- My name is Jon Hochkammer, I'm the Outreach Manager for the Wisconsin Counties Association. And we are, as an association, just really extremely pleased that we are a part of Wisconsin Rural Partners. We thank the board for just all the involvement that they have with us and our association. So thank you, again, to the board. I am going to be moderating this program. I'm going to follow the lead of my colleague Bill Korrer and not read the bios because you have all that information before you. I just have to say that I have met these three women just this afternoon, we have not known each other before. But I already feel like I have a connection with each of them. So Joye, who's going to speak first, has been long time involved with county or with government, local government in Clark County, and I do a lot of work with Clark County. And I just recently completed 43 years of service myself in local government, so a lot of my life has been dedicated to that. Leslie, the real closest connection I think we have there is she previously worked for the Friends of the Horicon Marsh in the Visitor Center. And for those of you that love kayaking and canoeing, I was out there on 4th of July three years ago. It is a great place to go kayaking and canoeing.

So, check that out. And then Marsha lives in Plymouth, where my father-in-law had lived for quite some time. He's still in Sheboygan County in Elkhart Lake. And I was mentioning to her that she has an involvement with the Area Agency on Aging and aging issues in general. A lot of experience there. So, I'm serving, over 20 years, I've served with the Dane County Area Agency on Aging as well. And I had mentioned to her that my parents for many years in Manitowoc County owned and operated an assisted living facility. So that's where I got my background in aging issues, human services type issues. And my father passed away about a year and a half ago and my mom just passed away in December. They were both in their early 90s. And really, everything that I know about those issues and those areas comes from them and my dedication and hard work in serving the community comes from them as well. So enough on me, I would like to first have Joye speak on her issues, and then we'll move down the line. And again, we'll hold all the questions until the end, thank you, Joye.- So I talked to my daughter over the lunch hour, and she said, "How is the summit going?" And I said, "Oh, it's so awesome, so many great takeaways." I said, "But I realized my PowerPoint's not so great." And she said, "Don't worry," she said, "Just do something distracting and no one "will analyze the PowerPoint." I said, "What do you suggest?" And she said, "I don't know, just randomly stand up "on a chair or do a jumping jack." 
(audience laughing)
 
That seems like a lot of work. So, I'm going to let you do the jumping jacks. If you see a PowerPoint you don't like, you can do the jumping jack. So this is the best slide so far, I did that with clip art and WordArt, that shading. So my name is Joye, I am the clerk for the village of Granton. I'm here today to share a couple of amazing ideas that we were able to implement in our village. And they had tremendous effect on our little village. So before I share with you these ideas, I want to tell you a little bit about Granton.

In Granton, we have a school, educating grades K through 12.

We have a bank, a hardware store.

We have a grocery store, a post office, a vet clinic.

A cafe, a community center, and of course, in Wisconsin, you have to have a bar and grill. We have a park, a campground, a trout pond.

A ballpark, a playground, tennis courts.

So what, you say? Well, we also have a cemetery and two churches.

Well, what makes us unique is that first off, I'm going to show you where Granton is. We are nestled right in the middle of Marshfield and Neillsville, you see where it says Granton? No? That's 'cause it's not there. Quite often, we're missed on the map. So this is Granton, what makes us so unique is we are one mile by one half mile with a population of 359. I did Google in the middle of the presentation that Mindoro has now grown to 1177. So I do believe that that makes us the winner in the smallest population represented today. So I wanted to kind of give you guys perspective as to what we're doing in this small town. One of the things that we have done is that also in our tiny town is that we have a library.

The library merged in 2012. We combined forces with the public school. We were operating Samson Memorial Public Library that has been operating since 1942.

So in 2012, we closed the library. The inventory and the staff was consolidated with the school, and Granton Community Library was created.

This merger came with some amazing benefits, okay. The hours of operation were doubled. Kids now have access to the library after school, evenings and weekends, okay. Normally, school library is only open during school hours. Okay, so that was a big benefit. The general public now has access to the library daily instead of alternating days. They had been open every other day, Monday, Wednesday, Friday, and they were only open from noon to 3:00. So this was a huge benefit to the general public as well. The other benefit that this merger gave was money. Public libraries are funded by the county based on the number of items checked out, also known as circulation, okay. In 2017, the circulation cost was $3.65 per item checked out. Now, we say item because it doesn't only include books, it includes videos, anything you're checking out at the library, magazines. So it was $3.65. Well, when we merged, and we put that public sector into the school, the circulation skyrocketed. So, what did that mean? It drastically improved the money. So with money, you can buy more books. They have a lot of different things that they're doing at that library with that money. So that was a huge, huge benefit. Also, we saved money by sharing staff. We only needed one director, and although, when you look at the hours of operation, the big benefit of savings came with the consolidation of benefits. So we have WRS and that saved us. So in essence, our library merge was a huge success.

Okay, so that was success number one. Our second success story we wanted to share with you is what do you think you get if you cross a very successful daycare mom with the public school?

Increased enrollment, did you guess it?

No? Okay, well, why does that increase enrollment? Well, what we saw in our tiny little school was that we kept losing more and more kids. We had families who were open enrolling their children to the neighboring townships who had never stepped foot in the school. Why, because they worked in the surrounding cities and they just started by enrolling their kids in daycare where they're working and they never stepped foot in the school. So we started there, we offered-- First off, it was a little bit of a challenge 'cause we had to convince this amazing daycare mom who had a wait list that was years down the road to come to us. And the big selling point that finally, I said, "Why did you do it? Why did you finally come to the school?" And she goes, "I could no longer afford "to be paid in eggs or chickens." So she said, "I agreed to move it into the school." And with that, what we saw is that the families that had never stepped foot in the school, we offered daycare at an affordable price. They started their kids there. So first off, we have parents that are informed about local school events which keep them grounded in the community, we've heard that over and over in this summit in the last day, okay. So they're grounded in the community 'cause they know what's happening, okay. The children make friends and create a comfort zone and don't want to leave, that is huge. If the kids don't want to leave, the parents are easily talked into keeping their kids there. There is no first day of school anxiety for the parents or the kids, they've been bringing their kids there for daycare all along. They've run into the elementary school teachers, they've created a bond with them, and they also have a couple of awesome programs that they work with, with the older kids. So they have a workforce so that they have the high school kids coming down to actually work in the school. When that happens, those older kids are creating a bond with these little kids. So they're doing some work programs there. and then that helps bind them to the community, They find out that, "Oh, this high school kid "is playing basketball." So the little kid gets invited to come play, watch a basketball game. That ground them in the community and helps them stay with us. The interaction with the older kids through the reading programs just is an amazing bind with the kids. A couple other benefits that we have seen with that creation of the daycare is that job creation, full house means added staff. It used to be one daycare mom running the show out of her house. With the amount of kids, and we now have two classrooms full of kids, one for the two years old and under and one for over two up through-- Well, they actually do an after-school program too, that includes kids all the way up to third grade. But we're now hiring five employees. And the daycare kids participate in the lunch program. With that, the federal government helps reimburse lunch fees. Putting those daycare kids into the lunch program has also helped our lunch program stay lucrative.

So with that said, that is another success.

So that is my little town's two success stories on a couple of ideas that we were able to implement that have really helped us in our small town.

(audience applauding)
- Thank you, Joye, and while Steve is getting the next PowerPoint ready to go, just two things I wanted to say. And one is on libraries, and I've been actively involved. I chaired the Dane County Library System for a long time, on the library board. And a lot what we hear from people as well, "Why are we putting money into libraries." "People are no longer reading books; everything is online." People will continue to read books as long as they're printed and published. Libraries are extremely important, and we certainly saw a lot of low-income people and seniors that are on fixed incomes that are trying to cut costs are eliminating their Internet services on their phones and they're going to the library. And that's where they're picking up their messages, that's where they're doing their research, and that's where they're socializing in a lot of cases, so the importance of libraries. And then the second thing, and I know we're ready to go on the next one, and that is on early childcare issues. There are more and more conversations that are taking place around the state on the challenges regarding childcare. We are partnering with a number of organizations that are looking at it on the statewide basis and even in regional. So I think we'll continue to hear more on those issues. And we want your ideas and your thoughts and advice if you have any. So with that, Marsha.- Hello, I'm Leslie Covell Hershberger, I'm the community program manager for Blue Zones Project in Dodge County. I'm here today representing Beaver Dam Community Hospital. Today, I want to talk a little bit about why we brought Blue Zones Project to Dodge County, kind of the history and what is Blue Zones Project. Has anybody here even heard of Blue Zones Project? Oh, a couple people, good, good. And then how we do the work and then some of the outcomes that we've had in Dodge County and what that looks like. So as you all know, we have a major healthcare epidemic in our country. The US spends more per capita than any other country, but we're not necessarily healthier than other countries. In fact, 69% of the population can be classified as overweight or obese. And while we may be living longer than previous generations, we're living sicker. For the first time in history, it's projected that our children's life expectancy will be shorter than that of their parents.

We also have an employment crisis here in rural Wisconsin, as well as an epidemic of dying downtowns.

After working with Blue Zones Project for the past two years, and I was kind of recruited into this, so I didn't know anything about it either when I first started. But what I found is that not only does Blue Zones Project improve the health of the residents in the communities where they live, but they also help revitalize the community economically. So why Blue Zones Project, why did Beaver Dam Hospital look into us as a program as an answer in their county? In 2013, Beaver Dam Community Hospital did a community health assessment. And in that, they found that Dodge County's rankings exceeded the national benchmark in binge drinking, tobacco use, depression, obesity, and lack of access to nutritional foods.

They also found that 56% of the deaths in Dodge County are attributed to diet and lifestyle. And when you think about that, Beaver Dam Hospital didn't have a public health unit and they thought, how can we tackle all these problems that we have in our county? And so they, Kim Miller, who was the former CEO of the hospital, found out about Blue Zones Project at a conference that she was in in Minnesota. And she thought, "Why not, let's look into it." And so with that, they began to look at options. So with those poor statistics, we found that there is a bright side. Blue Zones Project taught us that in 1999, the Danish twin studies established that 80% of longevity is determined by lifestyle factors in the environment. With only 20% determined by our genes, which is good news. It showed that your family medical history doesn't have to be your personal destiny. We believe that, because of this, we can make communities healthier and happier places to live and work through Blue Zones Project. And I'm not clicking, am I? Sorry, I'm behind. 
(laughs)

There you go, there's your statistics and what determines our health. So how did it all begin? It began with a guy named Dan Buettner.

He's a National Geographic fellow and explorer who traveled around the world to find and study where people live the happiest, healthiest, and the longest. He dubbed these areas Blue Zones. And there's nothing scientific about the name, it was just because they took a big fat magic marker and drew a blue circle around the areas that they were studying and they just began to call them the Blue Zones. And so that's how they came up with the name.

So after he did his research, he published a couple of books. First, he had, in 2005, he published a National Geographic, which was almost, it was the whole issue, and it's still like the third most popular issue. And then he published a bunch of books after it. But that wasn't the idea of what Dan had. What he wanted to do was take what he had learned in these Blue Zones and kind of reverse engineer it. Let's try it in the United States, let's see how we can take what we learned and make it work here. So the people living in the original Blue Zones areas don't live longer better because they have superior access to care or even the best doctors. Instead, their environment leads them to preventing diseases to occur in the first place. So today, I'm going to share lessons learned from these communities in the original five blue Zones, where the rates of healthy centenarians are astounding.

For example, in Sardinia, Italy, 1 in 250 people live to be 100, compared to America, where that number is 1 in 6000. It's pretty impressive. All of the people living in all the Blue Zones areas live longer and happier lives with lower rates of chronic disease and a higher quality to the life. So today, you're going to learn about how Blue Zones Project is putting those secrets of longevity to work in communities in the United States.

So first, let's define what well-being is. It's different than wellness.

The World Health Organization defines well-being as the state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. Blue Zones Project measures progress in many ways. The Gallup-Sharecare Well-Being Indexes are a primary measuring tool. It was developed in 2008. We call it the WBI. The WBI provides a resource to standardize how we measure health in these five areas. Purpose, social, financial, community, and financial, or physical.

So when Blue Zones goes into a community, they hire a local team, train them up in the project and how that works, and they hire you because you're invested in your community, you're a part of it, you have that social equity, you know where to go to get things done. And then they began by doing a Gallup survey. So we do that WBI polling and create a baseline so that we have a place to know where we started and we can measure against that. And then every year, we do it again to measure our progress.

So no one secret explains why people in the Blue Zones tend to enjoy long, healthy lives, it's rather a web of factors. We call these commonalities the Power 9. And that's something that we use in every aspect of Blue Zones Project. They're lifestyle choices that fall into the categories of moving naturally, having the right outlook, downshifting every day, eating wisely, putting family first, having a strong belief system, and connecting socially with others.

So how do we take those commonalities and incorporate them into a community? We work in something called the life radius. Life radius is that 5 or 10 miles of ground where you work and play and live that you spend about 90% of your time. And within that life radius, we focus on people, places, and policy.

So to improve places where you spend your time, we engage a critical mass of organizations to make permanent changes to their environments and adopt policies that will nudge people towards healthier choices.

We implement policy in these four areas. We believe this is one of the most profound ways we can improve community well-being. City policies impact everyone in the community regardless of whether they're aware or engaged in Blue Zones Project.

We make the healthy choice the easy choice in your community and that's kind of our little tagline, "Making the healthy choice, the easy choice."

We partner with existing initiatives and community leaders. I want to express that collaboration is key. We work with all kinds of different organizations from, you know, getting all the work sites and places involved, but also, the non-profits and more of the service agencies in your community. We just recently had a round table discussion and representing over 30 organizations. It's the first time that's happened in Beaver Dam.

Where traditional health improvements programs rely on behavior changes alone, Blue Zone Project takes a full environmental approach. Our goal is to move a community toward better well-being by reducing risk factors, but also improving the economic and social vitality of a community.

It's kind of just a side effect of what happens when we do all this work in a community. Our people strategies motivate and empower individuals to improve their well-being. We do this by motivating people to commit to the Power 9 principles, those commonalities that we talked about, by discovering their purpose or simply getting involved in the community by volunteering or some other way. Driving individuals to effect positive change through each other and their acts are our main way to reach the sustainable tipping point of a long-term well-being improvement. And we have something called a personal pledge. I've got copies of it in the back. But whether we're working individually at events and things like that or whether we're in a work site or a place, we ask everybody to sign a personal pledge; it's a way to get them to mentally commit to making behavioral changes. So when all these things come together, what results is a healthier culture for living longer and better.

Blue Zones Project is impacting communities across America. And you can see the numbers there. We've affected over three million lives, in 48 communities, in 11 states so far.

So with all that background, let's see what's happening in Dodge County.

So far, we have 68 approved places. These logos represent smaller companies and civic organizations, and then we have these other logos that represent large employers. Our goal was to get 10 of the top 20 employers involved to make healthy changes in their well-being programs at their work sites. And as you can see, we've got 68 altogether but--

So, we've really exceeded that goal of 10.

Work sites are finding that putting these kinds of measures in place to improve well-being helps lower cost, it reduces turnover, and it's also a draw for new employees. Young workers today want more than a paycheck. They want to know that their company is doing things for them and that they really care about them and as an employee. We also work in faith-based organizations. It's not our main target, but it is a way to reach people in other ways besides at work sites and by events. And we do, we have been very successful there.

We have eight approved and engaged restaurants. As you can imagine, this is a big part of our program, having healthy entrees and half portions available, taking the saltshakers off the tables, those are all things that improve a person's health. We have two approved grocery stores in Dodge. And in the four communities we're working in, there's only four besides, not counting Walmart. And so we have half of the grocery stores involved, we feel like that's really important. They've made 48 new healthy practices available to affect their customers' health. And then community policy, which we talked about before. I'm going to start with "built environment," that's one of my primary areas of work besides managing the program, I do most of the policy work, which is taxing. I can say if you've worked with city government before, it can be challenging sometimes. But the "built environment" part works with the infrastructure of the cities. Policies that we've passed are things like safe routes to school, complete streets, bicycle and pedestrian master plans, treescape master plans. And in addition to the policy work, each community is asked to do a marquee project that will impact their downtown of their city. This picture represents a project in Horicon. Horicon is a community of about 3500 people. This was a big project for them. It's a couple million dollars to improve Bowling Green Park. And they've added a lot of enhancements. And this is adjacent to their downtown. They want to start bringing more events here. And bringing the people where the businesses are is a smart thing to do, so it was a great project for them.

Here's a list of some of the "built environment" policies that we've passed in the different communities. You can see that most of these represent active transportation. Our goal is to make communities walkable and bikeable. That's what young people today want. It's a great way of attracting young families to your community; young families mean more workers. So that answers a lot of barriers that you might have in your community. And we also, of course, have the revitalization of the downtowns. And then we talked about the Gallup poll measuring our progress, but we collect metrics in every single area that we work in. Here's some "built environment" metrics. But we also collect things, metrics at work sites, at restaurants, at grocery stores, how many new businesses have opened in your community. We measure retention, insurance costs. We want to make sure that what we're doing and what we're implementing in the communities that we're in works. And so we're in the numbers game.

If you had to see the kind of tracking that we have, you'd probably lose your mind; it makes me crazy sometimes.

Food policy is another area. We've done smarter lunchrooms, safe and healthy food pantries. We're currently working on a program to implement SNAP EBT redemption program at farmers' markets. We hope to have that in place by June. Tobacco, alcohol, that was two of the primary areas that the hospital wanted us to work on, and alcohol was not an area that Blue Zones Project had dabbled in before. We are a pilot community for that, and we've been very successful. We have implemented something called SBIRT, it's Screening Brief Intervention and Referral to Treatment. It's done through primary care physicians in the Beaver Dam clinics. And then Place of Last Drink, which is just what it sounds like, if somebody's picked up or arrested for an alcohol related crime, they ask them, where did you have your last drink? And what's great about Dodge County is, right about the time we wanted to do this, all the police departments and the sheriff department got a new software system that talks to each other. And so it's made it very effective. They can pull aggregate reports and see all over the county what establishments might be over serving, and then they can address that issue. And it works, the number of DUIs are going down in Dodge County, which we're really excited about.

Engagement. We need lots of people to make this work, as you can imagine. We're working in the three communities that are our primary target, about 24,000 people. And within that 24,000 people, and that's, of course, some of those are children. But we need about 40% engagement. Gallup tells us that, if we can reach that 40% mark with 70% awareness, that we'll have kind of a tipping point, a perpetuation of that what we've put in place will continue. And so we're, at the last Gallup poll that we had in October of 2018, we were at 23% engagement and 67% awareness. And so we've been working really hard to get to that mark so that what's in place stays in place. We feel like, in the end, that we are definitely making communities healthier and we're impacting the economy in a positive way.

So the main story is, well-being in Dodge County is improving because of Blue Zones Project. And here's just some statistics also from our last Gallup poll that are a little different than what I showed you before, but these are some of the things that we measure. To become a Blue Zones approved city or area, there are certain criteria that we have to meet. And one of them is to have improvement in 10 areas on the WBI that shows that what's in place is working. And so we see that people-- And this is all self-reported data. The number of residents reporting they feel active and productive has increased by six points, smoking has dropped, life evaluation is up, and folks, that's a really really important statistic. When people are saying that the life evaluation is up, that means they're happy where they are. And you know, when you're trying to get people to move to your community and stay in your community, you want to have good life evaluation. And so we've been able to affect that number, in fact, I had a gal come in my office just day before yesterday, and she said, "I just moved to Beaver Dam last year "from Waupun, and I just can't tell you, "I just love it here, there are so many activities, "there's so much going on. "The downtown's starting to come back. "You know, I just, and I feel like more like I belong here "than I did living my whole life in Waupun." And that's a statement, I mean, that's somebody testifying to me personally that, in my office, how much they like what we're doing in their community. So does it work? I think it does. I feel like the numbers prove it. And so here's just another testimonial from our little lady that I'll share with you. This gal came into our office, she's probably about 80 years old. She had moved back to the area from being away for a lot of years. All her friends had either died or moved away. She was lonely and she joined a Moai group. A Moai is a group that meets for a common purpose, and we have all kinds of Moais. And one of the most popular is walking. And she joined this group of ladies, and it's just changed her life. She's walking a couple times a week. She's got new friends, she's got a support system, she's got a social life now. And it's because of one of the programs that we have through Blue Zones Project. So that's all I have for you today, and I'll entertain any questions in a little while, thank you. And I do have some information in the back. 
(audience applauding)
- Just while we're getting the next presentation set up, just, I wanted to mention another project that we work on at the Wisconsin Counties Association with a number of other partners. It's called, it's developing Health in All Policies. Have you heard about Health in All Policies? Perhaps that's an issue that we should have on agenda for a future rural summit. But one of the things that I found interesting working on that project and hearing from some of our partners, and the Population Health Institute is included in that, Center on Wisconsin Strategy, the League is involved, the Green Tier program that we work with through the DNR.

You know, for years, we have been talking about how DNA and family history really determines what happens with your health and eventually, your death. But when you see the research and the data that talks about where you live, broken down by zip code, by district or by ward, has more of an impact on your health than your own genetics. And I just find that fascinating, so something to think about, Marsha.- Thank you, good afternoon, everyone.

You're the diehard audience, the last panelist, right. It's been a long day. I've also heard the term death by PowerPoint, just so you know. 
(chuckles)
 But no worries, I have lots of pictures, so they're always worth 1000 words, right.

As we said earlier, my name is Marsha, I'm from Plymouth. We're the self-proclaimed cheese capital of the world. We have Sargento, Sartori, years ago, we had Borden's. We used to have cheese factories at all the crossroads in our townships, so that's kind of our history. And the story that I have to share is really kind of like Dr. Ivan said this morning, lead from behind, it was a grassroots community effort, start with nothing. And we built an intergenerational community center. And actually, that's a picture of it. It's called Generations as the name of the facility. Our mission, as you can see, is to maintain and promote opportunities that build and honor relationships between people of all ages, all the generations.

And our vision is to link them to build a stronger and healthier community and to support people of all ages and all abilities. And so, in order to do that, this is like okay, trying to tell you 20 years of work in 20 minutes or less, right. So talk really fast. And I thought about the story of Maisie that we saw this morning, that wonderful video.

And so I didn't collect cans, but I built a coalition, so Maisie, Marsha, I'm thinking oh my goodness. So here we go. So yes, indeed, I founded a coalition in order to do that. And so, this is a little bit of a busy slide telling you kind of our roots, and indeed, I started with the concept back in 1999. I work in healthcare, so working and living in Plymouth, I served on the parents' advisory board of our local daycare and learned how challenging providing quality childcare at a price that families can afford and trying to provide a living wage for teachers. It's still a really challenging business. At the same time, I was on our city committee on aging, which oversaw our senior center operation. They basically had one big room. Couldn't really do more than one program at a time. And yet in our nursing home, I worked in long term care for 25 years of my 40-year career in healthcare and heard the person in the back of the room just a little while ago aching about her mother and long-term care and not finding enough healthcare providers, and that's an equally challenging business. And yet I saw the children from our childcare come over to the nursing home and we'd have people that were non-verbal light up and sing familiar tunes with the children, right. And so my vision was to build a model for aging well, go way upstream. We know so much more. We just talked about Blue Zones and the science behind socialization and where you live and bringing the generations together. So we started to knit that together and look for ways that we could do this ourselves. And so working with these entities, I knew that the senior center, you know, a department under the city, they have no money. Childcare, they had no money to go build a building. And if they did, they'd have more than one building, and if they did a capital campaign, they'd be asking all the same people for money, right. That's not a good thing. So that's where we came from. 

So this shows our current tenant partners. What we developed was a business model that we actually were able to build our own center. A number of non-profits came forward to work with us, and we had to use our mission filter to screen for like-minded non-profits to join us to do a capital campaign. And so we actually qualified for one of the Obama stimulus grants early on, which enabled us to kick off a capital campaign in our small community. Plymouth is about the size of Rice Lake. We're a little over 8000 people. And so the Sheboygan Human Rights Association is the umbrella non-profit that runs the Head Start. And coming into our center, they helped us with the childcare that moved into our building and took that on. The Family Resource Centers of Sheboygan County, they started as the Every Child Coordinating Council of the schools. They have the birth to three health literacy, drug free Sheboygan County, parents as teachers. They serve thousands of families each year. We partner with the Sheboygan County Aging and Disability Resource Centers, so we have the senior dining program in our facility. And coming into our facility from where we were, we more than tripled the number of people coming in. Because it was being trucked in from 20 miles away, the quality of food wasn't that good. You know, like most seniors, it's like the church basement atmosphere, right, with the trays, and we wanted to look to the 21st century what seniors are looking for coming up, and that's what we've done. And then the senior center had been a function of the city, and now, it's a long story, but we run the senior center, PIC does, and we have a partial funding agreement from the city to do so. So it was a long number of years with vetting this idea, bringing people together, community focus groups, and really telling our story and building those partnerships. And so kind of like Maisie, people would say oh, there's Marsha again, she crazy. Are you still at it? That poor woman? Yes, don't give up, that's the message, do not give up. 'Cause this is what we were able to build. So we did qualify for a small planning grant early on and we did some community focus groups. I already talked about some of the shortcomings, but the Family Resource Center. They were sitting on top of each other, using conference tables for storage underneath, not ideal.

We couldn't do more than one program at a time at the senior center. The childcare was in our old, old 1800s building that had been the hospital, in the basement. The best quality childcare, they were at risk because they were the largest licensed accredited childcare. What's going to happen, they can't afford a new building and this building is kind of falling apart. And so we knew that new buildings would be good. The architect we worked with went to each of those partners and looked at who they served, what the shortcomings were, and essentially, they got to design their own space for the new building. So the other thing, as we looked at building our business case and our model is what are the synergies of combining these non-profits? Like I said, if they went out, we'd have four buildings. That's an energy footprint, four utility costs, four kitchens, four break rooms, right. Why couldn't we do this as a partnership, especially for non-profits. There just aren't enough resources to go around. And we wanted the green space as well.

So then we say, why intergenerational? And it was a long journey of teaching our community about that. They'd say, "What is that?" One community leader I talked to, it came out in our conversation that he envisioned one big room and one door and major chaos therein. I'm like no no no no no, that's not what we're talking about. But we know, and I experienced this firsthand working in healthcare, we really have become quite an age segregated society, right. We have senior housing, we have youth programs, you know, the schools, right. We had done a survey; we worked with our school district and the administrator shared that they had done a survey of students, and most of the young, like 80% of the students felt the older generation just didn't care about them. We're like no, this is not good. And we know that what happens when generations don't experience each other, that's where stereotypes come in and the myths, where young people think all older people are not productive, they're in rocking chairs, or they have dementia, right. Just like a lot of older people, if they have no experience with young people, right, they're all on their phones or they're on drugs or they're in trouble, right. 'Cause they don't-- We don't know each other. So we know that that was an issue and we wanted to bring the generations together. And so this was a really innovative project, the other reason it took us so long, there wasn't a model to follow. We found other programs where there was childcare within a nursing facility and some similar things, but not a model that we wanted. So we had to eke out our own and we had to build a case and we had to bring people along with us, so it's not for the faint of heart. We found United Nations even recognized the need for bringing generations together. So this is just a little bit about what is the intergenerational programming.

It's programs where the generations learn from each other, they learn about each other, and oftentimes, we put them together and they're working together side by side for a community project to better the community. And some of the examples, just simple ones, are, and these are pictures from our facility. We have high school students that teach older adults about technology, like how to use your smartphone in a better way, how to use apps, make greeting cards, set up your email, whatever it is that you're struggling with, right. Older adults coming in and sharing their knowledge of a career. What do you do to be an engineer, what is that like? And lots of career things or gardening and learning things together, which has been really really productive.

There's also different levels of intergenerational programming that we had to learn ourselves and teach our staff. We worked with Professor Matt Kaplan from the University of Pennsylvania. We brought him to Plymouth and learned about this from incidental contact, which is just, you know, maybe a senior might've had the grandkids for the weekend, they're tired, they just want to watch. And we have lots of opportunities for that around our facility. The kids come downstairs. I'll show you pictures. From basic, such as making cookies together for, you know, Valentine's Day or something. And so you have experience, you get a positive read on each other, but it's just an activity, right. And then intermediate would be a series of events. So it might be, you know, learning together about something, that's a series. And then sustainable is where we're really fostering those relationships, so some are the incidental, unplanned that turn into more, and some are really the planned, evaluated, sustainable. An example of that is we had high school kids come into our center, and they were on a project from school and they wanted to know what was dating like, you know, like 50 years ago, right. Had a ball just talking about, you did what? What kind of car did you drive? And so they got so excited, they developed a play that they did at the local high school. Well, of course, all the seniors and their families went to the play, they got to know these young people, and I heard some of the older adults say oh, I see, you know, so and so had church and we always talk after church and they get to know their families. And so there is some literature that shows young people should have at least four other older adults in their lives that are not related to help them, like, you know, "it takes a village," you all heard that term. 'Cause it does, right, they make better decisions. So here's some of the science we shared with our community to bring them along with us. 

Studies show that intergenerational programs help kids improve their attitudes, and you know, again, I went to a family living class one time at the high school to speak, and a young man, I said, "Well, "how many of you have grandparents that live in the area?" And we know families are scattered across the country, right, other states, sometimes other countries. And you know, what are older adults like? And I'll never forget this one young man raised his hand, he said, "They smell funny." That was his extent of experience with an older adult. I'm like no, this is not good. But he didn't have experience with these vibrant older adults that are changing our communities, coming back for second and third careers, they're exercising, they're being well, they're teaching. So, this is great. So you can see all the other benefits, from self-esteem. They don't fear their own aging, you know, the self-fulfilling prophecy, there's a lot of literature that those are things that really happen. So in order to teach people how to age well, we have to be an example, but we have to go way upstream and start when people are younger. And the civic engagement, you know, right now, our divided country, people run screaming away from politics, but it's like kids, you're our future. We're going to be in your hands, we want you engaged, right. So for older adults, the benefits are, they do become more motivated to learn new things and they have new people to learn new things from. Our center has become a whole community of people that care about each other, it's a vibrant, learning, positive place. It enhances their memory and cognitive skills, that's been shown, creating this strong sense of community. I care about other generations, I have a reason to get up in the morning. The biggest thing that I saw working in healthcare for 40 years is depression among older adults. It's been talked about earlier today as well. It's so easy if people don't have an opportunity or a place where those opportunities are available to sit at home and become isolated, right. Especially if they've lost a spouse or have some health issues. Then if you're depressed, you're much more at risk for other health conditions. And there's this downward spiral, right. So we're combating that. And so we have seniors that come in. 

We did a community wide survey before we built and we knew they were interested in health and wellness programs. We have 200 to 250 people a day that come through. Many of them are exercising. We have seniors that have dropped their blood pressure, shed their canes. They can reach a top shelf now, they said, "The only thing I'm doing different is coming here." So some of their physicians and chiropractors are referring people to us for our health and wellness programs. It's just really exciting.

So the benefit to the middle generation, it's like don't forget us, they're all the working people, right. So many of them are not-- They don't take out a membership with us for programs. But they contribute, they volunteer. Many of our companies send employees for the day of caring. They help us with our outdoor work, a lot of different things. Career opportunities: We have several young people that have joined our staff now that are just, they're on fire about intergenerational. They love coming to work. Community benefit: I worked for a not for profit, Aurora Health Care. So we encouraged our leaders to do community benefit, that's how I started this project on top of my more than full-time job. So you can record those hours that you give as community benefit and you can let people know that they can do that. You gain more knowledge. The for-profit companies, we have great relationships with Sargento, the Johnsonville Sausage people, right? They're in our backyard. They've been great supporters and do different things with them.

Sargento has the SECAP singers. They come and entertain every year, even though they're a for profit. And so, those relationships are great.

These are just a few of our community partners. I'm going to skip through this quickly 'cause I know we're running out of time. These are our memberships. Like I said, most of them are older adults that are members, but membership is very new for us in just the last five years.

And then this is our Plymouth Adult Community Center. That's the name for the senior center within our building. We opened our doors in 2011. In 2011, I'd say we were about half of what 2012 is, and it's increased, you know, exponentially. And you see now, in the last few years, it's leveled off, and part of that is we're already running out of space. We opened in 2011. We already have an expansion plan, 'cause we're-- And by the way, we were debt free after five years; we had a mortgage burning party.

So I got to burn the mortgage, we only had a bridge loan after our capital campaign. So this shows kind of our revenue. So how do we operate? Well, the business plan is, you know, the tenant rentals you see there, the people that are renter partners in the building, the Family Resource Center, the childcare, Head Start. We have a satellite office for the domestic violence program, so the rentals, the funding agreement with the city of Plymouth to run that senior center. Pic-A-Deli is our social enterprise. We built our food service not only that we offer for the seniors, for the senior dining program, for the kids at daycare and Head Start, but we started doing catering, and we rent our facility out for weddings and corporate meetings and other things. And you see that it's grown to about 38% of our revenue. We have a wonderful chef. This is a picture of how our chef sets it up for-- This is our building. We have a wonderful two-story atrium. It's a beautiful setting for weddings where we're getting more of those in to help us sustain our operations.

So this is how the revenues from that have increased in the last few years, really really been great for us. And again, social enterprises.

New sort of concept: we've been learning more about, it's an arm of your organization or a program that helps generate revenues for a lot of non-profits that budget for a deficit. Especially in this age with the tax laws changing, you can't itemize anymore, so a lot of philanthropists are sort of drying up. So you have to look for other ways to sustain your operations.

This is our building. This is an aerial view. And you can see that it's in kind of a rural area. It's not in a big city. On the right side is kind of our senior area. What you're seeing right in front is the childcare. And again, each area designed their own space and we have their own separate entrances, so we're careful not to have the childcare in the same entrance where seniors with walkers or slow movements would be coming in with parents trying to buzz in and kids running around, so they all have their separate areas. On the far side is the Head Start separate area.

So where to start if, you know, this could be a replication model for any of your small communities. Consider who you currently collaborate with, like this wonderful library program, right. So common goals, you guys talked about this all day. You sort of know that. Tell your story, build the business case, that's what we found, is like we learned all about it, so we were here, and city council was here. It's like, you have to explain the benefit, and we talked about that. So the next ones, they're just pictures I'll flip through really quick, and then we're done. These are some of our fitness areas, chair fitness. These are some of our young people from childcare learning yoga.

Intergenerational, we have Monday Morning Readers. The gentleman at the top is a board member, retired, never had children of his own. He's engaging with these young people and just loving it.

Monday Morning Readers, some of our seniors reading. We have Game On with the middle school, they come in. No, they can't use their thumbs and look at a screen. They have to do board games, they learn manners, they learn how to socialize, they love it.

Here's from February, the Olympics and Valentine's Day activities. March was happy Saint Patrick's Day. Plymouth High School brought their German band in, great practice for them, good entertainment for us. We had a donation of a stand-up freezer from the Kohler company. That's our chef Dave there.

Celebrating Mother's Day, we brought the dirt in and did plants with the kids for their moms.

Petting zoo coming in. Just lots of different things. And we collaborate with non-profits all over the county. So learning earthworms there. And at the end of the year, this is some of the Day of Caring volunteers doing some work and one of our fundraisers at the end of the year. So these are all real pictures at our site. We have other non-profits that come in and do programs within our facility as well. So thank you for listening way at the end of the day and going like really fast. And so I'll end there and then you can prompt the questions. Thank you. 
(audience applauding)

- So please join me in giving our panelists a thank you. 
(audience applauding)