthma & Children Fact Sheet. American Lung Association. www.lungusa.org/lung-
       disease/asthma/resources/facts-and-figures/asthma-children-fact-sheet.html
   7) National Idle-Reduction Campaign. U.S. Environmental Protection Agency.
       http://epa.gov/cleanschoolbus/antiidling.htm
   8) Emergency Preparedness, Response, and Recovery. Wisconsin State Health Plan:
       Healthiest Wisconsin 2020. Wisconsin Department of Health Services.
       http://www.dhs.wisconsin.gov/hw2020/pdf/emergency.pdf
   9) NACCHO Exchange. Promoting Effective Local Public Health Practice. Volume 10, Issue 2.
       Spring 2011. Preventing Chronic Disease.
       http://www.naccho.org/toolbox/tool.cfm?id=2481
   10) Physical Activity. Wisconsin State Health Plan: Healthiest Wisconsin 2010. Wisconsin
       Department of Health Services.
       http://www.dhs.wisconsin.gov/hw2020/pdf/physicalactivity.pdf
   11) Neighborhood Watch. City of West Allis Police Department. http://www.ci.west-
       allis.wi.us/police/police_crime_prevention/neighborhood_watch.htm
   12) Community Gardens. Centers for Disease Control and Prevention. U.S. Department of
       Health and Human Services.
       www.cdc.gov/healthyplaces/healthtopics/healthyfood/community.htm

Assessment Data and Objectives

Objective 1: By December 31, 2015, launch a community education campaign regarding the
new state law requiring carbon monoxide detectors.
Baseline: No community education campaign in place
Goal: Community education campaign in place

This objective will be tracked through the development of a community education campaign.

Strategies/Activities                          Responsibility   How is progress evaluated?
Utilize social marketing tools (i.e. video,   WAFD,WAHD         Educational materials
cable, website, Facebook, water bill) to
increase awareness of the new state law
requiring carbon monoxide detectors
Use CDBG block grant funds to purchase        WAFD,WAHD         Number of detectors
carbon monoxide detectors for low
income community members

                                                                                          Page 19
HEALHY HOMES AND NEIGHBORHOODS

Develop an educational board to display in      WAFD,WAHD          Display
public settings to promote the use of
carbon monoxide detectors
Explore partnering with community               WAFD,WAHD          List of businesses and
businesses for access to low cost detectors                        responses

Objective 2: By December 31, 2015, increase by 5% the number of children under six years old
in West Allis and West Milwaukee who have had their blood lead level tested.
Baseline: 1,673 children under five tested in 2010
Goal: 1,778 children under five years tested in 2015

Objective 3: By December 31, 2015, reduce to less than 1% (from 1.7%) the percent of children
under six years old in West Allis and West Milwaukee having elevated blood lead levels.
Baseline: 1.7% of children under age five years have elevated blood lead levels
Goal: Less than 1% of children under age five years will have elevated blood lead levels

These objectives will be tracked through the Stellar database.

Strategies/Activities                       Responsibility          How is progress evaluated?
Outreach to parents using social marketing WAHD                    Log of marketing strategies
tools to promote lead screening                                    used
Outreach to health care providers          WAHD                    Log of outreach to providers
regarding the importance of lead screening
Expand the use of the XRF machine for      WAHD                    Number of screenings
home lead screening

Objective 4: By December 31, 2015, strengthen asthma education, prevention, management,
control and access to services using American Lung Association of WI (ALA/W) trainings.
Baseline: No plan in place for annual trainings
Goal: Three ALA/W training programs per year offered to school personnel, daycare staff, and
coaches/recreation department staff in West Allis-West Milwaukee through the Community
Asthma Network

This objective will be tracked by the number of trainings completed annually.

Strategies/Activities                             Responsibility    How is progress evaluated?
Host three Asthma 101 programs per year         Community          CAN statistics/pre and post-
utilizing trained ALA facilitators to educate   Asthma Network     tests at each program
school, daycare, and coaches/recreation         (CAN)
dept. staff regarding asthma education,
prevention, control, and safety

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