The Human Resources and Information Technology Committee met 07/12/2023. The item that took up the bulk of the meeting was the changes to the table of organization for the Health Department and the Community and Economic Development Department. This item was also voted on by the Board of Health and received as an information item by the Community and Economic Development Committee.
This recap is focused on the Human Resources meeting, although I have provided not only a transcript of the discussion by the Human Resources Committee but also the Board of Health. I do not have a transcript of the Community and Economic Development Committee discussion.
The basic request was to:
- Create a new Community Health Supervisor position within the Health Department that would report to the Health Officer.
- Move the coordinated Entry Specialist position currently housed within the Community and Economic Development Department over to the Health Department where they would report to the newly created Community Health Supervisor. The position would be physically located within the Appleton Police Department’s Community Resource Unit to increase collaboration efficiency within the coordinated entry system.
These changes would allow the Health Department to better comply with statute 140 of the Wisconsin Department of Health Services, improve the city’s ability to qualify for certain health-related grants, and increase the city’s ability to address local health issues.
The financial impact was expected to be limited at least in the short term. The Coordinated Entry Specialist position was currently paid for with already secured external funding and the new Community Health Supervisor position would be funded through 2026 with ARPA dollars as well as a program through the CDC. The city would also look for new revenue to offset the cost of the new position thereafter.
Health Officer Charles Sepers told the committee these changes were important because they provided the infrastructure for data collection which was used to inform things like the Community Health Improvement Plan that was required be the DHS 140 statute. He said in 2015 Calumet, Outagamie, and Winnebago Counties as well as the cities of Appleton and Menasha along with the major health systems in the area performed a community health assessment; however, the primary data collection included 147 cold calls to landlines which was not sufficient to meet the needs to state statute. The proposed changes would help them perform a more robust community assessment.
Additionally, federal money was available to local health departments for things such as dealing with opioid misuse and smoking cessation, but because the city didn’t have the manpower to be able to spend that money [which I took to mean, to run programming that would use up those dollars], it didn’t qualify for those grants. In fact, Human Resources Director Jay Ratchman told the committee that just this past year, there were three federal programs that the city could have applied for if they had had staffing to be able to manage those grants, but they had not.
Finally, they wanted to move the Coordinated Entry Position out of the Community and Economic Development Department and into the Health Department so that it could be given a health framing rather than an economic development framing. “That framing is the understanding that those elements related to human health extend beyond things like clinical services, right? So, assuring that folks have access to healthy foods, safe housing, transportation, all of these things, these have a greater impact on human health than what we would consider even personal behavior, right? And we think about clinical interventions, education, that kind of thing—those have a much smaller impact on human health than what we would consider social determinants, and housing is one element of that.”
The position would be physically housed in the Police Department because many times the people that are in need to those coordinated entry services have their first contact through the Police Department.
Director Ratchman assured the committee that a lot of work went into any proposed reorganization that they brought forward. Staff members from Human Resources, Community and Economic Development, the Health Department, the Police Department, and the Finance Department had started discussing this back in April of this year.
Both Alderperson Chris Croatt (District 14) and Sheri Hartzheim (District 13) asked about funding for the new Community Health Supervisor position. Health Officer Sepers said that they had DHS ARPA funding for the position through the end of 2024 and then a new CDC federally funded program would be able to fund it through 2026 and possibly for part of 2027. Additionally, the Health Department was looking at its fee structure to raise more revenue.
Alderperson Hartzheim was concerned about the funding for the position beyond 2026 and wondered if the position should be reviewed by 2026 to make sure it was doing what they expected it to do for the citizens of Appleton. She wondered what metrics should be used for a review.
Health Officer Sepers said that the one metric that would be very impactful would be the DHS 140 audit which happens every 5 years and was next scheduled to happen in 2027.’
Alderperson Hartzheim also asked if the Health Department would be working in direct competition with local non-government organizations. She would rather see more individual organizations rather than to have the local health department grow. She mentioned that she served on the board of director of Community Action For Healthy Living as used that as an example of an organization promoting community health.
Health Officer Sepers responded that part of what the modern role of the Health Department was to work with private partners to help them understand where there were gaps in public health. He also noted that there were a number of different long-standing, noncompetitive grants that the city could pursue if they make these proposed changes to the health department staffing.
Alderperson Denise Fenton (District 6) noted that it had been difficult to get a new Health Officer and wondered if it would be similarly difficult to find someone to fill the new Health Supervisor role. Director Ratchman was optimistic that they would be able to fill the position and thought that, while it was a high-level position, it was not to the level of the Health Officer and was probably an attractive role for someone with the right educational background.
Alderperson Fenton also wanted to know who the Coordinated Data Entry Specialist would report to until the new Health Supervisor was hired. Director Ratchman answered that they would keep things as they currently were until the new supervisory position was filled.
Alderperson Alex Schultz (District 9) was appreciative of the changes. “It used to be that APD would interact with an individual who’s consuming alcohol and creating a public nuisance on public private property, get a citation, and nothing would be resolved. And I think we’re moving into that space now where we’re trying to recognize and abate some of this behavior and understand that, short term, yeah, that’s quick solution, but you’re never going to get a long-term solution. So it just really—when I when I hear what you guys are all doing collectively as, as the city of Appleton to try and work through the things that we all have to deal with in our in our community, I’m just super appreciative to hear this and that we’re moving forward and trying to find dollars to fund this when those opportunities arise, and I think make us a stronger and more resilient community.”
Police Chief Polly Olson said that, in addition to having the Coordinated Entry Specialist located in the Police Department, the Police Department had a goal of one day finding funding for a social worker that would be housed at APD and who would work with the Coordinated Entry Specialist to address basic issues that people are experiencing including access to healthcare and housing. “And quite honestly, the way the community should be treated is by not necessarily increasing resources, because we’re not doing that. What we’re doing is increasing accessibility to resources and allowing for those resources in place to find you know, where they need to be found by the consumers that require them. And right now, I feel like that’s lacking in our city which is leading to the increased calls to police because people just aren’t getting connected the way they need to in the way they should.”
The Human Resources and Information Technology Committee voted unanimously to approve the table of organization changes. The Board of Health also voted unanimously to approve the changes.
View full Human Resources and Information Technology Committee meeting details and video here: https://cityofappleton.legistar.com/MeetingDetail.aspx?ID=1111447&GUID=EE176917-455B-425D-AD30-31B895A661FE
View full Board of Health meeting details and video here: https://cityofappleton.legistar.com/MeetingDetail.aspx?ID=1109121&GUID=C51DEBAA-23BA-4ED9-A33C-A649226ACA8C
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