Racine County weighs health services consolidation; municipalities to decide – Journal Times

6September 2020

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RACINE — A proposal to put services provided by the Central Racine County Health Department under the auspices of the Racine County government is being taken up by the CRCHD member municipalities.

The Sturtevant Village Board on Tuesday approved a statutory one-year notice resolution authorizing the village’s withdrawal from CRCHD and approving the consolidation of Health Department services into county government.

In a related move, village trustees also approved an ordinance modifying and changing health-related sections and subsections of the village Municipal Code.

Sturtevant Village Trustee Kari Villalpando, a public health nurse employed by CRCHD, abstained from the votes.

“All the municipalities are going to be doing this, every single one of them,” Sturtevant Village Administrator Gerald Nellessen said in a post-meeting interview. “We might be the first, or close. We’re required by state statute that to provide at least a year’s notice that you plan to withdraw.”

The Caledonia Village Board is set to discuss and possibly act on the plan at its meeting on Tuesday.

Decentralization in the ‘90s

Among Wisconsin’s 72 counties, Racine County is one of the few to not have a county-run health department, according to Racine County Executive Jonathan Delagrave. Health services locally are “municipality-driven” by the City of Racine Health Department, which also serves Wind Point and Elmwood Park, and the Caledonia-based CRCHD, 10005 Northwestern Ave., which is responsible for providing public health services to the other 14 county municipalities.

The 30-employee CRCHD earned national accreditation from the Public Health Accreditation Board earlier this year.

Prior to the 1990s, Racine County operated a full county health department, Delagrave said.

“Some of the municipalities thought they weren’t getting the bang for their buck on health department services, so the county split up into three health departments,” Delagrave said. Those were the City of Racine department, the CRCHD and the Western Racine County Health Department, which served the municipalities west of Interstate 94. The latter was merged into the CRCHD in 2015.

CRCHD Health Officer Margaret Gesner said the impetus for the proposed consolidation of CRCHD operations into Racine County government “came out of the Central Racine County Board of Health” and its concerns regarding the long-term viability of the CRCHD “given its unique structure,” particularly in the light of the COVID-19 pandemic, which has driven a 40-fold increase in department workload.

“It’s important that it came from our Board of Health,” she said. “What COVID-19 did for the Central Racine County Health Department is it elucidated the things that were our great strengths.”

Those included a “nimble, small amount of staff doing a large amount of work” and a CRCHD per-capita tax levy running half the state average, Gesner said, who added that the Wisconsin Policy Forum’s 2018 “Building Bridges” report that showed the CRCHD’s per-capita levy was $7.13 versus $25.50 for the City of Racine Health Department.

But with the advent of COVID-19, Gesner said CRCHD’s strengths quickly “became liabilities for us.”

“While COVID was the impetus, the thought was what would best serve the residents in our jurisdiction … in the most effective and efficient manner,” she said. “That’s why the Board of Health reached out to Jonathan (Delagrave).”

Proposal ‘makes sense’

Delagrave said investigation and discussions around consolidation makes sense.

“Our Human Services Department here in Racine County is the best in the State of Wisconsin and we deliver really creative services,” he said. “A lot of those services are partnerships with the Central Racine County Health Department. We’re doing a lot of services together.”

Delagrave said COVID-19 has really stretched the capacity of the CRCHD.

“The litmus test is does it (consolidation) enhance service or least keep it the same? Does it fiscally make sense for the whole county? And, ultimately, can we move forward where we can make the services sustainable?” Delagrave said. “In that light, this consolidation of service does make sense.”

Ultimately, Delagrave said, the choice to consolidate or maintain the status quo is up to the CRCHD municipalities, which have received PowerPoint presentations on the consolidation proposal.

The proposal objectives are to enhance fiscal and operational stability for the Health Department, create synergies and reduce redundancies between the Health Department and Racine County departments, improve effectiveness and efficiencies of public health services for residents, and determine an equitable funding mechanism for a health department. Gesner said specific details of the proposed consolidation “have not been determined at this time,” but are anticipated by the end of the year.

“We’re trying to be conscientious of the municipalities,” Delagrave said. “This was kind of brought to us. We said if it makes sense, we’d put a plan together and then the municipalities can vote on it. We’re not out there saying ‘you have to do this,’ but it does makes sense and, I think, with Margaret’s expertise, we have a good plan moving forward.”

Consolidation trend

With twin goals of financial prudence and delivery of quality services, Delagrave said the success of past county consolidation initiatives bodes well for this proposed consolidation.

“This is going to be a win-win for county taxpayers and it’s going to be a win-win for municipal budgets,” Delagrave said. “This is a real opportunity … I’m hearing the municipalities are very interested.”

Gesner is supportive of the consolidation proposal.

“This is really seen as an opportunity,” she said. “The opportunities are many with a strong health department and a strong county government.”

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