Jackson County officials and employees addressed four legislators Friday during a legislative breakfast to discuss budget and access concerns related to the mental health and substance abuse problems plaguing the county.
The event was coordinated by the Jackson County Department of Health and Human Services and included presentations from more than 10 county employees and officials about the struggles facing the Jackson County health system.
State Sen. Patrick Testin (R), state Reps. Nancy VanderMeer (R) and Treig Pronschinske (R) and a representative from U.S. Rep. Ron Kind’s (D) office attended.
The most prevalent issues discussed by attendees were mental health and substance abuse.
“My background is in psychology, that’s my bachelor’s degree, and that is what I have a passion for,” VanderMeer said. “I just want to sidestep a little bit and I think sometimes when I want to talk about mental health in our rural areas, it is one of those invisible diseases because sometimes we are so isolated in our rural areas.”
Mary Beth White-Jacobs, Black River Memorial Hospital CEO, agreed that mental health and substance abuse issues were a big deal in Jackson County, something data has shown at the hospital.
“We do see the same patients over and over in our ER. We suspected that number has been going up recently and so we decided to look at the data and just in the first three months of this year already we have had over 300 patients come to our ER/urgent care either for substance abuse or mental health related primary or secondary diagnosis,” White-Jacobs said. “Ninety of them primarily came because that was their primary problem because of mental health, overdose, alcohol and we are looking at 70 percent of those people being sent out maybe with no follow-up care and that’s why they are coming back again.”
Sheriff Duane Waldera agreed that the Jackson County Sheriff’s Office sees the same people over and over again for mental health and substance abuse issues.
“I think that it is important for the state to start taking a lead in getting facilities, or if it is a funding issue, trying to find funds for these facilities so that we do not keep cycling these issues and putting individuals in our community. In a 72-hour period, we are having contact with these people one, two times and their health issues are not addressed,” Waldera said.
Several speakers talked about the lack of facilities and that it is really hard to get a spot. Dan Williams, Jackson County DHHS children and families division manager, said that he has had parents come into the office requesting mental health and substance abuse help, but DHHS can’t find a place for them to get the services they need.
The county can send people facing a mental health crisis to the Winnebago or Mendota mental health institutes, but those in attendance said those are not always good options.
“Right now we are talking about the lack of other providers and the lack of beds. They (Winnebago and Mendota) can’t turn people away, but that means that clients that are having mental health crises have to sleep in the hallway,” Heather Holcomb, Jackson County DHHS business manager, said adding it is also expensive for the county. “In 2016 it was 28 percent of our total budget, just for Mendota and Winnebago. It can range from $1,000 to $1,400 a day.”
Monica Lobenstein, Jackson County University of Wisconsin-Extension 4-H youth development agent, said that many of these mental health issues are also being seen in children, so she has focused on teaching students how to cope with stress, a leading cause of mental health issues.
“What we know from the research is that one of the major precursors of serious mental health issues is high levels of stress and so if we can teach young people and adults how to better cope with the stress they are experiencing, better self-management or compassion for themselves and other people, then we will hopefully see fewer mental health crises down the line,” Lobenstein said.
Lobenstein said that what really spurred teaching students coping skills was an interaction she had with a young lady while Lobenstein was teaching students how to help someone in a mental health crisis.
“We were providing that training in a classroom one day and one sharp, young woman raised her hand. She had eraser marks on her hands, it is another form of cutting. It is using an eraser to create a burn sensation. She raised her hand and said, ‘This is great. Thanks for teaching us how to stop a suicide. What are you going to do to teach us how not to get to that crisis point?’,” Lobenstein said.
Williams is also seeing more severe foster care cases with the increase in mental health and substance abuse issues.
“The youth that we are seeing have increased mental health and AODA (Alcohol and Other Drug Abuse) issues, which is hard because not only are we seeing it with the parents, but we are also seeing it with the youth,” Williams said, adding it is having a negative effect on the social workers involved in these cases.
“I just wanted to point out the stress on our child welfare professionals because they are dealing with all of this,” Williams said. “Currently, 58 percent of our child welfare staff has under two years of experience and we have two vacancies. So the turnover because of that stress level causes all kinds of problems. Every time we switch a case worker for a family, we lose about six months of progress.”
Pronschinske acknowledged this negativity.
“I do residential construction. Everything that I have done in my career has improved someone’s life and it is a positive thing. I just realized a short time ago when I started representing the people of the city of Mondovi, because I am the mayor as well, that everybody’s profession isn’t a positive thing,” Pronschinske said. “I’m lucky that I picked one that really is. The truth is, there is a negative impact on people that are in this field and it happens day after day.”
With all of these issues surrounding mental health and substance abuse, many were also concerned about the new federal health care bill that could cut Medicaid funding.
“If we have cuts to Medicaid, this is going to be devastating to mental health and substance abuse,” White-Jacobs said. “I would say right now over 50 percent of people seen in our urgent care are actually on Medicaid. Prior to the Affordable Care Act, many of them didn’t have any coverage at all.”
White-Jacobs said cutting Medicaid spending could also put the Black River Memorial Hospital in serious financial distress.
“I’d say the hospital has a huge economic impact on the community as well, and so does the school district, as does the businesses we have here, but because the hospital is in town here, indirectly and directly it is over 400 jobs and the economic impact is over $60 million in revenues. So we need to be able to support this hospital and cuts to Medicaid are not going to do that for us,” White-Jacobs said.
Brad Pfaff, deputy chief of state in Wisconsin for Kind’s office said, “Let me be blunt with you, this is a strong word and I don’t use it very often, but this thing (health care bill) will decimate Medicaid. Medicaid in a county like this is important and what happens with Medicaid, and you don’t have to listen to me, the Congressional Budget Office is non-partisan. The director, who was appointed by the majority party, has stated that 23 million people will fall off as a result. Medicaid is something that is extremely important to this area.”
With all of the health challenges facing Jackson County, Testin said that state legislators have started the Rural Wisconsin Initiative to focus on helping improve rural Wisconsin, including the health care system.
“What this initiative aims to do is focus on workforce development, education, health care and technology. I have been really pleased to see the progress we have made in the few short months since I have been in office,” Testin said.
Other topics discussed by those in attendance included finding ways to attract doctors to rural hospitals and helping to fund other state programs that help with public health initiatives.