County Continues Discussion On Coroner, Elderly Services
The Thursday, June 6 meeting of the Marinette County Executive Committee continued the public debate on possible changes to the relationship between Marinette County Elderly Services and the Marinette County Health and Human Services Department. Also included in a separate contested topic is the investigation into whether or not the County should consider switching from the current coroner to the proposed Medical Examiner Model.
The Executive Committee challenged County Administrator Ellen Sorensen last October to propose ways county government could reduce its budget by 10 percent. Both of the proposals are just ideas presented by Sorensen where the reductions could take place, among others, to reach that goal.
The public debate began at last months Executive Committee with a rationale document developed by the Health and Human Services Department for combining the Marinette County Aging Unit with the HHSs Aging and Disability Resource Center. Pertinent items included were: improved access to services by having a primary agency provide services; improved service delivery by coordination of services through just one agency; increased services by establishing an economy of services which could also save tax levy dollars.
The HHS document pointed out that the County provides approximately $180,000 of tax levy annually to Elderly Services. It assumed that a savings could be seen by combining the work of Elderly Services into the work of the ADRC. The document also pointed out that there are currently only seven non-profit Aging Units like Marinette County Elderly Services in Wisconsin. The 65 other counties all have their aging units combined with their HHS Departments in some way.
At the June 6 meeting, several speakers responded to proposal of possibly combining the units under the auspices of HHS. During the Public Comment section of the meeting, Mary Basak and Pam Mueller-Johnson were the first to speak, both quoting liberally from a prepared document entitled, Rationale for Providing Aging Programs through a Private Non-Profit Entity, along with personal comments. Both were timed by County Board Chairman Vilas Schroeder to make sure they didnt exceed the 5 minute time limit for public comments.
Pertinent items in the document include: Elderly Services has a dedication and passion for their mission of providing quality service to senior citizen, a passion that shows itself in a willingness to work for wages and benefits that are much less than those offered in the government sector. This dedication shows itself in personalized relationships and response patters between staff and seniors which would likely be lost in the event of government management.
The document also pointed to an Aging Study performed by Marinette County back in 2007 which compared what was offered by HHS and Elderly Services. The conclusions reached were: there is no duplication of services; the two agencies actually complement each other, the agencies work together to share information and strive to make referrals, and both agencies provide efficient and effective services/programs to the elderly of Marinette County.
Also pointed out was that while the ADRC is set up to provide short-term case management, Elderly Services provides direct services such as nutrition, transportation, family caregiver programs, prevention classes, and provides long-term care and support to seniors. Many of the things Elderly Services offers are things with which the ADRC has no mechanism or experience.
Back in the 1970s when the Older Americans Act Funding became available, Marinette County chose to place Aging Programs separate from the County because they did not want it run as a county department. Doings so would have meant county wages and benefits. Instead, to make the best use of federal and state funds, they opted to have an outside agency operate these services. The rationale document says this model remains the best, cost effective model that continues to work out extremely well for the senior of the County.
As a private entity, Elderly Services can also perform fund-raising, which the government cannot do. Elderly Services can also capture United Way and M&M Community Grants, Title V Senior Worker Program Funds, and many other grants and fund-raisers along with personal, organization and corporate donations which a government agency cannot pursue.
Mueller-Johnson also pointed out that Elderly Services also receives substantial in kind donations from hundreds of volunteers who donate over 8000 hours yearly to help enhance all senior programs. She said they volunteer because they feel ownership and a sense of belonging for doing good things for older people. These in kind donations are also a match requirement to receive federal and state funds which the county has no plan to replicate. As such, the lost revenues from these sources would amount to nearly $190,000 if the County took over Aging Programs.
Other county residents also spoke during the Public Comment Section. Elaine Sevener, the manager of the Marinette Senior Center, gave a history of the center and how well its meal program is received. Her concern was that if the County took over the program, the Senior Center would probably close.
Tom Westlund of Westlund Bus commented that Elderly Services provide a great and high quality service to the elderly of the county. He mentioned that he has personally seen many positives in the lives of those touched by the agency. He encouraged that funding continue for Elderly Services.
Donna Compton read a Letter to the Editor she had written in support of Elderly Services which was printed in the Peshtigo Times.
Ken Christiansen, a volunteer at the Crivitz meal site, mentioned that all the meal sites serve a lot of people. He said that the dedication of Elderly Services is beyond compare. He talked about how the current organization is very efficient and cannot be duplicated by the county. He also brought up the possibility of cutting the budget for the Library instead of Elderly Services, and also mentioned a May 22 article in the paper about replacing the County Administrator.
Marge Banaszak, the President of the Crivitz Food Pantry, spoke on the value of Elderly Services and how well the organization works with the Food Pantry. She noted that if the County took over, donations and volunteer hours would be cut off. It was her opinion that if the County took over, the rural areas especially would suffer.
Mary Raabe, a past Elderly Services board member, spoke in favor of the organization. She noted that Marinette County, through Elderly Services, is still one of the only counties in the state that still provides home meal delivery.
Nancy Fifarek, a disabled Senor Citizen, talked about Elderly Services programs and how much they mean to her.
Supervisor Paul Gustafson, District 25 Supervisor and also Chairman of the Marinette County Elderly Services Committee, emphasized the volunteer hours put in by the staff and many others. He felt this could not be replaced by the County. He concluded by saying, If its not broken, dont fix it.
Supervisor Bill Walker also commented on the quality meal program and the other activities and socializing opportunities that are provided by Elderly Services.
The members of the Executive Committee did not respond to any of the comments made during the public comment section of the meeting. They did, however, speak about some of the concerns that were expressed during the next agenda item which read, Discuss/consider Costs of Operations for 2014.
This item was put on the agenda by County Administrator Ellen Sorensen to see if any other items needed to be placed on the Capital Improvement Project document before it went to the Finance Committee for consideration. She mentioned that the County still has a $1.7 million structural deficit and that digging out cannot be done in one year. She said the deficit would have to be dealt with in a multi-year approach.
County Board Chairman Schroeder noted that the meeting seemed to be focusing on Elderly Services and the Coroner System. He assured the Committee members and the crowd that he was relatively confident that there would be no cuts and not changes to Elderly Services for 2014.
Supervisor Connie Seefeldt added that she wanted to hear both sides of the issues before making a decision. She also wanted to state that she wanted to keep rumors from spreading just because the Executive Committee wanted to talk about ways to save money.
Supervisor Ted Sauve added he hoped the Finance Committee would give consideration to the Public Comments as it develops a plan to approach the 2014 budget.
The next agenda item was to discuss and consider (again) the Medical Examiner model verses the Coroner Model. Marinette County currently operates under a Coroner Model. The agenda item included a discussion of the options of contracting/sharing medical personnel.
Brent Miller, the Brown County Director of Administration, was present at the meeting. He was invited to make a presentation on a proposed regionalized Medical Examiner system that is being considered by other counties in Northeast Wisconsin. Miller emphasized that the program would employ a Board Certified Licensed Pathologist, which would be centered in Green Bay.
Miller concentrated on the fact that the Medical Examiner model would mitigate liability for all counties involved in the regional program. It would also standardize training and procedures for all death examiners, provide better support and assistance for Sheriffs Departments and District Attorneys offices.
Supervisor Kathy Just questioned cost increases experienced by other counties that have jumped from the Coroner Model to a Medical Examiner Model. Her research seemed to indicated that at least one county saw a $90,000 increase in death investigation expenses.
The answer given was that the costs to the counties who would join the regionalized system are not yet known because it is not known how many counties would join.
Supervisor Alice Baumgarten asked if Brown County has autopsies performed now. Miller replied that they do, but that they are performed by a medical doctor, Dr. Mark Witeck. The new plan would be for a Board Certified Licensed Pathologist to perform all autopsies for the counties in the regional system. Miller, once again, also talked about the liability issue. He would later add that a pathologist system would have the adequate insurance.
The whole question on liability to stems from a concern about the coroner not being a county employee in case of a lawsuit, especially if someone claims a wrongful determination of death.
In 2012, Marinette County had 21 autopsies performed, at a total cost of around $24,000, according to Coroner George Smith.
The two most recent criminal complaints for First Degree Intentional Homicide filed in Marinette County, point out that the autopsies were performed by Dr. Mark Witeck, a forensic pathologist, who is board certified,
The summer 2007 issue of The Examiner, a publication of the Wisconsin Coroners and Medical Examiners Association states that Dr. Mark Witeck is board-certified by the American College of Forensic Examiners and the American College of Forensic Medicine. After attending college in the Dominican Republic, he studied pathology at St. Lukes Medical Center in Milwaukee and forensic pathology at Wayne State University in Detroit.
From 1990-1998, he served as the Medical Examiner in Kenosha County. He has been in private practice since that time, providing service to several counties in Wisconsin and Illinois. He performs 250-300 autopsies annually, and estimates he has done about 5000 cases in his career.
As the discussion continued at the Executive Committee meeting, it became apparent that, as they had asked at the May meeting, a more precise estimate of costs involved with switching to a Medical Examiner model was not forthcoming.
Investigating the costs on our own, the Peshtigo Times has learned that Oconto County joined the Brown County System in 2007. A review of Oconto County budgets showed that in 2007, the county spent $43,730 on their coroner system. In 2007, the budget increased for the Medical Examiner System to $76,667. By 2010, the Oconto County Budget for the Medical Examiner System stood at $91,663.
Under the Brown County system, the latest available information showed that on call medical examiners in Oconto County receive $3.00 per hour when they are on call and that the on call part of the budget amounts to $25,000 per year.
In 2007, Oconto Countys sitting coroner urged the County Board to move to the Medical Examiner System because the position was overworked/underpaid as she was putting in 30-35 hours per week for inadequate compensation of $12,000 per year salary and there was lack of administrative help for the Coroner position from the County itself, for example, the County provided no office space or equipment to perform the job.
As the discussion on the Medical Examiner model among the Marinette County Executive Committee began to wind down, County Board Chairman Schroeder stated the County was still in the fact-finding phase and that he didnt expect any action at this meeting.
Supervisor Walker asked if the County ever had a problem with the current system. In an odd response, Corporation Counsel Gale Mattison replied that the question was a wide open question, but she again went back to the liability issue.
Supervisor Ken Keller made a motion to authorize County Administration to continue dialogue with Brown County regarding creation of a Medical Examiner position with the potential to join the regionalized group. After a vote, it was announced that the motion passed by a 6 to 5 vote. Voting in negative were Supervisors Ken Casper, Baumgarten, Behnke, Sauve and Walker. The seven other Committee members accounted for the six positive votes. It appeared that Supervisors Christiansen, Keller, Just, Russ Bousley, Seefeldt and Russ Bauer were the six in the affirmative, with Schroeder not casting a vote.
In other matters, the Committee approved an amendment to the Personnel Policies and Procedures document in section 1.26 Conditions of Employment (a) Hours of Work. Most of the changes are related to the change taking place in the County to move all new employees to a 40 hour week. Those who were hired to 35 hour weeks prior to Dec. 31, 2011 will stay at 35 hours per week.
This sets up the scenario that at least one county department is experiencing where experienced employees who were hired at 35 hours per week have to stay at that level, but a new, incoming employee will get to work a 40 hour week.
The Committee then went into Closed Session to confer with legal counsel for the governmental body who is rendering oral or written advice concerning strategy to be adopted by the body with respect to litigation, namely Circuit Court Case 2012CV000374, Pro Union v. Marinette County.
Upon re-entering Open Session, it was approved that Corporation Counsel was authorized to retain the law firm of Phillips Borowski to pursue legal action related to the above mentioned case in an amount not to exceed $15,000.00.
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