Monday, June 24, 2019

Winnebago County committee endorses Medicaid expansion, citing potential gain of $104 million

The Evers administration says Medicaid expansion will bring these benefits to Winnebago County.
By Miles Maguire
After a spirited debate between Oshkosh’s two state representatives, a Winnebago County committee voted June 24 to endorse the idea of expanding Medicaid in Wisconsin, a move that could bring more than $100 million to the local community.

The vote was preceded by an extended exchange between Rep. Gordon Hintz (D-54th) and Rep. Michael Schraa (R-53rd). Hintz’s district encompasses most of the city of Oshkosh, while Schraa represents mostly surrounding communities such as Algoma, the town of Oshkosh, Omro, Black Wolf, Nekimi and Rosendale.

One of the few things they agreed on is that health care funding is a complicated issue that involves an array of tradeoffs, offsets and exceptions. Another thing is that health scare spending is taking up an increasingly large part of the state budget.

“Medicaid is an arrow up, and it is scaring everyone in state government,” Schraa said, gesturing with this hand to show how the cost is rising rapidly. “It takes up such a large portion of our state budget that there is less money to go into schools, to go into education, to go into everything else.”

Democratic Gov. Tony Evers had proposed accepting $324.5 million in federal Medicaid subsidies, which he said would help to trigger the availability of a total of $1.6 billion from Washington. Most other states have taken this kind of approach. But in Wisconsin the Republican-controlled legislature rejected this plan and is poised to vote this week on the next two-year budget without such a provision.

Advocates for expanding Medicaid in Wisconsin believe that the shift is inevitable. Republican opponents are equally adamant that the change will never happen as long as they control the legislature.

To try to sell his plan, Evers developed county-specific fact sheets to show how federal dollars would be spent. His administration estimated that Winnebago County would gain $104 million.

The beneficiaries would include 2,010 residents who would be covered under Medicaid, local physicians who would see $1.5 million in new funding and local hospitals that would see an additional $11.2 million.

Other programs that would be expanded include crisis intervention, lead poisoning prevention, postpartum coverage for new mothers, mental health consultation and cardiopulmonary resuscitation.

Bill Topel, the county’s human services director, said the Medicaid expansion would save the country several hundred thousand dollars. “But the larger piece is that our hospital systems, our dentists, our personal care workers, our nursing homes are all going to benefit greatly because Medicaid is a much better payment source than commercial markets have ever been.”

Schraa argued that the influx of new federal money would be offset by a loss of funds the state currently gets to help low-income residents purchase health insurance. He said the state can’t afford to continue to expand welfare programs.

“I would be willing to do it if it made financial sense,” Schraa said. “It’s an easy talking point--take the free money. But when you come down to it, the numbers just don’t make sense.”

One of the reasons why Wisconsin has been reluctant to accept the federal Medicaid money is a concern that it would be taken away at some point in the future, creating a major budget gap.

Hintz said the health care money would be like federal highway money, which may fluctuate over the years but has come to be a reliable part of transportation planning. He also discounted the idea that the federal Medicaid subsidy could be easily eliminated.

“Part of the reason it’s probably never going to go away is that if you have 36 or 37 states that have it cooked into their budgets, you’re going to have 72 senators in the United States Senate whose state that they represent have it baked into their budget,” Hintz said.

“And if you get rid of [the Medicaid subsidy], they are going to have to cut funding for schools or universities or other programs. Or they are going to have to raise taxes,” he added. “They would be hearing it from whoever their constituents are.”

The county Legislative Committee adopted the resolution in favor of accepting Medicaid money by a vote of 10-2. The measure now goes to the full Board of Supervisors.

Aaron Wojciechowski, who introduced the resolution, represents the UW Oshkosh campus and a nearby neighborhood. He said he realizes that the local Republican lawmakers remain adamantly opposed. “That’s why we are doing this--to hopefully put pressure on and to say this is something that we care about.”

Thursday, June 20, 2019

Former UW Oshkosh officials in settlement talks; criminal case agains Wells, Sonnleitner postponed

Former Chancellor Richard Wells and former Vice Chancellor Thomas Sonnleitner are due back in court Aug. 29.

By Miles Maguire
At the request of a state prosecutor who says a “global resolution” is in the works, the trial of two former UW Oshkosh officials for misconduct in office has been delayed once again.

“The parties are making substantial progress in resolving the case,” said Randall Schneider, an assistant attorney general.

The case was filed in April 2018 against former Chancellor Richard Wells and former Vice Chancellor Thomas Sonnleitner. It alleges that the two exceeded their legal authority to facilitate real estate transactions involving the UW Oshkosh Foundation. Neither profited personally from the deals.

Both Wells and Sonnleitner, who pleaded not guilty, were due in court June 20 but now are not expected back until Aug. 29. This is the second postponement of scheduled hearings in the case.

Monday, June 17, 2019

Chairman of Winnebago County supervisors joins calls for Busby to step down from coroner position

Board Chairman Shiloh J. Ramos presides at a recent meeting of the Winnebago County supervisors.

By Miles Maguire
The chair of the Winnebago County Board of Supervisors has added his voice to the calls for the resignation of Coroner Barry L. Busby.

"Based on what I know, assuming it is accurate, I think it would be best for all involved if the coroner resigned," said Shiloh J. Ramos, of Neenah. "That is not a statement I take lightly."

Busby has come under fire or his treatment of associates and his extended absences from office. He has also been the subject of an ethics investigation by the Wisconsin Coroners and Medical Examiners Association based on allegations of sexual harassment.

But Busby has defended the performance of his office and given no indication of plans to step down.

Ramos joins County Executive Mark Harris, Sheriff John Matz and Supervisor Bill Wingren, who heads the board's Judiciary and Public Safety Committee, in calling for a change in leadership in the coroner's office.

"In terms of the coroner situation, I certainly think it is unfortunate," Ramos said. "I am concerned for both the coroner’s office and the coroner himself given the situation."

Because Busby holds an elected office, he does not have any administrative supervisor in county government. To remove him from office would take a recall election or action by the governor, Harris said.

Frustrated by their lack of control over the situation, some officials are exploring the idea of moving from the current elected coroner model to one that would rely on an appointed medical examiner.

Ramos expressed caution about this change. "In terms of moving to a medical examiner model, certainly that would require further study to better understand the pros and cons of it versus the coroner model," he said.

Concerns about Barry Busby prompt Winnebago officials to look again at medical examiner model

Screenshot from Oshkosh Media shows a recent meeting of the county Board of Supervisors.

By Miles Maguire
Winnebago County officials are once again considering the medical examiner model for handling suspicious deaths as they struggle to find ways to deal with the incumbent coroner, who is under fire for his treatment of associates and his extended absences from office.

“That’s an issue that’s come up many times,” said County Executive Mark Harris. Bill Wingren, who chairs the Judiciary and Public Safety Committee of the county Board of Supervisors, said he has already begun the process of looking “into all the aspects of getting a medical examiner, which we should have done long ago.”

Most Wisconsin counties have a choice between using an elected coroner or an appointed medical examiner. Currently 40 counties, out of 72, have a medical examiner, according to the Wisconsin Department of Health Services. Because of their size, Milwaukee and Dane are required to use medical examiners.

Over the last five years the statewide trend has been away from coroners and toward the use of medical examiners. Most of the counties that border on Winnebago County use medical examiners, including Calumet, Waupaca, Waushara and Fond du Lac. Outagamie and Green Lake counties have coroners.

“Medical examiners tend to have more qualifications, but they are also paid more,” said Harris. “Elected coroners don’t necessarily have to have qualifications, but they are generally paid a little less.”

Under Wisconsin law, coroners or medical examiners are authorized to investigate:
  • All deaths in which there are unexplained, unusual or suspicious circumstances.
  • All homicides.
  • All suicides.
  • All deaths following an abortion.
  • All deaths due to poisoning, whether homicidal, suicidal or accidental.
  • All deaths following accidents, whether the injury is or is not the primary cause of death.
  • When there was no physician, or accredited practitioner of a bona fide religious denomination relying upon prayer or spiritual means for healing, in attendance within 30 days preceding death.
  • When a physician refuses to sign the death record.
  • When, after reasonable efforts, a physician cannot be obtained to sign the medical certification as required within six days after the pronouncement of death.
Coroners can appoint deputy coroners to carry out these investigations, and one of the criticisms of the current county coroner, Barry Busby, is that he is relying too much on his deputies while he is out of state, which in turn drives up costs.

Busby is also under scrutiny because he recently fired a longtime deputy coroner and based on allegations of sexual harassment at meetings of the Wisconsin Coroners and Medical Examiners Association.

Despite multiple calls for his resignation and an unspecified medical condition, Busby has defended the operations of his office and given no indication that he plans to step down.

Tuesday, June 11, 2019

Winnebago County Coroner Barry Busby urged to resign

The Winnebago County coroner's office is in the basement of the Orrin King Building on Algoma Boulevard.

By Miles Maguire
Local officials are calling on Winnebago County Coroner Barry L. Busby to resign in the wake of his recent erratic behavior, including extended absences from the state, the dismissal of his longtime chief deputy and sexual harassment incidents that have gotten him temporarily banned from meetings of the state professional association whose members investigate suspicious deaths.

Busby, who is in his 70s, has taken a high-profile role in addressing issues such as drug-related deaths and teen suicides. He has enjoyed such a strongly positive reputation that he was re-elected in November to a four-year term with the largest vote total of any candidate on the local ballot.

But county telephone records show that the coroner spent most of this past winter in Florida, starting just weeks after the votes were tallied. His office is responsible for investigating suspicious or unexplained deaths such as murders, suicides and overdoses as well as providing services such as cremation permits and death certificates.

In an interview Busby defended his record while alluding to medical-related personal issues. He noted there have been no complaints about the operations of his office, said the firing of his deputy was fully documented and denied any inappropriate sexual behavior. “I am currently under medical care, and I have no other comments,” Busby said.

The coroner, a Republican, has served in that office for more than 20 years and earns an annual salary of $72,989. He oversees a budget of slightly more than $500,000 and is assisted by three part-time workers: an administrative associate and two deputy coroners. A website biography says Busby worked in the Oshkosh Police Department for 27 years and retired as a sergeant.

As an elected official, Busby does not have any administrative supervisor and answers only to voters. But County Executive Mark Harris, who holds a nonpartisan position, and Sheriff John Matz, a Republican, both said they have spoken to Busby and suggested that he relinquish his post.

“I am concerned about him as a human being,” said Bill Wingren, who chairs the Judiciary and Public Safety Committee of the county Board of Supervisors. But “my personal opinion is ... that the public and Barry would be served by his resignation as soon as possible.”

Wingren’s committee, which has budgetary authority over the coroner’s office although no direct oversight of how it operates, has met in closed session to discuss the situation. The panel recognizes that it cannot force Busby from office, said Wingren, who represents an eastside neighborhood of Oshkosh. “There is nothing we can do about it.”

Wingren said he is concerned about the situation both because the coroner’s role is to “deal with people at the most sensitive point in their life” and because the allegations against Busby raise serious questions about someone who has until now has been so highly regarded.

Busby ran unopposed in 2018 and has earned wide respect based on his community work. In a September 2018 letter to county officials, Busby enumerated his accomplishments, such as helping to start the county’s Heroin Task Force, promoting suicide prevention efforts through the Community for Hope and the Yellow Ribbon Program, serving on the Child Death Review Team and contributing to the re:TH!NK partnership, a countywide effort to promote healthy living.

“Barry and I have had that conversation about what he’s added to the coroner’s office,” said Matz. “There’s a time when you relish in all your accomplishments, but there’s also a time when you ride off into the sunset.”

Harris acknowledged Busby’s strengths, including his empathy when dealing with people under tragic circumstances. But “since his election, I think he’s been taking advantage of the public,” Harris said.

Busby has a county-issued cellphone, and the digital records it creates can be used to trace his location. According to call logs obtained from Winnebago County, Busby’s phone “pinged” out-of-state cell towers, mostly in Florida, during various timeframes amounting to at least 83 days starting in mid-December and continuing through the next four months into the spring.

The coroner’s office investigates about seven deaths a month with autopsies performed by the medical examiner in Milwaukee. The standard practice is to have someone from the coroner’s staff attend the autopsy, with Winnebago County covering the travel costs. An indication that Busby has not been working locally is that he has requested reimbursement for only four of the 27 autopsies that were completed through April, according to county records.

Busby argues that his absence from the state has not affected the quality of service his office provides. But Harris said there is a cost to taxpayers because one of the deputy coroners has to pick up the slack when Busby is not around. The deputies are paid on a per diem basis with additional expense reimbursement.

Matz said regardless of cost or service, another issue is the duty of elected officials to be available to local residents. Like Busby, the sheriff was voted into office and is not directly accountable to anyone in county government.

“I have had a conversation [with Busby] about my perspective on the expectations of voters and taxpayers as a peer,” Matz said. “If I voted in an elected official, I would expect that the elected official is available at all times. If an elected official is out of state, he is not available … to voters and taxpayers.”

While there were previous concerns about Busby’s work schedule, the issue came to a head after March 6, when the coroner fired his chief deputy, Chris Shea, who said he had worked in the office for 14 years.

Busby said that Shea’s termination was “properly documented and appropriately handled.” But without releasing any details of the underlying facts, county Human Resources Director Michael Collard disputed this account.

According to statute the deputy coroners serve at the pleasure of their boss. “That overrides county policies on employment actions,” Collard said. “In such a case, we do not do all the types of things we would do for a typical county employee.”

Shea, now working as an investigator for the Fond du Lac County Medical Examiner’s Office, said he thinks that what set Busby against him was his knowledge of the sexual harassment complaint that was investigated by the state coroners organization.

“He knew that I knew a lot of things, and that scared him,” Shea said.

The complaint, which Shea said he originally learned of from Busby, is based on an incident at the fall 2017 conference of the Wisconsin Coroners and Medical Examiners Association.

Miranda Zuhlke, a licensed physician assistant who was then working for a nonprofit tissue donation service, described the incident in a letter of complaint to WCMEA.

At a dinner on Oct. 23, she “was approached by Barry Busby, Winnebago County coroner, who expressed explicit unwelcomed sexual comments,” wrote Zuhlke, who holds two master’s degrees and served as a sergeant in the Army, according to her online profile.

At one point Busby grabbed at her hand, Zuhlke said, and then “continued to express drunken sexual comments in which I did not respond or give attention to.” Busby tried to apologize the following morning at breakfast, complimenting Zuhlke and her colleagues as “just really pretty,” she said in her complaint.

“This narcissistic comment represents the rape culture that many men believe warrants their unwanted actions,” Zuhlke wrote. “Although in his mind he ‘apologized,’ he was only trying to justify his lack of self-control and urges by blaming me as the victim for my appearance.”

According to her letter, Busby has engaged in similar behavior previously. “He has made multiple gestures and actions towards other women that attest to his debauchery,” she wrote.

She called on WCMEA to take her complaints seriously. “Through my military and medical experience, I have seen sexual harassment and assault too often swept under the rug.”

Although Busby denies that the incident occurred, Zuhkle said in an interview that she has multiple witnesses. In response to the complaint, WCMEA formed an ethics panel to look into Busby and ended up issuing a temporary ban on his attendance at meetings.

“Our Ethics Committee has been looking at the issue at length and has written their evaluation of the case,” said Angela Hinze, the chief medical examiner in Columbia County and the current WCMEA president. She said the report is being examined by legal counsel before being submitted to the group’s board of directors.

“It is the board’s discretion as to the outcome,” she said in an email message. “Mr. Busby was asked not to attend the conference training until the board makes its final disciplinary decision.”

Harris said he confronted Busby about his absences from the state in mid-April and suggested he resign. But Busby, according to Harris, said he could not resign “because that would mess up my real estate closing on a condo in Florida.”

“I am not Barry’s boss,” Harris said. “He really only answers to the public.”

As an elected official, Busby is subject to a recall election. But under state law he cannot be recalled for at least one year after an election, Harris said. “The public has limited recourse.”

Harris said he has notified the governor’s office about the situation. But since there are no allegations of criminal conduct, it’s questionable whether the state will get involved, Harris said.